Dr. Yoel Moyal: The Clinique Revolution du Plateau In Montreal

Dr. Yoel Moyal: The Clinique Revolution du Plateau In Montreal

Dr. Moyal is at the cutting edge of new injection techniques to offer a variety of treatment choices for his patients.

Name: Yoel Moyal MD CCFP EM
Clinic: Clinique Revolution du Plateau
Location: Montreal, Quebec, Canada
Website: clinicrevolution.com

Can you tell us more about your career transition from specializing in Family Medicine to Emergency Medicine to Aesthetics?

I have worked in Emergency Medicine and Family Medicine since graduating and recently became interested in esthetics as a means of doing more procedures and fine techniques. I also use my esthetic practice to balance out the often hectic environment of the Emergency Department with the quiet, serene environment of my office.

How do you market yourselves to patients and what do you do that your competitors aren't doing? 

Marketing medical esthetic services to clients is tricky as our ethical code in Quebec does not allow for the solicitation of a client/patient by a physician. We can inform people of the services we offer but can not incite patients to have a procedure done.

This applies to injections of Botox, dermal fillers and other medical-surgical procedures. Treatments such as laser hair removal, IPL and other esthetic services not performed by a doctor can be marketed. Doctors may not sell, endorse or associate any product or brand  to their name in Quebec.

Canadian Cosmetic Medicine Dr. Yoel Moyal

Are there any treatments or technologies that you're especially excited about that haven't hit the market yet? What do you think about new therapies like stem cells or others? 

I am excited about autologous fat transfers for restoration or augmentation and hair cloning for hair transplantation.

As a physician it is wiser to offer services that are exclusive to our profession such as injections or surgical procedures. It is difficult to compete in a market where anyone can offer the same services. For example in Quebec anyone can offer IPL , laser hair removal or tattoo removal but only doctors can inject. A doctor offering laser hair removal in his clinic can not compete with an esthetician doing so in her basement.

That being said, at our clinic we offer Laser hair removal as some people want to go to a clinic where there is medical supervision but the majority do not place much value on that. The majority of our practice revolves around  minimally invasive procedures such as injections of Botox and dermal fillers.

I do not encourage physicians to invest heavily in machinery as the technologies are often overpriced and often underdeliver in terms of results. Many estheticians can obtain similar results (in most cases) with mechanical (low cost) treatments with less risky side effects compared to  new technologies.

Technology has its place but not as much as savvy salespeople would have you believe.

The way to add new technologies is to introduce them into your practice based on the foreseeable demand from your own established clientele and the clienetele that you wish to attract. For example, your current clientele is between 45 to 65 years old doing BOTOX and dermal fillers regularly , the majority of your clients have sun damaged skin or pigmented lesions , they often ask if there is anything to be done. You should consider adding resurfacing technology or IPL at this point.

If you are considering adding a new service then careful market research in the territory you serve is vital- do not take the salesman’s word for it that  there will be people will be breaking down your door to try your newest machine and spend significant amounts of money.

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Toronto Plastic Surgeon, Wayne Carman, MD, FRCSC

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...

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Dr. Michael J. Brown, Plastic Surgeon In Virginia & Maryland

Dr. Michael Brown's practice includes three offices across Virginia and Maryland.

Name: Michael J. Brown MD
Clinic: The Loudoun Center for Plastic Surgery
Locations: Ashburn & Richmond VA, Bethesda MD
Website: rejuven8u.com

About: Dr. Michael J. Brown has been voted a Top Plastic Surgeon in Virginia and Top Doctors in Virginia by Northern Virginia Magazine and Best Cosmetic Surgeon in Virginia by Virginia Living Magazine in 2012. Dr. Brown has also served on the editorial board of a cosmetic surgery magazine. He is an active committee member for the The American Society for Aesthetic Plastic Surgery.

As a clinic that is primarily focused on plastic surgery but offers nonsurgical treatments, how is your clinic organized?

The Center is organized with 4 components. There is the medical office that's devoted to plastic surgery. The Center has a nurse who is trained and provides assistance with injectable treatments like Botox, Restylane, Juvederm, Dysport

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Italian Plastic Surgeon, Dr. Egidio Riggio's "Zenith System" For Breast Augmentation

Dr. Egidio Riggio focuses on innovation and research related to plastic surgery, both aesthetic and reconstructive. 

Name: Egidio Riggio, M.D.
Location: Milan, Italy
Website: chirurgiaplastica.mi.it/it/home/

That's interesting: Dr. Egidio Riggio is the creator of an innovative philosophy and aesthetics of an original surgical approach to breast augmentation he calls the "Zenith System" which he claims lead to more natural breast augmentation results. He has performed mor than 100 cases and published this proceedure in the international journal of cosmetic surgery most authoritative, Aesthetic Plastic Surgery August 2012.

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Plastic Surgery & Medical Tourism

Medical tourism just doesn’t make a whole lot of sense.

