| gENDER gAP | aNaLYSiS Female patients will even rent
accommodation in the local area, for 1 week perhaps — Dr Evans’ practices are in Plymouth and Torquay, which are favoured English holiday destinations — so that they can be around for any follow-up. 'The reason for this is that females
actively seek a female surgeon [because of] ‘embarrassment’ or supreme privacy procedures. They need to feel safe and confident.' A secondary consideration is that prices outside London can be up to 20–30% cheaper. Now, some 95% of Dr Evans’ surgery is
carried out on women. Within breast surgery, she has the most requests for enlargements. Tummy tucks, eyelid surgery and facelifts are also popular. Liposuction less so, she says.
Demand Hidden and pent-up demand for cosmetic surgery is and remains large. As long ago as 1998, Dr Evans was the subject of a BBC series called Medicine Women, which featured fly-on-the-wall documentaries on the theme of females in traditionally male-dominated roles. She got a huge mailbag from women wanting to access a female surgeon following the televising of the programme. A driver for her has been the goal of
improving the chances of women getting into surgery. This seems to be happening. There was a time when there was a 30% quota of women in medical schools. Now over 60% of first-year students are female. This is because the perception of the surgeon is improving, and more females are coming through the system. Fellow consultant Barbera Jemec
agrees. 'Traditionally this role has not been done by women. It’s a time-consuming job. But things will change with more women going into medical school,' she says. Dr Jemec, who works at the private
Wellington Hospital and the NHS Royal Free Hospital in London, is, however, less convinced by calls for more women in surgery. 'For certain procedures, women do feel better with women. But for others, this is just an added bonus.' She adds: 'As to women surgeons, it’s not important per se. What’s important is the quality of service.' It may all boil down to bedside manner.
'We appreciate that, as a patient, you have to take your clothes off, and you need trust and comfortableness. But essentially, it doesn’t matter what sex the surgeon is. The
These sites aim to replicate the mature
conversations that female patients can have when having face-to-face consultations. Advice that conforms to FDA recommendations is imparted. For example, women are encouraged to acknowledge that breast implantation may not be a one-time surgery, and that additional surgery and visits to the surgeon over the course of one's lifetime will be necessary; many changes to the breast are irreversible, and implant removal is likely. As the ASPS points out, a recent FDA
key issue is that patients feel comfortable with a good, nice, friendly surgeon.'
Medical tourism Women who don’t wish to see a male consultant may be tempted to take their business outside the UK. The Wellington’s Dr Jemec says that medical tourism is not as good as locally-available surgery for two reasons: you cannot as easily check who the surgeon is, or their level of training; and you are not close to the surgeon. 'If you get a problem who do you go to?'
she asks, recalling the case of one patient who had buttock implants in Peru and experienced problems back in the UK. 'The UK competes on quality. If you
want quality, you have to pay for it,' she says, adding that there are good surgeons in every country. The lower prices charged by some
medical tourism businesses hinge on the expectation that patients will not come back to them, says Dr Jemec. 'We give a 1-year return policy in the UK. That builds in insurance and allows for follow-up for 1 year. If you can offer a ‘cheap and cheerful’ facelift, it’s because you don’t have to build in such costs.' Dr Evans agrees: price can seem
tempting, but what happens when it goes wrong? 'There's no substitute for using a properly-trained surgeon who can provide postoperative care. Select a good service is the message. It’s not all about money.'
Mature advice For those who wish to search more locally for a female surgeon, in the US this can now be done via the internet, with portals offering a service that matches customers with woman surgeons regarded as being the 'best fit' for them.
report stressed that many women with silicone implants will need surgery to modify or remove them within a 10-year period because of common complications. The FDA’s Center for Devices and Radiological Health (CDRH) director, Jeffrey Shuren, advises women with implants to seek regular check-ups.
Acceptance increasing Such open advice is good for the development of the market. Indeed, breast augmentation and certain other cosmetic procedures are now considered by young women as relatively normal — the recent high-profile criticism from certain female celebrities and Hollywood actors notwithstanding. The job market being tough at present,
people also want to look better or younger to give them confidence. In the economic crisis 2 years ago, many people cancelled or thought twice about their operation. But now they are seeing that their savings are not getting a good rate of interest, and are more likely to spend their cash now. 'What is most important is that these
treatments should only be available under the care of trained people,' says Dr Evans. BAAPS is always trying to put that message across. In this sense, the question of male or female surgeon is a lesser consideration. Perhaps ironically, males are the great
untapped market, while females often feel the need for more female consultants. There is demand to be met in both areas. In the end, successful cosmetic surgery businesses are those that have tapped into customer preferences and needs. This is vitally important, says Dr Evans.
'Many people are tempted to view cosmetic surgery as not real, as ‘pretend’.' She adds: 'But it’s very real, and it makes people’s lives better.'
1 American Society of Plastic Surgeons. 2010 Cosmetic Plastic Surgery Statistics. http://tinyurl. com/3zolgz9 (accessed 7 September 2011)
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