A high number of board certified plastic surgeons within one community is good for the consumer. It means that you have a high concentration of qualified cosmetic surgeons from which to choose when shopping for a surgeon. Still, even among board-certified surgeons, there's adequate ... there's good ... and there's top shelf.

When it comes to safeguarding your health and appearance, you definitely want the best physician available, so here are some points to look for when researching plastic surgeons in your area. Be sure the doctor is:

- Board certified in plastic surgery by the American Board of Medical Specialties (ABMS).

- A member of one or both of the plastic surgery societies, ASPS (American Society of Plastic Surgeons) and ASAPS (American Society of Aesthetic Plastic Surgery)

- Has "staff" privileges at a local recognized hospital

- Operates in hospital operating rooms or in accredited facilities rated by AAAASF, JCAHO, Medicare or AAAHC.

Regarding the first point - the ABMS is a not-for-profit organization consisting of 24 medical specialty boards and is the preeminent entity overseeing physician certification in the United States. You can check any doctor's medical board certification by going to the ABMS website or by calling their toll free information line: 1-866-275-2267.

The catch to this part of your search is that many doctors in specialties other than plastic surgery also perform cosmetic procedures after taking a short course consisting of days (or even just hours) concerning the techniques. You wouldn't take your car to a day care center for an overhaul, no matter how admirably the licensed owner of that facility takes care of children - neither should you trust your health and attractiveness to someone who does plastic surgery "on the side."

The doctor best qualified to perform cosmetic surgical procedures is one who has trained the longest and most thoroughly in cosmetic and reconstructive procedures - a plastic surgeon. It's up to the consumer to determine which kind of doctor is offering the procedure he or she seeks, so buyer beware.

Point number two... Be sure that the surgeon is a member of one or both of these societies: American Society of Plastic Surgeons (ASPS) or The American Society of Aesthetic Plastic Surgery (ASAPS). You can go to their websites and look for a listing for the doctors you are considering. Membership in either or both of these societies assures you that you're with a surgeon who has years of surgical training, participates in on-going education and meets strict ethical and professional standards.

Point number three... In each of our communities, there are accredited local hospitals where doctors attain what are known as "hospital privileges" (meaning that they are allowed to perform surgical and other medical procedures within that hospital). The process requires that a physician submit medical and licensure data as well as prove his/her ability and training in medical procedures in their specialty. Through this process the hospital guarantees that their operating room facilities are only going to be used by surgeons fully trained in specific medical operations, so a heart surgeon isn't going to be doing brain surgery and vice versa.

Since most cosmetic surgery procedures are performed in a physician's office or in an independent operating facility, some doctors who don't have hospital privileges for a procedure do procedures in a non-hospital setting. Certain off-site surgical accreditation organizations such as AAAASF require hospital privileges as part of their criteria for approval. If you are unsure of a physician's hospital status on any procedure you are considering ask for a copy of his or her hospital privileges report.

Point number four... You don't want to have surgery in any non-hospital based facility that has not been accredited by one of the following organizations: AAAASF, JHACO, Medicare or AAAHC. Accreditation ensures that certain basic operating room criteria are met and that the facility meets standards of staffing, licensing, certification, equipment and physical plant standards. Operating Rooms in a good office based or free standing operating facility should be at the same standards you would expect to find in a full-service hospital. Typically non-hospital operating rooms provide only outpatient surgical services and do not provide on-going 24 hour care within the facility.

Finally, ask questions - ask as many probing, detailed questions as you need to ask to be sure that you are under the care of a highly trained and experienced board certified plastic surgeon. The guidelines listed above should take you a long way in obtaining the best and safest medical care.