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Cosmetic Surgery: Who Really Needs It?

Plastic Surgeon vs Cosmetic Surgeon

Most of us probably think that a cosmetic surgeon and a plastic surgeon are two terms for the same qualified individual. That however is not always the case.

While plastic surgeons do cosmetic surgery, not every doctor who performs cosmetic procedures is a board certified plastic surgeon with the proper training and credentials. A cosmetic surgeon may in fact be board- qualified in another specialty, and has turned to doing cosmetic procedures, attracted by the lucrative income to be made in the field.

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The American Board of Plastic Surgery (ABPS) is the only certification board that is recognized by the National Board of Medical Specialties, the parent panel that oversees all other medical credentialing boards. The ABPS has the highest standards in regard to training, skills, knowledge, judgment, ethics, safety and oversight. Plastic surgeons credentialed by the board must meet a high standard of qualifications to earn the distinction.

A plastic surgeon will present him by that title; it is one he’s earned by right of hard work, training and the acceptance of a standard of ethics. Commonly it is the doctors with other specialties not certified by the ABPS that refer to themselves as cosmetic surgeons, trading on the public’s ignorance of the distinction.

Why does this difference matter? In the hands of a board certified Plastic Surgeon, the patient will receive the highest and most ethical quality of care; if complications arise the patient can trust that a plastic surgeon will be able to take corrective action. Cosmetic surgeons usually learn plastic surgery procedures in non-accredited training, which can be seriously deficient in all but the barest mechanics of how to place an implant or perform some other technique.

What is Cosmetic Surgery?

Cosmetic surgery refers to the branch of plastic surgery that devotes itself solely to performing elective surgeries that improve or alter personal appearance. Reconstructive surgery is the other branch of plastic surgery, doctors certified in this type of surgical practice repair and reconstruct defects, deformations and disfigurements which occur as a result of congenital defect, developmental failure, traumatic injury, or as a result of a disease or condition (reconstructing breasts after mastectomy due to cancer is an example.) The goal of reconstructive surgery is to restore function; a normal appearance is often also restored, but it is not the main goal of the surgery.

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Cosmetic surgery can refer to a number of treatments and techniques that do not actually involve incisions and what is formally thought of as a surgical procedure. Some of these cosmetic treatments include injections of Botox; microdermabrasion; laser skin resurfacing and hair removal; and Hyaluronic Acid (Hylaform, Juvederm, and Restylane) treatments. The actual plastic surgery procedures that fall under the cosmetic surgery category include:

Rhinoplasty (nose)
Blepharoplasty (eyelids and periorbital facial area)
Abdominoplasty (tummy tuck)
• Mammoplasty which includes breast augmentation, reduction, lifts and male breast reduction (due to gynecomastia).
• Lower body lifts (buttock augmentation and buttock lift).
• Facelift

Other surgical procedures include chin and cheek augmentation; brow lift, and octoplasty (ear modification, including pinning back protuberant ears or correcting shape).

Cosmetic Surgery Cost

Cosmetic surgery prices are variable, depending on what type of procedure or combination of procedures is to be done. Costs also depend on how invasive a procedure is. Those surgeries which require open incisions and major body remodeling will cost more than those that are minimally invasive. Nonsurgical cosmetic procedures such as chemical peels and Botox injections generally cost under $1000 in the U.S., breast lifts, augmentations and reductions which require incisions and tissue removal or remodeling run in the thousands, anywhere from $2000 to $10000 and more.

Cosmetic surgery is generally not covered by medical insurance plans in the United States, unless a true medical need exists, which must be heavily documented. Cosmetic surgery financing is therefore offered by most of the providers of these services to improve affordability.

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Consumers should be wary of low cost cosmetic procedures, sales promotions and other gimmicks to entice patients into having appearance improving surgeries performed. This is where the differences between a cosmetic surgeon (who may be a doctor of anything) and a plastic surgeon will become evident. Fully qualified plastic surgeons will cost more, but are vastly safer to use, while some cosmetic surgeons are competent with good success rates, those not board certified by the ABPS are risky to use. Horror stories hit the media regularly reporting cosmetic surgery mishaps that result in death or permanent disability; almost without exception these are the results of non-credentialed doctors performing the procedures.

Cosmetic Surgery in Other Parts of the World

Many countries completely separate elective cosmetic procedures completely from plastic surgery, differentiating the cosmetic as being elective surgeries (at patient request); and plastic surgery as operations medically necessary in the wake of illness and injury to restore function. Unlike the U.S. where the terms tend to be used interchangeably, this separation reinforces understanding in the minds of the public of the distinction.

One of the largest cosmetic plastic surgery clinic networks in the United Kingdom is Mya Cosmetic Surgery Ltd. (Mya stands for Make Yourself Amazing). Mya has clinics in Leeds, London, Manchester, Newcastle, Nottingham, Liverpool, Bristol, Birmingham, Chelmsford, Preston and Cardiff and claims to have some of the most qualified and experienced plastic surgeons in the world. They also boast membership in and compliance with U.K regulatory agencies such as General Medical Council (registered surgeons) and the Nursing and Midwifery Council (registered nurses). The clinics are registered with the Care Quality Commission (CQC) which inspects Mya facilities and makes the results of the inspections available online.

Another location that is becoming more widely known as an affordable source of cosmetic surgery Thailand stands out in terms of affordability and quality of services. Many plastic surgeons in the country are medically trained in the United States, with almost all of them licensed internationally. The hospitals specializing in cosmetic surgery in Thailand are internationally accredited as well. Caution must still be exercised, credentials verified; but the country is gaining a widespread reputation for high quality, affordable cosmetic surgery. Thailand is the beneficiary of a new kind of tourism, called “medical tourism” where patients avoid the high cost of U.S. healthcare and receive treatment overseas.