Plastic surgery. Few of the body-centered ideas trigger so many emotional reactions and opinions. Reconstructive and corrective procedures have been a part of the history of medicine since ancient times. The introduction of advanced elective treatments over the past few decades has turned cosmic surgery into a nearly $ 20 billion industry in the United States alone. The increase in disposable income, the growing impact of mass media and the importance of celebrity and influencer culture are contributing to the steady growth of the market.
Just last month, a single social media post sparked fierce discourse within the fashion, beauty and cosmetic surgery industries. Model Linda Evangelista shared with her million followers on Instagram a dramatic story of “disfigurement” suffered as a result of cryolipolysis or CoolSculpting. She filed a landmark $ 50 million lawsuit against ZELTIQ Aesthetics, the company behind the treatment. Ongoing public coverage calls into question the role of plastic surgery in our media lives.
The United States consistently ranks first in the world for the number of non-invasive procedures and overall spending on elective cosmetic treatments. To better understand the complex socio-economic dynamics within this market and the potential impact of Evangelista’s disclosures on consumers and service providers, it was time to turn to industry insiders. I reached out to Jerry Chidester MD, a Utah-based expert plastic and hand surgeon with an inspiring and educational social media portfolio where he is better known as Doctor Chiddy. From browsing headlines to engaging audiences with informative captions to sharing big projects, we discussed what makes a successful cosmetic clinic business today.
Let’s jump in. How could something like this happen to someone like Linda Evangelista?
First, it is truly unfortunate for Linda Evangelista that she suffered from a seemingly rare condition known as Paradoxical Fat Hyperplasia (PAH) from CoolSculpting. Patients, celebrities or not, are looking for non-invasive or minimally invasive procedures to reduce downtime and risk. However, every procedure carries risks, even potentially unwanted effects that can leave a patient worse off than when they started. It is extremely important to be fully informed of any chosen procedure, including rare complications. This should be discussed openly both during the initial consultation and during the pre-treatment appointment. I believe women like Linda Evangelista have led the fashion and beauty industry, playing an important role in what people perceive as changing standards of beauty. Unfortunately, this is also an opportunity to advance our understanding once again.
How would you rate the overall impact of celebrity culture and social media on the cosmetic surgery field?
Social media influencers play an important role in what the public considers desirable, more than any magazine or TV show before. On the other hand, for people curious about aesthetic procedures, social networks allow them to learn at their own pace. As they become more comfortable, curiosity turns into informed action. My DMs are full of questions about the risks, benefits, and recovery for various procedures and surgeries. Obviously, I do not offer medical advice by courier. However, I am regularly available on Instagram Live for general inquiries.
Speaking of which, what role does social media play in the work of healthcare professionals these days?
I tell people that social media has rebuilt my practice. I took advantage of the lockdown last year to invest in my presence on Instagram, Facebook and TikTok. It magnified my voice to educate the public and fight misinformation. My strategy was simple: be consistent, be honest, be informative, and be myself. it seems to work ! Social media has made my clinic a national business. Almost 40% of patients now come from the other 49 states and Puerto Rico. Being “insta-popular” as a doctor is rewarding, but also trying. Reward in what people see me as the voice of reason in plastic surgery. My advice matters. Tax, because it takes enough time. Ultimately, I appreciate the responsibility and the positive change it has brought to many. I now devote some of my time to helping other surgeons strategically implement social media in their practice. In fact, the American Society of Plastic Surgeons (#ASPS) just invited me to speak on this specific topic.
You mentioned confinement. How has the pandemic impacted the field of plastic surgery? The other day someone joked with me that they should put their “Zoom Face” on… Do remote work and videoconferencing influence decision-making regarding cosmetic procedures?
In my professional experience, the impact of the pandemic has been twofold. First, during the closures in spring 2020, we saw an influx of patients for the first virtual consultations. When elective in-person medical services resumed in May, demand had increased exponentially. We found that new and old patients felt they now had time to recuperate at home due to remote work and mask mandates to discreetly cover up any bruising or swelling in public. Second, besides the increased use of social media, being on Zoom and other video technologies has forced people to watch themselves on screens several hours a day. This correlates with the growing demand for facial related treatments and procedures like Botox, lip fillers, chemical peels, and lasers. People prioritize their appearance for the realities of a digital workforce.
Are there any circumstances in which you would advise against a procedure for a potential patient?
Any patient who is not physically or mentally fit to undergo a procedure is not a candidate. This is medical ethics 101. From a surgeon’s perspective, in the age of filters it is extremely important to display honest surgical results without “photoshopping” to improve their appearance. Otherwise, the audience is comparing apples and oranges in terms of realistic expectations. Transparency trumps business acumen and technical know-how to build trust with patients. For example, I always stress the importance of understanding that results are not instantaneous. Popular “Before and After” photos do not show the swelling, bruising, discomfort, complications, and revisions in between. I try to share patient journeys (with their permission) to highlight these often overlooked aspects of plastic surgery.
What motivated you or continues to motivate you to work in this high-stakes field?
When I decided I wanted to pursue a career in plastic surgery, I was motivated by the fact that it would always keep me on my toes. It is an area that continues to innovate and evolve. I am now driven by the desire to integrate a holistic approach to healing which addresses not only the physical nature of plastic surgery, but also the emotional, mental and spiritual components. I find it appropriate that Salt Lake City consistently ranks in the top 10 for the most plastic surgeons per capita in the United States. Utah’s tourism slogan is “Life Elevated” which I think resonates with the life changing work of our patients. There is something special about this place that does wonders for recovery. I believe that in the near future we have the potential to fundamentally change the way we approach plastic surgery.
Who informs your personal and professional ideas of beauty?
I have noticed that contemporary visions of beauty have become a multicultural and multiracial mix. There is no longer a dominant norm and it is very empowering and liberating. Photographers like Mario Testino, Mert Alas, and Lina Tesch (to name a few) provide insight. Professionally, my inspiration comes from great plastic surgeons like Dr Alfredo Hoyos in Colombia (who by the way has nearly a million followers!), Dr Michael Miroshnik in Australia and Dr Baris Cakir in Turkey. It is a global industry and an international community of united peers. Each of them is a pioneer and an icon in my specialty and I admire them.
What is the most pressing question that comes to your mind right now?
How can I help transform plastic surgery into the 21st century? The most powerful myth about cosmetic surgery is that it makes people look “wrong”. The majority of our patients seek to restore a certain aesthetic that they have lost due to injuries or illnesses or to improve an area of the body that has always been of concern to them. They want subtle or even imperceptible changes. Educating the public through my work is a real vocation. How can I continue to innovate, improve and inspire so that people can undergo these life affirming procedures with confidence?