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YOUR DOCTOR'S CREDENTIALS & RESEARCHING YOUR PLASTIC SURGEON
Ten
Questions To Ask Your Plastic Surgeon
Credentials: Evaluating
Cosmetic Surgery Referral Sources
Credentials: Why Select A Board-Certified Plastic Surgeon
For Your Cosmetic Surgery?
The American Board Of Plastic Surgery (ABPS)
Credentials: Training And Certification Of Plastic
Surgeons
Credentials: Your Cosmetic Surgery Consultation- Ask
The Right Questions
Office Surgery: Guidelines
Safety Of Cosmetic Plastic Surgery
Choosing a qualified plastic surgeon who is right
for you will be the most important factor in the success of your
surgery. But, how can you be sure you’re getting a qualified,
competent plastic surgeon? First, do your research and make sure
you’re informed. Talk with friends, doctors, nurses and hospitals.
Hospitals have rigid requirements for physician qualifications.
You can call your local hospital and ask if the doctor is allowed
to perform the procedure you want at the hospital - even if your
surgery will not be done there. This is a good indication that your
doctor meets the accepted standards expected of physicians in the
community.
To locate a board-certified surgeon in your area click on Find
a Plastic Surgeon.
What Is The American Board Of Plastic
Surgery And Why Is It Important?
The most qualified and well respected plastic surgeons are certified
by the American Board of Plastic Surgery, which
is the only plastic surgery board recognized by the American
Board of Medical Specialties. By choosing a plastic surgeon
who is certified by the ABPS, a patient can be
assured that the doctor has graduated from an accredited medical
school and completed at least five years of additional residency
training-usually three years of general surgery, and two years of
plastic surgery. To be certified, by the ABPS,
a doctor must also practice plastic surgery for two years and pass
comprehensive written and oral exams. This process requires the
passing of a rigorous written examination, followed a year later
by an equally rigorous oral examination by the nation’s most
respected plastic surgeons. Be aware, in most states, a licensed
physician may perform plastic surgery without being board-certified
in plastic surgery. Just because a doctor is board-certified does
not mean he or she is certified by the American Board of
Plastic Surgery (ABPS).
Only members of the American Society of Plastic Surgeons
may display the ASPS logo (looks like an incomplete
circle). It tells you that you are choosing a physician who is certified
by the American Board of Plastic Surgery. Only
surgeons who have met the stringent training and ethical requirements,
and who are active members of the American Society of Plastic
and Reconstructive Surgeons can display this symbol. Only
these surgeons are certified by the American Board of Plastic
Surgery and are dedicated to the highest standards of patient
welfare and surgical excellence. While good credentials can't guarantee
you a successful outcome, they can significantly increase the odds.
--The Plastic Surgery Information Service
of the ASPS is an excellent source of names of
qualified plastic surgeons. Simply call the toll-free number,
1-888-4-PLASTIC (1-888-475-2784), and leave
your name, address and the procedure you're interested in. They’ll
send you the names of five plastic surgeons in your area. You can
show this list to a doctor you trust and ask if he or she has any
recommendations. You can also check the list against the one you
may have received from the hospital.
--Special directories. You can find the
names of board-certified plastic surgeons, listed by state and city,
in two reference books available in most public libraries: The Directory
of Medical Specialists, published by Marquis Who's Who, and The
Compendium of Certified Medical Specialists, published by the American
Board of Medical Specialties (ABMS).
TEN QUESTIONS TO ASK YOUR PLASTIC SURGEON
Qualified surgeons will welcome your questions about their background
and be
willing to provide you with any necessary information. Here are
ten questions to guide you in selecting a qualified plastic surgeon.
- Are you Board Certified by the American Board of Plastic
Surgery? What is the American Board of Plastic Surgery?
- Do you have hospital privileges to perform this surgery?
If so, at which hospitals?
- How many procedures of this type have you performed?
- Where and how will you perform my surgery?
- Are you up to date on the latest surgical techniques
(continuing education)?
- Is the surgical facility accredited or in the process
of being accredited by a national or state-recognized accrediting
organization?
- What are the risks involved with my procedure?
