After more than three decades of helping people look younger, fresher and more confident, Dr. Ralph Rosato – the name many island residents think of when they hear “plastic surgeon” – is hanging up his scalpel. Known for his steady hands and reassuring honesty, Rosato has been shaping not only faces and bodies, but also expectations, for 33 years.
Born in New Jersey and raised in Connecticut, Dr. Rosato completed his Plastic and Reconstructive Surgical Residency at the Cleveland Clinic in Ohio. When he moved to the Treasure Coast in 1992, he was quickly recruited by Lawnwood Hospital in Fort Pierce, opened his own practice in Vero Beach that October, and by December had privileges at Indian River Hospital. Six years later, he built the first state-licensed plastic surgery center in Indian River County, a facility where 99 percent of his procedures are still performed.
It was a bold move at the time, but one that cemented Dr. Rosato’s place in the community. His state-of-the-art center allowed patients to undergo surgery safely and return home the same day, long before outpatient surgery became the standard.
“I’ve always believed patients recover better in their own environment,” he said. Out of some 25,000 procedures, only two required hospital admission, according to Dr. Rosato, both due to preexisting conditions – a record that speaks volumes about his skill and dedication to safety.
Over the years, Dr. Rosato has witnessed sweeping changes in the world of plastic surgery. Some have been welcome – like safer implants and advanced fillers – while others, he admits, have made his work more challenging.
He says social media, for instance, has skewed people’s perceptions of what’s possible. “Part of my job is to set realistic expectations,” he explained. “There are computer programs that simulate what a patient will look like after a procedure, but they can be misleading. The same surgery looks very different on a 25-year-old than on a 60-year-old.”
To combat false expectations, Dr. Rosato built his own library of before-and-after photographs, using real patients rather than computer simulations. “Plastic surgery isn’t about perfection – it’s about improvement,” he said. That philosophy has guided him through thousands of consultations, where he has always emphasized realistic expectations over rosy promises.
One of his strongest messages to patients has been the importance of training and credentials.
Plastic surgery is one of the longest medical residencies, requiring seven to eight years of specialized training. Yet Dr. Rosato has seen a troubling rise in practitioners marketing themselves as plastic surgeons without undergoing this rigorous residency.
“Today dermatologists, ophthalmologists, and even some ear, nose and throat doctors call themselves plastic surgeons,” he said. “It’s important for patients to know exactly what their doctor is trained in. Not everyone with a syringe or scalpel is a plastic surgeon.”
The confusion, he notes, can have real consequences. A common misconception is that an eyelid lift performed by an ophthalmologist will also rejuvenate the face. “The insurance-covered eyelid lift is designed to improve vision, not appearance,” Dr. Rosato explained. “Once the excess skin is removed, you can’t go back later and lift the brows. A plastic surgeon looks at the whole picture – function and aesthetics – to determine the best approach.”
Still, Dr. Rosato has embraced many of the advancements in his field. He praises modern injectables and fillers, often referred to as “liquid facelifts,” which can restore volume, soften wrinkles, and provide subtle lift without the risks of surgery. “They don’t make you look 20 years younger, but they can make you look refreshed,” he said. “They’re affordable, minimally invasive, and the results are almost immediate.”
When it comes to surgical facelifts, Dr. Rosato is just as frank. “It’s not just about the face. If your cheek and jawline look great but your neck doesn’t match, that’s not a good look. The goal is balance,” he said.
He also stresses that patients should undergo procedures for the right reasons. “If you want to feel more confident in your career, that’s valid. But if you’re doing it to improve a relationship, that’s not a good reason. Surgery should be for yourself, not for others.”
One of the greatest threats to patient safety, in his view, is the growing trend of medical tourism. He has treated multiple patients who traveled overseas for cheaper procedures, only to return with dangerous infections or complications. “I’ve seen people come back from South America, Mexico, even Turkey, with unfixable damage,” he said. “Facilities abroad aren’t regulated the way they are here. It’s a gamble with your health just to save a few dollars.”
Despite the pitfalls, Dr. Rosato sees enormous progress overall. Breast implants, once considered risky, are now much safer. Fillers are more reliable. Outpatient procedures have become the norm, offering comfort and convenience without compromising safety. “We’ve come a long way from the days of silicone injections and long hospital stays,” he said.
As for the future, Dr. Rosato believes artificial intelligence will shape the field in profound ways – both positively and negatively. “AI can help us share knowledge quickly, but nothing replaces examining a patient in person,” he reflected.
“As computers get more sophisticated, we have to make sure we don’t lose the diagnostic skills that come from really seeing and touching a patient. In the end, plastic surgery will become safer, but the human connection must remain at the center.”
As it approaches its conclusion, Dr. Rosato says his career has never been just about beauty. It has been about giving people the courage to look in the mirror and smile. “Plastic surgery is about helping people feel like the best version of themselves,” he said.
And for 33 years, Dr. Rosato has done just that.
Dr. Rosato’s official retirement date is Nov. 13, but he isn’t disappearing entirely.
He will continue consulting with spas and practitioners, helping to ensure that standards remain high across the region. His existing patients will still have access to his care, but he will no longer accept new cases or perform surgeries.
Records can be requested by contacting his office directly at 772-562-5859.
