FAQs about Plastic and Cosmetic Surgery
To help you make an informed decision about your plastic surgery procedure, the following list of frequently asked questions is provided for your convenience. If you cannot find the answer to your question, please contact us for a confidential response.
- What is the difference between a plastic and cosmetic surgeon?
- How can I determine whether a surgeon has adequate training?
- What does Board Certified mean?
- Are all Medical Boards Created Equal?
- What is the American Board of Medical Specialties?
- Is accreditation for office surgery facilities important?
- What are my anesthesia options?
- Does length of surgery affect chances for complications?
- What is the normal recovery time for surgery?
- When can I return to exercising?
- What is the Silberg Tissue Preparation System?
Plastic surgeons that are members of the American Society of Plastic Surgeons (ASPS) have undergone extensive training in both cosmetic and reconstructive surgery. Because many cosmetic procedures are rooted in reconstructive plastic surgery, ASPS Member Surgeons are uniquely qualified to handle your cosmetic needs. No regulations govern what type of medical practitioner can perform cosmetic surgery procedures; hence, any physician can claim to be a cosmetic surgeon.
Choosing a Member Surgeon of the American Society of Plastic Surgeons (ASPS) is the first step to finding a qualified surgeon because it represents the highest standards in the industry. Unlike other specialty organizations, each ASPS Member Surgeon must meet the following criteria:
- Operate only in accredited medical facilities.
- Be Board Certified by The American Society of Plastic Surgeons (ASPS), which is the only board dedicated to plastic surgery. ASPS certification ensures in-depth surgical training in all aspects of plastic surgery.
- Have six or more years of surgical training and experience, with a minimum of three years in plastic surgery.
- Be experienced in all plastic surgery procedures, including face, breast, body, and reconstruction.
- Fulfill continuing medical education requirements, including standards and innovations in patient safety.
- Adhere to a strict code of ethics.
Good credentials cannot guarantee a successful outcome; however, they can significantly increase the likelihood of it. The following are organizations where you can obtain information about a doctor’s credentials:
- The Medical Board of California – to obtain information on license verification, education, board certification, and disciplinary action.
- The American Society of Plastic Surgeons (ASPS) – to obtain information on top board-certified plastic surgeons in cosmetic and reconstructive surgery.
- The American Board of Plastic Surgery (ABPS) – to obtain information regarding board certification in the specialty of plastic surgery.
- The American Board of Medical Specialties (ABMS) – to obtain information on board certification in any specialty and contact information for individual specialty boards.
Board certified means that a doctor has completed a training program after going to medical school, and they have taken certification examinations to determine their proficiency in a particular specialty of medicine. It is important to note that any group of medical professionals can create its own “certification” board. When a doctor claims to be “board certified,” ask by which board. Only one, the American Board of Plastic Surgeons (ABPS) is recognized by the American Board of Medical Specialties (ABMS) to certify doctors in the specialty of plastic surgery.
No.In recent years, cosmetic procedures have changed the practice of medicine. Not long ago, cosmetic surgery was the domain of plastic surgeons. Plastic surgeons spend many years obtaining extensive training in cosmetic and reconstructive surgery. They complete years of training in a surgery residency plus an additional three-year residency in plastic and reconstructive surgery. Because most cosmetic procedures are done in doctor’s offices, no certification by hospitals is required. (Cosmetic surgery is real surgery and complications do occur. Not having hospital privileges is significant.)
Now all it takes is a medical license to do cosmetic surgery – a family doctor, general surgeon, or even a gynecologist can take weekend courses and advertise as a cosmetic surgeon. There is a basic difference in training between a plastic surgeon and someone who might advertise as a cosmetic surgeon. As a result of the evolving landscape in cosmetic surgery, a number of cosmetic boards have been created so that physicians can obtain board certification in cosmetic surgery. But here is the thing: not all boards are created equal with some boards having much lower standards than others. When considering a physician's board certification, a patient should make sure that the board is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934, to confirm maintenance of higher standards, commitment to professionalism, and better care. There is no ABMS recognized certifying board with “cosmetic surgery” in its name.
When a physician or surgeon is Board Certified by an ABMS specialty board, it means he or she has chosen to achieve expertise in a medical specialty or subspecialty by meeting the profession-driven standards and requirements of one (or more) of the 24 ABMS certifying boards. Board Certification and the ABMS Program for Maintenance of Certification (ABMS MOC®) are highly-visible indicators that physicians know today’s standards of practice. Board Certification is the beginning of a physician’s personal commitment to providing quality patient care. The ABMS Program for MOC activities emphasize ongoing professional development and assessment that is aligned with other professional expectations and requirements within health care. Patients expect that their physician’s certification reflects ongoing education and practice improvement.
