Cosmetic surgery continues to be vilified as the greedy stepchild of dermatologic surgery. Although Mohs micrographic surgery has achieved acceptance within academic circles as a necessary if anti-intellectual endeavor, cosmetic surgery has not. The most successful operators of private laser centers and cosmetic surgery 'spas' are viewed by some academics as slick, glib businessmen who have reduced dermatology to cosmetology. They may be perceived as proponents of expensive but ineffectual treatments who pander to the often unreasonable vanity of their clients for profit. The practitioners' credibility is further eroded because they court the media, particularly the editors of glossy lifestyle magazines. Finally, the high income requirements of cosmetic surgeons and their relative lack of interest in the work of the university dermatology department ensures that they are resented by many full-time dermatology faculty. As a result, when teaching hospitals hire cosmetic surgeons, the union may be bitter and brief.
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