Most physicians who perform facial surgery are not facial plastic surgeons. Understanding that distinction — and what it means for your outcome — is the most important thing you can know before choosing a surgeon.
In the state of Hawaiʻi, a physician with a general surgery license can legally perform a facelift, a rhinoplasty, or a blepharoplasty. A dermatologist can administer injectables. A nurse practitioner can operate a laser. None of these require specialty training in facial plastic surgery — and most do not have it.
Board-certification through the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) is not a marketing credential. It is a clinical standard — one that requires a dedicated fellowship, a defined surgical case volume, a written examination, and an oral examination before a panel of specialists. It is the only credential in the United States that requires a physician to have trained exclusively in the surgical anatomy of the face and neck before being tested on their competency to operate there.
Dr. Susan Tan holds this credential. She completed a fellowship at the University of Toronto — one of the most competitive and rigorous facial plastic surgery training programs in the world. She has spent over 17 years operating exclusively on the face and neck. She is the only physician in Hawaiʻi who is both fellowship-trained in facial plastic surgery and a woman — bringing a particular quality of listening and understanding to the patient experience that her patients tell her they did not find elsewhere.
Dr. Tan is the only female fellowship-trained board-certified facial plastic surgeon (ABFPRS) practicing in Hawaiʻi. There is no equivalent anywhere else on the island.
Years of surgical practice — every procedure in the same anatomical territory. The face and neck, exclusively. No body surgery. No breast surgery. No deviation from the specialty.
Board certifications — Facial Plastic and Reconstructive Surgery (ABFPRS) and Otolaryngology, Head & Neck Surgery. The combination that governs both the surface and the structural layer beneath it.
Specialty training is not just about the credential. It is about what happens in the operating room — and what your surgeon sees when she looks at your face.
A facial plastic surgery fellowship trains a physician to understand the face at every anatomical layer — from skin to subcutaneous fat, through the SMAS, into the deep plane, to the retaining ligaments that govern how the face ages and how it responds to surgery. This is not knowledge that can be acquired through weekend courses, cadaver labs, or observational rotations. It accumulates through supervised surgical volume, patient follow-up, and complication management over an intensive year of dedicated specialty practice.
A general plastic surgeon — even a talented one — divides that developmental year across the face, the breast, the body, and the hand. The result is broader competency across a wider territory, but shallower mastery within any one of them. The difference is not a matter of skill. It is a matter of what the training was designed to produce.
Dr. Tan's fellowship at the University of Toronto concentrated that entire developmental year in one anatomical territory. Every case was a face. Every complication was a face. Every refinement was a face. That concentration is what produces the kind of surgical judgment that allows her to look at a patient in consultation and know — before a single incision — exactly where the anatomy will behave, where it will resist, and where the result will live.
Surgical judgment is not taught. It is accumulated — through thousands of decisions made in the operating room, reviewed in recovery, and refined over the course of a career. The surgeon who has performed a facelift two hundred times has developed a different quality of judgment than the surgeon who has performed it twenty times alongside body and breast procedures.
Over 17 years of practice — every procedure in the same anatomical territory — Dr. Tan has accumulated the kind of judgment that cannot be shortened. She has seen faces that healed unexpectedly well and faces that required revision. She has learned which anatomical variations change the surgical plan and which do not. She has developed the ability to anticipate outcomes with a precision that only concentrated volume produces.
This is why patients who have consulted with multiple surgeons consistently describe her assessments as categorically different. She is not reading from a procedural checklist. She is applying 17 years of concentrated surgical experience to one face, in one consultation, with one goal — understanding exactly what that face needs and whether surgery is the right answer.
This is the clinical differentiator that is unique to Dr. Tan — and it is the one that patients who have been in the non-surgical aesthetic world for years notice most immediately.
When a dermatologist recommends a filler, they are thinking about volume replacement at the surface layer. When Dr. Tan recommends a filler — or advises against one — she is thinking about what is happening at the SMAS, at the retaining ligaments, at the fat compartments that govern how the face ages structurally. She is thinking about whether volume is the right answer or whether laxity is the actual problem, and whether adding volume to a face with early laxity will produce a result that ages well or one that will need to be reversed in two years.
No dermatologist, no nurse injector, and no general plastic surgeon in Hawaii brings this depth of structural thinking to a non-surgical consultation. The HFPS Facial Longevity Assessment — the clinical evaluation that governs all non-surgical recommendations at this practice — was designed precisely because Dr. Tan believes the structural layer cannot be separated from the surface. You cannot address hyperpigmentation intelligently without understanding whether the skin barrier is intact. You cannot recommend injectables without understanding what the face's structural layer is actually doing.
Every non-surgical protocol in this practice was designed by a surgeon. That is not a marketing statement. It is the reason the outcomes are different.
Board-certified surgeons are held to safety standards that aesthetic practices and med-spas are not. Hospital privileges — the credential that allows a surgeon to operate in a hospital setting — require demonstration of surgical competency, ongoing peer review, and compliance with institutional safety protocols. They are not automatically granted and they are not permanent. They must be maintained.
A surgeon who maintains hospital privileges has been evaluated by other physicians — not just by a credentialing body — and has been found competent to operate in a regulated environment. That evaluation is ongoing. It means the standard of care Dr. Tan applies in her private practice is governed by the same accountability structure that governs hospital surgery.
