Plastic surgeons and cost

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About plastic surgeons...

The term “plastic" in plastic surgery comes from the Greek word “plastikos,” which means to mold or give shape. Plastic surgery is the reconstruction of one’s facial or body appearance and the plastic surgeon molds and gives shape to a particular area on a patient, to make it more aesthetically pleasing. Plastic surgeons are found all over the world and provide cosmetic procedures for all types of patients.

Many people feel their physical appearance needs an improvement and this is where cosmetic plastic surgery comes into play. There are many reasons for wanting plastic surgery; some people have suffered an injury that has altered their appearance, some have had deformities in their appearance since birth, and some have had natural appearance-altering effects occur, such as age, weight gain, or pregnancy, and are looking for a way to restore their appearance. Plastic surgeons aim to improve their patients appearance. Most people who undergo plastic surgery find that their appearance has significantly improved and that their confidence and self-esteem has greatly increased, leading to healthier, happier lives!

Plastic surgeons deal with the repair, reconstruction, or replacement of physical defects, either of form or function, involving the skin, musculoskeletal system, cranio-maxillofacial structures, hand, extremities, breast and trunk, external genitalia. Plastic surgeons also deal with cosmetic enhancement of these areas, as cosmetic surgery is an essential component of plastic surgery. Plastic surgeons use cosmetic surgical principles to improve overall appearance and to optimize the outcome of reconstructive procedures.

Plastic surgeons require special knowledge and skill in the design and surgery of grafts, flaps, free tissue transfer and replantation.  Plastic surgeons must also be competent in the management of complex wounds, the use of implantable materials, and in tumor surgery.  Competent plastic surgeons possess basic medical and surgical knowledge, operative judgment, technical expertise, ethical behavior, and interpersonal skills in order to resolve problems and ensure patient satisfaction.

Patients considering plastic surgery must be familiar with the plastic surgeon's credentials in order to determine whether that surgeon is the right one to perform the procedure. Any doctor can perform plastic surgical procedures and call themselves a “plastic surgeon.” The term “plastic surgeon” has become generic and it is up to the patient to determine whether the qualifications and certifications of their prospective surgeon suit their needs.

The term "Board Certified" alone is not sufficient qualification as there are many self-proclaimed boards of plastic or cosmetic surgery that are not recognized by the American Board of Medical Specialties (ABMS), the main body of the 24 recognized medical specialties. Boards should ensure that plastic surgeons have successfully completed an accredited residency program in plastic surgery and that they have fulfilled the examination process necessary to obtain board certification. Certification by the American Board of Plastic Surgery (ABPS), a member of the ABMS, guarantees that the plastic surgeon has fulfilled these requirements.

The terms " facial plastic surgeon" and "general plastic surgeon" are often confused since there is an ABMS recognized board certifying facial plastic surgeons, however, they are only certified to perform aesthetic procedures on the face, head and neck. These surgeons can legitimately identify themselves a plastic surgeons and some offer procedures on other body areas. Patients must determine for themselves what procedures a surgeon is board certified to perform.

The term "general plastic surgeon" was derived by facial plastic surgeons to differentiate their specialty from plastic surgeons certified by the ABPS. However, this term seems to imply that an ABPS plastic surgeon is not proficient in performing facial plastic surgery, and the ABPS certificate implicitly states that plastic surgeons are certified to perform "cosmetic and reconstructive surgery of the face, head and neck, trunk, and extremities." ABPS plastic surgeons may sit for the facial plastic surgery boards, but there is no reason to do so as they are already certified by an ABMS specialty. Facial plastic surgeons are not eligible to be certified by the ABPS unless they complete an accredited plastic surgery residency program.

In most states, licensed physicians may perform plastic surgery without being certified in plastic surgery. Sometimes plastic surgeons are referred to as cosmetic surgeons, however, most "cosmetic surgeons" are not true plastic surgeons and are not qualified or experienced in plastic surgery. Doctors who call themselves “cosmetic surgeons” tend not to be certified to perform plastic surgery. There are so-called cosmetic surgery boards such as the American Board of Facial Plastic Surgery (ABFPRS) or The American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), however, these boards are not recognized by the ABMS.   At the extreme end of the spectrum, there are even doctors who will attend a weekend seminar on how to perform cosmetic surgeries such as liposuction and breast augmentation.

Obviously these doctors are not qualified to perform these plastic surgery procedures, however, it is perfectly legal for any doctor to perform plastic surgery, which is why it’s pertinent that those seeking out plastic surgery must be very selective in choosing their plastic surgeon, and must be sure to check credentials.   In order to be sure that the chosen surgeon is a true plastic surgeon, be sure to choose an ABPS certified plastic surgeon. Physicians may be certified by another one of the 24 official medical boards and call themselves “board certified” physicians, but that does not mean they are board certified in plastic surgery. Be sure to ask not only if the physician is board certified but also whether they are board certified in plastic surgery. Remember that while “cosmetic surgeons” may list board certification under their credentials, only the ABPS oversees the training of plastic surgeons.  

