Do You Get What You Pay For?
An important concept in cosmetic plastic surgery is that of value. In short, what are you getting for your money? The importance of a good return on one’s investment is one factor of how you will interpret the result and the experience.
While talking frankly about a patient’s expectations before surgery remains the cornerstone of good ‘doctor-patient’ communication and goes a long way toward a patient’s satisfaction afterwards, the ‘value’ concept in plastic surgery is often overlooked. What is the inherent value or lifespan of the operation or procedure? In other words, how long will the results last? Interestingly, this will vary greatly amongst the many surgical options available.
Certain plastic surgery procedures have tremendous value because they will essentially last a lifetime, almost regardless of the patient’s lifestyle postoperatively. In this category would be procedures such as rhinoplasty (nose job), otoplasty (ear pinning), and facial implants (e.g., chin implant) for example. Once these changes are made, barring complications, they are permanent and will never change no matter what the patient’s lifestyle. The same can almost be said for breast augmentation and abdominoplasty (tummy tucks), although how permanent these results are is influenced by the patients’ age at the time of surgery. If a woman is done having children, these two operations can have a long lifespan with little change. If you amortize these more ‘permanent’ procedures over one’s remaining lifetime, they can become well less than a dollar a day. It is hard to find anything you could buy that would last so long at such a low lifetime cost.
More moderate lifetime value plastic surgery procedures are those which can be influenced by one’s lifestyle…the potential for weight gain and a lack of care for one’s self. Liposuction is the leader in this category. While immediate postoperative changes can be quite gratifying, the short and long-term benefits of the procedure are only going to be as good as long as the patient continues to support their original investment ( proper nutrition and exercise). Any anti-aging facial procedure, such as a facelift, browlift, or blepharoplasty (eyelid tucks), falls into this category because it treats the symptoms of the problem and not the actual problem itself – aging. Therefore, time will always outlast the surgical benefits (and I would argue you want to outlive how long these operations will last!). The value of these procedures must be judged more in the intermediate term (5 to10 years) and the cost must be averaged over this time period, which makes it a few dollars per day.
Ironically, those procedures that have the shortest value period (Botox, injectable fillers) have become tremendously popular during this decade. While Botox lasts just four months, its cosmetic uses account for nearly a billion dollars in sales nationally. These very short value procedures overcome the economics due to how easy they are to administer, immediate results, and lack of any recovery from them. In other words, an instantaneous fix at a relatively low cost (compared to actual surgery) increases their relative value.
While elective cosmetic plastic surgery decisions are really emotionally driven, it is interesting to look at their economic value in terms of the lifespan of their results. Such considerations are not a major determining factor in the decision for surgery but may help in deciding if a certain procedure is ‘worth it’.
Dr. Barry Eppley