February 2026 Edition
- thestitchprs
- Feb 2
- 6 min read
10 min read
Welcome to the February edition of The Stitch. This month's articles explore how the history, pathway to residency, and perioperative care shape modern plastic surgery. Pieces examine the impact of the research year, honor foundational Black leaders in the field, and review recovery protocols that optimize patient outcomes. Each piece offers insight beyond the operating room.
We hope this issue encourages thoughtful perspective as you continue your journey in plastic surgery.
The Stitch Editorial Board
Black American Foundations of Modern Plastic Surgery
Article by Colton Brown, University of Florida Class of 2028
February is known as the month of love but also a time for reflection and celebration of African Americans, surrounding culture, innovation, strength, struggle, endurance of overcoming adversity, and so much more. Black pioneers have shaped the world of surgery. Dr. Arthur L. Garnes is highly acclaimed as the first African-American plastic surgeon in the United States. Born in Manhattan, he became the co-founder and visionary leader of the Harlem Hospital plastic surgery unit which holds the title as the first accredited plastic surgery residency program in a predominantly Black hospital. He integrated academics with surgery in underserved regions and mentored generations of surgeons, shaping the diversity and power of the workforce. He did not only practice surgery, but institutionalized and revolutionized it for Black physicians at a period of history when surgical training access was intentionally restricted.
The revered father of Black cosmetic surgery was Dr. Harold E. Pierce Jr. As a dermatologist, Dr. Pierce focused his efforts on reframing cosmetic surgery as an ethnically informed surgery, before skin of color became a mainstream concept of academics. He introduced surgical techniques specific to patients of color with respect to keloid treatments, hair transplantation in Black demographics, and dermabrasion and chemical peels in darker skin tones. The first African American President of the American Society of Plastic Surgeons was Dr. Steven R. Williams. Elected in 2023, he became the first Black surgeon to lead the world’s largest plastic surgery organization, and notably the first to graduate from Yale’s plastic surgery program. This represents a significant milestone in system-level leadership, integrated standards, patient safety policies, and workforce equity through a culturally influenced lens on the national level.
Dr. Rose M. Lewis, the first Black female plastic surgeon in the United States, and by some accounts, the world. She attended medical school at the University of California, San Francisco. She broke barriers despite an era where few formal programs accepted women, women of color. She held clinical roles at Mount Zion and the Children’s Hospital of San Francisco prior to operating her own private practice serving local and underserved communities expanding patient access to reconstructive and general plastic surgery. She has become a global health educator, providing a lecture on breast disease at the 1985 United Nations Decade for Women Conference in Nairobi, Kenya. She is the personification of strength, persistence, and self-definition in hostile academic environments.
By honoring those who paved the way in reshaping medicine despite systemic barriers, we are reminded that progress is not inherited but continued, nor is it complete. These legacies challenge us to remember and move forward with intention and courage as there continue to exist barriers to people of color in medicine. Continue to expand access, dismantle inequities, and advance the medical system to be ethnically, culturally, and socially inclusive. In doing this, we honor those pioneers in remembrance and in action.
The Research Year Effect: What It Really Means for Plastic Surgery Applicants
Article by Fatima Khan, University of Toledo Class of 2027
In recent years, the research year (RY) has gone from “nice-to-have” to nearly a rite of passage for many aspiring plastic surgeons. For students juggling packed preclinical schedules and demanding clinical rotations, a dedicated year of research offers something rare: time to publish, present, and dive deeply into academic work that might otherwise be unavailable or unreachable. But does that extra year actually move the needle when it comes to matching?
A 2024 study by Wang and colleagues set out to answer exactly that. Analyzing 974 applicants to integrated plastic surgery residency programs between 2017 and 2021, the authors found that about one in five had completed a research year. Applicants who pursued an RY didn’t just pad their CVs, but also matched at higher rates. Eighty-three percent of RY applicants were successfully matched, compared with seventy-four percent of their peers who followed the traditional path.
On average, RY applicants reported more than double the number of presentations and publications, and statistically, they were eighty percent more likely to match overall. The advantage grew even stronger at the top of the field: those with a research year were significantly more likely to land spots at top 20 plastic surgery programs, especially applicants with 15 or more—and even 20 or more—publications to their name.
