Cosmetic Surgery New Jersey
Recently, I answered a question in the section “Ask the Doctor” for New Jersey Health and Life Magazine about what type of doctor to go to for cosmetic surgery. I said, go to a plastic surgeon because they are the ones in charge of the human appearance. Well, I have been thinking about my answer. I didn’t have much time to reflect before responding and I felt a bit guilty of my self-serving recommendation. I began wondering if I should call back the editor and change my answer. Then, I thought more about what my answer should be. Why is it that plastic surgeons are in charge of the human appearance? Plastic surgery is a subspecialty of surgery that deals with the shape of our body. The word comes from the Greek plastic meaning shaped or moldable . It takes anywhere from three to most often five years of general surgery training to just qualify to be accepted to a plastic surgery residency program. It is so competitive that today most candidates are fully trained in general surgery and some like myself are board certified in general surgery. Some do a year of fellowship in micro-vascular surgery or do research before being accepted and finally some don’t get accepted at all. Then it takes two to three years of training in an approved plastic surgery residency program. After a residency, it usually takes two years of experience to be able to finish the board’s exams in plastic surgery and be certified. To belong to the American Society for Aesthetic Plastic Surgery, one has to demonstrate that they do a number of cosmetic cases in a year and maintain a set number of CME training hours in cosmetic surgery. Compare this kind of rigorous requirements to a weekend course or watching a video on you tube. Why would anyone if they where properly informed, chose to go to someone with less training for their cosmetic procedures?
Why is it necessary to go through specialty training in the first place, if everyone could just declare his or her specialty without being trained in it?
It reminds me of one of our general surgery residents who wanted to become a plastic surgeon, but didn’t make the cut. He couldn’t find a residency program in plastic surgery after five years of general surgery training, so he decided to go back to his home state and simply declare himself a cosmetic surgeon. This guy at least had some training in plastic surgery while he was doing his residency in general surgery. But, I also remember an internist, practicing in a nearby state doing breast augmentation, after starting a cosmetic clinic and giving people Botox and Restylane injections. This gentleman called himself a cosmetic surgeon. I remember asking him, “how did you become a surgeon, never mind a cosmetic surgeon?” He answered, “I watched a surgeon do a breast augmentation and there are a lot videos.” I couldn’t believe that this was happening and without regulation limiting the scope of practice, this kind of thing could happen more frequently. There was a time when there weren’t enough specialists available and general practitioners did some surgical procedures including cesarean sections in areas where there was no gynecologist. General surgeons or general practitioners performed orthopedic procedures when there was no orthopedic surgeon available, but this was years ago and when the proper specialist arrived, this kind of practice stopped. Today there are many plastic surgeons, well trained and eager to do what they spent lifetime training for. The patient needs to know the difference. After much reflection, I decided that my response was correct and that indeed, board certification in plastic surgery (which happens after many years of training in surgery and plastic surgery) is the absolute minimum requirement to qualify a physician to do any plastic surgery procedure. Of course this doesn’t mean that every plastic surgeon is capable of obtaining optimal results. There are differences in people’s natural talent. In plastic surgery, an artistic eye, a creative mind and personal skills are more important than in any other specialty. The public should consider the board certification in plastic surgery, a minimum requirement and then do their homework to find the best plastic surgeon. This is something that is in the public interest and the government officials should pay more attention to it. There should be a limit on what an MD or DO without proper surgical training can do. The reason for this blog is to increase public awareness.