Non-ABPS boards

[goadyso]

What are general thoughts on non-ABPS certifications?
American Academy of Cosmetic Surgery
American Board of Facial Cosmetic Surgery
American Boar of Facial Plastic & Reconstructive Surgery

Obviously the ABPS hates them. But if you're a general surgeon doing one of these and NOT planning on doing flaps or real reconstruction, just cosmetic surgeries, is there any problem with it?

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[Jordan Miller]

What are general thoughts on non-ABPS certifications?
American Academy of Cosmetic Surgery
American Board of Facial Cosmetic Surgery
American Boar of Facial Plastic & Reconstructive Surgery

Obviously the ABPS hates them. But if you're a general surgeon doing one of these and NOT planning on doing flaps or real reconstruction, just cosmetic surgeries, is there any problem with it?

Are AACS fellowships legit? Kinda seems too good to be true. In regards to your question I think the other boards dislike them bc there are probs some surgeons out there doing things they probably aren’t qualified to be doing, but I think if you just wanted to add some cosmetic stuff to your practice it wouldn’t be bad.

 

[drpatelplasticsurgery]

I'm an ABPS-certified plastic and reconstructive surgeon and a member of our national aesthetic society (formerly ASAPS).

Don't do these so-called "fellowships" geared for non-core physicians. Stick to what your training enables you to do.

If you're a general surgeon without additional subspecialty fellowship training, practice general surgery (hernias, gallbladders, appendectomies, trauma), not liposuction and not Brazilian butt lifts. Doing a one-year fellowship sponsored by a non-ABMS recognized 'Board' is a recipe for unsafe surgeries and worse, patient mortality. Simply Google 'BBL Miami death' for a deeper dive.

If you're ENT (Otolaryngology) trained and go on to do an additional fellowship in Facial Plastic Surgery, then you're well within your rights to get Board-certified in that specialty. But don't start operating below the clavicle doing breast augmentations! The only things and ENT should do below the clavicle are harvesting rib for rhinoplasty or a free fibula for head and neck reconstruction.

Having done three years of general surgery, three years of plastic surgery, a year of aesthetic fellowship training, and six months of oculoplastic surgery training, and now in my 4th year in practice as an attending, there are a lot of surgeries I could probably "figure out" how to do myself. But if a hospital is not going to credential me to do those things, then I probably should not be doing them. This is the problem with non-core surgeons - they will happily spend their weekends sucking out fat, but not be credentialed to manage a complication like uncontrolled hypertension, postop ileus from opioid overuse, fat embolism, skin necrosis, pneumothorax, bowel perforation, or DVT/PE if and when those complications occur. They simply have a call service shipping them to the ED, where a Boarded Plastic Surgeon like myself has to clean up the mess, if the patient comes out of the situation alive...

I am also a licensed attorney who regularly helps review both plaintiff and defendant cases. Imagine the worst thing that could happen, and imagine that it's YOUR name in a lawsuit. How will your lack of appropriate credentials look to a jury? Simply because it is legal to do something under your state medical license does not equate to it being appropriate for your level of training, or ethical, or moral.

I treat my own patients as if they were my own family members on the operating room table. If I wouldn't recommend my own family members to see a surgeon without the proper training, then I do not think that kind of surgeon should be performing cosmetic (aesthetic) surgery, as innocuous or benign-seeming a procedure might be.

We're Board Certified because we are rigorously tested on handling the worst possible complications that could happen to your patients, both in real life during residency and during the final Oral Examination, after submitting nine (9) months' worth of our own portfolios of cases, representing an appropriate depth, breadth, and complexity of plastic and reconstructive surgery.

 

[TheLesPaul]

If you're ENT (Otolaryngology) trained and go on to do an additional fellowship in Facial Plastic Surgery, then you're well within your rights to get Board-certified in that specialty. But don't start operating below the clavicle doing breast augmentations! The only things and ENT should do below the clavicle are harvesting rib for rhinoplasty or a free fibula for head and neck reconstruction.

Echo your sentiments except to say that ENT or oculoplastics (my specialty) also microliposuction fat for facial fat grafting, not for the goal of primary liposuction, which is part of routine clinical practice and for which I am credentialed by the hospital. It is not a gigantic step to go from harvesting fat with the goal of transferring 50cc of fat, to doing liposuction for the sake of doing liposuction and/or transferring it to the butt. I have not chosen to take that step, but I can see how others might. I do not think it is advisable, but the potential for scope creep is there. Also, I do not think PRS is primarily managing bowel perf or pneumothorax (unless GS trained?).

