"Doing the Wife's Tummy Tuck" - An informal survey of surgeons' reactions

About 2 weeks ago, an American plastic surgeon told the story of how he performed his own wife's "tummy tuck" - a cosmetic surgical procedure to remove excess, sagging skin from the abdomen.  The blog post is on the popular medical blog aggregator site, KevinMD, and also on Dr. Di Saia's own website.  Rather than having me recount the story, I encourage you to follow one of the links and read the brief post for yourself.  Reading it on Dr. Di Saia's website may give you a better appreciation of his practice context and expertise.

I shopped this story around the surgeons' lounge last week and the response was vigorous and unanimous: Bad idea.  The surgeons expressed several concerns:

First, while the outcome for the patient/wife was good in this case, any surgeon knows that this will not always be so.  In the rare case when things go wrong in the operating room, it becomes an extremely stressful and dangerous situation very rapidly.  In those cases, the patient's best asset is a calm, dispassionate surgical team that can think clearly and act decisively.  Every surgeon I spoke with admitted that their judgement would suffer if they were called upon to lead the team managing their loved one's surgical crisis.

Next, many of the surgeons wondered about the possible effects on a marriage if the results of the surgery were not exemplary.  Would the wife be comfortable in raising a concern to her husband?  If her own lifestyle depended on her husband's professional reputation, would she admit that she was dissatisfied with the outcome?  How would the surgeon/husband balance his professional appraisal of the cosmetic result against his personal satisfaction with his partner's appearance?

One surgeon commented that there is a ethical prohibition against physicians establishing intimate relationships with their patients, and wondered how that principle should be applied in this case.  The intertwining of professional and personal relationships can be messy.

During the discussions, almost everyone commented that they had, at one time or another, rendered some medical care to their family members: antibiotics for strep throat, sutures for a cut suffered while at the cabin, or various and sundry slings, splints and bandages.  And, most agreed that, in case of an emergency with absolutely no other suitable care available, they would operate on a loved one to save their life.  But this doesn't apply to a tummy tuck - the ultimate in elective, cosmetic surgery.

Some other comments:

How would Dr. Di Saia obtain full, informed and free consent to blog/tell the world about his wife's surgery?  

Was there any commercial incentive to perform this surgery, and then tell the story (i.e. "I'm so confident of my skills that I operated on my own wife!")?

Did the facility where the surgery was performed have any rules about this situation?  How did the rest of the surgical team feel about this? 

What do you think?  Are we over-reacting to this story?