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Who Is Providing Aesthetic Surgery? A Detailed Examination of the Geographic Distribution and Training Backgrounds of Cosmetic Practitioners in Southern California

Camp, Matthew C. M.D.; Wong, Wendy W. M.D.; Wong, Ryan Y. D.C.; Camp, Jennifer S. B.A.; Son, Andrew K. B.S.; Gupta, Subhas C. F.R.C.S.C., F.A.C.S.

Plastic and Reconstructive Surgery: April 2010 - Volume 125 - Issue 4 - p 1257-1262
doi: 10.1097/PRS.0b013e3181d0accf
Cosmetic: Special Topics

Background: In recent years, there has been a significant increase in the number of non–plastic surgeons performing cosmetic procedures. This has the potential to have an impact on the plastic surgery practitioner by increasing competition and bringing into question the assurance of patient safety. In this study, a demographic analysis was performed of providers of invasive and minimally invasive cosmetic treatments in the Southern California region.

Methods: Providers of minimally invasive aesthetic procedures were catalogued using the sales lists from the manufacturers of the hyaluronic acid fillers Juvéderm and Restylane. The data set was further analyzed to enumerate the providers of surgical treatments, with a focus on the provision of liposuction. Data were analyzed using Environmental Systems Research Institute ArcGIS to focus on the Southern California area. Physician board certification and training background were detailed exhaustively.

Results: In the 45,238–square mile area encompassing the San Diego/Los Angeles megalopolis, there are 1867 cosmetic practitioners offering hyaluronic acid injections. Of this number, 495 are trained in plastic surgery. In the same geographic region, there are 834 individuals offering liposuction. Practitioners are concentrated in downtown Los Angeles and San Diego, where the potential patient-to-provider ratios are 1088:1 and 1185:1, respectively. Interestingly, primary care physicians comprise the third largest group providing hyaluronic acid fillers and the fourth largest group of liposuction providers.

Conclusions: The authors' data demonstrate that there are numerous non–plastic surgeons performing cosmetic procedures, especially in the field of minimally invasive therapies. In addition, there is a growing contingent of non–surgery-trained individuals providing surgical cosmetic treatments, especially liposuction.

Loma Linda and Redlands, Calif.

From the Department of Plastic Surgery, Loma Linda University Medical Center; private practice; and the Environmental Systems Research Institute.

Received for publication September 10, 2009; accepted September 25, 2009.

Disclosures: Software from the Environmental Systems Research Institute was used in the generation of the maps for this article. This software was provided free of charge. Jennifer S. Camp, B.A., is an employee of Environmental Systems Research Institute. She provided the software and expertise in generation of the maps gratis.

Matthew C. Camp, M.D.; 11175 Campus Street, Suite 21126; Loma Linda, Calif. 92354;

©2010American Society of Plastic Surgeons