Myths About Plastic Surgery

Thursday, April 7th, 2011

As Plastic Surgery becomes more popular, many misconceptions arise. Part of this is due to popular media that does not always research their subjects thoroughly before publication and how TV and the movies portray it to make their plots work better. I thought that I would try to deal with some of the most prevalent ones.

1. All “Board Certification” is the same. In fact, it isn’t. If I wanted to create a
   “Board,” say for “Laser Zit Removal,” it would cost me just a few dollars in Raleigh. I could then issue “Board Certification” to anyone I wished. The original Boards, of which the American Board of Plastic Surgery is one, are certified by the American Board of Medical Specialties (ABMS). The only other Board certifying any cosmetic surgery is the American Board of Otolaryngology for facial cosmetic. The American Boards of Facial Cosmetic Surgery and Cosmetic Surgery are not overseen by the ABMS. Certification by an ABMS Board requires meeting vigorous, ongoing standards.
2. Only surgeons certified by the American Board of Plastic Surgery can legally do Plastic Surgery. In fact, anyone with a medical or dental license can advertise and perform Plastic Surgery. This is almost always done outside a hospital, since most hospitals require some certification in the procedures performed. Highlands-Cashiers Hospital requires certification by an ABMS board in the procedures done.
3. All Plastic Surgery is performed in a facility certified as safe. As stated above, many physicians, in order to avoid hospital privileging, do their surgery in an office setting. Many of these facilities have no oversight, since certification of the facility is expensive and requires hospital transfer agreements and physician privileging. Both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery require their members to do all surgery with sedation or anesthesia in a certified facility. Highlands-Cashiers Hospital maintains Gold Seal Approval by the Joint Commission, the oldest certifier.
4. Plastic Surgery is only for the rich and famous. While this was somewhat true in the beginning, most people having Plastic Surgery are just like you. We now have ways of dealing with whatever bothers you that fit every pocketbook.
5. Extreme Makeovers are routine. Though TV has made it seem like remaking the entire body is the norm, in fact, it is quite rare and most people have only one area treated at a time.
6. It is disrespectful to ask the surgeon tough questions. Most physicians expect hard questions. We look upon them as an indication of how involved you are with your care. With surgery, especially, we see it as further proof that you understand the procedure and that your consent is truly informed.
7. It is inappropriate to speak to former patients. While simply giving you the names of patients to call violates patient confidentiality, many patients are quite happy to discuss their procedure with you. We encourage this if you are having trouble deciding about a procedure, as it gives a totally unique prospective.
8. It is inappropriate to ask about results and risks. Not only is this NOT inappropriate, it is imperative that you do. The only way you can decide between several options that are frequently available, is to know everything you can about each. Also, choosing a surgery or procedure really entails making sure the benefits outweigh the risks, The only way to do this is to understand both. It is also important to know what a particular surgeon’s problems have been, as they sometimes vary from surgeon to surgeon. We keep before and after pictures available so you can evaluate the possible results, but you must translate these to what the procedure can do for you.
9. Plastic Surgery procedures cost the same no matter who performs them. Not true. They vary greatly, but you generally get what you pay for. Recently a number of people died or were hospitalized because they sought cheap Botox. The “Botox” used, to reduce the cost, was a nonstandard fake. Where I used to live, a family practitioner did Breast Augmentation cheaper than anyone in town. He did this by using poor quality, non-approved implants in a non-certified, unsanitary OR, and allowing only three visits. If his patients had a problem or question, he told them to “see a Plastic Surgeon.”
10. Plastic Surgery is based on looks, not science. This is really not true. Most Cosmetic Surgery procedures are based on reconstructive ones. All those are based on extensive research. Plastic Surgery has, for many years, led the way in developing new procedures and techniques. Plastic Surgery developed tissue transplant technology in an effort to improve wound coverage. Presently, we have discovered that the fat removed during Liposuction contains multipotential stem cells. Research is trying to determine how we can best use their potential. Even “standard” procedures are changing as we examine our results and change our methods based on those findings. This is why I totally changed my Facelift technique nine years ago. I went to a technique that did not result in the problems I saw with the “standard” one. I continue to evolve it based on further observation.
11. Silicone Breast Implants have not been scientifically proven safe. This was the contention in 1992 when they were withdrawn from the market. After more than fourteen years and exhaustive research that proved them safe, they were released again. There is now more data on these than on almost any other medical device known.