Having just completed my Plastic Surgery Board re-certification test this past weekend, I am again reminded of the vast amount of knowledge it takes to be a well-qualified cosmetic plastic surgeon and it reiterates in my mind how those who are not Board Certified in Plastic Surgery cannot safely perform these kind of procedures.  Plastic Surgery Board re-certification is actually a “maintenance of certification” process that culminates in a “final exam” every 10 years.  Every 3 years our Board analyzes ”tracer” procedures, or surgical cases (anonymously, of course), that we submit to them to review.  We also must have a certain number of ”continuing medical education” hours,  including designated “patient safety” hours.  We must continually update the Board on our medical license status and hospital privileges.  We must submit peer evaluations and complete a plan for improvement based on our surgical outcomes.   They even review our website and any advertising material to ensure it meets ethical standards.  In the 10th year of the cycle we submit a  case log of every surgery we performed in the previous 6 months, including any complications, in order to be accepted to sit for the “final exam”.  The exam is four hour test based the particular area of focus of our practice i.e. cosmetic surgery (in my case), or hand surgery, or craniofacial surgery.  I realize most of you don’t really care about the details, but I want to emphasize the extreme amount of oversight necessary to be certified by The American Board of Plastic Surgery.   Do you think the family practitioner or dermatologist performing Smart Lipo in their office or even the OB-Gyn or anesthesiologist giving Restylane or Botox injections have this level of accountability?  The answer is absolutely not.  They would not even be granted hospital privileges in these procedures because it would be too big of a liability for the hospital.  Unfortunately there isn’t anyone out there to stop them from doing it as long as they have an M.D. behind their name.  Our Board is the only board that has a designated cosmetic surgery exam like the one I took this past weekend, and I would speculate that any other non-plastic surgery physician would not pass that exam.  Just something to think about before you choose your doc for cosmetic procedures.