January/February 2018 Vol. 39, No. 1 · 2020. 3. 12. · January/February 2018Facial Plastic Times...

January/February 2018 Facial Plastic Times 1

January/February 2018Vol. 39, No. 1

PARTERNING WITH THE AMA:

AAFPRS MEMBERS

MOVING MEDICINE

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Specialty interests always seem more vital tomost facial plastic surgeons; and for thatreason, our members value their AAFPRSmembership the most. When I discuss the

AMA with facial plastic surgeons, there is usuallylittle knowledge or appreciation of the accomplish-ments that the AMA obtains for medicine that di-rectly impact us as physicians and our patients.

Just this past year alone, AMA action and testi-mony was instrumental in having the U.S. govern-ment deny the Anthem/Cigna insurance mergers,which would have cut physician reimbursements,saving physicians over $500 million a year in pay-ments. The AMA comments were so impressive thatthey were included in the final decision.

The AMA has had an incredibly positive impacton the lives of our patients and each of our practices.It has achieved far-reaching initiatives education-ally, scientifically, legislatively, in the courts, andwith third-party and governmental payers.

Hardly known to many of us, the AMA respectsand has been extremely supportive of our smallspecialty. For many years, our Academy has benefitedfrom a close-working and mutually beneficial rela-tionship with the AMA. The AMA was one of the firstmajor medical organizations to recognize the subspe-cialty of facial plastic and reconstructive surgery.

As early as 1978, we were seated in the AMAHouse of Delegates representing our specialty with avote, which allows us to speak up at any of the AMAmeetings when issues of concern to us are broached.As such a small specialty as we are, comprising justa few of the hundreds of thousands of physicians inthis country—especially when you compare our sizeto such groups as the internists—having that kind ofinput is exceedingly important. It is this level playingfield, this openness and fairness in deliberations,that is so democratic and so rare in other nationalmedical organizations.

See Together, We are Stronger, page 6

The Academy is excited to present FacialRejuvenation 2018: Master the Techniques,April 12 - 15, at the Sheraton Grand Chicagoin the Windy City. This year's planning

committee—Rami K. Batniji, MD, co-chair; Andrew A.Jacono, MD, co-chair; Steven H. Dayan, MD,injectables course chair; Stephen W. Perkins, MD,senior advisor; and Phillip R. Langsdon, MD, meet-ings director—along with an esteemed AdvisoryBoard, have coordinated expert, global faculty acrossspecialties such as facial plastic surgery, dermatol-ogy, oculoplastic surgery, plastic surgery, and prac-tice management.

This four-day course incorporates interactivepresentations and training in both surgical andnonsurgical procedures. You will not want to missthe new and innovative format that promises toexcite and inspire you. Additionally, you can counton pre-recorded live surgeries, video sessions, live

See The Windy City, page 7

FACIAL REJUVENATION:

MASTER THE TECHNIQUES

2 Facial Plastic Times January/February 2018

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.

January/February 2018Vol. 39, No. 1BOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORS

William H. Truswell, MDPresident

Fred G. Fedok, MDImmediate Past President

Phillip R. Langsdon, MDPresident-elect

Theda C. Kontis, MDSecretary

Harrison C. "Chris" Putman, III, MDTreasurer

Richard E. Davis, MDGroup VP for Education

Paul J. Carniol, MDGroup VP for Membership & Society Relations

Patrick J. Byrne, MDGroup VP for Public & Regulatory Affairs

Sam P. Most, MDGroup VP for Research, Development, and

Humanitarian Programs

David W. Kim, MDGroup VP for Education-elect

Lisa E. Ishii, MDGroup VP for Research, Development, and

Humanitarian Programs-elect

Jamil Asaria, MDCanadian Regional Director

Theresa A. Hadlock, MDEastern Regional Director

Benjamin C. Marcus, MDMidwestern Regional Director

Anthony E. Brissett, MDSouthern Regional Director

Travis T. Tollefson, MDWestern Regional Director

J. David Kriet, MDDirector-at-Large

Scott James Stephan, MDYoung Physician Representative

Steven J. JurichExecutive Vice President

PRESIDENT’S MESSAGE:

The AAFPRS has sailed very success-fully for five decades. We have facedchallenges and fought battles. Weovercame them, grew in stature, and

became branded as facial plastic surgeons. Our membership grew and flourished.The tide on which we sailed then started toturn, at first imperceptibly. As moneytightened in the Great Recession, we sailedinto increasingly rougher waters. Amidfinancially challenging times for all, indus-try support diminished. Membership

declined. Some of our courses failed to make a profit. The Academy wasoperating in financially difficult circumstances.

