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Cosmetic Surgeon versus Plastic Surgeon

What's the Difference?

by John Di Saia MD


A Cosmetic Surgeon is a surgeon who performs Cosmetic Surgery and a Plastic Surgeon (of course) performs Plastic Surgery. It sounds obvious, but what does this really mean?


Plastic Surgery is a body of knowledge encompassing amongst other things Cosmetic Surgery. In order to become a real Board-certified Plastic Surgeon, one completes a Plastic Surgery Residency. In order to qualify to enter a Plastic Surgery Residency, one must complete at least three years of a General Surgery Residency. Many Plastic Surgery Residents have already completed a full General Surgery Residency (Five to Seven Years, depending upon the institution) or a full Orthopedic, Urologic, Otolaryngologic, or Neurosurgical Residency.


Most Plastic Surgeons are trained for an additional two to three years after their first Residency. This translates into total education of at least:
4 Years College
4 Years Medical School
3 Years Surgical Residency (more often 5-7 as noted above)
2 Years Plastic Surgery Residency


Legally any doctor can offer cosmetic surgery. Being that traditional medicine has seen an enormous decline in reimbursement, doctors from many specialities other than plastic surgery have started to perform cosmetic surgery. Now Otolaryngologists (ENT doctors), Ophthalmologists, and Plastic Surgeons (and even a few Dermatologists) perform cosmetic eyelid surgery. They do it a bit differently. It is debated as to who is the best at the actual surgery.

Residency-trained Plastic Surgeons (those that have completed a Plastic Surgery Residency) have been trained how to do Cosmetic surgery as part of that residency. Physicians trained in other specialties have had more variable training in this regard.


The ABMS is the board that oversees the training in 24 different specialties, including Plastic And Reconstructive Surgery. Board Certification (and/or Eligibility) by one of these specialties is considered by those in American medicine the mark of a quality physician.

The training imparted by training in any residency program has a great deal to do with the field in which the training occurred. In Plastic Surgery, this means a great deal, as there are many differently trained physicians performing surgery in many areas of the body.

Why Do I Mention This? Well in my surfing I have found site including one of a doctor specializing in phalloplasty (Plastic Surgery Of The Penis). I do not perform this type of surgery, so I proceeded to look into the featured physician's qualifications. He is board certified by the American Board Of Otolaryngology, an ABMS board, meaning he is trained in surgery of the Head and Neck. Since when was surgery of the Head and Neck inclusive of surgery of the genitalia? One of the doctor's other board qualifications (stated on his web site) is the American Board Of Facial Cosmetic Surgery. This is not at present an ABMS board and really means little in surgery of the genitalia.

At the present time, there is not one board in the ABMS listing with the word "Cosmetic" in it. Therefore, I would suggest to you that you should be suspicious when a surgeon presents a board qualification to you including the word "Cosmetic." Look for eligibility and/or certification in ABMS boards when you choose your surgeon. Then look to see what that residency teaches.


You as the consumer (or potential consumer) are thereby left with the choice of whom to trust with your appearance. With this in mind, here are a few suggestions for you....

(1) Inquire with regards to your potential surgeons training....Is he/she Board Eligible or Board Certified? By what Board? By the American Board of Plastic Surgery? (This means he/she has completed a Plastic Surgery Residency.)

"My doctor is a member of the American Board of Cosmetic Surgery. Isn't this just as good?"

(2) Has he/she performed this procedure much? Was training in how this is done included in his/her residency? If he/she has performed quite a few of these, are photographs of "Before and After" available.


A very important item in your choosing a surgeon is his or her philosophy. Many surgeons are trying to race through as many operations they can in a given day. My point of contention is that you may not want "Dr Quickie." Haste is not so great when it comes to the detail work that optimizes your possible outcome.


© John Di Saia, MD... an Orange County California Plastic Surgeon       

Serving Southern California since 1997 * (949) 369-5932