Richard T. Vagley, MD, FACS
Medical Director, PIPS

(click here for background)

What is plastic surgery? Plastic surgery is not easy to define. Other medical/surgical specialties focus on the treatment of problems limited to a specific organ, like the heart in the case of cardiology, or a specific organ system, like the bones and joints in the case of orthopedic surgery, but plastic surgery encompasses the treatment of problems which affect the entire body, in a variety of ways and with a variety of consequences. The common denominator to the universe of problems plastic surgeons treat is physical deformity, whether the truly abnormal, as is the case with disfigurement secondary to a birth defect or an injury, or the perceived abnormal, sometimes called the "unhappy normal", as is the case with a body part "out of sync" with the rest of the body, owing to unfavorable growth and development or the unavoidable changes secondary to pregnancy, aging, etc. Plastic surgeons like to categorize the scope of their specialty into Four C's, specifically:

  • Cancer Surgery - the surgery of not only cancers, such as skin cancer (still the most common of all cancers), but also the consequences of cancer treatment. An example of the latter is breast reconstruction undertaken to replace a breast removed because of breast cancer;
  • Catastrophic Surgery - the surgery of injury/trauma, such as that related to motor vehicle accidents;
  • Congenital Anomaly Surgery - the surgery of birth defects, such as cleft lips/palates or extra fingers; and finally
  • Cosmetic Surgery - the surgery of the "unhappy normal" and that surgery most often associated with plastic surgery and plastic surgeons.

Perhaps most interesting about plastic surgery is the continual blurring of the line between cosmetic and non-cosmetic surgery. For example, the use of Liposuction in certain obese individuals can prevent or at least limit their tendency to develop diabetes mellitus ("sugar diabetes"), a non-cosmetic application of what commonly is regarded as a cosmetic surgical procedure.

What is a plastic surgeon? I guess the answer to that question depends upon how narrowly one defines the term "plastic surgeon". Legally speaking, as far as Pennsylvania and many other states are concerned, any licensed physician can label himself/herself a plastic surgeon and undertake surgery commonly associated with plastic surgery, since, as is the case with all medical/surgical specialty designations, the terms "plastic surgery" and "plastic surgeon" are not protected by law and, therefore, are not limited in use to a certain "class" of individuals. Within the medical profession, though, the term "plastic surgeon" refers to a physician (M.D.) or, much less commonly, an osteopath (D.O.) who completed training in a nationally recognized/approved plastic surgery residency (or training program) after appropriate grounding in a nationally recognized/approved general surgery (or similar) residency. A plastic surgeon who is Certified by (also known as a Diplomate of) the American Board of Plastic Surgery is one who, subsequent to training and a minimum period of practice afterwards, successfully passed a rigorous examination (in fact two examinations, one written and one oral) by nationally recognized plastic surgeons who possess extensive - and in some cases, unique - academic and clinical expertise in plastic surgery.

Like most plastic surgeons, given my education, training and experience, I choose to identify myself as a "plastic surgeon" as opposed to a "cosmetic surgeon" (a term which, because of its overuse and misuse, has become meaningless), even though more than 95% of my practice consists of cosmetic surgery. Admittedly, most of my patients are less concerned about who or what I am than they are about my ability to provide them the services which address their clinical/cosmetic concerns, producing the results they seek within the limitations of their time and budgets. Unfortunately, too many patients think that plastic surgery is just a collection, a menu so to speak, of surgical procedures from which they can choose relatively simple solutions to what often are not so obvious nor so simple problems. Additionally, because of the cosmetic nature of many of the surgical procedures plastic surgeons undertake, frequently patients also think that plastic surgery is not real surgery and therefore can be undertaken just as safely outside, as inside, a hospital, at no more risk and less cost, with perhaps the additional benefit of anonymity. Since I am, in the following order, a physician, artist and small businessperson, I endeavor to provide my patients, again in the following order, the safest, most up to date, personalized care, in a well staffed, fully equipped (all the "bells and whistles") setting, with attention to both user-friendliness, cost and privacy. My staff and I believe that we offer the best value in plastic/cosmetic surgical services anywhere. Furthermore, we continually "tweak" our services to meet - and exceed - the ever-changing needs and expectations of our patients. Consider that:

  • "24/7" accessibility to PIPS is only a toll-free telephone call (1-800-321-7477) away;
  • parking at PIPS is plentiful, complimentary and no more than a few steps from our front door;
  • consultations are complimentary and available at convenient times, compatible with today's demanding schedules, even those of working couples;
  • initial and subsequent consultations are with a plastic surgeon, not a non-physician "intermediary";
  • patients enjoy on-site access to PIPS' extensive plastic surgical library;
  • all surgical and related costs are projected/confirmed in writing - no surprises - and surgical fees are guaranteed for 180 days or the remainder of the applicable calendar year, whichever is greater;

My staff and I hope you find PIPStreet informative and look forward to the opportunity to serve your plastic/cosmetic surgical needs.



Dr. Richard T. Vagley, a Board Certified Plastic Surgeon, is Medical Director of The Pittsburgh Institute of Plastic Surgery and a Contributing Editor of Outpatient Surgery Magazine.

The Pittsburgh Institute of Plastic Surgery | 5989 Penn Circle South | Pittsburgh, Pennsylvania 15206-3828 | Tel: 412.345.7477
| Fax: 412.345.7478