Medical Spa MD: Physician community of skin clinics, laser centers, plastic surgeons, dermatologists and aesthetic doctors practicing nonsurgical cosmetic medicine.
In looking at this infographic, I'm somewhat surprised that 34% of the procedures are on women over 55. I would have thought that number would be somewhere in the 20% range and the 30-39 year range much higher than 12%.
Dr. Nick Carr shares his thoughts on the medical education system in Canada as a plastic surgeon and eductor.Name: Dr. Nick Carr
Location: Vancouver, Canada
Website: skinworks.ca
That's interesting: Dr. Nick Carr is a Royal College Examiner in Plastic Surgery.
The first point of contact for a patient to ask post-surgical questions should be the surgeon who performed said surgery. The trend seems to be in exactly the opposite direction.I've noticed a concerning trend. I participate in websites like RealSelf.com that connect plastic surgery patients and cosmetic surgeons. These sites are allowing patients to have near immediate access to expert plastic surgeons from across the nation and plastic surgeons to interact with potential patients.
In the past few months an increasing number of patients in the early post-operative period (some with dressings still in place!) have posed questions to “online surgeons” seemingly before seeking follow-up with the plastic surgeon who just performed the procedure. It is concerning that a patient would seek advice from a surgeon they do not have a doctor-patient relationship with and who is unfamiliar with the specifics of the surgery that they've recently undergone. Patients have even gone so far as to inquire about where to seek second opinions and whether revision surgery will be necessary all within the first post-operative week.
The early post-operative timing of this phenomenon is most concerning. This is the period in which we need to reassure our patients that bruising and swelling will resolve, dressings and sutures will be removed and that they truly will look great once they’ve healed. This period can cause patients significant distress and many require a lot of hand holding at this point.
We’re obviously failing some of our patients if they're reaching out online during this period instead of calling our offices and dropping in to be evaluated. I agree that second opinions are highly valuable and would not hesitate to arrange such for a concerned patient. However, a patient-initiated second opinion from an unfamiliar, online surgeon who has an incomplete picture of the patient's history is problematic at any time point let alone while the compression dressing is still in place!
What could possibly be responsible for this trend? As cosmetic surgeons are we so difficult to reach that our patients need to seek online advice from others? As we become more amenable to interacting with potential patients online are we failing to care for those who have already made a trip to our operating room? Is it simply easier for our patients to log onto a website rather than call the doctor's office? What can we do to direct those online inquires back to our own practices rather than into the digital ether?
As a Facial Plastic Surgery practice, my entire team is in the business of building relationships. If a patient has a professional, responsible and ethical plastic surgeon, the first point of contact to ask post-surgical questions should be the surgeon who performed said surgery. This trend seems about as far astray of that goal as one could imagine.
Has anybody else noticed this trend online? Have you experienced this with one of your own patients? What you have done to prevent this from happening in your practice? Please contribute your thoughts.
Name: Michael Kreidstein, MD, MSc, FRCS(C)
Location: Toronto, Canada
Website: drkreidstein.com
That's interesting: In 2010 he was appointed by the College of Physicians and Surgeons of Ontario (CPSO) to serve as a Physician and Premises Inspector of private surgical clinics for the Out of Hospital Premises Inspection Program. In 2011 he was appointed by the CPSO to serve as a Plastic Surgeon Peer Assessor. He is committed to excellence in Cosmetic and Reconstructive Plastic Surgery.
If you're not already aware, Medical Spa MD has physician members from 70+ countries... meaning that there are a number of differences in the way that medicine is practiced across the community. The map above shows some of the distribution of Members by location. The reason that I bring this up is to highlight that there are differences between where and how members of our community practice medicine.
Let me tell you a story or two about some of these differences.
A few years ago at a major cosmetic medical conference in Las Vegas with very well known physicians presenting. I atteneded a presentation by a plastic surgeon from Mexico discussing one of the new (at that time) suture plication techniques for facelifts. I'll call the presenter Dr. M.
