Choosing a Surgeon

How to choose a surgeon

What does Board Certified mean? What is a cosmetic surgeon? It is difficult to know what questions to ask. When you decide to pursue plastic and cosmetic surgery, you will do internet research. Most of my patients have told few friends they did anything, so it is common you think “I don’t know anyone who has done this.” To educate yourself, you Google, read websites, and go to chat rooms. Cosmetic surgery still stirs up emotions, so it tends to be private, particularly in Palo Alto and the Bay Area.

Anyone can call themselves a plastic surgeon. (shocking, isn’t it?) The term does not tell you their training. If you want to find what specialty a doctor trained in residency, see by what board they are certified. I have found local “plastic surgeons” boarded in internal medicine, family practice, and dermatology. These are not surgical residencies. They are not trained as surgeons. With the difficulty of practicing medicine and insurance reimbursement declining, many non surgeons have tried to break into cosmetic surgery. Some take a simple weekend course and start doing procedures.

"I believe you must feel comfortable and open with your plastic surgeon." - Dr. Greenberg
*Individual results may vary
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Plastic vs Cosmetic Surgeon

Terminology

“Plastic Surgeon” is a general term. “Plastic” comes from the root to change or mold. We, as plastic surgeons, are trained in an array of surgeries: flaps, microsurgical techniques, hand surgery, facial fractures, cleft lip and palate, and cosmetic surgery. The basis of these surgeries involves a core of tissue movement, detailed technique, and aesthetics. True Plastic Surgeons are trained in general surgery followed by an accredited plastic surgery fellowship.  To see if your doctor is a true plastic surgeon, ask by what Board they are certified.  Only those who complete the rigorous plastic surgery residency and pass the written and oral boards are certified by the American Board of Plastic Surgery.

“Cosmetic surgeon” is someone who does cosmetic surgeries. These surgeries are elective. Cosmetic surgery includes facelift, eyelift, breast augmentation, breast lift, liposuction, and tummy tuck. NOT ALL COSMETIC SURGEONS ARE PLASTIC SURGEONS. If you want to find someone who is a Board Certified Plastic Surgeon AND a cosmetic surgeon, you can look for members of ASAPS, our aesthetic society, which I am a member of. Many people who search using Google type in “cosmetic surgeon” – this search will get you qualified and unqualified responses.  Please read these blogs: which boards are real? and cosmetic societies.

“Facial plastics” is a term used by surgeons trained in ENT head and neck surgery. They do general surgery the first year, followed by ENT surgery (surgery of the ear, nose, and throat). A fellowship in facial plastic surgery specializes in cosmetic surgery only of the head and neck.

Women do better with Women surgeons

Yes.

Statistically significantly, women patients do better with women surgeons. “”Women operated on by male surgeons are more likely to have adverse outcomes than women operated on by female doctors.” JAMA (the Journal of American Medicine) published a large study of 1 million patients. They found a “small but statistically significant” increased risk when women patients have male surgeons. (There was no increased risk for male patients to see female surgeons). They are not sure why. It may harken back to feeling comfortable and open with your surgeon- Do women patients voice concerns to female surgeons more easily? It may be that women surgeons understand women’s bodies better, as we have had kids, breastfed, bought bathing suits, worn yoga pants, gone through menopause.  It may be that we spend more time with our patients. I don’t know the answer.

 

So, what to look for?

First, find someone who is Board Certified by The American Board of Plastic Surgery. The Board of Plastic Surgery has a rigorous process to screen its members. You must train in general surgery, then do a fellowship in a certified residency program in Plastic Surgery. There is a minimum of five years of surgical training. You then take a written test. Once in practice you submit your cases. Then, if those are approved, you sit for your oral boards. Re-certification is required every 10 years.

What if they are not Board certified? Board Certification is an additional voluntary credential a physician chooses to obtain after medical school and residency. If not board certified, it can mean the surgeon did not complete the requisite training requirements, completed training outside the Unites States or Canada, did not take the exam, or failed the exam. Again, find what residency program they did. If they trained in an official plastic surgery residency, find why they are not board certified.

The American Society of Plastic Surgeons is our society. I am a member. To be a member, you must be:

The American Society for Aesthetic Plastic Surgery is our Aesthetic society.  I am a member.  To be a member, you must:

Second, find someone who’s aesthetic you like. The Bay Area has a wealth of board certified plastic surgeons. How do you choose which one? Look at the photos. For example, with a breast augmentation: every doctor has what they consider “a pretty breast.” For me, I like natural. I love it when a patient comes in with the story, “I was changing in the locker room and my friend asked me how I look so good after three kids. She couldn’t tell I had done anything.” All of us cosmetic surgeons have photo books. Look at them.

Third, find a surgeon you are comfortable with. Do you like the doctor? the staff? the office feel? Do you meet with the doctor or a nurse? When you talk with the doctor, do you feel like they hear you or do you feel like you are a number? We all expect a smooth surgical experience. If there is a problem, is that the doctor you want?

Dr. Greenberg is exactly the kind of honest, ethical, accomplished, well-studied, professional,caring doctor that you want in a physician. She presents a realistic expectation of what she can achieve with an emphasis on healthy expectations and natural looking results. I have zero hesitation about recommending her to my friends and family and look forward to a future full of many happy returns.

Michelle Bissonnette

May 22, 2015

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