Plastic Surgeons in Hawaii

By: Dr. Michael Pasquale


What is a plastic surgeon?

Plastic and reconstructive surgeons

A plastic surgeon or what is sometimes known as a plastic and reconstructive surgeon is one of the most highly trained surgeons of all the surgical specialties. They are not only surgeons who perform beautification surgery and procedures, but carry out very complex reconstruction of injuries. For example, when other surgeons cannot close a massive wound, plastic surgeons will be called in to bring in new tissues to cover the wound. Other times peripheral nerves will be repaired or reconstructed by specialized plastic surgeons called microsurgeons. Arm replantations, total face transplants (recently reported in the media) were developed and successfully performed by plastic surgeons.

The Surgeon’s Surgeon

These remarkable surgeons are sometimes known as the “surgeons surgeon” as they are all trained in general surgery, most actually complete the requirements to be a board certifed general surgeon. This five years of rigorous training is completed even before they start their formal plastic surgery education. Plastic Surgery training adds a minimum of two more years which makes Plastic Surgeons the surgeons with the most years of training – thus a surgeon’s surgeon.

Reconstructive Training

This reconstructive aspect and formal training in general surgery are what differentiate the plastic surgeons from the non-plastic surgeons who perform cosmetic procedures. Plastic Surgeons are trained to operate on all tissues. A simple perusal through the plastic surgery literature will show you that it is it is filled with surgical procedures on all parts of the body. The hand, the nerves, the small blood vessels, muscles and skin are all within the plastic surgeons domain.

The Selection Process

The selection process for a plastic surgeon is more rigorous as it is a very competitive specialty and demands the highest standards in surgical care. Many attempt to obtain the training, but only a few are actually picked to become plastic surgeons. These are select individuals who have the grades, the skills and the mind to serve the profession well. It is not easy and as mentioned very competitive which assures the public of the highest quality surgeon who entrust their care.

Continuing Education and Certification

Plastic Surgeons continue to educate themselves through their career as this is a ever advancing field. They attend conferences, read the journals and other contining education activities. After the plastic surgeon becomes board certified they must become recertified as well. This requires taking a exam which tests if the plastic surgeon keeps up with his knowledge. In Hawaii the plastic surgeons (like all American plastic surgeons) have gone through this rigorous selection and traning process.

What is a Fully Trained Plastic Surgeon?

By using the term “fully trained” plastic surgeon we mean the surgeon has undergone formal and approved training specifically in the field of plastic surgery. This is known as a plastic surgery residency.

This residency in the United States is at least two years in length, but only after the surgeon completes prerequisite surgical training such as an orthopedic surgery residency (5 years) or an ear nose and throat residency (4-5 years). The more common requisite training to become a plastic surgeon is through a general surgery residency for (a minimum of 3 years). The surgeon must be promoted each year to the next level. It would not say much for a surgeon who did three years of surgery, but all at the first year level. So to be approved the surgeon must have at least three years of progressive training, before even entering plastic surgery residency. 

This means a total of 5 years at a bare minimum, after medical school. Plastic Surgery is serious surgery and not something one can learn in a few weekend courses. This is one of the longest training programs in all of medicine. Dr. Pasquale completed an approved 5 year general surgery residency and an approve 2 year plastic surgery residency after medical school.

Is it legal for Physicians to practice plastic surgery without the approved residency training?

Yes it is – and our job is not to say they should not. We will say that it was not until recent years that hospitals even required formal residency training in most specialties. In fact, today there are some excellent cardiac surgeons who never did a special residency in cardiac surgery, but most of these doctors were some of the doctors who started the field. 

Likewise, there are physicians who are presently practicing plastic surgery, who have not completed the formal requirements of an approved residency. This is not to say they are not “good” physicians, surgeons or plastic surgeons. Yet today the most common way to acquire the knowledge and skill to be a plastic surgeon is through a formal training program of 2 to 3 years specific to plastic surgery after many years of basic SURGICAL training. 
Weekend Courses do NOT make a plastic surgeon.

