How to Choose the Best Plastic Surgeon
THE WORD "PLASTIC" doesn't just refer to a man-made, petroleum-based substance that's currently choking the world's oceans. It also means that something is moldable or flexible, and when this term is used in relation to surgery, it conjures up images of Hollywood stars with perfectly chiseled noses, bountiful breasts and taut tummies. But there's much more to plastic surgery than just face-lifts and breast implants; the medical specialty has its origins in reconstructing body parts after major trauma or surgery to remove disease or deformity.
The American Board of Plastic Surgery reports that "plastic surgery deals with the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial [head, mouth, skull and face] structures, hand, extremities, breast and trunk, external genitalia or cosmetic enhancement of these areas of the body." Whether you're trying to enhance your bust line for aesthetic reasons or reconstruct a breast after a mastectomy to treat breast cancer, the plastic surgeon is the doctor to help you achieve your goal.
These surgeons often work on a range of different body parts. Some focus on treating patients undergoing elective, cosmetic procedures (such as a tummy tuck, breast augmentation or liposuction), while others focus on reconstructing body parts damaged by trauma, such as rebuilding a person's face after a bad car accident. In all of these instances, you want an experienced surgeon who has worked on lots of similar cases.
Dr. Daniel Maman, an ABPS board-certified plastic surgeon with 740 Park Plastic Surgery in Manhattan, says some patients find the search for the right plastic surgeon for their needs confusing. "The problem with plastic surgery is that you have a lot of other specialists – primary care physicians, podiatrists, gynecologists, dermatologists engaging in plastic surgical procedures" after having taken a weekend course to learn how to do a breast augmentation, for example, Maman says. These practitioners then hang out a shingle and start operating on people, and sometimes it works out. "They might get lucky the first 30 times they do it and not have a problem. But then suddenly they have a catastrophic problem down the road," in which a complication arises during surgery that the doctor isn't trained or equipped to deal with. This can result in scarring, disfigurement, infection or even death in the most extreme cases. Fixing the problem may take several, costly corrective surgeries.
There's nothing inherently illegal about practicing outside your area of specialty, although Maman notes he would likely be held liable for malpractice if the procedure went wrong. "As a board-certified plastic surgeon, I can decide that I'm going to remove a brain tumor if I want. There's no state law that prohibits you from doing that. Once you have a medical degree, you can do whatever you want. The problem is, I don't know how to do that and the patient's not going to do well."
Therefore, just like you would carefully research and select a board-certified neurosurgeon to remove a brain tumor, Maman says it's important to find a board-certified plastic surgeon to handle any and all plastic surgery procedures you're considering. "The key is choosing a plastic surgeon who's board-certified by the American Board of Plastic Surgery, period," he says. The ABPS reports there are about 6,800 board-certified plastic surgeons currently practicing in the United States. The ABPS is the only specialty board for plastic surgery and cosmetic procedures that's recognized by the American Board of Medical Specialties, the gold-standard certifying body for specialty boards.
Maman says it's important to look at the website of surgeons you're considering to determine their credentials. "Everybody under the sun says in their bio that they're a board-certified surgeon. Which board certified them is the key." You can verify whether a surgeon you're considering is certified by the ABPS through the website.
To earn ABPS certification, doctors must complete at least six years of surgical training following medical school, with a minimum of three years of plastic surgery residency training. Once that intensive training period is complete, the surgeon must pass a comprehensive oral and written exam. The surgeon must also supply the board with documentation of cases completed since leaving training. The board "even wants to know how you're billing, and there's a very specific protocol you have to follow when you submit your cases," says Dr. Gregory Wiener, a board-certified plastic surgeon in private practice in Chicago. "They want to make sure you're billing ethically, why you made the decisions you made and how you followed up on cases and cared for patients afterwards." It's a lengthy and stressful process, but one that Wiener says lets patients know the doctors are capable of performing the surgeries they say they can. To remain board-certified, the doctor must take a renewal exam every 10 years.