to view - American Society of Cosmetic Physicians

Network With Us
MAY/JUN 2015 F VOLUME 1 F NUMBER 3
Your Link, Your Voice, Your Society
HARMONY
through Balance
Gerry Stanley, MD
Erin Stanley
PracticeWing
Mara Shorr, BS
Jay Shorr, BA
member
spotlight
Robert Bowen, MD
island trends
& topics
W.Y. Chung, MD
4S Facelift
Modified Minimal Access
Cranial Suspension
Jaime Calderon, MD
dial-a-doctor
Francisco Franco, MD
island trends and topics
Aloha, My name is Dr. W.Y.
Chung MD, I wanted to share
with you some insights as to
what it’s like for “an island
practice.” I currently reside
and am the founder of the Skin
Center of Hawaii and InkOff.
MD, located in Honolulu,
Hawaii.
As one of the world’s top
travel and tourism destinations,
the state employs thousands
of people in the hospitality
industry. One of the trends
we’ve seen is the increased
demand for services in leg and
vein care. Varicose veins have
become a common health issue
for many hospitality workers,
because this group spends a
majority of time standing and
working on their feet. As many
of you are aware, varicose veins
result from defective or diseased valves in the legs. When
valves are damaged, they don’t
close properly, causing blood to
accumulate which force the vein
walls to bulge.
One of the top procedures in
my practice is Endovenous Laser Ablation (EVLA), and it has
resonated with patients. Here’s
what one patient shared after
the procedure.
procedure, I haven't thought about
that vein even once. I don't feel any
of the pain that was associated
with the vein nor do I have any
swelling.” (A. A.)
TATTOO REMOVAL
Tattoos play a big part in
Hawaii. It goes hand in hand
with the year-round comfortable temperatures, the prevalence of outdoor activities
and the rich tattoo tradition
associated with native Hawaiian
and Polynesian culture.
In the last year, tattoo removal
has become a huge industry, as
more companies enact policies
to ban visible tattoos, such as
the Honolulu Police Department, whose visible tattoo-ban
policy took effect in July. Last
April, the United States Army
also modified its tattoo policies,
affecting the number and size
members could have, in certain
areas of the body.
At InkOff.MD, I was the first
doctor in Hawaii to offer the
PicoSure laser, the most effective technology available today
to remove tattoos.
by:
An Insight into
the Effects
“I would recommend EVLA to
in my same situation. I used
of Geographic others
to be very self-conscious about the
bubbling look of the broken vein
Location
in my thigh and ever since the
Ann
e
tte
Est
rell
a
Q: How long have you been in practice?
It’s the world’s only picosecond
aesthetic laser that effectively
erases tattoos with fewer treatments and better results.
“I started treatments previously on
the mainland, completing four or
five of them, but the green color
remained very bright.
I started going to Dr. Chung
because I saw an article about
the PicoSure laser that he uses to
remove green ink. I’ve had three
treatments with Dr. Chung and the
green is now gone.” (Deanna)
At the practice, it’s all about
serving the needs of our
patients, and I look forward to
continuing to offer the most
revolutionary treatments
available.”
Q: What is the most rewarding part of
being a Cosmetic Physician?
A: Witnessing the patient’s initial reaction
(post surgery) and having them thank me
for their transformation is priceless. Being
able to boost a patient’s life in a positive way
is extremely rewarding to me. I’ve also been
lucky to establish amazing friendships with
colleagues along the way.
Q: What is your favorite procedure to perform and why?
A: Facial Cosmetic Surgery; rhinoplasty, in particular is my most frequented procedure. My father is an
otorhynolaryngologist; since I was younger I established a deep love and appreciation for this art; I
embedded the visual process and grew fond of helping others as my father did. Being able to offer someone
positive reinforcement via procedure in this case is most rewarding to me. Attaining “natural” results and
offering short recovery periods also makes this process very much appealing.
Here’s what two patients had
to share about their PicoSure
experience.
“The tattoos were significantly
lightened after every treatment.