In recent years medical tourism has become an option increasingly available to potential plastic and cosmetic surgery patients. These potential patients often imagine that inexpensive, high-quality surgical care can be obtained by traveling to such countries as India, Mexico, Costa-Rica, Thailand, and the Dominican Republic. Add to that the price-conscious “savvyness” of the internet coupon generation, and the options increase exponentially. The guiding principles often celebrated by proponents of medical and cosmetic surgery tourism are the promotion of patient consumerism and, most notably, cost savings.

In the age of global digitalization, outsourcing of various business practices has become commonplace. Beginning with the export of information technology and call center jobs, outsourcing has now extended its reach to include medicine, surgery, and even plastic surgery. Several developments have facilitated this trend. Prohibitive health care costs at home, increasing denials of insurance claims and decreasing provider reimbursement rates, increasing overall demand for plastic surgery, long waiting times, and lastly, and perhaps most importantly, cost savings, have all contributed.

Medical tourism is marketed on the basis that health care can be off-shored much like the production of computers and cell phones or the provision of professional services such as bookkeeping and accounting. Good surgical care, however, involves more than just the technical act of surgery itself. It requires extensive and careful preoperative consultation, deliberate formulation of reasonable treatment plans, and implementation of proper postoperative care. Yet, such goals are unlikely to be achieved when patients fly to a foreign country, undergo surgery, recuperate oftentimes for less than a week, and return home with no plan for follow-up care. Furthermore, with increasing numbers of reports about patients traveling abroad and returning home with serious complications, the merits of “globalizing” health care must be questioned.

All too often I consult with patients who tell me of lamentable stories of “plastic surgery gone wrong” abroad. The informed consent process, a standard component of patient-physician communication in the United States, involving full disclosure of risks and benefits of treatment, risks and benefits of alternative forms of treatment, and consequences of not undergoing treatment, is virtually non-existent. Most of the time, the patient cannot even recall the name of the surgeon, or even identify him/her in person preoperatively. In all of medicine, but especially in elective plastic surgery, in order for choices to be made in a meaningful and appropriate manner, patients need to receive accurate and comprehensive information. Inadequate communication before surgery and the seemingly non-existent culpability lead some patients to have procedures that in health care settings with higher standards would never be deemed as falling within the professional realm of care.

When considering the cost savings purported to be an attractive feature of medical tourism, one must always consider the added costs of revisional surgery and medical care incurred with the potential for adverse outcomes. These costs increase on the whole when one considers the increasing frequency of surgical complications incurred with surgery in health care settings that do not meet the standard of care. Medical travelers often purchase cosmetic surgery packages without physician consultation and without knowledge of the medical implications to their health and well-being. Medical tourism companies and destination health care facilities, often owned and operated by non-physicians, benefit from maximizing profits without the necessary medical knowledge, legal responsibilities, and unfortunately, moral compunctions either.

All in all, elective plastic surgery is a drastic measure to undergo in order to change your appearance. So if you do it, you should have all the support from family and friends that you can get to help you get through it. Being home in a comfortable and familiar environment is also instrumental in proper healing. Going away to a foreign country to get this done just doesn’t make a whole lot of sense. And that’s the bottom line.

Georgios Hristopoulos MD: Plastic & Aesthetic Surgery In Germany

Georgios Hristopoulos M.D., Specialist in Plastic and Aesthetic Surgery in Germany

Cosmetic medical technologies offered in Germany are attracting medical tourists. 

Name: Dr. Georgios Hristopoulos
Clinic: Pantheon Aesthetic Center
Location: Cologne, Germany
Website: pantheon-aesthetic-center.de, beethoven-klinik-koeln.de

That's interesting: Dr. Georgios Hristopoulos is employed as Head of the Department of Aesthetic Plastic Surgery of the Beethoven Klinik in Cologne, Germany and at the same time runs his private office, named Pantheon Aesthetic Center. His surgical focus is the Breast Surgery and specifically the complete sub muscular Breast Augmentation (inner Bra) as well as the Dermolipectomies on trunk and extremities.

He speaks German, Greek, English and Spanish. 

How does your surgical practice function? How is it organized? 

I am the Chief of the Department of Aesthetic Plastic Surgery of a small private clinic in Cologne / Germany called Beethoven-Klinik. The clinic is one of the oldest and biggest private Clinics of Plastic and Aesthetic Surgery with government concession in the North Rhine Region and maybe in whole Germany. We have an interdisciplinary occupation with Orthopaedists, Trauma-Surgeons and a Dermatologist.

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Dr. Rafael Estevez, Plastic Surgeon In The Dominican Republic.

Medical tourisim is growing rapicly. In this interview, Dr. Rafael Estevez talks about the current state of cosmetic medicine in Dominican Republic.

Dr. Rafael E. Estevez Dominican Republic Plastic SurgeonName: Rafael Ernesto E. Estevez, M.D.
Location: Santo Domingo, Dominican Republic
Website: doctorestevez.com

Can you tell us what is it like practicing cosmetic surgery in Dominican Republic in comparison with what you see in other countries?