During this surgeons presentation, Dr. M discussed case study after case study in a way that made it apparent to every other doctor in the audience that he was in fact 'experimenting' on patients in order to guage how results would differ with different techniques.
Dr. M was detailing how he had arrived at what he felt was the optimial technique by identifying likely canditate patients, offering them a greatly reduced price, and then basically trying out a different technique to determine an outcome. The clear message was that he was just trying different things out to see what worked and what didn't work, i.e., experimenting on patients.
You could see a lot of slightly raised eyebrows in the room.
As is usual after a conference presentation, a group formed around Dr. M after his presentation to ask follow up questions or make a connection. After a couple of handshakes the questioning started to revolve around a very specific theme. The US physicians (the very clear majority since we were in Vegas) began asking questions that expresed a large amount of skepticism that they could have interpreted the presentation correctly. Namely, that any plastic surgeon could be performing experimental treatments on patients in the way that he'd described. (I should clearly state that Dr. M indicated that he clearly informed all of these patients of what he was doing and got their consent.)
The physicians weren't really challenging this physicians techniques or professionalism as much as questioning Dr. M about his patient practices and wondering how he could actually get away with this with his malpractice insurance and medical regluatory agencys.
The questions started to revolve around patients who were unhappy with their outcomes and how this physician was handling them. Dr. M freely admitted that there had been any number of failures and that some patients had had poor outcomes and were unhappy but expressed the sentiment that that was really not a big deal.
The US physicians were somewhat incredulous and one slightly exaperated physician asked, "What do you do if they come back to your office and complain?"
"We call the police," he said nonplussed.
Raised eyebrows all around.
Now, to be fair, Dr. M's answer was really based on his perception that the question was about a patient raising hell in his clinic and that answer would be the same answer that any physician would give, but the incredulity that prompted the question was really about how any doctor could get away with performing experimental procedures without being sued out of existence.
What's even more eye-opening to a lot of American physicians was that Dr. M had never been sued.
If you're a plastic surgeon in the US and you've been practicing for a while, the odds are good that you've been sued by a patient and if you're practicing new treatments that could be defined as experimental as a plastic surgeon, you're going to be sued... and dropped by your malpractice carrier. It seems that if you're a plastic surgeon in Mexico you don't have the same considerations to deal with.
Does it mean that plastic surgery outside the US is less safe? Possibly, since there's no other country that regulates the practice of medicine the way that the US does, but it's also the case that many of the 'medical tourism' destinations are staffed by US trained physicians. (If anyone has stats on this I'd be interested to see them.) There are a growing number of hospitals outsourcing xrays to radiologists in India, medical tourisim is increasingly mainstream, and US physicians are traveling outside of the US for trainings.
Medical Spa MD has members around the world. If you're smart, you'll take the opportunity to learn from everyone, no matter where they are.
Read: Plastic Surgery Malpractice Lawsuits In The US & Canada
The Medical Spa Physician Report is critical information compiled from the answers of experienced doctors in cosmetic medicine.Each Medical Spa Physician Report includes a survey of cosmetic clinics around the worlds physician interviews and case studies. We reach out to not only our member base, but also other prominent doctors in cosmetic medicine to find out what doctors are really thinking about technology, marketing, staffing and clinic operations.
And this is an experienced group.
Look at this graph from the last Physician Report and you'll see that 58% of physicians indicating that they've been practicing full time cosmetic medicine for 6 years or more.
You can always find the latest Medical Spa Report (as wells as previous issues) free to download in the Medical Spa MD Free Deals for Members... and if you're not a Member yet, you can join the thousand of other physician members and access all of the free deals right now.
AA look at plastic surgery in Germany with Dr. Lila Bratani.Physician: Dr. Lila Bratani
Location: Karlsruhe, Germany
Website: www.drbratani.com, http://www.estheticon.de/chirurgen/dr-lila-bratani
That's interesting: Dr. Lila Bratani is recognized as a member of Stanford's Who's Who for having demonstrated outstanding leadership and achievement in her field.
