You want the best result, and the best surgeon. How can you tell? Truthfully, the surgeon with the highest standards for his or her own performance reliably holds the highest standards across the board. The best surgeon will have the highest level of training and certification, and will offer you the best care, and likely the best result.
So how can you know? Plastic surgeon or cosmetic surgeon? The differences may surprise you. Because of common misconceptions surrounding cosmetic plastic surgery, you should understand what’s behind the scrubs and the white coat.
Operations that improve the human body are called Plastic Surgery after the Latin plasticus: that may be molded. The two types of plastic surgery are reconstructive surgery, after injuries, and aesthetic (cosmetic) surgery, to improve appearance. Cosmetic surgery is only a part of plastic surgery, but to perform it well, the physician must be fully trained in the entire specialty.
1. All plastic surgeons are cosmetic surgeons but not all cosmetic surgeons are plastic surgeons.
Board Certified Plastic Surgeons have more training and ARE qualified to perform both reconstructive and aesthetic/cosmetic surgery.
A Cosmetic Surgeon is NOT certified to perform plastic/reconstructive surgery.
2. The American Board of Plastic Surgery (ABPS) is the ONLY board approved by the American Board of Medical Specialties (ABMS), which accredits surgical training programs.
Plastic Surgeons ARE certified by the American Board of Plastic Surgery (ABPS).
The American board of Plastic Surgery does NOT acknowledge Cosmetic Surgeons.
3. Don’t all certifying boards have high standards? My surgeon said he’s board certified.
Confirm not only that that your doctor is “Board Certified,” but that he/she is certified by the American Board of Plastic Surgery (ABPS).
Cosmetic Surgeons who claim to be board-certified may have received their certificate from the American Board of Cosmetic Surgery; the American Board of Medical Specialties (ABMS) does NOT recognize this board.
4. Is my surgeon trained to perform my surgery?
After graduating medical school, a Board Certified Plastic Surgeon must be selected among many applicants for residency training in Plastic Surgery. If chosen, the physician learns how to be a surgeon for three to five years, then trains for at least three more years in plastic surgery. Training involves closely supervised continuous evaluation and management of many complex clinical situations, and matures the surgeon personally and professionally. Successful completion of the post-graduate residency years qualifies the surgeon for written and oral examinations administered by the American Board of Plastic Surgery. Surgeons must submit an entire year of his or her surgical accomplishments for the exam. Surgeons are not eligible for the exam until they have been practicing plastic surgery independently for two years or longer.
There are no such requirements for Cosmetic Surgeons. Cosmetic surgeons are doctors who merely decide to perform cosmetic surgery in their practice. The may be certified in any medical specialty such as a gynecology, dermatology, family physician, ear,-nose-throat, etc. Their training may consist of several short weekend courses to a one-year cosmetic surgery fellowship.
5. Why do hospitals and surgery centers only allow doctors certified by the American Board of Plastic Surgery(ABPS) to perform cosmetic procedures?
Because they know the difference! Board Certified Plastic Surgeons CAN perform both reconstructive and aesthetic/cosmetic surgery in hospital or outpatient surgery centers.
Cosmetic Surgeons are NOT privileged for cosmetic surgery at these facilities and are not allowed to perform reconstructive plastic surgery. For this reason, cosmetic surgeons usually perform surgery in office based operating rooms.
6. The American Society of Plastic Surgeons (ASPS) embraces excellence in plastic surgery. Education, research, intellectual exchange and promoting unity are core values.
Only doctors certified by the American Board of Plastic Surgery(ABPS) can become a member of the American Society of Plastic Surgeons (ASPS)
7. The American Society for Aesthetic Plastic Surgery (ASAPS) is an exclusive privilege and requires proven excellence in aesthetic/cosmetic plastic surgery.
- Members MUST be certified by the American Board of Plastic Surgery(ABPS).
- Participate in accredited Continuing Medical Education (CME) programs.
- Document the performance of a significant number and variety of cosmetic surgical cases to demonstrate a wide range of experience
- Be sponsored by two ASAPS-members to ensure that the applicant’s professional reputation meets the high standards required by The Aesthetic Society.
- Abide by ethical standards for professional conduct outlined by the Society’s Bylaws, Code of Ethics, and Conflict of Interest Policy observed by all ASAPS members.
ASAPS does not offer membership to doctors who are trained in specialties other than plastic surgery; therefore Cosmetic Surgeons do NOT meet these requirements.
