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Back in 1868, P.T. Barnum was touted to have said, "There's a sucker born every minute." Unfortunately, in this decade, the same unscrupulous principles are still being practiced The only difference today, however, is that the "modern day snake-oil salesman" comes in all shapes and sizes – from companies making ridiculous claims on the radio and internet, to greedy physicians who stray outside their areas of expertise to make a fast buck.
According to the American Society for Aesthetic Plastic Surgery, the cosmetic industry (in terms of both surgical and non-surgical aesthetic procedures) generated over 12.4 billion dollars in 2004. This number is staggering, but reflects only the portion derived from actual plastic surgeons who were trained in accredited plastic and reconstructive surgery residency programs. With the current state of health care and poor insurance reimbursements, many other types of physicians are jumping on the "cosmetic bandwagon," often performing procedures in which they have no formal training or knowledge. What they lack in knowledge, training, and experience is often substituted by what little they learn through a weekend course or from a sales representative of a laser machine or medical product. In practice, they're no better or more qualified to perform these procedures than the mechanic down the street if he were to take the same course.
What makes matters worse is the confusing terminology that these non-plastic surgeons have concocted to give themselves the appearance of legitimacy. Obstetricians sometimes call themselves "Women's health specialists" in hopes that they may sound like experts on all aspects of the female body, including the face, breasts, and skin, instead of just the vagina. .Family practitioners and internists occasionally refer to themselves as "Cosmetic enhancement specialists." I'm a plastic surgeon and I'm still unsure what that means exactly. Botox® and Restylane® injections, laser treatments and skin care, unfortunately, are nowhere to be found on the curriculum of these specialties. Some of these non-plastic surgeons have even taken matters a step further, by creating so-called "boards" in which they are members. (Quick hint: question the worthiness of any board which contains the word "cosmetic" or "academy"). Prospective cosmetic patients should always ask themselves why such physicians would make the time and take the risk to venture out of their areas of expertise. Perhaps they are simply not very good at their chosen specialties, or perhaps they are opportunists driven by greed. Regardless, the real question that patients should ask themselves is whether or not they would want such qualities in someone who's coming at them with a needle, laser, or worse yet, scalpel.
Physicians, unfortunately, are not the only ones who are preying on the public's lack of education and awareness. Corporations often set up so-called "cosmetic" and "laser" centers in order to cash in on the cosmetic industry's popularity. Their advertisements are frequently seen in newspapers and heard on radio. If you actually call one of these supposed "medically-supervised" centers, it is unlikely that the receptionist even knows the doctor's name, much less the physician's actual specialty. More often than not, the physician's name is displayed for show only. As a result, plastic surgeons and dermatologists have both seen in increase in patients seeking corrective treatment for significant complications caused by untrained physicians and even non-physicians after laser/light hair removal and rejuvenation/resurfacing procedures, chemical peels, and acne treatments. Can you imagine what the "girls" at the laser center must be thinking as they're scratching their heads when you come back with a scar, burn, permanent skin discoloration, or misdiagnosis of a skin cancer? Incidences of severe complications are also rearing their ugly heads. Several people, who were injected with botulinum toxin in a "cosmetic center," were hospitalized in Florida after severe reactions. There have also been deaths from lidocaine toxicity after treatment in "laser centers" in North Carolina and Arizona. These incidences have just now prompted some health officials to look into the increased dangers when medical products and procedures are performed by non-medical personnel and non-specialty physicians.
What are also potentially dangerous and even more hideous (not to mention cheesy) are the ludicrous advertisements for miracle creams and pills. Fortunately, the public is usually smart enough to reject their assertions. Claims of safety and jumping two cup sizes are not supported by any legitimate scientific studies. What these products have managed to do, however, is bypass FDA inspection by promoting themselves as non-pharmaceutical. The advertisements for these miracle pills often claim that they enlarge breasts "naturally" by stimulating estrogen receptors. First, there is nothing "natural" about taking a pill to hormonally stimulate breast growth. That's why hormones are prescribed by physicians with warnings. Secondly, any educated physician can tell you that stimulating estrogen receptors can stimulate something else as well…..this thing called breast cancer. Without adequately controlled long-term scientific studies, potential dangers can never be ruled out. To add insult to injury, these ads often use scare tactics by referring to surgical breast augmentation as dangerous. With a proven track record after decades of safety (over 340 thousand women underwent the procedure in 2004 in the U.S.), breast augmentation remains the only safe and proven method to augment the breasts. Unfortunately, as long as there is money to be made in the cosmetic industry, plastic surgeon wanna-be's will always be there to take advantage of the public and look upon us as potential "suckers."