August 2017 Vol. 38, No. 6 · The rhinoplasty topics include innovations, nasal reconstruc-tion,...

August 2017 Facial Plastic Times 1

August 2017Vol. 38, No. 6

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The AAFPRSAnnualMeeting,October 26 -

28, in Phoenix, hasbeen crafted basedon your feedback andto ensure you get themost value possiblefor your time awayfrom your practice.Program co-chairsLouis M. DeJoseph,MD, and JaimieDeRosa, MD, andmeeting director,Phillip R. Langsdon,MD, invite you toparticipate in this innovative,educational meeting structuredwith more speakers, lessbreakout rooms, and more re-search presentations. After yourfill of instructive sessions eachday, the beauty and fun of Phoe-nix awaits and will not disappoint.

The educational sessions willoffer three full days of rhino-plasty, aging face, facial recon-struction, and practice manage-ment. Interesting panels, presen-tations, abstracts, minimallyinvasive, and emerging trendswill also be highlighted breakoutsessions throughout the meeting.

The rhinoplasty topics includeinnovations, nasal reconstruc-tion, form and function, ethnicrhinoplasty, mastering thecrooked nose, correcting thecomplex septal deformity, compli-cations, secondary rhinoplasty,endonasal rhinoplasty, nasal tiptechniques, and nasal dorsalcontouring.

Breakout sessions on theaging face will cover managementof the upper one-third of the face,management of the periorbitalarea, surgical techniques andapproaches to lateral face andjawline, management of the neck,otoplasty, facial implants andvolume, fat, complications offacial rejuvenation, facelift, hairrestoration, and transgendersurgery.

Facial reconstruction ses-sions will encompass the follow-ing subjects: congenital deformityreconstruction, vascular malfor-mations/hemangiomas, facialtrauma, and reanimation. Therewill also be a microvascularworkshop.

For the new and seasonedsurgeon alike, the practice man-agement breakouts will be practi-cal and informative. Themes willcover personnel, marketing,finances, legal, design and brand-ing, public relations, reviews,

paid search, Website logistics, andsearch engineoptimization. In addition to thephenomenal educa-tional gatherings,there will be non-CME sponsoredpresentations inthe exhibit hallduring breaks andlunches. On Friday,the Women inFacial PlasticSurgery will host aluncheon; allattendees are

welcome. There will be a lun-cheon for all academic practition-ers on Saturday.

If this is your first time visit-ing Phoenix, prepare to be awedand amazed. In the immediatevicinity of the hotel, you will findsports arenas, live music, rooftoplounges, museums, theaters, artgalleries, and a plethora of res-taurants. The surroundingattractions include the GrandCanyon, Sedona, Desert Botani-cal Garden, Heard Museum,Roosevelt Row, South MountainPark and Preserve, Old TownScottsdale, and more.

Register online for the AnnualMeeting, www.aafprs.org, beforeAugust 25, to take advantage ofearly bird fees. Reserve your hotelroom at the Sheraton GrandPhoenix by calling (800) 325-3535; be sure to mention you areattending the AAFPRS meeting inorder to receive the special rate,$215. See you in Phoenix! M

ANNUAL MEETING DESIGNED TO MAXIMIZE YOUR ROI

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2 Facial Plastic Times August 2017

Articles signed by their authors express theviews of those authors only and do notnecessarily express official policy of theAcademy. The Academy does not necessarilyendorse the products, programs, andservices that appear in paid, non-AAFPRSadvertisements.

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Executive Editor: Steven JurichMedical Editor: Steven H. Dayan, MDManaging Editor: Rita Chua MagnessFreelance Writer: Lynnette SimpsonFacial Plastic Times is published by theAmerican Academy of Facial Plastic andReconstructive Surgery (AAFPRS)310 S. Henry St., Alexandria, VA 22314;Phone: (703) 299-9291; Fax: (703) 299-8898E-mail: [email protected]; www.aafprs.org.

August 2017Vol. 38, No. 6BOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORS

Fred G. Fedok, MD*President

Edwin F. Williams, III, MD*Immediate Past President

William H. Truswell, MD*President-elect

Minas Constantinides, MD*Secretary

Harrison C. "Chris" Putman, III, MD*Treasurer

Richard E. Davis, MD+Group VP for Education

Paul J. Carniol, MD*Group VP for Membership & Society Relations

Wm. Russell Ries, MD*Group VP for Public & Regulatory Affairs

Sam P. Most, MD+Group VP for Research, Development, and

Humanitarian Programs

Theda C. Kontis, MD+Secretary-elect

Patrick J. Byrne, MD+Group VP for Public & Regulatory Affairs-elect

Andres Gantous, MDCanadian Regional Director

Theresa A. Hadlock, MDEastern Regional Director

John S. Rhee, MDMidwestern Regional Director

Phillip R. Langsdon, MDSouthern Regional Director

Travis T. Tollefson, MDWestern Regional Director

J. David Kriet, MDDirector-at-Large

Lisa E. Ishii, MDYoung Physician Representative

Anthony E. BrissettSouthern Regional Director-elect

Benjamin C. Marcus, MDMidwestern Regional Director-elect

Jamil Asaria, MDCanadian Regional Director-elect

Steven J. Jurich+Executive Vice President

*Member of the Executive Committee+ Ex-officio member of the Executive Committee

PRESIDENT’S MESSAGE:

Some of you, possibly many of you,are aware that within the lasttwo years, I have changed myvenue of practice and created a

solo private practice in facial plastic andreconstructive surgery, Fedok PlasticSurgery, in Foley, Ala. Here, along the GulfCoast, I have ample opportunity to developa contemporary wide scope of practice withan impact extending from Louisiana toFlorida. It’s a great setting, but things justdon't happen on their own.

Certain key business principles must be adhered to: cash flow,bottom line, expense management, personnel management, etc., I havedone this in the past, several decades ago in California; and later, livedunder an expanded set of principles during my academic practice until2013. Planning has to be done with an attentive eye on the present andinto the future.

On another axis, there has to be planning regarding the professionalevolution of one's surgical practice. One has to have a fairly clear visionof where you want the practice to go or else it will develop via entropy.Several years down the road you might find yourself doing a scope ofpractice that you did not really want to be involved with or plan on.

