• Jean-Paul Abboud, MD, PhD

"Are you a Board-Certified Plastic Surgeon?"

Updated: Dec 8, 2019

I was recently asked by a patient, who was referred to me (by a plastic surgeon) for a droopy eyelid (ptosis), if I were a “board-certified plastic surgeon.” The question is, quite frankly, unsurprising. Over the years, the American Board of Plastic Surgery, which grants board certification to plastic surgeons, and the American Society of Plastic Surgeons have done a fantastic job, not only by ensuring that plastic surgeons are well trained, but also by launching an effective awareness campaign encouraging patients to seek a BOARD. CERTIFIED. PLASTIC. SURGEON. for all their plastic surgery needs.


FOCUS

However, while plastic surgeons are trained in plastic and reconstructive surgery of the whole body, oculofacial plastic surgeon (or oculoplastic surgeons, for short) focus their training and their careers only on the face, with greater emphasis on the eyelids, the brows, the tear drainage system, and the eye socket. For instance, in my practice, 90% of what I manage involves the cosmesis and reconstruction the eyelids, the brows, and the midface.


SURGICAL TRAINING

General plastic surgeons have varied training and experience with eyelid surgery. The American Board of Plastic Surgery’s official Training Requirements documentation states that a rotation in “oculoplastic surgery or ophthalmology” is not one of the “required clinical experiences,” but is rather a “strongly suggested clinical experience.” Most plastic surgery trainees, therefore, receive at most 1 to 2 months of training in ophthalmology, oculoplastics, and eyelid surgery. While there are some plastic surgeons who perform quite a few eyelid cases and are very adept at the surgery, there are others who focus more on the body, such as breasts and liposuction, and perform fewer eyelid procedures.


On the other hand, oculofacial plastic surgeons spend 3 years in ophthalmology residency training focusing on microsurgical techniques of ophthalmic and oculoplastic surgery, and then 2 additional years devoted exclusively to the face, focusing primarily on the eyelids, brows, and orbits (eye sockets). [I additionally spent my intern year training in general surgery at the beginning of my career]. During their training, oculoplastic surgeons perform hundreds of surgeries on the eyelids and brows, and thus gain an intimate knowledge of eyelid and brow anatomy. As such, oculoplastic surgeons are uniquely qualified to repair eyelid ptosis (droop) and to perform complex eyelid reconstructions.


BOARD CERTIFICATION

Oculofacial Plastic Surgery is a sub-specialty within ophthalmology. For various reasons, none of the sub-specialties within ophthalmology receive board-certification. Therefore, the highest level of board certification a surgeon may receive in any ophthalmology sub-speciality, including oculofacial plastic surgery, is certification by the American Board of Ophthalmology. However, the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), the foremost organization that oversees oculofacial plastic surgery in the United States, has recognized the need to distinguish those who have received the rigorous training and have achieved a level of competency to perform oculofacial plastic surgery from those who have not. To ensure quality training, ASOPRS