There is an increasing trend of untrained and non-certified physicians performing cosmetic procedures. The recent trends in manage care and physician compensation has caused providers to look for other ways to increase revenue in a system that continues to punish physicians in compensation. The term cosmetic surgeon is a very broad term that does not necessarily mean a trained plastic surgeon. A cosmetic surgeon could be your obstetrician, family doctor, orthopedic surgeon, or HEENT; in other words, anybody. Why is this? Our state and federal governments are missing the ball in their lack of regulation for physicians, paramedical professionals, and technicians performing cosmetic procedures and surgeries without proper certification and credentials. For example, any physician can take a weekend course and do liposuction in his office with minimal regulation and effort, and there is no strict regulation that prohibits it. I see patients weekly that have had cosmetic surgeries that require surgical corrections. People trust physicians and even intelligent and well-educated patients make the mistake of having surgeries by untrained physicians. There is only one recognized BOARD CERTIFIED SPECIALTY for cosmetic procedures and it is the BOARD OF PLASTIC SURGERY. Don’t be confused by others so called Boards that are not approved like the Board of Cosmetic Surgery and the Board in Facial and Plastic Surgery, among others. When it comes to cosmetic surgery, the premiere specialty is plastic surgery. Plastic surgeons are cosmetic surgeons but cosmetic surgeons are not necessarily plastic surgeons. When choosing your surgeon, make sure you check his/her credentials. Check his/her website and make sure that there are lots of before and after pictures. In Houston, there are tons of the so called cosmetic surgeons that are not plastic surgeons like Dr. Nikko, who is a dematologist; Dr Pina, who is an otoralingologist; the Houston Vein and Cosmetic Center under its director, Dr. Paul Wintle Des Ruisseaux, among others. Educate yourself before choosing your surgeon. To become a plastic surgeon, 6 to 7 years of training after 4 years of medical school are required. Do you think a weekend course or one year of a non-accredited “cosmetic fellowship” is enough? Why would you go to a family practitioner for liposuction? Would you come to me to treat your chest pain or a cold?