How did your cosmetic medicine training kick off?
Back when I was a teenager, I was attracted to aesthetic medicine and of course beauty and anti-aging. My first step in Plastic Surgery was when I got a good training by my teacher, Prof. Muehlbauer, one of the leading aesthetic surgeons in Germany and recognized worldwide. I also completed a fellowship in advanced aesthetic medicine and got trained in cadaver courses in Brazil (Sao Paulo and in Brasilia). I was working with great colleagues and I am still learning a lot of new techniques in the aesthetic medicine field. The art of this profession gives the ultimate satisfaction.
Can you tell us more about your surgical clinic and how it's organized?
I’m the chief of the Plastic and Aesthetic Department in a private clinic. The owners are dermatologists and it works perfectly. We offer plastic surgery, hand surgery as well as non invasive treatments such as laser. We also have 3 cosmeticians in our skin cosmetic center. The clinic consists of: 1 plastic surgeon (me), 6 dermatologists, 3 cosmeticians, 1 practice manager, 1 PR and clinic manager, 1 OR nurse, 3 frontdesk assistants and 8 physician assistants. We serve to a mix of private and state health care patients.
The requirements for hiring staff in our plastic and aesthetic surgery clinic are very high. PA’s and nurses have to understand that they need to have this extra “service” for extraordinary plastic surgery patients. We like them to have a corporate identity that represents our clinic well and of course a fabulous attitude and behavior.
We use commission on the cosmetic sales.
What laser technologies are you using? What are your thoughts about the technologies you’re using now?
We don’t use IPL, but we are using Alexandrite, Ruby, NdYag laser and Fraxel, CO2-Laser. I like most of the Fraxel and new devices of Radiofrequency (Thermage and BodyTite). I have a lot of experience on the smooth liposuction with radiofrequency using the BodyTite device and so far, I'm seeing great results with skin tightening.
Where do you spend money on advertising? What works best for your practice?
We have websites, social media as Facebook, publications on newspapers and journals such as Vogue. We also distribute e-newsletters for existing patients via email. In the waiting rooms, we showcase programs with different techniques of aesthetic procedures. This kind of advertising works much better than handing out external flyers or ads.
(Sponsored: See Frontdesk waiting room videos for plastic surgeons and dermatologists.)
What are the in demand treatments in your clinic? Are you planning to add something new?
All kind of aesthetic surgery procedures like breast augmentation, facelifts, liposuction and face skin rejuvenation with radiofrequency as well the small procedures as fillers such as Botulinum toxin therapy. I will be adding more fat grafting and liposculpturing techniques soon.
What have you learned about practicing cosmetic medicine? What stories can you tell?
I have learned to offer what I think is good for the patients and not to please the unrealistic demands of someone. Sometimes patients bring their own drawings of unrealistic body parts. I’m aware of dysmorphophobic patients and refuse to do anything on those.
What advice would you give to other physicians based upon your experiences?
Working hand in hand with other colleagues is a benefit for starting into aesthetic medicine. You may share the cosmetic lasers and IPLs (which are very expensive) when starting your own clinic. Never underestimate the non-invasive procedures, even we plastic surgeons love it than being in the operating room with the scalpel in the hand. Set your own “branding” so that patients will be pleased with your work and aura and will bring you more patients via word of mouth, which is also a great marketing tool.
About: Dr. Lila Bratani completed her Craniofacial and Plastic Surgery fellowship in Nova Southeastern University. With over 10 years of experience in Plastic, Aesthetic, Reconstructive, Laser and Hand Surgery, she is a university lecturer, medical manager and an esteemed health care consultant in New York,USA. She specializes in burn surgery and tissue engineering. Other than that, she is an active member of the Society of Plastic Surgeons of Germany DGPRAEC, WOSAAM (World Society of Anti Aging Medicine), IPRAS (International Society of Plastic Reconstructive and Aesthetic Surgeons) and DGBT (German Society for Aesthetic Botulinum Toxin Therapy.