However, while dozens of grants fund clinical research projects, paid positions in plastic surgery research remain scarce. For many students, taking an unpaid year away from medical school simply isn’t financially feasible. This raises a bigger question about equity in an already ultra-competitive specialty.
If institutions are serious about leveling the playing field, one key step would be to invest intentionally in paid research fellowships. Even limited funding, when directed thoughtfully, can unlock opportunities for talented students who might otherwise be excluded.
Plastic surgery prides itself on innovation, precision, and distinction. But as the authors and advocates alike point out, the field also has a responsibility to reflect the diversity of the patients it serves. While disparities in the path to matching persist, making the research year more accessible could be a meaningful step toward a more embracing and representative future for the specialty.
References
Wang CY, Mellia JA, Levy L, et al. The Association of a Research Year With Matching Into an Integrated Plastic Surgery Residency. J Surg Res. 2024;303:22-31. doi:10.1016/j.jss.2024.08.010
Galbraith LG, Avasarala VS, Jinka SKA, Collar J, Prassinos A. Plastic Surgery Research Year: An Equalizer or Disparity?. Plast Reconstr Surg Glob Open. 2023;11(8):e5102. Published 2023 Aug 1. doi:10.1097/GOX.0000000000005102
Introduction to Enhanced Recovery After Surgery (ERAS) Protocols
Article by Mihir S. Kulkarni, University of South Florida Class of 2028
For a long time, recovery after surgery only meant one thing: rest. However, since the 1990s, efforts have been made to improve this phase of patient care. Enhanced Recovery After Surgery, referred to as ERAS (not affiliated with the other ERAS) are set of standardized protocols with the intention of reducing recovery time while improving post-operative outcomes. ERAS interventions span the entire surgical continuum, from preoperative care to postoperative care.
Specific interventions include preoperative optimization—including smoking cessation, weight loss, and carbohydrate loading—alongside intraoperative measures like maintenance of normothermia and the use of opioid-sparing multimodal analgesia. Postoperatively, the protocol emphasizes early mobilization and oral intake within 24 hours, frequent flap monitoring, and structured physical rehabilitation to enhance recovery and reduce complications. The ERAS Society’s specific guidelines for breast reconstruction have served as a blueprint, allowing plastic surgeons to adapt these high-recovery standards to many procedures across the field.
A 2025 systematic review by Foster et al. found multiple benefits of the ERAS protocol in plastic surgery including faster discharge, reduced opioid dependency, patient satisfaction, and BMI benefits. However, the review highlighted potential bleeding risks that occurred in some studies, which may warrant further studies.
ERAS protocols provide a solid blueprint to enhance patient recovery, thus contributing to improved patient outcomes. However, it is important to ensure that implementation is tailored to individual patient needs and contexts.
References
Foster, L., Foppiani, J., Patel, A., Brady, K., Adams, A. J., Choudry, U., & Lin, S. J. (2025). The use of Enhanced Recovery after surgery (eras) protocols in plastic surgery: A systematic review and meta-analysis of the literature. Journal of Plastic, Reconstructive & Aesthetic Surgery, 103, 273–281. https://doi.org/10.1016/j.bjps.2025.01.072
Home. ERAS® Society. (2025, September 29). https://erassociety.org/
Lombana, N. F., Mehta, I. M., Zheng, C., Falola, R. A., Altman, A. M., & Saint-Cyr, M. H. (2023). Updates on enhanced recovery after surgery protocols for plastic surgery of the breast and Future Directions. Baylor University Medical Center Proceedings, 36(4), 501–509. https://doi.org/10.1080/08998280.2023.2210036
Temple-Oberle, C., Shea-Budgell, M. A., Tan, M., Semple, J. L., Schrag, C., Barreto, M., Blondeel, P., Hamming, J., Dayan, J., & Ljungqvist, O. (2017). Consensus Review of Optimal Perioperative Care in breast reconstruction: Enhanced recovery after surgery
(ERAS) society recommendations. Plastic & Reconstructive Surgery, 139(5). https://doi.org/10.1097/prs.0000000000003242
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