After 21 years in practice, I had pretty much thought I had seen it all. However, if you think the title of this article is tongue in cheek, sadly it’s not. I am all for taking advantage of a good value, however, when it comes to aesthetic surgery or cosmetic treatments, I strongly caution against taking advantage of a deal that sounds “too good to be true” because sadly, it probably is, and the risks to your overall health and body are simply not worth it.

Because of a lack of “scope of practice laws” in Arizona (and many other states), we find ourselves in a situation where we have obstetricians providing breast augmentations, family practitioners performing liposuction, and all types of providers (physician and non physician) administering BOTOX and filler injections, all within the limits of the law. Every time I sit through yet another heartbreaking consult with a patient who has had a prior procedure and is very disappointed with their result at the hands of one of these types of providers, I gently ask them whether they were aware that the person who provided their care was not actually a plastic surgeon, or even worse, not even a doctor. The look of shock and horror I am often met with, usually says it all.

As a board certified plastic surgeon with over 20 years of experience, I am very fortunate to have a great deal of patients who come to me via “word of mouth”. However, I do receive many inquires and phone calls from my website, where sometimes people are surprised that I charge a fee for a consultation. Many of these callers choose not to come in for a consult because of that fee, (likely) believing they can get the same level of care for less. Both my staff and I worry about these prospective patients a great deal.

They undoubtedly will find someone, maybe a doctor, maybe not, who will perform their desired procedure at a reduced rate, but how is that possible? Often, it’s because that’s the only way many of these providers can attract patients. Since they don’t have the requisite experience, training or board certification, they often can only stay in business by charging less for their services. While there may be a savings, the cost to the patient can ultimately be extreme. At a minimum, disappointment with the results, (not to mention the possibility of needing more complex and expensive revision surgery) or worse, disfigurement and health problems that cannot be easily rectified.

Surgeons with a great deal of experience, appropriate training and board certification (by the American Board of Plastic Surgery), tend to have a commitment to safety and a track record of excellent results. They generally have low complication rates and extremely satisfied patients. As you might imagine, these Board Certified Plastic Surgeons are likely to have higher fees. The same is true of seasoned, successful professionals of all types. You really do get what you pay for, and when it comes to your safety and overall heath, you should want, and expect the best results possible, which in some cases may cost a bit more, but as many patients on both ends of the spectrum will tell you, it’s well worth it.

You may have read my articles about this in the past, but because I think this particular issue is a public safety concern, I feel compelled to re-visit it.
At this point, you are probably asking yourself: how can healthcare providers essentially pose as plastic surgeons?

A valid question indeed.

In Arizona, if you have a medical license and have completed a year or two of residency training (regardless of which field) you can simply call yourself an “aesthetic” or “cosmetic surgeon” and advertise accordingly. Many of these doctors purchase membership in the American Board of Cosmetic Surgery which is not recognized by the American Board of Medical Specialties—thus it is easy to understand how patients are confused especially when the certificates are large, gilded, attractive and usually prominently displayed in the doctor’s waiting room.

As a prospective patient, you might ask, What should I do to stay safe? You can start by making sure that any physician you seek out for care is board certified by the American Board of Plastic Surgery and a member of The American Society for Aesthetic Plastic Surgeons (ASAPS, surgery.org). Members of these groups have gone through appropriately lengthy residency training in plastic surgery and have passed rigorous exams that allow them to obtain membership/certification. Years of training in general surgery, otolaryngology or orthopedics are required before plastic surgery residency can even commence. In my opinion, this background training is absolutely imperative to prepare surgeons for plastic surgery training and practice. It is important to note that none of this is required for those providers who call themselves “cosmetic surgeons”.

Next you might ask: Why would any physician want to practice a specialty that they didn’t train for?

Sadly, the answer is often: purely for financial gain.

It is no secret that aesthetic surgery and non-invasive cosmetic treatments are very popular. It is also no secret that many physicians have seen a dramatic decline in their incomes, thus turn to “weekend” training classes to try to learn how to perform invasive aesthetic procedures (that take others years to master) as a way to supplement their income.

Weekend courses simply do not provide the type of training and repetition it takes to achieve consistently desirable outcomes. I personally would never feel comfortable trying to “wing-it” through a hysterectomy or treat a complex case of congestive heart failure, nor would I take a weekend course and call myself an Ophthalmologist, thus find it truly unethical when others pretend they have appropriate training just because the law allows them to say so.

I look forward to the day when this unfortunate loophole is closed and the public is more protected. I hope to stop hearing, ” If only I would have known he wasn’t a plastic surgeon I would have never let him do this operation.” Something really ought to be done, but until it is, play it safe and ask any doctor you are considering for cosmetic improvements, “are you board certified by the American Board of Plastic Surgery?” If the answer is no, move on.

I was recently asked to do a special segment for the television program Caring For Arizona (on KTVK 3TV – Phoenix and KMSB FOX 11 Tucson about “Board Certification and Plastic Surgery” Below is an expert from my interview.

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