The AAFPRS leadership is charged with many tasks in its oversightand advisory capacity. In summer 2014, we started to look for answers.

In the early winter of 2015, amid financial challenges and concernsabout the need to strengthen both membership and industry support,four of us in the Academy leadership held strategizing conference callsto understand what was occurring and to begin the process of turningthese problems around. The participants on those 2015 calls were thenpresident-elect Edwin F. Williams, III, MD; then president Stephen S.Park, MD; southern regional representative Phillip R. Langsdon, MD,who has a wealth of personal experience running medical meetings; andmyself as treasurer. The immediate outcome of those calls was to fullyinvolve the entire Board of Directors.

The Board met in April 2015, in Boston, during the COSM Meetingand again in July 2015, during the Advances in Rhinoplasty Course inChicago. To better control the quality and bottom line of meetings andcourses, the Board decided to return the meeting planner position as afull-time staff employee. Additionally, we acknowledged the need toimmediately initiate a search for a new EVP, in light of the approachingretirement of Steve Duffy, in the fall of 2016.

After the 2015 Annual Meeting, Dr. Williams, the 2015-2016 AAFPRSpresident, and I, as treasurer, flew to Washington and spent one andone-half days at the Academy office. We sat and had a frank discussionwith Mr. Duffy. I spent half the day with our financial consultant, and Ithen joined Dr. Williams in meeting individually with each employee. Weheld candid and instructive interviews with each staff member. After allthose illuminating question and answer sessions, we left understandingthat the architecture of the Academy and the culture in the officeneeded an extensive and strategic overhaul.

Dr. Williams was also the key leader to engage in the arduousprocess of searching for a new EVP. In the summer of 2015, he reviewedover 100 applications, interviewed dozens of applicants over the phone,and narrowed the choices for a new EVP down to three finalists. TheBoard of Directors listened to presentations by all three finalists andinterviewed these individuals at the Facial Rejuvenation Meeting inMarch 2016, in Beverly Hills. Knowing that they had found the bestcandidate, the AAFPRS Board of Directors asked Steve Jurich, who hasa background in medical association leadership in managing an organi-zation with financial and operational challenges, to become the newAAFPRS EVP, and he accepted the position.

At the start of his tenure, Mr. Jurich and the incoming president,Fred G. Fedok, MD, unearthed a myriad of structural, cultural, andfinancial difficulties that had been evolving for several years. Fred andSteve rolled up their sleeves and began the hard work of reversing thecourse of the Academy.


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WELCOMING CHANGES

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Challenges that we arecorrecting include membershipconcerns, financial stability,better engaging of our industryrelations, and restructuring thearchitecture and culture of theAcademy office, including me-chanics and personnel. Onemajor task is to increase thevalue of the AAFPRS to its mem-bers across the full membershiplifespan from our younger mem-bers to our seasoned members.

Education is one of theprimary pillars of the Academy.We have revamped the structureof our meetings and courses byappointing Dr. Langsdon in 2016to be the meeting director—a newthree-year position. Working withthe various meeting chairs andpartnering with staff, Dr.Langsdon has overseen changesto the structure, physical plan-ning, concepts, and finances ofthe meetings, symposia, andcourses.

The 2017 Annual Meeting,one of our best, was terrific andreceived overwhelming kudosfrom the attendees. We have hada multitude of fresh, new faces atthe podium—far more than everbefore, allowing us to enhancethe engagement of our youngermembers. The excitement andenergy of the young physicianswas palpable and is something weplan to build upon in our educa-tion and other member benefits.Dr. Langsdon was also elected asthe AAFPRS president-electduring the 2017 meeting, so we’lllook forward to his leadership inthis area for the foreseeablefuture.

