Over the past two decades, plastic surgery has increasingly been connected to scientific research and publication. Scientific publications and research now drive an area that once existed through mentorship and experience. Data from the International Society of Aesthetic Plastic Surgery indicates that over 30 million aesthetic surgeries were performed globally in 2022. This growth seems to have fueled interest in establishing safety, satisfaction, and long-term follow-up. In this environment, practices would be scored not only on the quality of service provided but also on their participation in evidence-based practices and research.
Canada reflects this transformation. There are academic teaching hospitals and affiliated surgeons involved in multi-center studies in reconstruction, breast surgery, and microsurgery. There have been numerous Canadian studies published in journals such as Plastic and Reconstructive Surgery and Journal of Plastic, Reconstructive, & Aesthetic Surgery. In many instances, these studies focus on complications, quality of life, and functional outcomes, particularly in breast reconstruction. There are private clinics that remain affiliated with academic surgeons who engage in post-market evaluation or studies, even when those studies initially take place within a hospital.
Edelstein Cosmetic Plastic Surgery, established by Jerome Edelstein in 2006 in Toronto, is one such practice operating in this professional environment. Despite operating as a private clinic, its administrators maintain connections with surgeons engaged in research. Through connections made with hospital-based specialists, private practices can ensure that their clinical experiences feed back into research by providing added strength to research initiatives through clinical observations. This is important in areas such as breast reconstruction and reconstructive microsurgery.
Collaborative work within the clinic includes contributions from Dr. Toni Zhong and Dr. Fialkov, both major academic surgeons who also perform cosmetic surgery at Edelstein Cosmetic Plastic Surgery in addition to their university-based practices. Zhong and Fialkov are affiliated with academic surgery departments in Toronto and have a strong body of work in microsurgical reconstruction and quality-of-life metrics. Work conducted within this stream, between 2010 and 2022, has increasingly emphasized physical function, psychological adjustment, and satisfaction, using standardized questionnaires, and has implied that the measure of a successful surgery is more complex than its technical outcome.
Today, patient-reported outcomes have become the foundation for new plastic surgery studies. BREAST Q and FACE Q are currently standard tools used in plastic surgery studies, as well as practice audits. In 2021, Plastic and Reconstructive Surgery reported that over 70 percent of current scientific studies on breast reconstruction include objective patient surveys. Centers that base their evaluation on these tools can offer valuable information for comparative studies. At Edelstein Cosmetic Plastic Surgery, the evaluation process is already based on these reporting guidelines, enabling discussion of study results aligned with published studies.
Cosmetic and reconstructive surgery studies commonly focus on the safety of implants, improvements in surgical procedures, and post-operative care. Even though large-scale studies are typically organized within academic hospitals, private clinics may serve as treatment or supplemental data-collection sites. This approach widens the scope for patient enrollment while strict regulations remain in place. Health Canada and institutional review boards are the oversight entities that regulate these studies, intending to monitor all ethical aspects. Within this context, private clinics operate according to agreed protocols rather than novel research designs, indicating cooperation rather than solo endeavours.
Evidence-based practice has also influenced how surgical teams evaluate procedural modifications. Rather than introducing rapid changes, most updates are implemented after peer-reviewed validation and consensus statements from professional bodies. Organizations such as ISAPS and the Canadian Society of Plastic Surgeons issue clinical guidelines that summarize current research findings. Clinics that follow these recommendations align their practice with published standards rather than proprietary methods. Edelstein and the associated surgical team have operated within these parameters, integrating guideline-based care into routine clinical decision making.
Another research focus within cosmetic and reconstructive surgery involves long-term complication tracking. National databases and professional audits monitor rates of capsular contracture, infection, revision surgery, and implant failure. CIHI has reported steady growth in elective surgical volumes in Canada since the mid-2000s, increasing the importance of consistent outcome reporting. Clinics that maintain structured follow-up schedules contribute indirectly to this surveillance through physician reporting obligations and registry participation. This form of data contribution supports public health monitoring rather than individual institutional promotion.
Education and knowledge transfer are related components of academic engagement. Surgeons who participate in research frequently present findings at conferences and continuing medical education programs. These activities help translate study results into everyday practice across both hospital and private settings. While private clinics typically do not host primary research programs, professional participation in these educational networks helps clinical teams stay aligned with current evidence. Edelstein Cosmetic Plastic Surgery is part of a professional community where research-based evidence is a mandate. It has influenced the way procedures are organized and the way patient counseling is conducted, thanks to the evidence organized and moderated within this professional category.
At the mid of the 2020s, private practices assumed a more recognized position where collaboration, standardized patient information, and strict following of evidence-based guidelines became standard practice. It is now more of a body with its own procedures, not just for direct service delivery, but also for initiating more talks within research circles, a practice that has been in the community since its inception in 2006. Edelstein Cosmetic Plastic Surgery, as part of this research-oriented community and through the academic involvement of its surgeons, including Dr. Toni Zhong and Dr. Fialkov, keeps abreast of evidence-based guidelines for both cosmetic and reconstructive procedures.
