Plastic Surgery News, January/February 2023

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Plastic Surgery News

January/February 2023 Vol. 34 No. 1

The mission of the American Society of Plastic Surgeons is to support its members in their efforts to provide the highest quality patient care and maintain professional and ethical standards through education, research and advocacy of socioeconomic and other professional activities.

ASPS PRESIDENT Gregory Greco, DO plasdoc39@msn.com

CHIEF MEDICAL EDITOR

Summer E. Hanson, MD, PhD shanson.mdphd@gmail.com

ASSOCIATE MEDICAL EDITORS

B. Aviva Preminger, MD, MPH premingermd@gmail.com Richard Baynosa, MD richard.baynosa@unlv.edu

ADVERTISING EDITOR

Scot B. Glasberg, MD scotbg@gmail.com

EXECUTIVE VICE PRESIDENT Michael Costelloe mcostelloe@plasticsurgery.org

STAFF VP OF COMMUNICATIONS Mike Stokes mstokes@plasticsurgery.org

MANAGING EDITOR Paul Snyder psnyder@plasticsurgery.org

SENIOR NEWS EDITOR Jim Leonardo jleonardo@plasticsurgery.org

CONTRIBUTING EDITORS

Anu Bajaj, MD; Arun Gosain, MD; Joe Gryskiewicz, MD; Jeff Kozlow, MD; Paige Myers, MD

CONTRIBUTING WRITERS

Erika Adler; Madison Freeman; Jun Magat; Darcy McLaughlin; Peggy Pissarreck

COVER DESIGN Paul Snyder

DISPLAY ADVERTISING SALES

Michelle Smith, (646) 674-6537 michelle.smith@wolterskluwer.com, Wolters Kluwer Health

CLASSIFIED ADVERTISING

Jeanne Embrey, jembrey@plasticsurgery.org

Plastic Surgery News (ISSN 1043-4119) is published eight times per year: March, June, September, December single issues – and combined January/February, April/May, July/August and October/November issues – by ASPS.

Phone: (847) 228-9900; Fax: (847) 228-9131

POSTMASTER, send address changes to: ASPS Membership Department

Plastic Surgery News 444 E. Algonquin Road Arlington Heights, IL 60005

Periodicals postage paid at Arlington Heights, IL, and at additional mailing offices. USPS# 508-890. The views expressed in articles, editorials, letters and other publications published by PSN are those of the authors and do not necessarily reflect the opinions of ASPS. Acceptance of advertisements for PSN is at the sole discretion of ASPS. ASPS does not guarantee, warrant or endorse any product, program or service advertised. 2023

Basic subscription rate: $90; for foreign subscriptions add $90 for first class service. The subscription price for PSN is included in annual membership dues. Letters, questions or comments should be addressed to: Editor, Plastic Surgery News, 444 E. Algonquin Road, Arlington Heights, IL 60005.

A Virtual Event March 17-18, 2023

The ASPS Plastic Surgery Coding Workshop provides attendees with the most up-to-date coding information and specialty-specific instruction. This comprehensive learning program is a live, online interactive meeting that allows new coding professionals and those with more experience to learn accurate coding a nd implementation strategies from experts in the field.

This is the only ASPS Coding Workshop in 2023 and it will not be recorded. Don’t miss out! Make plans to join us virtually on March 17-18!

PRESIDENT’S MESSAGE

By Gregory Greco, DO ASPS President

As 2023 begins, I’d first like to wish each of my fellow ASPS members a happy new year and reiterate that it is my distinct privilege to serve as ASPS president. I look forward to working with all of you in the months ahead as we continue to strengthen our organization and the specialty at large.

The biggest change we will see this year is the new face of our Society’s governance structure. This restructure will undoubtedly give our members an amplified, more representative voice in ASPS.

To keep up to date with the governance restructure and the implementation timelines, please visit the “Community” tab at plasticsurgery.org

As plastic surgeons, we have proudly endured the rigors of residency, fellowship, board certification and continuous certification. We are committed to optimizing patient outcomes and placing patient safety at the forefront of every effort. As board-certified plastic surgeons, we are all experiencing the erosion and encroachment of our beloved specialty by not only non-plastic surgeons, but non-physician providers. Scope-of-practice battles continue to be a front-of-mind concern as practitioners from various specialties in the greater house of medicine encroach upon our work – one need look no further than my own backyard in New Jersey, where nurse practitioners have efforts underway to secure independent practice rights – but that’s just one of myriad examples from across the country. All members of ASPS recently received a call-to-action email about the American Board of Oral & Maxillofacial Surgery seeking board-certification from the ABMS. ASPS continues to monitor and oppose any proposed state-sanctioned board equivalency that can put patient safety in jeopardy.

Having served as the Society’s Vice President of Advocacy and Health Policy and having made numerous trips to Washington, D.C., to work with lawmakers on various efforts to protect the work that plastic surgeons do every day, I know these battles will continue – but I also know of the successes we have had in the past and will continue to have going forward.

That success, however, is entirely dependent upon unity within our profession. Too often, plastic surgeons allow ourselves to be parsed into different groups – academic, private, solo, group, reconstructive, cosmetic, not to mention any of the numerous subspecialties. As we focus on protecting these smaller territories, we sometimes inadvertently allow practitioners from larger fields to co-opt or take away the procedures that we’ve fostered and pioneered. We are currently seeing some evidence of this with other specialties now performing breast reconstruction.

I think I can safely assume that most ASPS members do not limit their participation in organized medicine to one group or society – and I know well the importance of membership and engagement at local, state and national levels. Nevertheless, regardless of our practice types, geographical locations, the organizations and societies to which we belong or any other measure by which we define ourselves as medical professionals, the fact remains that we are all plastic surgeons fighting to preserve the integrity of our specialty as we provide the best care possible to our patients. Now, more than ever, we must be cohesive and collaborative with our colleagues to protect the longevity and legacy of our profession.

One for all

I am humbled to lead the world’s largest organization of board-certified plastic surgeons and as our international membership continues to grow year after year, I feel duty bound to remind each of you that there is much we can learn from each other to propel our specialty forward and keep the spirit of innovation burning brightly. ASPS has taken the lead in creating a worldwide public education social media video campaign with our international partners that underscores the importance of choosing a properly credentialed plastic surgeon. During our global leadership forum in Boston, we learned that our concerns are not limited to our own borders. Many of our partners from around the world espoused stories concerning practice creep by unqualified providers.

Working together to solve these problems and continue to drive innovation requires effort from all corners of our organization – and as a private practitioner myself, I want to underscore the importance of all kinds of practice types to ASPS and our specialty as a whole. When it comes to matters such as research funding and support of innovative ideas and business models, it’s easy to think of academic and research institutions enjoying the lion’s share of those benefits, but our statistics show that private, solo and small group practices – which constitute roughly 50 percent of our membership – also reap the benefits that ASPS and The PSF provide to our members.

In addition to the research funding opportunities that are available to our members on an annual basis, we’re entering the second year of the Society’s partnership with MedTech Innovator, the largest accelerator of medical devices in the world. Our partnership provides a direct pipeline for our members to push both inventions and incredible business ideas to a level where they can receive feedback, potential partnerships and possible investments. It was a very exciting and proud moment in Boston to see that two of the 10 finalists came from the ASPS pipeline/partnership.

As I mentioned earlier, 2023 is also the year that – after several past attempts that never came to fruition – our Society’s governance structure will also be revamped. For more detail on the changes, you can reference the article on page 7, but the big takeaway of this restructure is finding a way to make our government function in a bottom-up – rather than top-down – manner. The goal is to better-engage all levels of membership and to give you a stronger voice in how we move forward and evolve in the coming years.

I’ve been fortunate to see how my involvement with ASPS since my time as a young plastic surgeon made a difference in everything from how a small organizational decision is made to how national policy can be affected. Together, we can continue to make a difference every day – and I look forward to engaging each of you as we navigate new territory in the year ahead. PSN

EDITOR’S

MESSAGE

You can never be too prepared

By B. Aviva Preminger, MD, MPH PSN Associate Medical Editor

Benjamin Franklin once said, “By failing to prepare, you are preparing to fail.” Longer ago than I care to admit, I began an expansion of my office with a plan to add two full O.R.s and a recovery room. I’ve often heard that with any construction project, I should anticipate it taking twice as long as expected – and costing twice as much. I’m not sure that it’s quite double yet, but I definitely feel like I’m on my way there.

I’ve done construction before, so the delays didn’t really surprise me. Construction in Park Avenue co-op buildings in New York brings its own set of special hurdles, with landmarks approvals and finicky boards. There are noise requirements, fixed periods during which construction is permitted and paint colors that must be matched so as not to (God forbid) deviate from antiquated exteriors – even in courtyards no one will ever see.

As if the normal frustrations and costs of construction were not enough, what followed were seemingly endless expenses for backup systems, installed “just in case.” Every anesthesia machine has its own internal backup system. I backed them up further on a central UPS system. Multiple special outlets were added to backup everything else that might be needed in an emergency. Emergency lights were installed in case the power failed. I ordered a special medication refrigerator with an internal monitor to ensure that medications requiring refrigeration are always maintained at the proper temperature. I made sure there were multiple cauteries, venodyne machines and liposuction machines. There were backups for the backups. I took every precaution, but I confess that I sometimes secretly felt that it was possibly excessive, and, hopefully, would never be necessary. Much like insurance, it’s something you pay for and hope to never use.

On Jan. 2, I sat in front of the TV watching Sunday night NFL football and saw the unimaginable unfold. Buffalo Bills safety Damar Hamlin collided with a player from the Cincinnati Bengals and suffered a cardiac arrest on the field. The 24-year-old Hamlin stood up, appeared to adjust his helmet and took two steps before falling backward and appearing limp in a horrifying moment for all those tuned into the game.

At the time of writing this column, Hamlin was awake and reportedly neurologically intact. We all know that the first moments are critical in a cardiac arrest. Hamlin’s recovery is a credit to the first responders and to the NFL’s emergency action plan (EAP), which seems to have worked exactly as intended under these circumstances.

The NFL’s EAP is utilized in instances of severe trauma. Teams are required to rehearse their EAP twice prior to the start of the preseason, once at the stadium and once at the practice site – and the drills must, at minimum, address scenarios relating to spine and head trauma, hyperthermia, cardiac arrest/arrhythmia and trauma to the abdomen/lower body that could lead to internal bleeding.

An hour before each game, team and league medical personnel – as well as third-party medical personnel assigned to the game – are required to meet on the field to cover in-game health and safety procedures, including the EAP. They reiterate the locations of emergency equipment (such as a defibrillator) and stadium exit routes in case a player needs transport. During this meeting, they also designate who among the physicians will be the lead in the event of cardiac arrest, as was the case in Hamlin’s situation.

On average, there are more than two dozen medical professionals and physicians from various specialties required onsite for any NFL game. These individuals can be identified by a red cap. The NFL mandates that an “airway management physician” (AMP) must be board-certified in emergency medicine or anesthesia and credentialed at a Level I or Level II trauma center.

It’s unclear how much the NFL actually spends on this type of emergency preparedness, but in the days that have passed since, it’s clear to everyone that this expenditure is not only worth it but absolutely necessary.

As plastic surgeons, many of us possess the unique privilege of having our own, freestanding surgical suites. Complying with AAASF and The Joint Commission requirements can sometimes feel onerous. Nevertheless, as John F. Kennedy and Peter Parker’s Uncle Ben said in different ways, “With great power/privilege comes great responsibility.”

The Monday morning following that Bills game, I walked into my construction site and breathed a sigh of relief as I glanced over many of the backup systems I had put in place. I hope I will never need them, but I’m so happy they’re there. PSN

Fortifying our specialty, together

ASPS/PSF governance restructure kicks into gear

By ASPS Staff

After years of effort and previous attempts that ultimately failed to gain traction, ASPS is restructuring its governing body. On Jan. 1, the Society adopted the new ASPS and PSF Bylaws, which officially started the clock on the overhaul. The restructure will effectively do away with the Executive Committee, which for many years made the operational decisions for ASPS and The PSF, and expand outreach to different groups to increase participation and input to the ASPS and PSF Boards of Directors.

“Ultimately, I think it was just the right time,” says ASPS past President Joseph Losee, MD, who shepherded the restructuring proposal during his presidency. Although previous efforts to reorganize the Society’s leadership structure never reached fruition, Dr. Losee says the ASPS/PSF leadership recognized the opportunities restructuring held.

“We had the right people in the room that could all work together and get the necessary work done,” he says. “It wasn’t easy. It took a lot of time and effort, but I’m very proud to see it cross the finish line.”

In March 2020, the ASPS/PSF Governance Committee began exploring options to provide a wider range of opportunities for members and affiliated organizations to become more involved with the Society’s decision-making process. This included considering revisions to the composition of the ASPS and The PSF boards of directors.

Dr. Losee convened the ASPS Board/EC Composition Task Force at the start of his presidential term in November 2020 to accelerate the work of the Governance Committee, as well as to recommend ways through which restructuring the Society’s and Foundation’s Boards would accommodate affiliated organizations representing specific clinical or professional interests of members within the specialty.

As the task force explored possibilities, its focus expanded to state and regional societies, subspecialty societies and member groups within ASPS (special interest groups and forums). Work continued in 2022 as a framework was developed for the Council of Representatives, providing more opportunities for different stakeholders to provide input to the Society’s governing body. Concurrent with the development of the Council of Representatives, the task force also recommended changes to the composition of the ASPS and The PSF boards.

The proposed governance restructure was laid out in the December 2021 issue of PSN, with town halls following during the winter of 2021-22 to elicit feedback on the proposed changes, after which the concept was further refined.

The ASPS/PSF Board of Directors approved the task force’s recommendations last year, along with the timeline and steps needed to modify bylaws to implement the revised governance structure. In November, members were asked to vote on proposed bylaws amendments to revise the composition and reduce the size of the ASPS and PSF boards of directors and the introduction of the ASPS Council of Representatives.

The new board composition will go into effect with the 2024 leadership term, which begins Oct. 30. The first meeting of the three subcouncils to the Council of Representatives is expected to be held in conjunction with Plastic Surgery The Meeting 2023 in Austin, Texas.

Council of Representatives

The purpose of the newly formed council is to actively engage the full range of membership and to provide a grassroots leadership structure to facilitate new ideas within membership

A loaded calendar

The dates below show the key milestones through 2023 of the implementation of the new ASPS/PSF governance restructure.

Jan. 1

New ASPS Bylaws and PSF Bylaws affecting the composition of the ASPS and PSF Boards of Directors, creation of the Council of Representatives and composition of the ASPS/PSF Nominating Committee go into effect Jan. 4

Stakeholder Entity Application launched, with email messages distributed to state and regional societies, subspecialty societies, and ASPS Forums and SIGs inviting them to apply to become “Recognized Stakeholder Entities” to one of the three Subcouncils Feb. 1

Deadline for receipt of Stakeholder Entity application March 9

ASPS/PSF Board of Directors to vote to approve stakeholder entity applicants that meet the requirements listed in the Process to Become Recognized Stakeholder Entity in the Council of Representatives March 13

Stakeholder Entity Applicants will be informed whether the ASPS Board approved their application, at which time they will become “Recognized Stakeholder Entities,” and about the number of Subcouncil delegates to which they are entitled March 27

Communication campaign launched to solicit the names of Official Delegates from the Recognized Stakeholder Entities May 31

Deadline for receipt of Official Delegate names June 26

Official Delegates shall be invited to apply for a Subcouncil Leadership position July 17

Deadline for Official Delegates to apply for a Subcouncil Leadership position Aug. 1

Online election of Subcouncil Leadership begins Aug. 31

Deadline for voting in the Subcouncil Leadership election

Sept. 7

Subcouncil Leadership election results to be announced Sept. 21

Official Delegates to nominate members to the Nominating Committee Sept. 26

Notice of the place, day, time of the Subcouncil’s meeting to be distributed to the Official Delegates to each Subcouncil Oct. 5

Deadline for nominating members to the Nominating Committee Oct. 16

Notice of how to access the Subcouncil agenda will be published to Official Delegates Oct. 26

1) Deadline for Recognized Stakeholder Entities to name Designated Alternates to substitute for their Official Delegate

2) Inaugural Subcouncil meetings in Austin and election of Subcouncil Representatives to the Nominating Committee Oct. 30

2023 Leadership Term ends at the conclusion of the Annual Business Meeting and the 2024 Leadership Term begins

and stakeholder groups. According to ASPS President Gregory Greco, DO, by combining forces, state and regional societies, along with subspecialty societies and ASPS special interest groups, a stronger, more unified voice will be created within the specialty.

“This is an incredibly important effort that not only relies upon outreach to different groups and reorganizing ASPS in a bottom-up fashion, but it’s also completely dependent upon everybody participating at the level they need to be,” he says. “We’ve always been a membership-driven organization, but this isn’t just talking the talk. The increase in representation here is truly significant.”

The council is composed of the voting members of three subcouncils – the Subcouncil of State and Regional Societies, the Subcouncil of Subspecialty Societies and the Subcouncil of Member Sections. It does not have independent leadership, is not expected to meet and does not have independent authority to take action.

Subcouncil delegates represent the perspectives of their stakeholder entity in the decision-making process during subcouncil meetings and in advocating to improve the health of patients and the specialty. The Subcouncil of State and Regional Societies has an advocacy focus; the Subcouncil of Subspecialty Societies has an education focus; and the Subcouncil of Member Sections has a member and professionalism focus.

The following ASPS member entities are grandfathered into the Subcouncil of Member Sections:

• Young Plastic Surgeons Forum

• Women Plastic Surgeons Forum

• Military Forum

• PRIDE Forum

• Plastic Surgeons of Chinese Descent Forum

• Residents and Fellows Forum

• Medical Students Forum

Council, subcouncil leadership

Although there are no leaders of the full Council of Representatives, there might be occasions – especially during the inaugural term – when the leaders of all three subcouncils would like to convene to discuss administrative matters or other topics of mutual concern. However, no binding action can be taken during these conventions.

Each subcouncil will be led by a chair, vice chair and secretary who must be Active Members, and will each serve a one-year term that will typically begin at the conclusion of the Annual Business Meeting and continue until the conclusion of the next Annual Business Meeting. Subcouncil leaders elected during the implementation period will begin their term of service upon notice of the outcome of the election and continue until the conclu-

sion of the Annual Business Meeting held in conjunction with the 2024 Annual Meeting. Each subcouncil chair will have a seat on the ASPS and PSF boards of directors, along with voting rights.

To ensure continuity of governance, it’s anticipated – but not required – that the vice chair will succeed to chair, and the secretary to vice chair. Upon election, the chair, vice chair and secretary continue to represent their stakeholder entity on the subcouncil, with all associated delegate rights and privileges. No two leadership positions within a subcouncil can be held by delegates from the same stakeholder entity.

