Pediatricians, family doctors, internal medicine specialists and other doctors increasingly practice outside their specialties, offering cosmetic procedures that put patients at risk. "It's absolute cowboy medicine. It's Wild Wild West stuff," plastic surgeon Keith Jeffords said. Georgia is among the states that do not regulate in-office operations or restrict doctors' practices. Doctors who are not board-certified in plastic surgery put patients at risk for more complications because they have not had rigorous training in the field and do not know how to screen out unsuitable plastic surgery candidates, said plastic surgeon Susan Kolb.