What Does Board Certification Really Mean?

If you're a regular reader of The AEDITION, you know we always emphasize finding a 'board certified' provider to perform your preferred cosmetic procedure. But what does it mean to be a board certified plastic surgeon or dermatologist? How do doctors go about becoming certified? We're here to shed some light on the board certification process and why it matters.

Medical Licensure vs. Board Certification

First things first, a licensed doctor is not the same as a board certified one. A medical license is required for all doctors who wish to legally practice medicine in the United States, and medical licensure is handled at the state level by state medical boards. Doctors must receive individual licenses in each state they wish to practice in, and they must be renewed periodically.

While the protocol varies from state to state, you can be sure that all licensed physicians (at the minimum) graduated medical school, underwent some level of postgraduate residency training, and passed a comprehensive national licensing exam (either the United States Medical Licensure Examinations [USMLE] for medical doctors or the Comprehensive Osteopathic Medical Licensing Examination for doctors of osteopathic medicine).

Board certification, meanwhile, signifies that the physician has successfully completed a residency in their chosen specialty. In order to become board certified, a doctor must have completed his or her undergraduate education, medical school, one-year internship, a residency in their chosen specialty, and passed the residency board exam.

Unlike a medical license, board certification is not required to practice medicine in the U.S., but it is an important tool in distinguishing whether or not a provider has specialized in a particular area. Additionally, board certification does not last forever. Many medical specialty boards now require recertification every 10 years or so, ensuring doctors keep on top of their skills.

Why Board Certification Matters

Board certification is important for all fields of medicine, but it is particularly necessary in the aesthetic space. While it cannot guarantee the quality of results, it can certainly point you in the direction of qualified doctors for the procedure you are interested in or care you need.

Titles like cosmetic surgeon, plastic surgeon, and cosmetic dermatologist have seemingly become interchangeable, but the qualifications of such doctors can vary greatly. Because there is very little regulation governing how doctors refer to themselves, understanding your provider's board certification(s) can ensure you are consulting with a doctor or surgeon who is actually trained in plastic and reconstructive surgery, otolaryngology, ophthalmology, or dermatology (i.e. the specialties that most relate to aesthetic medicine).

How Doctors Become Board Certified

The American Board of Medical Specialties (ABMS) is comprised of 24 certifying boards that are known as the Member Boards of ABMS. Specialties range from internal medicine to radiology, and while it's pretty straightforward that a pediatrician would be certified by the American Board of Pediatrics or a gynecologist would be certified by the American Board of Obstetrics and Gynecology, gaining certification in aesthetic medicine is less clear.

Sure, there is an American Board of Plastic Surgery (ABPS) and American Board of Dermatology (ABD) that offer subspecialties in hand surgery, dermatopathology, and pediatric dermatology, but there are no member boards for specialities like oculoplastic surgery or cosmetic dentistry. Further complicating matters is the fact that there are board certifying organizations that exist outside of ABMS. While some have standards that are as rigorous as the written and oral examinations Member Boards administer, not all do.

When choosing a provider to perform a cosmetic procedure or cosmetic surgery, look for a specialist in the following categories:

Plastic and Reconstructive Surgery

General plastic and reconstructive surgeons complete three to five years of general surgery training followed by a two to three year cosmetic and reconstructive plastic surgery residency. Plastic and reconstructive surgeons can pursue board certification via the American Board of Plastic Surgery, and they may be dual-certified by the American Board of Surgery (ABS). While they are board certified to perform cosmetic and reconstructive surgeries on the face and body, their work often focuses on the breasts and body.

Facial Plastic and Reconstructive Surgery

After completing a five-year residency in otolaryngology (a.k.a. ears, nose, and throat), facial plastic and reconstructive surgeons pursue year-long fellowships in cosmetic and reconstructive procedures specifically related to the face and neck (think: rhinoplasties, facelifts, chin and jaw surgeries, etc.). While there is no ABMS Member Board specifically for facial plastic and reconstructive surgery, they should be board certified by the American Board of Otolaryngology – Head and Neck Surgery (ABOTO). The American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) is also an accreditation that many facial plastic surgeons seek.

Dermatology

Medical dermatologists diagnose, treat, and prevent conditions affecting the skin, hair, and nails. While there are subspecialties within the field, all dermatologists board certified by the American Board of Dermatology undergo non-surgical, cosmetic dermatology training during their residency program. Dermatologic surgeons (i.e. those qualified to perform liposuction, fat transfer, and Mohs surgery, in addition to non-invasive treatments) are often fellows of the American Society for Dermatologic Surgery (ASDS). Asking to see before-and-after photos and inquiring as to how often they perform certain cosmetic treatments and procedures will shed further light on their aesthetic expertise.

Oculoplastic Surgery

While a facial plastic surgeon is able to perform eyelid surgeries (like blepharoplasty), oculoplastic or oculofacial surgeons are experts in procedures that reconstruct the eyelids, tear ducts, and orbital area. They should be board certified by the American Board of Ophthalmology (ABOP) and have additional fellowship training with the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS).

Fellowships & Societies

Doctors who wish to further specialize in a particular area of medicine may choose to continue their training and education via a fellowship. Fellowship programs are often highly competitive and last one to three years each. Due to the lack of ABMS Member Boards in certain subspecialties, fellowships may be used to denote expertise. An ophthalmologist who wishes to subspecialize in oculoplastic surgery, for instance, would complete a two-year fellowship through the aforementioned ASOPRS.

Society memberships, meanwhile, offer another way (separate from licensing, board certification, and fellowships) for providers to continue their education, in addition to offering mentoring and networking opportunities. Below are some of the academies and societies related to aesthetic medicine, cosmetic surgery, and dermatology:

• American Academy of Aesthetic Medicine (AAAM)
• American Academy of Cosmetic Dentistry (AACD)
• American Academy of Cosmetic Surgery (AACS)
• American Academy of Dermatology (AAD)
• American Academy of Facial Plastic & Reconstructive Surgery (AAFPRS)
• American Society of Aesthetic Plastic Surgery (ASAPS)
• American Society of Cosmetic Laser Surgery (ASCLS)
• American Society for Dental Aesthetics (ASDA)
• American Society of Dermatologic Surgery (ASDS)
• American Society of Hair Restoration Surgery (ASHRS)
• American Society of Liposuction Surgery (ASLS)
• American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS)
• American Society of Plastic Surgeons (ASPS)

While these affiliations are voluntary, a doctor may display their memberships as an indicator of interest and engagement in their specialty.

The Takeaway

There is perhaps no more important task in your aesthetic journey than finding the right physician to perform your cosmetic surgery procedure, and understanding the board certification process is a key part of that. While all the certifications, licenses, and credentials in the world cannot guarantee results, knowing that your doctor specializes in the procedure you are interested in is the first step toward ensuring you get the best care for your needs.