Weekend courses and other short term training programs are good for a surgeon to take, but for them to be useful one should have the fundamentals of surgery training completed and approved first. 

There are two approval bodies for plastic surgery training (residency) in the United States that are accepted by the United States Government and Hospitals as approved by the JCAOH. The JCAOH is the big daddy of accreditation of most hospitals. If a Hospital is not accredited by this orginzation they may have serious problems.

These two organizations which are both PRIVATE organizations are under the auspices of the American Osteopathic Association (AOA)  and the American Board Of Medical Specialties (ABMS). Both organizations are essentially equivalent. For a plastic surgeon to have approved training he or she must have received the blessing of one of these organizations specifically for PLASTIC SURGERY.

Due to the competitive nature of plastic surgery there are at times rivalry between these two organizations for Plastic Surgery, which has undulated over the years. For example if you were to call the society representing the plastic surgeons who had their training approved by the ABMS and asked about a non-ABMS surgeon (like Dr. Pasquale who was approved by the other organization the AOA) they may not even acknowledge that the surgeon exists.

Yet they will tell you that their surgeons (which are due paying members) are the only ones approved by the American Board Of Medical Specialties. True, but somewhat misleading. As I explained, that is not the only legitimate approval body. Try asking them if there is another approval body for plastic surgeons,  they best tell you that you should check with the AOA. If they do not, or mislead you to believe that their organization is the ONLY   legitimate one, We would like to know. Email if this is the case.

Don’t be mislead by marketing propaganda. If you have further questions please send us an Email or check on this yourself at the following web sites.

The American Medical Association Link explains about physician training and specialty. AMA 

The American Osteopathic Association has information as well. AOA
You can check with the American Board of Medical Specialties for some plastic surgeons here, but Dr. Pasquale is not member of that organization. 

Note that this ABMS site is not approved JCAHO and NCQA to verify credentials. ABMS CERTIFIED
You can also check with the American Board of Facial Plastic and Reconstructive Surgery. (ABFPRS

Verify Dr. Pasquale’s Board Certification by calling (770) 939-8555.

What is a Board Certified Plastic Surgeon?

Dr. Michael Anthony Pasquale is a Honolulu Hawaii board certified plastic surgeon practicing for over 23 years. He is a former micro nerve surgeon and reconstructive surgeon. He is considered an authority on face lift and breast surgery and has traveled and lectured extensively throughout the world in regards to plastic surgery.

What Exactly Does Board Certified Plastic Surgeon Mean?

Plastic Surgery Board Certification is a good standard in which to judge a plastic surgeon. It means that the plastic surgeon has completed his residency in plastic surgery (not some unrelated specialty). Additionally, he has passed a written test, an oral examination by his peers and presented his cases to a panel of surgeons to judge if the surgeon has handled them appropriately.

There are three boards which examine plastic surgeons. Why there are three probably has more to do with politics than of any significant deviation. You can compare the three boards: All are private organizations whose members pay dues. None is a government agency.

To be considered a board certified plastic surgeon one must have completed the requirements of at least one of these boards in the United States. Dr. Pasquale is certified at the present time by the Board of Certification in Plastic Surgery. He is presently in the process of obtaining certification through the Board Of Osteopathic Surgery in Plastic Surgery so he will be certified by two boards of Plastic Surgery instead of one soon.

What Does Board Certification Not Mean?

It does not guarantee a good outcome for your surgery. It does not even mean the doctor is competent at the present time but was when he was certified. A better judge of current competence is to check at the hospital to see if the plastic surgeon has privileges in plastic surgery. The reason for this is that the Hospital is more likely to know sooner if their is a problem with the doctors competence.

As far as actual training, Dr. Pasquale now a teacher/lecturer of cosmetic procedures is one of the most formerly trained plastic surgeons in Hawaii. This is in both cosmetic and reconstructive surgery, not only in actual years of training, but at some of the better institutions in the world.

