Dr. Wayne Carman opens up about his thoughts on Canada's medical health system and his own cosmetic surgery clinic.

Name: Dr. Wayne Carman, MD, FRCSC
Clinic: Cosmetic Surgery Institute
Location: Toronto, Canada
Website: drcarmanplasticsurgery.com

That's interesting: Dr. Wayne Carman is Past President of the Canadian Society for Aesthetic Plastic Surgery and is the Secretary-treasurer of the Canadian Society for the Accreditation of Ambulatory Surgical Facilities. Other prestigious positions include membership on both the editorial board of the Aesthetic Surgery Journal and also the Premises Inspection Committee of the College of Physicians and Surgeons of Ontario.

Your practice is relatively close to the US border. Do you have patients coming from the US? Is this increasing or decreasing? Do you see this as 'medical tourism'?

In the past, I have had the opportunity to treat many American patients and have enjoyed the opportunity to contribute to their care. More recent restrictions on our professional insurance have curtailed the ability of plastic surgeons to see foreign patients. Those of my colleagues in border cities have sometimes chosen to make individual arrangements to allow treatment of Canadian non-residents, but most plastic surgeons have not found this to be practical. It’s hard to predict the future, but for the present time, our ability to electively treat US citizens remains limited.

How does practicing cosmetic medicine in Canada differ from practicing in other countries? 

The surgical community is one in which national borders are becoming less relevant. The exchange of knowledge and interplay of clinical ideas and concepts is a process that really knows no boundaries. International plastic surgical societies are becoming increasingly popular and so the ability to learn from our colleagues worldwide has never been greater.

The one area that Canadian plastic surgeons can offer the benefit of our experience is with devices, such as breast implants, that are not yet approved in the US. Our ability to gain familiarity with this group of items and products leads to a sharing of information that will definitely benefit our American colleagues.

You're a member of the American Society of Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons. As a plastic surgeon in Toronto, why have you chosen to be a member of American medical societies?

Most Canadian plastic surgeons have memberships in a number of major professional Societies. The American Societies (ASPS and ASAPS) have Canadian counterparts (CSPS and CSAPS) to which virtually all Canadian plastic surgeons belong. Our Canadian Societies have a close liaison with our US counterparts and share educational and organizational information regularly.

The advantage of multiple memberships for a surgeon lies in the ability to network with a larger group of colleagues and to take advantage of the educational resources available with bigger organizations. Many plastic surgeons are also members of international Societies leading to even greater synergies.

Is practicing plastic surgery in Canada less prone to malpractice or legal problems that practicing in the US would be? 

I think that the nature of plastic surgery practice really does not vary much with geographic location. The possibility of a malpractice claim is present no matter where the surgery takes place. Patients have their priorities and if these are not addressed, problems can arise. The concept of open communication is well recognized, but not always followed. Most legal issues can be avoided by careful pre op counseling and proper attention to detail.

Are your patients inquiring about nonsurgical options? Do you see a time when plastic surgery is going to be replaced at least in part by nonsurgical technologies? Is this an opportunity or threat for plastic surgeons?

Non-surgical methodologies are being developed with increasing frequency. The application of laser, ultrasound and other modalities is becoming a valuable part of rejuvenative medicine. Plastic surgeons play an important role in the delivery of these techniques because we are the only group who can also offer surgical alternatives. Non-surgical specialties will also offer some of these techniques giving the patient (the consumer) greater choice in who treats them and how they are treated.

There will be a steady increase in patient interest as non-surgical methods become more sophisticated. My advice to patients and surgeons alike is to be careful in adopting brand new ideas – they do not always stand the test of time.

Can you give us a picture on how your surgery clinic is organized and runs? 

My clinic was custom designed to solely address the needs of private plastic surgery patients. I do not share the clinic with other physicians, and so the atmosphere and clinic environment are under my direct control, allowing every detail of patient care to be optimized.

The clinic is located in a private building, so access does not require the use of public lobbies and elevators as would be necessary in a larger office building. Privacy is assured and patients find that their experience is more intimate and comforting

We have the facilities to keep overnight patients, which allows the surgery I perform to be undertaken safely with a more personal level of nursing care, ensuring a smooth recovery during the post op period.

My staff and I try to anticipate the physical and psychological needs of our patients in order to make the surgical undertaking a positive experience and one that they will recommend to their friends.

What's the best advice you've ever received as a physician?

Surgery is never 100% predictable and surgeons must always be prepared to deal with post-op problems. My greatest mentor stressed the importance of waiting for the right time to consider revisionary surgery. His message was that “patience is a virtue”, his advice was “never try to cut your way out of a jam”. I’ve never forgotten it, and the advice has served my patients well.

About: Dr. Wayne Carman is a fully qualified Plastic Surgeon certified by the Royal College of Surgeons of Canada. He is a graduate of the University of Toronto and has been in private practice in Toronto for over 25 years. He is the Chief of the Division of Plastic Surgery at Scarborough Hospital and is the past Director of the Scarborough Hospital Burn Unit. 

Dr. Carman’s broad experience in both cosmetic and reconstructive plastic surgery, as well as his ongoing interest in the governance and evolution of his specialty, affords him a unique perspective in providing effective, personalized patient care.

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.