We are all familiar with the job of a facial cosmetic surgeon, that is face lifts, nose jobs, and lip fillers. But what you may not know is that the training to become a facial cosmetic surgeon is drastically different from Doctor to Doctor. I took a dive down the rabbit hole to figure out where (and why?) these differences come from.

After finishing a brutal four years of training in medical school, future Doc's are still years short of practicing medicine in the real world. First they have to take part in a multi-year residency to refine their skills in the specialty of their choice.

In order to get into that residency, they first must be part of the Match. The Match uses a mysterious algorithm to fit medical students into the residency programs that want them (Hogwarts sorting hat may or may not be involved).

Here is where the difference in training between surgeons lies.

A medical student may choose to embark on a 5 year long general surgery residency. A general surgery residency prepares an MD to operate on any part of the human body, except the eyes, ears, neck, nose and brain. After completing his or her 5 years, a resident's training is considered complete.

However, some masochistic residents can opt-in to further specialization called a fellowship, where they can further hone their skills operating on a specific part of the human body. A Plastic Surgery fellowship is three years long, amounting to 8 total years of post-graduate training.

Another route for future Facial Plastic Surgeons is to choose a residency in Otorhinolaryngology (Ear, Nose and Throat for the less Latin-inclined). ENT residencies prepare MDs for operations of the neck, ears, sinuses, skull base, nose and the bony and soft tissue of everything above the shoulders (except brain and teeth). An ENT residency is usually 5 years long, but can be up to 6 years.

Board certification in ENT technically allows Physicians to perform cosmetic procedures on the face without any further training. But to be certified by the American Board of Plastic Surgeons, a One year fellowship in Facial Plastic and Reconstructive Surgery must be completed, amounting to 6 - 7 years of post-medical school training.

So to put it all together, general surgeons can become facial plastic surgeons, but only after 8 years of training. ENT docs can become plastic surgeons after 6-7 years of training. Ultimately, all MDs who are certified to perform facial plastic surgery will have been well trained and qualified to straighten out that nose or put a little puff in your lips.