Jul 21, 2009
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I have heard several people mention "derm-plastics" to me as interesting, what exactly is entailed in this field? Is it an extra year of training or something? I had heard about certain residency programs giving their residents some plastics training (e.g. facelifts at Miami), could anyone comment on
a)what is derm plastics
b)what residency programs give their residents training in plastics? (if so what procedures)


Sorry for the new SN, I have posted around here several times but decided to go with something a little more humble... hope all is well for everyone.
 

reno911

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:idea:
I have heard several people mention "derm-plastics" to me as interesting, what exactly is entailed in this field? Is it an extra year of training or something? I had heard about certain residency programs giving their residents some plastics training (e.g. facelifts at Miami), could anyone comment on
a)what is derm plastics
b)what residency programs give their residents training in plastics? (if so what procedures)


Sorry for the new SN, I have posted around here several times but decided to go with something a little more humble... hope all is well for everyone.
1. There's no such thing as "derm-plastics".

2. Some dermatologists perform procedures that one often associates with plastic surgeons (liposuction, facelifts, hair transplants, blepharoplasties are the most common ones I can think of right now).

3. You will generally need to do a Mohs/Procedural fellowship to become comfortable enough with these procedures to do them on your own. Few residencies will give you enough experience with these procedures to perform them WELL. Even among procedural fellowships there is great variety. In some procedural fellowships you'll get a lot of experience with lipo (for example), and in others you'll get none. It all depends on what procedures are done in your fellowship program.

4. In the last survey I saw, < 10% of dermatologists performed tumescent liposuction. I think that <10% is probably the figure for the other procedures I listed as well.

5. My advice to students and residents is that if you want to perform these procedures make sure you get fellowship training so that you can learn to do them well. The dermatologists that I know who offer these procedures, do them very well. As a dermatologist, you are almost held to an even higher standard if you do these things, because most people don't (or can't) understand that it is possible for a dermatologist to be well trained in these procedures. And if you mess up it reflects poorly on yourself and all of us who do perform these procedures.
 
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I meant specific programs, for example I had heard miami trained their residents at least somewhat to do facelifts.....
 

N-Surge

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I meant specific programs, for example I had heard miami trained their residents at least somewhat to do facelifts.....
Having observed/assisted a few of these procedures during my Cosmetic Plastics rotation in med school, I must say that I would hope no one other than a Plastic or Facial Plastic Surgeon would even attempt the "true" face lift procedures. They are very intricate, both anatomically (danger zones) and with regards to skill (putting the right tension on the SMAS, here and there, during the procedure is a pretty amazing thing to watch).

On the other hand, injectables and botox can be used in certain areas to "somewhat" give an overall face lift look.
 

reno911

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Having observed/assisted a few of these procedures during my Cosmetic Plastics rotation in med school, I must say that I would hope no one other than a Plastic or Facial Plastic Surgeon would even attempt the "true" face lift procedures. They are very intricate, both anatomically (danger zones) and with regards to skill (putting the right tension on the SMAS, here and there, during the procedure is a pretty amazing thing to watch).

On the other hand, injectables and botox can be used in certain areas to "somewhat" give an overall face lift look.
The risk of these face lifts rarely justifies the downtime and cost compared the more superficial lifts, which are the most common lifts done by dermatologists and plastic surgeons.

Properly plicating the SMAS is really not that hard (although I suppose a lot of people do it wrong). It is a fundamental cutaneous surgery technique that you should know not only for rhytidectomy but if you want to be any good at skin cancer reconstruction.
 

cancerman51

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If you are interested in plastic surgery, you should probably do plastic surgery.

Most derm residents, including almost everyone I know, struggle to get more than a few laser cases and injectables during residency. I've been involved in over 500 surgical cases in my first two years (which is less than some of my classmates), but have not injected any botox or fillers, and doubt it will occur before the end of residency. I think this is normal, sadly.

It sounds as if procedural derm fellowships offer more training, and there certainly seem to be cosmetic fellowships that will make you into a master.

most seem to goto cosmetic boot camp types of courses.
 

reno911

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If you are interested in plastic surgery, you should probably do plastic surgery.

Most derm residents, including almost everyone I know, struggle to get more than a few laser cases and injectables during residency. I've been involved in over 500 surgical cases in my first two years (which is less than some of my classmates), but have not injected any botox or fillers, and doubt it will occur before the end of residency. I think this is normal, sadly.

It sounds as if procedural derm fellowships offer more training, and there certainly seem to be cosmetic fellowships that will make you into a master.

most seem to goto cosmetic boot camp types of courses.
Having scant botox and filler experience during residency is not abnormal, but only "a few laser cases" in two years is probably below average (but not unheard of).