Hess Plastic Surgery Blog

Last week, USA TODAY ran a front-page story and series of articles that explored controversy about surgical complications and even deaths occurring among people who had cosmetic surgery at “low cost, high volume cosmetic surgery clinics.”

A quote from the article in USA TODAY:

“While these clinics typically employ plastic surgeons who are either board-certified or up for certification, lawyers, victims and other plastic surgeons say these new-style surgery clinics are under so much sales pressure they often don’t sufficiently screen patients for medical problems, do inadequate follow-up and persuade patients to undergo procedures that are either unnecessary or unlikely to get good results. “

Are you putting yourself at risk if you choose one of these high volume, low cost cosmetic surgery clinics? We asked several respected plastic surgeons to respond to this question:

Detroit plastic surgeon Dr. Ellen Janetzke writes:

I definitely agree that people put themselves at risk at the high volume plastic surgery centers. The patient has no idea who their doctor is and what their credentials truly are. There is very little of the traditional doctor-patient relationship, which I feel is SO vital especially in the plastic surgery field.

Washington DC plastic surgeon Dr. Chris Hess of Fairfax, Virginia also commented:

I think people who really want a procedure but have limited money will find someone to do their surgery. They will overlook the negatives and only focus on the fact that what they want will be done. I think these “high volume” centers are dangerous and prey on this kind of patient.

Dr. Bruce Genter, a plastic surgeon in Philadelphia responded as well:

Safety is the primary concern with all surgery, especially cosmetic surgery which is not medically necessary. Likewise, the doctor-patient relationship is the foundation of our health care system. Patients should be wary of clinics where patient evaluations beyond basic intake and screening information are performed by non- physicians and the patients are unable to consult with the physician who will perform the surgery prior to making a financial commitment. It is unacceptable to not meet your surgeon prior to the day of surgery for an elective, cosmetic operation. How can a patient expect to get quality treatment without an evaluation by the person providing the treatment? Patients should worry if paying money seems to be more of a priority than providing information.

Long Island plastic surgeon Tracy Pfeifer argues that physicians practicing in these centers are violating the medical principle to do no harm:

The key factor is that in these cases, medicine is becoming a commodity. The underlying problem is that the patients are choosing their plastic surgery based on cost alone. The physicians who work for these companies, in my opinion, are in violation of the Hippocratic Oath they took when they became physicians. Often the patient is not treated as a human being but rather as a source of income. It is disgraceful.

Dr. Richard Rand, a Seattle plastic surgeon, says he has seen the consequences of these clinics near his office in Bellevue, Washington.

To assume that you can get the same quality of result, safety, and personalized care from a surgeon at a discount “surgical factory” is naive at best and denies a basic understanding that no two surgeons are equal in talent, training, artistry, ethics, and commitment to care. I have seen many unfixable disasters from such places in my area and have also been aware of a death at a laser liposuction clinic directly across the street from my fully accredited surgery center. The law should step in and shut these places down but it does not. Consequently, even though the discounted prices may be tempting, patients choosing these facilities literally risk their health and maybe even their lives. This is clearly not intelligent and I sincerely hope the message is getting out exposing this growing danger.

Indiana plastic surgeon Dr. David Robinson agreed that corners will be cut at high volume clinics.

I do believe that high volume cosmetic surgery centers do come with increased risk. Their goal of high volume at reduced prices is a recipe for disaster. In order to keep prices low, they often have to cut corners. This can include employing less qualified staff such as non-board certified physicans, some of which are not even surgeons. Many of these individuals also have limited training in cosmetic surgery, often taking weekend courses or receiving training from non-accredited organizations. The facilities may also not be accredited which means they are not held to the rigorous standards put in place by states and the federal government.