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The Johns Hopkins and University of Maryland Resident Aesthetic Clinic: A 10-Year Review of Surgical Outcomes

Ainsley Taylor, BS1, Pathik Aravind, MBBS1,2, Myan Bhoopalam, BA, MS1, Jonlin Chen, BS1, Alisa Girad, MBS1, Salih Colakoglu, MD1, Kate Krucoff, MD3, Kristen Broderick, MD1, Nelson Goldberg, MD, FACS4, Paul Manson, MD, FACS1, Ariel Rad, MD, PhD1,5 and Sashank Reddy, MD, PhD1, (1)The Johns Hopkins University School of Medicine, Baltimore, MD, (2)Yale University School of Medicine, New Haven, CT, (3)Froedtert & Medical College of Wisconsin, Milwaukee, WI, (4)University of Maryland Medical Center, Baltimore, MD, (5)SHERBER+RAD, Washington, DC
Goals/Purpose: The Plastic Surgery Residency Review Committee of the ACGME recently increased minimum aesthetic surgery requirements. Consequently, the resident aesthetic clinic (RAC) has become an ever more important model for providing plastic surgery residents a dedicated space to train in a diverse range of aesthetic procedures. However, reports on long-term surgical outcomes for patients utilizing the services of these clinics are limited. In this study, we analyze demographics and long-term surgical outcomes of all aesthetic procedures performed at the Johns Hopkins and University of Maryland (JH/UM) RAC. Patient safety and surgical efficacy is then compared against peer RACs and national benchmarks.

Methods/Technique: We performed a retrospective chart review of all patients who underwent aesthetic procedures at the JH/UM RAC between 2010 to 2020. Incidence of major complications was compared to peer RACs and the CosmetAssure database. CosmetAssure was utilized as a national outcomes benchmark. Revision rates and demographics were compared against peer RACs only. We used Pearson’s chi-square test to compare complication rates between patient populations, with a significance set at 0.05.

Results/Complications: Across the 10-year study period, 491 procedures were performed on 285 patients (mean age 47.1 years; mean follow-up 129.2 days). Of the 491 procedures performed, 73 patients underwent 78 breast-related procedures, 169 patients underwent 199 body contouring-related procedures, and 95 patients underwent 214 facial-related procedures. The most common procedures for breast, body, and face were breast augmentation (n=33), abdominoplasty with or without liposuction (n=118), and blepharoplasty (n=55), respectively. There were 9 major complications (1 from breast procedures, 2 from body contouring, and 6 from facial procedures) with an overall major complication rate of 1.8%. Peer RACs had comparable complication rates of 1.7% and 0.2%, while CosmetAssure had a major complication rate of 2.0% (P=0.76). Incidence of complications between CosmetAssure vs the JH/UM RAC were as follows: 1.5% vs 1.3% (P=0.89) for breast surgeries, 2.7% vs 1.0% (P=0.15) for body contouring surgeries, and 1.1% vs 2.8% (P=0.02) for facial procedures. Revision rates for each procedure type at the JH/UM RAC was 6.9% for breast, 12.6% for body contouring, and 10.3% for facial. Overall revision rate was 10.6% while RACs at peer institutions reported revision rates of 12.8% and 2.9%.

Conclusion: The JH/UM RAC provided plastic surgery residents with training in a diverse range of aesthetic procedures while producing surgical outcomes comparable to peer RACs and a national benchmark. This study supports the RAC model for achieving competency in aesthetic surgery without compromising patient outcomes.

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