A woman was found dead, lying on a massage table with bloody gauze on her buttocks inside a business that performs eyelash extensions in Dallas on February 19th. It appears that this woman had paid about $520 to have something injected into her buttocks as a buttock enlargement procedure. Exactly who injected exactly what is not clear at this point, but arrest warrants have been issued for Denise Ross, who goes by the name of Wee Wee, and her transgender companion Jimmy Joe Clarke, who goes by the name Alicia, for practicing medicine without a license (both are pictured above). This is such a tragic story, and unfortunately it’s not all too uncommon. News reports keep popping up about people who have silicone injected directly into their buttocks or breasts, the procedure being performed by someone who may be in the area only for the weekend. Complications occur, and the injector has long-since vanished.

It is precisely because of tragedies like this that credentialing is so important. One type of credentialing is word of mouth. A friend or colleague went to this place or that place, had something done, was happy with the result, and she tells you about it or posts a positive review online. That type of credentialing can be very helpful and may (or may not) come from a trustworthy source. In medicine, another type of credentialing comes through certification by a Board recognized by the American Board of Medical Specialties (ABMS). This is an entity composed of 24 medical specialty Boards. The American Board of Plastic Surgery is one of the twenty-four. Doctors who are Board Certified by one of the 24 ABMS member Boards and who participate in the Maintenance of Certification program are part of a demanding process that repeatedly assesses and enhances their professionalism, judgement, medical knowledge, and clinical techniques.   ABMS and its member Boards establish lifelong learning standards that ensure physicians keep abreast of the latest practices and treatments.  Before becoming Board Certified by the American Board of Plastic Surgery, a candidate must have completed a plastic surgery training program at an accredited institution.  A list of those institutions reads like a Who’s Who, including essentially every major university medical center you have ever heard of.  A surgeon cannot become Board Certified by the American Board of Plastic Surgery without completing training at one of these 100+ member institutions.

From time to time I’ll Google some key words, like ‘breast augmentation Fort Worth’, just to see what pops up.  Occasionally I run across something unexpected, like a website of a surgeon that is new to the area, or at least new to me.  So, I’ll look at the website and try to find out a bit about the doctor.  Who is he/she?  What type of practice is it?  Where did the doctor do his/her training?  What types of certification does he/she (I’ll just use ‘he’ or ‘his’ from this point forward) have?  Sometimes the information is easy to find on the site.  Sometimes it’s almost impossible.  As consumers we all want to know as much as possible about the products and services we buy.  With something as important, even ‘intimate’, as surgery, we have a right to know what qualifications a person who may be operating on us has.  One thing I’ve found as I’ve looked at these various websites is that a doctor who trained in plastic surgery will display that training proudly on the first page of the website and on his biography page.  It’s not hidden in the website somewhere; you don’t have to dig through pages of the site to find it.  A surgeon who is certified by the American Board of Plastic Surgery displays that information on page one.   On the other hand, another thing I see a lot on websites relates to doctors who say they are ‘Cosmetic Surgeons’.  Frequently those sites look great.  Lots of animation on the site, lots of color, lots of pictures, even some nice testimonials.  All of this sounds and looks just great, and often these are very good doctors and surgeons.  Something that bothers me about many sites like this, however, is that it’s often hard to find out the details.  What is the doctor’s background, and where did he do his training? It may be surprising to learn that often these doctors originally did their training in something like family practice or radiology, then decided to start doing cosmetic surgery. In situations like that, it might be worth knowing how exactly the doctor got into doing particular procedures, for instance, liposuction or breast augmentation. Did he attend a weekend course and start doing it? On many of these types of websites that information just is not displayed. The websites look great, but the depth of content regarding training is lacking. And that, at least to me, raises questions.

I am not comparing these doctors to the unknown, non-physicians who inject unknown substances into people, similar to the situation mentioned at the beginning of this blog. To be a licensed physician in Texas, a doctor has to have undergone verified training and passed specific examinations. On the other hand a random person injecting unknown substances into buttocks in a nail salon…well let’s just say his or her training is more suspect. What it really comes down to is this:credentialing matters. Word of mouth and positive online reviews are helpful. Board certification in Plastic Surgery or Cosmetic Surgery is, at least in my opinion, essential.