Plastic surgery is part of the ENT surgeon repertoire

Do ear surgeons perform facelifts? Absolutely!

And we perform nose surgery and throat surgery, too!

A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons.  However, the implication of the title “Ear surgeons performing facelifts,” is misleading and overlooks the fact that a large portion of training in the specialty of ear, nose and throat surgery includes plastic and reconstructive surgery of the face, head and neck.

Otolaryngologists (ear, nose and throat specialists) are regional experts in the anatomy of the face and neck. After four years of college, four years of medical school, selection into one of the most competitive specialties in the U.S., and then another 5-6 years of surgical training, otolaryngologists are fully trained and qualified to perform cosmetic surgery above the shoulders.

The American Board of Otolaryngology – Head and Neck Surgery (ABOto)  is one of the oldest certifying agencies in the U.S., and one of 24 members of the American Board of Medical Specialists (ABMS). Twenty five percent of the examination is devoted to facial plastic surgery. Other topics include surgery of the ears, nose, throat and neck, except for the spine. This broad training in the basic anatomy and physiology of this area makes otolaryngologists as much experts in facial plastic surgery as are general plastic surgeons, who devote a good portion of their training to cosmetic and reconstructive surgery of breasts, hands and other body areas.

ENT surgeons with additional training and experience in facial plastic surgery may be additionally certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). Like many well-respected specialty societies, the ABFPRS is not one of the original 24 ABMS societies.  However, the two-day written and oral examination is as strenuous as the examination of any of the ABMS member boards. The ABFPRS as been recognized as equivalent to the ABMS societies in every state where use of the term “board certified” has been challenged.  The ABFPRS requires a minimum of two years experience after residency and a detailed peer review of over 100 facial plastic surgery cases before allowing candidates to take the examination.

In general, there are numerous specialties performing “plastic surgery.” Pediatric urologists correct botched circumcisions and reconstruct abnormal genitalia. Gynecologists lift sagging uteruses and tighten leaking bladders. Orthopedic surgeons perform delicate hand reconstruction. Oral and maxillofacial surgeons perform complex reconstructions of the facial skeleton. And yes, ear, nose and throat surgeons perform facelifts, eyelid surgery, and nose jobs.

Undoubtedly, there are surgeons reaching beyond their training and expertise. For an ENT physician to perform a tummy tuck, as mentioned in the New York Times article, is unconventional. The prudent consumer should consider not only board certification, but also training and experience when choosing a cosmetic surgeon. Ask for recommendations from friends and physicians. Ask your physician about his or her current experience with the procedure.  If you’re not comfortable, get a second opinion.

Mike Armstrong is an otolaryngologist at Richmond Facial Plastics.

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