Plastic Surgeons and Board Certification: What’s the Big Deal?

By Stephanie Guler - Senior Content & Social Media Developer | January 31st, 2012

Would you allow an orthopedic surgeon to perform a heart transplant on yourself or a loved one?

Hopefully, your answer is no, and the reason why should be very clear.

Essentially, patients should be choosing doctors for their expertise. A heart transplant surgeon is the only type of doctor qualified to perform heart transplant surgery, and most likely, would never offer knee or hip replacement procedures in their practice.

The same goes for orthopedic care. These surgeons are specially trained in repairing arthritis damage and sports-related injuries, not fixing hearts, delivering babies or treating cancer.

This makes sense, right? Do the job you’re good at; better yet, the one you’ve received extensive training in.

For some reason, this simple concept doesn’t seem to apply to the plastic surgery industry. In recent years, more non-plastic surgeons have started to capitalize on the industry’s popularity, with dentists doing Botox, oral surgeons performing facelifts, and OB/GYNs performing tummy tucks and breast lifts.

Experts believe this is due to the lucrative nature of the plastic surgery business.

Elective plastic surgery procedures aren’t usually covered by insurance, which means an opportunity to receive out-of-pocket payments from patients, yielding big profits for doctors that normally have to battle with insurance companies to get their pay.

While this might not seem like such a big deal at first (they’re all board-certified doctors anyway, right?), the end result usually speaks for itself – simply, not up to par.

This unusual phenomenon has gained a lot of media attention in the past couple of years, with the most recent story coming from The New York Times.

The article featured Joan, a 59-year-old with a job in finance. When she moved from New York to Los Angeles for a new career opportunity, Joan decided she needed an aesthetic boost to her appearance.

She found a board-certified doctor and received a facelift and a tummy tuck, but the final result was far from satisfying.

It turns out that Joan’s doctor had board-certification in otolaryngology, the medical specialty that focuses on the treatment of ear, nose and throat (ENT) conditions; not plastic surgery like she had originally assumed.

The ENT doctor botched Joan’s surgery, leaving her with major scarring on her temples and a “wavy abdomen”, according to the New York Times report.

She confessed, “I had to use all my savings to get a real plastic surgeon to fix what he did to me. I have an M.B.A. I’m not stupid. But when the doctor has a nice clinic and all those diplomas and certifications on the wall, you think he knows what he’s doing.”

Unfortunately, this is usually not the case.

The American Society of Plastic Surgeons (ASPS), which regulates and awards board-certification to plastic surgeons worldwide, has been well aware of this issue for a while now. The organization has reported a dramatic increase in unhappy patients, which means board-certified plastic surgeons are left to repair thousands of botched procedures that were performed by doctors inexperienced in plastic surgery.

Dr. Patti Flint, a plastic surgeon in Mesa, Arizona, told the New York Times, “I’m seeing cases like this on a weekly basis now, when a few years ago I hardly saw any.”

The worst part is, most of these poorly executed surgeries could have been prevented, saving a lot of time, money and heartache for patients.

This can be done in two ways: first, an increase in laws and regulations among doctors who practice outside of their specialty, and second, by providing more information about the importance of board certification to prospective plastic surgery patients.

Dr. Malcom Z. Roth, chief of plastic surgery at the Albany Medical Center in New York, and president of the American Society of Plastic Surgeons told the New York Times, “The public needs to be protected from doctors who are not upfront about what board certifications they have.”

To receive board certification on one of the 24 boards in the American Board of Medical Specialties (including plastic surgery with ASPS), doctors are required to complete a minimum three-year residency in their chosen specialty, and they must also pass an intensive set of oral and written examinations, according to the New York Times article.

These extensive requirements are in stark contrast to rival organization, American Academy of Cosmetic Surgery (AACS), which is made up of doctors who aren’t board-certified in plastic surgery.

