Separating the Wheat from the Chaff: Plastic and Cosmetic Surgery Coverage in Consumer Media

The idea of personal transformation is extremely seductive. It speaks to deeply held values of social mobility and self-determination. Combine those more lofty concepts with a society increasingly interested in maintenance of a more healthy and youthful appearance, and it’s no wonder that there is so much coverage of the cosmetic surgery industry. Unfortunately, the flood of articles, internet postings and television programs is rife with mischaracterizations and misinformation.

Shows like “Dr. 90210” and “Nip/Tuck” are examples of perhaps entertaining but less-than-academic coverage on TV. In print and on the web, where production costs are far lower, there is an even greater quantity of articles that favor public relations over research. I recently reviewed an article that I found to be a perfect example of the type I find disturbing.

This article in the Harper’s Bazaar summer issue was entitled “Best Body Firmers,” and was divided into 4 sections: flabby arms, thick thighs, belly fat and cellulite. The author discusses a procedure that she calls “micro-liposuction.” Reportedly, one uses a cannula the size of a pen point to create immediate correction of “bat-wings…permanent Spanx for your arms.” There are so many areas with which I take issue in just that short first paragraph that a full response would be too long for this article. I have written and presented peer reviewed, controlled studies using liposuction alone to achieve skin tightening of the upper arm. It is neither consistent nor immediate nor permanent.

Furthermore, cannulae the diameter of a pen point (0.1-0.2 cm) would not be efficient tools to achieve liposuction easily, if at all, because of clogging. I will try to comment on all my other disagreements with this article in a future posting on this blog, but it is only one example of a category that I encounter frequently.

However, there is also a lot of well-written, carefully researched information available – articles that meet both journalistic and scientific standards. The American Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery give out annual Journalistic Achievement Awards to writers who meet those standards. This is good for both journalists and consumers, but ASPS and ASAPS can’t individually vet every article you read. Even without a medical degree, however, you can make a reasonable evaluation by weighing a few considerations.

Who wrote the article? Is the author a board-certified plastic surgeon? Frequently, magazine articles and blog posts are written by PR professionals working on behalf of a particular doctor or other group. If the article was written by a journalist, rather than an MD, look to see if the author writes frequently on cosmetic and plastic surgery, or on health issues more generally.

Consider what “studies” the piece cites, if any at all. Were these studies published in a peer-reviewed scientific journal? Were they performed at an accredited research university? Your average Glamour article isn’t going to include regression tables, but use your common sense. Extraordinary claims require extraordinary evidence.

Unfortunately, lay press articles do not contain the conflict of interest disclaimers that are required at presentations at medical meetings or in the peer-reviewed literature. Many of the names that are seen over and over again in the media have lucrative consulting contracts and other financial arrangements with companies whose devices they are promoting. Sometimes it is difficult, even when presented with the disclaimers, for the professional audience to accurately assess the magnitude of these financial relationships. I question how the public can reasonably be expected to do so.

Finally, if you really aren’t sure, ask a board-certified plastic surgeon. A practicing surgeon should be keeping apprised of the latest advances in his field. Although one certainly can’t be expected to be an expert in every procedure out there, he or she should be able to tell if a claim passes the sniff test. You can also email your questions to me here, and I can get back to you, or address them in a future post.

In my practice, I spend a significant amount of time either correcting misinformation or contextualizing studies about which patients have read in the consumer media. I believe it’s important to teach my patients how to separate the wheat from the chaff, so to speak. This motivation to empower my patients to make the best choices for themselves was why I wrote “Hospital Smarts” in 1997, and why I continue to speak and write about this topic with my patients.