Cosmetic versus Plastic Surgery

There is often a degree of confusion about the differences between a plastic and cosmetic surgeon.  Indeed, for most people, the term plastic surgery is synonymous with cosmetic surgery.  However, plastic surgeons are surgery generalists, whereas cosmetic surgeons are specialists in aesthetic surgery.  

Plastic surgeons complete an approved and accredited residency training program in plastic and reconstructive surgery under the NHS.  This programme covers a wide range of surgical procedures, incuding treatment for burn victims, reconstruction of deformities (for example, cleft lip), or breast reconstruction after cancer.  It also includes aesthetic procedures such as lipsuction and face lifts.

By contrast, any licensed physician (for example, ENT surgeons, dermatologists, GPs, ophthalmologists, general surgeons, and plastic surgeons) can train in and offer cosmetic surgery.  It is important to note that cosmetic surgery is not, at present, an individual specialty in the UK, and there is no specialist register.  

Although the criteria to become a qualified plastic surgeon are stringent, there is a minimal emphasis on training for aesthetic outcomes.  Cosmetic procedures are not about curing illness.  Rather their objective is to improve a patient's aesthetic look.  Cosmetic surgeons are particularly interested, experienced, and skilled in delivering aesthetic results.

The demand for cosmetic surgery procedures has surged in the UK since 2011 and, as the costs for these are not covered by the NHS, most are performed by private practitioners.  In 2014, there were approximately 43,069 cosmetic surgery procedures carried out by members of the British Association of Aesthetic Plastic Surgeons, however, the number of practitioners in the UK not affiliated with this association is at least three times that.  Hence the need for creating a board certification and a specialist register for Cosmetic Surgeons in a country like UK.  Cosmetic Surgeons from all backgrounds perform only cosmetic surgery in the independent sector, while some Plastic Surgeons work in the NHS and do not do any cosmetic work.

As an increasing popular area of healthcare, Cosmetic Surgery, particularly here in the UK, poses some risks of substandard treatment and perhaps irreversible complications.  For these reasons, extreme care should be of concern to all ethical surgeons and practitioners of aesthetic surgery.

As the NHS does not offer it, and the GMC does not recognize it as a separate specialty, it may be unlikely that there will ever be a specialist register for cosmetic surgery in the UK.  Procedures are performed in the UK with virtually no regulation, however, since the PIP breast implant scandal the government has begun a process of evaluating how to better serve the public in this area.  The publication of Sir Bruce Keogh’s report in 2013 has outlined a set of recommendations that the GMC is in the process of implementing.  As an organisation with a great many practitioners in the area of body sculpting, the BABS is a non-profit group that was formed with the objective of helping assist the government in determing best processes for this aspect of cosmetic surgery.