David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

My Take on the Wall Street Journal: “10 Things Plastic Surgeons Won’t Tell You”

imagesYesterday’s Marketwatch by the Wall Street Journal sported an article about 10 things “plastic surgeons” won’t tell you prior to surgery (and, yes, I’ll explain the parenthesis later). These are things that the authors suggest you should know “before you and your wallet go under the knife.” But before I go any further, let me go on the record saying that if you and your wallet can’t afford plastic surgery, don’t have plastic surgery! That one’s pretty simple.

However, they have come up with 10 things that you may or may not be told by your doctor. When I first saw this article, my blood pressure predictably went up, and those around me reported steam actually came out of my ears. But as I read more, I realize that a better title for this article is “10 things that non-plastic surgeons who are attempting to perform plastic surgery won’t tell you.” Clearly, the original title has more pizazz. But, insofar as they quoted several of the leaders in plastic surgery (all good guys whom I know and respect) to support their assertions, the discussion has more to do with what real plastic surgeons (as in board-certified or board-eligible plastic surgeons) will tell you that others won’t.

Here’s the list:

  1. I trained a whole weekend to learn this procedure.”

True for non-plastic surgeons. Some may have taken a weekend course and then start doing facelifts and liposuction. Real plastic surgeons (and when I say plastic surgeons or real plastic surgeons, I am referring to board-certified and board-eligible plastic surgeons) have at least 6 years of surgical training. And, anytime a patient asks about my training, I am completely forthcoming.


  1. “Discomfort? More like extreme pain and oozing.”

Again, this one’s easy. Plastic surgery is real surgery, and there will be some pain, inconvenience and recovery. However, many of us are using long lasting local anesthetics to help prolong pain relief and make the process easier. But, we always discuss the recovery and what it entails.


  1. “Bargains can come back to bite you.”

Absolutely agree. Many times you get what you pay for. As my wife says, would you buy a discount parachute?


  1. “Long-term effects? Beats me.”

I spend a lot of time talking to patients about these. However, the authors have concerns, which may be valid,about newer procedures; those that may not have a proven track record. That’s why most of us don’t jump on the band wagon right away, but wait until there are studies and scientific evidence that support the new technology and its effectiveness.


  1. “I make a mint off of other surgeons’ mistakes”

Not true for almost all of us. From time to time I do see patients who have previously had plastic surgery and need some type of revision. Fortunately this is not the majority of my work!


  1. “You look great; your husband needs work.”

I am a bit puzzled by this one. I guess the supposition is that women tend to have facial rejuvenation earlier than men might be correct. But all of us are seeing some increase in the number of male patients.


  1. “Sure I can turn back the clock, but it starts again.”

Absolutely true. I tell all my facelift patients this.


  1. You’d be better off spending money on a good therapist.”

I probably take as much issue with this as with any of the statements in this article. Certainly body dysmorphic disorder (BDD) patients are not psychologically stable when it comes to their appearance. However, the article talks about some studies that have shown an increase in suicide rates in women having breast augmentation. These studies have been primarily from Scandinavia, and while the authors have noted this statistic, none can say the one is related to the other: that is to say, breast augmentation doesn’t cause you to be suicidal. Unfortunately what is not mentioned here are the many studies showing the positive psychological benefits from aesthetic surgery.


  1. “Of course I’m board certified, for what it’s worth.”

They got this one right but the wording sort of stepped on itself. Most physicians are board certified in some area of medicine. Just because you are board certified, doesn’t mean you are a plastic surgeon who is certified or eligible to be certified by the American Board of Plastic Surgery. This certification is rigorous and is important.

10. “Those who need surgery the most will benefit the least.”

This last one I will take some exception to. If the authors are saying that the people who will look the best after plastic surgery are those who are healthy and fit, I would agree. But that’s not what this statement implies. Here’s an example: First is a women who is healthy and fit (works out five days a week, and has a body mass index of 22), has had three children and doesn’t like her abdomen. After a tummy tuck, she will look great and love to put on her bikini again, something she hasn’t done since the first child.

Second is a women who has had massive weight loss (over 200 lbs. following a gastric bypass), and has tons of excess skin that hangs down and makes it difficult for her to wear normal clothes. After a body lift and the removal of 8 pounds of skin and fat, her life will become immeasurably easier. But you won’t find her in a bikini. However she probably derived more benefit from the surgery than the first woman.

ASpsIf you’re going to have plastic surgery, do your homework and see a board-eligible or board-certified plastic surgeon.

All in all, the message from this article is that you want to see a board-certified plastic surgeon if you are considering plastic surgery, and I would agree. These are the real plastic surgeons. In the midst of all the confusion of who’s who, just remember four letters: ASPS (American Society of Plastic Surgeons). Its members are all board-certified and held accountable for their standards of care. Here is how to find one in your area and if you live in Knoxville, Tennessee, here is the list of all the board-certified plastic surgeons in town.

All the best,

David B.

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