What are the Differences and Which Is Right for You?


Dr. Constance Chen

Board-certified plastic surgeons are sure to be trained in cosmetic surgery, general surgery, and reconstructive surgery. Cosmetic surgeons may not be able to offer the same assurance. Certification is the best place to start in deciding if a surgeon is right for you.

Reconstructive surgery and cosmetic surgery are both elements of plastic surgery that are closely related but they are not the same. “The first thing to understand is that reconstructive and cosmetic surgery both improve the body but with different goals” says plastic surgeon Dr. Constance M. Chen. The primary difference between them is not the procedures the surgeon performs – some of these are the same – but the qualifications to perform them. The surgeon’s training, experience, and certification can be quite different.”

Reconstructive surgery is dedicated to correcting defects and restoring function to parts of the body damaged functionally or aesthetically by birth or developmental disorders, trauma, infection, or disease. Examples include breast reconstruction following mastectomy, cleft lip and palate correction, skin cancer removal, burn repair, and scar revision. Reconstructive surgeons can move healthy, live tissue from one part of the body to another using techniques such as skin grafts, flap surgery, and microvascular surgery. Reconstructive plastic surgery is generally covered by insurance.

Cosmetic surgery is focused entirely on enhancing appearance. It includes both surgical and non-surgical procedures and may be performed on any part of the body. It includes procedures such as face lift, rhinoplasty (nose job), tummy tuck, liposuction, breast augmentation and breast lift, and skin resurfacing. Cosmetic surgery is generally considered elective and is often not covered by insurance.

“All plastic surgeons are trained in both reconstructive and cosmetic surgery, but they may specialize more in one than the other,” says Dr. Chen. “A prospective patient considering a particular procedure that could be performed by either – say, a face lift or breast augmentation – would be wise to consider the surgeon’s area of specialization.”

Both reconstructive and cosmetic surgeons may identify themselves as “board-certified” if they are certified by the American Board of Plastic Surgery (ABPS), which is recognized by the American Board of Medical Specialties (ABMS), the governing body for medical specialty boards since 1934. Board certification by the ABPS requires graduation from an accredited medical school; a minimum of six years of additional training in surgery, at least three years of which must be in plastic surgery residency, which includes training in cosmetic surgery; and passing comprehensive oral and written examinations. There is no certifying board for cosmetic surgery that is recognized by the American Board of Medical Specialties and there are no residency programs devoted exclusively to cosmetic surgery. The American Board of Cosmetic Surgery (ABCS) is not recognized by the ABMS.

“Board-certified plastic surgeons are sure to be trained in cosmetic surgery, general surgery, and reconstructive surgery,” says Dr. Chen. “Cosmetic surgeons may not be able to offer the same assurance. Certification is the best place to start in deciding if a surgeon is right for you. The website of the American Board of Plastic Surgery has a convenient lookup feature that identifies board-certified plastic surgeons. You can find it here.” Once you’ve determined that a surgeon is certified, Dr. Chen recommends additional factors to consider:

Hospital privileges: If your surgery is to be performed in the doctor’s office or in an outpatient surgical center, ensure that your surgeon is also approved to perform the same procedure at a local hospital. Board-certified plastic surgeons will have transfer privileges to at least one local hospital in case of emergencies.

Experience: Make sure your surgeon doesn’t just offer the procedure you want but has performed it many times with good results. Ask for before-and-after photos, patient satisfaction data, how many times she has performed it in the last year, what complications she has encountered and how they were managed.

Bedside manner: Choose a doctor and a practice who listen carefully to your goals and expectations, whose aesthetic recommendations match yours, who make you feel comfortable and supported, give you plenty of time, lots of information, and answers to all your questions.

“Board certification does not guarantee that a surgeon will be right for you,” Dr. Chen concludes, “but it’s a good way to ensure a high level of professional training and standards. Learning about a doctor’s experience, patient results, and approach to the doctor-patient relationship will help ensure you get the best possible care.”

Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. http://www.constancechenmd.com

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