Any licensed physician can call himself or herself a Cosmetic Surgeon, so the importance of finding a properly trained and certified provider is paramount. The goal of this post is help patients looking for a qualified Plastic Surgeon know what to ask and how to check on their prospective doctor. I encourage everyone considering cosmetic plastic surgery to spend as much time researching their doctor as their procedure.
For Plastic Surgery Think PS
If you are considering cosmetic surgery there are three main goals that are mandatory, and the first two letters of Plastic Surgery can help. The three goals are:
- Proper Surgery
- Proper Surgeon
- Proper Setting
You want the most appropriate procedure performed by a qualified and experienced surgeon in a setting that provides for your safety.
Underground Plastic Surgery
Underground Plastic Surgery has grown along with the Board Certified variety. As Cosmetic Plastic Surgery has gained acceptance and popularity so has the quest for a bargain. There are no exact numbers, because those practicing cosmetic surgery illegally do not track or report their procedures to a national society like the American Society of Plastic Surgeons (ASPS) or the American Society for Aesthetic Plastic Surgery(ASAPS), but more about them later.
The way we usually hear about illegal plastic surgery is when something goes horribly wrong. On January 3, 2013, a second person was arrested and charged in the death of a 37-year-old woman who died from pulmonary complications after receiving silicone-like injections to enlarge her buttocks. The patient was introduced to the unlicensed practitioner after paying $200 to an Internet referral source. The fact that the procedure was performed at home, rather than a medical facility, should have been a big red flag.
This unfortunate patient had the wrong procedure, performed by the wrong person in the wrong setting. While fat grafting has gained some traction as a viable way to provide buttock enlargement in selected cases, there are currently no FDA approved off-the-shelf injections available in the US for buttock enlargement. Anyone offering these types of injections, no matter how low the cost, is not doing you a favor, and is not practicing medicine within the current standard of care.
Licensed Plastic Surgery
As mentioned above, any licensed physician can call himself or herself a cosmetic surgeon. At one meeting. I met a doctor, not from the San Francisco Bay Area, who performs Breast Augmentation one day a week, and works as an Emergency Room doctor the rest of the week. The state of California finds this perfectly reasonable, because he is a licensed physician.
Plastic Surgery was born from a union of General and Head & Neck Surgeons, who had an interest in plastic and reconstructive surgery. There is a lot of overlap between Plastic Surgeons and other specialists like Otolaryngologists, Ophthalmologists and even Gynecologists. Each of these specialists receives specific surgical training in their discipline, but Emergency Medicine?
Trained Plastic Surgery
I knew early on that I wanted to be a Plastic Surgeon. As a result, I chose the most direct path available: Surgical Internship, General Surgery Residency and Plastic Surgery Fellowship. All along the way I had my eye on the prize, to become a Board Certified Plastic Surgeon. I did not start learning plastic surgery after completing some other discipline. My desire to be a plastic surgeon shaped my training from its inception. I was fortunate enough to be in a General Surgery training program that had Plastic Surgeons, but no plastic surgery residents. This gave me the opportunity to get a head-start on my Plastic Surgery Training well before my Plastic Surgery Fellowship.
After finishing my General Surgery Residency, I completed a three-year Plastic Surgery Fellowship. There I concentrated only on plastic surgery. I was fortunate to train in a program that not only provided a firm foundation in Reconstructive Plastic Surgery, but also was strong in Cosmetic Plastic Surgery. This depth and breadth of this training cannot be provided by a weekend course, or a few proctored cases. It’s the best way to learn plastic surgery, and it is why I chose to complete a Plastic Surgery fellowship as my path to becoming a Plastic Surgeon.
Board Certified Plastic Surgery
The San Francisco Bay Area is currently home to two Plastic Surgery Training programs: UCSF and Stanford, and for a long time was home to the oldest plastic surgery training program west of the Mississippi at Saint Francis Memorial Hospital. Additionally, the Bay Area is a nice place to live, so finding a well trained Plastic Surgeon in our area is pretty easy.
Board Certification is a process that occurs throughout the course of a Plastic Surgeons practice. Lifetime certificates where given out before I started my training, but currently certification requires continuous maintenance. The details for Plastic Surgery Board certification are available here: Certification by the American Board of Plastic Surgery.
The goal of Board Certification is to provide recognition for the most qualified practitioners in their discipline. It means they have the best training and have been vigorously evaluated by other Board Certified doctors to make sure their expertise is up to the standard of care.
The Three PS’s
PS #1 – Proper Surgery - Finding the proper procedure on the Internet can be difficult. While there are many sources of good information, there are a lot of claims that are too good to be true. While it is good to have an idea of what procedure will work, it is best to reserve final judgement until after an in-person consultation. A big part of my job is listening to what is bothering you, and finding the best way to fix it.
PS #2 – Proper Surgeon - Finding a Board Certified Plastic Surgeon is a good start in being certain you have the proper surgeon. For selected procedures, there is overlap with other specialties. Board Certified Ophthalmologist are well trained in Blepharoplasty and Board Certified Otolaryngologists are well trained in Rhinoplasty. What you will need is a well trained professional with experience. This helps assure that good skills are coupled with good judgement.
PS #3 – Proper Setting - Real surgery requires the correct setting. While Botox and Injectable Fillers, and minor surgical procedures can be safely done in an office setting, Breast Augmentation, for example, should be performed in an operating room. An operating room in an accredited facility is preferable. Placing a Breast Implant requires an FDA approved device and sterile technique; otherwise, you won’t be keeping it long.
To be an ASPS Member Surgeon, a physician must meet these rigid requirements:
- Board certified in plastic surgery by the ABPS
- Graduate from an accredited medical school
- Complete a combination of at least five years of general surgery and plastic surgery residency training
- Pass comprehensive oral and written exams
- Operate only in accredited medical facilities
- Adhere to a strict code of ethics
- Fulfill continuing medical education requirements, including standards and innovations in patient safety
An easy way to be certain you have the PS’s covered is to seek an ASPS member. If you are considering cosmetic plastic surgery, a subset of the society, the ASAPS, are ASPS members dedicated to the cosmetic side of plastic surgery.
You Owe it to Yourself
It takes dedication, persistence and effort to maintain Board Certification, and so does being a Plastic Surgeon. You owe it to yourself to do the research and check your plastic surgeon before having any procedure. The Internet makes it easy. The following links, will make it even easier. Just click on what you want to do:
Check if your doctor is Board Certified by the American Board of Plastic Surgery.
Check if your doctor is Board Certified by another American Board of Medical Specialties board. You will need to register to use this site, but it is safe, free and fast.
Check if your doctor has an unrestricted California Medical License. Read the disclaimer and click “Continue to Search” at the bottom. If you are not in California, Google your local medical board for a link.