Jeffrey Frentzen

When it comes to the role of marketing and PR in the plastic surgery arena, I tend to lump all the players under one heading. By definition, marketing (especially that which is done by corporate entities) attracts dishonest practices. In the aesthetic universe, you probably have noticed the explosion of dishonesty in this area. It covers a wide range, from the largest of multinational corporations pushing new or untested products to the single plastic surgery practice running a small ad in online Yellow Pages sites.

Just check out all the billboard ads littering the countryside that advertise cosmetic procedures at laughably low rates. Marketing propaganda in the aesthetic field is running wild. While not a new phenomenon, the noise levels have increased greatly in recent years. It is a response to an egregiously competitive business environment and deep economic recession. All involved entities have had to respond dramatically to a profit-and-loss landscape that chokes them at every turn.

In late November 2009, the BBC reported that Nigel Mercer, president of the British Association of Aesthetic Plastic Surgeons, went way out on a limb publicly, calling the UK cosmetic surgery industry was placing patients undergoing aesthetic procedures at more risk than ever before.

To Mercer, the industry had reached a stage where “public expectation, driven by media hype and—dare one say—professional greed, has brought us a perfect storm.” Mercer demanded a ban on discount offers for surgical procedures, which he said governments would not tolerate in any other medical discipline.

Have calls for self-control, self-regulation, or plain old government intervention had an effect? For the most part, quality control issues have continued to spiral out of control in the UK. In the US, corporate propaganda always needs vigilant, serious scrutiny but rarely receive more than a passing glance by a self-serving mass media that is bought and paid for, in many cases, by the very companies that it should be watching.

For these and other reasons, I applaud a recent move by the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS) to clamp down on practitioners and companies that market so-called stem cell-based procedures and products claiming to incorporate adipose stem cells in aesthetic treatments. Within the plastic surgery community, there has been vigorous disagreement about the methods, safety, and efficacy of fat grafting and the use of stem cells. These societies have at least tried to address the false perception being perpetrated on consumers—via advertising, press coverage, and other forms of corporate propaganda—that the use of stem cells has demonstrated a proven value in aesthetic procedures.

The ASPS and ASAPS have limited recourse when tracking down marketing abuses, but I believe they can adequately police their own members.


A few watchdog groups, not backed by industry but by concerned citizen physicians, have sprung up around the marketing and use of injectables. I would like to see more of this behavior develop around the marketing of medical devices, too, especially in the aesthetic business. The FDA has been working on ways to monitor the claims of device manufacturers, but that comes only after the aesthetic industry allowed itself to go hog wild in disseminating poor or unsubstantiated claims about untried products.

A recent example of this phenomenon is the marketing effort behind the Zerona laser, which has created many skeptics among physicians who then labeled the product a sham. Yet, the Zerona was prominently on display at this year’s ASAPS scientific meeting. Nonetheless, not all is lost in the battle against false claims and marketing lies. One clever surgeon prominently displayed a photo during one of his panel discussion at ASAPS, showing the Zerona machine as one of the units currently collecting dust in his practice’s basement.

Ultimately, we cannot back away from the need for physicians to do all they can to inform and protect their patients from unscrupulous colleagues and dealers. The corporate propaganda “machine” in the US has always subscribed to PT Barnum’s remark about a sucker being born every minute, and despite all measured good intentions will never veer away from placing profit above patient safety.