At the University of Michigan, Dr. Paul Cederna often asks faculty, residents, and visiting professors to describe barriers to dissemination and uptake of novel, evidence-based approaches in plastic and reconstructive surgery. In a complex health care system with many stakeholders, it is clearly not enough to generate an idea or hypothesis and to provide compelling evidence to support it. In fact, the initial steps of identifying a specific problem, offering a solution, and generating evidence may take years, if not decades, for motivated surgeons and researchers.

All aspects of plastic surgery demand rigorous study to ensure patient safety prior to widespread adoption. However, as the evidence accumulates supporting the efficacy and safety of any new approach, the next challenge becomes the diffusion and uptake of this approach in appropriate clinical scenarios.