Avoiding the Cosmetic “Wild West”

First, we need to refute an extremely common misconception. The terms “plastic surgeon” and “cosmetic surgeon” are not synonyms. Board-certified plastic surgeons undergo years of additional training and a highly rigorous and specific board-certification process. As for cosmetic surgeons, there are no legally required qualifications beyond having the same degree in general surgery all physicians must obtain. Some may take extra classes, but that’s a personal choice. They aren’t required to take any.

A recent Los Angeles Times article reported on a “cosmetic surgery wild west” situation with patients suffering sometimes dire or even fatal consequences following procedures performed by doctors calling themselves cosmetic surgeons. In one tragic incident, the Times reported that a woman passed away due to complications after a doctor performed liposuction. In this case, a trained pediatrician who had switched to cosmetic surgery without any additional training recklessly went ahead with an operation on a patient who had uncontrolled diabetes.

Plastic surgery is among the most demanding of all medical disciplines, so getting enough training could not be more important. Yes, cosmetic surgeons may tend to charge less, but there’s a reason we keep saying that shopping on price for plastic surgery is a terrible idea. It’s one thing to buy shrimp instead of lobster, heat the swimming pool only during the summer, or get your gasoline from Costco, and quite another to find a less expensive doctor for surgery. Apart from the importance of protecting your safety and appearance and avoiding the kind of horror stories you might see on a show like Botched, you might also want to consider that getting revision procedures can be vastly more expensive than simply paying a little more to ensure you get a good outcome the first time.

Safety in Non-Surgical Procedures

There are many other reasons to be careful of cut-rate providers, even for nonsurgical procedures that may seem relatively simple and easy to perform. In most cases, even these treatments are best performed by board-certified plastic surgeons, not only for maximum safety but for achieving the most desirable outcomes in terms of aesthetics.

Among the most popular of today’s “lunchtime procedures” that provide temporary improvements for issues such as wrinkling are injectables like Botox and facial fillers. While these can be highly effective, they must be touched up periodically to maintain results. Surgical facial rejuvenation procedures provide more long-lasting outcomes and can often be combined with nonsurgical techniques for maximum impact. Whatever choice you make, it’s essential to get your work from reputable medical providers who maintain strict best practices. This includes making sure they are not trying to cut corners by getting their materials from questionable providers.

Counterfeit Products

On May 1, 2024, the Food & Drug Administration (FDA), issued an official warning on the use of counterfeit Botox.* The statement alerted healthcare professionals and consumers that a wave of botulism poisonings in several U.S. states that sent 11 people to the hospital and sickened several others, was associated with counterfeit Botox sold by unlicensed providers. The FDA noted that the faux Botox was bought by both licensed and unlicensed medical groups. No doubt, many of the providers were fooled by false packaging, they all should have been aware of the risks of dealing with cut-rate suppliers.

The risks were especially high in this instance. As you may know, Botox is a derivative of botulism – in its pure form a dangerous toxin manufactured by a bacteria known as Clostridium botulinum. Of course, real Botox has been greatly diluted and altered. It’s long been FDA-approved and has been in wide use for decades, so it’s extremely safe. However, it is a product that should only be used by medical experts and, of course, made by its authorized manufacturer, AbbVie. All procedures carry some risks but using counterfeit products is playing Russian roulette with your appearance and health.

Playing it Safe with Plastic Surgery and Cosmetic Procedures

If you are considering obtaining plastic surgery such as a facelift or breast augmentation, you should only consider experienced board-certified plastic surgeons. It’s crucial both for ensuring your safety and obtaining the best possible aesthetic outcomes. On top of the two years of additional training required to become a plastic surgeon, board certification is essential to ensure your doctor is fully competent to perform plastic surgery.

The board certification process involves proving a doctor’s knowledge and abilities to a board comprised of leading plastic surgeons. It is highly rigorous and must be renewed every ten years to ensure doctors can perform quality work. While it is not a guarantee of a beautiful outcome, it does establish a baseline level of assurance that you are working with a competent professional. Getting the best possible results requires being highly selective.

Payam Jarrah-Nejad, M.D., F.I.C.S., F.A.C.S., better known simply as Dr. J, has made himself a leader in the ultra-competitive realm of Beverly Hills and Los Angeles plastic surgery. He has built an international following through social media and word of mouth. He has earned countless online 5-star rave views on RealSelf and Yelp, as well as the kind of outstanding results that you can see by browsing through our highly acclaimed before-and-after galleries.

To be able to always do his absolute best work with the highest level of safety, Dr. J also insists on being double-board-certified. This means that, in addition to regularly renewing his plastic surgery certification, he also maintains his board certification in general surgery, which most plastic surgeons allow to lapse. The doctor believes this ensures that all his skills remain finely honed and that he has the maximum number of skills and knowledge needed to perform the best and most consistent work.

Live the Dream® Now!

If you want plastic surgery or a cosmetic procedure, don’t wait for a “perfect time” which never arrives. Dr. J and his friendly and compassionate team of healthcare professionals invite you to get in touch to schedule an initial consultation. It’s the only way to find out if the procedure(s) you’re considering are right for you. To get started, call us at the phone number on your screen or reach out via our contact page today!


* “Counterfeit Version of Botox Found in Multiple States,” U.S. Food and Drug Administration (FDA). Updated May 1, 2024.


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