How To Choose A Plastic SurgeonJuly 31, 2013
One of the most important decisions you will make regarding plastic surgery after weight loss is choosing your surgeon. Thousands of plastic surgeons nationwide perform procedures that can help you achieve more flattering body contours, but how do you know which one is right for you? Knowing what training and experience to look for can help you narrow your choices. Finding a surgeon with whom you can communicate and feel comfortable is also key. Because your choice of surgeon is important, you will want to give significant time and thought to the decision-making process.
Beginning the Search
You have many options when it comes to finding a qualified plastic surgeon. A good first step is asking your friends, family, and physicians for referrals. If you belong to a support group for weight loss patients, consider asking the members of your group for recommendations. If you have had bariatric surgery, check with the doctor who performed your procedure. Many bariatric specialists maintain professional relationships with local area plastic surgeons and routinely offer referrals. After you have a list of names, visit each doctor’s website. This can give you a better idea of the surgeon’s practice and experience with post—weight loss plastic surgery procedures.
You also can use the Internet to search for physicians, but be aware that many plastic surgery websites are simply for-profit ventures that will list any plastic surgeon for a fee without verifying qualifications, training, or experience. When looking online for a plastic surgery specialist, you may want to confine your search to the sites of reputable medical organizations, such as the American Society of Plastic Surgeons. This site offers a convenient physician-finder tool to help you locate qualified surgeons in your area.
Surgeon Qualifications: What to Look For
Any surgeon you’re considering should have the proper education, training and licensure. He or she also should be board-certified and have experience performing bariatric plastic surgery procedures.
Education and Training
Several years of formal education and specialized training are required to become a plastic surgeon. The first steps in the lengthy process are graduating from a four-year college or university and completing an additional four years of medical school. The medical school should be accredited, which means the institution meets standards set by a national authority for medical education programs.
After earning an M.D. degree from medical school, doctors who want to become plastic surgeons must complete several years of additional hands-
on training. This training begins with at least five years of hospital training called a residency. During the residency, doctors perform surgery under the guidance of senior-level surgeons. The first few years of the residency typically cover general surgery procedures; the final years focus on plastic surgery procedures. Doctors take on increasing amounts of responsibility as their residency progresses. By the time they complete it, they’ve gained ample hands-on surgical experience and are able to assume responsibility for the complete care of patients.
After their residency is completed, many plastic surgeons continue their training through a fellowship that concentrates on a specialized area of plastic surgery. However, training doesn’t end there. As long as they remain in practice, all plastic surgeons are required to take continuing medical education courses to maintain certification. This requirement ensures that doctors are current on the latest advancements in plastic surgery techniques.
All surgeons who are members of the American Society of Plastic Surgeons (ASPS) have undergone their training at accredited institutions. In addition, they meet the ongoing ASPS requirement to document their continuing medical education courses, including those relating to ethics and patient safety.
To practice medicine, all doctors must be licensed by the state in which their practice is located. A license to practice medicine is usually granted only to medical school graduates who have passed a comprehensive exam. Having a state license allows the physician to practice medicine only within that particular state.
You can verify a plastic surgeon’s licensure with your state’s medical board. Through this board, you also can investigate any complaints made or disciplinary actions taken against your surgeon. You can find a complete list of state medical boards with links to their individual web sites on the Federation of State Medical Boards web site.
Board Certification: Why It’s Important
You’ve probably heard that it’s important to choose a plastic surgeon who is “board-certified.” But what does that mean and why is it so important? A doctor who is board-certified has not only fulfilled the educational and training requirements necessary to become a licensed physician but has also made a voluntary commitment to lifelong learning within a specialized field of medicine, such as plastic surgery.
Board-certification is offered in twenty-four specialties through the member boards of the American Board of Medical Specialties (ABMS). For instance, a doctor can earn board certification within the field of dermatology, obstetrics and gynecology, surgery, or plastic surgery, among others. Being board-certified, however, doesn’t mean that a doctor has expertise in plastic surgery. That’s why it’s essential to make sure that your doctor is board-certified specifically in the field of plastic surgery. The American Board of Plastic Surgery (ABPS) is the only board authorized to offer certification in plastic surgery.
