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Who Can You Trust?

EVOLV / April 1, 2015

By Frank Barone, MD, FACS

The statistics are hard to believe. An estimated 15.6 million cosmetic procedures were performed in the U.S. in 2014 and continues to increase. Nearly 56 billion (yes…billion!) dollars were spent in this country last year on beauty products and cosmetics. These staggering numbers reveal the dramatically increasing demand in our society where we all will be living and working longer as well as the human desire to feel attractive and look our best.

But who is performing these aesthetic services and procedures? Have they been appropriately trained and certified? Do you really know what exactly is in the bottle of cosmetics, skin care or health supplement product that you will be using? An alarming number of reports of complications from cosmetic surgery and aesthetic procedures or treatments along with numerous studies implicating misleading labeling, fraudulent ingredients and unsupported claims in health and skin care products are serious cause for concern.

No one can deny that clever marketing and advertising, especially with the huge impact of social media, has been an extremely powerful and effective motivator of human behavior. But is it truthful and can we trust the message and the source? Is their potential bias or conflicts of interest?

Consider the example of mass marketing in aesthetic (cosmetic) plastic surgery and aesthetic services. Lifestyle Lift, a national chain of cosmetic surgery centers headquartered in Detroit Michigan, last month closed all of its 50 cosmetic surgery centers laying off all employees. As recently as 2013, Lifestyle Lift surgeons were performing nearly 20% of all facelifts done in the U.S. Founded in Troy, Michigan in 2001 by a physician board certified in otolaryngology (ENT), Lifestyle Lift grew to nearly 80 surgery centers nationwide by spending up to $1 million per week on advertising and promotion of a ‘less expensive and less invasive’ facelift perfumed under local anesthesia. But the surprising facts are that the ‘Lifestyle Lift’ was a marketing term and not an accepted or recognized procedure in the plastic surgery literature. Lifestyle Lift ‘board certified’ surgeons were hired physicians and not board certified in plastic surgery but in other specialties and most had never completed accredited residency training in facelift and aesthetic procedures. Unfortunately most Lifestyle Lift patients never had a clue about these misleading claims. Not surprisingly a high number of complications and law suits have resulted.

These misleading marketing and unsubstantiated claims are also prevalent in the medical skin care, cosmetics and health supplement industry. In February the New York Times reported that the New York State attorney general’s office had accused four major retailers of selling fraudulent and potentially dangerous supplements. They had investigated GNC, Target, Walgreen’s and Walmart and had found that four out of five products did not contain any of the herbs on their labels and some had cheap fillers or other non-useful ingredients.
Many people do not realize that the FDA does not regulate or control the ingredients in cosmetics and supplements so there is no guarantee on product purity unless it is certified by a separate regulatory agency.

How much do you really know about the ingredients, safety or effectiveness of your sunscreen or skin care product? The Environmental Working Group (EWG), a nonprofit health research organization, recently tested 1400 over-the -counter sunscreens. Their findings? Surprisingly only 25% if the 1400 sunscreens tested actually performed or functioned to the level of sun protection claimed. Some sun screen ingredients ironically were found to be unstable in sunlight! This is an especially important report considering the epidemic increase in sun related skin cancers, particularly in young people.
What is clear is that there is a concerning and growing erosion of trust between the patient consumer and the service providers and products in the aesthetics profession. This has resulted from the increasing demand for aesthetic services and products along with the lack of appropriately trained professionals and research proven products. The highly motivated consumer is often ‘manipulated’ by misleading and unsubstantiated claims and marketing of cosmetic procedures/products promising results that are not realistic nor proven by credible research or clinical studies. Correcting unfavorable outcomes or complications, when even possible, can be expensive and disappointing for many patients.

Trust is the critical factor behind the doctor- patient relationship. Trust must be earned by consistent and clear communication, authenticity and honesty. This requires a professional and ethical responsibility to patients to only offer services that are within the scope of professional certification and training and to recommend and utilize aesthetic products that have proven efficacy and safety.

The demand for safe and effective aesthetic services and products is likely to continue to increase. At evolv Medical Aesthetics and Frank Barone MD Plastic Surgery, we believe in and have experienced the power of properly done aesthetic surgery and services as well as the use of advanced medical skin care products and treatments to improve skin health, reduce the signs of aging and ultimately to improve quality of life for many patients. We would like to encourage any patient considering cosmetic services or products to carefully check the training and qualifications of their potential service provider. Please be sure that the products that you consider purchasing and using have been proven to be effective and are made by a reputable and trusted company. Don’t be afraid to ask questions…obtaining a safe and natural appearing result these days requires that you do your homework.