Board-Certification in Plastic Surgery

Publication date: 12/30/2023

Dr. Mittermiller is proud to announce he is now officially board-certified by the American Board of Plastic Surgery!

Becoming board-certified by the American Board of Plastic Surgery (ABPS) is a significant achievement for plastic surgeons, signifying a high level of expertise and dedication to the field. The process to attain this esteemed certification is rigorous, encompassing several key requirements that candidates must meet.

First and foremost, candidates must complete an accredited plastic surgery residency program. This typically involves several years of intensive training in both general surgery and plastic surgery, ensuring a comprehensive understanding of surgical principles and techniques. Following residency, candidates must accumulate a minimum number of cases during their professional practice in plastic surgery, demonstrating their commitment to the field and gaining valuable hands-on experience.

A crucial aspect of the board certification process is the successful completion of a written and oral examination. The written exam assesses the candidate’s knowledge of plastic surgery principles, while the oral exam focuses on the application of this knowledge in clinical scenarios. These exams are designed to evaluate a candidate’s competency, critical thinking skills, and ability to make sound clinical decisions, ensuring that board-certified plastic surgeons are well-equipped to provide high-quality patient care.

Continuing medical education is another essential component of maintaining board certification. Plastic surgeons must actively engage in ongoing learning, attending conferences, workshops, and courses to stay abreast of the latest advancements and techniques in the field. This commitment to lifelong learning is integral to ensuring that board-certified plastic surgeons remain at the forefront of their specialty, providing patients with the best possible care.

In conclusion, achieving board certification from the American Board of Plastic Surgery is a multi-faceted process that demands a combination of education, training, experience, and ongoing commitment to professional development. Those who successfully navigate this rigorous path can proudly display their board certification, a symbol of excellence in the field of plastic surgery. This stringent certification process not only safeguards the quality of care provided to patients but also upholds the standards and reputation of the plastic surgery profession.

Click here to see if your surgeon is board-certified in plastic surgery: Is your surgeon certified?

Relevant links:
American Board of Medical Specialties
American Board of Plastic Surgery

Scope Creep into Plastic Surgery and Cosmetic Surgery

Addition: 4/3/2024

An article recently came out in the LA Times titled “She died after liposuction by a pediatrician. Doctors warn of cosmetic surgery’s ‘Wild West’.”¹ This article discusses some of the dangers associated with scope creep. Scope creep refers to the process by which physicians increase their scope of practice beyond their original training. This article describes a case in which a patient died after undergoing liposuction by a physician whose training was in pediatrics but who offered cosmetic surgery. The subtext is that physicians who extend beyond their scope of practice are at higher risk of incurring severe complications.

One organization that is highlighted in the article is the American Board of Cosmetic Surgery. This organization is generally comprised of physicians who did not complete residency or fellowship training in plastic surgery. The concern with this board is that by marketing themselves as board-certified cosmetic surgeons, consumers may be confused into thinking that the training received by this surgeon is is equivalent to the training received by a board-certified plastic surgeon. In 2018, the Medical Board of California (MBC) determined the training to be not equivalent.² This decision by the Medical Board of California prevents members of the American Board of Cosmetic Surgery from marketing themselves as “board certified” in cosmetic surgery according to California law (below).^{3, 4}

Physicians are prohibited by BPC Section 651 (h)(5)(C) from advertising as “board certified” unless they are certified by:
          1. An ABMS member specialty board;
           2. A specialty board with an Accreditation Council for Graduate Medical Education (ACGME) accredited postgraduate training program; or
          3. A specialty board with equivalent requirements approved by the Board prior to January 1, 2019.

Although there are laws preventing misleading advertising, there are no restrictions preventing scope creep. According to the LA Times article previously referenced, “In California, licensed physicians may ‘practice in any area of medicine, if they do so in a competent manner that complies with the law’.” Put in other words by Dr. Michael Wong in the same article, “you could be trained in pediatrics, and then, if you have the cojones, you could be doing surgery”.

In order to protect themselves, consumers of any types of procedures should ask a variety of questions to their providers. Valuable questions provided by the LA Times are listed below:

Is your doctor board-certified and by which board?
What kind of training is required by that board?

Patients can also perform their own research on these topics. The American Board of Medical Specialties (ABMS) has an online search tool (hyperlinked) that allows the general public to check if a physician is certified by one of the recognized boards.

There are some areas of surgery, such as facial feminization surgery, that do not solidly lie within one ABMS-recognized board. In these cases, it is important for prospective patients to have a full understanding of their surgeon’s training background and their experience with the procedures. Patients can gain insight into the surgeon’s familiarity with the operation by asking how many procedures of this type the surgeon has performed and what percentage of his practice is dedicated towards these types of operations.

