Section § 1638

Explanation

This law explains what "oral and maxillofacial surgery" entails and sets the rules for obtaining a special permit to perform this kind of surgery in California. It defines the surgery as involving both functional and esthetic treatments on the hard and soft tissues in the face and mouth regions. Individuals who are already licensed physicians and surgeons, and who have held a dental license in another state but not in California, can apply for this permit. To qualify, these applicants must also be certified, or eligible for certification, in their specialty by a recognized board. They must submit an application form, pay a fee, and provide fingerprint sets.

(a)CA Business & Professions Code § 1638(a) For purposes of this article, “oral and maxillofacial surgery” means the diagnosis and surgical and adjunctive treatment of diseases, injuries, and defects which involve both functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
(b)CA Business & Professions Code § 1638(b) Any person licensed under the Medical Practice Act (Chapter 5 (commencing with Section 2000)) as a physician and surgeon who possesses, or possessed, a license to practice dentistry in another state, but is not licensed to practice dentistry under this chapter may apply to the board on a form prescribed by the board for an oral and maxillofacial surgery permit.
(c)CA Business & Professions Code § 1638(c) The board may issue an oral and maxillofacial surgery permit to an applicant who has furnished evidence satisfactory to the board that he or she is currently certified or eligible for certification in oral and maxillofacial surgery by a specialty board recognized by the Commission on Accreditation of the American Dental Association and holds a current license in good standing to practice medicine in the state.
(d)CA Business & Professions Code § 1638(d) An application shall be accompanied by an application fee required by the board and two classifiable sets of fingerprints on forms provided by the board.

Section § 1638.1

Explanation

If dentists in California want to perform elective facial cosmetic surgeries like nose jobs or facelifts, they must have a valid dental license and a special permit. To get this permit, a dentist needs to apply and show they've completed relevant surgical training, including having performed a number of surgeries under supervision. The law outlines different categories of surgeries, and a credentialing committee will review applications to decide if a dentist is qualified. The permit is valid for two years and requires ongoing education and insurance. Violations can lead to license suspension, revocation, or other penalties. Regular reports to the Legislature track the number of permits issued and any complaints received.

