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Is Asian Plastic Surgeon Proficiency Overestimated?

In our recent Asian Plastic Surgery Predictions for 2011, we made note of an interesting phenomenon, namely, the recent emergence of a rather large crop of self-proclaimed "specialists" in Asian cosmetic surgery in the United States who are nevertheless only a few years out of their training programs. Characterized in their own advertising as "top experts" if not "world-renown," their numbers closely parallel the rising demand for cosmetic surgery from patients of Asian descent in the West rather than being explained by any sudden increase in specialty training programs or substantial hands-on experience.

While any surgeon can make exaggerated claims regarding expertise in advanced subspecialty operations after posting a few three minute marketing videos on YouTube, in fact even basic proficiency is difficult to measure. Self-annointed "experts" thus can (and do) range from highly skilled super-specialists to sincere but inexperienced wannabees.

A report on a recent presentation in an unrelated field of surgery sheds at least some light on this trend and urges caution.

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A study headed by urologist Dr. Prasanna Sooriakumaran at the Weill Cornell Medical College in New York suggests that more than a few board-certified surgeons now performing difficult operations in that specialty are far from proficient, let alone experts.

The study concluded that doctors who perform robotic-assisted prostate cancer surgery are not proficient until they have undertaken the procedure more than 1,600 times.

Not sixteen times. Sixteen hundred times.

The authors suggested that such operations are being performed far too often by surgeons without enough experience, most typically by doctors who perform less than one hundred and sometimes only a handful of procedures annually.

"The operation is not easy to perform," said the lead author, "and it takes a lot of experience in order to get the best results." He later added, "The enthusiasm in the United States needs to be tempered in terms of...what sort of surgeons should be allowed to do these operations."

APSG Comment: Nice idea, but unfortunately there are no rules or restrictions that stop a doctor from doing whatever operation he or she wants within the specialty.

A spokesman for the manufacturer of the multimillion dollar robotic equipment who hadn't yet read the report nevertheless called its conclusion "absurd" and claimed that proficiency could be attained after about only fifty operations.

The authors concluded by suggesting that such procedures should be "centralized" to allow a smaller group of surgeons to amass sufficient experience rather than being performed by a much larger number of occasional practitioners who then dilute the patient pool while providing inferior care.

APSG Comment: "Routine" operations take years to master. More challenging operations take many years to master. Simply advertising an interest in a subspecialty field of cosmetic surgery does not confer expert status on a beginner surgeon.

So how does a potential patient go about finding a proven top-rated specialist in Asian cosmetic plastic surgery? Know what to look for before you start your search.

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Specialist Surgeons in Asian Plastic Surgery