The three subcouncils are tentatively scheduled to hold their inaugural subcouncil meetings during Plastic Surgery The Meeting. Recognized stakeholder entities will be required to name their official delegates by May 31, although they are able to name a designated alternate to substitute for their official delegate in the event that the official delegate is unable to attend the subcouncil meeting. In that case, the designated alternate will have all voting rights of the official delegate.

Board of Directors

The ASPS and The PSF boards of directors remain responsible for supervising, controlling and directing the business and affairs of the organization – as well as its committees and publications. Under the restructure, the ASPS Board of Directors is obligated to consider recommendations forwarded to it by the three subcouncils. The voting members of the ASPS Board of Directors, effective Oct. 30, when the 2024 leadership term begins, will be:

• ASPS President

• PSF President

• ASPS President-Elect

• PSF President-Elect

• ASPS Immediate Past President

• PSF Immediate Past President

• ASPS/PSF Board Vice President of Academic Affairs

• ASPS/PSF Board Vice President of Development

• ASPS/PSF Board Vice President of Education

• ASPS/PSF Board Vice President of Finance and Treasurer

• ASPS/PSF Board Vice President of Health Policy and Advocacy

• ASPS/PSF Board Vice President of Membership

• ASPS/PSF Board Vice President of Research

• Chair, Subcouncil of State and Regional Societies

• Chair, Subcouncil of Subspecialty Societies

• Chair, Subcouncil of Member Sections

The PSF Board of Directors will be composed of the same 16 members as the ASPS Board of Directors, plus up to three public members who serve only on The PSF Board of Directors.

The schedule to implement the Council of Representatives has been timed so that subcouncil leaders are elected by Aug. 31, and so that each subcouncil elects two Active Members to the ASPS/PSF Nominating Committee during their subcouncil meeting at Plastic Surgery The Meeting in Austin.

A more detailed roundup of the governance restructure – including FAQs and information on participation – can be found at plasticsurgery.org/GovernanceRestructure Other questions can be directed to governance@plasticsurgery.org or by calling Peggy Pissarreck at (847) 228-3334.

Toddler’s burn care comes at the right time – and place

By Jim Leonardo

Timing was everything for a boy named Gonnie, age 3, who in August suffered road rash burns and other injuries after being ejected from a vehicle and skidding across highway pavement near Raleigh, N.C. According to WakeMed Children’s Hospital in Raleigh, Gonnie’s mother and her partner jumped out of their vehicle to check on her two children immediately after the accident. Although her daughter was fine in the backseat, the toddler was nowhere to be found – his door had been ripped off by the crash, and the car seat was empty. As they frantically searched, they heard a man’s voice in the distance screaming, “Baby! Baby!” Gonnie’s mother ran toward the voice and found her son, severely injured and faintly crying. Someone called 911 and EMS arrived on the scene shortly thereafter.

The PSF past President C. Scott Hultman, MD, MBA, was still settling into his role as inaugural Plastic and Reconstructive Surgery Department chair at WakeMed Health in Raleigh when he was called to tend to the young boy’s wounds.

Gonnie (pronounced “Johnny”) sustained second- and third-degree burns to his arms, trunk, legs, face, scalp and hands – as well as a humeral fracture to his left arm and a broken collarbone. After Gonnie’s arrival at the WakeMed Raleigh Campus Children’s E.D., Dr. Hultman took charge of his care in the new, state-of-the-art plastic surgery department, which he developed from scratch. Prior to the launch, Gonnie would’ve been transferred to UNC Hospital in Chapel Hill – a roughly 30-mile distance that would have posed logistical hardships for Gonnie’s family, led by a single mother from Raleigh.

One major factor in Gonnie’s thus-far successful treatment was Dr. Hultman’s use of two relatively new modalities: Kerecis®, a fish-skin, omega-3-based tissue-regeneration template that can reduce the need for skin grafts; and Recell®, a spray-on, autologous, regenerative therapy for wound treatment.

“The timing was serendipitous for Gonnie – and it provided us with a unique opportunity,” Dr. Hultman tells PSN. “I hadn’t used Kerecis before, but WakeMed had very recently approved its usage, which became a tremendous asset in his treatment. We also used Recell for his wounds, but what made that noteworthy was that we used both technologies together and concurrently – which is very unusual. Recell expands the surface area up to 80 percent – and we created it within the O.R. using kits, so it’s a point-of-care technology that saved time and cost.

“Kerecis has amazing regenerative capabilities, primarily because it’s laden with omega-3 fatty acids for direct delivery of that nutrient right to the wound. It doesn’t simply provide skin-graft coverage or closure – it somehow modulates inflammation,” he adds. “I’ve discovered I can put this on road rash, and it regenerates skin particularly well, so I don’t have to excise as much of the wound. Using these two products together is more expensive, but we’re getting great results – and for Gonnie, a much quicker discharge.”

Gonnie was the first WakeMed Plastic & Reconstructive Surgery patient to receive fish skin for wound closure of some of his wounds, the first patient to receive spray-on skin – and the first significant pediatric-burn admission for the hospital. His skin grafts were confined to his left arm and chest.

“Having done that has changed my practice pattern a little,” Dr. Hultman says. “I’ve

learned quite a bit from Gonnie – and other patients have since benefited from that.”

From injury to reconstruction

Patients also have been benefiting from the new department launched WakeMed and led by Dr. Hultman.

His process of building the burn center at WakeMed, which has a Level I trauma center, is well underway, with elements coming slowly together in an ever-growing burn service line – the only such service line run by plastic surgeons in North Carolina.

“As director of plastic and burn surgery, I’ll be involved from injury to resuscitation to reconstruction of these burn patients,” Dr. Hultman says. “Once we’re approved, we’ll have the only burn center in North Carolina run just by plastic surgeons. From my experience at Hopkins, plastic surgeons have the end in mind – which isn’t just about survival, but also quality of life and rehabilitation.”

Part of this process is gaining approval of a certificate of need and recognition by the American Burn Association.

“We don’t have our own ICU right now and we won’t be able to have a verified ICU bed until we get the certificate of need approved,” he says. “I’m building the team incrementally – I’ve got to bring in wound care, occupational/physical therapy and nursing. There’s a lot of training we need to complete for all staff to be comfortable taking care of major burns.

“But as far as the O.R., we’re fully up-tospeed; I can take care of a 90-percent burn in the O.R.,” he adds. “But surgery is only one small component of burn care. I can do the operation, but then to pull them through I need the nursing care, P.T., etc. It’s going to

take about a year until we can manage the more complicated patients.”

Nevertheless, having an immediate access point for patients in Raleigh – no matter how complicated the case might be – remains the goal.

“I expect that before long, we’ll be serving the community with the best care possible,” Dr. Hultman says. PSN

Send in your statistics

The ASPS annual procedural statistics help us promote the Society’s member surgeons nationwide. Now more than ever, with so many non-plastic surgeons performing procedures, it’s critical that you complete and return this year’s annual questionnaire to help ASPS educate the public that we are the leaders in these procedures that board-certified plastic surgeons perform each year.

Annual procedural statistics generate millions of dollars in advertising value each year for ASPS and its members. The media consistently relies on our annual procedural statistics to understand the national trends of procedures that we are performing.

The statistics questionnaire may be completed at plasticsurgery.org/prostat22. You can then download a PDF printout that you may complete and fax back to ASPS at (847)7097506, or you can email the completed form to research@plasticsurgery.org PSN

The gray areas charted by patient concierges, brokers and advocates

By Anu Bajaj, MD

Editor’s Note: “An Ethical Matter” is written by Anu Bajaj, MD, who served as the Ethics Committee chair in 2018. Readers are encouraged to submit queries to her at anukbajaj.mac@mac.com. The views expressed in this column are those of the author and should not be considered legal advice. The ASPS ethics and compliance resource page can be accessed at plasticsurgery.org/ethics. for further information.

At some point last year, my receptionist took a message from a so-called “patient concierge.” She left a Post-it note on my desk with the information after relaying the various points of the call to me. The concierge said she had access to hundreds of patients who wanted me to be their surgeon – the pitch being that if I agreed to work with this woman, she would refer these patients to me and guide them through the surgical process.

This concept has been around for years in various forms – someone works with potential patients looking for a plastic surgeon, refers them to you and guides them through the surgical process. These individuals can go by different monikers (patient concierge, beauty broker or patient advocate, just to name a few), but the idea has gained increasing traction in the past few years – the increasing prevalence of social media in the world of plastic surgery has seemingly brought this job into the mainstream consciousness.

Recently, I had a patient inform me that she hired such an individual locally to help her navigate the process of choosing a plastic surgeon and asking the “right” questions (Full disclosure: I do not work with any of these advocates or brokers). The patient was concerned that she had breast implant illness (BII), so she hired a local BII advocate to assist her through her journey. This individual also advised my patient on how to prepare for surgery and what surgeons to interview, in addition to assisting her during the recovery.

These brokers/advocates/concierges work in different ways – some charge the patient directly for the service, others might seek physician membership into their program and others could do a combination of both. The increasing popularity of patient brokers raises interesting questions. What is allowed regarding referrals and what isn’t? And just what is the role of the broker (or concierge, or advocate)? I’ve always assumed that many of these business propositions were either illegal or unethical – if not both.

The rules regarding patient referrals can be tricky, and once you get beyond the legal and ethical concerns, there’s the personal component – what do you feel comfortable with? From a legal standpoint, the recommendation is that you check with your state’s medical board or society to be sure that there are no specific regulations prohibiting referral programs.

In Section II. Article I(F)(2), the ASPS Code of Ethics prohibits “Payment and/or acceptance of rebates or referral fees to or from any person, including agents and employees of the member, in exchange for the referral of patients. Nothing in this Principle shall be construed to prohibit a Member from participating in a referral service, in which the member’s paid participation is disclosed, where permitted by state law.”

Confusing, right?

The Code of Ethics says you can’t pay another individual for referrals, nor can you

accept a rebate for referrals. However, the code then provides something of a loophole: You can be involved with a referral service –an organization or service to which you pay a fee which then refers you patients – and this payment must be fully disclosed to the patient(s).

A referral service’s primary goals are to obtain more patients for you and make you a part of a group of trusted surgeons so that patients choose you. To be fair, many of us utilize referral services –think about the Society’s own Connect service, or outfits such as RealSelf and even listings on manufacturer websites. However, these referral services aren’t exactly the same

as the new world of patient broker/concierge – or are they?

Some of the plastic surgery brokers who frequently post on social media also strive to educate potential patients about preparing for surgery, expectations and what to do after surgery – all of which are good things. Others view their role as identifying qualified surgeons, although their definition of “qualified” might not be as clear cut as mine. For example, to participate in ASPS Connect, you have to be a member of ASPS. Other brokers can base their determinations regarding qualifications on less-concrete variables – and when this occurs, I feel as if my surgical skill and judgment has been called into question.

Many of these brokers not only refer pa-

Trepsat p Facial Flap Dissector Scissors

tients to you, but also act as patient guides/ advocates. Some will attend the consult and even go into the O.R. as the patient’s surrogate. None of these add-ons appeal to me. As a surgeon, I view it as part of my responsibility to communicate with my patient, to take the time to understand their goals and expectations and also communicate my medical opinion.

Essentially, by working with some brokers/concierges, you might be allowing someone else to control the conversation with your patient(s). I’m not sure I want a third party who is neither the patient nor the patient’s family member telling me what do or judging my skillset. I do not want someone else acting as the middleman in my relationship with the patient.

PlastyPAC’s impact on the 2022 midterm election results

By Darcy McLaughlin

The 2022 midterm elections proved to be a historic election cycle, as millions of voters across the nation showed up at the polls to have their voices heard on key issues. Once again, Election Day stretched for weeks after Nov. 8, with many races initially deemed too close to call and the balance of power on Capitol Hill at stake. The 2022 election cycle installed a divided government in Washington, D.C., with Republicans regaining the House for the first time since the 115th Congress but losing ground in the Senate, where Democrats strengthened their majority to 51-49 seats.

The midterms altered the makeup of the 118th Congress to be the most racially, ethnically and age-diverse ever. The 2022 election results delivered the greatest number of women elected to Congress, including the highest number of Black and Latina women in the House of Representatives. The 118th Congress will also welcome a younger class, including its youngest member of the House and first “Gen Z” representative, 25-year-old Maxwell Frost from Florida.

The new balance of power

Despite House Republicans falling short of many “red wave” predictions, the party won control of the House of Representatives by picking up nine seats, surpassing the 218 seats necessary to control the chamber.

Former Speaker of the House Nancy Pelosi, announced she was stepping down from her leadership role shortly after the nation learned of the final election results – ending her 20year tenure as House Democrats’ top leader and the nation’s first female Speaker. Weeks later, the House Democratic Caucus unanimously voted for 52-year-old Hakeem Jeffries (D-N.Y.) to lead them, ushering in a younger generation of Democratic leadership along with him.

Meanwhile, House Republicans struggled to unify to choose the Speaker of the House immediately, although front-runner Kevin McCarthy (R-Calif.) ultimately secured the title after 15 votes spread over three days. The swearing-in ceremonies of House members and planned business were postponed until the consensus was reached. The opening days for the House marked the first time in 100 years that multiple ballots were required to determine the House speaker.

The 2022 midterm elections also marked the first time in more than a century where American voters reelected every Senate incumbent running for reelection. Pivotal races in six battleground states – Arizona, Georgia, Michigan, Nevada, Pennsylvania and Wisconsin – determined control of the Senate. Victories by Democratic Lt. Gov. John Fetterman in the open seat race in Pennsylvania and by incumbent Sen. Raphael Warnock (D-Ga.) in the Georgia runoff election sealed Senate Democrats’ victory and strengthened their majority to 51 seats, meaning Democrats don’t have to rely as much on Vice President Kamala Harris to serve as the tie-breaking vote in the chamber.

PlastyPAC lays the foundation

Heading into the 2022 midterms, PlastyPAC recognized that the results of this election cycle had potential to transform the healthcare industry and directly impact plastic surgeons and their patients. As a result, the PlastyPAC Board of Governors (BOG) planned an aggressive strategy focused on member mobilization, education and voter turnout on election day.

Immediately following the 2020 election cycle, the BOG mobilized to identify members of Congress who were champions of plastic surgery’s priorities. The board remained committed to utilizing its comprehensive scorecard system to grade political candidates on how they have supported plastic surgery priorities before contributing to their campaigns. While the PAC understands there are issues outside of healthcare that are important to ASPS members, PlastyPAC does not back candidates based on their political party or their positions on non-plastic surgery issues. Rather, every political candidate is judged on their track record of standing behind plastic surgery issues: fair physician reimbursement; access to breast reconstruction; medical liability protections; prior authorization reforms; graduate medical education funding; balance billing reforms; and congenital anomalies coverage.

Additionally, the PlastyPAC BOG prioritizes political giving in a bipartisan and bicameral fashion. In this cycle, there was a near 50-50 split in giving to candidates (26 Democrats and 25 Republicans) that supported plastic surgery issues. The PAC recognizes that in order to be successful in Congress, it’s important to support and foster relationships with allies on both sides of the aisle.

PlastyPAC continued to focus on educating senators and representatives on critical issues that affect plastic surgery practices and patients. A key role of PlastyPAC is having ASPS members and staff directly educate political candidates about the work of plastic surgery and advocate for pro-physician policies. Over the past two years, PlastyPAC conducted educational meetings with members of Congress and ASPS members in their home districts as part of its PlastyPAC Speakers Series and in Washington, D.C., at ASPS Fly-In events.

Wins and losses for plastic surgery

PlastyPAC’s success rate during this midterm election cycle was 94 percent, with only three candidates who received contributions from the PAC losing their election bids. PlastyPAC recognizes the importance of electing physicians to Congress and supported 12 physician candidates: Ami Bera, MD (D-Calif.); Larry Bucshon, MD (R-Ind.); Michael Burgess, MD (R-Texas); ASPS member Mary Ann Contogiannis, MD (R-N.C.); Andy Harris,

MD (R-Md.); Ronny Jackson, MD (R-Texas); Kermit Jones, MD (D-Calif.); John Joyce, MD (R-Pa.); Mariannette Miller-Meeks, MD (R-Iowa); Greg Murphy, MD (R-N.C.); Raul Ruiz, MD (D-Calif.); and Kim Schrier, MD (D-Wash.).

Last year, ASPS was also proud to see one of its physician members run for Congress. Mary Ann Contogiannis, MD, ran for election to the U.S. House in the Republican primary for North Carolina’s 6th Congressional District. For decades, Dr. Contogiannis has been an active and engaged member of the Society and a leader in its advocacy efforts. She served in leadership positions on the ASPS/PSF Board of Directors, Legislative Advocacy Committee, PlastyPAC Board of Governors, ASPS Delegation to the AMA and other committee roles. Unfortunately, Dr. Contogiannis lost to Republican nominee Christian Castelli in the May primary election. Dr. Contogiannis executed a strong campaign and represented plastic surgery priorities well in her bid in a rapidly redistricted congressional district.

One of PlastyPAC’s key allies in Congress, Rep. Marianette Miller-Meeks, MD, prevailed again in her reelection battle to the House, where she will continue to represent Iowa’s 1st Congressional District. Dr. Miller-Meeks’ margin of victory on election day was thousands of more votes than her six-vote victory in 2020. As an ophthalmologist, Rep. Miller-Meeks demonstrated unwavering support for the physician community on Medi-

care payment reforms, access to reconstructive care, balance-billing reforms and graduate medical education funding. She has served as a keynote speaker at every ASPS Fly-In event since being sworn into Congress and was a guest speaker at Plastic Surgery The Meeting in Boston. Over the years, she has provided invaluable advice to the Society’s residents and practicing physicians on how they can become effective advocates within their health systems and in Congress.

Another critical win for PlastyPAC was the reelection of Sen. Maggie Hassan (D-N.H.), who was in one of the most competitive races in the Senate. This was one of PlastyPAC’s most critical races, as Sen. Hassan has been a leading voice for many plastic surgery issues, including balance-billing reforms and congenital anomalies coverage. Sen. Hassan’s reelection strategy was successful because she focused on demonstrating to New Hampshire voters that she’s an independent leader through a track record of working both sides of the aisle to get legislation passed for her constituents.

Forecast for the 118th Congress

The 118th Congress will usher in a new era of divided government in Washington after two years of Democratic control. House Republicans and Senate Democrats have very narrow majorities, which will necessitate the need for more bipartisan deal-making in both chambers. The start of the 118th Congress was a preview of what was to come this term. As demonstrated by the initial House speakership votes, the narrow majorities will encourage more listening and deal-making between party leadership and smaller voting bloc groups, such as the Freedom Caucus, on issues to advance critical legislation.

