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Entries in Plastic Surgery (32)


Top 10 Countries For Cosmetic Procedures

According to the International Society of Aesthetic Plastic Surgery, here are the top 10 countries ranked by number of cosmetic procedures.

Top 10 Countries For Cosmetic Procedures - Medical Spa MDSome interesting facts according to the report:

  • Japan moved from #6 in 2009 to #4 in 2011.
  • France moved from #14 to #9 in the same period.
  • The US dominates with just under 18% of procedures worldwide.
  • Asia performs the most treatments by continent with 28.8% of plastic surgeons and 31.7% of total procedures. North America is second with 24.3% of the worlds plastic surgeons and 24.6% of the total procedures.

American Cosmetic Surgery Numbers By Region


Dealing With Anonymous Patient Reviews As A Physician

Reputation Management for DoctorsThe internet is a double edged sword to the Plastic Surgeon.

Patients from near and far can read about and research our skill and services but at the same time a handful of malicious people can significantly tarnish a great reputation which we have strived to achieve and maintain.

As a surgeon and as a human I have always strived to maintain the highest ethical and moral pathway. Most of us went into medicine to help people. What we do as cosmetic surgeons may not save lives but it does save quality of life and that is evident in our patients' smiles and behavior after successful cosmetic surgery. As doctors we strive to achieve and maintain a pristine reputation but as in anything else in life, it is impossible to please all the people all the time.

The internet has given a voice to everyone but it seems like angry, bitter, malicious people take advantage of this soap box and platform much more often than normal happy folks. You can see this on comments on YouTube or blogs or chat rooms of all kinds - not just medical or plastic surgery related.

But in our field, we depend on our reputation and while you may have thousands of happy patients, a small handful of unhappy ones can affect your reputation. Personally I have seen that the vast majority of my negative online anonymous patient reviews or ratings are from people who I have either never seen in my office or have seen but refused to operate on as patients. I recently had a "1 star negative review" on YELP from a person who has never even come to my office nor met me but decided that she did not want to pay $100 for an hour of my time for a consult and felt obligated to give me a negative rating for not offering free consults! We have all had such occurrences. But how do you deal with it?

My method has always been dealing straight forward with any and all comments.  If it is out there then it begs clarification and a reply from my staff or office managers or even myself.  There has to be accountability.  In the restaurant industry, restaurants can actually review and rate their patrons, not just vice versa! As physicians, we have to respect patient confidentiality and HIPAA but that does not mean we must be silent and let any anonymous person's comments go without a reply or clarification especially when most of us work so hard to do the right thing and practice with skill, ethics and integrity.

Resources for physicians:


Top 5 Cosmetic Surgery Treatments In 2011

According to the American Society of Plastic Surgeons cosmetic surgical procedures increased 2 percent, with nearly 1.6 million procedures in 2011. The top five surgical procedures were:

• Breast augmentation (307,000 procedures, up 4 percent) 
• Nose reshaping (244,000 procedures, down 3 percent)
• Liposuction (205,000 procedures, up 1 percent)
• Eyelid surgery (196,000 procedures, down 6 percent)
• Facelift (119,000 procedures, up 5 percent)



Richard D. Gentile, MD MBA, A Plastic Surgeon In Ohio

Our interview with Dr. Richard Gentile of Gentile Facial Plastic & Aesthetic Laser Center with three locations in Ohio.

Name:  Richard D. Gentile, M.D., M.B.A.
Location: Youngstown, Akron, and Cleveland, OH

That’s interesting: Dr. Gentile is deemed as one of America’s Top Facial Plastic Surgeons by the Consumer’s Research Council of America. 

Profile: Graduate of Ohio State University, The University of Cincinnati College of Medicine and Baylor College of Medicine Residency Program. International lecturer and author of many publications including the 2011 Textbook “Neck Rejuvenation” published by Thieme. Dr. Gentile is a past member of the Executive Committee of the American Academy of Facial Plastic & Reconstructive Surgery and served as its Treasurer from 2004-2007.

