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Friday
Jan062017

Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Starting out as a Primary Care Physician, Dr. Jenny Weyler branched out to aesthetics, exclusively practicing the field since 2010 in our interview with the Physician.

Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Name: Dr. Jenny Weyler
Clinic: Aponi Aesthetics
Location: Worcester, MA
Website: http://aponiaesthetics.com/

Brief Bio:

I am a Board Certified family practice doctor, who graduated in 1992 from the Medical College of Pennsylvania (now part of Drexel University) in Philadelphia, PA. I completed my family practice residency in 1995 at the University of Massachusetts in Worcester, MA. I practiced as a primary care physician from 1994-2004, and then worked in an Urgent Care clinic from 2004-2010. In 2010 I started taking classes to learn aesthetic injections, and I opened my own business in December 2010. Initially we did some primary care here, but I loved doing aesthetics so much, and that part of the practice grew so quickly that we became exclusively aesthetic providers in 2014 and changed our name to Aponi Aesthetics.

How did Aesthetics interest you and it influence your practice?

When I was doing primary care I always loved doing procedures: stitches, mole removals, biopsies and any minor surgical procedure. Learning aesthetic injections was a great way to incorporate my love of procedures with the excitement of learning a whole new field of medicine. The results are so obvious, amazing and gratifying. People love the results, so the clients are enthusiastic and how could I not love making people look and feel better? As I honed my skills in injections, I started to learn more about lasers and skin care products and we added that to our repertoire as we went along. I have logged well over 100 hours of direct hands-on training in injectables and laser safety and use, as well as many more hours of lectures on the same subjects. Aesthetics is constantly evolving and advancing, and I love...

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Friday
Jan062017

Dr. Jennifer Trent - American Dermatology Associates, Florida

With more than 10 years of experience under her belt, Dr. Jennifer Trent practices medicine and writes journal articles and text books in Dermatology, in our interview with the Florida-based Dermatologist.

Dr. Jennifer Trent - American Dermatology Associates, Inc., FloridaName: Dr. Jennifer Trent
Clinic: American Dermatology Associates, Inc.
Location: Sarasota, FL
Website: http://www.americandermatology.net/

Brief Bio:

Jennifer Trent, MD FAAD completed a 6 year combined BS-MD at the University of Miami with an undergraduate major in biology and a minor in chemistry. While in medical school, she interrupted her formal course to participate in a 2 year research fellowship in Dermatology at the University of Miami. The focus of her work was hos-pital care of dermatology patients, toxic epidermal necrolysis, and wound care. Dr. Trent graduated from Medical School with research distinction as well as the Univer-sity of Miami Department of Dermatology’s medical student of the year award.

She completed her internship in internal medicine and her residency in Dermatology and Cutaneous Surgery at the University of Miami/Jackson Memorial Hospital. Dr. Trent has presented her research on toxic epidermal necrolysis and methicillin re-sistance staphylococcus aureus several times at the Society of Investigative Dermatol-ogy and the annual American Academy of Dermatology meetings. She was recipient of the Celia and Samuel Resnik Award for dermatology research from the University of Miami Department of Dermatology and the prestigious Young Investigators award for research from the American Academy of Dermatology for her work on toxic epider-mal necrolysis. Dr. Trent has also received several awards for teaching from the Uni-versity of Miami Department of Dermatology.

At what point in your life did you discover your interest in cosmetic medicine?

Ever since I started medical school, I was also fascinated by the skin. How it exists as this beautiful intermediary between the harsh environment and our delicate bodies. It is a strong but vulnerable gatekeeper. During my residency at the prestigious University of Miami Department of Dermatology, I learned that dermatologists are artists. We can “re-sculpt”...

Dr. Jennifer Trent - American Dermatology Associates, Inc., Florida

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Thursday
Jan052017

Labioplasty, Vaginoplasty... Where's The Line Around Genital Cosmetic Surgery

What's going on with the growing trend of labiaplasty and genital surgery?

aesthetic labioplasty

There's been a pretty dramatic increase in genital aesthetics in the last decade. What's up with that? Is it market demand or are aesthetic clinic just getting better at marketing to a deeply personal fear.

In the United States, it's being circulated that a labiaplasty surgeon can earn up to $250,000 a month (which seems unrealisticly high). Simone Weil Davis, professor of American studies, told Shameless magazine in 2005 that surgeons are perpetuating the idea that there is a right way for women's genitalia to look; because most women see only their own vaginas or pornographic images, it is easy to make them doubt themselves, and for cosmetic surgeons to provide an answer.

But not everyone is on the hooha beautification bandwagon...

Click to read more ...