This matters most in the event of a complication. A surgeon who has trained for complications — who has managed them in a supervised setting, who has the anatomical knowledge to identify what is happening and respond appropriately — provides a fundamentally different quality of safety than a practitioner who has not. Complications in facial surgery are rare with an experienced specialist. But the difference between a surgeon who manages them and a practitioner who does not know what they are looking at is not a trivial one.
This is not a judgment of other providers. It is an honest accounting of what different types of training produce — and what that means for you.
| Clinical Consideration | General Plastic Surgeon / Dermatologist / Med-Spa | Dr. Susan Tan · ABFPRS · Fellowship-Trained |
|---|---|---|
| Surgical training in the face | Rotation or self-directed — not specialty fellowship | Dedicated fellowship · University of Toronto · face and neck exclusively |
| Board-certification specific to facial surgery | ✕ Not required to perform facial procedures | ABFPRS board-certified — the only US credential requiring dedicated facial surgical training |
| Anatomical knowledge of deep structural layers | Surface to SMAS — often without deep plane expertise | Full anatomical depth — skin through SMAS to deep plane, retaining ligaments, fat compartments |
| Non-surgical recommendations | Based on product training or surface assessment | Based on surgical anatomy — structural layer governs surface recommendation |
| Complication management | May require referral to a specialist | Trained in recognition and management — hospital privileges maintained |
| Surgical volume in one territory | Divided across multiple body areas | 17+ years exclusively face and neck — no division of focus |
| Continuum from skincare to surgery | Typically requires referral across providers | Complete physician-directed continuum — one practice, one philosophy, nothing referred out |
| Female surgeon perspective | Not available in most Honolulu practices | The only female facial plastic surgeon in Honolulu — 17 years of patients who chose her for this |
The difference between a specialist and a generalist is most visible not in credentials but in the quality of the conversation, the precision of the plan, and the honesty of the recommendation.
"Why does Dr. Tan's assessment feel different from every other consultation I've had?"
Because she is not assessing you against a procedure she wants to perform. She is assessing your face against its own anatomy — understanding what is changing, what is driving the change, and what the most precise response is. That might be surgery. It might not be. The recommendation comes after the assessment, not before it.
"Why does the surgical plan feel specifically designed for my face?"
Because it is. Dr. Tan does not apply a standard facelift technique to every patient. She identifies the specific anatomical factors driving your concerns — the depth of laxity, the volume distribution, the quality of the skin — and designs the approach around those findings. Two patients with similar presenting concerns may leave with different surgical plans. That is what specialist judgment produces.
"I'm not ready for surgery. Does specialist training still matter for injectables and skincare?"
Especially then. A surgeon who understands what is happening at the structural layer makes categorically better decisions about surface treatments. She can tell you when volume replacement is the right answer and when it will worsen a result. She can tell you whether your pigmentation concern is a surface issue or a structural one. That kind of assessment requires surgical anatomy knowledge. It is not available at a med-spa.
"What happens to the patient relationship after surgery?"
At most practices, it ends. At Hawaii Facial Plastic Surgery, surgical patients are integrated into the non-surgical continuum — the Pigmentation Protocol, the Collagen Clinic, injectable maintenance — so that surgical results are protected and maintained over time. The goal is not a result that lasts a year. It is a face that ages well for a decade. That requires continued physician-directed care, not a single procedure and a discharge summary.
"Achieving balanced, natural-looking outcomes is the result of a seamless fusion between surgical and non-surgical solutions. That fusion is only possible when the same mind governs both — and that mind has been trained, at the deepest level, in the anatomy it is treating."
— Dr. Susan Tan, MD ABFPRS · Founder, Hawaii Facial Plastic Surgery
The only US board-certification requiring a dedicated facial plastic surgery fellowship as a prerequisite. Requires written and oral examination before a specialist panel. The standard that distinguishes facial plastic surgeons from physicians who perform facial procedures without specialty training.
Board-certification in head and neck surgery — the anatomical foundation beneath facial plastic surgery. This double certification means Dr. Tan understands the structural, functional, and reconstructive dimensions of the face and neck at a depth that single-specialty training does not provide.
One of the most competitive and rigorous facial plastic surgery fellowship programs in the world. Advanced training in deep plane facelift, rhinoplasty, blepharoplasty, and facial reconstruction — the full surgical spectrum of the face and neck, under intensive specialist supervision.
Fellow of the AAFPRS — the professional organization for facial plastic surgeons nationally. Membership requires board-certification and adherence to specialty practice standards. Provides ongoing education, peer review, and access to the latest research in facial surgical technique.
Castle Connolly Top Doctor recognition is awarded based on peer nomination and independent evaluation — not patient review volume or self-submission. It reflects the assessment of Dr. Tan's colleagues in the medical community, not just her patients.
Recognized as one of Modern Luxury Hawaii's Dynamic Women — an acknowledgment of Dr. Tan's professional achievement, leadership, and contribution to the community she practices in. One of the few physician honorees in a recognition focused on women building something meaningful.
A private surgical consultation with Dr. Tan is where the clinical picture becomes personal. She will review your concerns, examine your anatomy, and tell you honestly what she sees — and what she recommends. No pressure. No template. No treatment menu.