Plastic Surgeon Vs. Facial Plastic Surgeon: is There a Difference?

I am a Facial Plastic Surgeon and proud to be so. Obviously, my perspective is biased based on my training, a training devoted to the face and neck.

However, I think there are several observations a prospective patient should consider in making their decision.

The Individual Surgeon:
I can assure you that if you are seeing a Facial Plastic Surgeon or General Plastic Surgeon, there is a high probability you are seeing a surgeon who has excelled academically and clinically in Medical School, Residency, and post-residency training. Both specialties have a very high percentage of Alpha Omega Alpha graduates, and both specialties are highly sought after as residencies, and therefore highly competitive. These attributes definitely don't assure good technical skill or an artistic/aesthetic sensibility, but they are a good start.

The Specialty:
Both Facial Plastic Surgery, and General Plastic Surgery have legitimate claims, as specialties, to providing expertise toward cosmetic and reconstructive procedures of the face. As other posters have correctly stated, the individual surgeon may have been in a residency program where there was minimal or major emphasis on facial anatomy, surgery, or pathology. Learning technical and judgmental skills in surgery is not a one step process; it requires careful study and consideration and an ability to apply a three dimensional approach, understanding that every action has an equal and opposite reaction. The failed Rhinoplasties/Facelifts of countless Hollywood celebrities provide proof that these concepts can be difficult to learn. Facial Plastic Surgeons obtain training in cosmetic surgery both in their residency training and in their fellowship training; this training is exclusive to facial procedures, and does not involve training in breast, body, hand or genital surgery, like General Plastic Surgeons.  Facial Plastic Surgery is recognized as a surgical subspecilaty by the AMA and the American Board of Facial Plastic and Reconstructive Surgery is considered ABMS equivalent in Florida and throughout the United States.  The American Public believes in specialization; in facial surgery, it makes sense to see a Facial Plastic Surgeon or a Plastic Surgeon who specializes in faces.

The Consultation:
I would encourage prospective patients to use their eyes and their intuition to judge if a surgeon will be able to meet their needs. Seeing a number of surgeons is the best way to do this. Let the surgeon impress you with his/her positive qualities; any surgeon who uses as much effort in putting other surgeons/specialties as emphasizing their own attributes is deserving of wariness. In my experience, the best surgeons I have worked/trained with are true gentlemen (women) and don't need to waste their time with "trash talking".

The History:
Facial Plastic Surgery and General Plastic Surgery have a long history of sniping and turf battle issues. Both sides feel passionately about their strengths and expertise. I have worked with excellent Facial Plastic Surgeons and excellent General Plastic Surgeons, and I have seen the disasters of the less gifted of each specialty. The Bell Curve applies to every specialty.

Summary:
Seek a number of opinions, listen to word of mouth, and go with your intuition.

The difference is in 2 main aspects:

1. Training - Plastic Surgery is a sub-specialty of General Surgery where as Facial Plastic Surgery is a sub-specialty of Otolaryngology-Head & Neck Surgery (commonly known as ENT).  Plastic Surgeons train in all body surgery which includes the face whereas Facial Plastic Surgeons train only in the face, head, and neck surgery.

2. Focus of practice - Facial Plastic Surgeons - obviously as the name describes - limit their surgical practice to procedures on the face.  Therefore, experienced surgeons in this field most likely will have performed more facial surgery - and likewise will have more experience - than general plastic surgeons who work on the entire body.  

That being said, there are great surgeons in both fields - your decision should be based on your meeting with your surgeon, and your opinions of their outcomes as evidenced by their before and after results.  Good surgeons should be honest and forthcoming with photos, and be able to provide you with references from previous patients.  In my opinion, there are certain procedures where you should choose with particular care - such as Rhinoplasty or more complex breast surgery.  In these areas, you should seek surgeons with experience and excellent and proven before and after results.