This is where one's concept of what facial plastic surgery comes in.Personally, I see it as a field and discipline that encompasses anythingand everything that comes within the spectrum of facial plastic andreconstructive surgery.

This large scope of facial plastic surgery continues to evolve in thesame way all other medical fields have evolved to incorporate technologi-cal advances, key professional collaborations, social changes, andindustry. The contemporary field of facial plastic surgery rightfullyembraces all of these dynamics. Taking this back to my practice for amoment, if it is to be viable and progressive, we must keep an eye andrespond to all these factors.

Organizational rebranding and evolution has many parallels tomedical practice building. As such, certain principles must be applied tothe AFFPRS new “practice.” In order for an organization to functionoptimally and with longevity, certain basic principles must be adheredto. There has to be an organizational structure, there must be a hierar-chy of leadership, it must be fiscally sound, and must be very clear onits purpose and mission. As with the development of an individualpractice, this doesn't happen on its own; it has to be done with adeliberate attention to action, reaction, and ongoing necessaryadjustments.

The AAFPRS stands with facial plastic surgeons and represents all.Where along that spectrum one wants to practice is dependent on one'sskills, training, personal preferences, and practice setting. So, whetherone is in a small private practice, a large multispecialty group, anacademic practice, or any other variation of such, one can work tohonorably and professionally develop a great practice in facial plasticsurgery—as a facial plastic surgeon!

Mission is ultimately important. The principles and members of anorganization have to rally around a core solidifying purpose. To digressfor a moment, in the last year we have witnessed and paid homage tothe passing of a number of facial plastic surgery founders and


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WHAT IS OUR MISSION AND HOW DO WE ATTAIN IT?

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luminaries. We have expressedtribute to them in a number ofvenues. For the sake of space andtime, I cannot list them by nameat this point, but you know whothey were. A very common char-acteristic of all these great lead-ers in facial plastic surgery wasthe clarity and laser focusedpurpose and dedication theyexhibited as they forged the wayfor facial plastic surgery. Theywere passionate and driven. I amquite sure those of you who arereading this are among thenumber of people who literallyowe their careers to this smallnumber of surgeons who mademuch of this possible.

To develop a point, I want toshare a recent dinner conversa-tion with a principal of a multina-tional company (one of theseproverbial stories of a smallventure starting in a garage andafter several decades becomingan industrial leader in the techfield). The conversation revolvedaround organizational structures,buy-in by members and employ-ees, and mission statements. Oneobservation we discussed wasthat an effective mission of anorganization must both empowerand inspire its members. Missionstatements are usually mosteffective when they not onlyincorporate tangible businessgoals, but also express a higherideal. For example, the mission ofthe AAFPRS is not only to edu-cate. The mission of the AAFPRSis not only to represent members.The mission of the AAFPRS is notonly to advocate. The mission ofthe AAFPRS incorporates all ofthose activities; but the missionof the AAFPRS is to foster the bestfacial plastic surgery in the world.The ultimate goal is to be thebest representative and torepresent the best advances infacial plastic surgery. Andfurthermore, the AAFPRS shouldbe the most visible, undeniable

leader in those tenants to benefitthe world.

How do we better our standingthere? It starts from the bottomup. It has to involve changeswithin the office—with our rela-tionships with members and withthose outside the AAFPRS. Therecontinues to be changes in thecentral organizational structure.The newest members of Mr.Jurich's team include JennWaugh—who is serving as thenew AAFPRS director of opera-tions to assist our EVP withenhancing the operational andfinancial processes at the Acad-emy office—and Ada Phillips, whocame on board in early August toserve as our new director ofmeetings and CME. There will befurther announcements of theirhire by Mr. Jurich. The profes-sional capacity and makeup ofthe central office is not onlychanging, but the entirereporting mechanism within theorganization is changing in orderto make it much more functionaland to take advantage of collabo-rations, rather than personnelworking in their own silos ofactivity.

The next important an-nouncement is that Theda C.Kontis, MD, will be heading ourTask Force on MembershipEnhancement and Engagement.The task force will be developingsome of the membership relatedconcepts that came out of theBoard's strategy meeting thattook place in Alexandria, Va., inMarch. In order to maintain andgrow an informed and dedicatedmembership, the AAFPRS needsto advance various mechanismsand benefits that will ignite theprofessional passions of our vitalmembers. Without question,constructive and ardent memberengagement fuels our core objec-tives, mission and vision. We needto more deeply involve all of ourmembers, as well as new and

potential members, in our crucialmission-focused efforts!

By the production of nextmonth's Facial Plastics Times, Iwill be able to report on theactivation of the Task Force onIndustry Relations. This similarlycame out of the Alexandriastrategy meeting. The goal of thistask force is to develop bettercollaborations and reciprocalengagement between the AAFPRSand industry. In fact, I foresee amarkedly improved, mutuallybeneficial, dynamic between theAAFPRS and industry in order tosupport the Academy's mission,members, and industry innova-tion.

We want to make the AAFPRSthe most important organizationalrelationship in the professionallife of each facial plastic surgeon.We want our members and indus-try partners to be passionateabout the success of the AAFPRS.And we want to make the AAFPRSthe most important voice of facialplastic surgery.

Finally, I am excited to an-nounce that the contract for the2018 AAFPRS Annual Meetingand 12th International Sympo-sium venue has been signed. Themeeting will be in Dallas and thedates for the educational pro-gramming will be Monday, Octo-ber 15, 2018, through Thursday,October 18, 2018. It is a newfeature to combine the AAFPRSand our international societies atone venue. It is slated to be agreat, new meeting concept!

Enjoy the last month ofsummer. Much more to come. Bewell and best regards,

Fred G. Fedok, MD


FALL CONSUMER NEWSLETTER TARGETS TRENDS

Fall is around the cornerand that means anotherissue of Facial PlasticSurgery Today. This issue

is sure to engage your readers—potential and current clientele—and inspire them to make anappointment to see you.

The cover article, “Confidence,Career, and Companions DriveMen to Embrace Cosmetic Sur-gery,” will share the results ofsurveying 618 men regardingfacial plastic surgery. Fromwrinkle-busting injections andlaser skin resurfacing to lifts,more men are having proceduresto stay competitive, relevant, andmarketable in today's youth-drivendating game and workplace.

