In Reply.—Besides thanking Dr Elson for giving me many new examples of ad hominem abusive arguments for my next group of logic students, it is difficult to know how to respond to his letter. Let me begin by stating that it was not my intention to fuel further the debate between ear, nose, and throat specialists and plastic surgeons with regard to who should be able to perform cosmetic surgery. Since the editorial footnote that accompanied my article was hardly a ringing endorsement of my thesis, it seems unfair to use my article to mount an attack against this journal and the medical specialty it addresses. Despite this misplaced attack, I was nevertheless delighted to learn that Dr Elson found my article so stimulating. Unfortunately, however, if I limit my response to those portions of his letter that do not misrepresent and mischaracterize my article, there is not much