How did you realize you were meant to practice cosmetic medicine?

As an undergraduate student I had the privilege of spending a week externship with a Plastic Surgeon in Columbus Ohio. It was really my first exposure to medicine and I was significantly influenced by the mentoring that occurred. During medical school I was equally influenced by head and neck cancer procedures and elected to pursue postgraduate residency studies encompassing both cosmetic head and neck and reconstructive surgery.

With three different locations in Ohio you must be busy. Can you describe how your clinics operate and how you staff them?

The Facial Plastic & Aesthetic Laser Center is a fully integrated aesthetic practice with a free standing state licensed and nationally accredited surgery center adjacent to it. There are satellite offices in Akron and Cleveland Ohio where consultation and minor surgery is offered. We are privileged to see patients from all regions of Ohio, Western New York, Western Pennsylvania and West Virginia. We also see patients from other states and foreign countries as well. A full service medical spa is located in the Boardman office and one of the largest private laser clinics with 20 different aesthetic lasers.

Our main office is not located in a large metropolitan area so staffing is sometimes a challenge. (Larger metro areas feature more cosmetic practices training staff who then have experience in medical spas or pastic surgery centers when they interview for new positions.)

Unless someone moves into our area we usually do not have the opportunity to hire experienced personnel so we have to train them on site. Another disadvantage is the smaller surgery centers need per diem or part time staffing patterns unless they operate five days a week and frequently it is difficult to find personnel who are interested in more limited schedules. Understanding these special needs allows us to zero in on those candidates who are interested in the employment opportunities we offer. We have several aestheticians, a cosmetic surgery coordinator who also assists our marketing efforts, two RN’s one exclusively dedicated to the surgery center and anesthesia staff who are retained from a national staffing firm. Our front office has a billing director and a receptionist.

What IPL or laser technologies are you using? What are your thoughts about the technologies you’re using now?

We have two Lumenis One platforms one in Boardman and one in Cleveland. They are equipped with IPL, Light Sheer laser hair removal diode laser and Nd:Yag. We also utilize three fractional lasers the Lumenis Ultra Pulse with deep FX , the Cynosure SmartSkin laser, and the Sciton Contour with ProFractional capabilities. We also utilize radiofreqency units for skin tightening with LumenisAluma and Pelleve. We frequently combine these modalities in multi-modality laser skin rejuvenation. The Cynosure Med Lite is one of our most frequently utilized lasers and is used for Tatoo removal, non ablative skin rejuvenation and dermal toning. A 532 nm diode laser is used for non-ablative treatment of vascular and pigmented lesions. Laser Lipolyis is a big part of our practice particularly in the head and neck and we developed many of the facial surgery protocols for laser assisted facelifting procedures or Smartlifting™ procedures.

Have your marketing efforts successfully increased the volume of patients coming in your clinic?

We use or have used virtually all media to market our practice and find particular success with internet based, social media, and seminars to educate the public about the procedures we offer. Being features on the websites of our technology partners also helps to let patients know about the services we offer.

Our favorite referral are those that come from a satisfied and happy patient sending their friends and family members to us and those make up about 50% of our new patients.

Are there particular treatments that have increased your profits dramatically?

Our services are divided about 50-50 between surgical services and the other office based non surgical services including neurotoxins (Botox), dermal fillers and laser procedures. Among our surgical procedures 90% are facial plastic & reconstructive in nature but primarily cosmetic and not as much reconstructive surgery as previously.

A small percentage of our practice revenue comes from skin care products and related sales.

What lessons have you learned in your practice that you can pass on to those who have just started their medical spa?

Listen to your patients. I think it is important that they are not always in your office so that you can give them the result you think they should have. They are there to hear about how you can best help them achieve the result they are interested in. The closer you come to achieving their goals the more satisfied and happy they will be. Learn from the unhappy patients so that it can help you to either modify your approach or better select patients so as to not try to please the difficult to please patients.