The 118th Congress will have significant committee changes, especially to the prominent healthcare committees in the House and the Senate. With member retirements and a shift in majorities, there will be new chairpersons in the top healthcare committees in Congress. Over the next few weeks, rankand-file members will also be busy discussing and positioning themselves to be placed on the prominent committees.

With House Republicans regaining control, Rep. Cathy McMorris Rodgers (R-Wash.) will take over as chairwoman of the prominent House Energy and Commerce Committee. Over the years, the Society has fostered a great relationship with her and strongly aligns with her on issues such as balance-billing reforms and congenital anomalies coverage. Rep. Frank Pallone (D-N.J.) will

Thank you, PlastyPAC contributors

California

Jack Bruner, MD

Amber Leis, MDs

Farrah Liu, MDn

Bernard Markowitz, MDI

Arthur Yu, MD, PhD

Kansas

Heather Pena, MDs

Massachusetts

Theodore Calianos, MD

Samuel Lin, MD, MBAu

Michigan

Steven Haase, MDu

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Charles Pierce, DO, MPHI Nikita Shulzhenko, MDn

New York

Robert Grant, MD, MScu

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Michelle Roughton, MDs Ohio

R. Michael Johnson, MDI

Pennsylvania Gunnar Bergqvist, MDI

Tennessee Nicholas Tarola, MDI Texas

Daniel Freet, MDJ Jessica Rose, DO

Newly published volumes from ASPS focus on history, business

Editor’s Note: PRS has proudly published reviews of books, DVDs, practice management software and electronic media items of educational interest to reconstructive and aesthetic surgeons for more than half a century. The journal is excited to announce that book and media reviews will find a new home in ASPS’ award-winning news publication, PSN This move allows for more timely publication of reviews and maintains a broad readership. Regular review of articles from other medical journals will continue to be published in PRS. For more information on reviews, or instructions on where to send books and any other material for consideration by PSN, contact Managing Editor Paul Snyder at psnyder@plasticsurgery.org.

Reviews are solely the opinion of the reviewer; they are usually published as submitted, save for copy edits to align text with magazine style. Like PRS, PSN does not endorse or recommend any review so published.

– Arun K. Gosain, MD Reviews Editor

From Trenches to Tranplants: Changing Lives With Plastic Surgery

Author: R. Barrett Noone, MD American Society of Plastic Surgeons, 2022

Plastic surgery is a specialty often misunderstood by lay people and even many health professionals. The stated purpose of From Trenches to Transplants: Changing Lives with Plastic Surgery is to “demystify the medical practice we know as plastic surgery.” The author, former ABPS Executive Director and The PSF past President R. Barrett Noone, MD, is particularly qualified to accomplish this task. Dr. Noone was a practicing plastic surgeon for more than 50 years and also served in many leadership roles within the specialty. In writing this book, he chose to provide clarity regarding the specialty by reviewing its history. Although reconstructive surgical procedures were performed as early as 1000 B.C. in India, plastic surgery only developed as a defined surgical specialty after World War I. It has, therefore, only existed for slightly more than a century. Dr. Noone utilizes firsthand experiences to relate the most-recent half of the specialty’s history in a personal, almost biographic manner. Much of the information related to the earlier years of the specialty was gleaned from conversations Dr. Noone had during his initial years in practice with Robert Ivy, MD. Dr. Ivy was a founding member of what’s now the American Association of Plastic Surgeons, the first plastic surgery organization. Dr. Ivy’s memories are supplemented by discussions with Joseph Murray, MD, the only plastic surgeon to win the Nobel Prize, and several other early leaders of the specialty. These personal perspectives on the specialty enliven the history and make the book extremely readable and entertaining.

An early chapter describes the critical role World War I played in the genesis of the specialty. Facial deformities, often generated by shrapnel injuries, created challenges rarely experienced previously by the surgeons trying to return injured soldiers to fruitful lives. Surgeons interested in these problems provided the core of individuals that ultimately developed the specialty. Later chapters discuss how World War II provided another large influx of patients with challenging reconstructive problems. The U.S. Army established Valley Forge General Hospital as a center for surgical reconstruction during the latter stages of the war. The unit was directed by James Barrett Brown, MD, and served as an incubator for the development of many in the next generation of skilled plastic surgeons, as well as new reconstructive techniques.

Early studies in tissue transplantation carried out there were applied by Dr. Murray in the first kidney transplant, which he performed upon returning to Boston from Valley Forge after the war. In subsequent chapters, Dr. Noone describes his own path into the specialty, and his own experiences treating patients with many different types of problems. In each chapter, he recounts the stories of specific patients – often accompanied by photographs – and then describes the treatment he provided. After initially focusing on his own patients, he discusses composite tissue transplants carried out more recently by colleagues, highlighting the continued innovation in the specialty.

The epilogue describes one of Dr. Noone’s last patients, a personal friend and University of Pennsylvania colleague, whose last years of life were significantly improved by a series of relatively simple, but well-planned procedures, carried out with local anesthesia alone. This patient’s story highlights the fact that not all problems require extremely complex solutions.

Seasoned plastic surgeons might already be aware of much of what’s discussed in From Trenches To Transplants. Nevertheless, I believe that they, like medical students and plastic surgery residents, will still enjoy the book. The nonmedical audience, to whom the book was directed, is very likely to gain an increased level of respect and appreciation for our specialty. With this volume Dr. Noone accomplished his goal of demonstrating that plastic surgery unquestionably provides great benefit for its patients.

W. Thomas Lawrence, MD Stillwell, Kan.

Making the Cut: The New Reality For Plastic Surgeons

Authors: Gregory R.D. Evans, MD, and Dana Fox

American Society of Plastic Surgeons, 2022

When this book, Making the Cut (not to be confused with Getting Cut, a seminal work by Virginia O’Connell on failing to survive surgical residents), was sent to me for a review for PSN, a somewhat desultory musing occurred: “Wonder what this thing costs?”

It doesn’t matter. The work is absolutely priceless. Priceless. My aspiration in penning this review is to persuade the reader – be it the plastic surgery resident on the threshold of graduation, the young academician or private practitioner, the mid-career plastic surgeon or the senior surgeon riding the wave in – to get their hands on this book. The scope of the audience is dictated by the scope of the educational objectives established by the authors.

The two individuals who are the principal authors are ASPS past President Gregory R.D. Evans, MD, and Dana Fox. Besides being a past president of the Society, Dr. Evans is also known to most of us as chair of the plastic surgery unit at University of California-Irvine for more than two decades. Fox, meanwhile, is a veteran of the provision of plastic surgeons via consultantships of practice and office organization, as well as marketing and branding strategies. Their efforts here are complimented by contributions from others, but clearly the book is the product of that duo.

The organization is generally into four broad sections: “Choosing Your Career Path,” “Staffing and Training,” “Creating and Marketing Your Brand” and “Exit Strategies.” The first section outlines the pros and cons of private practice (Fox) and the academe (Evans). Dr. Evans does a superb job of arming the prospective academician with information and questions necessary to detail the elements of a job offer. The private practice topic is subdivided into group and solo models. What characterizes this section is true for the book in toto – and this point deserves emphasis: the detailed, practical and pragmatic advice to the reader. This is not a conceptual discourse. This is a laboratory or dissection manual on how to succeed in a professional life. The heart of the book lies in the two middle sections, “Staffing and Training” and “Creating and Marketing Your Brand.” These chapters are written by Fox and enable the plastic surgeon who entered practice, or perhaps the mid-career practitioner concerned that they have not competed in the marketplace to their satisfaction, to address those concerns. This reviewer, limited by space considerations, cannot satisfactorily convey the value of the advice and recommendations contained in these two sections, so permit me to seize two examples as a vehicle.

The first is the use of email marketing. In four pages, the author outlines the principal components of email marketing as just one element of an overall marketing strategy. The second example is Chapter 21 on medical spas – a section that on merit could stand alone. All of the potential pitfalls are carefully outlined.

If one criticism could be offered – and every book review is compelled to do so – it would be the final chapter on retirement. The chapter seemed to lack a focus: the surgeon on the threshold of retirement or the perception of the patient population of a senior surgeon. Actually, the entire topic of issues revolving around pre- and post-retirement deserve more than just a single chapter. For the next and inevitable edition, ASPS might consider tapping Jim May, MD, and Dave Larson, MD, who have provided an excellent seminar on retirement at the annual meeting of the American Association of Plastic Surgeons over the past several years.

Regardless, buy the book. In your hands you hold a top-of-the-line practice and career consultation.

Edward Luce, MD ASPS Past President Memphis

YPS Perspective

By Bahar Bassiri Gharb, MD, PhD

YOUNG PLASTIC SURGEONS PERSPECTIVE

WRIT TEN BY AND FOR YOUNG PL ASTIC SURGEONS

Thinking inside the box: Virtual microsurgery outreach

The innovative spirit in plastic surgery isn’t limited to breakthroughs in the O.R. At Plastic Surgery The Meeting in San Diego in 2019, The PSF past President Andrea Pusic, MD, MHS, chief of plastic and reconstructive surgery at Brigham and Women’s Hospital, and Amanda Gosman, MD, chief of plastic surgery at UC San Diego, met to discuss the Society’s budding partnership with COSECSA (The College of Surgeons of East Central and Southern Africa) and the Surgical Society of Kenya, with the intent to provide plastic surgery training and long-term sustainability to areas in sub-Saharan Africa – where access to plastic surgery is extremely limited and collaboration between plastic surgeons is nearly impossible.

The result was the organization known as Surgeons in Humanitarian Alliance for Reconstructive, Research and Education (SHARE), born through The PSF to enhance collaboration in improving care and surgical capacity in regions with a limited number of plastic surgeons – and a high incidence of conditions requiring plastic surgery treatment.

Just a few months after this meeting, the onset of the COVID-19 pandemic abruptly halted plans for in-person training and on-site boot camps. Nevertheless, an innovative spirit remained and with change came opportunity. As the weeks of pandemic-related surprise and disbelief faded, educational activities transitioned to virtual, and all institutional and interinstitutional collaborations went online.

As we applied the telecommunication technology to continuing the education of residents and Fellows, we discovered an opening to better connect with our partners across the country and across the globe. Drs. Gosman and Pusic had no intention to postpone plans for the 2020 SHARE program and quickly decided to provide the program’s global learners with a virtual curriculum. Reconstructive surgery and microsurgery were identified as priority areas for training. With our experience directing microsurgical training at Cleveland Clinic, Dr. Gosman approached us to discuss the first virtual microsurgery workshop.

Inside the box

The first challenge of virtual microsurgery training is to determine how exactly anyone can teach microsurgery virtually. During my plastic surgery residency in Italy, I had no access to live animal microsurgery training, but I found that learning even basic principles of microvascular suturing with a plastic pad or chicken thigh vessels was effective in improving my skills in performing anastomosis. Maybe we could teach virtual microsurgery. We started meeting regularly as a team with Drs. Pusic and Gosman. Even in a virtual setting, we needed magnification, microsurgery

instruments, sutures and a model that would be effective in a video or teleconference format. A survey was sent to SHARE global learners to determine what was available to them that could be used for microsurgery training. We

learned that 80 percent of the learners had access to surgical loupes, but only one had access to an operating microscope. One of the SHARE faculty, Mohamad Rachadian (Ryan) Ramadan, MD, suggested we use a cardboard

model to hold a smartphone – and then use the smartphone’s camera zoom function for magnification. Although 80 percent of the learners had a smartphone, most did not have access to sutures smaller than 6-0.

We started adapting what we knew about microsurgery training to see if this setup would work. For the first SHARE session, in order to teach how we anastomose a vessel, we created a set of basic training videos using a glove model for end-to-end and end-to-side anastomosis with regular surgical instruments and the smallest available suture.

The learners were observed and directly mentored during a live workshop. Of course, challenges with internet connections and using regular instruments emerged, but ultimately, the first milestone was reached.

The chicken thigh

Following the first course, we discussed how to improve and how to address challenges. Drs. Gosman and Pusic were travelling to Rwanda for a site visit, and they used this trip to deliver microsurgical instruments and sutures to the learners.

We continued preparation for the second workshops. The chicken-thigh model has been used for microsurgical training in many programs around the world. We adapted the model and provided the learner with a video showing how to expose and prepare the femoral vessels and how to perform the microsurgical anastomosis and test for patency.

The last challenge was how to assess proficiency over time. Greta Davis, a UC San Diego medical student, provided the faculty with a worksheet which contained two validated, available tools for structured feedback from assigned mentors. Following course completion, a survey completed by the participants reported high satisfaction with course learning objectives. There was a trend toward improvement in self-reported pre- and postcourse confidence levels for key microsurgical skills. The SHARE learners reported a high level of personal progress in suture handling, use of the chicken thigh model, end-to-end anastomosis, instrument selection, vessel preparation and economy of motion.

We learned, then, that nothing is impossible. Creating a virtual microsurgery curriculum in the face of the pandemic and under the confines of limited resources simply became another means by which we can reinvent our educational methods. Furthermore, the virtual microsurgery course could represent an accessible format for training surgeons across the globe in basic microsurgery skills. YPS

Payam Sadeghi, MD; and Craig Clark, BS, also contributed to this article. SHARE thanks The Smile Train for its generous support, which helped fund the purchase and distribution of microsurgical instruments for SHARE Global Fellows for this exercise.

(Top to bottom) A modified cardboard box to improve magnification and visualization of the field using a smartphone zoom function and screen; end-to-side anastomosis with 4-0 nylon suture at maximum smartphone zoom, followed by a patency test; and a chicken thigh model and femoral artery anastomosis with 6-0 prolene suture. Sciatic nerve and femoral vein are also prepared for repair.

Working through the backlog of cleft care delayed by COVID-19

By Clint Morrison, MD

Before the COVID-19 pandemic, global reconstructive surgery posed several challenges to the plastic surgeon seeking to provide care to underserved populations. Providing high-quality, safe surgery in a sustainable fashion with the goal of meeting the needs of the population – now, as well as in the future – has always been our goal. Of course, the coronavirus changed all of our lives. The lasting impacts of the pandemic are immense, pervasive and, perhaps, not completely understood, but what became abundantly clear is that the developing world had much less of a healthcare reserve than the United States.

I had my first experience in international surgery as a plastic surgery resident travelling with Operation Smile to Morocco and have been involved with international cleft mission work to Guatemala and Mexico since 2016. I’m fortunate to have a rewarding academic practice focusing on cleft and craniofacial surgery in the United States, but I have found unique satisfaction in aiming to improve the quality of care in less-fortunate communities, as well as incorporating said experiences into residency education.

Our Rochester, N.Y.-based surgical group, Help Us Give Smiles (HUGS), in 2018 partnered with Tess Unlimited, a cleft charity named for Tessa de Goede de Ordóñez in Antigua, Guatemala, that aims to elevate the quality of cleft care in Central America. Moving cleft care forward in developing nations from simply primary lip and palate reconstruction is an obvious target for those of us familiar with the comprehensive care that we provide in the United States. Making that happen in a rural, impoverished commu-

nity in Guatemala, however, is no small feat. Nevertheless, we began to do just that. Tess Unlimited built a locally sourced, sustainable team comprising pediatrics, dentistry, orthodontics, speech pathology, psychology and nutrition.

About 400 infants with cleft lip and palate were enrolled annually. Through a feeding program, babies were nourished presurgically, with the goal of lip repair at around 4 months of age and palate repair before 18 months –consistent with standards of care in the United States. Experienced plastic surgical teams

were developed to provide safe, high-quality surgery with low complication rates.

Then COVID-19 threw a wrench into all the progress. Surgery stopped. Visits to rural villages to provide nutritional support and pediatric care became difficult – if not impossible – with travel restrictions. International surgical groups couldn’t get into the country to help. In about 18 months, Tess and her group developed a backlog of more than 1,000 babies with unrepaired clefts.

How does one work out of that kind of backlog in such a resource-limited place? Un-

fortunately, the answer is: slowly. In the fall of 2021, we were finally able to assemble a team and navigate international travel to reach Antigua. We completed a second mission trip in September 2022, with three surgeons performing 58 cleft surgeries over the course of five days. Tess Unlimited has 14 missions planned with various organizations from the United States, Canada, Mexico and Europe in 2022 with about 450 planned surgeries in total. To be sure, that’s a tremendous accomplishment – but it barely covers the new babies born into the program each year. Tackling the backlog will likely take years, and Guatemala has a very small, native plastic surgical community with little ability to provide its own care for these infants without external surgical support.

One of the challenges in the surgical reconstruction of cleft deformities in the developing world is that, as evidence teaches us, timing does matter – particularly as it applies to palatal reconstruction and speech outcomes. In post-pandemic Guatemala, the average age of cleft lip repair is about 8 months and palate repair 3-4 years of age. Although I’m glad that more babies are again receiving reconstruction, I also know that fixing cleft palates at 3-4 years of age is doing these infants a major disservice. We must strive to do better.

What’s happening in Guatemala is just one example of a global problem. Many leaders in our field have strived for decades through various delivery models to improve care for infants with cleft lip and palate around the world. The pandemic certainly set us back. However, I remain optimistic that we, as plastic surgeons, have a unique skillset, creative minds and good hearts. We will work together to ensure the fight continues, one child at a time. YPS

e NLIGHTEN SERIES

ASPS Patient Education e-Brochures

Dr. Morrison with Chief Resident Megan Pencek, MD, and a cleft patient in Antigua, Guatemala, on a trip in September 2022.

THE PSF THANKS YOU

The PSF thanks all those who donated in 2022

The PSF’s excellence and leadership within the specialty depend greatly on the generosity of ASPS members. From annual gifts that make an immediate impact to endowed gifts that support future generations of plastic surgeons, contributions to The PSF serve as the catalyst of innovation for our specialty.

Last year, your generous contributions, professional achievements and selfless enthusiasm enabled The PSF to perpetuate its reputation as the most distinguished research foundation in the specialty. Thanks to your generosity, The PSF provided grant funding for investigator-initiated research projects, international scholars at U.S. plastic surgery institutions, distributed Breast Reconstruction Awareness Fund grants to U.S.based charities and awarded Charitable Care Breast Reconstruction Awareness Fund grants to cover breast cancer surgical care costs for women who otherwise could not afford reconstruction. Donations were made from Jan. 1 through Dec. 31, 2022.

Platinum

Scott Hollenbeck, MD

Sherwood Smith, MD

Diamond

Julia Cook Beresford, MD

Daniel Careaga, MD

Eugene Cherny, MD

Freeman Co.

