Training of a Cosmetic Surgeon

There is much confusion about the difference between a cosmetic surgeon and a plastic surgeon. Both specialties require over a decade of training. Very basically, a cosmetic surgeon is trained to improve or enhance the aesthetics of appearance. A plastic surgeon is specifically trained in reconstruction, trauma, and correcting deformities. A plastic surgeon may or may not have concentrated training in aesthetics. A cosmetic surgeon may be a plastic surgeon, or may have previously specialized in another surgical area. This is because there is no cosmetic surgery residency program in the United States.

As stated on the American Board of Cosmetic Surgery (ABCS) website, “Cosmetic surgery is practiced by doctors from a variety of medical fields including dermatologists, facial plastic surgeons, general surgeons, gynecologists, oral and maxillofacial surgeons, ophthalmologists, otolaryngologists, plastic surgeons, as well as doctors from other fields.” As I stated above, there is no cosmetic surgery residency program in the United States. Consequently, to competently practice cosmetic surgery, a doctor of one of the above mentioned specialties may continue on to pursue a fellowship in cosmetic surgery.

The path any surgeon must follow is this: 4 years pre-medical undergraduate work, 4 years of medical school, the 4th year is clinical rotation (this happens at a teaching hospital, and the word “rotation” refers to rotating duties in various medical specialties, in other words, each medical student experiences a bit of all specialties). After that is the 1 year internship, which is specialty training. The year-long general surgical internship may be included in a residency program. Then there is a 3 to 5 year residency program to specialize. As I said above, there are currently no residency programs in the United States devoted exclusively to cosmetic surgery. This means that to become a board certified cosmetic surgeon, one must follow his or her residency with a fellowship. Many other specialties in medicine also continue with fellowships. Fellowships are offered by accredited facilities and board certified physicians in a particular field. Fellowships can last for 1 to 3 years. However, to become a board certified cosmetic surgeon by the American Board of Cosmetic Surgery, one must have at least one previous board certification and complete a fellowship training in cosmetic surgery.

So although the training of a plastic surgeon may have a residency in general surgery, and another 2 or 3 years training in plastic surgery, the focus is not on cosmetic treatment. Some programs do indeed include aesthetic surgery as a main track, such as UCLA, but this is not common. There is no guarantee that a plastic surgeon has more expertise or experience with any given cosmetic procedure. Licensing and board certification alone does not tell the potential patient how many times any given surgeon has performed a procedure, nor how recently. In fact, if a plastic surgeon does not concentrate on the cosmetic aspects of surgery, he or she may actually have less experience than a cosmetic surgeon in any given procedure.

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