Brian Buinewicz MD, Plastic Surgeon At Le MedSpa In New Jersey

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Juggling tasks at the medspa, at a hospital and at the university is no easy task. Let's see how Dr. Buinewicz handle multiple responsibilities and manage priorities.

Name: Dr. Brian Buinewicz
Clinic: Le MedSpa of Buckingham and Flemington
Location: Doylestown, PA and Flemington, NJ
Website: lemedspabucks.com

Your clinic basically offers a holistic approach in a sense that it covers everything from face, to body and even health and nutrition. How did you grow your business? How is your clinic organized? 

Our practice is a dual physician based practice covering all of the patient’s needs from nutrition, exercise, primary health care, weight management in addition to our full service medical spa and plastic surgery services. The business grew naturally by constantly offering the best and newest treatments for our patients. We evolved over the years to have a “tool chest” full of options to offer our patients, not just surgical intervention, for example. When the only tool you have is a hammer, the whole world becomes a nail.

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Michael A. Persky, MD, FACS In Encino, CA

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Dr. Persky considers his work to be as much an art form rather as a medical procedure.

Name: Dr. Michael A. Persky
Clinic: Persky Sunder Facial Plastic Surgery
Location: Encino, CA
Website: drpersky.com

What IPL or laser technologies are you using? What technologies do you like? Which do you dislike and why?

We have used the complete line of Fraxel lasers since their inception. Initially, many colleagues were skeptical about the results we were seeing, now Fraxel lasers have become the gold standard for laser skin rejuvenation and resurfacing. We do not use IPL in our practice, but feel that our Fraxel Dual laser treats brown spots like “an IPL on steroids”.  We currently are using Ulthera to non-invasively lift and tighten the face, neck, and eyebrows as well as treating fine lines around the mouth and eyes. We find that when combined with Sculptra and other facial fillers, results are quite satisfying for both patient and physician.

Technology companies may tell the physician anything to sell them the item. Physicians must do their “due diligence”, and not believe everything that they are told. Technologies such as Thermage have not lived up to their hype, and others like Zerona are just plain “snake oil”. The latest technology that we are most excited about is Cellulaze, a minimally invasive one time treatment that effectively treats cellulite.

What treatments have you observed to be the most profitable? Have you dropped any treatments?

Surgical treatments are most profitable. Next come non-invasive treatments such as Ulthera, Fraxel, and CoolSculpting. Injectables are profitable as well, including Sculptra, Botox, Dysport, Juvederm, Restylane, and Radiesse. The use of cannulas for injection has revolutionized our use of Radiesse for “quick” facial volumization. We have dropped laser hair removal and radiofrequency skin tightening treatments.

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Dr. Lisa Lynn Sowder, A Female Plastic Surgeon In Seattle

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Dr. Lisa Lynn Sowder

Dr. Lisa Lynn Sowder manages an accredited surgical facility and plastic surgery practice in Seattle, WA.

Name: Lisa Lynn Sowder MD FACS
Clinic: Seattle Plastic Surgery
Location: Seattle, WA
Website: sowdermd.com

That's interesting: Dr. Lissa Lynn Sowder is past president of the Northwest Society of Plastic Surgeons and the Washington Society of Plastic Surgeons, past chair of the King County Medical Society Grievance Committee and former Trustee of the King County Medical Society.

Your operating room is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF). How much benefit is there for a physician who owns their own surgical suite instead of using other facilities?

The headaches are staffing and supplying the operating room. Equipment needs to be maintained and replaced. Supplies need to be ordered. The floor needs to be mopped, etc. Employees need to be trained. There is a boat load of paperwork necessary for AAAASF certification. Just doing it all right isn’t enough – it all has to be documented and documented and documented. It’s expensive and

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Dr. Shervin Naderi, Rhinoplasty, Botox, & Injectables In Virginia & Maryland

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Shervin Naderi MD focuses on Rhinoplasy and injectibles at the Naderi Center for Rhinoplasyt & Cosmetic Surgery in Herndon, Virginia and Chevy Chase, Maryland.

With his emphasis on Rhinoplasty, Botox, Dysport and filler injections, Dr. Maderi has other plastic surgeons referring patients to his clinics in Virginia and Maryland. We thought we should sit down and learn from Dr. Naderi what he thinks about running a cosmetic practice.