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.
Sitting down with Dr. Stephen Weber of Lone Tree Facial Plastic & Cosmetic Surgery Center outside of Denver, Colorado.Physician: Stephen Weber MD, PhD
Location: Lone Tree, CO
Website: http://www.lonetreefacial.com
That's interesting: Dr. Weber has participated in the "Face to Face" program where local plastic surgeons donate their services to the victims of domestic violence and has participated in the annual humanitarian mission surgical trips providing free care to medically isolated, indigent patients.
Profile: I am a double board-certified Facial Plastic and Reconstructive Surgeon practicing at Lone Tree Facial Plastic & Cosmetic Surgery Center in the Denver metro area. My practice involves all aspects of facial cosmetic surgery including facelift, browlift, blepharoplasty, rhinoplasty, otoplasty, facial implants, facial resurfacing and scar revision. Our office also provides comprehensive treatments for facial aging including Botox and Dysport to reduce facial wrinkles, dermal fillers to minimize facial lines and folds as well as fractional laser (Fraxel and MiXto) resurfacing.
Can you tell us a little bit about you and how you got started in cosmetic medicine?
I became a Facial Plastic & Reconstructive Surgeon by a very circuitous route. In medical school, I planned to become an Infectious Disease specialist and even obtained a Ph.D. in Immunology and Microbiology in pursuit of that goal. However, my first rotation after successfully defending my thesis was in head and neck surgery. I knew that first day that I wanted to become an Otolaryngologist (Head & Neck Surgeon, ENT). During my residency training in Otolaryngology and Head & Neck Surgery I realized that my goals of performing a diversity of procedures in a technically demanding sub-specialty made Facial Plastic Surgery a very well suited specialty. I trained as Dr. Shan Baker’s fellow in Facial Plastic Surgery at the University of Michigan and then entered practice.
Can you tell us more about your clinic and the services available?
My practice is a single specialty clinic. We have two plastic surgeons here at the practice, myself and Dr. Rick Schaler who is my partner and practice owner. We have eight other staff including one nurse, five estheticians, one front desk staff member and a billing manager. We offer the full range of facial reconstructive and cosmetic surgery. Our office has a fully functional operating room in which we perform all of our cosmetic procedures under IV sedation. On the medical spa side, we offer all of the available injectable treatments including Botox, Dysport, Xeomin, Restylane, Perlane, Juvederm, Radiesse and Sculptra. We perform laser services including Fraxel and MiXto (fractional CO2) resurfacing, vascular laser and laser hair removal treatments. We also perform a full complement of facial peels and facial treatments. Our patient population comes from the surrounding suburbs of Lone Tree, Highlands Ranch, Littleton, Parker as well as Denver proper.
How are you dealing with staff in your clinic?
Fortunately, we have not had the need to fire staff. The reason for this is that we’re very careful with the hiring process. The communication between members of our office is very clear. When we set out to hire a new member of the office we have a clear, articulated goal regarding our needs and the type of person we want to hire. Everybody in the office has a chance to veto a potential new member of the office staff. Each member of the office also has the opportunity to veto that potential candidate. We tend to hire from a pool of people already familiar to the office or from strong referrals from friends of the practice. We have avoided print advertising of open positions of late as this always leads to a huge response with relatively low yield of the type of candidate that we need.
For the front desk staff, compensation is hourly. For procedure or treatment oriented members of the office, including physicians, compensation is heavily weighted toward production. This is the most fair compensation method and encourages productivity. The formula is simple, clearly articulated and fair. Employees are paid a percentage of net collections. An employee can review their production at the end of each month, if requested. I review my own production at the end of every pay period and encourage the rest of our staff to do the same.
What laser technologies are you using now? How do you decide on new purchases?
