Why do ophthalmologists call themselves plastic surgeons?

Question

Is the training to became an Occuloplastic Surgeon the same as a member of the American Board of Plastic Surgery? If not, what kind of training is involved?

Mehryar (Ray) Taban, MD, FACS · Answer

Oculoplastic Surgery is a subspecialty that requires 2 year fellowship AFTER completing ophthalmology residency. This subspecialty focuses on reconstructive and cosmetic plastic surgery of the eyes and surrounding areas, and they are members of ASOPRS.  They are different than those board certified by ABPS; the latter encompasses a group that have completed general surgery residency with subsequent fellowship in plastic surgery of the whole body (which can be reconstructive and/or cosmetic).

Stephen Prendiville, MD · Answer

It's very simple:  Occuloplastic Surgeons are Occuloplastic Surgeons.  Based on your previous posts, it appears as if you have been given partisan information. The history of modern plastic surgery dates to an Otolaryngologist, Sir Harold Delf Gillies in the period associated with the two great wars.  Gillies was heavily influenced by a French Maxillofacial Surgeon, Hippolyte Morestin. Modern "Plastic Surgery" is a conglomeration of knowledge from Otolaryngology, Ophthalmology, Maxillofacial Surgery, Orthopedic Surgery, and General Surgery.  There are different disciplines in aesthetic surgery composed of 4 major "core" groups:  Facial Plastic Surgeons, Occuloplastic Surgeons, Plastic Surgeons, and Dermatologists.  Gaining entry into any of these specialties requires exceptional performance in medical school and residency.  As opposed to historical internecine animosities, there is a great spirit of cooperation between the specialties.  However, there are outliers who do not support cooperation.  I would be careful about equating your own bad experience with an individual surgeon with the qualities of training of any specialty.  In my training and practice, I have worked with individuals from each of the 4 core groups, witnessing both superstars and marginal Surgeons.

Kenneth D. Steinsapir, MD · Answer

This is confusing because there is a specialty that calls itself "Plastic Surgery." Other surgical and medical specialties that offer high quality plastic surgery include facial plastic surgery, otolaryngology, ophthalmology and oculofacial or oculoplastic surgery, dermatology, and certain very specifically trained maxillofacial surgeons.  Beyond this there is a degree of crossover in what is offered.  For example, general surgeons without a formal training in general plastic surgery may offer cosmetic surgery.  Some of these individuals may in fact be fellowship trained outside of ACGME approved fellowships and residencies.  It is confusing for the public.  The slogan "only go to a board certified plastic surgeon" is the public relations slogan of the general plastic surgeons.  We live in a subspecialty world.  Many of the subspecialty surgeons offer work that is truthfully much better than what one may find with a particular plastic surgeon.  The important thing to understand is that good people are where you find them.  In your community, you may find general surgeons who practice a very high level of oncoplastic breast surgery and this type of work may not be offered by the local plastic surgeons.  You may live in a community with excellent aesthetic oculoplastic surgeons and the level of service may be much better than that offered by other surgeons.In ophthalmology, blepharoplasty and other oculoplastic surgeries are a part of core training in ophthalmology.  Beyond this, an ophthalmologist, having completed a 3 year accredited residency, can go on to do a two year fellowship in oculofacial surgery.  During that training, the fellow is involved in well over 2500 eyelid and facial plastic surgeries.  These numbers dwarf the exposure other surgical specialties offer their trainees in these surgical areas.  Most of the oculofacial fellowships actually offer the fellows more facial plastic surgery training than general plastic surgeons are exposed to in their residencies.  You can decide for yourself if in-depth training makes a difference.  Common sense says that it does.Now how about for a particular set of surgeons.  Say you have narrowed your choice down to an oculoplastic surgeons vs. a general surgeon for an eyelid procedure.  This can some times be a difficult decision.  Ask yourself which office did you like more.  How did you like the particular surgeon. Do they listen to you?  Do they make sense?  Study their respective websites.  Which one seems more focused on your area of concern?    How detailed was your examination?  Does the doctor have the equipment needed to carefully examine the eyes?

James R. Gordon, MD, FACS, FAAO · Answer

Oculoplastic Surgeons are doctors who completed a residency in ophthalmology and then went on to study specialised  facial plastic and reconstructive surgery with a focus around the eyes. Oculoplastic surgeons do not just perform cosmetic eyelid surgery, but also functional surgery, reconstruction, orbital surgery and repair of complications. With that being said, when it comes to cosmetic surgery of the eyelids, many specialty surgeons (plastic, otolaryngologists, dermatologic surgeons and oculoplastic surgeons) can perform excellent work.

