Using a Doctor in a Fellowship Program - Opinions?

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.

The surgeon you refer to in Birmingham is very consciencious and would be the one to ask about the skill level of his fellow.  In his case, his fellow is not permitted to operate independently until he/she has demonstrated skill and safety to the satisfaction of the fellowship director.  Fellows earn their position after they have completed residency, so the individual is already experienced and at least Board Eligible in a surgical specialty.

That being said, fellow or not, all aesthetic surgery comes with risk.  You are best to go with someone you trust and who has a demonstrated track record achieving the kind of results you desire.  If you can't afford the surgeon you want, consider saving a little longer and working toward that goal.  Many patients like you think hard about this process and are balancing their goals against the financial constraints they have.  Let me offer you a scenario:  If a plastic surgeon offered you a FREE facelift and you knew you had a much much higher chance of having a bad outcome, would you risk it?  Cost is a factor, but you should rank it BELOW your goals.  If you genuinely feel you would get the same results between two surgeons you trust and who have demonstrated to your satisfaction their skills, then consider cost.

All the best!

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.

This will vary with the program and involvement of the main surgeon.  They are skilled surgeons and were selected from many applicants so you are dealing with surgeons who are at the top.  There is no substitute for experience, but their training is learning from those who have years of experience.  Ask for photos of patients before and after, and then make your decision.

There is significant fee variety all over the country and around the region for different facial rejuvenation and all cosmetic related procedures. Often, it is related to the experience and expertise of the surgeon. This is one time where you should not trust your face, your breasts, or your body contouring to the lowest price of a surgeon or a billboard with a “new look” offer. In medicine and in life, you get what you pay for. You only have one face, one nose, and one body that you want to re-shape or restore. Secondary cosmetic surgery is far more difficult and the results are far less appealing and satisfying than having it done right primarily. Choose your Board Certified Plastic Surgeon wisely based upon experience and expertise in facelift surgery.

 

I, like many of my colleagues on this website, performed Facelifts during my fellowship.  Were the results good and the patients happy?  Yes.  Are my Facelift results much better 10 years later?  Absolutely.  As you mentioned in your question, experience and skill come with a price.  Although you can obtain an adequate result from a Surgeon in fellowship, the risk of being less than satisfied is inevitably higher than a Facelift with an experienced Surgeon.  Likewise, your access to follow up may be limited.  You must weigh these concerns with your concerns about cost and make the best decision you can.

Just like for any surgery, experience and training matters. Speaking from experience, some fellows perform hundreds of facial procedures on their own in well designed "hands on" fellowships. However, some fellowships are more observatory in nature with little hands-on experience. Should you decide to have a fellow perform your surgery, than you would ask this beginning surgeon to view his/her before and after photos and speak to former patients, just like you would any other surgeon.

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

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.

Residents or Fellows are already good surgeons. They just lack experience. A good fellowship director should monitor all surgeries carefully. Therefore you should be in good hands.