facial plastics board certification

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entresident

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What do you guys think about becoming board certified in facial plastics without completing a fellowship
 
What do you guys think about becoming board certified in facial plastics without completing a fellowship

I'd say that 100% of your patients will never know the difference, and most of your colleagues won't either...until they start revising your patients.
 
I'd agree that most patients won't know the difference. I do think many oto residency programs will train you to perform facial plastics competently, especially those with a VA experience. IMO most cosmetic procedures are not technically demanding (with the arguable exception of rhinoplasty).

Also IMO, most FPRS fellowships involve holding retractors, mixing botox, answering pages from high-maintenance cosmetic patients for a year.
 
I'd agree that most patients won't know the difference. I do think many oto residency programs will train you to perform facial plastics competently, especially those with a VA experience. IMO most cosmetic procedures are not technically demanding (with the arguable exception of rhinoplasty).

Also IMO, most FPRS fellowships involve holding retractors, mixing botox, answering pages from high-maintenance cosmetic patients for a year.

Agree on the fellowship part, but there is a lot to be said about watching what is done.

I did about 20 rhinoplasties as a resident -- above the key indicator requirements by the ACGME at the time. I can do basic rhinoplasty. However, there is a real art to doing cosmetic rhinoplasty that I just don't get. There really is a lot to be said about experience in this area.
 
Agree on the fellowship part, but there is a lot to be said about watching what is done.

I did about 20 rhinoplasties as a resident -- above the key indicator requirements by the ACGME at the time. I can do basic rhinoplasty. However, there is a real art to doing cosmetic rhinoplasty that I just don't get. There really is a lot to be said about experience in this area.

I think there is a huge value to watching a "master" do a complicated case. This is something that you realize when you become a bit more advanced in your training. The best little tricks that I have have come from watching someone who is really good at a certain case.

Also, while you might know the technical aspects to doing a case, if you aren't involved in the pre-op analysis and planning, you won't do very well. If you can't look at someone's face, find out what they don't like, analyze their problems, and then come up with a plan, you're useless. A good friend of mine did a lot of Facial Plastics in his ENT residency. He went on to a big-name FPRS fellowship and said that he'd never really realized how much he didn't know about the pre-op analysis and post-op management of facial aesthetics.
 
A fellowship is much more than just doing a bunch of cases. It is really meant to be a year to focus your time and effort towards learning advanced concepts in a particular area. Many facial plastics fellowships are heavily weighted towards cosmetics and therefore they are mostly observational. However, you can learn a ton from watching someone very experienced do a procedure even if you don't participate much. Another important aspect of a fellowship is developing a relationship with a mentor that will last through your career.

You want to start a practice with confidence that you have the knowledge and ability to safely offer your patients a service. The knowledge, experience and mentorship a fellowship provides is much more valuable than a certificate on the wall.
 
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