Who is a facial plastic surgeon? Multiple Board Certifications.. I'm Confused.

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Facial plastic surgery has emerged as a transformative field, offering individuals the opportunity to enhance their facial features and regain confidence. As the demand for facial rejuvenation procedures continues to rise, it is essential for prospective patients to understand the distinction between surgeons that perform facial plastic surgery.  In this blog, we will delve into the realm of facial plastic surgery, explore the nuances of each specialty, and empower readers to make informed decisions about their aesthetic goals.

I. Understanding Facial Plastic Surgery:

Facial plastic surgery encompasses a range of procedures designed to enhance or restore facial features. These can include rhinoplasty, facelifts, eyelid surgery, and various non-invasive treatments like Botox or dermal fillers.  In addition the entire field of reconstructive facial plastic surgery such as restoration of defects created surgically for treatment or cancer or traumatic injuries can also be considered facial plastic surgery.  The primary goal of all facial plastic surgery procedures is to achieve natural-looking results that harmonize with the patient's overall facial aesthetics.  Facial plastic surgery equals plastic surgery on the face.  

II. So what exactly is a Facial Plastic Surgeon:

It follows that a facial plastic surgeon is a surgeon that operates on the face.  In practice this can depend on whether the public or surgeons are discussing the term.  The public typically would consider a facial plastic surgeon as a surgeon that only performs procedure on the face and most commonly understood those procedures would be for purely cosmetic purposes.

Surgeons, on the other hand, will usually understand the otolaryngologists that have done additional fellowships in aesthetic facial plastic surgery will present themselves as facial plastic surgeons.  This is certainly appropriate given otolaryngolists typically receive wide training of head and neck procedures typically in excess of plastic surgeons when in comes to intranasal, intraoral, inner ear which are usually exclusive territory to otolaryngolists.

Education and Training: Facial plastic surgeons undergo a residency in Otolaryngology-Head and Neck Surgery followed by additional fellowship training in facial plastic and reconstructive surgery. This specialized training equips them with a deep understanding of facial anatomy and aesthetics.

What about plastic surgeons?

Board-certified plastic surgeons encompass a broad spectrum of procedures, including those related to the entire body. They are trained to perform surgeries ranging from breast augmentation to body contouring, facelift, eyelid, rhinoplasty, etc and also facial reconstructive procedures and or trauma reconstruction.

Education and Training: Board-certified plastic surgeons complete a either a comprehensive residency in general surgery/otolaryngology/orthopedics (5 years) followed by specialized training in plastic surgery (3 years) or complete a plastic surgery residency immediate following medical school (6 years).  This extensive training provides them with a holistic understanding of the entire body's anatomy and aesthetics.

Versatility: Board-certified plastic surgeons have the versatility to address various aesthetic concerns beyond facial procedures. Their expertise extends to body contouring, breast augmentation, and reconstructive surgeries.

So in short there are several "types" of surgeons that a qualified to perform facial plastic surgery.  I as a board certified plastic surgeon feel very comfortable performing facial plastic surgery.  This is due to extensive reconstructive experience including skin cancer reconstruction, trauma reconstruction (that I continue in small amounts presently) and a focus of my aesthetic practice especially under local anesthesia.  I feel very comfortable performing deep plane facelift, browlifts, necklifts, eyelid lifts under local anesthesia in our Austin office routinely.  This is not because I do not have privileges at a surgery center or hospital.  I have numerous.  But facial procedures under local anesthesia has minimal risks and what really is different is the amount of swelling versus when performed under a general anesthesia is remarkedly better.

A. The Artistry of Rhinoplasty:

One of the cornerstones of facial plastic surgery is rhinoplasty, a procedure aimed at reshaping the nose for functional or aesthetic purposes. Skilled facial plastic surgeons possess a nuanced understanding of facial proportions, ensuring that rhinoplasty results not only enhance nasal aesthetics but also complement the entire facial structure.  In my practice I am happy to evaluate patients for rhinoplasty and discuss in details what surgical maneuvers are needed to produce each desired change.  I also know the limitations of what I am comfortable and will certainly have no shame in asking for help from other local surgeons for any unusual or truly challenging redo rhinoplasty cases.

