Choosing a plastic surgeon is one of the most consequential decisions you will make. The letters after a surgeon's name, the facility where they operate, the volume of cases they perform each year — these are not marketing details. They are meaningful signals about training, competency, and safety standards. Yet the abundance of credentials, designations, and titles in the cosmetic surgery world can make it genuinely difficult to tell what matters and what does not.
This guide cuts through the noise and explains exactly what each credential means, what questions you should ask in a consultation, and what should give you pause before you commit.
Board Certification: The Only Credential That Matters Most
When a surgeon says they are "board certified," the critical question is: certified by which board? There are dozens of medical certification boards in the United States, and not all are recognized by the American Board of Medical Specialties (ABMS) — the gold-standard authority for physician certification.
The credential you want to see for plastic surgery is certification by the American Board of Plastic Surgery (ABPS). ABPS certification is the only ABMS-recognized credential that specifically covers plastic and reconstructive surgery. To earn it, a surgeon must complete an accredited surgical residency followed by a dedicated plastic surgery residency of at least two to three years, then pass rigorous written and oral examinations administered by the board.
What ABPS Certification Does Not Guarantee
ABPS certification confirms that a surgeon met a baseline standard at the time of their examination. It does not guarantee specialization in a specific procedure. A surgeon who is ABPS-certified can technically perform any plastic surgery procedure — from hand reconstruction to rhinoplasty to body contouring. Volume and subspecialty focus are separate considerations that matter equally in your evaluation.
Boards to Be Cautious Of
Some surgeons advertise certification from boards like the American Board of Cosmetic Surgery (ABCS), which is not recognized by the ABMS. These boards have different training requirements and do not require completion of an accredited plastic surgery residency. This does not necessarily mean a surgeon is unqualified, but it means their training pathway was different — and you should understand what training they did complete before trusting them with your care.
What FACS Means
The designation FACS — Fellow of the American College of Surgeons — is a peer-reviewed honor conferred by the American College of Surgeons. It is awarded to surgeons who meet standards of education, training, professional qualifications, surgical competence, and ethical conduct. It is not simply a membership you can purchase; it requires a nomination and review process.
FACS is a meaningful credential because it represents ongoing peer recognition, not just a one-time examination. Surgeons who hold FACS typically operate in accredited facilities and adhere to the College's standards for surgical practice.
Fellowship Training: Where Specialization Is Built
After completing a plastic surgery residency, some surgeons pursue additional fellowship training in a subspecialty — aesthetic surgery, craniofacial surgery, hand surgery, burn surgery, or microsurgery. An aesthetic surgery fellowship, in particular, provides intensive additional training in cosmetic procedures beyond what residency covers.
Fellowship training is where a surgeon develops the refined technical skills and aesthetic eye that distinguish competent plastic surgery from exceptional plastic surgery. When evaluating a surgeon for an aesthetic procedure, ask specifically whether they completed a fellowship and where — and what that fellowship focused on.
Dr. Newman completed his aesthetic surgery fellowship at Georgetown University, one of the most respected programs in the country, following his plastic surgery training. That additional year of focused aesthetic training shapes the way he approaches every cosmetic case.
Surgical Volume and Specialization: Ask the Direct Question
A surgeon can hold every credential listed above and still perform your procedure of interest infrequently. Credentials establish the foundation; volume and focus build mastery. Research consistently shows that surgical outcomes improve with procedure volume — the more times a surgeon performs a specific operation, the more refined their technique, the more familiar they are with complications, and the better they become at achieving consistent aesthetic results.
Ask your surgeon directly: How many times have you performed this specific procedure in the past year? A high-volume aesthetic practice focusing on breast surgery, for example, should be performing breast augmentations hundreds of times annually. If the answer is vague or surprisingly low, that is relevant information.
Subspecialty focus also matters. A surgeon who divides their practice equally between hand reconstruction, pediatric craniofacial surgery, and cosmetic body contouring will have less refined aesthetic expertise in any single area than one who concentrates the majority of their practice on a defined set of procedures.
How to Evaluate Before-and-After Galleries
A surgeon's before-and-after gallery is one of the most valuable tools available to you — but only if you know how to read it. Here is what to look for:
- Are the photos of the surgeon's own patients? Some practices use stock photos or images licensed from implant manufacturers. Always ask if the photos shown represent actual patients operated on by this specific surgeon.
- Is there anatomic diversity in the gallery? A legitimate gallery will show patients with a range of body types, not just the most flattering cases. Look for patients who started with anatomy similar to your own.
- Are the photos standardized? Consistent lighting, positioning, and camera distance make before-and-after comparisons meaningful. Inconsistent photography can hide or exaggerate results.
- Are scars visible and properly healed? For procedures like tummy tucks or breast lifts, look carefully at scar placement and quality. Well-executed surgery produces low, thin, well-healed scars. Thick, wide, or poorly placed scars are relevant data points.
- Does the aesthetic match your goal? Surgeons have aesthetic preferences that show up in their work. If every patient in the gallery looks the same — same implant projection, same breast shape, same nose profile — consider whether that matches what you want, or whether you prefer a surgeon who customizes results to the individual.
Consultation Red Flags
A thoughtful consultation tells you almost as much about a surgeon as their credentials. Several behaviors should cause concern:
- Pressure to book immediately. Any surgeon who creates urgency around scheduling — limited-time discounts, "I only have one slot left this month" — is using sales tactics that have no place in surgical decision-making.
- Downplaying risks. Every surgical procedure carries real risks. A surgeon who dismisses your questions about complications or makes the procedure sound effortless is either not being honest or lacks the experience to understand what can go wrong.
- Operating in non-accredited facilities. Your surgery should be performed in an AAAHC- or JCAHO-accredited facility, or a licensed ambulatory surgery center. These accreditations mean the facility has passed independent safety inspections and maintains equipment and staffing standards. Never have elective surgery in a physician's office that lacks this accreditation.
- Inability to show a substantial gallery of their own patients. If a surgeon has been practicing for more than a few years, they should be able to show you a meaningful collection of their own results for your procedure of interest.
- A price that seems dramatically lower than the range you've seen elsewhere. Surgeon fees reflect training, experience, support staff, facility quality, and time. A surgeon offering your procedure at half the price of their peers is cutting costs somewhere — and in surgery, the most likely places are experience level, facility quality, and time spent on your care.
Why Beverly Hills Attracts Highly Trained Surgeons
Beverly Hills and the surrounding Los Angeles area are home to a disproportionate concentration of ABPS-certified, fellowship-trained plastic surgeons. This is not coincidental. The patient base in Beverly Hills is highly discerning, well-researched, and vocal about results. Surgeons who build and maintain reputations here must consistently produce exceptional outcomes because their patients compare notes, seek second opinions, and leave public reviews.
This competitive environment means that mediocre surgeons tend not to thrive. It also means that a surgeon who has built a long-term reputation in Beverly Hills has typically earned it through consistent results and patient satisfaction over many years — not through marketing alone.
When evaluating any surgeon, regardless of geography, return to the fundamentals: ABPS certification, fellowship training where applicable, high procedure volume in the specific surgery you need, a gallery that demonstrates consistent, natural-looking results, and a consultation style that prioritizes your informed decision over quick booking. These criteria will serve you well wherever you are.
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Dr. Newman is board-certified by the American Board of Plastic Surgery and fellowship-trained at Georgetown University. We welcome the opportunity to answer your questions in person.
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