Facial Plastic and Reconstructive Surgery Fellowship

Why Choose UT Southwestern Facial Plastics and Reconstructive Surgery?

The Facial Plastic and Reconstructive Surgery Fellowship at UT Southwestern offers comprehensive training with a particular emphasis on advanced reconstruction of the face, head and neck, microvascular surgery, facial trauma, facial nerve reconstruction, and rhinoplasty for both aesthetic and reconstructive indications. The program is designed for surgeons seeking the breadth of a comprehensive facial plastic surgery fellowship combined with the advanced reconstructive training necessary to develop or lead a tertiary-care facial plastic and reconstructive surgery practice. Fellows train with four full-time facial plastic and reconstructive surgery faculty members whose complementary practices encompass advanced reconstruction, rhinoplasty, and aesthetic facial surgery.

A distinguishing strength of the fellowship is the volume, diversity, and complexity of its reconstructive experience. Working alongside two AAFPRS fellowship trained, high-volume microvascular reconstructive surgeons, fellows encounter challenging problems ranging from major oncologic defects to osteoradionecrosis and secondary reconstruction, vessel-depleted necks, and severe facial trauma. Advanced procedures include complex mandibular and midfacial reconstruction using both fibula and scapula free flaps, as well as selected highly specialized reconstructions described below.

The fellowship places particular emphasis on the decision-making behind complex reconstruction. Fellows learn not only how to perform sophisticated operations, but also how to select appropriate patients, evaluate reconstructive alternatives, anticipate complications, and develop reliable and repeatable operative plans. Virtual surgical planning and patient-specific implants are used extensively to translate challenging three-dimensional defects into systematic, reproducible surgical solutions. The goal is to provide fellows with the technical foundation and surgical judgment to approach complex cases confidently early in their careers.

This reconstructive emphasis is complemented by substantial experience in facial trauma, facial nerve reconstruction, and functional and aesthetic rhinoplasty, with additional opportunities in facial rejuvenation and other areas of facial plastic surgery.

Program Overview

The one-year fellowship provides longitudinal training across multiple clinical environments, including William P. Clements Jr. University Hospital, Parkland Memorial Hospital, Children's Medical Center Dallas, and the VA North Texas Health Care System. These institutions offer a broad spectrum of pathology, patient populations, and surgical experiences, supported by faculty with diverse clinical interests.

Microvascular and Complex Reconstructive Surgery

Advanced reconstructive surgery forms the foundation of the fellowship. Fellows participate in a high volume of soft tissue and osseous free-flap reconstruction following major head and neck oncologic surgery, treatment of osteoradionecrosis, and complex secondary reconstruction.

Advanced reconstructive experiences include mandibular reconstruction with immediate dental implant placement in selected patients, complex orbito-maxillary reconstruction, and challenging reconstructions in previously operated, irradiated, or vessel-depleted fields. The program also offers exposure to specialized techniques performed in collaboration with other surgical disciplines, such as microvascular jejunal reconstruction of the esophagus, skull base reconstruction, and dental rehabilitation. Virtual surgical planning is extensively utilized for nearly every osseous case. Fellows will learn the fundamentals of designing cutting guides and custom implants and will have the opportunity to lead planning sessions with faculty supervision and guidance.

Training emphasizes flap selection, reconstructive design, restoration of three-dimensional anatomy, functional rehabilitation, and the incorporation of aesthetic considerations into major reconstruction. Fellows are encouraged to develop a systematic approach to complex problems that can be adapted to different clinical environments and available resources.

Additional experiences include local and regional flap reconstruction, cutaneous defect reconstruction, and selected pediatric procedures, including microtia reconstruction.

Facial Trauma

Parkland Memorial Hospital, a major Level I trauma center, provides experience in the evaluation and management of complex facial injuries, including panfacial fractures, high-energy motor vehicle trauma, ballistic injuries, and secondary reconstruction of traumatic deformities.

Fellows participate in operative planning and surgical management, with progressively greater responsibility for appropriate cases. The experience also includes teaching and supervising otolaryngology residents under faculty oversight.

Facial Nerve Reconstruction and Facial Paralysis

Facial nerve reconstruction is an important component of the fellowship, particularly in the setting of radical parotidectomy, oncologic facial nerve sacrifice, and complex head and neck defects.

Fellows gain experience with nerve grafting, nerve transfers, static suspension, temporalis tendon transfer, and selected dynamic reanimation techniques, including functional muscle transfer. Training emphasizes comprehensive facial paralysis management, including both surgical and nonsurgical approaches, and the selection of treatment strategies based on the patient's anatomy, prognosis, and functional goals.

Rhinoplasty and Aesthetic Facial Surgery

Functional and aesthetic rhinoplasty are substantial components of the fellowship, with experience in nasal airway surgery, structural rhinoplasty, and the application of rhinoplasty principles to nasal reconstruction.

Additional exposure to facial rejuvenation and aesthetic surgery is available through university faculty and established relationships with community facial plastic surgeons. Fellows may pursue additional experience in these areas according to their interests and educational goals while maintaining the fellowship's primary reconstructive focus.

Educational Philosophy and Progressive Responsibility

Complex facial reconstruction involves more than replacing missing tissue. It requires restoring distorted anatomy, addressing functional deficits, and understanding how reconstructive decisions influence both facial appearance and function. Achieving good outcomes requires a broader understanding of the interplay between skeletal reconstruction, microvascular techniques, neural rehabilitation, and aesthetic surgical principles.

Our educational philosophy is built around developing surgeons who can integrate these perspectives in the management of complex problems and assume responsibility for their patients' care, from initial evaluation and surgical planning through operative management and recovery.

As the fellow's experience and competence develop, they are expected to take increasing ownership of patient evaluation, reconstructive planning, operative execution, and postoperative management. The goal is for the fellow to function progressively as a junior surgical colleague, serving as the primary operating surgeon for appropriate cases under faculty supervision and participating in resident and medical student education.

Training can be individualized to the fellow's prior experience, strengths, clinical interests, and professional goals. Although advanced reconstruction remains the foundation of the program, the relative emphasis on different aspects of facial plastic surgery can be adjusted to support each fellow's development.

Faculty mentorship emphasizes technical proficiency, sound clinical judgment, thoughtful management of complications, and the ability to apply reconstructive principles to unfamiliar problems. The ultimate goal is to prepare graduates to practice across the breadth of facial plastic surgery while developing the technical expertise, clinical judgment, and confidence to manage complex reconstructive problems and assume leadership roles in tertiary-care surgical practices.

Research and Academic Development

The fellowship provides opportunities for clinical research and academic development within a large academic medical center. The Facial Plastic and Reconstructive Surgery section maintains active research interests in reconstructive outcomes, virtual surgical planning, patient-specific implants, and innovation in complex facial reconstruction.

In accordance with AAFPRS fellowship requirements, fellows are expected to complete a research project and submit a manuscript for publication during their fellowship year. Faculty mentorship, ongoing research projects, and institutional resources are available to support this work.

Living in Dallas

Dallas offers the cultural amenities, restaurants, arts, entertainment, and professional opportunities of a major metropolitan area. The Dallas–Fort Worth region is home to a diverse population and provides numerous opportunities for recreation, travel, and life outside the hospital.

UT Southwestern's central Dallas location places fellows near a variety of neighborhoods and communities, with access to both urban living and quieter residential settings.