Public Perception of Cosmetic Surgeons versus Plastic Surgeons: Increasing Transparency to Educate Patients

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Recently, we received notice of a publication by Shah et al. entitled “Public Perception of Cosmetic Surgeons versus Plastic Surgeons: Increasing Transparency to Educate Patients” (Plast Reconstr Surg. 2017;139:544e–557e.).1 The research for this article was funded by the Aesthetic Surgery Education and Research Foundation and the American Board of Plastic Surgery membership. The article begins by stating that many physicians have been financially motivated to perform aesthetic surgery, and states that training in plastic surgery is associated with improved safety and better outcomes in appearance (cosmetic) surgery. In addition, the authors state, “there are many physicians who name themselves plastic surgeons, irrespective of their credentials.” Citations from lay press and scientific journals are included as evidence of this risk to the public. In totality, these assertions are preposterous.
An argument is sound if it is valid and its premises are true. It is possible to have a deductive argument that is logically valid but is not sound. Fallacious arguments often take this form. The premise that physicians trained in plastic surgery have better outcomes and lower risk is not proven by the research in this article. It is substantiated with sensational articles in the lay press using mottled and limited statistics in the references cited. To provide data to support the truth of the premises of this article and its conclusions, we would need a study that evaluated patient safety and outcomes of appearance operations performed by those:
With these accurate data, we can evaluate the truth of the premise of the association of training in plastic surgery with improved safety and better outcomes. If physicians trained in plastic surgery obtain better outcomes and with lower risk than physicians specifically trained in appearance (cosmetic) surgery, I would like to inform my patients of this conclusion.
The problem and its correction seem simple. Explain to the public that the campaign the American Board of Plastic Surgery and its members funded was with the best of intentions (the argument was valid), but the generalized conclusions are false (as the argument was not sound based on unsupported premises). Plastic and cosmetic surgeons are not adversaries, but rather colleagues and at times can be one and the same. Appearance (cosmetic) surgeons are a group of physicians from many subspecialties, trying to help their patients toward their goals. We are all subject to the same Hippocratic oath and mission to first do no harm. Qualification in cosmetic surgery should be based on the actual education, training, and experience of the surgeon in the specific procedure.
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