As you know, men and womenin their 20s and 30s are optingfor preventative measures tothwart bigger procedures andsurgery. What steps are theytaking? “Prevention Forestalls

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Major Procedures,” will focus onthe latest options available forpreemptive action.

The “Ask the Expert” featuresthe question, "While I thoughtgauging [stretching earlobesusing large-gauge earrings] wasfun and cool during college, I nowhave holes that are about an inchand one-half in diameter. I wouldlike to repair them before gradu-ating and moving into theworkforce. What can I do?” Theanswer will explain reconstruc-tive surgery; and for those thathave more recent tears or lesssevere splits, they may have theoption to allow the lobes to healon their own.

November is Healthy SkinMonth. The “Health Tip” willrecommend easy-to-implementsuggestions to develop a simple,anti-aging skin routine.

Patients will be intrigued bythe “What's New” column, featur-

ing a recently U.S. patentedmolecule, QR 678, that treatshair loss in patients. The mol-ecule is injected into the dermisof the scalp, stimulates hairfollicles, and boosts hair growth.Treatment has shown effective forpatients with androgeneticalopecia, alopecia areata, femalepattern baldness, secondaryalopecia, in addition to chemo-therapy patients who have suf-fered hair loss throughout thecancer treatment process.

In honor of October's domesticviolence awareness month,“Facial Plastic Surgeons GiveBack,” will feature how facialplastic surgeons are donatingtheir expertise and time throughthe FACE TO FACE program.

Don't miss this excellentmarketing opportunity for yourpractice. Refer to the enclosedorder form to order your digitalcopy today. M


ASSI AD


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MESSAGE FROM THE MEDICAL EDITOR: WHEN IS ENOUGH…

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By Steven H. Dayan,MD, Medical Editor

Saturation isa point atwhich acapacity is

at its fullest, andany greater intakeleads to no further effect and/ornegative consequences.

When I ask friends, relatives,and colleagues if there is any-thing in life that they can neverhave too much, I almost alwaysget the same reflexive answer, “Ofcourse, money, love, or happi-ness.” If thought through deeply,however, even too much moneyand happiness can lead to anexpanding potential for negativeconsequences. Saturation existsin food, chemistry, fun, light, andin all aspects of nature. Quitefrankly, there is little to nothing Ican think of that doesn't eventu-ally reach a point of saturation,other than perhaps love for one'sown DNA either manifested asthyself or in one's offspring.Beyond this, most everything innature has a point at which beingsatiated is reached and anyfurther intake will lead to noeffect and likely negative conse-quences.

If this is true, could there be apoint at which the number ofaesthetically talented medicalproviders reaches saturation?When have we effectively re-cruited and trained all of thosethat have the necessary prerequi-site skill set to effectively deliver apositive outcome or experience,and any further training leads toa downward trend in the productdelivered?

Recently, I was teaching aresident class on how to injectfillers. As any preceptor in anytechnically challenging field cantell you, those who have "greathands" are quickly identified.However, just as easily discoveredare those lacking the hand-eyecoordination, emotional intelli-gence, and judicious acumen to

deliver aesthetic services effec-tively. Certainly, a determinedminority lacking one of the pre-requisites with significant studyand pounding practice can gainproficiency overcoming congenitalnaivety and a shallow skill set toemerge as an excellent provider.But there is a vast majority, whodespite all efforts, may neverreach a level of proficiency intechnical skill, judgement, oremotional reserve to excel. Theresult will be that both an aes-thetically seeking populous andthe aesthetically dependentmedical field suffer when theseproviders enter into the market.

Aesthetic medicine is uniquefrom traditional medicine; thosewho succeed at the highest levelneed an ability to see threedimensional as well as that whichdoesn't exist—and then be able tocreate it. Also, even more highlyspecific for aesthetics is a retailaffability woven with a fiduciarythread to treat and care for avulnerable patient population.This is a pattern not necessary inother medical fields; yet, we don'tteach how to weave it. In fact, it isshunned when we should beemphasizing how to carefully,respectfully, and ethically braidthe strands. Without formaltraining, it can take many yearsand many regrets before reachinga position of aptitude. But for theartisans who work past theseobstacles and deliver the crafts ofcosmetic medicine, the rewardscan be grand. This is entranceinto perhaps the last field ofmedicine in which a doctorpatient relationship is still sacro-sanct. Aesthetic physicians arechosen based on reputation, noton a participating insuranceplan. And yes, there can be afinancial upside and a glamourfor an aesthetic physician, butboth are over exaggerated. Yet,this doesn't stop the masses fromstorming the gates wanting toenter the club.

The question I have: Is there asaturation point of skilled aes-

thetic providers who exhibit thenecessary technical, emotional,and judgment skill set to deliveran excellent product? Just like inother fields in which membershiprequires three standard devia-tions in excellence, not everyonecan be a Navy Seal, an NFLplayer, or a NASA astronaut…fewmake it through. As both the NFLstrike season of 1982 and expan-sion in baseball have proven,diluted talent leads to a dilutedproduct and a disappointedconsumer.

Even if a saturation point ofaesthetic providers does exist,perhaps it doesn't matter. Maybethere will be a secondary marketfor less than talented techni-cians/doctors and outcomes. Forexample, minor league baseballdoes attract a sizeable following,especially in areas where theMLB games aren't easily acces-sible. However, will a collectiveaesthetic medical communityand, in general, a society accept asecond class of outcomes. Theanswer for pharma may seemeasy even if a saturation point isreached. Then, why not cultivatetalent in the next level of deliver-ers? Extended providers (nursepractitioners and physicianassistants) are a growing fieldwith a larger pool of talent tochoose from and increasingresponsibility and professional-ism. The unstated risk, though, isif a saturation point of providersis surpassed, do we then shift thewhole paradigm of results to theleft and less than ideal outcomesbecomes the norm?

The logical conclusion to moreproviders delivering more aes-thetic services is a regressiontoward the mean. And the meanoutcome is secondary to masstraining based on educationalplatforms designed by industry tocomply with FDA indications.Industry has the largest reach,resources, and incentive to trainproviders. The training programsthat are conceived within indus-try, however, promulgate out-


ENOUGH?