Plastic surgeon generally undergo more training in cosmetic plastic surgery than facial plastic surgeons, especially if they complete an aesthetic fellowship. Plastic surgeons complete 3-5 years of training in general surgery after which they complete 2-3 years of training in cosmetic and reconstructive plastic surgery. Often many plastic surgeons complete an extra year of fellowship training after the plastic surgery residency. During their experience, they learn from a number of experts in plastic surgeons.

Facial Plastic surgeon, however, generally do one year of cosmetic surgery training after they have completed 5 years of Ear, Nose, and Throat surgery where they remove cancers from the head and neck, remove tonsils, perform sinus surgery, etc.

The American Board of Medical Specialities ONLY recognizes the American Board of Plastic Surgery as a member board performing cosmetic surgery. Many other types of surgeons like Dermatologists and ENT surgeons, etc have created NON-member boards such as the Board of Facial Plastic Surgery and Board of Cosmetic Surgery in an effort to confuse patients. 

So when selecting your surgeon, ensure they have experience in the procedure you are electing to undergo. You should ensure they are certified by the American Board of Plastic Surgery. Avoid slogans from surgeons who advertise that they do only faces because the reality is they are only capable of performing facial surgery. Instead rely on their credentials such as training, ask your colleagues / friends, and other physicians for recommendations for a plastic surgeon. There are good and bad plastic surgeons and facial plastic surgeons, so doing your homework and avoiding aggressive sale pitches will improve the chances of achieveing what you hope for. Thus, by default facial plastic surgeons only can perform cosmetic surgery on the face. Most Plastic Surgeon have been trained to sculpt, transform, and mold the head, neck, and body. 

Hi Sonya,
General plastic surgeons are trained with 5 years of general surgery followed by 2-3 years of general plastic surgery including the face, neck, chest, breasts, arms, hands, legs, feet, burns). General plastic surgeons are qualified to perform all plastic surgical procedures.
Facial plastic surgeons usually are trained with 1-2 years of general surgery, then 3-4 years of head and neck surgery (also known as ear, nose, and throat surgery, including facial plastic and reconstructive surgery), followed by an optional year of facial plastic surgery fellowship. Facial plastic surgeons are qualified to perform plastic surgical procedures from the neck up (rhinoplasty, eye lid surgery, face lift, etc.)
Both specialties have surgeons with variable skills, most are exceptional, some average, and unfortunately like everything else in life, a few are below average. The major difference between general plastic surgery (total body), and facial plastic surgery is that clothing cannot be used to cover poor post operative surgical results on the face. Whether performed by general plastic or facial plastic surgeons, when operating upon the face, the surgeon must be meticulous, experienced, skilled, and have an excellent sense of natural beauty and aesthetics. An unsatisfactory scar, nose, or eye lid cannot be covered up with clothing.
Whether choosing a general plastic or facial plastic surgeon, patients must choose their surgeon most carefully. Good luck and be well.
Dr. P

Plastic surgeons are trained in Plastic surgery. Facial Plastic Surgeons are trained in ENT. Both are trained to work on the face.
There are simply two different surgical pathways to get there. One is through Plastic Surgery training, leading to "Board Certified in Plastic Surgery," the other through ENT, leading to "Board Certified in Facial Plastic Surgery".
There are fine individuals in both camps. Both have done surgical residencies.
This is very different from a "cosmetic surgeon", a term that does not require any surgical residency, and no certification by any Board.

Unfortunatley, many ENT surgeons try to pass themselves as a Board Certified Plastic Surgeon by telling the public that they are a "facial plastic surgeon". now a these days the podietrist that do foot surgery call themselves "foot Plastic surgeon".
Although there is a subspecialty of facial plastic surgery for ENT surgeon, if an ENT wanted to be a plastic surgeon why does'nt he/she just do their training in Plastic Surgery.

