Surgeons at work

Are cosmetic plastic surgery patients at risk? The short answer — say American plastic surgeons Stuart Linder,  M.D. and Robert Kotler, M.D. — seems to be: depends on what nation you’re in.

The British medical journal, Clinical Risk, recently printed an article, “Cosmetic Surgery Patients at More Risk than Ever” which highlighted high and low points in plastic surgery in various nations.

The eminent Beverly Hills board-certified cosmetic plastic surgeon Robert Kotler, M.D.  (who blogs as Dr. Face) along with Stuart Linder, M.D. (the Dr. Body blogger) read – and carefully noted — the article for salient points for plastic surgery patients who want to visit a private American clinic.

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Dr. Face (Dr. Kotler): The state of plastic surgery sounds like the wild West in England, with increased marketing, lack of regulations and “overwhelming” media hype.

Dr. Body (Dr. Linder): All this came about when the editor of Clinical Risk asked leading experts in the United Kingdom to write about the state of plastic surgery in England and a few other nations.

Dr. Face:  The writers sure got off on the right foot because they look at everything from an aspect of patient safety.

Dr. Body:  One French plastic surgeon joined in the discussion and noted that any surgical procedure in his nation can only be done by a surgeon who is “a registered specialist” and deemed competent. And I wish this fact was more widely known by American cosmetic plastic surgery patients, and I quote: “Possession of a general medical degree, and the fact the practitioner is ‘experienced’ are not deemed sufficient qualifications” for performing plastic surgery.

Dr. Face: Well, that’s a good idea. In America, we have plenty of cosmetic plastic surgeons who are deemed competent by our demanding medical boards. Of course, a long formal training period is required first. At the end, surgeon must take a written and oral exam that “certifies” us as being recognized by the medical profession as a fully-qualified specialists. Rather than use the word “recognized” the phrase patents should look for in the U.S.  is “ board-certified”. That means the doctor has passed the tests and a board of examiners has declared him or her fit to treat patients. There are 23 recognized medical specialties that test and certify applicant-M.D.s.

Dr. Face: That’s right, we are members of our certifying boards and then licensed by the state or states in which we practice. The boards can also police our business practices. Of those 26 boards, two are for face and body cosmetic plastic surgeons.

Dr. Body: Also worthy of note are the remarks of the president of the International Society of Aesthetic Plastic Surgeons (ISAPS). He writes how important the “safety diamond” is.

Dr. Face: True enough, doctor! And we American plastic surgeons also concentrate on those four things: patient, facility, procedure and surgeon.

Dr. Body: We have to make sure the patient is having surgery for the right reasons, that he or she is healthy enough for surgery and that the surgical facility is also certified, having met the highest standards for patient safety.

Dr. Face: The procedure has to be appropriate, too. And that’s about doctor judgment, which can never be regulated or certified. If a prospective patient requests cosmetic plastic surgery that is either medically unsafe or unwise  – or because the risks of disappointment or even complications are too high — the patient should be respectfully declined. There are no forces that can make a surgeon operate if he does not believe it is in the patient’s best interests.

Dr. Body: As for checking on the surgeon’s particular training, background and experience, we’ve already discussed how to find the appropriate training and certification of American cosmetic plastic surgeons in their websites. It’s wise to choose somebody who does the procedure you want at least once weekly. It is no longer possible for any one plastic surgeon to be a master of all the complex and newer procedures.

Dr. Face:  European surgeons writing in the Clinical Risk article also discuss some “improvements” that would not go over in America at all.

Dr. Body: Both the British and the French authors recommend banning all forms of  direct and indirect plastic surgery advertising and publicity in whatever form, including the Internet.

Dr. Face: Whoa, there! I don’t think that’s wise. In America, honest advertising is really a source of information that allows patients to get up to speed and learn about medicine…. even if it is considered marketing or advertising. Both Dr. Linder and I have authored books that focus on the consumer issues a prospective plastic surgery patient should know about. The books contain insider information from two highly-focused, superspecialist MDs who know their stuff.  The books? The Beverly Hills Shape by Dr. Linder and Secrets of A Beverly Hills Cosmetic Surgeon by yours truly, Robert Kotler, M.D.

Dr. Body: Plus, using a surgeon’s website can be a great help. Just the vast collections of before and after plastic surgery pictures can help narrow down the search. The more research and homework you do, the more chances you will have finding the precise doctor who matches your needs.

Dr. Face: So the $64,000 question is: Are plastic surgery patients also at risk in America?

Dr. Body: The short answer is, informed patients who know what’s involved in plastic surgery and know how to check for themselves the patient “safety diamond” (patient, facility, procedure and surgeon) are very, very likely to be pleased.

Dr. Face: On the other hand, if you select a surgeon used by a friend, or a friend of a friend, make sure you at least see the before and after photos and speak with the surgeon after checking on his or her credentials. Then, you will really learn what the doctor’s practice is like.

Remember, just having an M.D. degree and some experience is not enough for performing plastic surgery.

(Read the plastic surgery report about cosmetic surgery patients at risk.