Name: Shervin Naderi, MD, FACS
Location: Herndon, VA and Chevy Chase, MD
Website: VirginiaFacialPlasticSurgery.com

That's interesting: Dr. Shervin Naderi is Board Certified Facial Plastic & Reconstructive Surgeon and ultra specialized in Rhinoplasty and minimally invasive facial injections.  Hes' also a Board Examiner for the American Board of Facial Plastics & Reconstructive Surgery and a consultant and instructor for Allergan and Medicis, teaching Botox, Dysport and facial dermal filler injections to other physicians and nurse injectors.

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Dr. Brett Kotlus, Cosmetic Surgeon At Allure Medical Spa In Michigan

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Dr. Brett Kotlus; from gene mapping to plastic surgery.

Physician:  Brett Kotlus, M.D., M.S.
Location Update: Dr. Kotlus has recently moved to NYC. His new practice webesite is at DrKotlus.com

That's interesting: Dr. Kotlus has traveled to Mongolia on a humanitarian medical mission to instruct local doctors. He also had the opportunity to travel to Malaysia and Thailand to conduct a peer-to-peer laser training. In 2007, he was the first recipient of two Cosmetic Surgery Foundation research grants.

Dr. Brett Kotlus Michigan Plastic Surgeon

About: I went to Penn State for my undergraduate education and I stayed on to finish a Master’s program in genetics. My thesis involved gene mapping in mice. I then decided I wanted to work with people, and I went to medical school at Tel Aviv University. After a residency in ophthalmology in New York, I completed two fellowships, one in oculofacial plastic surgery accredited by ASOPRS and a two-year cosmetic surgery fellowship accredited by the American Academy of Cosmetic Surgery. I then joined a cosmetic practice in Michigan.

How did you fell in love with cosmetic medicine? What was your training like?

My AACS-accredited fellowship in general cosmetic surgery was a major influence on my career. I had the opportunity to train with fantastic oculofacial surgeons, ENT/facial plastic surgeons, general plastic surgeons, and general surgeons to round out my aesthetic knowledge.  The exposure to a growing field involving new technology was an attraction early on.

Who runs your plastic surgery center an medical spa and what services do you offer?

The office is an hour north of Detroit. There are 2 full-time physicians, 2 part-time physicians, and 2 physician assistants. The scope of the practice includes non-surgical and surgical cosmetic procedures including functional oculoplastic surgery, varicose vein treatments, medical weight management, and hormone replacement. The office has an accredited operating suite.  

Are you using new technologies in your clinic? Can you share your experience using these?

We are strongly involved in new technology. There is a lot of excitement in the practice right now for the nonsurgical fat reduction devices. We are using CoolSculpting and Liposonix and both have shown better results than any previous non-surgical fat reduction modality. With CoolSculpting for example, we have found an average of 25% subcutaneous thickness reduction after a single treatment, as measured by diagnostic ultrasound. The market for body contouring is huge, especially when it can be done with minimally-invasive means.  

For skin resurfacing I generally use the erbium Fraxel or the fractional CO2 (Lumenis ActiveFX and DeepFX) depending on the client’s tolerance for downtime. Ulthera is a new addition to the practice and I think it will supplant Thermage for non-surgical firming.     

How are you driving new patient traffic?

Obviously, we put a good deal of focus on the internet with our website and adwords campaigns. This is an ongoing project, and we work with an SEO firm as the ranking rules continue to evolve. We did a Groupon campaign that was very successful in the sense that it introduced our practice to clients that may not have known about us. It was definitely worthwhile.

Internal marketing to our existing patientsis our most valuable form of advertising. We rely on referrals from happy clients and we regularly schedule seminars and events to generate excitement and offer education about the procedures we offer.

Many surgeons are less than enthusiastic about nonsurgical treatments. What's your on using nonsurgical treatments alongside surgery.

Injectables continue to amaze me in terms of being able to achieve great results in a short period of time with minimal downtime.  Neuromodulators and fillers are often downplayed by cosmetic surgeons because they want to be in the OR, but they should embrace the minimally-invasive advances in our field. I find injectables to be just as professionally rewarding as surgery. 

One of my favorite stories about appearances comes from my own family. My grandmother underwent cataract surgery a few years ago. She called me afterward because she thought the surgery gave her more wrinkles and made her face look older. To me, she looked the same, but her vision was dramatically better, so she was able to see the wrinkles. From her perspective, she aged 10 years in an instant. She couldn’t believe that she had been walking around like that for all these years. She still imagines herself as a youthful person. Some of the time in cosmetic medicine we are focusing on a wrinkle when we should be focusing on a perspective. 

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.