Public Confusion About the Meaning of Plastic Surgeon

Addition: 12/19/2024

An article recently came out in the journal Plastic and Reconstructive Surgery titled “Plastic Surgery or Facial Plastic Surgery: Can the Public Tell the Difference?”⁵ This article attempts to determine whether the general public understands the distinction between these two specialties. They conclude the following:

Despite increasing advocacy by professional societies and the member societies of the American Board of Medical Specialties, this study demonstrated that the lay public is unaware of factually different training and certification pathways given similarity in nomenclature. This study was notably not designed to draw conclusions or imply superiority of one specialty, certifying board, or training model over the other.

This can potentially be problematic since patients should understand the training of their surgeons and physicians. However, attempting to shed light on this issue has resulted in tension between the specialties with surgeons being concerned that a distinction may be seen as demeaning as noted in a response by Drs. Kontis and Papel.⁶

Nonetheless, the author of the original paper attempted to clarify the reasons for determining whether there is public confusion and why the distinction is important.⁷ Their response is included below.

In regard to the comments […] our article indicates that our survey and article is not intended to imply superiority of one specialty designation or training model. In fact, in the article we indicated there are many circumstances where both specialties learn and collaborate with one another. The article goes on to say that the findings only serve to highlight the poor health literacy among laypeople in understanding the differences in training and certification amongst providers. Although this may not have been an issue 40 years ago, the advent of social media, much of which is unregulated, has reignited this discussion. Ultimately, we believe in being fully transparent with the public, and this article demonstrates that the public feels associated confusion with nomenclature. Part of the confusion is related to how providers play with words and market their services on social media platforms. For example, there are non-ABPS plastic surgeons on social media advertising as “plastic surgeons.” As stated in the article, we believe the term plastic when used to describe surgery refers to this creative and innovative surgical specialty, established in 1937 by the ABPS, and to a general philosophy and approach to molding human tissues to optimize form and function. It is our responsibility to our patients to continue educate them on these differences to allow them to make an informed decision.

As mentioned in the prior excerpts, this attempt to clarify and distinguish these two particular specialties has been ongoing for decades and will likely not be resolved in the near future.

Misrepresentations of Physicians on Social Media

Addition: 1/10/2025

A new article was released recently suggesting a misrepresentation by physicians on social media who are not board certified by the American Board of Plastic Surgery.⁸ In their study, they found the following: “Altogether, 1141 individuals were explicitly listed as “plastic surgeons” on Instagram, nearly a quarter of these (325 individuals, 28%) were not certified by the ABPS, and nearly a fifth (251 individuals, 22%) received no training in plastic surgery.”

1. Reyes EA (2024) She died after liposuction by a pediatrician. Doctors warn of cosmetic surgery’s ‘Wild West’. LA Times. https://www.latimes.com/science/story/2024-03-31/california-cosmetic-surgery#. Accessed 4/3/2024 2024
2. Hermes P (2019) Medical Board of California: ABCS is not equivalent to ABMS board. American Society of Plastic Surgeons. https://www.plasticsurgery.org/for-medical-professionals/publications/psn-extra/news/medical-board-of-california-abcs-is-not-equivalent-to-abms-board. Accessed 4/3/2024 2024
3. Information Pertaining to the Practice of Medicine.  Medical Board of California. https://www.mbc.ca.gov/Licensing/Physicians-and-Surgeons/Practice-Information/default.aspx. Accessed 4/3/2024 2024
4. Business and Professions Code Section 651.  Legislative Counsel Bureau of the State of California. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC&sectionNum=651. Accessed 4/3/2024 2024
5. Pyon RE, Sayadi LR, Pakvasa M, Vyas RM, Wang ED (2024) Plastic Surgery or Facial Plastic Surgery: Can the Public Tell the Difference? Plast Reconstr Surg Glob Open 12 (3):e5679. doi:10.1097/GOX.0000000000005679
6. Kontis TC, Papel ID (2024) Clarifying the Distinction between Plastic Surgery and Facial Plastic Surgery Accurately and Respectfully. Plast Reconstr Surg Glob Open 12 (8):e6079. doi:10.1097/GOX.0000000000006079
7. Wang E (2024) Reply to “Clarifying the Distinction Between Plastic Surgery and Facial Plastic Surgery Accurately and Respectfully”. Plast Reconstr Surg Glob Open 12 (12):e6078. doi:10.1097/GOX.0000000000006078
8. Singh NP, Holohan MM, Harmon C, Fallah KN, Gross J, Patel A, Boyd CJ, Greives MR, de la Torre J, Gordillo G, King TW (2025) Instagram Versus Reality: Who Are Actually Plastic Surgeons? Plastic and Reconstructive Surgery – Global Open 13 (1):e6426. doi:10.1097/gox.0000000000006426 https://journals.lww.com/prsgo/pages/articleviewer.aspx?year=2025&issue=01000&article=00012&type=Fulltext