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Marshall T. Partington, MD answers: Why are oral surgeons allowed to do breast reduction surgery?

In today's Seattle PI there is a story about a woman who is suing an oral surgeon for a botched breast reduction ("Oral Surgeon faces new suit").  The doctor also has a record of a cosmetic facial procedure that led to a death. How does this happen in the first place? The story says the doctor was not trained in plastic surgery.  Why isn't this against the law, or is it?


Marshall T. Partington, MD
12 months ago

Confidence and trust are the two main requirements in choosing the right plastic surgeon. However, there is one very important factor that often gets missed when emotions are running high and the goal seems so close within reach! Many states do not have laws that protect the consumers from false or misleading advertising when it comes to choosing a plastic surgeon.  Washington is one of those states.  Within the medical community it is a well know fact that anyone with an active medical license may perform cosmetic procedures.  Some of these procedures, such as Botox, Restylane and other fillers do not require that the physician be a surgeon.  On the other hand, it is becoming increasingly more common that OB/GYN’s, Dermatologist’s, ENT’s, Oral Surgeon’s and General Surgeons are practicing the art of Plastic surgery.  This movement is driven almost exclusively by the diminishing returns in serving the public based on medical reimbursements.  As the cost of being a surgeon increases, and the reimbursements from insurance plunge, many surgeons are reaching out to one of the only venue that relies solely on cash returns…plastic surgery!

Since there are no laws in Washington that require such full disclosure, whose responsibility is it to keep you informed?...Well it’s yours of course.  That may sound a bit unreasonable considering that you are choosing a medical professional. Why would you be responsible for such an important decision; it’s not like you would choose a plastic surgeon to perform brain surgery; you would depend on the medical community to identify the right surgeon for the job.  Well it’s quite simple, most plastics surgical procedures are considered elective and are performed under the guideline that “beauty is in the eye of the beholder” and is governed mostly by combining art and science to provide an aesthetic result. Unfortunately, plastic surgery is not as protected by the same regulatory standards that protect other surgical fields.

 

Now that you know it’s up to you, the consumer, to sleuth out the truths and tails, let’s start with the basics.  First off, all surgeons within good standing are board certified in something. It is up to you to ask what they are board certified in.  For example:  It is best to ask the question “are you certified by the American Board of Plastic Surgery (ASPS)?” rather than “are you board certified?”. This line of questioning should also be followed by the most important question of all…”do you have privileges to perform my cosmetic surgery at a local area hospital”.  If the answer is “yes” then that individual has been recognized by that hospital’s regulatory committee as trained and qualified as a plastic surgeon.  If the answer is “no” then it can be assured that the physician that you are considering has not completed the additional surgical education that qualifies him/her in this field, keeping in mind that just because they are not board certified in plastic surgery does not mean that they are not well qualified in their field of practice; in most cases, quite the opposite.  But if it’s a plastic surgeon you are looking for than it is a plastic surgeon you should have.

We will continue to fight for better laws!

Best of luck,

Marshall T. Partington, MD FACS

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A: It is an outrage

Richard P. Rand, MD
12 months ago

There should be laws against doctors practicing surgery beyond their scope of training.  An oral surgeon has no formal training in plastic surgery of the breast.  As such, it is only ego and hubris that allows someone to think they can do this operation.  Foolishly and naively, they are taking on a very challenging operation, one which has been a leading cause of lawsuits even against doctors properly trained in performing it.

Unfortunately, the law does not protect the public against these doctors as well as it should.  Having a certificate from a weekend meeting makes these type of doctors believe they are adequately trained to do a new surgery.  If the government tries to stop them they claim it is a restraint of trade infraction against them.

All of us learn new procedures and teach them as we practice plastic surgery over our careers.  But these are variations on themes for which we have received extensive formal training.  On the other hand, an oral surgeon has never had formal Board Certified training in plastic surgery and has no training at all in surgery of the breast.  So it is totally outrageous.

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A: It's unfortunately a common practice

Shahram Salemy, MD
12 months ago

I don't think I can add much to what has already been said, other than to say it happens and it can be very difficult for patients to know the exact training and qualifications of their surgeon. In general, surgeons who are properly trained with the proper credentials are more than happy to share them with you, as are their respective boards or medical organizations. Bottom line: take the time to check out their backgrounds before letting them operate on you.

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