Does or did it matter if your PS was a member of the ASBPS vs. ASPS?

My journey continues. Today I saw a PS who thinks I only need a abdominoplasty, no anchor cut. The first PS I saw thought I needed that as well as a LBL and would do an anchor cut. Both of these consults were ASPS members. The one I see tomorrow is a member that PLUS the ASBPS ( B is for Bariatric Plastic Surgeon).

Did you find any difference in your PS being a member or fellow of Bariatic PS? Does it really matter?

Thanks for any advice or information you can share. I am confused how the recommended courses of surgery could be so different.

Diana

I consulted with both types.  I went with a non-bariactric surgeon because he had the best plan for my work.  I think he's probably the one of the very best surgeons in town.  After four rounds of plastics, my surgeon's work  has been completed to a state of near perfection.  He has always exceeded my expectations. 

As for conflicting advice, I encountered the same thing during my consult phase.  I shared these opinions from other consults with my current surgeon during our first consult.  He expained why his plan for me would work better and what the shortcomings were of the other approaches.  It made sense to me and I knew that he was right. 

Diana, I've done quite a bit of research on qualifications, including reading a book by a plastic surgeon whose own opinion was that, even though she is a member of the ASPS, societal memberships are basically worthless in determining a surgeon's qualifications.  Boards are the deciding factor.  They are who exhaustively test and interview the doctors and maintain a watch on their continuing education.  Her recommendation is that your plastic surgeon be Board certified by both the American Board of Surgeons (ABS) and the American Board of Plastic Surgeons (ABPS).  She cautions that any surgeon can perform reconstructive surgery, and all plastic surgeons are reconstructive surgeons, but not necessarily cosmetic surgeons.  She likened the difference to the fact that a reconstructive surgeon can put anything back together.  It's a cosmetic surgeon who has the skill and takes the time to make it look the best.

My bariatric surgeon gave me a prepared list of cosmetic surgeons in the central Maryland area.  He told me they are all good or they wouldn't be on his list, but if I wanted someone who had both the utmost skill in cosmetic surgery after weight loss and the best bedside manner, Dr. Larry Lickstein was his recommendation.  I went to one of his seminars, scheduled a consult (he spent a leisurely one hour with my husband and me - no rushing whatsoever), and I never looked back.  I am having a circumferential body lift and breast mastopexy on December 11.  I am as confident that he is the cosmetic surgeon for me as I was that Dr. Moein was the bariatric surgeon for me.  I think if you get that comfort/confidence level, coupled with having investigated their experience (before and afters, recommendations), and the recommendation from your bariatric surgeon, you've likely found that special doc.  I really think you know in your heart.  Don't ru**** don't base your decision purely on cost.

Hope this helps.

Terri

Thank you both BigCityGirl and Terri for your most informative and helpful replies.

Diana

As for differing opinions, that is common and I can only say that you should seek several  consults and look at before and afters of individuals who look like you.  The more aggressive surgeries generally produce better results and more complete correction, but at the expense of more scars and more surgery.  Each patient has to decide on this.  I see patients who could have a body lift, but basically decide that the buttock and hip correction is not worth the extra work/time/scars.

As for membership societies, the best answer is that they vary highly in their requirements. The ASPS is far from "worthless" and actually requires maintaining continued medical education couses at a higher level than many states require. They also enforce ethical guidelines in advertising at a level much higher than most states require.

Notice my web model photos say "model" and actual patients are labelled as such.  That's an ASPS rule. So is the disclosure box that keeps the nude images a few clicks away and requires a disclosure before viewing.

ASBPS has less stringent requirements.

Both societies require board certification, and I agree that a board-certified PS should be your baseline requirement. 

My personal definition and experience define post-WLS PS is a reconstructive and not a cosmetic procedure.  Here's how post-WLS PS differs from an average cosmetic procedure:

-It's correcting a deformity, so you have to understand the deformity.  Post WLS skin excess is a complex defomity requiring innovative techniques.  UBL is a prime example here...the operation wasn't even invented until recently, and is done differently by many of us. http://www.drlomonaco.com/houston-upper-body-lift.shtml

-Post-WLS plastics has a much higher risk profile than the average beauty procedure, and requires greater training and experience on the part of the surgeron.

-It requires far more technical skill than a cosmetic procedure with large amounts of skin being  removed and re-draped.

-It requires  a far greater understanding of things like hernias, nutritonal alterations, prior scars, port placements, and psychological factors, etc. than the average cosmetic procedure.

Remember, a dermatologist, family practice doc, Ob-Gyn, or any doc can call themselves a "cosmetic surgeon" in most states.  The so-called "American Board of Cosmetic Surgery" is a non-accredited board  that is not recongnized by the ABMS.

Hello Dr. L:

Just curious ... would you say that a FL on a post WLS pt. should also be done by a PS experienced in WLS patients?  Or, when it comes to the "average" face of a WLS pt., that's an exception that most PS who excel at FL can handle? 

Hi Slowgoing.  Excellent point. 

The techniques for facelift are NOT going to be all that different for WLS patients, the healing issues are much less of a factor, and there simply hasn't been a need to develop the same kind of new an innovative techniques for the face as we have for the body.

I will do standard facelifts, but I refer out patients who want eyes, nose, brow, and face done all at once to an ENT-facial expert.  Board-certified of course !