Doctors Certification Confusion, How Do I Know What I Should be Looking for?

I have a question about credentials and board certification (for a face lift, mid-face and brow lift.) I have found a doctor I like but I’m confused about his Certifications. His Certification is with the “American Board of Otolaryngology” and not the “American Board of Plastic Surgery”. Does that matter? He is also board certified by “American Board of Facial Plastic and Reconstructive Surgery” & a Fellow in “American Academy of Facial Plastic and Reconstructive Surgery”. I'm confused .....

Doctor Answers 8

Doctors certification

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The American Board of Plastic Surgery and the American Board of Facial Plastic Surgery are both excellent qualifications for surgeons to perform facial cosmetic surgery.  The American Board of Otolaryngology, otherwise known as ear, nose, and throats doctors, is an additional certification that a facial plastic surgeon must go through prior to receiving his facial plastic surgery board certification.  The American Academy of Facial Plastic Surgery is an organization, and membership does not represent any true credentials.  Look for a surgeon who has extensive experience in the procedures you are interested in and critically review all of his or her before and after photos.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Choosing a surgeon

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The doctor is an Otolaryngologist and should be adequately trained for a cosmetic procedure of the face. Many Otolaryngologists refer to themselves as Facial Plastic Surgeons just like many Ophthalmologists refer themselves and Oculoplastic Surgeons. The Ophthalmologist should be more than qualified to operate on your eyelids. Don't let the word "Plastic" throw you. Plastic Surgeons lost the fight to prevent others from using the word "Plastic" many years ago.

What you really need to do is discuss this with your surgeon. As part of the informed consent process and your feeling comfortable choosing a specific surgeon that surgeon has to answer all your questions, clear up confusions and make you comfortable going through with the surgery.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Board certification confusion

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Facial plastic surgery is a subspecialty unto itself. The American Board of Facial Plastic and Reconstructive Surgery requires doctors to be certified by either the American Board of Plastic Surgery or the American Board of Otolaryngology first in order to qualify to take the ABFPRS exam. They then must submit 100 cases for review and take a 2 day written and oral exam to become ABFPRS certified. Your doctor has the appropriate credentials for the procedures you are seeking. Go for further information.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

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Certifications and Choosing a Surgeon

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It sounds like the doctor you have seen is an Ear, Nose, and Throat doctor who has completed additional training in plastic surgery of the face.

This means that they are qualified to perform the procedures you are interested in- but I would be very worried of this doctor offered you liposuction of your abdomen (clearly not part of facial plastic surgery training).

As in all cases, given this information, your choices should depend on your relationship with the doctor, the qualifications of the facility where your procedure will be performed, those of the anesthesia provider, and the quality of the doctor's outcomes (look at photos).

Best of luck.


It is critical that your surgeon is board certified.

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At the same time, board certification is no guarantee that your surgeon has the aesthetic skills you need to have a successful surgical outcome.

It is essential to understand that much of the confusion is surgeon created and arises from economic competition among competing surgical subspecialties.  The principle surgeons providing aesthetic services are general plastic surgeons, facial plastic surgeons, oculofacial plastic surgeons, and dermatologists.  Secondary specialities that also provide aesthetic services including surgery are maxillofacial surgeons, and increasingly gynecologists.  On the margins are general surgeon who practice cosmetic surgery, and internists and family physicians who provide aesthetic services likes BOTOX, fillers, and laser procedures.

As a bit of self promotion, general plastic surgeons have a decades old public relations campaign suggesting that you should only go to a board certified general plastic surgeon for cosmetic surgery.  Originally in the sixties, this campaign was directed against otolaryngologists practicing facial plastic surgery.  This campaign has been quietly resuscitated in the face of increasing competition for other specialities offing cosmetic plastic surgery.

Do general plastic surgeons provide the highest level of cosmetic surgical care among any of the other surgical specialties to justify their public relations slogan?  Well there is no scientific evidence to support such claims.  Feeling that one is the best possible surgeon does not make one the best qualified surgeon.  In California, Facial Plastic Surgeons ( Board certified otolaryngologist who are fellowship trained in facial plastic surgery) sought board equivalent recognitions equal to that of general plastic surgeons.  This is a technical legality regarding the ability to advertise one's self as board certified.  The California Medical Board reviewed the surgical case logs of California plastic surgery residents training at arguably some of the best plastic surgery residencies in the United States vs Otolaryngologist training in California based facial plastic surgery fellowships.  The conclusion of the California Medical Board was that the facial plastic surgeons clearly had more training in facial plastic surgery than the general plastic surgeons and therefore it was clear that their training was at least equivalent.  Interestingly in informal comments made by the Board as part of these hearings, it appeared that general plastic surgeons were inadequately trained in facial plastic procedures.  General plastic surgery residents were lucky to have completed their residencies having been primary surgery on more than one facelift, liposuction, no laser resurfacing, and minimal eyelid and nasal surgery.  

