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Plastic Surgeons vs. Cosmetic Surgeons: What's the Difference?
If you’ve been searching for “plastic surgery Chicago”, you’ve probably seen the terms plastic surgeon and cosmetic surgeon everywhere you’ve looked. If you’re like most people, you probably thought they were interchangeable words for the same type of surgeon.
It’s true that the terms are used interchangeably, especially by Chicago plastic surgeons who choose to focus their practices on cosmetic surgery.
Due to falling reimbursements, there are also many doctors and non-surgeons in unrelated fields claiming to be cosmetic surgeons.
This can be misleading and has led to some confusion in public perception. Even doctors in other medical fields can’t distinguish the difference. This is due to the fact that there are many conflicting descriptions in the media and by surgeons themselves with respect to the two.
Cosmetic surgery and plastic surgery both deal with surgical alteration of the human body. The fields are therefore closely related, but not the same
1. Cosmetic Surgery & Plastic Surgery Differ in Their Objectives.
While both cosmetic surgery and plastic surgery deal with alteration to the human body, the ultimate goals may differ and thus the guiding principles with regard to training, research, and emphasis of procedures may differ.
Chicago Cosmetic Surgery: Focused on Enhancing Appearance Aesthetically
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 some plastic surgeons.
Here are some of the most requested cosmetic surgery procedures:
- Lipo 360
- Breast Augmentation
- Breast Lift
- Breast Reduction
- Tummy Tuck
- Mommy Makeover
- Brazilian Butt Lift Fat Transfer
- C-Section Scar Removal
Chicago Plastic Surgery on the other hand 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 reconstructive in nature as it is primarily concerned with restoring function, while maximizing form is of secondary concern.
Although many of the surgical principles in regard to maximizing aesthetic appearance of the final result are the same, plastic surgery’s primary objective is to restore the underlying function of the body part whether it be mobility, bodily function, or protective tissue coverage.
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 and the same.”¹
Some examples of plastic surgery procedures:
- Breast reconstruction after mastectomy
- Cleft-lip repair
- Hand surgery and finger re-plantations
- Scar revisions
- Scar and skin graft surgery for burns
- Skin flaps for tissue defects.
2. Cosmetic Surgery and Plastic Surgery Differ in Their Training.
The training required to become a board-certified plastic surgeon in Chicago is distinctly different than the training to become a board-certified cosmetic surgeon in Chicago. Since the scope and type of procedures performed by each are different, it’s logical that each specialty undergoes a different training and certification.
Plastic surgery training is completed through a post-graduate or combined residency program.
To make things even more confusing, there are two tracks to becoming a plastic surgeon. Some complete an entire 5 years of general or otolaryngology surgery training plus an additional 2-3 years of post-graduate training in plastic surgery.
Another path to plastic surgery is a “combined” program in which surgeons complete 3 years of general surgery training followed by 3 years of plastic surgery training.
The commonality between the two is that a large portion of the training is dedicated to general surgery or otolaryngology (3-5 years) followed by a period (2-3 years) in which a plastic surgeon must master all aspects of reconstructive surgery including craniofacial surgery, hand surgery, burn surgery, microsurgery, and some cosmetic surgery.
In total, only a very small portion of a plastic surgeon’s training (a few months over 6-7 years) is dedicated to training in cosmetic surgery and not all cosmetic surgical procedures are taught.
It is for this reason that many plastic surgeons choose to undergo additional fellowships or apprenticeships in cosmetic surgery in order to be comfortable and proficient at specific cosmetic procedures.
Therefore the title “board-certified plastic surgeon” indicates a certain level of training and experience with respect to plastic surgery and the vast scope of procedures that are required in their training.
Because the scope of training is so broad, the actual number of cosmetic surgical procedures required to graduate from a plastic surgery program may actually be very few (see chart above).
Furthermore, this certification does not require experience or exposure to many common cosmetic procedures.² Certification only denotes that the surgeon has been exposed to at least the minimum number of qualifying cases in the field, and in regard to cosmetic surgery cases, that minimum number varies greatly between plastic surgery and cosmetic surgery.
Currently, there are no ABMS 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 and certified in a primary surgical specialty and then fellowship-trained specifically for cosmetic surgery.
When it pertains to cosmetic surgery, the training, experience, and knowledge required to become a board-certified cosmetic surgeon reflects specialization in cosmetic surgical procedures above and beyond what is required in plastic surgery.
Each surgeon who is board-certified by the American Board of Cosmetic Surgery has completed a one- or two-year fellowship training dedicated to cosmetic surgery alone. 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 5-6 year residency program in a related discipline like general surgery, otolaryngology, oral-maxillofacial surgery, or plastic surgery.
