Training in Aesthetic Surgery at a University Clinic - The "Munich Model"

Background: Aesthetic surgery is regarded as one of the 4 pillars of plastic surgery. To assure safety in this field of surgery, a structured and well guided surgical training is indispensable. However, during the specialist training for plastic and aesthetic surgery, plastic aesthetic interventions are often carried out in low numbers only. Objective of the present study was the development, implementation and evaluation of a new training concept in aesthetic surgery. Patients: Over a period of 2 years, 304 aesthetic operations were performed in the fields of body contouring, breast surgery and facial surgery as an educational surgery. Educational surgeries were performed by resident surgeons under the guidance of experienced specialists and under favourable financial conditions. As indicator for safety of the interventions, the incidence of complications was recorded and assessed. Results: Out of a total of 304 operations included in the study 47.7% were performed as an educational surgery. In the fields of body contouring and breast surgery, the majority of interventions (51.3% and, respectively, 53%) were carried out as educational surgeries. In aesthetic surgeries of the face only 28.4% were educational surgeries. In 4.9% of all cases complications occurred. The incidences of complications were approximately the same in the educational surgeries (5.5%) and in the surgeries carried out by experienced specialists (4.4%), showing no significant difference. Conclusion: The presented training concept aims at ensuring high quality in patient care by structure and quality of surgical training. Our data give evidence that a structured training of residents in the field of aesthetic surgery is possible without loss in quality. We expect that sufficient surgical education and the associated quality will consequently contribute to keep aesthetic surgeries a domain of plastic surgery and to prevent these procedures from being taken over by other surgical disciplines.