Plastic surgeons do at least 6 years of training. I did 8 — I'm also a fully trained general surgeon. We do burn surgery, hand surgery, trauma reconstruction, cancer reconstruction, microsurgery, and pediatric reconstruction. Cosmetic surgery is one slice of the field, not the whole thing.
A question came in that I love answering — because most people don't actually know what plastic surgery is.
I get comments all the time from people saying "what would you know, all you do is implants?" — and it tells me how much my own specialty is misunderstood, even by patients considering surgery.
Let me walk through what plastic surgeons are actually trained to do. I think you'll be surprised by the breadth.
Before we even get into the scope, let me set the baseline:
We are not "people who only do breast augmentations." That framing represents about 5% of what our specialty actually does. The rest of the field is, by any measure, big, hard, reconstructive surgery.
For more on the board certification piece and why the specific board matters, I've written about it separately. The "American Board of Plastic Surgery" is real. The various made-up "cosmetic boards" that some practitioners cite are not.
Here's a (probably incomplete) tour of the field. Most plastic surgeons end up picking a few areas to specialize in for their actual practice — but during residency, we're trained across all of the following.
Yes — cosmetic surgery is part of plastic surgery. This is the visible tip of the iceberg:
This is what most people think of when they think "plastic surgery." But it's a sliver of the actual scope.
A lot of patients don't know this: plastic surgeons do burn care.
This is some of the most physically and emotionally demanding work in the field, often involving young patients with life-altering injuries.
This one really surprises people.
All plastic surgeons are trained in hand surgery. This includes:
A few plastic surgeons specialize entirely in hand surgery and rarely do anything else.
When someone has a serious traumatic injury that's caused significant tissue damage, plastic surgeons are typically the ones called in to repair it:
If a piece of someone's anatomy is missing or destroyed, we're the ones who put it back together.
This is, honestly, where I do the bulk of my reconstructive work:
When an oncologist removes a tumor, plastic surgeons rebuild what was removed. This is some of the most meaningful work in medicine, and it's a major part of what most academically affiliated plastic surgeons do.
Because we are reconstructors of the body, plastic surgeons are the experts in microsurgery — operating under a microscope to suture tiny blood vessels.
During residency, all of us are trained in:
The microsurgery training plastic surgeons receive is one of the things that distinguishes our specialty. Few other specialties do this level of microsurgical work.
A lot of plastic surgery is pediatric:
The plastic surgeons who specialize in pediatric work are doing some of the most technically demanding and emotionally meaningful surgery in medicine.
Beyond the standard plastic surgery residency, there are additional fellowships for plastic surgeons who want to specialize further:
I did additional specialized training. Many of my colleagues did too. The field rewards depth in specific areas.
Here's the key thing I want patients to understand:
Plastic surgery is, at its heart, the specialty of fixing problems.
We fix problems caused by:
What unites all of these is that we're looking at the body as a functional and structural system, not just an aesthetic surface. We think about:
This is what allows us to be excellent at cosmetic surgery as well. We aren't just doing aesthetics. We're applying reconstructive principles, microsurgical training, and a deep understanding of tissue behavior to aesthetic goals.
That's why a plastic surgeon doing your breast augmentation brings something fundamentally different than a "cosmetic surgeon" who completed a 3-month internal fellowship and started doing implants.
Even though we're trained across all of the above, most plastic surgeons in real-world practice pick a few areas to focus on:
But all of us came through the same broad training before we picked our lanes. That broad training shows up in how we think about every individual case, even after we've specialized.
The reason most people think "plastic surgery = cosmetic surgery only" is honestly social media and cultural visibility.
So when patients hear "plastic surgeon," they often picture the very public cosmetic side and miss the entire iceberg below it.
Plastic surgeons are some of the most highly trained physicians in medicine — minimum 6 years of training, often 8 or more, across an enormous range of complex surgical work.
We do:
Most of us specialize after training, but the breadth of our background is what makes us excellent at whatever subset we end up focusing on.
So next time someone in a comment section says "what would you know, you just do implants" — that comment reflects a misunderstanding of what plastic surgery actually is. The implant work is downstream of years of training in reconstructive surgery, microsurgery, hand surgery, burn care, and oncologic reconstruction.
We're fixing problems. The cosmetic work is one slice of a much broader field.