Cosmetic Dermatologic Surgical Training in US Dermatology Residency Programs

Bauer, Bruce M.; Williams, E. L.; Stratman, Erik J.

doi:10.1001/jamadermatol.2013.6713

Cited by 33 publications

(21 citation statements)

References 8 publications

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“…White World War I veterans who underwent procedures to reconstruct their appearance because of their need to be employed or to have a more socially acceptable visage were, however, not viewed in the same light. 9,13 There are similarly shifting boundaries in the realm of dermatology, where some program directors have questioned whether dermatology residents should use their limited training time to learn cosmetic dermatology, 14 with its implied contrast to the diagnosis and treatment of real dermatological diseases. In other words, there is a perceived dichotomy between treating real illnesses, such as acne, and pandering to the vanity of members of the upper middle class through Botox ® skin tightening.…”

Section: A Lessonmentioning

confidence: 99%

Historical Situatedness of Categories' Meanings in Medicine

Gilman

2018

AMA Journal of Ethics

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Dichotomies in medicine are real, and the boundaries that define them are constantly shifting. Radical antitheses such as healthy versus ill, reconstructive versus aesthetic, or medical dermatology versus cosmetic dermatology can be more clearly understood by considering the cultural context of medicine. This essay examines the latter two antitheses and asks whether medical dermatology should be a category limited to somatic illness. It also examines how the tendency to create and endorse dichotomies distorts the meaning and delivery of surgical procedures as well as reimbursement practices in contemporary medicine. Shifting Boundaries Between Aesthetic and Reconstructive Surgery In 1992, US Food and Drug Administration (FDA) Commissioner David Kessler, later a distinguished dean of the Yale Medical School, facilitated the FDA's decision to limit access to silicone breast implants. 1 The implants had been allegedly silently leaking their contents and causing a wide range of autoimmune illnesses, including scleroderma, lupus, rheumatoid arthritis, and fibromyalgia, and, it was argued, increasing the risk of breast cancer. 2 Introduced in 1962 by Dow Corning, 3 but not subject to safety testing by the FDA until 1976, 1 the implants replaced a range of substances, from autogenous body fat to paraffin, which had been employed in breast enhancement from the mid-1890s. 3 Kessler, relying on a scientific committee report, halted their general use, but allowedand here was a critical point of contention-"access to silicone breast implants for patients … who undergo reconstructive surgery at the time of mastectomy." 1

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Section: A Lessonmentioning

confidence: 99%

Historical Situatedness of Categories' Meanings in Medicine

Gilman

2018

AMA Journal of Ethics

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“…42 The latter group was identified as the preferred provider of cosmetic procedures of the skin, 43 but the extent of their training on these procedures has not been standardized and may vary. 44 With this history in mind, let's first consider who may provide therapeutic gene-editing services. All medical specialties may one day have the option of gene editing as an intervention for their patients.…”

Section: Dawn Of a New Profession?mentioning

confidence: 99%

A Brief Comparative History Analysis

Haga¹

2018

Gender and the Genome

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With the advent of gene-editing tools, changes to sequences encoding genes or regulatory elements can be made with relative ease compared to prior technologies. The development and anticipated commercialization of new applications using gene-editing technologies may span the gamut from therapeutic interventions to agricultural applications to cosmetic or enhancement procedures. Although objections have been raised about the purpose and on whom gene editing should be performed, limiting its uses in the absence of demonstrated harm may be difficult and unwise at this time, even at this early stage of development. The fledgling field may benefit from a review of the history of plastic and cosmetic surgery that underwent a similarly rocky start and continues to evolve to this day. From this brief comparative historical analysis, we may gain some insight about the path forward regarding the use of gene-editing tools for cosmetic purposes.

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“…Of physician subspecialists, dermatologists and plastic surgeons had the highest proportion of litigation (17% each) ( Fig 2); this is likely due to these specialties performing a higher volume of the relevant procedures. [3][4][5] The majority of disciplinary actions were reprimanding physicians for not being present while a nonphysician employee injected patients with softtissue fillers. In 3 of the 5 reprimands, physicians were functioning as medical directors of medical spas.…”

Section: J Am Acad Dermatolmentioning

confidence: 99%