"Cosmetic Surgery"
became a catchword during the latter part of the twentieth century.
The surgical
alteration to improve ones appearance is very popular today. In the past
year, over two million people have undergone such a procedure.
This type of
surgery has a very long history, is changing rapidly, and will probably
have a significant role in our future culture. It is important for anyone
contemplating a cosmetic surgical procedure to understand the current status
of this medical field.
Historically,
surgeons have been called upon to correct a patient's physical appearance
as far back as the Middle Ages. One example of this surgery was the rebuilding
of noses. A common form of punishment, for adultery, in the 15th and 16th
century throughout Europe and Asia was nasal amputation.
There are detailed
records of individual surgeons who developed operations to create new noses
for those ostracized individuals.
A further impetus
for cosmetic surgery was the trench warfare of World War I when almost
a million soldiers received facial deforming wounds. A group of surgical
specialists were brought together to treat these patients.
The team consisted
of mainly general surgeons, ear, nose and throat surgeons, and oral surgeons.
The experience of these doctors led to the formation of the American Society
of Plastic and Reconstructive Surgery in 1937.
It is now known
as the American Society of Plastic Surgery (or ASPS) a specialty devoted
to the care of the deformed.
Initially, the
specialty of plastic surgery was recognized as a field of medicine in which
its members were trained to care for congenital deformities, burns, and
traumatic injuries covering all parts of the body.
This experience
and training provided these surgeons with the necessary skills and techniques
to treat patients with cosmetic deformities as well.
While the demand
at first for cosmetic surgery was not great, the desire to improve one's
appearance increased, especially after World War II as society became more
educated and the standard of living greatly improved. By 1976, when
the American Society of Aesthetic Plastic Surgery (ASAPS) was formed, face
lifts, nose jobs, breast enlargement and tummy tucks were a part of our
every day vocabulary.
The ASAPS was
made up of surgeons trained in plastic and reconstructive surgery whose
practices were orientated towards cosmetic surgery. There are presently
5,000 board certified plastic surgeons in the United States and of these
about half are members of ASAPS specializing in cosmetic surgery. All of
these surgeons have at least seven years of post medical school training
and proven experience in
aesthetic surgery.
During the twentieth
century, these specially trained surgeons performed most of the cosmetic
surgery operations done in the United States. However, in the past decade
changes in American medicine have been altering this figure.
The financial
changes that have occurred between patient and doctor are the main reason
for this change.
The onset of the
HMO system of medical insurance and the relatively low payment distributed
to doctors by both the HMO's and competing health insurance companies greatly
changed the financial aspect of many medical specialties. A significant
part of their income had been dependent on insurance payments.
These specialties
included general surgery, ophthalmology, otolaryngology, obstetrics and
dermatology.
These doctors
historically had large numbers of patients receiving specialized care,
which was largely subsidized by insurance payments. When the lowering of
standard fees by the insurance companies and HMO's took place, these doctors
experienced a marked decrease in their incomes.
To help recover
this loss of income, general surgeons, obstetricians, ophthalmologists
and dermatologists began to perform liposuction, tummy tucks, eyelid and
face lifts and breast reductions. They used their large patient pools to
promote these cosmetic surgeries.
For the most
part these surgeons did not receive any significant additional training
in order to carry out these difficult procedures. In most states all that
is needed legally to perform cosmetic surgery is a general medical degree.
Proof of special training is not required. "Let the buyer (or
in this case, patient) beware!"
Today's population
is educated, motivated and wants to make the most of their personal appearance.
More and more people are choosing cosmetic surgery in order to help achieve
their goals.
It is important
that you choose your surgeon wisely. Find out their experience and where
they received their training.
Be sure that
he or she is board certified and a member of the American Society of Aesthetic
Plastic Surgery which in and of itself is a guarantee of approved special
training and experience in cosmetic surgery!
--
William J. Fisher M.D.
Board Certified Plastic
Surgeon
Member of the American Society
of Plastic and Reconstructive Surgeons, Inc.
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