Plastic surgery has never been more popular, and is on the rise most everywhere in the world. According to a study performed by the International Society of Aesthetic Plastic Surgery in 2013, well over 23 million cosmetic surgeries were performed worldwide. Not only is plastic surgery becoming more popular, but the gender bias is also shifting. Over 3 million cosmetic procedures were performed on men, which comes to 12.8% of the total. Although this might seem fairly insignificant, it represents a 273% increase in a five year period.
In the public eye, cosmetic surgery has gone from a serious medical procedure to an almost recreational and in vogue past time, with facelift clinics opening up in malls, and plastic surgery coupons being used as birthday presents.
The extent of the problem
With such great demand, it is no wonder so many have jumped on the plastic surgery bandwagon. Unfortunately, an alarming percentage is made up of under-qualified or even unqualified practitioners. How alarming? A recent study showed that only 3.5 percent of practicing plastic surgeons in the USA are truly qualified to perform aesthetic procedures.
As it stands now, regulations in most countries do not differentiate between a qualified plastic surgeon and a doctor with a basic medical degree. This means that a general practitioner can perform rhinoplasty or a breast augmentation within the full confides of the law. Plastic surgery is often viewed as little more than a nip here and a tuck there, but the truth is that it carries the same risks as any other surgical procedure. Unlike other surgeries, however, practitioners of cosmetic surgery are seldom held responsible for mistakes, ranging from scarring to infection and even death. In the majority of cases patients have willingly opted for the procedure, so surgeons are often not held liable for any malpractice. These legal loopholes mean that many plastic surgeons have become salesmen rather than medical professionals.
Attempts at regulation
The majority of attempts at regulating the cosmetic surgery industry have been self-regulatory in nature. This hinges on compiling a registry of certified surgeons and practices, on a voluntary basis. This approach has, for the most part, failed. It has done so largely because these voluntary codes only incentivize the best doctors in the field to better their practices, while the unqualified and unscrupulous are free to continue their unsafe practices unhindered. It might be argued that voluntary codes have only augmented the disparity of this rapidly growing field. In addition, nothing is being done to regulate the psychological aspects of plastic surgery. Many patients who want plastic surgery are suffering from body-image issues that cannot be solved with a scalpel. It is crucial that patients talk to a trained psychologist, are given time to think about their options and are informed about alternative solutions. Without these kinds of regulations, it is easy to see why less scrupulous surgeons are nudging their patients towards plastic surgery in a bid for profit. Unlike most countries, France is paving the way for safer and more regulated plastic surgery. As a reaction to many severe plastic surgery scandals, the French government worked closely with top surgeons to make the industry safer. The result was a law that is designed to avoid abuse and monitor the practice of cosmetic surgery. This law dictates that patients must be informed on the surgeon’s qualifications, the cost of the procedure as well as a detailed breakdown of risks involved.
Marketing as a part of the problem
Plastic surgery has lost almost all of the stigma and taboo that went along with it only a few decades ago. It is glorified in the media, with celebrities flaunting their implants and procedures to a susceptible public that is often unaware of the risks. Plastic surgery is being treated more as a coveted commodity than a serious medical procedure. This can clearly be seen in the marketing of cosmetic procedures in printed media, television, and especially the internet. Cosmetic procedures are often advertised using limited offers including “buy one get one free” deals, vouchers and even surgery holidays to exotic countries where regulation is non-existent and procedures are inexpensive. These and similar advertising efforts are often misinterpreted by those it is aimed at, and trivialize the entire industry. Top surgeons around the world are calling for a ban on this type of marketing, in much the same way that there was an outcry against tobacco advertising.
Calls for action
Around the world, the rise in plastic surgery-related deaths has caused both a public and professional outcry for more stringent and functional regulations. From a beauty pageant winner in Venezuela dying after complications resulting from abdominal liposuction, to three recent deaths of women in Australia, the casualty count is rising. Australian doctors are calling for a mandatory two week waiting period after consultations before a person can get a plastic surgery. The British Association of Plastic, Reconstructive and Aesthetic Surgeons is fully backing new attempts at regulating the industry. They maintain that cosmetic surgery is effective and safe when carried out by well-trained, experienced surgeons in sterile and properly staffed and equipped surroundings.
What the industry needs is a comprehensive overhaul, led by an independent and unbiased umbrella body that will monitor training, facility conditions, qualifications, counseling and aftercare. Better communication between medical professionals and governmental bodies is essential if effective legislature is to be passed. In addition, the public needs to be made aware of the risks and alternatives, rather than being exposed to fraudulent or misleading advertising campaigns. Until such a time, the domain of plastic surgery will remain a veritable wild west of medicine.
Elizabeth Marigliano is an alumna of Stanford University. Her interests include cosmetic & plastic surgery.