Difference in certification: American Board of Plastic Surgery vs. American Board of Cosmetic Surgery for breast reduction?

Question

I have two consultations for breast reduction scheduled for next month. I have large breasts (40J) and know breast reduction would be beneficial. Insurance won't cover it, so I'll pay out of pocket. Surgeon 1 is certified by the American Board of Plastic Surgery and has only a few pictures on his website, but they're all of patients with smaller breasts than mine. Surgeon 2 is certified by the American Board of Cosmetic Surgery and the American Board of Surgery; he also has multiple pictures of his work on his website with patients who look similar in size to me. My question is: What is the difference between these certifications? Should one be considered over the other for a breast reduction on larger breasts? Thanks in advance for taking the time to answer this question!

Yasemin Aydinli, MD · Answer

The American Board of Plastic Surgery is the certification recognized by the American Board of Medical Specialties and requires completing a full plastic surgery residency, which includes extensive breast surgery training. The American Board of Cosmetic Surgery is not an ABMS member board and its diplomates come from different residencies; your second surgeon also holds American Board of Surgery certification, meaning he trained as a general surgeon and then added cosmetic training. For a large reduction such as a 40J, the technical questions are the pedicle choice, whether a free nipple graft may be needed and how the surgeon handles complications, so I would give weight to the formal plastic surgery training and to the hospital privileges the surgeon holds. At the same time, ask surgeon 1 directly for photos of patients your size; a lack of website photos does not mean a lack of experience. Choose the surgeon who explains the plan for your specific size clearly and operates in an accredited facility. For readers comparing with other countries, in Turkey these separate boards do not exist: the specialty of Plastic, Reconstructive and Aesthetic Surgery is the equivalent of ABPS certification, and there is no other official branch that may use the title plastic surgeon or aesthetic surgeon. The training is six years of medical school followed by a five year residency in plastic surgery.

Michael D. Baratta, MD · Answer

Hello,
This is a great question. There is a distinction between those two certifications that hopefully I can clarify. I am a board certified plastic surgeon. To say this means I went through a rigorous 6 year plastic surgery residency and was trained in the full scope of plastic surgery including reconstruction and aeshtetic. I then did an extra one year aesthetic fellowship to refine my skills and technique. During this time I also passed a written national exam which made me eligible to then collect my personal surgical cases for a year when I started practicing and then sit for my oral boards. Oral boards is the culmination of all of this work and takes much thought, care, and detail to pass. They also assess you in regards to your ethical conduct and morals. After you pass all of this you are then officially a board certified plastic surgeon. In regards to be a board certified aeshtetic surgeon these are doctors who come from other types of surgical training such as general surgery or OB/GYN and then did a one year cosmetic fellowship. I do not know the standards for their testing after the fellowship to be certified for their board. My point in saying all this is I think there is a true difference in the surgical training, education, experience, and testing that makes a surgeon a board certified plastic surgeon compared to a board certified cosmetic surgeon. In regards to choosing a surgeon to perform your breast surgery or any other plastic surgery I would weight this information heavily and go from there. Hope this is helpful!
Michael Baratta, MD

Gary M. Horndeski, MD · Answer

American Board of Cosmetic Surgery is not an approved board by the AMA. The American Board of Surgery and the American Board of Plastic surgery are approved by the AMA. It is most likely the physician that is certified by the American Board of Surgery is certified in general surgery and may or may not have taken a fellowship in cosmetic breast surgery. In terms of breast reduction, I recommend an alternative technique called the Bellesoma. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction and long term stability. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Luis A. Mejia, MD · Answer

Thank you for your question, Prioritize the surgeon certified by the American Board of Plastic Surgery (ABPS) because ABPS requires years of rigorous residency training focused specifically on complex tissue reconstruction and breast flap viability, which are critical for a high-volume (40J) reduction. While Surgeon 2 has more representative photos online, their credentials (general surgery plus a one-year cosmetic fellowship) offer less specialized depth in complex plastic surgery; ask Surgeon 1 during your consultation to view their private, in-office photo gallery, as surgeons routinely keep large reconstructive case photos off public websites for patient privacy., check if they adapt to your goal,
Dr. Luis Mejia
Let's make ir better

Mats Hagstrom, MD (license on probation) · Answer

You should 100% choose a board certified plastic surgeon.
If you’re having any kind of neck or back pain related to the size of your breast, that insurance should pay for your breast reduction.Why do you think insurance will not cover the procedure?
It’s usually not that difficult to get insurance authorization for breast reduction surgery.
It requires having a plastic surgeon who is willing to accept insurancereimbursement, which many are not because they are simply too greedy.
You should first and foremost, confirm why this isn’t covered by medical insurance.
Of course, if you don’t have neck and back pain, skin, rashes,shoulder, grooving, or any other issues related to having large breasts, then insurance wouldn’t pay for it.
If you however, do have neck or back pain related the size of your breast and insurance should pay for it.
To be board certified in plastic surgery requires doing a formal plastic surgery residency, which is either two or three years long.
This is after doing typically 3 to 5 years of general surgery or board certification in another surgical specialty.
As far as I know, there’s not a single board certified plastic surgeon who is a member of the American Board of cosmetic surgeons.
To be a memberof the American Board of cosmetic surgeons requires no residency in plastic surgery. It’s an organization pretty much any doctor can join regardless of background.
It is not under the umbrella of the American Board of medical specialties.
There’s not a single academic institution that offers training leading to certification in cosmetic surgery. The proper certification is in plastic surgery.
The cosmetic surgeon you went to most likely has a background that’s not related to plastic surgery at all.They may have spent some time training with another cosmetic surgeon who also had no plastic surgery training.
It’s not illegal to form an organization and call it a board.
No plastic surgeon in the United States recognizes the American Board of cosmetic surgery as a legit organization. 
It’s what you get when you didn’t wanna go through plastic surgery training or you weren’t good enough to get accepted.This is where the charlatans hang out.
Get smart and consult with a few more board certified plastic surgeons in your community.
Look for plastic surgeons to do breast cancer reconstruction.
Surgeons to doreconstructive work I used to working with insurance reimbursement and are usually really good breast reduction surgery.
They’re also used to accepting insurance reimbursement and know how to get patients approved.
Don’t pay for a procedure that should be covered by your insurance company.
Best,
Mats Hagstrom MD

Difference in certification: American Board of Plastic Surgery vs. American Board of Cosmetic Surgery for breast reduction?

Answers (5)

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