Five primary educational pathways provide the prerequisite training needed to develop a practice composed of a high volume of aesthetic facial surgery:

1. Otolaryngology-head and neck Surgery, coupled with a postresidency fellowship in facial plastic and reconstructive surgery.

2. Plastic surgery, with prerequisite residency training in general surgery, otolaryngology-head and neck surgery, orthopaedic surgery, or urological surgery. A postresidency fellowship in facial plastic and reconstructive surgery is helpful, if the plastic surgery residency program did not include a high volume of aesthetic facial surgery.

3. Ophthalmology, with a postresidency fellowship in oculoplastic surgery.

4. Dermatology, with a postresidency fellowship in procedural dermatology or Mohs’s surgery.

5. Oral and maxillofacial surgery (OMFS) with a postresidency fellowship in cosmetic surgery of the face, head, and neck.

Each of the preceding routes has advantages—and disadvantages—compared with the others. It is not the purpose of this book to recommend one over the other. Aspiring facial surgeons should explore each route and determine in their own mind which best fits the scope of practice to which they aspire.

Not all practices devoted to aesthetic and reconstructive facial surgery are alike, nor should they be. Even in limiting one’s practice to aesthetic and reconstructive surgery within the head and neck, it is difficult to be all things to all people, even if one would like to be.

I was once told by an international business consultant that the extraordinary individual or corporation “finds its place in the universe.” It fills an existing void, and fills it better than the rest.

Aesthetic procedures range from isolated superficial (level I) skin resurfacing to full facial rejuvenation with facelifting, blepharoplasty, and level III skin resurfacing at the same sitting.