Tennessee Cosmetic Surgery | The Plastic Surgery Group P.C.

I was very pleased to read the two day multipage USA lead article on the state of “cosmetic surgery” practitioners in the United States. The in depth approach taken by the author included commentary by American Board of Cosmetic Surgery leadership that really exposed the “man behind the curtain”. I am sure we would all agree that surgical residency training is “not necessary”. You should find training “on your own”… and, then, let your internal ethical compass guide what you should and should not do. That sure sounds like the “Modern Doctor” I want to take care of me and my family. The consumers of the United States are among the most powerful economic engine in the world, and USA Today has certainly “Spoken Truth to Power”.

As noted in the article, this approach to training only exists for cosmetic surgery practice. No one is suggesting that your heart doctor, your pediatrician, your gastroenterologist, your allergist, or your gynecologist, find training outside the infrastructure created by the American Board of Medical Specialists (ABMS) to ensure measurable, reliable training practices across the US. Cosmetic Surgery is isolated in this “Modern Approach”.

The ABMS was established in the first half of the last century to organize the explosion of medical specialties created during that period of medical enlightenment. The principle goal of the ABMS, in simplistic terms, is to protect us from the snake oil salesmen of medicine. It is not a club or an evil empire. It is a mutually agreed upon bureau, outside the Federal Government, that sets the bar for what it means to be a “Board Certified” physician in the US. The ABMS is the BOARD. Of course, now that we have all learned that “Board Certified” is a good thing, that very term has been hijacked (see the ARTICLES section of REFINEDLOOKS.COM for The Hijacking of Board Certification). One simply has to open a company as an LLC, create a “Board-Sounding” name; and certify yourself. It’s that simple, and there is no law to stop it.

When I hear those outside of Plastic Surgery Training discuss it, I am reminded of Mark Twain. He said, “First get your facts straight, then distort them as you need”. If any “cosmetic surgeon” out there wants to know more about the rigors of plastic surgery training then they can apply for our residency. It is three years long, and you better be at the top of your class. We typically have about 25-30 talented, already board eligible general, ENT, OMF, and even orthopedic surgeons interview for two spots on an annual basis.

I spent this past weekend in Nashville with the directors of UT’s state wide medical teaching faculty. Our residency training programs are all well thought through. The candidates, the curriculum, the teaching methodology, the teachers, and the means by which all these concerns are annually assessed are thoughtfully poured over. Those residents who aspire to ABMS certification are trained in programs where the oversight of the teaching is not just vigorous, it is intense. Multiple accrediting agencies continuously review the work of the residency training programs for quality control of the product – the graduated plastic surgeon. If your residency does not meet these stringent requirements, it is closed. The mentorship or fellowship process of training plastic surgeons no longer exists because it did not provide equality of training across the US. Yet it is this type of training atmosphere that the “cosmetic surgeons” ask you, now, to believe is better or more highly specialized. You know, “FIND TRAINING ON YOUR OWN”. (See USA Today) Cosmetic Surgery is not a board certification granted by the ABMS.

So, here’s what the public really needs to know.

The American Board of Plastic Surgery is no “Club”. You cannot get in with just a dues membership, and you do not get to stay forever unless you meet a series of re-evaluation benchmarks over the course of your career.

Ear Nose and Throat surgeons are permitted to be referred to as Facial Plastic Surgeons by nature of their Ear Nose and Throat Residency training. I was trained and board certified in General Surgery before I became a plastic surgeon. In that training, I performed breast surgery, abdominal surgery, thyroid and neck surgery, vascular surgery, and even heart surgery. When was the period in ENT residency where breast examination was mastered? When was the period when abdominal examination was mastered? When was the period when intensive care medicine was mastered (should anything untoward happen during a surgical procedure)? I think I would choose someone like me to do your surgery.

If there is some scientific evidence, some statistic, that indicates that the people I train…those who have been trained as I have… achieve outcomes with higher complication rates, let us bring the data forward. But, when it is brought forward, be sure that it will undergo scrutiny by academic surgeons who do not suffer fools gladly. We find the use of poorly organized self serving, advertising campaigns masquerading as science to be beneath contempt.

There are NO- repeat- NO hospital privileges granted for “Cosmetic Surgery” at any significant health care institution. Hospital privileges are typically granted by ABMS board certification. (For example, OB/GYN, ENT, Plastic Surgery, Internal Medicine…) The plastic surgeons in my practice could, without question, transfer their skills and obtain hospital privileges in Plastic Surgery at any academic medical center in the United States.

Roy Exum’s recent piece on the “Best of What” at Chattanoogan.com outlines our feelings toward the Times Free Press’ Best of the Best advertising event. As I noted, though we receive nomination, the ethics policy of the American Society of Plastic Surgeons and the American College of Surgeons prohibits involvement in these types of media packages. It works well, I suppose, for Best restaurant, but not for Physicians.

The Plastic Surgery Group has been a fixture in the medical landscape of Chattanooga for over 50 years. I, myself, perform almost a thousand surgeries every year, and I’ve been doing it for over 16 years. I can only begin to imagine the number of lives that our practice has touched. I am very proud of the work that my partners do every day, and equally proud of the dedicated young men and women it has been our privilege to train in Plastic Surgery. You can be sure that the Plastic Surgery Group will continue to focus on providing the Chattanooga community with the type of first rate, cutting edge cosmetic and reconstructive surgery that has been the hallmark of my Group’s performance since its inception.

Thanks for reading my thoughts,

M. A. Brzezienski, MS MD FACS