INFORMATION PLASTIC SURGEONS WON'T TELL YOU: NUMBER 3

3. “Bargains can come back to bite you.”

With social media sites handing out cosmetic-treatment discounts like candy, it’s easy to get caught up in bargain-hunting for Botox. But cosmetic procedures — from facial fillers to face-lifts — are not commodities that are equivalent regardless of the practitioner, some doctors caution. “No two surgeons have the same pair of hands, experience and knowledge,” says Dr. Foad Nahai, editor-in-chief of the Aesthetic Surgery Journal, a publication of the American Society for Aesthetic Plastic Surgery, and a plastic surgeon in Atlanta. Complications from botched procedures can range from the cosmetic (think: frozen facial muscles) to the fatal, as in cases where patients have died from infections and other post-surgery complications.

                                      

Plastic surgery perfected with 3-D?

3-D technology is helping plastic surgeons make more-precise cuts and easing patients’ anxiety by giving them an advance look at their future faces. The WSJ’s Kurt Achin reports from Seoul, South Korea.

Patients should also be cautious about going abroad for treatments, some experts say. While a tummy tuck in a developing country might set you back $3,000, half of what it costs here, that savings can be easily swallowed up if complications occur. Dr. Eric Swanson, a plastic surgeon in Kansas City, Kan., says he treats patients who’ve had less-than-optimal surgeries abroad. In the case of a tummy tuck, he may have to fix the belly button scar or even redo the entire surgery. There are plenty of skilled surgeons abroad, says Swanson, who spent part of his training in Mexico City, but in some places doctors’ skill levels vary more than here, and regulations can also be more lax. “It’s not like taking a cheap cruise, where you’re not taking a chance with your life,” Swanson says.

INFORMATION PLASTIC SURGEONS WON'T TELL YOU: NUMBER 2

2. “Discomfort? More like extreme pain and oozing.”

Before Kim Gregson, 49, had her tummy tuck and liposuction operation several years ago, her doctor told her she’d experience some “discomfort” after the surgery. The reality was some of the most intense pain she’d ever experienced, says Gregson, a human resources professional in Madison, Wis. While she couldn’t be happier with her results three years later, she still shudders at the memory of the recovery: Despite regular doses of two prescription painkillers and ibuprofen, “I was miserable,” she says. Blood oozed from the two temporary drainage pipes that hung from her hipbone-to-hipbone incision. After the worst of the pain subsided, the swelling began. Her doctor’s office said it would be “mild.” Instead, she had massive swelling that lasted for seven months. Forget about skinny jeans — she didn’t fit into her regular, pre-surgery pants for more than two months after surgery. Gregson had requested two weeks off work but ended up taking three and a half, returning swollen and sore nonetheless.

                                       

Weight-loss surgery that isn’t just about vanity

More patients are opting for tummy tucks or other "body contouring" procedures after serious weight loss or bariatric surgery that aren’t just about vanity: they lessen the risk of infection and improve healing after surgery. Laura Landro reports. Photo: Miami Plastic Surgery.

There’s a general perception in society that cosmetic surgery is somehow less physically taxing than regular surgery, since it’s elective and aesthetic in nature, says Dr. Robert X. Murphy Jr., president of the American Society of Plastic Surgeons and a practicing plastic surgeon at the Lehigh Valley Health Network in Bethlehem, Pa. Surgeons should stress during the pre-operative discussions that “this is a real operation, not something whimsical,” he says. He uses diagrams to reinforce that message, showing how much of the body is affected by different procedures. (Some patients might be surprised that work during a tummy tuck extends from the rib cage all the way down to the pubic bone, for example.)

Dr. Jack Fisher, president of the American Society for Aesthetic Plastic Surgery and a practicing plastic surgeon in Nashville, says there’s a “continuum of recovery” with plastic surgery procedures, and some patients fall on one end or the other. Tummy tucks cause some of the worst discomfort of any procedure, he says, since they tend to involve a long incision and extensive muscle repair and tightening; what’s more, of all tummy tucks, those done after extreme weight loss on excess skin (as opposed to on postpartum pooches) tend to be the most intensive, Fisher says. Gregson had her surgery to trim excess skin after losing 60 pounds on her own beforehand.

INFORMATION PLASTIC SURGEONS WON'T TELL YOU: NUMBER 1

1. “I trained a whole weekend to learn this procedure.”

Dentists, gynecologists, barely trained spa technicians — it seems like everyone’s offering anti-aging treatments these days. And no wonder: Cosmetic treatments are a lucrative business, with $11 billion spent (on 14.6 million procedures) in the U.S. in 2012, up 5.5% from 2011, according to the American Society of Plastic Surgeons. That’s appealing not only to physicians hoping to offset the costs of higher malpractice premiums and lower reimbursements from insurance carriers but also to so-called medical spas that don’t even have a doctor on site when certain treatments are administered.

Traditionally, doctors from just four medical specialties — plastic surgery, dermatology, otolaryngology (ear, nose and throat), and ophthalmology — have handled the bulk of cosmetic offerings, including everything from minimally invasive aesthetic treatments like botulinum toxin (sold under the brand name Botox) to more involved procedures like face-lifts. And those specialists spend years honing their chops in residency training programs that teach skills unique to each specialty in addition to basic surgical skills.

