So you have decided to increase your breast size or lipo out the extra cushion that is slowly surrounding your hips. You've spent hours researching the procedure and are armed with numerous questions that you plan to present to your intended surgeon during the consultation, but have you spent just as much time researching that surgeon as you have the procedure? Do you know the meaning behind the initials MD, DO, and FACS? Do you you know the difference between a plastic and cosmetic surgeon? Do you know if your surgeon's certification is recognized by the American Board of Medical Specialties? If you can't answer each of these questions, this article is for you.

Plastic and cosmetic surgery can be invasive. Both may involve anesthesia, being cut open, and having your organs moved around. Sounds like fun, right? Yet many people spend more time researching a potential car than they do a potential surgeon. If you are going under the knife, you definitely want a surgeon who has both the skill and the training to do a great job. Not only does his expertise determine how well the surgery will go, but it will also determine how you will look at the outcome.

Horror stories abound regarding fraudulent and unethical surgeons who claimed to be certified and weren't, or who were certified in a different field entirely, or of surgeons who were highly qualified but, upon a botched job, were found to have a stack of medical malpractice suits leaning against them. What steps can you take to ensure that you are choosing the most qualified surgeon for your job?

MD, DO, FACS-What do they all mean?
Let's begin with the basics. Two types of medical degrees exist: an MD (medical doctorate) and a DO (doctorate in osteopathic medicine). An MD and a DO have studied the same base coursework, but a DO also studies nutrition and hands-on therapies. DOs look at the patient as a 'whole'. Both must pass the same national exam; therefore, they are looked at as equals in terms of education, skill, and training.

At times you will see the initials FACS (Fellow (in the) American College of Surgeons) after a surgeon's name. This means that the surgeon went on to pass a set of extensive evaluations, including those for their surgical competency, and rigorous exams through the American College of Surgeons. This association was founded in 1913 to ensure that a surgeon was highly educated and trained, which in turn would improve a patient's surgical care. Becoming a member of FACS is voluntary, so not all surgeons have this designation. However, a surgeon must be board certified to become a member.

Cosmetic or Plastic Surgeon?
Ask many people the difference between a plastic and cosmetic surgeon and they'll answer, "There isn't one," even if they have already been under the knife. There is a difference, though, and you should know the difference before you begin your search for a surgeon.

A cosmetic surgeon performs surgeries to enhance the cosmetic appearance of the patient. These doctors have been through medical school and have studied a particular field, such as dermatology. They then completed a residency in that program, as there is no residency program for cosmetic surgery as its own specialty. Following residency, the doctor may or may not have attained board certification (more on this later) in his particular field of study, or in another field of study, such as plastic surgery.

Plastic surgeons perform surgeries to repair defects. These might include cleft palates or birth defects on various parts of the body. Plastic surgeons complete medical school and a residency in plastic surgery, which is its own field. Again, the surgeon may follow this training and education by becoming board certified in the field of plastic surgery.

And a tip: Cosmetic surgery can be performed by any medical doctor, so one trained in dermatology could theoretically advertise and perform breast augmentation procedures. Do you really want someone trained to take care of your eyes working on your breasts? Probably not. Upon meeting the doctor, ask about his training and education.

Board Certification
Chances are you will hear people say, "Make sure your doctor is board certified." Have you ever asked them what this means? Board certification can be obtained in one of 24 specialty areas through the American Board of Medical Specialties (ABMS). Board certification is the highest standard that a physician can attain. Not all physicians are board certified; in fact, certification is a completely voluntary procedure that entails rigorous testing and peer evaluation by others who are specialized in that particular area.

Yet finding a doctor that is board certified does not provide you with enough information. Since each specialty is quite different, the testing and requirements for meeting board certification in each specialty vary widely. Therefore, what one physician studies when becoming board certified in Family Medicine will be different from what one studies when becoming board certified in Allergy & Immunology. The American Board of Plastic Surgery, or the ABPS, is the only specialty out of the 24 that has been recognized for plastic surgery.

And what about cosmetic surgery? Cosmetic surgeons may be board certified in their particular field (such as dermatology), but the ABMS does not offer board certification in Cosmetic Surgery. However, a cosmetic surgeon may go on to become certified in the American Board of Plastic Surgery.

What if your doctor says that he is board certified in cosmetic surgery? A designation of board certification in cosmetic surgery does exist, but this certification is not one that is completed through any of the 24 medical boards recognized by the American Board of Medical Specialties (ABMS). Instead, certification is reached through requirements set forth by the American Board of Cosmetic Surgery, a nonprofit organization this is not associated with ABMS.

Is That All?
So you've found a surgeon who has studied plastic surgery, is board certified in Plastic Surgery, and is a member of FACS. Does this mean that you can relax in the all-knowing hands of your accomplished physician and continue on with your procedure? Not exactly. Cases have shown that even the most qualified doctors make mistakes. Of course, if you read statistics you will find that nearly fifty percent of certain high-risk doctors have at least one malpractice suit pending. This doesn't mean that the doctor has made errors in each case, or that he is incompetent, but it should raise a red flag. Just like with anything, too much of something is not a good thing. If your doctor has been repeatedly disciplined or sued, you should look elsewhere.

But it's not like your doctor will say, "Hi, I'm Doctor X and I've been sued 10 times and disciplined often. I'd love to perform your surgery." (And if he does say this, run in the opposite direction as quickly as your legs will carry you.) So what's a patient to do? Begin by contacting the medical board in your state to ensure your physician has been licensed in the state. You can do this by phone or by visiting the Federation of State Medical Boards.

Next, determine if your physician has had any disciplinary action taken against him. To do this, visit DocBoard.org, "the only combined public online physician database in the nation that has its direct source of data from state government licensing boards and that also remains free of charge to the public." Malpractice suits cannot be found through this report, however, so in order to determine whether your doctor was involved in a suit you need to contact your county courthouse or speak with the clerk of the court in the county in which your surgeon practices. You can also contact the state's Medical Board for this information.

While all of this information will not absolutely guarantee perfection on surgery day, it will certainly be valuable as you seek a surgeon with the experience, training, and expertise you (and your body) deserves.