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MedSpa or Plastic Surgeon: Who should you see for your aesthetic concerns?
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Incisions: What should you look out for?
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  Did You Know?
Breaking down the differences between
Cosmetic and Plastic Surgeons and Med Spa’s

Procedures and treatments to reverse aging, minimize fine lines and wrinkles, and rejuvenate your appearance are extremely common today. But with more availability to these procedures, comes more room for confusion when you’re doing your research.

Should you get Botox at a med spa or go to a plastic surgeon? What’s the difference between a plastic surgeon and a cosmetic surgeon? What does board-certified mean?

We’ll break everything down so you can understand exactly who to see for your aesthetic concerns.

Med Spa’s vs. Plastic Surgery Practice. What’s the difference?

When it comes to aesthetic and cosmetic procedures, the possibilities are endless. With new med spas popping up everywhere, the possibilities of where to get a treatment are endless as well. But when it comes to facial aesthetics and rejuvenating your appearance, is a med spa really the best place to go?

Med spas offer the convenience of multiple treatment options in one office. They typically offer a wide array of non-surgical services such as Botox, filler, facials, and even lasers. The limitations of just non-surgical services may lead to recommendations that aren’t the best option for you. Depending on your rejuvenation goals, you may see the most benefit from a surgical treatment.plastic surgery practices offer more rejuvenation options

In addition, because nurses are commonly the only providers, there may not be a physician available if complications arise or overseeing the practice of medicine on a daily basis.  Just because a med spa offers everything in one place, doesn’t mean it’s the best place to go.

A plastic surgery practice offers everything a med spa offers, plus more. Not only can nurses or surgeons provide non-surgical services, they offer a broader array of more effective and longer lasting surgical rejuvenation options.  By including a more comprehensive array of services for rejuvenation, you can better address your goals and make a choice of aesthetic procedure with confidence.

Additionally, the nurse providers and medical estheticians at plastic surgery practices are under direct, day-to-day supervision of a plastic surgeon. A med spa doesn’t always have the access to a doctor, let alone a facial plastic surgeon, because the oversight regulations differ for a med spa versus a plastic surgery practice.

Plastic Surgeon vs. Cosmetic Surgeon. They aren’t the same thing.

Often, plastic surgeon and cosmetic surgeon are used interchangeably. Most believe that the two professions are one in the same, but they are different.

Put simply, a cosmetic surgeon focuses on elective aesthetic surgery while a plastic surgeon has broader training and expertise in medically necessary surgery, not simply elective aesthetic procedures.

Did you know that any doctor can call themselves a cosmetic surgeon?  A urologist looking to change careers? Cosmetic surgeon. An ER doctor that  wants to slow down? Cosmetic surgeon. There is nothing prohibiting the claim of being a cosmetic surgeon. 

I n order to protect oneself, the key to consider is board certification.  It is an important distinction for consumers considering any elective procedure. But keep in mind not all board certifications require demonstrated skill and knowledge within a specialty related to the procedure you may be pursuing.

A cosmetic surgeon may not have any training or experience in aesthetics or in surgery, they only need to be a physician.  If a physician refers to  themselves as a plastic surgeon or facial plastic surgeon, they MUST have completed a residency or specific training in plastic surgery or facial plastic surgery. 

Even though both cosmetic and plastic surgeons can be board-certified. Only the board-certified plastic surgeon or facial plastic surgeon is recognized by the American Board of Medical Specialties. The American Board of Cosmetic Surgery is not recognized by the American Board of Medical Specialties.

Which brings us to our next point: what’s the difference between the board certifications and why does it matter?

Board Certifications

Board-Certified Plastic Surgeon

According to the American Board of Plastic Surgery, a plastic surgeon becomes board-certified after:

  • Graduating from an accredited medical school
  • Passing all oral and written exams
  • Completing six years of training as a resident surgeon at a program by the Accreditation Council for Graduate Medical Education

Board-Certified Cosmetic Surgeon

According to the American Board of Cosmetic Surgery, a cosmetic surgeon becomes board certified after:

  • Training for one year exclusively in cosmetic surgery
  • Performing at least 300 cosmetic surgeries of the face, breast and body
  • Receiving additional training in non-surgical cosmetic procedures and skincare
  • Passing a comprehensive 2-day oral and written exam

Board-Certified Facial Plastic and Reconstructive Surgery

According to the American Board of Facial Plastic and Reconstructive Surgery, a facial plastic surgeon becomes board-certified after:

  • Completing an approved residency after medical school in one of the two medical specialties of otolaryngology/head-and-neck surgery or plastic surgery
  • Earning prior certification by the American Board of Otolaryngology, the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada in otolaryngology/head-and-neck surgery or plastic surgery
  • Practicing a minimum of two years
  • Having 100 operative reports reviewed and accepted by a peer-review committee
  • Passing an 8-hour written and oral examination
  • Operating in an accredited facility
  • Holding the appropriate licensure and adhering to the ABFPRS Code of Ethics

Recognition by the American Board of Medical Specialties

The American Board of Medical Specialties sets forth a comprehensive list of standards that surgeons across 24 specialties must meet to become board-certified. This board-certification ensures the surgeon has the appropriate skills and expertise to perform these surgeries. Among these 24 specialties is facial plastic surgery and plastic surgery.