- What is the most common complication you encounter
with this procedure?
- What is your reoperation rate and what is the most
common type of reoperation you perform?
- Can I see the results obtained by previous patients?
(Before & After pictures from several angles)
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CREDENTIALS: EVALUATING COSMETIC SURGERY
REFERRAL SOURCES
Source: The American Society for Aesthetic Plastic Surgery
There are many potential sources for cosmetic plastic surgery referrals,
but not all are equally credible. The American Society for Aesthetic
Plastic Surgery (ASAPS) offers the following tips to help consumers
evaluate referral sources:
- The American Society for Aesthetic Plastic Surgery (ASAPS):
Toll-free referral service (888-ASAPS-11) Members are American
Board of Plastic Surgery-certified surgeons who specialize in
cosmetic surgery of the face and body.
- Other professional medical societies: High standards mean reliable
referrals. Organizations of medical professionals do not all share
the same high standards. When evaluating a medical organization
as a source for cosmetic surgery referrals, be certain that the
American Board of Plastic Surgery certifies its members.
- Friends: Every surgery is unique. Referrals from a friend who
has had cosmetic surgery can be useful. But surgery, recovery
and results will vary. Every patient presents a unique set of
characteristics that require a customized surgical plan.
- Family doctors: Can be helpful. If a family doctor is well
acquainted with the work or results of surgeons in the community,
he or she may be a good resource. Be sure to ask the doctor to
recommend a surgeon who is certified by the American Board of
Plastic Surgery.
- Web sites: Good and bad. There is a wealth of information about
cosmetic surgery on the Internet; there is also a great deal of
misinformation. In general, trust web sites affiliated with recognized
medical societies. Be cautious when dealing with commercial web
sites that offer referrals to doctors, sometimes in conjunction
with patient financing. Independently check the credentials of
any physician referred by any site.
- Advertisements: Can be misleading. Be wary of advertisements
that promise painless or easy surgery, guarantee unrealistic results,
or use misleading language. Appropriate advertisements state a
surgeon’s credentials, including board certification and
the name of the certifying board. Surgeons should never be selected
on the basis of advertising alone.
- Consultants: May not be objective. In most cases, it is impossible
for a prospective patient to determine what considerations motivate
fee-for-referral arrangements. Such referrals may be made in the
consultant’s best interests, and not necessarily the patient’s.
- Media coverage: No guarantee of a surgeon’s qualifications.
The media frequently interview plastic surgeons. Some surgeons
serve as spokespersons for reputable professional organizations,
and others hire public relations representatives. A doctor’s
appearance in the media is no guarantee of training or skill.
- Bids for surgery: Price should not rule. While the surgical
fee needs to be considered, it should never be the primary factor
in selecting a plastic surgeon. The surgeon’s training,
certification and experience are key to the success of cosmetic
surgery.
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CREDENTIALS: WHY SELECT A BOARD-CERTIFIED
PLASTIC SURGEON FOR YOUR COSMETIC SURGERY?
Source: The American Society for Aesthetic Plastic Surgery
- Plastic surgeons are trained to perform surgery. It may sound
obvious, but many people don't realize that only some of the 24
medical specialties recognized by The American Board of Medical
Specialties include surgical training. Plastic surgery is a surgical
specialty.
- Plastic surgeons are experts in both facial and body procedures.
Board-certified plastic surgeons complete a minimum of five years
of surgical training following medical school, including a plastic
surgery residency program. In-depth training encompasses surgical
procedures of the face and the entire body.
- Plastic surgeons are trained to prevent and, if necessary, handle
emergencies. A comprehensive education, including a sound foundation
in anatomy and physiology, provides plastic surgeons with an understanding
of all body systems-including ventilation, circulation, fluid
and electrolyte balance-which is vitally important to patient
safety.
- Plastic surgeons' training develops technical skill and aesthetic
judgment. Experience gained during years of training in complex
reconstructive surgery provides plastic surgeons with outstanding
technical skills. Additionally, however, the continuous attention
to form as well as function provides these specialists with a
finely tuned sense of aesthetics-a unique qualification that is
critical to the success of cosmetic surgery where judgments of
balance and proportion are called upon.