Tuesday
Jan032017

Physician Burnout in the Cosmetic Medicine Community

Physicians are under immense pressure, which could lead to exhaustion that may cost their time in the practice but also their patients. In this article, we tackle the causes of burnout in the field of cosmetic medicine.

Physician Burnout in the Cosmetic Medicine Community

It is not uncommon for any working adult to say, “I’m tired, I want to quit”.

Physicians may feel this burden heavier others considering the amount of pressure over a career.

Medscape has done a study on physician burnout and bias last January. Measures of burnout were based on low sense of personal accomplishment, feeling of cynicism, and loss of enthusiasm for work. In cosmetic medicine (i.e. dermatology and plastic surgery), the top reason for burnout is bureaucratic tasks. Other reasons cited were computerization of practice, outcome of the Affordable Care Act, and lower received income.

In an article by dermatologist, Dr. J. Michael Knight, he points out the causes of burnout for aesthetic medicine practitioners (i.e. dermatology and plastic surgery). He further elaborates on the causes also enumerated by Medscape, which contribute to the physical and mental exhaustion of a doctor in cosmetic medicine. Bureaucratic tasks and adoption of telemedicine seem overwhelming to cosmetic practitioners. Time is mostly dedicated to patients, and the growing use of technology in the clinic seems a never-ending race. 

Patients are also a key factor in physician burnout. In cosmetic medicine, old procedures evolve and new procedures are implemented. With the increase of insecurities brought upon by social media and peers, more individuals look to aesthetic practitioners for their source of self-esteem. That demand increases, making it difficult for some physicians to fulfil a patient’s request. That could have a butterfly effect as that one patient could network to more individuals seeking treatment, which could mean less inquiries and walk-ins for new and potential patients. 

As similarly pointed out by the surveyed doctors in Medscape, low income is a cause for physician burnout as well. Some physicians know that costs are piling up, yet are paid less than most. In an example by Knight, they overshadowed by the deals presented by online sites that would entice their patients to purchase cheaper procedures done by non-physicians. Knight adds that it does not help they are working more hours with lesser pay. 

One way to prevent this from happening again is to educate and inform the staff about this occurrence. Acknowledging that physician burnout is important. The fact that other physicians take notice, staff could be made aware of the pressures faced by physicians whether it is medical or practice related. 

Another way is to make time for other activities. It will be difficult considering the demanded number of hours, but it is always recommended to make time for yourself or the activities that you once did which could help take your mind off work. A recommended activity is exercise, as it is one of the best ways to relieve any stress.

Aside from this, Mayo Clinic presented nine strategies to avoid burnout and you could find the resource here: http://www.mayoclinicproceedings.org/article/S0025-6196(16)30508-0/pdf

Article Links:

http://modernaesthetics.com/2016/06/physician-burnout-careers-in-crisis-part-1
http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview
http://www.medscape.com/features/slideshow/lifestyle/2016/dermatology
http://www.medscape.com/features/slideshow/lifestyle/2016/plastic-surgery
https://wire.ama-assn.org/life-career/avoiding-burnout-strategies-senior-physicians
http://catalyst.nejm.org/physician-burnout-endemic-healthcare-respond/
http://medicaleconomics.modernmedicine.com/medical-economics/news/what-price-physician-stress-and-burnout?page=0,0

Tuesday
Jan032017

Patients Do Better With Female Physicians?

Female doctors patients may have lower death and readmission rates. Does that have any relevance to your clinic?

JAMA Internal Medicine published a study about patients favoring women as their doctors. The study is centered on readmission and mortality rate among the elderly. The authors selected random data, in which a third of the physician sample were female. 

For the study, researchers examined hospital readmissions and mortality data for a random sample of traditional Medicare beneficiaries 65 or older who ended up in acute-care hospitals from Jan. 1, 2011, through Dec. 31, 2014. Those data consisted of slightly more than 1.5 million hospitalizations, in which patients were seen by 58,344 physicians. About a third of those physicians were women.

The researchers adjusted the data to account for different characteristics of hospitals and patients, as well as physician characteristics that were not based on sex, such as experience level. These types of adjustments ensure that the study's findings do not simply reflect a situation where male physicians are seeing sicker patients, for instance.

The female physicians tended to be younger––their average age was 42.8 years, compared with 47.8 for men. They also were more likely to have training in osteopathic medicine and to have treated fewer patients.

Findings:

  • Patients treated by women had mortality rates of 11.07%, compared with 11.49% for those seen by men.
  • Readmission rates were 15.02% among those seen by women, compared with 15.57% for male physicians.

