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    Fewer regulations enable South American surgeons to maintain innovation, creativity

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    Just as it is in most countries and cultures throughout the world today, cosmetic surgery is very popular in South America. But one internationally renowned surgeon says what differentiates the field on this continent is the pioneering spirit that is driving the industry.


    Dr. Blugerman
    "Cosmetic surgery in South America has always been very popular and has traditionally been at the forefront of innovations in terms of evolving surgical techniques and procedures. This may be due to the creativity of the surgeons, coupled with relatively mild restrictions from medical regulatory bodies," says Guillermo Blugerman, M.D., co-director with Diego Schavelzon, M.D., of Centros B&S de Excelencia en Cirugía Plástica, Buenos Aires, Argentina. Dr. Blugerman is also president of the Argentine Association of Cosmetic Medicine and Surgery and the only honorary member of the American Academy of Cosmetic Surgery (AACS) from South America.

    More than a decade ago, Dr. Blugerman was part of the team that helped to develop laser-assisted liposuction with the Smartlipo (Cynosure) device, which received approval from the Food and Drug Administration in 2006. He has also been working with the BodyTite (Invasix) device, a radiofrequency-assisted liposuction technique that is pending FDA approval, for the past three years. He has 20 years' experience with numerous semi-permanent fillers composed of polymethyl methacrylate (PMMA), one of which received FDA approval several years ago (Artefill, Suneva Medical).

    FREEDOM TO EXPLORE South American surgeons have the advantage of exploring new frontiers and testing fledgling techniques, Dr. Blugerman says, because of more lenient regulations imposed upon the physicians and the available cosmetic products, working inside of the ethical limits of the profession. According to Dr. Blugerman, many unethical procedures, such as liquid silicone injections in the gluteal or breast, are performed by criminal "colleagues" who pose a danger to the health of patients.

    "I believe that the excess of regulations in the United States limits the use of newer techniques and evolving medical devices. As a case in point, we never stopped using silicone breast implants in our patients during the FDA moratorium in the 1990s. These have recently become very popular again in breast implant surgery in the United States. Moreover, I believe that the malpractice industry in the United States clearly limits the doctors' spirit to be innovative," he says.

    Of the more invasive cosmetic surgery procedures, the most popular ones in South America are very similar to those performed in the United States. They include the varying techniques of liposuction, breast augmentation, rhinoplasty, facelift, abdominoplasty, blepharoplasty and hair restoration.

    According to Dr. Blugerman, cosmetic surgery is very popular throughout South America, particularly in Brazil and Argentina, followed by Colombia and Venezuela. This may be directly related to the size and economic status of those countries as compared to other South American countries, he says.

    "The choices of procedures performed are related to the phenotypic characteristics of the population in a particular country," Dr. Blugerman says. "Buttock implants are very popular in Paraguay because Paraguayan women typically have a flatter gluteal region, and therefore, will often request volume enhancement procedures here. Calf augmentation and buccal fat pad extraction are popular procedures in Chile, Bolivia and Peru because of the racial characteristics of these populations."

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