The healing process was much
quicker with PicoSure, and you see
noticeable changes with each treatment, compared to the traditional
laser where it took several treatments to see any results.” (Sara)
an interview with with
Dr. Francisco Franco Gonzalez
A: I’ve been practicing Cosmetic Medicine for
the past 10 years. As an Otorhinolaryngologist; I always had an incredible desire to aid
patients in achieving optimal breathing and
overall wellness and health. I realized that via
the Cosmetic Surgery I was able to enhance
the quality of a patient’s life on a regular
basis.
W.Y. Chung MD
InkOff.MD offers the latest
technology in tattoo removal.
I’ve been in private practice since
2007, after working as an emergency physician for 10 years,
at several hospitals in Illinois,
California and Hawaii.
For more information, please
visit www.hawaiivein.com or
www.inkoffhawaii.com.
DidYou Know
Because the
architecture and chemistry
of coral is so similar to human
bone, coral has been used to
replace bone grafts in helping
human bone to heal quickly
and cleanly
Q: What specific technology or technique have you
implemented in the last few years that have given you
the best return?
A: I’ve implemented the use of lasers and radiofrequency
devices to my practice; I’m especially fond of the fractional laser
skin treatments; the results attained are truly exceptional. The
scalpel is by far worth its weight in gold as well.
Q: Do you advertise your practice using social media?
A: As far as keeping up to par with all of the social media outlets.
I find myself lacking time! I’ve been extremely fortunate to have
patient’s voice their support in favor of my practice; I’m
extremely grateful for word of mouth advertising; there’s no
better feeling.
Q: When you need to get your mind off of your practice,
what activities or hobbies do you participate in?
A: I really enjoy playing golf and spending quality time with family
and friends; creating memories is what life is all about. Through
the society I’m happy to say I’ve established amazing friendships
with colleagues; creating bonds that surpass barriers.
“The scalpel by far is worth it’s weight in gold”
ADDRESSING PRACTICE DEVELOPMENT AT THE:
Practice
Wing
While print advertising, e-newsletters and websites are no longer optional in the world of today’s
cosmetic physicians, it all comes down to going the extra mile to give your marketing a boost.
How do you stand out in a sea of sameness?
Attach call tracking phone numbers to all of your campaigns. We always say that what gets
measured gets managed, and what gets managed get measured. You’ve put time, effort and hard
earned dollars into your latest print advertisement, Facebook post, radio campaign, e-newsletter
and direct mail postcard… so why aren’t you attaching a unique tracking number to each piece to
manage your response? You may find that an expensive magazine advertisement left you without a
single phone call, saving you thousands of dollars when you realize you can safely remove it from your
budget. After all, remember that appointment requests are the entire point of your marketing campaigns.
4S Facelift: Modified Minimal
Access Cranial Suspension
ABSTRACT
We recognized that most of our patients who want a cosmetic
improvement, want to avoid any distortion or any complications.
The main group of patients who want to develop a face lift are
young and have no extreme facial ptosis. Since 1999 a strong
tendency in performing a less dramatic facelift technique based on
recommendations made by Dr. Siya Saylan with his technique of
facelift called S Lift.
S Lift
Each staff member should feel empowered with his or her own business card. Each and every
provider, from your physician to your esthetician, should have a customized business card. In
addition, make sure each of your administrative personnel, including your “Director of First
Impressions” (previously known as your receptionist), is armed with a stack as well. Whether they’re
bragging about your skills to their friends and family or showcasing your amazing work to inquiring
strangers at the grocery store, make it easy for all staff members to refer patients to your office.
Don’t assume you have your patients’ current email address. Even if your patient comes in
regularly for treatments, continue to check all forms of contact information, including his or her
email address. For example, s/he could have switched employers since the last visit, resulting in
a new email address… causing your well-crafted e-newsletter to fall on deaf ears as it bounces into
oblivion.
Utilize your on-hold messaging for marketing messages. It’s always easiest (and cheapest) to go
with the standard on-hold elevator music or standard “we’ll be right with you” messaging, but
use the time your patient is waiting on the phone to promote your newest, strongest, or most-inneed-of-promotion service. Do you specialize in rhinoplasty? Does your patient-base understand that
you don’t just treat females? Do they know you’ve opened up a second location? Do they know you
offer gift cards? Use this time to tell them!
