How to Choose a Plastic Surgeon
In today's increasingly commercialized marketplace with widespread advertising and marketing by physicians (and even non-physicians) claiming specialization and certification, finding the right physician has become a difficult and confusing task. To make matters worse, anyone with a medical license is legally allowed to do just about anything they please in their office, including cosmetic surgery. Any type of specialization or specialty training is voluntary. Choosing a properly trained and specialty certified physician for your needs, however, is the single most important choice you will need to make. Since the physician, and not technological wizardry, will determine your eventual well being (physical and emotional), a thorough search and knowledgeable evaluation of credentials is essential.
Check for ABMS Accredited Specialty Board Certification. Be careful, there are over 100 non-accredited specialty 'boards' which can make things utterly confusing. The term 'board certification' by itself is meaningless, as just about anyone can obtain "certification" by some non-accredited board. As a matter of fact, anyone with a basic medical license can claim 'board certification'. How is that possible? To obtain a basic medical license (after medical school) one must pass a medical licensure exam (equivalent to the 'bar' for lawyers), given by the National Board of Medical Examiners, a legitimate board. Passing this mandatory basic medial licensing exam automatically conveys certification by the National Board of Medical Examiners. The individual can now, truthfully, claim that they are 'board certified'. The real issue you need to know, however, is whether they are certified in their specialty by an accredited specialty board. In the United States, the American Board of Medical Specialties (ABMS) is the official oversight board which has the authority to accredit the specialty boards, such as the American Board of Plastic Surgery, American Board of Surgery, American Board of Internal Medicine etc. Any board not accredited by the ABMS is a self-designated, self-proclaimed, non-accredited specialty board. ABMS, for example, does not recognize an "American Board of Cosmetic Surgery". You can inquire about a physician's accredited specialty board status on the ABMS website.
How do I know my doctor is a real plastic surgeon?
The American Board of Medical Specialties has a list of authorized medical specialties. Board certification indicates that a surgeon has passed his or her boards within a specialty. At a minimum, your surgeon should be board certified. However, as important is in what board is he/she certified? Only a true plastic surgeon can say that he/she is board certified in plastic surgery by The American Board of Plastic Surgeons. The American Board of Medical Specialties does not recognize “cosmetic surgery” as a medical specialty. Therefore, the term “Board certified cosmetic surgeon” is a very loose term that could include, OB/GYNs, dermatologists, ophthalmologists, oral surgeons, or ENTs, but it is not recognized by the American Board of Medical Specialties.
Only a physician who has successfully completed a residency or fellowship recognized by the American Board of Plastic Surgery is a real plastic surgeon who is board eligible in the specialty of plastic surgery. A true plastic surgeon will tell you he is a plastic surgeon-either by being board certified in plastic surgery or as a member of the American Society of Plastic Surgeons.
What is the single most important thing to look for when searching for a plastic surgeon?
The single best criterion when selecting a plastic surgeon is membership in the American Society of Plastic Surgeons (ASPS). Choosing an American Society of Plastic Surgeons member ensures that you have selected a physician who:
- Has completed at least six years of surgical training dedicated to the practice of plastic surgery.
- The training occurs within a residency approved by the American Board of Plastic Surgery.
- Is trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction.
- Operates only in accredited medical facilities
- Adheres to a strict code of ethics.
- Fulfills continuing medical education requirements, including standards and innovations in patient safety.
- Is board certified by The American Board of Plastic Surgery or in Canada by the Royal College of Physicians and Surgeons of Canada®.
Look for the ASPS Member Surgeon seal.
What questions should I ask my doctor?
The list of questions below is a good start in terms of what you should know about your plastic surgeon.
- Are you certified by the American Board of Plastic Surgery?
- Are you a member of the American Society of Plastic Surgeons?
- Were you specially trained in the field of plastic surgery?
- Do you have hospital privileges to perform this procedure? If so, at which hospitals?
- Is the office-based surgical facility accredited by a nationally or state recognized accrediting agency, or is it state licensed or Medicare-certified?
- How many procedures of this type have you performed?
- Am I a good candidate for this procedure?
- What will be expected to get the best results?
