Cosmetic Surgery, Plastic Surgery—What’s the Difference?

If you’ve always thought cosmetic surgery and plastic surgery were one in the same, you’re not alone. A significant number of plastic surgeons choose to focus their practice on cosmetic surgery, and as such, the terms are often used interchangeably. But this is not technically correct. Cosmetic surgery and plastic surgery are closely related specialties, but they are not the same.

1. Cosmetic Surgery & Plastic Surgery Have Different Goals

While both cosmetic surgery and plastic surgery deal with improving a patient’s body, the overarching philosophies guiding the training, research, and goals for patient outcomes are different.

Cosmetic Surgery: Focused on Enhancing Appearance

The procedures, techniques, and principles of cosmetic surgery are entirely focused on enhancing a patient’s appearance. Improving aesthetic appeal, symmetry, and proportion are the key goals. Cosmetic surgery can be performed on all areas of the head, neck, and body. Because the treated areas function properly, cosmetic surgery is elective. Cosmetic surgery is practiced by doctors from a variety of medical fields, including plastic surgeons.

The scope of cosmetic surgery procedures includes:

  • Breast Enhancement: Augmentation, Lift, Reduction
  • Facial Contouring: Rhinoplasty, Chin, or Cheek Enhancement
  • Facial Rejuvenation: Facelift, Eyelid Lift, Neck Lift, Brow Lift
  • Body Contouring: Tummy Tuck, Liposuction, Gynecomastia Treatment
  • Skin Rejuvenation: Laser Resurfacing, Botox®, Filler Treatments

Plastic Surgery: Focused on Repairing Defects to Reconstruct a Normal Function & Appearance

Plastic surgery is defined as a surgical specialty dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease. Plastic surgery is intended to correct dysfunctional areas of the body and is reconstructive in nature. While many plastic surgeons choose to complete additional training and perform cosmetic surgery as well, the basis of their surgical training remains reconstructive plastic surgery. In fact, in 1999, the American Society of Plastic and Reconstructive Surgeons changed its name to the American Society of Plastic Surgeons to more strongly communicate the message that “plastic and reconstructive surgeons are one in the same.”¹

Examples of plastic surgery procedures:

  • Breast Reconstruction
  • Burn Repair Surgery
  • Congenital Defect Repair: Cleft Palate, Extremity Defect Repair
  • Lower Extremity Reconstruction
  • Hand Surgery
  • Scar Revision Surgery

2. Cosmetic Surgery Training is Obtained Separately from Plastic Surgery Training

As cosmetic surgery and plastic surgery each have distinct practice goals built around a specific procedure set, it only follows that the training and certification process for a board certified cosmetic surgeon will look very different from that of a board certified plastic surgeon.

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Plastic surgery training is completed through a post-graduate residency program

Physicians who become board certified in plastic surgery must complete a general surgery residency plus another 2 years in plastic surgery. Residency programs in plastic surgery may include cosmetic surgery as a portion of a surgeon’s training, but typically do not include training on every cosmetic procedure.

Therefore the title “board certified plastic surgeon” indicates a certain level training and experience with respect to plastic surgery, but it does not indicate the same thing with respect to cosmetic surgery, as the residency training required to become board certified in plastic surgery may not include training with respect to many common cosmetic procedures.² Nor does it tell you that the doctor has more or less cosmetic surgery training than a physician board certified in another specialty.

Cosmetic surgery training is completed primarily after residency training

There are currently no residency programs in the United States devoted exclusively to cosmetic surgery. Because of this, cosmetic surgeons primarily obtain training and experience after completing their residency training. This is done by completing a post-residency fellowship.

Board certified cosmetic surgeons are residency trained + fellowship trained in cosmetic surgery

The training, experience, and knowledge required to become a board certified cosmetic surgeon reflects specialization above and beyond what it takes to become board certified in a related discipline, such as plastic surgery. Each surgeon who is board certified by the American Board of Cosmetic Surgery has completed a 1 year fellowship training exclusively in cosmetic surgery. During this fellowship, surgeons receive thorough training in all cosmetic surgery procedures of the face, breast, and body, plus non-surgical cosmetic treatments, performing a minimum of 300 individual cosmetic surgery procedures. This fellowship training is in addition to completing a 3-5 year residency program in a related discipline.

Because any licensed physician can legally perform cosmetic surgery, regardless of how they received cosmetic surgery training, it is extremely important to do your research when choosing a cosmetic surgeon. To find the most qualified doctor for a specific cosmetic procedure, you must compare doctors’ overall (residency and post-residency) training, experience, and proven competence with respect to that specific cosmetic procedure.

¹http://www.plasticsurgery.org/articles-and-galleries/history-of-plastic-surgery.html
²Morrison, M.Sc., Colin, A Survey of Cosmetic Surgery Training in Plastic Surgery Programs in the United States, Plastic and Reconstructive Surgery – Journal of the American Society of Plastic Surgeons, pp.1570-1578, 2008.