Board-certified plastic surgeons may be very skilled and qualified to perform cosmetic surgery and may be the most experienced in those procedures in your area. However, it is important to understand that this is not always the case.
If you look at requirements and training to perform a cosmetic procedure, plastic surgery certification doesn’t always equate to more proficiency compared to a dedicated board-certified cosmetic surgeon. That is why some board-certified plastic surgeons seek to also become board-certified cosmetic surgeons.
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.
In the end, the title doesn’t matter if the surgeon can’t perform a procedure safely and proficiently and this goes back to adequate training. To find the best plastic surgeon in Chicago 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 that you want to get.
A plastic surgeon may not always be the most well-trained surgeon when it comes to a given cosmetic procedure, just as a cosmetic surgeon may not be the best surgeon to perform a reconstructive procedure.
Also remember that many doctors claiming to be cosmetic surgeons aren’t certified surgeons at all. This is why doing your research and asking the right questions are paramount.
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.
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REVIEWS FROM AROUND THE WEB
I don’t even know where to begin with how absolutely amazing Dr.T and his staff are. I had a breast augmentation on March 5 2020, and just everything from the start has been smooth and effortless. I never felt like just another number, I was taken care of every step of the way. He is warm kind honest and will point you in the right direction, and it’s so awesome to have my own nurse anytime I need to get ahold of to answer questions. He is a true artist and I am so happy with the outcome, look, feel everything im obessed. It was an honor to have work done by him, if you are interested in any type of cosmetic procedures don’t look any further.
My experience with Dr T was amazing!!! Though I seen him in Florida, I am glad I did! It was Back in 2013 for Breast Augmentation! I can Not Complain! Omg its going on 7 years this 3/21, and I must Say I STILL LOVE MY BREAST!!!!
Dr. Truong has given me life-changing results. He did a wonderful job on my Lipo360 and my confidence has sky-rocketed since. I see muscle tone in my abdomen at the gym now; I knew it was hiding under there! Great bedside manner and a very talented surgeon.
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Breast Augmentation Chicago – The Basics You Should Know
What is Breast Augmentation?
Breast Augmentation, or augmentation mammoplasty, is a procedure in which implants are placed in order to change the size and shape of the breasts. “Augmentation” is a term used in plastic surgery Chicago that means to change or enhance an existing body part. In some cases, however, breast augmentation can also be considered a “restorative” procedure in which breasts that have lost volume or shape due to weight changes, pregnancy, or other causes are restored to a more youthful state. Other, more unscientific terms used are “breast enhancement,” “breast implants,” and “breast enlargement” which essentially describe the same procedure.
The decision to undergo breast augmentation and the surgeon you choose are very important, but the decisions don’t stop there. There are many other factors to consider and choices to make regarding this surgery. During your consultation, your surgeon should discuss these options with you and fully educate you on every option so that you and you Chicago plastic surgeon can make the decisions that are right for you. Make sure you are fully aware of the following:
Step 1 – Anesthesia
Breast augmentation is typically done under general anesthesia with an anesthesiologist who will put you completely asleep, using a temporary breathing tube. Very rarely are breast augmentations done under local or tumescent anesthesia with sedation. Not every surgeon has privileges at a facility accredited for general anesthesia so be sure to ask if this is the case with the surgeon you are thinking of using. Medication is administered for your comfort before, during, and after your surgery. In healthy patients with no significant medical history, the risks of general anesthesia are very low and complications from anesthesia are rare.
Step 2 – The Location of Incision
Incisions are made in inconspicuous locations to lessen noticeable scarring. You and your surgeon will go over which incision location options are available for your individual anatomy and desired result. Incision alternatives consist of:
- Inframammary incision: This incision is ideal for most patients with a well-defined inframammary fold and those who do not want a scar around the areola or nipple. It generally heals very well and is hidden in the fold underneath the breast. It can be used easily for silicone implants and can be used repeatedly for future replacements or revisions.
- Transaxillary incision: This is ideal for patients who don’t want any scars on or around the breast. The incision may be visible when in a swimsuit or sleeveless dress but only when you raise your arm. It is more difficult to place silicone implants through this incision and also difficult to perform revisions since it offers less direct vision of the pocket. Some surgeons use a camera or endoscope to perform this approach.
- Periareolar incision: This is also known as the nipple incision and is placed from 3 o’clock to 9 o’clock around the areola. It generally heals very well and can be used to place silicone or saline implants, and can be used for revisions easily as well. Because of the placement on the border of the areola, these incisions are barely visible once healed. There is a slightly higher risk of nipple numbness and a slight increase of incidence of infection with the nipple incision, since the milk ducts do contain a small amount of bacteria.