(a)CA Business & Professions Code § 1638.1(a) A dentist shall possess a current license in good standing and an elective facial cosmetic surgery permit to perform elective facial cosmetic surgical procedures authorized by this section.
(b)CA Business & Professions Code § 1638.1(b) The board may issue an elective facial cosmetic surgery permit to perform one of the following categories of elective facial cosmetic surgical procedures:
(1)CA Business & Professions Code § 1638.1(b)(1) Cosmetic contouring of the osteocartilaginous facial structure, which may include, but is not limited to, rhinoplasty and otoplasty.
(2)CA Business & Professions Code § 1638.1(b)(2) Cosmetic contouring or rejuvenation of the facial soft tissue, which may include, but is not limited to, facelift, blepharoplasty, facial skin resurfacing, or lip augmentation.
(3)CA Business & Professions Code § 1638.1(b)(3) Procedures under both paragraphs (1) and (2).
(c)CA Business & Professions Code § 1638.1(c) A licensee who desires to perform elective facial cosmetic surgery shall apply to the board on an application form prescribed by the board and submit all of the following:
(1)CA Business & Professions Code § 1638.1(c)(1) Proof of successful completion of an oral and maxillofacial surgery residency program accredited by the Commission on Dental Accreditation of the American Dental Association.
(2)CA Business & Professions Code § 1638.1(c)(2) Proof that the licensee has satisfied all of the criteria specified in either subparagraph (A) or (B):
(A)Copy CA Business & Professions Code § 1638.1(c)(2)(A)
(i)Copy CA Business & Professions Code § 1638.1(c)(2)(A)(i) The licensee is certified, or is a candidate for certification, by the American Board of Oral and Maxillofacial Surgery.
(ii)CA Business & Professions Code § 1638.1(c)(2)(A)(i)(ii) A letter from the program director of the accredited residency program, or from the director of a postresidency fellowship program accredited by the Commission on Dental Accreditation of the American Dental Association, stating that the licensee has the education, training, and competence necessary to perform the surgical procedures set forth in paragraph (1), (2), or (3) of subdivision (b) that the licensee has notified the board the licensee intends to perform.
(iii)CA Business & Professions Code § 1638.1(c)(2)(A)(i)(iii) Documentation of at least 10 operative reports from residency training or proctored surgical procedures performed at minimum in the role of surgical first assistant within five years from the date of application for each category of permit set forth in paragraph (1) or (2) of subdivision (b) for which the licensee seeks a permit. If the licensee seeks a permit set forth in paragraph (3) of subdivision (b), the licensee shall submit 10 operative reports for each category specified in paragraphs (1) and (2) of subdivision (b). Each operative report shall indicate all of the following:
(I)CA Business & Professions Code § 1638.1(c)(2)(A)(i)(iii)(I) Name of the licensee.
(II) Category of procedure and specific type of procedure performed.
(III) Date of the procedure.
(IV) The role in which the licensee participated in the procedure.
(iv)CA Business & Professions Code § 1638.1(c)(2)(A)(i)(iv) Documentation showing the surgical privileges the licensee possesses at any licensed general acute care hospital and any licensed outpatient surgical facility in this state.
(B)Copy CA Business & Professions Code § 1638.1(c)(2)(B)
(i)Copy CA Business & Professions Code § 1638.1(c)(2)(B)(i) The licensee has been granted privileges by the medical staff at a licensed general acute care hospital to perform the surgical procedures set forth in paragraphs (1) to (3), inclusive, of subdivision (b) at that hospital.
(ii)CA Business & Professions Code § 1638.1(c)(2)(B)(i)(ii) Documentation described in clause (iii) of subparagraph (A).
(3)CA Business & Professions Code § 1638.1(c)(3) Proof that the licensee is on active status on the staff of a general acute care hospital and maintains the necessary privileges based on the bylaws of the hospital to maintain that status.
(d)CA Business & Professions Code § 1638.1(d) The application shall be accompanied by an application fee required by the board for an initial permit. The fee to renew a permit shall not exceed the maximum amount prescribed in Section 1724.
(e)Copy CA Business & Professions Code § 1638.1(e)
(1)Copy CA Business & Professions Code § 1638.1(e)(1) The board shall appoint a credentialing committee to review the qualifications of each applicant for a permit. Upon completion of the review of an applicant, the committee shall make a recommendation to the board on whether to issue or not issue a permit to the applicant. The permit may be unqualified, entitling the permitholder to perform any facial cosmetic surgical procedure authorized by this section, or it may contain limitations if the credentialing committee is not satisfied that the applicant has the training or competence to perform certain classes of procedures, or if the applicant has not requested to be permitted for all procedures authorized by this section.
(2)CA Business & Professions Code § 1638.1(e)(2) The credentialing committee shall be comprised of five members, as follows:
(A)CA Business & Professions Code § 1638.1(e)(2)(A) A physician and surgeon with a specialty in plastic and reconstructive surgery who maintains active status on the staff of a licensed general acute care hospital in this state.
(B)CA Business & Professions Code § 1638.1(e)(2)(B) A physician and surgeon with a specialty in otolaryngology who maintains active status on the staff of a licensed general acute care hospital in this state.
(C)CA Business & Professions Code § 1638.1(e)(2)(C) Three oral and maxillofacial surgeons licensed by the board who are board certified by the American Board of Oral and Maxillofacial Surgeons, and who maintain active status on the staff of a licensed general acute care hospital in this state, at least one of whom shall be licensed as a physician and surgeon in this state. Two years after the effective date of this section, any oral and maxillofacial surgeon appointed to the committee who is not licensed as a physician and surgeon shall hold a permit pursuant to this section.
