Introduction 1

 

 

Cosmetic Medicine at the Millennium

The New Cultural Paradigm

The Business of Cosmetic Medicine Today

What Is It? The Vendors

The Customers The Procedures

Altering the Body

Public Alterations: Cosmetic Medicine as

Entertainment

Private Alterations: The Quest for Beauty,

Youth, Sex, and Transformation The Body in the Eye of Society

The Body in the Eyes of Those around Us

The Body in the Mind’s Eye: Body Image and

Transformation Body Fashions

A History of Body Enhancements

 

5

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7

79

13 16

19

 

19

 

22

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28

30 32

 

 

iv

 

 

 

 

three:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

four:

 

 

 

 

 

 

 

 

 

 

 

 

five:

 

Contents

 

 

You Can Be Pretty, Too: A Century of

Selling Beauty and Cosmetic Medical Care

The Beauty Doctors

Potions and Patent Medicines

Physicians Just Say “No” to Ads

The Birth of the Specialty of Plastic Surgery

Plastic Surgeons Take on Cosmetic Surgery

Cosmetic Surgery after World War II

Opening the Floodgates

Marketing Beauty: Getting the Word Out

Sex and Youth Sell

Marketing Cosmetic Medicine

Commercialism in Medicine

Targeting the Cosmetic Medical Consumer

Industry Providers

One-Stop Shopping and Vendor Networks

Medical Tourism

Rags to Reality Television: Cosmetic Medicine

as a Pop-Cultural Phenomenon

Media and Cosmetic Medicine

Magazines and Newspapers

The Internet

Radio and Television

Cosmetic Surgery on Television

Anatomy of a Cosmetic Surgery Reality Show

Reality Television Plastic Surgery and

Real Plastic Surgeons

Ethics and Cosmetic Medicine: Medical

Care off the Rails

Physician-Patient Relationship

Follow the Money: Honesty, Science, and

Financial Conflicts of Interest

Physicians and Patients in the Media Spotlight

Patients on Television: A Different Standard

of Care?

 

 

 

 

 

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37 39 40 40 41 43 45 45 48 50 52 53 53 56 60

60

 

 

63

64 66 67 67 70 71

 

75

 

 

79

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84

86

 

87

 

 

Contents

 

The Value of Bribery

Providers Dictate, but Producers Rule

More Is Better

Leaving Out the “Care” in Medical Care

The Public Interest: The Impact of Entertainment

Medicine on Viewers

Do People Respect Their Doctors Anymore?

Ethics and Professional Organizations

The Price of Patient Autonomy

 

v

 

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90 91 91

 

94

95 96 97

 

six:

 

 

 

 

 

 

 

 

 

 

 

 

 

seven:

 

First Things First: What You Can Do

To Stay Safe

The Florida Story

Responsibilities Patients Must Accept

The Five Elements of the Safety Equation

Full Disclosure

Research the Provider Research the Facility

Learn about the Products

Learn about Procedures and Their Risks

International Cosmetic Surgery

Beyond the Hype: Finding a Good Doctor

How to Get Started

Getting Information

Closing In on the Targets

The Value of Skepticism

Taking Your Time

Finding a Good Cosmetic Provider

Scope of Practice

Credentials

Labels

Licensure

Medical Specialty Training and Continuing

Education

Board Certification

Society Memberships

Hospital Privileges

 

 

 

99

100 102 103 103 103 106 110 114 116

121

121 121 123 125 125 126 127 128 128 129

 

130

132 135 136

 

 

vi Contents

 

 

Experience 137

References 137

 

The Consultation

Whose Agenda Is It Anyway?

Consultation Fee

History and Physical

Discussion

Decision Making

Financial Obligations

Coverage of Complications Treatment

Informed Consent

Facility, Staff, and Anesthesia

Record Keeping

 

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139 140 141 142 145 146 148 148 149 152

 

eight:

 

The Cosmetic Medical Care Product Line:

What Works and What Doesn’t and

How Physicians Choose

Specific Procedures

Body Contouring

Cellulite Treatments

Liposuction Tummy Tuck

Trunk and Extremity Lifts

Buttock, Thigh, Calf, Biceps, Triceps, and

Pectoral Implants

Mesotherapy

Breast Surgery

Breast Augmentation

Breast Lift

Breast Reduction

Ear Surgery

Facial Rejuvenation/Reshaping

Eyelid Surgery

Facelift

Forehead Lift

Injectables and Implants

Injectables

 

 

 

 

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158 158 158 159 160 161

 

162

163 164 164 166 167 168 168 169 170 172 173 173

 

 

Contents

 

Facial Implants

Lip Enhancement

Jaw and Chin Surgery

Nose Reshaping

Skin Rejuvenation/Resurfacing

Chemical Peels

Dermabrasion and Microdermabrasion

Laser Resurfacing and Photorejuvenation

Radio Wave Treatments

Nitrogen Plasma

Other Skin and Hair Procedures

Hair Transplantation Laser Hair Removal

Skin Pigment Correction

Scar Revision

Stretch Marks Treatment

Micropigmentation

Destruction of Skin Blood Vessels

Vascular Lasers

Sclerotherapy

Drug Delivery Systems

A Few More Words about Lasers in Cosmetic

Medicine

Dental Cosmetic

Skin Care and Products

Cosmetic Medical Grab Bag

The “We Just Don’t Know” Category

The “We Don’t Know AND It Could Be

Dangerous” Category

The “Too Good to Be True” Category

 

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181 182 183 185 185 186 187 189 189 190 190 190 190 191 192 192 193 193 194 195

 

195

196 198 201 201

 

202

203

 

nine:

 

What They Don’t Always Tell You:

Cosmetic Medical Care Risks, Complications,

Outcomes, Satisfaction Rates, and the

Dissatisfied Patient

Risk Factors

Complications

 

 

 

 

 

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206 207

 

 

viii

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ten:

 

Contents

 

Early Wound Complications

Systemic Complications

Late Complications

Psychological Complications

Outcomes

Goals Versus Outcomes

Physical Results—Less May Be Better

Patient Satisfaction

The Dissatisfied Patient

Equal Opportunity: Cosmetic Interventions

for Men

Male Rhinoplasty

Male Facelift, Eyelid Lift, and Brow Lift

Hair Transplantation

Body Contouring for Men: Liposuction and

Implants

Male Breast Reduction

Outcomes for Men

 

 

 

 

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211 213 216 217 217 218 219 221

 

 

225

227 227 228

 

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eleven:

 

 

twelve:

 

No Color Barrier: Cosmetic Medicine for

Non-Caucasians

All in the Family: Cosmetic Interventions

for the Very Young, Teens, and the Very Old

Children

Teens

Statistics

Psychological Considerations

Eating Disorders

Marketing to Teens

Specific Cosmetic Procedures for Children

and Teens

Decision Making for the Parents of Teens

Elderly—Over Seventy-five

 

 

 

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