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Mukit FA, Kim EY, Hilliard G, Pilkinton S, Walker ME, Wilson MW, Fowler BT. Scope of practice of oculofacial plastic and reconstructive surgeons: a public perception survey. Orbit 2024:1-7. [PMID: 38815176 DOI: 10.1080/01676830.2024.2348015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/21/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The purpose of this study is to determine the public's perception of the scope of practice for oculofacial plastic and reconstructive surgeons (OFPRS). METHODS A 49-question survey was distributed by QualtricsⓇ to a panel similar to the US demographic composition. Responses collected underwent bivariate statistical analysis. RESULT A total of 530 responses were obtained, with most respondents being white, female, over the age of 35, from the Midwest, and with at least a college education or above. Most respondents did not think ophthalmologists or optometrists were surgeons, and only 158 people (29.8%) knew the primary specialty of OFPRS was ophthalmology. Board certification was preferred by 98.87% of respondents, and 95.28% preferred ASOPRS-trained OFPRS. CONCLUSIONS Our study highlights the gap in knowledge about OFPRS as a field, the qualifications and training required, and the scope of practice. Notably, even for OFPRS-specific procedures, PRS remained the leading subspecialist chosen for interventions such as orbital decompression (58.5% vs. 71.5%), orbital reconstruction (57.9% vs. 74.2%), enucleation/evisceration (48.1% vs. 53.4%), optic nerve-related surgery (39.8% vs. 43.4%), orbital cancer resection (42.8% vs. 46.8%), and tear duct surgery (41.9% vs. 52.5%). Additionally, most respondents did not feel that facial fillers, laser skin resurfacing, eyelid cancer removal, or cataract surgery were within the OFPRS scope of practice.
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Affiliation(s)
- Fabliha A Mukit
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Emily Y Kim
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Grant Hilliard
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sophie Pilkinton
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Marc E Walker
- Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Matthew W Wilson
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Brian T Fowler
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Brown KW, Moss CA, McCandless MG, Mukit M, Walker ME. Plastic Surgery: Beware the Candle Burning at Both Ends. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5495. [PMID: 38145151 PMCID: PMC10745237 DOI: 10.1097/gox.0000000000005495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 11/02/2023] [Indexed: 12/26/2023]
Abstract
Background Plastic surgery dates back to 800 BC, where forehead flaps were used to reconstruct noses in India. Today, it is one of the most romanticized fields in medicine. Due to the influence of social media, there has never been a larger spotlight. Ironically, this spotlight brings a narrowed perception of the scope of plastic surgery. This study aimed to assess the scope through the eyes of the average American to identify gaps in knowledge to better represent the field. Methods A series of questions were developed under survey methodologists and administered by Qualtrics. Responses were gathered, and data were analyzed to assess the public's knowledge of plastic surgery's scope. Results Two thousand five hundred responses were obtained, balanced across demographics similar to that of the United States. The US population has a poor understanding of the scope of plastic surgery and how to obtain board certification. Conclusions This survey demonstrates a gap in awareness of plastic surgery as a field and the scope outside aesthetic procedures dramatized by the media. There remains no clear understanding of the qualifications of plastic surgeons or the provider makeup of the field of cosmetic surgery. Subspecialties proved to be overlooked, and knowledge of board certification was sparse. Further effort is needed to educate both the public and patients of the scope of plastic surgery, so that they might seek and gain access to appropriate treatment in the most efficient manner to optimize outcomes regarding the form and function of the body.
