Cosmetic procedures can be huge, life-changing decisions, and you want to make sure you’re in the hands of a knowledgeable, experienced professional who knows exactly what they’re doing. But imagine going under the knife with a surgeon who has no training in the procedure he’s performing. It’s a terrifying thought, but it’s surprisingly common.
A general surgeon can claim to be a plastic surgeon with minimal (if any) real experience or know-how of the specialized field. And it’s not illegal. We recently explored this phenomenon among dermatologists, and wanted to get the truth behind the trend among surgeons.
We asked Dr. Tracy Pfeifer, a board-certified plastic surgeon in New York, about the certifications a plastic surgeon should have, and what we should look out for when selecting a surgeon.
Fake board certifications do exist. And they’re more common than you think.
There are board certifications that sound like the be-all and end-all of certification and expertise. But they’re not. Dr. Pfeifer says that these “boards”—the American Board of Cosmetic Surgery, for example—aren’t actually overseen by the American Board of Medical Specialties.
“As such, they don’t meet the most rigorous standards. These ‘boards’ claim that they are equivalent to to ABMS, but they are not. A doctor can be certified in general surgery and then perform breast augmentations (with little to no training) and still claim to be board-certified because they are a member of the American Board of Cosmetic Surgery,” Dr. Pfeifer explains. You should be aware of exactly which board a surgeon is certified by before choosing to do any procedure with them.
What certifications should a reputable plastic surgeon have?
A plastic surgeon should be certified by the American Board of Plastic Surgery at a minimum. “To be certified by the board, a surgeon has to train in an accredited plastic surgery program, taking tests each year and taking on a certain number of cases. In addition, once we finish training, we take written and oral boards to ensure our competency,” Dr. Pfeifer told us. “Certification by the ABPS does not necessarily guarantee expertise, but it does guarantee rigorous training that is overseen by the American Board of Medical Specialties.”
Surgeons who are certified by the ABPS can also be members of other organizations like the American Society of Plastic Surgeons or the American Society for Aesthetic Plastic Surgery. (But a surgeon is highly qualified only if he or she is a member of one of these organizations in addition to the ABPS, not instead of the ABPS.)
Dr. Pfeifer believes it’s important to find out whether a surgeon you’re considering belongs to these secondary organizations. “A plastic surgeon can choose not to be a member of either society, but I feel that membership to these organizations shows a commitment to the profession and a desire to stay up-to-date. This is especially true of the American Society for Aesthetic Plastic Surgery. Not only do members have to show that they have done a certain number of aesthetic cases to qualify, but they must also attend a meeting every few years to maintain their membership. To me, ASAPS is the most prestigious society for plastic surgeons practicing cosmetic/aesthetic surgery.”
Does a plastic surgeon have to re-apply for their certification?
“We have to maintain our certificate once we’re board-certified. Literally, this is called MOC (Maintenance of Certificate). In order to do this, we have to do certain activities each year, which include a certain number of educational requisites that are logged and tracked. Failure to meet the requirements will result in loss of certificate,” Dr. Pfeifer explains.
Other than certifications, what are other signs that a surgeon is qualified?
“The best way a patient can tell if the doctor has at least the basic training to perform the procedure is to ask the doctor if they have hospital privileges to perform the procedure,” Dr. Pfeiffer advises. “Most hospitals will not give the doctor surgical privileges unless they have completed the appropriate residency training. For example, a hospital usually will not give a general surgeon privileges to perform abdominoplasty or otolaryngologist privileges to do breast augmentation.”
“Plastic surgeons also show they are experts in their given areas by speaking at national meetings, writing papers, teaching residents, etc. You can also check with the your state’s Department of Education (or the department that oversees physician licensing in your state) to see if there are any malpractice claims against the doctor.”
What red flags should we look out for?
There are lots of signs of an unethical doctor that you can see during a consultation. According to Dr. Pfeifer, some of the most glaring signs include:
+ Pressure to sign up for surgery the day of the consultation, in exchange for a reduced fee
+ Not requiring preoperative medical testing and clearance (“I know of a patient who was told she could have surgery the next day—no labs checked or anything!”)
+ A dismissive attitude about questions or concerns, and not explaining alternatives or risks
+ A doctor who is okay with doing several large procedures at once
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