Not every surgeon who offers breast augmentation has the training to perform it safely. In a field where terminology like "cosmetic specialist" and "aesthetic surgeon" can mean almost anything, understanding what credentials actually signify is essential before choosing a provider. For patients in the Seattle area seeking a board-certified breast augmentation specialist, the difference in qualifications can translate directly into the difference in outcomes.
Dr. Sepehr Egrari holds dual board certification from the American Board of Plastic Surgery and the American Board of Surgery, practices in a fully accredited surgical facility, and leads Egrari Plastic Surgery Center as its sole physician and surgeon. Read on for what those credentials mean, why the facility matters, and what to look for before committing to care.
Why Board Certification Matters for Breast Augmentation
Board certification reflects a surgeon's comprehensive training, ethical standards, and dedication to surgical excellence. According to the American Society of Plastic Surgeons, any physician with an MD can legally perform cosmetic procedures regardless of their specialty background. Certification by a recognized plastic surgery board is what confirms a surgeon has the training to do so competently and safely.
For breast augmentation, that training shapes the quality of every decision made during surgery. Implant selection, incision placement, pocket technique, and complication management all require a depth of specialty knowledge that general medical education alone does not provide.
Key Credentials: ABPS and the American Board of Surgery
The American Board of Plastic Surgery (ABPS) is the only board under the American Board of Medical Specialties (ABMS) that certifies surgeons comprehensively in plastic and reconstructive procedures. Earning certification requires at least six years of surgical training after medical school, rigorous written and oral examinations, and ongoing participation in continuing education and case review. Some boards using terms like "cosmetic surgeon" fall entirely outside the ABMS framework and may require far less.
The ABPS designation is the credential patients should verify. Dr. Egrari holds dual certification from both the ABPS and the American Board of Surgery. General surgery board certification is not required of plastic surgeons; Dr. Egrari has maintained it voluntarily as a reflection of his broader commitment to surgical science and patient safety.
The Role of Accredited Surgical Facilities in Patient Safety
Where surgery takes place matters as much as who performs it. Accredited surgical centers are evaluated by independent organizations including AAAASF, AAAHC, and the Joint Commission against strict requirements for every aspect of patient care:
- Emergency equipment and readiness protocols
- Qualified and credentialed anesthesia providers
- Infection control and sterilization standards
- Staff competency and ongoing training requirements
- Postoperative monitoring and patient safety procedures
Accreditation is not a designation a facility self-assigns. It is granted after independent verification that documented safety standards are being met consistently.
Accredited vs. Non-Accredited Settings: What Patients Should Know
Non-accredited office-based surgical settings operate under fewer regulatory requirements. No independent body verifies their equipment, staff qualifications, emergency preparedness, or infection control protocols. For a procedure performed under general anesthesia, that gap in oversight carries real risk.
Accredited facilities are held to standardized protocols across anesthesia administration, sterile technique, emergency response, and postoperative care. Selecting a board-certified surgeon operating in an accredited facility is the clearest way for patients to establish that both the provider and the environment meet a verified standard of care.
How Board Certification and Accreditation Improve Outcomes
Board-certified surgeons in accredited settings are required to follow evidence-based techniques, maintain continuing education, and submit outcomes data for ongoing quality review. In 2022, ASPS member surgeons performed nearly 300,000 breast augmentation procedures, with technique patterns tracked and published through the ABPS Continuous Certification process.
That process requires surgeons to document clinical cases as evidence of ongoing improvement. Practice patterns are benchmarked against peers and expected to reflect current evidence of outcomes. The result is a measurable accountability structure that non-certified practitioners are not subject to, and that patients in accredited settings benefit from directly.
Verifying Surgeon Credentials and Facility Accreditation
Patients have direct tools available to confirm qualifications before scheduling. Before booking a consultation, take these steps:
- Confirm ABPS certification at abplasticsurgery.org
- Ask about hospital privileges, which signal that an independent institution has vetted the surgeon's qualifications
- Request written proof of facility accreditation and verify current status through the certifying agency's website
- Inquire about anesthesia providers and their credentials
The FDA also requires that all legally marketed breast implants carry updated labeling including a patient decision checklist, which must be reviewed and signed with a physician before surgery is scheduled. A credentialed surgeon will treat this as a substantive step, not a bureaucratic one.
Current Trends in Breast Augmentation Techniques
Breast augmentation is the most frequently performed cosmetic plastic surgery in the United States. Technique has shifted considerably over the past decade, with board-certified surgeons tracking these changes through the ABPS Continuous Certification process:
- Incision location: Inframammary incisions (under the breast fold) are now strongly favored, supported by evidence of reduced scarring and improved precision
- Implant placement: Submuscular placement has grown substantially, associated with lower capsular contracture rates and more accurate mammogram screening
- Implant surface: Textured implants have been discontinued entirely following FDA warnings about BIA-ALCL
These shifts reflect ongoing clinical evidence, not preference. The continuous certification structure ensures that board-certified surgeons practice in alignment with current safety and outcomes data.
What a Comprehensive Patient Consultation Should Cover
A thorough consultation addresses far more than implant size or style. Cleveland Clinic identifies the full range of topics patients should expect to cover before committing to surgery:
- Implant type, size, and placement options
- Incision location and expected scarring
- Recovery timeline and activity restrictions
- Complication risks, including capsular contracture, rupture, and revision likelihood
- Imaging recommendations for ongoing implant monitoring
- Both augmentation approaches: implants (saline or silicone) and fat transfer breast augmentation
The consultation should also address cost, realistic expectations, and a surgical plan specific to the patient's anatomy. Surgeons who communicate clearly across all of these areas are the ones best positioned to deliver results that hold up over time.
Informed Consent and Long-Term Follow-Up
Informed consent for breast augmentation is a formal, regulated process. The FDA requires that patients receive detailed information about implant risks, device surveillance, and potential complications before agreeing to surgery. Updated labeling for all legally marketed implants includes a patient decision checklist that must be reviewed and signed by both the patient and the implanting physician prior to scheduling.
A thorough informed consent process covers:
- Full disclosure of implant risks and the likelihood of future revision surgery
- Device surveillance requirements, including MRI or ultrasound for silicone implants
- How implants may affect mammograms, and the recommendation to use ACR-accredited imaging facilities
- Documentation of implant type and manufacturer for long-term tracking
Patients should review and sign consent materials before any surgery date is set.
The Impact of Surgeon Experience on Complications and Revisions
Breast augmentation carries a high satisfaction rate, but complications do occur. Capsular contracture, implant rupture, infection, and malposition are among the issues that can require revision. Minimizing their occurrence and managing them effectively when they do arise requires the kind of clinical judgment that develops over thousands of procedures.
Experienced, board-certified surgeons bring that judgment to every decision in the operating room: implant selection, pocket creation, tissue handling, and closure. For patients considering revision surgery or augmentation following a previous procedure, that experience is what determines both safety and outcome.
Dr. Egrari: Dual Board Certification and Accredited Care in the Seattle Area
Dr. Egrari's dual board certification, hospital privileges, and national recognition for surgical excellence place him among a select group of plastic surgeons in the Pacific Northwest. The practice's fully accredited Bellevue facility is held to the same rigorous protocols as the highest-tier surgical centers in the country, with Dr. Egrari as its sole operating physician on every case.
For patients whose goals extend beyond augmentation, Dr. Egrari also performs breast lift and breast reduction procedures with the same standard of individualized care. Schedule a consultation with Dr. Egrari to begin.
