Should My Plastic Surgeon Be Board Certified?

There's good reason to check whether your plastic surgeon is Board Certified. Too often, news emerges with stories of patients who elect to go to providers who may not have the qualifications to perform cosmetic procedures or surgeries. With the popularity of cosmetic plastic surgery, it can attract unqualified (and sometimes unscrupulous) people who are lured by what they see as quick profit.

In some cases, the service provider may not even be a legitimate doctor. There have been several stories this past year about people posing as doctors and performing non-surgical procedures as well as actual surgeries in hotel rooms or back offices. There have been cases of people being injected with non-medical ingredients such as cement or silicone directly into the breasts, buttocks and even the face. These are highly toxic and can be extremely caustic, causing burns, infection, serious wounds and even disfigurement. Botox® and facial fillers are being used by people who have no training in facial nerve structure or the underlying muscles of the face, and mis-use of these products can result in droopy eyes, temporary paralysis, and even nerve damage.

In other cases, it may be a doctor who does not have sufficient training in this specialized field. They may be a generalist, gynecologist or other physician who has no formal training or experience in plastic surgery. They may have simply taken a weekend course in breast augmentation or liposuction and may have little experience with surgery. Generally people undergoing any type of surgery want someone with specialized training and competence.

Some are turning to the trend in "awake" surgeries. Procedures performed while the patient is "awake" can be risky if they do not have the equipment necessary to monitor a patient, do not have emergency equipment necessary to resuscitate a patient should there be a complication or if a licensed anesthesiologist is not in attendance during the surgical procedure. Even though the patient may be "awake", it does not decrease the risk associated with the sedation medications that patients are given. It is still surgery!

Tourist or vacation plastic surgery is also seeing an increase as those who want cosmetic surgery but don't want to or cannot pay the going rate seek alternatives. We've seen women who have flown to a foreign country such as Mexico, Asia or South America to receive a $2,000 tummy tuck and now have complications such as severe infection or a poor outcome that could cost many more thousands to try to correct. It is rare to receive appropriate pre-operative and post-operative care at foreign facilities, with patients eager to get on with the vacation end of their trip, or in getting back home, putting themselves at even greater risk of complications. It is usually recommended that you do not fly for at least 2 weeks or more following any type of surgery, and cosmetic plastic surgery is no exception.

So what is the difference between an internist and a plastic surgeon?

Obtaining a medical license to diagnose and treat patients means a physician meets a minimum level of competency requirements to become a doctor, but it is not specific to any one specialty. Board Certification demonstrates a level of expertise in a specialty and is considered the "Gold Standard". Board Certification by the ABPS ensures that the surgeon has had at least six years of surgical training, years of surgical experience, has passed both oral and written exams and has had surgical cases reviewed by the Board in order to demonstrate proficiency within the field of plastic surgery. They certify that they only operate in accredited medical facilities such as hospitals and accredited outpatient surgery centers. They are licensed physicians who have made a choice to make plastic surgery their primary focus as a medical professional.

Robert N. Young, founder of Aesthetic Enhancement Cosmetic Surgery & Laser Center, is a Board Certified Plastic Surgeon with over 30 years experience. He has been trained and has extensive experience both as a reconstructive plastic surgeon and a cosmetic plastic surgeon. As a leading breast augmentation specialist in San Antonio, Texas, Dr. Young is a member of the following professional organizations:

• ABPS Diplomate - Board Certified by The American Board of Plastic Surgery (ABPS)

• Member, American Society for Aesthetic Plastic Surgery (ASAPS)

• Member, American Society of Plastic Surgeons (ASPS)

• Fellow, American College of Surgeons

• Member, Texas Medical Society (TMS)

• Member, San Antonio International Society of Plastic & Reconstructive Surgery (SAISPRS)

• Bexar County Medical Society (BCMS)

• Accreditation by the American Association for Ambulatory Surgical Facilities (AAAASF)

Dr. Robert N. Young encourages patients to take the time to check the credentials of anyone you're considering for cosmetic surgery procedures. The two major societies, the ASAPS and ASPS are good resources for more information about plastic surgery and Board Certified Plastic Surgeons around the country.

REFERENCES / RESOURCES FOR MORE INFORMATION:
Herald Tribune - Plastic Surgeons Warn of Trade's Dark Side
Locate A Doc - Cosmetic Surgeon Imposter Jailed for Practicing Without a License
The Baltimore Sun - Health Officials Alarmed Over Silicone Injections For Fuller Buttocks
The Smoking Gun - Silicone Sister Busted For Butt, Hip Injections
USA Today - Lack Of Training Can Be Deadly In Cosmetic Surgery

Choose Credentialled, Qualified and Experienced Specialists

Stories pop up over and over again about patients who willingly select doctors without appropriate credentials, or those who practice out of uncertified facilities. The outcomes of these are often tragic for the patients involved.  What sometimes saves a bit of money ends up putting their health or life in jeopardy.

