Plastic Surgeon Vs. Cosmetic Surgeon - What's the Difference?

Can somebody tell me what the difference is, if any, between a cosmetic and plastic surgeon?  I am also unclear about how facial plastic surgeons compare to otolaryngologists or oculoplastic surgeons...can anyone help there?

Doctor Answers 16

Plastic Surgeon vs Cosmetic Surgeon Not all board certification is equal - Here's how to choose a plastic surgeon

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Thousands of physicians with no residency training in plastic surgery and without certification from the American Board of Plastic Surgery (the only Board recognized by the American Board of Medical Specialties that certifies plastic surgeons) promote themselves as `cosmetic surgeons' and `plastic surgeons'.  

Some physicians performing plastic surgery procedures are primary care physicians, some are emergency room doctors; some have never completed a residency training program in any specialty and are not eligible to take any specialty board exam. Many take `weekend courses' on liposuction, or breast augmentation, or facelifts, then return to their practice and begin promoting that procedure and performing it on patients.

The minimum amount of training in plastic surgery that will allow a physician to be eligible for certification by the American Board of Plastic Surgery is five years, and many board-certified plastic surgeons, myself included, have several additional years of training in general surgery and plastic surgery. There are a number of reasons for such a significant training requirement. Chief among them are the following: one does not acquire sophistication in diagnosis and treatment planning, superior surgical skill, and the capacity to minimize the possibility of complications and unfavorable outcomes by taking weekend courses. It requires years of training experience under the direction of talented mentors. It requires devotion to the art and practice of plastic surgery.

Be careful in evaluating physicians whose `Board Certification' is by a `Board' which is not recognized by the American Board of Medical Specialties (ABMS), and who belong to an `Academy' that does not require residency training in plastic surgery. Some will claim that they are `double-' or even `triple-board certified', when only one (and occasionally none) of those `boards' are recognized by the ABMS. Visit the ABMS website to see which specialties have ABMS recognition.

It takes just a few mouse clicks to verify a surgeon's credentials online. Make sure that the surgeon or surgeons that you are considering are certified by the American Board of Plastic Surgery and are active members of the American Society of Plastic Surgeons (ASPS). ASPS members are also eligible for membership in the exclusive American Society of Aesthetic Plastic Surgeons (ASAPS), the premier professional association of board-certified plastic surgeons with a specialty practice in cosmetic surgery.
Membership in ASAPS, the organization for plastic surgeons with an emphasis on performing aesthetic surgery can also help clear up the difference betwen who is who. 

The following are a few things that can distinguish some surgeons from others

1) Graduating from a top tier medical school at the top of their class.

2) Membership in Alpha Omega Alpha. This is the medical honors society. Alpha Omega Alpha is to medicine what Phi Beta Kappa is to undergraduate universities.

3) Formal surgical training from prestigious medical universities. The minimum number of years of surgical training for plastic surgeons to be board certified in five years. Some physicians have as many as ten years of formal surgical training. There simply is no substitute for stelar academic and practical surgical training.

4) Very experienced surgeons with meticulous surgical technique and natural looking outcomes will have photgraphic evidence of their work. Patients should be able to view many photos of the surgery of interest, photographed from three different perspectives all with similar lighting, distance from the camera and cropping

The elite experience extends beyond the surgeon to the facility, and the surgical team. You should be able to see the surgical theater and know who else will be in the OR with you during surgery. The Joint Commission (JCAHO) is an organization that provides certification to hospital OR's. The Joint Commission and AAAASF are two of the organizations that can provide certification to surgical suites. Some plastic surgeons elect to have their surgery centers dually certified.

The anesthesia experience is critical to a safe and comfortable surgical experience. A board certified anesthesiologist can administer general or MAC anesthesia. My preference is to have a board-certified anesthesiologist at the bedside of my patients for the duration of surgery.

Plastic surgeons who cater to high profile individuals who place a high value on privacy will have a private first floor entrance and exit so patients never need to be in a public lobby or elevator for pre-operative or post operative visits.

I am consistently surprised by the number of patients I see for revision surgery following complications by a physician without appropriate training or board certification. This happens to many savvy, intelligent people. Realself is a wonderful source of information. I urge all prospective patients to take your time, check credentials very carefully and never rush into surgery, or schedule surgery because you feel pressured to do so. 

