In this week's edition
- ✍️ Letter from P'Fella
The match reality: When great candidates go unmatched. - 🤓 The Sunday Quiz
New rules this round! - 🖼️ Image of the Week
Dupuytren's disease: Clinical image. - 🚑 Technique Tip
How to optimise fat graft retention. - 🎈 Upcoming Events
A curated list of webinars, courses, & conferences - 📖 What Does the Evidence Say
What is the true retention rate of fat grafts? - 🔥 Articles of the Week
Trends in plastic surgery match, how many publications do you need to match?, & is plastic surgery the most competitive specialty?: with 1-sentence summaries. - 💕 Feedback
Suggest ideas & give feedback!
A Letter from P'Fella
The Match Reality: When Great Candidates Go Unmatched
Let’s be clear — the residency 'Match' isn't perfect. Every year, genuinely talented medical graduates face the harsh reality: "You did not match." It's brutal, heartbreaking, and damaging to plastic surgery.
The Ugly Truth
We've unintentionally created an arms race — students padding CVs with abstracts, posters, and superficial metrics. Nearly half (46.9%) match within their medical school’s geographic region, underscoring the powerful role of networking over objective metrics.
The independent plastic surgery match is even tougher. Between 2019 and 2022, match rates fell dramatically — from 82% to 56% — while the number of applicants soared (up 42.3%). Even strong applicants face harsh odds, with successful matches linked to having more than eight interviews, USMLE scores above 230, and exceptional ABSITE scores.
Collateral Damage
Missing the Match isn't just disappointing — it's devastating. Careers stall, confidence crumbles, and talented future surgeons are left questioning their worth, simply because they didn't navigate an inherently challenging system.
Turning the Tables
We must do better. Unmatched candidates deserve meaningful clinical fellowships, structured mentorship, and honest feedback. It's time to prioritize true clinical potential over arbitrary metrics. If you have opportunities or programs specifically for unmatched candidates, please connect with us below 👇
Let's support our community,
P’Fella ❤️
The Sunday Quiz
New Rules This Week!
Welcome to a fresh round of The Weekly Quiz.
Each edition of thePlasticsPaper includes a quiz question designed to challenge and engage our readers. Keep your wits about you and join in every week — the winner at the end of six rounds will earn you a one-year subscription to thePlasticsPro.
Image of the Week
Clinical Presentation of Dupuytren's Disease
In this section, we feature an anatomical illustration. This week’s image showcases Dupuytren’s disease, a fibroproliferative disorder of the palmar fascia leading to progressive digital contractures. Characterized by nodular thickening and cord formation, it most commonly affects the ring and little fingers. Advanced stages may limit hand function, necessitating surgical intervention.
Learn more about Dupuytren’s disease and its treatment options.
Technique Tip
How to Optimise Fat Graft Retention
This week, we’re focusing on maximising fat graft viability during harvesting. Here are some key considerations for optimal graft survival.
- Donor Site: No significant difference across common donor areas.
- Infiltration: Wet technique improves adipocyte viability.
- Local Anesthetic: Bupivacaine has the highest cell viability.
- Harvesting Technique: Coleman technique ensures better adipocyte retention.
- Cannula Selection: Large bore cannulas reduce cellular damage.
- Suction Speed: Constant and slow suction minimizes trauma.
Find detailed insights on fat grafting techniques in the table below.
Upcoming Events
A Curated List of Webinars, Courses, & Conferences
We continuously update our event page with fresh additions — both hand-picked by our team and suggested by you.
What Does the Evidence Say?
What Is the True Retention Rate of Fat Grafts?
To improve fat graft survival, cell-assisted lipotransfer (CAL) was developed, which involves injecting fat along with adipose-derived stromal cells (Laloze et al., 2018). Meta-analyses have shown that CAL significantly improves fat graft survival rates compared to conventional fat grafting (64% vs. 44%) (Laloze et al., 2018; Zhou et al., 2016).
However, CAL is associated with a higher incidence of complications (8.4% vs. 1.5%) (Laloze et al., 2018). Factors affecting fat graft survival include obesity phenotypes, low-grade inflammation markers, and injection volume (Gentile et al., 2016; Laloze et al., 2018). Further research is needed to establish standardized protocols (Doornaert et al., 2018).
Articles of the Week
3 Interesting Articles with One-Sentence Summaries
From 2019–2022, independent plastic surgery match success correlated with ≥8 interviews, US allopathic degrees, university-based training, Step 1 >230, and high PGY1–3 ABSITE scores, despite fewer programs and rising applicants.
Since manuscript publications may hold more weight than total research items in the integrated plastics match, actual publication counts offer a more meaningful metric of applicant competitiveness.
From 2016–2020, integrated plastic surgery had the highest USMLE scores and among the highest research outputs, yet offered limited residency positions, confirming its status as one of the most competitive specialties.
