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What is a ‘Real’ Plastic Surgeon?

Seems like everyone is getting or is interested in getting ‘work done’ these days. The demand and interest in cosmetic or aesthetic surgery, services and products has never been higher as our society works and lives longer and improved technology and techniques offer more natural and effective results. More people of any age are seeking and benefitting from improvement in self-confidence, psychological well-being and quality of life.

But, how do you go about selecting a properly trained and qualified professional for your cosmetic surgery or aesthetic service? What is a “real” plastic surgeon anyway and why should that matter?

The internet has dramatically and forever changed the landscape of our lives, particularly the interaction of health-care consumer (our patients) with providers (medical professionals). Despite growing demand particularly for aesthetic services and products, there has not been a corresponding increase in regulations with regard to who performs aesthetic surgery, dispenses aesthetic products as well as the cost of these services and products. The result of this discrepancy is increased risk and significant safety issues for patients when faced with selecting a medical provider. Can patients really trust that all physicians and professionals offering surgery and aesthetic services are properly trained and qualified? Recent studies and rising complications prove they cannot.

A recent report surveying over 5,000 people in a respected medical journal reveals that a huge majority of consumers…87%… believed that physicians must have special training and credentials to perform these procedures. Many are surprised to find out that they do not.

The study also confirms that the public and ultimately the consumer are confused by the titles ‘plastic surgeon’ or ‘cosmetic surgeon.’ More than half of those surveyed were also not sure about what kind of training is required to become a ‘Board-Certified’ plastic surgeon or cosmetic surgeon. Confusing medical marketing and unproven claims further magnify the problem for potential patients.

Survey Results

Here are some other interesting results from this recently published survey studying the opinions of over 5,000 people:

  • Only 10% of persons surveyed realized that there are no legal requirements for a provider to have adequate training or credentials to perform cosmetic (aesthetic) surgery.
  • 4,900 of 5,000 responders falsely believed that the medical system would prevent providers from performing surgery or procedures that they are not trained to perform.
  • Over 61% of people surveyed believed that board certification in plastic surgery is a legal prerequisite to perform aesthetic surgery – it is not.
  • Most people surveyed did not know the difference between a ‘Board Certified’ plastic surgeon and a ‘Board Certified’ cosmetic surgeon nor did they understand the significant differences in required training for those certifications.

The only official governing body for all recognized medical specialty based certifications is the Aesthetic Board of Medical Specialties. The American Board of Plastic Surgery certification is recognized by the American Board of Medical Specialties while the “American Board of Cosmetic Surgeons” certification is not because “cosmetic surgery” is not a recognized specialty by the board. Another essential difference is that board eligibility in plastic surgery requires 6 or more years in specialty training while only 1 year is required by the Board of Cosmetic Surgery.

The purpose of this discussion is not a turf battle or to limit another physician’s practice, but rather to educate consumers of aesthetic services on how to appropriately identify qualified providers. The lack of adequate regulation or oversight of medical marketing combined with the lack of awareness by the consumer on the important differences between the training of surgeons performing cosmetic surgery has severely compromised a patient’s ability to choose a properly trained provider. The process of choosing a properly credentialed aesthetic provider is critically important because accumulating evidence indicates that procedures performed by those without appropriate training and qualifications can and do compromise patient care and safely, sometimes with severe or lifelong consequences.

Studies also show that the most important factor in a satisfying a safe aesthetic outcome is not the technology but the ability and training of the provider. The doctor-patient relationship is built on transparency and trust. By educating patients and helping them make informed decisions, we are following the lessons learned in our first days of medical school – ‘primum non nocene’…first do no harm.

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Frank Barone, MD, FACS

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