Objections to Trademarked Surgical Facelift Procedures.

Earlier this month I was interviewed by Connie Thompson, the Consumer Reporter for KOMO News, Channel 4 in Seattle. Connie is an ace when it comes to interviews, always making me feel comfortable and at ease. It was actually a lot of fun to just sit and chat in my operating room after the office had closed down for the day. I barely knew the camera was running.

The subject matter was why I feel surgery procedures should not be patented, licensed or trade marked. I had a number of objections to this, as does The AMA which recently passed a resolution condemning this trend. I took notes beforehand, most of which Connie let me get into the interview. But the next week when I re-read what I had jotted down, it really made a lot of sense to turn that into my second blog on my website. So here, expanded and corrected into sentences and paragraphs are my prep notes for that interview.

Dear KOMO Viewers:

The quality of any surgical result really depends more on the experience and skill of the surgeon than the technique used. Cookie cutter approaches are for cookies not your own unique face. A good surgeon will take what he knows about two or three different procedures and combine or modify them to get the best result for you. Having only one tool in the tool box means only a few patients will look much better with it than if you can use your artistry and imagination, and all the tools you have available.
When you ask your carpenter to remodel your older kitchen would you tell him he could only use a hammer? I think not!
Everyone’s skin and muscle configuration is a little different and needs a custom approach. While you might be able to buy a dress off the shelf without modification you shouldn’t buy your new face off the shelf.
Aging depends on several things, especially how much sun damage you have had. Equally important is the genes you got from your mother and father. Patented, “one style fits all” procedures over-simplify this equation and overlook these unique problems.
There are more than a dozen types of mini-lifts that have been published down through the years in the Plastic Surgery scientific journals. They all have one thing in common: a short scar may mean a short recovery. But are the benefits also short lived? I know my results can last up to ten years or more in some patients but in others who have crummy skin and a lot of sun damage I would never make that kind of promise.
Since I cannot tell how these patented procedures go about it I can’t tell you whether they are good or bad ideas. The surgeons who sign up with these companies sign very complex agreements that they will never discuss with anybody how the procedure is done or they can be sued for huge amounts of money. What they are really signing up for is the marketing program that comes with it. Long infomercials are expensive. I could never afford to do one on my own. (nor do I feel I need to.)
I suspect that the only breakthrough here is in the marketing not the technique used. These contracts signed by the surgeon who is seen on TV specifies that a certain portion of the fee he or she collects before the surgery automatically goes back to the company right away. Guess what THAT pays for. Most consumers don’t understand it. Unfortuantley they are blinded by the promise they can go back to their regular lifestyle in a few days. But you know what? I have lots of patients that do that too. I just am very careful not to promise it because there can always be a patient who bruises more than I, or she, expected. Recovery will be a few days longer for her but I didn’t mislead her to sign up for surgery with a false promise.
Some of these techniques are more related to marketing than any surgical breakthrough. I read the ads in the Sunday newspaper and shiver thinking of how misleading they can be and that a few poor patients are going to be angry in the end. That’s when they come back to me or other Board Certified Plastic Surgeons.
The worst problems can take me hours to reverse. Putting suspension sutures into a patient’s face, a technique that goes by names like “threadlifts,” etc, doesn’t last long in my opinion. In fact they can relax in a matter of months not years. When I have to take those nasty sutures out and do the right procedure that the person should have had in the first place I am going to charge them my normal fee. I have some remorse for these poor patients, but I don’t give away sorrow. They wind up paying a high price for not doing their homework first.
Some of these procedures are treated like a “Trade Secret” not a patent. It’s like the formula for Coca-Cola. No one outside of the top echelon in the company really knows what’s in it. While this may be cool for a soft drink wouldn’t you want to know what’s going on before you spend thousands of dollars on your face?
Medical breakthroughs are based on the time honored tradition of sharing new knowledge not protecting it. It improves and refines the technique when it is peer reviewed by other doctors. They can try it out, modify it and report their own breakthroughs in it. But every other surgeon then gets to benefit from the new modifications right away. This also tests whether or not this new procedure really is an authentic breakthrough.
Restricting access to the new technique can prohibit dissemination of new knowledge. This trend, if it got larger, would bring innovations in health care to a standstill. It sets a dangerous precedent and is opposed by the AMA and lots of other medical groups. No one wants to stymie medical advancement like this, whether it is cosmetic surgery or life saving devices or medications. The trend is really bothersome to a lot of us.
Thank you, Connie Thompson and KOMO for letting me tell the public about what they really need to know.

Learn more about this plastic surgeon in Seattle Washington

How Real People Make Decisions About Cosmetic Surgery

When people fire off darts objecting to women who choose to have cosmetic surgery they really let their ignorance shine through. The personal decision to choose a surgical procedure to these “plastic surgery bashers” is impulsive, harmful, and demeaning to women. Well, I say, limiting what a woman chooses to do because it doesn’t fit your personal morals is just as demeaning and harmful, and it is a revelation of just how uptight these people probably are about their own bodies. And it is rarely an impulsive decision as I will show you soon. Thank God in America we can make our own choices.

