California oral surgeons want to expand scope

Plastic surgeons warn of safety issues.

By Myrle Croasdale, AMNews staff. July 19, 2004.

The California Legislature is considering a bill that would give oral and maxillofacial surgeons the right to perform elective cosmetic surgery on the jaw, face and adjacent structures. The bill is ardently opposed by the California Society of Plastic Surgeons and other physician groups.

Oral surgeons are authorized to perform such surgeries in 28 states and Washington, D.C. James Wells, MD, immediate past president of the American Society of Plastic Surgeons, wants to make sure California doesn't become the 29th.

Facelifts and other elective cosmetic procedures are beyond the scope of oral surgical training, which Dr. Wells said does not include the same level of patient care responsibilities as shouldered by medical residents.

Dr. Wells works alongside oral surgeons on cases such as automobile crashes and cleft palettes. The oral surgeon handles the boney structural work while he handles the aesthetic, soft tissue side. He said this kind of collaboration gives patients the best outcome.

Oral surgeons "do wonderful foundation work," he said. But allowing them to do soft tissue surgery is a completely different situation. "We have a number of plastic surgeons who were oral surgeons," Dr. Wells said. "They didn't feel comfortable taking the next step without more training."