Program Director Survey of Aesthetic Plastic Surgery Fellowships in the United States: Current State-of-the-Art.

[BACKGROUND] Aesthetic surgery is a core component of plastic and reconstructive surgery. In 2014, the Accreditation Council for Graduate Medical Education established aesthetic surgery minimums for plastic surgery residents in training. Although many plastic surgery graduates successfully enter practice as an attending plastic surgeon after completion of plastic surgery training, others choose subspecialization. Aesthetic surgery fellowships offer further instruction in surgical and nonsurgical aesthetic procedures in addition to a unique opportunity for mentorship. The American Society for Aesthetic Plastic Surgery currently endorses 25 aesthetic fellowships. However, the literature regarding fellowship specifics is lacking.

[OBJECTIVES] This study aimed to better define the current aesthetic surgery fellowships programs regarding operative experience, fellowship autonomy, program strengths, didactic learning, research experience/opportunities, compensation, and geographic region.

[METHODS] This study was performed by Emory University, Division of Plastic and Reconstructive Surgery, Atlanta, Georgia. In February 2019, an anonymous survey was sent via e-mail to all American Society for Aesthetic Plastic Surgery-endorsed aesthetic fellowship program directors. Three weeks later, a reminder e-mail was sent. No incentives were provided for survey completion.

[RESULTS] A 40% survey response rate was achieved (10/25). Aesthetic surgery fellowships are diverse in exposure, number of procedures, and training environment. In all programs, the fellow functioned as the first assistant in most cases. The percentages of face, breast, and total body procedures varied greatly among fellowships, as well as fellow involvement in critical portions of a case. Nearly all fellowships (9/10) offered a fellow's clinic. Didactic learning and research are components of all programs.

[CONCLUSION] This study provides an overview of the current state of plastic surgery aesthetic fellowships in the United States, serving as the first of its kind.