A Systematic Review on the Implementation and Educational Value of Resident Aesthetic Clinics

A 10-Year Analysis of Resident Aesthetic Surgery Clinic: Abdominoplasty Performed by Residents Is Safe and Leads to Comparable Outcomes to Attending Surgeons

INTRODUCTION

Resident-led aesthetic clinics have been introduced in plastic surgery training programs to enhance residents' experience in cosmetic procedures. Although these clinics provide valuable hands-on training, concerns regarding the safety of resident-led surgeries, such as abdominoplasty, remain. This study aims to evaluate the safety of abdominoplasty performed by residents compared to those performed by attending surgeons.

METHODS

A retrospective cohort study was conducted for abdominoplasty cases performed at a single academic center between 2012 and 2022. Cases were categorized based on whether the primary surgeon was a resident or an attending physician. Patient demographics, operative details, and complications (both acute and long-term) were collected and statistically analyzed. Outcomes were compared using comparative statistics and regression analysis.

RESULTS

A total of 89 abdominoplasty cases were reviewed, with 49 led by attending physicians and 40 by residents under supervision. There was no statistically significant difference in overall complication rates between the 2 groups (P > 0.05). Resident-led cases had a longer operative time (P < 0.0001) and more frequent concurrent liposuction (P < 0.001). Despite these differences, acute complications, such as seroma and hematoma, and long-term complications, such as hypertrophic scarring and skin necrosis, were comparable between groups, supporting the noninferiority of resident-led procedures.

CONCLUSIONS

The outcomes of abdominoplasties performed by residents in a supervised clinic were comparable to those conducted by attending surgeons, affirming the safety of resident-led aesthetic clinics. These findings support the integration of resident clinics into plastic surgery training, where they offer significant educational benefits and maintain high standards of patient care. Further multicenter studies are recommended to corroborate these findings and assess additional outcome measures, such as patient satisfaction.

Aesthetic Specialization: A Comparative Study across Medical and Surgical Specialties

BACKGROUND

Postresidency fellowship training has become increasingly popular as a career option. Specifically, the subspecialty of aesthetic surgery has grown tremendously over the past 2 decades within several fields, including plastic and reconstructive surgery (PRS), otolaryngology, dermatology, and ophthalmology. However, the popularity of aesthetic specialization through fellowship remains unknown. The present study aims to analyze trends in aesthetic specialization across these specialties and compare its popularity to other fellowships.

METHODS

A retrospective review of data from the San Francisco Match, National Resident Matching Program, American Society for Dermatologic Surgery, and the Accreditation Council for Graduate Medical Education was performed. Data on graduating residents and applicants to fellowship were collected. Analysis of variance and t tests were used to compare differences between groups.

RESULTS

Significant disparities were observed in applicants and matched applicants to aesthetic fellowships among the 4 residencies ( P < 0.001). Aesthetic fellowship was the most popular option after otolaryngology residency (12.5% to 27%, depending on the year) and the second most popular choice after PRS (8% to 17%) and dermatology (2% to 5%). A comparison between PRS and otolaryngology demonstrated a significantly higher percentage of the latter choosing aesthetic fellowship over time ( P < 0.001). However, no significant difference in applicants to aesthetic fellowship was found between dermatology and ophthalmology ( t test, P = 0.060).

CONCLUSIONS

The number of applicants to aesthetic fellowship has increased over time across all eligible residencies with the more surgery-heavy specialties (otolaryngology and PRS) having the highest percentage of applicants. Differences in aesthetic training between fields was also observed, which may reflect underlying variations in training and residency exposure.

Art and Safety of Gluteal Augmentation: Future Directions

Gluteal augmentation is a quickly evolving field that continues to grow in the realms of patient safety, surgical education, and technological advancement. This article discusses innovation in gluteal augmentation and suggests potential new pathways for developing the practice of gluteal augmentation.

Productivity and Efficiency of a Department Resident Aesthetic Plastic Surgery Clinic

Background

There has been increasing demand for aesthetic surgery procedures in the United States, highlighting the critical importance of the competence of plastic surgery residents and rigorous methods of aesthetic surgery training.

Objectives

The objective of this study was to review procedures and outcomes from our plastic surgery resident aesthetic clinic. Outcomes and costs were compared to national averages and reports from the literature.

Methods

A retrospective chart review identified all adult patients who presented to the Resident Aesthetic Surgery Clinic at NYU Langone Health in 2021. Patient demographics, comorbidities, procedural data, postoperative complications, revisions, and surgeon fees were compiled. A brief confidence survey was distributed to participating residents before and after their clinic rotation. Data were analyzed using IBM SPSS software (Armonk, NY).

Results

In 2021, 144/379 consultations led to an operation (38.0% conversion rate), resulting in 420 distinct surgical procedures. The majority (53.3%) of procedures involved the head and neck. Complication and revision rates were 5.5% and 1.0%, respectively, with surgeon fees consistently below the national average. Residents reported being significantly more confident performing face lifts, rhinoplasties, and aesthetic surgery in general following their clinic rotation.

Conclusions

These data represent the largest annual reported study of plastic surgery resident aesthetic procedures and outcomes, demonstrating the high volume and productivity of the NYU Resident Aesthetic Surgery Clinic. These results further support resident aesthetic clinics as a robust training modality.

Level of Evidence 4

A 10-Year Review of Surgical Outcomes at the Johns Hopkins and University of Maryland Resident Aesthetic Clinic

Background

In 2014, the Plastic Surgery Residency Review Committee of the Accreditation Council for Graduate Medical Education (ACGME) increased minimum aesthetic surgery requirements. Consequently, the resident aesthetic clinic (RAC) has become an ever more important modality for training plastic surgery residents.

Objectives

To analyze demographics and long-term surgical outcomes of aesthetic procedures performed at the Johns Hopkins and University of Maryland (JH/UM) RAC. A secondary objective was to evaluate the JH/UM RAC outcomes against those of peer RACs as well as board-certified plastic surgeons.

Methods

We performed a retrospective chart review of all patients who underwent aesthetic procedures at the JH/UM RAC between 2011 and 2020. Clinical characteristics, minor complication rates, major complication rates, and revision rates from the JH/UM RAC were compared against 2 peer RACs. We compared the incidence of major complications between the JH/UM RAC and a cohort of patients from the CosmetAssure (Birmingham, AL) database. Pearson's chi-square test was used to compare complication rates between patient populations, with a significance set at 0.05.

Results

Four hundred ninety-five procedures were performed on 285 patients. The major complications rate was 1.0% (n = 5). Peer RACs had total major complication rates of 0.2% and 1.7% (P = .07 and P = .47, respectively). CosmetAssure patients matched to JH/UM RAC patients were found to have comparable total major complications rates of 1.8% vs 0.6% (P = .06), respectively. At JH/UM, the minor complication rate was 13.9%, while the revision rate was 5.9%.

Conclusions

The JH/UM RAC provides residents the education and training necessary to produce surgical outcomes comparable to peer RACs as well as board-certified plastic surgeons.

Level of Evidence 3