Dr. Ashish Jha, co-author of the study, also can’t figure out the discrepancy, raising concern about how men could be thought of not being better practitioners. In addition, he suggests that issues like gender and pay gaps should be further discussed finding the latter unacceptable. 

In the case of cosmetic medicine, a study by Huis In ‘t Veld; Canales; and Furnas, with the latter two being plastic surgeons part of the research as well. The sample consisted of 200 patients, all of which were female. In addition, the study delved in which areas of concern that the patients want to undergo on.

Study findings:

  • Among the sample, 26% chose a female surgeon, and another 12.5% chose the female surgeon (Furnas) in the study
  • Area of concern for those who favored a female surgeon: breast, body, face, and genitalia
  • Generally speaking, gender did not matter so long as the surgeon had a reputation and experience

In another research, a study was published in 2015, modelled from an older study conducted to British patients. The sample consisted of 515 women, with only 500 accomplishing the provided questionnaire. Similar to the above research, gender also did not matter as knowledge and experience were the major factors for choosing surgeons as well. 

Study findings:

  • Among the sample, 190 patients preferred female surgeons.
  • More than half (59%) had no preference to which gender. 

This raises the question as to why patients choose female physicians, which could pose a gender gap issue in practicing physicians. For cosmetic medicine, a reason linked for female patients choosing female doctors is due to the intimate areas of the body. In addition, patients favored female doctors because of more comfort and lesser embarrassment. 

Studies cited:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131538/
https://www.ncbi.nlm.nih.gov/pubmed/27913412
http://www.modernhealthcare.com/article/20161219/NEWS/161219912

Sunday
Jan012017

Dr. Bertha Baum - Hollywood Dermatology, Florida

Dr. Baum shares how she got into cosmetic dermatology and some management and marketing tips for fellow physicians in our interview.

Dr. Bertha Baum - Hollywood Dermatology, Florida

Name: Dr. Bertha Baum
Clinic: Hollywood Dermatology
Location: Florida 
Website: www.drbaum.com, www.hollywooddermatology.com

Brief Bio:

Dr. Bertha Baum is a Florida based board certified dermatologist & cosmetic surgeon, considered a skin care expert who provides her patients with the most current and advanced treatments for all conditions which affect the skin, hair, and nails. Throughout her career, Dr. Baum has built a reputation as a top cosmetic dermatologist by providing leading-edge treatments, dedicated and personalized patient care, and excellent aesthetic results.

What can you tell us about Hollywood Dermatology?

We do a lot of internal marketing, for example once or twice a month we run an event and a promotion for our loyal or VIP patients. Also we offer our patients the benefits of the Brilliant Distinctions program or the Galderma Aspire rewards. We have done some marketing on local magazines but we truly believe in word of mouth because our patients are satisfied and they send more patients and thats our success. We have Instagram and Facebook and try to be as active as we can promoting new procedures or the latest in skin care products.

Dr. Bertha Baum - Hollywood Dermatology, Florida

We do a lot of Botox, Dysport and some Xeomin; also all the fillers available in the market. Laser can be a big source of profit once the machine is paid because you are able to charge and not pay for the product. Plasma PRP is also another great source of income with excellent results

We still do clinical dermatology in our office so it was a very busy day at the office and I told one MA that was not with me in the rooms at that moment to get blood from a patient for plasma. After 5 minutes I go back into a clinical derm patient it was actually a full body exam and their first visit and I see the patient had a band aid on her arm freshly placed and as soon as I introduced myself she says “wow I’ve been to a lot of Dermatologist and they have never done bloodwork on my first visit, you are very thorough.” I realized that the MA had done in on the wrong patient and explained to the patient there had been a mistake, thank God the patient understood the situation and then told the MA she had gone to the wrong room to get bloodwork for plasma. I’m grateful this was not a big mistake but we definitely learn from...

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Sunday
Jan012017

8 Rules in Finding Patients (and Saying No!) in 2017

With 2017 coming up, more and new challenges are afoot in managing practice and performing cosmetic procedures. You may encounter new patients who have no idea about cosmetic procedures or get quirky ones who have jumped from one physician to another.

Before all that, here are three things to evaluate in the upcoming year.

Practice ways you can market

Marketing will always stay a crucial factor in getting patients. Whether you are marketing through word-of-mouth or social media (SEO), strengthen that further.

Not getting your desired results? Try a different approach. There are other marketing approaches other than basic marketing in social media. You could mix it up in other social media platforms. Read more about our Marketing Strategies in 2017 here.

Set your current policies and rules

This one deals with mostly updating your current guidelines to staff and patients; this is in dealing with new patients and caring for them. It could act as a refresher to old staff or new information for your new staff as well.

