First off, you do need an M.D. to get accepted into a plastics fellowship following an OMF residency. Most plastics fellowships are about 2 years. OMF surgeons generally don't apply for plastics fellowships, and they can be somewhat more difficult for OMF surgeons to get into. Following the fellowship, you are eligible to be board certified as a plastic and reconstructive surgeon. At this point, the fact that you have a D.D.S. is almost irrelevent as it would be far more lucrative, generally speaking, doing everyday plastics procedures including breast augmentation, face lifts, etc. This is the option of during a 1 year cosmetic fellowship following OMF residency (in combined MD programs) that offer training in a variety of plastics procedures. These programs, however, are generally looked down upon by the plastic surgery community as those who complete such programs are not eligible for board certification (though are still technically allowed to do virtually any plastics procedure).