How do you know that the “cosmetic surgeon” that you are about to see for your Botox, fillers or liposuction has the training to perform these procedures? In this day and age where finessing the truth is the norm, it takes some work on the part of the patient. Board certified plastic surgeon Dr. Caroline Glicksman of Sea Girt, NJ, hosts No Spin Live Episode 72, joined by her colleagues Dr. Kristi Hustak of Houston, Dr. Mary Gingrass of Nashville, and Dr. Christine Hamori of Boston. How can doctors get away with these false claims and what is the best way for patients to protect themselves from falling for their deceitful marketing ploys?
The Difference between Cosmetic Surgeon & Plastic Surgeon
Although the terms “cosmetic surgeon” and “plastic surgeon” are often used interchangeably, they are not the same thing. A cosmetic surgeon performs a procedure that is elective while a plastic surgeon performs one that is necessary, such as breast reconstruction. However, a plastic surgeon can specialize in cosmetic surgery. The current issue is the lack of accountability for “cosmetic surgeons,” leading to many to be woefully unqualified to be performing any medical procedure.
There are people out there who are calling themselves cosmetic, aesthetic, anti-aging doctors who have never been trained in plastic surgery. These guys (or gals) are gynecologists and dentists who have maybe taken a weekend class on injectables, then assume to have the same experience and skill as a plastic surgeon who spent 10+ years in school, residency, and fellowships. Needless to say, this does not always turn out well for the patient.
Board Certification = Trustworthy
It’s also bad news for actual plastic surgeons who have devoted years of schooling, residency and training to their chosen profession in order to deliver safe, exemplary results. The Drs. on the No Spin Live episode are members of the American Society for Aesthetic Plastic Surgery (ASAPS). This means that they have not only had their credentials verified by the board, but that they passed a series of rigorous tests in order to gain board certification.
Any ASAPS member must follow a set of by-laws and ethics; offenders will be reported. On an ASAPS member’s website, all images must be of actual patients or else state clearly that the person in the photo is a model. Fake plastic surgeons have no rules and no oversight. They can manipulate their marketing to make it sound as if they’re accomplished. And they do, but this does not mean that they are.
A Weekend Does Not an Education Make
“There are people who really are just taking weekend courses,” shares Dr. Gingrass. “They may be an MD, they may not be an MD.” Just because someone is a doctor does not mean that he or she has training in aesthetic procedures. Gynecologists, dermatologists, internists and even dentists today are looking at plastic surgery and seeing that there is a lot of money to be made there. They think: ‘I want to get in on that game,’ so they start doing Botox and fillers without having necessarily studied facial aesthetics or anatomy.
Then, maybe, they move on to taking a weekend course on liposuction. “I think some of the problem is not only that the public is not educated, but it looks very easy to do these procedures,” says Dr. Hamori. They don’t think that they need to get the training. Then, a patient comes in for a pap smear and could use a little liposuction so the gynecologist performs it. And the patient trusts her physician to do the right thing. “It’s a vicious cycle,” she says.
Manufacturers to Blame
At the salon where Dr. Glicksman has her nails done, there is a nurse practitioner who calls herself a cosmetic dermatologist in her marketing materials. What she has done is set up a collaborative agreement with an internist and a pediatrician. The doctors purchase the Botox and fillers from the manufacturer, but this woman injects the product. She has never gone to medical school. “What gets me is that the manufacturers sell to them and really don’t care,” shares Dr. Hustak. Plastic surgeons support the manufacturers with what they do, but it is not quid pro quo. Manufacturers would honestly, “like a hot dog truck where you just walk up and get your Botox.”
Manufacturers are supporting people who basically make up their own board. “It’s with the complete intent of deceit,” says Dr. Hustak. And patients understandably fall for it hook, line and sinker. One of the top providers of breast augmentation surgery a decade ago was not a plastic surgeon. He was a dermatologist who offered MOHS surgery for skin cancer, which is why he could call himself a “surgeon”. Basically, you had a guy who’d completed a 6 month class in how to shave cancerous skin away who was placing implants. He had no training in all the things that could potentially go south, but he still got implants from the manufacturers. To many, this situation seems obviously wrong.
How to Protect Yourself?
With all of this out there, how can patients protect themselves? One of the fastest ways is to see a board certified plastic surgeon. Another is to find out whether or not this “surgeon” that you are seeing has hospital privileges? If he or she only operates out of a surgical center that is a huge red flag. While there are plenty of ethical doctors who operate in their own surgery center, they also have hospital privileges. People who are taking these weekend courses are not certified by a real board, which is why hospitals will not grant them the right to operate there.
The good news is that patients are getting educated today. The bad news is that oftentimes this education comes to them the hard way. “By the time they get to my office to help fix some of these problems, they’ve done their homework and they know exactly what mistakes they’ve made,” explains Dr. Gingrass.