Q. I'm thinking about having some surgery to change some aspects of my body that I am unhappy with and think I should seek out a "plastic" surgeon. What does the word "plastic" mean?

A. The word "plastic" comes from the Greek word "plastikos" which means "to shape or mold". A plastic surgeon specializes in shaping or molding your body.

Q. How does a doctor become a plastic surgeon?

A. To become a board certified Plastic Surgeon, who is certified by the American Board of Plastic Surgery, the surgeon must have graduated from an accredited medical school, then spent 3-5 years in a General Surgery residency, then finished a Plastic Surgery residency program, then taken and successfully passed his oral and written examinations by the American Board of Plastic Surgery after he has established his practice.

Q. That sure seems like a long time to train for a surgical specialty.

A. Cardiothoracic (heart and chest surgery) and plastic surgery are two of the longest training programs in the United States. Most surgeons certified by the American Board of Plastic Surgery are over 30 years of age before they start their practices.

Q. What is the American Board of Plastic Surgery?

A. The American Board of Plastic Surgery http://www.abplsurg.org is the certifying agency that is responsible for granting certification to physicians who have successfully completed their training in plastic surgery. This Board is one of the certifying Boards in the United States that are recognized by the American Board of Medical Specialties (ABMS) http://www.abplsurg.org . They include such Boards as Pediatrics, Orthopedics Surgery, Internal Medicine, etc.

Q. Does this mean that all organizations that have the title "American Board of…" are recognized by the American Board of Medical Specialties?

A. No, the generic term "American Board of …" can be used by any organization and at last count there were almost 200 organizations using this title in the United States. Membership in many of these organizations is dependent on paying your dues and little or no effort is made at verifying quality training. Most of these organizations would love to have a surgeon certified by a Board recognized by the American Board of Medical Specialties (ABMS) http://www.abms.org as a member.

Q. Does the state or federal government check up on what surgeons do to verify that they are trained in their specialty? Certify surgeons in their specialty?

A. Most state medical licenses say that the doctor is licensed to "practice medicine and surgery in the state " with no stipulation or qualification to specialty.

Q. Do hospitals check and make sure that the physicians on their staff are fully trained and certified?

A. Yes, and this is a good way to check on your doctor to see if he is fully trained in his specialty. Due to liability concerns today, most hospitals require and do research to make sure that surgeons on their staff are Board certified (by a Board recognized by the ABMS) in their specialty.

Q. What if my doctor wants to operate in his office and not in a hospital?

A. Many surgeons have certified operating rooms in their offices and perform many safe procedures. However, the patient should remember that the surgeon's license probably states that he can practice medicine and surgery in his state and does not specify what kind of surgery. A surgeon can literally do any procedure in his office operating suite without any verification of his training or expertise.

Q. How can this be in the United States? I thought that medical procedures were regulated.

A. We live in the United States, which functions under the legal principal of "caveat emptor", which basically means, "consumer beware". It is the consumers (or patients) responsibility to check before spending their money. There is no "lemon law" for surgical procedures in the State of Georgia.

Q. What is the American Society of Plastic Surgeons?

A. The American Society of Plastic Surgeons http://www.plasticsurgery.org is the organization to which surgeons who are certified by the American Board of Plastic Surgery can belong. It is a dues paying organization, however, plastic surgeons who are members must prove their ongoing education in plastic surgery by earning continuing medical education credits (CME's) to maintain their membership.

Q. What does it mean when a doctor says he is a Fellow of the American College of Surgeons (FACS)?

A. The American College of Surgeons http://www.facs.org is an organization in which surgeons are nominated for membership by other surgeons in their community. The surgeon must be board certified by a Board recognized by the ABMS (American Board of Medical Specialties) and have shown himself to possess outstanding integrity, committed to the principles of a qualitfied surgical practice.

Q. Now that I have decided that I want to go ahead with surgery and I am sure of the credentials of the surgeons I am going to have a consultation with, how do I choose my surgeon?

A. I would recommend that you have consultations with at least 2 or even 3 surgeons. The Internet is full of information on particular procedures so that you will have some basic knowledge. Write your questions out and take notes. Discuss the procedure with your surgeon and ask to see some before and after pictures.

Go into your consultation with an open mind. Your final result will depend upon what you bring to the surgeon, your skin type, bone structure, your ability to heal which may be modified by smoking, allergies, medicines, or dietary habits that you practice. Also your ability to follow precise directions and post operative care. Your surgeon will bring to the operating room his skill, sensitivity, and artistic ability but you also have a responsibility as you embark on this surgical journey together.

Q. What if I can't decide when three different surgeons suggest three different operations?

A. Many times there are different ways to treat the same problem. Don't hesitate to see another surgeon but be warned that sometimes too much information can thoroughly confuse you. It is important that you understand your options and trust your surgeon. Complications don't usually occur but if one does, you want a surgeon who will be caring, competent, and genuinely concerned about you and achieving the best results possible.

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