People have different reasons for becoming plastic surgeons, but I venture to say that all of you have one thing in common: You really like doing the surgery. Otherwise, you wouldnโ€™t have endured all those years of medical school, residency, internships, and fellowships. When you were going through this process, all but perhaps the youngest of you almost surely thought that you would spend your entire post-training career doing, well, surgery. And that was more than fine with you.

Now, if your goal was to go into private practice, you knew that you had to have some sense of business management, even if you hired others to take care of the details of your practice. And because youโ€™re not operating on cadavers anymore, you knew you had to develop some interpersonal skills if you didnโ€™t already have them. But most of all, you wanted to improve and display your surgical skills and artistry in the operating room.

Well, that was then, and this is now. Just how are you spending your time? Is your workday filled only with performing surgery and the tasks related to it? Or has something else crept into your practice?

This sounds sinister, but of course it isnโ€™t. What Iโ€™m getting at is the rise in nonsurgical procedures performed in plastic surgery practices.

The buzzword for these procedures is โ€œnoninvasive,โ€ although thereโ€™s nothing truly noninvasive about injecting a patient with botulinum toxin Type A, hyaluronic acid, or fatโ€”or even training a laser beam on his or her skin. The American Society of Plastic Surgeons prefers the term โ€œminimally invasive,โ€ and that makes a lot more sense to me. Whatever you call it, it isnโ€™t surgery; and by definition, itโ€™s not what you were trained for and love to do.

You donโ€™t need to be told that what you love to do and what you actually do arenโ€™t necessarily the same thing. (If they were, weโ€™d have a world full of professional golfers and surfers.) I donโ€™t think that any plastic surgeon today feels that he or she is forced to add nonsurgical procedures to keep the practice afloat, but many are enjoying a great deal of economic success from having done so.

Are you among this group? If so, what was your motivation? Probably not peer pressure or a great pitch by a laser sales rep, Iโ€™ll wager. Very likely, it was a combination of patient demand and a desire to make your practice more competitive. You surmised that if you didnโ€™t offer skin treatments, the surgeon in the medical building up the road would, and that the next sound you would hear would be potential patients closing the door on their way out of your office.

But waitโ€”thereโ€™s more. Some plastic surgeons are expanding their practices from performing nonsurgical treatments to opening medical spas and more. They offer fitness centers, diet counselingโ€”practically anything that contributes to overall wellness.

It wouldnโ€™t surprise me if many readers have mixed feelings about this trend. (For one surgeonโ€™s reaction, please see โ€œThe Last Wordโ€ on page 78 of this issue.) Whatโ€™s your take on it? Is it taking you away from your โ€œcoreโ€ business? Do you feel that itโ€™s a necessary evil for maintaining your business? Or do you embrace the trend?

This isnโ€™t exactly a formal survey, but I would like to receive your feedback. Please email me at the address shown below. Weโ€™ll publish all the interesting responses.