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Published on: August 19, 2025
Enhancing Aesthetic Breast Surgery Training: A 10-Year Comparison of Outcomes Between Resident- and Attending-Led
Hilary Y Liu1, Christopher J Fedor1, Sumaarg Pandya1
1University of Pittsburgh Medical Center, 1350 Locust Street, Pittsburgh, PA, 15219, USA.
Background:
The resident aesthetic clinic is a practice in which plastic surgery residents oversee patient care, thereby gaining autonomy and hands-on experience in cosmetic surgery.
Objective:
This study evaluates outcomes of resident-led cosmetic breast surgeries in a resident aesthetic clinic compared to attending-led procedures.
Methods:
A retrospective analysis was conducted of patients who underwent cosmetic breast surgery at a single institution's resident clinic from 2012 to 2021. Resident-led cases were matched with attending-led cases, and comparisons in demographic information, procedure type, operation details, follow-up, re-operations, and complications were performed.
Results:
Among 134 female patients at a resident aesthetic clinic, 27 (20.1%) underwent breast augmentation, 7 (5.2%) had mastopexy, and 12 (9.0%) received augmentation mastopexy, with a matched control group of attending-led cases. Residents favored silicone implants and inframammary incisions, while the attending preferred saline implants and peri-areolar incisions (p < 0.001). For breast augmentation, complication rates for breast augmentation were similar between residents and attendings (18.5% vs. 11.1%, p = 0.704), with identical re-operation rates (11.1%; p = 1.000). In mastopexy, residents had no complications, while attendings had a 25% complication rate (p = 0.467). In augmentation mastopexy, complication rates were 25.0% for residents and 33.3% for attendings (p = 0.500), with lower re-operation rates in residents (0.0% vs. 16.7%, p = 0.238).
Conclusion:
Resident-led cosmetic breast procedures demonstrate comparable safety outcomes to attending-led surgeries, supporting the efficacy of resident training in aesthetic surgery and highlighting the importance of resident-led clinics in surgical education.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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