Psychiatrists Perform Botox? So Do Gynecologists...

MakenzieR on 21 Sep 2011 at 4:00pm

Does this really happen?  It did.  "Went to a new clinic and just 'knew' after the injections that they weren't done right. Find out that the dr is a Psychiatrist, with very little facial Botox experience," wrote RealSelf member Sacramento9355 in the forums.  Another member mentions in her RealSelf posting: "I once went to a doctor who did [Botox] on the side (she was an gynecologist who decided to offer this at her office)...the results there were poor."

We developed this Botox for Depression video to raise awareness that, regardless of training or specialty, in the US any medical doctor (MD) can perform cosmetic procedures from Botox to breast jobs.

In reality, it takes little more than a sign on the door and a website for a doctor to market themselves as a "cosmetic surgeon".  Robert Singer, a board-certified plastic surgeon based in La Jolla, CA explains that legally any non-specialist in cosmetic medicine can sell these services:

Unfortunately there is no law in any state that restricts the scope of practice strictly to a physician's board certification. While there are some "pedigree" laws that require physicians disclose board certification, unfortunately few consumers understand or recognize the authenticity of board certification in the 28 member boards that are recognized by the American Board of Medical Specialities (ABMS) and the countless self-proclaimed and unrecognized board that provide nebulous credentials.

This topic was front page of USA Today last week -- a story that highlights what can go wrong with an unqualified doctor. Although the article links these doctors to tragedies like "death by lipo," that's not to say finding a board-certified specialist is the easy solution when considering cosmetic procedures. 

Dermatologist Dr. Margaret Weiss, an Assistant Professor of Dermatology at Johns Hopkins, told RealSelf "Board-certification in dermatology means that the physician is extremely knowledgeable about the skin, but the consumer should check their experience, interest in, and patient satisfaction with cosmetic procedures performed."  

President of the American Society of Plastic Surgeons, Dr. Phil Haeck, echoed her sentiment: "It doesn't mean you're going to have a perfect result just because you had a board-certified surgeon operating on you." RealSelf member kittykat in texas personally attests that "Board-Certified does not guarantee good results."  She was unhappy with her Botox results and rated it Not Worth It.

What else can you look for? Hospital privileges, fellowships, and residency training, to name a few. Echoing Dr. Haeck, Susan Weinkle, MD, incoming President of the American Society for Dermatologic Surgery (ASDS) recommends that “consumers should make sure that they receive their cosmetic medical procedures from physicians who have appropriate training.” Dr. Weinkle adds that “the ASDS believes that appropriate training includes a thorough understanding of facial anatomy and the effects of aging and illness, knowledge of the skin and its underlying structures, familiarity with all aspects of the procedure and its indications, and residency and/or fellowship training in a specialty such as dermatology, plastic surgery, otolaryngology, and ophthalmology.”

With so many things to consider, how can patients feel confident they are choosing the right provider for their cosmetic procedure?  

Try these "Must-ask" questions before picking a doctor.  As Dr. Robert Kotler says "a 5-minute phone call can save you 2 hours and $200."

Comments (6)

NPR did a great piece on "pumping" -- aka back alley injections -- yesterday. Features Dr. Malcomn Roth, the new president of ASPS

Listen to it here

  • Reply

This video started quite the discussion on my Facebook when I posted it.  It seems like especially recently this has been a growing concern for people.

  • Reply
Definitely thought provoking.
  • Reply

Thanks for the feedback. I agree it's an important topic, but the reality is that it's a tough message to get attention to when delivered like a public service announcement. We're very open to alternative ways on getting people to listen to the facts.

  • Reply
Thought it was a little over the top. For a serious topic I thought it was too sophomoric.
  • Reply

Also wanted to share this relevant opinion from a doctor not typically associated with cosmetic procedures...

"Oral surgeons' training is similar in length and difficulty to that of most medical surgeons. It entails hospital surgical residencies of at least four to six years, for a total of eight to 10 years of professional study. Oral surgery residents focus their training on the mouth, jaws and face. By contrast, plastic surgeons spread their curriculum over the entire body," Dr. Mark Feldman, executive director of the New York State Dental Association, wrote in response USA Today.

He added "Cosmetic facial surgeries have always been part of the training of oral surgeons, and those who are qualified to do these surgeries should not be prevented from doing so by restrictive laws."

  • Reply