Outcomes Analysis of a Resident Cosmetic Clinic

Abstract

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 best be gained first hand, there exists a special and symbiotic relationship between a surgeon-in-training and his or her patient. Benefits stem from the opportunity for a surgeon to gain independent experience while offering cost effective benefits to patients who may or may not otherwise have access to cosmetic surgery. To meet the needs of both patients and the surgeons-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 17 years. Each chief resident serves as primary surgeon 1 day a week during the chief year. We present a 7-year retrospective outcome analysis of this experience. The authors performed an Institutional Review Board approved retrospective chart review of all patients who received major cosmetic procedures performed in the WFU chief resident clinic over a 7-year span from 2000 to 2007. A total of 210 charts were reviewed. Fourteen charts were excluded because of inadequate records or non esthetic procedures performed concomitantly. All procedures were viewed as independent events. A total of 196 patients underwent 272 procedures. All procedures were evaluated for major and minor complications and revisions. A total number of 272 initial cosmetic procedures were performed in a 7-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 8.0%. Overall revision rate was 14.4%. Procedures with greatest probability of revision were abdominoplasty and reduction mammaplasty. 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 desire secondary touch up procedures, a rate of 14.4% in this cohort is neither unexpected nor unacceptable. In addition, the postoperative evaluation and the decision to pursue secondary procedures provides a unique perspective to the chief residents. A chief resident run clinic can be an effective and safe learning tool, providing benefit to patient and the surgeon in training.

Progressive Independence in Clinical Training: Perspectives of a National, Multispecialty Panel of Residents and Fellows

“…12 Other initiatives designed to provide opportunities for independence include chief resident clinics and telephone triage systems with formative feedback [13][14][15] These interventions may serve as building blocks for the development and implementation of additional objective measurements of resident ability.…”

Evaluación de Programa de Especialidad de Cirugía Plástica, Reparadora y Estética de la Universidad de Chile: Visión de los últimos 6 años por egresados

“…Existen distintas estrategias empleadas en el desarrollo docente quirúrgico que han demostrado resultados satisfactorios 1,3,[4][5][6][7][8] . Sin embargo, al momento de evaluar la formación quirúrgica de especialistas en Cirugía Plástica de manera íntegra y transversal la evidencia es escasa.…”

Minor surgery procedures: A retrospective review and prospective survey in a pediatric population

“…There were no major complications, defined as events that pose risk to life or limb (9), in any of the procedures. Minor complications, however, were reported in 36 of 219 total procedures.…”