Susan Orra

Applying to Integrated Plastic Surgery Residency Programs: Trends in the Past 5 Years of the Match.

Background: The average integrated plastic surgery applicant spends over

Pterygopalatine Fossa Anatomy for a Surgical Approach to Sphenopalatine Ganglion.

6000 for interviews. The average program director reviews over 200 applications per cycle. It is important to make the application process efficient and cost effective for both applicants and programs. The authors analyzed recent trends and the literature in an attempt to increase the likelihood that applicants match, suggest means of reducing applicants’ costs, and improve the process. Methods: A cross-sectional study of the National Residency Matching Program Charting Outcomes and results and data for the years 2009 to 2014 was performed. Applicant profile elements were examined for differences between matched/unmatched U.S. senior medical students. In addition, a literature review was performed. Results: The number of integrated plastic surgery positions rose from 69 in 2010 to 130 in 2014. Both matched and unmatched U.S. senior medical students have higher Step 2 scores, research and volunteer experiences, than 5 years ago. The likelihood of matching into an integrated plastic surgery residency has increased (2009, 52 percent; 2011, 44 percent; and 2014, 71 percent). Successful match rates were associated with Alpha Omega Alpha status and graduating from a top-40 ranked medical school (p < 0.05). Applicants with a lower number of ranked programs had increased match rates in 2014 than in previous years. Literature review revealed that program directors also value strong recommendation letters, publications, persistent work ethic (“grit”), away rotations, and an accurate curriculum vitae. Conclusions: Within the setting of increased applicant competitiveness, the authors recommend maximizing subjective qualities in order to differentiate themselves from a highly eligible applicant pool. In addition, applicants should diversify the types of programs at which they interview to maximize their chances of matching.

Periorbital Phenol-Croton Oil Chemical Peel in Conjunction with Blepharoplasty: An Evolving Technique for Periorbital Facial Rejuvenation.

AbstractThe sphenopalatine ganglion is an extracranial neural structure within the pterygopalatine fossa. Modulation of this region via implantation of a neuromodulatory device presents a novel therapy for the treatment of facial and head pain. Yet sex, race, and genetic factors contribute to morphological variations between individuals. This study defines the standards and variations of the bony landmarks surrounding the pterygopalatine fossa. One hundred dry skulls were analyzed from the Hamann-Todd osteological collection. Ten anatomical dimensions were measured on each side of the face for each specimen (vidian foramen, zygomatic buttress, zygomatic maxillary suture, pyriform rim, infraorbital rim, pterygoid maxillary suture, greater palatine foramen, auditory canal, and pterygoid fossa). A statistical analysis was performed for both sides of the face based on sex and race. When stratified by sex, 7 of the 10 measurements revealed a statistically significant difference bilaterally. When stratified by race, 5 of the 10 measurements demonstrated a statistically significant difference bilaterally. Both male and African American skulls showed greater hemifacial values bilaterally when compared with their respective counterparts. The only statistically significant measurement on both the left and right sides of all skulls was the length from the vidian foramen to the infraorbital rim. Defining the anatomical mean distance between skull landmarks and highlighting differences between sex and race not only provides further insight into relative skull anatomy, but also sets the stage for device innovation.

Milestones contributing to the evolution of craniofacial surgery

INTRODUCTION: Blepharoplasty can restore a youthful appearance to the periorbital region; however, surgery alone is often unable to address the issue of periorbital fine lines and hyperpigmentation. The literature is replete with publications regarding the efficacy of phenol-croton oil peel, yet, there is little specifically addressing peels of the periorbita. We present a series of patients who underwent a peel combined with blepharoplasty, or peel alone, in order to improve fine lines and/or hyperpigmentation. The authors describe their surgical methods and complications with this technique and how it fits into the plastic surgeon’s armamentarium for periorbital rejuvenation.

Who is Publishing in Facial Cosmetic Surgery? A Citation Analysis Across Specialties Over Five Decades

AbstractCraniofacial surgery (CFS) has a rich history of collaboration with a wide variety of surgical and nonsurgical specialties. This has resulted in a large volume of publications across this spectrum of subspecialties cataloging the advancements across the field. The authors aim to analyze the characteristics of the most cited articles in CFS. A literature search was performed using the Thomson/Reuters Web of Knowledge database to identify the top 50 most cited articles in CFS. The articles were analyzed for journal distribution, total citations, year of publication, citations per year, number of authors, type of article, institution, departmental affiliation, national affiliation, and top contributors. The articles were extracted from an assortment of 21 journals. The number of citations per article ranged from 115 to 1092 (average of 185). Forty-eight percent of articles were published in the 1990s, and 22% in the 2000s. The average number of years since publication until the present time was 21.34 (range 6–45 y). The most cited article (1092 citations and 52 citations/y) was an article by McCarthy et al on human mandible lengthening via gradual distraction. Departmental distribution indicated that the majority were attributable to departments of Plastic and Reconstructive Surgery for 21 articles (42%). Twenty articles were categorized under cranial defect/bone substitutes, 12 under craniosynostosis, 7 under surgical modeling, 6 under distraction osteogenesis, and the remaining 5 under other. These articles qualitatively represent important milestones in CFS. This study affirms the potential value of “number of citations” as a meaningful metric when assessing the importance of an article within CFS.