The process of certification by the American Board of Plastic Surgery (ABPS) is one of the most comprehensive and intensive of all specialties. It requires graduation from an accredited university hospital residency training program in plastic and reconstructive surgery, a passing grade on an arduous written examination, being in practice for a minimum of 2 years, a review by board members of all surgical procedures done by the candidate over a 1 year period to ensure adequate volume and diversity of operative cases, and lastly satisfactory performance in an intensive 3 day oral examination. Thus, in short, a physician who is board certified by the ABPS is one who has been fully-trained in all aspects of cosmetic and reconstructive plastic surgery in a six to eight year university training program and has been determined to possess superior knowledge, technical skills, experience in the field of plastic surgery and has been judged to be of high moral character and a member of good-standing in local community hospitals.

To perform operations in a hospital, a physician must be on staff at that hospital which requires a strict review of their credentials. To perform operations in an outpatient or office based operating room a physician must have graduated from medical school. That is it! No residency training is required, no certification is necessary. There is no scrutiny from any outside board or panel to determine if the individual is adequately trained or is even a surgeon at all. Most cosmetic procedures are done in this setting. Therefore, it is legal for any doctor to do any procedure in an office based operating room. In my community there are oral surgeons doing facelifts, anesthesiologists doing breast augmentations and dermatologists doing liposuction! Who is qualified to do what procedure? Only fully trained plastic surgeons are qualified to do all cosmetic procedures. Dermatologists (skin doctors) are trained to do laser resurfacing of the skin but certainly shouldn't be doing liposuction. ENT (ear, nose, throat) doctors should do rhinoplasties but certainly not tummy tucks. Non-surgical doctors such as family practitioners, internists, psychiatrists, etc. should not be doing any cosmetic surgery.

How does one determine a doctor's credentials and competency?

Ask them if they are board-certified and, if so, in what specialty. Ask them what local hospital they are on staff at and check with the medical staff office at that hospital to confirm their credentials. Check with the American Board of Medical Specialties to confirm board certification. (www.abms.org)

Society memberships are a less valuable method of determining clinical competency. Many societies can be joined simply by paying annual dues. Other societies, such as the American College of Surgeons, American Society of Aesthetic Plastic Surgery and American Society of Plastic Surgeons are far more selective in their membership.

To ensure selection of a clinically competent and well-trained plastic surgeon start with those certified by the American Board of Plastic Surgery.