We perform laser treatments including Fraxel and MiXto (fractional CO2) resurfacing, vascular laser and laser hair removal treatment. In terms of new purchases, laser companies really need to show us a substantial improvement in results before we will purchase new technology. We are marketed to by phone, mail, email and at conferences. I am interested in new radiofrequency technologies but I think the jury is still out and we’re holding out on making that purchase.
How do you market your clinic?
In terms of social media, we market on Facebook , Twitter, as well as LinkedIn. We’re trying to determine whether Pinterest can be leveraged with pre- and post-op photos and other images. We use social media to communicate with current and prospective patients with informational posts and product samples/ give-aways. Our email list of current patients is our most valuable marketing tool. Providing current patients with updates that they can forward to friends is invaluable. We also put on open houses and seminars that allow us to provide education, meet new patients and learn more about our current clients.
In the pay-per-click arena, we use Google AdWords with a relatively conservative budget. That has drawn a lot of traffic to our website and helped generate surgical cases. We have been testing the waters of direct mail and print advertising. Direct mail has had moderate result. Print advertising has been disappointing. We do not currently take part in Groupon, Living Social or any other daily deal sites. The main reason for this is cost and questionable ability to develop lasting relationships with users of these services.
What are the most coveted treatments/services in your practice? Have you tried removing some of your services?
The sun and dry air in Denver are the reason why people flock to this area. However, they wreak havoc on facial skin. As a result the demand for lasers and peels here is tremendous. On a volume basis, Fraxel skin resurfacing and Botox are the most common services in our office. However, the fixed cost associated with these services is significant. From a revenue perspective, surgery provides the greatest revenue and greatest profit for the practice. About 75% of our cases are elective in nature. We have not dropped any procedures recently. When I joined the practice, I introduced Sculptra facial injections and Radiesse hand rejuvenation and we’ve seen high demand for these treatments.
What have you learned about practicing cosmetic medicine?
I’ve developed a thicker skin and learned not to take things personally. In the past, when a patient booked surgery with a competitor I assumed that I had erred in some way or not provided excellent photos of patient results or …. I’m noticing today more and more patients that will meet multiple surgeons and come back to book surgery with me. When I’ve asked why, the answers that patients provide are incredibly vague. It really is a gut feeling that people have that you are or are not the surgeon that will provide what they’re looking for. All we can do is provide as much information and education, quality photos of surgery results, a top notch facility and a warm, caring environment to convince patients that we’re the right team for them.
Any last thoughts on advice for your physician colleagues in the cosmetic industry?
I would urge physicians, especially in the plastic surgery realm, to compete by providing exceptional service. With Groupon and other daily deal sites, there is increasing pressure to compete on cost. Some of these deals will temporarily drive patients into the practice. However, few are likely to be loyal patients when the practice down the road runs an even cheaper deal. The daily deal trend has provided consumers with cheap (not necessarily quality) services. However, this has come at the expense of sustainability for practices that jumped in without doing enough research. The bottom line is that daily deals will lead to a spike in volume composed of largely price-oriented patients. Further, the deal seeking crowd is unlikely to see the value in your services. Continuing to drive down prices when our costs are fixed is not only unsustainable but diverts your attention from providing services, such as surgery, that are the profit engine for the practice. When you offer services at cost, you CANNOT "make it up on volume."
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.
Medspa MD's interview with Dr. Anthony Youn, MD, FACS, a plastic surgeon and author practicing in Michigan.Physician: Dr. Anthony Youn, MD, FACS
Location: Troy, Michigan
Website: www.dryoun.com
That's interesting: Dr. Youn has been named one of the top three plastic surgeons in the United States by askmen.com and the only Michigan plastic surgeon named as a Top Doctor by U.S. News and World Report.
Profile: I am a board-certified plastic surgeon in private practice in Troy, Michigan. I am a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, and an Assistant Professor of Surgery at Oakland University / William Beaumont School of Medicine.
Can you tell us a little bit about your background and how you got started as a plastic surgeon?
