Already here....

Implications: Discount cosmetic surgery is already here, but not via large commercial companies.  Retention of actual plastic and reconstructive surgeons may be difficult if they are not paying well.  There is a place for this, however the solo practitioner will continue to have word of mouth and a place.

Analysis: There are already discounters of cosmetic surgery and some of those are on a large scale.  They typically employ surgeons directly out of training with a "Board Certified Surgeon" on-staff. 

Is this a bad thing? Well, caveat emptor.  Will it replace the present system, probably not.  However there is a place for it for people who care more about price.  The self limiting part of this is whether or not they have an increased amount of complications...but those will go unreported....we will never know.

The lawsuits, or lack of, will tell...

Retention of actual plastic and reconst5ructive surgeons will be difficult over long periods.  Fortunately, there are a lot of other doctors calling themselves cosmetic surgeons....