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Affiliation(s)
- Kathryn W. Brown
- From the Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Miss
| | - Clayton A. Moss
- School of Medicine, University of Mississippi Medical Center, Jackson, Miss
| | | | - Muntazim Mukit
- From the Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Miss
| | - Marc E. Walker
- From the Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Miss
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Schols RM, Dip F, Lo Menzo E, Haddock NT, Landin L, Lee BT, Malagón P, Masia J, Mathes DW, Nahabedian MY, Neligan PC, Newman MI, Phillips BT, Pons G, Pruimboom T, Qiu SS, Ritschl LM, Rozen WM, Saint-Cyr M, Song SY, van der Hulst RRWJ, Venturi ML, Wongkietkachorn A, Yamamoto T, White KP, Rosenthal RJ. Delphi survey of intercontinental experts to identify areas of consensus on the use of indocyanine green angiography for tissue perfusion assessment during plastic and reconstructive surgery. Surgery 2022; 172:S46-S53. [PMID: 36427930 DOI: 10.1016/j.surg.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND In recent years, indocyanine green angiography (ICG-A) has been used increasingly to assist tissue perfusion assessments during plastic and reconstructive surgery procedures, but no guidelines exist regarding its use. We sought to identify areas of consensus and non-consensus among international experts on the use of ICG-A for tissue-perfusion assessments during plastic and reconstructive surgery. METHODS A two-round, online Delphi survey was conducted of 22 international experts from four continents asking them to vote on 79 statements divided into five modules: module 1 = patient preparation and contraindications (n = 11 statements); module 2 = ICG administration and camera settings (n = 17); module 3 = other factors impacting perfusion assessments (n = 10); module 4 = specific indications, including trauma debridement (n = 9), mastectomy skin flaps (n = 6), and free flap reconstruction (n = 8); and module 5 = general advantages and disadvantages, training, insurance coverage issues, and future directions (n = 18). Consensus was defined as ≥70% inter-voter agreement. RESULTS Consensus was reached on 73/79 statements, including the overall value, advantages, and limitations of ICG-A in numerous surgical settings; also, on the dose (0.05 mg/kg) and timing of ICG administration (∼20-60 seconds preassessment) and best camera angle (61-90o) and target-to-tissue distance (20-30 cm). However, consensus also was reached that camera angle and distance can vary, depending on the make of camera, and that further research is necessary to technically optimize this imaging tool. The experts also agreed that ambient light, patient body temperature, and vasopressor use impact perfusion assessments. CONCLUSION ICG-A aids perfusion assessments during plastic and reconstructive surgery and should no longer be considered experimental. It has become an important surgical tool.
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Affiliation(s)
- Rutger M Schols
- Maastricht University Medical Center, Masstricht, Netherlands
| | - Fernando Dip
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
| | | | | | - Luis Landin
- FIBHULP/IdiPaz, Hospital Universitario La Paz, Madrid. Spain
| | - Bernard T Lee
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Paloma Malagón
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jaume Masia
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | | | - Gemma Pons
- Hospital de la Santa Creu, Barcelona, Spain
| | - Tim Pruimboom
- Maastricht University Medical Center, Masstricht, Netherlands
| | - Shan Shan Qiu
- Maastricht University Medical Center, Masstricht, Netherlands
| | - Lucas M Ritschl
- Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Warren M Rozen
- Monash University, Peninsula Campus, Frankston Victoria, Australia
| | | | - Seung Yong Song
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Mark L Venturi
- VCU School of Medicine INOVA, National Center for Plastic Surgery, Washington, DC
| | | | - Takumi Yamamoto
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Kevin P White
- ScienceRight Research Consulting Services, London, Ontario Canada
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Odenthal J, Knoedler L, Oezdemir B, Prantl L, Machens HG, Broer PN, von Isenburg S, Rieger UM, Kauke M, Panayi AC, Knoedler S. How to attract our future? - Perception of plastic surgery among medical students. J Plast Reconstr Aesthet Surg 2022; 80:4-12. [PMID: 36931006 DOI: 10.1016/j.bjps.2022.08.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/17/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND There is a mounting body of evidence that underscores the worldwide and US national need for increased plastic surgery recruitment of trainees. Thus, plastic surgery must attract more applicants while maintaining the high-level qualifications of residency candidates. METHODS A total of 250 (w = 197) medical students rated the prototypical plastic surgeon (PS), general practitioner (GP), and craniomaxillofacial surgeon (CMF) with respect to traits derived from a literature review on the general perception of surgery, favorability, and their intention to pursue a respective career. RESULTS Factor analysis yielded two overarching dimensions of prototype perception in addition to femininity and resilience, one reflecting a coldhearted, narcissistic, competitive character (status primacy; SP), and one reflecting role-model-like traits (hard-working, healthy, admired, and empathetic). Prototypical PSs scored significantly higher on SP than GPs (t(249) = 18.72, p < 0.001, d = 1.26) and CMFs (t(249) = 5.73, p < 0.001, d = 0.36), while receiving significantly less positive evaluations (GP: t(249) = -9.93, p < 0.001, d = -0.63; CMF: t(249) = -3.52, p < 0.001, d = -0.22). The higher participants rated PSs on SP, the more likely a career in plastic surgery was excluded (OR = 0.71, p = 0.03). An opposite relationship with femininity approached significance (OR = 1.32, p = 0.06). CONCLUSIONS Given the growing need for PSs, worldwide and US national task fields have to overcome the outdated traits and highlight the field's pro-bono engagement. Furthermore, plastic surgery should further expand its leading role in promoting female trainees.
