Dr. Sammy Sliwin practices at the Forest Hill Institute of Aesthetic Plastic Surgery in Toronto, Canada, and he is working on new cosmetic stem cell therapies.
With the growing interest in and growing use of stem cell treatments around the world, we thought it would be a great learning experience to explore his thoughts. We got together with Dr. Sliwin to discuss his plastic surgery clinic, his practice, and talk about his work with adipose derived stem cell therapies.
Name: Sammy Sliwin, MD, FRCSC
Location: Toronto, Canada
That's interesting: Dr. Sliwin is the Founder and Medical Director of AdiSave – The Canadian Adipose Derived Stem Cell Bank.
Can you tell us a little bit about how you got started in cosmetic medicine?
I always wanted to be a neurosurgeon. When I was in medical school I went to observe Neurosurgery and was disappointed. I met a Plastic Surgeon at a family function and went to watch what he did. It changed my life. I was so impressed by the variety of types of surgery and areas that Plastic Surgery covered from reconstructive to cosmetic that I changed my path.
I have never regretted it.
Can you tell us how your clinic is set up and how it functions?
The Forest Hill Institute of Aesthetic Plastic Surgery is a free standing fully accredited surgical facility with multiple surgeons performing state of the art Cosmetic Surgery. We as well have a medical aesthetic program offering skin rejuvenation through peels, laser and light treatments and laser hair removal. In addition we carry a variety of aesthetic products chosen from the best medical aesthetics available. We have recently added an adipose derived stem cell bank and will begin working with Health Canada to start clinical trials for the use of these cells.
Staffing is critical to any business and nowhere more so than in an aesthetic surgical facility. We pride ourselves on having the best staff that all have the same goals of making the patients have the best experience and outcomes. We have learned over the years that from the first phone or email inquiry, everyone has to try to engage the patient and make them feel important. If we do not connect with the patient than we often will only have the one encounter. I do all my own injections for the same reason, if the patient is not important enough to have my time to do the injection they will often go to someone closer to their home that will give them that service.
Always check references – we have had applicants give us the most amazing confabulations of previous experience.
In the office and the aesthetic side we compensate with a combination of salary with bonuses/commission.
For technical training I rely on the manufacturer's trainer. For office staff I observe and at appropriate times review what is going well and what we need to improve.
What laser/IPL technologies are you using and what do you think about them?
We presently have an E-max from Syneron for IPL and diode with RF skin rejuvenation and hair removal. We as well have a diode Lasertight laser for skin tightening during liposuction.
We previously owned a CO2 laser for skin resurfacing as well as an Epilaser (Ruby) hair management as well as a Syneron IPL and Diode laser. Iam happy with the technologies we presently own. I now have a motto with new technologies, “ I need to see the result before purchasing”. I often feel that you never get a chance to have the technology pay for itself before the next best technology arrives with much fanfare but lacking proof of improvement over the previous technology. Often the manufacturers are the only ones making a profit.
Which technologies do you see being developed that might impact a plastic surgeon?
A safe quick reliable percutaneous fat sculpting and skin shrinkage technology. The developers keep working on it and are getting closer but the time and number of treatments is still too long.
Have you ever switched from a technology platform?
I used to use the ruby epilaser for permanent hair removal and switched to IPL + RF and then Diode + RF as the maintenance for my office and time commitment for the patient was too great. I used to have a C02 laser but it kept breaking down and the patients did not want such aggressive treatments so I traded the laser in for IPL + RF.
My surgical practice is the most profitable and creates the most revenue. We are always looking to add more treatments or procedures both in the surgical side and aesthetics. We always want there to be significant proof that the treatment or procedure is efficacious before we implement it.
We believe that a happy patient referring a friend is the best advertisement. We as well use the internet.
What is the most difficult challenge you face right now and how are you addressing it?
I am developing the first cGMP Adipose Derived Stem Cell separation and banking facility in Canada and centre of excellence to treat diseases. This has been challenging and rewarding at the same time. I am surrounding myself with capable associates to move this project through the challenges.
Can you tell us more about the Stem Cell therapies and clinical research you're involved with?
First we are doing research to optimize the harvesting of fat by liposuction to maximize the number and quality of the stem cells that we separate. We are as well doing research to optimize the separation process as well as a method of cryopreserving the stem cells in a completely autologous method (not using any animal or other human products). Once completed we will open up the stem cell bank utilizing these methods that we found. We will then apply to Health Canada to begin clinical trials for homologous uses which include cosmetic filling of facial areas, scars as well as deformities on the body. Once safety is proven we will apply to Health Canada to begin clinical trials for non homologous uses such as regenerative medicine and autoimmune therapies. In the future I believe that stem cell therapy will change the treatment of many degenerative and autoimmune diseases.
Where do you think Stem Cell therapies are going? What opportunities exist for stem cell therapies in cosmetic medicine?
In cosmetic medicine stem cells added to fat will increase the effectiveness of fat grafting making it more consistent. Stem cells placed under scars will improve their appearance/healing.
Have you seen anything that would concern you regarding these types of stem cell therapies?
Adult stem cells which are the ones in fat does not cause me any concern. In contrast to embryonic stem cells that concerns me as they do not have controls adult stem cells are meant to go to injured areas and help to repair the damage.
What's the best advice you've ever received as a physician or plastic surgeon?
When I was an intern a General Surgeon Staff man taught me by example the value of balance. He had his children later in life and unless there was a life or death emergency, he wanted to have dinner and put his children to bed. He was then prepared to work all night if necessary
What 's the best advice you can share to fellow physicians?
1. Always have the best team surrounding you. This includes your office staff, nurses anaesthetists and aestheticians. Having a team that feels part of a family will make working a pleasure.
2. Never buy technology until you have seen the results personally. All sales reps are just that, their job is to sell you. Have a little skepticism and it will save you a lot of money and preserve your reputation.
Brief Bio: Dr. Sliwin is a member of the Canadian Medical Association, the Canadian Society of Aesthetic (Cosmetic) Plastic Surgery, the Ontario Medical Association and The College of Physicians and Surgeons of Ontario. He is also His clinic is fully accredited by The Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF). The CAAASF is a national organization formed in 1990 to ensure that surgical procedures done outside a public hospital are performed safely and carefully. He recieved his medical degree and specialty degree in Plastic and Reconstructive surgery from the University of Toronto. He was then a Fellow at Toronto East General and St. Joseph’s Hospital. Dr. Sliwin is onstaff at The Scarborough Hospital.
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.