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Cleft Palates/Nerve Grafts

Discussion in 'Pre-Medical Allopathic [ MD ]' started by ihatecoldplay10101, 10.01.14.

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  1. ihatecoldplay10101



    I'm a College Senior and up until now I've always wanted to be a Family Physician. However, this summer I got to work with Smile Train, and was really affected by the work they do. I found it to be something I could do all my life, even if it means not working for the organization itself, I find cleft palate reconstruction something I'm really into.

    I was wondering what type of surgical speciality one would go into to pursue something like that? Also is it possible for a surgeon to sustain a career on basically only nerve grafts for facial paralysis and cleft palates?

    While Plastics sounds great, I don't think it is in my path to spend my career doing cosmetic procedures.
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  3. OtoHNS

    OtoHNS ENT Attending 5+ Year Member

    Attending Physician
    Plastic surgeons do the lion's share of cleft surgery in the US, but some ENTs do as well (usually those who have done extra training in facial plastic surgery or pediatric ENT). I'm not sure which specialty does more facial reanimation, but there are definitely certain ENT centers which do a large volume (Drs Chaney and Hadlock at Harvard, Byrne at Johns Hopkins).

    You could certainly make a career of cleft/craniofacial and other non-cosmetic plastics- the path of least resistance would be through academia but it could be done in private practice as well in the right situation. While you would need to have some cosmetics training in either plastics or ENT residency, you don't have to keep doing it for the rest of your career.
  4. Winged Scapula

    Winged Scapula Cougariffic! Staff Member Lifetime Donor SDN Chief Administrator 10+ Year Member

    Attending Physician
    Moving to Pre Allo.
  5. Symmetry11

    Symmetry11 2+ Year Member

    You might like this youtube page.
  6. bc65

    bc65 2+ Year Member

    Attending Physician
    Plastic surgery is the field that typically does cleft surgery and microsurgery, although, as noted above, some Head and Neck ( ENT ) surgeons do microsurgical reconstruction of the head and neck, and a very few do cleft surgery.

    As far as your reluctance to do cosmetic surgery is concerned, be advised that most plastic surgeons do mostly reconstructive surgery. Cosmetic surgery is a small part of most plastic surgeon's practices. Many plastic surgeons have practices that consist entirely of reconstructive procedures. You should not assume that everything you see on television reflects reality. You should certainly not base your career decisions on what you see on TV.

    You certainly can have a practice that consists entirely of a single procedure, or type of procedure, but it is quite unusual. However, your first hurdle will be getting into medical school. Once you're in med school, you may find that you are interesed in entirely different fields. I can guarantee you that the experience of doing a rotation in plastic surgery, and of being a plastic surgeon, will be different than spending a week on an overseas trip watching a plastic surgeon. If you do decide to pursue plastic surgery, you would need to get into a plastic surgery residency. To do that, you will need to be in the top 10% or so of medical students on the standardized exams, along with doing extremely well on your rotations, and doing research in the field. The odds of getting into a plastic surgery residency these days is quite daunting. You would then need to do a craniofacial fellowship, and then find an academic position that will provide the patients for you to operate on. Cleft patients are relatively uncommon, so you need to be at an academic center where these patients will be referred, but even then, the more senior plastic surgeons in your department might get the cleft cases. In fact, it's the relative rarity of these cases that is one of the factors motivating plastic surgeons to go abroad to do them. So I suggest that you keep an open mind and not have your heart set on doing that type of surgery. Even once you are a physician, regardless of specialty, you may find that your practice and / or interests evolve in unexpected ways.

    Other specialties can be quites similar to plastic surgery in the types of procedures that are done. ENT and Ortho are both quite similar and overlap quite a bit with plastic surgery. However, ENT and Ortho are only marginally easier to get into than plastics.

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