For cosmetic surgery, your safest choice is a surgeon certified by the American Board of Plastic Surgery who is also a member of the American Society of Plastic Surgeons and/or the American Society of Aesthetic Plastic Surgeons. Quality is the difference.
Better understanding of aging anatomy is heralding a NEW era of smaller, safer, easy recovery plastic surgical procedures with long lasting changes that essentially prevent an aged appearance for your entire adult life. Even in your sixties, seventies, and eighties, with annual, bi-annual, or semi-annual maintenance and attention to smaller procedures, men and women can manifest youthful vibrance and allure. You’ll NEVER lie about your age, your appearance will do it for you.
Gravitational settling of facial soft tissue is managed by segmental (minor) lifts rather than a full face and neck lift. Cheek lift, temporal brow-lift, eyelid-lift, ear-lobe lift are all office procedures. Even minor face and neck lift operations can be performed safely and comfortably in the office while you’re awake and relaxed. Some skin sagging is corrected by removal and re-arrangement of descending tissue. Examples of this are jowl removal ,lip-lift, and “anguloplasty” (corner of lip lift) procedures. Skin wrinkling can be treated by laser or by filling with fat or off-the-shelf products. Hollows on the aging face create shadows that send a signal of darkness, depression, and sadness. Others interpret this as hostility and avoid you. The face should reflect light, and be bright. Small implants, fat grafting, minor surgical lifts, and off the shelf fillers re-shape surface contours to reflect light in a youthful way.
Subtle improvements offer the added advantage that others notice you look good, but don’t really know that something was done. You still look like yourself, but younger. Although major rejuvenation still requires a trip to the operating room for general anesthesia, Dr. Steve Laverson, a San Diego Plastic Surgeon, performs many improvements in the office under local anesthesia. Among these minor enhancements, he includes brow-lift, upper and lower eyelid lifts, cheek-lift, minor nose re-shaping, lip shaping and lip lifting, facial fat transfer or filler, neck liposculpture, jowl removal, laser skin smoothing and wrinkle removal, laser skin tightening, and others.
Procedures to maintain youth are secondary to healthy lifestyle, especially moderate diet and regular exercise. Cosmetic and plastic surgery are most effective in the context of ideal body weight and overall fitness.
Choosing minor procedures doesn’t mean they can be performed well by a “minor” cosmetic surgeon. Certification by the American Board of Plastic Surgery means your plastic surgeon has met the highest standard for his or her own performance, which increases the chance that he or she will hold himself or herself to the highest standard for your care and your result.
Dr. Steve Laverson is certified by the American Board of Plastic Surgery, is a member of the American Society of Aesthetic Plastic Surgeons, the American Society of Plastic Surgeons, a fellow of the American College of Surgeons, and has been in practice in North San Diego County since 1993. For consultation, call his Encinitas office at 858-295-4001 or visit feelbeautiful.com.
Innovative approaches for preventing and controlling pain after cosmetic surgery may be combined to help patients tolerate procedures as much as they will enjoy the result. New methods we incorporate include:
1. Surface (topical) anesthetics before skin injection: These can include Ethyl Chloride, a fine spray that instantaneously freezes the skin, overwhelming nerves that transmit pain impulses with sensation of cold so that subsequent painful stimulus is not recognized. Also, local anesthetics such as benzocaine, prilocaine, lidocaine, and tetracaine are now formulated into creams or gels that promote better penetration through your skin surface to create numbness in the area to be treated. These applications are spread over the area to be treated 20-30 minutes beforehand to allow absorption into the skin. Covering the skin with plastic wrap prevents evaporation, and may improve effectiveness. These skin anesthetics are popular before cosmetic laser and injectable enhancements.
2. Regional anesthetics: These include injection of local anesthetics to neutralize a specific sensory nerve that transmits pain from a specific area of the skin. Lips are among the most highly sensitive areas of your face and body, so this method is valuable before lip augmentation with filler. Dr. Laverson uses topical anesthetic on the skin, then carefully numbs the specific nerves that supply sensation to your lips. This allows completely pain free lip enhancement. Filler must be placed well within the substance of the lips, and topical (surface) anesthetic doesn’t penetrate deeply enough to sufficiently numb your lips without addition of a regional anesthetic to block pain impulses.
3. Cannulas for injection instead of needles: Blunt tipped fine sterile cannulas are now marketed to allow distribution of cosmetic injectables within the face or body without painful needles. These cannulas offer the added benefit of avoiding nerve or blood vessel injury. Sharp needles more easily cut small nerves and vessels beneath the skin, leading to bruising and other side effects. Blunt tipped cannulas, when carefully used, are more likely to push aside these structures, allowing injection to proceed with less trauma to surrounding tissues.
