Sorting through the hype: how to choose a plastic surgeon

American Fitness, Nov-Dec, 2003

The advertising and public relations world has continually brought physicians' names to the public. Ten years ago if a doctor called himself a cosmetic surgeon, the patient knew precisely what that title meant. Currently, doctors in various sub-specialties, such as dermatologists, gynecologists, opthamologists and even dentists, are performing cosmetic surgery procedures. This can utterly confuse prospective patients trying to find the most qualified surgeons. How, wonders Dr. Stanley Taub, a New York City plastic and reconstructive surgeon, "is a prospective patient to know who is a diligent, excellent, caring physician and who is a charlatan?" Taub wants to disseminate information the public can use to select a cosmetic surgeon in a country now brimming with doctors calling themselves "cosmetic surgeons."

"Public law and policy do not necessarily protect us from unreasonable and untrue claims," declares Taub. "A physician needs to be licensed in medicine which means earning a recognized medical degree--and can hang out a shingle in any specialty he chooses. The state does not control what area of medicine he practices or which type of specialist he says he is unless there are complaints and he is brought before the Office of Professional Medical Conduct. Often, however, by then it is too late."

How do we ascertain a physician's expertise and qualifications before placing ourselves under his or her care? Four basic areas must be investigated--a physician's training, certification, associations and attitude toward his or her patients.

TRAINING

"A physician should have and be willing to provide evidence that he or she has trained in the area of their expertise," Taub states. "For example, patients want to locate a plastic surgeon who trained in plastic surgery, which means a post-surgical residency fellowship in the sub-specialty. Each residency or fellowship program gives a certificate [indicating] the dates of service as well as the hospital or department in which the physician trained." Most physicians keep certificates and other diplomas framed in their offices. If these are unavailable, at least a curriculum vitae or brochure describing a doctor's training should be available and carefully examined by the patient. "If a physician is either unable or unwilling to disclose this information, it becomes a clear issue of 'medical consumer beware,'" Taub warns.

CERTIFICATIONS

Each medical or surgical sub-specialty has a certifying board approved by the American Board of Medical Specialties[R] (ABMS). After training the requisite number of years, a physician must take an examination to become certified. After being certified, a surgeon often applies for a fellowship at the American College of Surgeons. These credentials can be checked in The Official ABMS Directory of Board Certified Medical Specialists, available in public and hospital libraries, which lists all physicians and their specialties as well as a number of local physician directories. "Unfortunately, the AMA and other state and local medical societies often allow physicians to self-designate a specialty, [which] can be misleading," explains Taub. A patient must be wary of self-designated specialists. "For example, The American Board of Cosmetic Surgery is not approved by [ABMS] and neither are a host of other so-called 'boards,'" says Taub, who is board certified with the American Board of Plastic Surgeons, Inc., the only plastic surgery board recognized by ABMS. Gynecologists, ENTs or general surgeons may be exquisitely trained physicians, but where did they learn to perform cosmetic surgery? Was it on-the-job training or a correspondence course? How often do they go for a refresher course? Are they affiliated with a certified hospital in case of emergency?

Moreover, Taub advises the would-be medical consumer "not to be impressed by a P.C. after the physician's name--it only means they are incorporated." People should look for a surgeon with the medical titles M.D. (i.e., Medical Doctor) and F.A.C.S. (i.e., Fellowship of the American College of Surgeons), which indicate the physician has the proper qualifications.

TOP FIVE COSMETIC SURGICAL PROCEDURES

1. LIPOSUCTION (372,831 *)

Liposuction removes unwanted fat lumps and bulges. A vacuum and hose are attached to cannulae (i.e., thin suction tubes) which are placed into body fat through small incisions. Although healing time varies for individual patients, stitches are generally removed after the first week, bruises begin to fade after three weeks and swelling completely disappears after six months.

2. BREAST AUGMENTATION (249,641)

Augmentation mammoplasty (i.e., breast augmentation) enhances breast size and shape. An implant is inserted behind each breast after an incision is made either in the crease where the breast meets the chest, around the areola (i.e., dark skin around the nipple) or armpit. Once the incision is made, the surgeon lifts the breast tissue and skin to create a pocket. After the surgery, patients will probably feel tired and sore, but most discomfort can be alleviated with medication. Stitches are removed in approximately 10 days, but swelling may take three to five weeks to disappear.