The State of Cosmetic Surgery: The Health, Vanity and Politics around the medical turf war

Cosmetic surgery and aesthetic medicine are unique branches of healthcare that have been going through reform for past few decades. Like the overall healthcare scenario, matters of greed, dirty competition, backstabbing and monetizing have sipped in the field of aesthetic medicine. All the stakeholders of aesthetic medicine is getting negatively affected whether they are care providers, topical agents, medical equipment, imaging techniques- even the practice itself has been ridden with problems.

The field of cosmetic surgery has also faced increasing politics. It is really difficult for independent surgeons to offer such services with all hassles of credentials, privileging and humongous amounts of politics and monopolies to overcome. Now many ambulatory centers have started offering cosmetic services because there is politics about who could perform such procedures. Even the state medical boards and regulatory bodies have tightened their grip on cosmetic surgery and a single slip can cause them severe damage to their profession- unless they have a group of board members backing them up!

The Societal Pressure of Looking Good

Our culture of social media and Instagram has made us aim for the perfect look. Celebrities are becoming role models for teens and they would do anything to look like them. The society has put a strong pressure on us to look good and many just undergo cosmetic surgery to get their desired look.

The trend is really upsetting and brings ethical concerns regarding the profession. UK’s Nuffield Council on Bioethics published a report which touched on the subject. It found that the games and apps that make people look like celebrities give rise to unrealistic expectations. The social and economic pressure on people including women and girls make them want to conform to the definitions of good looks and fueled by rating of body images.

This trend has led to the commercialization of cosmetic surgery and sales and marketing stances are clouding important questions like who should get a procedure and for what cost. Cosmetic surgery has prompted many people to save thousands of dollars which they never save for serious medical concerns.

Cosmetic Surgery is a No Man’s Land

Cosmetic surgery is regarded as the dreamland thought it is also one of the most litigated branches of medicine. Physicians who choose to tread this path are often attracted by the luxurious nature of cosmetic surgery.

However, in spite of it all, the field is ridden with hostility and resentment. The liability in this field of medicine travels beyond the doctor patient relationship to state medical boards and also to plastic surgeons and cosmetic surgeons.

But why?

Cosmetic surgery is an entirely cash based medical procedure which has no relation to insurance companies. This nature has fueled a turf war of its own accord which extends till the highest ranks of the government. Bureaucracy is also impacting this field of medicine and the monopoly and market has turned volatile.

Cosmetic surgery has become monopolized, ridden with politics, commercialized and might fall into the wrong hands. Cosmetic surgery is also being offered to people who don’t have an intrinsic need of it. Even the Nuffield Council on Bioethics found the trend unsettling and blamed the cosmetic apps partly for the reason.

Cosmetic Surgery is a Medicinal Field

Cosmetic surgery has always been a part of medicine and doesn’t have to singularly do with how you look. It can be performed to raise your confidence, self-esteem and give back functionality to different body parts. A patient is treated based on his individual professional physical, social, psychological factors.

Unfortunately, the current trend has come to a situation that we have also caused harm with the outcome. Cosmetic surgery wasn’t supposed to be a money making business as it is today. Instead, it was supposed to ensure that patients felt better about themselves. It was to ensure that one could lead their daily normal lives, just like before. And it was to make people be more comfortable with themselves.

Physicians take up aesthetic medicine to avoid the ever increasing mandates and regulations of the government but in vain. An orthopedic doctor is challenged by neurosurgeons for performing spine surgery. If a maxillofacial surgeon performs a tummy tuck he will be faced with resistance but if a general physician delivers babies, he may be complemented for his or her service. The former is lucrative and everyone wants a pie of the profit hence is more politically charged.

Knowledge and skills are personal characteristics but has been surpassed by profiling, segregation, politics and monopoly.

But what makes physicians pivot in the first place?

The answer is physical burnout, unruly healthcare system and financial rewards. Physicians also need appreciation for what they do and the notion of appreciation is associated with specialties. Treating pharyngitis is as important as malignant melanoma because it has value for the patient. The way a physician diagnoses, treats and interacts with their patient also generates value.

A physician must be able to practice independently based on his skills and comfort. Physicians also need to adopt personalized medicine so that they can treat cosmetic surgery patients accurately. They also need to be on top of compliances and patient safety ensuring a quality service; not just looking to satisfy medical board regulations and accreditations.

We have to act now and use the available technology with hands on support. Physicians need to form alliances with all stakeholders without compromising their individual practice and autonomy. We have to understand that cosmetic medicine is same as any other medical field and the patients are no different. They also qualify for personalized care and better service at affordable rates from physicians of their choice.

We need doctors with appropriate training and experience and have to get rid of the politics and monopoly. That being said, we also have to empower the doctors and the patients and improve quality of care in aesthetic medicine.