It has been a great privilege to practice Facial Plastic & Reconstructive surgery for nearly 25 years and the greatest development from early practice to later practice is the accumulation of wisdom from the early years of practice. When first starting in practice you sometimes carefully walk into the exam rooms of post op patients not quite sure what the result is going to be like or whether there will be complications. 25 years later you pretty much know what to expect and the kinds of results that will be achieved. We are always innovating and trying to add modifications to our techniques that will enhance our patients post- operative results. So while we are getting closer all the time our practice continually strives to obtain the best surgical and non surgical results available anywhere.

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.


Symbol of Excess: Is Any Publicity Good Publicity In Medicine?

By Patricia Walling

Once upon a time, cosmetic surgery was talked about in hushed tones.

Hollywood starlets were whisked through back doors into surgical suites, swathed in scarves and sunglasses to protect even the whisper of an identity. Then celebrities began talking, and soon Americans were seemingly obsessed with the transformative promises of cosmetic surgery. From requests for Nicole Kidman’s nose to Angelina Jolie’s lips, cosmetic surgeons were soon being asked to transform patients into lesser versions of their favorite stars. Larger breasts, higher cheekbones and a smaller chin soon became normal requests. Yet some may wonder, has this quest for perfection taken a toll on the American psyche? When is cosmetic surgery a beneficial procedure, and when is it simply one more symbol of excess and vanity in an increasingly image-oriented society? There are no easy answers.

When reality TV starlet Heidi Montag announced in January of 2010 that she had undergone a marathon of cosmetic surgery, racking up 10 procedures in a single day, many wondered if her dreams of the perfect body and face hadn’t become an obsession. However others in the medical community, such as those in medical transcription, saw in the 10 surgical procedures something more terrifying, addiction.

By all accounts, Montag was beautiful, a blonde-haired, blue-eyed young woman with a natural smile, but when discussing the plastic surgery procedures with People Magazine, she referred to herself as “an ugly duckling.” From a mini brow-lift to Botox to liposuction to breast and buttock augmentations, the procedures nearly killed Montag, but she stood firm behind her decision, saying Hollywood’s visions of beauty had pressured her into it. However, apparently 10 surgeries were still not enough. When the hoopla died down around the reality star’s new look, her husband announced later that year that she wanted to augment her breasts again. The surgery was to be filmed for a new reality show they were shopping. Was her subsequent admission to a plastic surgery addiction just another reality show ploy or did the superficial nature of Hollywood push her to a true addiction?

These days, it seems that more and more women feel the need to get some type of plastic surgery to order to achieve the Hollywood beauty ideal. According to an article in Medical News Today cosmetic surgery procedures increased an astonishing 700 percent between 1995 and 2005. Similarly, in an in an article discussing the psychological ramifications of Montag’s procedures, Fox News noted that 91 percent of all patients opting to have elective cosmetic surgery were women. While the average age of a patient wanting plastic surgery has not skewed younger, it has become far more socially acceptable for individuals, generally women, in their teens and 20s to have plastic surgery procedures.

A teenager going under the knife is hardly news anymore, but even children are getting in on the act. One mother recently made headlines when her seven-year old daughter had her ears pinned back and a fold on one ear corrected. An article in the New York Daily News details the mother’s decision, which she said was made to prevent bullying. She recounts adults making comments about her daughter’s ears, in front of her daughter. Oftentimes other children would refer to the girl’s ears as “gross” and wonder what had caused them to look strange. The plastic surgeon that performed the procedure, Dr. Steven Pearlman, agreed that children born with seemingly minor differences can face major harm in terms of the “development of their self-identity” if such deformities are not corrected. All of this raises the specter of a major ethical conundrum. At what point is it appropriate to refuse a patient’s cosmetic surgery procedure? What problems can be fixed through therapy or friendships rather than rhinoplasty and brow lifts? There is no easy answer.

A list of guidelines published by Mayo Clinic notes a number of things that individuals considering cosmetic surgery should keep in mind. Beyond considerations about expense and risk, individuals should think about what they expect the procedure will accomplish. If a woman believes that having Angelina Jolie’s lips will make her look like Angelina Jolie, she will be disappointed with the results. Likewise, if she believes that the procedure will make her happier, she is likely to be equally as disappointed.