In the area of eyelid surgery, oculoplastic surgeons receive extensive surgical training in eyelid and orbital surgery in a two year fellowship programs after completely accredited residencies in ophthalmology.  Typically, they are involved in 2500 eyelid and orbital surgeries often exceeding the number of eyelid surgeries cases that general plastic surgeons are involved in during their training by a factor of 100.  Ironically, oculoplastic surgery fellowships are providing stronger facelift training that is  available in many general plastic surgery residencies.  That is not to diminish the importance of general plastic surgery.  There is no specialty that is better qualified to offer burn care, or breast surgery than general plastic surgery.  The reality is that no primary surgical residency provides adequate training for its residents in cosmetic surgery.  That includes ophthalmology, otolaryngology, dermatology, and general plastic surgery.  To become a great cosmetic surgeon requires fellowship training in a surgery specialty such as facial plastic surgery fellowship after training in otolaryngology, an aesthetic surgery fellowship after a general surgery residency,  or a general cosmetic surgery fellowship following a dermatologic fellowship or oculofacial fellowship.  Going to someone for cosmetic surgery who has simply hung out a shingle after completing their surgical residency in any of these specialties is almost a guarantee of getting unsatisfactory cosmetic surgery.  

The rub is that while all this additional training is necessary, it is not sufficient to assure a good outcome.  These are just minimums.  This type of extensive training simply means that is more likely that the well trained individual is likely to provide better surgery that someone who is not as extensively trained.  There are individuals who are truly gifted so it is possible that with great personal effort and skill they can over come their lack of training but this is rare.  

The point is that credentials are very important but training in a particular speciality is not assurance that you will get the cosmetic surgical outcome you seek.  It is very important to study your surgeons credentials.  Are they affiliated with a University teaching program, do they publish papers and book chapters, do they lecture and teach other surgeons, do they hospital privileges for the surgeries they perform, do they carried appropriate malpractice insurance, are they in good standing with the Medical Board of the State in which they practice.  Finally, when you see them, do they make sense, did they spend enough time with you that all your questions were answered.  Did they describe the anticipated course of recovery and discuss possible complications?  Did you feel heard?  Did the office and the surgery treat you with respect and dignity.  Spend time reviewing their website.  Are there any red flags here?  Do you like the before and after images the surgeon is showing.  This will be their best work.  If you do not like what you see, do not expect that your result will be any better.  

I wish there was a simple answer to this but it is complex.  Many surgeons will offer what you are looking for.  It is ultimately your job to determine which surgeon is right for you.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Board certification

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Otolaryngology-Head and Neck Surgery is the specialty that focuses on surgery of the head and neck, including esthetic and reconstructive surgery of the face. Some Otolaryngology specialists go on to acquire further specialized training in facial plastic surgery, either cosmetic, reconstructive, or both.

Doctors from either Otolaryngology or Plastic Surgery may chose to become certified by the American Board of Facial Plastic and Reconstructive Surgery. To be eligible to do so, they must be already Board certified by the American Board of Otolaryngology or the American Board of Plastic Surgery.

I hope this helps, but to essentially, the doctor you saw has the training and the credential. What remains for you to determine is if you feel comfortable with him and if his reputation or examples of his work correspond to your goals.

Mark Samaha, MD
Montreal Facial Plastic Surgeon
4.9 out of 5 stars 97 reviews

Certification in plastic surgery

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You are correct in that your doctor is not a "plastic surgeon" in the sense of being a Board Certified Plastic Surgeon.  However, he does have the credentials to do what you want if you like him and the photos of the work he has shown you.

Excellent credentials

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Rhinoplasty surgeons generally fall into two categories- Facial plastic surgeons (ABFPRS) train in otolaryngology (ear, nose and throat) and facial plastic surgery and general plastic surgeons (ABPS) who train in general surgery and general plastic surgery, including the breast, body and the face. Facial plastic surgeons feel their training is better for treating both the form AND the function of the nose. There are also general plastic surgeons who excel in rhinoplasty. The most important thing for the consumer is to find a surgeon who has a special focus in rhinoplasty and who shares your aesthetic vision.

J. Charles Finn, MD
Raleigh-Durham Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.