Cosmetic Surgery Times, Mar 1, 2006

Columns

Generosity runs deep

By Lisette Hilton

The most common mistake made with rhinoplasty is similar to errors often made with facelift, eyelid surgery and other cosmetic procedures: over-aggressiveness.

'High road' supports profession

By Jim Carraway, M.D.

Ethical decisions confront us every day. Most of the time, it is quite clear whether we are taking the high, middle or low road.

Cosmetic dermatology: One last 'golden egg'

By David J. Goldberg, M.D.,J.D.

Because it is largely, if not exclusively, a fee-for-service business, cosmetic dermatology has become one of medicine's few remaining golden eggs. As is the nature of all occupations, where money goes, ethical questions are expected to follow.

Sections

Surgeon error disclosure makes sense from multiple perspectives

By Cheryl Guttman Krader

When a cosmetic surgery patient suffers a complication that may be a result of surgeon error, truthful disclosure is the ethically correct path to follow but may also be advocated for mitigating medicolegal consequences and to diminish emotional suffering for both the patient and provider.

Analyzing, addressing patient motivation

By Karen Nash

Cosmetic Surgery Times talked to several surgeons around the United States about when they feel the decision to operate is not a simple medical or aesthetic choice, but presents ethical issues as well. How do they handle those situations?

'God did not make me this way'

By Michelle Tackla

Ethical questions about cosmetic surgery confront patients just as they do doctors. Patients have the ethical responsibility to make good decisions about their bodies, however "good" is defined, just as physicians are called to "First, do no harm," in the form of what J. Edward Hill, M.D., American Medical Association president, calls "a covenant." According to Dr. Hill, "First, the practice of medicine is, by nature, a moral endeavor that takes the form of a covenant" ? a solemn agreement between physicians and their patients.

Consider where insurance money, medicine meet

By Melissa Heltzel

Fraud, particularly insurance fraud, can take many forms and come in many gradations. Perhaps one of the worst cases reported involved accusations against California surgeon William W. Hampton, M.D., and Mamdouh S. Bahna, M.D. In October 2005, they were accused of committing insurance fraud by luring people with private health insurance who were also willing to have unnecessary surgeries. Allegedly, they paid patients cash or gave them discounts on procedures then pocketed whatever the insurance companies paid out. Drs. Hampton and Bahna pled innocent to the charges.

To tell or not to tell

By Lisette Hilton

Offering information about judgments, lawsuits, experience and more is an ethical, versus a legal, obligation for surgeons. The tables turn, however, when patients ask direct questions. Then, not only is it surgeons' ethical obligation to answer honestly, but dishonest replies could come back to them in a malpractice battle.

Ethical marketing

By Linda Marie Wetzel

With so many advertising avenues open to cosmetic surgeons, from the Yellow Pages to print ads, from radio and television to the World Wide Web, how do cosmetic surgeons decide which practices are reasonable, and when does marketing cross a line into being misleading or totally unethical?

Physicians and medspas

By Leslie Harris O'Hanlon

Alexander Rivkin, M.D., a facial plastic surgeon and owner of Westside Medical Spa in Los Angeles, believes physicians should own medical spas and maintain tight control over what happens in them.

Age before beauty?

By John Jesitus

What age is too young or old for cosmetic treatments? Experts contacted by Cosmetic Surgery Times generally avoid cosmetic procedures for minors; however, sources say norms for older patients may be shifting.

Cosmetic ethics: to treat or not to treat?

By John Jesitus

In determining whether it's ethical to treat a cosmetic patient, experts tell Cosmetic Surgery Times that the answer involves both clear-cut warning signs and subtler insights into patient motivation and expectations.

Special Reports

Unrushed preoperative 'face time' with patients critical to satisfaction

By Cheryl Guttman Krader

With the goal of maximizing patient satisfaction in mind, cosmetic surgeons would do well to remember that an adequate informed consent and realistic patient expectations are hallmarks for success in these elective procedures, Patrick G. McMenamin, M.D., says.

'The enemy of good is great'

By David Sobel, M.D., J.D.

Moreover, as the adage implies, the surgeon must strike the delicate balance of treating the patient without harming that patient.

Enhancing the practice

By Neal Reisman, MD, JD

Minimal scarring and minimally invasive surgery may yield very good results, but patient selection is critical. Be careful not to misrepresent expectations to capture the patient.

Managing Expectations for Breast Augmentation Patients

By Jane Schwanke

Cosmetic surgeons who employ a process of interaction with their breast augmentation patients are able to get a much better idea about those patients' expectations and then can more effectively manage those expectations.