Bio

Bio


Dr. DeCoster received his undergraduate (magna cum laude with departmental honors), M.D. (with distinction), and Ph.D. degrees from the University of Kentucky College of Medicine. He completed a Surgeon-Scientist post-doctoral fellowship through the National Cancer Institute under the mentorship of Henry Vasconez, MD, FACS, and Mark Evers, MD, FACS, where he focused on breast implant and medical device safety which included investigating the molecular mechanisms of breast implant-associated anaplastic large cell lymphoma. In addition to medical device safety, his current research interests are also focused on modulating the mechanical properties of irradiated soft tissue in experimental models, and his work is currently funded by the Plastic Surgery Foundation. Dr. DeCoster is a peer reviewer for Plastic and Reconstructive Surgery, Plastic and Reconstructive Surgery-Global Open, the Aesthetic Surgery Journal, and Annals of Plastic Surgery.

Prior to college, he served six years on active duty in the U.S. Navy, which included deployments to Iraq (Operation Iraqi Freedom, 2d Battalion, 6th Marine Infantry Regiment), Hurricane Katrina (Joint Task Force Hurricane Katrina; USNS Comfort T-AH20, Guantanamo Bay, Cuba (Joint Task Force-Guantanamo Bay Cuba), Saudi Arabia, Turkey, France, Greece, and Bahrain (26th Marine Expeditionary Unit, USS Carter Hall).

Clinical Focus


  • Residency
  • Plastic and Reconstructive Surgery

Honors & Awards


  • National Institutes of Health Oncology Research Training for Surgeon-Scientists(T32CA160003), Lucille P. Markey Cancer Center, University of Kentucky

Boards, Advisory Committees, Professional Organizations


  • Member, Researcher Education Committee, American Society of Plastic Surgeons (2020 - Present)
  • Member, Legislative Advocacy Committee, American Society of Plastic Surgeons (2020 - Present)
  • Peer Reviewer, Plastic and Reconstructive Surgery (2019 - Present)
  • Peer Reviewer, Plastic and Reconstructive Surgery-Global Open (2020 - Present)
  • Peer Reviewer (ad hoc), Aesthetic Surgery Journal (2020 - Present)
  • Peer Reviewer, Annals of Plastic Surgery (2019 - Present)

Professional Education


  • Ph.D., University of Kentucky College of Medicine, Clinical and Translational Science
  • M.D., University of Kentucky College of Medicine

Publications

All Publications


  • Trends in the Surgical Management of Lower Extremity Gustilo Type IIIB/IIIC Injuries PLASTIC AND RECONSTRUCTIVE SURGERY Burns, J. C., DeCoster, R. C., Dugan, A. J., Davenport, D. L., Vasconez, H. C. 2020; 146 (1): 183–89

    Abstract

    Over the past 20 years, innovations in microsurgical technique have coincided with advances in orthoplastic approaches. However, no single algorithm exists to guide management of limb salvage versus amputation. As such, one would expect these procedures to be performed at equal rates given studies showing similar outcomes. Anecdotally, the observation at the authors' institution is that amputations are being performed more frequently. The purpose of this study was to determine trends in lower extremity trauma management.A retrospective cohort study was conducted at a Level I trauma center on patients with Gustilo type IIIB/IIIC lower extremity trauma from 2005 to 2014. Overall, 148 patients were included. Patients were subdivided into amputation (n = 69) and reconstruction (n = 79) cohorts. The Spearman rank correlation coefficient was used to compare trends in amputation and reconstruction groups. Plastic surgery consultation data were analyzed using the Mann-Whitney U and chi-square tests and the Pearson correlation coefficient.Amputation was performed more frequently over the study period (r = 0.292; p < 0.001). Plastic surgeons were consulted in 67.5 percent of cases. A plastic surgery consultation was obtained in only 30 percent of amputation cases (p < 0.001).Although the data show a trend toward amputation and a shift in management of lower extremity trauma, the observed trend may be attributable in part to deviation from an orthoplastic approach to lower extremity trauma. However, lower extremity reconstruction remains a viable option in select patients, and advances in microsurgery can provide excellent outcomes in the face of severe lower extremity trauma.

