Renaissance Plastic Surgery

If you are a movie fan, you will probably remember Jack Nicholson's famous line in "A Few Good Men" when he told Tom Cruise, "You can't handle the truth!" Apparently he was not alone in that thought.This has also been the attitude of many non-plastic surgeons who advertise their services under the moniker of "cosmetic surgery."

Lawmakers in Florida decided that this practice has gone too far and have structured a remedy in the Truth in Medical Education (TIME) law. Under this law, health care practitioners must identify the license under which they practice. Any misrepresentation of medical qualifications is a violation of the "federal unfair trade and practices statutes" and would result in a $10,000 fine.

What this law means, in Florida at least, is if you go to a "medi-spa" for a Botox injection, the person doing the injection has to display or identify his or her credentials. If the practitioner does not demonstrate some sort of a license, such as MD or RN or Medical Assistant, then said license probably doesn't exist.

Another important aspect of this statute is that a physician cannot claim board certification unless he identifies the specialty in which he is certified. In other words, a physician cannot advertise himself as "board certified, specializing in plastic surgery" if he is certified by the American Board of Obstetrics and Gynecology. This is not meant to single out gynecologists, the majority of whom would never consider such a practice, but this type of misrepresentation is practiced by several specialties with alarming regularity. This law also restricts use of the term board certification to those specialties recognized by the American Board of Medical Specialties, which hopefully will limit the practice of forming new, unsupervised organizations containing "cosmetic surgery" in their name whose main purpose is to certify their members.

The American Society of Plastic Surgeons (ASPS) has publicly supported the Florida TIME law, praising it for raising public awareness of these questionable practices and increasing the transparency of qualifications for those who want to practice plastic surgery, which can only lead to more protection for patients. The ASPS is currently working to support a federal law that would provide similar protections to plastic surgery patients on a national level, but at this time it is currently residing in a subcommittee of the House Energy and Commerce Committee. If you believe in the importance of this issue as I do, contact your representatives in Congress and ask them to support this bill. Until we have this type of protection on a federal level, the catch phrase for prospective plastic surgery patients must unfortunately be: "Let the buyer beware."

Bariatric, or weight loss, surgery has grown exponentially in in past 20 years as the problem of obesity has become more pronounced and technical advances have made surgical treatment safer. Today almost 50% of adults are overweight and about 6% are morbidly obese, which is usually defined as more than 100 lbs. overweight. If you are wondering if you fall into this category, a simple test is to calculate your body mass index by following the simple directions at the following link to the Medical College of Wisconsin. If you have a Body Mass Index (BMI) greater than 30, then you are considered to be medically obese.

Bariatric Surgery is not for just anyone who is overweight, but it is reserved as the last resort for those who are obese enough to be having medical problems and have failed other weight loss methods. There are two basic surgical techniques for weight loss: gastric restriction and gastric bypass.

Gastric restriction includes any surgery which reduces the size of the stomach. The traditional procedure was the vertical band gastroplasty in which a metal band was placed across the stomach to reduce its' size and cause patients to feel full with less food. This technique was updated with an adjustable band that can be placed by laparoscopy through a small incision.

Gastric bypass procedures rearrange the connections between the stomach and small intestine so the food is digested farther down along the intestinal pathway. The result is that less food is absorbed, creating a type of controlled malabsorption so that fewer calories are absorbed.

Each of these two types of procedures have their pros and cons, and the right choice for each patient can only be made through a consultation with a bariatric surgeon; be sure to choose one that is part of a certified Bariatric Surgery Center of Excellence.

Anyone who has bariatric surgery will be left with large amounts of loose skin after the weight loss process is complete, and virtually every one of them will at least consider plastic surgery. As plastic surgeons, we are the ones who are trained in the art of body contouring surgery. The most common procedure after massive weight loss is a Tummy Tuck. Other procedures to remove excess skin include Breast Lift, thigh lift, arm lift and total body lift. Going from severe obesity to a body shape that is satisfying is a journey, and plastic surgery is the final road and an integral part of that journey back to good health and a positive self image.