LAM FACIAL PLASTICS

Dear Dr. Lam,

I understand you're in Cartagena at the moment, so if you can't answer right away-entiendo.

I was reading something on Wiki today about a (might be described as flamboyant B.A. zealot) Beverly Hills plastic surgeon regularly featured on a television program. Specifically, that he is not board certified. On further inspection, his (website) vita only say that he is thoroughly educated in plastic surgery, making no mention of specific board certifications.

I realize that Wikipedia may not be all inclusive. Perhaps he didn't feel like bragging and chose not to mention his board certification(s) on his own site.

How much should we consider board certification or lack thereof?

Well, it is not my place here to discuss board certifications, as it would be unfair to pass judgment. Suffice it to say that I believe that a surgeon who does not sit for the boards or pass them may be a result of one of several reasons. First, he or she may not be board eligible, meaning he or she has not sufficiently proven to the board that he or she has completed a sufficient number of cases and number of years to qualify. Or, that surgeon´s training was not appropriate to qualify for board certification. Additionally, the surgeon may not be able to pass the boards due to an inability to pass oral and written exams. Part of almost every board out there, you also have to be in good standing in terms of ethical standards, which if violated would disqualify you from taking the board exam.

Also, there are so many boards out there now. I am certified by the American Board of Facial Plastic & Reconstructive Surgery and by the American Board of Otolaryngology Head and Neck Surgery. In order to sit for these boards, I have to have completed a residency in head and neck surgery or plastic surgery then meet additional qualifications in terms of years in practice, etc. to sit. This board certification differs from the American Board of Plastic Surgery since it is not ABMS or American Board of Medical Specialties. The ABPS makes a big deal that the ABFPRS is not ABMS. However, the ABMS only allows one board per specialty so the ABFPRS will never be allowed to be an ABMS board. However, the ABOTO, of which I am a diplomate, is an ABMS board. The ABPS has actually said that the ABFPRS is not legitimate since it is not ABMS. However, in over 20 states in the U.S. in which litigation was carried out, the ABFPRS has won equivalency status in every single contest due to the strict training, education, and psychometrically validated oral and written board examinations.

I also just passed the American Board of Hair Restoration Surgery in order simply to prove to my hair transplant patients my dedication to that specialty. Because of the small size of the ABHRS diplomates, only about 120 in the world, they do not have much legal representation to push matters but also therefore they fly a bit under the radar. The ABHRS also has stringent requirements to pass including 150 operative cases submitted, 5 before and after results, 3 years experience and passing a day long oral and written board examination.

For those out there to understand this better, for me to sit for the ABFPRS, I had to complete training as a head and neck surgeon and pass that exam first. I also went through subspecialty training or fellowship in facial plastic surgery. In summary, 2 years of general surgery, 4 years of head and neck surgery that includes a quarter of the experience in facial plastic surgery, a 1 year accredited fellowship in facial plastic surgery, then a 6 month unaccredited preceptorship in Asia. Most plastic surgeons who are boarded in plastic surgery, spend 5 years in general surgery (abdominal or belly surgery) and 2 years in plastic surgery with in most programs almost all of the training is in the body. Ask your general plastic surgeon how many face cases he did in residency and then in fellowship, probably few to none. Go look at plastic surgery websites that do full body work and face and look at how little they dedicate to the face. Then look at the quality of that work.

Now, not to confuse matters further but there is a board, the American Board of Cosmetic Surgery, that certifies dermatologists, surgeons, and non surgeons and has broader qualifications in my opinion for entry. I do not want to speak negatively about this board certification but I do not fully support it in my personal estimation.

After all of that being said and done, I think even board certification in any of these boards is insufficient for a prospective patient to choose a surgeon. You must choose that surgeon on his integrity, passion, relationship with you but above all that is his excellence in his work. You can have a board certified surgeon who truly is terrible. You can also have an excellent surgeon who is not board certified. I would always be careful however if you choose a surgeon who is not board certified by his respective specialty and should probably investigate why that is the case.
hope that is clear,
sml

Thank you for that helpful and typically comprehensive answer. I feel pure grace led me to the right and best facial plastic surgeon. I DID look into your certifications and I researched your background, education (they're still not letting too many into the schools you attended) before my first work with you in '05.

I don't need any body work at the moment, but if I should, I will understand more about what (or what not) these various certifications may mean.

Ultimately, I think most of us want to believe we've done due diligence in selecting a doctor. I'll always remember sage advice from your office manager: It's your face!

Thanks again.

My pleasure. Just trying to give you the most honest and comprehensive (albeit with a little partisan) response that I can.
sml