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Germany to Ban Teen Cosmetic Surgery

Deputies from Germany's dominant Social Democratic Party (SDP) laid the groundwork for a legislative ban on cosmetic surgery for teens, Wednesday. Rising numbers of medically unnecessary procedures for minors is cited as the reason to introduce the new law.

"I believe that the beauty ideal, mostly for teenagers but also for children, has gone astray," said SDP health expert Karl Lauterbach according to an AFP report. The German Federation of Paediatricians supports the ban, while unsurprisingly, the German Society for Cosmetic and Plastic Surgery is rather less enthusiastic.

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U.S. Plastic Surgery Groups Fail Minors

Following up on yesterday's story about Australian bans on plastic surgery for minors, it is fast becoming clear that surgeons' groups here in the USA have no plans to follow suit. Or to even consider the matter.

The American Medical Association, which has no policy positions on under 18s according to a spokeswoman, and does not plan to even consider the pros and cons of a ban, despite the skyrocketing numbers for cosmetic procedures ranging from breast augmentations to botox.

The American Society for Plastic Surgeons has no formal position on surgery for minors, and neither does the American Society for Aesthetic Plastic Surgery. The latter states: "Most experts agree that for appropriately selected teenage patients, cosmetic plastic surgery can have a positive impact on physical and emotional development." But a spokeswoman declined to cite references for those experts.

Watch this space as we look further into training and guidance provided to accredited plastic surgeons with regard to minors (or the lack thereof) . Oh and remember, a doctor doesn't have to have any special training or be board certified in order to call him or herself a plastic surgeon.

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Australian Bans on Teen Procedures

The Australian state of Queensland has banned cosmetic surgery procedures for under 18s, a move lauded by the doctors of the Australian Medical Assocation. New South Wales had already planned to implement a three month “cooling off” period on decisions by teens to undergo cosmetic surgery starting July 1 and may now go further.

Australian Medical Association (AMA) NSW branch president Dr Andrew Keegan said a cooling-off period was "heading in the right direction", but a total ban was preferable when it came to teenagers.

"We'd have them leaning toward making it even tougher for young people to get surgery," Dr Keegan said.

"I think the possibilities of a ban need to be considered."

Dr Keegan said he worried teenagers were seeking physical solutions to what may be psychological problems.

"There is a psychological dimension involving body image in the impulse to seek cosmetic surgery," he said.

"If you've got low self esteem, then you have to have your self esteem improved - you don't need some kind of reconfiguring."

New South Wales already has already banned breast augmentations and rhinoplasties on minors from its public hospitals. Most significant, in a country known for its beach culture and embrace of active lifestyles, is the recognition of the need to protect the immature against a culture of profiteering by surgeons pushing cosmetic procedures as a psychological shortcut amid a culture of unrealistic physical perfection. Further recognizing the unique nature of cosmetic surgeons as aggressively seeking to sell procedures to the imperfect, NSW is also calling for advertising to include information regarding the reality of  those ubiquitous before and after pictures.

In the USA meanwhile, 2007 provided a bumper crop of breast augmentations for the under-18 set, with cosmetic surgeons reaping over $40 million, a 260% increase on 2006’s total. In the US, there is a ban on augmentations From KMBC's reporting on a teen who died as a result of the surgery:

The Food and Drug Administration doesn't approve breast augmentation for patients under 18. However... there are plastic surgeons who ignore the 18-and-under warning.

Indeed, the FDA does not approve of breast augmentation for under 18s. But this FDA disapproval also comes with loopholes big enough to render it meaningless.

"As in most cases, the devil will be in the details," said Dr. Thomas J. Gampper, vice chair of plastic surgery at the University of Virginia in Charlottesville. "The law allows procedures to correct deformities would be allowed [sic], along with undefined procedures to help a teenager's medical, psychological or social well-being. Those three exceptions are the reasons for the vast majority of all our adult cosmetic procedures, so theoretically, it may not ban any procedures on teens."

The FDA's regulations have been in place since 2000. The loopholes allow for saline implants to be inserted into the breasts of minors for reconstruction and to correct asymmetry.  And the regulations were put in place, there has been a four-fold  increase in the number of breast augmentations for minors. The figures for breast reductions, also genuinely used to to correct asymmetry, have remained constant.

