BARGAIN BOTOX: Why ‘Deal Of The Day’ Plastic Surgery Is A Risky Purchase

BY Anthony Youn, M.D., FACS |

When times are good, people love a good deal. When times are bad, they are desperate for them. This principle explains Groupon’s explosion in today’s marketplace.While there is nothing wrong with discount shopping, especially during hard times, there are exceptions to the rule. Bargain shopping is okay for some things, but not when it comes to your health.

For example, would you click “buy” on the offer for heart surgery at 50 percent off? What about buy one, get one free colon screenings? Of course not, because these are serious medical procedures, and we understand that it’s risky to choose a doctor based only on who bids the lowest.

This leads me to question why so many people are willing to buy cosmetic plastic surgery procedures on Groupon. Because cosmetic surgery is now so widespread in our society, we have a tendency to think that these aren’t real medical procedures – and that they don’t come with real risks. It often takes a tragic death from botulinum poisoning or surgically induced internal bleeding to remind people, for a moment at least, that real dangers do exist.

Today, Groupon discounts exist on everything from Botox and laser hair removal to liposuction, brow lifts and hair transplants. These are serious procedures, with patients susceptible to long-term injuries if done incorrectly. Yet each of these is routinely offered on Groupon – and hundreds purchase the half-off coupons.

Many physicians, myself included, are against this practice for a bevy of reasons, including the ethical and financial implications with this type of exchange. There are simply too many factors being overlooked. Despite the footnote on the Groupon site which states that services are contingent on a formal screening, a promise of services has already been made, sight unseen.

In my practice, I regularly turn down one out of every five patients who come in for a cosmetic plastic surgery procedure. The reason I do that is because not everyone is a good candidate. And allowing people to purchase your services online makes it harder to properly screen and consider those patients prior to treating them.

A main responsibility entrusted to a reputable plastic surgeon is to evaluate potential patients, both medically and psychologically. These evaluations are used to not only ensure they are in good physical health but also to rule out psychological conditions like body dysmorphic disorder (BDD).

BDD is a serious psychological disorder in which the affected person has a poor body image and is often preoccupied with minor flaws in his or her physical features. Never happy with how they look, these patients will undergo multiple cosmetic surgery procedures, even to the point where they are risking their health. A good example is Heidi Montag, who underwent 10 surgical procedures in one day.

It is estimated that 10 to 20 percent of plastic surgery patients suffer from BDD, making the screening process critical. The mere fact that someone is willing to buy discounted surgery may be reason enough to disqualify them as a good candidate for surgery.

But that isn’t the only trouble with this method of finding patients. Doctors, like any other business people, are willing to offer these discounted rates because they are betting on repeat customers. The patient comes in first for the discounted treatment but then returns to “fix” his or her other problems. These doctors know that they must make long-term patients out of these one-time bargain shoppers if they hope to get their money back, let alone make a profit.

Groupon isn’t the only way plastic surgeons are reaching out to potential new patients. Many are using social networking sites like Facebook to connect to larger groups of potential clients, many using similar gimmicks and discounts to lure them into the office.

But these coupons and discounted services are treading on dangerous territory. The American Society of Plastic Surgeons (ASPS) prohibits its members from giving plastic surgery away as a prize, and some argue the same should be said of coupons and discounts.

Patients might feel pressure to undergo the surgery or procedure because of their initial purchase, and at the same time, a doctor might feel more compelled to agree to work on a patient because they have already purchased the services. This can create a murky relationship between the doctor and patient before they even meet.

One doesn’t have to look too hard to see that the rise in cheap cosmetic surgery is linked to an increasing number of ‘plastic surgery gone bad’ stories in the news recently. It’s important for a patient to ask herself, why would a qualified, experienced surgeon with an established reputation in the local community offer an expensive treatment at half-off? And, if the doctor isn’t making money on the procedure itself, are they planning on making you a repeat customer? Will they cut corners to save costs? Scam artists are also out there – and Groupon deals make it easier for them to find new patients.

While it can be hard to say no to what seems like a “too-good-to-be true” offer, in the case of cosmetic surgery, you should. It’s one thing to get a 40 percent off coupon on a purse, and quite another to be offered such a deal on a brow lift or nose job. In my opinion, the benefits simply don’t outweigh the risks for patients.

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