                                        

Americans spend billions on cosmetic plastic surgery every year but MarketWatch's Thomas Bemis says there are things you may want to know before you and your wallet go under the knife. (Photo: Getty Images)

By contrast, those hoping to offer a little Botox in between filling cavities or giving Pap smears tend to opt for quicker training in cosmetic procedures, including weekend workshops offered by the International Society of Cosmetogynecology, an organization that promotes plastic surgery as an extension of gynecology, two specialties that are linked mainly by their female patient base. (Dr. Marco A. Pelosi III, a cosmetic gynecologist and founder of the association, says that the relevant skills and knowledge necessary to grasp and master the majority of common aesthetic contouring is easily understood and quickly learned, as the requisite skills are common to all surgery.)

Indeed, less formal training doesn’t necessarily correlate to reduced proficiency. Experts urge consumers to look for physicians with extensive experience, which could potentially compensate for shorter training. Still, some experts worry that it’s difficult for consumers to distinguish between hype and quality: “Unfortunately, this is an industry where the most creative, assertive, sexiest marketing often drives the business, but it may not be someone with the best experience,” said David B. Sarwer, a professor of psychology at the Perelman School of Medicine at the University of Pennsylvania.

SMOKING AND FACIAL AGING

Arlington Heights, Ill. (October 29, 2013) - Twins who smoke show more premature facial aging, compared to their non-smoking identical twins, reports a study in the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
The study finds significant differences in facial aging between twins with as little as five years' difference in smoking history, says a new report by ASPS Member Surgeon Dr. Bahman Guyuron, Professor and Chairman, Department of Plastic Surgery, University Hospital Case Medical and Case School of Medicine, Cleveland. The results also suggest that the effects of smoking on facial aging are most apparent in the lower two-thirds of the face.

COMPLICATIONS HIGHER IN GERIATRIC BLACKS AND HISPANICS

Researchers say pre-existing medical conditions make a difference.

WEDNESDAY, Oct. 2 (HealthDay News) -- Older black and Hispanic patients are more likely than white seniors to have complications after surgery, and pre-existing medical conditions are a major reason for that difference, a large new study suggests.
Researchers examined the rates of 13 common types of complications among more than 587,000 white, black and Hispanic patients aged 65 and older who had general, orthopedic or vascular surgery in 600 hospitals in the United States.
The investigators found that black patients were nearly three times more likely than white patients to develop 12 of the 13 complications. Hispanic patients were twice as likely as white patients to develop nine of the 13 complications but less likely to develop two of the complications.
However, the number of complications among black and Hispanic patients dropped significantly when the researchers accounted for hospital and patient characteristics, according to the study published in the September issue of the Journal of the American Geriatrics Society.
"The risk of developing a postoperative complication may be attributed to a number of factors. Most pronounced, however, was the effect of pre-existing medical conditions," study lead author Dr. J. Margo Brooks Carthon, at the University of Pennsylvania School of Nursing, said in a journal news release.

COMPLICATIONS INCREASE WITH HIGH BLOOD SUGARS

Arlington Heights, Ill. - A new study released today shows that among patients undergoing surgery for chronic wounds related to diabetes, the risk of wound-related complications is affected by how well the patient's blood sugar levels are controlled before surgery. These findings appear in the October issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
The risk of serious wound complications is more than three times higher for patients who have high blood glucose before and after surgery, and in those with poor long-term diabetes control, according to the study by ASPS Member Surgeons, Drs. Mathew Endara and Christopher Attinger of the Center for Wound Healing at Georgetown University, Washington, DC. The researchers emphasize the need for "tight control" of glucose levels before surgery for diabetic patients at high risk of wound complications.

Board Certified - Make Sure the Board is Recognized by the ABMS

2013 Legislative Session Delivers a Victory for "Name Your Board" Legislation in Nevada

Posted June 17, 2013 -- As session wrapped up, Nevada joined the growing list of states that limit physician advertising of board certification.   On June 1, Gov. Brian Sandoval signed Assembly Bill 456 into law.  The bill requires physicians who advertise as "board certified" to disclose the full name of the medical specialty board from which they receive their certificate. The legislation also implements criteria that medical specialty boards must meet in order for physicians to be permitted to advertise as "certified." ASPS worked with stakeholder physician groups and Nevada ASPS member Michael Edwards, MD to champion the proposal as it moved through the legislature.  Dr. Edwards worked tirelessly the past two legislative sessions to seek passage of this important measure and was a key player in this victory.  The law becomes effective Jan. 1, 2014. 

Board certification is an important part of a doctor's credentials. The American Board of Medical Specialties (ABMS) is the only recognized organization in designating which boards are legitimate and meet rigorous criteria for their members.  Any doctor can advertise as being "board certified" - without being recognized by a legitimate board designated by The American Board of Medical Specialties. A doctor can take a course or undergo abbreviated training and be issued a piece of paper stating they are "board certified"- this means absolutely nothing and is misleading to the public.  More states should enact legislation to protect patients from misleading advertising of credentials. Unfortunately, the attorneys and lobbyists many times prevent good legislation.

The American Board of Plastic Surgery is the only board recognized by the ABMS in certifying Plastic Surgeons.