The Depression era bank robber, Willie Sutton, is famously reported to have said he robbed banks because, “That’s where the money is.” In today’s medicine, the money is in cosmetic surgery and the good doctors, the bad doctors, and the private equity investors are flocking to cash in.
Necessary medical procedures are usually covered by insurance while elective cosmetic surgery procedures are not. Insurance often caps the amount a surgeon can charge for a procedure. Since cosmetic procedures are usually paid for by the patient out of his or her own pocket, the only limit to what a surgeon can charge is what the patient can be persuaded to pay. And when it comes to making yourself beautiful and sexually desirable, people are willing to pay a lot.
Private equity firms and their investors are always looking for a way to get big returns on their investments. Hiring doctors and opening a plastic surgery clinic is an excellent opportunity. The patients are willing to pay out of pocket with cash or credit cards and to pay generously. No fussy insurance companies to bill and argue with. The doctors do not need to be trained plastic surgeons. They may need some minor training to learn to do the procedures but there are programs that offer such training over a weekend or a few days. Anyone who is licensed to practice medicine can hold himself or herself out as a cosmetic surgeon and the state medical boards won’t say a word.
Needless to say, there is a ready supply of doctors out there who are happy to sign up to work for a plastic surgery chain. There is no reason for the private equity firms to spend the money necessary to hire highly trained and experienced surgeons. As a matter of fact, the chains generate the most money, if they don’t pay very much for the surgeons they hire. In medicine, as in so much else in life, you often get what you pay for. If you are not paying for quality and experience, you probably get neither. There are a lot of lawsuits pending against plastic surgery chains. Some allege that the chains hire doctors with troubled pasts. Certainly some doctors working for plastic surgery chains fit that description.
There is also the problem of overpromising and underdelivering. The plastic surgery chains have locations in many cities and run enticing ads in all of them. The ads prey on the wishes and desires we all have to look beautiful and youthful. Lovely young women with willowy figures and flawless skin gaze out at us from the advertisements. You too can look like this, the ads suggest. If only it were true. Even the most skilled surgeon can do only so much. This is especially true if the procedure is being performed on tissue that has been the subject of one or more prior procedures. Frequent cosmetic surgery patients are the ones most at risk for the catastrophic outcomes we see on the internet.
Finally, there is the problem of post-surgical complications. There can be post-surgical complications following the most perfect surgery performed by the world’s best plastic surgeon. Those are not the surgeries performed at these chains. They tend to have a higher complication rate. And according to many of the malpractice suits filed against the chains and their doctors, they often do not respond well to these complications.
Infection is always a concern following surgery. It can happen even in the best of circumstances. Infections can be devastating, especially if they are not treated promptly and properly. Almost all of the cosmetic surgery performed at one of these chain offices is performed on an outpatient basis. Patients who need continued observation after the surgery are often sent to unlicensed and understaffed recovery centers. Some are sent to rented hotel rooms. Many patients who have gotten into trouble following their surgery at a plastic surgery chain have sued and contended they were left on their own or received little or no help when they called to report developing problems. Some patients died of untreated infections that progressed to septic shock.
Often the surgeons at the chain facilities do not have privileges at the local hospital and cannot admit their patients there. Some patients allege they were actively discouraged from going to the local emergency department when they developed complications. If they do go to the emergency department and are admitted, the surgeon who did their operation will not be able to treat them there unless they have privileges at that hospital. Needless to say, having someone new take over the patient’s care after a problem develops is less than optimal.
If you have decided to pursue cosmetic surgery, do yourself a favor and look into the qualifications of the surgeon into whose hands you are going to entrust your body and face. Make sure she or he is a fully-trained cosmetic surgeon, who has completed a plastic surgery residency and is board certified as a plastic surgeon. Check your state’s medical board and see if your surgeon has been disciplined or has been the subject of multiple complaints. Make sure your surgeon has hospital privileges so she or he can care for you in the hospital should an unfortunate complication arise. Make sure you understand where you will be doing your recovery and what personnel and equipment will be available to you during this period.
There is nothing you can do to guarantee yourself a good outcome, should you elect cosmetic surgery, but these steps will give you the best chance to avoid a disaster.
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