Michelle A. Spring, M.D.

What does "Board Certified" mean?

2010-12-28T11:17:00.000-08:00

Most people seeking plastic surgery or any other type of medical treatment are aware that they should look for "board certification" among the credentials of their plastic surgeon or other physician. In reality, most people do not understand what this means and what is involved in becoming board certified. There is a lot of confusing information that is propagated - in the media, from different medical providers, and even friends and family.

Many patients are surprised to learn that any licensed medical doctor, regardless of training, can legally perform plastic surgery and call her or himself a plastic surgeon. Numerous doctors listed under the title of "Plastic Surgeon" or "Cosmetic Surgeon" on the internet and in the yellow pages have not completed an approved residency in plastic surgery and are not Board Certified in Plastic and Reconstructive Surgery, even though he or she might advertise as "Board Certified" (in something).

The American board of Medical Specialties (ABMS) is the national agency whose function is to oversee sub-specialty boards.The American Board of Plastic Surgery (ABPS) is one of 24 medical specialty boards that make up the American Board of Medical Specialties (ABMS). Through ABMS, the boards work together to establish common standards for physicians to achieve and maintain board certification. The boards were founded by their respective specialties to protect the public by assessing and certifying doctors who meet specific educational, training and professional requirements. The ABPS is an independent, non-profit organization. Over the years more than 100 boards have submitted to the ABMS for certification, but only 24 have met their strict educational and examination criteria. They are as follows:

Allergy and Immunology
Anesthesiology
Dermatology
Colon and Rectal Surgery
Emergency Medicine
Family Practice
Internal Medicine
Medical Genetics
Neurology
Neurological Surgery
Nuclear Medicine
Obstetrics and Gynecology
Ophthalmology
Orthopedic surgery
Otolaryngology (ENT)
Pathology
Pediatrics
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry
Surgery
Thoracic Surgery
Urology

The American Board of Plastic Surgery is the evaluating body that is responsible for determining and evaluating the training and certification of plastic and reconstructive surgeons. It is the only plastic surgery board approved by the American Board of Medical Specialties at this point in time.

In order to become certified by the American Board of Plastic Surgery, a surgeon must first complete an approved residency in plastic surgery, then pass a written qualifying examination, and then an oral certifying examination. This takes many years of training, examinations, and continuing medical education credits to qualify. In addition, the American Board of Plastic Surgery requires that the candidates adhere to strict ethics regarding billing, advertising and the practice of the specialty. This is NOT like any other specialty board requirements, and is one of the many factors that differentiate plastic surgeons from other providers doing cosmetic procedures.

There are other surgeons, besides plastic surgeons, who have the ability and experience, which enable them to do cosmetic surgery. Otolaryngologists (Ear Nose and Throat specialists) perform nose surgery, hair transplant surgery, and facial plastic surgery; ophthalmologist (eye specialists) do eyelid surgery; and specially trained dermatologists do dermabrasion, laser skin surgery, Botox and fillers.

There are also boards other than the American Board of Plastic Surgery, which provide certification for other surgeons who perform cosmetic surgery. A few of the boards, which are not certified by the American Board of Medical Specialties (ABMS), include:

Oculoplastic Surgery, Dermatological Surgery, American Board of Cosmetic Surgery
Oral and Maxillo Facial Cosmetic Surgery, Liposuction Surgery

Simply being "board certified" can have a variety of meanings. By knowing exactly which has certified your surgeon, and whether or not the American Board of Medical Specialties recognizes that board, you will better understand your surgeon's training and qualifications.

Another important indication of a certified plastic surgeon is whether she or he is also a member of the American Society of Plastic Surgeons (ASPS).
Membership requirements are:

Are certified by The American Board of Plastic Surgery® or The Royal College of Physicians and Surgeons of Canada®.
Have at least six years of surgical training and experience, with at least three years in plastic surgery.
Operate only in accredited medical facilities.
Adhere to a strict code of ethics.
Fulfill continuing medical education requirements, including standards and innovations in patient safety.

