Physicians enjoy considerable liberty in the creation of entrepreneurial ventures in the new frontiers of medicine. Professional societies may opine about a new procedure but professionals may feel free to ignore their counsel as well. Two case studies are used to discuss this method of new venture creation; the cases are trait selection through pre-implantation genetic diagnosis and female cosmetic genital surgery (FCGS), both controversial practices. We discuss the ethics and legitimacy of both and how one can use theory to analyze whether or not these are legitimate businesses and how to develop them.