title: Outcomes analysis of a resident cosmetic clinic: safety and feasibility after 7 years.
abstract: Cosmetic patients have many options when seeking out their surgeons. In midsize and larger cities, these options span not only different specialties but also different levels of experience. Because surgical experience can best be gained first hand, there exists a special and symbiotic relationship between a surgeon-in-training and his or her patient. Benefits stem from the opportunity for a surgeon to gain independent experience while offering cost effective benefits to patients who may or may not otherwise have access to cosmetic surgery. To meet the needs of both patients and the surgeons-in-training, the Wake Forest University Plastic and Reconstructive Surgery Training Program has set up and maintained a chief resident run cosmetic surgery clinic for 17 years. Each chief resident serves as primary surgeon 1 day a week during the chief year. We present a 7-year retrospective outcome analysis of this experience. The authors performed an Institutional Review Board approved retrospective chart review of all patients who received major cosmetic procedures performed in the WFU chief resident clinic over a 7-year span from 2000 to 2007. A total of 210 charts were reviewed. Fourteen charts were excluded because of inadequate records or non esthetic procedures performed concomitantly. All procedures were viewed as independent events. A total of 196 patients underwent 272 procedures. All procedures were evaluated for major and minor complications and revisions. A total number of 272 initial cosmetic procedures were performed in a 7-year span. Adverse events were divided into major and minor complications. There were no major complications for any of the procedures. Overall minor complication rate was 8.0%. Overall revision rate was 14.4%. Procedures with greatest probability of revision were abdominoplasty and reduction mammaplasty. Chief resident clinics provide a unique experience wherein surgeons-in-training are allowed to hone previously developed surgical acumen while providing a safe and expectedly desirable result for their patients. Because many cosmetic patients desire secondary touch up procedures, a rate of 14.4% in this cohort is neither unexpected nor unacceptable. In addition, the postoperative evaluation and the decision to pursue secondary procedures provides a unique perspective to the chief residents. A chief resident run clinic can be an effective and safe learning tool, providing benefit to patient and the surgeon in training.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston Salem, NC, USA.
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Pyle
authors.forename: Jeff O
authors.initials: JO
authors.lastname: Angobaldo
authors.forename: Allyson K
authors.initials: AK
authors.lastname: Bryant
authors.forename: Malcolm W
authors.initials: MW
authors.lastname: Marks
authors.forename: Lisa R
authors.initials: LR
authors.lastname: David
mesh_terms: D002983:Clinical Competence; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000592:standards*; D015995:Prevalence; D012086:Reoperation / Q000706:statistics & numerical data; D013518:Surgery, Plastic / Q000592:standards* / Q000706:statistics & numerical data*; D016896:Treatment Outcome