Is Plastic Surgery Still a Lawless Land?

Credit: Anton Zabielskyi/Shutterstock

Here is an interesting fact: Only 3.5 percent of doctors in the U.S. are truly qualified to perform aesthetic procedures. If you're not shocked by that news, you should be. It's one of the reasons board-certified plastic surgeons and dermatologists are calling the cosmetic enhancement industry the "wild west" of medicine as the number of doctors performing surgical procedures without the proper qualifications keeps climbing.

Even with all of the horror stories splashed across the tabloids and news affiliates about botched jobs and unqualified doctors, the unruly landscape of aspirational aesthetic beauty is only growing. "It's becoming increasingly worse as more individual doctors are leaving managed care programs and other specialties and are entering into cosmetic procedures with little to no training" says La Jolla, CA, plastic surgeon Robert Singer, MD. "In California, as in most states, it's legal for doctors without any appropriate and necessary training to perform cosmetic procedures. Patients think this is all being regulated, but there are no good regulations in place." This is why, for instance, you might see an advertisement for Botox injections at your dentist's or your gynecologist's office—with current legislation, doctors can perform cosmetic procedures without any training and without being board-certified in that particular area of expertise.

Without strict laws to govern plastic surgery and dermatology, it's more important than ever as a patient and consumer to be extremely aware of what qualifies a doctor to perform cosmetic procedures on you or a loved one. "If you are getting a cosmetic procedure, it is absolutely important to check credentials of your doctor. Not only to make sure they are board-certified, but to know what board. The American Board of Plastic Surgery is the only board that certifies an individual in face, body and breast surgical procedures. Otolaryngologists are trained in cosmetic procedures from the neck upward, and dermatologists also have training in some of the noninvasive procedures. None of this, of course, guarantees you good results, but it at least gives you confidence that the doctor has had the appropriate training," says Dr. Singer.

"A board-certified plastic surgeon means that the person you are seeing has passed  the stringent board certification examinations offered by the American Board of Plastic Surgery; a dermatologist by the American Board of Dermatology. Otolaryngologists are certified by the American Board of Otolaryngology. What this also means is that they have spent several years learning procedures in an accredited supervised program where they have been properly trained to do the procedures that are within the scope of their specialty. If you find someone that is not trained to do the procedure you are considering you should ask yourself why they are doing it? Are they trying to make ends meet? Are they dabbling?" says West Palm Beach, FL, dermatologist Kenneth Beer, MD.

It’s important to remember that botched jobs aren't only stories to tell sell magazines, they happen in real life. "This happens a lot," says Dr. Beer. "The worst botched job I have ever seen was one from a doctor who never treated a live patient in his career but retired to Florida and opened a Medi Spa. Apparently he decided that he could do lasers and liposuction and proceeded to treat people with these devices even though he had no training in them. The patient that stands out had both dents and scars where he worked and it is unlikely that this can ever be fixed. Other people that I see have had illicit injections that became infected over time and pose an ongoing health issue," he says. Some of these cases from inadequately or untrained individuals have resulted in fatalities.

If you are considering a cosmetic procedure there are certain questions you need to ask. "Are you board certified? Which board? Who will be doing the procedure? If it's surgical, who is the anesthesia provider? Do you have hospital privileges from a hospital that is an accredited institution for the procedures that you are going to perform? How long have you been doing this? How many times have you done this procedure? What are the pros and cons of the procedure? What are the potential problems as well as the upsides? What are the alternatives?" says Dr. Singer. "If the procedure sounds too good to be true, it probably is."

To find a board-certified plastic surgeon, facial plastic surgeon, oculoplastic surgeon or dermatologists, check out our Doctor Finder, where 100 percent of the experts featured meet the strictest of criteria.

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Michael Law MD
Excellent post. I'm glad my patients are pleased with my before and after photos. But, that is a small part of the process of selecting a plastic surgeon. I have information about what it means to be a board-certified plastic surgeon on my website and in my office, but still some patients don't really pay attention to that.
Posted February 25, 2013 8:54 PM EST
1
Jose A. Morales-Gonzalez, MD
This situation is not only happening in the U.S., but worldwide as well. I'm a Board Certified Plastic and Reconstructive Surgeon with a private practice in Ensenada, Mexico and have been seeing a continously growing number of NON Plastic Surgeon Doctors, performing cosmetic procedures.. eg: Aesthetic Gynecologist, General Practitioners, Dentists, etc... Almost anybody that advertises himself with the "aesthetic" complement to his practice, is sure to have a lot of patients, even with NO Legal regulation to his (her) training, credentials, board certifications and more dangerously.... with NO MEDICAL TRAINING AT ALL.... Therefore you can see cosmiatrist, beautty parlor attendants, massagist, nurses, etc... practicing cosmetic procedures like Botox, Fillers, Peelings and even real surgical procedures like mamary augmentation, rhynoplasties, lipos, etc... As a member of The Mexican Plastic, Aesthetic and Reconstructive Asociation (AMCPER), I can only see that neither our Sanitary Regulators nor our Laws can do anything to stop this continous growing problem of charlatans and medical impostors, whose only interest is on the money. SIncerely Jose Antonio Morales-Gonzalez, MD Board Certified Plastic Surgeon www.bajaplasticsurg.com
Posted February 06, 2013 6:28 PM EST
2

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