Plastic Surgery Training and the ACGME Guidelines: Evaluating Patient Satisfaction in a Resident Clinic

Goals/Purpose:  Resident cosmetic surgery clinics, or “chief clinics,” are arguably the most effective way to provide cosmetic surgery training.  Approximately 70% of plastic surgery training programs utilize a “chief resident clinic” to augment their cosmetic surgery experience, even though a quantitative outcome scale is lacking to guide education.  We report the use of the FACE-Q, a novel patient outcome tool, to evaluate patients’ satisfaction with non-surgical facial rejuvenation performed by residents. 

Methods/Technique:  The FACE-Q “Satisfaction with Facial Appearance Overall scale” was administered to patients prior to and one week after receiving non-surgical facial rejuvenation performed by plastic surgery residents.  All patients received non-surgical facial rejuvenation with botulinum toxin A and hyaluronic acid, free of charge, as part of resident facial aesthetics training. 

Results/Complications:  Eleven patients completed the pre- and post-injection FACE-Q survey.  Average overall facial appearance satisfaction scores of 47.6 pre- and 51.1 post-injection were found, with a total possible range of 17-68.  Ten patients (91%) reported feeling satisfied or very satisfied with the overall appearance of their face following injection.  Table 1 demonstrates patient pre and post-injection FACE-Q scores.

Conclusion:  Our experience supports utilization of the FACE-Q to optimize and endorse resident cosmetic surgery clinics.  The learning curve for facial cosmetic procedures can be adversely affected by limited time availability or exposure to improvement variables when initially performing the procedure.  It is imperative to any technique that direct, and preferably quantitative, feedback is given so that an immediate modification can be generated and successive patient outcomes improved.

 

Region	Pre-Injection	Post-Injection
Overall Face                      17 questions, max. score (ms) 68	47.6	51.5
Tear trough                      16 questions, ms 64	32.7	30.0
Cheekbones                      12 questions, ms 48	37.3	47.0
Nasolabial folds                   8 questions, ms 32	26.5	17.4
Marionette lines                  9 questions, ms 36	22.5	24.3
Nasal bridge                      17 questions, ms 68	46.0	47.9