Cosmetic vs. Plastic Surgery

Plastic surgery training involves a broad scope of procedures to restore the body’s normal appearance and function, where cosmetic surgery training focuses exclusively on aesthetic procedures. Yet many plastic surgeons offer cosmetic procedures at their practice. This may leave you wondering, how does cosmetic surgery differ from plastic surgery? 

Each kind of surgeon undergoes different training, and while there are many skilled, well-trained cosmetic and plastic surgeons, learning the difference can help you make sense of each surgeon’s credentials and experiences.

What is cosmetic surgery?

Cosmetic surgery includes surgical procedures intended to enhance the appearance, whether by adjusting the proportions of the face or body, augmenting certain features, or improving symmetry.

Cosmetic procedures are elective, meaning that patients decide to undergo these procedures on areas of the body that do not require an improvement in function. Cosmetic surgeons are trained in aesthetic principles, and facial cosmetic surgeons, in particular, specialize in aesthetic procedures for the head, face, and neck. While basic surgical training is acquired in residency, the specialty of cosmetic surgery is typically learned post-residency through hands-on experience.

What is plastic surgery?

Plastic surgery is a wide category of procedures that includes both cosmetic surgery and reconstructive surgery. Reconstructive procedures are performed to restore the body’s appearance and function after an injury, illness, or congenital problem. Plastic surgery residency training involves a number of required plastic and reconstructive surgeries, of which cosmetic procedures and principles are a part. Training in plastic surgery is typically received during medical residency.

Cosmetic vs. plastic surgery

1. Plastic and cosmetic surgery share many surgical techniques and tools.

The techniques used by plastic surgeons to restore the body’s appearance and function are often similar to those that cosmetic surgeons use to improve the body’s appearance. For example, cosmetic breast augmentation is a sought-after procedure that shares similarities with breast reconstruction after cancer, a core procedure in plastic surgeons’ training.

2. Plastic or reconstructive surgery may be covered by insurance, but cosmetic procedures are not.

Reconstructive plastic surgery may be deemed medically necessary, but cosmetic surgery is nearly always elective, which means that the patient chooses to undergo a procedure even though it is not typically deemed critical for the patient’s health by insurance companies.

3. Plastic and cosmetic surgeons hold different board certifications.

Plastic and reconstructive surgery training is often acquired in a medical residency. Post-residency, surgeons furnish evidence of their required clinical experience in order to be board certified by the American Board of Plastic Surgery (ABPS).

Plastic surgery board certification requires these steps:

  • Medical school
  • Residency training in plastic and reconstructive surgery

Cosmetic training is acquired in post-residency fellowship. General cosmetic surgeons may hold board certification from the American Board of Cosmetic Surgery (ABCS), while those who specialize in facial cosmetic surgery hold board certification from the American Board of Facial Cosmetic Surgery (ABFCS), which certifies cosmetic surgeons who specialize in cosmetic procedures of the head, face, and neck. All ABCS and ABFCS board-certified cosmetic surgeons are required to hold a primary board certification in another surgical specialty, as well.

Cosmetic surgery board certification requires surgical training followed by extensive, documented experience with cosmetic surgery. There are two routes by which a surgeon may become a board-certified cosmetic surgeon. For one, surgeons may begin with medical school:

  • Medical school
  • Residency
  • Primary board certification in residency area
  • Cosmetic surgery fellowship training or extensive facial cosmetic surgery experience
  • Successfully pass the board certification exam

Additionally, oral and maxillofacial surgeons may become board-certified facial cosmetic surgeons through the following route:

  • Single degree (DDS or DMD) or dual degree
  • Completion of an accredited oral and maxillofacial surgery residency
  • Board certification through the American Board of Oral and Maxillofacial Surgery
  • Cosmetic surgery fellowship training or extensive facial cosmetic surgery experience
  • Successfully pass the board certification exam

4. Board-certified cosmetic surgeons specialize in aesthetic procedures, while board-certified plastic surgeons may study a broad range of surgeries.

Board-certified cosmetic surgeons either train in a 1-2 year post-residency fellowship that concentrates solely on cosmetic procedures or demonstrate equivalent rigor through their practice experience. Before being eligible to sit for the board exam, surgeons are required to perform a minimum number of common cosmetic procedures that shows they are specialists in the necessary procedures.

Plastic surgery training during medical residency involves reconstructive procedures to improve function and restore appearances after injury, illness, or a congenital disorder. While cosmetic procedures are addressed during this training, it is not the sole focus; aesthetic training is only one of 12 categories of procedures included in the training requirements to become board-certified by the American Board of Plastic Surgery (ABPS), including burn reconstruction, surgery of the hand, and craniomaxillofacial trauma surgery. While some plastic surgeons may pursue post-residency fellowships to specialize in cosmetic surgery, additional training is not required for board certification.

Choose a surgeon with experience and training in your desired procedure.

Your surgeon is the first and most influential choice you make when it comes to cosmetic surgery. A licensed physician from any specialty may legally perform cosmetic procedures, so it is key to do your homework and choose a surgeon who not only specializes in your desired procedure, but also has the right credentials. If the procedure you seek is cosmetic in nature, then choosing a cosmetic surgeon means that your surgeon’s focus is on safely achieving a sound aesthetic outcome. Read more about how to choose a cosmetic surgeon.