Cosmetic Facial Plastics Fellowships

[ENTologist]

I'm interested in primarily pursuing cosmetic facial plastics, especially rhinoplasty. I am aware of the AAFPRS fellowship list, just wondering if anyone on here is aware of particularly good fellowships which focus on cosmetics. I'm not really interested in micro in my practice, so trying to avoid a micro heavy fellowship.

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[Fah-Q]

The best thing to do is ask the facial plastics attendings at your program. They can help steer you to programs that will meet your goals. The problem is the cosmetic heavy fellowships are typically the lower tier of available fellowships. These really aren't even fellowships, they are more like "observerships". You can certainly learn a lot observing but not operating for a year can hurt your technical ability and you really need a reconstructive experience in a fellowship. Being a good reconstructive surgeon will help you become a good cosmetic surgeon and vice versa. You really can't have one without the other. Maybe you've done enough recon in residency and not seen enough cosmetic cases, in which case I think a cosmetic observership is a reasonable way to spend a year.

 

[ENTologist]

The best thing to do is ask the facial plastics attendings at your program. They can help steer you to programs that will meet your goals. The problem is the cosmetic heavy fellowships are typically the lower tier of available fellowships. These really aren't even fellowships, they are more like "observerships". You can certainly learn a lot observing but not operating for a year can hurt your technical ability and you really need a reconstructive experience in a fellowship. Being a good reconstructive surgeon will help you become a good cosmetic surgeon and vice versa. You really can't have one without the other. Maybe you've done enough recon in residency and not seen enough cosmetic cases, in which case I think a cosmetic observership is a reasonable way to spend a year.

Thanks for the valuable insight. I am interested in reconstruction, just not as much microvascular. Are you saying that strong microvascular fellowships will likely best prepare me for a future non-microvascular based practice due to the increased anatomy exposure and surgical skill development? The idea of a 1 year observership is certainly not exciting. I do speak with my faculty regularly, but a fresh perspective is always appreciated. It sounds like finding a place somewhere in the middle is (as usual) ideal.

I have read on several of the fellowship descriptors that the fellows get hands-on cases through operating at the VA and booking their own cases through resident clinics etc (obviously not of the facelift/cosmetic rhinoplasty variety).

Thanks again, I will keep looking around.

 

[Fah-Q]

Thanks for the valuable insight. I am interested in reconstruction, just not as much microvascular. Are you saying that strong microvascular fellowships will likely best prepare me for a future non-microvascular based practice due to the increased anatomy exposure and surgical skill development? The idea of a 1 year observership is certainly not exciting. I do speak with my faculty regularly, but a fresh perspective is always appreciated. It sounds like finding a place somewhere in the middle is (as usual) ideal.

I have read on several of the fellowship descriptors that the fellows get hands-on cases through operating at the VA and booking their own cases through resident clinics etc (obviously not of the facelift/cosmetic rhinoplasty variety).

Thanks again, I will keep looking around.

A fellowship should offer a good volume of Mohs reconstruction, facial reanimation, facial fractures and functional rhinoplasty cases. Some will also have a cleft lip/palate experience. You don't necessarily need a microvascular experience but you are correct that doing those cases will help you develop your technical ability immensely. The vast majority of your cosmetic cases in fellowship will be observational no matter where you go. That's why a recon experience is so important because you don't want to spend a year observing and not operating. The ideal fellowship allows you to watch your very experienced fellowship director(s) operate and then practice some of these techniques on VA/County patients where you are operating as an attending and teaching residents.