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

Abstract

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 (JHUM) RAC. A secondary objective was to evaluate the JHUM 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 JHUM RAC between 2011 to 2020. Clinical characteristics, minor complication rates, major complication rates, and revision rates from the JHUM RAC were compared against two peer RACs. We compared the incidence of major complications between the JHUM 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 = 0.07 and P = 0.47, respectively). CosmetAssure patients matched to JHUM RAC patients were found to have comparable total major complications rates of 1.8% vs 0.6% (P = 0.06), respectively. At JHUM, the minor complication rate was 13.9% while revision rate was 5.9%. Conclusions The JHUM RAC provides residents the education and training necessary to produce surgical outcomes comparable to peer RACs as well as board certified plastic surgeons.

Commentary on: A 10-Year Review of Surgical Outcomes at a Resident Aesthetic Clinic

“…This original article 1 demonstrates that resident aesthetic clinics, or RACs, provide residents with the skills necessary to safely perform many common cosmetic procedures—a finding demonstrated across multiple academic institutions 2–4 and mirrored by my experiences as an aesthetic fellowship director. Though safety is a critical component of all surgical training, the uniquely subjective nature of aesthetic surgery makes it an insufficient metric for evaluating the competency of future aesthetic surgeons.…”