Surveys have revealed that the decision to have an elective surgical procedure is anything but rapid or quick or impulsive. When I get my patients talking about it they will confirm what I and many other surgeons have known for a long time. Most of people who chosse surgery have given this decision a lot of thought for years, not months. How many years? How about at least five or six. Or a whole lot more. Many will tell me they’ve dreamed about it ever since puberty when they realized they didn’t get the same kind of body or face that their sisters and friends did. Or that they love their kids but hate what pregnancy did to their body a few years ago (or even more than a decade ago.)

The phases of decision making take place over the course of many years for most people and they go something like this:

I call the first phase, “Coming to grips with it.” This is when my patients look at themselves in the mirror and realize they want to change what they see. They finally get over that little mental hurdle, the nagging inside that says “leave well enough alone.” Once they let their inner selves open up to the possibilities, once they surrender to their own desire to get on with making a personal change, once they open the door to this part of the brain that allows the freedom for the rest of the brain to explore, that’s when the research starts.

The second phase, “Researching it,” can last just as long as the first, or for some, it can take place quite quickly. It all depends on that person’s own personal style of getting enough information to seal the deal. This is the research phase. For women in a relationship they can clearly recognize the same phase in their husbands or boyfriends, it’s just a different object, like a new flat panel TV or a new car, not a cosmetic surgery. In this phase I get the sense that women and men are not that different.

The research phase really takes on two separate aspects that run simultaneously. It involves personal contacts but for more and more patients, it also involves the Web. Of course if you want to do your research confidentially, some women skip the contacts part altogether.

Knowing someone or meeting someone who has “gone under the knife” goes a long ways to personal acceptance of the possibility for yourself. Even if their result may not be what you want, just being able to discuss what it was really like, and finding out that they too thought about it for a long time, is really important. It is confirmation that it is okay to dream. And maybe even that it was a lot easier than you might think. For guys in the research phase of buying a car or TV it is talking to someone who owns one, or knows someone who owns one. They chew it over with a beer at the game or the bar. Women do essentially this same networking but are genetically just a whole lot better at it, I think.

So I call this first part of the research phase the “Asking around phase.” This involves talking it over with people who really matter in your life. Like your personal physician, your older sister, or maybe an old friend you haven’t talked to in a while. Even if they give an objection or two, or try to talk you out of it, it just adds the seeds to thinking about it more and more. It fuels the inner debate, even if it prolongs the decision. But many times it confirms the feeling that it’s alright to proceed onto the next phase, the internet search.

Very few of my new patients come in for their first consultation without having spent time doing their homework about plastic surgery on the web. You’re doing it right now by reading this blog. Like the first phase of the decision making process this one can also go on for a long time, even years. Or for some it is just a quick phase, an absolute last minute task since they have already decided to “go for it” and they just want to know a few more facts. That means the second part of the research phase has to be called
“Gotta go the web,” phase

And here’s the really interesting part of my business. I have found that there are really just two kinds of patients who get to this point in their quest for cosmetic surgery. Those who admit to having spent less than fifty hours or so on the internet researching it, and those who admit they have spent possibly “hundreds” of hours studying plastic surgery.
If there is a significant other in the exam room when I ask about this phase that person is quite often smiling or even laughing as my new patient admits they are a web junkie on this subject.

This phase is also the hardest part because it involves finding the right doctor, if you didn’t get a referral about one from a friend or a relative. That’s where my website comes in. The last few years for me have been very revealing. Up until about 2001 or so, more than half of my patients wanted me to tell them more about myself, my training or my Board Certification. Now however, it is altogether very different. I still ask everyone if they want to know more about me during that initial consultation. I used to be shocked at the following answer, even a little unnerved by what comes next. But the answer is now so common I have gotten over it. The overwhelming majority of women and men when I ask if they want me to tell them anything more about myself will say, “No thanks. I’ve already found out everything I need to know about you from the Web.” Like I said, I’ve gotten over it. Google has changed my life forever.

So the last phase, Signing up for it, unlike the first phases, takes place for most people really fast. Once they meet me, once thy see what the costs will be, the decisions have pretty much all been made. The big one, when to do it, means matching the recovery process to their schedule and just plain finding the right time.

So this may all seem very familiar to many people who read this. It is not a quickie impulsive decision for most patients. It is getting much easier to get the facts, especially with the internet loaded with endless pages of information (and mis-information, sadly.)
More people than ever have had cosmetic surgery so there are more opportunities to talk to someone who experienced it. And surgeons like me always like to talk about what it can do for you if you are the right person to go on to surgery.

Seattle Plastic Surgeon - Dr. Phil Haeck