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comes that are not based on whatlooks more attractive or natural,but rather on outcomes to gainindication. These studies have adifferent goal than that which iscommon to everyday practice. Thephase three studies are designedto deliver a noticeable difference.But a recognizable improvementin the nasolabial fold, glabellarwrinkle, or crow's feet leads to aresult that may appear frozen orunnatural. This is precisely whatthe populous is begging us not todo. And when the mean outcomefrom mass trained providers is anunnatural appearance, the wholeaesthetic field suffers. The morewe indiscriminately train, themore we regress to the mean, themore our field delivers a less thanideal product, and the more webecome commoditized.

In essence, there are twoissues with a sizeable spread.One is protecting the public; thesecond is protecting the trade.Medical school, residency, andstate licensing boards are taskedwith assuring the public provid-ers reach a defined level of com-petency. However, there is noregulatory for effectively assuringthe public and ourselves a level ofsuperiority for delivering anaesthetic medical treatment.While board certification andCME are in theory mechanisms toassure competency, all of those inthe field know these hurdles haveat best an arguable correlationwith true clinical excellence. Inthe United States, we have a freemarket system that should serveas a defacto regulator. Those thatdeliver excellence should thrive,while those who deliver less falter.However, today's social mediaallows for less than ideal out-comes to flourish from less thanideal providers who master theart of appealing to a naïve popu-lous.

As a Darwinian and a capital-ist, albeit a cautious one, I sup-port the state of nature withlimited regulations; but reject theshackles that excess regulations

A Call forCommittee Volunteers

AAFPRS members have theunique opportunity to be moreactive and offer their services tothe AAFPRS at the committeelevel. If you are interested inserving on a committee, pleasecomplete the form below andreturn it to AAFPRS by fax (703-299-8898) or by e-mail([email protected]) on or beforeFriday, September 15, 2017.

Positions are expected to beavailable as current membersfulfill their term of appointment.However, it is not possible toassure that everyone who applieswill have a position. President-elect William H. Truswell, MD, willtry to place interested individualswhere they can make a difference.

Refer to the 2017 MembershipDirectory for a list of committees(Academy on pages 9-11 andFoundation on pages 22-24) orvisit: www.aafprs.org/academy/committees and www.aafprs.org/foundation/committees.

Appointments will be an-nounced in the fall. Thank you.

Name

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Address

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City

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State and Zip Code

___________________________________

Phone

_______________________________________________________

E-mail

___________________________________Please list the committee onwhich you would like to serve:

1st choice

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3rd choice

_____________________________________________________( ) No preference; any committee

bear down on creativity, society,and trade. What is the solution? Idon't profess to have the answer.But I believe in any free marketeconomy; it is innovation whetherin product, technique, or thoughtthat always leads the path outfrom under the herd. And thebeneficially adapting mutationwill most likely stem from anindividual doctor serendipitouslystumbling across a new way ofexceeding patient expectations,leading to a disruptive selectionand a break from the chains ofcommoditization.

As aesthetic medicine reachesa saturation point, outcomes willregress toward the mean andcommoditization will ensue. Themarket will become stagnant. Itwill be incumbent on prosperousseeking industry leaders andaesthetic societies to cultivate afertile environment where pro-gressive pioneers in innovationare welcomed, encouraged, andpromoted. It is when the rightelements from heterogenouspopulations and minds are allowedto mingle that new and more fitbeginnings are birthed.

The future of aesthetic medi-cine requires forward-thinkingorganizations and strategies tomeet the imminent challenges ofsaturation. M

2017 AAFPRSCommittee MeetingsThe Board of Directors andcommittees are scheduled to meeton Wednesday, October 25, 2017,starting at 7:00 a.m. For those ofyou who serve on Academy andFoundation committees, pleaseplan your travels accordingly.

Refer to the 2017 MembershipDirectory for a list of committees.(Academy committees on pages 9-11 and Foundation committees onpages 22-24.)

Contact your staff liaison todetermine the time of your meet-ing. All meetings will be held atthe Sheraton Grand Phoenix, thesite of the Annual Meeting.


PR COLUMN: A GUIDE TO BEING YOUR OWN PUBLICIST

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There is no doubt that apower publicist can putyour practice on the map,but hiring such a profes-

sional costs time and money, andmay not be the right call for everypractice…yet.

First, try being your ownpublicist to determine whetheryou enjoy working with the mediaand to get a baseline feel for thepotential return on your invest-ment. Start by asking some basicquestions: why, what, who, how,and when.

Why? Why do you want mediacoverage? Some doctors enjoyspeaking up and out via media,while others do it out of necessity.Where and how do you fit in? Areyou looking to book more surger-ies? Generate more leads? Makemore money? Show your peershow amazing you are doing?There is no right or wrong an-swer. Be honest, as your motiva-tion will be the best way to chartyour course going forward.

What? The media—whetherprint, online, or television—wantsexperts on a wide variety of topicsand there is no shortage of buzzor newsworthy stories in thisspace. To become a go-to guru,you must be in the know about alltrends and public figures movingthe anti-aging needle. If actress-turned-wellness-icon GwynethPaltrow is promoting yoga as ananti-ager on her Web site, Goop,you need to know all about it andbe willing to tell the media why itis or isn't the next best thing. Youneed to watch or at least setGoogle alerts for any reality showfeaturing any Kardashian familymember. If they do it, say it, downit, or laud it, “it” will cause amedia frenzy. This is in additionto following the relevant journalsand US Food and Drug Adminis-tration activity. In short, you needto stay on top of your game andbe at the ready to provide soundbites on many topics, not justsecondary rhinoplasty techniquesor best ways to deal with SMAS.Keep in mind that most media

and the readers they are trying toreach tend to be generation X, Y,and Z.

Who? Reach out to anybusiness or consumer journalistsyou respect, including highlyregarded beauty, health, lifestyle,or mommy bloggers who have asubstantial following. Let themknow you are ready, willing, andable to discuss a wealth of topics-even when they are under tightdeadlines. When you read areporter's story on a subject thatyou are an expert on (even if youweren't quoted), reach out andtell him or her what you likedabout the piece and ask to bekept in mind for future stories.(Flattery will get you everywhere.)

