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Summary:. The Tracking Operations and Outcomes for Plastic Surgeons (TOPS) data registry, first launched in 2002 by the American Society of Plastic Surgeons (ASPS) in collaboration with the Plastic Surgery Foundation (PSF), was designed to avoid the perceived shortcomings of other national data registries as they pertain to interests of the plastic surgery community. Given the diversity of plastic surgery practice, the ASPS and PSF sought to ensure that the TOPS registry platform would support detailed collection of data useful to plastic surgeons practicing in all subspecialties. Therefore, a key design element of the TOPS registry is its ability to incorporate custom-made modules that allow for focused collection of topic/procedure-specific information. Although the TOPS database has collected information on more than 1.6 million plastic surgery procedures and outcomes since its inception more than 20 years ago, only a handful of custom modules have been created. This article outlines the senior author’s experience collaborating with the ASPS and PSF to successfully develop and implement a custom module within the TOPS registry. This information serves to promote further awareness, usage, and creation of TOPS modules, as these modules enable assessment of complex clinical conditions by leveraging data collection efforts through the single largest national plastic surgery organization.

Background:. We evaluate the performance of plastic surgeons in converting National Institutes of Health K grants in early career to R grants intended for established investigators. We also investigate characteristics that may positively predict successful transition from K to R grants. Methods:. K08, K23, and R01 (or equivalent) grants awarded to plastic surgeons and physicians within the departments of ophthalmology, dermatology, and neurosurgery were collected. Analyses of successful conversion rates from a K to an R grant between plastic surgeons and physicians within the selected departments were performed. Cross-sectional analysis of characteristics among identified plastic surgeons was completed via logistic regression to elucidate possible predictors of successful conversion. Results:. Comparison of pathway initiation rates demonstrate that plastic surgeons receive significantly fewer K grants relative to the size of their field when compared with other specialties (all P < 0.01). Of the analyzed plastic surgeons, 52.9% successfully converted to an R-series grant within 5.4 years of beginning their K-series grant. Conversion rates were not significantly different between plastic surgeons and physicians within the selected departments. Logistic regression analyses revealed that the time-adjusted mean relative citation ratio of K series–associated publications is a positive predictor of successful conversion (P = 0.047). Conclusions:. With regard to increasing National Institutes of Health funding via the K-to-R pathway, we believe the field of plastic surgery could benefit from an increased effort to pursue a pathway of K-to-R conversion with a focus on quality over quantity when publishing articles associated with a K-series grant.

Background:. Although long-term benefits of reduction mammaplasty have been proven, the appropriate age for adolescent reduction mammaplasty has been highly debated due to possible need for revision surgery. Practitioners often delay offering breast reduction to adolescents below age 18 based on presumed insurance denial. We reviewed trends in insurance denial at a single children’s hospital to analyze whether age and/or insurance carriers have a significant impact on coverage of breast reduction. Methods:. A retrospective chart review from 2012 to 2022 of cisgender female patients with macromastia aged 12–20 years at the time of diagnosis was analyzed for differences in breast reduction insurance coverage based on age and body mass index at the time of diagnosis, referral to plastic surgery, and surgery. Results:. A total of 121 cisgender women were included. There were no significant differences in the mean ages of patients who underwent breast reduction versus those who did not (16.46 years versus 16.96 years, respectively; P = 0.089), or in the mean body mass index for patients who did versus those who did not receive breast reduction (28.58 kg/m² versus 29.05kg/m², P = 0.382). Furthermore, there were no significant differences in the proportion of patients undergoing breast reduction by age (P = 0.200) or by insurance class (P = 0.403). Conclusion:. Although insurance varies with carrier, the present findings suggest that surgeons need not delay in facilitating preauthorization for breast reduction in symptomatic patients presenting anytime during their teenage years.