Surgeon selection

Surgeon selectionPeople who are contemplating cosmetic surgery are usually advised to take time to investigate the training and qualifications of any physician consulted. This is important, but difficult for a lay person to do successfully. That’s because the credentialing of cosmetic surgeons is so variable, even within a single geographic region, and few practitioners are equally qualified in every aspect of each cosmetic procedure. The patient seeking consultation for a desired change in appearance does not necessarily know in advance which cosmetic procedure is best to effect that change, and therefore cannot be sure that the physician consulted has expertise in the procedure that is actually likely to best be of benefit.

Credentialing of the cosmetic surgeon

Cosmetic surgeons come from a variety of backgrounds in surgical, and even dermatological, training. In most countries, a licensed physician can claim expertise in “cosmetics” without training or Board Certification in any of the specialties that are recognized by the medical profession as being part of plastic and cosmetic surgery. A physician can legally advertise cosmetic services even when he or she is not recognized as adequately qualified in cosmetic surgery by experts in the field. The fact that those experts have more than one possible Board Certified Specialty and course of training, complicates the patient’s ability to recognize which physicians are adequately trained in cosmetic surgery. An understanding of which specialties are qualified to perform cosmetic procedures, and which procedures are performed by each is important in evaluating a potential provider of cosmetic surgery.

“Most facial plastic surgeons do their residency training in Otolaryngology-Head-and-Neck Surgery”. (US based, International Membership) [5]

Oculoplastic Surgery includes cosmetic surgery of the forehead, eyebrows, eyelids and mid-face. Surgeons are usually board-certified ophthalmologists with fellowship training in ophthalmologic plastic surgery. (Training in UK)[ http://www. oculo-plastics. org. uk/ ]

“Dermasurgeons (dermatologists) play an ever-expanding role in the management of cosmetic patient concerns. As a specialty, they have advanced and pioneered safe liposuction, noninvasive endovascular venous technologies, ablative and nonablative laser approaches, and minimally invasive suture-based lifting procedures”.(Advanced Cosmetic Surgery Sadick NS – Dermatol Clin – 2005 Jul; 23(3); xi)

Oral and maxillofacial surgeons

One group of professionals who are generally recognized as having expertise in cosmetic surgery are not physicians at all, but dentists. Graduates of Dental School who go on to post-graduate residency training in Oral Surgery with adequate experience in facial cosmetic surgery may practice cosmetic facial surgery. “Because of their surgical and dental background, oral and maxillofacial surgeons are uniquely qualified to perform cosmetic procedures that involve the functional and aesthetic aspects of the face, mouth, teeth and jaws.” [7]

Interdisciplinary organizations

Some professional organizations dedicated to Cosmetic Surgery now include members of various disciplines [8]

Cosmetic procedures by other specialists (General Surgeons, Vascular Surgeons, and others)

Certain types of procedures are usually performed by specialists whose training and practice is not typically in cosmetic or reconstructive surgery. Vascular surgeons have special expertise in removing varicose veins, and general surgeons, gynecologists, and urologists have expertise in cosmetic procedures of the genitals, anus, and perineum.

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