Ethical Considerations in Plastic and Reconstructive Surgery

Plastic and reconstructive surgeons care for a variety of patients, including those with recent trauma, chronic wounds, and craniofacial anomalies. Ethical questions in plastic and reconstructive surgery routinely involve informed consent, risk disclosure, and the roles of values such as cosmesis and functioning in clinical decision making. The April 2018 issue of the AMA Journal of Ethics also considers plastic and reconstructive surgeons’ potential conflicts of interests in commercial self-promotion and advertising, the roles of some in endorsing aesthetic norms that can be harmful to patients, and standards according to which plastic and reconstructive surgeons should be trained. 

Volume 20, Number 4: 307-417 Full Issue PDF
  • Case and Commentary
    Apr 2018

    When Is Posting about Patients on Social Media Unethical “Medutainment”?

    Katelyn G. Bennett, MD and Christian J. Vercler, MD, MA
    Plastic surgeons who use patient images for online advertising should ensure informed consent and not exploit the patient-physician relationship for gain.
    AMA J Ethics. 2018;20(4):328-335. doi: 10.1001/journalofethics.2018.20.4.ecas1-1804.
  • Original Research
    Apr 2018

    Facial Disfigurement and Identity: A Review of the Literature and Implications for Facial Transplantation

    William J. Rifkin, Rami S. Kantar, MD, Safi Ali-Khan, Natalie M. Plana, J. Rodrigo Diaz-Siso, MD, Manos Tsakiris, PhD, MSc, and Eduardo D. Rodriguez, MD, DDS
    Facial transplantation provides a viable option for those patients with severe facial defects who are more likely to adapt to their new facial appearance.
    AMA J Ethics. 2018;20(4):309-323. doi: 10.1001/journalofethics.2018.20.4.peer1-1804.
  • In the Literature
    Apr 2018

    Plastic Surgery’s Contributions to Surgical Ethics

    Chad M. Teven, MD and Scott B. Grant, MD, MBE
    Proliferation of innovative procedures and treatments in surgery has led to novel and distinct ethical challenges. Medicine can learn from plastic surgeons’ approaches to informed consent and potentially harmful treatments.
    AMA J Ethics. 2018;20(4):349-356. doi: 10.1001/journalofethics.2018.20.4.nlit1-1804.
  • Medicine and Society
    Apr 2018

    When Is Advertising a Plastic Surgeon’s Individual “Brand” Unethical?

    Carly P. Smith, PhD and Daniel George, PhD
    Advertising a plastic surgery practice on social media can be ethically fraught, and deceptive online marketing techniques can lead to patients feeling betrayed.
    AMA J Ethics. 2018;20(4):372-378. doi: 10.1001/journalofethics.2018.20.4.msoc2-1804.
  • Medicine and Society
    Apr 2018

    Can Plastic Surgeons Maintain Professionalism within Social Media?

    Pablo L. Gutierrez and Debra J. Johnson, MD
    Plastic surgeons’ use of patient images on social media should conform to the American Society of Plastic Surgeons’ advertising and image use guidelines.
    AMA J Ethics. 2018;20(4):379-383. doi: 10.1001/journalofethics.2018.20.4.msoc3-1804.
  • Medicine and Society
    Apr 2018

    What Should Be the Surgeon’s Role in Defining “Normal” Genital Appearance?

    Devan Stahl, PhD, MDiv and Christian J. Vercler, MD, MA
    Social and cultural influences significantly contribute to our conceptions of healthy and pathological anatomy, and surgeons play critical roles in how these influences are expressed in clinical settings and social media.
    AMA J Ethics. 2018;20(4):384-391. doi: 10.1001/journalofethics.2018.20.4.msoc4-1804.
  • Art of Medicine
    Apr 2018

    Instrumental

    Ryoko Hamaguchi
    This watercolor depicting students’ reflections on what they learned conducting autopsies won honorable mention in the 2017 Conley Art of Medicine Contest.
    AMA J Ethics. 2018;20(4):392-395. doi: 10.1001/journalofethics.2018.20.4.imhl1-1804.
  • Personal Narrative
    Apr 2018

    How Tattoos Can Complement Breast Reconstruction

    Lisa Franczak, CPCP
    Tattooing offers expanded possibilities for creative expression among women who have undergone mastectomies and breast surgeries.
    AMA J Ethics. 2018;20(4):396-402. doi: 10.1001/journalofethics.2018.20.4.mnar1-1804.