Marcel Daniels, MD, a plastic surgeon in Long Beach, CA, says he’s seen about a 50 percent increase in patients coming to him to fix botched plastic surgeries in the last few years. The reason: Most people don’t know the difference between a plastic surgeon and a cosmetic surgeon. Here’s what you need to know. 

The difference lies in training, credentials, and certification, says Adam D. Schaffner, MD, a plastic surgeon in New York City and a clinical assistant professor at Weill Cornell Medical College. “Any MD can call themselves a cosmetic surgeon after taking a weekend course, while a plastic surgeon’s residency requires years of plastic surgery training after they’ve completed medical school.”  What’s more, plastic surgeons must operate in accredited facilities, whereas cosmetic surgeons do not. That means you could visit a doctor who is board-certified in, say, otolaryngology—ear, nose and throat—and he could still legally perform a facelift. There are no laws in the United States requiring doctors to practice only in the areas they were trained. Because doctors are getting less reimbursement from insurance companies than they used to, while overhead costs such as staff salaries and medical malpractice insurance rates continue to rise, some are dabbling in cosmetic surgery to make up the difference.

“I get paid about half of what I got paid 20 years ago,” says Dr. Daniels. “Like anyone whose livelihood is being threatened, doctors are turning to other ways to make money, and cosmetic surgery is lucrative because it isn’t controlled by insurance companies.” Because most patients pay out of pocket for cosmetic procedures, there’s more money in it for the docs.  The best way to protect yourself is to do your homework: Look for the right certification. All those diplomas hanging from your doctor’s wall may look impressive, but you still need to do some digging. Legit plastic surgeons will be board-certified by the American Board of Plastic Surgery or be members of the American Society of Plastic Surgeons. To check your doctor’s specialty, go to the American Board of Medical Specialties, which has a search engine that lets you plug in your doctor’s name and location. Play detective. Check with your state medical board for any disciplinary actions against the doctor you’re considering. You can find a link to your state’s medical board through the Federation of State Medical Boards (FSMB), or you can search though FSMB’s database for $9.95.  Ask for recommendations. You wouldn’t hire a sitter without references, and the same should apply here. Contact local hospitals and ask about plastic surgeons on staff. Your primary care physician may also be a good screening tool as they see everyone’s work.  Go in with questions. Bring a list of questions to your consultation, including: 

What field did you start in?How many times have you performed the surgery and how recently?How many years have you been performing this surgery?Is the medical facility where the surgery is taking place accredited?

Be skeptical. If the price sounds too good to be true, it probably is. You don’t want someone who’s cutting corners—such as having fewer staff on hand—with your medical care.    Also see: Natural Surgery Alternatives, Get Your Doctor To Listen, 14 Worst Hospital Mistakes To Avoid