A major project is in theworks. Revamping the Web site isa priority of the Board of Direc-tors. It should be very userfriendly. Of the many changes wewant to implement, one of themost important is to make ourWeb site serve as a means betterto direct patients to our offices. Itshould also house an enormousamount of medical informationrelated to our specialty. The site

should be the go-to site for infor-mation on rhinoplasty, facelift,facial reconstruction, congenitalfacial abnormalities, vascularmalformations—all aspects offacial plastic surgery.

The public, government,media, etc., should all look to oursite first for relevant information.This will give us more recognition,visibility, and “free media” thanany marketing firm can do ontheir own. We want it to providebusiness services to our membersto help them start and run theirpractices. Additional services weare discussing could possiblyinclude items such as contracttemplates, practice businessformulas, policy and proceduremanuals for offices, and so on.

Educational materials mustbe extremely affordable and easilyaccessible. CMEs need to beoffered through our Web site on amore comprehensive and afford-able level. As you can see, this isno small project. It will have ahuge cost in dollars and time. Weare tuned in to the membershipconcerns and are working to fulfillthese needs. All of this will taketime.

The second major pillar isadvocacy. Our standing as facialplastic surgeons has been chal-lenged in many states at thelegislative level including beingable to call ourselves board

certified facial plastic surgeons.The grass roots advocacy effortthat the AAFPRS has undertakento defend the ABFPRS credentialhas occurred most notably inCalifornia where so many in ourgroup practice. These challengesrequired our leadership and ourattorney, Tom Rhodes, over theyears to travel to these battle-ground states to obtain legislativeapproval, recognition, and sanc-tion to allow us to state who weare and advertise who we are.

Today, the AAFPRS, alongwith the ABFPRS, continuouslymonitors all 50 state legislaturesand puts out fires as they arise. Ifit weren’t for the vigilant advo-cacy of the AAFPRS, we may verywell be calling ourselvesotolaryngologists doing facialplastic surgery in the head andneck. We, as individual practitio-ners, are not always aware of thebenefit of advocacy, but it isresponsible for us being able toidentify ourselves and practice asfacial plastic surgeons.

Our Academy had reached acrossroads. It had become obvi-ous that significant change wasexigent. It has been three yearssince we had those conferencecalls in the early winter of 2015.We have already made significantprogress in slowing and stoppingprocesses that were detrimental See Making Progress, page 13


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It is official. Starting in July2018, Google is going to startusing mobile page speed as aranking factor in their search

results. I’m sure many of youhave been aware of this for quitesome time. After all, being speedyand fast in mobile has been themantra of many vendors andsearch engine optimization (SEO)specialists alike for quite a while.

With that said, this does markthe first time that an official datehas been set. On January 17,Google announced a new rankingalgorithm designed for mobilesearch, calling it the “SpeedUpdate.” While it will only impacta small percentage of queries, I'dbet you're better off having ascreaming fast mobile site than aslow one.

And by the way, Googlerecommends using their new andupdated PageSpeed report to testyour site. So, the 500-poundgorilla has spoken again andthey've given you the tool to use.

This is interesting because wemonitor and adjust our sitespeeds (and other factors) on aregular, rolling basis. In a meet-ing on Tuesday, January 16, welearned that our average mobilesite speed had improved to 96/100. The team speculated thatthis was indeed an algorithmicchange and the Google an-nouncement suggested that wewere seeing the results of thatwith our sites.

This brings me back to arecent conversation I had withanother vendor in the industryand with whom we work. He toldme that a company had sug-gested he ignore Google’s Page-Speed tool and instead useanother tool like Pingdom. “Noway,” I told him. “Why take therisk? If Google tells me to dancearound in circles at night beforegoing to bed, I'm going to do it.”

The point is, the change iscoming and there’s a date set.Simply search for GooglePageSpeed Insights, click thelink, and enter the URL of your

INTERNET INSIDER: ON YOUR MARK, GET SET, GO!

site. Find out where you stand. Ifit's not good, at least 90, get itchanged quickly.