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Affiliation(s)
- Jan Odenthal
- Department of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Leonard Knoedler
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
| | - Berkin Oezdemir
- Faculty of Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Hans-Guenther Machens
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - P Niclas Broer
- Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany
| | | | - Ulrich M Rieger
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, AGAPLESION Markus Hospital, Frankfurt am Main, Academic Teaching Hospital of the J. W. Goethe University Frankfurt am Main, Germany
| | - Martin Kauke
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Adriana C Panayi
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Samuel Knoedler
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Do Our Colleagues Accurately Know What We Do? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4104. [PMID: 35242489 PMCID: PMC8884532 DOI: 10.1097/gox.0000000000004104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022]
Abstract
Introduction: Plastic surgery is a unique field‚ and its scope is beyond a specific demographic group or anatomic part. The poor understanding and misconception about plastic surgeons’ scope of practice has been well-established among the public, especially in Saudi Arabia; but the question is, do healthcare physicians share the same misconception? This study aims to answer this question. Methods: This study was conducted between September 11, 2021 and November 1, 2021. This is a cross-sectional, survey-based study utilizing a self-structured questionnaire targeting physicians in Saudi Arabia. Results: A total of 261 medical and surgical physicians participated in this study. Nearly 45% of them demonstrated a poor understanding of plastic surgery and its scope of practice, whereas only 16.1% were sufficiently knowledgeable. Male physicians were more likely to understand the field of plastic surgery when compared with female physicians. More than 80% of the physicians knew that cosmetic operations are done by plastic surgeons, whereas 50% or less knew that reconstructive operations are conducted by plastic surgeons. Conclusion: This study shows that 44.1% of the participating physicians demonstrate poor knowledge regarding plastic surgery as a field, in addition to a lack of understanding about the scope of practice of plastic surgeons. We recommend enhancing promotional efforts that raise awareness about the nature of plastic surgery as a specialty among healthcare physicians.
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Demographic and Cultural Differences in the Acceptance and Pursuit of Cosmetic Surgery: A Systematic Literature Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3501. [PMID: 33777604 PMCID: PMC7990019 DOI: 10.1097/gox.0000000000003501] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 11/26/2022]
Abstract
Worldwide, the numbers of cosmetic procedures continue to climb. However, cosmetic surgery (CS) continues to be plagued by negative stigmatization. This study reviews the literature to identify how attitudes toward CS vary by sex, age, race, culture, and nationality, and aims to determine how other factors like media exposure interact with demographics to influence how well CS is accepted. Methods A PRISMA-guided systematic review of the literature was conducted to identify all English-language papers reporting on CS or plastic surgery acceptance, attitudes, or stigmatization, specifically examining for data on age, sex, race/ethnicity, culture, and media influence. Results In total, 1515 abstracts were reviewed, of which 94 were deemed pertinent enough to warrant a full-text review. Among the potential demographic predictors of CS acceptance, the one with the most supportive data is sex, with women comprising roughly 90% of all CS patients in virtually all populations studied and consistently exhibiting greater CS knowledge and acceptance. Culturally, the pursuit of beauty through CS is a universal phenomenon, although different countries, races, and cultures differ in how willingly CS is embraced, and in the aesthetic goals of those choosing to have it. In countries with culturally diverse societies like the United States, non-Hispanic Whites continue to predominate among CS patients, but the number of CS patients of other races is rising disproportionately. In this trend, social media is playing a major role. Conclusion Healthcare practitioners performing cosmetic procedures need to consider demographic and cultural differences of the patients in order to enhance their understanding of their patients' aesthetic goals and expectations.
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