(3)CA Business & Professions Code § 1638.1(e)(3) The board shall solicit from the following organizations input and recommendations regarding members to be appointed to the credentialing committee:
(A)CA Business & Professions Code § 1638.1(e)(3)(A) The Medical Board of California.
(B)CA Business & Professions Code § 1638.1(e)(3)(B) The California Dental Association.
(C)CA Business & Professions Code § 1638.1(e)(3)(C) The California Association of Oral and Maxillofacial Surgeons.
(D)CA Business & Professions Code § 1638.1(e)(3)(D) The California Medical Association.
(E)CA Business & Professions Code § 1638.1(e)(3)(E) The California Society of Plastic Surgeons.
(F)CA Business & Professions Code § 1638.1(e)(3)(F) Any other source that the board deems appropriate.
(4)CA Business & Professions Code § 1638.1(e)(4) The credentialing committee shall meet at a time and place directed by the board to evaluate applicants for permits. A quorum of three members shall be required for the committee to consider applicants and make recommendations to the board.
(f)CA Business & Professions Code § 1638.1(f) The board may adopt regulations for the issuance of the permit that it deems necessary to protect the health, safety, and welfare of the public.
(g)CA Business & Professions Code § 1638.1(g) A licensee may not perform any elective, facial cosmetic surgical procedure except at a general acute care hospital, a licensed outpatient surgical facility, or an outpatient surgical facility accredited by the Joint Commission, the Accreditation Association for Ambulatory Health Care (AAAHC), the Medicare Program, or an accreditation agency approved by the Medical Board of California pursuant to subdivision (g) of Section 1248.1 of the Health and Safety Code.
(h)CA Business & Professions Code § 1638.1(h) For purposes of this section, the following terms shall have the following meanings:
(1)CA Business & Professions Code § 1638.1(h)(1) “Elective cosmetic surgery” means any procedure defined as cosmetic surgery in subdivision (d) of Section 1367.63 of the Health and Safety Code, and excludes any procedure that constitutes reconstructive surgery, as defined in subdivision (c) of Section 1367.63 of the Health and Safety Code.
(2)CA Business & Professions Code § 1638.1(h)(2) “Facial” means those regions of the human body described in Section 1625 and in any regulations adopted pursuant to that section by the board.
(i)CA Business & Professions Code § 1638.1(i) A holder of a permit issued pursuant to this section shall not perform elective facial cosmetic surgical procedures unless the permitholder has malpractice insurance or other financial security protection that would satisfy the requirements of Section 2216.2 and any regulations adopted thereunder.
(j)CA Business & Professions Code § 1638.1(j) A holder of a permit shall comply with the requirements of subparagraph (D) of paragraph (2) of subdivision (a) of Section 1248.15 of the Health and Safety Code, and the reporting requirements specified in Section 2240, with respect to any surgical procedure authorized by this section, in the same manner as a physician and surgeon.
(k)CA Business & Professions Code § 1638.1(k) Any violation of this section constitutes unprofessional conduct and is grounds for the revocation or suspension of the person’s permit, license, or both, or the person may be reprimanded or placed on probation. Proceedings initiated by the board under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
(l)CA Business & Professions Code § 1638.1(l) A permit issued pursuant to this section shall be valid for a period of two years and must be renewed by the permitholder at the time the dentist license is renewed.
(m)CA Business & Professions Code § 1638.1(m) A permitholder shall be required to complete 24 hours of approved courses of study related to elective cosmetic surgery as a condition of renewal of a permit. Those courses of study shall be credited toward the total continuing education hours required by the board pursuant to Section 1645.
(n)CA Business & Professions Code § 1638.1(n) Permits issued prior to January 1, 2025, that limit the type of procedure under the general permit category provided under paragraph (1) or (2) of subdivision (b) authorized to be performed by the permitholder shall not be renewed. This subdivision shall not apply to a permit that authorized the permitholder to practice any procedure under the general permit category specified under paragraph (1) or (2) of subdivision (b). The permitholder who seeks to continue performing the procedure previously limited by the permit shall submit an application to the board for issuance of a new permit under paragraphs (1) to (3), inclusive, of subdivision (b) and the board may request the permitholder to submit additional documentation demonstrating the permitholder’s competency for issuance of such permit. The application shall be treated as a renewal application for purposes of subdivision (m) of Section 1724.
(o)CA Business & Professions Code § 1638.1(o) On or before January 1, 2025, and every four years thereafter, the board shall report to the appropriate committees of the Legislature on all of the following:
(1)CA Business & Professions Code § 1638.1(o)(1) The number of persons licensed pursuant to Section 1634 who apply to receive a permit to perform elective facial cosmetic surgery from the board pursuant to this section.
(2)CA Business & Professions Code § 1638.1(o)(2) The number of persons receiving a permit from the board to perform elective facial cosmetic surgery.
(3)CA Business & Professions Code § 1638.1(o)(3) The number of complaints filed by or on behalf of patients who have received elective facial cosmetic surgery by persons who have received a permit from the board to perform elective facial cosmetic surgery.
(4)CA Business & Professions Code § 1638.1(o)(4) Action taken by the board resulting from complaints filed by or on behalf of patients who have received elective facial cosmetic surgery by persons who have received a permit from the board to perform elective facial cosmetic surgery.
(p)CA Business & Professions Code § 1638.1(p) As used in this section, “good standing” means the license is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

