Using a Doctor in a Fellowship Program - Opinions?

I am 51 and in excellent health. I see a facelift in my near future. I have made several appointments for consults. One of the Drs. is highly skilled and at the top of the food chain in our area. Along with that comes a higher price tag. Rightly earned I am sure. He does have at least one Dr. in his Fellowship program. Of course their costs are much lower for obvious reasons. What is the skill level of these Drs? Can you tell me more about the training they go through during this program.

Doctor Answers (21)

Fellowship doctor doing your surgery

+4

There are several questions you should ask of the Fellowship Director before having his or her fellow be the primary surgeon.  Among the most important are:

- How many of these procedures has the Fellow seen? Done?

- Will you, as Fellowship Director, be in the operating room - or just available?

- Do you, as Fellowship Director, feel that the Fellow has sufficient technical skills and judgment to do the procedure competenty?

- How long is he procedure expected to last?

I have been a facial plastic surgery Fellowship Director for the past 16 years, and in selected cases my fellows do procedures at a reduced fee, but I am always present during the procedure, both for teaching purposes and for quality control.  Of course, there are only a limited number of these procedures done by the Fellow in any given year.


Springfield Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Facelift from fellowship

+2

Many good posts here.  Your questions should be similar to choosing another doctor for a facelift:

-What are their credentials?

-How many have they observed/performed?

-Will the fellowship director be in the room to observe/assist?

I have performed procedures during my fellowship experience under these circumstances with great results.  Usually, the patient was someone i knew, or they wanted to save money.  All surgeons do their first facelift sometime ( :

A fellowship director with a great reputation is unlikely to let a fellow operate under their direction unless they feel confident they will do a great job.  And remember, a fellow is a highly trained surgeon that already has good surgical skills.  They are pursuing a fellowship to take their skills to the next level.  Best of luck, and let me know if you have any additional questions.

Richard Castellano, MD
Tampa Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

To fellow or not to fellow, that is the question

+2

I am 51 and in excellent health. I see a facelift in my near future. I have made several appointments for consults. One of the Drs. is highly skilled and at the top of the food chain in our area. Along with that comes a higher price tag. Rightly earned I am sure. He does have at least one Dr. in his Fellowship program. Of course their costs are much lower for obvious reasons. What is the skill level of these Drs? Can you tell me more about the training they go through during this program.

speaking personally, I was a good fellow with excellent results. I was better after 5 years of practice. better still after 10. now after 15 I think I'm even better. naturally my fees have gone up as well. What you pay depends on your perception of value. when it comes to yur face, you have to determine your risk profile. that is not talking about safety. the fellow will be safe. I am talking about YOUR risk aversion profile. good luck.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

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Surgery by a trainee or an experienced surgeon - they are not the same

+2

All of us were trainees once and all of us know that we are much more skilled surgeons now after years of practice.  So, to save dollars you can have a trainee do your surgery but you need to know that the result will almost certainly not be quite as good as if it were done by the top surgeon in your area.  You need to make that call but don't "hope" that you can get the best result for less from a rookie.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

Should you allow a facial plastic surgery fellow to perform your surgery?

+2

This is a fantastic question. I would echo my colleagues' comments that fellows just like board certified surgeons carry different levels of experience, technical skill and confidence. You will save money having a Facial Plastic Surgery fellow perform your surgery but there is a trade-off. In many cases, the fellowship director is willing to be present for the entire procedure or for the critical portions of the procedure (incision planning, SMAS elevation, etc). I would recommend that you meet and discuss your surgery with the fellow and fellowship director. My colleagues have described great questions that you can ask about the arrangements for surgery. Cosmetic procedures that I performed during my fellowship were closely scrutinized by my fellowship director and that level of supervision is helpful both for the patient and the trainee surgeon. Lastly, the "fellow" will likely be a fully-qualified "surgeon" in a mere two months after their fellowship ends. They have likely performed several thousand surgical procedures already during their training. I hope that this is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 43 reviews

Surgery done by fellows

+2

As a former facial plastic surgery fellow, I am sympathetic to your situation. In order to be a fellow, the surgeon has already completed a surgical residency and may even be board certified. When doing a facial plastic surgery fellowship, the fellow is generally assisting during the director's surgeries and may have his or her own patients. It is important to ask if the fellow will be directly supervised by the director and if there is a complication or further procedures are needed, will that cost be included in your surgical fee and will the revisions be done by another fellow or by the director. Depending on the fellow, you could get a comparable result to that done by the director, but at less cost. If you decide on having surgery done by the fellow, I would wait until the end of the fellowship period so that he or she has as much observational experience as possible.

Gregory J. Vipond, MD, FRCSC
Inland Empire Facial Plastic Surgeon
4.5 out of 5 stars 5 reviews

Skill levels of Fellows are well below the established surgeon

+2

 I was a fellow and have trained numerous ones over my 20 plus year career.  You get what you pay for.  The fellow will learn from performing your Face Lift, that's how we all learned.  If you're OK with that, then it's a good match but be certain that you understand the fellow's skill and experience level performing your Face Lift will be a quantum level below that of the established plastic and cosmetic surgeon.  Experience is the key. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

I am sure the fellow is a very capable person.

+2

Having said that, they are still in the sheltered womb of their fellowship.  They have not been subject the battle for survival that occurs in practice where some surgeons establish themselves as sought after, world class surgeons and other don't.  The senior surgeon who trains fellows is a survivor.  That is why he or she is out training the next generation of surgeons.  Of course the fellow needs practice and that is why their services are offered at a discount.  Now this is your face we are talking about.  Putting it another way, if you need a brake job, do you want the cheapest brake job or the best break job?  Despite the desire to believe that the cheapest job will be everything the best job is, we all know that it is often true that you get what you pay for.  Choose carefully.  This is not a place to cut corners.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

Plastic Surgeon Fellows are like all plastic surgeons, skills and experience vary.

+2

All plastic surgery fellows need to have some experience in cosmetic surgery to enable them to go into practice with confidence that they are truly trained across the wide spectrum of plastic surgery.

You need to have a consultation that includes the fellow and ask questions r.e.:

  • will he be supervised or working independently?
  • will you be his first case or more in the middle of his year?
  • how long will it take him to do your surgery and what will be the ancillary cost. (trainees typically take longer and some of the cost saving may be used up by increased anesthesia and operating room cost.
  • who will be providing your followup care and will you have access to the resources such as aesthetics, makeovers, etc.

Just as you need to choose your plastic surgeon carefully, you now need to choose the fellow with the same care.

In order to have well trained plastic surgeons, we must have well trained fellows.  You are likely to be helping both yourself and the fellow if you choose well.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD
Fort Lauderdale Plastic Surgeon
4.5 out of 5 stars 7 reviews

Using a fellow for surgery

+1

This entirely depends on the skills of the fellow you are selecting.  The patient in the link below was my first unassisted face lift performed during my fellowship year, and she received about 40% off the standard fee.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 145 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.