What does a plastic surgeon do?

In this blog I will discuss the tasks and specialisations of plastic surgeons, including the training they complete and the various subfields within plastic surgery.

I will also explain why it is advisable to choose a plastic surgeon for cosmetic procedures.

What does a plastic surgeon do?

A plastic surgeon is a doctor who has completed the specialist training to become a plastic surgeon. The basic medical training in the Netherlands consists of 4 years of medicine at university, followed by 2 years of clinical placement (semi-physician internship, formerly known as co-schappen).

After this university education you become a basic doctor. You can then specialise to become a specialist, which means you focus on a specific subfield of medicine. Well-known specialisations include, for example, internal medicine for internists, gynaecology for gynaecologists, and surgery for surgeons.

General practice medicine is the training to become a GP. In the same way, there is also a specialist training for plastic surgeons. There are only a limited number of training places for plastic surgeons in the Netherlands, spread across different regions. There are many interested candidates, all with a strong CV, which makes it difficult to secure a training place.

Usually all candidates start with placements at various plastic surgery clinics. The training to become a plastic surgeon begins with a 2-year general surgical part, after which the remaining four years are devoted to specialisation in the various areas of plastic surgery. The training concludes with an examination.

So which subfields of plastic surgery are there?

Plastic surgery in the Netherlands is divided into various areas, although ideas about these subfields may differ and combinations are possible.

1. Reconstructive plastic surgery: This includes reconstructions of the body after another surgeon has removed cancer. Well-known examples are breast reconstructions after a breast cancer amputation.
2. Dermatoplastic surgery: This covers all skin tumours and the associated reconstructions. There is close collaboration with dermatologists, for example in Mohs surgery, or with oncological surgeons in the treatment of melanomas.
3. Traumatic plastic surgery: Examples of this are facial injuries after accidents.
4. Paediatric plastic surgery: This covers all congenital abnormalities of the hands, skulls or skin, such as a cleft lip or cleft (schisis).
5. Hand and wrist surgery: Abnormalities of the hand or wrist are treated in the Netherlands by plastic surgeons. Abroad this is sometimes done by orthopaedic surgeons.
6. General plastic surgery: This includes treatments that are possible with any plastic surgeon, such as breast reductions and minor hand surgery such as trigger finger or Dupuytren’s disease.
7. Pressure ulcers and wounds: Plastic surgeons have experience with closing wounds, whether surgically or not, including chronic wounds, pressure sores and burns. They also have the expertise to close defects in the body using, for example, tissue flaps.
8. Aesthetic (cosmetic) plastic surgery: I deliberately mention this subfield last because it is the focus of Kliniek het Bolwerk. Well-known procedures we perform are eyelid corrections and labia corrections.

In the past it was common to be trained in all areas, but nowadays plastic surgeons increasingly specialise in one or two subfields.

So a plastic surgeon is a mark of quality for your treatment!

Plastic surgeons are members of the Dutch Association for Plastic Surgery (NVPC), which safeguards the quality of training and of plastic surgery in the Netherlands. Plastic surgeons are reviewed once every 5 years to ensure they keep their experience up to date and continue their professional development.

So why do other doctors perform cosmetic procedures?

In the Netherlands there is no restriction on performing treatments. As soon as someone is authorised and competent, he or she may perform a procedure without restriction. This means that any doctor may perform injectable treatments, eyelid corrections or labia corrections.

It is often difficult for consumers to assess quality via the internet. Experience is crucial here. Ask the treating doctor how long they have been performing the procedure and how many procedures they have done. Read reviews and make sure you are well informed during a consultation, and do not let yourself be guided by price alone.

So what is a cosmetic doctor?

Since 2019, the training to become a cosmetic doctor has been a recognised programme. This training lasts only 2 years and is followed after passing the basic physician examination. The Dutch Association for Cosmetic Medicine (NVCG) is the scientific professional association for cosmetic doctors who have qualified in injectables (botox and fillers), energy-based treatments (lasers, IPL, LED, etc.), peelings and anti-aging.

So why still go to a plastic surgeon?

If you choose a treatment with a plastic surgeon, you know that they have been extensively trained and are qualified to perform the treatment. Plastic surgeons have ample experience with the treatments during their training.

If something does not go according to plan, the plastic surgeon is well able to resolve problems. They often also solve the problems that arise with others who work in the cosmetic field. In short, investing in a plastic surgeon is an investment in yourself.