“Anyone can hold the helm when the sea is calm” – Publius Syrius, 100 B.C.

The recent explosion in popularity and media associated with Plastic Surgery has brought with it much hype and confusion about the field and what is meant by “Board Certification”. Telephone directories abound with physicians who did not complete a proper residency in Plastic Surgery and yet market themselves as “cosmetic” or “plastic” surgeons. They can do this because the state has few limits on which procedures a physician can perform or how they can advertise themselves. In fact, any licensed physician legally can call himself or herself a cosmetic surgeon, regardless of their training!

Only surgeons who have completed a full residency in Plastic Surgery have learned to perform the full range of aesthetic and reconstructive procedures such as rhinoplasties, facelifts, breast augmentation, breast reconstruction, tummy tucks and accident reconstruction. During their training, a Plastic Surgery resident works full time, spending over 3000 hours per year under the direct training and supervision of more senior and fully qualified Plastic Surgeons to learn to plan, perform, and follow-up procedures and to properly deal with any complications which might occur. Weekend training courses or certification by non-ABMS recognized Boards such as “Cosmetic Surgery” are not the same.

1. Definition of “Board Certified in Plastic Surgery”

2. How do you know your surgeon is Board Certified in Plastic Surgery?

3. Not all “Plastic Surgeons” are Board Certified in Plastic Surgery

4. Questions to ask your doctor about their training and Board Certification

5. About the Specialty Boards

Why should my doctor be Board Certified by a recognized Board?

It is up to the patient to ask the right questions and check on the qualifications of the doctor who will be making permanent changes to their body. On the surface, a procedure may appear cheaper or easier from some non-Board Certified doctors. The old Roman saying, “Caveat emptor” (Let the Buyer Beware!), still rings as true today as it did more than 2000 years ago.

Definition of “Board Certified in Plastic Surgery”

Due to the confusion in terms, the following definitions are provided:

“Board Certified” simply means a physician has been given a Board Certification by an organization called a “Board”. This includes formally recognized entities such as the American Board of Plastic Surgery but may include unrecognized or other entities calling themselves “Boards”. This can create significant confusion with the terms (see below).

“Board Certified in Plastic Surgery” means that a surgeon has been awarded Board Certification by the American Board of Plastic Surgery.

Board Certification in Plastic Surgery is awarded only after finishing a formal residency in Plastic Surgery and also passing a rigorous written examination (usually taken 6 or 18 months after completion of all training) and a difficult oral examination which includes cases from a surgeon’s own practice (usually taken at least 18 months following completion of all training).

Board Certification in Plastic Surgery can only be awarded by the The American Board of Plastic Surgery.

Board Certification in Plastic Surgery can not be awarded by any other organization, including the American Board of Facial Plastic and Reconstructive Surgery (approved training in plastic surgery in the area of the head and neck only, formal plastic surgery training encouraged but not required), the American Board of Cosmetic Surgery (not a recognized Board by the ABMS, no formal plastic surgery fellowship required), or the State Medical Board (grants medical licenses, not board certifications). These organizations do not require formal residency training in plastic surgery.

ABMS (American Board of Medical Specialties) – The ABMS is the umbrella Board that overseas all recognized medical specialties such as pediatrics, internal medicine, cardiology, orthopedic surgery etc. The American Board of Plastic Surgery is the only ABMS recongized plastic surgery board. There is no ABMS Board of cosmetic surgery, for example. For a full list of ABMS boards please visit the ABMS website.

How do you know your surgeon is Board Certified in Plastic Surgery?

An easy way to confirm your surgeon is Board Certified in Plastic Surgery is to look for the symbol of the American Society of Plastic Surgeons (ASPS), shown here:

Only members of the ASPS may display this symbol and ALL members of the ASPS are required to be Board Certified in Plastic Surgery.

Also, only Plastic Surgeons awarded Board Certification by the American Board of Plastic Surgery may state “Board Certified in Plastic Surgery.”