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Cosmetic Surgeon vs Plastic Surgeon

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In order for a physician to be a plastic surgeon, one must complete an approved Residency training program in Plastic Surgery. Plastic surgery involves a spectrum of different components, including cranio-facial surgery (e.g. cleft lip or palate), burn surgery, hand/microsurgery, maxillo-facial trauma, general and breast reconstructive surgery, and cosmetic surgery (facelift, tummy tuck, liposuction, etc.). Because the field of plastic surgery is so broad and extensive, the training required to become a plastic surgeon is between 6-8 years after medical school.

Some plastic surgeons, especially in more rural areas, offer the full spectrum of plastic surgery, but most tend to specialize - i.e. - tailor their practice with greater emphasis on one or two areas of plastic surgery. But whether a plastic surgeon chooses to specialize in hand surgery or cosmetic surgery, they are still "plastic surgeons" as deemed by the American Board of Medical Specialities (ABMS).

In reality, any licensed physician can offer cosmetic services, as this is not illegal. The term "cosmetic surgery" is not a recognized discipline by the American Board of Medical Specialities, i.e. - there is no Board Certification by ABMS in Cosmetic Surgery. There are numerous opportunities to "train" in cosmetic surgery (usually 6 months to 1 year) - but none leading to a board certification by ABMS. So if someone is a "cosmetic surgeon" - s/he could be an ENT surgeon, a Dermatologist, a General Surgeon, an Opthalmologist, a General Practioner, or a Plastic Surgeon.

This may come as a bit of shock for most people, as many people equate plastic surgery with cosmetic surgery. As a plastic surgeon specializing in cosmetic surgery, I do not pass any judgement on physicians of different disciplines practicing cosmetic surgery, as long as they are well trained and honest about their credentials (as I would expect of plastic surgeons as well). I do have a problem with cosmetic surgeons misleading patients into thinking that they are plastic surgeons, taking advantage of the common misconception that public has about synonymity of plastic surgery with cosmetic surgery.

Finally, there are a multitude of terms out there, including facial plastic surgery, oculo-plastic surgery, etc. These terms are often coined by ENT surgeons (for facial plastic surgery) and opthalmologists (for oculo-plastic surgery), as they often represent further training of the aforementioned disciplines, i.e. an ENT may extend their training in plastic surgery of the face. These training opportunities are usually offered only to certain disciplines (e.g. an oculo-plastic surgery fellowship is offered to only opthalmologists).

Bottom line: Ask questions about your doctor's credentials, training, and board certification. There are many confusing terms, all trying to denote some degree of extra expertise or specialty, but at times it's misleading - whether it'd be intentional or unintentional.

Christopher Chung, MD (retired)
Corona Plastic Surgeon

Plastic surgeon vs cosmetic surgeon

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A Board Certified Plastic Surgeon has had rigorous training for between 6 and 8 years or longer after medical school on all aspects of surgery and plastic surgery. As such, they represent the gold standard for plastic surgeons. All plastic surgeons are cosmetic surgeons but not all cosmetic surgeons are plastic surgeons.

Facial plastic surgeons are ENT trained surgeons who have a special interest in cosmetic surgery above their basic otolaryngology Board Certification. There are many outstanding surgeons in this group.

Oculoplastic surgeons are ophthalmologists who have a special interest in cosmetic procedures around the eyes. Dermatologists also do cosmetic surgery, especially liposuction. Unfortunately, there are also general surgeons, oral surgeons, gynecologists and even general medical doctors doing cosmetic surgery and procedures all giving explanations as to why they are the best choice for you even though they have never even had one day of plastic surgery training.

All in all, it is a buyer beware market. You should carefully evaluate your doctor and for the face, stick with a plastic surgeon or a facial plastic surgeon whom you trust and whose work you admire. For the body, stick with a plastic surgeon only.

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The difference between a Plastic Surgeon vs. a Cosmetic Surgeon? Training...

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With more and more physicians leaving the insurance side of their practice and entering elective medicine, the line between a Plastic Surgeon and a Cosmetic Surgeon is becoming more confusing. But, in reality, there is a big difference!

Plastic Surgeons complete a minimum of two years of focused training in Plastic Surgery. In contrast, any physician can call themselves a Cosmetic Surgeon... no matter what their background of training is in. In other words, your local "Cosmetic Surgeon" may be an Emergency Room physician who, after buying the latest and greatest laser, now calls himself a Cosmetic Surgeon.

