Plastic Surgeon

What is a plastic surgeon?

Plastic surgeons repair injuries and congenital (present at birth) defects affecting appearance or function. They use reconstructive and cosmetic techniques to restore areas impacted by major illnesses such as cancer. They also perform procedures to enhance physical features for aesthetic reasons.

Their areas of expertise include the:

• Breasts and chest.
• Extremities, such as your arms, legs, hands and feet.
• External genitalia, including your penis, testicles and vagina.
• Facial structures, like your mouth, face, ears, head and neck.
• Skin.

What conditions do plastic surgeons repair or restore?

Birth defects

• Cleft lip and palate.
• Congenital hand differences.
• Craniosynostosis.
• Hypospadias.
• Microtia.
• Syndactyly (webbed fingers or toes).

Trauma

• Burns.
• Complex wounds.
• Cuts involving delicate tissue, such as your hands, feet, lips, eyelids, nose, genitals or nerves.
• Facial fractures.
• Scars that limit natural movement.

Cancer reconstruction

• Head and neck cancer.
• Breast cancer.
• Colorectal cancer.
• Gynecologic cancer.
• Skin cancer.
• Testicular cancer.
• Vaginal cancer.

Gender dysphoria

Plastic surgery to treat gender dysphoria is for transgender and nonbinary individuals whose physical appearance doesn’t reflect their gender identity.

What are plastic surgeon education requirements?

Plastic surgery training starts with traditional medical school to earn a doctor of medicine degree (MD). Another option is osteopathic education to earn a doctor of osteopathy degree (DO). Osteopathic doctors learn a holistic approach that considers a person’s mind, body and spirit.

After medical school, doctors complete a six-year plastic surgery residency. During this time, they learn general and plastic surgery techniques. Alternatively, many doctors complete a five-year general surgery residency and follow that with an additional three years of training with a focus on plastic surgery.

After their residency training, plastic surgeons may choose to complete a rigorous exam to become board certified. The American Board of Plastic Surgery is one organization that grants board certification. Once these requirements have been achieved, plastic surgeons may choose to pursue further training in one of several sub-specialties listed in the section below.

Plastic surgeons maintain board certification through a Continuous Certification Program. They also have to complete a certain number of continuing medical education (CME) credits each year to maintain their medical license.

What types of specialty training are available to plastic surgeons?

Plastic surgeons can pursue a one-year fellowship after residency to become subspecialists in:

• Body contouring.
• Microsurgery.
• Craniofacial or craniomaxillofacial surgery.
• Gender affirmation surgery.
• Cosmetic surgery.
• Hand surgery.
• Burn surgery.

Is a plastic surgeon the same as a cosmetic surgeon?

Cosmetic surgery and reconstructive surgery are both sub-specialties of plastic surgery. Reconstructive plastic surgeons treat people with medical issues affecting appearance, form or function. Cosmetic plastic surgeons enhance the appearance of physical features for aesthetic reasons rather than medical.

Cosmetic surgery is a part of all plastic surgeons’ training. Healthcare providers who wish to become full-time cosmetic surgeons sometimes complete extra training through additional fellowships.

Other healthcare providers may elect to seek certification in cosmetic surgery only. However, these individuals don’t receive formal plastic surgery training and aren’t certified by the American Board of Plastic Surgery.

What do plastic surgeons do?

Plastic surgeons use various techniques to treat severe injuries, improve function and restore a natural-looking appearance.

These include:

• Microsurgery involves the use of a microscope to help surgeons carry out complex procedures. You may need microsurgery to reconnect tiny blood vessels or nerves.
• Prosthesis preparation is for people who lose part of their body. Techniques involve preparing for a replacement (prosthesis). In some cases, it includes attaching a donor or human-made replacement. Prosthetics are used most commonly in breast reconstruction (breast implants), but may also be used in other forms of reconstruction.
• Skin grafts are sections of healthy skin that surgeons shave off and attach to a different area of your body. After surgery, the graft survives by connecting to existing blood vessels. Skin grafts help repair large wounds, including burns.
• Flaps. A flap uses a person’s own tissue to repair defects caused by cancer resection or trauma. Skin, fat and sometimes muscle are often moved from another area.
• Free flap surgery (free tissue transfer) is similar to skin flap surgery. However, the section of skin, fat and/or muscle is removed from its original blood supply and transferred to a different area of your body. Surgeons connect it to a new blood source near the implant site.
• Tissue expansion involves placing a balloon-like device under your skin and filling it with saline to slowly stretch or expand it. During a second procedure, surgeons remove the expander and use the skin to close a wound that covers a large area. Tissue expansion is often used in breast reconstruction.
• Complex wound care is for people with large or complex wounds. Plastic surgeons can sometimes use techniques to close the wound while minimizing scarring. They may use a variety of techniques, including microsurgery and skin grafts.

What types of cosmetic procedures do plastic surgeons perform?

Cosmetic procedures that plastic surgeons learn during their medical training include:

• Facelift rejuvenates a youthful appearance by tightening skin that has become loose with aging.
• Brow lift repositions your forehead to ease creases, frown lines and sagging eyebrows.
• Blepharoplasty removes excess skin, muscle and fatty tissue from eyelids.
• Rhinoplasty reshapes your nose to enhance appearance or repair medical issues.
• Hair transplant adds fullness to hair on your head by transplanting it from other areas of your body.
• Injectables are products such as Botox® or Juvaderm® that are administered to correct facial wrinkles.
• Lasers can perform peels, hair removal and treatment of spider veins.
• Liposuction can help remove difficult-to-lose fat deposits.
• Breast augmentation helps increase the volume and shape of your breast.
• Breast reduction removes fat, skin and other tissue to make breasts smaller.
• Breast lift elevates and reshapes your breast to achieve a more youthful figure.
• Body contouring shapes areas of your body and tightens skin.
• Tummy tuck removes excess fat and skin from your abdomen.
• Arm lift tightens sagging skin.
• Thigh lift helps restore a more youthful figure.
• Body lifts tighten sagging buttock skin.
• “Mommy makeovers” restore much of your pre-pregnancy appearance.

What happens during my first visit with a plastic surgeon?

It’s important to find a surgeon you trust and who makes you feel comfortable. Your initial visit is an opportunity to get to know the surgeon and your procedure options. They review your medical history and perform a physical exam before making recommendations.

You can get the most out of this appointment by:

• Asking questions about the plastic surgeon’s experience with the procedures they recommend.
• Finding out about the risks, benefits and what to expect for each option.
• Bringing files, notes or test results from previous healthcare providers that will help the plastic surgeon tailor care to your needs.
• Knowing your medical history, including medical conditions and medications you’re taking.
• Thinking about and being able to tell your healthcare provider what you’d like to get out of surgery.

A note from Cleveland Clinic

A plastic surgeon performs various procedures to restore function and improve appearance. You may benefit from their services if you experience a severe illness or injury. You may also visit a plastic surgeon to enhance facial features and certain areas of your body. Plastic surgeons undergo rigorous training, giving you many treatment options to choose from. It’s important to receive services from a qualified surgeon you feel comfortable with. During your first appointment, ask a lot of questions so you can choose the surgeon and procedure that’s best for your needs.