Who’s the Real Botox Doc, a Dermatologist or a Plastic Surgeon?

Cosmetic dermatologist or plastic surgeon, who is the real Botox doc? As the procedure continues to skyrocket in number, anyone with some sort of medical training – and even in many cases non-medical training – want to get on the bandwagon with Botox injections. Weekend courses are taught on how and where to inject Botox, but how could such a course rival the years and years of training plastic surgeons and dermatologists spend before starting a practice?

Board certified plastic surgeons respond in the latest episode of No Spin Live!

What should patients know about the two disciplines?

Dermatology and plastic surgery cross over more and more with Botox, filler injections, and even the slew of non-invasive or minimally-invasive devices out on the market that remove fat or tighten skin. If a patient is at their dermatologist’s office for a more dermatologic need, but notice that the practice also does Botox, should that patient feel their physician is properly trained? Or should they seek out a plastic surgeon instead?

“I have a tremendous working relationship with the dermatologist in my community,” shares Dr. Cliff Clark, a board certified plastic surgeon in Florida.” They do a tremendous job and I respect their training. Obviously they have much better insight into skin function and physiology and I have a better insight into facial anatomy as it goes deeper. I think that we’ve gotten along really well with dermatologists for a long time and both of our messages have been to go to a board certified physicians for these types of things. I don’t think there’s really an argument as to who does it better, I just think there’s a lot of people who emphasize cosmetic improvement in the face and there’s many plastic surgeons who do an awesome job as well as a number of dermatologists.”

Plastic surgeons agree that dermatologist do indeed have the training and expertise to properly perform Botox and filler procedures, assuming they are board certified of course.

“I agree with Cliff,” says Dr. Dan Del Vecchio, also a board certified plastic surgeon who practices in Boston. “First of all, in a lot of practices, the physician doesn’t even do the injection, it’s a nurse. So the real question might be is a nurse in a dermatologist’s office better qualified than a nurse in a plastic surgeon’s office. The answer is, that’s ridiculous, no. There’s no difference. I don’t see what the issue is, I think it’s much to do about nothing. Dermatologists probably do more injections of things than we do in the office, from acne to cysts and everything else, so if we’re just talking about dexterity with a needle they probably do it more than we do anyway.”

Seeking an Expert and Not Going for What’s Cheap

The bottom line for patients seeking any cosmetic procedure – even if it’s just Botox – is to do your homework. A board certified plastic surgeon or a board certified dermatologist isn’t ALL you need to ascertain. Does the surgeon or physician often do Botox injections? Do they have before and afters to show you to verify their expertise? Some surgeons may really enjoy injectables and believe in what they provide and thus perform many, while others may concentrate on surgical procedures. A board certified dermatologist may be on the cutting edge of skin treatment, but may have little experience with injectables like Botox. Homework is always the answer.

“Both disciplines certainly have that core training,” explains Dr. Adams. “With injectables, there’s all sorts of people doing injectables. Hairdressers, people who don’t even have a medical license. If you’re going to have an injectable done, you gotta do your homework. Just because they’re a cosmetic dermatologist or a plastic surgeon, it doesn’t mean they have expertise although they do have the training. You gotta do your homework.”