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What is a Plastic Surgeon?

Who are the “Wolves in sheep’s clothing?”

The potential patient needs to be very careful about who they take on as their “Plastic Surgeon”, particularly regarding Cosmetic surgery.  There many claiming to be plastic surgeons who are NOT the real deal. In Northern Colorado we have an anesthesiologist doing cosmetic procedures, family doctors doing cosmetic procedures, a maxillofacial surgeon doing breast augments and tummy-tucks, amongst others!

As Cosmetic surgery can be lucrative there are many practitioners who want to jump on this bandwagon. Generally Cosmetic surgery is “cash up front” and excludes the rigmarole of getting insurance approval and payments, and furthermore the doctor sets his/her own fees. Unscrupulous practitioners view this as the “Cash Cow” waiting to be milked.

Consequently there are many practicing cosmetic surgery who have not been trained in cosmetic surgery. Many of these have attended a weekend conference in Las Vegas (eg) and received a fancy certificate which they display in a prominent place in their waiting room, stating that they are trained in this or that cosmetic procedure! BEWARE.

How can the system allow impostors to operate? Our Healthcare system should be protecting the public!

Many impostors have their own office facility, where there is no outside control or standard set, and they simply do as they please.

Hospitals and surgery centers generally have boards which examine the credentials of surgeons and give them permission (privileges) to perform certain operations. Of course there are centers which are hungry for work, especially surgery which pays well, and sometimes these allow doctors to perform operations for which they are not properly trained.

What makes a real plastic surgeon?

Look for the MD degree, Residency Training and the Board certification in Plastic surgery.


  1. MD degree – 4 years at medical school
  2. Surgical Training
    • There are 2 routes to becoming a plastic surgeon in the USA.
      • Traditional: 4 years of General surgery residency and then 2 years of Plastic surgery residency
      • Integrated: 2 or 3 years of General surgery residency and then 2 or 3 years of Plastic surgery residency. (This newer approach is not offered in all training centers).
    • In recent years the shorter Integrated training has been implemented as the nature of general surgery has changed, becoming more sub-specialized, and many residents headed for plastic surgery did not get the exposure and training to the broad scope of general surgery.
      We believe that the traditionally trained Plastic Surgeon with a broad scope of general surgical training develops the most competencies, and is best prepared to operate all over the body and meet the needs of our patients.
    • All our surgeons have completed a full general surgery training, and have been board eligible/certified in general surgery and ABMS Board certified in plastic surgery.
    • Our surgeons are approved to do cases by the hospital/surgery centers/ and office procedures that are regulated, approved and monitored.
    • Training includes both reconstructive and cosmetic surgery. (The average American Plastic surgeon spends 75% of his/her time doing reconstructive surgery and 25% cosmetic surgery)
  3. Fellowship training
    Many Plastic surgeons go on to do additional training in an area of special interest. This is called a “Fellowship” and is usually of one year’s duration, a few fellowships taking 6 months. Some examples include Craniofacial surgery, Microvascular surgery, Cosmetic surgery, etc. These special areas are included in a Plastic surgeons base training, however the Fellowship gives opportunity to train in greater depth.


Once fully trained the Plastic surgeon ought to become Board Certified by the American Society of Plastic Surgeons. An additional 2 years of practice as a Plastic surgeon is required, following which the surgeon submits extensive documentation of the patients he/she has cared for, including operations, complications, outcomes, etc. If the surgeon’s documentation and outcomes are satisfactory then he/she undergoes written and oral examinations. Successful candidates are now Board Certified Plastic surgeons.

The board requires that both the General surgery and Plastic surgery training is done in the USA. For this reason surgeons who have done part of their training in a foreign country are unable to become American board certified, unless they repeat their training in the USA.

Who are the Plastic Surgeon Imposters?

Some examples in increasing order of scariness!

  1. Surgical specialists in other fields:
    Whilst these doctors have at least had surgical training, this training was not in plastic surgery.
    On account of the potentially lucrative nature of cosmetic surgery, a trend has been for other specialists to set up their own training in cosmetic surgery.
    For some time an ENT surgeon could do a one year fellowship training in facial cosmetic surgery. Some opthalmologists are properly trained in blepharoplasty.

    • Ear, Nose and Throat surgeons (otolaryngologists)
    • Opthalmologists
    • General surgeons
    • Obstetrician-gynecologists
  2. Family doctors
  3. Dentists (look for the DMD degree. They do not have a MD degree)
    • Dental general practitioners
    • Maxillofacial surgeons
  4. Others with some medical qualifications
    • Nurse practitioners
    • Physician Assistants
  5. Others with random or no qualifications
    • Massage therapists
    • Lay people