Craniofacial Fellowship - Department of Plastic and Reconstructive Surgery Fellowships

• Duration and Scope
• Description of Fellowship
• Clinical Goals and Objectives
• Didactic Goals and Objectives
• Research Opportunities
• Application Process

Craniofacial Surgery

At UPMC, we seek to attract and train the future leaders in craniofacial and pediatric plastic surgery, as well as craniofacial biology research. Our fellowship includes the in-depth study of disorders of the soft and hard tissues of the face and cranium, such as congenital anomalies, post-traumatic, and other acquired deformities. Fellows trained in craniofacial and pediatric plastic surgery at our institution will be able to manage any craniofacial or pediatric plastic surgery problem and have the training to pursue an academic surgical career of their choice.

Duration and Scope

• Length of educational program is a 1 year clinical fellowship with a required clinical research project and highly encouraged opportunities in the department’s clinical or basic science laboratories.
• Admission is open to surgeons who have satisfactorily completing an accredited plastic surgery residency program and who are board eligible or certified.
• Participation in the San Francisco Match program is required.

Description of Fellowship

1. Comprehensive experience with the preoperative evaluation, treatment planning, operative treatment, and postoperative management of patients with congenital and acquired craniofacial and pediatric plastic surgery diagnoses.
2. Comprehensive weekly involvement with a large interdisciplinary cleft-craniofacial team, with formal exposure to team members and their respective roles.
3. Weekly outpatient clinic experience in the preoperative evaluation and postoperative management of craniofacial patients.
4. Comprehensive experience with pediatric otolaryngology, focusing on the difficult airway clinic.
5. Comprehensive experience with maxillofacial surgery requiring fellow performed cephalometric analysis, fabrication of dental models and orthognathic splints, surgical treatment planning, virtual surgery and orthognathic surgery.
6. Comprehensive experience with the reconstructive management of post-ablative defects from malignancy about the craniomaxillofacial region with free flap surgery and bone grafting techniques.
7. Comprehensive experience with craniomaxillofacial trauma, both acute and post-traumatic deformity reconstruction.
8. Comprehensive experience in the broad scope of pediatric plastic surgery including vascular anomalies, congenital nevi, cleft lip and palate, brachial plexus, congenital hand (if interested), etc.
9. Formal weekly conference with the fellowship director and pediatric faculty to review assigned readings in core curriculum topics relating to craniofacial and pediatric plastic surgery topics.

Clinical Goals and Objectives

• To experience a broad education in the art and science of craniofacial surgery and pediatric plastic surgery.
• To experience progressive senior surgical responsibility in the essential phases of patient care: preoperative evaluation, therapeutic decision making, operative experience, and postoperative management.
• Participate in the diagnosis, planning, operative treatment, and postoperative care of craniofacial diagnoses including: craniosynostosis, midface hypoplasia, facial symmetries, Treacher Collins syndrome, Craniofacial Microsomia, Pierre Robin sequence, congenital and traumatic orbital dysmorphologies, craniofacial clefting and orbital hypertelorism, atrophic and hypertrophic disorders such as Romberg's disease and hemifacial hypertrophy, craniofacial bony neoplasms such as fibrous dysplasia and osteomas, neurofibromatosis, vascular anomalies, post traumatic craniofacial deformities, and craniofacial exposures in cranial base surgery.
• Participate in a multidisciplinary integrated craniofacial team.
• Gain experience in the surgical correction of congenital clefts of the lip and palate both primary and secondary repairs and revisions.
• Gain experience with the evaluation and treatment of pediatric plastic surgery diagnoses such as: traumatic deformities, giant congenital nevi, vascular anomalies, congenital hand including brachial plexus reconstruction.
• Gain experience in reconstructive management of defects after ablative surgery for malignancy of the craniomaxillofacial region.

Didactic Goals and Objectives

• Demonstrate knowledge of normal and abnormal embryology and fetal development of the head and neck.
• Demonstrate ability to interpret radiological studies including dental radiographs, cephalometric analysis, CT and MRI imaging modalities.
• Demonstrate expertise in the construction of dental study models, orthognathic splints, and their use in craniofacial and maxillofacial surgery.
• Appreciate the standards of cephalometric normalcy as they relate to the face.
• Demonstrate an understanding of bone healing, including primary healing, malunion, nonunion, osteomyelitis, and the physiology and methods of bone grafting.
• Demonstrate an understanding of the use of alloplastic materials in craniofacial reconstruction.
• Demonstrate knowledge of congenital, developmental, and secondary deformities of the head and face.

