In the two-part series published on September 14thand 15th in USA Today, reporter Jayne O’Donnell writes about the dangers that stem from the “commoditization of cosmetic surgery.” The growing demand for cosmetic procedures, as well as the attraction of self-pay elective surgery in an era of managed care, has encouraged physicians from various specialty-training backgrounds to assume the mantle of “cosmetic surgeon.”
The article also focuses attention on board certification. O’Donnell notes, “residencies — the years-long stints working in hospitals under the guidance of more senior physicians — are required for board certification and are the principal distinction separating plastic and cosmetic surgeons, who typically instead do year-long fellowships or private training.” All plastic surgeons with board certification from the American Board of Plastic Surgery are trained in “cosmetic surgery”, but all ‘cosmetic surgeons’ are not trained in plastic surgery.
“This article just reinforces that patients must do their homework when choosing an aesthetic plastic surgeon,” says Jeffery M. Kenkel, MD, president of ASAPS. “There is tremendous confusion about plastic surgery. Television shows trivialize the experience, and advertisements often intentionally mislead. It’s important for people to realize that when the surgeon is properly trained and the facility is accredited, patients are much more likely to be satisfied with the outcome.”
There is no such thing as ‘risk-free’ surgery but there are steps patients can take to help ensure their safety and satisfaction when undergoing cosmetic surgery. The Aesthetic Society offers the following list of questions as a guideline of what to ask during a consultation with a plastic surgeon:
- Check Board-Certification: A doctor’s board-certification is the best indicator of his or her training in a particular medical or surgical specialty. Look for certification by the American Board of Plastic Surgery (ABPS), the only Board recognized by the American Board of Medical Specialties (ABMS) to certify doctors in the specialty of plastic surgery.
- Check ASAPS Membership: ASAPS membership ensures that a doctor not only is ABPS-certified (or, in Canada, certified in plastic surgery by the Royal College of Physicians and Surgeons of Canada.) but also has significant experience in cosmetic surgery. ASAPS membership is by invitation only.
- Check Facility Accreditation: Cosmetic surgery can safely be performed in a hospital, a surgicenter or an office-based surgical facility. Current published data show that accredited office-based facilities have a safety record comparable to that of hospital ambulatory surgery settings. However, the majority of office-based surgical facilities are not accredited. Another advantage of selecting an ASAPS member is that all ASAPS surgeons operate in accredited, state-licensed or Medicare-certified facilities.
- CheckHospitalPrivileges: Before granting operating privileges, hospital review committees evaluate a surgeon’s training and competency for specific procedures. Wherever the surgery will be performed, be sure that the surgeon has operating privileges in an accredited hospital for the same procedure being considered.
- Check Reliable Sources: Asking a patient’s primary care doctor for recommendations is a good place to start, and friends may offer suggestions, but the surgeon’s board-certification should always be verified independently by contacting the American Board of Plastic Surgery(www.abplsurg.org). Free referral information to board-certified plastic surgeons with significant experience in cosmetic surgery can be found on www.surgery.org . ASAPS’ web site also offers extensive information about cosmetic surgical procedures.
- Check Thoroughness: The consultation is an important opportunity for questions to be asked and answered. It should include a candid discussion of risks as well as benefits of the surgery. A thorough consultation also involves a review of medical history including any existing medical conditions. All these factors help the surgeon to custom-tailor the operation to best meet the needs of each patient.
- Check Rapport: Even the most experienced surgeon is not the “right” surgeon for every patient. Any successful relationship depends on good communication. Patient satisfaction is enhanced when surgeon and patient candidly discuss goals, agree on realistic expectations, and plan the course of the surgical journey together.
- Check Experience: Experienced aesthetic plastic surgeons generally perform a wide range of cosmetic surgeries on a regular basis. Patients should ask about the surgeon’s experience with the particular procedure being considered. If considering a “new” technique or technology, patients should inquire whether results substantiating safety and effectiveness have been published in a peer-reviewed journal.
- Check Follow-up Care: Good surgical care does not end with the surgery. Patients should inquire about follow-up visits and about the doctor’s policies should surgical revisions be necessary.
- Check Cost: National averages for surgeons’ fees can be found on www.surgery.org . Fees may vary considerably depending on geographic region, surgeon experience and individual patient factors. Not all patients can be treated with the same technique, and the complexity and length of surgery affect cost. Patients should note that cosmetic surgery usually is not covered by insurance.
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.