Dear Editor:

I recently came across Malcolm Paul, MD’s articulate defense of the Lifestyle Lift, as published in PSP magazine in September 2012. I practice in an area where there are several surgeons who offer the Lifestyle Lift. Paul’s article glossed over the indisputable facts that the Lifestyle Lift company was fined $300,000 in New York by the Federal Trade Commission for filing fake online reviews, and your article came out too soon to list the fact that the company was subject to a “cease and desist” order from the Attorney General in Florida for calling the procedure “revolutionary” and “ground breaking,” and instructed to reimburse payments made by prospective patients who canceled surgery and did not get a refund of their deposit. These are not the actions of a company that is striving to maintain high ethical standards.PSP09_2012_lifestyle_lift

I find the advertising by the company to be disingenuous in portraying dramatic results with minimal surgery, while adding the disclaimer that “additional” procedures were done, without enumerating these additional procedures.

My real problem with the company is precisely what you propose to be its strength: a streamlined, efficient business model that takes the surgeon out of the equation until almost the day of surgery. We are not just technicians offering a manual service. We are physicians first, and I will never operate on a patient who I did not consult on in advance.

I have heard over and over from former Lifestyle Lift patients who come to see me that they did not even see a surgeon until surgery had been scheduled and they had paid. The person they see is an employee of the Lifestyle Lift Company who is specifically trained to “close the deal.” I repeatedly hear that patients felt they were subjected to a “hard sell” approach, something I associate more with selling used cars than with surgery. In addition, many patients have informed us that they felt the magnitude of, and discomfort from, the procedure were misrepresented, and that it was much more surgery and more painful than they were led to expect. This makes me question the protocols for obtaining informed consent from patients.

It is also a fact that many, if not most, facilities that offer the Lifestyle Lift are not accredited. True, they don’t have to be, since the procedures are being done under oral sedation and local anesthesia. My partner and I chose to build our office with a surgical suite that is licensed by the State of Florida as a full ambulatory surgery center, capable of offering any type of anesthetic, including general anesthesia. We did this at great cost to us, and lowered profits, because we wanted to not just meet, but also exceed, the requirements for patient safety. Operating in a nonaccredited facility goes against the guidelines of the American Society of Plastic Surgeons, in spirit, if not in fact. While, technically, Level 1 cases probably do not fall under this rule, it still reflects a willingness to “get by” that I feel has no place in our specialty.

I am surprised that a properly trained, board-certified plastic surgeon would affiliate themselves with such a company. At a time when we are seeing more and more competition from surgeons purporting to be “plastic” or “cosmetic” surgeons, without the requisite residency training and certification that we labored so hard to obtain, I cannot imagine why anyone would take a position that only further undermines our claim to legitimacy as plastic surgeons. I can only guess that the operating principle here is that “if you can’t beat them, join them.”

It is my opinion that practices that rely largely on patients from their advertising don’t have to be as concerned about results, since there will always be new patients gleaned from their marketing. In my practice, more than 90% of patients that come to me are referred by former patients.

Sincerely,

Richard T. Bosshardt, MD, FACS

Tavares, Fla

Malcolm D. Paul, MD, FACS, responds:

Dear Editor:

Lifestyle Lift was in the process of achieving accreditation for each center, even though Level 1 anesthesia does not require one to operate in an accredited facility. Lifestyle Lift surgeons have as much, or more, facelift experience than anyone else—both within the US and elsewhere—and I would match many of the results that I have seen with those published and presented at national meetings. We have limited our recruiting to board-eligible or board-certified surgeons from Plastic Surgery, Facial Plastic Surgery, and Ear, Nose, and Throat/Head and Neck.

Being involved at the operating and consulting level, my experience has been that no surgical plan is agreed to nor performed without a preoperative consultation with appropriate medical clearance when indicated. These surgeons typically performed hundreds of aesthetic facial plastic surgery procedures per year, and most joined so that they could stop running a business to focus on what they enjoy most: operating and taking care of patients.

All of the above may be of historical interest because the Lifestyle Lift Company is in the process of filing for bankruptcy protection.

The demise of the company was likely due to an overaggressive expansion during the great recession, and had nothing whatsoever to do with the 80-plus surgeons who I was proud to associate with.

Malcolm D. Paul, MD, FACS

Lifstyle Lift Consultant/Surgeon

Newport Beach, Calif

Editor’s note: At press time, Lifestyle Lift shut down the majority of its business and said it is considering filing for bankruptcy.

Much of the controversy surrounding Lifestyle Lift’s modus operandi played out on the pages of PSP magazine. ?Here is Paul’s original article and a rebuttal from nine physicians: http://tinyurl.com/mp5sx6x?  and http://tinyurl.com/pusc46d