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Plastic Surgery in 2014: Predicted Trends

Tim Neavin

Beverly Hills plastic surgeon Dr. Tim Neavin discusses capsular contracture.

2014 for plastic surgery is here. I look forward to seeing some of the new trends in cosmetic surgery this year. Some will make it through the year, and others may fizzle out before long. Last year, we saw probably a mild surge in injectables including things like Botox, Juvederm, Restylane, and Radiesse. These provided minimally-to-noninvasive ways to improve beauty at a rather affordable price, relatively speaking. Surgical procedures to correct wrinkles, skin laxity, facial volume loss and the other terrible things that go along with are typically much more expensive, but provide generally better and longer lasting results.

In past few years, we saw an anemic economic recovery, and spending for plastic surgery nationwide has still not rebounded to the 2006 or 2007 levels. Thus, I predict injectables will continue to become more and more prevalent as credit has been very difficult for people to obtain. Historically, many women and men could and would finance their plastic surgery through the equity of their home using lines of credit and credit cards. Following the economic crisis years ago, people are still finding it excessively difficult to re-finance their homes and obtain equity because, for one, many people’s home values have dropped and render this option impossible, and two, banks have become much more difficult lending money. However, the good news is that if you *can* obtain a loan through home equity, your interest rates for your facelift, rhinoplasty, or tummy tuck will be much-much lower than they were years ago.

Other trends I think we’ll see include new marketing strategies by large companies getting into the game of plastic surgery. We first saw a blast of this type of marketing years ago with SlimLipo and SmartLipo. These companies developed catchy names and broadcasted on billboards and radios “new techniques” that claims their liposuction machines to be “superior to traditional methods”. Consumers upon seeing or hearing these ads don’t call a plastic surgeon – they call the company that directs these patients to doctors (some plastic surgeons but many that aren’t) that bought these excessively expensive machines (which are necessarily expensive to pay for the marketing behind the fad). This is a very smart way of making money in plastic surgery; however, probably this is not the most ethical way, nor does it generate the best results. Another example is the Lifestyle Lift. The Lifestyle Lift has become a well known “procedure”, but it shares a similar marketing strategy to the liposuction machine market. A patient sees a commercial, then calls a number to be directed to a regional office that subcontracts out this procedure to plastic surgeons in the community who participate in this program. The large majority of plastic surgeons do not participate with Lifestyle Lift because they have their own successful private practice. And, it pays poorly to the doctor. Regarding these billboards for “new technology” machines, consider this. Most of these new devices plastered in magazines and highway billboards are not better than traditional surgical methods that have stood the test of time. Two, they cost more money for you, the consumer, because you are paying for the marketing that was added into the purchase price of the machine. Third, and most important, most of these of devices can potentially be more dangerous. Many of the billboarded liposuction methods with fancy names can cause burns and seroma formations that are generally not found with traditional liposuction procedures. In addition, for most of these products, there are no real clinical trials proving the efficacy over the safer traditional methods that are less expensive. However, where there is money to be made legally (and this kind of marketing it legal), there will be a market.

I predict this big business plastic surgery model will be a continued trend in 2014 and beyond, particularly because more doctors than ever are now performing cosmetic or plastic surgery. But did you know that many of these doctors aren’t plastic surgeons? This leads me to the next trend in 2014. Due to the declining reimbursements in doctor’s payments from Medicare and insurance companies, and the increased paperwork and overhead to provide care to patients with insurance companies whose main goal is to not paying doctors, forcing offices to fight madly for reimbursement post facto, many doctors are finding alternative ways to make money with their degree. This includes cash services that do not require third party payers like insurance company or Medicare. What I am talking about, of course, is cosmetic surgery. More dermatologists, family practice doctors, gynecologists, radiologists, emergency room doctors, pediatricians, and dentists are performing plastic surgery. And if consumers don’t do their homework and look for Board Certified Plastic Surgeons, they very well unknowingly may be getting their breasts done by an ears, nose, and throat specialist, or their liposuction done by a pediatrician. And yes, I have seen both. Thus, the trend of 2014 will include market erosion with unqualified doctors performing plastic surgery, and big business brainwashing consumers to seek experimental machines that may be unsafe and inefficient.

The good news for the consumer is that the supply and demand curve will shift to draw down the average cost of plastic surgery procedures, even if they are performed by plastic surgeons because they will be forced to compete in the saturated and eroded market. Of course it is only good news, however, if you choose you surgeon wisely.