In many parts of the world, cosmetic surgery is an elective procedure that a patient chooses to have for several reasons. On the other hand, plastic surgery can be the medical solution to reconstruct a person’s appearance after injury, illness, accident, or defect/deformity. The talented professionals who complete these life-altering medical procedures are referred to as Plastic surgeons; medical doctors who improve and reconstruct the physical appearance of patients, by performing reconstructive or cosmetic surgery.
Plastic surgery can be divided into two specialties: Cosmetic (or aesthetic) surgery, and reconstructive surgery. Cosmetic surgery is intended to improve the appearance of a person, while reconstructive surgery is intended to improve function, or approximate a normal appearance.
What is a Plastic Surgeon?
Contrary to popular belief, a plastic surgeon does much more than simple tummy tucks, and facelifts. While it’s true that many plastic surgeons specialize in cosmetic procedures meant to enhance the outward appearance of a patient, plastic surgeons also specialize in reconstructive techniques that improve function and mobility.
Board-certified plastic surgeons are educated and trained in the many components of both cosmetic and reconstructive surgery. They can specialize in very specific areas of the body, or perform non-surgical techniques; for example, Botox injections, tattoo removal or chemical peels.
A solid understanding of surgical anatomy, pathology, physiology and other basic sciences is also fundamental to a plastic surgeon specialty, as is, technical expertise, ethical behavior, manual dexterity, surgical judgment and interpersonal skills. Maintaining strong and up-beat patient relationships is also imperative to a successful outcome after, and before surgery.
As “partners in care,” patients and their surgeons should meet prior to surgery to discuss a patient’s reason(s) for having plastic surgery, goals and expectations, possible risks involved with all surgeries, and any other questions or concerns the patient may have.
Educational Requirements to Become a Plastic Surgeon
A plastic surgeon's education is comparable to that of any other physician, which begins with a four-year undergraduate science degree. Coursework is designed to meet medical school prerequisites, and is typically weighted in the sciences, mathematics and the humanities. The first two years of medical school build on this foundation, with courses in advanced sciences, physiology, pharmacology and ethics. The third and fourth years of medical school comprise of hands-on clinical experience. As with most medical fields, the path to becoming a plastic surgeon is competitive and demanding. A prospective doctor must work long and hard to obtain their goals to secure a coveted spot as a plastic surgeon.
Step-By-Step Educational Path to Become a Plastic Surgeon
Step One — Earn a Bachelor's Degree
Medical schools require all aspiring plastic surgeons complete pre-med courses during a student’s undergraduate years. These include: Physics, Biology, and Organic and Inorganic chemistry. Prior to graduating, a student should also take the Medical College Admissions Test (MCAT), as well as collect letters of recommendation from mentors, people of good standing in the community, professors, and if possible, plastic surgeons currently practicing. Working in a hospital setting, demonstrating leadership qualities, and participating in extracurricular activities are all ways a prospective doctor can gain an advantage when applying to medical school.
Step Two — Graduate in good standing from Medical School
The first two years of medical school a student will take advanced courses in the sciences; pathology, microbiology, pharmacology, biochemistry, physiology and anatomy. This is followed by two years of clinical rotations, where a student gains experience working hands-on with patients. Students can earn a Medical Doctor degree (M.D.), or if a student chooses to attend an osteopathic medical school, he or she will earn a Doctor of Osteopathic Medicine (D.O.) degree.
Step Three — Earn a License
In order to practice medicine in the United States, all doctors must earn a medical license. Medical doctors (M.D.’s) must pass the United States Medical Licensing Examination, or USMLE. Doctors of Osteopathic Medicine (D.O’s) must pass the Comprehensive Osteopathic Medical Licensing Exam, or COMLEX. Each test consists of three parts, each meant to see how well a doctor applies basic and advanced science concepts to the practice of medicine.
Step Four — Acquire a Plastic Surgery Residency
An aspiring plastic surgeon has two options for plastic surgery training after becoming a licensed physician. The doctor can fulfill three-years of general surgery residency, which includes clinical rotations in various types of surgery, followed by a three-year residency in plastic surgery. Or, the doctor can fulfill a six-year integrated residency which includes both forms of training. Plastic Surgery residencies may also include conducting research, attending conferences, teaching, and dissecting cadavers.
When a student completes his or her residency, they may elect to acquire board certification in allopathic plastic surgery. The American Board of Plastic Surgery (ABPS) offers board certification for all plastic surgeons. The American Osteopathic Board of Surgery (AOBS) offers board certification for osteopathic plastic surgeons. A doctor must participate in continuing education and renew certification once he or she becomes board certified.