Offer private label skincare. Make sure your logo, branding, and contact information are the
first thing your patients use when they wake up in the morning, and the last product they use at
the end of their day. After spending thousands of dollars to smooth out their wrinkles and tighten their skin, they want to invest in the products to keep them looking their best. Remind them of all
that you do with a product branded with your logo, website and phone number on the front… and give
them a reason to keep coming back.
TAKE YOUR PRACTICE TO THE NEXT LEVEL
with Jay Shorr and Mara Shorr
June 6, 2015
Marketing and Practice Management Seminar
Fort Lauderdale, FL
Contact ASOCP for more details (520) 574-1050
Contributing Authors:
Jay Shorr, BA, MBM-C, CAC I-VI (ASOCP Faculty)
Mara Shorr, BS, CAC II-VI (ASOCP Faculty)
This technique was taken
by Drs Tonnard and
Verpaele as a basis for its
proposal MACS Lift
Taken up from Tonnard
and Verpaele, Minimal
Access Cranial Suspension
Lift 2000
MACS Lift
Vertical vectorial facial lifting tendency
Tonnard & Verpaele,
Minimal Access Cranial
Suspension Lift 2000
These techniques are based on the suspension of ptosis of the facial
tissues based on purse string sutures suspended in hardy cranial
tissues which are represented by a process that can be performed
under local anesthesia; the authors have considered some modifications to the previous techniques such as the incision and how to
make the drawstring suture, respecting their fundamental principles,
but trying to decrease scars by simplifying the process, and maintaining efficiency. We called this technique the 4 S facelift.
We make an incision only in the temporal region and into the
anterior aspect of the helix of the auricle. This requires the use of
long double tipped needles for carrying out the purse string sutures
over hardy, deep temporal fascia. Reduced handling of needle holder
requires a longer incision with sutures. The effective vertical lifting
of ptotic facial features of the lateral aspect of the face is achieved.
We developed a technique that achieved this goal through a minimal
incision, a suspension of the malar bag for a lifting of it with previous premaxillar subperiosteal dissection using elastic sutures raising
the anterior aspect of the ptotic face.
In 20 months, we had
operated on 47 patients
using this technique, with
satisfactory results. These
patients were about 48
years old, with the oldest
patient being 58 and the youngest 39. We describe step by step, each
phase of the surgical technique. This demonstration and discussion
of the technique is done mainly by comparing the 4S Facelift with
MACS, MACS LIFT and LIFT PLUS.
f3
1o
Part
INTRODUCTION
Some techniques are more invasive while others are less invasive.
The invasiveness of the technique can dictate the quantity of scars,
while, in each case improving various aspects of aging.
Certain techniques may be less aggressive in some parts of the face
and have better scar outcomes.
It is considered, that with a selected technique, we can have less
scars while providing long and pleasing results.
We have searched for more of a facial scarless than traditional
periauricular 4S Facelift to avoid attenuating even the small scars.
MACS LIFT
In the history of rhytidectomy have appeared minimally invasive
techniques such as spiculated sutures, vectors with sutures, polyacrylamide sutures that have been suggested by Marlene Medical
Sulamanidze with, Maximiliano Flores, and Dr. Nicolai Serdev,
respectively. However, if we analyze the effectiveness of the techniques that achieve long term results without a convenient embodiment of a subcutaneous dissection and tissue convenient SMAS
suspension at the level of the deep temporal fascia, we find no
effectiveness on these kind of techniques.
On the other hand, we noticed an important effectiveness in these
suggested techniques. In each case, we prepared the deep temporal
fascia tissue for the SMAS, letting the resection of excess skin,
ptotic, according to Dr. Dilson Luz way.
Keywords:
4 s Facelifs
scarless facelift
Closed rhitydectomy
No scar vertical rhytidectomy
A MACS LIFT modified without preauricular incision
RESEARCH QUESTION
Is it possible to achieve effective results with a safe
Vertical Rhytidectomy by a reproducible technique that
decrease or avoids scars on the facial region?
Dr. Jaime Calderon Ortiz
Dr. Marco Antonio Conde
Pérez
Dr. Sanjeev Sharma
Dr. Guillermo Blugerman
part 2 in next issue
P
Of
W
E
R
Each of us
is aware
that the
ASOCP is
made up
of individuals from
varying
backgrounds,
different
medical
training,
diverse
age ranges, and its
membership
covers
a vast
array of
geographic areas.