While bigger breasts for teenagers have become big business, the numbers for otoplasty (ear surgery) and rhinoplasty (nose surgery) have declined.

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Your Yucky Body - Mommy Makeover Edition

Cartoon by Michaela B. Reid.  Originally posted here.

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Vulvas with a Difference

Vulvas With a Difference - This is an old article, but Faith Wilding's 2001 analysis of the rhetoric of designer vagina surgery and female genital mutilation is so prescient and so right on, we're posting it again. (While watching a Cialis commercial on late night TV.)

Checklist for a New You

New Beauty Magazine, which touts itself as "the world's most unique beauty magazine" (note - with its sole focus on artificial procedures and products, this should be translated:  "the world's most commercial beauty magazine"), publishes a monthly pre-cosmetic procedure checklist.  On their blog, the post is appropriately titled, "New Year... New You?"  Here's the checklist:

"Before you embark on your quest for an appropriate provider, it’s vital that you seek your potential procedure for the right reasons. Test your motivations and how you rate as a candidate by making sure each of the following statements are true for you:

1. I am choosing to enhance my appearance because I want to. Others support me, but no one is influencing, pressuring or forcing me.

2. I am realistic about what I want to achieve. I’m not looking for radical results, and I don’t want—or expect—to change who I am.

3. I understand that cosmetic enhancement can improve my appearance, but it cannot change my life.

4. I accept that the results of my treatment may be permanent, and I will have to live with them for the rest of my life.

5. I know that surgery comes with potential risks and that no result is guaranteed.

6. My physical health and emotional health are stable. I am not being treated for any chronic health disorders or serious mental health conditions.

7. I can afford all surgery costs, including non-monetary costs such as recovery time."

And quite a sensible checklist it is, especially #s 2-3, which remind consumers that new body parts do not  new persons make. Too bad their sincerity gets compromised by the accompanying ads blazing "A new you with CareCredit" whose website further promises that you'll "Get approved! You'll get a decision in a matter of seconds.  It's that easy!" 

In this month's print version of the magazine, New Beauty also commendably publishes a list of red flags which should send you running out of a surgeon's door.  One of those red flags includes limited-time-only or special offer pricing in an effort to get you to commit to a procedure immediately.  How then is CareCredit's harping on the their easy/instant/immediate financing approval process so markedly different? Just like the limited time offer, it's a marketing tactic predicated on capturing the consumer in a moment of impulsive behavior, discouraging a wait time in which she may think rationally about and potentially start to reconsider her decision.  It's also in direct conflict with #7 on the list.  If one is in a financial position to truly afford surgery, she shouldn't need a new line of credit to be able to afford it.

We also take issue with #1 on the checklist, in which a consumer is encouraged to affirm that "no one is influencing, pressuring or forcing" her to make the decision to undertake cosmetic surgery.  We agree, but... Ahem.  With its sole function as conduit for beauty industry promotion, what does New Beauty do other than influence people to have cosmetic surgery and purchase related products?  And a cover headline that pushes 2008's beauty "must-haves" sounds an awful lot like pressure. 

Maybe New Beauty should check their editorial and their advertisers' claims against their own checklist.

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Undo-plasties on the Rise

An extensive article in the London Times addresses the booming market for reversing cosmetic surgery procedures. Be they eyebrow raises that result in an expression of permanent surprise, nose jobs that take out all but a thin rail of cartilage or facelifts that result in that windswept look, the UK's cosmetic surgeons report surging demand for repairs and modifications to existing work: the undo-plasty.

The underlying buyer's remorse seems to indicate, in many cases, not just dissatisfaction in the surgical outcomes. Instead, there appears to be a post-operative realization that buying the same straight nose and 36 C/D boobs as everyone else was not in fact the right way to deal with more profound psychological maladies:

“To some extent,” says Linda Blair, a clinical psychologist and spokesperson for the British Psychological Society, “there is probably a backlash against identikit looks and the sameness of appearance that many people who have had facial alterations possess. Erasing wrinkles can iron out facial expressions, a mark of individuality and a conveyor of someone's characteristic personality traits.