B. Facelifts: Rejuvenating the Aging Face:

Facelifts have become synonymous with turning back the hands of time. Expertise in this area involves addressing sagging skin, wrinkles, and loss of facial volume. A facial plastic surgeon's proficiency lies in creating natural-looking outcomes that reflect the patient's unique facial characteristics.  The techniques change over time and are mostly categorized by how "deep" the facial tissue are separated.  

A subcutaneous facelift is the oldest technique and involves separating the skin from the deep layers pulling it back to around the ears and cutting out excess skin.  In all but the rarest of cases this form of facelift is no part of the modern approach.  

Then we have plication techniques which involve separating the skin and placing deep stitches to the superficial muscle layer to pull this layer back or up for the effect.  The skin is then cut but without tension.  Certainly an improvement over skin only techniques but the facial ligaments are not cut or released which can result in recurrence of sagging of facial tissues.  

Finally we have deep plane techniques which involve separating the skin, and then separating the SMAS or superficial muscle layer above the deeper structures.  This also involves cutting though the ligaments that suspend the facial tissues which allows for repositioning of the facial tissues without being held to the bone or muscles/fascial.  The deep  plane is potentially a dangerous area to work in because the nerves, vessels, and ducts exist at this level.

My own personal technique is refined continuously but I favor a deep plane face and necklift, with fat grafting, and extensions to the lateral brow when needed.  The face skin can be resurfaced if necessary and additional techniques such as eyelid lifts, lip lifts, rhinoplasty can be performed as needed.

C. Eyelid Surgery – Precision and Detail:

Eyelid surgery, or blepharoplasty, demands a delicate touch to address issues such as drooping eyelids or bags under the eyes. Facial plastic surgeons specialize in the intricacies of eyelid surgery, preserving the patient's youthful appearance and improving overall facial harmony.  Occuoplastic surgeons are ophthalmologists that have also undergone additional training in aesthetic and function surgeries on the eyelids and surrounding areas in addition to plastic surgeons that perform eyelid surgery.

III. Making Informed Decisions:

As patients contemplate facial plastic surgery, it is crucial to align their goals with the expertise of the chosen surgeon. Key considerations include:

A. Desired Procedures: Does your surgeon possess appropriate training and experience to determine the best surgery to achieve your goals.  Do they perform adequate number of procedures to get reproducible results.

B. Experience and Track Record: Researching the surgeon's experience and reviewing before-and-after photos of previous patients can provide insights into their proficiency in achieving desired outcomes.  Spend time reading reviews.  Many reviews are standard 5 stars without much substance but you will find some highly personal reviews that can lend insight into the surgeon's style and demeanor which is important.

C. Board Certification: Ensuring that the chosen surgeon is board-certified by reputable organizations such as the American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery instills confidence in their qualifications.  Being double or triple board certified can certainly be impressive on casual inspection however we are really interested in board certification by relevant boards.  For example stating your are board certified in general surgery and plastic surgery that's great if your having a general surgery procedure.  If your having a plastic surgery procedure than I am interested in board certification in plastic surgery.


Facial plastic surgery is a dynamic field that empowers individuals to enhance their facial aesthetics and embrace newfound confidence. Understanding the nuanced differences between facial plastic surgeons/board-certified plastic surgeons/and or occuloplastic surgeons is important in making informed decisions aligned with individual goals. In a city as big as Austin, you will find surgeons referring to themselves as facial plastic surgeons, aesthetic plastic surgeons, cosmetic surgeons, occulplastic surgeons, plastic surgeons, etc.  By delving into the intricacies of each specialty, prospective patients can embark on their facial rejuvenation journey with confidence, knowing they have chosen a skilled and specialized professional to guide them through the transformative process.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.