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Cosmetic Surgery: The Cutting Edge of Commercial Medicine in America.

Lewis, Victor L. Jr., M.D.

Section Editor(s): Hoehn, James G. M.D., Review Editor

Plastic and Reconstructive Surgery: September 1st, 2003 - Volume 112 - Issue 3 - p 909
doi: 10.1097/01.PRS.0000075090.92867.13

As a service to our readers, Plastic and Reconstructive Surgery ® reviews books, videotapes, and electronic media items of educational interest to reconstructive and aesthetic surgeons. All items are copyrighted and available commercially. The journal actively solicits information in digital format (e.g., videotapes, CD-ROM, and Internet offerings) for review.

Reviewers are selected on the basis of relevant interest. Reviews are solely the opinion of the reviewer. Reviews are usually published as submitted, with only copy editing. Plastic and Reconstructive Surgery ® does not endorse or recommend any review so published.

Editor’s Note: Book Reviews for Cosmetic Surgery: The Cutting Edge of Commercial Medicine in America are presented by two reviewers. Dr. Lynch was involved in the Board of Directors and the officer ranks of the American Society of Plastic Surgeons (then the American Society of Plastic and Reconstructive Surgeons), and Dr. Lewis was likewise involved almost a decade later. Both were asked to review this most interesting book from their unique perspectives. The Book Review Editor found the book a very revealing study on how an educated “outsider” viewed the organizational activities of plastic surgery during this very turbulent period.

Cosmetic Surgery: The Cutting Edge of Commercial Medicine in America. By Deborah A. Sullivan. Pp. 233. Rutgers University Press, New Brunswick, N.J., 2001. Price: $22.

Sometimes the critical gaze of an outsider sees us more clearly than we see ourselves, but sometimes not. Author Deborah A. Sullivan journeyed to the Countway Library and read more papers of the American Society of Plastic Surgeons and more writings of the leaders of our societies than most plastic surgeons.

As a sociologist, her purpose in doing this research was to analyze the phenomenon of the growth of aesthetic surgery and the effect of the use of aesthetic surgery on the specialty. She includes the American Academy of Facial Plastic and Reconstructive Surgery and the American Academy of Cosmetic Surgery in her analysis.

The author uses her own words to make us realize how quickly most of us have changed our concept of advertising from something “probably bad” to something we expect our national society to do, if not our regional societies and individual members.

Perhaps kindly, however, Sullivan sees us also as victims of the deregulation of medicine, which most in medicine opposed at the time it occurred. She believes the increased competition for patients has led to the commercialism of medicine, with the attendant growth of patient risk, poor patient selection, and office surgical centers without regulation or peer review.

Ultimately, Sullivan sees the real villains as, first, our own ideas of appearance and what we think improved appearance will mean and, second, the commercialization of medicine with the attendant introduction of compromised medical ethics and quality. She deals less with the growth of aesthetic technology, the changing patterns of reimbursement for traditional reconstructive procedures, and the legitimization of aesthetic surgery in the minds of the medical community.

A comparison of the record attendance at the just-concluded American Society for Aesthetic Plastic Surgery meeting with that of the contemporaneous association meeting may indicate in which direction our discipline is going. Your reading of Sullivan’s book may help you decide if our direction is entirely prudent, and if we have always been wise and principled in getting to where we are now.

©2003American Society of Plastic Surgeons