From the traditional facelift to Botox injections or laser resurfacing, procedures that focus on aesthetics have changed drastically in recent years.
And people looking to find the right provider might have trouble determining what kind of doctor they’re looking for.
One big issue for many people is that a cosmetic surgeon and a plastic surgeon may be conflated. But while cosmetic surgery is a type of plastic surgery, cosmetic surgeons can only perform cosmetic procedures, explains Dr. Alan Matarasso, president of the American Society of Plastic Surgeons (ASPS).
Feeling confused yourself? You’re not alone.
A 2017 report in Plastic and Reconstructive Surgery, found that people were confused between the terms “plastic” and “cosmetic” surgeons.
In a survey of 5,135 people, 87 percent believed that surgeons had to have special credentials and training to perform cosmetic procedures or to advertise themselves as aesthetic, cosmetic, or plastic surgeons. More than half were unsure what the requirements were to be “board certified.”
“The results demonstrate the need to eliminate confusing medical marketing in order to have a transparent system, where informed patients are assured a safe and aesthetically acceptable outcome,” Dr. Rod J. Rohrich, a physician at The University of Texas Southwestern Medical Center in Dallas said in a statement.
Two types of plastic surgery
If you’re still not sure what the difference is, here’s what to know. First, there are two types of plastic surgery:
- Reconstructive plastic surgery treats parts of the body affected aesthetically or functionally by infection, tumors, disease, congenital defects, developmental abnormalities, or trauma.
- Cosmetic plastic surgery enhances or reshapes parts of the body.
Reconstructive plastic surgery may be covered under insurance, whereas cosmetic plastic surgery is elective and usually not covered.
Having a breast reconstructed after a mastectomy is a reconstructive procedure that only a plastic surgeon should perform. Having a breast lift (augmentation) is a cosmetic procedure that could be performed by a plastic or cosmetic surgeon.
Plastic and cosmetic surgery can include surgical, minimally invasive, or even nonsurgical procedures.
“Most people think that plastic surgery is cosmetic surgery,” said Dr. Alexander W. Sobel, president of the American Board of Cosmetic Surgery (ABCS).
What ‘board certified’ means
Surgeons have different board-certification requirements depending on the board that certifies them.
“Real” board-certified plastic surgeons have been credentialed by the American Board of Plastic Surgery (ABPS). ABPS provides a plastic surgery certification under the American Board of Medical Specialties, which has maintained standards since 1933. ASPS members are certified under the ABPS.
Board-certified plastic surgeons have completed at least six to eight years of specific training by an accredited plastic surgery training program in the United States that is regulated by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME accredits most graduate medical training programs in the country, he added.
The American Society of Plastic Surgeons (ASPS) is the other major society certifying plastic surgeons.
The American Board of Cosmetic Surgery (ABCS) certifies surgeons exclusively in cosmetic surgery.
Cosmetic surgeons may not have board certification to call themselves that. Any doctor from a dermatologist to an oral surgeon can call themselves cosmetic surgeons, Rohrich told Healthline.
“[It’s] quite amazing and astounding as we don’t have any regulations on who can call themselves what in the USA,” Rohrich said.
Medical marketing mania
A bigger problem than knowing the difference between surgeons is that many people seek cosmetic procedures from professionals who are not cosmetic surgeons.
This can include a dentist or a gynecologist who also provides fillers, for example. Those doctors may offer a few cosmetic options, but they may not give patients all of their options, nor be able to handle complications.
If they can only do one or a few procedures, they’re not going to give you the choices based on your anatomy and specific needs — their recommendations are based on what they can do instead, Matarasso said.
“If they don’t have the training to offer you all the choices, then it’s not fair for the patients,” Matarasso said.
Physicians who label themselves as “cosmetic doctors,” as opposed to cosmetic surgeons, may have some training on one or a few cosmetic procedures.
But they give patients limited treatment options, and may prevent patients from understanding all of their options. On the flip side, a cosmetic surgeon would be able to pinpoint which technologies are best for an individual and give them all of their options.
“The real confusion lies in the fact that, legally, any physician with a valid medical license can perform cosmetic procedures, regardless of their training,” Dr. Jordan Jacobs, chief of plastic and reconstructive surgery at Mount Sinai Downtown in New York, told Healthline. “Therefore, any physician can advertise as a cosmetic surgeon.”
Matarasso, who performs only cosmetic procedures, sees patients on a daily basis who had a procedure done but were not ideal candidates for it. They had poor outcomes as a result of not being properly educated on all of their procedure options.
Seeking a board-certified doctor is so important instead of finding a doctor who performs just one service, said Matarasso. It offers the full gamut as opposed to just one thing.
What patients can do
Patients who enlist doctors who perform cosmetic procedures in their office or at an outpatient surgery center should make sure the physician is approved to perform the same procedures at a local hospital, Jacobs explained.
According to the ABPS, board-certified plastic surgeons can only operate in properly certified facilities and can only perform procedures in the office for which they also have hospital privileges. They must have transfer privileges to at least one local hospital in case of an emergency.
“When they see a physician advertising themselves as a ‘board-certified plastic surgeon,’ be sure to ask which board,” Jacobs added.