- Plastic surgeons have access to a wide range of potential treatments.
Of all the different medical specialists, plastic surgeons have
the training to offer their patients the entire scope of cosmetic
treatment modalities. Their recommendations are not limited by
lack of training or inability to obtain hospital privileges to
perform complex procedures when necessary.
Because state laws permit any licensed physician to call him -
or herself a "plastic" or "cosmetic" surgeon
- even if he or she has not been trained as a plastic surgeon or
has had no surgical training at all - prospective patients must
select their doctor carefully.
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THE AMERICAN BOARD OF PLASTIC SURGERY
(ABPS)
Purpose
The prime purpose of the American Board of Plastic Surgery (ABPS)
is to evaluate and pass judgment on the training and knowledge of
broadly competent and responsible plastic surgeons. The ABPS establishes
the prerequisite requirements for those desiring training in plastic
surgery and sets the standards for graduate education in the plastic
surgery specialty. The ABPS conducts qualifying written and oral
exams for certification.
History
Established in 1937. Officially recognized in 1941 as the board
responsible for certifying physicians in the specialty of plastic
surgery by action of the American Board of Medical Specialties and
as approved by the Council on Medical Education of the American
Medical Association.
Education Requirements
There are two major paths toward obtaining acceptable graduate level
training in plastic surgery: the Independent Model and the Integrated
Model.
- An Independent Model consists of at least three years of general
surgery residency training (or complete training in a designated
surgical discipline), followed by two or three years of plastic
surgery residency training.
- An Integrated Model does not make a distinction between prerequisite
training (general surgery) and requisite training (plastic surgery),
as the two are combined into one training model.
Content of Training
Training covers the entire spectrum of plastic surgery including
reconstructive and cosmetic surgery of the face and body. In addition,
plastic surgery training programs provide in-depth education in
emergencies, shock, wound healing, blood replacement, fluid and
electrolyte balance, pharmacology, anesthetics, and chemotherapy.
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CREENTIALS: TRAINING AND CERTIFICATION
OF PLASTIC SURGEONS
Source: American Society for Aesthetic Plastic Surgery
Often portrayed as a "turf battle," the issue of training
and credentials in plastic surgery is actually an issue of public
safety about which responsible doctors are necessarily concerned.
Would you want your plastic surgery performed by someone who has
never had any formal surgical training? It can easily happen ...
- There are many physicians today practicing plastic surgery who
have received their formal training in another specialty -- often
a nonsurgical specialty. These doctors may call themselves plastic
surgeons, but they may not be trained in plastic surgery.
- Some physicians without plastic surgery training, as well as
trained and qualified plastic surgeons, perform cosmetic surgery
in their offices. The difference is that a board-certified plastic
surgeon will also have privileges to perform these procedures
at an accredited hospital.
- When we talk about a "board-certified plastic surgeon,"
we mean one who is certified by the American Board of Plastic
Surgery (ABPS), the only board recognized by the American Board
of Medical Specialties (ABMS) to certify physicians in the full
range of plastic and reconstructive procedures. To be certified
by the ABPS, a physician must have at least five years of approved
surgical training, including a residency in plastic surgery. He
or she must also pass a comprehensive written and oral exams in
plastic surgery.
- Many physicians who call themselves "facial plastic surgeons"
are trained in otolaryngology, a surgical specialty which includes
training in plastic surgery of the head and neck. Physicians who
call themselves "cosmetic surgeons" could be trained
in any specialty, including a nonsurgical specialty, because anyone
who has a medical license can legally call him/herself a surgeon
even if they have no formal surgical training.
- Membership in the American Society for Aesthetic Plastic Surgery
is by invitation only and is limited to ABPS-certified surgeons
who demonstrate wide experience in the major aesthetic surgical
procedures.
