There are numerous practitioners of plastic surgery. However, only a select few are board certified by the American Board of Plastic Surgery (the only board recognized by the American Board of Medical Specialties). Board certification ensures completion of a rigorous training program of at least 6 years (with at least 3 years of dedicated plastic surgery training. Board certified surgeons have also completed written and oral examinations to determine competency and participate in a continuing medical education programs as a prerequisite of maintaining certification. With regards to your specific question, you need to ask yourself...what is a cosmetic surgeon? What sort of training have they had? When you are consulting with a plastic surgeon certified by the American Board of Plastic Surgeons, you know the answers.Ultimately, certification ensures a measure of certainty when comparing surgeons. You can be assured that your board certified plastic surgeon has seen and treated it all before and is uniquely qualified to manage you pre-operatively, intra-operatively, and most importantly post-operatively.