title: Clinicians performing cosmetic surgery in the community: a nationwide analysis of physician certification.
abstract: BACKGROUND
  Practitioners who are not board-certified by the American Board of Plastic Surgery are practicing cosmetic surgery. The extent of this issue across the United States has yet to be examined in detail.
  
  
  METHODS
  A systematic search using Google was performed to evaluate the qualifications of clinicians marketing themselves as plastic surgeons. For every U.S. state, the following searches were performed: [state] plastic surgery, [state] cosmetic surgery, and [state] aesthetic surgery. The first 50 Web sites returned for each search were visited and scrutinized using the American Society of Plastic Surgeons and American Board of Plastic Surgery Web sites.
  
  
  RESULTS
  In total, 7500 Web sites were visited, yielding 2396 board-certified plastic surgeons (77.9 percent of all practitioners). There were 284 board-certified ear, nose, and throat surgeons, 61 (21.5 percent) of whom practice outside their scope; 106 board-certified general surgeons, 100 (94.3 percent) of whom practice outside their scope; 104 board-certified oral and maxillofacial surgery surgeons, 68 (65.4 percent) of whom practice outside their scope; 70 board-certified ophthalmologists/oculoplastic surgeons, 49 (70 percent) of whom practice outside their scope; and 74 board-certified dermatologists, 36 (48.6 percent) of whom practice outside their scope. There were also 16 internal medicine doctors, 13 obstetrics and gynecology physicians, six emergency medicine physicians, three pediatricians, two urologists, two anesthesiologists, and finally one phlebotomist; all of these practitioners practice outside their scope as defined by Accreditation Council for Graduate Medical Education core competencies.
  
  
  CONCLUSIONS
  Many clinicians performing cosmetic surgery are not board-certified. This finding has important implications for patient safety.
authors.affiliation: New York, N.Y. From the Institute of Reconstructive Plastic Surgery, Department of Plastic and Reconstructive Surgery, New York University Medical Center.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Barr
authors.forename: Sammy
authors.initials: S
authors.lastname: Sinno
authors.forename: Marcus
authors.initials: M
authors.lastname: Cimino
authors.forename: Pierre B
authors.initials: PB
authors.lastname: Saadeh
mesh_terms: D002568:Certification / Q000706:statistics & numerical data*; D002983:Clinical Competence; D020407:Internet; D013518:Surgery, Plastic / Q000706:statistics & numerical data*; D014481:United States