Oculoplastics

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boondocksaint

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Does anyone have info on which procedures oculoplastic ophthalmologists most commonly perform? What's their "bread and butter" so to speak? Do they usually do a lot of cosmetic stuff like bleph's? (last I knew that was the #1 peformed cosmetic surg in the US). And what about salary? I know ophthos have really taken a hit lately, starting at around 100K and averaging like 250K once established. I'm assuming that since oculoplstic guys spend another 2 years in fellowship, they're doing a little better at least. Please share whatever info you have!
 
boondocksaint said:
. I'm assuming that since oculoplstic guys spend another 2 years in fellowship, they're doing a little better at least.
Doing a fellowship in a subspecialty does not guarantee a better income. Some sub-specialties make less than specialists.

When I was a medical student, the all the rheumatologist in that division were complaining that they were making less than internist. They thought they were smarter but made less.
 
I've worked with a few Oculoplastic Guys (Though I am a senior undergrad at UCLA) and a lot of their work is Bleph. Check out Norman Shorr, and Raymond Douglas, their on the web and most of their publications are on Pubmed. I think the fellowship at Jules Stein has helped all the Fellows in many different ways, hope this is helpful 🙂
 
Visioncam said:
Doing a fellowship in a subspecialty does not guarantee a better income. Some sub-specialties make less than specialists.

yeah, but that's not really the case for oculoplastics 😉

If you get busy with plastics procedures, then you can make a lot more then an average general ophthalmologist.
 
Oculoplastics is traditionally divided into lids, orbits, lacrimal and for some extends to face. It obviously includes functional and cosmetic. The make-up of procedures ranges a great deal between surgeons. I would say that for almost all, however, lids are the most common area of surgery. Blepharoplasty and blepharoptosis surgery are probably the most common. If you are in a high sun-exposure state and are not heavily cosmetic, eyelid tumor removal and reconstruction (or post-Mohs reconstruction) may make up a portion of the practice. If you are in private practice, you may do almost no orbit and maybe only a small proportion of lacrimal. The whole cosmetic and reconstructive breakdown is highly variable, with most new oculoplastic surgeons doing mostly functional. Doing cosmetics takes the right personality and marketing skill, so some never do much of cosmetics (although some would argue that the main motivation behind many patients with insurance-covered blepharoplasty is still cosmetic, they just happen to qualify because their visual fields are slightly clipped). So the number of cases for different surgeons doing botox, lasers, facelifts is highly variable.

In terms of salary, I don't think starting salaries are much higher. My non-ASOPRS friend looking for a first job is looking at offers around 170k in the city. (I don't think ASOPRS trained necessarily get much higher initial offers especially since they are pushed strongly towards academics) For comparison, a senior resident looking for general ophthal jobs has gotten offers 130-160. As with any surgical fellowship, it does make you more marketable, but again the initial salary boost may only be 20-40,000. In the long run, a lot of it has to do with how business-savvy you are. Even though cataract surgeries are only reimbursed ~700$ by medicare, some cataract surgeons still do quite well. Oculoplastics definitely gives you the tools to do a greater range of surgeries, but the functional reimbursement is not very good, so of course the amount of cash-pay/cosmetic surgery performed heavily impacts salary as does the sheer number of surgeries performed.

Ultimately, I don't think salary should play that big of a role in specialty choice (unless of course you're considering medical neurooph or peds and you cant take the big salary hit) -- any ophthal can do lasik or botox and try to set up a lasik factory or botox salon.. or just set up a good optical shop.
 
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