While
some
could
argue
that the
intrinsic
diversity
of the
ASOCP is a
potential
weakness,
I would
argue that the diverse makeup of this organization, as
well as its powerful message
of inclusivity and training
without boundaries makes
it an organization with a singular and powerful focus...
education for the benefit of
our patients.
After spending 4 years practicing rural family medicine
and surgery, I found myself
in a situation in which I had
a skill set of a family doctor,
general surgeon, OB/GYN,
ENT, and orthopedist...yet it
was the skill set of a dying
breed of physician. In the
spring of my medical career,
I was surrounded by physicians in their late winters.
After spending a year doing
facial cancer surgery in a
federally qualified health
center, I was introduced
to a group of physicians
who welcomed diversity
and encouraged physicians
from varying backgrounds
to sit down, share their
knowledge, and apply their
own unique techniques to
advance cosmetic medicine
and surgery. After my initial
introduction to the ASOCP I
was amazed at the intense
level of collegiality that
was shared. Aware of the
politics of modern healthcare, the ASOCP has made
the decision to put patients
first by encouraging state of
the art training programs in
of practice evolution (never
underestimate the power of
an organization that includes
your spouse). The sense of
community that the ASOCP
has established has been the
guiding force in my cosmetic
practice. If work to emulate
the physicians that trained
me, and I encourage my staff
to connect with the support
Inclusivity
which physicians not only
learn, but share their unique
medical perspectives to improve upon each procedure.
What makes this concept so
revolutionary, to me, is that
it was the method by which
medicine advanced itself for
centuries, until the politics
of the late 1900’s emerged
and we stymied collegiality
for the pursuit of power.
The ASOCP has been able
to re-establish the
roots
upon
which
medical
thought
was founded and
re-introduced a generation
of physicians to the concept
of standing on the shoulders of the giants that went
before them.
Apart from the training,
didactics, and discussions,
the ASOCP has become a
place in which physicians
can establish friendships
to share in the evolution of
modern medicine. A place
in which office managers
can build relationships to
share programs and marketing ideas, where nursing
staff can connect on ways to
improve the patient experience, and spouses can
commiserate on the process
staff of facilities I marveled
at, all the while hoping to
pay it forward and find ways
in which I can share with
other physicians, in search
of education, in the same
manner that the ASOCP has
shared with me.
Tailoring thoughts and perspectives;
a journey in achieving a perfect fit
“The Sense of
community that
the ASOCP has
established
has been the
guiding force
in my
cosmetic
practice.”
O
ne of my favorite things about cosmetic
surgery is that we operate as a small business.
Our practices are not just medical practices,
they are family-owned businesses. Therefore,
we come across many husband-wife teams: my
husband and I being one of them. By being associated with ASOCP, I get to meet other husband-wife
teams, and hear how they make it work. What
makes a husband-wife team tick is different for
everyone, whether you are the nurse, the office
manager, a stay-at-home parent, or you have your
own job. The underlying most important aspect for
a successful practice and marriage is balance.
by:
Dr. Gerry Stanley
The American Society of
Cosmetic Physicians is not
just an organization of like
minded physicians. It is MY
organization...it is
YOUR organization...it is OUR
organization. And
so I would challenge each of you:
share your knowledge,
teach your colleagues,
and build a better
future for our
organization and our
patients.
Dr. Gerry Stanley attended his residency
in rural family medicine and surgery at
the renowned North Colorado Medical
Center where he served as the Chief
Resident in his final year. After completing his initial training, Dr. Stanley served in the National Health
Service Corp for 4 years doing charitable work in low-income
and critically underserved areas of the Midwest. Following
his service, he spent an additional year training on minimally
invasive and contemporary cosmetic surgical procedures. In
addition to being certified in cosmetic surgery, Dr. Stanley also
became certified in bariatric or obesity/weight loss medicine.
“What makes a husband-wife
team tick is different for
everyone, whether you are the
nurse, the office manager, a
stay-at-home parent, or you
have your own job. The
underlying most important
aspect for a successful
practice and marriage
is balance.”
A
nd I know firsthand managing the work-wife with
home-wife comes with its challenges! I am married to
Dr. Gerry Stanley.
