High Prices Make Plastic Surgery Look Attractive

A general economic rule of thumb is that when the price of something goes up, the demand goes down. The exceptions to the rule are certain luxury goods such as high-end cars, designer clothes and, according to a new survey, cosmetic surgery.

A team of surgeons and an economist surveyed members of the American Academy of Facial Plastic and Reconstructive Surgery about the frequency and fees of four common cosmetic procedures in 1989 and 1999. They found that when the price of a face or brow lift or an eye or nose job increased, so did the demand.

“People tend to feel that if a surgeon is expensive, they’re getting something special,” says Dr. Ramsey Alsarraf, a surgeon at the Massachusetts Eye and Ear Infirmary in Boston. “The surgeons who are charging $15,000-$20,000 for a face lift are probably good surgeons or else they wouldn’t survive.” But that doesn’t mean that a less expensive surgeon doesn’t do as good a job, he says.

“There is that BMW/Mercedes mentality. If it’s a name that you’ve read about in Vogue then the belief is that he has to be good,” Alsarraf says.

Alsarraf, who is also the co-author of the textbook “The Aging Face: A Systematic Approach,” suggests that prospective patients not only check the doctor’s credentials, but that they ask questions about whether he or she has published articles in medical journals or written a textbook. Also, does the surgeon train other doctors? Does he or she have an academic affiliation? If the doctor uses a private surgical suite, does he or she also have operating privileges at a hospital?

Archives of Facial Plastic Surgery 2002; 4:105-110

High Blood Pressure Could Be Result of Mom and Dad’s Behavior

Your genetic heritage may put you at risk for health problems such as cancer and heart disease, but scientists are learning that behaviors learned from parents also may play an important role. Take high blood pressure, for instance. The way a person learned to respond to stress could influence whether he or she will have high blood pressure, just like Mom and Dad.

In a study that measured heart rate, blood pressure and behavioral responses to stress, 32 healthy college students whose mother, father or both had hypertension were compared with 32 whose parents didn’t have it. When put through several stressful situations, such as having to solve a difficult math problem and role-playing a stressful encounter, those with a family history of hypertension had an increase in blood pressure--and they tended to behave negatively. They rolled their eyes, sighed and made more disagreeing statements than the students whose parents didn’t have hypertension.

If these behavior styles are a risk factor for heart disease, the West Virginia University researchers concluded, then learning new skills for dealing with conflict and stress might lower one’s chances of following in parental footsteps health-wise.

Health Psychology 21 (3) 244-253

UC Davis Study Aims to Boost Participation in Cancer Trials

Clinical trials offer people with cancer the opportunity to try experimental treatments that may be more effective than the current standard of care, but only 2% to 3% of Americans with cancer enroll in the trials.

The UC Davis Cancer Center has an unusually high participation rate--about 14% of its patients newly diagnosed with cancer enter a clinical trial. In an continuing study at the Sacramento center, researchers observed interactions between doctors, doctors and patients, and patients and their families. The results of the first phase of the study were presented in May at the annual meeting of the American Society of Clinical Oncology.

The researchers identified several broad categories of barriers that keep people from joining a trial.

The problems include a patient’s lack of financial resources; health insurance issues; confusion about study procedures and the differences between the care received in the clinical trial and routine medical care; and misunderstanding the illness and its severity.

“Practical information about how participating in a trial will fit into their lives is what’s needed,” says Debora A. Paterniti, an assistant adjunct professor of medicine at the Center for Health Services Research in Primary Care at UC Davis. “Most people haven’t been involved in any scientific enterprise before so they aren’t familiar with concepts like randomization.”

The researchers are now doing in-depth interviews with patients in hopes of developing strategies for improving understanding of, and recruiting to, trials. Paterniti already has some advice of people considering this option: Read the consent form and ask questions.

Surgery Complications Not Uncommon, Hospital Finds

Surgery may be riskier than we think, and no one knows for sure what the complication rate is for many operations. That’s what prompted University of Vermont researchers to look at the major and minor complications that occurred in their own hospital during an 18-month period. Although the number of deaths at their hospital was comparable to others across the nation, the Vermont researchers found that complication rates were two to four times higher than those provided by a recent Institute of Medicine report.

Mark A. Healey, assistant professor of surgery at the University of Vermont, and his colleagues also found that nearly half of the complications following general surgery, trauma surgery and cardiothoracic surgery at their hospital were “provider related,” meaning they probably could have been avoided. However, true negligence was unusual, Healey says.

“The public is led to believe that if you go to a good surgeon in a good hospital that you will fly through surgery with no complications. When something goes wrong, they think something substandard has occurred. And that has set people up for deteriorating expectations of doctors. Complications do occur and ... frequently, Healey says.”

Archives of Surgery 137 (5): 611-618

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Dianne Partie Lange can be reached by e-mail at [email protected].