(i) The following surgical procedures qualify for inclusion on operative logs. The logs must be detailed enough so that the credentials committee can determine that the procedure meets the requirements set forth on page 2 hereof.
Abdominoplasty of all types
Ablative Chemical peeling(into papillary dermis) and of same size requirement as dermabrasion
Brachioplasty
Breast augmentation by implant (bilateral counts as one procedure)
Calf implants
Canthoplasty/pexy
Chin implants
Dermabrasion of the face for extensive scars or wrinkles (must be at least the size of one entire cosmetic unit such as lips and chin, cheek, forehead, periorbital)
Direct brow lift (bilateral counts as one procedure)
Face Lifts of all types
Fat grafting done as an independent procedure
Forehead/Brow lift (all types)
Genioplasty
Gluteal implants
Glutealplasty (Buttock lift)
Hair lift
Hair transplantation grafting
Hair restoration flaps
Labiaplasty
Laser resurfacing with same size requirements as dermabrasion
Liposuction of the face and/or neck (counts as one procedure)
Liposuction of the abdomen, flank and/or waist (counts as one procedure)
Liposuction of the back and/or buttocks (counts as one procedure)
Liposuction of the legs (counts as one procedure)
Liposuction of the breast (counts as one procedure)
Lower blepharoplasty (bilateral counts as one procedure)
Malar implants
Mandibular Osteotomy
Mastopexy (bilateral counts as one procedure)
Maxillary Osteotomy
Midface lift
Nasal dorsal augmentation by implantation or grafting not done as part of a rhinoplasty
Neck Lift (platysmaplasty) when not in conjunction with face lift, with or without liposuction after platysmaplasty
Otoplasty (bilateral counts as one procedure)
Pectoral implants
Reduction mammoplasty (bilateral counts as one procedure)
Rhinoplasty with or without grafting
Scalp reductions or extensions
Soft tissue augmentation (noncutaneous) with human collagen, fat or alloplastic material (all areas on one patient equal one procedure)
Subperiosteal malar lift or SOFF lift NOT done at the time of a traditional face lift
Thighplasty (Thigh lift)
Upper eyelid cosmetic ptosis repair as a separate procedure
Upper blepharoplasty (bilateral counts as one procedure)
Varicose vein surgery (injection sclerotherapy, microstripping, SF or SP junction ligation)
(ii) The following procedures DO NOT QUALIFY for inclusion on the operative logs:
Bone grafting as a part of osteotomies or rhinoplasty
Botox injections, GFX or radio frequency ablation
Cosmetic tattooing of any area
Dental implants
Ear lobe split repairs
Excisions of lesions with or without plastic repairs
Facial fractures
Microdermabrasion
Pigmented lesion, tattoo, laser treatment
Repairs or reconstruction of trauma
Scar revision by dermabrasion, laser, or chemical peeling
Sclerotherapy of cutaneous ectasias
Septoplasty
Skin flaps or skin grafts to reconstruct skin lesion removal
Superficial chemical peeling with glycolic, salicylic, trichloroacetic acids
Thread Lifts
Vascular lesion laser treatment or hair removal
Zyderm or Zyplast injections, or injections of other fillers
(iii) SURGICAL LOG REQUIREMENTS
a) The typewritten surgical log must meet the following criteria before the credentials committee will consider it:
COLUMN 1
(Procedure number in
consecutive order) COLUMN 2
(Date of procedure)
COLUMN 3
(Medical Patient
Number Per HIPPA) COLUMN 4
(Type of procedure)
b) The surgical log should be tallied on a separate page:
COLUMN 1
Type of procedure
(e.g. hair transplantation)
(upper blepharoplasty) COLUMN 2
Total number of cases
(e.g. 10 cases)
(24 cases)
NOTE: Grand total for Column 2 should equal the required number of cases.
