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From Health magazine

Watch for these red-flag phrases that suggest your “skin-care specialist” is subpar, says San Francisco ophthalmologist Krista Ramonas, MD, who has treated medical and aesthetic patients for six years.

“You’ll look 20 years younger.”
Beware the cosmetic doctor who overpromises, Ramonas says. Instead of flattering you, he should be discussing what you can reasonably expect from the procedure and addressing possible side effects.

“I’m an artist.”
The prima donna who tosses this phrase around may value her vision over standard operating procedures. “There is a little bit of art to it,” Ramonas points out, “but there’s a lot more science. We have certain parameters we all have to follow.”

“I’m so good, I’ve never seen complications.”
That may be code for “not very experienced,” Ramonas says. “Medicine is always about being prepared for complications.” You need a doctor who can handle the unexpected.

Of these, the greatest is the 'Artist'.

Plastic surgery marketing in Argentina is booming, with medical spa advertising a common experience for Argentine women. Plastic surgery advertising is seen as putting tremendous pressure on wome to have proceedures like liposuction, breast augmentation, and Brazilian Buttlifts.

The result is sometimes a tragedy, like the death of Solance Magnano, a former Miss Argentina.

From a news story.

38-year-old former Miss Argentina Solange Magnano died after complications arising from plastic surgery on her buttocks.

Solange Magnano, the 1994 winner and a mother of 8-year-old twins, died of pulmonary embolism Sunday three days after having a gluteoplasty, a procedure that involves placing implants to enhance firmness. News of her death shocked her fans. The cause of her death was under investigation, the authorities said. Officials said the injected liquid went into her lungs and brain.    

In the past half decade, the number of people seeking plastic surgery in Argentina has soared by 60 percent, to around 50,000. Estimates say that 1 in 30 Argentines has gone under the knife, making plastic surgeons in Argentina some of the most experienced on the globe, attracting large number of medical tourists.

Medical tourism in Argentina has seen a huge jump over the past decade, and is projected to be a 100 billion dollar global industry by 2010, according to the Deloitte Center for Health Solutions, a U.S. research center focused on trends in the health care system.

What a tremendous waste. Perhaps the worst quote of the story is that the 'injected liquid went into her lungs and brain'.

Medical spas in the US and elsewhere have increased in numbers and are popular as medical tourism destinations. Several countries have reported problems of medical spas undertaking medical procedures that neither the spa nor the staff are qualified to do.

Unfortunately, this reflects badly on the majority who are professional. They have tended to fall between the gaps in legislation, but one of the first countries seeking to remedy that is the USA. Nationally, the number of medical spas around the country has grown from 500 in 2004 to 2,500 today. If this growth rate continues, more states will follow the four who are preparing regulations, and almost every sate has discussed the idea.

According to the International Medical Spa Association, the official definition for medical spa is a facility that operates under the full-time on-site supervision of a licensed health care professional. The facility operates within the scope of practice of its staff, and offers traditional, complementary, and alternative health practices and treatments in a spa-like setting. Practitioners working within a medical spa will be governed by their appropriate licensing board, if licensure is required.

The death of a nurse, who had a liposuction procedure performed, has raised concerns over the safety of medical spas to the level that several states are progressing legislation. The proposed legislation is now travelling through several state medical boards in Massachusetts, New York, Florida, and Utah. Proposed legislation would require owners of medical spas to have certain credentials, dictate which procedures can be performed, and set a minimum level of training for those performing particular procedures. Legislation does not want to stop consumers having medical procedures in spas, but to ensure that the procedures are performed safely and by someone with the correct training.

The concern of cosmetic surgeons is the lack of training or experience of some employees at medical spas. An employee of a medical spa may start out performing one procedure and move to another more difficult procedure without much experience. Indeed, lack of experience with certain medical procedures has resulted in serious consequences for some customers, but more common is minor problems such as second-or third-degree burns from improperly conducted laser hair removal procedures.

Medical spas in the US offer treatments including laser hair removal and liposuction, as well as massages and other traditional spa treatments. The types of procedures performed in medical spas have expanded to include chemosurgery for skin cancer and reconstructive surgery.

Massachusetts health officials want to crack down on medical spas, following the lead of Florida, which has been preparing legislation for three years. In Massachusetts a medical spa task force has been set up to advise the state legislature on how best to regulate the facilities. It would prefer a system of federal regulation of medical spas as it would be more cohesive than a state-by-state model but believes that is unlikely to happen, as medical and other professional boards, like nursing, electrology and aestheticians boards, are regulated and licensed by individual states. But the government has just decided to take insurance regulation away from states into a national body, so national regulation is a possibility. The task force has proposed that spas be required to get licenses from the Massachusetts Department of Public Health, and recruit a physician or nurse with special training to remove age spots or tattoos with a laser. Non medical practitioners - cosmetologists, electrologists, and aestheticians - will be allowed to remove body hair using a laser, but only after special training and certification. The task force reported that doctors and other professionals not specifically trained in dermatology have begun offering laser skin procedures, presenting an unacceptable risk to patients.

