The plastic surgeon’s path

Mark Foglietti, D.O. (’82), speaks to OU-COM students about his field, cosmetic surgery

By Richard Heck

Feb. 17, 2009

Excelling at general surgery is the first step in becoming a plastic surgeon, members of
OU-COM’s Surgery and Sports Medicine Club learned Monday, Feb. 16.

“I want my residents to be board-certified first in general surgery,” said Mark A. Foglietti, D.O. (’82), FACOS, who presented a noon lecture on plastic surgery to the club. Foglietti is director of the Cosmetic Surgery Institute in Northeastern Ohio and of the Cleveland Clinic’s plastic surgery residency at South Pointe Hospital, where he also serves as clinical professor for OU-COM.

“In my program we choose the best general surgeons we can,” Foglietti said, explaining that a surgeon who can operate on internal organs will make a better plastic surgeon. 

Currently, osteopathic plastic surgeons must undertake a five-year general surgery residency or, in some cases, five years of either an orthopedic or an ear, nose and throat residency, followed by two years of plastic surgery residency. But those requirements may change soon, Foglietti said.  

Next month, leaders in osteopathic medical education will consider mandating a four-year general surgery residency, followed by a three-year plastic surgery residency. This would parallel similar changes in allopathic requirements for board-certification in plastic surgery, which will go into effect in 2010.

Cosmetic surgery is more than Botox and vanity, Foglietti said. “The field encompasses many areas,” Foglietti said, including reconstructive breast and neck surgery, repairing face and hand trauma, healing hand and upper extremity diseases, and correcting birth abnormalities.

While the top five types of plastic surgery—liposuction, nose reshaping, breast augmentation, eyelid surgery and tummy tucks—remain cosmetic in nature, they can improve the emotional and mental health of patients, often increasing confidence and activity levels, which positively impacts physical health, Foglietti said.

In fact, a cosmetic procedure that Foglietti witnessed during his third-year rotation at Doctors Hospital in Columbus persuaded him to enter the specialty. A young girl underwent an otoplasty, a procedure that sets prominent ears closer to the head.  

Especially considering the ridicule that children can impose (think “Dumbo” or “Mickey Mouse”), Foglietti said, “I was so excited for that girl that it changed my focus from family practice. I wanted to make people feel better about themselves.”

Although the number of cosmetic surgery procedures has reduced some in recent months, the field has proven surprisingly resilient to recession, said Foglietti, who reported that the current economic slowdown so far has not reduced the number of Botox treatments his practice provides.  

Unlike Foglietti’s own unpaid plastic surgery residency at Des Moines Mercy Hospital (he moonlighted in the ER every other weekend to pay the bills), the number of paid residencies has increased, Foglietti said.

According to Foglietti, only four osteopathic plastic surgery residency programs currently exist in the country, two of which are at CORE hospitals in Ohio: South Pointe Hospital accepts three residents annually and Doctors Hospital in Columbus accepts two.

“The CORE is a premier system, and OU-COM is an optimal example of osteopathic education. Our school and these CORE residencies rank among the elite of our profession,” Foglietti said.