Facial Cosmetic Surgery Training in American Oral and Maxillofacial Surgery Residency Programs

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Facial cosmetic surgery is rapidly being incorporated into the contemporary oral and maxillofacial surgery (OMS) practice. The Commission on Dental Accreditation (CODA), the accreditation body for American Oral and Maxillofacial Surgery residencies, mandates a minimum requirement in 4 major categories. Facial cosmetic surgery procedures are included in the “Facial Cosmetic and Reconstruction” category. This requirement stipulates that each graduating resident must complete at least 20 facial cosmetic and/or facial reconstructive procedures. We hypothesized that some OMS programs meet and exceed the minimum graduation requirement set forth by the CODA in the facial cosmetic and reconstruction category solely with cosmetic procedures. We also speculated that some OMS programs surpassed the minimal graduation requirements of medical specialties most commonly associated with performing facial cosmetic procedures. Finally, the research was intended to investigate whether there was a difference, in terms of cosmetic surgery experience, between 4-year OMS certificate programs and OMS programs with an incorporated medical degree (dual degree or 6-year program). Surveys were sent to all 102 CODA-accredited OMS programs. These data were analyzed to evaluate the total number of facial cosmetic procedures completed at each institution over a 5-year period and the average number of facial cosmetic surgery procedures per chief resident. In addition, a comparison was made between single and dual degree programs. Finally, these numbers were compared with medical residencies/fellowship accredited by the Accreditation Council for Graduate Medical Education (ACGME). Twenty-two of 102 programs returned the survey. Over the 5-year period (2011-2016), accredited OMS programs completed an average of 211 facial cosmetic procedures ranging from zero procedures to 1073. Genioplasties and rhinoplasties were the most common facial cosmetic surgery procedures tallied. Four-year OMS programs completed 20.3 procedures per chief resident while dual degree programs completed 9.7 cases on average. OMS programs with the largest volume of cases reached and exceeded many of the minimum procedure requirements set forth by plastic and reconstructive surgery residency programs and American Academy of Cosmetic Surgery Fellowships. With the vast differences among training requirements, it is challenging to assess what is a reasonable number of procedures to ensure a surgeon is comfortable and, more importantly, competent and proficient. When compared with the variability of requirements from medical specialties that commonly perform facial cosmetic procedures, the data support that comprehensive experience in facial cosmetic surgery is attainable within American Oral and Maxillofacial Surgery Residencies.