The History of ASAPS on its 50th Anniversary Open Access

In 1967, two plastic surgeons, Dr Simon Fredricks and Dr John Lewis, started a new society within plastic surgery strictly committed to aesthetic surgery called the Society of Aesthetic Surgeons.¹ While at a meeting in Italy, they first discussed the formation of the society at the Excelsior Hotel in Florence, Italy.² They initially thought the society would be a travel club of 28 friends who would discuss aesthetic surgery in exotic locales.³ They wrote down the original group of members on a napkin at Harry’s Bar in Venice, and this list contained some of the most influential plastic surgeons of that era who performed aesthetic surgery² (Appendix A, available online as Supplementary Material at www.aestheticsurgeryjournal.com).

At that time, aesthetic and cosmetic surgery was not accepted into mainstream plastic surgery. And decades before, surgeons who performed cosmetic surgeries could have been considered quacks.³ Original manuscripts and lectures on aesthetic surgery were summarily rejected at all major national and international meetings. Courses to teach and exchange ideas in aesthetic surgery did not exist. There was only one reputable textbook on cosmetic surgery at the time, Fomon’s Cosmetic Surgery (Lippincott, 1960).⁴ Many training programs in the United States diminished the value of aesthetic surgery within plastic surgery. In order to learn aesthetic surgery, young surgeons would have to observe or be an apprentice under more established surgeons. During that period, most surgeons were secretive and did not wish to share their knowledge or allow visitors into their operating room. Some would even require a recommendation from a confidant or fees to watch them operate.⁵ As one might imagine, young surgeons faced many challenges and had to expend considerable effort to pursue subspecialty training.

The original Society of Aesthetic Surgeons has turned into one of the largest and most influential aesthetic surgeries societies in the United States. This transformation occurred through efforts of all of the presidents of the society over the last 50 years (Appendix B, available online as Supplementary Material at www.aestheticsurgeryjournal.com). Today, the American Society for Aesthetic Plastic Surgery (ASAPS) has over 2600 members and continues to grow.⁶ ASAPS has partnered with many international and foreign aesthetic societies and has members from 38 countries.⁶ The society’s mission is to promote education, research, patient safety, and advocacy within aesthetic surgery. The society maintains its strict requirements in order to gain membership. The society also expects its members to strive for excellence in their work while maintaining the highest standards in patient care and safety.

In order for one to become a member of ASAPS, the following requirements⁶ must be satisfied: (1) be certified by the American Board of Plastic Surgery, or certified in plastic surgery by the Royal College of Physicians and Surgeons of Canada; (2) participate in accredited Continuing Medical Education (CME) programs; (3) performed a substantive and varied amount of cosmetic surgery cases; (4) sponsorship from 2 current ASAPS members; and (5) adhere to ethical guidelines set forth by the ASAPS bylaws, code of ethics, and conflict of interest policies.

BRIEF HISTORY OF ASAPS

In 1967, shortly before the inception of ASAPS, Thomas Baker and Howard Gordon decided to invite aesthetic surgeons to lecture and share their knowledge at the first Baker-Gordon Symposium in Miami, Florida.

The first group of surgeons invited to perform live surgery included Salvador Castanares and Thomas D. Rees. Both were initial members of ASAPS. Approximately 20 plastic surgeons attended this meeting and approximately 50 years later, this annual meeting continues to be held in Miami and is one of the largest symposia with live aesthetic surgery.

The first unofficial meeting of ASAPS took place at the Royal Orleans Hotel in October of 1968 in New Orleans, Louisiana. There were approximately 100 attendees who all met in the Dauphine Room to discuss the latest advances and techniques in aesthetic surgery. At the time, Dr Stanley Klatsky had completed his plastic surgery training at Columbia-Presbyterian Hospital in New York City under the guidance of Dr George Crikelair. Dr Klatsky planned to move to the Baltimore metro area to begin his private practice. At that meeting, Dr Klatsky was fortunate enough to be sitting next to Dr Simon Fredricks and struck up a conversation. Dr Simon Fredricks had spent time at Johns Hopkins and then moved to Houston and developed an instant connection with Dr Klatsky. Dr Fredericks appointed Klatsky as the first candidate member of ASAPS which led to Klatsky’s involvement with the organization and eventual development into becoming president of the society.

The first ASAPS scientific or annual meeting was in 1969 in Miami, FL. There were approximately 100 attendees, and it was at this meeting were the name was changed to ASAPS.⁵ The initial by-laws and constitution were drafted at this meeting. In its early stages, ASAPS was primarily run by a small group of organizers consisting of the founders and their wives. Even the first logo was created by Chris Lewis, wife of one of the original founders, Dr John Lewis.⁷ There was a general do-it-yourself attitude that pervaded throughout the organization and growth continued in the years to come. More ASAPS-sponsored meetings and courses took place, and the society established itself as a strong stand-alone organization despite concerns of developing friction with American Society of Plastic Surgery (ASPS). It took 8 years to sponsor a rhinoplasty symposium with the ASPS which was initially denounced by ASPS members, but in retrospect proved to be a great success.⁴ The American College of Surgeons (ACS) also granted ASAPS a seat on the governor’s board.

