Connecting with a Canadian physician practicing cosmetic medicine in Toronto, Dr. Ahmad Rabb.

Name: Ahmad Rabb, MD

Clinic:Medical and Cosmetology Centre

Location: Toronto, Canada

That's interesting: Dr. Rabb leads Bio Ethics Seminars for medical Undergraduates at the University of Toronto School of Medicine. He speaks English, Urdu, Punjabi, Sindhi.

You started out in family medicine but then switched to cosmetic medicine. Why did you switch?

It took me couple of years to transition from family medicine into cosmetic medicine. Over the years I realized that non-invasive and non-ablative skin care techniques were becoming increasingly popular and effective in reasonably reversing the adverse affects of different aging types ex. Photo-aging, Intrinsic aging (age related aging) and environmental aging.

With a special interest and prior experience in skin care during my family medicine practice, I could very well appreciate the phenomenal growth and advancements in skin care technologies and procedures. Additionally, the demand for cosmetic dermatology in this demographically diverse world caught my interest. The statistics indicates that people's life span has also increased and people like to look & feel good as they live longer.

All the above mentioned factors backed by my zest & passion for skin care became the basis of my transition to cosmetic dermatology.

How does practicing cosmetic medicine in Canada differ from practicing in other parts of the world? 

I think the ethos of practicing cosmetic medicine in North America and Canada remains similar to a large extent. Canada has become increasingly multicultural with people immigrating from all over the world. In order to treat patients safely and effectively cosmetic physicians must gain expertise in treating both ethnic and Caucasian skin.

The US has a more structured regulatory system and defined licensing cosmetic medicine practice standards compared to Canada and different US states sometimes have their own special requirements. While the FDA largely oversees and gives necessary approvals on different technologies developments and updates, we observe somewhat similar standards here. The US certainly has a larger cosmetic medicine market compared to Canada due to the population difference.

Europe and Australia also are well developed market in cosmetic dermatology with well developed training and regulatory institutions similar to Canada and the US but other developing & underdeveloped countries however are way behind the developed countries and struggling as followers to catch up with the technology and expertise.  

Which technologies do you see being developed that might impact a cosmetic dermatologist? What do you think of them?

The existing non-surgical and non-invasive treatment options in cosmetic medicine practices like laser, botox, fillers and other beauty gadgets being used for skin/body rejuvenation, correction of skin tone, texture, and color and skin firmness are offering patients alternate treatment choices and that's a very good thing for both physicians and patients.

I guess the cosmetic medicine technologies would bring positive changes in overall skin care scenario in the years to come and should not impact  plastic surgeons who will always have their own unique role to play in skin care. I think a professional collaboration between plastic surgeons and cosmetic physicians could help to redefine and improve current practice standards.

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

Our anti-aging & laser clinic accommodates the different needs and specific problems of skin color and Caucasian white skin. Ethnic skin is structurally different from Caucasian skin and mode of treatment and choice of skin care equipment/laser is likewise different.

Due to increased melanin content ethnic skin is more prone to certain skin conditions like erythema, pigmentation problems including post inflammatory hyperpigmentation, hypopigmentation, lentigenes, nevus, melasma and uneven skin tone. Skin of color is also more likely to develop hypertrophic scars, keloids and acne due to increased vascular reactivity and fibroblast activity and increased oil gland production/transepidermal water loss (TEWL)  which is a great source of discontent in patients with darker skin types. The Caucasian skin on the other hand is  thin with low melanosome content  therefore largely affected with sun/age spots, freckles, sun burns & damage (Actinic keratosis), pre mature aging, elastic loose skin & worst of all skin carcinoma if significant damage by sun occurs.

We put lot of emphasis on detailed patient consultation, skin mapping in order to accommodate the individual unique needs, choose the right treatment, improve the outcome and minimize the risk for side effects and complications. We keep in mind factors like economic treatment burden, individual expectations of treatment, age, condition of skin, before discussing the treatment options and plan with our patients. We give them pertinent details, pros and cons related to the suggested treatment and then let them freely ask any relevant questions in order to help them voluntary choose the appropriate skin care  and give an informed consent. At our clinic we put a lot of emphasis on patient education and guide them through all stages of the skin care treatment.

Our trained skin care staff makes always make sure to give them a warm welcome & services in the congenial and serene atmosphere of our clinic with gestures of hospitality to make them home until they leave clinic with highest satisfaction.