    View details for DOI 10.1097/PRS.0000000000006912

    View details for Web of Science ID 000547085600051

    View details for PubMedID 32590662

  • Autologous Fat Grafting Does Not Increase Risk of Oncologic Recurrence in the Reconstructed Breast ANNALS OF PLASTIC SURGERY Vyas, K. S., DeCoster, R. C., Burns, J. C., Rodgers, L. T., Shrout, M. A., Mercer, J. P., Coquillard, C., Dugan, A. J., Baratta, M. D., Rinker, B. D., Vasconez, H. C. 2020; 84: S405–S410

    Abstract

    Autologous fat grafting (AFG) is a popular and effective method of breast reconstruction after mastectomy; however, the oncological safety of AFG remains in question. The aim of this study was to determine whether AFG increases the risk of cancer recurrence in the reconstructed breast.A matched, case-control study was conducted from 2000 to 2017 at the senior author's institution. Inclusion was limited to female patients who underwent mastectomy and breast reconstruction with or without AFG. Data were further subdivided at the breast level. χ analyses were used to test the association between AFG status and oncologic recurrence. A Cox proportional-hazards model was constructed to assess for possible differences in time to oncologic recurrence. The probability of recurrence was determined by Kaplan-Meier analyses and confirmed with log-rank testing.Overall, 428 breasts met study criteria. Of those, 116 breasts (27.1%) received AFG, whereas 312 (72.9%) did not. No differences in the rates of oncologic recurrence were found between the groups (8.2% vs 9.0%, P < 1.000). Unadjusted (hazard ratio = 1.03, confidence interval = 0.41-2.60, P < 0.957) and adjusted hazard models showed no statistically significant increase in time to oncologic recurrence when comparing AFG to non-AFG. In addition, no statistical differences in disease-free survival were found (P = 0.96 by log rank test).Autologous fat grafting for breast reconstruction is oncologically safe and does not increase the likelihood of oncologic recurrence. Larger studies (eg, meta analyses) with longer follow-up are needed to further elucidate the long-term safety of AFG as a reconstructive adjunct.

    View details for DOI 10.1097/SAP.0000000000002285

    View details for Web of Science ID 000562462800013

    View details for PubMedID 32049757

    View details for PubMedCentralID PMC7225026

  • The Role of Muscle-Derived Stem Cell-Enriched Scaffolds for Treating Volumetric Muscle Defects PLASTIC AND RECONSTRUCTIVE SURGERY DeCoster, R. C., Rinker, B. D., Butterfield, T. A. 2020; 145 (1): 202E–203E

    View details for DOI 10.1097/PRS.0000000000006337

    View details for Web of Science ID 000507912200057

    View details for PubMedID 31834233

    View details for PubMedCentralID PMC6935394

  • Oncogenic Drivers of Breast Implant-Associated Anaplastic Large Cell Lymphoma PLASTIC AND RECONSTRUCTIVE SURGERY DeCoster, R. C., Rinker, B. D., Butterfield, T. A., Vasconez, H. C. 2020; 145 (1): 195E–196E

    View details for DOI 10.1097/PRS.0000000000006331

    View details for Web of Science ID 000507912200051

    View details for PubMedID 31609289

    View details for PubMedCentralID PMC6935400

  • Appalachian Status Is a Negative Predictor of Breast Reconstruction Following Breast Cancer Resection ANNALS OF PLASTIC SURGERY DeCoster, R. C., Stout, M. A., Burns, J. C., Shrout, M. A., Wetzel, M., Dugan, A. J., Rinker, B. D., Butterfield, T. A., Webster, J., Vasconez, H. C. 2019; 83 (6): E15–E19