Organize a list

For what, you ask. Everything you do and will do in your practice, and now that you have probably figured out which services you want to keep, it’s best to know which new procedures you could do with existing ones. That includes updating your menu of services.

Promote services that keep your practice alive. Don’t let your old devices collect dust in the corner. Sell them while you still can or probably re-use them.

Considering having your staff undergo training? Enumerate it there. Do not only expand your experience, give them opportunities to make them grow.

Now that you have set-up, what about the new patients that would come in your office come 2017. The holidays are finally over, and they would need a new look over the new year. Some would come with the weirdest requests while others would come in without knowing anything. This is where you come in and educate them about what you offer and how you manage your practice.

Have a sit down with the patient and assess the situation objectively

Allow them to come to your office and listen to them. Ask them where they got the idea to get the new treatment. Once you have heard their story, discuss what options they have or recommend what other alternatives for their desired treatment.

Explain the expected outcomes (for their preference and of your assessment)

Many patients come in the clinic without expecting risk at all; most would think it would only enhance them. As their physician, it’s your responsibility to inform them of everything involved around their favored procedure.

For example, if their desired procedure or treatment is attainable in another way, offer that one instead. Spare no details of the risks and costs involved. This way, your patient knows the effects of undergoing the procedure, rather than leaving you with a bad review. Yikes!

Stand your ground

This comes hand-in-hand with the policies and rules you have prepared, and later we will briefly elaborate on saying no to your patient. Don’t be a pushover to your patient, and approach them as to how you will be performing the procedure without being aggressive either.

Remember to ask about their history

Patients may forget to disclose their past surgeries or physicians they have gone to, and from there you can determine how you could work out your process in treating them.

Get insight from past patients

Learn from your past and apply it in your present. You might think that this one patient was similar to someone you have encountered before, tell a background about how some patients reacted to the treatment.

Saying no can be a daunting task. Most aim to please their patients, which could be a factor to getting good reviews, but not all procedures and treatments are plausible or doable, as they pose risks to your patient and to your practice. In order to avoid that, politely apologize to avoid any misunderstanding from the patient; the prospective patient may not appreciate your initial turning down. Thus, elaborate why you will not perform the procedure, and how risky and costly it could be.

In doing so (and saying no), remember three things in mind.

Empathize first

Many patients would undergo a procedure just to enhance a specific area of concern, and this could be a valid reason. Some others would do it for other people, and not for themselves. Let them know that surgery would not be the immediate answer to their concerns. Instead, offer them an alternative.

Offer other options

Their procedure may not be attainable, offer alternatives as to how to achieve similar results or that would greatly benefit them. Another scenario is after you have assessed them, and recommend the treatment that would suit them best.

Stay firm

In the case where the patient is insistent on getting their wanted procedure, assert and assure that the options you laid out would be the safest. Emphasize how the treatment won’t be achievable. Remind them as a physician all you want to offer your patient is better care and services.

Sunday
Jan012017

Fillers in Men; Reshaping the Face of Masculinity

Fillers in Men

Guest Post by Dr. Ebtisam Elghblawi, an aesthetic dermatologist in Libya.

Dr. Elghblawi's interview.

Nowadays it is vital to feel confident, self assured and self content about the general look. Face and beauty is always appealing and pursuing beauty is one of the most deeply ingrained human drives as always and as ever.

It has been found that beauty is innate preference as they have noticed a three- months babies were staring for long on beautiful faces.

Over the recent years, demands for medical cosmetic procedures have growing by leaps and bounds, with an immense potential. It has been noticed that the number of patients who is receiving cosmetic has risen. Cosmetic procedures have dramatically increased in popularity over the past two decades in the USA and men newly represent a growing percentage of all consumers, beside women who still make up the main bulk of the filler market.

More than ever, males nowadays are seeking cosmetic procedures for various reasoning. They become more self-concerned and self-conscious to look their best in the impossible quest with the possible available non invasive ways.

This surge could be attributed to the pressure of the media, glamorous lifestyle magazines, and tempting television adverts and offers with movies promoting men’s trendy styles, baby “boomer” male, grooming appealing utilities, and fitness merchandise. This new trend is contributing to the rise of male aesthetic procedures in dermatology.

Men nowadays are much more open and proactive about their appearance and it’s not considered a taboo as it used to. And this can be explained to the reason of quick fix at lunch time with no downtime.

Some men will recognize particular areas of concern to combat, while others point out only the overall aging appearance.

Men generally are less price sensitive comparing to their counterpart women, and are difficult in making follow up appointment and more pain sensitive comparing to women. They want a less bruise work and pain free fix with easier administration.

