Cosmetic operations – breast implants, nose, chin and eye restructuring, facelifts and the like – are being performed by surgeons who are are not trained in plastic surgery, sometimes resulting in painful disfigurement. These services are often promoted by salespeople who allow the customer inadequate time to check the credentials of the surgeons or companies involved. In some countries there is no simple national and easily recognisable way for patients to know whether they are in safe hands because the surgery is not a recognised speciality. Anyone from fly-in fly-out operators with no qualifications to medical graduates and GPs can give themselves the title of “cosmetic surgeon”.
In the 1989 over 600,000 Americans had plastic surgery according to the American Society of Plastic and Reconstructive Surgeons (ASPRS), probably more than twice as many operations actually took place. ASPRS requires its members to have a medical degree, to have completed three years' surgical training and a three year residency in plastic surgery, and to have passed written and oral tests. But membership in ASPRS or any other recognized body is required to practice plastic surgery. Some companies offer to train doctors how to do chemical peels, a legitimate procedure to remove wrinkles or facial scars, and to market their services in one week. In the UK anyone who is qualified as a doctor is eligible to carry out cosmetic operations. Plastic surgeons having a certificate of accreditation from the Royal College of Surgeons spend a minimum of eight years in training.