Daniel Freet, MD

Daryl Hoffman, MD Eugene Podsiadlo

Gold

Nebil Aydin, MD

James Fernau, MD

Gregory Greco, DO

Matthew Greives, MD

Meegan Gruber, MD

Karol Gutowski, MD

Cassidy Hinojosa, MD

Kelly Juarez

Peter Neligan, MB

Linda Phillips, MD

Peter Ray, MD

Luis Rios Jr., MD

Christine Rohde, MD

David Song, MD, MBA

Hannah Van Hoof

Sterling

Ahmed Afifi, MD

Frank Agullo, MD

Bryan Armijo, MD

Alberto Aviles, MD

Bruce Baker, MD

Richard Baynosa, MD

Devra Becker, MD

Gunnar Bergqvist, MD

Keith Berman, MD

Nada Berry, MD

Steven Bonawitz, MD

Robert Bragdon, MD

Maliniac Circle

The Maliniac Circle was named for ASPS co-founder Jacques Maliniac, MD. Fellows of the Maliniac Circle have made an outright gift of $50,000 or more, or a minimum deferred gift of $100,000, advancing plastic surgery to a higher level through research, innovation and public service. The following is a complete list of Maliniac Circle members. We thank them for their commitment to the specialty.

Dr. Bruce* and Tamara

Achauer

Dr. John and Candese Alexander

Dr. Bernard and Susan Alpert

Christopher Brooks, MD

Hoang Bui, MD

Brian Buinewicz, MD

Theodore Calianos, MD

Earl Campbell, MD

Angela Cheng, MD

Tae Chong, MD

Kevin Chung, MD, MS

Mimis Cohen, MD

Christopher Costa, MD, MPH

Michael Costelloe

Richard D’Amico, MD

Lynn Damitz, MD

Anthony Dardano, DO

Ryan Diederich, MD

Sepehr Egrari, MD

Frederick Eko, MD

Daniel Ferry Neil Fine, MD

Alberto Gallerani, MD

Katerina Gallus, MD

Peter Geldner, MD

Gayle Gordillo, MD

Arun Gosain, MD

Jeffrey Gusenoff, MD

Josef Hadeed, MD

Summer Hanson, MD, PhD

R. Scott Haupt, MD

Melinda Haws, MD

William Hoffman, MD

Julie Holding, MD

Karen Horton, MD, MSc

Amy Hughes

Kenneth C. W. Hui, MD

Lynn Jeffers, MD, MBA

Jay Jensen, MD

Debra Johnson, MD

Bram Kaufman, MD

Timothy King, MD, PhD

Neil Kundu, MD

David Larson, MD

Justine Lee, MD, PhD

Kimberly Lee Peter Lee, MD

Drs. Darrick and Elizabeth Antell

Dr. Stephan and Viviane Leao-Baker

Dr. Mark T. Boschert

Dr. Keith and Tina Brandt

Dr. Garry Brody*

Dr. Richard E. and Colleen A. Brown

Dr. Brentley and Diane Buchele

Dr. Rafael C. Cabrera

Dr. Theodore and Sheryl Calianos

Dr. John and Laurie Canady

Drs. Paul S. and Jean B. Cederna

Drs. Andrew and Amy Chen

Dr. Eugene and Ruth Ann Cherny

Dr. Bernard Cohen*

Joanne Lenert, MD

Samuel Lin, MD, MBA

John LoGiudice, MD

David Low, MD

Brian Mailey, MD

Bernard Markowitz, MD

Timothy Marten, MD

Evan Matros, MD

Martha Matthews, MD

Aaron Mayberry, MD

Mark Migliori, MD

Michael Neumeister, MD

Minh-Doan Nguyen, MD, PhD

Son Nguyen, MD

Eamon O’Reilly, MD

David Otterburn, MD

Anke Ott-Young, MD

Keith Paige, MD

John Persing, MD

Elizabeth Peterson, MD Samuel Poore, MD, PhD Anil Punjabi, MD, DDS

Patty Radwanski

Michael Reed, Esq. Charlotte Rhee, MD

Carolyn Rogers-Vizena, MD

Leonard Roudner, MD Justin Sacks, MD, MBA C. Andrew Salzberg, MD

Betsy Podsiadlo Sands

Rajendra Sawh-Martinez, MD, MHS

Kenneth Shaheen, MD

Reginald Sherrill, MD Nicole Sommer, MD

Aldona Spiegel, MD Srinivas Susarla, MD, DMD, MPH

Gregory Swank, MD

Jesse Taylor, MD

Winnie Tong, MD Jon Paul Trevisani, MD Holly Wall, MD Amy Wandel, MD

Dr. Norman* and Pat Cole

Dr. Sydney R. Coleman

Dr. Mark and Charlotte Constantian

Dr. Mary Ann Contongiannis and Ralph E. Huey

Dr. Robert N. Cooper

Dr. James R. and Gayle Cullington

Dr. J. Douglas and Barbara Cusick

Drs. Richard and Brenda D’Amico

Dr. Tancredi D’Amore

Dr. Lynn Damitz

Dr. Glenn and Maryann Davis

Dr. Sara R. Dickie

Dr. Sharadkumar Dicksheet*

Dr. T. Michael Dixon

Dr. Greg and Helga Dowbak

Philip Wey, MD

Steven White, MD Libby Wilson, MD Michael Wong, MD

Silver

Valerie Ablaza, MD Todd Adam, MD

Ghada Afifi, MD

Richard Agag, MD

Jayant Agarwal, MD

Faris Almugaren, MD, SB

Ashley Amalfi, MD

Marco Túlio Junqueira Amarante, MD, MSc

James Anthony, MD

Lauren Archer, MD Mariam Awada, MD Stephen Baker, MD

Jo Barta

Richard Bartlett, MD Mohamad Bazzi, MD Glenn Becker, MD Michael Bentz, MD Mario Bernier, MD

Paul Berry, MD Keith Blechman, MD Darryl Blinski, MD

Adam Boettcher, MD

Lisa Bootstaylor, MD

Richard Bosshardt, MD

Jeanne Bovill

Thomas Bracalento

James Bradley, MD Kristen Broderick, MD

Brentley Buchele, MD

Susan Buenaventura, MD Duc Bui, MD

Athleo Cambre, MD

Robert Carpenter, MD

Larry Carson, MD, MBA

Lisa Cassileth, MD

Jennifer Chan, MD Robert Chandler, MD

Dr. Sepehr Egrari

Dr. Walter and Carolyn Erhardt

Dr. Daniel J. Freet

Drs. Heather J. Furnas and Francisco L. Canales

Dr. Roberta Gartside

Dr. John E. and Margaret M. Gatti, Esq.

Drs. David and Lisa Genecov

Dr. Scot and Alisa Glasberg

Dr. R. Cole Goodman

Dr. Gayle Gordillo

Dr. Arun and Smita Gosain

Dr. Gregory A. Greco and Daniel Ranger

Dr. Richard and Robin Greco

Dr. Matthew Greives

Dr. B. Rai Gupta

Dr. Subhas and Seema Gupta

David Chang, MD

George Chatson, MD

Andrew Chen, MD

Yoon Chun, MD

Susan Chung, MD Mark Clemens, MD

Joshua Cooper, MD

Jeffrey Copeland, MD

John Corey, MD

Jennifer Cross

Michael Curtis, MD

Jeffrey Darrow, MD

Alexander Davit III, MD

Konrad Dawson, MD

Joseph Dayan, MD

Carolyn De La Cruz, MD

Jorge de la Torre, MD

Sara Dickie, MD

Ronald Downs, MD

Chandra Dunbar

S. Alexander Earle, MD

Patricia Easton

Brent Egeland, MD

Frederick Ehret, MD

Eric Emerson, MD

Lars Enevoldsen, MD

Loren Engrav, MD Heather Erhard, MD

Gregory Fedele, MD

Randall Feingold, MD

Robert Fernandez, MD Sean Figy, MD

Ellen Flanagan

Ronald Ford, MD

Thomas Francel, MD

William Franckle, MD

Heather Furnas, MD

Noopur Gangopadhyay, MD

Patrick Garvey, MD

Aviram Giladi, MD, MS

Paul Gill, MD

Eduardo Gonzalez, MD

Arin Greene, MD

David Greenspun, MD

Dr. Geoffrey and Kathryn Gurtner

Dr. Karol and Ellen Gutowski

Dr. Bahman and Lora Guyuron

Dr. Neal Handel

Dr. Dan and Mrs. Lynsi Hatef

Dr. James* and Barbara Hoehn

Dr. Scott Hollenbeck

Dr. C. Scott and Rev. Suzanne C. Hultman

Dr. Ron and Nancy Israeli

Dr. Ronald and Virginia Iverson

Dr. Jeffrey and Emily Janis

Dr. John and Marcia Jarrett

Dr. Debra J. Johnson

Dr. Michael Kalisman

Dr. Susan Kaweski

Dr. Brian Kinney

Jennifer Greer, MD

Richard Ha, MD

Anoush Hadaegh, MD

David Halpern, MD

Hauw Han, MD

Michelle Hardaway, MD

Stephen Hardy, MD

Jim Hartman

Al Hassanein, MD, MMSc

Theresa Hegge, MD

Peter Henderson, MD, MBA

Lloyd Hoffman, MD

Collin Hong, MD

Emily Hu, MD

Peter Hyans, MD

Clyde Ishii, MD

Lisa Jacob, MD

Jeffrey Janis, MD

George Jennings, MD

John Jensen, MD

Robert Jetter, MD

Sang Yoon Kang, MD

Nolan Karp, MD

Martin Kassan, MD

Charles Kays, MD

Robert Kearney, MD

Angela Keen, MD

Christine Kelley-Patteson, MD

Christopher Killingsworth, MD

Gilson Kingman, MD

Janae Kittinger, MD

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Edmund Kwan, MD

Khoa Lai, MD

Janice Lalikos, MD

Rene Largo, MD

Danielle LeBlanc, MD

Charles Lee, MD

Gordon Lee, MD

Nathan Leigh, MD

E. Dwayne Lett, MD

Eric Chien-Wei Liao, MD, PhD

Kant Lin, MD

H. Peter Lorenz, MD

Raman Mahabir, MD

Algird Mameniskis, MD

Erik Marques, MD

Patricia Mars, MD

Bruce Mast, MD

Alan Matarasso, MD

Tim Matatov, MD

David Mathes, MD

Gwendolyn Maxwell, MD

Colleen McCarthy, MD

Meghan McGovern, MD

Patricia McGuire, MD

Daniel Medalie, MD

Dr. Gurmander and Maninder Kohli

Drs. Joshua and Siobhan Korman

Dr. William and Linda Kuzon

Dr. David and Sherry Larson

Dr. David C. Leber

Drs. Bernard and Britt Lee

Dr. Charles K. Lee

Dr. J. William Little

Dr. Scott Loessin

Drs. Joseph Losee and Franklyn Cladis

Dr. Adam Lowenstein

Dr. Dennis and Mary Lynch

Dr. Sergio Pasquale Maggi

Dr. Raman C. Mahabir

Fred and Mary McCoy Foundation

Dr. Michael Francis McGuire*

John Menard, MD

Charles Messa III, MD

Paul Mills, MD

Nana Mizuguchi, MD

Joseph Mlakar MD, FACS

Andrea Moreira, MD

Donald Morris, MD

Lisa Murcko, MD

Jason Mussman, MD

Thomas Mustoe, MD

Alejandro Najar Mendez, MD

Sanjay Naran, MD

G. Newton, MD

John Nigriny, MD

Morry Olenick, MD

Kerry Owens, MD

Thornwell Parker III, MD

Ash Patel, MBChB

Tarak Patel, MD

Eric Payne, MD

Manuel Pena, MD

Michael Philbin, MD

Brett Phillips, MD, MBA

Emilia Ploplys, MD

Kirk Potter, MD

Kannan Prema, MD

Julian Pribaz, MD

Andrea Pusic, MD, MHS

Norman Rappaport, MD, DDS

Benjamin Rechner, MD

Puli Reddy, MD

Joseph Reichman

Debra Reilly, MD

Renee Robbins

Bruce Rodgers, MD

Michelle Roughton, MD

Sandra Sacks, MD

A. Neil Salyapongse, MD

Marc Salzman, MD

Loren Schechter, MD

Warren Schubert, MD

Steven Schuster, MD Jaime Schwartz, MD Graham Schwarz, MD

Deana Shenaq, MD

Michele Shermak, MD

Sachin Shridharani, MD

John Siebert, MD

Devinder Singh, MD

Sumner Slavin, MD

Lane Smith, MD

Alison Snyder-Warwick, MD

Isaac Starker, MD

Rita Stice, MD, CEO, CPE

John Stranix, MD

Steven Struck, MD

Michael Sweet, MD

Roxanne Sylora, MD

Simon Talbot, MD

Dr. Dan and Jan Mills

Dr. Peter Neligan

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Dr. R. Barrett and Barbara Noone

Drs. John and Katie Osborn

Dr. Douglas Ousterhout

Dr. and Mrs. Vasu Pandrangi

Dr. Christopher Pannucci

Dr. Janet Parler

Dr. Ash Patel

Dr. James and Diane Payne

Dr. John and Susan Persing

Drs. Linda and William Phillips

Dr. B. Aviva Preminger

Dr. Patrick Proffer

Drs. Andrea and Martin Pusic

Dr. Norman and Deborah Rappaport

Rudolf Thompson, MD

Sue-Mi Tuttle, MD Leo Urbinelli, MD

Theodore Uroskie, MD

Victoria Vastine, MD Marc Walker, MD, MBA Robert Wallace, MD

Dawn Wang, MD Stewart Wang, MD Paul Weiss, MD

Monica Wentworth, MD

Virgil Willard II, MD

Joel Williams, MD

Gregory Wittpenn, MD June Wu, MD

Michael Yates, MD

Diana Yoon-Schwartz, MD Teanoosh Zadeh, MD

Luis Zapiach, MD Andrew Zwyghuizen, MD

Bronze

David Abramson, MD

William Adams Jr., MD

Anthony Admire, MD

Peter Aldea, MD

Mohammed Alghoul, MD

Andrew Amunategui, MD Kahlil Andrews, MD Michael Angel, MD Mokhtar Asaadi, MD

Steven Bernard, MD Michael Bernstein, MD David Bottger, MD

Joseph Boykin Jr., MD Wilfred Brown, MD William Bull, MD

Riesa Burnett, MD

James Butterworth, MD Chris Campbell, MD

Martin Carney, MD Harvey Chim, MD Karan Chopra, MD Maria Cipollone, MD Mark Clayman, MD

R. Brannon Claytor, MD

Alvin Cohn, MD

John Coleman III, MD Mary Ann Contogiannis, MD Grady Core, MD

William Cullen, MD Alexander Dagum, MD Vigen Darian, MD Lisa David, MD Joanne Dennison Barry DiBernardo, MD J. Frederick Doepker, MD Susan Downey, MD Frederick Durden Jr., MD

Dr. Debra Ann Reilly-Culver

Dr. William Riley

Dr. Luis M. Rios, Sr.*

Dr. Luis M. Rios, Jr.

Dr. Rod Rohrich and Diane Gibby

Dr. Stephen Ronan

Dr. Michelle Roughton

Dr. Robert and Cynthia Ruberg

Dr. Robert and Anne Russell

Dr. Justin Sacks

Dr. Kenneth* and Luci Salyer

Dr. Bernard* G. and Rhoda G. Sarnat

Dr. Loren S. Schechter

Dr. James D. and Kathleen Schlenker

Dr. Paul and Barbara Schnur Dr. Reginald R. Sherrill

Patricia Eby, MD

Ubaldo Carpinteyro Espín, MD

Kelvin Eusebio, MD

Gregory Evans, MD

Heather Faulkner, MD, MPH

Jose Foppiani, MD

Richard Fox, MD

Onelio Garcia, MD

Lisa Gfrerer, MD, PhD

Amir Ghaznavi, MD

Robert Gilman, MD, DMD

Michael Gimbel, MD Lawrence Glassman, MD

Wendy Gottlieb, MD

Jannine Griese Leonard Grossman, MD Steven Haase, MD

Dennis Hammond, MD Michael Hanemann Jr., MD

Richard Havard, MD

Gwendolyn Hoben, MD, PhD Maarten Hoogbergen, MD, PhD

Robert Howard, MD

James Hoyt, MD Tara Huston, MD

Olivia Hutchinson, MD Louis Iorio, MD

Jordan Jacobs, MD

Sonu Jain, MD

Thomas Jeneby, MD

Loree Kalliainen, MD Heather Karu, MD Surinder Kaur

Charles Kessler, MD Mark Kiehn, MD Brian Kinney, MD John Kirkham, MD Peter Koltz, MD

Ewa Komorowska-Timek, MD

William Kuzon, MD, PhD

A. Charlotta La Via, MD Mark Labowe, MD Charles Lee, MD Mary Lester, MD Scott Lifchez, MD Donald Mackay, MD Gregory Mackay, MD Edward Malin IV, MD Michele Manahan, MD Peter Marzek, MD Aaron Mason, MD Hajime Matsumine, MD, PhD G. Patrick Maxwell, MD Basil Michaels, MD

Raymond Mockler, MD Adeyiza Momoh, MD Steven Montante, MD John Moore, MD Isidoros Moraitis, MD

Dr. Petra Schneider-Redden and Curt Redden

Dr. Ali Seif

Dr. Jack and Anita Sheen

Dr. Michele Shermak and Mr. Howard Sobkov

Dr. Randy Sherman

Dr. Geoffroy and Lauren Sisk

Dr. Margaret and Stephen Skiles

Dr. Sherwood and Judith Smith

Dr. David H. and Janie Song

Dr. Scott* and Cynthia Spear

Dr. John (JT) Stranix

Dr. Anne Taylor and David Heutel

Dr. Kevin Tehrani

Dr. Jacob Unger

Dr. Karen B. Vaniver*

Martin Morse, MD

Gregory Mueller, MD

Robert Murphy Jr., MD

Rajasekhar Nalluri, MD

Gregory Neil, MD Wendy Ng, MD

Victor Nguyen

R. Barrett Noone, MD

Dennis Orgill, MD, PhD

Steven Ozeran, MD

Frederick Park, MD

Christopher Patronella, MD Sabrina Pavri, MD

Gregory Pearson, MD

Anne Peled, MD

John Potochny, MD

Cynthia Poulos, MD

Ariel Rad, MD, PhD

Gregory Ratliff, MD Edward Reece, MD

Brian Reedy, MD

Jody Rodgers, MD

Paul Rollins, MD

Mauro Romita, MD

Lorne Rosenfield, MD

Alvin Rosenthal, MD Malcolm Roth, MD Vas Sabeeh, DO

Moises Salama, MD

George Sanders, MD

Robert Schnarrs, MD

Himansu Shah, MD

Christopher Shale, MD

Daniel Shapiro, MD

Brian Slywka, MD

Darren Smith, MD

Jason Souza, MD

Matthew Stanwix, MD

Michael Stefan, MD

Victoria Yongsook Suh, MD

Jeff Swail, MD

Ellis Tavin, MD

Ariel Troncoso, MD

Glenn Vallecillos, MD

Susan Vasko, MD

William Wallace, MD Renata Weber, MD Mark Wells, MD Jane Weston, MD Carlos Wiegering, MD Steven Williams, MD

Drs. Nicholas B. Vedder and Susan R. Heckbert

Dr. Charles and Gale Verheyden

Dr. Amy Wandel

Dr. Philip D. and Elizabeth L. Wey

Dr. Linton and Renata Whitaker

Dr. Thomas C. Wiener

Dr. Robert* and JoAnne Winslow

Dr. Robin T.W. Yuan

Dr. Elvin* G. and Sharon Zook

Anonymous (3)

FOCUS ON PLASTIC SURGERY RESEARCH

Using AR to improve care of traumatic craniofacial fractures

By Jim Leonardo

Editor’s note: The following is part of an ongoing series highlighting The PSF Research Grant Award winners, and research they’re conducting to improve patient safety and develop new technologies for plastic surgeons. These features examine research funding awarded prior to the current year, as projects to which grants were awarded this year may not yet have results ready to discuss.

