Current Trends in Aesthetic Surgery Fellowship Training

Goals/Purpose: The Aesthetic Society-endorsed Aesthetic Plastic Surgery fellowship application process became formalized in 2017 under the San Francisco Match. Since that time, the number of Society- endorsed aesthetic fellowship positions has grown substantially. Over the same period, positions for post-graduate plastic surgery fellowship training in Craniofacial Surgery, Hand, and Microsurgery have also increased. However, the impact of these increases on resident applications, program fill, and program match rates has not been evaluated. The present study compares the changing landscape of available positions, applicant interest, match rates, and program fill rates across Craniofacial, Hand, and Microsurgery fellowships as well as with Facial Plastics fellowships through Otolaryngology.

Methods/Technique:

San Francisco and NRMP Match data for Aesthetic Plastic Surgery, Craniofacial Surgery, Microsurgery, and Hand Surgery fellowships were obtained from 2018-2022. Program, position, and application numbers were also obtained for Facial Plastic Surgery fellowships through Otolaryngology over the same time period. The data were evaluated to assess the absolute and relative impact of the number of available positions on applicant interest and match rates.

Results/Complications:

The number of Aesthetic Plastic Surgery positions increased 143% from 17 positions upon joining the SF Match in 2018 to 41 positions in 2022. Over the same time period, Facial Plastics increased positions by 11% from 50 to 59. Craniofacial Surgery, Hand Surgery, and Microsurgery saw more modest growth with increases of 3.4%, 6%, and 2.5% respectively. Despite these increases, there was no significant change in either the relative or absolute number of resident applications to any of the post-graduate sub-specialty fellowships over the period studied.

Consequently, match rates for aesthetic surgery increased from 60.7% in 2018 to 89.3% in 2022. However, match rates for craniofacial, hand, and microsurgery had little change over the same time period (77.4%-72.7%, 90.4%-92.8%, and 69.4%-76.9% respectively). The percentage of unfilled aesthetic and craniofacial positions increased (0%-39.0% and 17.2%-46.7% respectively), while unfilled positions in microsurgery and hand remained unchanged (15.0%-15.2% and 3.4%-3.2% respectively).

Conclusion:

The marked increase in the number of positions and improved match rates for Aesthetic Plastic Surgery fellowships have not been followed by an increase in relative or absolute numbers of fellowship applications. Similarly, increasing numbers of positions in Craniofacial, Hand, Microsurgery, and Facial Plastics fellowships have not been followed by a greater number of applications to these programs.