I usually arrive home at the end of the workday in time to catch the 6:00 P.M. local TV news. Interspersed between police chases, carjacking stories and drive-by shootings, there is all too often the obligatory cosmetic surgery story. Teased in sensational terms, I am encouraged to stay tuned for this remarkable new “breakthrough”- laser stretch mark removal, lunch hour facelift or latest cellulite cure. What do I as a plastic surgeon make of this phenomenon?
First, it is obvious that the public interest in plastic surgery is soaring. The news director knows it. It’s not about the news; it’s about ratings! We as a culture are more consumed about our appearance than ever before. There are more plastic surgeons than ever before, in part to meet the rising demand, and in part because doctors with limited plastic surgical training are performing cosmetic surgery to offset the economic consequences of health insurance changes. This has led to increasing competition and the lowering of fees, which in turn, has made cosmetic surgery available to more people on a limited budget. Thus the cycle of supply and demand is at the heart of this boon. Demand by the public and a changing medical insurance environment has led to an increased number of cosmetic surgeons (supply). Increasing supply has decreased the cost that in turn has created a new and greater demand.
Second, the relationship between the plastic surgeon and the publicist is now commonplace. There are no statistics to reveal the vast number of doctors in our country who are performing cosmetic surgery. Some have spent seven or eight years in a training program. Others have merely taken a weekend course. Suffice it to say that there are plenty, especially in the big cities where the competition for market share is fierce. How does a cosmetic surgeon develop a following or a practice? Just one generation ago, a surgeon’s reputation was built the hard way, through good work and service to the community. Now it is done through the media- and done quickly. How? The P.R. people tell their physician client, “Come up with something new.” And they do!- on command! Old techniques are retooled or renamed. Or old methods are claimed as new or their own by the publicity seeking surgeon. Tens of thousands of viewers are subjected to one contrived story after another and flock to the doctor du jour for these latest easy fixes.
Third, and most concerning, is that the science of our specialty is now revealed moments after “discovery” by way of the local news rather than through the scientific community. Medical doctors once adhered to strict protocols, followed their subjects over long periods of time, submitted their findings to hospital and peer review boards and published their findings in prestigious journals. Now, their latest “revelation” is “patented” and comes to us as a thirty-second sound bite at 6 PM.
All of this diminishes a field of medicine with a remarkable and visionary history.