More information is available at:

the ABPS website: www.abplsurg.org
the ASPS website: www.plasticsurgery.org
the ABMS website: www.abms.org

Dr. Spring is a diplomate of the American Board of Plastic Surgery
(or, she is Board Certified in Plastic Surgery)

The Risks of Smoking and Surgery

2010-07-12T14:44:00.000-07:00

Premature aging is one of the main reasons people inquire about the services of a plastic surgeon. Face lifts, chemical peels, and dermal fillers are very popular requests among smokers. How else are they going to deal with the lines around the mouth, the uneven skin tone, the sagging and the wrinkles caused by years of lighting up?

We all know that smoking is not good for our health or our personal appearance. It greatly increases our risk for vascular disease, cancer and emphysema; and it ages us by causing shortness of breath, wrinkles, staining our teeth and making our clothes and hair smell. If you ask your surgeon who makes a good candidate for plastic surgery (or any kind of surgery) the common answer, among other things, will be “non-smokers”.

Why does smoking greatly increase the risk for surgery? Whether you smoke two packs a day, or consider yourself to be a “social smoker” you are susceptible to prolonged healing and major complications during surgery. Cigarette smoke contains nicotine and carbon monoxide. Nicotine makes the heart work harder, so it needs more oxygen, but carbon monoxide prevents blood from carrying oxygen to the heart. This strains the heart and increases the risk of pulmonary lung complications while under an anesthetic.

Postoperatively, smoking greatly interferes with the healing process and increases risk for infection. “Nicotine is a powerful substance that decreases blood flow to healing tissues. This increases the risk of infection, delayed healing, tissue loss and scarring. Smoking or using any other nicotine-containing products four weeks before or four weeks after surgery can adversely affect your results, causing general dissatisfaction which may not be repairable” says Dr. Spring of Seasons Plastic and Reconstructive Surgery in Ponderay, Idaho.

MAKE SUNSCREEN A PART OF YOUR REGULAR ROUTINE

2010-06-29T08:57:00.000-07:00

Summer is right around the corner! That means biking, beaches, hiking, and of course sunshine. Some people think it’s great to walk away from the beach with a suntan, but that’s not the only thing you’re walking away with. Excessive sun exposure is responsible for most of the skin damage associated with aging and skin cancer. Although we get Vitamin D from the sun, it’s thought that you really don’t need more than minutes of sunshine a week to get the required amount. Unfortunately, there is really no such thing as a safe tan, so make sure to stay protected.
Choosing a sunscreen can seem very confusing these days so here are a few points you should keep in mind when selecting one.
• When choosing a SPF you should know that the number gives an indication of how well a sunscreen will protect your skin from UV-B light (which causes sunburn and skin cancer). It is recommended that you use at least a SPF 15 every day. You are still receiving some of the negative effects of sun through light clothing and even car glass windows.
• For protection against UV-A light (which causes wrinkles and also contributes to dangerous forms of skin cancer) be sure that your sunscreen includes ayobenzone, MexorylA, titanium dioxide and/or zinc oxide.
• Using the correct amount is also very important. One of the main causes of sunscreen failure is that people just don’t use enough, so slather it on - particularly after swimming or sweating, and repeatedly during the day if you are out in the sun for prolonged periods.
• Some sunscreens stay on better than others, and this is important if you will be sweating heavily or swimming. In general, titanium dioxide & zinc oxide stay on the skin longer than other sun screening agents. To reduce the chance that titanium or zinc based sunscreens will look white on the skin, choose products containing ‘ultra-micronized’ titanium or zinc. These are so fine that it is transparent to visible light but still do a great job of absorbing and reflecting UV light.

It’s important to know that there are sunscreens out there that feel good on your skin, aren’t greasy, and don’t make you break out. It’s good to get into a habit of applying it every morning and it makes it much easier to do so if you like the way it feels. So, if you’d like to slow the clock down, keep your skin from showing signs of premature aging and protect yourself from skin cancer, make sunscreen part of your daily regimen and ENJOY SUMMER!

DO BREASTS DEFINE A WOMAN?

2010-06-22T13:44:00.000-07:00

A female plastic surgeon’s perspective

Breasts are a functional anatomic part of the female body, nourishing infants and bonding mothers to their young. Breasts are also an aesthetically beautiful part of a woman, enhancing sexual attraction and providing physical pleasure. Breasts come in all shapes, sizes, colors, densities and contours. Most women do not have completely symmetric breasts, just like each side of the body and face is not a mirror image of the opposite side.

