FAQs

Plastic surgery is a surgical sub-specialty that deals with the healing and restoration of patients with injury, disfigurement or scarring resulting from trauma, disease or congenital defects. It includes aesthetic (also called cosmetic) surgery to correct or rejuvenate facial and bodily features not pleasing to the patient. Derived from Greek, the word plastic means molding or giving form and does not refer to the use of plastic materials.

What qualifies a physician to be a plastic surgeon?

Training to become a plastic surgeon is one of the most rigorous pathways known to medicine. To become board certified by the American Board of Plastic Surgery a physician must complete a specialized post-graduate training course of five to seven years. Background training usually includes a thorough grounding in general surgery however, a background in ENT or orthopaedics may be acceptable; The final two to three years of training must be in an approved plastic surgery training center. Prior to official certification by the American Board of Plastic Surgery the physician must pass a rigorous set of both written and oral examinations. Although numerous physicians use the term "plastic" surgeons only those certified by the American Board of Plastic Surgery are true plastic surgeons.

Credentials and Board Certification

One of the first things to check are the credentials of the doctor you are considering. A simple way to determine appropriate training is to check for board certification. "The intent of the certification of physicians is to provide assurance to the public that a physician specialist certified by a member board of the American Board of Medical Specialties (ABMS) has successfully completed an approved educational program and an evaluation process which includes an examination designed to assess the knowledge, skills, and experience required to provide quality patient care in that specialty." (from the ABMS Assembly)

The American Board of Medical Specialties (ABMS) is the board that oversees certification of 24 sub-boards including the American Board or Plastic Surgery. The ABMS is the one medical board-certifying agency that you can rely.

The American Board of Plastic Surgery (ABPS) is the specialty board accredited by the American Board of Medical Specialties (ABMS) that certifies plastic surgeons. The ABPS is the only one of the 24 boards approved by the ABMS that certifies surgeons in plastic surgery of the face and all areas of the body.

How do you find out which doctor is board certified?

You can check on specific physicians through the American Board of Medical Specialties Website at abms.org and then click on "Who's Certified." Verbal verification is available through the ABMS toll-free telephone service by calling 866 ASK-ABMS (275-2267). Verification is available in The Official ABMS Directory of Board Certified Medical Specialists, published annually. The directory can be found in many medical and public libraries. Written verification is available by contacting the individual specialty board in the physician's field of practice.

Hospital Privileges:

Major hospitals are very diligent in credentialing surgeons for privileges to perform specific procedures. Furthermore, in a hospital setting, surgeons are subject to peer review (case reviews), which enforces acceptable standards. Any hospital medical staff office can provide this information. One can simply call a hospital staff office and ask if the doctor they are interested in has privileges to perform the procedure they desire. If a doctor doesn't have privileges to perform that procedure, a patient should be wary.

Specialty Organizations

The American Society of Plastic Surgeons (ASPS) requires ABPS certification for membership. The ASPS oversees continuing medical education, practice standards and ethics. The symbol of the ASPS has become a symbol of excellence in plastic surgery. Plasticsurgery.org

The American Society of Aesthetic Plastic Surgeons (ASAPS) also requires board certification by the ABPS as well as expertise in the subspecialty of cosmetic surgery. Surgery.org

Dr. Adams feels that obtaining information about credentials and hospital privileges must be part of your decision to select a particular surgeon. Other factors that one should consider are the surgeon's reputation, referrals by physicians or friends and - most importantly - one's comfort level and confidence in the surgeon. One can only determine this after a consultation with the physician personally.

Does certification by the American Board of Plastic Surgery ensure that a patient will get a perfect result from an operation?

Guarantee of perfection or even a good result can be given. Nevertheless, the more thorough the surgeons training, skill and experience the greater likelihood for a desirable result. Board certification by the American Board of Plastic Surgery means that the surgeon has completed the rigorous requirements for full time practice as a specialist in plastic surgery.

What is aesthetic surgery?

Aesthetic surgery, also known as cosmetic surgery, seeks to improve an individuals appearance. These type of operations most often involve the nose, ears, face, forehead, eyelids, breasts, abdomen, hips and thighs.

Does plastic surgery leave scars?

Scarring is an inevitable result of the wound healing process. However a very fine lined scar placed in the correct orientation may be virtually invisible. A plastic surgeon has spent years mastering techniques to place scars in the most desirable location. Nevertheless there are certain areas of the body such as the back and chest which produce more severe scarring regardless of the technique used for reconstruction and closure.

Does plastic surgery always involve skin grafting?

No. Skin grafting is used when it is the best way of closing a wound or defect. A qualified plastic surgeon has years of training to allow good judgment in deciding the best way of reconstructing a defect. A skin graft may appear to have poor color match and texture compared to the native skin, however with careful selection of a skin graft donor site these problems may be minimized.

What is a pedicle graft or flap?

A pedicle graft also called a flap, consists of a segment of skin, underlying subcutaneous tissue and/or muscle which is shifted from one area to an open wound or defect for coverage of that wound. The word pedicle means that the blood supply to the flap is never divided. When the blood supply is completely divided and reattached this is called a free flap, and requires specialized skill in microvascular surgery.

What operations are performed to improve the appearance of the breasts?

Three common procedures are performed: augmentation mammaplasty, mastopexy, reduction mammaplasty.

Augmentation mammaplasty is a procedure that can safely enlarge a small breast. Various techniques are utilized, however, in general this is done using a saline breast implant. Implants may be placed in different positions depending on the physical make-up of the patient and her breasts. The implant may be introduced through three different incisions: below the breast, around the nipple areolar complex, or in axilla (arm pit).

Mastopexy or breast lift is used when the patient is happy with the size of her breasts however due to aging and pregnancy the breast gland has begun to droop. Various techniques are employed to accomplish a breast lift and results are generally excellent.

Reduction mammaplasty or breast reduction is designed to make overly large breasts smaller. Patients seeking this type of surgery often have multiple severe physical symptoms secondary to their large breasts including neck, shoulder, back pain, paresthesia of the arms and bra strap grooving of the shoulders. The technique of reduction mammaplasty requires lengthy incisions; however, they may be placed in inconspicuous locations such as the fold underneath the breast. Typical symptoms of back pain, neck pain etc. are almost always improved after reduction mammaplasty if not completely eliminated. This procedure is often covered by insurance.

Can tattoos be removed?

Tattoos can be difficult to remove depending on the type and color. Presently the use of the YAG laser offers some of the best results in tattoo removal. Generally speaking six to eight treatments spaced six weeks apart are required for satisfactory results.