I once bought the DVD “Spider-man” from a street vendor in New York. The movie was still in the theaters and although I felt unlikely that this was legit, it was only $5. To my surprise, the movie was actually on the DVD. It was a low quality home video obviously taken by a patron of the movie. The gentleman’s head in the row ahead cut out the bottom third of the screen. Clearly, “knock-offs” are rarely the same quality as the original.
I should have known better. The gentleman who sold me the movie kept his movies in a “pack and run” blanket and kept looking nervously over his shoulder.
Unfortunately “knock-off” cosmetic surgeons do not tip their hand as easily. Years ago, a patient simply had to make sure that their plastic surgeon was board certified to be safe. I can assure you that this is no longer the case. There are thousands of physicians doing plastic surgeons who are “board certified” but have no training in plastic surgery.
I received a fax last week from the American Board of Cosmetic Plastic Surgery offering me “certification” by their board. Their requirements for certification were 1) be a physician, 2) have a pulse, 3) send an application and 4) have $300. I would receive a beautiful framed certificate to hang proudly in my office. For an additional $200 I would be given the title Fellow of the American College of Plastic Surgeons. There is virtually no training prerequisite. These are meaningless titles.
The largest such board is the American Board of Cosmetic Surgery. Their website has the audacity of implying that a “cosmetic surgeon” has specialized training above and beyond that of a plastic surgeon. The criteria to become certified doesn’t have any teeth. You have to be board certified in basically anything else (dermatology, oral surgery, OB/Gyn, family practice…) and send in an application. There is actually a little more to it but not much.
Be very careful if your surgeon uses the term “cosmetic surgeon” at all.
There are dozens of cosmetic surgery boards. There is only ONE board that certifies plastic surgeons. The American Board of Plastic Surgery. This is the only board that is recognized by the American Board of Medical Specialties. The training requirements are strict. The ethical standards are strict. The cosmetic surgery training is balanced and complete.
It is downright sneaky how close to the “American Board of Plastic Surgery” some of these boards have come with their names. An innocent patient when asking about the board status of a cosmetic surgeon could hear “yes, I am certified by the American Board of Cosmetic Plastic Surgery” and think nothing of it. In fact, the name would imply that they are a sub-specialized plastic surgeon in the field of cosmetic surgery. Purposely misleading.
It will unfortunately take a high profile death and exposure by mass media (think Oprah) before the general public will understand the difference.
Taxi drivers are excellent drivers. Their license fortunately doesn’t allow them to fly planes.
Family practice physicians are excellent doctors (my dad is one). Unfortunately, their license does allow them to do cosmetic surgery. Some with poor judgement are attempting it. Scary but true.





















With the announcement that Dysport received FDA approval a few weeks ago, I have been hoping that the price point would be significantly less. Botox is around $450 for a 100 Unit vial. Dysport is around the same price for a 300 Unit vial. Dysport is around 1/3 the price per unit. However, Dysport is approximately 1/3 as potent as Botox. So the cost to the consumer looks like it will be roughly the same.