We own SCULPT Contemporary
Cosmetic Surgery in Omaha, Nebraska. Since we opened in 2012,
I have played many roles in my husband’s practice. I am the
mouthpiece...I drive business…I assist our staff…I scrub toilets…You
name it, I’ve done it. I’ve had my own job outside the practice, I’ve
been the office manager, and right now I’ve transitioned into a business
development role, which we have found works best for us and our practice.
Our two-and-a-half year old practice has been fortunate to experience
rapid growth over the past year. We got busy enough that Gerry asked
me to come on board, full-time as the office manager. We thought it
was a wise decision to keep the money in the family, and who cares
more about the business and the doctor than me? So I quit my job as a
marketing manager and came aboard the family business. Little did I know
that managing our small practice would be the toughest job of my life!
by:
Erin Stanley
As office manager, we had some of the most
profitable months to date. It was a position I
took pride in. As we all know, running a business is stressful: there is always someone or
something to worry about, and it was tough
for me to “turn it off” when I got home. And
while my staff is used to wife Erin, they didn’t
always respond the best to work Erin’s new
ideas, flows, and best practices. At times they
were met with resistance by staff. That was
tough for me, because our staff is like family
to me, and switching “hats” was a big challenge. Managing an office is difficult yet rewarding, but managing staff was not my forte.
There are times that Gerry and I bring work
home, and I am sure you do too! At times,
it is necessary. Other times, it’s not. If it is a
necessity, we try our best to make it a point
to keep the conversation contained, so that it
doesn’t interfere with us personally and our two
boys. “OK, we are going to talk about this tonight after the kids go to bed and come up with a
solution,” then we will leave it at that.
Other times, we have to make it a point
that we won’t talk about work tonight.
It is a case-by-case basis.
Gerry and I have recently brought on a wonderful office manager, who has experience running
a busy practice and enjoys managing the staff. I
have transitioned into a business development
role, which allows me to work “on” our business, rather than “in” it. While I still manage
the finances of the practice, I am able to find
a balance between my professional strengths
and my personal relationship. I get to support
my husband, professionally, in the best way I
know how: getting out in the community and
getting people in the door. By no means do I
consider hiring an office manager a failure on
my end, but rather a learning and growing experience for Gerry and I, as business owners,
and as a married couple.
We are finding what makes us “tick” as a
husband-wife team.
Bottom line is that you and your spouse need
to find your balance, whatever that may
be. Whether it is you managing the office,
whether it’s you not being a part of the office,
or a small part of the office, you have to find
what works best for your practice, but most
importantly, your marriage. Gerry and I very
much enjoy working together. It gives me no
greater joy than to see him succeed, and I do
my very best to help him with that endeavor,
because he deserves it. I look forward to meeting many of the other husband-wife teams at the
upcoming ASOCP meeting in October.
spotlights
and
elemental facts
featuring, Dr robert Bowen
s
Wisdom i t
a
knowledge ible
its most ed
state
COCONUT WATER is not only sterile, but it
also works extremely well as a sports/hydration
drink, is nearly isotonic, and in an emergency
can also be used as an IV fluid.
LEMON
JUICE promotes
perspiration and helps block
pain. When lemon juice is
heated, salicylic acid – the
chemical cursor of aspirin’s
active ingredient
is produced.
Member Spotlight
Growing up in southern Illinois in the 1960s I
was inspired by the compassion, knowledge,
and skill of my family’s doctor, ( there was no
such thing as a "family doctor" as a specialty
then ) a board-certified general surgeon who
delivered babies, treated congestive heart
failure, set fractures, and treated my asthma
and allergies. Although things had already
started to change by the time I finished my
residency and fellowships in 1984, physicians
were still encouraged to practice individualized/
personalized medicine in the process of caring
for their patients. Today, medicine has become
dependent on algorithm like application of
"evidence-based medicine". Standardized,
evidence-based care may be an overall positive
development for the majority of our patients
but often “standards of care” or “clinical
pathways” do not address the needs of patients
who are considered "nonresponders". For
this patient cohort, their welfare depends on
using judgment and common sense based on
knowledge of anatomy, biochemistry, pharmacology, physiology, etc. . These skills seem to be
receiving less attention in medical schools and
training programs. This loss of independent,
creative judgment is responsible in part for the
decreasing level of satisfaction among practicing physicians.