To become board-certified, a plastic surgeon must have completed a residency program in both general surgery and plastic surgery and passed comprehensive written and oral exams. To maintain certification, plastic surgeons must participate in a program of continuous professional development and must continually meet the moral and ethical standards set by the ABPS.
A plastic surgeon is not required to be board- certified to perform plastic surgery. However, choosing a plastic surgeon who meets the stringent standards set by an independent board may give you additional peace of mind. You can verify that a plastic surgeon is board- certified on the ABMS web site.
Be aware that some doctors claim to be “certified” by organizations other than the ABPS. These organizations don’t have the same rigorous requirements and, therefore, don’t provide you with the same assurance that a physician has expertise in plastic surgery. It’s also important to understand that many states permit any licensed physician to perform “cosmetic surgery” even though he or she is not a trained plastic surgeon. To ensure your safety, it’s best to limit your search to board-certified plastic surgeons.
Experience in Plastic Surgery after Weight Loss
In addition to board certification, you should seek out surgeons who have experience in performing post— weight loss plastic surgery procedures. You will find they have a more thorough understanding of their patients’ special needs and concerns after massive weight loss. Fortunately, a growing number of physicians are adding post—weight loss procedures to their repertoire, and some are choosing to specialize in this type of surgery.
How much experience is necessary? As a rule of thumb, look for a surgeon who regularly performs the procedures you are considering on a monthly basis.
A number of organizations can help direct you to a plastic surgeon who is experienced in bariatric plastic surgery. ObesityHelp.com is an online community of weight loss patients that keeps an extensive database of plastic surgeons dedicated to bariatric plastic surgery. The American Society of Bariatric Plastic Surgeons , established by plastic surgeons who specialize in body contouring surgery specifically for the needs of weight loss patients, also has a physician finder feature.
The Surgical Team
When your operation takes place, your surgeon will be accompanied by a surgical team that may include nurses, surgical assistants, and a person who administers anesthesia. To ensure your safety, you may want to make sure your anesthesia will be administered by a board- certified physician anesthesiologist or by a certified registered nurse anesthetist. These professionals have completed specialized training that qualifies them to administer anesthesia and to monitor your well-being during your surgery.
The Surgical Center
Because most post—weight loss procedures are considered major surgery, they usually take place in hospitals or outpatient surgery centers. These surgical settings typically offer more extensive recovery facilities than office-based surgical suites.
No matter which surgical setting is used for your procedure, be sure to check that the facility is accredited, meaning that it meets rigorous national standards for quality and safety. To become accredited, a surgery facility must meet requirements regarding surgeon credentials, personnel experience, equipment, and overall safety in the operating room. Depending on the state in which the facility is located, accreditation may be voluntary or mandatory.
Accreditation is offered by a number of organizations, including the American Association for the Accreditation of Ambulatory Surgery Facilities, the Accreditation Association for Ambulatory Health Care, the Joint Commission on Accreditation of Health Care Organizations, and Medicare. Verifying that your surgeon uses an accredited facility that meets stringent safety requirements may add to your peace of mind.
Little Things Count
A surgeon’s education, training, board-certification and experience at an accredited facility are all important factors to consider when you are choosing a plastic surgeon. But other aspects, such as a courteous office staff and a good rapport with your surgeon, also can play important roles. If the surgeon’s office staff is welcoming and makes you feel comfortable and relaxed, your overall surgical experience may be enhanced. Even more important, when you feel comfortable with your surgeon, you are more apt to communicate your goals clearly and to ask questions. By asking questions and talking about your goals, you will have a much better understanding of what to expect from plastic surgery after weight loss and increase your chances of being satisfied with your results.
Thomas McNemar, MD, FACS, is a noted cosmetic plastic surgeon, as well as co-author of Breast Augmentation & Body Contouring and a new book entitled Bariatric Plastic Surgery: A Guide to Cosmetic Surgery after Weight Loss. For more information visit bariatricplasticsurgeon.com.
Editor's Note: This article was previously published in OH Magazine, an ObesityHelp.com publication.