Dr. Pasquale for many years, was on staff at some of Hawaii’s best Hospitals such as the Queens Medical Center. Military hospitals and outer Island Hospitals ranging from Hilo Medical Center to Kauai. Additionally before coming to Hawaii he was on staff at some of New York’s City’s most well known institutions for plastic surgery. In his younger years, he took some of the most devastating damaged cases in hand surgery, facial reconstruction and other emergency and trauma cases. Now Dr. Pasquale’s focus is on cosmetic plastic surgery so he maintains his own operating room with a specialized staff for cosmetic procedures. By focusing on cosmetic surgery and limiting his practice to aesthetic procedures he is able to bring all of his talent to this specialization. This super sub specialization in cosmetic assures you this is his expertise.

Plastic Surgery Hawaii

Many times it is unspoken, but has been studied over and over. Initial success does depend on appearance. Many of us are taught that “its what is on the inside that counts” and that may be true in the long run, but first impressions do count. Perhaps this counts more than it should, but that is today’s reality for success. Appearance can make all the difference if the person gets a job, a desirable mate or makes a sale or closes a deal. Looks do make a difference like it or not. It’s a competitive world not of our design but is the reality.

When people meet, this initial contact has been studied at major universities with the use of eye tracking technology and recordings. These and similar studies have shown that eyes focus on the more attractive person, people perceive them as successful, rather than the unattractive. Dilation of the pupils show this as do the eye movements. Many of these studies come from prestigious American universities such as M.I.T. This is an indisputable and well established scientific fact.

A strong chin in a male denotes strength. Tired eyes show stress even if one does not feel that way. A curvy figure in the female indicates desirable feminine characteristics. Many times overweight people are perceived as lazy though they may be the hardest workers around. Unfortunately genetics determines your appearance, yet today these can be corrected through plastic surgery. So why not change what you feel is needed and be who you want to be. Today plastic surgery is safe and affordable.

Our Plastic Surgery Hawaii at Infinity Life Centers is some of the best the world offers. We recognize that to be a successful executive or simply to be be seen as a winner your outer appearance and the health you project may determine how others perceive you. Our doctors, surgeons and staff know and understand this and will work with you to optimize your outer appearance and inner health. That is what we do with our team of plastic surgeons, wellness physicians, nutritionist, skin care specialist, lifestyle and exercise coaches. We help bring out the best in you.

VIP Plastic Surgery Privacy in Hawaii

Our Hawaii facility for plastic surgery is state of the art, all with your privacy in mind. It is designed with two private elevators so you may have your procedure and leave without any one even aware you were there. Our VIP exit for high profile patients was designed for complete confidentiality. You have to see it believe such a facility is here.

Contact us so we can discuss the options available through plastic surgery to aide you in your quest for success.

Finding the Best Plastic Surgeons in Hawaii

Ask any plastic surgeon – who are the top three plastic surgeons in Hawaii, and he will have trouble naming the other two. Of course any surgeon (especially a plastic surgeon) will tell you he or she is the best, and it’s arguable they should have that attitude to some extent.

Determining who is the top plastic surgeon is much like trying to figure out your favorite flavor of ice cream, most are good. However, there may be differences and these should be considered as more of personal preference as opposed to an absolute.

Doctor Reputation

Hawaii is a very small, very competitive area for just about anything, and word travels very fast. Any plastic surgeon who has owned a clinic here for more than a few years is most likely very competent, highly trained and skillful. Reputations, good or bad, tend to propogate rather quickly in Hawaii compared to most any other mainland state or large capital cities.

Word of Mouth

Word of mouth can be a great tool in Hawaii, and odds are you have a friend, auntie, cousin or classmate who has been there or done that. Someone who has personally interacted with a surgeon can tell you firsthand what they thought, how they connected, what their overall experience and result was. I would encourage everyone to listen to firsthand experiences, but realize everyone has their own opinions.

