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Demographic and Geographic Analysis of Providers of Cosmetic Services in the Greater Los Angeles Area: 2008 to 2009

Camp, Matthew C. M.D.; Camp, Jennifer S. B.A.; Ray, Andrea O. M.D.; Gupta, Subhas M.D., C.M., Ph.D.

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Plastic and Reconstructive Surgery: August 2010 - Volume 126 - Issue 2 - p 115e-116e
doi: 10.1097/PRS.0b013e3181df709f
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Sir:

The profession of plastic surgery has in recent years seen a tremendous boom in the number of minimally invasive procedures that can be offered to the patient, paired with a concurrent boom in the number of non–plastic surgeons offering such services.1,2 Many of these nonsurgical treatments do not require a surgeon's skill to administer but are a gateway treatment to future operations.3 As such, the presence of outside practitioners offering the same services may act to dilute the flow of revenue into the practice of the plastic surgeon. The purpose of this article is to measure the number of practitioners offering minimally invasive cosmetic treatments and categorize them by their training background. Los Angeles and surrounding areas were selected for the analysis.

Provision of Restylane was used as a marker of providers engaged in the cosmetic marketplace. The names of Restylane providers were obtained from the manufacturer, Medicis Pharmaceutical Corp. (Scottsdale, Ariz.). All providers located within a 50-mile radius encompassing Los Angeles were catalogued (Fig. 1). The names and addresses of these practitioners were then cross-referenced with the American Board of Medical Specialties to confirm their training background. This analysis was carried out from January of 2008 to March of 2009.

Fig. 1.
Fig. 1.:
Map showing zoom view of Wilshire Boulevard. Included are 120 practitioners and 61 plastic surgeons.

The number of practitioners increased 14 percent from 889 individuals in January of 2008, to 1014 in March of 2009. Of the 125 new practitioners, 80 percent are from outside the core specialties of cosmetic surgery. Family medicine composes the fastest growing provider segment, having doubled their number from 59 in 2008 to 118 in 2009. A breakdown of providers by specialty is provided in Table 1.

Table 1
Table 1:
Restylane Providers by Professional Training: 2008 to 2009

The training backgrounds of physicians entering the field of cosmetics are diverse. Plastic surgeons now compose 21 percent of Restylane providers and with the current trend can be expected to compose an even smaller percentage of providers in the years to come. The current recession and concurrent influx of new providers will suppress the profitability of injectable cosmetics. The diminished financial reward of providing injectable cosmetics is less important to the aesthetic surgeon than the opportunity cost of fewer new patient contacts. A recent survey has found that patients who have a good experience with a non–plastic surgeon in the receipt of minimally invasive cosmetic treatments will likely return to that practitioner for future treatments.4 The attraction and retention of cosmetic clientele is critically important for the survival of the aesthetic surgeon, and the increasing number of outside practitioners seen in this study further underscores the magnitude of the competition. Although many other practitioners are competent to administer an injection, we have a depth of background and expertise in planning the management of the patient's facial aging that is not found in the historically nonaesthetic specialties. In the interest of optimum patient care and our own professional vitality, it is imperative that we attract and retain these patients for the lifetime of their cosmetic needs.

DISCLOSURE

Software from ESRI was used in the demographic analysis for this article. This software was provided free of charge. Jennifer Camp, B.A., wife of Matthew C. Camp, M.D., is an employee of ESRI. She provided the software and expertise in data analysis. Drs. Gupta, Ray, and Camp received no compensation in the generation of this article.

Matthew C. Camp, M.D.

Department of Plastic Surgery

Loma Linda University Medical Center

Loma Linda, Calif.

Jennifer S. Camp, B.A.

ESRI

Redlands, Calif.

Andrea O. Ray, M.D.

Subhas Gupta, M.D., C.M., Ph.D.

Department of Plastic Surgery

Loma Linda University Medical Center

Loma Linda, Calif.

REFERENCES

1. American Society of Plastic Surgeons. 2006 cosmetic surgery age distribution. Available at: http://www.plasticsurgery.org/Documents/Media/2006-Cosmetic-Surgery-Age-Distribution-40-55.pdf.
2. American Society of Plastic Surgeons. 2006 cosmetic surgery gender distribution. Available at: http://www.plasticsurgery.org/Documents/Media/2006-Cosmetic-Surgery-Gender-Distribution-Male.pdf.
3. D'Amico R. Cosmetic medicine: The big picture. Paper presented at Cosmetic Medicine: The Bottom Line; September 7, 2007; New York, NY.
4. D'Amico RA, Saltz R, Rohrich RJ, et al. Risks and opportunities for plastic surgeons in a widening cosmetic medicine market: Future demand, consumer preferences, and trends in practitioners' services. Plast Reconstr Surg. 2008;121:1787–1792.

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