THE RESEARCHER

Solomon Lee, MD Title: PGY-5, University of California-San Francisco

Award: ASMS/PSF Research Grant

Project: An Augmented Reality Model for Evaluating Traumatic Craniofacial Fractures

PSN: Why are you studying augmented reality for traumatic craniofacial fractures?

Dr. Lee: Accurate diagnosis and spatial assessment of craniofacial fractures is critical for preoperative planning, precise fracture reduction and reducing postoperative complications. This can be difficult in complex craniofacial trauma involving multiple fracture patterns, where miscalculation can lead to significant morbidity including poor fracture reduction, damage to adjacent structures or decreased functional status. Augmented reality (AR) is an emerging tool with the potential for better diagnostic evaluation than traditional three-dimensional (3D) reformats. Our project aims to introduce and evaluate a novel, mobile-based AR model in the context of traumatic craniofacial fractures. Surgical

task cognitive load using the NASA Task Load Index. Our project aims to be a proofof-concept pilot on the clinical application of AR for craniofacial fractures.

PSN: What have you learned thus far?

Dr. Lee: With data collection nearly complete, 83 percent of providers preferred the AR model overall. Diagnostic sensitivity and specificity were equivalent between traditional 3D reformats and the AR model. Stratified by training level, less-experienced providers found the AR model required less effort (p=0.02), was less frustrating (p=0.01) and was preferred for fracture displacement characterization (p=0.04). The AR model had less impact on more experienced providers. Qual

lished approach to fracture evaluation. Our study demonstrates that our mobile-based AR model is a preferable interface to traditional 3D formats for spatial assessment tasks and decreasing task cognitive load, most notably with less-experienced providers for whom perioperative practices are less-established.

PSN: What do you see as the practical applicability of this in the specialty?

Dr. Lee: Our project’s validation of the AR model, with its accessible, mobile-based platform and affordable minimalist equipment requirement, facilitates wider adoption of the technology by providers treating craniofacial fractures. At scale, we envision a comprehensive AR system synced to a hospital’s picture

PSN: Did anything unexpected surface as you worked on this?

Dr. Lee: We were surprised by how important the provider level of training was on the impact of the AR model. Although all providers noted the AR model’s intuitive controls, junior providers significantly favored the AR model compared to senior providers. Junior providers also found the AR model most helpful as a diagnostic tool, while senior providers found the model more helpful during the treatment phase. The disproportionate impact of the AR model on less-experienced providers suggests future research opportunities by tailoring the AR model as a learning tool for less-experienced providers and patients.

PSN: Do you have any theories as to what’s behind that development?

Dr. Lee: We theorize the differential outcomes by provider training experience is related to the extent of established practice for a provider. Less-experienced providers are still learning how to navigate complex craniofacial scans and are thus more amenable to introducing a new element such as the AR interface into their initial diagnostic workup. Senior providers, on the other hand, already have well-established workflows upon which the AR model has less impact.

PSN: Who would you like to thank for their help with this project?

Dr. Lee: Jesse Courtier, MD, has been the cornerstone for this project as my primary mentor and the developer of the AR model. He has been pivotal in continuing to evolve the model for clinical optimization through this project and beyond. I’d also like to thank Jason Pomerantz, MD, Ben Laguna, MD, and William Hoffman, MD, who have provided invaluable clinical insight into the study design and application of the AR model to craniofacial fractures. Additional thanks to Niel Panchal, who has worked tirelessly in assisting with data collection, and the UCSF Center for Advanced 3D+ Technologies for their exceptional 3D processing work.

PSN: What did you want to be when you

An artist in elementary school; a global health worker in middle school; a doctor in high school; and, finally, a surgeon in college. I never imagined I could fulfill all my childhood dreams as a plastic surgery resident and aspiring craniofacial surgeon. I’m so grateful to be in my field, to all those who supported me along the way and for the exciting opportunities still ahead.

PSN: What was your favorite research project outside this The PSF research?

My favorite prior research was with Jason Pomerantz, MD, studying the role of the Alternative Reading Frame (ARF) protein in zebrafish cardiac regeneration. ARF is a tumor suppressor lacking in vertebrates capable of epimorphic regeneration, thus implicated as a context-sensitive suppressor of regeneration in mammals. We developed transgenic zebrafish expressing the ARF protein and studied their regeneration after induced myocardial injury. We found that ARF gene expression was upregulated during the cardiac regenerative process and slowed the rate of morphological recovery. Working in the Pomerantz lab was a foundational research

Above: Dr. Lee and Osita Obi-Oswuagu, MD, conduct a neuror rhaphy in an O.R. at Zuckerberg San Francisco General Hospital; (right) Dr. Lee and his wife, Sabrina Sandalo, kayak in Kaua’i, Hawaii.

The power of you

The media may have changed, but the message remains the same: If you’re considering a plastic surgery procedure, consult a plastic surgeon certified by the American Board of Plastic Surgeons.

By Madison Freeman & Paul Snyder

Since it was established in 1997, the Plastic Surgery Education Campaign (PSEC) has remained dedicated to promoting the specialty and the importance of consulting an ASPS Member Surgeon for any cosmetic or reconstructive procedure. The mission of the PSEC is to keep ASPS and its members positioned as the most-trusted sources of specialty information through a combination of national digital, broadcast and print campaigns, media relations, SEO and more – and empower patients with the knowledge they need to make the most-educated choice when it comes to plastic surgery.

The PSEC launches a new campaign to educate and empower patients.

Given the rise in plastic surgery procedures performed in the wake of the COVID-19 pandemic, when people weren’t spending money on travel and found themselves with unlimited amounts of recovery time at home, the educational efforts by the PSEC became even more vital.

“Since a lot more people were working remotely – and since we did experience a boom in plastic surgery during the pandemic – more people were doing their own research into plastic surgery procedures,” notes ASPS Public Education Committee Chair Josef Hadeed, MD. “Thanks to the work of the PSEC, we created more awareness on the importance of board-certification and the value of ASPS membership to the general public when they researched plastic surgeons for the procedures they were interested in.”

Seizing upon that increased consumer interest, the PSEC developed both digital-ad and social media campaigns using the Society’s in-house video production capabilities to create its most publicly engaging content to date. As news outlets focused on patient-safety issues, the PSEC crafted poignant messaging about breast implant safety and plastic surgery precautions during the pandemic to educate the public and demonstrate the leadership plastic surgeons took on these issues. The PSEC also produced more content – distributed through ads, social media, coverage by national media, as well as ASPS assets such as plasticsurgery.org and e-newsletters – than at any previous time in the organization’s history. The PSEC’s efforts in 2020 and 2021 yielded roughly $25 million in advertising value.

What’s more, the effort appeared to reach consumers. Campaigns not only demonstrated increased engagement (e.g., a “Mommy Makeover” patient testimonial bested the health-industry average for click-through rate by more than 80 percent and the beauty-industry average by more than 40 percent), but the increased digital engagement allowed the PSEC to increase its use of analytics and delve deeper into cultivating a community through contextual targeting. To ensure the Society’s ads are seen by prospective patients most likely to engage with members, ASPS works with media buyers to direct ads to prospective patients online who fit a desired demographic and indicate specific interests – at an optimal time for their engagement. In other words, patients are viewing Society ads within the same context of the material they search, read about and watch online.

“The messaging of the PSEC – in terms of constantly reiterating the importance of choosing a board-certified plastic surgeon and reinforcing the need to do the appropriate due

diligence ahead of any procedure – has never wavered,” says ASPS President Gregory Greco, DO. “What’s been really exciting to see unfold in the past few years is how we can leverage not only different media and social media outlets to spread that message, but also how it can directly reach a patient who might start some cursory research about getting plastic surgery.

“There’s a lot of noise on social media and a lot of people who should never be performing plastic surgery in the first place doing everything they can to try to get that patient’s business,” he adds. “It’s been a constant battle that has evolved with shifting media platforms and it will continue – but we can’t give up any ground in that fight, and we’re doing everything we can to make sure we don’t.”

Dr. Hadeed says that if anything, the PSEC has evolved into a stronger presence than at any time in its history – and it’s reaching an ever-growing audience.

“The emphasis has shifted to showcase more of the average person who most people considering plastic surgery can relate to, rather than showing the models or people with body types that might not be representative of the population at large,” he says.

‘You. Renewed.’

January marked the launch of one of the most ambitious PSEC campaigns to date: “You. Renewed.” Developed based on insights gleaned through consumer research that identified motivations and concerns of potential plastic surgery patients, the centerpiece of the campaign is a promotional video, digital ads and an audio component that will appear on targeted websites, social media and streaming services such as Hulu and Spotify.

“It’s a more appealing, fresh and relatable campaign than any I’ve seen,” notes Michele Shermak, MD, vice chair of the Society’s Public Education Committee. “The branding is amazing. I anticipate we will maintain the ‘You. Renewed.’ slogan for a long time, which will also help solidify brand recognition. You can’t beat the message. It works for such a wide range of procedures, individuals – and ASPS members.”

The multifaceted campaign will direct consumers to an ASPS landing page and aims to educate patients on the importance of consulting an ASPS member to ensure board-certification in plastic surgery and why ASPS members are uniquely qualified to provide the expert care patients deserve when seeking a plastic surgery procedure.

The landing page will highlight the video and allow patients and surgeons to download an eBook that will help patients in their

plastic surgery journeys prepare for their consultation. The eBook includes prompts such as “Questions to Ask Yourself When Considering Plastic Surgery” and checklists on needto-knows for patients to educate themselves properly as they consider the life-changing decision to have plastic surgery. When patients download the eBook, they are further encouraged to stay in touch and sign up for the Society’s newsletter, additional communications and content relevant to their patient journey and interests in plastic surgery.

“The campaign really drives home the point that plastic surgery should be done for personal reasons and not because someone else is pressuring you into it,” Dr. Hadeed says. “I think this will really resonate with most people considering plastic surgery and that we’ll continue to see and build on that theme in the PSEC campaigns moving forward.”

The national campaign will use a funnel-marketing strategy with key tactics aligned at every portion – nurturing patients from awareness to conversion. Using the campaign video, paid and organic social media posts, influencer campaigns, promotional items, innovative programmatic display and more, the “You. Renewed.” campaign will appear on all digital communications platforms where the ASPS target audience has found a home.

The PSEC has continued to use both ASPS market research and year-over-year statistics, as well as the Society’s 2022 Insights and Trends Report, to make data-driven decisions surrounding the campaign. Under the guidance of the Public Education Committee, the ASPS team used both resources to make decisions throughout the construction of the campaign. Doing so helped inform the creation of patient segments, targeting and positioning of the brand to effectively communicate with patients on the topics about which they care greatly.

“The Public Education Committee has been spending a great deal of time on plasticsurgery.org to improve consumer access to information through Q&As and social media; promoting media relations; creating a video library of roundtable discussions focusing on important plastic surgery-related topics; updating consumer education brochures – and creating this amazing new campaign,” Dr. Shermak says. “ASPS membership should see even more consumer engagement by providing content and interacting with the social media platforms.”

That’s certainly a positive for membership, which will be asked to vote on whether to renew the next three-year cycle at the 2023 ASPS/PSF Annual Business Meeting, slated to be held later this year during Plastic Sur-

gery The Meeting in Austin, Texas. ASPS President-elect Steven Williams, MD, says that even without the statistics – ad value, click-through rates, engagement, etc. – the PSEC is, at its core, reflective of Society membership.

“We are the ones who shape the image of this specialty,” he says. “This is who we are, and we can determine how we present ourselves to our prospective patients and the public at large. The impact of the PSEC is beyond question.”

Wholly representative

Although much of the consumer-outreach efforts are focused on patient education surrounding aesthetic procedures, reconstructive work – as well as the pioneering efforts of plastic surgeons – are also part of the PSEC’s storied history.

Recording artists Jewel and Patti LaBelle have joined forced with the PSEC to help bolster breast reconstruction awareness efforts, while the Patients of Courage: Triumph Over Adversity awards, a mainstay of Opening Ceremonies every year at Plastic Surgery The Meeting, have shone a light for 20 years on the powerful, life-changing effects that reconstructive surgery can have on patients. Entries each year consistently outnumber the stories that can be highlighted during Opening Ceremonies, but those tales nevertheless were told in the pages of PSN and in other PSEC campaigns over time.

As the public’s opinion of plastic surgery was shaped by “reality” TV shows and drama on network and cable channels alike in the first part of the 21st century, the PSEC put resources into “The Innovators,” a video series focused on reconstructive surgery and the lasting effects that plastic surgeons and their work can have on patients. ASPS past President Jeffrey Janis, MD, says the series gave plastic surgeons a platform to do “true reality TV.”

As the ways in which the public gathers information and researches topics of interest in plastic surgery – aesthetic or reconstructive –evolve through available technologies and platforms, the PSEC remains steadfast in its ability to keep pace and anticipate these changes.

“It’s the main tool we have to beat the drum for the importance of board-certification and provide members with the best information they can share with our patients,” Dr. Greco says. “But it’s also really the only thing out there that really provides an entire look at the depth and breadth of our specialty and the amazing things that plastic surgeons can do every day.” PSN

For additional ASPS/PSF meeting information, visit the Meetings & Education page at www.plasticsurgery.org/meetings; e-mail registration@plasticsurgery.org; or call (800) 766-4955 / (847) 228-9900. Dates, locations and program information are subject to change without notice.

JANUARY

17-18

27-29

38th Annual Atlanta Breast Surgery Symposium

Atlanta

Contact: (435) 901-2544 Web: sesprs.org

FEBRUARY

3rd World Congress on Surgery, Surgeons and Anesthesia Zurich, Switzerland

Contact: +0044-2033180199 Web: surgeon.euroscicon.com

APRIL

2-5

Women Plastic Surgeons Symposium Charleston, S.C.

Contact: (847) 228-9900 Web: plasticsurgery.org/wpssymposium Directly Provided by ASPS

9-11

57th Annual Baker Gordon Educational Symposium Miami

Contact: (305) 854-8828 Web: bakergordonsymposium.com

23-26

Mountain West Society of Plastic Surgeons Annual Meeting Crested Butte, Colo.

Contact: (847) 228-3330 Web: mwsps.org Jointly Provided by ASPS

23-26

ACAPS 2023 Winter Meeting New Orleans

Contact: (978) 927-8330 Web: acaplasticsurgeons.org/winter

MARCH 2

12-June 7

ASPS In-Service Exam For Surgeons

Online

Contact: (847) 228-9900 Web: plasticsurgery.org/exams

Directly Provided by ASPS

19

The Rhinoplasty Society Annual Meeting 2023

Miami Beach, Fla.

Contact: (904) 786-1377 Web: rhinoplastysociety.org/meetings

19-23

The Aesthetic Meeting 2023

Miami Beach, Fla.

Contact: (562) 799-2356 Web: meetings.theaestheticsociety.org

26-29

30th Stuttgart Advanced Course For Rhinoplasty & 4th Stuttgart Symposium on Nasal Reconstruction Stuttgart, Germany

Contact: +49 (0) 89 18 90 46-0 Web: stuttgart-rhinoplasty.com

29-May 2

AAPS 101st Annual Meeting

Chicago

2

ASPS In-Service Exam for Residents Online

Contact: (847) 228-9900 Web: plasticsurgery.org/exams Directly Provided by ASPS

3-5

ASPS Spring Meeting Online

Contact: (847) 228-9900 Web: plasticsurgery.org/spring

Directly Provided by ASPS

9-12

Dallas Cosmetic Medicine & Rhinoplasty Meeting

Dallas

Contact: (877) 809-7525 Web: dallasrhinoplastyandcosmeticmeeting.com Endorsed by ASPS

17-18

Plastic Surgery Coding Workshop Online

Contact: (800) 766-4955 Web: plasticsurgery.org/coding

Directly Provided by ASPS

Contact: (978) 927-8330 Web: https://meeting.aaps1921.org MAY

Contact

Contact: (847)

Phoenix

Contact: (847) 871-4610 Web: arizonasps.org Jointly

Top resident abstracts honored at annual meeting

An impressive number of scientific papers were submitted for consideration by resident authors from 22 different countries for the 2022 Plastic Surgery The Meeting Resident Abstract sessions. More than 190 resident abstract presentations were accepted, of which the top 50 resident authors were invited to present their research during the live abstract sessions held in Boston on Oct. 28. Highly favorable reviews were tendered from those who attended the in-person sessions and from the moderators who facilitated the sessions.

