Department of Otolaryngology - Service Chief Reports

Richard Westreich, MD, Director

The Division of Facial Plastic and Reconstructive Surgery, under the direction of Dr. Richard Westreich, performed over 200 plastic and reconstructive surgeries during the past academic year. The annual case load in facial plastic surgery for PGY-4 and PGY-5 residents was once again well above the national average.

There was an even distribution of facial plastic surgery cases including trauma surgery, post-ablative reconstruction, congenital deformity repair, functional nasal correction and cosmetic facial procedures. Active facial plastic surgery services and on-call coverage were maintained at all of the affiliate hospitals and several satellite office sites.

The weekly facial plastic resident clinic at Long Island College Hospital logged over 500 outpatient visits for patients with a variety of facial and rhinologic deformities. Clinics at the Kings County Medical Center and the Brooklyn Veteran's Hospital have added additional patient encounters in this area. The residents receive a significant operative facial plastic surgery experience at these institutions. As such, they continue to be a valuable resource for resident and medical school education within the discipline of facial plastic surgery.

During the past academic year, attending and resident papers were published on nasal tip grafting procedures, nasal cartilage biomechanics, and perioperative surgical complications. Resident research projects in the areas of volume fillers, auricular reconstruction techniques and nasal surgery are currently underway. In several of the past years, one or more residents, has successfully matched in an AAFPRS approved facial plastic surgery fellowship and will continue their post-graduate studies.

Dr. Richard Westreich, a fellowship trained facial plastic surgeon, joined the division in July, 2005. Dr. Westreich, who trained at Mt. Sinai Medical Center, has directed resident education in facial plastic surgery for the program while pursuing his clinical interests which include all aspects of facial plastic and reconstructive surgeryIn 2006, Dr. Westreich assumed the role as Director of Facial Plastic Surgery at the Long Island College Hospital. In 2007, he became the Director of resident eduation at the Long Island College Hospial.

Dr. Afshin Parhiscar, a dual trained otolaryngologist and general plastic surgeon has close ties to the division and oversees the head and neck microvascular surgery program. He provides expertise resulting in a complimentary interdisciplinary effort for head and neck reconstruction. The residents achieve additional case experience in facial plastic surgery through their interactions with him at the Long Island College Hospital.

Drs. Westreich and Parhiscar worked together to develop a comprehensive facial plastic surgery resident curriculum, which is scheduled on a two year cycle. Resident lectures, attending lectures, and case presentations are incorporated into the didactics. A compendium of articles which complements these lectures is distributed to each resident and updated periodically. Guest lectures from individuals with areas of specific expertise are also included.

In addition, we instituted two new off-site private practice rotations for the PGY-4 residents. From rotations with Dr. Mark Erlich and Dr. Mark Avram, they are exposed to facial plastic surgery in a private practice setting and receive exposure to hair restoration techniques and treatments.

In summary, the Division of facial plastic surgery continues to provide residents and medical students with significant exposure to cosmetic and reconstructive procedures of the face. Our recent staff additions have provided continuity and helped to preserve the volume of cases critical to resident training. We expect further growth over the next few years in all aspects of the subspecialty.