As the recession has continued now for over two years, most businesses have noticed. The number of cosmetic procedures performed has been no different. After continuous and unprecedented growth for over a decade, the number of elective plastic surgery procedures has taken a downturn these past couple of years. With this downturn has come the ‘shrunken pond’ effect that inevitably occurs when the same number of fish occupy a smaller body of water… competition for food increases dramatically. In the world of sales this translates to an increase in discounting for some to keep a steady flow of customers.
While discounting is a great idea for retail products like cars, jewelry and clothes, it has definite drawbacks in plastic surgery. Price reductions and the ever famous :Buy One, Get One Free” advertisements have appeared like never before. While the use of clever marketing is ethical and business-savvy, bargain-basement operations could exact their own price. The recent rash of major problems and deaths from plastic surgery procedures in the news is an example. Most of these tragic events are related to choices of doctor training, location where the procedures were formed, and the use of unethical or illegal substances and procedures.
One method of cost-cutting in plastic surgery that I have noticed to be prevalent is the use of local or sedation anesthesia as opposed to a general anesthetic which requires an anesthesiologist. While usually touted as being safer and offering a quicker recovery, it is understandable while some people would be attracted to it. But that doesn’t mean it is the most comfortable or allows the surgeon to perform the best job. A recent story covered one physician nationally touting breast augmentation without general anesthesia. In the story the doctor claimed that he would sit the half-awake sedated patient up during the operation so they could agree to the size of their breasts before he stitched them back up. Had a board-certified plastic surgeon developed this method I might have listened but these arguments from a gynecologist are less persuasive.
Much of this discount approach to surgery is being led by doctors who have studied an unrelated area of medicine and have entered cosmetic surgery through a low-fee approach. Not having to bill and process insurance makes the allure of patients who pay up front very appealing. Doctors not trained as plastic surgeons usually have to perform their procedures in their office. While they can legally do so, they also have to because they don’t have the privileges for these procedures in hospitals and surgery centers. Unfortunately, some privately-owned surgery centers are so crimped for cash that they may allow the stringest requirements of training that hospital requires to be bypassed to get any doctor in there to do procedures.
Breast augmentation and liposuction are the most common cosmetic surgeries where discounting and dubious training seem to parallel each other. This is particularly prevalent in bikini-clad sections of the country like Miami, Southern California and Las Vegas. We see less of it here in more clothed Indiana but it still is not rare. But body contouring is not alone in this trend, the facelift franchise known as the Lifestyle Lift offers a ‘mini-facelift’ at a discount rate under local anesthesia. While volume surgery may be predicated on rapid turnover…your face may be more interested in a long-lasting result that is suited to your aging needs…even if it costs more.
While bad plastic surgery is not always cheap plastic surgery, it can be a warning sign. Plastic surgeons with great skills and experience usually don’t have to resort to discounting to sustain their business. If you want to save money, do it when buying a vacation, clothes, or a gym membership. Think twice before being price swayed when considering plastic surgery. Skill, experience and a track record of satisfied patients is more important than a low price.
Dr. Barry Eppley