Plastic surgery is an interesting medical specialty that uses a number of surgical and nonsurgical techniques to change the appearance and function of a person's body. (Comstock Complete)

Plastic surgery is an interesting medical specialty that uses a number of surgical and nonsurgical techniques to change the appearance and function of a person's body.

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The word "plastic" derives from the Greek plastikos meaning to mould or to shape.

As a medical student in Manitoba, most of the procedures I saw were functionally reconstructive operations after trauma or diseases. Later as a community physician I became more aware of the more cosmetic enhancements that emphasized improved aesthetics and were considered elective surgery. These being non-essential procedures they of course are non-insured and can be increasingly expensive.

While many Manitobans stay locally to get procedures, some travel to other countries as "surgical tourists" for procedures that may not be offered locally or for better prices.

Anyone of course may book a trip anywhere and register themselves at a foreign clinic. However concerns about the quality and safety of work emerge as returnees encounter difficulties and complications.

I spoke with several Winnipeg plastic surgeons who related many of the complications they encounter with patients who had received procedures abroad.

"What you get is what you paid for," summarizes the quality of the work done. They review patients with significant complications such as empyemas (pus in the lungs) from overlying skin infections. It is ironic that people seeking to look more beautiful would be so sick from sloppy work. Simple surgical procedures were obviously done quickly and carelessly that should have easily been prevented.

These people also have no recourse for follow-up except at home as the original surgeon is usually beyond reproach or litigation in a developing country.

LOSE QUALITY ASSURANCE

Of course many people undoubtedly have straightforward procedures and are content. But people seeking plastic surgery outside our health-care system also lose the quality assurance and regulatory bodies that ensure clinics do not cut corners on safety or cleanliness. Each patient should have a connection with their plastic surgeon for follow-up after surgery and appropriate check-up appointments. Sometimes a revision or adjustment needs to be done.

Having a plastic surgeon you can actually return to see, if you have a problem, is a great relief for patients.

I have great respect for the reconstructive work done by my Winnipeg colleagues and recognize that they also spend time on people who want to improve their appearances. I would encourage Manitobans seeking cosmetic procedures to consider going local despite any deals they may find overseas. All of the plastic surgeons I know do much more than just nose jobs, tummy tucks and breast implants. Having a surgeon who is more than a simple procedurist guarantees a much higher level of quality patient care.

The Canadian Association of Plastic Surgeons (www.plasticsurgery.ca) makes some suggestions for how to select a plastic surgeon, including how they are certified, complaints and feedback from regulatory bodies. The association does state that there is no foolproof way to choose a plastic surgeon or to guarantee your results and this should always be kept in mind.

Cosmetic surgery is frequently a source of amusement and jokes in our culture but for many people who do choose to change themselves for a variety of reasons, it is important to supply them with good and competent care and not let them be taken advantage.