    Abstract

    Health care disparities in Appalachia are well documented. However, no previous studies have examined possible differences in the utilization of breast reconstruction (BR) in Appalachia. This study aims to determine if a disparity in BR utilization exists in women from Appalachia Kentucky.A retrospective, population-based cohort study was conducted from January 1, 2006, to December 31, 2015. The Kentucky Cancer Registry was queried to identify population-level data for female patients diagnosed with breast cancer and treated with mastectomy. A multivariate logistic regression model controlling for patient, disease, and treatment characteristics was constructed to predict the likelihood of BR.Bivariate testing showed differences (P < 0.0001) in BR utilization between Appalachian and non-Appalachian women in Kentucky (15.0% and 26.3%, respectively). Multivariate analysis showed that women from Appalachia (odds ratio, 0.54; confidence interval (95), 0.48-0.61; P < 0.0001) were less likely to undergo BR than non-Appalachian women. Interestingly, the rate of BR increased over time in both Appalachian (r = 0.115; P < 0.0001) and non-Appalachian women (r = 0.148; P < 0.0001).Despite the benefits of BR, women from Appalachia undergo BR at lower rates and are less likely to receive BR than non-Appalachian Kentuckians. Although the rates of BR increased over time in both populations, access to comprehensive breast cancer care remains a challenge for women from Kentucky's Appalachian region.

    View details for DOI 10.1097/SAP.0000000000001965

    View details for Web of Science ID 000496948400002

    View details for PubMedID 31513081

    View details for PubMedCentralID PMC6851444

  • Comment on "Training the Surgeon-Scientist in Today's Healthcare Environment'' ANNALS OF SURGERY DeCoster, R. C., Bautista, R. F., Evers, B. 2019; 270 (6): E124–E125

    View details for DOI 10.1097/SLA.0000000000003302

    View details for Web of Science ID 000503422400059

    View details for PubMedID 31726641

  • The Role of Intraoperative Laser Speckle Imaging in Reducing Postoperative Complications in Breast Reconstruction PLASTIC AND RECONSTRUCTIVE SURGERY Bonaroti, A., DeCoster, R. C., Mazdeyasna, S., Huang, C., Yu, G., Halcomb, F., Wong, L. 2019; 144 (5): 933E–934E

    View details for DOI 10.1097/PRS.0000000000006124

    View details for Web of Science ID 000492989300031

    View details for PubMedID 31425417

    View details for PubMedCentralID PMC6832801

  • Finding Consensus After Two Decades of Breast Implant-Associated Anaplastic Large Cell Lymphoma SEMINARS IN PLASTIC SURGERY Clemens, M. W., DeCoster, R. C., Fairchild, B., Bessonov, A. A., di Pompeo, F. 2019; 33 (4): 270–78

    Abstract

    Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging and indolent, but potentially fatal cancer of the immune system that can develop around textured-surface breast implants. The World Health Organization first recognized BIA-ALCL as a unique clinical entity in 2016. To date, over 600 confirmed cases have been reported worldwide. BIA-ALCL most commonly presents with disease confined to the capsule, as a seroma or a mass adjacent to the implant. While BIA-ALCL has a fairly indolent clinical course, with an excellent prognosis in early stage disease, disseminated cancer and death have also been reported. In this review, the authors focus on the early diagnosis and treatment, including reconstructing the breast following BIA-ALCL, and also discuss recently updated National Comprehensive Cancer Network guidelines. They also review the current epidemiology and risk factors associated with BIA-ALCL. Finally, they discuss important medicolegal considerations and the bioethics surrounding the continued use of textured-surface breast implants.

