My Experience in IAAPS-accredited Aesthetic Surgery Fellowship Programme

Introduction

Plastic surgery is a broad specialty with a wide spectrum of cases like microvascular surgery, cleft and craniofacial surgery, hand surgery, aesthetic surgery and oncoplastic surgery. The scope for training in aesthetic surgery in academic hospitals during residency is restricted due to the limited caseload of aesthetic surgery in these hospitals. ¹ Hence, additional training is required in this area to achieve expertise in this field. There are well known aesthetic surgery fellowship programmes in countries like Australia, Canada and USA.^2–6 But less is known about such programmes in India.

IAAPS (Indian Association of Aesthetic Plastic Surgeons) has introduced its unique Gurukul Fellowships to bridge this gap, offering specialised aesthetic surgery training to board-certified plastic surgeons. Under the guidance of highly qualified mentors, fellows gain hands-on experience in high-volume aesthetic surgery centres. Currently, 15 centres across India offer IAAPS-accredited aesthetic surgery fellowships, providing specialised training in aesthetic surgery under expert mentorship. ⁷ I had the unique opportunity to attend the fellowship programme under Rajat Gupta. Through this article I want to share my experience so that this information might guide future aspiring plastic surgeons.

The Fellowship Programme

Rajat Gupta leads one of the busiest aesthetic surgery practices in the country, attracting patients from across India and abroad. His surgical team, comprising three surgeons under his leadership, handles a high volume of cases. During my one-month fellowship, I had the opportunity to observe and participate in 63 surgeries, covering a wide spectrum of aesthetic procedures (Table 1). Most of the patients had come for multiple procedures in the same sitting; hence, the number of procedures I witnessed were more than 100. The clinic is open from Monday till Saturday with surgeries done in the morning session from 8:30 AM till 2:00 PM in the afternoon. Most of the cases were done on day care basis but there is provision for inpatient admission. After a brief lunch break, the outpatient clinic would start which had both fresh patients and follow-up patients that would run till 7:00 PM. I was made to assist in all the surgical cases and had access to all outpatient department (OPD) cases, where I could observe patient assessment, making a treatment plan, patient counselling etc. Diagnosis and various treatment options were discussed in all cases.

Table 1.

Operative Procedures.

Sl No.	Surgical Procedure	No. of Cases
1	Gynecomastia correction (liposuction+gland excision)	23
2	360° liposuction	9
3	Abdominoplasty	6
4	Mastopexy	2
5	Breast reduction	2
6	Breast augmentation	3
7	Buttock augmentation	3
8	Chin augmentation	2
9	Blepharoplasty	7
10	Vaginoplasty	1
11	Face fat grafting	8
12	Otoplasty	2
13	Pinna repair	2
14	Scar revision	7
15	Umbilicoplasty	1
16	Rhinoplasty	2
17	Neck lift	1
18	Radio frequency neck skin tightening	14
19	Breast cyst removal	2
20	Facelift	1
21	Face laceration repair	1
22	Buccal pad fat excision	3

The faculty would also take time to teach the theoretical aspects and would include us in active case discussions. We also had access to various research articles, surgical videos and presentations made by Rajat Gupta.

We were included in the planning of management of the cases and were encouraged to come up with treatment plans.

Things That We Learnt

1. Planning: We were included in most of the preoperative markings with the patient’s consent which is done every day before the procedure. This helped us to get valuable insights regarding preoperative planning

2. Surgical procedures: As listed in Table 1, we got to see and assist in a wide spectrum of cases in aesthetic surgery. The learning experience by visually seeing and assisting the cases is unparalleled.

3. Technical expertise; Rajat Guptas team uses various cutting-edge surgical techniques like Vibration Amplification of Sound Energy at Resonance (VASER), radio frequency-assisted lipo-coagulation and power-assisted liposuction. We were taught how to use these equipment and how to calibrate them in a proper way. We also got to understand the functioning, proper technique to use them and maintenance of these instruments.

4. How to approach an aesthetic surgery patient? This is a very important aspect of aesthetic surgery practice and is seldom learnt by reading. Since we had access to all the OPD consultations, we could watch and learn from how Rajat Gupta and his team interact with patients and address their issues and counsel them.

5. Postoperative period: We were included in the postoperative dressings, application of postoperative pressure garments, mobilisation of postoperative patients etc. We also were included in the postoperative rounds. We learned a whole lot and developed new insights by the follow-up of the patients, including postoperative management, intraoperative–postoperative correlation of surgical techniques, patient feedback and complications if present and how to address them.

6. How to build a surgical team? Surgery is like a team sport. Rajat Gupta has a well-oiled team which consists of three surgeons, three anaesthetists, operation theatre (OT) nurses and technicians, inpatient department (IPD) and OPD staff. There is an excellent rapport between various team members and everyone knows their responsibilities. Since a well-coordinated team is present, procedures are standardised and time is conserved, thus giving patients the optimum results. We learnt the importance and the various aspects of team building and management by direct observation

Summary

Rajat Gupta and his team have provided me with a wholesome experience in the field of aesthetic plastic surgery. The experience that I have received in the one-month period has given me a solid foundation to build my own aesthetic surgery practice. The one-to-one mentorship, active involvement in cases, good variety of caseload enriched my experience and I could see the world of aesthetic surgery in a whole new light. I highly recommend this fellowship to young surgeons interested in the field of aesthetic plastic surgery, because of the extensive surgical exposure it offers and the quality of the surgeons involved.