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

Predictions & Protections: The Year Ahead In Plastic Surgery

plastic surgery predictions in 2013Anyone got a crystal ball?  When looking ahead to what may happen in the coming year in medicine and plastic surgery, that might come in very handy! I guess the same can be said about predicting what may happen with the country’s economy. We seem to have averted one “fiscal cliff” and set us up for three others. And while I don’t mean to get sidetracked on our country’s economic future, it will have some impact on what happens to plastic surgery in the coming year(s).

Predictions For Our Practice
We have seen an increase in larger operations such as facelifts and “Mommy Makeovers” in 2012. This, I believe, is due to an increase in consumer confidence due to the economic recovery. This trend is likely to continue in 2013. On the other hand, credit is tight and will probably remain so. People looking to finance operations may have a little bit of a harder time doing this. Fortunately, CareCredit is still a major player which is good. But, qualifying and limits on credit may be a sticking point for some.

When the economy was really suffering, we all saw an increase in non-surgical procedures, chiefly injectables like Botox, Juvederm, Radiesse, etc. These increases have been sustained and with the continued interest in such products we have developed safer, more effective ways of using them. For instance, flexible cannulas which we have been using for over a year will probably become the standard for such injections, and this is a good thing.

There is always a push to identify new technologies that can give real results with limited down time and recovery. CoolSculpting or fat reduction by cooling – cryolipolysis for those who like technical terms – is something that we have brought into our office. We are expecting to see a big increase in demand for this.  It’s a “for real” treatment for the right patients. And because there is no downtime for recovery, it eliminates one of the biggest hurdles in having such a procedure: time.  Time away from work, time away for normal activities, time that must be taking out of your time off or vacation time.  We will see more of these technologies, and more people bringing them into their practices. But each new technology needs tough scrutiny to insure that it is something that really works. There’s an awful lot of snake oil out there!

Economy & Healthcare Impact Decisions
But the biggest changes or trends will be driven by what is happening with healthcare, and reimbursement for health care. Clearly dollars spent on health care by insurers and the government will be cut wherever possible. The first thing that we will see, and have been seeing, is that some procedures will be excluded from coverage. Breast reductions, scar revisions, body contouring surgery after massive weight loss, secondary reconstructive operations and things of this nature may be on the chopping block if they are not already there.

However, the biggest concern for Board Certified plastic surgeons will be procedures done by under-qualified or unqualified people (who may or may not be doctors) let alone surgeons. And the motivation for this is always financial. Someone finds their reimbursement for what they should be doing going down so they decide to do something they are not qualified to do in order to make a quick buck.

Barely a week goes by where there is not a story about some patient being mistreated, harmed, or even killed by such occurrences. The examples are numerous. Unqualified surgeons may be bungling operations that are main stream for trained surgeons. A physician may try to do an operation in his office that he does not have privileges to do in a hospital, and does so under local anesthesia and ends up overdosing the patient with these medications. Non-physicians masquerading as doctors may inject substances into the bodies of unwitting people, or ever attempt to operate on them! While some of these people end up behind bars, others do not.

Protecting Yourself: Awareness and Safety
One way to help the public is Truth in Advertising laws. Such laws, as they apply to medicine, require a physician to state the accredited medical board that he/she is certified by. This gives a level of transparency to the real qualifications of practitioners. These laws must be passed by each state. Hats off to Maryland as one of the most recent state to pass such laws! I would hope that more states will pass such laws, but as you might imagine those wishing to practice outside of the area of their training will offer stiff opposition.However, the burden will always be on the patient to do your homework when choosing a plastic surgeon.

As you look ahead to 2013, if plastic surgery is in your future remember four letters: ASPS. All members of the ASPS (the American Society of Plastic Surgeons) are board certified by the American Board of Plastic Surgery. We are the plastic surgeons. We adhere to a code of ethics and are required to continue our education through the life of our practices. And, one of our primary concerns is patient safety. Plastic surgery “gone bad” when done by non-plastic surgeons affects us and our field. Our goal is to make sure that anyone undergoing plastic surgery has this done properly, safely, and in the right settings.

I hope that 2013 will be a great and healthy year for us all. While there may be doom and gloom surrounding the future or health care, I am continually reminded of the tremendously positive changes I have been able to be a part of with my patients. This is what medicine and plastic surgery is about, and I look forward to much more of this in the years ahead.
I wish you all the best in 2013!
David B.

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