So who exactly is the American Board of Plastic Surgery (ABPS)? The American Board of Plastic Surgery, Inc. was organized in June 1937 by representatives of various groups interested in plastic surgery and received recognition as a subsidiary of the American Board of Surgery in May 1938.  The American Board of Plastic Surgery, Inc. was given the status of a major specialty board in May 1941. The ABPS is a member board of the American Board of Medical Specialties (ABMS), created to protect patients by regulating the quality of medical education. The ABPS does not determine who is eligible to practice plastic surgery procedures, however, it does monitor the qualifying requirements for applicants requesting certification and regulates comprehensive examinations and certification for those who meet the requirements.

The essential purposes of the ABPS are:

  1. To establish requirements for the qualifications of applicants who request a certificate of their ability in the field of plastic surgery in its broadest sense.
     
  2. To conduct examinations of approved candidates who seek certification by the Board.
     
  3. To issue certificates to those who meet the Board's requirements and pass the respective examinations.
     
  4. To do and engage in any and all lawful activities that may be incidental or reasonably related to any of the foregoing purposes.

The ABPS is the only one of the 24 boards approved by the ABMS that certifies physicians in plastic surgery of the face and all areas of the body.

To be ABPS board-certified, plastic surgeons have proven their ability by meeting these rigid requirements:

  • Graduate from an accredited medical school
  • Complete a least five years of additional residency – usually three years of general surgery and two years of plastic surgery
  • Must be recommended by the head of the training program.
  • Actively practice plastic surgery for two years
  • Pass comprehensive oral and written exams
  • Must meet the moral and ethical standards of the board.

Board-certified plastic surgeons must have completed an approved surgery residency of at least five years, followed by an approved plastic surgery residency of an additional two to three years, passed rigorous oral and written examinations, and practiced medicine for at least two years, all in addition to earning undergraduate and medical degrees.

Plastic surgeons certified by the ABPS have had at least five years of residency training in general surgery and plastic and reconstructive surgery, and have all of the required training and knowledge needed to be a "real" plastic surgeon. 

Those who want cosmetic procedures must seek out a board-certified plastic surgeon if they want to undergo a safe and effective procedure. Remember, it is completely legal for any doctor to perform plastic surgery, so it’s important to be very careful in selecting a plastic surgeon.

Many radio stations have contests where they offer breast augmentation (or another type of plastic surgery procedure) as the prize. A good thing to note is that ABPS board-certified plastic surgeons are not able to participate in promotions, such as radio contests, as this goes against the ABPS code of ethics. Plastic surgeons donating their services as a prize are not board-certified by the ABPS. Additionally, since there is minimal regulation in advertising, doctors can advertise themselves as plastic surgeons regardless of their training, skills, and background. Many doctors listed under “Plastic and Reconstructive Surgery” in the Yellow Pages have not completed an approved residency in plastic surgery.

Being recognized by the ABPS is held in the highest regard, and plastic surgeons who have completed the requirements are referred to as diplomats of the American Board of Plastic Surgery (ABPS). Diplomats of the ABPS must become re-certified approximately every 7-10 years by going through continuing education, having their credentials reviewed, and possibly further examination, ensuring that they are always up to date on current procedures. These “diplomats” are recognized to possess extensive skill in these following areas:

  • Congenital defects of the head and neck, including clefts of the lip and palate, and craniofacial surgery.
  • Neoplasms of the head and neck, including the oropharynx and training in appropriate edoscopy.
  • Cranio-maxillofacial trauma, including fractures of the mandible and maxilla.
  • Aesthetic (cosmetic) surgery of the head and neck, trunk and extremities.
  • Plastic surgery of the breast.
  • Surgery of the hand/upper extremities.
  • Plastic surgery of the lower extremities.
  • Plastic surgery of congenital and acquired defects of the truck and genitalia.
  • Burn managements, acute and reconstructive.
  • Microsurgical techniques applicable to plastic surgery.
  • Reconstruction by tissue transfer including flaps and grafts.
  • Surgery of benign and malignant lesions of the skin and soft tissue.

Interesting to note, is that the ABPS continually monitors their members. Some applicants may fail the exams and are retake them many times after. Those looking into plastic surgeons may ask the potential surgeon how many times they took the exams and whether they passed the written and the oral on their first attempt.

