title: Aesthetic surgery performed by plastic surgery residents: an analysis of safety and patient satisfaction.
abstract: BACKGROUND
  Aesthetic surgery is an integral component of plastic surgery. Despite its importance, adequate training in aesthetic surgery is met with challenges. Although the educational benefit of resident clinics has been demonstrated, such clinics are rarely found outside the United States. The objective of the present study was to assess safety and patient satisfaction associated with aesthetic surgery procedures performed by plastic surgery residents at a German academic medical center.
  
  
  METHODS
  The study had 2 components, namely, a retrospective chart review and an administration of a patient satisfaction survey. Only patients who underwent a surgical intervention by a plastic surgery resident between 2003 and 2011 were included in the study. Parameters of interest included age, sex, procedure performed, number of procedures, revenue (in &OV0556;), length of follow-up, revision rate, and postoperative complication rate. Patient satisfaction was assessed by the client satisfaction questionnaire-8.
  
  
  RESULTS
  A total of 273 aesthetic procedures were performed in 206 patients with an increase in recent years. The median follow-up period was 49.5 months. The most frequently performed procedures were liposuction (n = 59), breast augmentation (n = 53), and upper eyelid blepharoplasty (n = 31). One hundred ninety-two (90.3%) patients had an uneventful postoperative course. The client satisfaction questionnaire-8 questionnaire was completed by 110 patients (response rate, 50.2%). The median value of 28 indicates a high degree of patient satisfaction. An association between occurrence of major complications and patient satisfaction was seen.
  
  
  CONCLUSIONS
  Aesthetic surgery performed by plastic surgery residents under supervision by attending physicians is safe and provides for high levels of patient satisfaction postoperatively. Offering these services may be able to bridge the gap between providing high-quality aesthetic surgery training while yet recruiting an increasing number of patients who may appreciate the lower fees associated with these services.
authors.affiliation: From the *Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, Freiburg, Germany; and †Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors.forename: Georgios
authors.initials: G
authors.lastname: Koulaxouzidis
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.forename: Filip
authors.initials: F
authors.lastname: Simunovic
authors.forename: Florian
authors.initials: F
authors.lastname: Lampert
authors.forename: Holger
authors.initials: H
authors.lastname: Bannasch
authors.forename: G Björn
authors.initials: GB
authors.lastname: Stark
mesh_terms: D003357:Cosmetic Techniques; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D061214:Patient Safety / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000193:education*; D011795:Surveys and Questionnaires