October 2009

After the positive response to last month's Girls Night Out article and event, I wanted to continue on that thread of “Don't Trust That Face to Just Anyone!”

We received so many positive emails and more new patients than ever! Many people assume that because someone in medicine is performing a service and because the current laws allow it, that the physician is properly trained and has medical board approval. Patients often mistakenly assume an implied message that the person performing the service has been through appropriate training. Sad to say, that in Texas, as the law stands, anyone, even those who have not been through a recognized by the American Board of Medical Specialties that governs residency training programs can call themselves a cosmetic surgeon. There are doctors in Texas who perform surgery without even one single day of surgical residency training! They do this in their own offices (minimally invasive procedures) or privately owned surgical facility (for surgical procedures). They would never be allowed to perform any of these procedures at a hospital. Hospitals have strict credentialing requirements which ensure the physicians are only performing the procedures covered in their residency or fellowship training program. This always comes as a shock to so many patients. Unfortunately, some of them learn it after they have received inferior results.

That brings us to the Not All Injectors Are Equal. I often see plastic surgery practices that hire Nurse Injectors for the purpose of saving time and increasing profit margin. I see their websites that say something like “I personally trained this person...” If facial anatomy, including nerves, muscles, veins, and arteries were that simple, why don't they train their nurse injector to do a facelift or a eyelift? If they can personally train a nurse injector to navigate around structure that was not part of their nurse practitioner training, why don't they just make the statement “I personally trained my nurse to perform your bilateral augmentation mammoplasty?” Because most people do know that nurses should not perform surgery! I wouldn't trust my breast surgery to a nurse, why would I trust my face to one? Breasts are not something everyone sees, but our face is!

I researched which training programs included intense facial anatomy training. Hospitals would only credential the following physicians (not nurse injectors) to perform injectables procedures. Those were limited to plastic surgery, oral maxillofacial surgery, otolaryngology (ENT or head and neck), and now dermatologist for minimally invasive procedures but a recognized fellowship (following residency) is required for certain surgical procedures such as Mohs. These are things I want to know to make the best decision for me. When patients come to us with a drooped eyebrow, or over relaxed lid (causing visual field obstruction) as a result of poor injection technique, we ask them “Who did the injection?” The majority of the time it is someone who did not complete one of the above mentioned training programs. The patient's shame and embarrassment for not researching all of the facts is almost as strong as their concern for their less than desirable appearance. Most of the time, the ill effect wears off in 3 to 6 months, but in a limited amount of cases, the effect is more severe.

Rest easy knowing that Dr. Barlow, a Board Certified Plastic Surgeon, is well-trained in facial structure and anatomy for both invasive (surgery) and minimally invasive (injectables).

Practice Manager and Patient Advocate