There are many things we take as a matter of course. One of these things is that professionals are qualified and competent to perform the services that they offer to the public. Unfortunately, this is not always clear and obvious to consumers of cosmetic surgical procedures.
Entering the field of cosmetic plastic surgery is particularly attractive to non-board certified individuals. This is dangerous, as becoming board certified in plastic surgery requires a long and arduous training track. After four years in medical school, we must complete a rigorous training program that lasts for at least six years, followed by extremely difficult written and oral examinations administered by the American Board of Plastic Surgery. Only after completing all of these measures can one become certified by the American Board of Plastic Surgery, and therefore eligible to be inducted into the membership of the American Society of Plastic Surgeons. By passing all of these requirements, you are assured that the doctor meets the highest standards in the skilled, safe, and ethical provision of plastic surgery.
Many websites are out there that have been well designed and look very attractive. Non-plastic surgeons’ advertising is effective and sites often look just like a real plastic surgeon’s material. The clues are in the details. If the provider is described only as “board certified”, this could mean anything. There are approved board certification programs in many specialties, such as emergency medicine, pathology, psychiatry, and family medicine – none of which contain any training related to the safe provision of actual plastic surgery. There are also boards not recognized by the American Board of Medical Specialties, in areas such as “cosmetic surgery” or “dermatological surgery” or “cosmetic facial plastic surgery”. These individuals cannot get hospital operating room privileges, and as such can only perform services in their office. The absence of hospital privileges is a red flag that the person is not qualified to perform invasive surgical techniques.
I have studied the spread of non-qualified providers in the field of plastic surgery over the past decade and published some of the concerning results listed below. On a weekly basis I meet patients unfortunate enough to have been treated by those who do not have the requisite training to perform effective, safe treatments. Many patients are completely blindsided by the fact that their provider was untrained and unqualified. A suboptimal result needs correction by an actual plastic surgeon. When you go to a website, look for the ASPS symbol of quality, which can only be obtained by surgeons who have met and passed the highest level of training and are Board Certified in Plastic Surgery.
In the interest of patient safety, the Medical Board of California has recently started cracking down on physicians who are promoting themselves as “board certified cosmetic surgeons”, but are not actually certified by the American Board of Plastic Surgery, which is the only plastic surgery certification board recognized by the American Board of Medical Specialties. The Medical Board of California has determined that being certified by the American Board of Cosmetic Surgery (ABCS) is not equivalent to the level of training and rigor that comes from certification by the American Board of Plastic Surgery (ABPS). This trend will likely continue in other states as the public recognizes the adverse outcomes that can result from well meaning, but unskilled hands. The American Board of Medical Specialties runs an informational patient education website called certificationmatters.org where you can look up any physician and see what board(s) he/she is officially certified in. Dr Brian Windle, a board certified plastic surgeon in Washington State, also has an extremely detailed post on this topic. Dr Gregory Buford also nicely outlines the entire process on his site.
Cosmetic surgery is safe and beneficial, and can be very rewarding. Just make sure you have a Board Certified Plastic Surgeon as your doctor.
Camp M, Ray AO, Gupta SC: Demographic and Geographic Analysis of Providers of Cosmetic Services in the Greater Los Angeles Area. American Association of Plastic Surgeons 88th Annual Meeting and Symposium March 21-25, 2009 Rancho Mirage, California.
Matthew C. Camp, Jennifer Schneider, Andrea O. Ray, Subhas C. Gupta: Demographic and Geographic Analysis of Providers of Cosmetic Services in the Greater Los Angeles Area: 2008-2009. Plastic and Reconstructive Surgery. Volume 126, Number 2 pp 115e-116e.
Matthew C. Camp, M.D.; Wendy W. Wong, M.D.; Jason L Mussman, M.D.; Subhas C Gupta, M.D., Ph.D., FRCSC, FACS. The Battle for Hearts and Minds: Who is Communicating Most Effectively with the Cosmetic Marketplace? Aesthetic Surgery Journal 2010 30: 614
Wendy W. Wong, M.D.; Matthew C. Camp, M.D.; Subhas C Gupta, M.D., Ph.D., FRCSC, FACS. The Quality of Internet Advertising in Cosmetic Surgery: An in depth Analysis Aesthetic Surgery Journal 2010 30: 735
Wendy W. Wong, M.D.; Matthew C. Camp, M.D.; Subhas C Gupta, M.D., Ph.D., FRCSC, FACS. Canary in a Coal Mine: Does the Plastic Surgery Market Predict the American Economy? Plastic and Reconstructive Surgery. 2010 Aug;126(2):657-66
Matthew C. Camp, M.D.; Wendy W. Wong, M.D.; Ryan Y. Wong, D.C.; Jennifer Schneider, B.A.; Andrew K. Son, B.S.; Subhas Gupta, M.D., C.M., Ph.D., FACS. Who is providing Aesthetic Surgery? A Comprehensive Review of the Training Backgrounds of Cosmetic Practitioners in Southern California. Plastic and Reconstructive Surgery 2010 Apr; 125(4):1257-62.