Certification: Competence and Patient Safety

I recently saw a young lady for breast augmentation who at the time of her physical exam admitted to having undergone liposuction of the abdomen and flanks just one week earlier. Asking her why she did not see her surgeon for breast enlargement too, revealed the fact that he did not perform breast surgery. It turns out that he is board certified in Ear, Nose and Throat Surgery and not Plastic Surgery. The post operative care for this patient did not include the standard of medical practice which consists of compression garments for at least three weeks. She was not informed of this crucial part of the procedure and her exam revealed bruising and swelling that could have been avoided and would have sped up her recovery. Also the exam showed that minimal liposuction was performed leaving her with residual large amount of fat that will require another procedure. She states that the surgeon informed her that he was certified and she assumed that he was a plastic surgeon. I have run across too many such situations involving other specialties passively allowing patients to ASSUME that they are in the hands of a board certified plastic surgeon. The American Board of Medical Specialties only recognizes the American Board of Plastic Surgery and not the many self proclaimed boards such as American Board of Cosmetic Surgery or American Board of Facial Plastic Surgery. These boards were established by dermatologists and ENTs who wish to perform cosmetic surgery without the rigorous training involving 6-8 years of post medical school learning, operating, research, and teaching that culminates in written and oral exams that are needed to be certified as a plastic surgeon. The plastic surgeon has the competence and lengthy experience in cosmetic surgery. Cosmetic surgery is rightly associated with board certified plastic surgeons. Unfortunately many other physicians want to carry the title without the same level of training. Do not be intimidated; ask your potential surgeon by what board he/she is certified. It is important for best results and your safety.