My first taste of plastic surgery was when I underwent major reconstructive surgery to my jaw in the summer between high school and college. Prior to this surgery, my mandible was so large it was twice the size of Jay Leno’s and dubbed “Jawzilla.” At the time I hoped that this surgery would transform me, a skinny Asian American nerd with no nerve, no game, and no clue, into an Adonis: A ladies’ man. Unfortunately, this surgery started a four-year dating drought, and didn’t really teach me that changing your appearance could change your life until much, much later.
My real introduction to plastic surgery came in the form of an eight-month-old boy who was mauled by a raccoon. His face was literally eaten off. The moment I saw the plastic surgeon make plans to reconstruct this poor child’s face, I was hooked. I describe this scene in great detail in my book.
I completed my plastic surgery residency at Michigan State University in Grand Rapids, a fellowship in aesthetic plastic surgery in Beverly Hills, and stared my private practice in Metro Detroit.
Can you tell us more about your practice and how it's organized?
Youn Plastic Surgery, PLLC is a private practice plastic surgery clinic. I have six employees: a receptionist, a patient coordinator/scheduler, a medical assistant, two aestheticians, a nurse injector, and myself. The office inhabits 4000 sq feet on the 12th floor of the tallest high rise building in Metro Detroit. We offer a full range of surgical and non-surgical plastic surgery treatments, including laser treatments, injections, cosmetic and reconstructive plastic surgery.
Staff compensation is often a question for docs. How do you handle that?
All of my employees are paid hourly, with no pre-set incentives or commission. Full time employees get full benefits, including health insurance, 401K, and profit-sharing. I work with a practice management company to help with payroll and other employment issues.
What are your thoughts about the IPL and cosmetic lasers that you’re using in your clinic?
Due to my frequent media appearances, I often have new technology come through my office, usually for limited periods of time. I frequently present the newest laser and light-based technology for several television programs, and have partnered with various companies who supply them to me on a trial basis. That being said, I also own several ‘workhorse’ devices that are used on a daily basis. I have the Cynosure Cynergy laser, which combines pulse dye and Nd-YAG lasers in one, and the Syneron eLight with Refirme, hair removal, and skin rejuvenation treatment heads. My office also uses the Dermosonic device for the temporary reduction of cellulite and a microdermabrasion machine as well.
Sound's like you're fortunate in that you're really busy which leads to the next question: How are you marketing your practice?
I’m fortunate that the only advertising I purchase is the maintenance of my three websites:dryoun.com, celebcosmeticsurgery.com, and institchesbook.com. I’m often featured in local and national media, which has given me a significant amount of exposure. In the past I’ve used many sources of advertising, including newspapers, local magazines, internet SEO, local TV and radio, all with varying results. I find that internal advertising using Constant Contact (email software) has been our most effective means of getting the word out. The yellow pages is the one media source I recommend other providers not waste their money on.
I recently went on a book tour to promote my book which included articles in several magazines and newspapers, including Plastic Surgery Practice and Plastic Surgery News. This exposure has been really valuable for my practice.
What treatments or services are most profitable for you?
No question, Surgery. The vast majority of the profits of my practice come from surgery. Although approximately 25-30% of the gross practice revenue stems from non-surgical treatments, approximately 60-70% of this revenue goes to supply costs, like Botox vials, Restylane syringes, and laser maintenance costs.
Plastic surgeons, like all doctors in cosmetic medicine, usually have some interesting patient stories to tell. Do you have one that really stands out?
As a plastic surgeon, I often encounter patients whom I suspect suffer from Body Dymorphic Disorder, or BDD. Typically, I encourage them to seek counseling and avoid plastic surgery. Unfortunately, most BDD patients don’t believe they have the disorder and refuse to see a therapist. I remember a patient I’ll call “Jane.”
Jane was a librarian in her mid-forties who consulted me for eyelid surgery. It didn’t take long for me to diagnose her with BDD.
“So what would you like to talk about today?” I asked her.
