Background: Cosmetic patients have many options when seeking out their surgeons. In midsize and larger cities, these options span not only different specialties but also different levels of experience. Because surgical experience can only be gained first hand, there exists a special and symbiotic relationship a surgeon-in-training and his or her patient. Benefits stem from the opportunity for a surgeon to gain independent experience while offering financial discounts to patients who may or may not otherwise have access to cosmetic surgery. To meet the needs of both patient and surgeon-in-training, the Wake Forest University Plastic and Reconstructive Surgery Training Program has set up and maintained a chief resident run cosmetic surgery clinic for seventeen years. This is a four year retrospective outcome based review of our experience.
Methods: The authors performed a retrospective chart review of all patients who received invasive cosmetic procedures in a four year span from 2002-2006. Of the 141 charts reviewed 115 were complete enough to evaluate. All procedures were viewed as independent events. A total of 115 patients underwent 159 procedures to include the following operations: 35 abdominoplasty (complete and mini), 30 breast augmentation, 3 breast reduction, 16 mastopexy, 27 liposuction, 12 Facelift, 19 blepharoplasty, and 17 other cosmetic procedures. All procedures were evaluated for specific complications based on a collection of outcome measures presented in previous studies.
Results: A total number of 159 initial cosmetic procedures were performed in a four year span. Adverse events were divided into major and minor complications. There were no major complications for any of the procedures. Overall minor complication rate was 11.0%. Overall revision rate was 17.0%. Procedures with greatest probability of revision were abdominoplasty and liposuction which compares with national standards.
Conclusions: Chief resident clinics provide a unique experience wherein surgeons-in-training are allowed to hone previously developed surgical acumen while providing a safe and expectedly desirable result for their patients. Because many cosmetic patients benefit from secondary procedures, a rate of 17.0% in this cohort is neither unexpected nor unacceptable. The benefit to both surgeon and patient is significant. A resident run clinic can be safe for patients and an effective aspect of a resident training program.