We offer wide range of advanced laser services for hair removal, scarring, acne,dark marks on face (melasma), redness spots or prominent vessels, varicose veins on legs, sun damage/excessive sweating of under arms and hands, anti aging services include wrinkles treatment (Botox), volume loss treatment (Fillers), medical graded acid peels and microdermabrasion. We also offer minor surgery for common skin conditions like moles, tags & liquid nitrogen & AHA therapy for warts.

We run our signature weight loss program in our clinic usually stretched over 10 weeks period. This is comparatively a unique program along with other usual weight loss methods like medications, life style changes, work outs and education. We have put a large emphasis on proper nutritional and vitamin supplements which are research proven to boost metabolism and facilitate weight loss effectively and correct Basic metabolic index (BMI) with minimal workouts /physical activity. Our super foods plan also contains metabolism boosters, natural balanced nutrition with low glycolic index, helps them later to maintain the desired weight in a longer run. Our program has met tremendous success and also increased our patients turn over.

Our key success factors over our competition include a team of trained skin care professionals, hi tech equipments excellent service standards in the safety of congenial environment at a competitive price to give them a sense of best value for their money and this leads to repeat visits at our clinic .

We also place high emphasis on combination therapy in cases and conditions that are less responsive to one mode of treatment. We would like to combine different technologies according to individual skin condition like Radio frequency, Titan (infra red light) phototherapy, Galvanic therapy, high frequency,  different fillers  for several skin conditions like moderate to severe acne, melasma, stretch marks, deep dermal pigmentation cellulite, keloids/hypertrophic scars, loose elastic skin, obesity, volume loss and so have shown better & early improvements  with combo therapies.

A number of patients would certainly inquire about new non-surgical options since they see these treatments with less down time and risk sometimes. There are other factors behind such queries- Some personal, medical or financial reasons or in case they are unable or don’t choose to undertake plastic surgery.

I would say these trends have largely changed over the last two decades since the technology advancements.

How do you ensure patient satisfaction?

Like everyone else we are no exception and want patients that are completely satisfied.

In the past, we embraced a new technology as an add on with additional safety and effectiveness objectives in mind but the claims of fantastic outcomes did not match our own experience. In such cases we do some revisions in our treatment protocols and try to be more cautious the second time around.

Rarely our patients show up with some side effects of the treatment and in such cases we pull up the patient treatment records and do a thorough consultation to look into the cause and then do whatever is necessary. If the patient is still not satisfied with it we would return the whole treatment cost on demand.

On the positive note when one modality is not getting us anywhere close to desired treatment outcome then we take reasonable chances to hit on combinations therapies in selected cases and sometimes would be amazed to see the positive results on the patient’s skin.

Where do you see the most competition from other physicians in your area? How do you market your clinic in order to compete with them?

With increasing demand and influx of trained skin care professionals in cosmetic medicine, the competition certainly have gone intense but I believe a healthy competition could work to our advantage if we keep our ethical and professional standards high and prevents compromise on service standards and treatment quality. As patients are more knowledgeable and aware about technology than ever before it has become essential to exceed their expectation about treatment outcome. The golden rule would be to promise less & deliver more. A truly satisfied patient finds best value for the money spent and can spread the word to add to our patient turn over. This is how we market and what we try to achieve in our cosmetic medicine practice.

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

Beauty is more than just a pretty face. It is not only about treatment procedures but about choosing a certain life style where everything like sleep, food/nutrition, stress, sun protection, hydration, skin care routine matters a lot. We should not merely treat the individual skin conditions but also educate them to achieve a balance in their life style which is vital to fight aging and maintain healthy skin in order to boost the effects of skin treatments.

In our treatment we should have a 3–D approach to beauty and see face as a whole unit rather than treating individual skin conditions. For example fillers may complement effects of Botox where there is a volume loss. We could use other tools like microdermabrasions, peels in a step wise fashion to rejuvenate skin and improve its tone & texture.

About: Dr. Ahmad Rabb is a Physician with great deal of expertise in cosmetic medicine, dermatology, and anti-aging. He is experienced in all major medical aesthetic techniques/procedures. He has trainings in various procedures like cutaneous lasers and volume restoration from well reputed centres.

He also holds a Master of Health Science (MHSc) degree from University of Toronto along with a Medical Degree. He is also a Seminars leader for Medical Undergraduates at Faculty of Medicine, University of Toronto.

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.