Difference Between Facial Plastic Surgeon or Plastic Surgeon and an ENT or Otolaryngologist?

I expect you are confused, because just about the entire general public is too. When there are overlaping areas of competence between specialties, there is the possibility of conflict. There are several such areas in medicine today. Orthopedics and Neurosurgery interact with spinal surgery, Gastroenterologists and General Surgeons both perform colonoscopies, Sports Medicine and Physiatry are both involved in physiotherapy. And there is for the most part friendly competition amongst them. However in the area of Cosmetic Surgery the 'turf war' unfortunately is sometimes bitter and acrimonious. 

The 2 major players are Plastics and Otolaryngology, although Opthalmology and Dermatology are clearly also involved. Plastic surgeons often feel they 'own' the term and can be upset when others use it. Otolaryngologists are cursed with an unpronouncable name and often use Facial Plastic surgery to identify what they do to the public. Currently there are few doctors who would not support the position that both specialties share competency in Rhinoplasty surgery. Therefore a patient should look beyond the titles and try to select the best surgeon for the job.

I would disagree to some extent with Dr. Naderi.

You should understand that there is a turf battle between ENT surgeons and plastic surgeons, and plastic surgeons are usually annoyed when docs with ENT training call themselves "plastic surgeons."

Most ENT surgeons do a 5 year residency in ENT (otolaryngology).

Most Plastic surgeons do a 5 year residency in general surgery (although ENT, urology, and orthopedics are other pathways), and then a 2-3 year residency in plastic surgery.

Both residencies give exposure to cosmetic surgery, however, cosmetic surgery exposure tends to be greater in plastic surgery residencies. After residency, some plastic surgeons will take additional training in cosmetic surgery (fellowship). After ENT training, and ENT surgeon that wants to do cosmetic surgery will take additional training, and then be qualified to become certified in Plastic Surgery of the Head and Neck.

It is important to note the Plastic Surgery of the Head and neck is not a separate ABMS board. This can be verified at their site. abms.org

However, some states, like CA, recognize this certificate and give it equivalence with the ABMS certification for otolaryngology and plastic surgery.

Dr. Naderi (and other ENT docs) make it sound like ENT and plastic surgery are entry points to become facial plastic surgeons. I know of no plastic surgeon that has done additional training, and then calls himself a facial plastic surgeon, as surgeons know that" facial plastics" refers to those with ENT training. Plastic surgeons who have additional training in the head and neck call themselves craniofacial surgeons. Plastic surgeons specializing in cosmetic surgery of the face call themselves "plastic surgeons specializing in the face."

Any doctor can work anywhere on the body, although it is difficult to get hospital privileges to do so. In a doctor's office that has a surgery center, this is not closely regulated. Therefore, there are many ENT/facial plastic docs that do surgery of the breasts and abdomen, but the public is not aware that they do not have specific training to do so.

When it comes to the nose, ENT, facial plastics, and plastic surgeons are all trained in these procedures. The nose is one of the most challenging procedures to perform. Therefore, the most important qualification here is experience. As a plastic surgeon, I would prefer an ENT surgeon with great experience to a plastic surgeon with little experience, and vice versa.

The most important questions to ask are regarding the surgeon's personal experience doing the recommended procedure, along with his/her actual formal training.

Best of luck going forward.

 

Historically speaking, what we describe as "Plastic Surgery" long predates the development of modern medicine, or even the foundation of the United States.  Modern Plastic Surgery, or indeed modern Facial Plastic Surgery arose from the great need created by World Wars I and II to treat traumatic defects of the face and body.  The Surgeons who were instrumental in developing techniques were General Surgeons, Otolaryngologist-Head and Neck Surgeons, Ophthalmologists, Oral Surgeons, and Orthopedic Surgeons.  Sir Harold Delf Gillies, a pioneer in facial reconstructive surgery, was an Otolaryngologist-Head and Neck Surgeon from New Zealand.  Jaque Joseph, largely credited with the first cosmetic Rhinoplasty, was Austrian Orthopedic Surgeon. The less interesting part of the history is the ugly "turf battles" which ensued in the 20th century between General Plastic Surgeons and Facial Plastic Surgeons (who have the basis of their training in Otolaryngology-Head and Neck Surgery).  The use of the term "ENT" is a bit of a historical put down revived by the partisan quips of Dr. Alexander.  I think that marketing terms like "Quicklift" which is advocated by Dr. Alexander, deserve far more scrutiny than do the credentials of a Facial Plastic Surgeon.

The facts are as follows:  1) Facial Plastic Surgery belongs in the hands of someone who specializes in the face.  This can include a Surgeon trained in Facial Plastic Surgery or Plastic Surgery,

2)  It is hard to find a Surgeon more qualified to perform a Rhinoplasty than a Facial Plastic Surgeon.  A large percentage of Facial Plastic Surgeons and General Plastic Surgeons finished in the top 10% of their medical school classes, and are competitive, well trained Surgeons.

3) Both General Plastic Surgeons and Facial Plastic Surgeons receive cosmetic and reconstructive surgery training in the face; the extent of this training varies with the individual program, not the specialty,

4) The ABMS was founded by the American Academy of Otolaryngology and Ophthalmology (in the early 20th century) and recognizes the ability of Otolaryngologists to perform Facial Plastic Surgery.  The lack of inclusion of Facial Plastic Surgery is, in itself a historical turf battle.  For this reason, Facial Plastic Surgery shares ABMS equivalency in Florida and all states in the Union.  This is an argument that those most interested in a "turf battle" seem to cling to; I have found that most patients prefer specialization in the face to Surgeons who bad mouth other Surgeons.

5) As eloquently stated by Dr. Agarwal, the general public has far more to fear with Dentists performing Facelifts and Botox, with Gynecologists performing tummy tucks, and Family Medicine Doctors using lasers than they do from a Facial Plastic Surgeon or Plastic Surgeon performing a Rhinoplasty.