The popularity of plastic surgery today is no secret; 13.8 million cosmetic procedures were performed in 2011 alone. Unfortunately, however, an increasing (and unsettling) number of people in the United States are undergoing procedures conducted by unlicensed, so-called “underground,” individuals these days—individuals who have no business billing themselves as plastic surgeons.
The primary factor leading people to the doors of these backdoor doctors is, of course, cost. There’s no way around it: plastic surgery is expensive. Most board-certified plastic surgeons offer financing and other options in an effort to make their services more accessible, but some prospective patients simply can’t—or don’t want to—come up with the cash that an aboveboard procedure will ultimately require, so they go looking for alternatives.
What these patients don’t seem to realize, however, is that there’s a reason that underground procedures carry such a low price tag: the individuals offering them have neither the qualifications nor the skill to perform them safely and successfully. Even someone who has an M.D. is not equipped to perform a cosmetic surgery procedure of any kind unless they’ve completed the training required of board-certified plastic surgeons—training that takes place over a minimum of five years, and which includes specific, in-depth instruction for face and body procedures.
Perhaps even more important than the artistry and experience that board-certified plastic surgeons bring to the table is the fact that they are prepared to handle emergencies. If you think that the worst thing you can end up with after an underground procedure is some bad scarring or less-than-optimal results, you’re fooling yourself: multiple people have died in the past five years after letting unlicensed “plastic surgeons” operate on them. Even in well-equipped facilities, complications can arise; just think what can happen if something goes wrong while someone working out of an apartment or private home—someone not subject to any of the usual safety regulations—is operating on you.
The practice of going abroad for less expensive plastic surgery is not necessarily a great choice either, unfortunately: According to a 2011 study performed by the International Society of Aesthetic Plastic Surgery (ISAPS), a startling number of patients who travel to other countries in hopes of getting the same results at a lower cost end up with post-op complications. More than 50% of the board-certified plastic surgeons that responded to the ISAPS’s survey said that patients had come to them when they developed infection, dehiscence (wounds reopening at the suture lines), contour abnormalities, or hematomas after undergoing plastic surgery outside of the country, and that the majority of those patients ultimately required follow-up surgeries.
As a doctor, it’s my job to look out for my patients’ well being—and it’s a job I don’t take lightly. But as a patient, it’s your job to be your own advocate, too. In the U.S., there are no laws in place to prevent licensed physicians of any kind to call themselves “plastic” or “cosmetic” surgeons, regardless of their training (or lack thereof)—which means that you have find out for yourself what your doctor’s credentials are. Take it upon yourself to ask for proof of board certification and to make sure that any cosmetic procedure you undergo is performed by a qualified plastic surgeon in an accredited facility. Don’t get taken in by false promises; don’t risk your life over bargain pricing. Go to a board-certified plastic surgeon, and get the results you deserve.
Usha Rajagopal is a board certified plastic surgeon with over 17 years of experience. She practices at the San Francisco Plastic Surgery and Laser Center.