Yelp and Ratings Websites

YELP and many other ratings sites and directories must be taken with an oftentimes large grain of salt. Plastic surgeons have become one of the most advantageous and profitable businesses for patients (or directories) to extort or blackmail. I wouldn’t say that YELP is entirely toxic, but as is with everything, there are always a few bad apples.

Some plastic surgeons have perfect ratings, which may be suspect as well and may reflect that something other than honest reviews are afloat. The Federal trade commission caught one company faking 100s of reviews on a well advertised face lift procedure and fined them $300,0000. My point is even the so called Top Plastic Surgeon will have an occasional negative review and if not be suspect.

Doctor Ratings & Directories

The doctor rating websites are generally trustworthy and impartial, but unfortunately not all of them. Some of these websites won’t allow a Doctor to be listed in their directory unless they sign a contract to promise to use their product and nobody else’s. They thereby boost and promote their exclusive surgeons via their brand and attempt to portray the others as lacking. Seems a bit unfair after all.

Trendy or Superficial Choices

Some people choose their plastic surgeons based on who is trending, or who is hot on Instagram. Popularity ebbs and flows with just about everything in this world and in the Kardashian era in which we live, it should be painfully obvious to everyone that fame isn’t always warranted or deserved. Look for substance, human connection and don’t follow the rest of the sheep.

Do You Specialize?

Also not every plastic surgeon is the top plastic surgeon in everything. Some super specialize in eyelids for example. Most cosmetic plastic surgeons are good generalist in body, breast and facial procedures. So when your considering for example perhaps an eyelids procedure, make sure that the top plastic surgeon in Breast Augmentation does eyelids as well.

Comfort & Communication

Also extremely important is just feeling comfortable with your plastic surgeon. Certainly he or she may have a lot of marketing and the most fabulous office and the most glamorous staff, but when all that is sorted out its the surgeon, his or her skill and ability to communicate with you. After all, you need honest answers with regard to the money you will be spending. Your trusting your body to that surgeon. The glitz is always nice, but remember what is most important – its your body.

Plastic surgeons in Hawaii like elsewhere are highly trained individuals with years and years of study in the field. There are screening processes along the way to weed out bad ones. So its a very difficult task to look for the number one when there are so many that are very good. How do you pick out the best from the best ?

Here at Dr. Pasquale’s clinic we understand these issues and do what it takes to be the top plastic surgeon for you. This is careful balance of skill, personality and experience. It takes a staff that works as a team and a plastic surgeon that puts your interest before his. This is what we do and why we have been successful for over 25 years.

About Plastic Surgeons in Hawaii

Some thoughts by Dr. Pasquale after 20 years in Hawaii on Hawaii Plastic Surgeons and competition.

Hawaii Plastic Surgeons are a significant group of all the Plastic Surgeons in the world of plastic surgery. Overall, Hawaii plastic surgeons are very well trained, experienced and what one would say are above the average of plastic surgeons as a group. The newer plastic surgeons in Hawaii although may not have the experience or board certifications, appear still to be quite capable. One likely reason for this is that Honolulu Hawaii it is a very competitive market with upwards of 25 plastic surgeons in the community for a population of about 1 million. Competition does indeed bring out the best. That is a good thing for the people of Hawaii and for those who travel here for treatment with Hawaii Plastic Surgeon. Simply put you get some of the world’s best plastic surgeons.

Hawaii is still part of the USA which means physicians are strictly regulated and the standard of care is very high. Those who travel say to Mexico for cheaper prices may not know what quality is there and many of the places are regulated very little. A patient would have no recourse if a problem resulted in underdeveloped country even though the price may be cheap. Hawaii Plastic Surgeons are closely scrutinized for quality and safety of their practice.

