Archive for March, 2011

Other “plastic surgeons” ?

Monday, March 28th, 2011


The American Board of Medical Specialties (ABMS) was formed in the early twentieth century to regulate the training differences between specialties in medicine and surgery for the clarification of the public. Plastic Surgery was a defined separate training pathway.

In the 1970’s other specialists decided they wanted to enter the plastic surgery arena. With a decidedly political vote of the ABMS members, other surgical subspecialists were allowed to independently develop “plastic surgery” training within their limited areas: otolaryngology, ophthalmology, dermatology.  As a result, “facial plastic surgeons”, “ophthalmic plastic surgeons”, and “dermatologic plastic surgeons” arose.

Needless to say, this approach is very confusing to the public.


Beware of Media Exaggerations

Monday, March 21st, 2011


The march issue of Town and Country has a typical article of overstatement about plastic surgery entitled “ The Last Inch”.

“Non-invasive” laser liposuction has been marketed for several years. In addition to having the marketing magic associated with the word “laser”, these “minimal” procedures are supposed to internally dissolve fat to provide “more uniform fat removal for a smoother contour”. In fact, heating is more damaging to the remaining fat, so that contour irregularities and liquified fat collections may be more common than standard liposuction.

In addition, the claims that laser heat tightens the collagen in skin to make less dimpling is scientifically impossible. Burning the undersurface of the skin to the point of collagen contraction requires heating to over 50 degrees centigrade. That amount of heat destroys skin blood supply and would kill the skin. Sin can contract somewhat from deflation of fat volume, unrelated to laser heat.

Finally, “non-invasive” external machinery is being heavily marketed. Ultrasound, radio frequency, red light, and cold application have all been shown to dissolve fat in laboratory animals. The problem is that in humans they can only do a small amount of fat dissolution in a small surface area. As a result, they are impractical.

Style and Beauty editors know that we all want magic. Big benefit – small undertaking. And writers always want to emphasize “what’s new”. But the informed patient would wait until these hyped “new” techniques prove themselves.


Plastic Surgery Training

Wednesday, March 16th, 2011


At the current time, there are two parallel tracks to into Plastic Surgery after first achieving an M.D. degree. The traditional tract is to first train in General Surgery or Otolaryngology, then do a second residency in Plastic Surgery. The alternate pathway, more recently established, it to do a six year program in Plastic Surgery alone, with educational rotations on related services.

At the completion of Plastic Surgery training, the graduate is eligible to pursue certification by the American Board of Plastic Surgery.


Who is a Plastic Surgeon?

Tuesday, March 8th, 2011


With the advent of managed health care, payment to doctors dropped by as much as 80%. As a result many doctors ( even dentists) started looking for alternate areas of practice. It may surprise you to know that medical licensure is a state by state issue. And specialization is not licensed. What that means is that once a physician achieves an M.D. degree and acquires a Texas license, he or she can practice whatever area of health care they chose, regardless of additional training!

Anyone with a medical degree can advertise themselves as a “plastic surgeon” without restriction. So before consulting with a “plastic surgeon”, do your homework on their formal training background. Check to see if your surgeon is certified by the American Board of Plastic Surgery. Be careful, there are a lot of “self-designated” boards that sound similar.