Is this simply a turf war? Absolutely not. The American Board of Medical Specialties (the only official certifying board) does not recognize Board Certification in "Cosmetic Surgery". In addition, Florida just passed legislation requiring physicians who claim themselves to be Board Certified to disclose to the public the area in which they are actually certified.

When looking for a physician to perform your Plastic Surgery, ask them a series of questions. First, ask them about their training, how long they have been Board Certified, and how many Cosmetic procedures they perform in a given year. Ask them about their complication rate and, most importantly, ask to see before/after photos and ask to speak to a patient who has undergone the procedure you are interested in.

Do not be drawn in by cost savings. Many physicians will provide incentives at various times of the year but others always discount prices simply in order to draw in the budget conscious. Keep in mind that it is far more expensive to fix a bad result than to simply get a good result the first time around.

Not all Surgeons are Surgeons...

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With so many medical professionals offering cosmetic treatments, it can be confusing trying to determine who you should be trusting.

In Canada (where I practice) and in the USA, the title Plastic Surgeon pertains only to surgeons who have completed a designated residency training program in plastic surgery. This training includes both reconstructive and cosmetic plastic surgery.

Check your physicians credentials by asking if:

  • they completed a plastic surgery residency
  • they are board certified in plastic surgery (or in Canada ask if they are a Fellow of the Royal College of Surgeons of Canada in Plastic Surgery),
  • they are a member of the American Society of Plastic Surgeons or American Society for Aesthetic Plastic Surgery (in Canada: the Canadian Society of Plastic Surgeons and the Canadian Society for Aesthetic Plastic Surgery). These societies limit their memberships to officially residency trained, board certified plastic surgeons.

These surgeons are trained to perform all types of cosmetic surgeries on all body areas and have also received training in non-invasive cosmetic treatments such as fillers, Botox and lasers.

The title facial plastic surgeon is used by otolaryngologists (ear nose throat) doctors who have done some training in facial plastic surgery i.e.: rhinoplasty, facelifts, blepharoplasty etc. They have not completed a plastic surgery residency and are not board certified in plastic surgery but have received legitimate training in facial plastic surgery procedures. They have not necessarily received training in cosmetic procedures on other areas of the body. Ask your surgeon to explain his or her training to you.

Occuloplastic surgeons are either ophthalmologists (eye doctors) or plastic surgeons who specialize in plastic surgery procedures around the eye. Ask questions to clarify your surgeons' training if you are considering a procedure on another part of your body.

The term "cosmetic surgeon" can be used by any physician. There is no official residency training in "cosmetic surgery". This physician might not necessarily even have legitimate surgical training. In Canada, any physician with any training can call themselves a cosmetic surgeon and perform non-invasive or invasive cosmetic procedures... with little or no training.

As a general rule, at your first consultation, ask your surgeon to explain his or her training to you. Ask what residency program they completed, ask if they are board-certified and in what specialty, ask if they belong to any societies and ask what the entrance requirements are for that society.

When it comes to your body don't be afraid to ask questions.

Kim Meathrel, MD
Ontario Plastic Surgeon

What a Facial Plastic Surgeon Is

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A Facial Plastic Surgeon is a surgeon first board certified in Otolaryngology-Head and Neck Surgery. This requires at least 1 year of General Surgery (abdominal, hernia, gall bladder, vascular, trauma surgery), followed by 4 years of Otolaryngology. Otolaryngology is a regional surgical specialty which is devoted to disorders, anatomy, birth defects, and reconstruction of the face, neck, and structures associated with it. This includes cosmetic and reconstructive surgery on the face. This training gives unparalleled knowledge and surgical anatomy of the face and neck. Those who choose to do so can proceed with a fellowship in Facial Plastic Surgery for further expertise and refinement. A secondary board certification can then be obtained from the American Board of Facial Plastic Surgery (ABFPRS). The ABFPRS is not an ABMS board for political and other reasons. However, the ABFPRS is considered ABMS equivalent in Florida and virtually all other states. There is every reason to expect the highest standard of care when seeing a Facial Plastic Surgeon for facial rejuvenation.

Unlike our colleagues in General Plastic Surgery, our training is not devoted to hand surgery, closure of abdominal wounds, chest wounds and other areas of surgery. Training in various programs will determine the level of expertise in facial surgery.