Not depicted here is the trans-umbilical or belly button incision, which is only done by a few surgeons and can only be done using saline implants.
Incisions differ based on the kind of implant, degree of enlargement desired, your pre-existing anatomy, and patient-surgeon preference. Each incision has advantages and disadvantages, so be sure to discuss all of these options with your surgeon.
Step 3 – Implant selection: Silicone breast implants or saline breast implants?
Saline implants are essentially made of a silicone “shell” that has a valve much like a balloon through which sterile saline or salt solution is injected after the implant is in place. They can be filled with different quantities of saline which can impact the shape, suppleness and feel of the breast. If the implant happens to leak, which is rare, the saline will be harmlessly absorbed by the body since it is essentially the same composition as the water in your body. If this happens, the implant can be replaced immediately.
Silicone or “gel” implants are made of the same silicone “shell” but are pre-filled with a silicone gel solution which is an elastic semi-solid material. Silicone gel implants do not have a valve and cannot be adjusted. Silicone gel implants are more pliable and feel more like natural breast tissue compared to saline implants. A leaking silicone implant may not collapse. Because the gel is a solid, it will generally stay confined inside the shell and does not “flow” out like a liquid. You should see your cosmetic surgeon regularly to ensure the implants remain intact. An ultrasound or MRI screening can examine the condition of implants breast augmentation and the time frame of such check-ups may vary.
Implants not only come in different sizes, but also can have different shapes such as “round” or “tear-drop” and can have different “profiles.” The profile of the implant determines its height or projection relative to its width. Your surgeon can recommend the best shape and profile for you based on your anatomy and your measurements.
Implant suppliers or inventors occasionally introduce brand-new designs and types of implants, so there may be extra options available, so be sure to ask your surgeon if this is the case.
The FDA currently approves saline implants for augmentation in women 18 years of age and older.
The FDA currently approves silicone implants for augmentation in women 22 years of age and older.
Be sure to discuss the pros and cons of each implant type with your surgeon to determine the right type for you.
Step 4 – Placement of the Breast Implant and Pocket Type
After the incison is made, a “pocket” is created beneath the breast in order to place the implant. This pocket can be created either in the submuscular plane (behind the pectoralis muscle), or in the subglandular plane (above the muscle, but directly beneath the breast tissue), or in a “dual plane” in which the upper part of the implant is partially covered by the muscle and the lower part is subglandular.
In general, submuscular or dual-plane placement is preferred due to increased tissue coverage of the implant. In this method, approximately 10% of the pectoralis muscle is cut or “released” at its inferior and medial attachment to the sternum in order to make room for the implant. There may be mild movement of the implant when flexing the chest muscles, but this is generally not bothersome to most patients. Most patients also do not notice a significant change in strength of the muscle.
In some cases the subglandular placement is preferred, such as when there is mild ptosis and no lift is being done, or in body-builders and males who have thick pectoralis muscles or need full function of these muscles.
Make sure you discuss this very important aspect of the implant placement with your surgeon as each surgeon may have a different preference or insight.
Step 5 – Size of the Implant
Once the type of implant, incision, and placement of the implant is decided, the size of the implant needs to be determined. This should be done using measurements of the chest and breast(s) as well as sizers or simulators to approximate the final result. Keep in mind that your surgeon should help you realize your aesthetic goal, but there are limitations on the size of implants that can be placed, especially if your breasts are very small and your skin is very tight. Your surgeon will help guide you in making a good aesthetic decision to achieve your desired look, while not exceeding the safe range in terms of your pre-existing anatomy.
Step 6 – Set Your Date & Prepare for Breast Augmentation Recovery
Remember that although it is a cosmetic and elective procedure, it is still a surgical procedure so you must plan accordingly. When choosing your date, make sure to allow plenty of time for recovery as well as time for the breasts to settle into their final result. A good rule of thumb is to plan your schedule around your surgery and not the other way around.
Because it is a surgical procedure, there is always the possibility of an unpredictable healing process or complications that are unforeseen, so be prepared for additional healing time if necessary. If you have significant medical history or have certain risk factors, you may need to do some pre-operative tests such as an EKG or a mammogram prior to your surgery.
Overall, breast augmentation is a very safe procedure for most with a very high satisfaction rate. You will increase your chances of being satisfied with your result if you take the time to educate yourself on what to expect and the options you have. A good Chicago plastic surgeon will guide you through the decision-making process and make sure you are fully educated in your decisions.
Best of luck on your journey! For more information on breast augmentation and how you can get a complimentary consultation to see what options are right for you, please go here.