Factors that contribute to the appearance of a woman’s breasts include genetics, hormones, body weight, pregnancy, breast-feeding, and the aging process. Women with excessively large breasts have problems finding clothes and bras that fit, difficulty exercising, and suffer from chronic neck, back, shoulder pain, and rashes.. Other women are embarrassed about the size or shape of their breasts, nipples, or areolas. Many women are unable to fully enjoy their lives because of significant embarrassment about their bodies. They may not engage in normal social activities because of this insecurity and emotional or physical pain, and they may not feel attractive to their significant other.

Like it or not, societal and cultural norms contribute to the way we see ourselves. Movies, magazines, television, childhood teasing, and our parents and peers impact our self-esteem and body image long before we have the capacity to decide these things for ourselves.

I struggle to think of one woman I know who believes that her body is perfect. When pressed, most of us do inherently understand that our bodies are amazing to begin with and serve us well throughout life. However, self-esteem and confidence are influenced by how we feel on the outside as well as the inside. Following the natural changes that breasts undergo throughout life, many women are unhappy with their breasts and consider surgery. Women who consider breast surgery usually just want to feel more “normal” or more attractive. They want to improve their body image, self-esteem and confidence.

Over the years, surgical technical advances and anesthetic safety have allowed thousands of woman to successfully reduce, enhance, tuck, lift, change contour, create symmetry and even create new breasts that have been lost or ravaged from cancer treatment, burns, congenital defects and trauma.

Following mastectomy or other treatment for breast cancer, women may be left with a chest or breast deformity, complete breast loss, or dramatic asymmetry. Breast reconstruction surgery can restore cancer patients’ body image and allow them to feel whole again. They don’t have to wear an external prosthesis or feel the uneven weight of having only one breast. All of this can have a profound impact on feelings of well-being, optimism, and healing.

Some girls develop with one or both breasts being constricted or severely asymmetric, or the nipple-areolar complex may be positioned abnormally low on the breast mound. This can be a cause of significant embarrassment and low-self esteem that can follow a girl or woman throughout her entire life and affect many of her personal relationships. Other women develop excessively large breasts and suffer for years before realizing that something can be done, and that breast reduction surgery is often covered by health insurance. Many other women notice significant changes in the size or fullness of their breasts following pregnancy. As breasts mature, they lose density and become more fatty. Upper fullness is lost, and the entire breast starts to sag. A breast lift (with or without an implant) can restore a more youthful, natural appearance. All of these issues can usually be corrected with outpatient breast surgery and minimal recovery time.

Breast surgery is not for everyone. Poor candidates for surgery are women who are severely depressed, who are considering it as retribution for a damaged relationship, or women who wish to change their bodies to please someone else. Women who smoke, are obese, or otherwise lead unhealthy lives should not pursue elective breast surgery.

So, DO breasts define a woman?

I believe that our bodies do reflect our state of mind. Often, I see a woman’s personality change when she comes into the office after surgery standing taller, smiling more, and engaging more because she is just a little bit happier and more confident. Many women will readily explain how breast reduction surgery changed their lives – how they can buy regular clothes or go to the gym without wearing three sports bras, or that they no longer have chronic pain. Many women feel that breast surgery helped them feel more secure and confident with their bodies, which in turn created a better sexual relationship with their significant other.

As a plastic surgeon and as a woman, I feel that our minds, hearts and bodies define us. I have come to believe that all three are inexorably entwined, and therefore breasts do play a part in defining women. Feeling good about our bodies enhances our lives, and for many women breast surgery is a positive factor in the quest for personal satisfaction.

Michelle Spring, M.D.

Dr. Spring is a plastic and reconstructive surgeon with offices located in Sandpoint and Coeur d’Alene, Idaho. She specializes in all aspects of cosmetic and reconstructive breast surgery.

Study blasts lack of training in cosmetic surgery marketplace

2010-04-09T12:51:00.001-07:00

Study blasts lack of training in cosmetic surgery marketplace

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