(iv) OPERATIVE REPORTS
Operative reports must be typewritten in narrative form, similar to those completed for hospital reports, and must be signed by the primary surgeon. The front page of the report must contain a list of all procedures performed. Only those procedures listed on the front page will be counted by the committee. The reports must list any and all co-surgeons and assistant surgeons. The reports will show pre and post operative diagnoses and the indication for surgery. The narrative description must be sufficiently detailed such that a physician not fully familiar with the procedure will understand what was done. Important items such as estimated blood loss should be included in the report. Liposuction procedures must list the amount of fluid infused into the tissue, the total volume of aspirate, the total volume of the infranatant fluid and the mg/kg dosage of lidocaine.
Clearly labeled publication quality before and after photographs when required, shall be securely attached to said operative report. Pictures must clearly demonstrate treated area(s). For example, an abdominal liposuction should include a lateral view and liposuction of the lateral thighs should include an anterior or posterior view. All pictures should be labeled with >BEFORE= or >AFTER= labels.
(v) EXPERIENCE ROUTE CASE LOG REQUIREMENTS
The committee will evaluate each candidate’s case log based on the depth and breadth of the cases submitted. Candidates with extremely narrow practice scopes will not be approved. Candidate must submit a minimum number of operative reports with publication quality pre and post operative photographs securely attached. The minimum number of operative reports and photographs varies dependent upon the area of certification sought. Minimum number of operative reports and photographs for experience route candidates are set forth on the following pages.
BODY, BREAST & EXTREMITY COSMETIC SURGERY – Applicant shall submit operative reports from five (5) of the eight (8) categories noted below subject to the review of the credential committee. Applicant shall submit a minimum of twenty (20) operative reports for each of the five categories selected (total minimum of 100 operative reports). Ten of the twenty operative reports submitted for each category must contain publication quality pre and post operative photographs securely attached to the operative reports. (Total minimum of 50 operative reports with photos).
1. Abdominoplasty
a. Complete
b. Partial
2. Arm Lift or Thigh Lift
3. Breast
a. Augmentation with implant
b. Mastopexy
c. Reduction
4. Body Implants (other than breast
a. Extremity
b. Gluteal
c. Pectoral
5. Fat Transfer
6. Labiaplasty
7. Liposuction
a. Trunk
b. Upper and Lower Extremities
c. Face and Submental
8. Varicose Vein Surgery
Once the candidate meets the minimum requirement of patients per procedure, the list comprising the balance of the 1000 cases may be any mix, provided the procedures are on the approved list included in this application booklet.
________________________________________________
(vi) EXPERIENCE ROUTE CASE LOG REQUIREMENTS
The committee will evaluate each candidate’s case log based on the depth and breadth of the cases submitted. Candidates with extremely narrow practice scopes will not be approved. Candidate must submit a minimum number of operative reports with publication quality pre and post operative photographs securely attached. The minimum number of operative reports and photographs varies dependent upon the area of certification sought. Minimum number of operative reports and photographs for experience route candidates are set forth on the following pages.
FACIAL COSMETIC SURGERY – Applicant shall submit operative reports for seven (7) of the ten (10) categories noted below subject to the review of the credential committee. Applicant shall submit a minimum of fifteen (15) operative reports for each of the seven categories selected (total minimum of 105 operative reports). Ten of the fifteen operative reports submitted for each category must contain publication quality pre and post operative photographs securely attached to the operative reports. (Total minimum of 70 operative reports with photos).
1. Rhinoplasty
2. Cosmetic Eyelid Procedures
a. Upper Blepharoplasty
b. Lower Blepharoplasty
c. Canthoplasty / Pexy (as a separate procedure)
d. Cosmetic Ptosis Repair (as a separate repair)
3. Brow /Forehead Lift
4. Face Lift (all types excluding thread lifts)
a. Traditional
b. Deep Plane
c. Subperiosteal
5. Maxillofacial Cosmetic Surgery (augmentation with facial implants)
a. Augmentation
b.Osteotonies (Genioplasty, etc.)
6. Cervicofacial Liposuction
7. Fat Transfers
8. Otoplasty or Cheloplasty
9. Hair Loss
a. Hair Transplant
b. Scalp Flaps
c. Expanders
10. Facial Skin Resurfacing (Ablative)
a. Laser Resurfacing
b. Dermabrasion
c. Chemical Peels
Once the candidate meets the minimum requirement of patients per procedure, the list comprising the balance of the 1000 cases may be any mix, provided the procedures are on the approved list included in this application booklet.