Moderators were volunteer members representing ACAPS, ASPS and YPS:

Aesthetic, Recon/Burn/Microsurgery, Research Session: Malcolm Paul, MD; Jessica Suber, MD

Hand, Research Session: Amber Leis, MD; Alexander Spiess, MD

Maxillofacial, Research Session: Nirav Patel, MD, JD; George Varkarakis, MD

Breast Reconstruction, Research Session: Sarah Bishop, MD; John Stranix, MD

Breast Reconstruction Session: Jordan Frey, MD; Nicholas Panetta, MD

The following were honored as the outstanding resident presentations:

Aesthetic, Recon/Burn/Microsurgery, Research Session

Virtual Surgical Planning Flattens the Learning Curve for Free Fibula Flap Mandible Reconstruction: A Propensity Score-Matched Cohort Study

Luke Grome, MD Baylor College of Medicine

Hand, Research Session

Decoding and Modulation of Spiking Activity of the Sciatic Nerve in an Awake and Moving Rodent Katharina Fischer, MD

BG Trauma Clinic Ludwigshafen, Germany

Maxillofacial, Research Session

Managing Mandibular Gunshot Wounds: An Institutional Review and the “FLOSS” Severity Scoring System

Lynn Bourn, MD (co-winner) St. Louis University

Disparities in Mandibular Trauma: A Retrospective Analysis Dylan Kahler, MD (co-winner) Temple University Hospital

Breast Reconstruction, Research Session

Evidence-Based Medicine: Systemic Perioperative Antibiotic Prophylaxis for Prevention of Surgical-Site Infections in Plastic and Reconstructive Surgery

Kevin Klifto, DO, PharmD University of Missouri-Columbia

Breast Reconstruction Session

Use of Antibiotic-Impregnated Polymethylmethacrylate (PMMA) Plates for Prevention of Periprosthetic Infection in Breast Reconstruction

Kelsey Lipman, MD Stanford University

Outstanding paper and poster presentations of Plastic Surgery The Meeting 2022

The following paper and poster presentations received honors during Plastic Surgery The Meeting 2022 in Boston.

Aesthetic Session 1 85 Cases Gummy Smile Correction by Dr.Vitusinee’s Technique Vitusinee Udee, MD

Session 2 Comparative Outcomes of Malar Implants vs. Fat Transfer to Cheeks Among Transgender Women Undergoing Malar Augmentation

Bachar Chaya, MD

Session 3 Intestinal Perforation After Liposuction: A Systematic Review

Jenna Bekeny, MD

Session 4 Facelift in the Filler Filled Face: A Difficult Challenge

Renato Calabria, MD

Session 5 Volumetric Analysis and Quality of Life Outcomes Three Months After Hyaluronic Acid Injectable Facial Filler Ankoor Talwar

Session 6 Pulmonary Embolism Risk after Cosmetic Abdominoplasty

Christopher Kalmar, MD, MBA

Session 7 The Impact of Platelet-Rich Plasma on Patient-Reported Quality of Life in Treatment of Hair Loss Abigail Meyers

Breast Session 1

Risk Factors for Upper Extremity Dysfunction after Breast Cancer Treatment: A Single Institution Retrospective Review

Hannah Carr

Session 2 Robotic vs. Standard Harvest of Deep Inferior Epigastric Artery Perforator Flaps: Early Outcomes

Elizabeth Bailey, MD

Session 3 Breast Reconstruction Free Flap Failure: National Outcomes Based on Preoperative Comorbidities

Christopher Kalmar, MD, MBA

Session 4 Breast Reconstruction with External Pre-expansion and Autologous Fat Transfer

vs. Standard Therapy (The BREAST- Trial) Andrzej Piatkowski de Grzymala, MD

Session 5

Results of Modified Goldilocks Procedure as Total Autologous Breast Reconstruction: A Single Surgeon Experience of 275 Consecutive Cases

Alexandra Grubnik, MD

Session 6

No Cancer Occurrences with 10-year Median Follow-up After Prophylactic Nipple-Sparing Mastectomy Carter Boyd, MD

Session 7

An Aesthetic Comparison of Extended Pedicle Technique vs. Free Nipple Graft Reduction Mammoplasty for Patients with Gigantomastia Ankoor Talwar

Session 8 Language Disparity Predicts Poor Patient-Reported Outcome and Follow Up in Microsurgical Breast Reconstruction Fei Wang, BA

Session 9

CD138 Expression is Upregulated in the Breast Tissue of Women with Sub-Glandular Breast Implants Megan Fracol, MD

Session 10 (Tie)

Case-Mix Adjustment To Compare Nationwide Healthcare Institution Performances After Reconstructive And Cosmetic Breast Implant Surgery Juliet Vrolijk, MD

Pathologic Mechanical Signaling Mediated by Rac2 Promotes The Foreign Body Response To Biomedical Implants Dharshan Sivaraj

Session 11

Trends in Insurance Coverage for Adolescent Reduction Mammaplasty Rotem Kimia, MD

Session 12

The Nipple Preserving Inferior Ellipse Mastectomy: A New Technique for Masculinizing Top Surgery Isabel Robinson, MD

Session 13 Prospective Study of Complications Following 500 Explantations with Simultaneous Breast Lift

Stephen Nicolaidis, MD

Craniomaxillofacial

Session 1

US Air Pollution is Associated with Increased Incidence of Cleft Lip/Palate: a CDC Vital Statistics Investigation Kelsi Krakauer

Session 2

Gender Authorship Trends Among Craniofacial Publications in the Past 20 Years: Where Are We Now? Fei Wang, BA

Session 3 Implementation of an Ambulatory Cleft Lip Repair Protocol: Surgical Outcomes Jenn Park, BS

Session 4

The Application of 3D Scanning and Ultrasound Technique in the Congenital Microtia Reconstruction with Tissue Expander Xiangxia Liu, MD

Session 5

Speech Outcomes of Palatal Lengthening using Buccal Myomucosal Flaps for Velopharyngeal Insufficiency Karen Bach

Session 6 Utilization of a Large Animal Translational Model to Evaluate a Stiffness-Matching Approach to Skeletal Reconstruction Hardware Nada Khattab, MD

Session 7 Twist1 Mutation and Environmental Factors Synergistically Exacerbate Craniosynostosis Eloise Stanton Session 8

True Incidence of Marginal Mandibular Nerve Palsy Following Neonatal Mandibular Distraction Osteogenesis Sarah Myers

Session 9 Coverage Gaps and Inconsistencies: The Landscape of Insurance Coverage for Orthognathic Surgery in the U.S. Arya Akhavan, MD

Session 10

An Evaluation of Patient Reported Appearance Outcomes Following Facial Feminization Surgery in Transgender Women Justin James

Session 11 Violent Paediatric Craniofacial Fractures: Features, Indicators and Outcomes Anne Glenney

Global Partner

Session 1 Influence of Parthenolid on the Regeneration of the Median Nerve Following Reconstruction By Non-Neuronal Tissue in a Rat Model Jonas Kolbenschlag, MD

Session 2 Outcomes After Tumor Resection with Reconstruction of Facial Skin Cancer: A Prospective Cohort Juan Carlos Marzan, MD

Hand Session 1 T Cell Repertoire Diversity in Lymphedema: Investigating the Antigens Driving the T Cell Response Adana Campbell, MD

Session 2 Modified Brunelli Pull-Out Technique or Reconstruction of Flexor Tendons in Zone II Alexandru Georgescu, MD, PhD

Session 3 Unscheduled Healthcare Contact after Outpatient Surgical Fixation of Distal Radius Fractures: Does the Treatment Facility Matter?

Evan Woodard

Session 4 Distal Radius Fracture Rotational Malalignment with Dorsal Spanning Plating Jordyn Farewell

Session 5 The Use of Vibrators as a Novel Analgesia Modality for Injections into the Upper Extremity: A Randomized, Controlled, Quality Improvement Study

Sami Tarabishy, MD

Session 6 Illuminating the Proximal Phalanx: Revisiting Osseous Perfusion by Micro-Computed Tomography

Andrew Abadeer, MD

Migraine

Session 1 Targeted NAC Reinnervation (TNR) with Nerve Fascicle Split in Gender Affirming Double Incision Mastectomy with Free Nipple Grafting

Lisa Gfrerer, MD, PhD

Session 2

Vascularized Denervated Muscle Targets: A Comparison with Regenerative Peripheral Nerve Interfaces to Determine Association Between Muscle Graft Size and Pain Kimberly Khoo

Session 1 Environmental Sustainability of Breast Implant Supply Chains

Christopher Kalmar, MD, MBA

Session 2

Streamlining and Consistency in Surgery: Lean-Six-Sigma to Improve Operating Room Efficiency

Rebecca Suydam, BA

Session 3

Greening the Plastic Surgery Operating Room: Strategies for Waste Reduction in Plastic Surgery Procedures

Ethan MacKenzie, MD

Session 4

Gender-Affirming Chest Reconstruction: Does Hospital Volume Influence Admission Charges?

Christopher Kalmar, MD, MBA

Session 5 Does the Camera Type Matter to our Patients? An Analysis of Patient Opinions in Office Photography

Joseph Tarr, MD, PhD

Session 6

Frailty in Plastic Surgery: Assessment of the Five Favor Modified Frailty Index

Sneha Subramaniam, MD

Reconstructive Session 1

Reconstruction of Large Sacral Defects with Freestyle Perforator Propeller Flaps

Seyda Guray Evin, MD

Session 2 The Importance of Plastic Surgery Flap Techniques to Preserve Critical Limb Length in Patients with Transmetatarsal Amputations: Long-Term Outcomes

Gina Cach

Session 3 The Omental Lymph Node Mapping Project

Wasan Janetanakul, MD

Session 4 Should the Microsurgery Pendulum Swing from Fasciocutaneous to Muscle Free Flaps in Peripheral Vascular Disease Patients? An Analysis of Outcomes in the Comorbid Limb Salvage Population

Adaah Sayyed

Session 5

Mineralocorticoid Inhibition Speeds Healing and Modulates Glucocorticoid Activity on Healing Burn Wounds

Shawn Loder, MD

Session 6

All or Nothing: Barriers in Access to Mastectomy with Reconstruction at Multiple Hospital Centers within a Single Network Paul Asadourian

Session 7

Reconstruction of Quadriceps Function Using a Single Functional Gracillis Muscle Transfer with an Adductor Longus Nerve to Femoral Nerve Branch of the Rectus Femoris Nerve Transfer Kaley Donaldson, MD

Session 8

Cryopreserved Adipose Successfully Mitigates Complex Burn Adhesion and Contracture in a Multi-Staged Reconstruc tive Approach

Shawn Loder, MD

Session 9

Complete Reduction of Leg Lymphedema in 126 Patients with Liposuction Without Recurrence - 20 Years’ Follow-Up

Hakan Brorson, MD, PhD

Session 10

Abdominal Donor Site Complications

Following Breast Reconstruction Using the Deep Inferior Epigastric Perforator Free Flap: A Multi-Institutional Multi-Surgeon Study Lucas Ohmes, MD

Session 11

Introduction of Targeted Muscle Reinnervation (TMR) and Regenerative Peripheral Nerve Interfaces (RPNIs) for Chronic Pain Control and Prosthetic Function at MD

Anderson Cancer Center: Review of 61 Cases and Outcomes

Margaret Roubaud, MD

Research & Technology

Session 1

In Vitro and In Vivo Studies on the Biosafety and Efficacy of Biodegradable Magnesium Alloy for Skin Staple Yi-Chia Wu, MD

Session 2

Exhale and Decell: Environmentally Sustainable Sterilization and Decellularization of Cartilage Grafts Via Supercritical Carbon Dioxide Nicholas Vernice

Session 3

Circulating Donor-Derived Cell-Free DNA: A Novel Non-Invasive Biomarker for Allograft Rejection in Vascularized Composite Allotransplantation Ogechukwu Onuh

Session 4

A Novel Model to Study Wound Healing Over Exposed Critical Structures in Rodents with a 3D-Printed Wound Frame Fuat Baris Bengur, MD

Session 5

The Difference in the Occurrence of Capsular Contracture According to the Characteristics of the Tissue in Contact with the Breast Implant in an Irradiated Rat Model Hyunho Han, MD, PhD

Session 6

Activating MAP2K1 Mutation in Zebrafish Endothelial Cells Causes Arteriovenous Shunts Christopher Sudduth, MD

Session 7

Galvanotactic Flexible Closed-Loop System for the Interrogation of Wireless Wound Healing Through Single Cell Analysis Artem Trotsyuk, PhD

Session 8

Identification of Novel Circulating Non-Hematopoietic Cells Orchestrating Tissue Fibrosis After Injury Dominic Henn, MD

Session 9

CleftGAN: Leveraging A Style-Based Generative Adversarial Network To Create New and Unique Cleft Lip Images Mitchell Stotland, MD

Session 10

Patient-Specific, 3D-Printed Models for Craniofacial Trauma: A New Application for Virtual Reality Surgical Planning Sydney Mathis

Session 11 Recombinant Elastin Biomatrix Improves Autologous Fat Grafting for Soft Tissue Reconstruction Stefan Roberts, PhD

Surgical Pearls

Session 1

Targeted NAC Reinnervation (TNR) with Nerve Fascicle Split in Implant Based Breast Reconstruction Lisa Gfrerer, MD, PhD

Best Posters of PSTM22

Aesthetic Simulating the Ideal Rhinoplasty: Individual Perspectives from Surgeons Worldwide Alexandra Townsend

Breast

Preserving Nipple Sensitivity after Mastectomy: A Systematic Review and Meta-Analysis Varsha Harish

Craniomaxillofacial Efficacy of Autologous Cranioplasty Using a Dental SafeScraper Device Jinggang Ng

Hand Pediatric Hand Trauma: Demographics, Injury Patterns and Operations

Casey Zhang

Practice Management (Tie)

At the Interface of Atrocity, Art and Anatomy: A Review of Eduard Pernkopf’s Atlas of Topographical and Applied Human Anatomy in Surgical Anatomy of Medical Ethics

Margaret Botros

What’s on the ‘Gram’: Social Media Content Among Integrated Plastic Surgery Residency Programs

Sarah Struble

Reconstructive (Tie)

Plastic Surgeon

Ethical

At least the most common referral services that most of us use (ASPS Connect, RealSelf, etc.), aren’t involved in the conversation once the patient has initiated contact with me. Maybe that’s the fundamental difference (at least for me) between a broker and a referral service?

Going back to the ethics questions, what’s the bottom line? You can participate in a referral service – and many of us already do. The world of the patient broker, however, seems different. With certain caveats, many might be able to work within the framework of the Code of Ethics and the law, but the more substantial question remains: “Is this the right relationship for you?”

After receiving the message from my receptionist, I glanced at the Post-it note and threw it in the trash.

continue to lead Energy and Commerce Democrats as the ranking member of the committee as Republicans move into the driver’s seat. Chairwoman McMorris Rodgers has already signaled that healthcare issues will be one of her top priorities on the committee’s agenda.

The retirement of House Ways and Means Committee Republican leader Kevin Brady yielded a highly competitive race to fill the top leadership spot in one of the House’s oldest and most powerful committees. Reps. Vern Buchanan (R-Fla.), Jason Smith (R-Mo.) and Adrian Smith (R-Neb.) are vying for the chairmanship, with Rep. Buchanan and Rep. Smith being the frontrunners for the leadership post. The Republican Steering Committee is expected to vote on this leadership position and other pending committee assignments in the coming weeks.

Party control did not flip in the Senate. Still, the Senate Health, Education, Labor, and Pensions (HELP) Committee will have new leadership this Congress. Sen. Bernie Sanders (I-Vt.) will lead the committee as former Chairwoman Patty Murray (D-Wash.) steps down to become the new chair of the powerful Senate Appropriations Committee. Longtime PlastyPAC ally and gastroenterologist Bill Cassidy, MD (R-La.), is slated to become the new ranking member on the Senate HELP Committee. Sen. Cassidy has been a strong advocate for the specialty over the years on balance-billing reforms and congenital anomalies coverage. These two issues will remain top priorities for the Society in the new Congress, and

ASPS looks forward to working with new leadership on real solutions for physicians and patients.

During the 118th Congress, healthcare will continue to be a top priority for both parties in Congress and the Biden administration. The divided Congress provides the opportunity for both parties to advance bipartisan healthcare policies such as lower drug prices, addressing physician shortages and permanently extending telehealth flexibilities. Polarizing healthcare issues – such as Medicare for All – will continue to receive partisan attention, but they seem unlikely to advance through Congress and be signed into law. ASPS is eager to collaborate with lawmakers on enacting prior-authorization reforms and congenital anomalies coverage – two priorities that had overwhelmingly bipartisan and bicameral support last Congress.

What lies ahead

PlastyPAC recognizes that plastic surgeons must have a seat at the table in the 118th Congress to ensure that members of Congress are educated and advocate for issues that directly affect plastic surgery practices. Healthcare issues dominated the congressional agenda throughout the past two years of the pandemic and are expected to continue to be a top issue in the 118th Congress. With ongoing congressional action on plastic surgery issues dealing with physician reimbursement and patients’ access to quality surgical care, the PAC and ASPS members cannot afford to sit on the sidelines. PlastyPAC remains focused on supporting candidates on both sides of the aisle who work alongside ASPS to protect the future of plastic surgery.

PHOTOGRAPHIC GUIDELINES

Researcher

experience where I learned to manage animal models, perform microscopic surgical procedures, develop bench protocols and systematically apply the scientific method.

PSN: How do you spend your time away from the lab?

Dr. Lee: The joys of my life beyond work are found with my wife, Sabrina, our two cats, Artemis and Nimbus, and my dear community of family and friends. We love snaring Dungeness crab or foraging for gaper clams along the California coastline, as well as camping, photography, hosting dinner parties and enjoying concerts in the city.

PSN: What sounds are heard in your O.R.?

Dr. Lee: Our O.R. is an amalgamation of our attendings’ varied musical tastes, ranging from classics such as Etta James and Led Zeppelin to more contemporary artists such as John Legend and Kygo. When I have the opportunity to DJ, I enjoy operating to relaxing beats from Petit Biscuit or Finneas, sprinkled with melodic overtones from Jason Mraz and H.E.R. – and the occasional dance number by Bruno Mars or Martin Garrix.

For more information about the many research studies funded by The PSF or to support our current and future research initiatives, please go to ThePSF.org PSN

OPPORTUNITIES

Plastic Surgeon For Clinic and Surgical Hospital in New Orleans

The Center for Restorative Breast Surgery is actively seeking an exceptional Board Certified/ Board Eligible Plastic Surgeon to join our specialized group.

Contact encouraged by applicants with microsurgical experience and a focused interest in breast reconstruction. Competitive salary and generous benefit package included.

All interested candidates are encouraged to submit a cover letter along with their curriculum vitae to:

The Center for Restorative Breast Surgery

Attention: HR Department 1717 St. Charles Avenue New Orleans, LA 70130 Corianne.Green@scsh.com https://www.breastcenter.com

Palm Beach County, FL

Seeking BC/BE plastic surgeon to acquire boutique aesthetic practice with prestigious reputation. Opportunity to join and transition practice. Fully accredited AAAASF surgical suite with overnight facility. Excellent opportunity to assume an established practice. Located in a desirable area with beautiful beaches and excellent schools. Please send CV to plasticsurgery561@gmail.com

Plastic Surgery Practice For Sale in Morris County,

N.J.

This well-established practice includes a 3,000 sq ft facility comprised of one AAAASF certified operating room, 6 exam rooms, 2 private offices, recovery room. Turnkey opportunity. Please email Joe@AlignHRE.com or call 908.420.2700.