ABPS does not love to play well in the sandbox with ENT/oculoplastics/OMFS in facial plastics in certain markets, hence the proliferation of some of these questionable boards. Again, not justifying -- just pointing out the reason for it.

 

[igap]

I'm an ABPS-certified plastic and reconstructive surgeon and a member of our national aesthetic society (formerly ASAPS).

Don't do these so-called "fellowships" geared for non-core physicians. Stick to what your training enables you to do.

If you're a general surgeon without additional subspecialty fellowship training, practice general surgery (hernias, gallbladders, appendectomies, trauma), not liposuction and not Brazilian butt lifts. Doing a one-year fellowship sponsored by a non-ABMS recognized 'Board' is a recipe for unsafe surgeries and worse, patient mortality. Simply Google 'BBL Miami death' for a deeper dive.

If you're ENT (Otolaryngology) trained and go on to do an additional fellowship in Facial Plastic Surgery, then you're well within your rights to get Board-certified in that specialty. But don't start operating below the clavicle doing breast augmentations! The only things and ENT should do below the clavicle are harvesting rib for rhinoplasty or a free fibula for head and neck reconstruction.

Having done three years of general surgery, three years of plastic surgery, a year of aesthetic fellowship training, and six months of oculoplastic surgery training, and now in my 4th year in practice as an attending, there are a lot of surgeries I could probably "figure out" how to do myself. But if a hospital is not going to credential me to do those things, then I probably should not be doing them. This is the problem with non-core surgeons - they will happily spend their weekends sucking out fat, but not be credentialed to manage a complication like uncontrolled hypertension, postop ileus from opioid overuse, fat embolism, skin necrosis, pneumothorax, bowel perforation, or DVT/PE if and when those complications occur. They simply have a call service shipping them to the ED, where a Boarded Plastic Surgeon like myself has to clean up the mess, if the patient comes out of the situation alive...

I am also a licensed attorney who regularly helps review both plaintiff and defendant cases. Imagine the worst thing that could happen, and imagine that it's YOUR name in a lawsuit. How will your lack of appropriate credentials look to a jury? Simply because it is legal to do something under your state medical license does not equate to it being appropriate for your level of training, or ethical, or moral.

I treat my own patients as if they were my own family members on the operating room table. If I wouldn't recommend my own family members to see a surgeon without the proper training, then I do not think that kind of surgeon should be performing cosmetic (aesthetic) surgery, as innocuous or benign-seeming a procedure might be.

We're Board Certified because we are rigorously tested on handling the worst possible complications that could happen to your patients, both in real life during residency and during the final Oral Examination, after submitting nine (9) months' worth of our own portfolios of cases, representing an appropriate depth, breadth, and complexity of plastic and reconstructive surgery.

I somewhat disagree with this sentiment. Virtually no plastic surgeons in practice today manage some of the complications he/she might encounter. E.g. - bowel perf, pneumothorax, dvt/pe, fat embolism. There are cases of board-certified plastic surgeons missing these injuries and resulting in patient injury. I'd like to believe that the average ABPS board-certified plastic surgeon would be the safest option from a complication minimization/recognition standpoint.

I am one of the "old school" plastic surgeons out there who is ABPS board certified in general surgery, and plastics. I think that the biggest advantage to having the full general surgery training is understanding risks, and using that information to avoid them. And when a complication occurs, knowing how to quickly and safely manage that complication. A lot of the trouble surgeons get in, is when they miss complications resulting in delay of care, and worse outcomes.

I looked up the president of the AACS who is a guy named J Kevin Duplechain. He is a board-certified ENT surgeon whose website states that he does hundreds of facial and body cosmetics operations per year. He has been practicing for nearly 30 years and runs a 1 year cosmetic fellowship for residency-trained surgeons. For purely facial cosmetics that makes sense, but I'm not sure about the body stuff. Though I was credentialed from day 1 to do cosmetic brow lifts, blephs, otoplasty, facelift, rhinoplasty, etc even though I didn't have much experience doing them in my residency.

It seems hypocritical to say that someone has to be ABPS certified in plastic surgery to perform these cases. Many countries have different certification processes/requirements and seem to do just fine. If someone can prove that they have the expertise then I don't have a problem with them doing the cases. I'm open to the idea that the AACS one year fellowship (which claims to have the fellow involved with over 1000 cases) is adequate for the appropriate candidates (e.g. - board eligible general surgeons, and ENT). I think the problem comes in when someone starts doing cases that they are not adequately trained for. An example would be an ob/gyn surgeon who took a week-long course in Hawaii on how to do liposuction and suddenly starts doing BBLs and body contouring in their office.