Cosmetic Laser Spa’s & Botulinum Toxin Centers Versus Plastic Surgeons in Hawaii

Today from recent years seems there is a new “cosmetic” clinic springing up every other week. The reason of course is the financial benefits. Doctors like others are suffering from the bad economy and courses are springing up all over to educate in quick courses “how to inject Botulinum Toxin” or “how to learn a quick way to liposuction to increase your revenue” for family doctors and nurses. Recently we have seen chiropractors advertising they are doing liposuction type procedures. We are not making judgements about who should do what yet we question some of the motivation. If cosmetic surgery was these practitioners passion why only now do they learn this ? Seems that if they were truly devoted to a specialty as an art and science then that would have been their chosen fields, rather than financial gain only.

Doctors in general can practice cosmetic surgery and in Hawaii there are places which advertise as Plastic Surgery Centers or clinics and and there is no plastic surgeon there so beware! Cosmetic Surgery does not require a special license or special board at this time to practice and its not illegal nor dishonest as the law governing cosmetic surgery is fairly broad. The fact is legally any doctor, even your family doctor can practice cosmetic surgery.

Yet for one to call them selves a plastic surgeon the criteria that is generally accepted is as follows:

  • Must have completed a Plastic Surgery residency meaning that they must have trained in a program of at least two years duration in Plastic Surgery that is approved.
  • They must have completed the prerequisite training in SURGERY before entering plastic surgery training (#1 above) which ranges from 3 years of general surgery to up to 5 years of general surgery or another approved SURGICAL specialty before one can enter a plastic surgery training program. One cannot by any means call themselves a plastic surgeon after a month course or fellowship but must have approved training of two years duration or more on top of the prerequisite surgical training.
  • There are two approval bodies for plastic surgery training, one under the MD certification pathway and one is under the D.O. or osteopathic pathway. Both are considered equal by the state and federal government as well as Hospitals such as Queens medical Center, the military, Medicare and the like. Both are very similar in terms of years of training required. The differences are more philosophical than in years or types of training.
  • There is also a Cosmetic Surgery Board which is not similar in its training requirements. This board does not require approved plastic surgery residency as a prerequisite to their certification. This board is for physicians who may be board certified in another specialty but wish to practice some aspect of cosmetic surgery. There are several experienced cosmetic surgeons in Hawaii who have very good reputation who do very good work, but they are not Plastic Surgeons nor would they tell you that they are.

The other group aside from the True plastic surgeons and the cosmetic surgeons are the non surgeon and in some cases some nurses who inject Botulinum Toxin, injectables and the minor procedures.Some are good some may not be but they are largely unregulated. So take care when you see the cheap prices and realize that there are some serious ramifications such as skin loss, paralysis and the like to even simple injectables such as Restleyene, Juviderm and the like.

Cosmetic surgery and procedures are not simply like going to the beauty parlor nor going to get your nails done. It is very serious business which requires proper training and credentials so do not take your decision lightly.

Very lucky to live in Hawaii

Those in New York, Los Angeles, Tokyo, Paris or other major cities have many excellent plastic surgeons to choose from, but…there are also many doctors not of high standards. Hawaii is different, its easy to choose on the basis of quality as the plastic surgeons here are ALL of high quality.

Hawaii is a very diverse international place, but small in population

Hawaii is a small geographic area with a relatively small population – around 1 million. There is also something known here as the “coconut wireless” which is another way to state that people talk amongst themselves very often and live in very close knit communities. The bad doctors just do not last here and soon leave due to the pressure of the cocconut wireless as information spreads quickly. This means that any plastic surgeon who is not of the highest standards will not survive here due to “word getting out” fast. Simply put, it is too small a place for a bad doctor to hide, so any physician who makes too many mistakes or a plastic surgeon who does not have consistantly good result will not remain. As you will see later we have presented each plastic surgeon and how long they have been in Hawaii so consider this in your decision.

Hawaii – a desirable location can attract the Best Plastic Surgeons

Although Honolulu is a relatively small place compared to Los Angeles or Tokyo, the state of Hawaii due to its desirable location tends to attracts leaders in their fields. Plastic Surgery is no exception.