Sonya,
There are many similarities between Facial Plastic Surgeons and Plastic Surgeons - the first is that they are both experts of the face. However, there are also many differences. As many have noted below, plastic surgeons are the only speciality that also specialize on the rest of the body. While cosmetic surgery is a core topic in plastic surgery training, some plastic surgeons go on to do fellowships specifically in aesthetic plastic surgery to include additional training in facelifts and rhinoplasty. Just as some ENT or other specialities go on to do fellowship in facial plastic surgery which concentrates on cosmetic surgery of the head and neck. Asking your surgeon about their training is very important in choosing your surgeon. You should also preview their before and after pictures and talk to some of their previous patients. Good luck in choosing your surgeon.
I hope this was helpful.
David Shafer, MD

Typically facial plastic surgeons, cosmetic surgeons and anything other than "plastic surgeon" represent physicians who have trained in fields other than plastic surgery as part of their primary training. In some cases titles like "cosmetic surgeon" are used to disguise training that is not typically associated with aesthetic surgeries (gynecology, anesthesia etc.)
But in some cases (more typically for "facial plastic surgeons") some of these physicians have gone through additional training (usually fellowships) and specialize in specific (usually facial) aesthetic surgery. (Most "facial plastic surgeons" are ENT doctors who may have additional training in aesthetic procedures of the head and neck.)
In addition to training for reconstructive and cosmetic procedures of the head and neck typically plastic surgeons have additional training for reconstructive and cosmetic procedures of the entire body.
The important thing to look for is Board Certification (for plastic surgeons from the American Board of Plastic Surgery) and experience with your procedure. Some facial plastic surgeons can produce wonderful results and are well trained in face lifts and other facial plastic procedures.
Patient beware though. A patient should always ask:
Is the doctor board certified by an recognized board? (ie American Board of Plastic Surgery)
What is the doctor's training? (medical school, internship, residency, fellowship)
How commonly do they perform this procedure?
Sometimes the answers are suprising.
Hope this helps.

1) A plastic surgeon is a plastic surgeon

2) A Facial Plastic Surgeon is a Facial Plastic Surgeon

These are 2 completely different specialties with totally different training backgrounds.

A) Facial Plastic surgeons are usually ENT surgeons who went above and beyond and did one more year of training ONLY on the face and neck.  That is 6 years EXCLUSIVELY on the face and neck.

B) Plastic surgeons are either general surgeons who spent 5 years operating inside the abdomen taking out gall bladders and fixing hernias then they spent 2 more years learning plastic surgery of THE ENTIRE body from head to toe.  Or they did a combined program where they did 3 years of general surgery then 3 years of plastic surgery of the entire body.  That includes burn, hands, free flaps, body surgery and face surgery. 

Both of these specialists are "certified" by the ABMS or given equivalency to the ABMS to perform plastic surgery of the face and neck but only the plastic surgeons are certified to perform body plastic surgery.

It is THAT simple.  

The nastiness and bitter words and mudslinging you see by a few ignorant plastic surgeons is just that.  The vast majority of plastic surgeons and facial plastic surgeons are very cordial and work together.  For my practice I have about 6-8 plastic surgeons who defer nosejobs to me and send me their patients who want rhinoplasty and in turn if a patient wants a breast augmentation at the same time as their nose job then we work together (Facial Plastics with Plastics).  There is no bitter rivalry at all.

Know the facts and stay away from people who try to bad mouth others.  

Both specialties have excellent surgeons and both have very lousy surgeons.  Do your homework.

As far as the plastic surgeons on here who keep trying to insult facial plastic surgeons and call us ENTs: Just remember, Michael Jackson's nose and face surgeries were all done by a VERY famous and esteemed Plastic Surgeon! 

A facial plastic surgeon’s original training is in otolaryngology (ear, nose, and throat surgery). Once they are board-certified in ear, nose, and throat, they further their training with fellowship and another set of boards and become board-certified in facial plastic surgery. Plastic surgeons usually have an original background in general surgery and perform two to three years of general plastic surgery. Facial plastic surgeons are uniquely positioned to address difficult facial cosmetic and reconstructive needs such as facelifts, eyelids, and nasal surgery.