When choosing a surgeon, it makes sense to consider a surgeon who specializes on the area you are focusing on. For facial surgery, this can include a Facial Plastic Surgeon or a General Plastic Surgeon.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Plastic surgeon vs cosmetic surgeon and others

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The American Board of Medical Specialties (ABMS) is THE official and authoritative body in the US for certification of Medical and Surgical specialties.

Boards certified by the ABMS for the training and certification of Plastic Surgeons:

-The American Board of Plastic Surgery. That's it.

Boards NOT certified by the ABMS for Plastic Surgery:


An oculoplastic surgeon is certified by his specialty board to do plastic surgery around the eyes. He is not certified or trained to do any other type of plastic surgery, such as facelifts.

A facial plastic surgeon is certified by his specialty board (otolaryngology) to do plastic surgery in the head and neck area. He is not certified or trained to do any other type or plastic surgery such as liposuction of the body, breast augmentations, butt lifts, etc.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Difference between Plastic Surgeons and Cosmetic Surgeons

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Unfortunately these terms might mean a fully certified surgeon who performs cosmetic surgery, or could mean another sort of physician who doesn’t have proper training or Board Certification but practices plastic surgery anyway.

To attain status as a plastic surgeon alone takes a lot of commitment, time, and educational training. To attain status as ‘board certified’ it requires even more of those things and a rigorous examination process as well. Often, to achieve the status of ‘cosmetic surgeon’ a doctor can just start using that term without any true certification or training at all. Therefore, such a doctor would not be certified by the American Board of Plastic Surgeons like a ‘Board Certified Plastic Surgeon’ would be.

However within the field of plastic surgery there are many specialties, including hand surgery, reconstructive surgery, pediatric plastic surgery and cosmetic surgery. So the term cosmetic surgery could possibly mean a specialist within the field of plastic surgery that is an expert in aesthetic procedures.

So that means you should always check credentials of your potential surgeon and verify that they are indeed ‘Board Certified’ by the American Board of Plastic Surgeons.

Scott W. Mosser, MD
San Francisco Plastic Surgeon

Plastic Surgeon vs. "Cosmetic Surgeon"

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Notice I put cosmetic surgeon in quotation marks. This is because there really is no such specialty as far as the American Medical Board is concerned. So beware.

To be come a plastic surgeon you have to be dedicated and endure a long road of education, training and examinations. To become a board certified plastic surgeon, there is even more scrutiny that you must face and conquer. To become a plastic surgeon one must complete 4 years of medical school. Then there is residency and you must complete a minimal of 5 years of training, which is usually focused in general surgery. This means you pretty much operate on all parts of the body. This includes being training in dire circumstances like trauma and so forth. Then there is a minimal of another 2 years or 3 years of plastic surgery training. So the training to become a plastic surgeon is very long and strenuous. Then to become a board certified plastic surgeon you have to pass a challenging written exam and then an oral exam where you are challenged by 6 different examiners.

To call yourself a "Cosmetic Surgeon" all it takes is to take a weekend coarse on how to do this laser or that laser or even liposuction. Then take a test after your didactic Saturday coarse and you can call yourself Board Certified.

So dont be fooled, always ask what is the doctors board certification in. If it is not plastic surgeon or if you dont see the ASPS logo, then I would walk the other way. You are asking for problems that would be difficult to fix. A lot of these non plastic surgeons will lower their cost to attract the patients. But again is it worth it to pay less and suffer more later?

The most important thing to look for when you are interested in a plastic surgery procedure is to feel comfortable with the Board Certified Plastic Surgeon you choose. You should also obviously enjoy and appreciate the results they have achieved in their before and after album. Lastly should be the cost factor. Remember it is a lot let expensive to get it done right the first time than to have to do multiple revisions later on. Besides the final product will never look the way it should, if it was done right the first time.

Good luck!

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Plastic Surgeon Vs. Cosmetic Surgeon - What's the Difference?

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I think Justice Louis D. Brandeis said it best, "Sunlight is said to be the best of disinfectants..."  In other words, becoming well informed about the differences between the extensive and rigorous education and training of plastic surgeons vs that of "cosmetic surgeons" is important to any consumer desiring to have aesthetic plastic surgery.  Becoming primarily educated in a field having nothing to do with plastic surgery and then self-labeling as a "cosmetic surgeon" with very limited plastic surgery education, training, and skills are no substitutes for doing the very hard work of becoming a board certified plastic surgeon.

Paul Fortes, MD
Houston Plastic Surgeon
4.1 out of 5 stars 17 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.