There are other ways to reachjournalists too. Do you have auniversity affiliation? If so, con-tact your public affairs team ormedia relations department andmake them aware of your areas ofexpertise and provide them withyour contact information. Also,alert them to any key happeningsin your specialty—a newly ap-proved filler or laser indication,new statistics from a nationallyrespected medical association likethe AAFPRS, or even importantresearch in one of the journals.They may be able to do your legwork for you and let media knowthat they have a source.

Other outlets, such asNewswise “Expert Pitch” (www.newswise.com/experts) and Helpa Reporter Out (www.helpareporterout.com), allowdoctors to list themselves asexperts. Reporters often tap theseoutlets when they are under thegun or looking to expand theirown e-Rolodex. Don't forget tokeep a list of local media, includ-ing anchors on the 6:00 news,health editors in your localpapers, reporters who cover yourbeat, beauty writers from theSunday magazines in your area,etc. Reach out to them too to getacquainted and let them knowyou are available. Invite some ofthem to your practice to talk

about interesting trends or newswith a local angle that might be ofinterest to them.

These simple exercises re-quire minimal effort and will helpbuild a pretty impressive medialist.

How? This is simple. When areporter calls, take the call. Letyour office staff know if you areexpecting any calls from themedia. If you are running late, letthe reporter know. During theinterview, stay on topic. Do notpivot and start talking about yourlatest device if it is not 100percent pertinent. Speak in plainlanguage for consumer press, butfeel free to use more medicalterminology when talking withtrade journals.

After your interview, send thereporter a follow-up email. Lethim or her know what you likedabout the story and that you areaccessible in the future. (It's not abad idea to causally mentionother topics you are well versedon as well.) Be accessible andgive media your cell phone num-ber to reach you when they areon deadline. Don't set up hurdlesfor them to get in touch; keep itsimple stupid (K.I.S.S.). The moreresponsive and accessible youare, the more likely they willreach out and quote you.

Finally, make sure you pro-mote all articles where you arequoted or featured on your socialmedia channels and your Website. This will dramatically in-crease the number of eyes on thecoverage and will help solidifyyour place in journalists' data-base of experts. The more theysee your name, the more theywant to interview you.

When? The final question iswhen; the answer is now.

After a few months of pitchingyourself, evaluate how things aregoing and whether you think youneed or want outside help. M

Editor’s note: This column wasprepared by the Academy’s publicrelations firm, KELZ PR.


IN BRIEF: ADAMSON’S APPOINTMENT

Peter A. Adamson, OONT,MD, FRCSC, FACS, ofToronto, was appointed tothe Order of Ontario, the

province’s highest honor thatseeks to recognize the extraordi-nary achievements of current andformer Ontario residents. Among500 nominations, Dr. Adamsonwas selected and participated inthe investiture ceremony on June28, 2017, with 25 other recipi-ents. He was acknowledged as aninternationally recognized facialplastic and reconstructive sur-geon whose techniques aretaught worldwide and who regu-larly leads teams of plastic sur-geons on medical missionsthrough his Face the FutureFoundation.

Lieutenant Governor ofOntario Elizabeth Dowdeswellstates, “As Chancellor of theOrder of Ontario, I proudly recog-nize 26 Ontarians who havedemonstrated excellence andachievement at the highest level.Having distinguished themselvesin the fields of journalism, medi-cine, human rights advocacy,community building, the arts,and sport, they join a society ofmerit that has been an inspira-tion to Ontarians for 30 years. Ioffer them my warm congratula-tions on behalf of a gratefulprovince.”

Dr. Adamson's career hasspanned 35 years, during whichhe has been recognized as anexpert rhinoplasty surgeon andhas been president of numerousmedical boards and societies,including the AAFPRS in 1996—the only Canadian to ever serveas president.

In addition to his service tothe AAFPRS, Dr. Adamson'sdedication to the advancement ofcertification began well over 25years ago when he wasinstrumental in leading a largeteam of U.S. and Canadiansurgeons to develop the ABFPRSexamination for specialty certifi-cation. Since its inception, theABFPRS examination has been

recognized as the first and besttesting vehicle to examinestandards for surgeons choosingto achieve facial plastic surgerycertification.

Dr. Adamson was the fourthABFPRS president, 1997-2000. Hecurrently serves as a past presi-dent and senior adviser on theABFPRS Executive Committee.

Dr. Adamson has also been atireless advocate in developingand promoting the InternationalBoard for Certification in FacialPlastic and Reconstructive Sur-gery (IBCFPRS). He began work toexpand facial plastic surgerycertification efforts on an interna-tional level and has served as theIBCFPRS president since 2012,and was re-elected to a second,three-year term in 2015. To date,the IBCFPRS has certified almost100 surgeons throughout Europe,Australia, the Middle East, Asia,and Latin America.

Through the AAFPRS fellow-ship program, Dr. Adamson hasmentored 31 surgeons at theUniversity of Toronto, where hehas been head of the Division ofFacial Plastic and ReconstructiveSurgery, Department of OHNS,since 2008. He has produced 155peer reviewed papers, journal andchapter articles, published twobooks, and produced 30 educa-tional videotapes, some of whichare in the AAFPRS video library.Dr. Adamson has taught in over40 countries and went on his firstFACE TO FACE humanitarian tripto Russia in 1994.

Dr. Adamson has receivednumerous top awards for teach-ing and clinical research, includ-ing the Academy's Mark RafatyMemorial Award, Sir Harold DelfGillies Award, 1887 Member ofthe Year Award, the Gene TardyScholar and Lecturer, and theABFPRS Schoenrock Award.

Through Face the FutureFoundation—which he created in1996—he has led 31 surgicalmissions, during which he andhis teams have performed 1,250complex operations and donated25,000 hours of volunteer time.

In response to this excep-tional honor, Dr. Adamson hum-bly expresses, “Whatever contri-butions I have made, have beendue to the exceptional support Ihave enjoyed from family, col-leagues, and friends, especiallymany of those in our Academy andBoard.”

Congratulations to you, Dr.Adamson. The Academy is proudof you and your dedication toexcellence, teaching, leadership,

andhumanitar-ian services. M

JOINING DR.ADAMSON IN HISPROUD MOMENTARE (FROM LEFT)HIS DAUGHTERHEATHER; WIFENORA; AND SONGEOFFREY.(DAUGHTERELIZABETH ISNOT IN THEPICTURE).

