Medical Minute: What Are the Differences Between Oculoplastic and Plastic Surgeons?

Medicine has many different specialties, and sometimes the procedures performed by these different specialties overlap. Two such examples are the specialties of Plastic Surgery and Oculoplastic Surgery. Both perform reconstructive and cosmetic procedures on the face, but there are some definite differences worth noting.

First, we will discuss Oculoplastic Surgeons. The training of Oculoplastic Surgeons begins after medical school and an internship with a residency in Ophthalmology, or eye surgery. This training involves understanding in intimate details the eye, eyelids and facial region around the eye. A key portion of Ophthalmology training is surgery on the eye itself. This is very delicate surgery and requires an exquisitely delicate touch. Some of the sutures we use in eye surgery are so fine they float on small breezes in the air when trying to tie them. After Ophthalmology training those specializing in Oculoplastic Surgery undergo fellowship training. Since Ophthalmology training involves such fine suturing, the delicate touch obtained there translates into a precise and careful touch when performing eyelid and facial plastic surgery in Oculoplastic Surgery training.

Now, we will discuss Plastic Surgeons. Plastic Surgeons begin their training after medical school and an internship with a residency in General Surgery. General Surgery involves everything from bowel surgery to hernia surgery to arm and leg amputations and other very large body procedures. The sutures used when manipulating the intestines and other big body parts are dramatically larger than those used in Ophthalmology. Next comes a fellowship in Plastic Surgery, which involves trauma repair, burn care and skin flap surgery. This, again, involves larger sutures than those used in Ophthalmology and Oculoplastic surgery. Plastic Surgeons also cover many different body parts (i.e. breast, abdomen, arms, legs, face) whereas Oculoplastic Surgeons train and specialize in the face alone.

What Are the Differences

  • Where the training in Oculoplastic surgery begins with the fine touch obtained in Ophthalmology, Plastic Surgery beings with the large touch and big body and bowel manipulation obtained in General Surgery training.
  • Where Plastic Surgeons cover many body parts and are generalists in this regard, Oculoplastic Surgeons cover the face and areas around the eyes and are specialists in this regard.

There are great Plastic Surgeons and great Oculoplastic Surgeons who perform facial surgery, but I believe Oculoplastic Surgeons like myself have a bit of an edge when performing aesthetic facial surgery. I often think of it with the following metaphor: Plastic Surgeons are like big sculptors carving stone and chipping away to obtain a beautiful result. Oculoplastic surgeons are like diamond cutters, using fine, small, precise movements to get a beautiful result. The fine, precise, finessed touch that is learned in Ophthalmology and Oculoplastic fellowship provides a great basis from which to perform eyelid and facial plastic surgery, where paying attention to small details results in better surgical and aesthetic outcomes.

There are Plastic Surgeons out there who do a great job on facial and eyelid surgery, but I feel that Oculoplastic Surgery with its emphasis on finesse and fine touch make us generally better surgeons when considering eyelid and facial plastic surgery.