Do Cosmetic Surgeons Learn More Cosmetic Surgery Than Plastic Surgeons?

Dr. Michael S. Beckenstein

Some surgeons who declare themselves as cosmetic surgeons state that they learn more cosmetic surgery than plastic surgeons. This is a ridiculous argument and demonstrates a dangerous lack of fundamental knowlege and judgement. It is the training that lays the strong foundation for a surgeon.

Let’s start with basic training for a surgeon; the residency. this is where a surgeon builds the strong foundation of knowlege and experience in his/her field. A true residency has a board examination process that must be satisfied to obtain certification. This board should be recognized by the American Board of Medical Specialties (ABMS). This is where the basic fundamentals of surgery are learned. This includes not only learning how to operate, but how to manage patients before during and after their surgery. Essenetial to a successful residency is learning how to stay out of trouble and how to manage complications and challenges that might arise. Wounds, scarring, and other issues arise in plastic surgery patients as with other specialties, often the plastic surgeon is the last specialist brought in to finally solve and coreect a complex surgical situation. this is where the plastic surgery residency is invaluable to the plastic surgeon and those who depend on him/her. No other residency teaches and provides the vast experience with these complex issues.

Plastic surgeons are trained in plastic surgery which includes cosmetic and reconstructive surgery of the face and entire body. Often the reconstructive training is called upon to manage difficult and challenging situations, especially pertaining to cosmetic surgeries. These surgeons must become certified by the American Board of Plastic Surgery (ABPS) to demonstrate competence in performing plastic surgery, including cosmetic surgery.

Cosmetic surgeons are ENT, gynecologists, general surgeons, and other non surgical specialties who also perform cosmetic proecdures, after completing some sort of cosmetic surgery fellowship, which is not a residency. Some participate in weekend type courses to learn cosmetic surgery! They do not possess the strong foundation that plastic surgeons have. Plastic surgeons, after completing their residency requirements, can compete a cosmetic surgery fellowship to augment the training in cosmetic surgery they already received in their plastic surgery residency. They are building an even stronger foundation of knowlege and experience that those deemed cosmetic surgeons.

Fellowships are designed to enhance training so a surgeon can specialize and further hone knowlege and skill of what was learned during residency. It is NOT to learn new techniques on parts of the body that are “foreign” to them where there is no “comfort zone” when operating in those areas. Cosmetic surgery is very challenging and demanding with little margin of error. Many fellowships are not “hands on” as patients only desire the teaching surgeon to perform the procedure. So the fellow usually takes on an assisting or observational role. With an appreciation of performing these procedures already, a plastic surgeon can effectively learn in this environment where others can not. So again, here an ENT surgeon, with no real training in breast surgery, could not have the same appreciation for mastering procedures on the breast and body when compared to the plastic surgeon, in this circumstance. They are focusing on the how to perform the basics of the procedure where the plastic surgeon is learning the nuances of how to do it better. So cosmetic surgeons stating they learn more cosmetic surgery than plastic surgeons is a ridiculous one as they do not have the foundation, nor the hands on experience compared to plastic surgeons. You can’t even compare a cosmetic surgeon to a plastic surgeon who completed a cosmetic surgery fellowship.

Cosmetic surgeons often take weekend courses on cosmetic procedures, perform a few under some sort of “supervision” and then feel they are ready and adequately trained to go out and operate. They use the argument that plastic surgeons often take weekend courses and learn a new procedure, why can’t they? Well, the reason is plastic surgeons have the foundation to stand on to appreciate, learn, and more readily perform the new techniques. Again, there is no merit to this flimsy argument used by cosmetic surgeons!

Imagine an ENT surgeon performing a breast reduction or enhancement, after a weekend course or “fellowship”. Plastic surgeons have much more experience here as they completed at least 2 to 3 years of general surgery where breast surgery is learned and another 3 years learning plastic surgery of the breast. Who would you want to operate on your breast, abdomen, or perform liposuction on your thighs? This is the question you must ask when you are choosing a cosmetic surgeon. Make sure he/she is certified to perform cosmetic surgery by an ABMS specialty, has adequate experience, and has a good, safe reputation! This responsibility is yours and the consequences can be dire if you make a poor, uniformed decision.

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