Section § 1638.2

Explanation

If you have a permit to do elective facial cosmetic surgery, you can't perform the surgery unless the patient gets a physical exam and written approval for the surgery within 30 days before the procedure. This checkup needs to be done by a licensed doctor or another licensed person with a permit like yours. The exam should include the patient's medical history. If you do both on the day of the surgery, that's considered okay. Breaking this rule is not a crime.

(a)CA Business & Professions Code § 1638.2(a) Notwithstanding any other provision of law, a person licensed pursuant to Section 1634 who holds a permit to perform elective facial cosmetic surgery issued pursuant to this article may not perform elective facial cosmetic surgery on a patient, unless the patient has received, within 30 days prior to the elective facial cosmetic surgery procedure, and confirmed as up-to-date on the day of the procedure, an appropriate physical examination by, and written clearance for the procedure from, either of the following:
(1)CA Business & Professions Code § 1638.2(a)(1) A licensed physician and surgeon.
(2)CA Business & Professions Code § 1638.2(a)(2) A person licensed pursuant to Section 1634 who holds a permit to perform elective facial cosmetic surgery issued pursuant to this article.
(b)CA Business & Professions Code § 1638.2(b) The physical examination described in subdivision (a) shall include the taking of an appropriate medical history.
(c)CA Business & Professions Code § 1638.2(c) An appropriate medical history and physical examination done on the day of the procedure shall be presumed to be in compliance with subdivisions (a) and (b).
(d)CA Business & Professions Code § 1638.2(d) A violation of this section shall not constitute a crime.

Section § 1638.3

Explanation

This law specifies that the fee for renewing a permit to practice oral and maxillofacial surgery is determined by another section. Additionally, it states that all rules and requirements for dentists also apply to those holding a special permit for these surgical practices.

(a)CA Business & Professions Code § 1638.3(a) The fee to renew an oral and maxillofacial surgery permit shall be the amount prescribed in Section 1724.
(b)CA Business & Professions Code § 1638.3(b) Every provision of this chapter applicable to a person licensed to practice dentistry shall apply to a person to whom a special permit is issued under this article.

Section § 1638.5

Explanation

If you have a permit for oral and maxillofacial surgery, it will be automatically put on hold if you lose your valid medical practice license in California.

An oral and maxillofacial surgery permit shall be automatically suspended for any period of time during which the holder does not possess a current valid license to practice medicine in this state.

Section § 1638.7

Explanation

This law requires a study of the training and practices of dentists and oral surgeons, which should be included in the next occupational analysis. After the study is completed, a report must be given to the committee that oversees boards and consumer protection.

The next occupational analysis of dental licensees and oral and maxillofacial facial surgeons pursuant to Section 139 shall include a survey of the training and practices of oral and maxillofacial surgeons and, upon completion of that analysis, a report shall be made to the Joint Committee on Boards, Commissions, and Consumer Protection regarding the findings.