Research Opportunities

While at least one clinical research project leading to presentation and publication is expected during the fellowship year, significant clinical, translational, basic and applied basic science research opportunities are available and highly encouraged. For those interested, research experience can be obtained in one of several nationally known laboratories.

The Plastic Surgery Research Laboratories at the University of Pittsburgh

The Plastic Surgery Adipose Stem Cell Research Laboratory is directed by Kacey G. Marra, PhD, Associate Professor of Plastic Surgery and Bioengineering and Faculty of McGowan Institute for Regenerative Medicine and J Peter Rubin, MD, Professor of Plastic Surgery, Chairman Department of Plastic Surgery. This laboratory conducts scientific investigation in multiple interdisciplinary areas. The scope of projects revolves around the two future avenues of tissue reconstruction: transplantation and tissue engineering. Modalities are investigated to manipulate the immune system in order to achieve transplantation of composite tissue allografts. Novel biomaterials are being designed for skin, bone, and nerve regeneration, with a strong focus on polymeric materials, both native and synthetic. This laboratory isolates preadipocytes from human adipose tissue, and is exploring applications of these adult stem cells in soft tissue reconstruction. Of recent interest is the differentiation of preadipocytes into adipocytes, neural progenitor cells, and osteoblasts for tissue engineering applications.

The Pediatric Craniofacial Biology Laboratory is directed by Greg Cooper PhD, Associate Professor of Plastic Surgery and Joseph E. Losee, MD, Professor of Plastic Surgery, Vice Chairman Department of Plastic Surgery. The Experimental Animal Surgery Laboratory and the Posvar Hall Animal Care Facility is directed by Mark P. Mooney, PhD, Professor in the Departments of Oral Medicine and Pathology, Anthropology, Plastic Surgery, and Orthodontics. Dr. Mooney and Dr. Cooper are craniofacial biologists who study craniofacial growth and development as well as wound healing following surgical manipulation and device implantation - using comparative animal models. Their interests include the etiopathogenesis of craniofacial anomalies. Ongoing projects in this laboratory involve the development of cytokine and gene therapies to rescue craniosynostotic sutures and prevent postoperative resynostosis in a congenital rabbit model of craniosynostosis; the use of guided tissue regeneration with growth factors and osteogenic cells to prevent postoperative fibrous nonunions in craniofacial surgery; and, the facilitation of osseous wound healing in critical sized craniofacial defects using tissue engineered bone scaffolds.

The Vascularized Composite Allotransplantation Laboratory is directed by Dr. Mario Solari, Associate Professor of Plastic Surgery.The VCA Laboratory engages in basic and translational research to advance the broader understanding of VCA immunobiology and to develop strategies that facilitate reduction of systemic immunosuppression, prevent acute and chronic rejection, promote allograft survival, and maximize functional outcome. The lab focuses on studies in small and large animal (mechanistic and pre-clinical) models of limb, face and abdominal wall allotransplantation related to basic immunologic mechanisms, drug and cell-based therapy, tolerance induction, nerve regeneration, and functional outcomes. The ultimate goal is translating new research findings into novel strategies that will improve the care and quality of life after clinical VCA such as hand and facial tissue allotransplantation. The laboratory is located within the Thomas E. Starzl Transplantation Institute. The research faculty has diverse backgrounds and expertise that facilitate the execution of high-level multidisciplinary science in collaboration with leading institutional, national and international centers of research, academia and industry partners with the support of funding from federal (NIH, DOD), private, industry or intramural entities.

Application Process for Craniofacial and Pediatric Plastic Surgery Fellowship

If you have not done so already, please register with the San Francisco Fellowship Match for Craniofacial Surgery (http://www.sfmatch.org).

Applications are now being coordinated through the American Society of Craniofacial Surgeons common craniofacial fellowship application. (http://ascfs.org/fellowships.cgi).

We will still accept paper applications. Please include the following:

• Completed Craniofacial Fellowship Application (PDF)
• Curriculum Vitae
• Copy of USMLE Step I, II and III Scores
• Personal Statement
• Three letters of recommendation, including one from your plastic surgery program director.

You may mail your completed Craniofacial Fellowship Application materials to:

Jennifer Szczepaniak
Craniofacial Fellowship Coordinator
4401 Penn Avenue
Faculty Pavilion, 7th Floor, Suite 7104
Pittsburgh, PA 15224

Phone: 412-692-6203
Fax: 412-692-8614
Email: Jennifer.szczepaniak@chp.edu

If you have any questions or require additional information regarding the Fellowship or Match, please do not hesitate to contact us.

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