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Discussion in 'Ophthalmology: Eye Physicians & Surgeons' started by broadway, May 2, 2007.
Is it beyond the scope of an ophthalmologist to do liposuction?
Unless there is a new tool for peri-orbital fat liposuction.
Hmmm...Maybe I should invent this!
To answer this question differently...do you think it is beyond the scope of a plastic surgeon to do cataracts?
Depends on where the lipo is being done. I did my oculoplastics rotations with a well-respected, asoprs fellow-training, oculoplastic group where the guys do lipo under the chin to complement other facial rejuvenation such as thermage, injectable fillers, and laser resurfacing. It seems totally appropriate in terms of location and context of other services provided.
I do not think it is outside the scope of oculoplastics to do liposuction for reconstructive purposes. I've done abdominal liposuction to harvest fat for an orbital case. There is really no mystery to it. I do think it is outside the scope of ophthalmolmolgy to do cosmetic tummy tucks. There are an ever increasing number of oculoplastics folks interested in cosmetics, for which I think liposuction of the head and neck is acceptable and within the the scope of their practice/training. The butt? Thighs? No.
I think that with the appropriate training it is completely acceptable. In the course of my oculoplastic fellowship I learned to operate well outside the head for harvesting purposes: dermis, fat, fascia lata and skin all of which require an ability to plan, operate and provide postoperative care for operative sites elsewhere. Liposuction for harvesting purposes versus for cosmetic purposes needlessly confuses the issue. In either case, the surgeon must know the indications, the procedure and how to provide appropriate postoperative care. As long as you can meet those requirements, the purpose for doing the liposuction procedure is secondary.
One business consideration is the issue of malpractice liability. A practice that does liposuction for cosmetic purposes can face substantially higher liability insurance costs than a practice that does not. Much depends on how you present your practice to your patients and the volume of cases you do for cosmetic indications only. Many insurers want to see your advertising copy before providing a rate quote, for example.
I do not do liposuction in my practice and would not particularly want to spend a lot of time in a cosmetic body contouring type of practice. But I do not think that should be a procedure that is off limits either. (I have reservations about the particular procedure of liposuction with translocation of fat elsewhere as a filler largely because I suspect that it becomes devitalized, but that is besides the point.)