Check Your Doctor
Non-plastic surgeons performing cosmetic procedures is on the rise.
In speaking with numerous plastic surgeons, a trend started to arise throughout the discussions: the proliferation of non-plastic surgeons performing procedures; family practitioners, ob/gyns, radiologists doing liposuction, face-lifts and tummy tucks.
What is the difference between a plastic surgeon and any other doctor?
“We feel that board certification by The Board of American Plastic Surgery is the gold standard for plastic surgery,” says Dr. George Weston of Austin-Weston–The Center for Cosmetic Surgery in Reston. “If you are not a plastic surgeon, you have not spent six years of training to learn how to do plastic surgery. You have probably taken a weekend course somewhere, taught by a non-plastic surgeon, because board-certified plastic surgeons are not going to teach non-plastic surgeons how to do these procedures. So they will go somewhere for a weekend course on how to do liposuction, buy an expensive laser liposuction machine and then start doing liposuction. Sometimes the results are simply not very good, and sometimes they are uncorrectable.”
How is this possible?
“Their M.D. degree gives them license to do anything that they can convince a patient to allow them to do. It doesn’t mean they are well-trained to do it,” says Weston.
So why are these doctors dipping their hands in the plastic surgery pot?
Dr. Roberta Gartside, of New Image Plastic Surgery, surmises it’s due to the economy and the healthcare regulations: “In the business, we all know we have our fixed and variable overhead expenses, but this is the only business where your income is regulated by the government but your costs are not,” she explains. “The only way to supplement, sometimes, that issue is to go to self-pay outside the control of the government insurance companies. Then we end up having radiologists doing liposuctions, family practitioners doing tummy tucks … If a patient wants a tummy tuck, I don’t have to check with an insurance company to ask if they are going to pay for it. These are out-of-pocket expenses, which are income to the physician.”
Men Expand Their Wheelhouse
Plastic surgery is no longer a woman’s game. According to the American Society of Plastic Surgeons, men took care of 9 percent of all cosmetic procedures in 2013, up 22 percent from 13 years ago. Area plastic surgeons are seeing this trend, and in some practices the number of men coming in is higher than the average.
“Most of the men that we see come in come in with their wives or girlfriends and after their wives or girlfriends have cosmetic surgery then they have it,” says Dr. George Weston of the Austin-Weston Center for Plastic Surgery. “If your wife looks like your daughter, it’s a motivator for you to come in and look like you belong with your wife.”
But it’s about more than jumping on the bandwagon of their partner. Most surgeons we spoke to said that men’s desire to get surgery or injections is to keep up their appearances with the workforce getting younger.
“Men as young as 45 or 50 are coming in wanting to stay more acceptable to their standards in the community, and their work situations are such that they are feeling a little bit more pressure from the younger generation,” says Dr. Haven Barlow of Capital Plastic Surgeons and the chief of plastic surgery at Inova Fairfax Hospital. Over the past five years, he has seen an increase of 30 percent for male patients at his McLean practice, and they are mainly coming in for the subtle, less invasive procedures for facial rejuvenation.
Dr. Saeed Marefat of Metropolitan Plastic Surgery, with practices in both Arlington and Woodbridge, has seen a steady increase of male patients, noting that Botox injections are becoming popular among male patients, as is surgery of the breasts, which is skewing toward younger patients. “It’s not unusual to see young boys come for that because they are interested in being able to go to the gym and the pool but feel self-conscious taking their shirt off,” he says. “It’s becoming more socially acceptable to do this.”
With any type of cosmetic surgery, Dr. Marefat notes that the younger age group is more for congenital deformities or a lack of growth of something. Generally speaking, it’s after the late 20s and early 30s where he sees patients come in for cosmetic reasons because they start to see signs of aging.
Trends
“Cosmetic surgery was not held in high esteem. It used to be for the rich, vain and foolish. In the last 20 years, we realized everyone wants to look as good as they feel. Why is it people have cosmetic surgery? Basically, we want our faces and bodies to be an accurate representation of who we are. If not, then we wear a mask that is a lie about us. One of the best things cosmetic surgery can do for someone is to get their mind off of their appearance so their appearance is no longer an issue. They don’t even think about it so they can live their life fully without their appearance being an issue.”
–Dr. George Weston, Austin-Weston–The Center for Cosmetic Surgery
“More and more people want to come have something done, not take a lot of time off of work [and] not go under the knife with surgery. [They want the] new small little things to make them look good and return to work quickly. That is on the rise. More plastic surgeons are recommending these minor procedures because we realized that everyone is interested in doing something that can be done easily with low risk and low downtime. That is the general trend of the future in plastic surgery is to do small things that can keep people looking good without having too much time off of work and without undergoing big surgeries.”
–Dr. Saeed Marefat, Metropolitan Plastic Surgery
“The reason we’re seeing more and more emphasis on minor or minimally invasive-type procedures is because we’re seeing younger patient populations. The skin type, the age of the skin and its adaptive characteristics are much more likely to be responsive to these minimally invasive-type procedures. In the little bit older patient, redundancy in skin is now an issue; certainly that can be corrected by removing the extra skin. But volume is always an issue for both the younger and older patient.”
–Dr. Haven Barlow, National Center for Plastic Surgery
“A trend that has been going on for a while is we’re doing a lot less lower eyelid surgery. Volume and fullness is youthfulness, and loss of volume is age. What we missed years ago in doing aesthetic facial plastic surgery … people in the ’90s were being pulled flat and taught. Youthfulness isn’t flat and taught. Youthfulness is volume and fullness. So we were missing that third dimension: the volume.”
–Dr. Howard Heppe, Plastic Surgery Services of Fredericksburg
“We’ve seen an increase in face-lifts. This could be for the aging baby boomer. We’ve gone through the period of breast augmentation and tummy tucks, and now we’re getting into face-lifts. We’re doing mainly mini face-lifts (incision is shorter). That is the biggest thing in our practice that has changed in the past year or two. We can pretty much do a full face-lift through this mini face-lift incision. [Patients] can get more of a correction through a limited incision, and that is where a lot of plastic surgery is going; we’re trying to limit incisions as aesthetically as possible.”
–Dr. Heppe
“Women are starting to notice the signs of aging, entering into menopause. Estrogen levels start to go down and your collagen elastic fibers aren’t as good. They aren’t ready for a face-lift. In the past it was fillers or wait until you need a face-lift. Now we have micro-invasives in tightening procedures that I can offer to that in-between individual: ThermiTight. It’s different from Thermage in that it is micro-invasive with minimal to no down time and is made through a teeny-tiny puncture, like getting your blood drawn. A small probe is inserted to heat up your skin from the undersurface, and it is more effective because you want to get the tissue up to 60 degrees (this is when collagen starts to contract and where you get some tissue damage, but not permanent damage, just enough to stimulate the body to start producing its own.) It isn’t always an immediate result, so you might see some immediate but over three to six months, sometimes longer, you’ll continue to see improvement.”
–Roberta Gartside, New Image Plastic Surgery
(April 2015)