“Don’t act like you don’t know, Dr. Youn. I see you staring at my eyes. Just like everyone who comes into the library. They pretend to read books or go through the card catalogue, but the moment I look away they stare at me. I catch them doing it all the time. I need you to fix my hideous eyes.”
“What’s wrong with them? I think they look fine.”
“Don’t patronize me. You know what’s wrong with them! I’ll pay you five thousand dollar cash to fix them. I hear you’re the best. I want you to make them perfect.”
I spent an hour trying to convince Jane that she didn’t need surgery and that she should seek professional counseling instead. She wouldn’t listen. She became increasingly agitated. Finally she said if I didn’t operate on her, she would take a scalpel and perform the surgery on herself in my office right then!
Cue creepy horror film music here.
I would never operate on Jane, who clearly seemed mentally imbalanced. But I wanted to say no to her as tactfully as possible. I pulled out my trump card. When things get ugly, I go to the one excuse that always defuses a situation, guaranteed to reject a patient for surgery without making her upset.
Sadly, it’s the same excuse countless women used on me during high school and college.
“Jane, it’s not you, it’s me. I’m not ready to do your surgery. I don’t think I’m a skilled enough surgeon to make you happy.
“Really?”
“Yes. Jane, I’m not good enough for you.”
Don’t laugh. She bought it.
Any final words of advice for other physicians running their own clinic?
I think the best advice I can give is this: When you are done with work, do things you enjoy. As physicians, we are accustomed to delayed gratification. It’s always a challenge for us to find balance in our lives. I currently split my time between my family, my work, and writing. We’ve each undergone over 23 years of schooling to become practicing physicians, and now is the time to enjoy the fruits of our labor. Find moments of happiness in your work and at home. I think the turtle in Kung Fu Panda said it best, “Today is the present, and that’s why it’s a gift.”
About: Dr. Youn is the author of a plastic surgery tell-all, In Stitches, recently published by Simon and Schuster and a regular contributor to CNN.com, MSNBC.com, and USA Today. Dr. Youn has been featured on the Rachael Ray Show, Good Morning America, the Dr. Oz Show, the CBS Early Show, and many others.
Dr. Youn has authored or co-authored several papers and scientific manuscripts on plastic surgery, including such procedures as the Volumetric Facelift and Facial Reshaping. In addition, throughout his career he has conducted scientific research on a variety of topics, extending from cosmetic surgery, to laser treatments, to reconstructive trauma surgery, to HIV medications. He is a member of the Editorial Advisory Board for Plastic Surgery Practice Magazine and has lectured throughout the country.
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.
The Consumer Guide to Plastic Surgery thinks they know what’s in store for cosmetic medicine in 2010, from how the newly proposed “Botax” could affect your self-improvement plans to which new products will come to market. Here's what you might see in 2010:
Even More Botox-Like Products Will Come to Market
First there was Botox Cosmetic; then 2009 brought the Botox alternative Dysport. In 2010, expect to see a few more Botox rivals, including a topical form of the popular wrinkle relaxer and at least one more injectable. A couple of injectable Botox cousins are in development, but PurTox will likely be the next to get a nod from the Food and Drug Administration (FDA). The main difference in these injectables seems to be how long the results last and how quickly the products start to work on your crow’s feet.
Fat Injections to the Breast Will Be Used Cosmetically
After being condemned by plastic surgery associations, fat injections to the breast were deemed OK for "touch-ups" after breast reconstruction in 2008. But these once controversial injections may soon play a role in cosmetic breast augmentation. Taking fat from a part of the body where there is too much (your thighs or butt, for example) and injecting it into your breasts where there is too little, may replace the need for breast implants when done in conjunction with a breast lift. Some kinks still need to be worked out, but fat injections to the breast are likely here to stay.
