Details of the Rochester Microsurgical Fellowship
The Rochester Microsurgical Fellowship was established in 2010 with the goal of promoting and preserving the art of microsurgery through quality teaching in the classic apprenticeship model. By the end of the fellowship, the trainee will have mastered the entire microsurgical skill set; he/she will be able to apply those maneuvers to tackle not only any breast or head & neck case but a variety of cases throughout the body.
Stephen Vega, M.D., Board-Certified Plastic Surgeon
Dr. Vega is a Board Certified Plastic Surgeon. He completed his undergraduate training at Amherst College, his medical degree from the University of Pennsylvania and completed his plastic surgical training at the University of Rochester. He was the first microsurgical fellow of Dr. Joseph Serletti, whose practice he subsequently assumed. After 4 ½ years as a faculty member at URMC, he entered private practice and maintains a robust microsurgical caseload that includes elective breast reconstruction, head and neck reconstruction, and cosmetic surgery. Dr. Vega is on the fellowship committee in ASRM. He also maintains memberships in ASRM, ASPS, and NESPS.
NB – The below numbers represent cases to be experienced by the one fellow only: no other fellows with whom to compete, no residents with whom to share. This is a definitive advantage over other seemingly larger programs where more overall cases are shared amongst a number of fellows and residents. The 130+ free flaps expected over the year compare well with the individual numbers of the fellows at the busiest centers across the country.
Micro Breast (100) The fellow will have unsurpassed experience in all types of breast free flaps and perforator flaps: DIEP, extreme muscle-sparing TRAMs, SIEA, and gracilis/TUG. Should the fellow desire to perform SGAP flaps, any appropriate candidate will be considered. Of note, Dr. Vega is one of the nation’s main proponents of the TUG/gracilis flap. Considered an authority on its use, he has authored one of the few larger series on the technique and teaches the annual TUG course at the national ASPS meeting each year. He has appeared on several panels and is well-known in the reconstructive breast surgery community.
Non-Micro Breast (200+) The fellow will master expander/implant reconstruction (both complete submuscular and with acellular dermal matrices), revisionary work, fat injection techniques, and nipple flaps.
Cosmetic The fellow will be exposed to a variety of cosmetic work, including rhinoplasties, breast augmentations, mastopexies, facelifts, browlifts, blepharoplasties, body contouring, and more. Cosmetic work accounts for approximately 30% of the typical caseload. Dr. Vega allows his fellows to offer discounted rates to encourage their own, autonomous cosmetic experience.
General Reconstructive Throughout the year, the fellow will experience an array of typical general reconstructive cases from head to toe. Should the opportunity arise to offer a superior solution to any given defect via microsurgical technique, this is certainly encouraged.
Autonomy/Development The fellowship is designed to promote the gradual transition from plastic surgery resident to an independently operating microsurgical attending. Dr. Vega aims to have his fellows capable of all aspects of these case by three months, and operating independently by the second half of the year or sooner. Fellows are treated as attendings at the hospitals involved, with full admitting and O.R. privileges.
The fellow typically takes one week of plastics call per month at one institution only (Unity Hospital). This is by any standard a low-volume call, and rarely does the fellow actually need to come into the ED, as the PAs there are quite capable. This call generates at most a few patients to be seen in the office over the week. The fellow is also responsible for some weekend call for the practice.
Fellows are required to author at least one research paper during their tenure. At their disposal is not only their own sizeable log of cases they will accrue over their year but Dr.Vega’s 750+ free flaps from years past. Fellows will be encouraged to present at multiple meetings (i.e. The Northeast Society, ASPS, ASRM) along with a stipend of $3000 for such activities.
Named America’s sixth most liveable city by Places Ranked Almanac’s 25th-anniversary issue in 2007, the greater Rochester area is home to over a million people. Diversions are plentiful: museums, music, wineries, minor-league sports teams, festivals, the public market, and the nearby Finger Lakes.
While frequent snow is certainly a reality (avg: 100 inches/year), it by no means defines the year’s experience. Most would argue that the beautiful spring/summer/and fall in upstate New York more than compensate! Learn more about Rochester by visiting www.visitrochester.com.
Notes from Dr. Vega’s fellows
After this past year, I can quite honestly say that I’d rather have trained at no other program than this. Dr. Vega is not only expert microsurgeon but a talented teacher as well; his enthusiasm for the art is contagious. To have the entire year learning breast reconstruction with a single high-volume surgeon offers an unparalleled continuity and depth of understanding. Dr. Vega’s technique is meticulous and reproducible, yielding a flap success rate of 100% for my year. I am now comfortable with TUG flaps, SIEAs, DIEPs, and more.
Over my year Dr. Vega took a keen interest in teaching not only microsurgery, but cosmetics, general reconstruction, research protocol, office management, finance management, and more. Truth be told, I was treated more as a colleague and friend than a trainee. I sincerely feel lucky to have had such an incredible learning experience from such an accomplished and gifted teacher. I now welcome any challenging case in my upcoming role as an attending, confident that I have the training and skills to rise to the occasion.
Dr. Vega’s microsurgical fellowship has played a tremendous role in my surgical training. After finishing my residency training, I did not feel comfortable performing free flaps independently; however, after this year’s experience, a free flap became just another operation. Dr. Vega teaches a very reproducible microsurgical skill set, and his setup in the operating room takes a lot of the stress and unknowns commonly experienced in microsurgery out of the picture.
Over the past year I have done over 120 free flaps including breast reconstruction (ms TRAM , DIEP and SIEA flaps), head and neck reconstruction (RFFF, ALT, fibula), sarcoma reconstruction and lower extremity reconstruction. Moreover, during the year I gained experience in expander/implant-based breast reconstruction (60+ cases), vulvectomy and vaginal reconstruction, general plastic surgery and cosmetic surgery. This is a truly comprehensive and unique experience in a private practice setting that allows one to grow as a plastic surgeon in a very controlled and supervised environment. I highly recommend Dr. Vega’s fellowship to anyone wanting to gain more experience and confidence in microsurgery.
Physicians interested in pursuing this unique opportunity should submit their application online at The San Francisco Match www.sfmatch.org. Our Program is Vega Plastic Surgery, Program ID 4969.
Due to the exclusive nature of this training experience, timely completion of your application is highly recommended.
At this time, we are only accepting applicants from US residency programs or Canadian Residency programs with a VISA to practice medicine in New York State.
Please direct any questions to Madelyn Garcia at [email protected] or (585) 383-4040.