A plastic surgeon is someone who has attended an accredited residency in plastic and reconstructive surgery where principles of wound healing, trauma, cosmetic surgery, hand surgery, lasers, and reconstruction are taught. Typically the requirements to apply for such a residency is to have completed at least 3 years of general surgery residency. Until recently, 4 or 5 years of general surgery residency were required followed by a 2 year residency for a total of 6 or 7 years of residency training. Now, only 3 years of general surgery training are required followed by a 3 year plastic surgery residency. Many plastic surgeons trained in the past only have 5 years of total training in both general and plastic surgery. A cosmetic surgeon is someone with any completed surgical residency including orthopedics, otolaryngology, obstetrics and gynecology, or general surgery, and complete a 6 month or 1 year apprenticeship working with a cosmetic surgeon. Typically, a cosmetic surgeon cannot perform cosmetic surgeries in an accredited facility because they are not residency trained.
Plastic surgeons become board certified by completing a written exam that evaluates knowledge of the general principles of plastic and reconstructive surgery. Once this is passed, the surgeon then participates in a case collection period. During this period, the surgeon keeps a log of all surgeries performed and submits this log to the board in charge of issuing certification. The log is reviewed for diversity and volume, and the surgeon is either invited to sit for the oral board or asked to collect more cases. A handful of these cases are then selected and the surgeon is scheduled to be examined. During the examination, each surgery case selected is scrutinized and critiqued. The surgeon is asked to communicate why certain decisions were made and an assessment is made regarding the appropriateness of the decision. Attempts have been made to eliminate the subjectivity in this process as personality conflicts historically may have led surgeons not succeeding in achieving board certification. The entire process after residency can occur in as little as 2 years but many times takes longer due to timing and deadlines.
Choosing a plastic surgeon is a personal decision. Word of mouth is usually a good way to hear about someone. But what happens if you don’t have that word of mouth recommendation. The next step is meeting your surgeon. Then follow your gut feeling. After meeting your plastic surgeon, do you feel like you’ve met an advocate? Many patients become mesmerized by marketing campaigns and savvy sales pitches. The recommendation to find someone who is Board Certified has become increasingly popular as more and more non plastic surgeons are offering plastic surgery such as quick lifts, lifestyle lifts, thread lifts, slimlipo, smartlipo, and Vaser liposuction.
Smart Lipo is liposuction utilizing lasers for lipolysis. What this means is that laser destroy the fat cells which are then removed by suction cannula. Laser lipolysis comes with the added risk of skin and deep tissue burns from the laser. Unfortunately, most physicians performing Smart Lipo are not plastic surgeons. The only regulation on the use of these machines is that the person using it must be a physician, even if that physician is a psychiatrist or family practitioner.
VASER is liposuction using ultrasonic technology. Not only has VASER been a game changing device in performing liposuction, VASER has recently been shown to be an excellent technology to use in harvesting adipocytes in fat grafting. Instead of destroying fat cells, VASER causes the fat cells to separate from one another turning it into liquid. The liquid is then removed using suction cannulas. By collecting the liquified fat into a container or syringe, you can then inject the fat in areas of the body and face to correct depressions, nasolabial folds, and thinning tissues. The fat is your own tissue, so it can’t be rejected. The ultrasonic energy is selective for fat cells sparing blood vessels making it much safer than other means of lipolysis. Because the fat cells aren’t destroyed, more cells survive providing a longer lasting effect.
While I’m all for do it yourself jobs, determining whether or not a mole is a cancer shouldn’t be one of them. Generally, lesions that are changing in character (color, shape, size, etc.) should be seen by an experienced clinician. Plastic Surgeons and Dermatologists see such lesions every day and many times can tell if a lesion is cancerous or not just by looking at them. Countless times patients develop a lesion and believe it’s a pimple or cold sore. If these lesions don’t disappear in less than a month or if they recur in the same spot time after time, seek the advice of a Plastic Surgeon or Dermatologist.