Dr. Kenneth Hughes, Harvard-trained, board-certified plastic surgeon in Los Angeles, performs many complicated plastic surgery procedures for reconstruction, revision, and aesthetic improvement.  Dr. Hughes performs a very wide gamut of procedures for which few plastic surgeons have experience.  The Aesthetic Society published recent surgery results about this very situation in plastic surgery and the rate of risk ascribed to procedures by plastic surgeons who do not perform procedures.

A 24-item survey was sent out to members of the Aesthetic Society. The survey focused on surgeon experience and attitude towards three procedures: filler rhinoplasty, gluteal augmentation with fat grafting, and submandibular gland excision.  189 completed surveys were returned.  50% of plastic surgeons say they do not perform filler rhinoplasty.  49% of plastic surgeons say that they do not perform gluteal augmentation with fat grafting otherwise known as Brazilian buttlift or BBL.  Almost 90% do not perform submandibular gland excision in their practices.

The majority of those who do not perform the procedures selected danger to the patient as the primary concern for each of the three procedures. However, these same surgeons overwhelmingly reported not learning these procedures in training. Additionally, surgeons perceived the risks of more common procedures such as abdominoplasty and breast augmentation-mastopexy to be significantly lower and more acceptable than those of the studied procedures.

When comparing the perceived complication rates to those in published data in the literature, particularly when looking at rates of serious or life-threatening complications, plastic surgeons overestimate the risks of procedures with which they are less familiar. This perception of risk, accompanied by the lack of exposure to techniques in training, may contribute to surgeons avoiding these procedures.

This perspective coincides with Dr. Kenneth Hughes’s perspective about many plastic surgeons who cite that certain procedures are dangerous or safe based solely upon their level of comfort with the procedure.