The practice of plastic surgery in the Dominican Republic has risen as time passes by, and so have its standards of care. We now have state of the art facilities, where you can practice plastic surgery in a safe manner.

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The Other Side Of Medical Tourism - A Surgeons Nightmare

The Other Side Of Medical Tourism - A Surgeons Nightmare

Medical TourismGuest post by Samuel Bledsoe MD

There is an element of a gamble inherent in the medical tourism industry as it currently exists.

An interesting thing happened to me at work the other day.  It was Friday afternoon, and I received a call from a primary care doctor. The phone call began with, “I’m really sorry about this, but I have a surgeon’s nightmare in my office.”

This is not a good way to begin a conversation.

He began to tell me about the patient. This particular woman had a Lap Band placed several years ago. For one reason or another, she decided that she would like this converted to a different procedure. She drove by my hospital to get to the airport, hopped on a plane and flew over hundreds of other well-qualified bariatric surgeons in order to reach a surgeon in Mexico where she had her Lap Band removed. She then returned 6 months later and had a sleeve gastrectomy. This is where things go bad.

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Interview With Serbian Board Certified Plastic Surgeon, Dr. Gorana Kuka.

Gorana Kuka MD, Board Certified Serbian physician

Dr. Gorana Kuka works in private plastic surgery practice at the Colic Hospital with patients coming from around Europe.

Name: Gorana Kuka, MD
Clinic: Colic Hospital
Location: Belgrade, Serbia
Website: dr-colic.com

That's interesting: Dr. Gorana Kuka is board certified by Serbian Medical Society.
She is a member of ISHRS (International Society for Hair Restoration Surgery), IPRAS (International Confederation for Plastic, Reconstructive and Aesthetic Surgery) and a women for women organization that aims to supply help by female surgeons to patients.

Your website is translated in eight different languages including English, German, French, Russian and Italian. Where do your patients come from? Are you seeing 'medical tourism'?

Since around 60% of our patients are coming from abroad, we had to translate our webpage into different languages. Most of our patients come from Switzerland, Germany and Austria. Some of them are of Serbian origin and some of them are foreigners. They have found about us either from their Serbian friends living abroad, or looking through internet for aesthetic surgery of best quality and lower fees.

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Medical Tourism Survey

Medical tourism is one of the topics covered in a new survey of outbound US travellers.

The ‘Ypartnership/Harrison Group 2010 Portrait Of American Travelers’ is a survey of the travel habits, intentions and preferences of Americans living in the USA.The national survey of 2,524 US households who are active travelers was conducted in February 2010. The results provide an in-depth examination of the impact of the current economic environment, social values and media habits on the travel habits of Americans with an annual household income of $50,000 or more.

Ypartnership is a leading marketing services company serving travel, leisure and entertainment clients. The agency's Insights group is a leading source of market intelligence on emerging business and leisure travel trends. Harrison Group is a leading market research and strategy consulting firm specializing in market strategy, market analytics, survey and forecasting services. This year’s survey was an in-depth examination of the impact of the current economic environment, prevailing social values and emerging media habits on the travel behaviour of American travellers. It seeks the underlying motivations with an emphasis on how they plan, purchase and share travel experiences; rather than a simplistic view of past travel habits. For the first time, the annual survey investigated medical tourism.

The survey is only about attitudes and the figures do not reflect anything on actual numbers who have travelled. In consumer research, attitude/intent is not necessarily transferred into actual purchase in any meaningful way. 50% of leisure travelers are now familiar with the concept of medical tourism, and 17% would consider having a medical procedure done outside the U.S. assuming it is perceived to be of comparable quality. 22% are not sure, suggesting they would also be open to considering this as an alternative to treatment at home if certain conditions were met.

Among adults who would consider traveling outside the U.S. for major medical care, 84% cite the lower cost as the primary reason why. 66% mention comparable or a better quality of care, while 43% cite access to medical treatments or procedures that are not covered by their insurance at home, and 41% mention shorter waiting periods to access care .22% cite access to experimental or non-FDA approved treatments and 20% mention concerns about privacy

Among countries measured in the survey as possible medical tourism destinations, Canada reigns as the number one choice. The top eleven countries:

  • Canada (42%)
  • United Kingdom (32%)
  • Germany (31%)
  • Sweden (28%)
  • France (24%)
  • Mexico (13%)
  • India (11%)
  • Singapore (10%)
  • Costa Rica (9%)
  • Brazil (7%)
  • Puerto Rico (7%)

These figures are on the basis that they are paid for by health insurers, financial incentives from insurers and/or employers are at least comparable to treatment in the USA, and quality of care is also equivalent. The figures do not reflect intent or willingness to travel for self-payers.

These results are another confirmation of a trend that many medical tourism experts accept, but others continue to deny, that travel time and nearness of destination are key to where medical tourists are prepared to go, not cost alone. American preference is within the American continent, followed by Europe, with Asia much less popular.