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Medical officials clarify policy on cosmetic surgery

WASHINGTON (AFPN) -- Air Force doctors perform cosmetic and reconstructive surgeries as part of essential training, but elective cosmetic procedures such as breast augmentations are not routinely available as perks to servicemembers and their families, according to Air Force Medical Service officials.

Recent published reports in civilian media suggested that elective procedures are prevalent in the military health-care system. Some reports also indicated that free cosmetic surgery is common among servicemembers and their families.

Air Force doctors, and their counterparts across the Defense Department, perform elective cosmetic surgeries, but not to the extent people have been led to believe, according to Air Force Medical Service officials.

In fiscal 2003, Air Force doctors performed roughly 50,000 total procedures, of which 405 fell into the six categories of cosmetic surgery: abdominoplasty or “tummy tuck,” 25; blephraplasty, (eyelids), 50; breast augmentation, 116; face lift, 31; liposuction, 151; and rhinoplasty, (nose), 32.

“The fact is all beneficiaries are eligible for these procedures but there are policies in place to govern this aspect of the military health-care system,” said Lt. Col. (Dr.) Joseph Legan, the Air Force Medical Service’s chief consultant for surgical services.

“There is no charge for reconstructive surgery related to trauma, burns or disease,” Doctor Legan said. “Solely cosmetic surgery for an active-duty Airman requires no payment unless cosmetic implants are part of the procedure; the implants are paid for by the Airman prior to surgery.”

No surgery is done on active-duty members for weight reduction, Doctor Legan said.

“For other beneficiaries, solely cosmetic surgery is chargeable based on the procedure and whether it is performed on an inpatient or ambulatory basis,” Doctor Legan said.

Payment arrangements are finalized before patients are placed on the surgery schedule.

Doctor Legan also said that solely cosmetic surgery is done only on a space-available basis, and may constitute no more than 10 percent of a plastic surgeon's workload.

He emphasized that such skills are crucial for Air Force doctors to keep pace with their civilian counterparts.

“Air Force plastic surgeons, as with other specialists, require hours of education, training and continuous practice to keep their skills within medical standards,” Doctor Legan said. “Without cosmetic surgery as part of their scope of practice, they would be deprived of experience in a fundamental part of their field.

“Additionally, military surgeons perform reconstructive surgery that often entails some degree of aesthetics,” he said. “Experience with cosmetic cases gives surgeons an ability to achieve the best possible results for reconstructive patients.

“The majority of our cosmetic cases are done in conjunction with training of surgical residents,” the doctor explained. “This not only teaches skills but is a necessary part of training well-rounded surgeons who are every bit as good as their civilian counterparts in all aspects of their respective surgical specialty.”

Within the Air Force, plastic surgery is currently available at Wilford Hall Medical Center in San Antonio; Wright-Patterson Air Force Base, Ohio; Keesler AFB, Miss.; Travis AFB, Calif.; and Andrews AFB, Md.

Medical service officials said cosmetic surgeries could also be performed by doctors other than plastic surgeons, specifically general surgeons, ophthalmologists, ear nose and throat surgeons and oral surgeons. The Air Force Academy has ophthalmologists and ENT surgeons who have done some cosmetic cases.

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