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INTERNET INSIDER: BLOGS AND BLOG POST CULLING

Who hasn't heard thatblogging is good forsearch engine optimi-zation (SEO)?

Conventional wisdom hasheld on to this for more than adecade, and I hear it espousedoften. And, while it still may bethe case, there are some changesyou should be aware of and thatmay impact your site. In fact, in2017, you may be able to improveyour efforts, increase efficiency,and power the visibility of yourmost important pages by reducingcontent instead of adding to it.

At the onset of search enginemarketing, one of the big discov-eries by SEO specialists was adirect correlation between creat-ing content on a consistent basisand getting great rankings. IfGoogle recognized that your sitewas growing “bigger” with moreand more pages, and on a regularbasis, it spoke to the health andimportance of your site. This inturn meant that the largeramount of relevant content wouldattract “long-tail” keywordsearches—those lower volume,more specific search terms thatyour site could dominate inbulk—ultimately increasing yoursite's organic search traffic.

This created a glut of low-quality blogs and blog posts, withsites going through the motions,publishing boring posts on amultitude of topics, and havingthem read by virtually no one.But it worked! By today's stan-dards, it was considered lowerquality SEO. In some cases, lowerquality literature, since somesites pushed for one blog postafter another in an assembly line-like fashion.

Google, in its infinite wisdom,has decided that it no longerwants to encourage perfunctorybusiness blogging as a bestpractice. In fact, with each pass-ing change that Google enacts inits quality assurance pursuits,these types of blogs tend tobecome less and less visible. Ithas come to the point whereGoogle would rather not indexthese pages—written about noth-

ing of importance for no one inparticular—at all. This is largelya result of Google getting smarterby the minute. Not only are theytracking the content on your site,the links to that content, and theway you technically produce andserve up that content, but theyare also closely monitoring theimpact of that content. Are yoursite visitors taking action? Arethey bookmarking your site? Arethey filling out a contact form?Are they clicking to call you?Often, these poor-quality blogposts have something else incommon: they are not producingmuch of anything in the way ofactivity from your users.

This is where the idea of blogpost culling comes in—i.e., theconcept of removing low-qualityblog posts from your site andredirecting those pages to moreimportant and topically relevantpages. After reading some con-vincing case studies performed byindustry leaders, we decided totest this technique, using ourown Web site, as well as a fewothers, as guinea pigs.

We started out conservatively,deciding only to remove thoseposts that had fewer than 10visits in the last 18 months andthat had not led to a conversionof any kind. The total posts thatmatched those criteria amountedto 72. We then redirected thesepages to other pages that hadrelevant concepts and were infact quite choosy about pickingthe right “target” pages.

Our hypothesis: If rankingsand traffic increase, then theaforementioned conventionalwisdom about blog posts is nolonger applicable, and removinglow-quality posts is more benefi-cial than adding more low-qualityposts.

It is early in our experiment;however, the data suggests thatour hypothesis is true. Ouraverage positioning index hasincreased 2.5 percent since weremoved the old posts; our trafficincreased 21.5 percent. Again, itis too early to say definitively thatthis strategy is sure to increase

visibility; butwhat we cansay is thatour keyperformanceindicators didnot go down, butinstead went up.

In the coming months, weplan on replicating this experi-ment, and we hope to have muchmore data to report. Keep an eyeout for it and consider changingup your own blog strategy to focusless on volume and more onquality, and use historical analy-sis to make some page-by-pagechanges.

Quick note about trust andGoogleGoogle has been getting toughabout pay per click (PPC), espe-cially in the medical industry.Certain procedures, phrases, andwords have caused issues. In thepast couple of months, we havehad to update some content toadhere to Google's latest AdWordspolicies. These policies require areduction in terms like “guaran-teed” and “best,” and revolvearound communicating to pro-spective patient concepts like“these results are not guaran-teed” and “you, as an individualpatient, should not expect perfec-tion.” They are designed to ensurethat Google as an advertisingplatform can be trusted to serveup trustworthy search results.

We figured that applying thesechanges to other pages, not justthose pages associated with PPCcampaigns, might result in a fewpositive changes as well. So, wetested this on entire sites—a veryrigorous process impactinghundreds of pages and requiringmultiple standard operatingprocedures. As with the testoutlined previously, the resultsare just rolling in and quite early,but they are positive. Makingthese “trust-improving” changesto entire sites have improvedsearch traffic on an average ofseven percent. If it is required forGoogle PPC, it must be good forthe rest of your site. M

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IMPLANTECH


FR2018

EDUCATING YOUR PATIENTS WITH BROCHURES AND BOOKS

Be sure to takeadvantage of theeducational materialsthat the Academy has

to offer with patient educationbrochures and The Face Book.

Patient brochures are astaple of every waiting room.Thirteen patient brochuresfeature the most frequentlyperformed procedures,described in detail with four-color photos and easy-to-readtext. Each major procedure isdescribed in a single brochureand reflects the latest in tech-niques and technology. Thebeautiful illustrations andeasily understood explanationsare useful as a before-consul-tation informational piece or aspart of the initial consultationwith the surgeon.

The series of brochureswas re-designed to match TheFace Book—making it a perfectcombination for your waitingroom. Because of its popularitywith the membership, half of theseries has gone back to print athird time. You may purchasethese brochures in packs of 50

and 100 print copies. With yourpurchase of each title, you areable to have a link to theAcademy’s patient brochure page

on your Web site. (You willneed to sign an agreementform prior to adding thislink.)

The third edition of, TheFace Book: A ConsumersGuide to Facial Plastic Sur-gery, features the latest facialaesthetic trends and treat-ments with three new chap-ters on neurotoxins, inject-able fillers, and non-ablativelaser and light therapies.This stylish, 144-page book isbased on dozens of patientand surgeon interviews. Aninformative, comprehensive,concise source of informationon all major procedures, it isa must-read for patients anduseful for referral sources.More than 100 before-and-after photographs and medi-cal illustrations highlight thetext. To view a sample, go towww.aafprsfacebook.org.Volume discounts are avail-able to members. To order

your copies and save 10 percent,refer to the enclosed order formand submit your order by October1, 2017. M

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By Steven J. Jurich, AAFPRSExecutive Vice President

On June 10–14, hundreds of physicians, medical students, residents, fellows, and state and

specialty societies gathered inChicago, for the 2017 AnnualMeeting of the American MedicalAssociation (AMA) House ofDelegates (HOD) to reflect upon adiverse mix of complex proposalsand topics. These include poten-tial replacement concepts for theAffordable Care Act and multipleconcerns regarding adequatedata supporting Maintenance ofCertification (MOC). Manydelegates want to further explorethe potential for how educationalgoals could be achieved throughan ongoing monthly educationprocess, rather than an extensiveexam. Yes, the issues were manyand quite diverse! The followingAcademy members attendedand represented our interests:J. Regan Thomas, MD, yourAAFPRS delegate to the AMAHOD; Paul J. Carniol, MD, yournew AAFPRS alternate delegate tothe AMA HOD; and Scott R.Chaiet, MD, your AAFPRS youngphysician representative to theAMA.

