Impact of Gender-Affirming Surgery on Craniofacial Exposure for Plastic and Reconstructive Surgery Training: A Preliminary, Single-Institution Study

Abstract

Objective: Current available plastic surgery positions in craniofacial surgery are not commensurate with the growing number of trained plastic surgery residents and fellows interested in the field. Despite this, there is growing demand for surgery in other areas of the craniofacial field, such as facial gender-affirming surgery (GAS), in which academic plastic surgery programs can increase resident and fellow case exposure. The present study sought to characterize the increase in craniofacial surgery exposure with the introduction of a GAS rotation among plastic surgery residents at one academic medical center. Methods: A single-center retrospective review of ten plastic surgery resident case logs between 2013 and 2021 was carried out. Case logs were evaluated for case frequency per year in craniofacial surgery and breast reconstruction surgery, which was used as a control. Case frequency was compared before and after the introduction of the GAS rotation in 2017. Results: Craniofacial surgery exposure increased from an average of 26 to 45 cases per resident per year after the introduction of a GAS rotation and overall increased from 17 to 29 cases per year. The average breast reconstruction caseload remained similar at the same time, from an average of 37 to 36 cases per year per resident. Conclusions: The introduction of a GAS rotation at one institution increased craniofacial surgery exposure for plastic surgery residents. Increasing craniofacial surgery exposure is crucial in the competitive landscape for job opportunities, further increasing resident exposure to the transgender and gender-diverse population, and expanding care for this patient population.