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Methods: The Accreditation Council of Graduate Medical Education provided national operative case logs of chief residents in independent and integrated plastic surgery residency programs for 2014. The number of cosmetic procedures performed by integrated and independent plastic surgery residents were compared with unpaired t tests. Additionally, the median number of cases performed by the bottom 10% and top 10% of residents for each category of procedures was determined and the fold difference computed.
Results: Integrated residents performed more blepharoplasty (47.8 ± 35.0 vs 35.4 ± 23.0, p = 0.003), breast augmentation (47.3 ± 38.0 vs 34.5 ± 19.0), breast fat grafting (2.1 ± 3.0 vs 1.1 ± 2.0, p = 0.005), mastopexy (32.2 ± 20.0 vs 23.7 ± 15.0, p < 0.001), abdominoplasty (30.4 ± 20.0 vs 24.3 ± 15.0, p = 0.014), and suction assisted lipoplasty (52.3 ± 36.0 vs 39.7 ± 24.0) cases. There was no significant difference in the number of facelift, brow lift, rhinoplasty, brachioplasty, body lift, thighplasty, botox, fillers, fat injection, and laser procedures (p > 0.05). A greater range of variation existed among integrated residents for most cosmetic procedures (p < 0.05). The fold difference in case volume between residents in the 10th and 90th percentiles ranged from 2.5 - 14.0 and was greatest for body lift procedures (p < 0.05).
Conclusions: Significant variability exists in the number of cosmetic procedures performed by plastic surgery residents. These differences may impact the competency and practice patterns of future plastic surgeons. Greater efforts are needed to ensure adequate cosmetic operative experience during plastic surgery residency.