The plastic surgery profession is both complex and fascinating. These artistic doctors are trained on aesthetic procedures from head to toe—everything from breast augmentations to bodylifts. Many of them complete additional training in subspecialties as well. They’re required to know all the anatomical minutiae of the human body, and they make it look easy. Here’s what it takes to join the prestigious plastic surgeon club, and the best and worst parts of the job, according to surgeons themselves.
Featured Experts
- Carmen M. Kavali, MD, a board-certified plastic surgeon based in Atlanta
- Daniel Hatef, MD, a board-certified plastic surgeon based in Nashville, TN
- Robert G. Bonillas, MD, a board-certified plastic surgeon based in Scottsdale, AZ
The Requirements
A bachelor’s degree. “The road to becoming a plastic surgeon starts with first completing a college degree of your choice,” says Scottsdale, AZ plastic surgeon Robert G. Bonillas, MD. “Many ‘pre-med’ students opt to major in science, but this is not mandatory. In fact, many medical schools like to see applicants from all different backgrounds other than science. Typically, most students complete their college degree in four years.”
Four years of medical school. “Medical school is also four years,” says Dr. Bonillas. “Usually the first half of medical school concentrates on bookwork, and the last half is spent hands-on rotating in various fields of medicine. By the third year or so, those looking to become plastic surgeons start looking into plastic surgery residency programs throughout the country. Usually in the fall of their fourth year of medical school, they will start applying and interviewing for plastic surgery residencies. In March of their last year is the Big Match Day throughout the country. That’s when they find out where they have matched. This will be where they attend their actual plastic surgery training for the next six years beginning in July after graduating from medical school.”
A minimum of six years of residency training. “This includes the full spectrum of plastic surgery, both reconstructive and aesthetic from head to toe,” says Atlanta plastic surgeon Carmen M. Kavali, MD. “It also includes annual written exams and surgical experience.”
Fellowship Training
Additional fellowship training is optional. “Any plastic surgeon finishing an accredited residency training program is fully prepared to practice plastic surgery, including aesthetic surgery,” Dr. Kavali explains. However, some surgeons choose to do more training to further hone specific skills. “Fellowships are available for different subspecialties, such as breast surgery, craniofacial surgery, body contouring, microsurgery, and hand surgery,” adds Dr. Bonillas.
Board-Certification
The American Board of Plastic Surgery is the only accredited board for plastic surgeons. “Board-certification is a rigorous and challenging process,” says Nashville, TN plastic surgeon Daniel Hatef, MD. “It helps ensure that surgeons are safe, consistent and ethical.” Training standards are set by the American Board of Plastic Surgery, which is a member of the American Board of Medical Specialties (ABMS), adds Dr. Bonillas. “This Board has approved medical specialty boards since 1934. It also sets aside those plastic surgeons with legitimate plastic surgery training from those who I call imposters. That is those medical doctors who call themselves ‘board-certified cosmetic surgeons.’ There is no such certifying board within the ABMS. These medical doctors—some not even surgically trained in residency—may be self taught. Or, they have just attended various training seminars on plastic surgery procedures and are perfuming these procedures in their offices without the proper training to do so.”
Tallying the schooling and training, it takes approximately 14 years after high school to become a plastic surgeon.
Dr. Bonillas
What It Takes to Achieve Board-Certification
A written exam. “After finishing residency, the new plastic surgeon sits for the written board examination,” says Dr. Kavali. “This is a six-hour test of our education, training, and knowledge.”
Submission of the surgeon’s cases for approval. “We are under the observation of the Board during a year-long collection period,” says Dr. Hatef. “The Board examines all of our cases and selects the toughest ones to quiz us on.” The Board also ensures that the surgery case list reflects enough diversity, complexity and volume of plastic surgery procedures to adequately assess competency.
An oral exam. “Once the surgeon’s cases are approved, they travel the next fall to complete an oral board examination,” Dr. Kavali explains. “This is a three-day experience. The exam includes some of the surgeon’s own cases, as well as ‘unknown’ cases. The surgeon is expected to create a proper diagnosis and surgical plan for each patient, including discussion of anatomy, surgical technique and management of possible complications. The surgeon is also expected to be able to design more than one surgical option to address each patient successfully. There is no more comprehensive examination process for any plastic surgeon than the one that ultimately creates a surgeon certified by the American Board of Plastic Surgery.”
Once board-certification is earned, the plastic surgeon then enters a continuous certification process. “The surgeon is committing to continue their knowledge through many learning platforms, as well as performing various assessments of their knowledge,” Dr. Bonillas says. “Recertification occurs every 10 years, and this ensures a plastic surgeon’s commitment to life-long learning and adherence to plastic surgery practice standards.”
The Best Part of Being a Plastic Surgeon
“We are basically artisans of the human body. The ability to apply the highest level of human technical expertise to obtain aesthetic excellence is both exhilarating and fulfilling.” —Dr. Hatef
“I love that I can operate from head to toe! There is never a dull day in plastic surgery.” —Dr. Kavali
“The best part of being a plastic surgeon is the ability to have the skills to work on just about any part of the body. This allows me to treat many different patient needs, and keeps my practice diversified.” —Dr. Bonillas
The Hardest Part of Being a Plastic Surgeon
“I sometimes joke that I practice ‘plastichiatry’—a hybrid of surgery and psychiatry. There is so much emotion that goes into plastic surgery decision-making, and that means empathy is something I have to practice every day. It is emotionally taxing to have to explain that no surgery will fix a failing marriage or create happiness. The surgery I do will enhance someone, not make them a different person. Unrealistic expectations are challenging for both the surgeon and the patient.” —Dr. Kavali
“The hardest part is dealing with unrealistic expectations. There are so many apps and filters that make us look a certain way, from slimmer to curvier, and even cartoonish. Patients become fixated on these, but many times, we cannot achieve these results. This leads patients to seek out other providers—sometimes unqualified ones—which results in complications and worse outcomes.” —Dr. Bonillas
“In some surgical disciplines, it is understood that complications happen and people are going to have bad outcomes. But plastic surgery is elective. No one needs a breast augmentation. So, when you’re an obsessive-compulsive perfectionist who can’t sleep because of the most minor unfavorable outcome, it can be very stressful.” —Dr. Hatef
