The terms “plastic surgery” and “cosmetic surgery” are often used interchangeably. Plastic surgery includes both reconstructive surgery and aesthetic surgery. Reconstructive surgery is done to restore a body part that is abnormal due to a trauma/accident or that is abnormal at birth. Some reconstructive surgery can be considered lifesaving or limb-saving. This type of surgery is covered by insurance because it is considered “medically necessary.”
Aesthetic surgery, more commonly known as cosmetic surgery, is surgery done to improve an already normal body part. It is done to improve or enhance the appearance of an already normal body. It is an elective procedure, meaning it is not necessary to save a person’s life. It is normally not covered by insurance because it is not deemed “medically necessary.” Both reconstructive and aesthetic surgery can improve a person’s quality of life, however.
Cosmetic surgery includes only aesthetic surgery. It is surgery done purely for enhancing a body part that has a normal shape and normal function. Of course there is a wide variation to what some people consider normal. For example when it comes to nose size, some noses are smaller and some noses are bigger with a large hump. While some people may not like the appearance of their “big” nose, as long as there is not a breathing problem, the nose is “normal.” Any surgery to make a normal nose look better, known as rhinoplasty, is considered “aesthetic.”
So now that the terms plastic surgery, reconstructive surgery, aesthetic surgery, and cosmetic surgery have been defined, the answer to the difference between a plastic surgeon and a cosmetic surgeon can be answered.
The Path to Becoming A Plastic Surgeon
Only 200 “plastic surgeons” are produced per year at major academic medical centers. There are two paths to becoming a plastic surgeon. The most sought after path is to obtain a highly coveted position as a plastic surgery resident directly after medical school. These programs are known as integrated programs or independent programs. In these types of program, residents train in both general surgery and plastic surgery. Residents learn how to perform both reconstructive and aesthetic (cosmetic) procedures.The second path involves two steps. The first step involves completing a residency in general surgery, otolaryngology, urology, orthopedic surgery, or neurosurgery, or completing an educational program in oral and maxillofacial surgery approved by the American Dental Association. The next step involves applying to a plastic surgery fellowship. As a plastic surgery fellow, both reconstructive and aesthetic surgeries are learned.
The Path to Becoming A Cosmetic Surgeon
For cosmetic surgeons, there is no direct path right after medical school. Similar to the second path for becoming a plastic surgeon, cosmetic surgeons have finished a residency in another discipline. However, unlike the second path for becoming a plastic surgeon, the residency is not necessarily a surgical discipline. There are many skilled cosmetic surgeons who have completed a general surgery residency and then gone on to complete a fellowship in cosmetic surgery. However, there are also cosmetic surgeons who were first family practitioners, obstetricians, gynecologists, dermatologists, etc. who decided that they wanted to dabble in the world of cosmetic surgery. Some have completed cosmetic surgery fellowships. Others have not undergone any rigorous training at all, yet have deemed themselves “cosmetic surgeons” after taking some weekend courses in Botox injection, liposuction, tummy tucks, etc. And this is where the problem starts.
Who Can Perform Plastic Surgery?
Who can perform plastic surgery and who should perform plastic surgery are two totally different concepts. It is a common misconception is that only a plastic surgeon can legally perform plastic surgery. In actuality, any doctor with a valid doctor of medicine degree can practice in any field of medicine. Many doctors will claim that they can perform cosmetic surgery, but they are not licensed plastic surgeons or cosmetic surgeons. They have not endured rigorous training. A well-trained plastic surgeon or cosmetic surgeon will have no reservations about revealing their training history. Beware of the surgeon who is not forthcoming in disclosing where s/he underwent his or her training, the duration of the training, and whether or not the program they trained at was an accredited program.
It is one thing to be able to perform a procedure. It is quite another thing to also be able to take care of a complication from a procedure. That is why having a plastic or cosmetic surgeon with legitimate training is so very important. Legitimate training programs expose their trainees to the good, the bad, and the ugly. “Cosmetic surgeons” who have only taken courses in aesthetic procedures, and have not undergone years of training, may not be fully versed in how to deal with the complications of the procedures they are performing.
In summary, when it comes to aesthetic surgery, it is prudent to know the educational background of who is operating on your body. For one, the change you seek is elective (not medically necessary) and two, the change you are seeking will likely be permanent.