title: Top five craniofacial techniques for training in plastic surgery residency.
abstract: BACKGROUND
  Despite increasing specialization of craniofacial surgery, certain craniofacial techniques are widely applicable. The authors identified five such craniofacial techniques and queried American Society of Plastic Surgeons members and plastic surgery program directors regarding their comfort level with the procedures and their opinion on resident training for these selected procedures.
  
  
  METHODS
  First, a select group of senior craniofacial surgeons discussed and agreed on the top five procedures. Second, active American Society of Plastic Surgeons were surveyed regarding their opinion on training and their comfort level with each procedure. Third, plastic surgery residency program directors were studied to see which of the top five procedures are taught as part of the plastic surgery residency curriculum.
  
  
  RESULTS
  The top five widely applicable craniofacial procedures are technically described and include the following: (1) cranial or iliac bone graft for nasal reconstruction, (2) perialar rim bone graft, (3) lateral canthopexy, (4) osseous genioplasty, and (5) bone graft harvest for orbital floor defects. For practicing plastic surgeons, comfort level in all procedures increased with advancing years in practice (except those with <5 years). A majority of plastic surgeons (>75 percent), especially those with craniofacial fellowship training, felt competent in all procedures except osseous genioplasty (53 percent). Plastic surgery program directors agreed that all top five procedures should be mastered by graduation.
  
  
  CONCLUSIONS
  Although program directors felt that all five selected craniofacial procedures should be taught and mastered during residency training, plastic surgeons without craniofacial fellowship training were less comfortable with the techniques. Residency training goals should include competence in core craniofacial techniques.
authors.affiliation: Los Angeles, Calif.; Miami, Fla.; New York, N.Y.; Philadelphia, Pa.; and Chapel Hill, N.C. From the Division of Plastic and Reconstructive, David Geffen School of Medicine at UCLA; University of Miami, Miller School of Medicine; the Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center; Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia; Division of Plastic Surgery, University of North Carolina School of Medicine; Plastic and Reconstructive Surgery, Miami Children's Hospital; and the Department of Biostatistics, University of California, Los Angeles.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fan
authors.forename: Henry K
authors.initials: HK
authors.lastname: Kawamoto
authors.forename: Joseph G
authors.initials: JG
authors.lastname: McCarthy
authors.forename: Scott P
authors.initials: SP
authors.lastname: Bartlett
authors.forename: David C
authors.initials: DC
authors.lastname: Matthews
authors.forename: S Anthony
authors.initials: SA
authors.lastname: Wolfe
authors.forename: Neil
authors.initials: N
authors.lastname: Tanna
authors.forename: Minh-Thien
authors.initials: MT
authors.lastname: Vu
authors.forename: James P
authors.initials: JP
authors.lastname: Bradley
mesh_terms: D005145:Face / Q000601:surgery*; D005147:Facial Bones / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D019651:Plastic Surgery Procedures / Q000193:education* / Q000379:methods*; D012886:Skull / Q000601:surgery*; D013518:Surgery, Plastic / Q000193:education*; D011795:Surveys and Questionnaires