Physicians jump into 'Wild West' of cosmetic surgery — and some patients suffer

Every week, the emergency department at Loma Linda (Calif.) University Medical Center sees a patient who experienced a serious complication from cosmetic surgery that was performed by a physician with no background in the specialty, according to a March 31 Los Angeles Times report. It is one example of the consequences of physicians with no surgical training flocking to the cosmetics world and patients' potential lack of awareness on the matter.

By and large, licensed physicians in the U.S. are not required to limit their practice to the fields they studied during their medical education. Thus, many physicians with little to no surgical training have tapped into cosmetic surgery, a lucrative arena where procedures are often performed in the outpatient setting and many patients pay out of pocket. 

For example, in California, physicians can practice in any area of medicine "if they do so in a competent manner that complies with the law," the state's medical board told the news outlet. In cases in which the state has barred physicians from performing cosmetic surgery, it is typically after the fact — after the medical board has received a complaint and investigated. 

"I shouldn't be delivering babies, right? … I'm not trained in that," Melinda Haws, MD, president of the Aesthetic Society, told the publication. "Yet there are people who are gynecologists who do liposuction — and it's a real surgery.

"... There's this misconception that cosmetic or aesthetic surgery is easy — and it's not." 

The Times cited a number of complaints in which patients were seriously harmed or died after experiencing complications when undergoing cosmetic procedures performed by a physician with no formal background in surgery, including a case in which a patient died days after undergoing liposuction performed by a pediatrician. 

At Loma Linda University Medical Center, up to two patients a week present to the ED with complications such as infections and improper wound closures after cosmetic surgeries were done by someone outside of plastic surgery. Over the past decade, the state's medical board has received more than 600 complaints alleging negligence in cosmetic surgery, though it is not clear how many of those are related to procedures performed by licensed physicians who are not certified in plastic surgery. 

"The cosmetic world is kind of the Wild West," Jeffrey Swetnam, MD, president of the American Board of Cosmetic Surgery, told the Times. "It's critical that patients be educated and know what they're getting." 

Research has indicated patients are largely unaware that any licensed physician can perform aesthetic surgery, and when they are informed, many patients report they are uncomfortable with that. 

Meanwhile, requirements meant to safeguard patients can be sidestepped. For example, some physicians may use local anesthesia for procedures that should be done with more sedation as a way to avoid rules that require outpatient facilities to be accredited when they are using a certain amount of anesthesia. 

Read the full report here

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