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CREDENTIALS: YOUR COSMETIC SURGERY CONSULTATION
- ASK THE RIGHT QUESTIONS
Source: American Society for Aesthetic Plastic Surgery
You may want to discuss the following points before scheduling
your consultation:
- Ask if the doctor is certified by the American Board of Plastic
Surgery (ABPS). When a doctor claims to be "board certified,"
ask by which board. Only one, the American Board of Plastic Surgery
(ABPS) is recognized by the American Board of Medical Specialties
(ABMS) to certify doctors in the specialty of plastic surgery.
- Ask about the doctor's hospital privileges. Some surgical procedures
can safely be performed in the doctor's office or other ambulatory
surgical facility. However, it is important to find out if the
doctor has operating privileges in an accredited hospital for
the same procedure you would like to have performed. Before granting
operating privileges, hospital review committees evaluate a surgeon's
training and competency for specific procedures. If the doctor
does not have hospital privileges to perform your procedure, look
for another surgeon.
- If the doctor operates in an ambulatory or office-based facility,
ask if the facility is accredited. Although most states do not
currently require ambulatory or office-based facilities to be
accredited, voluntary application can be made to an accrediting
body, such as the American Association for Accreditation of Ambulatory
Surgery Facilities (AAAASF). Facilites accredited by AAAASF have
met strict requirements for all aspects of operation, and such
accreditation denotes a high standard of care.
- If the facility is not accredited, ask more questions. It is
important to ask about the availability of life-saving equipment,
the type of monitoring devices in the recovery area, who is administering
anesthesia (ideally, a board-certified anesthesiologist or certified
registered nurse anesthetist), and the ancillary staff (ideally,
RNs).
During your consultation, the following questions can be discussed
with the surgeon:
- What experience does the doctor have in performing this procedure?
Ask what training has been completed, especially in new techniques,
as well as how often he or she performs the procedure. Ask to
see certificates of training.
- What are the possible risks? There are risks with any surgical
procedure. Find out what they are, how often they occur, and how
they will be handled if they do occur. If the doctor does not
openly discuss the risks or says that there are no risks, seek
another opinion.
- What is the expected recovery for the procedure? Important points
to discuss are postoperative restrictions on activity and typical
time periods for resuming work and social activities.
- What is the doctor's policy on surgical revisions? A small percentage
of cases may require surgical revisions to achieve the desired
result. Find out about any costs for which you may be responsible.
- How much will the surgery cost? Cosmetic surgery is not covered
by insurance, and payment usually is required in advance. Costs
include the surgeon's fee and fees for the surgical facility and
anesthesia. Other possible costs are the preoperative physical
and blood work, medications, surgical garments, and private-duty
nursing. While it is tempting to "bargain shop", or
compromise, the training and experience of your surgeon are the
most important factors in the success of your surgery. Do not
compromise.
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OFFICE SURGERY: GUIDELINES
Source: American Society for Aesthetic Plastic Surgery
According to American Society for Aesthetic Plastic Surgery (ASAPS)
statistics, 53% of cosmetic procedures are performed in office-based
surgical facilities. Published data have shown that accredited office-based
facilities have a safety record comparable to that of hospital ambulatory
surgery settings. However, the alarming fact is that most office-based
surgical facilities are unaccredited. ASAPS encourages prospective
patients to make sure their office-based cosmetic surgery meets
the following requirements:
- The operating surgeon is certified by the American Board of
Plastic Surgery.
- The office-based surgical facility is accredited by a nationally
or state recognized accrediting agency, or is state licensed or
Medicare certified. Nationally recognized accrediting agencies
include the American Society for Accreditation of Ambulatory Surgery
Facilities (AAAASF), the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO), and the Accreditation Association
for Ambulatory Health Care (AAAHC).
- The surgeon has privileges at an accredited acute care hospital
for the specific procedure being performed.
- Patients undergoing procedures that involve sedation are appropriately
monitored by registered nursing personnel. If general anesthesia
is used, it is administered by a board-certified anesthesiologist
or certified registered nurse anesthetist.
- The emergency equipment and anesthesia monitoring devices in
the surgical facilities are equivalent to those that would be
necessary for the same surgical procedure performed in a hospital
or freestanding ambulatory surgery center.
- Provisions are made for hospital admission in the event of unforeseen
complications.