Plastic Surgeon Opportunity in Palm Beach Gardens, FL

Pinsky Plastic Surgery is committed to finding an experienced Plastic Surgeon to join our expanding team. This community awarded premier plastic surgery practice is in beautiful Palm Beach Gardens, Florida.

Our dedicated team excels at providing patients concierge service and extraordinary care. Our busy, state-of-the-art facility is equipped with the latest technology and offers a robust list of aesthetic services.

Pinsky Plastic Surgery is partnered with one of Florida’s largest and fastest growing comprehensive dermatology practices, Aqua Dermatology.

The ideal candidate will possess the following interests:

Initial interest in reconstructive surgery (MOH’s closures, excisions, etc.)

• Cosmetic surgery and ancillary procedures

Clinical interest in breast reconstruction (free flaps, implant-based procedures)

• Complex trauma reconstruction

Living in Palm Beach Gardens offers a wealth of lifestyle opportunities: beautiful housing, beaches, sunshine, outdoor activities (golf, tennis, biking, running, swimming, boating, fishing, and more), symphony, theater, fine dining, private schools, parks and children’s activities, international travel, speed train, and so much more.

We offer a competitive benefit and relocation package. If you would like to learn more, please email your CV to Barbara Shannon, at bshannon@wederm.com or call (954) 232-1769.

Thriving Aesthetic and Reconstructive Plastic Surgery Practice in Houston, Texas

Memorial Plastic Surgery (MPS) is a leading aesthetic and reconstructive plastic surgery practice, focused on delivering an unparalleled surgical experience.

Excellent opportunity for Board-Certified/BoardEligible Plastic Surgeons who have a strong interest in breast reconstruction, cosmetic body contouring, or rhinoplasty/facial aesthetics.

MPS offers:

• Well-established and highly demanded practice for Associates to build practice and get busy quickly

Strong branding and global reach, built on high patient satisfaction, quality care, and aesthetic results

• High volume and patient overflow to perform breast reconstruction, cosmetic breast and/or body procedures

• Excellent set-up for facial plastic surgeon to start and grow facial practice

Great mentorship and support from prominent board-certified plastic surgeons

• Team-oriented staff for clinical and marketing support

Private AAAHC accredited OR’s, exclusively for MPS Surgeons to operate on-site

• Direct access to multi-specialty Ambulatory Surgery Center located in facility

Compensation:

• Competitive compensation models, with partnership track

• Covered medical malpractice insurance & comprehensive benefits package

Qualifications:

• Board Eligible or Board Certified in Plastic Surgery (or Facial Plastic Surgery)

• Aesthetic or Microsurgery fellowship preferred

Interested applicants are encouraged to email an updated CV and cover letter to: contact@memorialplasticsurgery.com

Winston-Salem, N.C.

Well-established, successful plastic surgery practice seeking BE/BC Plastic Surgeon to join our team. Cosmetically-focused practice with a strong reconstructive history offering a range of opportunities.

• Onsite AAAASF operating room

• Med Spa

• Family-friendly community and practice atmosphere

Easy access to mountains and beaches Email CV to: apply@salemplasticsurgery.com

Coastal North

Carolina

Partnership opportunity in the rapidly growing Southeast NC region. The ideal candidate must be BC and have completed a Cosmetic/Aesthetic Fellowship or have significant cosmetic experience. Currently the practice is about 95% cosmetic, but there is opportunity for reconstructive procedures if desired. We offer a competitive salary with quarterly productivity bonuses, Health/ Vision/Dental insurance, 401k plan, and medical malpractice coverage. We also offer a short partnership track and a shareholder opportunity.

Interested candidates should send their CV to: Andrea.p@labellevieps.com.

Greenville, South Carolina Partnership Opportunity

Upstate Plastic Surgery in Greenville, S.C. is seeking an additional partner to meet patient demand for our high volume private practice. Greenville is a growing community in the Upstate region of South Carolina. It is an easy driving distance to both the mountains and the beach. Greenville boasts a bustling downtown with a tree lined, twinkle-lit Main Street. This area is known for it’s culinary scene, boutiques, performing arts center and community festivals. Residents enjoy year around activities and love where they live. Work/life balance is valued in our practice. We live in a family friendly community as well.

Our private practice is located in a practice owned building with 3 floors sitting on a beautiful golf course which hosts the BMW Charity Pro Am on an annual basis. Our AAAASF office based surgery center is located inside our building along with our Medical Spa and Laser Center. There is close access to both local hospitals and the airport.

Our practice has an aesthetic focus. We currently perform both aesthetic and reconstructive surgery with an established referral base. We have received multiple community awarded honors. The office is essentially turn key with a talented medical and administrative staff. We are committed to marketing a new surgeon and helping him or her succeed. We are offering an attractive package including salary with a bonus structure, moving expenses, and benefits. We are looking for a long term relationship leading to a partnership/ownership track.

Our ideal candidate is BC/BE with an interest in performing both aesthetic and reconstructive surgery. An aesthetic fellowship or planning an aesthetic fellowship is preferred. We are looking for a surgeon who is well trained and has an entrepreneurial spirit. We offer a collaborative environment with a passion for excellence where a new surgeon can thrive.

Interested candidates please send your CV to jroberts@upstateplasticsurgery.com.

100% Aesthetic Practice in Dallas Metroplex

Well-established plastic surgery practice focused exclusively on aesthetic surgery seeks junior associate to join busy growing team.

Compensation

• Salary

• Medical malpractice insurance

• Productivity bonus

• Health insurance

• 401k plan

• Potential future partnership opportunity

Applicant

• Board Certified/Board Eligible in Plastic Surgery

• Passion for aesthetic surgery

• Focus on patient outcomes and experience

• Desire to work with a team

• Love for technology

About the Practice

• Four fully accredited AAAASF-certified operating rooms with two additional opening in spring 2023

• Five locations (Southlake, Plano, Dallas, Fort Worth and Frisco)

• Three medical spas with nurse injectors, aestheticians and many laser platforms

• Four Plastic Surgeons

• Two Aesthetic Plastic Surgery Fellows

• Four full-time anesthesia providers

• Great team to help you be successful, including marketing, social media, nursing, and other plastic surgeons to mentor you

Contact: All inquiries are confidential and can be submitted online via email to Sandy, V.P. of Business Development, at sandy@northtexasps.com. If you have any further questions, please feel free to reach out at 860-817-4344.

Plastic Surgeon – Green Bay, Wis.

“Best of both worlds!” Enjoy the autonomy of independent practice with excellent income potential and minimal buy-in, AND a built in referral base, payor contracting and employee benefits purchasing through participation in the Bellin Health Partners ACO, a nationally recognized leader in value based care.

Present Focus: Facial rejuvenation, cosmetic breast surgery and body contouring with special emphasis on breast reconstruction and skin cancer treatment. Ability to develop your practice as you wish – entrepreneurial cosmetic opportunity versus hospital system “worker bee.”

Call Coverage: Call very favorable to lifestyle; no hand call.

Physician Owned Surgical Center – AAAHC accredited, dedicated to plastic surgery and owned by the group.

Interested candidates can email their CV to tblom@gbpsa.com or call 920-436-8284.

Seeking BC Plastic Surgeon for Employment/ Partnership in Charlotte, NC

Well-established southeast busy solo cosmetic plastic surgeon seeks BC plastic surgeon to join practice with option for eventual partnership. Ideal candidate would be 100% cosmetic with proficiency in face and body. Practice includes a medical facial spa and AAAASF certified OR in our own building located across the street from a major hospital. Competitive salary with bonus structure and benefits. Email CV to: manager@natural-lookingresults.com.

Maine Plastic Surgery

Maine Plastic Surgery (MPS) is seeking a BC/BE Plastic Surgeon to join our extraordinary team. Recognized as the premier center for Cosmetic Surgery in the area for over 30 years, MPS is looking for an enthusiastic Plastic Surgeon with a passion for facial aesthetics, breast surgery and body sculpting procedures who will be driven to build our brand as a leader in all areas of cosmetic surgery.

We operate out of a brand-new facility with 3 on-site AAAASF operating rooms and established staff. Practice has been in Portland, Maine for 30 years with renowned reputation for cosmetic outcomes and one of the leading Med Spas in the Northeast.

Our practice has a growth minded, positive attitude and collaborative culture with a strong emphasis on patient experience. We are committed to delivering the highest quality care with a personal touch and seek a surgeon with like-minded goals and values. Our practice is 100% focused on Aesthetics and is exclusively fee-for service.

• Full-time Monday to Friday with alternating call with other surgeon covering MPS patients only

• BC/BE, aesthetic fellowship desired but not required

• Maine State Medical License – we will help with application

• Very competitive Base Salary plus Incentive Compensation and Benefits

Please direct inquiries to the practice manager Christina Alves (207) 775-1933 or christina@maineplasticsurgery.com.

Cosmetic Surgery Practice seeking BE/BC Plastic Surgeon in San Diego, California Successful well established Cosmetic Surgery practice seeking BE/BC plastic surgeon to join our busy private practice in San Diego, California.

Practice has a fully accredited on site surgical suite. Candidate would receive competitive salary with partnership opportunity and comprehensive benefits.

Interested candidates can email CV to: salavi@doctor.com

Florida is Open and Sunny Experienced BS Plastic Surgeons needed for a busy well-established Florida Cosmetic Surgery Practice.

Make your own schedule, full or part time! Independent Contractor, paid weekly on a mutually agreeable fee schedule. Cosmetic cases only. vmcallister@premierecenter.com

Practice for Sale, Olympia, Washington

A busy solo plastic surgeon is retiring after 40+ years of practice.

Currently this established practice is 100% cosmetic. The 3K sq/ft office is located directly across the street from the major hospital and has it’s own fully accredited AAAF certified surgical suite. The focus is primarily breast, body and facial procedures. A unique opportunity to assume an existing turnkey practice in an amazing setting on the Puget Sound with close access to sailing, mountains for hiking and skiing and the Pacific Ocean for fishing and surfing. Olympia is the state capital and home to 3 colleges. A great place to raise a family. Excellent income potential.

Contact: christine@drfoley.com

NavaDerm Bronx, NY

NavaDerm seeks to fill a lucrative Plastic Surgeon position at one of our thriving practices of 20+ years located in The Bronx, NY. We are looking for a talented provider who is dedicated to clinical excellence and exceptional patient care to join our growing team. The practice prides itself on producing high-quality patient care while achieving remarkable aesthetic results.

Qualifications:

• Must be Board Certified/Board Eligible

Must have New York State license

Why you should join Navaderm: With more than 40 Providers, team of Physician Extenders and eight locations throughout NY, NJ and PA, Navaderm is at the forefront of dermatologic innovation and research. Our providers are the best in the industry. We give you the tools to succeed in your career through mentorship, hands-on training, speaking opportunities and flexible schedules. Join our team and be part of the future of dermatology!

If working in one of the most vibrant and bustling cities sounds like your dream, this is the opportunity for you. New York has a strong economy, high-quality education, beautiful wildlife, and coastlines; endless recreational activities including Broadway shows cultural tours, Day Cruises and more. There is no shortage of activities for children and adults of all ages. New York is also well known for its diverse dining options and nightlife.

Do not miss out on this incredible opportunity. All inquiries are confidential.

CV Submissions should be emailed to Danielle Wilson, Director of Human Resources, dwilson@navaderm.com

Geisinger, Northeastern Pennsylvania

Geisinger is seeking plastic surgeons to join our team in central or northeastern Pennsylvania. Our services include general plastic surgery, cosmetic surgery, microsurgical and implant-based breast reconstruction, maxillofacial trauma, cancer/trauma reconstruction, and cleft/craniofacial care.

Our integrated plastic surgery residency provides opportunity for teaching, research, and program development. Geisinger has an established reconstructive and cosmetic referral base which is geared to building a thriving practice. We are supported by an excellent team of physician assistants, nurses, and staff. We also collaborate closely with multiple disciplines throughout the system.

For those candidates interested in cleft care, there is an opportunity to lead our accredited cleft program. We are looking for highly motivated, exceptional plastic surgeons who love the breadth of plastic surgery and want to be an integral part of this team and continue Geisinger’s tradition of innovation and excellent patient care.

If you want to learn more about these opportunities, we would love to speak with you.

Please reach out to Christian Kauffman, MD, Chair Plastic Surgery

c/o Sarah Lipka, Physician Recruiter, at slipka1@geisinger.edu

Scottsdale, AZ

Repta Plastic Surgery seeks a BC/BE plastic surgeon to join our world-renowned 100% cosmetic surgery practice. Recently built contemporary office and state of the art two operating room surgery center located in desirable downtown Scottsdale, Arizona. Honest, ethical, caring, and highly motivated to pioneer and further innovate new and improved

techniques in plastic surgery are a pre-requisite. Candidates interested in embarking on a long-term working relationship preferred. Contactjilljackson3@outlook.com.

Las Vegas Partnership Opportunity

Seeking a motivated Board Certified/Board Eligible Plastic Surgeon to join a growing, high volume practice with a built-in referral base. You will join a busy, established Las Vegas practice.

This is a full-time associate position with a partnership opportunity. We are offering a competitive base salary with a generous bonus structure. You will also receive a comprehensive benefits package that includes 401k, health and dental insurance. Please email your CV and cover letter to: LVplasticsurgeons@gmail.com

Busy SWFL Cosmetic Plastic Surgery Practice

Seeks BC/BE Plastic Surgeon

Busy plastic surgery practice located in Southwest Florida seeking a BC/BE plastic surgeon to join our well-established practice. The practice has a 21-year history of excellence in SWFL, and includes an 8,000-square-foot clinic, a luxury medical spa, and AAAASF certified OR.

Ideal candidate would be 100% cosmetic focused with proficiency in face, breast, and body. Highly competitive salary with bonus structure and benefits.

Must be ambitious and interested in a long-term relationship with our expanding practice.

To learn more, please send your CV and cover letter to plasticsurgeryswfl@gmail.com.

www.garramone.com

STUNNING NEWPORT BEACH, CALIF. PLASTIC SURGERY PRACTICE FOR SALE

Single-owner, thriving, plastic surgery practice for sale in highly desirable Newport Beach, CA - the shining crown jewel of Southern California’s coastline. Recently designed and built, this turn-key practice generates annual gross sales of $4 million plus with income streams from surgery, a med-spa, and a surgery center.

This ground floor location offers free patient and staff parking, easy access to all the major freeway systems, lighted signage visible from the street, and picturesque views from the many office windows onto a tree lined golf course and park. Computers, furnishings, EMR, multiple lasers, surgical and aesthetician instruments included. Med-spa includes a robust monthly membership program.

Sale of the practice includes a newly constructed AAAASF certified surgery center that features a separate entrance, state of the art equipment, the first ever Tesla back up power wall for a surgical setting and nightly UVC lighting for microbe neutralization. The facility is fully staffed and currently used by other physicians not associated with the practice, providing additional income.

The owner has been in practice 30 plus years with sterling Google reviews, a robust social media presence, 7000 plus email mailing list, and web traffic that drives more than 3,000 new patients each month. Current surgeon is willing to remain practicing during transition period. The new owner will be guaranteed a ten-year lease with multiple options for extension.

If you are interested in locating your practice in one of the world’s premier destinations in the world for plastic surgery, please submit email along with a copy of your CV to plasticsnewport@gmail.com.

PLASTIC SURGEONS NEEDED Suffolk County, Long Island

Long Island based multi-specialty plastic surgery group with several locations in Suffolk County seeking two Plastic Surgeons to join our private practice with strong academic affiliations.

Precision Medical Arts of New York, PLLC has been a well-established and reputable practice since 1992, with a focus on reconstructive surgery and our expanding cosmetic surgery practice.

Looking for two or three candidates who are board eligible and or board certified. We also welcome established Plastic Surgeons who would like to join a group and relocate. Sign on bonus, competitive salary, full medical coverage, pension plan, many bonuses, relocation expenses and many other incentives. Opportunity for partnership to follow.

Will accommodate all travel expenses for interview. Do not pass on this opportunity. Come join our team of courteous professionals in a friendly evolving practice.

Contact us today at: DrNKiridly@PrecisionPSNY.com or call Deborah at 631-447-9840.

COSMETIC NURSE PRACTITIONER/ COSMETIC PHYSICIAN ASSISTANT NEEDED Suffolk County, Long Island

Cosmetic experienced Nurse Practitioner/ Physician Assistant needed for expanding cosmetic Plastic Surgery practice in Suffolk County, New York.

Injectables/Fillers/Spa experience preferred. Part time/ full time available. Salary & bonuses.

Contact us today at: DrNKiridly@PrecisionPSNY.com

Or you can call Deborah at 631-447-9840.

Beverly Hills

Well-established plastic surgery practice in Beverly Hills is seeking a full-time plastic surgery associate to join our thriving practice.

Hiring package

• Salary

• Moving bonus

• Performance Incentives

• Health insurance, Vision, Dental

• 401k plan

• Potential future partnership opportunity

• Sponsored Equinox membership What we are looking for

• Board Certified or Board Eligible Plastic Surgeon

• Aesthetic surgery focused

• Prioritizes patient outcomes and experience

• Desire to work with a great team

• Excellent communication and surgical skills

• Experience in reconstructive and cosmetic procedures

• Experience in general and local anesthesia procedures

• Excellent bedside manner to build strong bonds with patients

About us

• State-of-the-art ambulatory center

• Upcoming expansion to Orange County and Calabasas

• Modern facilities

• Professional team environment

• Competitive compensation

• Onsite wellness suite with massage chair, Peloton, treadmill, library, foosball table, kitchen and meditation room

Contact: careers@barrettplasticsurgery.com

TRAINING

gram accredited by the ACGME and be board eligible or board certified in plastic surgery by the Fellowship start date and have or obtain an Oregon medical license prior to the start date.

Competitive salary. Health insurance and malpractice insurance are provided.

For inquiries, contact niloo@drmovassaghi.com

Oregon - Aesthetic Fellowship Opening July 2023

Aesthetic Society-endorsed Fellowship includes a full spectrum of aesthetic surgery services within an established successful private practice setting.

The experience entails broad, hands on exposure to comprehensive facial surgery (customized face-lifting and rhinoplasty), primary and revisionary aesthetic breast surgery, breast reconstruction, body contouring surgery as well as independent operating experience. It also encompasses exciting and cutting edge non-invasive and minimally invasive technologies treatments including hair restoration and skin resurfacing.

The Fellow will be exposed to our full medical spa with a wide range of technologies, including skin tightening, body contouring and light and laser technologies.

