WhAT IS the difference between a plastic surgeon and an aesthetic/cosmetic doctor/surgeon?

… Is there a difference?

1. What is the difference between a “plastic surgeon” and an “aesthetic/cosmetic doctor”?

1. PLASTIC SURGEON

• The title “Plastic Surgeon” is a protected professional title in Europe. It is also a protected professional title in Belgium: "doctor-specialist in plastic, reconstructive and aesthetic surgery".

• This title may therefore only be used by:

1. doctors who have completed first their training as a basic doctor (currently 6 years) 
2. have completed a subsequent university specialization (of at least 6 additional years) to become a plastic surgeon. 

• A Plastic Surgeon has therefore received a longer and more thorough training than a Cosmetic Doctor.

• You can therefore consider this professional title as a kind of quality mark in plastic surgery.

2. AESTHETIC/COSMETIC DOCTOR/SURGEON

• The title "Aesthetic/Cosmetic Doctor" is not an official title and may be used by any doctor in Belgium (at least training as a basic doctor). 

• In 2013, an additional protected professional title "doctor-specialist in non-surgical aesthetic medicine" was created in Belgium,  which a Basic Doctor can obtain provided that additional conditions are met. However, these (training and/or experiential) conditions have still not been worked out after 10 years, so that this professional title remains a dead letter. This is in contrast to the Netherlands, where the status of "cosmetic doctor KNMG" is already further regulated.

•  As a result, any doctor (basic doctor or specialist) in Belgium can continue to use the unrecognized title of "aesthetic/cosmetic doctor" as soon as he or she has an interest in aesthetic medicine. In principle, this is also possible without further training.

• Therefore, "cosmetic doctors" have not completed any legally required aesthetic training like a "plastic surgeon".

2. Why is this difference relevant? 
Who is allowed to do which aesthetic treatments?

1. Non-doctors (beauticians, nurses, hairdressers,...). 

• Recently (June 2022), the Supreme Health Council reaffirmed that it is absolutely forbidden for a non-doctor (for example, a beautician, a hairdresser, a nurse,...) to perform a medical procedure through the skin or mucous membranes. 
• As typical examples of prohibited treatments are given: Botox, Fillers, Dermaroller, Plasmalift, Suspension threads (wire lift), deep peeling, de-tattooing,...  A Needling with a certain depth (passing through the dermis) is also a good example.
• So know that these medical procedures are exclusively reserved for doctors and prohibited for non-doctors.
• This unlawful practice of medicine can be prosecuted.
• In case of problems, you as a "patient" or customer are left on your own. After all, these "practitioners" can never be insured for these (illegal) actions and, moreover, are not competent to solve any problems afterwards.
• It is a pity that people still fall into this trap and often do not dare to take action.

… Can any doctor also perform any type of aesthetic treatment? What can which doctor do?

2. PLASTIC SURGEON

The "Plastic Surgeon" is the only one authorized to do everything regarding aesthetic treatments, more specifically:

• Surgical + non-surgical aesthetic treatments:

Surgical treatments include surgery such as eyelid correction, breast augmentation, rhinoplasty, facelift,...

Non-surgical treatments include injections with muscle relaxants or fillers; medical peels and needlings,...

• all over the body.

3. OTHER PHYSICIAN-SPECIALISTS

Any other physician-specialist may also:

• perform all aesthetic treatments (surgical + non-surgical)

• but only on the regions of the body for which they are specialists, so not over the whole body:

Examples:

The ophthalmologist may also do aesthetic treatments and operations in the region of the eyes, but will not be allowed to do breast augmentation, for example.

The mouth, jaw and facial surgeon may also perform aesthetic treatments and operations on the region of the face and neck, but will not be allowed to do tummy tuck, for example.

The gynecologist may also perform aesthetic operations on the mammary gland, abdominal wall region and female genital organs, but will not be allowed to do rhinoplasty, for example.

These physician-specialists are therefore allowed to add "aesthetic surgery" to their signboard, but may only perform it for the specific anatomical region in which they specialize. However, they should not mention that they are "Plastic Surgeon" because that is another protected professional title.

4. specialist-DERMATOLOgist

De specialist-dermatologists are only competent for:

• the non-surgical aesthetic treatments + a number of listed surgical aesthetic treatments i.e. hair transplants; lipofilling (within certain limits); dermabrasion and liposuction (within certain limits).
• all over the body (excluding intramammary injections).

5. THe cosmetic/Aesthetic DOCTOR WHO IS ONLY GENERAL PRACTIONER (i.E. NONE OF THE AFOREMENTIONED SPECIALISTS)

These cosmetic doctors are only authorized for:

• the non-surgical aesthetic treatments + the following surgical aesthetic treatments (hair transplants + lipofilling (within certain limits))
• all over the body (excluding intramammary injections).

However, as long as the additional professional title of "physician-specialist in non-surgical aesthetic medicine" has not yet been carried out, the experience or training of these doctors is not subject to any control here.

6. HoW DO I RECOGNIZE A LICENSED PLASTIC SURGEON? 

• A real "Plastic Surgeon" has a NIHDI number ending in 210. You can look up this number for Belgian Plastic Surgeons on the website of the NIHDI. Often this will also be mentioned on the website of the Plastic Surgeon.

3. Is THIS REALLY SO IMPORTANT THAT I CHECK ALL THIS? WHat ARE THE POSSIBLE RISKS?

Actually, the consequences of your choice of practitioner can be very serious. 

• Not only may your practitioner lack the necessary knowledge and experience, which puts you at risk of a wrongly chosen or performed treatment.
•  Moreover, this person will not be insured for these operations. A doctor or other person (beautician, nurse) who goes beyond their legal authority will also never be covered by their liability insurance (if they already have one).
• Also, this person will often not know what to do in case of wrong treatment, so you are literally left to your own devices.
•  Also, be extra careful when traveling outside Europe for your aesthetic treatment and check what the regulations are there. The title Plastic Surgeon is a protected title in Europe but not always abroad.

4. Our advice

• Always check first what the  recognized title of your practitioner is and whether he also has the necessary specializations, experience and education. Am I dealing with a "plastic surgeon" or a basic doctor/physician-specialist who has a particular interest in "aesthetic treatments" (cosmetic doctor/surgeon)?
• In the latter case, it is best to do additional research into  the experience and training that this Cosmetic Doctor has in the aesthetic domain: there are cosmetic doctors who have years of experience and continuous training, but you can also deal with someone who has only attended one workshop and has no relevant experience yet.
• It is also the case that a plastic surgeon  can go a step higher in the process because he can also offer surgical treatments, for example an eyelid correction as an alternative if a treatment with anti-wrinkle injections no longer gives sufficient results. In addition, a Plastic Surgeon is additionally trained in scar treatment.

Click here for further information about the training and experience of your Plastic Surgeon Dr Nelissen.