| Mailbox letters
October issue of PRIME, which touches on the important subject of accountability and standards of practice in aesthetic medicine. Although I fully agree with your comments and opinions, I am compelled to add a few remarks that are, in my opinion, essential for a full comprehension of the subject. I began practicing aesthetic
medicine 4 years ago, after 23 years of practice of Nephrology. Being an artist for over 40 years, I was introduced to the world of aesthetics by two of my friends — artists who happen to be plastic surgeons from the south of France. My motivation to open an aesthetic practice was purely related to my artistic fascination with new possibilities. In a very short time I realised that the field is run by marketing rather than the pursuit of beauty. Moreover, the concept of beauty is mostly unknown to the majority of those who practice aesthetic medicine, including plastic surgeons, and dermatologists in particular.
Your comments and opinions to the Editor's inbox
Considering standards and regulation I read your editorial in the
During medical training,
residencies, fellowships, post‑graduate training, workshops or certification courses, there is not a single hour committed to the understanding of true aesthetics, visual perception, art form, or the concept of beauty. You learn how to inject botulinum toxin, but not the need for it. You learn how to enhance the breasts, but you are not required to understand what the ideal breasts are for any given patient. There is no semiological
research in the sense of asking questions: n What are ideal buttocks? n Ideal legs? n What is the ideal nose? n Which lines and folds need not be corrected?
n What are the ideal lips for a given face? The 'ideal', for clarification, is
not the subjective concept of 'the most beautiful'. It is the sum of many anatomical, cultural and artistic components that give rise to admiration. Unfortunately, the above are
not limited to the few rogue practitioners. This is an overwhelming problem that gives a bad name to this type of medicine. The monstrosities we see in popular mass media, as well as on the streets, were
created not by a few unlicensed physicians, but often by board‑certified specialists who claim exclusivity in aesthetics. The number of 'corrections' after breast enhancement or rhinoplasty would be unacceptable in any other surgical specialty. Yet, in aesthetic medicine it seems that aesthetic failure is not a problem. Claims that it was the patient
who wanted to have 'fish lips' are absurd if one calls himself an aesthetic physician! If, for example, I asked the surgeon who was about to remove my gallbladder to make a zig‑zag incision because it is my favourite pattern, my request would not be taken seriously by any ethical physician. I agree that there must be a
system of maintaining standards and a robust verification process, but they must be unified standards based on the outcomes and performance of all physicians who practice aesthetic medicine, regardless of their certifications. This is the only safe and fair way. Safe and fair for all our patients, that is. In aesthetic medicine, one
must never confuse knowledge and certificates on the wall with skills.
Marek Kacki, MD Nashville
Have your say: write to
rosalind.hill@informa.com with your comments. You can also join the debate on Twitter and LinkedIn @PrimeJournal
prime-journal.com | November/December 2011 ❚
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