An international survey of craniofacial surgeons: current trends in practice

Craniofacial surgery is a diverse subspecialty of plastic surgery that focuses on a wide range of head and neck pathology in children and adults. The purpose of this study was to define the characteristics of this group of surgeons and to compare subgroups within the specialty.

A 36-question, anonymous, electronic survey was sent to 403 craniofacial surgeons; the response rate was 30% (121). Distribution was to members of the International Society of Craniofacial Surgeons and to graduates of fellowships recognized by the American Society of Craniofacial Surgeons. Data were collected and analyzed for surgeon demographics, geography, practice setting (academic vs private), case mix and volume, and career satisfaction. Comparisons were made between US and international surgeons, males and females, and surgeons of different ages.

The craniofacial surgeons in this study ranged in age from 29 to 75 years (mean, 53 years); 92% were male, and 8% were female. They are largely academic (69%), high in academic rank (54% full professors), predominantly male (92%), and actively practicing craniofacial surgery. There are significant differences between international and domestic surgeons in terms of training background (64% vs 36% plastic surgery residency, P = 0.003) and volume of craniofacial surgery (56% vs 26% performing more than 5 complex craniofacial procedures per year, P = 0.002).

Craniofacial surgeons are a highly successful academic group with high career satisfaction. There are significant differences between US and international craniofacial surgeons in terms of demographics and practice, with more US surgeons performing fewer major craniofacial osteotomies. There is a significant gender disparity, which warrants further study.