Read those ads or websites carefully! In most states, physicians who are not Board Certified in Plastic Surgery may still state simply “Board Certified” without specifying by whom they are certified. They may advertise plastic surgery but only have a Board in another field, such as General Surgery or Pediatrics, or may make statements such as “Cosmetic Surgery Board Certified”, “Board Certified by the State Medical Board” etc. However, these doctors are not allowed to display the above displayed ASPS symbol in any state and may not print “Board Certified in Plastic Surgery.” Only surgeons awarded Board Certification by the American Board of Plastic Surgery may claim “Board Certified in Plastic Surgery.”

In fact, numerous physicians that appear routinely on television, in the newspaper or in other media as plastic surgeons have never passed their Board Exams in Plastic Surgery! Even popular shows such as “Dr. 90210” have not required their physicians to be Board Certified in Plastic Surgery.

Do not be afraid or feel shy about asking your doctor about their Board Certification. Any legitimately Board Certified physician is happy to be asked about this and will freely review their credentials. Board Certifications of any physician also can be confirmed easily on the American Board of Medical Specialties (ABMS) website. All Board Certifications are promptly uploaded, and physcians not listed do not have an ABMS recognized Board.

Dr. Granzow is Board Certified in Plastic Surgery and is a member of the American Society of Plastic Surgeons (ASPS).

Not all “Plastic Surgeons” are Board Certified in Plastic Surgery

Not all physicians claiming to be plastic surgeons are Board Certified in Plastic Surgery, and any licensed physician legally can call himself or herself a cosmetic surgeon.

Some may be on track for Board Certification in Plastic Surgery but may not yet have accumulated the cases or practice requirements after plastic surgery training, which may take several years.

Many doctors are in practice today who claim to be “Plastic Surgeons” and have not, and never will, finish a Plastic Surgery residency. Some may have finished training but cannot pass their exams, or may have other reasons for not finishing the requirements for Board Certification in Plastic Surgery.

In the United States, physicians are generally licensed as “medical practitioners” (i.e given their medical license) by the State Medical Boards. Federal laws do not govern the quality of specialty training or dictate the procedures a physician may aspire to perform. In effect, a medical school graduate with a medical license can legally claim to be a specialist of his or her own choosing, with or without residency training in that specialty.

This means that, legally, even a doctor only trained in another field, such as general surgery, can legally place breast implants, a dermatologist can do a tummy tuck, or a pediatrician can legally do facial lasers (all have been and continue to be done – surprising but true!)

Institutions, such as hospitals, will grant privileges (the allowance to perform certain procedures) only to properly trained physicians. Therefore, a hospital will only allow a Plastic Surgeon to perform breast implants just as it would only allow a neurosurgeon to perform brain surgery.

However, physicians who have their own surgery centers are not subject to such oversight. Here, physicians who have not had specialized training are legally allowed to perform procedures outside of their area. This is why the consumer / patient must carefully check their doctor’s training and background.

The state licensing boards, such as the Medical Board of California, grant medical licenses only.

Contrary to some claims, the state medical boards do not grant Board certification. Therefore, a doctor can be licensed but not “board certified” by the Medical Board of California, for example.

Only the major specialty boards, such as the American Board of Plastic Surgery, can grant Board Certifications in major specialties. Major specialty boards include boards such as the American Board of Plastic Surgery, the American Board of Orthopaedic Surgery, the American Board of Pediatrics etc. The organization which oversees the major boards is the American Board of Medical Specialties (ABMS). The 24 member boards, as well as the names of every board certified physician in every ABMS recognized specialty can be found on the ABMS website within weeks of that physician’s Board Certification.

Questions to ask your doctor about their training and Board Certification

Any doctor who is properly Board Certified in Plastic Surgery will be happy to be asked about their background, training and Board Certification. Avoid any doctor who seems evasive about any of the following questions.