For physicians who find themselves to constrained by the “medical industrial complex”,
cosmetic medicine and surgery, antiaging /
regenerative medicine, and concierge medicine
have become a refuge. Governmental interference may limit this sanctuary unless physicians
stand up for ourselves and our patients in
organization such as ASAPS, A4M, AACS and of
course ASOCP.
Enough for the soapbox then. Today I would like
to briefly introduce two areas of personalized
non-pharmaceutical medicine which I have
become especially interested.
Regenerative medicine could be defined as
the use of autologous cells and growth factors
to treat both disease and aesthetic concerns.
Platelet rich plasma (PRP) is obtained from a
sample of peripheral blood then centrifuged
to obtain separation of RBCs, buffy coat, and
plasma. Highest concentration of platelets are
found near the bottom of the plasma layer
it into the top of the buffy coat. Various kits
designed for the separation process are able to
concentrate platelets and their growth factors
such as PDGF, TGFB, FGF, and VEGF by factor
of 2× to 10-12x over physiologic concentration
depending on the method and the quantity of
blood obtained. PRP has been shown to be useful for treating chronic wounds, tendinopathies,
aging skin, and enhancing results and shortening recovery time from laser resurfacing, among
many others.
Adult stem cells are now known to be present
not only bone marrow but in a perivascular
location in all tissues. The process of lipoaspiration has been shown to be effective method
of harvesting these regenerative cells from
adipose tissue for point of care applications
like cell assisted fat grafting and joint injections
as well as experimental applications such as
critical limb ischemia, COPD, cardiomyopathy,
and tissue engineering. Low level light therapy
(LLLT), also referred to as photobiomodulation
(PBM ), offers another non-pharmaceutical
approach to disease management.
Every issue often has a “current “of its own.
For our early summer issue the main underlying
theme focuses on destination. Whether it be
about reaching your educational goal or travel
site; ultimately
EDITOR’S
it’s about
NOTE
making the best
of the journey.
We always find
ourselves en
route;
hopefully the
exchange of
knowledge and
information
fused within this issue
leads the way to a prompt and
triumphant arrival of your
ultimate destination. Again
we thank everyone for their
support and effort in
making the ASOCP a
vessel amongst the great
voyage of knowledge.
Annette Estrella
Editor-in-Chief
Unlike cosmetic ablative lasers, which vaporize
abnormal tissue and allow new more functional healthy tissue to replace it. LL LT helps
restore normal cellular metabolism to disease
or injured tissue. Power levels of these devices
are typically measured in milliwatts rather
than Watts and deliver fluences of around 4-8
J /cm2 over a few minutes rather than a few
milliseconds. Recently, some of the mechanism
of action of this LLLT have been elucidated:
Injured tissues have been found to have nitric
oxide binding to complex IV of cytochrome C
oxidase of the electron transport chain which
inhibits synthesis of ATP. Photons in the red and
infrared range are capable of displacing nitric
oxide and at the sub cellular level and allowing
return of normal cellular metabolism as well as
releasing nitric oxide into the local environment
and providing vasodilation. In addition, the photons are capable of upregulating the production
of nuclear factor kappa beta which influences
gene transcription and can increase production
of growth factors such as the TGF-beta family.
Like autologous cells and growth factors, light
therapy has shown promise in the treatment
of a variety of cosmetic and medical problems.
Such as healing of
chronic wounds,
musculoskeletal
injuries, skin rejuvenation, traumatic
brain injury, and even
myocardial infarction.
I believe that with
these and other tools
the cosmetic, regenerative, antiaging
physician can forge
a satisfying career of Robert Bowen MD
caring for patients
using an optimal blend of both art and science.
MEMBERSHIP
10th ANNUAL
ASOCP COSMETIC
CONFERENCE
INFORMATION
Partner (MD, DO, DDS, DMD)
$5,000
4 Has fulfilled the fee schedule
for lifetime partner.
4 Holds a genuine interest in
maintaining and encouraging
the mission of the ASOCP.
4 Holds a current and unrestricted license.
4 Performs or is interested in
cosmetic medicine.
OCTOBER 8-11, 2015
OMNI Championsgate Resort
Orlando, FL
Courses
Physician (MD, DO, DDS, DMD)
$500
4 Holds a genuine interest in
maintaining and encouraging
the mission of the ASOCP.
