AN OVERVIEW OF THE SPECIALTY
Patients (and even residents) frequently associate facial plastic surgery with “face lifts” and “nose jobs.” The reality is that facial aesthetic and reconstructive surgery are inseparable. Balancing the needs of functional and aesthetic facial reconstruction requires a unique blending of art, science, and innovation. Facial plastic surgery requires unparalleled precision and attention to detail. The thought process required in the planning of facial reconstruction may even supersede the technical skill involved.
Facial plastic surgeons have the unique privilege to take care of such an intimate part of people’s bodies, their faces. People’s faces are their calling cards to the world.
Malformations, cutaneous defects, and bony or soft-tissue changes caused by trauma or neoplasms can drastically alter a patient’s appearance, frequently impacting their self-confidence and self-worth.
It is an exciting time to be a facial plastic surgeon. With safer and minimally invasive procedures, facial plastic surgery has evolved into a natural extension of today's pursuit of a healthy lifestyle. Facial cosmetic procedures are more popular today than ever, and many different specialists are competing for these patients. This level of competition cannot be overstated. The rigorous training of the facial plastic surgeon, however, provides an unrivaled understanding of the anatomy and aesthetics of the face.
The great diversity that might have drawn you to otolaryngology is further represented in facial plastic surgery. Facial plastic surgeons operate on patients of all ages with procedural diversity ranging from non-surgical treatments such as laser resurfacing and injectable fillers to reconstruction after oncologic procedures, including microvascular surgery. The future of facial plastic surgery is already here with face transplantation, tissue engineering, and 3-D printing.
Facial plastic and reconstructive surgery is a craft that is best developed over time and seasoned with experience. This experience starts early on in otolaryngology – head and neck surgery training, as it has become an integral part of our residency experience. In fact, 25 percent of the otolaryngology written and oral board examinations are devoted to facial plastic surgery.
Fellowship training in facial plastic and reconstructive surgery affords you the opportunity of a one-year, focused experience in the evaluation and medical and surgical management of aesthetic and reconstructive problems of the face, head, and neck.
Residents in ACGME-accredited programs in otolaryngology or plastic surgery are eligible to apply for the more than 40 positions available each year. These fellowship programs are widely respected by the medical community and represent the finest postgraduate programs in the world for the training of facial plastic and reconstructive surgeons.
Fellowships are designed to prepare the surgeon for both private practice and an academic career in facial plastic and reconstructive surgery. Typical fellowship training includes: in-depth training in facial cosmetic surgery (facelifts, blepharoplasty, browlift, rhinoplasty, facial augmentation, etc.), as well as minimally-invasive techniques and office-based procedures (injectables and laser treatments), primary and revision rhinoplasty, facial reanimation, Mohs reconstruction, microsurgical techniques including free tissue transfer, trauma, congenital facial reconstruction, and anterior skull-base surgery. Many programs allow you to also spend time training across disciplines with oculoplastic surgeons, oral and maxillofacial surgeons, cosmetic dermatologists, and Mohs surgeons.
Most fellowships incorporate integrated settings, including university-based reconstructive and private cosmetic practices. This allows the fellow the opportunity to develop skills associated with managing a private practice clinic and surgery center, which are often missing from residency training.
All fellowship programs follow a standard curriculum. Oral and written board examinations are administered by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) after the completion of the 12-month fellowship. Following successful completion of these boards you will be double-board certified in otolaryngology – head and neck surgery as well as facial plastic and reconstructive surgery.
Facial plastic surgery fellowships utilize the San Francisco Match. Interviews are typically completed by the end of May of the application year preceding the fellowship start date. The match results are released to the applicant mid-June. This is a highly competitive sub-specialty, so if you if you think you might be interested in pursuing facial plastic surgery, consider contacting a mentor early during your residency to help you navigate the process.
Good luck and feel free to reach out to me with any questions!
David J Archibald, MD
Medical School: Mayo Medical School
Residency: Mayo Clinic, Rochester, MN
Fellowship: University of South Florida, Dr. Edward Farrior
Current Location: Center for Plastic Surgery, Castle Rock, CO
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