WEST DES MOINES, Iowa — The titles plastic surgeon and cosmetic surgeon are often used interchangeably — but they refer to two very different types of medical professionals, each with distinct training, certification, and standards of practice. This overlap in terminology can lead to confusion and, in some cases, misinformation for patients seeking aesthetic procedures. 

Elective aesthetic surgery is on the rise, with millions of Americans opting for procedures each year — and the numbers show no sign of slowing down. 

“I mean, aesthetics in medicine in general is really a booming industry. I mean, everywhere across the world, but across the United States. And it used to be people think of this as an East Coast or West Coast thing. But yeah, it’s everywhere,” said Dr. Michael Carlisle, Plastic surgeon at Koch & Carlisle Plastic Surgery & Spa in West Des Moines.

It’s an industry that has firmly planted itself in Iowa, with numerous surgery centers and med spas right here in the metro. As the procedures become more common, the demand increases, meaning more providers are entering the market to capitalize on the growing interest.  

“This is a growing industry. And sometimes that means you do get some people into the industry that maybe don’t belong there,” said Dr. Carlisle.

That’s why Dr. Carlisle says in today’s aesthetic marketplace, being an educated consumer isn’t optional, it’s essential, saying, “The American Society for Plastic Surgeons has been trying to educate the public for the last 20 years about the cosmetic surgery board, not necessarily, again, to talk bad about anybody in particular, but just to say, here’s the difference in training… Again, that doesn’t mean there aren’t any good cosmetic surgeons. You just have to do your homework.”

That means understanding the distinction between cosmetic and plastic surgeons, and knowing what various certifications represent when evaluating providers. 

“There are cosmetic surgeons who will not and really can’t call themselves plastic surgeons because they didn’t do plastic surgery training and they’re not board certified by a plastic surgery, by the plastic surgery boards. They have their own cosmetic surgery certification… So, the cosmetic surgery board is a board that’s not kind of under the main standards from all the other boards,” said Dr. Carlisle

The main boards are overseen by the American Board of Medical Specialties and the American Osteopathic Association, and include both Plastic and Facial Plastic Surgery with the cosmetic surgery board being a separate, independent board.  

“You’re basically meeting that board standards. I can make my own medical board if I want to. This is something very independent from licensure. So, boards of certification are voluntary. You don’t have to have a board certification to be a licensed doctor… I think sometimes the public gets that confused, where just because you have a medical license doesn’t mean your board certification is somehow overseen by that medical licensing,” said Dr. Carlisle.

That’s why Dr. Carlisle says anyone considering aesthetic surgery should look for a surgeon with clear before-and-after results and solid patient reviews, saying, “You have to trust your surgeon. You know, and again, much of that is that one-on-one interaction. And much of that is, again, reviewing reviews and looking at before-and-afters. But it’s that gut feeling of meeting with them, seeing, communicating, seeing if you’re on the same page. And I think that’s one of the biggest goals.” 

And that the provider has the skill and experience to address any complications that may occur post-op. 

“These are low percentage issues, but no surgery is risk-free… That’s what those high standards of the American Board of Medical Specialties and the American Osteopathic Association hold their physicians to is knowing how to deal with problems when they come, not if they come,” said Dr. Carlisle.

So that patients can continue to receive safe aesthetic surgeries with positive outcomes.  

“Aesthetic surgery is safe. Hundreds of thousands of these are happening every day. And because of recent things in Iowa, you know, I want people to know that just because there are some negative events that you hear about and that you have heard about doesn’t mean that that’s changing the overall picture of aesthetic surgery in Iowa and it is safe,” said Dr. Carlisle.