Plastic surgery vs. cosmetic surgery: What are the differences, risks?
Authorities are investigating the death of a Gulf Breeze, Florida, woman who died after her husband performed multiple plastic surgeries on her in his office.
Hillary Ellington Brown, 33, went into cardiac arrest and her husband, Dr. Ben Brown, 40, of Restore Plastic Surgery, called 911. She lapsed into a coma with such severe brain swelling that recovery was deemed impossible. She died a week later after being removed from life support.
The Santa Rosa Sheriff’s Office Major Crimes Unit and the District One Medical Examiner are now investigating Hillary’s death.
Her father, Marty Ellington, told the Pensacola News Journal that Hillary enjoyed having her husband regularly perform plastic surgery procedures on her face and body.
What is the difference between plastic surgery and cosmetic surgery?
There's a lot of overlap, and many people are understandably confused about the differences between the two, but plastic surgery and cosmetic surgery are not interchangeable.
"Simply put, cosmetic procedures are performed to enhance someone's overall appearance by reshaping and adjusting an anatomy that is already there as a way to make something more visually appealing," according to the American Society of Plastic Surgeons (ASPS). This can mean Botox injections, tummy tucks, nose jobs, breast augmentation or reduction, facelifts, and Florida's favorite, the dangerous Brazilian butt lift. Many plastic surgeons perform cosmetic surgery.
But much of what plastic surgeons do is reconstructive surgery that seeks to restore function and appearance to people with birth defects, repair damage caused by accidents or burns, and address the impacts of medical conditions such as different forms of cancer.
All cosmetic surgery is plastic surgery. Not all plastic surgery is cosmetic.
Do plastic or cosmetic surgeons need to be licensed?
Cosmetic surgery is considered elective, is generally minimally invasive, and can be performed by doctors from "a variety of medical fields," including plastic surgeons, according to the American Board of Cosmetic Surgery (ABCS).
But while cosmetic surgeons can become board-certified in cosmetic surgery procedures, there are no government requirements for any medical professional — which can also mean dentists, ophthalmologists, gynecologists, internists and more — to complete any formal training or certification before advertising and taking patients as a cosmetic surgeon.
In contrast, plastic surgery requires years of formal training and certification that is recognized by established authorities such as the state's Board of Medicine and the American Board of Medical Specialties. 92% of the board-certified plastic surgeons in the U.S. also are members of ASPS, the organization said.
How dangerous is plastic or cosmetic surgery?
While most cosmetic surgery performed correctly is safe and heals quickly, "all surgeries, including cosmetic procedures, carry risk," according to the Mayo Clinic. Even when the procedures are performed by trained surgeons, there are always chances of complications or accidents. People with obesity or diabetes may be at a higher risk for complications such as blood clots in the legs or lungs, the clinic said.
Some possible complications from any surgical procedure, according to the Mayo Clinic, include:
Complications related to anesthesia, including pneumonia, blood clots and (rarely) death
Infection at the incision site
Fluid buildup under the skin
Mild bleeding
Abnormal scarring
Separation of the surgical wound
Numbness and tingling from nerve damage, which could be permanent
Florida's most-searched cosmetic tweaks: BBLs, tummy tucks and hair transplants
And cosmetic surgery from someone who is not trained or is working under substandard conditions such as quickie clinics can lead to serious problems. In two Miami facilities run by the same doctor using non-board-certified staff for quick patient turnovers, nearly a dozen patients suffered critical complications including punctured internal organs over a period of six years and eight people died.
Four of them died after doctors injected transplanted body fat into their muscles during a Brazilian butt lift (BBL) intended to provide the hourglass shape made popular by the Kardashians, according to a 2019 USA TODAY investigation, a dangerous procedure many plastic and cosmetic surgeons refuse to do. According to a 2022 article from the American Society of Plastic Surgeons, it looked like the death rate for BBL procedures was as high as one in 3,000.
"The fat pooled in their hearts and lungs, killing them in minutes," the report said.
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Does Florida have laws about cosmetic surgery?
For a long time, Florida's lax cosmetic surgery regulations made the state a destination for people seeking cheap procedures and for shady practices looking for easy money, which led to multiple injuries and deaths.
In 2019, Gov. Ron DeSantis signed into law the first major reform in over a decade to give the state the power to suspend a clinic's operations or revoke its registration if it determines the facility poses an imminent threat to the public. It also prevented anyone named in the registration from registering another surgery office for five years.
The legislation was introduced weeks after the USA TODAY investigation into the South Florida plastic surgery business, mentioned above, whose owner kept changing its name to avoid the bad publicity. However, attempts to include background checks and bans against felons owning cosmetic surgery facilities were struck down before the bill was passed.
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How can I tell if my plastic or cosmetic surgeon is board-certified?
In Florida and many other states, if a doctor says they are board-certified they must indicate the name of the verifying board of whatever type of surgery they specialize in, i.e. Board Certified Facial Plastic Surgeon or Board Certified Plastic Surgeon, according to Palm Beach Gardens plastic surgeon Dr. Anita Mandal.
You can find accredited plastic surgeons by name or ZIP code at the ASPS' "Find a plastic surgeon near me" search tool. You also can search at the American Board of Plastic Surgery or, to get more specific, the American Board of Facial Plastic and Reconstructive Surgery.
For cosmetic surgery, you should look for surgeons not only board-certified in cosmetic surgery but also trained in the specific procedure you're considering. The ABCS has helpful tips on what to look for and what to ask. The organization also has a cosmetic surgeon search.
Contributing: Lianna Norman, USA TODAY Network-Florida
This article originally appeared on The Daytona Beach News-Journal: Plastic surgery vs. cosmetic surgery: Florida law, and dangers to know