4 Holds a current and unrestricted license.
4 Performs or is interested in
cosmetic medicine.
Aesthetic Professional $250
4 Holds a genuine interest in
Many
maintaining and encouraging
hange
fish can c course of
the mission of the ASOCP
g the
4 Performs or is interested in offering
sex durin thers, especialservices related to cosmetic medicine. their lives. O
e
a fish, hav
e
s
p
e
e
d
4 Non-physician.
le
ly rare
and fema
both male rgans.
sex o
Resident
No Cost
4 Holds a current and unrestricted license.
4 Currently practicing in a residency
or fellowship program.
4 Holds a genuine interest in maintaining
and encouraging the mission of the ASOCP.
TO APPLY FOR MEMBERSHIP:
Visit our website www.cosmeticphysicians.org
and fill out the form or you can simply
download form and fax/email back to ASOCP.
Fax number: (520) 545-1254
Email: [email protected]
Or contact us at (520) 574-1050
for more information.
ORCAS
are formerly
known as killer
whales. Orcinus orca
are actually dolphins.
They are the
largest of the
dolphin family.
LASER LIPOSUCTION
May 21-22, 2015
Location: Coeur d’Alene, ID
Kevin Johnson, MD
BOTOX COSMETIC &
DERMAL FILLERS
May 14-15, 2015
Location: Port Moody, BC, CAN
Haneef Alibhai, MD
INTRO TO INJECTABLES
May 22-23, 2015
Location: Reston, VA
Dima Ali, MD
MARKETING & PRACTICE
MANAGEMENT
SEMINAR
June 6, 2015
Location: Fort Lauderdale, FL
Jay Shorr, BA
Mara Shorr, BS
BREAST AUGMENTATION
June 5-6, 2015
Location: Framingham, MA
Sanjeev Sharma , MD
LASER LIPOSUCTION
June 18-19, 2015
Location: Coeur d’Alene, ID
Kevin Johnson, MD
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In women undergoing
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breast
augmentation,
a technique
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using transplantation of a small amount of the
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patient's own fat cells can produce better cosmetic outcomes, reports a study
cross
Hors d’Oeuvres
in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the
American Society of Plastic Surgeons (ASPS).
In particular, the fat grafting technique can achieve a more natural-appearing cleavage--avoiding the "separated breasts" appearance that can occur after breast augmentation, according to
the report by Dr. Francisco G. Bravo of Clinica Gomez Bravo, Madrid.
Dr Bravo analyzed the outcomes of breast augmentation surgery in 59 women. Thirty-eight
women underwent conventional surgery using breast implants only. In the remaining 21 patients, Dr. Bravo used a combination technique using breast implants plus "selective para-sternal
fat grafting."
In this approach, a small amount of the patient's own fat was harvested from elsewhere in the
body--such as the thighs or abdomen. After processing, the fat cells were carefully placed along
the inner (medial) borders of the breasts. The goal was to achieve a more natural shape, and
particularly to soften the "medial transition zone" between the sternum (breastbone) and the
implant edges.
Answer Key:
Across:
3. Dermabrasion
5. Tangram
6. Sutures
7. Abdominoplasty
11. Varicoseveins
12. Orlando
Down:
1. Ptosis
2. Botulinumtoxin
4. Blepharoplasty
8. Liposuction
9. Rhinoplasty
10. Grafting
Dr Bravo compared the results of women undergoing the two procedures by measuring
the distance between the medial border of the breasts, or "vertical aesthetic line" (VAL).
He also had 20 observers rate the attractiveness of paired breast photographs, digitally
altered to show a narrower or wider VAL distance.
Both groups of women reported high satisfaction rates. However, the results
showed a more natural cleavage in patients undergoing the fat grafting technique.
As measured on postoperative photographs, the average VAL distance was 2.26
centimeters in women receiving implants only versus 0.6 centimeter with fat
grafting plus implants.
On the breast attractiveness questionnaire, 95 percent of participants selected
images with a narrower distance between breasts. There were no complications
related to fat grafting--likely reflecting the small amounts of fat transplanted
and the gentle "micro-grafting" technique used.
