Procedures with best expected outcomes?

Hello. Due to costs, I am exploring having a few procedures done at a residency clinic- ideally UCSF or Stanford. Of course I am concerned about the experience of the surgeon. My question is - what procedures have the best expected outcomes? Maybe another way to ask is, what procedures are most predictably successful. I a specifically interested in a face lift and brow lift, with a possibility of fat transfer. Might the brow lift be the "safest" procedure to have done at a residence clinic?

Doctor Answers 16

Considering surgery at training program

That is a difficult question to answer as there may be complications following any type of surgery.  I do not think that brow lift is any more predictable than face lift surgery.  It is important for your surgery to be executed with technical skill as well as an aesthetic sense that will help you achieve your goals.  It may be worthwhile to consult at a resident clinic to meet the surgeon-in-training and learn more about the supervision process.  The trainee would be operating under a board-certified plastic surgeon.  If you feel comfortable after becoming well informed, then that is certainly your decision.  If you have any reservations or are choosing the resident clinic exclusively for cost savings, it may be worthwhile to wait a little longer or look into financing options with a board-certified surgeon with whom you feel comfortable.  It is important to consider that revision surgery if needed in the future is always more complicated and less predictable than the primary procedure.

Stephanie Power MD, MSc, FRCSC

Residency clinic

I would ask the resident which procedure he is most comfortable with. I would predict that the complication rate will be higher and the effectiveness less of any procedure done by a resident compared with a practicing surgeon. So much is leaned through experience and time. 
At the end of the day, you truly get what you pay for and this is especially true in cosmetic surgery

Best of luck

Procedures with the best outcomes.

Good outcomes depend on a number of factors, ie, your anatomy, your tissues, your health, plus your surgeons skill and aesthetic sense.  Choosing a surgeon at a highly respected program like Stanford is a good choice.  As the resident will be monitored and directed by the surgeon, so review the surgeons before and after photos.  While there are a nember of "different" facelift/necklift procedures, most involve some form of lifting and shaping the face using the SMAS layer and then smoothing the skin over the top of the SMAS.  Done well, this gives highly predictable results.  Subcutaneous brow lifts also give predictable results and is a very simple procedure to preform.  The least predictable results are from the fat grafting/transfer, as the volume retained and the uniformity of retention is not predictable.

Surgery Choice

Thank you for your question.  The best surgical choice, is the one you want.  In terms of best success- plastic surgeons are trained in various surgeries and techniques.  It would be best to have an experienced surgeon, but in a residency clinic, the residents are typically supervised by experienced surgeons.  Make sure you have your questions written in advance and that you feel comfortable with the treatment plan.  All the best,

Keshav Magge, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 27 reviews

What are the most predictable procedures for the face

Hi Swingforthefences, your question is a very difficult question. The most important factor when evaluating outcomes is surgeon experience. A resident surgeon may be very knowledgeable and technically sound however he or she will lack experience. There is a chance you could have a great outcome but it is definitely less predictable than if you went to a surgeon with a proven track record.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Browlift with Fat Transfer

Dear swingforthefences, There are many different techniques in brow-lift procedures depending on the patients needs. Personally, I perform the majority of my brow lift procedures with an endoscopic approach where I undermine past the zygomatic arch and also give the patient a mid face suspension with the procedure. These techniques have been highly modified through my thirty years of experience and now this procedure is one of the most requested procedures in my practice. I am not sure I would entrust my face to a resident surgeon for such procedures. If you do please be highly informed as to who else will be present in the operating room. Is the chief resident going to be performing the surgery or the resident. Seek as much information as possible. I have enclosed a link below of a endoscopic brow-lift with fat transfer patient to give you an idea of an expected result in this procedure. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 196 reviews

Procedures with best expected outcomes?

You are asking two questions, one is about safety, the other about outcome. I'm sure the residency surgical program is safe. When dealing with facial rejuvenation I would look to someone with a minimum of several years of experience if you are looking for best outcome unless the resident will have an experienced surgeon in the room at all times. Many University surgeons have tremendous experience with very difficult reconstructive surgeries and little cosmetic surgical experience so make sure you ask all the right questions. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Facelift, browlift and fat transfer

 Fat transfer tends to be the least predictable of the 3 procedures, and we rarely perform them. It is acceptable to have Resident performing the facelift and browlift procedure, however it's more important to look at who is going to be supervising the surgery. Look at the supervising physician's before and after photo gallery and experience with the procedures.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Best procedures for a residents' clinic

Thank you for asking about your face and brow lift.

  • UCSF and Stanford have great training programs and great plastic surgeons.
  • All of today's good plastic surgeons once were residents.
  • However any facial surgery is inherently challenging - 
  • And complications range from mildly annoying to severe.
  • The quality of the surgery depends on the surgeon -
  • There is no way to tell you in general what facial procedures is 'safest' -in the hands of a resident because it depends on the resident, just as it depends on the quality of the surgeon after training.
  • Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Outcomes of rejuvenation

There are far too many variables to give you a reliable answer here. The "best outcome" depends upon your current situation, anatomy, facial aging, and goals. Your outcome for the facelift may be better if your face is sagging more than your brows. Ultimately, you need to have confidence in the resident surgeon who is performing your procedure. I would talk to Hospital staff, and in particular, operating room nurses who have worked with that resident for the past few years to get a sense for whether or not he/she is excellent. As important, make certain that the supervising attending surgeon is excellent as well, as this is a safety net for the resident surgeon. I think speaking to those who work with the surgeons and residents is the best bet to get a sense of theirBest of luck!
Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA skill level. These hospital staff or his get to work with all of the residence and surgeons, and surely know who is talented.

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 48 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.