While it is possible that a patient with reasonable expectations will experience a boost in self-esteem, cosmetic surgery is not the panacea of the average and aging as portrayed by popular culture. A patient’s depression won’t improve just because her chin no longer juts out. Plastic surgery won’t turn a patient into the epitome of female beauty, nor will it save a marriage or improve a social life. It short, no amount of plastic surgery can buy happiness.

A Fox News article discussed the specific implications of Heidi Montag’s surgery shortly she revealed her totally remodeled body. Among those who weighed in on the pros and cons of plastic surgery was Debbie Then, a psychologist who specializes in women and appearance. She fears that many people who go under the knife, especially at a young age, want to change who they are as individuals, something that is simply not possible to do through cosmetic procedures. A new nose might give an individual confidence, but it will not suddenly transform her from a wallflower into a social butterfly. Yet, that’s just what popular culture seems to teach.

From teasing about big ears to beliefs that women lose something of themselves as they age, the reasons individuals opt for cosmetic surgery are numerous. Yes, there is an element of vanity to their decisions, and certainly plastic surgery is more common in cultures with significant disposable incomes, but the heart of the matter is in the values that are placed on beauty above personal substance. If a woman wants to fix her nose or plump her lips, she should not be reviled for doing so, no more than a man should be reviled for getting hair plugs. Improving one’s appearance in an effort to feel better about oneself is perfectly acceptable. However when that need to better oneself physically surpasses any belief in the intrinsic values of each individual’s personality, it is time to question the role cosmetic surgery has assumed in the popular conscience.

About: Patricia Walling is a contributor for several healthcare related blogs, including She self-identifies as a perpetual student of health care, and is based in Washington state.


Healthy Aging's Annual "Top of Class" Survey

Our friends over at Healthy Aging are gathering their annual "Top of Class" votes for our industry.  Cast your votes and we will publish their results in January.

Physicians must stay on the cutting-edge of technology. Your knowledge of leading industry reps, manufacturers and distributors can assist your colleagues during crucial equipment selection and purchasing decisions. Share your experience with colleagues in our annual "Top of the Class" survey, which allows dermatologists, estheticians and plastic surgeons to identify companies they feel are "among the elite."

Review the categories listed below, then cast your vote for your favorite vendors* by Dec. 30, 2010. We’ll tabulate the results and share the "Top of the Class" vendors online in January 2011. 

Click here for the survey.


Medical Spa MD {4} Mr. Adrian Richards MBBS, MSc, FRCS (Plast.) - Cosmetic Medicine In The UK

A real eye-opener for physicians in the US... In this episode of the Medical Spa MD Podcast we discuss cosmetic medicine in the UK with plastic surgeon Mr. Adrian Richards.

Listen to this episide here.

Mr. Richards qualified as a Doctor in 1988 and for the last 12 years has specialised in plastic surgery. He has full registration with the General Medical Council No. 3286812 and is a Member of both the British Association of Plastic and Reconsructive Surgeons (BAPRAS) and the British Association of Aesthetic Plastic Surgeons (BAAPS), the leading British professional bodies for plastic surgery and reconstructive surgery. He is an author and has written a best-selling textbook ‘Keynotes on Plastic Surgery’. He is founder of Cosmetic Courses, a company accredited by the Royal College of Physicians, which provides training to medical practitioners entering the aesthetic market and was the lead investigator in recent clinical research into the use of Botulinum Toxin A (Botox) for cosmetic purposes.

In this episode we're discussing cosmetic medicine in the UK with Adrian Richards. It will probably come as something of an eye-opener for physicians in the US to learn that; most cosmetic surgeons in the UK don't really worry too much about informed consent, being sued by a patient is a rarity, filler injections are unregulated, and that physicians are routinely employed by non-physicians. I found the differences to be striking.

We also discuss how Adrian markets his services through social media, videos, and podcasts of his own as we delve into cosmetic surgery across the pond.

Some of what we talked about in this episode.

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