Men differ from women when it comes to inject their faces, as different methods can be adopted due to the biological, anatomical and behavioural variation aspects.

Men have a squarer face, strong horizontal brow, a more angled and larger jaw, strong chin, and equally balanced upper and lower facial proportions. Thus feminizing men facial features will lead to patient’s dissatisfaction.

Any person per se is considered a piece of art, a sculpture, and herein we are creating an appealing exquisiteness. The face has divine measures. We have to look for an artist for each client faces to achieve what is desired. Also addressing patients’ main expectations and checking out realistic outcomes are the main goal in any successful aesthetic practice.

We have to hand men a large hand held mirror to appreciate and compare the treated and untreated areas.

In many instances some patients do have body ‘dysmorphia’ whereby they never appreciate nor see any positive outcomes even if it was merely subtle. It’s after all, patients own perception of their body and they could just make unnecessary troubles which we should ensure before any procedure to save the hurdles incurred after then.

The general joking says ‘the more fit men are, the worse they look, they look close to death’. As in fact heavy exercise causes fat to exhaust from a destitute area and build up in parts of the face where it conveys an ugly look for men. Many men want that quick subtle make over for their face to be probably ready for action.

In defining unique male characteristics we need to consider certain aspects in order not to feminize men. We have to emphasis on the masculine athletic look. For instance, the projected chin, chiseled jaw, and sculptured men jaw line, and the ‘alpha men’ are the preferable one. After all, men with wide angle, strong face and chin is the picture domain for most men.

There are different ways to approach men face with injectable fillers. In fact injectables are meant to shape the face subtly and not grossly without going under the knife.

Strong chin give the confidence look and adding 1-2 cm projection to the chin would imply as adding few inches to the actual height. In fact it gives the alpha men appearance. Also under eye darkness, bags, puffiness and hollowness would imply a tired look and adding little filler will give the rested and the super refreshed look and more youthful outlook.

Full face filler - subtle augmenting facial features treatment can be the right choice to approach after full face assessment. In fact small changes will give big impact and boost the self confidence and body image. Even nose hump correction, with the under eye, cheek, and chin augmentation would all reflect in one way or another with a positive attitude.

The ultimate aim is not to overuse and just aim to have a subtle favorable improved look. It’s in fact a combination between aesthetic and cosmetic reasoning to stay proactive and trendy.

It’s not favorable to augment men lips though some demand that in the western society in copying some celebrities. After all it’s everyone choice and should consider it from all aspects. However, pouty lips are considered to be sexually attractive by both men and women and certainly a feminine attribute. When augmenting lips in the male patient, under-correction is the rule to be undertaken.

Looking good is important to most people and everyone wish. Facial beauty can be defined by an amalgamation of factors that involve symmetry, visually pleasing and aesthetically pleasing geometrical proportion. After all, men are still only a small portion of most clinician’s total patient population.

The good about cosmetic injections that it offers immediate results with no downtime and thus a quick return to work after the procedure

Cosmetic dermatology continues to offer refined, improved, and new patient aesthetic treatments and desired therapies. Dermatology is a continuous, open-ended practice, and I always strive to perform the greatest procedures to my patients with the wish to enhance and improve the appearance of their skin. In many occasions, a new product and procedure doesn’t always live up to manufacturer’s promotion, expectations or advance reviews. My patient’s consulate me for advice about safety, effectiveness, and the painless performance of desired procedure, to keep them in the look they yearn for.

My greatest reward is when my patients are happy, and exceeded their expectations and improved their self esteem.

My patients in general, want to look younger, natural, refreshed, and vibrant, simply a better version of them and without any downtime.

My current driving passion is detection of skin cancer by the dermatoscope and applying my own skillful knowledge on cosmetic dermatology.

To come to an end, men who desire fillers have their own needs and anticipations. It’s important to optimize men satisfaction with the yielded outcomes. After all cosmetics are utilised to beautify, enhance attractiveness, and sometimes altering one’s look without affecting the underneath structure or functionality. And in order to optimize outcomes - cosmetic approach must be tailored for each patient individually and it’s important to have a proper understanding and a mutual communication to achieve the desired results.

Hyaluronic acids will keep on growing in both male and female patients, and the sole principles of the male face must be well-known as treatment goals in order not to feminize men. Furthermore, symmetry, steadiness, and an harmonious mix are the crucial objectives for delivering perfect treatment.

About the Author

Dr. Ebtisam Elghblawi is a Libyan-based Aesthetic Dermatologist. She is very much passionate in learning more about aesthetic medicine as she progresses in her career.

Submitting a guest post.

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