The clinical setting is a rewarding experience that emphasizes a full-scale approach including patient management, assessment training, practice management, business strategy and leadership. This Fellowship also has a strong mentorship component with monthly formal lectures/journal clubs. There will also be opportunities to enhance education and training via nationally organized meetings and local preceptorships.

Applicants to the Fellowship program must have completed a residency in a plastic surgery pro-

MGH/Harvard Advanced Peripheral Nerve and Microsurgery Fellowship

Reconstructive Fellowship offered at Massachusetts General Hospital (Boston, MA), a Harvard teaching hospital, beginning August 1, 2023 (12 months).

High volume experience in all areas of peripheral nerve surgery and microsurgery applied to complex and challenging reconstructive care spanning “head to toe” traumatic and oncologic defect restoration.

Emphasis on advanced microsurgical techniques and innovations within this rapidly evolving field including clinical and translational research projects and international visiting scholar travel program for select individuals.

Opportunities to participate in other areas of clinical interest, research, and teaching is heavily emphasized and supported.

Must have completed a plastic surgery, orthopaedic, and/or neurosurgery residency.

Forward CV to:

Dr. Ian Valerio 55 Fruit Street, WACC435 Boston, MA 02114 Fax: 617-726-1812 Email jldaddario@mgh.harvard.edu

Beaumont Integrated Reconstructive Microsurgery and Craniofacial/Skull Base Fellowship (CMF Micro)

The Division of Plastic and Reconstructive Surgery at Beaumont Health offers a 1- year fellowship combining microsurgery & craniofacial and skull base surgery.

This training experience is in one practice with Dr. Kongkrit Chaiyasate and his associates. The fellow participates in microsurgical cases including perforator flap breast reconstruction, head & neck free flap reconstruction (congenital, traumatic, and oncologic), skull base exposure and reconstruction, pediatric microsurgery, lymphedema reconstruction (LVA and LN transplant) & extremity free flap reconstruction.

The fellow is anticipated to graduate with 120+ flaps. A one-month elective abroad is provided. The fellow is expected to take part in facial reconstruction following Mohs resections, implant-based breast reconstruction & complex reconstructive cases.

The fellow plays a pivotal role in the monthly multidisciplinary Cleft Palate & Craniofacial Clinic. Each year, the craniofacial team performs at least 30 primary cleft lip & palate repairs, 60 secondary cleft lip & palate repairs including septorhinoplasty, 20 intracranial procedures including cranial distraction, 5 midface & mandible distractions.

The fellow will be able to develop skills in both fields and be able to bridge the gap using both disciplines for maximum patient outcomes.

The American Society for Reconstructive Microsurgery has awarded Dr. Chaiyasate with the “2014 Best Case of the Year”, “2017 Best Save of the Year”, “2019 Best Save of the Year awards”, and “2020 Best Case of the Year”. Candidate selection is completed through San Francisco Match Program.

For Further information please contact Dr. Kongkrit Chaiyasate directly at kongkrit.chaiyasate@beaumont.org.

MGH/Harvard Adult Reconstructive and Aesthetic Craniomaxillofacial Surgery Fellowship

Adult Reconstructive/Aesthetic Craniomaxillofacial Fellowship at Massachusetts General Hospital (Boston, MA), a Harvard teaching hospital, beginning July 1, 2023 (12 months).

High volume experience in all areas of reconstructive and aesthetic craniomaxillofacial surgery.

Emphasis on primary and secondary post-traumatic reconstruction as well as aesthetic facial skeletal contouring.

Opportunities to participate in other areas of clinical interest, research, and teaching. Must have completed plastic surgery residency.

Forward CV to:

Dr. Michael Yaremchuk 55 Fruit Street, WACC435 Boston, MA 02114

Fax: 617-643-5967 Email: sderrico@partners.org

THE RHINOPLASTY SOCIETY IS HIRING FOR EXECUTIVE DIRECTOR

As the key management leader of The Rhinoplasty Society, you are responsible for overseeing the daily administration, strategic planning, marketing for the organization. The position reports directly to the Board of Directors. Previous society management a must. Occasional weekend work and travel to meetings is required.

Key responsibilities include, not limited to: Work closely with the Board of Directors; maintain society database, plan/execute a one-day annual meeting, assist planning committees for the International Meeting of Rhinoplasty Societies (IMRhiS); process membership applications; work with all committees as requested; provide updates to the website, post relevant social media, assist with TRS webinars and the Rhinoplasty Mentoring Group. The Rhinoplasty Society is an equal opportunity employer.

Please email your resume to: Jeanie Hodges at rhinoplastysociety@gmail.com.

Well-established, thriving and innovative plastic and reconstructive surgery practice based in NYC and Long Island looking for a BC/ BE Plastic Surgeon to join our busy and expanding private practice.

State-of-the-art

•

•

•

Plastic/Reconstructive Opportunity with Partnership Track

Long Island & NYC

Excellent opportunity with partnership track. Well-established cosmetic plastic surgery practice with locations in Long Island and Manhattan seeks a plastic/reconstructive board certified/board-eligible surgeon to join our thriving practice.

Modern offices, professional team environment, state-of-the-art and accredited facilities, knowledgeable and professional staff, competitive compensation and benefits.

Greenbergcosmeticsurgery.com To apply, forward CV to docstg@aol.com or call 516-364-4200

MGH/Harvard Reconstructive/Aesthetic Breast Surgery Fellowship

Reconstructive/Aesthetic Breast Fellowship at Massachusetts General Hospital (Boston, MA), a Harvard teaching hospital, beginning July1, 2023 (12 months). High volume experience in all areas of aesthetic and reconstructive breast surgery. Emphasis on microsurgery and cutting-edge prosthetic techniques. Opportunities to participate in other areas of clinical interest, research, and teaching. Must have completed plastic surgery residency. Forward CV to:

Dr. William G. Austen, Jr. 55 Fruit Street, WACC435 Boston, MA 02114.

Fax: 617-643-5967

Email: sderrico@partners.org

MD Anderson Microsurgery Fellowship

Clinical Fellowship positions are available beginning 7/1/2023 at the University of Texas, MD Anderson Cancer Center in oncology-related reconstruction and microsurgery. A wide variety of complex reconstructive procedures are performed each year with a high volume of microvascular cases, especially autologous breast, complex head and neck, lymphatic, and perforator flap reconstructions. Opportunities are available to participate in microsurgery laboratory training and established basic science and clinical research projects. Fellowship duration: 12 months. Please send letter of intent and CV to:

Matthew M. Hanasono, MD Director, Microsurgery Fellowship Program Department of Plastic Surgery, Unit 1488

MD Anderson Cancer Center 1400 Pressler Houston, Texas 77030 (713) 794-1247

Email: mhanasono@mdanderson.org

University of Kansas Microsurgery Fellowship

The University of Kansas Department of Plastic Surgery Fellowship in Reconstructive Microvascular Surgery is a one-year non-ACGME accredited position starting August 1, 2023 that provides an in-depth experience with advanced microsurgical techniques. The fellowship offers extensive exposure to perforator flap breast reconstruction, as well as traumatic and oncologic reconstruction of the head and neck, and upper and lower extremities, lymphatic surgery, and gender affirming surgery.

Fellows have the opportunity to perform approximately 150-200 microsurgical cases per year. Fellows also may participate in non-microsurgical reconstructive and cosmetic cases as time allows. They will be responsible, along with the resident staff, for providing post-operative management of microvascular and complex reconstructive patients. The fellow will be expected to participate in resident teaching conferences as well as research projects.

Completion of an accredited Plastic Surgery residency and board eligibility is a requirement. Candidates must be eligible for a Kansas state medical license. Fellows have a faculty appointment in the Department of Plastic Surgery at the Instructor level.

Competitive compensation with production incentive and benefits will be offered.

Please forward a cover letter and CV to: Meredith Collins, MD

Microsurgery Fellowship Director University of Kansas Department of Plastic Surgery 3901 Rainbow Blvd, MS 3015 Kansas City, KS, 66160 Email: mcollins7@kumc.edu.

MISCELLANEOUS Surgery Suite For Sale

Remodeled 3000 sq/ft plastic surgery office with AAAASF accredited surgery suite for sale/ lease in San Francisco. Turn-key opportunity8 exam rooms, 3 offices, 2 bathrooms, 1 fully equipped OR with 2 recovery beds. Office situated in Union Square in large medical building with parking. Space can be subdivided. Contact: Yogy Mehta (415) 392-3333

Plastic Surgery Biller

Specializing exclusively in Plastic Surgery billing with over 25 years experience. We check for correct coding for maximum reimbursement, and review each claim before submission. Once the claims are submitted, we follow closely and appeal when necessary. We work remotely, off-site with excellent references. Call Ana at (239) 541-9993

South Florida Plastic Surgery Domain Names For Sale

Perfect for setting up a main practice or satellite web site. Will sell individual DNs or the entire lot. Email neilzemmel@mac.com for info.

SOUTHBEACHCOSMETICSURGERY.COM

SOUTHBEACHPLASTICSURGERY.NET

SOUTHBEACHPLASTICSURGERY.ORG

SOUTHFLORIDACOSMETICSURGERY.NET

SOUTHFLORIDAPLASTICSURGERY.NET

SOUTHFLORIDAPLASTICSURGERY.ORG

MIAMIBEACHCOSMETICSURGERY.COM

MIAMIBEACHPLASTICSURGERY.NET

MIAMIBEACHPLASTICSURGERY.ORG

MIAMICOSMETIC-SURGERY.COM

MIAMICOSMETICSURGERY.ORG

MIAMIFACIALCOSMETICSURGERY.COM

MIAMIFACIALPLASTICSURGERY.COM

MIAMIPLASTICSURGERY.NET

MIAMIPLASTICSURGERY.ORG

MOMMYMAKEOVERFLORIDA.COM

Classified Ad Policy

Rates for printed classified ads are based on word count and must be paid prior to publication. Logos, boxes and color enhancements can be designed for additional fee. The editors do not investigate positions of employment and assume no responsibility for them. ASPS reserves the right to accept, reject or cancel any advertisements in its sole discretion.

Ad Rates

■ 1 to 50 words: $165

■ 51 to 100 words: $305

■ 101 to 150 words: $440

■ 151 to 200 words: $555

■ 201 to 250 words: $763

■ More than 250 words: Contact jembrey@ plasticsurgery.org for “designed” ad options

To place a classified ad, email: Jeanne Embrey

Advertising Coordinator jembrey@plasticsurgery.org 847-228-3364

Visit the Job Opportunity Board plasticsurgery.org/job

ICOPLAST World Congress

Registration is now open for the second World Congress of ICOPLAST to be held on May 5-7, 2023! This meeting promises to be one of the largest international gatherings of plastic surgeons, with a 1,000 delegates hailing from 120+ countries.

Register now with code “ICPST23” and begin planning your trip to the Middle East’s fastest-growing, most dynamic and exciting cosmopolitan city.

Emirates Airlines is the o icial airline of the 2023 ICOPLAST World Congress and will provide special fares for ICOPLAST Congress delegates.

Robert Anderson, MD, Fort Worth, Texas, never doubted that he would one day become a medical professional – although if he had, the nine months spent between completing his undergraduate work and starting medical school would have removed all doubt. After graduating in early 1970, the next few months saw Dr. Anderson working in a factory that fired cinder blocks; selling the World Book encyclopedia door-to-door; cleaning huge vats for a nationally known bakery; and delivering dairy products early in the morning

“Those cinder blocks came out of the ovens and I stacked them,” he recalls. “By the end of my first day, I had worn holes in two sets of new, heavy gloves and my back hurt so much. I decided that was something I didn’t want to do. Next, I trained to sell encyclopedias and then cold-called people where I lived in Ogden, Utah. Some people would send in a card requesting a presentation, at the end of which they’d receive a single volume, but you could tell right away they weren’t going to buy the set. That was very uncomfortable for me; I felt like a used car salesman. That job didn’t last, either.”

He then worked at a Wonder Bread plant that made Hostess products, a night job that, among other duties, required him to lean into a front-load mixer outfitted with moving blades that combined the ingredients for the dough. “If someone had turned on the mixer, you’d break a lot of bones or be killed, Dr. Anderson recalls. “That was a bit scary, as some of my coworkers weren’t the most reliable people.” There was a tasty fringe benefit, however, as he was allowed to eat all the Ding Dongs, Snowballs, Ho Hos and Twinkies he desired.

He concluded his spring/summer job circuit by delivering products for Crème of Weber Dairy in Ogden – a job that depended upon a set route with delivery instructions for several addresses and demanded an unexpected level of athleticism.

“One house had the instructions: ‘Run up quickly, put the product in the box and run back; if there’s a mistake, don’t go back.’ The homeowner had so many thefts from his dairy box that he’d get in the bushes with his shotgun when he heard the milkman come up – and he was ready to shoot anyone who approached it,” Dr. Anderson says. “A note for a different house read: ‘Make two snowballs from the crushed ice in the truck; you’ll have to throw one at the dog that chases you up, and throw another when he chases you back.’ ”

Dr. Anderson says that although the work he performed in this period was demanding and harsh, it never swayed his desire to enter medicine – but it did create an appreciation for the men and women who toil daily under difficult conditions, just to earn a living. “We’re all in the same boat, trying to support our families and help others as best we can,” he says. “Knowing that God created us in His image keeps me focused on caring for my patients as I would like my family treated.” PSN

SURGEON SPOTLIGHT

Editor’s note: The bulk of PSN’s pages are devoted to specific elements of our mission statement – to keep members informed of the social, political and economic trends and educational opportunities that affect the specialty of plastic surgery.

PSN is pleased to take liberties with the “social” aspect of its mission statement by presenting a good-natured look at the lives of notable members who we believe are making significant contributions to the specialty.

In this issue, we present ASPS member Thomas Satterwhite, MD, San Francisco, founder and CEO of the group practice Align Surgical Associates. Dr. Satterwhite is a returning member of the ASPS Annual Meeting Educational Committee and PRIDE Steering Committee, and he’s also served several turns on the Resident Curriculum Review Committee. Dr. Satterwhite found time between tweaking his mother’s Chicken Adobo recipe and learning the game of chess to answer the following questions for PSN:

If I had to start my career over, I would... Do exactly the same thing and follow the same path – bumps and all. I wouldn’t be the person I am today if it hadn’t been for the experiences (good and bad) that shaped me. I’m truly grateful and honored to be a plastic surgeon.

The best thing I ever purchased for my office is... A cooling vest, as I run on the hot side – so being in the O.R. wearing a gown and being under the lights is unbearable for me. Therefore, in our surgery center I wear a vest attached to an ice chest that pumps ice-cold water throughout it as I operate. Otherwise, I’d be a sweaty mess.

The best thing a grateful patient gave me was... A drawing by a transgender woman for whom I performed facial feminization surgery. She’s a rather accomplished artist and comic book author who gave me a wonderful, personalized drawing of one of her comic book heroes. I’ve since framed it and have it hanging in my office.

The best dish I cook is... Chicken Adobo, which is the only dish I know how to cook. My husband is a phenomenal cook – he enjoys it much more than I do, and he’s definitely much more efficient and patient in the kitchen than I. I learned how to make Chicken Adobo from my mom, who’s Filipino. It’s very simple to make and hard to mess up. It’s a savory mixture of chicken, soy sauce, vinegar, brown sugar, bay leaves, pepper, onions and garlic, and it’s left to simmer for hours. By the time it’s done, the meat is falling off the bones. (It’s always served with white rice.) I’ve tinkered with it over the years but can’t quite get it to the same level as my mom’s.

During the shutdown, something outside of medicine that I worked on was... Chess. I had never played chess in my life, so I took the opportunity to learn it with my son after watching the TV show “The Queen’s Gambit.” He’s age 9 – and he’s become a much better player than me.

I couldn’t operate without... Debby, my physician associate. She’s been a godsend. I’ve worked with her for almost nine years, and not only is she technically gifted, but her clinical skills are superb – and she’s one of the kindest, most patient, selfless and compassionate human beings I know.

My all-time favorite movie is... Poltergeist. Since I was a kid, I’ve been a fan of thrillers and horror movies. Nowadays, it’s difficult to come across a thriller with a good, original plot; everything seems so formulaic and predictable. Movies such as Poltergeist, Carrie, The Shining, Halloween and The Silence of the Lambs are classics, and nothing can come close to recreating some of the great thrillers of this period. It’s not just the shock factor – it’s the wonderful, brilliant, well-calculated storytelling that keeps me enthralled.

20 YEARS AGO IN PSN

As lawmakers let Medicare reform stagnate while focusing on improving the economy and fighting the war on terror, plastic surgeons advocated the importance of reform to Congress after the proposed 2003 physician fee schedule contained a 4.4 percent pay cut.

ASPS members discussed the ramifications of inaction and why Congress needed to be pushed in the January 2003 issue of PSN:

“It’s a tough battle. But not one we are unfamiliar with. Nor is it one that our lawmakers are unfamiliar with. It will take more focus and attention, and certainly more advocacy from ASPS and other specialty groups to get lawmakers in Washington to understand the importance of this situation to our plastic surgery specialty and to our overall healthcare economy.”

One perspective I’ve developed since COVID-19 arrived is... To let go of unhealthy relationships. Over the years, I realized that there were several personal and professional relationships that were more negative than positive, but I maintained them out of habit. The pandemic gave me breathing space to reassess relationships and focus on those that actually make me a better person – family, friends and close colleagues.

The best part of next weekend will be... Spending time with my family. My husband, Harald, and 9-year-old son, Alexander, are my priority. I make every effort to devote weekends to family time and avoid doing any type of work or checking email. We’re creatures of habit and do the same thing every weekend. We live in Marin County, Calif., and our favorite thing to do is to go to Muir Beach and hang-out there for hours. We bring our beach chairs and a cooler with snacks, and we sit and watch the waves.

The words I try to live by are... “The best way to get things done is to simply begin.” There are times when I’ve been worried about starting something because of fear of failure or that it may not come out perfectly. But this only turns to procrastination, if not complete paralysis. I’ve learned that it’s best to jump into things even if I don’t have 100 percent of the information and there’s a chance for failure. I live my life with no regrets. Even with mistakes and “bad” decisions, I always try to glean something positive. There’s always something to learn about every encounter. Life is about experiences and enjoying the process, not just trying to attain the final goal. PSN

MILKMAN, CLEANER, SALESMAN AND LABORER – DURING ONE BREAK

Dr. Anderson dons a “throwback” uniform recalling his brief stint in 1970 as a delivery man for Crème of Weber Dairy before he started medical school.

– 2003 ASPS Representative to AMA John Derr Jr., MD Louisville PSN

Thomas Satterwhite, MD

Dr. Satterwhite, his son, Alexander, and his husband, Harald, enjoy the waters off the coast of Cabo San Lucas, Mexico, in late December.