The debate over which doctors are best qualified to perform cosmetic surgery — and who gets the best results for patients — has raged for decades.

Here’s why: A state-issued medical license grants a physician what a Federation of State Medical Boards policy statement called the “privilege of practicing the full breadth of medicine.”

That policy leaves the door open for any licensed doctor to perform cosmetic surgery after scant training, such as a weekend course in liposuction, and some doctors have done just that.

The federation adds that doctors “have a professional and ethical duty to put their patients’ best interests before their own and only offer treatments to patients that they are able to provide competently.”

But what credentials surgeons should hold and be permitted to advertise — the use of the term “board-certified,” in particular — remains contentious. And, for patients, figuring out which of those credentials and marketing claims to trust, and how to steer clear of doctors with troubled pasts, can be a challenge.

Here are tips for picking a cosmetic surgeon:

Do a background check.

The Federation of State Medical Boards operates an online site with information about a doctor’s practice history, including disciplinary actions. The federation also lists contacts for each state medical board. Many states compile profiles of doctors with details about their training and practice history. Some include medical malpractice payments to patients who filed suit.

Understand board certification.

In the field of cosmetic surgery, the American Board of Medical Specialties recognizes only the American Board of Plastic Surgery, which requires a minimum of three years training in plastic surgery as well as a written and oral exam.

Board-certified members of the American Society of Plastic Surgeons decry what they see as doctors with less training infringing on their territory, by citing unrecognized certifying boards to buff their credentials, among other things. The society posts a directory of its members here.

“A lot of people say they do plastic surgery,” said society president Scott Hollenbeck. “It’s confusing to patients.” The plastic surgery board “is the only one that is legitimate.”

Not so fast, say more than 400 surgeons nationwide who are certified by an alternative board called the American Board of Cosmetic Surgery.

The group says it accepts only doctors who have completed a residency training program in a surgical specialty, taken a one-year fellowship in cosmetic surgery, and passed a test of their competence and knowledge.

Yet the group has struggled to gain broad acceptance, it says, because of pushback from the plastic surgeons.

Jeffrey Swetnam, an Arkansas cosmetic surgeon and president of the American Board of Cosmetic Surgery, told KFF Health News that plastic surgeons have long sought to beat back competitors. Swetnam said that plastic surgery training focuses on a broad range of reconstructive operations, including cosmetic procedures, while members of his group focus exclusively on cosmetic operations.

“This whole deal is a money grab, a turf war over money,” he said.

In April, for example, Florida’s medical board rejected a request by cosmetic surgeons that they be permitted to advertise board certification without adding the caveat that their board is not recognized by the American Board of Medical Specialties.

In some cases, state medical licensing boards have disciplined doctors for allegedly misstating their credentials.

One was Kenneth Adams, a board-certified emergency medicine specialist, who opened Premier Liposuction in Las Vegas after taking a two-day course in liposuction and fat transfer, according to Nevada’s medical licensing board. In a civil complaint in April 2024, the board accused Adams of practicing “beyond the scope of his license.”

The complaint alleged that Adams’ advertising “misleads the public that his certification in Emergency Medicine provides the necessary training to perform liposuction surgery to inflate his credentials and induce patients to seek his services.”

Adams settled the case in November. The settlement prohibited him from performing liposuction, fined him $3,000, and issued him a letter of reprimand.

The American Board of Medical Specialties runs a website for checking a doctor’s board certification in recognized specialties, including plastic surgery.

Check for court action.

Some jurisdictions have posted dockets online, which can be searched by name to find lawsuits, though many charge for access and copies, costs that can add up fast. Gerald Hickson, a physician researcher at Vanderbilt University and expert on medical malpractice cases, said a pattern of lawsuits is a red flag. He said that most doctors don’t get sued often, regardless of their specialties.

Consider word of mouth.

It may sound old-fashioned, but some experts, including Hickson, recommend checking with friends and neighbors when picking a doctor. He added that patients need to use “common sense” when interacting with a medical practice to make sure it is right for them.

“Don’t shop for surgery like it’s a sale item,” adds cosmetic surgeon Swetnam. “Invest the time to choose a surgeon based on their training, outcomes, experience, and integrity — not just their title.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.