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Just When You Thought You’ve Heard of Everything…..

Just when I thought I had heard of everything, I recently heard about a website promoting free breast implants (and financial assistance for breast augmentation).  Having recently posted on the topic of  entrepreneurship in plastic surgery, I believe this website is a classic example of “going too far”.

The website serves as an “online community”.  A woman who has a “strong desire to enhance her physical appearance through cosmetic surgery” signs up and posts photographs and a plea for financial assistance for the costs of surgery. She stipulates the “type of contacts” she is willing to do to establish a relationship with the “Benefactor”  in exchange for financial assistance.  The Benefactor is a male member of the website who “wishes to help these women improve their self esteem and confidience through cosmetic surgery”.  In most cases, requests are made by the website member/Benefactor for photos of the prospective patient wearing certain types of clothing (or no clothing), but in some cases, requests are made for on-line chats or in-person interviews.

At best, this borders on pornography (giving strange men pictures of oneself in revealing clothing for financial gain), and at worst, it’s prostitution (a situation in which a woman may be financially indebted to a man who insists on meeting her to get a return on his investment).

In addition, anything posted on the internet is “out there” in cyberspace forever.  Imagine a young woman in her early 20’s who may have opted to use this website to finance her surgery 10 or 20 years from now….would she like those revealing photos to be accessible (to a significant other, a prospective employer, or perhaps even voters/constituents)? 

I believe this website is exploitation of women (and entrepreneurship) at its very worst!   A prospective breast augmentation patient should save her money until she can afford the procedure and protect her privacy and dignity!

Plastic Surgery and Entrepreneurship

As I mentioned in my last entry, Plastic Surgery can be very entrepreneurial.  And in that case of the first face transplant surgery in the U.S. on an electrical burn vicitm it is truly an amazing medical accomplishment that may eventually help soldiers or vehicular accident victims who sustain severe facial wounds.  But is all entrepreneurship in Plastic Surgery good?

There always seems to be a new Plastic Surgery procedure or product that claims to do something miraculous – either make our skin look flawless, our faces appear youthful, or our breasts and bodies seem more perfectly shaped.  And most of us are guilty of wanting to “grab the brass ring”.  But do all of these new procedures or products actually do what they claim to do, and how can we find out without either spending a fortune or without being disappointed in the results?

I frequently describe Plastic Surgeons as points on a bell curve.  There are a few entrepreneurs that are points on the beginning of that bell curve – they are the first to promote the new product or procedure.  Some of these physicians may be true geniuses, but many are merely trying to be “the first on the block” to provide the service so they can take advantage of those of us gullible enough to “grab the brass ring” before its worth is well established.  These physicians make a significant profit since they are the only ones providing the service.  Then there are the bulk of us Plastic Surgeons who are points at the top or the middle of the bell curve – the procedure or product has been determined to be “tried and true”, possibly better than a comparable procedure or product that is currently available – and so many physicians may choose to offer it.  It ends up not being overly profitable because the “pool of providers” has been diluted.  Sometimes these physicians opt not to provide the service because the expense is too great and they will not get a return on their investment, now that the pool is dilute. In addition, other options that are still “good” are still available.  At the other extreme of the bell curve are the Plastic Surgeons I refer to as “dinosaurs” – they have always performed the same procedures or provided the same services, and will not change, regardless if something else proves to be better.

It is my personal opinion that those Plastic Surgeons in the middle of the bell curve serve their patients best – they do not take advantage of the patients’ desire to “grab the brass ring”, but they are still mainstream, current with the trends, aware of those procedures and products which are worthwhile to offer to their patients.  I know I have said these two mantras before, but they bear repeating:  If it sounds too good to be true, it probably is. Realistic expectations are the key to satisfaction.

An example of Plastic Surgery and Entrepreneurship is laser assisted liposuction (LAL).  A few years ago, LAL was approved by the FDA.  The entrepreneurs advertised that it was “better”, there was no downtime , there were no side effects with this surgery.  Fortunately, my specialty society (American Society of Plastic Surgery) reviewed and compared LAL to the commonly performed technique of suction assisted lipectomy (SAL),  and the written position of the ASPS stated that neither LAL or SAL was a better or worse technique for body contouring – neither had better or worse results, neither had more or less risks.  The major difference between the two is the technology (laser) and as is typical with high tech procedures, the equipment has higher costs, and these cost are usually passed along to the consumers (patients).  For those entrepreneurs that invest in the technology early on, presumably their investments are covered; but for those in the middle of the bell curve, often it is no longer worth the investment unless the equipment can easily be rented or purchased by multiple Plastic Surgeons. When looking into Plastic Surgery services, always ask what are your available options and the differences in those options!