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    The evidence gap

    Finding research funds in a 'data-lite' discipline

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    Michael Rosenberg, M.D.
    Securing research grant funds in cosmetic surgery has become easier, thanks to the efforts of the discipline's professional societies to establish the kind of solid evidence bases which undergird other medical specialties. Most recently, the Cosmetic Surgery Foundation (CSF), the educational and research arm of the American Academy of Cosmetic Surgery (AACS), announced that six studies will benefit from the foundation's second year of funding. In early 2007, the CSF grant program awarded three research grants totaling $40,000. This year, the foundation increased funding to more than $81,000.

    Recipients this year include Raymond Doublas, M.D., Dustin Michael Heringer, M.D., David M. Morrow, M.D., Michael Rosenberg, M.D., Bryan S. Siers, M.D., Ph.D., and Emily P. Tierney, M.D.

    ASKING QUESTIONS Second-year CSF grant recipient Michael Rosenberg, M.D., tells Cosmetic Surgery Times that researchers in the aesthetic specialty are often overlooked by the government and other funding sources because they tend to be more interested in "life-preserving" studies. "In general, there are few resources for cosmetic surgery [research]," observes Dr. Rosenberg, a plastic and cosmetic surgeon from Mount Kisco, New York. "What the foundation allows us to do is ask basic questions and do the research as it relates to cosmetic surgery...I think the foundation is providing an incredibly important function for our patients."

    The foundation's objective is to support original research efforts designed to advance the art and science of cosmetic surgery and patient safety, according to the grant application. "It is vital...that we provide resources that not only advance the specialty, but arm investigators and clinicians with scientific and evidence-based outcomes," says Craig M. Sondalle, CSF executive director.

    DEFINING STANDARDS Dr. Rosenberg and two colleagues at the Institute of Aesthetic Surgery and Medicine, Mount Kisco, received grants in both 2007 and 2008 totaling $84,000, which will allow them to continue research that takes a critical look at local complications and long-term management of augmented breasts. The newest round of funding will allow them to hire a dedicated study nurse and pay a statistician to analyze data of their retrospective review of more than 400 cosmetic augmentation procedures in a five-year period. The study's ultimate goal? To define standards and resources for improved care.


    Ronald Mancini, M.D.
    So far, Dr. Rosenberg and co-researchers Danielle DeLuca-Pytell, M.D., a board-certified plastic surgeon, and Kathryn Spanknabel, M.D., a board-certified general surgeon specializing in breast surgery, have launched the patient resource-rich Web site http://www.breastimplantcare.com/, which not only points breast implant patients in the direction of credible resources, but also reinforces the importance of follow-up.

    "One of the things that we found...is that [implant] patients...often do not seek any particular follow-up," says Dr. Rosenberg. "In fact, a number of [our study] patients...do not even remember who their surgeon was." He and his colleagues are continuing to accrue patients to the study and are currently looking retrospectively at more than 300 breast implant patients — studying their outcomes, care (including follow-up studies) and problems. The researchers are also well into the prospective arm of their study — a breast implant follow-up schedule that includes radiographic and long-term care.

    "Right now, the data is not clear about what the best way to follow these women is," Dr. Rosenberg says. "The FDA has come up with guidelines, and they need to be evaluated. It's studies like this that will allow us to generate real rather than anecdotal information."

    FAT'S FUTURE Fat graft survival is another area of cosmetic study fueled by the CSF grants. Los Angeles oculoplastic surgeon Ronald Mancini, M.D., was awarded $5,000 from the foundation for his study to determine whether immune/inflammatory factors play a role in the viability of transferred fat. The study also examines the in vivo revascularization patterns of transferred fat.

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    Patty Reiman
    Patty Reiman has been a freelance writer for nearly 18 years for several healthcare outlets, specializing in dermatology and cosmetic ...
    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.

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