Tuesday, May 22, 2007

Smart Money's "10 Things Your Plastic Surgeon Won't Tell You"

Props to Dr. DiSaia for pointing out out an article on Smart Money.com called "10 Things Your Plastic Surgeon Won't Tell You".

  1. "I trained a whole weekend to learn this procedure."
  2. "I make a mint off other surgeons' mistakes."
  3. "Sure, I can turn back the clock, but it just starts ticking again."
  4. "You'd be better off spending this money on a good therapist."
  5. "Of course I'm board certified — for what that's worth."
  6. "You can get this done for a fraction of the price overseas."
  7. "I make my living off the fat of the land — literally."
  8. "Long-term effects? Beats me."
  9. "Silicone's back — and putting my kids through college!"
  10. "Those who need surgery the most will benefit from it the least."

You can click the link above (or here) to read this in context. I've actually touched on many of these "dirty secrets" here on Plastic Surgery 101, most of which are neither dirty nor secret. They touch on the issue of who/what can call themselves a Plastic or Cosmetic Surgeon (which is pretty much anybody), prevalence of psychiatric disease among patients, & patient selection among other things.

I'd strongly disagree with their point #6, the breezy attitude towards having cosmetic surgery in 3rd world countries (aka "scalpel tourism"). Just briefly scan Google's newswire to find dozens or reports highlighting peril with this. There are just too many potential variables to endorse that. You want to be in a place where you have access to your doctor or an associate for complications. These can be devastating, especially with some of the body contouring and facial procedures.

Fair or not, a true "dirty secret" is that you're going to get a big red flag attached to you for having surgery in remote locations as a likely problem patient for showing such poor judgement in the first place. Good luck trying to find a doctor on short notice in the USA who is going to be rushing to take care of someone else's complication, particularly when it occurred overseas.


Cindi said...

If you use the term "third world countries" on your blog I have to wonder what terms you use in private....hhhmm.

The rest of what you wrote here also reeks of a condescending attitude. Do you honestly think that those of us who seek medical care and/or cosmetic surgery abroad do so because we want to? We do so because we have no other choice when the care or procedure we need/want is out of our economical reach in this country.

I'm a college graduate, am fully employeed yet my health insurance only covers emergencies and urgent care. High cost of living plus extremely high medical costs means that I can't afford preventive care. I've had full dental work in Mexico with excellent results at over 60% off of what I would have paid in the States. I've had cosmetic surgery done in South America at huge discounts. I could have waited for years and saved up money for my cosmetic surgery or I could have saved up for 4 months and gone abroad. And that's what I ended up doing.

Just because I can not afford a US surgeon does not mean that I'm not entitled to medical or cosmetic procedures and just because I've had procedures done in developing countries does not mean that I didn't do my research as to the surgeon and facility that I chose. You would be surprised at the level of care and competence found in developing nations and at the amount of time that many of us "medical tourists" spend researching our international surgeons.

Dr. Rob Oliver said...

It's not condescension but realism I'm trying to communicate. Complications from cosmetic surgery, particularly after weight loss (which many medical tourists go to have), have high complication rates to begin with. A major complication in an unregulated latin American or SE Asian clinic can leave you in a desperate state.

It's realy not accurate to suggest that most lack "choice" and that people can't affordably have surgery done stateside. Financing at favorable rates has never been more available by multiple sources. If you're finances are so bad that you can't get financing, you have to ask yourself whether or not you should be spending money on cosmetic surgery in the first place.

I'm also not sure exactly how you feel you're able to accurately "research" physicians in distant locales. While I can name recognized internationl experts in many of these countries, by and large these are not the doctors people are traveling to as their fees can actually meet or exceed many US surgeons. When people here have trouble sorting out advertising and hype when choosing MD's, it's rings false that your average consumer looking on the web could do it.

Again, I warn people to really reconsider what is a risky proposition. It is the wild west for those kind of services & you could really end up not served well by it.

Cindi said...

I agree that the potential for complications is one of the top issues to consider when planning for surgery abroad. But it's something to consider in the States too where complications and lack of proper after care are not unheard of. One just has to look at the most popular plastic surgery forums and google articles to read the dilemmas that many patients have gone through at the hands of certified US surgeons. Going to a local surgeon is convenient but it does not provide a fool-proof guarantee against complications and patient satisfaction.

My finances are normal, like those of the vast number of Americans. In fact I'm somewhat atypical in the fact that I don't own credit cards and my only debts are my student loans. Of course I looked into financing, I considered everything including residency programs. What I experienced when searching for financing companies is that their rates are not that low, that not all surgeons accept financing and that those that do (whom I consulted with) want other forms of payment combined with financing, which combined with interests rates would still be quite expensive.

By the way the surgeon that I went to is a member of ISAPS and I did in fact contact both ISAPS and his country's plastic surgery association when doing my research as well as talking to previous patients of his, checking his publications, etc.

I think that when you make sweeping statements about plastic surgery abroad and what people who can't afford a US surgery should actually be doing with their finances, I think it's just arrogant. A broader and less biased understanding of people that choose international medical and cosmetic care would be welcomed.

Dr. Rob Oliver said...

Call me paternalistic, but as a practical matter I speak as someone who does this for a living and is a lot more familiar with issues re. follow-up, recovery, outcomes, & complications then you (as a patient) could hope to be.

I'll repeat, particularly for body contouring procedures and especially for the post-gastric bypass population, you are showing astoundingly poor insight into these procedures if you (not you in particular, Cindi)consider these operations abroad. I get nervous about having these people an hour or two away in my own state, much less a continent away. Also keep in mind that the window for complications to present in those patients is sometimes 6-8 weeks out from surgery.

I would not recommend a member of my family, someone I cared about, or even someone off the street to have cosmetic surgery in these settings unless I knew the surgeon and was personally going to be doing the post-operative care back stateside.

As I do not know of any surgeon running medical tourism in SE Asia or Latin America with a Plastic Surgeon in place for follow up, I cannot in good conscience endorse this.

Anonymous said...

To Cindy, or any other cosmetic surgery patient who presents to a state-side Emergency Room or plastic surgery clinic with a complication as a result of a cosmetic procedure done outside of the country (and if you arrived in the ER or called my clinic)- the FIRST and LAST question you would be asked is :

1.'What does your plastic surgeon want to do about your problem'?

Criticizing your decision to have cosmetic surgery overseas is not a comment on the qualifications or quality of plastic surgeons overseas. The point that Dr. Oliver appears to be making, and is shared by every plastic surgeon I know, including myself, is that you're an IDIOT for having a surgical procedure done in another country without a physician state-side who has been enlisted to care for you post operatively.