- While the Federal Court approved the above settlement in September 1994, by fall 1995 Dow Corning Corp. had filed bankruptcy. A report from the National Science Panel in 1998 and studies conducted on the safety of breast implants by the Institute of Medicine in 1999 all found that there was no connection between breast implants and illness in women. Eventually the parties agreed to a revised settlement, and payments were made in 2000.
- While all this was going on, the ASPS started a public awareness campaign to educate the public about the importance of ABPS certification. Following a 2000 article in W magazine, ASPS members were invited to appear on TV, and received more publicity through quotes in fashion and medical magazines. By 2003, ABC TV’s “Extreme Makeover” approached ASPS for support in allowing members to participate in the reality series. Because of it’s high standard of choosing participants, and an agreement to promote the importance of the patient-physician relationship, ASPS gave its support.
- The early 2000s brought many less-invasive cosmetic procedures, such as injectables like Botox®, to reduce symptoms of aging, increasing the popularity of cosmetic “surgery” and the willingness of patients to pay privately for the procedures. While these “self-pay” procedures were in increasing demand, another area of the plastic surgery specialty, reconstructive surgery, was not holding up its end, financially.
- Cosmetic surgeons faced a paradox. The lack of insurance reimbursements allowed them more independence in controlling their practices. But at the same time, reimbursement based solely from reconstructive surgery was not enough to maintain a practice. Rising malpractice premiums, malpractice suits, decreasing reimbursements, and bad press were causing so much damage to the some practices that many surgeons simply relocated.
- In 1999, 10 patients died after having cosmetic procedures done in their surgeons’ Florida offices. The publicity given these deaths resulted in Florida’s Board of Medicine to declare a 90-day moratorium on surgery done in surgeons’ offices. In 2000 the ASPS organized a task force to identify and evaluate the risk factors of office-based surgery, which culminated in the ASPS Board of Directors amending the by-laws to require, by July 1, 2002 “all members performing surgery under anesthesia do so in only accredited, licensed, or Medicare-certified surgical facilities3.”
- All of this publicity, both good and bad, had surprisingly great outcomes for the cosmetic surgery practice. By 2003 procedures increased 32 percent over 2002, with a 64 percent increase in injectable procedures.
- Having seen the need for more political involvement, the ASPS, by 2004, opened an office in Washington D.C. to increase the specialty’s visibility and to build coalitions in DC to preserve the interests of the practice. The ASPS was now positioned to learn about legislation and regulations that could adversely affect the practitioners of plastic surgery and the patients who would rely on them, and to take appropriate action.
- Among the ASPS’ concerns, increasing since the early 90s,was the need to monitor the legislative bills for any impact on medical practice. One of these bills enacted a law allowing New Jersey to tax cosmetic surgery. ASPS acted quickly to block similar bills in six other states over the next few months. By 2006, only two years after New Jersey enacted its taxation, it was clear that the revenues from this tax were insignificant, and lawmakers began taking steps to repeal the law.
- Plastic surgeons have succeeded in getting Congress to mandate insurance coverage for patients requiring breast reconstruction and are hopeful that coverage for treatment of children’s deformities will soon have the same coverge.
Responding to research outcomes ASPS has proven the safety of its procedures and is making inroads to new developments. Noting that infants in the womb heal without leaving any scars, research is being done to learn how this occurs so that they can use this knowledge to heal wounds scarlessly in children and adults.
