Although the procedures performed by cosmetic surgeons and plastic surgeons can often overlap, they are not the same. The main difference between a cosmetic and a plastic surgeon comes down to the training involved. Training for board-certified plastic surgeon in New York City. These surgeons are required to complete a residency that lasts from six to eight years after the completion of medical school, which focuses on providing training in plastic and reconstructive surgery. A plastic surgeon’s training includes cosmetic surgery and a full range of reconstructive options. In addition, some may go on to attend a fellowship in facial plastic and reconstructive surgery to learn not only cosmetic but also complex reconstructive procedures involving the face.  Training for cosmetic surgeons. These surgeons, on the other hand, can obtain their surgical training in many different specialties that do not necessarily have to be related to the face. Cosmetic surgeons are certified by the Board of Cosmetic Surgery, which is not recognized by the American Board of Medical Specialties. This certification can be obtained by any surgeon (e.g., a general surgeon or an OB/GYN surgeon) or dentist who performs a one- to two-year fellowship in cosmetic surgery. Thus, cosmetic surgeons may not be fully qualified to perform extensive surgeries to the degree a plastic surgeon or facial plastic surgeon can.