Pity the Plastic Surgeon

At the dining table next to mine, the evening got off to a terrible start. The two women were evidently friends, and had each brought a male date. After drinks were ordered, woman #1 asked woman #2′s date: “So, what do you do for a living?”.

Said date responded: “I’m a plastic surgeon”. Woman #1, clearly enraged by the ongoing Poly Implant Prothese (PIP) breast implant scandal, was off and running. He should be ashamed of his chosen profession. He was a parasite on women’s insecurities. He was a money-grubbing sexist pig. His entire field was a tool of oppression. And after that, she got critical.

The doctor was quiet throughout this torrent of abuse. When woman #1 finally paused in her indictment, he sighed the sigh of a person who has uttered a simple truth a thousand times and been ignored, but nonetheless continues in the quixotic task of educating the world around him.

He then said something like the following: “Cosmetic surgery is a sub-specialty of plastic surgery. I am one of many plastic surgeons who do no cosmetic surgery at all. My sub-specialty is pediatric plastic surgery. Pediatric plastic surgeons do not do boob jobs, brow lifts, fanny hoists, tummy tucks or lipo sucks. We repair infant boys’ penises when their urethra is obstructed or deformed. We fix cleft palates. We do skin grafts for children who have been burned. Things like that.”

The great thing about being the rude eavesdropper and not actually at the table meant I could get up and leave at this point, not having to participate in what had to be a rather awkward meal to follow.

The dinner date’s defense of his medical specialty is one I have heard from plastic surgeons before. Their entire field has become equated in the public mind with anorexic models toppling forward under the weight of silicone-filled D cups. It’s annoying for plastic surgeons both in the sense the doctor at the table next to me was annoyed (i.e., taking whatever guff the public wants to direct at cosmetic surgeons), but also because some people think all plastic surgeons are qualified and interested in giving them advice about hair implants, nose jobs, and breast lifts. If you think telling the person next to you on an airplane that you are a psychiatrist is dangerous, tell them you are a plastic surgeon and the flight may seem even longer (one colleague’s fellow passenger suddenly pulled up her shirt and asked for a medical opinion of an extraordinarily personal nature).**

This good doctor’s cause is hopeless. He will give his edifying speech a million more times before he dies, and he will be generally ignored. It is equally quixotic of me to post this statement of the difference between plastic and cosmetic surgery here. I do it not because I expect to fix the problem, but because this is a case where Sisyphus is a good egg and therefore deserving of company.

**FOOTNOTE: I learned long ago that describing oneself as a proctologist in such situations is a magnificent conversation stopper and I recommend it here to everyone in the health care racket.

[Cross-posted at The Reality-Based Community]

Keith Humphreys

Keith Humphreys is a professor of psychiatry at Stanford University. He served as a senior policy advisor at the White House Office of National Drug Control Policy from 2009 to 2010.