Cameron Chesnut, MD, FAAD, FACMS · Answer

Plastic surgery, by definition, is surgical restoration of the form of the body. It's etymology comes from the Greek word plastikē, meaning the art of molding – in this case flesh. The type of plastic surgery that we think of does not always mean cosmetic and can include lots of other types of reconstruction of the human form. In medical training, there are several ways to get to plastic surgery. The type most commonly thought of is those who do a general surgery residency and then do a subspecialty in plastic surgery. You can also get to this route by doing ophthalmology, ear nose and throat, or dermatology and then doing a fellowship for your subspecialty training.Those groups of physicians are commonly known as the "core four" of cosmetics, as there is a lot of overlap in the types of procedures that they do with relation to plastic surgery. That being said, all of those different subspecialties do you have a foundation in their respective areas prior to plastic surgery. For example, the general plastic surgeon has more experience with work on the body, so they are more likely to do breast surgery and reconstructions or butt surgery. The oculoplastic surgeon is more likely to do orbital surgery because of their background, the dermatologist is more likely to do reconstructions that involve the skin and soft tissue, not necessarily bony work.From a pure cosmetic standpoint, all of these physicians are likely to do basic aesthetic procedures such as neurotoxins or fillers. When it comes to facelifts, eyelid surgeries, etc. you want to make sure that your physician has a lot of experience with these during his or her fellowship training. The key emphasis there is fellowship training, even a plastic surgeon may only do a handful of faceless in the residency training, it's really that subspecialty training in cosmetics afterwards where your doctor can easily get five or 10 times the number of procedures that they did in residency.In summary, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties, find somebody that you like and trust, make sure they have done enough procedures, and find somebody who is passionate about that particular procedure that you seek - they will just do naturally better job, and you should be able to pick us up easily during your consultation.

William Marshall Guy, MD · Answer

Hello Patient 1969,The training for each specialty is different.  A plastic surgeon will have either completed 3 years of general surgery and then 3 years of plastic surgery (more recent graduates in integrated programs) or 5-6 years of general surgery and 2-3 years of plastic surgery (the traditional route).  The training really depends on the residency program of the surgeon to determine how much exposure there is to cosmetics versus reconstruction.  Some programs are more heavy towards one or the other.  They also train in the entire body as opposed to just focusing on a single part of the body. An oculoplastic surgeon would have completed an ophthalmology residency and then underwent a fellowship in oculoplastic surgery.  Again, the training received depends on the program with regards to how much is cosmetic vs. functional or reconstructive.  But all of their training would have been around the eye area.  I am a facial plastic surgeon.   I completed an otolaryngology residency and then complete a 1 year fellowship in facial plastic & reconstructive surgery.  This means all of my training has been in the head and neck area with my fellowship focused almost entirely on cosmetic surgery.  The gist is it is important to ask about the training for the procedure you want performed.  If your plastic surgeon spends 90% of his or her time doing breast augmentation then maybe you would choose a different surgeon for your face or eyes.  If your oculoplastic surgeon only does ptosis repair and trauma then maybe you'd choose the plastic surgeon who does more blepharoplasty.  There is a large degree of overlap and many competent surgeons in each of the specialties.  Before and after photos can help you appreciate what your surgeon is capable of performing.I hope this helps and good luck.

Malcolm A. Lesavoy, MD, FACS · Answer

Opththalmologists are NOT Plastic Surgeons!!The training of a Plastic Surgeon requires 4 years of University, then 4 years of Medical School, then 4 or 5 years of General Surgery training, followed by 2 years of Plastic Surgery.  It is the longest years of training of any medical or surgical specialty.  In Ophthalmology, it requires the same University and Medical school years, but just 3 years of Ophthalmology and if the doctor wants oculoplastic specialty, one extra year of fellowship. These doctors do excellent work around the eyelids, but they are limited to that area.Malcolm Lesavoy, MD

Why do ophthalmologists call themselves plastic surgeons?

Answers (7)

More Eyelid Surgery Questions

I have big protruding eyes (inherited, not a disease). Is cosmetic orbital decompression a good option? (Photo)

Is it be a good idea to raise my eyelid crease to 8 or 9mm?

Are there any oculoplastic or facial plastic surgeons trained in Dr. Flower's eyelid surgery technique in Florida? (photo)

What to do with my malar bags? How to get rid of them?

How to fix my under eyes? Young, in 20s. Is it orbital fat loss? Did my cheek pad fall? Please help. (Photo)

What did Kylie Jenner do to make her eyes bigger and eyelids sultry?

WE SEND PRETTY
EMAILS