Rejuvenate You: Virginia Plastic Surgeon Michael J. Brown, M.D., P.L.L.C

In an earlier blog, I wrote about making sure patients searching for cosmetic plastic surgery take time to learn about the procedures they are interested in and to be sure to select a board certified plastic surgeon with experience. To illustrate these points and how important judgement is, here are some current news stories dealing with cosmetic surgery complications.

A family medicine physician was sentenced to 9 months in jail for performing facial cosmetic surgery procedures on women which resulted in complications. He has been under investigation with the board of medicine and had a restricted license preventing him from performing cosmetic surgery. Despite this, he continued to perform facial and breast surgeries on people. He was convicted of aggravated assault and assault causing bodily harm. He was performing these surgeries and telling people he was board certified, but not by whom.

In Beverly Hills, a radiologist opened a liposuction center and was performing liposuction on people without training. He has a civil suit against him for allegedly allowing his girlfriend and another person to perform the surgeries. He was also using the fat to try and fuel his car, (also against the law). He has fled the country and now is practicing in South America.

In Oregon, a woman sued and won lawsuits against a dermatologist she believed to be a plastic surgeon based on the dermatologist deceptive advertising. She also sued and won a larger suit ($1.32 million) against the magazine publisher who allowed the deceptive advertising practices and even promoted that type of advertising. The verdict was affirmed by the state Supreme Court.

The point of these examples, is take time to Verify credentials. Do not believe what someone tells you or see in a magazine. Educate yourself, and select properly trained plastic surgeons with extensive patient examples and referrals. If something sounds too good to be true, it usually is. Never compromise or barter when it comes to your health or your body. It is a very precious resource.

Patients continue to be confused or misled from deceptive or less than forthright presentations of training and qualifications when it comes to cosmetic, plastic surgery and non surgical enhancements. The most common deception is the ‘board certified’ tag line in an advertisement. This appears to be the one line that patients look for when it comes to considering cosmetic enhancements, and the deception comes in the lack of ‘full disclosure’ of what the physician was actually trained in and/or what board exam they actually passed.

Physicians typically undergo additional training after 4 years of medical school. This additional training is called a residency. The residency period may be as short as one year or as long as six years. After a residency, some physicians, typically surgeons, may complete a second residency for additional training and certifications to further refine their areas of practice. After a residency or two, some physicians may spend an additional 6 months to 2 years in more training called fellowships. Fellowships may be acredited or non-acredited, meaning that they may be recognized by higher governing bodies as more valuable in educational experiences.

It is typically after a residency that a physician takes an examination (written and oral) to become board certified in what they have just been trained in. So being board certified means nothing if you do not know what they are board certified in.Every patient should ask what board the doctor is certified in and who is the regulatory body of the board. For example, the most credible boards (those used by hospitals to award priviledges) are governed by the American Board of Medical Specialties, ABMS. This is the premier board created to serve and protect patients. The American Board of Plastic Surgery is one of the 24 sub boards of the ABMS. This is the board that hospitals and lawyers check for when determing credentialing and expert status. The American Board of Plastic Surgery is the only board recognized as plastic surgeons, by the ABMS.

Unfortunately in the public’s eye, this is often overlooked or not understood. A doctor who completed a residency in OB/GYN, or Dermatology, Emergency Medicine can claim to be ‘board certified’, but they are board certified in those fields, not plastic surgery. Dentists, Oral surgeons, and any other doctor can also make these claims. They support their misleading advertising by joining a board that was created by others like them. They have created the American Board of Cosmetic Surgery, which is not recognized as a credible board by the ABMS or nearly all hospitals in every state in the US. In essence it is a board to support deception to the public. It is not against the law, and it is not their responsibility to inform a patient about its origins. The question to the public has to be, who do you really want performing procedures on you? It can be even more concerning because members of this American Board of Cosmetic Surgery, have created their own society to pad their credentials even further. The American Society of Cosmetic Surgery is this society.

Remember, ask what they are board certified in?, is it a member of the ABMS? and then think to yourself, is this what I am seeing this doctor for? You should not want a gynecologist to inject fillers into your face, or a dermatologist to do liposuction, or an ears, nose and throat surgeon to perform your breast augmentation or tummy tuck.

So when seeking to improve your looks be sure to look intelligently and ask the right questions to the right type of doctors and avoid complications before you get them. Do your homework, and compare to apples to apples and avoid the lemons.

It is clear from watching television or looking through magazines that celebrities elect to have cosmetic plastic surgery. It is also clear that just because they are celebrities, does not mean that they are getting good results. I receive lots of email questions about celebrities and cosmetic surgery and I answer them as best as I can. Since I am not standing next to these people, I can only evaluate them via television or print. With some of these cases, it is unfortunately easy to tell and this usually means that they are not getting really good results. The thought that just because they go to a doctor in Beverly Hills or Manhattan means that they must be good surgeons is ridiculous. Any doctor with any background can open an office in Beverly Hills or Manhattan or anywhere else for that matter. It does not mean that they are qualified to perform plastic surgery or non-surgical enhancements. Some of the lip augmentations that I am seeing and facial enhancements are simply poor. I watched a news comentator the other day and her Botox was not well administered and her brows were ’spiking’ terribly. I would stress to anyone looking into cosmetic plastic surgery to really investigate their surgeon choices and ask for result photographs and potentially even referrals. Just because it may be a relatively simple thing, does not mean that one should assume anyone can do it well.

Like any surgery, there are risks in plastic surgery. Just because these surgeries are elective does not mean that they should be taken lightly. Many people are performing surgeries without proper training or experiences. This only further increases the risks of complications with surgeries and elective cosmetic procedures. I see complications from prior surgeries, most of these patients believed that they were in the hands of a plastic surgeon when at times, they are not. Dermatologists, Ears, Nose and Throat surgeons, dentists and OB/GYN are all doing cosmetic procedures to improve their incomes. Most without significant training and without hospital priviledges to handle these procedures. Unfortunately they will say that they are ‘board certified’, they just fail to mention that they are not board certified in plastic surgery.

Even plastic surgeons can show poor judgement and perform too many procedures at one time and put their patients at risk. Kanya West’s mother suffered the most severe complication and died secondary to a non-board certified plastic surgeon’s poor judgement. The death of a patient is a tragedy regardless of who did it or why they died, especially with elective surgeries.

This point is really emphasized with the tragic death of a high school 18 year old girl who died on Sunday in Florida. Stepahnie Kuleba’s untimely death was unpredictable and could have occured with nearly any surgery that she had. She died from an anesthesia complication called Malignant Hyperthermia. Her body reacted to the anesthesia drugs by raising her body temperature to deadly levels. It can be a genetic trait and difficult to detect. It can happen in any setting including a hospital, or surgery center. When identified early enough, the condition is treatable. Interestingly, I operated on a woman today who has a family history of Malignant Hyperthermia. All precautions were taken, and she did very well.

Do not take cosmetic procedures, especially surgeries, lightly. Be sure and spend time with your surgeon to vet out their experiences and recomendations about what would be the correct surgery for you. Remember knowledge is empowering and will only improve your experiences.