ENT then PRS

[NYDO]

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Just wanted some clarification:

Can you enter a plastic surgery fellowship after completing ENT? I have heard that you are restricted to only doing facial plastic fellowships after ENT. However, certain sites write that their prereq. is either GS, ENT, Neuro, Ortho, etc. Anyone with experience of going into a plastics fellowship after completing ENT here?

 

[maxheadroom]

You can enter an Independent path Plastic Surgery residency (AKA Fellowship) after completing Oto-HNS, Neurosurg, Urology, Ortho, or General Surgery. This is a three year training program. Someone who completes Oto-HNS can also do a one year Facial Plastics Fellowship.

 

[DrDre311]

ENT is the #2 most common pre-plastics specialty (after GS).

 

[Pir8DeacDoc]

To echo the above. An ENT can certainly do a PRS fellowship. However, as more and more of the PRS fellowships move to three years it makes more sense for an ENT to do a facial plastics fellowship (one year) unless they have a really strong desire to do abdominoplasties and boob jobs. There are plenty of cosmetic and reconstructive things in the H&N (including recon after our big whacks) to keep a facial plastics trained surgeon plenty busy.

Some of the PRS guys will argue about the legitimacy of a facial plastics fellowship but that's a debate for another thread.

 

[droliver]

There are plenty of cosmetic and reconstructive things in the H&N (including recon after our big whacks) to keep a facial plastics trained surgeon plenty busy.

It's my impression that most facial plastic surgery fellowships are cosmetic rather then doing heavy duty H&N recon, no? I've never met a facial plastic surgeon that did any microsurgery during their training. Isn't that really the purvey of head & neck fellowships in ENT?

 

[NYDO]

excellent, thanks guys!! 🙂

 

[Leforte]

droliver - yes, most micro is done in our H&N fellowships, but there are a few facial plastics that do 50% cosmetic/50% micro/reconstructive. Most people I have known that pursue the facial plastics pathway are more interested in the cosmetic and occasional reconstruction regional flap (forehead, cervicofacial, etc) and avoid microvascular flaps like the plague.

 

[Pir8DeacDoc]

It's my impression that most facial plastic surgery fellowships are cosmetic rather then doing heavy duty H&N recon, no? I've never met a facial plastic surgeon that did any microsurgery during their training. Isn't that really the purvey of head & neck fellowships in ENT?

That's generally correct. The micro stuff tends to be in the H & N fellowship and facial plastics tends to be cosmetic.

However, the facial plastics "directors" write a short blurb about their interests on the FPRS website and the applicants then taylor their applications towards the directors who are doing what they want to learn. In fact, one of the places (UC-Davis) actually does clefts. I'm not familiar with any other place where ENT does clefts (although I don't really know many places to be honest)..

A facial plastics fellow can do a recon heavy fellowship with micro and the works or they can do rhinoplasties and rhitidectomies all day if they so choose. Kind of makes the fellowship application process very interesting in my opinion.

Hope this helps and I am more than willing to hear other's experience as FPRS is definitely something I am considering in the future.

 

[Fah-Q]

That's generally correct. The micro stuff tends to be in the H & N fellowship and facial plastics tends to be cosmetic.

However, the facial plastics "directors" write a short blurb about their interests on the FPRS website and the applicants then taylor their applications towards the directors who are doing what they want to learn. In fact, one of the places (UC-Davis) actually does clefts. I'm not familiar with any other place where ENT does clefts (although I don't really know many places to be honest)..

A facial plastics fellow can do a recon heavy fellowship with micro and the works or they can do rhinoplasties and rhitidectomies all day if they so choose. Kind of makes the fellowship application process very interesting in my opinion.

Hope this helps and I am more than willing to hear other's experience as FPRS is definitely something I am considering in the future.

You are right on. The FPRS match has a huge variety of fellowships: 100% cosmetics, skull base resections, craniofacial (i know of 4 fellowships that do clefts), free flap fellowships (some with >100 flaps per year), facial reannimation, post-Moh's recon and several combinations of everything I listed.

If you want general plastics after ENT then you have to be willing to spend the extra 2 years (3 years independent pathway vs 1 year FPRS fellowship) to learn burns, hand, body sculpting and boobs. But if you plan of working on the face then you aren't gaining much by doing the extra 2 years...unless you want a cleft practice because it is just difficult for ENT's politically.