Why does this matter? One of the biggest reasons is cosmetic surgery is not recognized by the American Board of Medical Specialties. Yes, a cosmetic surgeon can perform certain aesthetic procedures such as facelifts, rhinoplasties, and neck lifts, but a board-certified facial plastic surgeon has gone through extensive training to become recognized under this specialty specifically.

What is a fellowship?

Fellowship-trained means a physician or surgeon has the highest level of dedication and training for a specific field. For example, a fellowship-trained facial plastic surgeon has dedicated their practice and specialty to facial plastic surgery. They are an expert in this field across seven fields:

  1. Rhinoplasty, including revision
  2. Aging face, including minimally invasive
  3. Head and neck reconstruction
  4. Mohs reconstructions
  5. Facial Reanimation
  6. Trauma
  7. Congenital surgery

When you’re deciding who to see to address areas of concern, it’s important to do your research and understand the terminology. Our patient advisors and facial plastic surgeons at Facial Aesthetic Concepts are always available to answer whatever questions or concerns you have. If you’re interested in facial plastic surgery or addressing a specific area, please call us to schedule a consultation!


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Facial Plastic Surgery Incisions
and What to Look Out For 

One of the biggest concerns a patient has when getting a major surgery is the incisions. Where are the incisions going to be? Will they be visible? How will it heal?

Thankfully, facial plastic surgery has evolved, and Dr. Gangnes and Dr. Brandon have adopted techniques that make incisions virtually invisible. Although patients heal differently and surgeons can’t guarantee a scar won’t be visible, the placement of incisions and incision technique can greatly reduce the likelihood of a scar being visible.

It's also important to note the patient's anatomy and the type of procedures changes where and how an incision is made. Incisions aren't always a one-size-fits-all approach. 

Incisions for a Forehead Lift and Facelift

The idea with the incisions is to camouflage the incisions in natural anatomic areas. The important thing with the hairline, is women tend to have two tufts of hair: A tuft at the temple and a second just above the temple. The forehead lift incisions are placed behind the hairline to hide the incision naturally. Measurements are taken so the incision isn’t made too far back in the hairline, creating an unnatural scar.

Incisions for facelifts are made in and around the ear on the tragus. Our facial plastic surgeons make the incision on top of the tragus, so it’s hidden behind the natural curve in the ear. The incision continues behind the ear into the hairline. An irregular incision is utilized within the hairline to camouflage the incision making in invisible.  Nothing on our faces is linear, or in a straight line, a straight incision would look unnatural and too surgical.  An irregular incision is more easily hidden within the hair than a straight line which can be easily seen.

In the video below, our Double Board-Certified Plastic Surgeon, Dr. Gangnes, discusses where he makes incisions for a facelift and forehead lift.

Watch Facelift and Forehead Lift Incision Video

What to look out for

The placement and type of incision matter when it comes to certain areas of the face. In some areas, it’s better to use a beveled incision over flat because of the way the skin heals. Same goes for where the incisions are made during a procedure. There are certain areas that are better for placement because the incision won’t be as noticeable.

Straight vs. Irregular Incisions

As mentioned before, an irregular incision matches an irregular hairline and looks natural. If a straight incision is made, there is a straight layer of hair follicles, and it looks too surgical and noticeably unnatural. 

Beveled vs. Flat Incision

It’s important to make certain incisions beveled versus flat so the skin heals almost invisibly. If we create a flat incision, we run the risk of the center of the scar contracting inward while healing. This causes an indentation and a more visible scar.  

Incision Tension

While there isn’t a way to guarantee there won’t be a scar, there is a way to minimize how visible the scar is and where the scar appears. One of the ways to diminish the appearance of a scar from surgery is tension.

The more tension an incision has, the more the skin pulls apart during the healing process. This increases the width of the scar and makes it more visible. 

The surgical technique of both Dr. Gangnes and Dr. Brandon employ a strategy to naturally drape the skin into position during procedures to dramatically reduce skin tension, the visibility of incisions, and produce a more natural result.

Choosing the Right Surgeon for Your Procedure

It’s important to choose the right surgeon for the procedure you’re having. Someone who specializes specifically in facial plastic surgery and is board certified, may be a better choice than a cosmetic plastic surgeon. Yes, there is a difference between a plastic surgeon and a cosmetic surgeon!

Do your research and ask the right questions during your consultation. For example, ask where the incisions will be and how they are expected to heal. Our Facial Plastic Surgeons at FAC are happy to answer any of your questions. Call us to schedule a consultation today!


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