________________________________________________
(vii) EXPERIENCE ROUTE CASE LOG REQUIREMENTS
The committee will evaluate each candidate’s case log based on the depth and breadth of the cases submitted. Candidates with extremely narrow practice scopes will not be approved. Candidate must submit a minimum number of operative reports with publication quality pre and post operative photographs securely attached. The minimum number of operative reports and photographs varies dependent upon the area of certification sought. Minimum number of operative reports and photographs for experience route candidates are set forth on the following pages.
DERMATOLOGIC COSMETIC SURGERY – Applicant shall submit operative reports for three (3) of the five (5) categories noted below subject to the review of the credential committee. Applicant shall submit a minimum of twenty (25) operative reports for each of the three (3) categories selected, and an additional 25 operative reports from any category (total minimum of 100 operative reports ). One half of the operative reports submitted from each category must contain publication quality pre and post operative photographs securely attached to the operative reports. (Total minimum of 50 operative reports with photos).
1.
Ablative Facial Skin Procedures of at least one cosmetic unit
a. Laser Resurfacing
b. Dermabrasion
c. Chemical Peels
2. Liposuction
a. Face
b. Body
c. Extremities
3. Fat Transfers
4. Hair Loss Treatment
5. Varicose Vein Surgery
Once the candidate meets the minimum requirement of patients per procedure, the list comprising the balance of the 1000 cases may be a mix, provided the procedures are on the approved list included in this application booklet.
________________________________________________
(viii) EXPERIENCE ROUTE CASE LOG REQUIREMENTS
The committee will evaluate each candidate’s case log based on the depth and breadth of the cases submitted. Candidates with extremely narrow practice scopes will not be approved. Candidate must submit a minimum number of operative reports with publication quality pre and post operative photographs securely attached. The minimum number of operative reports and photographs varies dependent upon the area of certification sought. Minimum number of operative reports and photographs for experience route candidates are set forth on the following pages.
GENERAL COSMETIC SURGERY – Applicant shall submit operative reports for twelve (12) of the eighteen (18) categories noted below subject to the review of the credential committee. Applicant shall submit a minimum of ten (10) operative reports for each of the twelve categories selected (total minimum of 120 operative reports). Five of the ten operative reports submitted for each category must contain publication quality pre and post operative photographs securely attached to the operative reports. (Total minimum of 60 operative reports with photos).
1. Rhinoplasty
2.
Cosmetic Eyelid Procedures
a. Upper Blepharoplasty
b. Lower Blepharoplasty
c. Canthoplasty / Pexy (as a separate procedure)
d. Cosmetic Ptosis Repair (as a separate repair)
3. Brow/Forehead lift
4. Face Lift (all types excluding thread lifts)
a. Traditional
b. Deep Plane
c. Subperiosteal
5.
Maxillofacial Cosmetic Surgery (augmentation with facial implants)
a. Augmentation
b. Osteotonies (Genioplasty, etc.)
6. Cervicofacial Liposuction
7. Fat Transfers
8. Otoplasty or Cheloplasty
9. Hair Loss
a. Hair Transplant
b. Scalp Flaps
c. Expanders
10. Facial Skin Resurfacing (Ablative)
a. Laser Resurfacing
b. Dermabrasion
c. Chemical Peels
11. Abdominoplasty
a. Complete
b. Partial
12. Arm Lift or Thigh Lift
13. Breast
a. Augmentation with implant
b. Mastopexy
c. Reduction
14. Body Implants (other than breast)
a. Extremity
b. Gluteal
c. Pectoral
15. Fat Transfer
16. Labiaplasty
17. Liposuction
a. Trunk
b. Upper and Lower Extremities
c. Face and Submental
18. Varicose Vein Surgery
Once the candidate meets the minimum requirement of patients per procedure, the list comprising the balance of the 1000 cases may be any mix, provided the procedures are on the approved list included in this application booklet.
