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Reply: Clinicians Performing Cosmetic Surgery in the Community: A Nationwide Analysis of Physician Certification.

And perhaps more lax overall, “The purpose of labeling these surgeons as practicing out of scope is not to ostracize or question technical skills or training. Instead, the point is to demonstrate the unregulated manner in which cosmetic surgery is being performed across the country.” Interestingly you state, “It also did not make sense to search for the non–Accreditation Council for Graduate Medical Education recognized terms of ‘cosmetic surgery’ and ‘aesthetic surgery’ as they are used in an inconsistent manner in the medical and nonmedical communities [our highlights].” You then end with the somewhat contradictory, “On consumer-facing Web sites, board-certified dermatologists appropriately call their work ‘cosmetic surgery’ or ‘aesthetic surgery’ [our highlights].” We suppose this is the crux of the issue. Although we wholeheartedly embrace the American Society for Dermatologic Surgery Association Truth in Medical Advertising effort and admire Dr. Ashley A. Smith’s work,2 the problem is that whereas “99 percent of [survey] respondents want to know what type of practitioner is performing their cosmetic medical procedure, and 95 percent want to know the board certification of their physicians,” we suspect that a great many do not know what that information means, which we believe is an inescapable conclusion of our study. DOI: 10.1097/PRS.0000000000001423