Commentary on: Aesthetic Surgery Research Funding: Where Does It Come From and to Whom Does It Go?
Response or Comment
As Aesthetic Surgery Education and Research Foundation (ASERF) president, it was interesting to read and analyze this article by Hammond et al.1 It appears the impetus for this study germinated from the findings of an article by Tang et al.2 That article highlighted the fact that of the 100 top cited articles from 1950 to 2017, 56% were reconstructive vs 11% aesthetic and, as such, showed a discrepancy in cosmetic surgery innovation. One hypothesis for this discrepancy was the possible lack of funding for aesthetic studies, which, the authors believed, was driving the infrastructure for future studies. The authors researched these hypotheses and uncovered some interesting facts.
The current study utilized 10-year data from the Aesthetic Surgery Journal (ASJ), which ranks #1 in aesthetic surgery and #2 in plastic surgery based on impact factor.3 Their findings show 2 facts that seem to contradict the study by Tang et al, namely, an increasing number of original aesthetic surgery articles and a corresponding increasing trend of funded studies in ASJ.
The current analysis uncovered some interesting trends especially when comparing funded research from the academic setting with private practice. There seems to be an increasing trend for academic articles vs private practice articles. Private practice tended to rely heavily on funding from private industry, whereas academic centers had a more diverse portfolio when it came to funding. For example, published private practice articles received no funding from government agencies. There did not seem to be a discrepancy in the level of evidence-based submissions between the 2 groups.
Regarding the trend of funding in academic centers vs private practice settings, the authors appeared to generate their own hypotheses. They speculate that private practioners may have less interest in research, lack time, or lack of knowledge of available resources. These hypotheses seem to make sense but require further study.
As opposed to the undertones of Tang et al’s article, I think that the evidence clearly points to the fact the aesthetic surgery research is alive and well. We have all witnessed the meteoric rise in ASJ’s impact factor and the development and success of ASJ Open Forum. The development of ASJ Open Forum was partly due to the fact that ASJ was being overwhelmed by monthly submissions. In addition, ASJ Open Forum allows more aesthetic surgery research to find a place in the literature.
As we have seen ASJ flourish in recent years, we have also seen the growth of ASERF as measured by its financial growth and the amount of funding it provides for aesthetic surgery research. One of the major missions of ASERF is to promote research in aesthetic medicine and surgery. Although academic institutions have received major funding from ASERF, its underlying mission is to truly support research by aesthetic society members in private practice. The application process is somewhat rigorous but does not discriminate between academic and private practice settings. I certainly encourage aesthetic surgeons in private practice interested in research to seek out funding opportunities from ASERF.
Lastly, I want to comment on 2 advanced technology systems in which ASERF participates and will set the standard for research in the future. The authors mentioned the Aesthetic Neural Network (ANN). The ANN currently has 364 participating surgeons, clinics, and medical spas. It is a seamless and Health Insurance Portability and Accountability Act (HIPPA)-compliant system that captures data on a daily basis. It has so far recorded 6.6 million procedures and has the potential to harvest an immense amount of retrospective data. In addition, ASERF has invested in a HIPPA-compliant electronic data capture system contained within The Aesthetic Society’s Aesthetic One App. It is currently directly registering implants with the implant manufacturers, creating an implant registry, collecting data regarding breast implant procedures, and empowering patients by giving them information about their surgery and implants. ASERF is currently investing in a system that will allow the merging of these 2 technologies to run studies by members or industry through a digital platform. Hopefully, this will encourage industry to participate in more studies with our Foundation and Society.
Although this study has some limitations, as mentioned in the article, it does highlight the fact that aesthetic surgery and medicine research is increasing year by year. Other evidence, such as the increasing impact of ASJ and the development of ASJ Open Forum, supports this article’s conclusion. The one troubling trend seems to be the decreasing trend of private practice research, especially because there is a plethora of untapped clinical data in this setting. The authors have suggested a few reasons for this trend but will study this particular issue in the future. Some good clinical evidence is locked up in private practice, and the ANN and the Aesthetic One App may be a way to harvest this important clinical information in a seamless fashion. ASERF’s strategic plan is to find innovative ways to harvest this information—in essence, to expand the scope of private practice research. The best is yet to come!
The author declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
The author received no financial support for the research, authorship, and publication of this article.
1. Hammond J, Armstrong V, McMullen K, Bernard R, Teven C. Aesthetic surgery research funding: where does it come from and to whom does it go? Aesthet Surg J. doi: 10.1093/asj/sjaa335. [Epub ahead of print].
2. Yao-Mei Tang J, Pawliuk C, Bucevska M, Mulpuri V, Arneja JS. What is driving paradigm shifts in plastic surgery and is cosmetic surgery keeping up? Plast Reconstr Surg. 2020;145(5):1164-1171.
3.“About the Journal.” Oxford University Press. academic.oup.com/asj/pages/about. Accessed February 5, 2021.
Luis Rios, Jr, MD, Commentary on: Aesthetic Surgery Research Funding: Where Does It Come From and to Whom Does It Go?, Aesthetic Surgery Journal, 2021;, sjab006, https://doi.org/10.1093/asj/sjab006
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