It is my great pleasure to be asked to write the foreword for this excellent Clinics in Plastic Surgery issue that represents the collaborative efforts of “The Core Four Subspecialties” in facial esthetic surgery.

Obtaining the best surgical outcomes for our patients requires a detailed and thorough comprehension of surgical anatomy, preoperative evaluation techniques, and the varied surgical procedures we perform. There is no better way to assure precision and expertise in these areas than combining the education and experience of oculofacial plastic surgeons, general plastic surgeons, facial plastic surgeons, and dermatologic surgeons. The editors and section editors of this project have thus created a comprehensive and contemporary reference and shown the foresight to engage the core specialties to attain their goals.

I personally began my medical training at the Mayo Clinic Medical School in Rochester, Minnesota in 1978. During my anatomy course in the first year, our professor, Dr Don Cahill, mentioned to our class that there was a “turf” battle that existed among surgeons who operated on structures of the head and neck. I didn’t really comprehend what he was saying at that time; it was only later that I was to come to understand this concept more fully.

While a student at Mayo, I was offered a residency in General and Plastic Surgery by Chairman of Surgery, Dr Donald McIlrath. As chance had it, though, a random elective with Dr Robert Waller (Chairman of Ophthalmology at the time) changed my plans. Dr Waller introduced and guided me toward a career in oculofacial plastic surgery. Since entering practice in 1988, I have occasionally witnessed the barriers present between the core specialties and the negative effects those conflicts created for the advancement of patient care, education, and safety.

In 2006, I was fortunate to serve as President of The American Society of Ophthalmic Plastic and Reconstructive Surgeons (ASOPRS). During my tenure, I had the great pleasure to be involved with Dr Mark Jewell (President of the American Society of Aesthetic Plastic Surgeons), Dr Alastair Carruthers (President of the American Society for Dermatologic Surgery, ASDS), and Dr Ira Papel (President of the American Academy of Facial Plastic and Reconstructive Surgeons, AAFPRS) in the creation of the Physicians Coalition for Injectable Safety**. Although ASOPRS, ASDS, and the AAFPRS had been working together through a loose-knit Federation for about 20 years to promote education and safety, it was not until Dr Jewell conceptualized the “core four” specialties that the organization was formed to unite our various specialties at least on the topic of patient safety. Twenty-five years after I finished medical school, my former student peers and I were working together again as concerned physicians to increase the quality of patient care and safety.

This issue is but one of many positive outcomes that continue to evolve from the collaborative efforts of our physicians and surgeons practicing facial esthetic surgery.

My thanks to the decision-makers who pushed this project forward and my congratulations to the outstanding editors and authors for the excellent product that they have created.