Most of the senior plastic surgeon here are well published authors, noted teachers and highly respected by their peers around the world.

Many of the plastic surgeons here have conducted courses, lectured and been involved in training plastic surgeons from around the world. For example, Dr. Flowers has written many books and articles on plastic surgery, Dr. Parsa has been a senior advisor to many surgeons and author as well. Dr. Rizzo has taught asian nose surgery courses. Dr. Pasquale has taught hands-on courses such as “buttock augmentation” internationally, most recently in Korea. Dr. Peterson has lectured in Japan and on the mainland. These are some simple small examples, but all the plastic surgeons here have been wiling teachers and have contributed to the science. Rest assured that you are in good hands if you choose any of the Board Certified Plastic Surgeons in Hawaii.

The competition here assures quality

Another check and balance here is that there are a relatively high number of plastic surgeons for this small population. Although many of the plastic surgeons here have clients from Asia, the mainland and other parts of the world, it is still a very competitive environment. This means the pressure is on for each of these surgeons to perform his very best for you. Rest assured, if one surgeon makes you unhappy there are others here who will do their best and they all know this. This is one reason that if you choose a Board Certified Plastic Surgeon in the Aloha State of Hawaii they will be good at what they do.

A History of Plastic Surgeons in Hawaii 1940 – 2009

Hawaii was a territory starting in 1900 and became a state after world war II in 1959.

The history of plastic surgery in Hawaii starts with the first plastic surgeon in Hawaii, This plastic surgeon went by the name of Merton Mack who came in the early 1930’s to Hawaii as a plantation doctor.

Later Merton like most of the plastic surgeons of his day were not trained as formally as today’s plastic surgeons. They attended training as a general surgeon and then completed course work and preceptorships with plastic surgery teachers. This type of training was common at that time as surgery training was not as formal as it is today. However, there was a board to be taken.

Most plastic surgeons were general surgeons who had become interested in this area of surgery called plastic surgery. Specialists were rare. Merton was certified by the American Board of Plastic Surgery in 1956.

The next plastic surgeon to arrive in Hawaii was Leabert Fernandez, he like Merton was a plantation doctor. He completed a general surgery residency at Queens and obtained his plastic surgery training in California. He was born and raised in Hawaii and actually attended Punahou High School. Dr. Fernandez wrote one of the first papers on double eyelid surgery on Asians.

In the late forties an ophthalmologic surgeon also became trained in plastic surgery by the name of Vernon Jim. Another Plastic Surgeon arrived shortly after in the 50s was Elden Dykes who unfortunately died a very early death of colon cancer in his later 30’s. Another of note during this time was Tom Tavara of which little is known.

The 1960-70’s

In 1966 Dr. Victor Hay-Roe arrived as a plastic surgeon, having trained in Hawaii in the general surgery program after plastic surgery training worked at the Honolulu Medical Group. Dr Hay-Roe was followed a few years later by Dr. Robert Flowers who became a staff surgeon at Straub in 1968___orginally. Dr. Penoff arrived early 1972??______as well at Straub Clinic.

The 1980s and 1990’s

This generation of Hawaii Plastic Surgeons came in during the 1990’s and includes Dr. Clyde Ishii – local born but educated on the mainland, as with Dr. Vincent Nip and Dr. Benjamin Chu. These were all local boys who returned to Hawaii. Transplanted to Hawaii during this time from the Mainland are Dr. Robert Peterson, Dr. Michael Pasquale and Dr.Kevin Dieffenbach who now make Hawaii their home. Dr Gregory Caputy arrived during this time after training under Dr. Robert Flowers.

2000 to present

The newest group of plastic surgeons arrived during these years out of training. This includes Dr. Shim Ching who also did a fellowship with Dr. Robert Flowers like Dr. Gregory Caputy, both from Canada.

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