Building the Ideal Aesthetic Fellowship: Lessons Learned From 25 Years as a Fellowship Program Director

Aesthetic fellowship in plastic surgery has evolved substantially since The Aesthetic Society joined the San Francisco Match in the 2017 to 2018 application cycle. Recent match data demonstrate a marked and sustained increase in applicant interest, with fellowship position fill rates rising accordingly. Drawing on data from national resident and program director surveys, recent match analyses, The Aesthetic Society endorsement criteria, and the senior author's personal experience, this article examines what the ideal aesthetic fellowship should provide. We propose 5 defining features: breadth of exposure, graduated autonomy under close mentorship, elective time, protected time for clinical research and cadaver dissection, and education in the business and ecosystem of aesthetic practice. As competition within the aesthetic marketplace continues to grow, fellowship training will likely remain central to positioning plastic surgery graduates for long-term excellence.