Throughout the 50 years, ASAPS has many accomplishments to boast and has changed considerably since its early days. Despite early resistance towards accepting aesthetic surgery into the mainstream of plastic surgery, the society cosponsors numerous national and regional meetings dedicated to teaching and training of plastic surgeons. What were once one or 2 meetings a year have now evolved into multiple ASAPS sponsored and endorsed events occurring on an annual basis. Highlighted are a few of the major meetings and courses that have taken place: Aesthetic Meeting, Aesthetic Symposium, Cutting Edge Symposium, SESPRS Annual Oculoplastic Symposium, Annual Rhinoplasty Society Meeting, Baker-Gordon Educational Symposium.

The aesthetic fellowship affiliated with the Manhattan Eye, Ear, and Throat Hospital in New York City, is the oldest such program in the United States. This program began in 1970 and was directed by Dr Thomas Rees but is now under the tutelage of Dr Sherrell Aston. It formed a few years after the creation of ASAPS primarily to address the lack of subspecialty aesthetic surgery training at the time. Now there are a total of eighteen ASAPS-approved fellowships run by some of the most prominent plastic surgeons and ASAPS members.

In 1974, the American Medical Association (AMA) approved granting CME credit for courses and symposium associated with ASAPS. In the same year, ASAPS started the visiting professorship program and it sponsors visiting professors who travel around the country to educate residents, fellows, and board-certified surgeons about aesthetic surgery.

In the early 1980s, an administrative office was created in the Long Beach, CA to handle the growth and complexity of the society. In 1986, the first international meeting in aesthetic plastic surgery took place in China. The Communications Office was created in the early 90s to provide accurate information and news regarding aesthetic surgery. In the 90s, the society maintained a budget of approximately US$5 million and has had steady profits which have been invested towards education, grants, patient safety, and advocacy efforts.

ASAPS is closely tied to the peer-reviewed Aesthetic Surgery Journal (ASJ) which is the premier publication of aesthetic surgery. Initially, “Aesthetic Surgery” was a newsletter with some updates on the field with minimal clinical content.^3,8 As time passed, there was a need for a more full fledged journal with articles that underwent peer review. ASJ was founded in 1996 and its impact factor (2.502 in 2016) in surgery has increased steadily over the years due to the efforts of its editorial board. The journal was also indexed in PubMed in 2008. What was once an aesthetic surgery newsletter published by ASAPS has now become the foremost aesthetic surgery journal in the world. Beginning in 1997, ASAPS manages the oft-cited Cosmetic Surgery Statistics National Databank which tabulates statistics regarding cosmetic procedures performed annually in the United States. ASAPS has invested in the younger generation of plastic surgeons by making contributions to ASJ to provide complimentary access to residents and fellows in plastic surgery.⁹

In the new millennium, ASAPS formed the Aesthetic Surgery Education and Research Foundation to promote evidence-based research by funding scientific studies and educational endeavors of plastic surgeons. ASAPS and ASJ both have developed their own online websites and have extended their presence through social media (ie, YouTube, Facebook, Twitter). In the past decade, ASAPS has partnered with realself.com and other plastic surgery related websites to promote patient education. One of the primary goals is to help patients navigate and find board-certified plastic surgeons who are ASAPS members.

In 2010, ASAPS formed a marketing task force to detail how plastic surgeons who are ASAPS members are different from cosmetic surgeons or providers from other disciplines. In the past 5 years, task forces have been formed to address the scope of stem cell therapies and patient safety in outpatient surgery settings. The “We Are Aesthetics” campaign was launched in 2014 to describe the society’s uniqueness, dedication, and vision through all its efforts. The RADAR app (made by Anzu Medical) for mobile devices was conceived in 2010 with the goal of educating plastic surgeons and trainees on current technologies and procedures. It also serves as a guide to all content from ASJ and annual aesthetic conference, courses, and symposia. It now contains procedural videos, newsletters, and marketing advice. The society also offers free legal advice, marketing tools (Smart Beauty Guide), and practice building materials for its members. Looking ahead, ASAPS and ASJ would like to continue to impact training programs by emphasizing more exposure to aesthetic surgery and encouraging higher level, evidence-based studies performed at major academic institutions.³

In its first 50 years, ASAPS has experienced a level of success not envisioned by its founders and early members. In its campaign for emphasizing the importance and influence of aesthetic surgery, the organization has many achievements to be proud of. It continues to grow and expand as one of the major aesthetic societies in the world.

Supplementary Material

This article contains supplementary material located online at www.aestheticsurgeryjournal.com.

Disclosures

The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Funding

The authors received no financial support for the research, authorship, and publication of this article.

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