Four Specialties Legitimately Perform Cosmetic Surgery

Depending upon the procedure you desire, surgeons from several different specialties may be qualified and skilled in cosmetic surgery. Which specialties should you expect to encounter during your information gathering?

Doctors from various specialties may refer to themselves as Cosmetic Surgeons. These practitioners usually do not limit themselves to a given region of the body, such as the face and neck. There are no accredited residencies in cosmetic surgery, although fellowships are available to those who have completed residencies in other specialties (such as head and neck surgery or plastic surgery). While an American Board of Cosmetic Surgery exists, it is not recognized by the American Board of Medical Specialties.

Of course, board certification, society memberships, and hospital privileges are just starting points. All they guarantee is that the doctor has the necessary basic training: a medical degree, three years of approved general surgical training, an accredited two- or three-year residency in the specialty, at least two years in practice, and has passed oral and written exams, and has a place to conduct business. Board certification does not guarantee a perfect result.

-Joan Kron, author Lift: Wanting, Fearing, and Having a Face-Lift

Dermatologists are skin specialists usually trained in dermabrasion (sanding or planing), chemical and laser peeling for wrinkles and acne, and treatment of spider veins and facial scars. Some dermatologists also perform cosmetic surgery. Certification is granted by the American Board of Dermatology, founded in 1932.

Head and Neck Surgeons are among regional specialists who limit their work to the face and neck. Such surgeons may also perform reconstructive surgery for facial injuries or tumors, but perform no surgery on other parts of the body. Facial plastic (both cosmetic and reconstructive) surgery is a subspecialty of head and neck surgery. The fully qualified head and neck specialist is certified by the American Board of Otolaryngology, founded in 1924. The American Board of Facial Plastic and Reconstructive Surgery. A recent certification process has been developed to recognize specific training in plastic surgery of the face, head, and neck. Surgeons board certified in either plastic surgery or otolaryngology/head and neck surgery are eligible.

Requirements are documented training and experience in facial plastic surgery, which may include a one-year fellowship following residency training in a recognized ACGME Otolaryngology or Plastic Surgery program, a minimum two years of practiced experience during which time the surgeon performs a minimum of 100 facial plastic surgery cases and successful completion of a two-day examination.

The certification recognizes additional capability in facial plastic surgery, including reconstructive and cosmetic procedures. This relatively new board, though not yet recognized by the American Board of Medical Specialties, has been deemed equivalent to ABMS boards.

Some eye surgeons, or ophthalmologists, also perform cosmetic surgery on the eyelids and the eyebrows. The American Board of Facial Plastic Surgery, founded in 1916, certifies such specialists. Most ophthalmologists who routinely perform cosmetic surgery procedures have served fellowships in ophthalmic plastic surgery.

Specialists qualified to perform plastic surgery on all parts of the body are called Plastic Surgeons. Some plastic surgeons focus on breast and body sculpting; others concentrate on the head and neck region; some practice mainly reconstructive surgery, hand surgery or specialize in caring for burn victims through skin grafting. The American Board of Plastic Surgery, established in 1937, certifies the qualified specialist.

Specialty Overlap

A confusing issue facing prospective cosmetic surgery patients is specialty overlap: two or more recognized specialties, any of which may be equally capable of performing the same procedure.

Hints for Doctor Selection

You must determine if the procedure you are considering is one that the prospective surgeon "majors in." One clever way to determine this is to call the office and ask which five or six procedures the doctor performs most often. If your procedure is not mentioned, you're not talking to the office you want. Move on.

After you have narrowed your search, while visiting doctors' offices, look for the key terms cosmetic surgery, facial surgery or aesthetic surgery either on business cards, printed material or the office door. These suggest an emphasis on the surgery of appearance vs. general reconstructive surgery. A practice oriented to reconstructive not cosmetic surgery could include hand surgery, tumor surgery or treatment of burns. Observe the patients in the waiting room for obvious clues: if most don't seem to be there for cosmetic surgery, you need to, again, move on.

Hints about the practice's personality also come from décor, and the style, mood, and efficiency of the office. The top professionals surround themselves with top-notch staff. Do not be impressed by social column quips, photo opportunities, and fancy offices. Cosmetic surgery is not frivolous. Your appearance is important to you and requires a serious commitment by a surgeon who does not view it as irrelevant or minor. Look for the signs of a perfectionist personality with great seriousness about the work. The surgeon's career spent carrying people's appearance in his hands must be one of complete dedication. Look for a doctor who is positive about cosmetic surgery someone who is enthusiastic and enjoys all aspects of enhancing your appearance.

A quick, final hint: When comparing surgeons, place their respective professional biographies side by side. The focused cosmetic surgeon's professional history will be replete with references to cosmetic surgery training, experience, research and teaching. A surgeon who does not specialize exclusively in cosmetic surgery may be stronger in other work: cancer, reconstruction, trauma or birth defects. Add this information to what you gather through friends, medical personnel, and the office visit and you will be well on your way to short-listing the best surgeon for your needs.