The growing market for cosmetic surgery is raising questions about whether it can truly be regarded as traditional medicine. The New York Times reports that the number of corrective revision surgeries — “redos” — is worrying some prominent surgeons. “I’m seeing more than I think we should, given the number of primary procedures being reported,” says Dr Steven J. Pearlman, the president of the American Academy of Facial Plastic and Reconstructive Surgery.

One Los Angeles surgeon says that most of his patients have had three to five surgical procedure on their eyes. A Beverley Hills facial plastic surgeon reports that it is not unusual to treat patients who have had as many as 12 revisions of one body part. “We see people who’ve been to 10 doctors before and had 15 surgeries,” he told the Times.

With better treatment available, the number of revisions ought to be declining. But since any qualified surgeon can do plastic surgery, more and more doctors without appropriate training are entering the field because it is so lucrative. In one extreme example, a Virginia plastic surgeon specialising in gynecomastic, or male chest contouring, inherited an unhappy patient who had been operated on by a gynaecologist. Nonetheless, few patients bring malpractice suits because most cosmetic surgery is elective and some patients feel guilty about voicing even minor complaints.

Another factor is the dramatic rise in patients’ expectations, fuelled in part by reality TV. “I think it’s an outgrowth of Freudian psychology,” says Dr Brooke R. Seckel, of Harvard Medical School. “The boomers… are more centred, more self-focused and less concerned about others’ opinions.” Controversial shows like ABC’s Extreme Makeover” or MTV’s “I Want a Famous Face” make viewers think that plastic surgery is easy and safe, even though there are often complications which result in “redos”.

TV producers underplay the psychological risks as well. David Lyle, who produced “The Swan” for Fox, acknowledged this earlier this year. The Swan’ was a worthless piece of television I’m sad to say I produced. Those women were left sort of looking like cheap hookers and sent back to their small towns.” But the exploitation of the na?ve goes on. “Extreme Makeover” has taken to “nerd trawling” through internet discussion groups to recruit subjects.

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