    View details for DOI 10.1055/s-0039-1696998

    View details for Web of Science ID 000490888700011

    View details for PubMedID 31632211

    View details for PubMedCentralID PMC6797486

  • Recruiting the Next Generation of Surgeon-Scientists in Plastic and Reconstructive Surgery: The Value of Research Fellowships PLASTIC AND RECONSTRUCTIVE SURGERY DeCoster, R. C., Rinker, B. D., Vasconez, H. C. 2019; 144 (5): 944E–945E

    View details for DOI 10.1097/PRS.0000000000006136

    View details for Web of Science ID 000492989300041

    View details for PubMedID 31403567

  • CRISPR Craft: DNA Editing the Reconstructive Ladder PLASTIC AND RECONSTRUCTIVE SURGERY DeCoster, R. C., Vasconez, H. C., Butterfield, T. A. 2019; 144 (4): 714E–715E

    View details for DOI 10.1097/PRS.0000000000006051

    View details for Web of Science ID 000487668000034

    View details for PubMedID 31568336

    View details for PubMedCentralID PMC6938574

  • Rural-Urban Differences in Breast Reconstruction Utilization Following Oncologic Resection JOURNAL OF RURAL HEALTH DeCoster, R. C., Bautista, R. F., Burns, J. C., Dugan, A. J., Edmunds, R., Rinker, B. D., Webster, J., Vasconez, H. C. 2020; 36 (3): 347–54

    Abstract

    Breast reconstruction (BR) is the reconstructive surgical technique that focuses on restoring normal form and function to the breast following oncologic resection. The goal of this study was to determine if BR disparities exist among rural female patients in Kentucky.A retrospective (2006-2015), population-based cohort study was conducted on breast cancer patients (stages I-III) treated with mastectomy with or without BR. We used 2013 Beale codes to stratify patients according to geographic status. Chi-square tests were used to examine the association of BR along the rural-urban continuum. A multivariate logistic regression model controlling for patient, disease, and treatment factors was used to predict BR. The likelihood of BR was reported in odds ratios (OR) using a 95% confidence interval (CI).Overall, 10,032 patients met study criteria. Of those, 2,159 (21.5%) underwent BR. The rate of BR among urban, near-metro, and rural patients was 31.1%, 20.4%, and 13.4%, respectively (P < .001). Multivariate analysis revealed that women from near metro (OR 0.54, CI: 0.47-0.61; P < .001) and rural areas (OR 0.36, CI: 0.31-0.41; P < .001) were less likely to undergo BR than women from urban areas.Although BR benefits are well documented, women from rural Kentucky undergo BR at lower rates and are less likely to receive BR than their urban counterparts. Efforts should seek to promote equitable access to BR for all patients, including those from rural areas.

    View details for DOI 10.1111/jrh.12396

    View details for Web of Science ID 000485626400001

    View details for PubMedID 31508853

    View details for PubMedCentralID PMC7064371

  • Dermal Substitutes in the Setting of Flap Delay: A Reconstructive Technique to Enhance Flap Viability AMERICAN SURGEON Covey, S. E., DeCoster, R. C., Wallace, C. C., Moore, E. M., Vasconez, H. C. 2019; 85 (5): E235–E237
  • Muir-Torre Syndrome Presenting as a Sebaceous Carcinoma of the Nasal Ala AMERICAN SURGEON Coquillard, C., Boustany, A., DeCoster, R. C., Vasconez, H. C. 2019; 85 (3): E115–E117

    View details for Web of Science ID 000463511200001

    View details for PubMedID 30947781

    View details for PubMedCentralID PMC6486836

  • Risk Factors for Squamous Cell Carcinoma: A Case for Red Pigment in Tattoos AMERICAN SURGEON Shrout, M., DeCoster, R., Wermeling, R., Vasconez, H. C. 2019; 85 (2): E77–E78
  • Stretch-Activated Ion Channels Are Essential for Fiber Type Transition in Eccentric Exercised Muscle Abshire, S., DeCoster, R., Butterfield, T. A., Best, T. M. LIPPINCOTT WILLIAMS & WILKINS. 2013: 679

Latest information on COVID-19