The most recent story appeared this week about a woman who received cheek injections which turned out to be a mixture of ingredients including concrete!  Another patient who went to the same "doctor" sealed her incisions with superglue!  Unqualified doctors have performed procedures from Breast Augmentation to Brazilian Butt Lifts using products which are not medical grade, nor approved for use in cosmetic surgery.  Others perform "awake" procedures under local anesthesia in their office.  These can be very dangerous.

See the full story at:  http://www.huffingtonpost.co.uk/2011/11/30/cement-cheek-implants-fake-doctor-oneal-ron-morris_n_1120041.html?view=screen

The woman "doctor" in question was not Board Certified, was not a plastic surgeon, nor a licensed physician of any kind.  She did not perform the surgeries at a hospital or in a certified or licensed outpatient surgery center.

We hope that this serves as a warning to patients wanting to have cosmetic surgery procedures.  Prices which seem to good to be true usually always are.  Make sure that the plastic surgeon you choose is properly credentialed and practices in a licensed or AAAASF certified facility (and not a back room office) where essential safety equipment and procedures are in place for your well-being.  Remember, a Board Certified Plastic Surgeon has received extra training beyond his or her designation as a physician.  They have proven expertise in cosmetic and plastic surgery.  For more information about Licensure & Certification, visit http://www.dr-youngforever.com/DrYoung.php. 

I'm afraid of anesthesia...is the "awake" method good for me?

by Robert N. Young, M.D.

Board Certified Plastic Surgeon

We've seen a new trend in Cosmetic Plastic Surgery...promotions of "Awake Breast Augmentations".  It is talked about as something new, but in actuality, surgeries performed under "local anesthesia", or "twilight anesthesia" have been around for many years.  Whether it is a good choice for patients is being hotly debated.

Because Breast Augmentation has become such a popular procedure, and is more readily talked about by society, some feel it has become somewhat frivolized.  It is easy to forget that this is still a major surgical procedure. While endoscopic (minimal incision) techniques have made the surgery less invasive and easier to recover from, the procedure is best done under general anesthesia with a Board Certified Anesthesiologist. "Twilight anesthesia" can be dangerous without an anesthesiologist present.

There is quite a bit of debate recently about practitioners who are advertising "awake" surgeries.  These are usually performed by physicians who are not Board Certified Plastic Surgeons, and may not even be Plastic Surgeons at all.  Sometimes they are Dermatologists, General Surgeons, or even Family Practitioners who elect to perform the surgery under local anesthesia because they do not have  privileges in a hospital or certified surgery center to perform those procedures. In my Surgery Center, all anesthesia is administered and monitored by Board Certified Anesthesiologists who are experienced in Cosmetic Plastic Surgery.  I feel this is best for my patients, and myself, as it allows me to concentrate on my area of expertise, which is the surgery itself.

My Surgery Center is fully certified by the AAAASF and meets strict standards to perform surgical procedures. Sure, the surgery costs a little more, but it is worth having the extra standards and safety factors. That's why doctors are credentialed and surgery centers are certified. If we didn't adhere to these standards we would be cheaper also. So when you get a fee quote that is cheaper because it is under local anesthesia in an office back room, be careful of what you are asking for.

Board certification by an ABMS member board provides assurance of a physician’s expertise in a particular specialty and/or subspecialty of practice. Professional organizations, such as the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery (ASAPS) require that members be Board Certified within their specialty.

Some advertisements even go so far as to state that you'll be awake enough during your procedure to pick the size of your breast implants (this would only be possible with saline implants which are inserted and then filled to the desired size) during your surgical procedure itself!  If you have had sedation you are going to feel woozy and wobbly.  I don't think you would be coherent enough to make this selection during surgery!

We recommend that you ask questions that will ensure that you are well informed concerning the qualifications and experience of your surgeon and the types of anesthesia that you are offered.  Here are questions generally recommended:

• Are you Board Certified? 
• If so, what specialty board?
• Are you licensed to practice surgery in this state?
• How many breast augmentation surgeries do you perform each year?
• How many years have you performed breast implant procedures?
• Where is my procedure performed?  
• Is the surgical facility accredited?
  
• Who administers anesthesia during my surgery?
• Is the person who administers my anesthesia Board Certified in this specialty? 
  
• What are my options for anesthesia?
  

When you come in for a consultation visit with me, I will make recommendations based on my extensive experience as first a reconstructive and then cosmetic plastic surgeon. I invite you to ask questions regarding various surgical methods, anesthesia, recovery and any other questions you may have so that you can make an informed decision about your surgery.  You may contact my office at 210-496-BODY (496-2639) or e-mail me at nubody@dr-youngforever.com.