To become a member of this group, doctors are required to be board certified, but not necessarily in plastic surgery. It is also mandatory to complete an approved cosmetic surgery fellowship (which usually lasts about a year), or be in practice for at least six years, having performed no fewer than 1,000 cosmetic surgery cases, according to the AACS website. Potential AACS members are also obligated to pass a two-day oral and written exam, and be of good moral character.

But while the AACS requirements may seem stringent, a year’s worth of plastic surgery training simply isn’t enough to safely and effectively practice plastic surgery. It can be compared to getting a third of the way through medical school and being able to open a medical practice.

The problem is, there aren’t many laws in place that require doctors to state which medical specialties they are board-certified in. The only states that enforce this are Texas, California, Louisiana, and Florida. In the rest of the US, and worldwide, doctors might only say they are board-certified, so it’s up to the patient to do the extra investigating.

Dr. Joel Aronowitz, a plastic surgeon in Los Angeles and clinical assistant professor at the University of Southern California told the New York Times, “A doctor may be good and well trained in his or her specialty, but it takes more than a weekend seminar to achieve mastery in plastic surgery.”

He’s right. Plastic surgery requires much more knowledge beyond the inner workings of the human body. This medical specialty is all about appearance, so patients should choose a true artist with extensive experience and training.

However, since doctors are supposed to be trusted members of society, many patients don’t go the extra mile to look into their surgeon’s professional background, and this has caused a rise in medical malpractice injury and death lawsuits all over the country.

Michael Freeland, a medical malpractice lawyer in Weston, Florida said, “Not only are the doctors not properly trained in plastic surgery, but they are also operating in facilities, like tanning salons and med spas, that are not equipped to handle a medical emergency. The best they can do for you if things go wrong is call 911, and sometimes they don’t even do that.”

This is why it’s important to be an empowered patient. Do your homework and ask the right questions before undergoing plastic surgery of any sort. Otherwise, you could be facing a change to your appearance that you didn’t ask for, and once the surgery is done, there’s no going back to the way you used to look.

The ASPS recommends that all patients check for their surgeon’s board-certification in plastic surgery first, and then go in for a consultation.

Dr. John Santa, an internist and director of Consumer Reports’ Health Ratings Center advised, “Above all, I think common sense is in order. I would be suspicious of anyone who is operating way outside his or her specialty area, and always get a second opinion.”

He added, “When there’s no insurance involved, it’s really the Wild West, and there’s no sheriff in town.”

The ASPS gives some good advice on their website: “One of the first steps you can take towards a successful procedure is to become an educated consumer. Read about patient safety and how to make smart choices about your surgeon and the facilities where your procedure will be performed. Browse through before and after photos to see the kinds of improvements surgical and minimally invasive procedures can make. Watch videos about specific procedures and the latest developments in research.”

The moral of the story is, when it comes to plastic surgery or any other medical procedure, it is up to you, the patient, to inform yourself first. Whether you’re undergoing plastic surgery in the US, Turkey, Spain, Mexico or India, do not blindly rely on a doctor just because he has a fancy office, or because she seems experienced.

Dig deeper, and if the surgeon really does live up to their claims, you’ll be able to find information about their professional history and board certification fairly easily. If not, it’s best for your health, safety and appearance to continue your search for a qualified, board-certified plastic surgeon.

To learn more about plastic surgery options, contact a plastic surgeon near you.

References:

American Academy of Cosmetic Surgery (AACS). For Doctors: Board Certification. Web. Jan. 31, 2012. http://www.cosmeticsurgery.org/doctors/certification.cfm

American Society of Plastic Surgeons (ASPS). Articles and Galleries. Web. Jan. 31, 2012. http://www.plasticsurgery.org/Articles-and-Galleries.html

The New York Times. Health. “Ear Doctors Performing Face-Lifts? It Happens”. Web. Jan. 30, 2012. http://www.nytimes.com/2012/01/31/health/non-specialists-expand-into-lucrative-cosmetic-surgery-procedures.html

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