AMA UPDATE: HOUSE OF DELEGATES ANNUAL MEETING

As various resolutions wereconsidered, your AAFPRS delegateteam present at the AnnualMeeting made sure to thoroughlyreview many such proposals tosafeguard the unique clinical andprofessional needs of our vitalspecialty. Where our Academy isconcerned, there were two resolu-tions in particular that wereespecially relevant to our field;we took the stance of formallypromoting one such resolution,while opposing the other.

The first, Resolution 202,Protect Individualized Compound-ing in Physicians’ Offices, basi-cally urged the withdrawal of U.S.Food and Drug Administration(FDA) guidance on “InsanitaryConditions at CompoundingFacilities” with no further actionuntil revisions to the UnitedStates Pharmacopeia (USP)Chapter <797> on Sterile Com-pounding are complete. It alsocalled for federal legislation topreserve physician office-basedcompounding as the practice ofmedicine. This resolution wasconsistent with the AAFPRS’previous comments we submittedto the FDA on October 11, 2016,our support of an AMA resolutionon this matter at the 2016 In-terim AMA Meeting in Orlando,and subsequent work theAAFPRS has done with the AMAAdvocacy staff on further ad-dressing these serious concernswith the FDA and USP. Thus,your AAFPRS delegate teamsupported this resolution.

In the end, the AMA HODopted to reaffirm AMA POLICY H-120.930 (“USP CompoundingRules”) in lieu of Resolution 202.This AMA policy has severalimportant components to it,including having the AMA engagewith the FDA and work with theU.S. Congress to ensure thatsmall volume physician office-based compounding is preserved.Such efforts, per the policy,include the AMA forming a coali-tion with affected physicianspecialty organizations to jointlyengage with the USP, the FDAand the U.S. Congress on the

issue of physician office-basedcompounding preparations andthe proposed changes to USPChapter <797>—efforts that arealready underway via a coalitionthat the AAFPRS is an activeparticipant in. Additionally, thepolicy calls for the regulation ofcompounding in the physicianoffice for the physician’s patientsto be under the purview of statemedical boards and not statepharmacy boards. Our Academywill continue to work ardentlywith the AMA and others tomonitor and advance productiveactions by the FDA and the USPin this regard, defending ourmembers’ ability to engage appro-priately in office compounding (asexample, mixing aneuromodulator in your office)when providing care to yourpatients.

The other key issue yourAAFPRS delegate team vigorouslyaddressed was rooted withinResolution 225, Truth in Advertis-ing (TIA). This resolution basicallywas seeking to address “fakeboards” by requiring physiciansto fully disclose board certifica-tion status, medical licenserestrictions, and residency/fellowship status. It also called forrestricting the use of the title“doctor” in closed settings to onlymedical doctors. Given all of theAcademy’s years of TIA work andthe reality that we already havevery carefully crafted TIA modellanguage that has been developedjointly with others in our AMA-based TIA Coalition (languagethat was further clarified andstrengthened via our collabora-tive efforts just earlier this year),the AAFPRS team formally op-posed the resolution and yourdelegates shared our viewspublically with the ReferenceCommittee. We indicated that,while we support the intent behindthis resolution, the AMA TIACoalition work has developed acoherent approach to the problemthat should be respected, as theexisting and recently updatedmodel truth-in-advertising See AMA Membership, page 15

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AMA DELEGATE J. REGAN THOMAS, MD(LEFT) CONGRATULATES NEWLYAPPOINTED AMA ALTERNATE DELEGATEPAUL J. CARNIOL, MD. H


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By Amy Mladineo, OFPSA President

We are a little over three months away untilour Fall Meeting in Phoenix. Pleasecomplete the following tasks:O Renew your OFPSA membership, or join

if you haven’t already. The annual membership fee of$175 covers your whole office (www.ofpsa.org).O Sign up for the Fall Meeting.O Book your hotel by October 4, 2017, to get theAAFPRS rate, $215. Contact the Sheraton GrandPhoenix, (800) 325-3535, and be sure to mention youare a meeting attendee.

I would like to introduce you to the OFPSA vicepresident, Donna Graziano. Her energy, creativity,and joyful spirit, along with her diligence andthoughtfulness, have made her an incredible assetto all of us in the OFPSA. Donna works with StevenJ. Pearlman, MD, of Pearlman Aesthetic Surgery, inNew York. We’ve asked her to share a few insights inworking with this pratice and here are her thoughts.Thank you, Donna.

How long have you been with your practice and howdid you start in facial plastic surgery?I have been with Pearlman Aesthetic Surgery for fouryears. I have been a practice consultant for over 20years in both medical and dental. After my introduc-tion to medicine through practice development indentistry and oral and maxillofacial surgery, I be-came intrigued with skin care and treating agingskin. This prompted me to further educate myself inskin health and the histology of aging. I pursuedtraining as a licensed aesthetician. I wanted to find away to combine my experience in practice develop-ment with clinical work. The field of facial plasticsurgery was the obvious, ultimate choice. For me, itis the perfect fit.

What is your practice like?Our practice is very busy…however, busy is good.There is never a dull moment. Since I joined thepractice, each year we have increased revenue byclose to 50 percent per year. I am constantly trying tokeep up on what the latest trends are in our indus-try. Running a successful practice, plus adding thenew demands of social media, keeps us all on ourtoes.

What is your role in your practice?Technically, I am both the surgical cosmetic coordi-nator and practice manager; however, I am whateverDr. Pearlman needs me to be at any given moment.