Surgeons Will Invent – and Perfect – Body Contouring Surgeries to Follow Massive Weight Loss
More and more people are undergoing bariatric surgery to lose weight, only to be left with hanging fat and flab in highly visible areas. As plastic surgeons put on their thinking caps to better address these issues, expect to hear about many new procedures, including the corset trunkplasty. This new surgery targets above-the-belly-button flab, to recreate an hourglass silhouette in formerly obese women and get rid of love handles in men who have lost massive amounts of weight. This area has been ignored by many traditional body contouring procedures that target the lower abs, buttocks and/or thighs. We will hear more about corset trunkplasty and other innovative body contouring procedures in 2010.
Fat Freezing Heats Up in 2010
Fat freezing (or cryolipolysis) may give liposuction a run for its money in the coming years. This technology works by freezing fat cells and breaking them down. Zeltiq is in clinical trials now, and results look promising. Stay tuned.
Cohesive Gel Breast Implants Receive FDA Approval
These so-called "gummy bear implants" have been making their way down the pike for some time, and they just may get the long-awaited FDA nod in 2010. Filled with cohesive silicone gel, these leak-resistant implants – used in Europe and Brazil – are being studied in the United States. Gummy bear implants have the positive attributes of silicone gel, but the gel doesn't migrate. This is a good thing, because if the shell should fail, the gel wouldn’t leak into surrounding tissue.
Lipodissolve Study Results Stun Skeptics
Lipodissolve, an experimental "fat-melting" technology, is being billed as a non-surgical alternative to liposuction. Also called mesotherapy, lipodissolve is performed via injection of a cocktail of chemicals into muffin tops, saddlebags, love handles and other trouble spots to dissolve fat cells. Critics were outspoken, which is why the American Society for Aesthetic Plastic Surgery started a rigorous scientific study of lipodissolve, using standardized ingredients. And while even the trialists were skeptical at first, and the final results have not been tallied, it works. The study results – to be released in 2010 – may encourage many doctors to offer lipodissolve. Still, lipodissolve is only for small areas of localized fat and will never replace liposuction.
“Botax” Will Raise Eyebrows
A health care reform bill will be passed in 2010, and it just may include a five percent tax on all cosmetic surgery procedures (except those deemed medically necessary). Let’s say that breast augmentation with implants costs $10,000 in 2008; add a five percent levy, and the total becomes $10,500 in 2010. With business already down, most plastic surgeons are up in arms about the Botax. There is also fear that taxing cosmetic surgery in the U.S. will encourage many to seek out services abroad or through unskilled providers who offer procedures at cut rates in America, compromising their safety.
Surgery-Free Tummy Tucks Trim Waistlines
Non-invasive body contouring procedures such as Thermage, VelaShape, UltraShape, LipoSonix and Zerona will continue to grow in popularity in 2010. Once reserved for the face,
Thermage also uses radio waves to lift and firm skin on your stomach, knees, arms, legs, hands or butt. VelaShape employs bipolar radiofrequency energy to reduce the size of the fat cells, along with infrared heat to tighten the skin. And Zerona uses a “cold” laser to painlessly zap the fat cells beneath your skin. These technologies (and more) may give tummy tucks and lower body lifts a run for their money in 2010.
Face Transplants Face Upsurge
Face transplant surgery was once nothing more than fodder for sci-fi thrillers like the movie Face/Off, but they are now becoming a reality. Eight have been performed so far in the United States and abroad, but there will likely be many more as reconstructive facial surgeons further hone their skills and work toward perfecting their highly complicated techniques.
Minimally Invasive Cosmetic Procedures Experience Rebirth
As our economy starts to show signs of life again, more people may opt for cosmetic surgery procedures, reversing the steep decline of the last two years. Don't expect the numbers to reach their record highs anytime soon, though. There will likely be a slight increase in plastic surgery procedures – especially minimally invasive ones such as injectables that allow people to put off more invasive (and expensive) procedures like face lifts until they really need them (and can better afford them).
Consumer Guide to Plastic Surgery is published by Ceatus Media Group LLC, an online provider of health information and physician directories. Consumer Guide to Plastic Surgery is a registered trademark of Ceatus Media Group LLC. http://www.yourplasticsurgeryguide.com
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