You have to really love ENT because the plastics match is brutally competitive and you might not match.

 

[KitesurfDaEarth]

What FPRS fellowships offer cleft training?

You are right on. The FPRS match has a huge variety of fellowships: 100% cosmetics, skull base resections, craniofacial (i know of 4 fellowships that do clefts), free flap fellowships (some with >100 flaps per year), facial reannimation, post-Moh's recon and several combinations of everything I listed.

If you want general plastics after ENT then you have to be willing to spend the extra 2 years (3 years independent pathway vs 1 year FPRS fellowship) to learn burns, hand, body sculpting and boobs. But if you plan of working on the face then you aren't gaining much by doing the extra 2 years...unless you want a cleft practice because it is just difficult for ENT's politically.

You have to really love ENT because the plastics match is brutally competitive and you might not match.

 

[JaggerPlate]

Aren't brest augs and liposuction extremely common procedures/'bread and butter' for plastic surgeons?? It seems like an ENT with a facial plastics fellowship only doing facial plastic work wouldn't make as much as a PRS guy who does facial and body work. I mean, I'm sure they could charge more for the facelifts, nose jobs, etc, but wouldn't this still limit your business?? Sorry, I don't really know ANYTHING about this, I'm just curious what the earning potential difference would be.

 

[GSresident]

Aren't brest augs and liposuction extremely common procedures/'bread and butter' for plastic surgeons?? It seems like an ENT with a facial plastics fellowship only doing facial plastic work wouldn't make as much as a PRS guy who does facial and body work. I mean, I'm sure they could charge more for the facelifts, nose jobs, etc, but wouldn't this still limit your business?? Sorry, I don't really know ANYTHING about this, I'm just curious what the earning potential difference would be.

There is a facial plastics guy in Des Moines doing augs and abdominoplasties believe it or not. When he gets sued there will be no lack of expert witnesses for the defense.

Also, I doubt they can charge more for a facelift or any other procedure, at least where I live.

 

[JaggerPlate]

There is a facial plastics guy in Des Moines doing augs and abdominoplasties believe it or not. When he gets sued there will be no lack of expert witnesses for the defense.

Also, I doubt they can charge more for a facelift or any other procedure, at least where I live.

Yeah those are the people who get nailed. A lot of people (it seems) also do things like 'a full body fellowship' through the American Academy of Cosmetic Surgery to try and seem legit -which I can only assume wouldn't back you in a lawsuit.

I'm also not sure if they charge more for facial procedures, I was more wondering what percent of income came from cosmetic procedures that were out of facial plastic scope for PRS guys, how FP makes up for this, or if the two really don't compare each other across specialties??

This may also be the wrong place to ask, but while the subject is at hand, do ENTs ever do both ENT and facial plastic procedures?? Like work out of a cosmetic office a few days a week and do ENT the rest?? Or would this be too complicated/not worth it??

 

[Fah-Q]

What FPRS fellowships offer cleft training?

These are the ones I know of. There might be more.

UCLA
U of Minnesota
UC-Davis
Ducic in Ft. Worth
SUNY-Syracuse

 

[Fah-Q]

This may also be the wrong place to ask, but while the subject is at hand, do ENTs ever do both ENT and facial plastic procedures?? Like work out of a cosmetic office a few days a week and do ENT the rest?? Or would this be too complicated/not worth it??

It is much more common for a general otolaryngologist to do some facial plastics (septorhinos, botox and fillers, Moh's defects, etc.) as part of their practice than the other way around. Guys who market themselves as facial plastic surgeons often don't want to do general otolaryngology but they often have to until the facial plastics business picks up to the point where they can do it exclusively.

 

[Fah-Q]

There is a facial plastics guy in Des Moines doing augs and abdominoplasties believe it or not.

That is just stupid. I hope you start kicking his butt.

 

[GSresident]

That is just stupid. I hope you start kicking his butt.

I don't think he is that busy with augs and tummy tucks. There are a few really good PRS trained guys in Des Moines who have good reputations. The only way the ENT guy would get augs or tummy tucks is if he drastically cuts prices, which isn't all that easy to do. The only place you can really cut the cost of a procedure is by cutting your own fee.