Those researching plastic surgeons, should be aware of credentials such as:

  • Where did the plastic surgeon go to school? What type of plastic surgery training did they receive? Has the surgeon completed an accredited 2-3 year residency program specifically in plastic surgery? Was the plastic surgery training a shorter "fellowship" and was this only in a specific area?
  • Specific board certification - the only recognized board of plastic surgery is the American Board of Plastic Surgery (ABPS) and patients are encouraged to consider a doctor certified by the ABPS. There are some "certifications" that are not boards at all and do not require any testing or peer review. Also, be aware that some references and Internet sites list board certified doctors only if they pay to advertise. It is entirely possible for a plastic surgeon to be certified by the ABPS but not listed.
  • Local and state medical societies and memberships. Check the surgeon’s local and state medical societies and memberships in order to ensure no grievances or complaints have been filed against them.

Those researching a plastic surgeon should note the following important questions to ask:

  • Are you certified by the ABPS?
  • Do you have hospital privileges to perform this surgery? If so, at which hospitals?
  • How many procedures of this type have you performed?
  • Where and how will you perform my surgery?
  • Is the surgical facility accredited or in the process of being accredited by a national or state-recognized accrediting organization?
  • What are the risks involved with my procedure?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • Will I need to take time off work? If so, how long?

How much will my procedure cost? Are financing options available?

Also important to consider is the plastic surgeon’s experience and background:

  • How many specific procedures has the surgeon performed?
  • How much time did it take to perform the specific procedure?
  • Has the surgeon experienced any complications? Have they had any lawsuits filed against them, pending, or settled? This information is also available to the public through many state licensing boards, so be sure to ask.

Ask about hospital affiliations:

  • What are the hospital’s admitting and surgical privileges? Occasionally doctors that operate only from their office do so because they do not actually have hospital admitting privileges. Also, ensure the surgeon has surgical privileges especially in the chosen procedure.
  • Call respected hospitals in the community and ask for the names of board-certified plastic surgeons on staff. Make sure to ask for the names of surgeons who have surgical privileges to perform the particular procedure you are interested in. Check to see if your plastic surgeon is among those listed.

Check out the office facilities and policies:

  • Anyone can use a room and call it an operating suite, so make sure the operating suite and facility is accredited, and by whom.
  • For those planning to undergo an in-office procedure, be sure to ask what will happen, or where you will be taken if there is a problem.
  • Be sure to have a clear understanding about the policy for complications and revisions.

Ask the plastic surgeon for references:

  • Don't rely solely on word-of-mouth referrals, be sure to ask the plastic surgeon for references and a list of patients, then call the references and talk to them.
  • Ask to see photographs of patients who have undergone similar procedures and make sure these are the surgeon’s patients and not models.
  • Ask doctors and/or nurses for recommendations - your family doctor or an operating room nurse may be able to recommend a surgeon.

What to look for during the consultation:

  • The plastic surgeon should answer all questions thoroughly in an understandable way, and be open to questions regarding qualifications, experience, cost, payments, and potential complications.
  • Make sure to spend ample time with the surgeon and not just the nurse or counselor.
  • Be sure to discuss motivations and expectations.
  • The plastic surgeon should offer alternatives and other doctors' names for a second opinion without pressuring you to book surgery.
  • Be sure to discuss anything with the surgeon that could affect recovery, such as a strenuous job, smoking and drinking habits, medical conditions, or medications.

Be wary of paid advertising:

  • Plenty of plastic surgeons names can be found in the yellow pages and in other advertising sources. Remember that doctors can list themselves under any specialty heading they like, and can advertise any services they want to sell, regardless of their training and credentials.
  • Remember that ABPS board-certified plastic surgeons are not able to participate in promotions, such as radio contests, as this goes against the ABPS code of ethics.

Another important thing to consider when selecting a plastic surgeon is their artistic perspective, and whether they are able to see what is desired, in order to provide optimal results.

Those wanting to check whether the ABPS certifies their plastic surgeon may call the ABMS, give them the name of the surgeon, and they will disclose both if, and when the surgeon was certified by the ABMS.

 

 

 

 

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Top cities for plastic surgeons
• Akron
• Atlanta
• Austin
• Bakersfield
• Baltimore
• Beverly Hills
• Birmingham
• Boston
• Buffalo
• Charlotte
• Chicago
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• Kansas City
• Las Vegas
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• New Orleans
• New York
• Oakland
• Oklahoma City
• Orange
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• Riverside
• Sacramento
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• San Antonio
• San Diego
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• San Jose
• Santa Barbara
• Sarasota
• Seattle
• St. Paul
• Staten Island
• Syracuse
• Tampa
• Tucson
• Virginia Beach
• Washington DC
• Williamsburg
• Winston-Salem
• Yakima

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Top states for plastic surgery

• California
• Florida
• Georgia
• Illinois
• Indiana
• Massachusetts
• Michigan
• New Jersey
• New York
• North Carolina
• Ohio
• Pennsylvania
• Texas
• Virginia

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