On top of that,I still like toperform aesthe-tician treat-ments tokeep my hands-on abilitiesfacile. I like thediversitybecause I likechallenges.

What is yourfavorite part ofyour job?I take greatcomfort inknowing thatthe surgeon Isupport is honest, truly skilled, and doesn't cutcorners. I am shocked when I hear industry storiesabout doctors who don't fully staff an operating room.I also appreciate the confidence (and experience) wehave to turn away a potential patient with unrealis-tic expectations rather than encourage him or her topurchase an expensive surgery. Mostly, my favoritepart of the job is when I see a patient go from initialphone conversation, through the many steps leadingup to surgery, and ending with a beautiful result.

What is the most stressful part of your job?I really do not like dealing with the shoppers. Theindustry has changed over the past 20 years due tothe overwhelming number of providers includingextenders and medspas. The Internet has createdsuch challenges with marketing competition, Websites touting embellished credentials, search engineoptimization, and pay per clicks. Plus, no matter howgreat your credentials are and the experience youhave, patients are still looking for the bargain.

The most frustrating thing I hear: “I like Dr.Pearlman the best but I saw two other surgeons whocharge less.” I try to emphasize that this is your faceand it should be more about finding the best surgeonyou can, since you only have one face and shouldwant to get things done right the first time. Whyanyone would try to discount their face still bafflesme.

Are there any other fun facts you would like to share?We are all about making our patients happy andmore beautiful. Therefore, our tag line is: We em-power beauty. It is extremely heartwarming andrewarding when our glowing reviews also mention meand our fabulous staff. At least once a day, whenchecking-out a patient, we hear, “I want to work here.You all look like you're having so much fun.” I lovewhat I do. M

AN INTERVIEW WITH DONNA GRAZIANO

SEEN HERE IS DONNA GRAZIANO WITHFACIAL PLASTIC SURGEON STEVEN J.PEARLMAN, MD


2017AUGUST 3-6*13TH INTERNATIONAL FACIALNERVE SYMPOSIUMLos Angeles, CACo-directors: Babak Azizzadeh, MD,and William Slattery, III, MD

OCTOBER 25AAFPRS COMMITTEE MEETINGSPhoenix, AZ

OCTOBER 25AAFPRS YOUNG PHYSICIANS FORUMPhoenix, AZ

OCTOBER 26-28AAFPRS ANNUAL MEETINGPhoenix, AZCo-chairs: Louis M. DeJoseph, MD,and Jaimie DeRosa, MDMeeting Director: Phillip R. Langsdon,MD

FACIAL PLASTIC TIMES

AUGUST 2017

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2018APRIL 12-15FACIAL REJUVENATION:MASTER THE TECHNIQUESChicago, ILCo-chairs: Rami K. Batniji, MD andAndrew A. Jacono, MDChair, Injectables Course: Steven H.Dayan, MDSenior Advisor: Stephen W. Perkins, MD

JUNE 23-24ABFPRS EXAMINATIONWashington, DC

OCTOBER 15-18AAFPRS ANNUAL MEETING AND12TH INTERNATIONAL SYMPOSIUMOF FACIAL PLASTIC SURGERYCo-sponsored by the InternationalFederation of Facial Plastic SurgerySocieties (IFFPSS)Dallas, TX

*ENDORSED BY THE AAFPRS

CLASSIFIED AD

FOR SALE BY OWNER: Physicianinjector owned, full-service medi-cal spa in beautiful, rapidlygrowing tax advantaged westernstate. Build your surgical practicefrom the hundreds of patientsseen each month while generat-ing huge cash flow from injectingand the myriad other spa servicesperformed by your staff. Must beBE/board certified physician,residency trained, and/or veryexperienced injector. Annual$2M gross, $600k net (Ebitda).Fully staffed business, just hangup your coat and go to work.Owner financing considered forqualified buyer(s). Asking$3,000,000. Interested partiesshould send an e-mail to:[email protected].

From AMA Update, page 13language offers the best remedyfor such TIA challenges.

As a result of the valuabledialogue about this matter—anddue to our delegates’ strongadvocacy in this regard—the AMAHOD opted to reaffirm AMAPOLICY H-405.969 (“Definition ofa Physician”) in lieu of Resolution225. This AMA policy has severalimportant elements to it, includ-ing that the AMA will activelysupport the Scope of PracticePartnership in the Truth inAdvertising campaign. This willallow for the model truth-in-advertising language, which wasdeveloped by the AMA TIA Coali-tion (which, again, the AAFPRS isa member of) to continue to beutilized. These strategic position-ing efforts at the AMA AnnualMeeting, thus, have helped tofurther maintain and protect ourAcademy members’ ability tooperate as board certified facialplastic surgeons.

And lastly, here are severalitems of special note.

As mentioned earlier, Dr.Carniol, who has served for manyyears as an AMA alternate del-egate for the Medical Society ofNew Jersey, was recently ap-pointed as the new AAFPRSalternate delegate to the AMAHOD. Congratulations, Dr.Carniol.

Additionally, Dr. Chaiet (yourAAFPRS young physician repre-sentative to the AMA), was alsoappointed earlier this year for hissecond, two-year at-large memberterm on the AMA’s AdvisoryCommittee on LGBTQ Issues. Hewas then recently elected to chairthat AMA advisory committee.Congratulations, Dr. Chaiet.

Important Note: At the na-tional level, the AMA is ourpartner, and often our voice, with

MAINTAIN YOUR

AMA MEMBERSHIP

legislators, regulators and themedia—so it is without questionthat our Academy must continueits crucial representation at theAMA. In this regard, the AAFPRSwill soon be going through its five-year AMA review. Continuedrepresentation at the AMA re-quires that at least 20 percent ofour members are also AMAmembers. We certainly cannotafford to lose our seat at AMAHOD, so please be sure to main-tain your AMA membership—orkindly join if you are not yet anAMA member (see the ad on page12 for information on how to jointoday). M

Enclosed in this August issue of Facial Plastic Times are theAAFPRS Annual Meeting Brochure, FPST Newsletter Order Form,

and Patient Brochure and The Face Book Order Form.


Canfield, oick up Aug2016

August 2017 Vol. 38, No. 6 · The rhinoplasty topics include innovations, nasal reconstruc-tion,...

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