4. Long acting local anesthetics: Use of injectable anesthetics and/or anesthetics to moderate pain for as long as three days after surgery is available thanks to Pacira Pharmaceuticals’ introduction of Exparel®. Now FDA approved, this long acting local anesthetic (bupivacaine) is packaged biochemically as a “liposomal suspension” (within tiny lipid globules) for slow release. Exparel® can be distributed within your tissues before surgical closure. While not totally eliminating post-surgical pain, your discomfort may be reduced to a much more tolerable level. Use of Exparel® may diminish your dependence on narcotic analgesics such as morphine, oxycodone, meperidine, hydromorphone, and hydrocodone, all of which have undesirable side effects.
5. Nausea prevention: One cannot discuss advances in pain control without mentioning nausea prevention. The classically most effective analgesics are narcotic medications which promote nausea, easily their most miserable side effect. First off, if you are nauseated after rhinoplasty, breast implants, or tummy tuck, you’re unable to hold down pain medicine. You’re not only nauseated, but in pain, a difficult combination. Second, if you’re vomiting after nose, face, breast, or liposuction surgery, the entire experience of aesthetic enhancement becomes tainted with bad memories. We plastic surgeons want to prevent nausea and vomiting as much as possible, knowing that if you are miserable, you’re less likely to come back for more. The introduction of anti-nausea medications such as ondansetron (Zofran®), aprepitant (Emend®), scopolamine skin patch (Transderm SCOP®), and alvimopan (Entereg®) combined with traditional anti-nausea treatments droperidol, metoclopramide, and others offer much improved pain control by narcotics and a better surgical experience.
6. Finally, discovery and use of non-narcotic analgesics are helping. Intravenous acetaminophen (Ofirmev®) given toward the end of major surgery, ketorolac (Toradol®) in the recovery room, and tramadol extended release (Ultram® ER) at home to supplement narcotic medications offer significant relief with minimal side effects. Also, muscle relaxers such as Carisoprodol (Soma®) are useful.
Elle Magazine calls out the biggest factor that reveals your age: Your NECK! Elle tells us to forget about crow’s feet and frown lines– our jaw and neck might reveal more about our age than we realize.
In their February issue, Elle introduces ThermiRF as the new go-to technology that helps melt the “double chin” fat and tighten surrounding loose skin.
Feel Beautiful Plastic Surgery is privileged to introduce the ThermiRF aesthetic system to Encinitas. ThermiRF is the first FDA approved aesthetic technology system that generates controlled radiofrequency (RF) energy (radio waves) for tightening the skin surface and reducing fat anywhere on the face or body.
Dr. Laverson serves on the Clinical Advisory Board and is now practicing this new technology in skin tightening, cellulite reduction, fat melting, body contouring, and wrinkle reduction. All procedures are non-invasive or minimally-invasive with little to NO downtime.
“This is an extremely effective procedure for people that are interested in seeing great results without going into the operating room. By using radio frequency, I am able to use exact precision in a safe environment to achieve desired cosmetic results,” said Dr. Steve Laverson, Plastic Surgeon of Feel Beautiful Plastic Surgery.
If you’re ready to put your best chin forward, we’re here to help. 858-295-4001
Although research by London School of Economics Reader Satoshi Kanazawa has positively correlated beauty with intelligence and Timothy Judge, PhD, at the University of Florida has proven that feelings of self-worth and salary both correlate with objective measures of beauty, until now we’ve never understood from a neurological standpoint why these correlations exist.
We know that humans have a strong preference for attractive faces, but why is it that humans judge attractive people to be more friendly, honest, and intelligent? New research suggests that multi-tasking by specific regions of the brain may be responsible for this correlation. Takashi Tsukiura and Roberto Cabeza of Duke University used functional-MRI (magnetic resonance imaging) to prove increased activity in the medial orbitofrontal cortex, a reward center of the brain, when subjects viewed attractive faces and when they made “goodness judgments” about hypothetical actions. Reciprocal levels of activity were seen in the insular cortex of the brain. Because the same brain area interprets beauty and behavior of others, we correlate the two. On the other hand, because attractive people have increased sense of self worth and confidence, perhaps their personalities tend to be more socially desirable. Correlation between beauty and personality characteristics may thus be learned as well as innate.