|Simulation is key for success|
|Friday, 02 March 2012|
Matthew Kennedy reports on the Facial Aesthetic Surgery: Dissection Course for Surgeons, held at the RCSEd in November 2011.
Simulation is firmly established as a learning aid in surgical training. Aesthetic facial surgery in particular benefits from this method, as its exposure throughout specialist training is variable and inconsistent. Hands on opportunities are further limited with most procedures performed in the private sector.
RCSEd’s facial aesthetic surgery course is one of a series of cadaveric head and neck dissection courses run by the College. All relevant specialties were represented on the faculty with consultants from ENT, OMFS and plastic surgery there to offer expertise and share their experience.
“The format was deliberately weighted in favour of hands on dissection, with didactic teaching kept to succinct lectures covering key points in patient assessment”
The delegate list was a truly multi-national, multi-disciplinary mix, including plastic surgery, OMFS and ENT consultants, and trainees from the UK, Belgium, Germany, Norway and Australia. With six faculty members on hand for a delegation of 10, it made for a very comfortable and relaxed atmosphere, promoting plenty of discussion. The format was deliberately weighted in favour of hands on dissection, with didactic teaching kept to succinct lectures covering key points in patient assessment. Practical demonstration of the dissection technique followed immediately. Delegates then paired-up to share fresh frozen cadaveric heads.
The first session covered blepharoplasty and brow lifts. Techniques such as fat re-draping versus fat removal were demonstrated, the merits of each clarified before moving on to upper eyelid surgery. Endoscopic equipment permitted minimal access brow lift techniques to be performed using both resorbable and non-resorbable suspension methods.
The afternoon session was devoted to facelift techniques; Mid-face rejuvenation and minimal access cranial suspension (MACS). The cadavers provided a superb opportunity to demonstrate and observe the importance of the superficial muscular aponeurotic system (SMAS layer). The perils and pitfalls were discussed, with particular emphasis on safety around the facial nerve.
The second day commenced with neck lifts followed by pinnaplasty procedures. Closed rhinoplasty +/- nasal osteotomies completed the practical aspect of the course. A final demonstration harvesting rib cartilage brought the course to a close.
I would highly recommend this course to any surgeon with a developing interest in aesthetic facial surgery. The lectures were short, emphasising the salient points of each procedure. The practical demonstrations expanded on these points followed immediately by the opportunity to put them into practice on the cadavers.
Whilst no course can instantly provide the required competence to practice independently, it has certainly provided a solid foundation on which to build in future.
Matthew Kennedy MSc MFDS MRCS