In recent years, several different fat grafting approaches have been evaluated
for use in breast augmentation. Dr Bravo believes his combination technique
may be especially useful in preventing the "separated breasts" deformity
sometimes seen after implant-based breast augmentation. This problem is
especially common in thin women, occurring when the edge of implant is
visible on the inner side of the breast.
Careful fat grafting between the sternum and implant on both sides seems
to provide a significant cosmetic advantage, producing a smoother transition between the breasts and avoiding the artificial "separated breasts"
appearance. The results also support the concept that the VAL distance,
as a measure of the space between breasts, is a useful concept for plastic
surgeons to consider in achieving a more attractive, natural appearance
after breast augmentation.
Bravo, Dr. Francisco G. “Fat Grafting Technique Improves Results of Breast Augmentation.”
Parasternal Infiltration Composite Breast Augmentation 135.4 (2015): MNT. Web
LARGE VOLUME FAT GRAFTING WORKSHOP
May 2015 June 2015
Harold Bafitis, DO
West Palm Beach, FL
Edward Zimmerman, MD Las Vegas, NV
Grace’s PANTRY
SAVOR THE FLAVOR a CREATE THIS
CULINARY DELIGHT FROM
These light and healthy Vietnamese-influenced summer rolls are filled with cooked shrimp, rice
VIETNAMESE FRESH SPRING ROLLS
noodles, and plenty of fresh herbs and vegetables for flavor and crunch. Once your ingredients
Ingredients for the spring rolls (makes 8 spring rolls):
2 ounces rice vermicelli
8 rice wrappers (8.5 inch diameter)
8 large cooked shrimp - peeled, deveined and cut in half
1 1/3 tablespoons chopped fresh Thai basil
3 tablespoons chopped fresh mint leaves
3 tablespoons chopped fresh cilantro
1 c mung bean sprouts
1 med cucumber cut into sticks
2 leaves lettuce, chopped
are prepped, the rolling fun begins as sheets of rice paper are softened in water and used for the
wrappers. Dipped in a spicy peanut sauce, these rolls are a great hot-weather appetizer or light
lunch. Store the summer rolls in a dish or plastic container that’s roomy enough to hold them
without their touching. Place a damp paper towel in the bottom of the container to keep the rolls
moist. Cover tightly with plastic wrap.
Game plan: Be sure to have all your ingredients ready and easily accessible when you start to
roll, and give yourself plenty of time (and counter space) to make these. Also be sure to have a
few extra rice paper wrappers on hand—it may take a few tries before you’re rolling like a pro.
Ingredients for the dipping sauces:
4 teaspoons fish sauce
1/4 cup water
2 tablespoons fresh lime juice
1 clove garlic, minced
2 tablespoons white sugar
1/2 teaspoon garlic chili sauce
3 tablespoons hoisin sauce
1 teaspoon finely chopped peanuts
DIRECTIONS:
Bring a medium saucepan of water to boil.
Boil rice vermicelli 3 to 5 minutes, or until al dente, and drain.
Fill a large bowl with warm water. Dip one wrapper into the hot water for 1 second to soften. Lay
wrapper flat. In a row across the center, place 2 shrimp halves, a handful of vermicelli, basil, mint,
cilantro and lettuce, sprouts and cucumber leaving about 2 inches uncovered on each side.
Fold uncovered sides inward, then tightly roll the wrapper, beginning at the end with the lettuce.
Repeat with remaining ingredients. In a small bowl, mix the fish sauce, water, lime juice, garlic,
sugar and chili sauce. In another small bowl, mix the hoisin sauce and peanuts.
Serve rolled spring rolls with the fish sauce and hoisin sauce mixtures.
All of the information contained here within is printed in good faith and for general information purpose only. We do not make any warranties about the completeness, reliability and accuracy of this
information. Any action you take upon the information is strictly at your own risk. All of the views and opinions expressed within do not reflect those of the ASOCP.
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U S P O S TA G E
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Tucson, AZ 85756
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cosmeticphysicians.org
celebrate
DATE
CONTRIBUTING AUTHORS IN THIS ISSUE
Gerard Stanley MD
erin stanley
robert bowen MD
w.y. chung MD
jay shorr, ba
mara shorr, bs
francisco franco MD
jaime calderon md
don’t forget to register. . .
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