I often have patients tell me that they had their surgery performed by a plastic surgeon, but it is often a name that I don’t recognize. When I look them up on the state medical board website, it may be that they are not a plastic surgeon at all, but they advertise themselves as a “cosmetic surgeon”.
There are many questions and misconceptions about the two and many patients mistakenly believe that plastic surgeons and cosmetic surgeons are equal when they are not.
Aesthetic vs. reconstructive
Let’s start by defining plastic surgery. The term “plastic” in plastic surgery is derived from the Greek word “plastikos,” which means to mold or shape. There are several specialized fields under plastic surgery including reconstructive surgery which involves the restoration of almost any body part that is abnormal due to a trauma/accident, cancer or birth defect; and aesthetic surgery, (sometimes referred to as cosmetic surgery), which is the aesthetic enhancement of the body or re-shaping normal tissue to improve appearance.
In other words, aesthetic surgery is a sub-specialty of plastic surgery. Reconstructive surgery is often considered ‘medically necessary’ and may be covered by health insurance.
Cosmetic vs. plastic: The training
Following completion of medical school, a board-certified plastic surgeon serves first as a surgical resident for at least 3 years where they undergo rigorous training in all aspects of surgery and then 3 years of focused plastic surgery training. The process can take 6 to 8 years or more and many further their training in fellowships including microvascular, craniofacial, hand, pediatric and aesthetic. This is a key differentiator between a plastic surgeon and a cosmetic surgeon.
A practitioner referring to themselves as a cosmetic surgeon might belong to any medical specialty. He/she could be a general surgeon, gynecologist, dermatologist, family physician, internist, etc. who has decided that they want to perform cosmetic procedures. The training can be anywhere from a one-year cosmetic surgery fellowship to a handful of short weekend courses on topics ranging from how to perform liposuction, utilize injectables, or place breast implants.
It is always important to confirm that a plastic surgeon has been certified by the American Board of Plastic Surgery (ABPS) – the only Board recognized by the American Board of Medical Specialties (ABMS) to certify doctors in the specialty of Plastic Surgery, Only ABPS diplomates can call themselves a Plastic Surgeon. In Canada, a patient should look for certification by the Royal College of Physicians and Surgeons of Canada (RCSC). International plastic surgeons should be board-certified in their country of origin.
A Facial Plastic Surgeon has ENT training and performs aesthetic (cosmetic) surgery of the face and an Occuloplastic surgeon can perform aesthetic (cosmetic) surgery around the eyes after an Ophthalmology residency.
Cosmetic surgeons who claim to be board-certified may have received their certificate from the American Board of Cosmetic Surgery, which board is not recognized by the American Board of Medical Specialties. Alternatively, they may be certified by their specialty board which may not even be a surgical specialty, such as internal medicine. Cosmetic surgeons referring to themselves as board-certified can be misleading if you don’t know the right questions to ask.
It is important to note that while all plastic surgeons have extensive training and can perform both reconstructive surgery and aesthetic/cosmetic surgery, not all cosmetic surgeons can perform reconstructive surgery because they have not received the same aesthetic training as plastic surgeons.
In conclusion, if you are considering any type of aesthetic/cosmetic procedure it is prudent to be aware of the education and training of the surgeon you’re considering for your procedure. You can verify the credentials of a doctor by checking with your state medical board or verify you are seeing a board-certified plastic surgeon whose practice focuses on aesthetic surgery by visiting www.plasticsurgery.org to select a surgeon.