  1. Are you Board Certified in Plastic Surgery? (Board Certified in something else is not the same)
  2. Where did you do your residency and training?
  3. In what field(s) did you do your training?
  4. Did you learn to do the procedure which I am requesting in your residency or somewhere else?

 

About the Specialty Boards

Dr. Granzow is one of the few physicians Board Certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology

 

The American Board of Plastic Surgery

The American Board of Plastic Surgery is one of only 24 accredited specialty boards recognized by the American Board of Specialties (ABMS). These include the other major specialty Boards such as Cardiology, Pediatrics, Internal medicine, etc.

To be allowed to sit for these exams for the Board of Plastic Surgery, a surgeon must have completed:

  1. College (usually 4 years)
  2. Medical School (usually 4 years)
  3. Internship in General Surgery (1 year)
  4. Residency in either General Surgery, Otolaryngology – Head and Neck Surgery, Orthopedic Surgery, Urology or Neurosurgery (usually 4 to 7 more years)*
  5. Additional residency in Plastic Surgery (2 to 3 more years)*
  6. Additional fellowships (specializations) may be performed in addition to the above training

*a combined residency of 3 or more years of general surgery plus 3 years of plastic surgery now is also accepted

The American Board of Plastic Surgery, Inc. was organized in June 1937 by representatives of various groups interested in this type of surgery and received recognition as a subsidiary of the American Board of Surgery in May 1938. The American Board of Plastic Surgery, Inc. was given the status of a major specialty board in May 1941 by action of the Advisory Board for Medical Specialties

Any Diplomate of the American Board of Plastic Surgery, Inc., will have met the Board’s educational and plastic surgery training requirements. Specific clinical training is provided in the following areas:

  1. Congenital defects of the head and neck, including clefts of the lip and palate, and craniofacial surgery
  2. Neoplasms of the head and neck, including the oropharynx and training in appropriate endoscopy
  3. Crania-maxillofacial trauma, including fractures of the mandible and maxilla
  4. Aesthetic (cosmetic) surgery of the head and neck, trunk and extremities
  5. Plastic surgery of the breast
  6. Surgery of the hand/upper extremities
  7. Plastic surgery of the lower extremities
  8. Plastic surgery of congenital and acquired defects of the trunk and genitalia
  9. Burn management, acute and reconstructive
  10. Microsurgical techniques applicable to plastic surgery
  11. Reconstruction by tissue transfer including flaps and grafts
  12. Surgery of benign and malignant lesions of the skin and soft tissues.

 

The American Board of Otolaryngology – Head and Neck Surgery

The American Board of Otolaryngology was founded and incorporated in 1924, and is the second oldest of the twenty-four member boards of the American Board of Medical Specialties (ABMS).

At least five years of training in an ACGME accredited program is required. Then, successful completion of both a written and oral exam is required to achieve certification.

Board Certification in Otolaryngology – Head and Neck Surgery is awarded only after finishing a formal residency in Otolaryngology – Head and Neck surgery and also passing rigorous written and oral examinations (usually taken 6 to 12 months after completion of residency).

To be allowed to sit for the exams for Otolaryngology – Head and Neck Surgery, a surgeon must have completed:

  1. College (usually 4 years)
  2. Medical School (usually 4 years)
  3. Internship in General Surgery (1 year)
  4. Residency in Otolaryngology – Head and Neck Surgery (usually 4 to 5 more years)
  5. Additional fellowships (specializations) may be performed in addition to the above training

Specialists in Otolaryngology – Head and Neck Surgery are trained in the following areas:

  1. General Otolaryngology
  2. Head and Neck (Cancer) Surgery
  3. Otology / Neuro-Otology (hearing mechanisms and associated structures)
  4. Rhinology (Sinus diseases and nasal airway)
  5. Pediatric Otolaryngology
  6. Laryngology (Voice, Speech and Breathing)
  7. Facial Plastic and Reconstructive Surgery