Step Five — Complete a Fellowship
There are a number of sub-specialties of plastic surgery. If doctors choose to specialize, they may opt to complete a one-year fellowship program. In addition to valuable training in a specialty, post-residency fellowships offer doctors the opportunity to work side-by-side a practicing surgeon in a private practice office. Here, the doctor will learn how to choose staff and assign responsibilities, set up an office, and be exposed to any ongoing issues the doctor might face in order to grow his or her private practice. A fellowship doctor will guide and advise a new plastic surgeon, while providing practical insight, which can significantly lessen the stress of opening a private practice.
Understanding the career path
As with most doctors, plastic surgeons can choose to practice in a variety of settings, including: Academic and community hospital settings, a trauma ward, in research, in private practice, in a multi-specialty practice, or in an outpatient clinic. Plastic surgeons perform cosmetic or reconstructive surgery and many work more than forty-hours per week. As with all surgeries, plastic surgeons never perform an operation without a team of assistants or other surgeons present. Team-work can minimize patients' anxiety, and also lessen stress for the surgeon.
Plastic Surgeons may also be called on short notice to perform emergency surgery, in instances such as illness or injury. They typically work in brightly lit, sterile environments, such as an operating room at a hospital. Surgeons also work in academic settings to help other aspiring plastic surgeons sharpen their skills.
There are many benefits, as well as obstacles for a doctor choosing to open a private practice, with or without another practicing physician(s). Often, surgeons prefer the control and independence a private practice provides. However, acquiring and retaining patients can be time-consuming, costs to maintain a private practice can be much higher than in a group practice where costs are shared, vacations are difficult to schedule, work days are long, and renting an office can often be very expensive.
There are many factors that figure into the salary for a plastic surgeon. For example:
On average, the annual salary for a plastic surgeon just starting out can be as low as $67,000. However, an established surgeon with more than ten-years of experience can earn upwards of $360,000 annually. It has also been shown that if a surgeon chooses to practice in a general medical hospital, his or her salary can be much lower, as much as $100,000 less, per year.
Overall, plastic surgery (whether a surgeon specializes in cosmetic or reconstructive surgery) is the seventh highest ranked specialty, with a mean salary of $317,000 per year. About fourteen-percent of all plastic surgeons earn $500,000 or more per year; while eleven-percent earns $100,000 or less. It should be noted that female plastic surgeons earn nearly 14% less than their male counterparts.
It is also of interest that compensation varies dramatically depending on practice setting: On average a surgeon can expect to earn:
The American Society of Plastic Surgeons (ASPS) show cosmetic plastic surgery procedures, either minimally invasive or surgical, rose five-percent in 2010. In 2013, there were 15.1 million cosmetic surgeries performed, and according to the BLS, this number is expected to increase more than eighteen-percent from 2014 to 2022.
Furthermore, plastic surgeons also performed 5.3-million reconstructive plastic surgeries in 2010, up two-percent from 2009. These numbers are expected to rise as much as seven-percent in the next two years.
Obviously, with the increase in both cosmetic and reconstructive plastic surgeries, worldwide, comes an increased need for trained surgeons. In a 2011 survey by the American Society for Aesthetic Plastic Surgery, acceptance of cosmetic plastic surgery has broadened, with seventy-percent of people ages eighteen to twenty-four saying they approve of cosmetic procedures. Even a recent study by the Central YMCA shows young children, ages eleven to sixteen, have considered a procedure. As Baby Boomers age, it is also predicted that cosmetic surgery will increase in people ages fifty-five to seventy-five, now up nearly thirty-percent in the last five years. In addition, 5.7-million reconstructive surgeries were performed in 2013, up two-percent from the previous year.
Board Certification is one tool a patient can use when choosing a plastic surgeon. Certification by the American Board of Medical Specialties (ABMS) indicates a surgeon has completed a required set of education and training requirements beyond the minimum requirements for obtaining licensure. It also shows a surgeon has passed exams in his or her specialty.
The American Board of Plastic Surgery (ABPS) is one of twenty-four specialty boards recognized by the ABMS, that certifies a surgeon in the full range of plastic surgery specialties — cosmetic and reconstructive surgery.
All specialties are now requiring Maintenance of Certification (MOC), which requires a doctor complete specified continuing education. Many healthcare settings, and health care plans not require certification in order for a doctor to provide services in his or her relevant specialty.