- Where and how will you perform my procedure?
- If undergoing breast implants-what shape, size, surface texturing, incision site and placement site are recommended for me?
- How long of a recovery period can I expect, and what kind of help will I need during my recovery?
- What are the risks and complications associated with this procedure?
- How are complications handled?
- What are my options if I am dissatisfied with the outcome of my surgery?
- Do you have before-and-after photos I can look at for each procedure and what are reasonable results?
What are the other specialties sometimes confused with plastic surgeons?
Facial plastic surgeon - This is an Ear Nose and Throat doctor not a plastic surgeon, who has been trained under the rigor of the American Board of Plastic Surgery.
Oculoplastic surgeon - This is an ophthalmologist who did an additional year in periorbital surgery.
Board certified cosmetic surgeon - This does not mean the surgeon is a plastic surgeon. Almost all plastic surgeons will state “Board certified plastic surgeon” if they are a true plastic surgeon, and these plastic surgeons may state that they specialize or practice cosmetic surgery. These plastic surgeons are not to be confused with “Board certified cosmetic surgeons” which includes OB/GYNs, dermatologists, ophthalmologists, oral surgeons, ENTs, and others who practice cosmetic surgery, but this board is not recognized by the American Board of Medical Specialties.
Dermatologic surgeon - This is a dermatologist who practices surgery.
Advertising: separating myth from reality
In today’s cosmetic surgery environment, it can be very difficult for an individual, even a health provider, to discern an advertisement from true independent journalism. Advertisements may take the form of actual magazines such as New Beauty in which the “featured doctor” pays a large sum to be “featured.” Even legitimate magazines advertise directly to physicians to be listed in their “Top Docs” or “Best Doctors’ sections. The patient should be wary of these deceptive forms of advertising
Do the best aesthetic surgeons only perform aesthetic surgery?
Certainly, older cosmetic surgeons may limit their practice to cosmetic surgery, but almost all of the world’s best cosmetic surgeons began with reconstructive practices. In fact almost all of the groundbreaking techniques in cosmetic surgery have reconstructive origins. In reconstructive cases the patients’ problems are typically greater requiring more advanced and difficult techniques. However, as the surgeon achieves comfort and predictability with these advanced reconstructive techniques, they become powerful tools that can be adapted to the cosmetic patient. If a surgeon only performs cosmetic surgery, it is difficult, if not imprudent, to experiment with these advanced techniques in the cosmetic patient. A smaller repertoire of techniques will likely result in an improvement for most patients, but a surgeon well-versed in a multitude of advanced techniques has a much higher likelihood of safely achieving a spectacular result. The reconstructive challenges that Dr. Baker faces have given him experience and confidence in techniques that are difficult to develop when treating only cosmetic patients. The numerous complex reconstructive patients Dr. Baker sees have provided him the expertise to safely employ these complex techniques in his cosmetic patients.
Any tricks for finding the right plastic surgeon for your needs?
One tip I recommend to obtain an unbiased recommendation for a good plastic surgeon in your area is to call the plastic surgery department of any reputable medical center (far enough away from your location to avoid bias). Ask them who would be good in your city for your problem. They almost always have a list a surgeons to whom they refer friends, family, and relocating patients.
Ask around. Check with friends, who may have had a similar procedure, physicians or nurses. A quality reputation still takes years of hard work and dedication to develop and must be earned through skill and performance, unlike advertising which is available to anyone at an instant.
Check for Surgical Training. Did the person graduate from an accredited medical school and receive a Doctor of Medicine (M.D.) degree? If you are considering a surgical procedure, such as liposuction or other cosmetic surgery procedure, is the physician in question actually a trained surgeon? Did he or she graduate from an accredited surgical residency program? What type of residency? Plastic surgery, otolaryngology or other? How much training did they have? Any postgraduate fellowships or specialty training? What is their experience with the particular procedure that you are interested in?
Check for Professional Society Memberships. Just like board certification some societies are more meaningful than others. Get the exact name of the society, call them and find out what the membership requirements are. The following societies require certification by the American Board of Plastic Surgery —American Society of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, and the American College of Surgeons.