A short interview with cosmetic surgeon Dr. Aaron Stone as he keeps abreast of the latest developments and procedures in the cosmetic field.

Name: Aaron Stone, MD
Location: Los Angeles, CA
Website: aaronstonemd.com

That's interesting: Dr. Aaron Stone is a Medical Expert Reviewer for the Medical Board of California.

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

My office is in Beverly Hills where I do the usual head to toe plastic surgery with a few side interests in keloid treatments, pectus excavatum and hidradenitis suppuritiva. I see more of the latter type of patients than the usual plastic surgeon. I also run a reconstructive plastic surgery clinic for patients with little or no health insurance one morning a month at Cedars Sinai Medical Center. For the past 15 years I have volunteered my services at a tattoo removal clinic that rehabilitates gang members by removing their tattoos which they pay for with community service and then helps them get jobs.

I have been reviewing cases for insurance companies and the state medical board for over 10 years. This has been helpful in keeping me up to date on patient safety, current surgical techniques and getting optimal results for my patients. I try not to repeat the mistakes that I see others make.

You had postgraduate training at Rio de Janeiro & Sao Paulo (University of Sao Paulo), Brazil. Where do you see differences in how US physicians are educated and how physicians outside the US are trained? What do you think could or should be changed in US physician training?

Brazil is a rapidly changing country and the way plastic surgery was taught and practiced when I was there in the early 1990's is very different from now. In those days there was an apprentice residency system in place as well as a university based system. The patients had different cosmetic issues than in the US, desired different results than Americans and had a different type of relationship with their surgeons.

US plastic surgery training is very different now than it was when I was a resident. In those days most plastic surgeon did 5 years of general surgery and 2 years of plastic surgery. Nowadays more and more plastic surgeons do a full 6 or 7 years of plastic surgery. As a resident I felt the training was inadequate and spent as much time as I could with the ophthalmologists, dermatologists, oral surgeons etc. asking questions going to their clinics etc. to fill in the gaps I felt were present.

What advice would you give to other physicians about activities that might not directly benefit them financially but open up other opportunities?

The volunteer work I do makes me think it was all worthwhile when a very grateful patient is thankful and you see how much it changes their lives. I regularly receive holiday cards from some.

Where do you think that marketing should fit in a practice? Have you seen any marketing that you would consider to be "unethical" in some way?

Marketing is essential in today’s world but it needs to be tempered by sanity and ethics. I see unethical marketing on a daily basis and feel it is hurting plastic surgery in general in a number of ways. I have written in detail about some of these in my blog.

You blog as part of your online presence. How have you found blogging to help you? What benefits have you received?

Blogging has brought patients in my door that would have otherwise never found me. I refer prospective patients to it so they are fully informed about some procedures. I also regularly refer to the sections on patient safety when I have a diabetic patient or a patient with other medical problems to ensure a smooth surgery and recovery. Whenever I find new information that applies I added to sections of the blog as an addendum so the whole entity is constantly being updated. When I have a problem with a patient that is resolved I frequently blog about the learning experience as it solidifies in my mind what can happen and what should be done in those instances. The problem could be as simple as consulting an internist regarding a change in medication or a patient that needs special preparation before surgery.

As a plastic surgeon, how will nonsurgical techniques impact invasive cosmetic techniques? Where do you think will cosmetic surgery evolve? Will it be changed by technology?

I am not optimistic about the future of cosmetic surgery. I see companies create unproved technologies that are mass marketed, sold to whatever health care provider steps up to the plate and commoditized to the public. New methodologies appear on television shows rather than being investigated in appropriate peer reviewed medical journals. Prospective patients then ask around for a specific technology at the cheapest price. They do not realize that the tennis player is more important than the tennis racquet and end up running out of money spent on new technologies so they cannot afford definitive surgery. The number of patients showing up at the surgeon’s door for those surgeries drops. The number of marginally qualified practitioners is increasing at a faster rate than fully trained surgeons graduating from training programs. The scope of practice as to who does what is increasingly blurred. Finally the medical board case load of errant doctors performing cosmetic procedures keeps increasing.

The commoditization of plastic surgery combined with low fee schedules for insurance covered surgery in general will destroy the practice of plastic surgery outside university medical centers.

If you could change one thing or correct one mistake that you made earlier in your career, what would that be?

I would change the country I practiced and trained in.

About: Dr. Aaron Stone was raised in central Canada, went to college in Massachusettes, medical school at Yale University in Connecticut and spent his residency in Detroit at Wayne State University followed by additional post-residency plastic surgery training in New York and Brazil.

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.