“People who care enough about their appearance to change it could be deeply affected by the realisation they look like everyone else,” she says. “They think that their appearance defines them and so they enter into this seductive process trying to put everything 'right'.”

Having surgery to correct what was usually an unnecessary operation in the first place is part of what she calls the “redecorating effect”. “When you decorate a room in your home, the rest of the house looks a lot shabbier,” she says. “It can be the same with cosmetic work. You have one op and then you are not happy with something else so have that done. Then you become disillusioned with what you had done first.”

Blair thinks there are additional psychological underpinnings for the trend in cosmetic revision. “Cosmetic surgery has its place if people are doing it for the right reasons,” she says. “I guess that a lot of those who go back to change their original operations initially had work done because they thought it might change their career, fortune or relationship. Anyone who has surgery for those kinds of reasons is likely to end up dissatisfied with the result.”

It should be noted that The Times ran the article in its Women / Style section. Without any apparent sense of irony, next to the article were the following oppressively inaccessible images of "beauty" erm links to other Times articles. And where exactly does The Times think people get the idea that everything will be alright, if they can just improve their looks?

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Becoming A Statistic

The American Society For Aesthetic Plastic Surgery, a for-profit trade group, recently released its tenth set of annual statistics for procedures performed. Its reports make for fascinating reading and comparison. The volume of surgical procedures noted therein is nothing short of breathtaking. 11.3 million total procedures took place last year, with huge growth across the board when compared with only a decade ago:

                                                                                                                                              

	1997	2007
Breast Augmentation	101,176	399,440
Breast Reduction	47,874	153,087
Liposuction	11,168	456,828
Microdermabrasion	0	829,658

Remember: numbers for procedures such as breast augmentations are cumulative, meaning there are now millions of American women walking around with surgically-bigger breasts. When is market saturation achieved? When every single woman in the country has attained the Stepford homogeneity of the 36 C or D?

Ten-year increases for "drive-through" procedures are even more astonishing. They clearly demonstrate the degree to which casual acceptance for "minor" cosmetic surgery is now a given for large parts of our society.

                                                       

Botox Injection	65,157	2,775,176
Hyaluaronic Acid (Restylane)	0	1,448,716

We encourage you to go check out the stats yourself, for the clearest possible picture. For example, Restylane and Radiesse have cannibalized some of the filler business being pretty much monopolized by generic human and bovine collagen. And with the effect of anti-wrinkle injections lasting for only months in almost all cases, the cosmetic surgery practices are building themselves a base of repeat business about which Philip Morris can only sigh and envy.

Big business, it is, too, the ramifications of which are followed closely by Wall Street. We're not just talking Dow Corning's problems with silicone here. Take this report, covered by the drug press, analyzing the impact of choices between Restylane and Radiesse on their parent companies (Radiesse wins).

Like any other big business, there are always those looking to carve out a new niche for themselves. Designer vaginal rejuvenation, statistically insignificant in 2006, accounted for 4,506 procedures last year.

The target of the cosmetic surgery business, of course, continues to be women. No surprise there. Although some might be interested to learn that even this bias is on the increase. In 1997, women accounted for 86.3% of the procedures. In 2007: 91%.

   

Burnt Out

Most people think of elective cosmetic surgery as something between the individual and the surgeon, a personal decision with a personal impact. Of course, this is to ignore the law that claims equal and opposite reactions.

That collagen on offer for your lips, wrinkles or penis? It could, should be going to a burns patient in dire need, one of the 10,000 that die each year. But it might not, because the suppliers who harvest collagen from cadavers can make better margins working with cosmetic surgery practices than they can working with burns units. Would-be cosmetic surgery patients are prepared to pay more than the health insurers of those with genuine medical need.

The Orange County Register ran a thorough investigation into the issue years ago. That took courage, given the newspaper's home at the heart of cosmetic surgery mania. Check out this campaign ad, too, against Steve Kirby. His involvement in Collagenesis would seem to uniquely qualify him to run for the Senate on the GOP ticket, the reason for some news outlets to be dusting off the story again.