Many hospitals have independently made the decision to require Board Certification for staff privileges. Their leadership recognizes that diagnostic and treatment knowledge changes rapidly and learned skills in medicine can decline over time. They value the competencies for medical practice set by the profession and create procedures for their own institutions with respect to those competencies.
Various quality organizations and health care purchasers are committed to increasing value of the care provided. They look to the ABMS specialty certification system to help them identify excellence and commitment to professionalism, and continuous performance assessment and improvement.
You can check your physician’s certification at ABMS at http://www.certificationmatters.org.
Yes. Accreditation assures that the facility has been inspected by an organization recognized by the State of California and that the facility conforms to strict safety standards. Plastic surgery procedures performed in accredited surgical facilities by board certified plastic surgeons have an excellent safety record. Dr. Silberg’s surgical facility has been accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc.
Plastic surgery can be done under general or local anesthesia. If done under general anesthesia, it is most commonly done in a hospital or surgery center where the highest level of safety is assured by the presence of a staff specifically trained to take care of this type of anesthesia.
Most of our procedures are done under local anesthesia, which is commonly done with varying amounts of sedation (conscious sedation). These procedures are typically done in our on-site AAAASF accredited surgery facility. You may be given a pill that relaxes you before going into the operating room. When you go into the operating room, an IV is started, you are connected to monitors, and an intravenous sedative is given by an anesthesiologist that puts you into a very relaxed state. Local anesthetic, usually Xylocaine, is injected.
When the Tissue Preparation System is used, the local anesthetic, along with an antibiotic, is gently injected into the area of the surgery. After that, a special external ultrasound is used to disperse the anesthetic and antibiotic into the tissues. This allows local anesthetic to be used with much less sedation and often reduces the need for general anesthesia.
More information about anesthesia can be found at http://health.howstuffworks.com/anesthesia.htm.
Yes, for procedures performed under general anesthesia, studies have shown that the the length of time under general anesthesia is the only factor consistently and significantly related to an increase in complications. A similar analysis for all complications, both major and minor, showed that every additional hour of anesthetic meant an 18% increase in risk.* Dr. Silberg is an extremely skilled surgeon and most of the surgeries that he performs under general anesthesia are completed within 1 to 3 hours. When multiple complex surgeries have been required while under general anesthesia, he does not exceed 5 hours, but this is rare. If your surgeon is suggesting general anesthesia for your cosmetic procedure, be sure to ask how long that procedure will take.
*Boruk, M et al. Age as a Prognostic Factor for Complications of Major Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 2005;131:605-609
The length of time it takes to recuperate after plastic surgery varies depending on the person and on the specific procedure performed. Most patients will require assistance for the first two days. Then most patients are able to care for themselves, but may still need assistance if they have small children to care for. The lengths of recovery are outlined below by procedure. These are approximations, and do not include return to exercise.
Facelift Surgery: Patient can usually get around independently by the second day, but may not feel comfortable going out in public for 5-7 days. May require 10-14 days before returning to work if in the public eye.
Eyelid Surgery: Patient can usually get around independently by the second day, and, with sunglasses, may feel comfortable going out in public in 3-4 days. With makeup, patient could return to work by 5-7 days.
Breast Surgery: Patient can usually get around independently by the second day and may return to work at 5-7 days if not required to lift more than 15 pounds.
Liposuction: Patient can usually get around independently by the second day or earlier if a smaller number of areas are treated. Patient can return to work and normal activities within 5-7 days.
Abdominoplasty: Patients may take between 2-4 days before getting around independently, and can return to a desk job at 5-7 days, other jobs in 10-14 days.
The time a patient resumes regular exercises varies based on the person and on the procedure performed. All patients are encouraged to start a slow walking routine on the second postoperative day. Regular aerobic and more vigorous activities are not allowed during the first two weeks in order to decrease the risks of bleeding, swelling, and bruising. In most cases, weight lifting and contact sports are allowed at one month.
The Silberg Tissue Preparation System (TPS) is an FDA-approved method of gently dispersing fluid into tissues using ultrasonic micro-streaming. The device and technique were invented by Dr. Silberg and is used worldwide.
The technique prevents exposure dehydration and loosens tissues to make surgery less traumatic, resulting in lower postoperative complications, faster recovery with less bruising and discomfort, and a better overall result.
The technique also delivers local anesthesia more effectively making general anesthesia unnecessary in many cases. Using local anesthesia and conscious sedation is much safer and involves shorter recovery times.
The Silberg Tissue Preparation System is currently being used in an FDA/WIRB approved clinical study for direct delivery of antibiotics to target tissues.
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