Regulating medical spas is complicated because they combine many different professionals under one roof, including cosmetologists, electrologists, aestheticians, nurses, and physicians. In most US states each of these professions is licensed by its own board, and each has its own standards. There are no overall regulations governing who can do certain cosmetic procedures and what type of training is required, and there is no requirement that medical spas be licensed.

Venezuelans commonly borrow for plastic surgery.

In the subway you can see ads for clinics that offer credit for plastic surgery, Thermage, Fraxel, laser hair removal, breast augmentation, laser treatments and Botox treatments, and that women who work use their vacation bonuses and borrow from their work savings accounts. The cosmetic surgery and medical spa industry will make sure that cosmetic work remains within reach to ensure a steady flow of income.

THE NEED TO BE BEAUTIFUL

Despite the hefty price tag, the choice to get plastic surgery, Botox, or laser treaments is not considered a luxury for some Venezuelans.

"We need to be beautiful," said Patino.

Competition among women, by far the biggest consumers of plastic surgery in Venezuela, to look their best is fierce, and social pressure to get work done is high.

"Socially, there is a lot of demand, especially from men, to have a good body," said Prem Pratita, a 27-year-old who had a breast augmentation a few weeks ago.

In this image-conscious country, famous for beauty queens who win record numbers of international pageant titles, the idea of getting cosmetic surgery is instilled at a young age.

Patino recalls how, as a child, her mother and aunt dreamt of surgery to get rid of wrinkles. Now, with a child of her own, the subject is already on the table.

"I told my husband, 'Look honey, if she has your nose, she's going to get plastic surgery,'" said Patino.

Some young women even describe moving up a few cup sizes through plastic surgery as a rite of passage.

"It's a transformation from being a girl to being a woman," said Pratita, who said she was one of the last in her circle of friends to have the procedure.

"Everybody has a breast augmentation. Three or four of every seven women have one," said plastic surgeon Angel Pena, who likens his surgery to body decoration practiced for centuries.

"By nature, human beings have the desire to look better ... this desire is timeless and it's a desire that doesn't depend on your economic situation ... it's not that frivolous."

Bras are an often uncomfortable but necessary evil for the majority of women.

But if you've got serious bra issues and can't be bothered with a different strap arrangement for every occasion, plastic surgery now has the answer.

Israeli plastic surgeon Eyal Gur has invented the Cup & Up bra and there's no straps to be worried with... on the outside at least.

In fact, the invention is an alternative to breast implants and promises perky breasts for years without any of the drawbacks of implants.

The first guinea pig has already had her internal bra fitted and surgeons say it was a huge success.

Avi Cohen, managing director of Orbix Medical, the company helping to develop the bra, told the Daily Mail: "The operation went really well and the woman, who is in her 30s, has made a good recovery.

"The bra has given her the lift she wanted. Her breasts look natural and she is happy with the result. The surgeons have done a fantastic job."

The Cup & Up involves a kind of internal silicon bra. The 'straps' are attached to the ribs with titanium screws, stitched to silicon 'cups' and then it's all tightened into place.

As gruesome and unpleasant as that sounds, those of you in need of a lift can be in and out of hospital in a morning as the keyhole operation takes just 40 minutes.

Mr Cohen believes the internal bra will become widely available throughout Europe within the next 18 months.

"We have enough women volunteers in the trial and we will be doing our second patient just before Christmas.

"In a year's time we will have enough evidence that it works. Then we will be able to get the green light from the European medical licensing authorities."

Call us cautious, but we think we might wait a little longer.

Less-acculturated Latinas with breast cancer are less likely to have reconstruction surgery after a mastectomy, say researchers at the University of Michigan Comprehensive Cancer Center.

Amy Alderman, MD, MPH, assistant professor of plastic surgery at the U-M Medical School and lead author conducted a study to examine trends in breast reconstruction among different races, including white women, African-American women, and Latina women. The group of Latina women was further divided into women who were either highly acculturated into American society or less acculturated.

After looking at 806 women who were treated for breast cancer, researchers found 41% of white women and 41% of highly acculturated Latinas underwent reconstruction, while only 34% of African-Americans and 14% of less acculturated Latina did.

The study authors found that the lagging reconstruction rates did not correlate to lack of interest. More than half of the less-acculturated Latinas said they would have like more information about breast reconstruction.

When patients' satisfaction with their surgery was measured, the highest satisfaction rates were among white women who were satisfied with their treatment (94%) compared with the lowest rate, 56%, among less-acculturated Latinas who did not receive reconstruction.

Furthermore, this group was also less likely to report that their surgeon explained breast reconstruction, and they were less likely to be referred to a plastic surgeon than the other racial groups. The study also showed similar trends for African-American women, although the most significant data was among the less acculturated Latinas.

“Reconstruction is important to these women, but significantly more of the less-acculturated Latinas did not know how to get it. It suggests significant unmet needs for this vulnerable group. They have a desire for reconstruction, but no one's telling them about it,” Dr Alderman suggested.

The study authors suggest that more efforts be made to present breast reconstruction options to all patients, including those who speak only Spanish. Further research is planned to understand how language and other cultural issues affect whether women receive breast reconstruction.