Cosmetic Surgery vs. Plastic Surgery

There is considerable confusion about board certification when it comes to Cosmetic Surgery.  Recently there has been a great deal of disinformation about “Plastic Surgery and Cosmetic Surgery” and I would like to shed some light on where the differences lie and the important distinctions between the two specialties.  First, it must be said that not all “Cosmetic Surgeons” are board certified.  Second, all Plastic Surgeons should board certified, but this certification does not always mean they are experienced Cosmetic Surgeons.  To identify a board certified Cosmetic Surgeon, you should go to the American Board of Cosmetic Surgery website; and check.  All ABCS Certified Cosmetic Surgeons are qualified to do most Cosmetic Surgeries.  It bears repeating that not all Plastic surgeons are qualified to do Cosmetic Surgery.  The first graph below shows the number of years of training required to sit for the Cosmetic board; no easy task.  The second pie graph below, published in the American Society of Plastic Surgery Journal shows a comparison between The American Board of Plastic Surgery; that requires training in multiple areas and only one of those areas is Cosmetic surgery, compared to the exclusive training in Cosmetic Surgery by the ABCS.  According to another article published by a Dr. Zins, in the Journal of Plastic and Reconstructive Surgery, he found that without further training in Cosmetic surgery, many graduating Plastic Surgeons felt deficient in Cosmetic procedures due to lack of volume of procedures.  You can see this difference in case numbers required to complete training.  Notice that training for the American Board of Cosmetic Surgery is exclusively Cosmetic Surgery and dedicated only to Cosmetic Surgery.  Plastic surgery training is broader and includes other areas of emphasis, in some cases minimizing Cosmetic training.  The reason case numbers are important is the amount of experience gained caring for patients through pre-procedure evaluation, performing the procedure itself, dealing with problems after, if they occur, and managing post-operative care.  Like other surgery, Cosmetic surgery requires experience that can only be gained through exposure and training.

Board certification in Cosmetic Surgery requires a one-year fellowship that can only be applied for after attaining Board certification in one of seven primary surgical specialties.  Therefore, all board certified Cosmetic surgeons are at least double board certified.  Many board certified Plastic surgeons are as well, but many are not.  During the one-year Cosmetic surgery fellowship, training is dedicated solely to Cosmetic surgery.  During that year, fellows must complete a minimum of 300 cases of Cosmetic surgery to be able to take a written and oral examination in the specialty.  A fairly recent study surveyed the fellows participating in Cosmetic surgery fellowships and the number of cases performed far exceeded the minimum requirement.

The take home message is:

  1. Not all “Cosmetic Surgeons” are board certified or have done a fellowship so look for the ABCS certification.
  2. The American Board of Cosmetic Surgery certification is the only certification available that offers training exclusively in Cosmetic Surgery.
  3. All Board Certified Cosmetic surgeons have done a fellowship and have at least a 300-case experience in Cosmetic Surgery.
  4. Not all Board Certified Plastic surgeons perform Cosmetic surgery.
  5. Not all Board Certified Plastic surgeons have exclusive training in Cosmetic Surgery unless a Cosmetic surgery fellowship is done after the initial “Plastic Surgery” training.

My advice when selecting a surgeon for a cosmetic procedure is to look at their qualifications and check their certifications.  Check out pictures of patients the surgeon has operated on as board certification does not guarantee good results.  Ask for references if they are offered.  This can be a tricky thing with HIPPA, but you may get lucky.  Lastly, check out reviews.

I hope this helps clear the muddy water a bit.  If you are searching for a Cosmetic Surgeon, please call us at Swetnam Cosmetic Surgery, 479-966-4174.  Dr Swetnam is board certified in General Surgery, General Cosmetic Surgery, and Facial Cosmetic Surgery.  We would love to see you.

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