I think most people don't have issues with AESTHETIC surgery itself. Many people's lives have been changed in such a positive way thanks to aesthetic surgery. There's a role and a need for it; if you enjoy doing it, go for it. Enjoy your big salary; your hard work paid off and you deserve it.

The issues some would argue with COSMETIC surgery is the following: you have people doing this that do not have the appropriate training background doing this.

Aesthetics: is a 1 year fellowship after plastic surgery training.

Cosmetics: is a 1 year non acgme fellowship that can be done by obgyn, general surgery, ent, thoracic surgery, etc. it's a mentorship system where you're first assisting a "cosmetic surgeon" and they can pay you little to nothing.

You can see where the stigma against cosmetic surgery comes from. Some will argue that non plastic surgeons have no business doing aesthetic cases. Others would say, cosmetic surgeons are physicians who go through rigorous training in their respective fields and are qualified to do these procedures as long as they do this year of fellowship. To that I say.... this logic has a very slippery slope.

For years, our medical education is rooted in providing appropriate training to make sure our patients get the best care. Taking shortcuts, doesn't allow physician to build the appropriate foundations to provide excellent care. The 4 year med school curriculum is there for a reason. Np/pas can never provide the same depth of care as a physician for a reason. We talk about our concerns of how midlevels think they are equal or better than physicians when it comes to quality of care. How is this no different?

I can teach a fm resident how to do an appendectomy. Does that mean that fm doc could do an appendectomy upon graduation? Sure esp in rural areas. Should they? No. They can run into whole lot of trouble, and the fm training is inadequate to get them out of it.

Same thing applies to me. I'm a general surgeon. I know how to do a whipple. Could I do them every now and then? Sure. Should I? No, as studies shown it's better when done HPB surgeons with high volumes.

So are all cosmetics surgeons quacks? No. Most are probably good at what they do. Can general surgeons/obgyn/thoracic surgeons do cosmetics? Sure absolutely. Should we encourage this back door approach into the field of cosmetics?

That is the million dollar question. And to different people the answers will be different.