- There is a separate recovery area with monitoring equipment
equivalent to that which would be necessary for the same procedure
performed in a hospital or ambulatory surgery facility.
- Until the patient is fully recovered, a physician is at the
site, in addition to a registered nurse.
- Discharge from the facility is always determined by the responsible
surgeon.
Ensuring patient safety is key to ASAPS’ mission. It is the
Society’s position, backed by published data, that when the
above guidelines are followed, office-based surgery is a safe, convenient
and cost-effective option for properly selected patients.
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SAFETY OF COSMETIC PLASTIC SURGERY
Source: American Society for Aesthetic Plastic Surgery
When cosmetic surgical procedures are performed by properly trained
surgical specialists adhering to accepted standards of clinical
practice, serious complications are extremely rare. However, no
surgery is completely without risk. Patient safety is always the
most important consideration in cosmetic plastic surgery, and a
number of factors contribute to increased safety. The American Society
for Aesthetic Plastic Surgery (ASAPS), the leading organization
of plastic surgeons who are certified by the American Board of Plastic
Surgery and who specialize in cosmetic surgery, offers these safety
guidelines for anyone considering cosmetic surgery.
Credentials: Selected
surgeons should be certified by the American Board of Plastic Surgery
(ABPS). Any doctor (even one from a nonsurgical specialty) can legally
perform surgery. On the other hand, certification by the ABPS ensures
at least five years of surgical training, including two years of
training specifically in plastic surgery. Patients undergoing a
cosmetic procedure should select a member of the American Society
for Aesthetic Plastic Surgery (ASAPS) to help ensure that their
surgeon has extensive cosmetic surgical experience and has met ASAPS
requirements for continuing cosmetic surgery education.
Hospital privileges: Cosmetic
plastic surgery is often performed outside the hospital in an office-based
surgical facility. Wherever the surgery is to be performed, selected
surgeons should have hospital privileges to perform the specific
procedure in an acute care hospital.
Facilities: Published
data show that accredited office-based facilities have a safety
record comparable to that of hospital ambulatory surgery settings.
Ambulatory or office-based facilities should be accredited by a
nationally or state-recognized accrediting agency, or be state licensed
or Medicare certified.
Health: Candidates
for cosmetic surgery should be in generally good physical health
and must be candid with their physician about any drugs they are
taking. The medical history should include hormones (oral contraceptives
and estrogen replacement) and even aspirin, vitamins, and herbal
medications since these substances can interfere with blood clotting
or interact with medications used during surgery and could increase
surgical risk.
Patient education: Before
surgery, patients should be educated about all aspects of the planned
surgery, including whether to discontinue certain medications and
stop smoking. Postoperative care should be thoroughly discussed
with the surgeon, as surgery is not truly over until the patient
is ambulatory and has returned to a relatively normal routine.
Risks: Most cosmetic
surgery is extremely safe in the hands of surgeons certified by
the American Board of Plastic Surgery. However, even with the highest
level of care, every surgery carries risks as well as benefits,
and these should be discussed thoroughly before surgery is undertaken.
For example, multiple procedures performed at the same time may
increase the risks of surgery. There are risks associated with anesthesia,
analgesics and antibiotics. Smokers are at greater risk of complications
including delayed wound healing, skin loss, scarring, and poor surgical
outcome Other risks include deep vein thrombosis (DVT) [formulation
of blood clots in the veins] and pulmonary embolism (PE) [a blood
clot that goes to the lungs preventing the lungs from exchanging
air]. Factors such as general anesthesia and prolonged operating
time appear to increase the risk of DVT. Both DVT and PE are unpredictable
and can occur outside the surgical setting, as the result of certain
medical conditions or from immobilization; for example, individuals
have developed DVT following long airplane trips.
Postoperative monitoring and home care:
In the immediate postoperative period, any patient undergoing cosmetic
surgery should be monitored by qualified medical personnel and discharged
from the surgical facility only after evaluation by the surgeon.
Usually, cosmetic surgery is performed as an outpatient procedure;
occasionally, the surgeon may recommend an overnight stay. Patients
should arrange to have someone available for assistance for the
first day or two following surgery.
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Choosing A Surgeon