In the event you get pushbackfrom your vendor, you shouldunderstand that it's not easy tostandardize methodologies thatresult in extremely fast scores forhundreds of sites. In fact, it'staken us years to get to thispoint. I believe the chief reason isbecause many vendors (includingus) rely on content managementsystems like WordPress, Joomla,and Drupal. These are powerfuland robust platforms for publish-ing and developing Web sites. Atthe same time, however, they aredesigned to be easy-to-use andavailable to the masses. This isboth good and bad. Good, in thatyour average Joe can jump in andstart building a site.

Unfortunately, that alsomeans that it's easy to allowpoorly written plugins, modules,and blocks of code to enter theequation. After all, unless specifi-cally disallowed, anyone cancreate a WordPress plugin andmake it available to everyone else.

If it looks coolor does some-thing neat,then it mightseem like theperfect additionto a vendor'sclient sites. Butthose looks can bedeceiving and comeat a cost. From what I've seen, thegreatest cost is with speed, andsometimes even usability.

I speculate that if you getpushback on getting your site toscore over 90/100 or start ap-proaching 96/100, then whatyou're really dealing with is avendor who has utilized too manyof these plugins, modules, andthe like—aka “bloatware”—andthe costs associated with migrat-ing to a more streamlined solu-tion for many sites is a big cost. N

This article was submitted by Sur-geons Advisor, a Miami-based com-pany that maintains the Academy’sWeb site.

CALL FOR AWARDSIn an effort to present these prestigious awards to well-deservedfacial plastic surgeons, consider nominating your colleagues. E-mailGlenda Shugars at the AAFPRS office ([email protected]) toreceive a nomination form or visit www.aafprs.org/research/awards/for more information.

William K. WrightThis award may be presented each year to an AAFPRS member whohas made outstanding contributions to facial plastic and reconstruc-tive surgery.

John Dickinson TeacherThis award honors an AAFPRS fellow or member for sharing knowl-edge about facial plastic surgery with the effective use of audiovisualsin any one year.

F. Mark Rafaty MemorialThis award may be presented each year to any AAFPRS member whohas made outstanding contributions to facial plastic and reconstruc-tive surgery.

Community ServiceThis award may be presented each year to an AAFPRS member whohas distinguished himself or herself by providing and making pos-sible free medical service to the poor in his or her community.


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From Cover Story, page 1We may not always win our battles, but everyone

has the opportunity to speak, be heard, and convinceothers of the merit of our viewpoints. Through suchdiscussions and debate, the AMA sponsored andpublished our now over 10-year-old journal, AMAArchives of Facial Plastic Surgery, currently named,JAMA Facial Plastic Surgery. To be so recognized bythe AMA and to have our own journal under the AMAauspices is a great honor, providing recognition ofour specialty throughout the world. We are one ofonly 12 specialty journals the AMA publishes.

The AMA has gone to bat for us several timesover the years. With our input, they helped develop amodel state bill on truth in advertising, which allowsfor recognition of our ABFPRS. (We helped to facilitateseveral valuable updates to the model state bill justthis past year.) It is now in the hands of 50 statelegislatures as well as medical societies. The AMAhas worked hard on scope of practice issues, encour-aging that all health care teams be physician led andassuring the public that the education a physicianreceives provides excellence and the best in patientcare. In the issue of in-office medication compound-ing, which affects many in our membership, the AMAhas actively moved to unfetter us from over-restric-tive and unnecessary regulation. The AMA AdvocacyResource Center and litigation teams have helpeddefeat elective cosmetic surgery taxes in 14 states.The AMA has currently convened a coalition ofsocieties and specialties to combat the onerous priorauthorizations often required for medications andsurgery, with progress and changes being made dailyby insurance companies at our urging.

I could go on for pages elaborating on the manysuccesses from which we benefit because the AMAhas been willing to spend huge resources in federaland state advocacy for physicians. It has gone intothe weeds of detail so we can practice and concen-trate on patients.

It is difficult, however, for the AMA when it goes toWashington to state that it represents all thecountry's physicians when not all the country'sphysicians belong. The AMA is currently fightinghuge battles: to streamline EHRs and make theminteroperable and physician friendly, to addressphysician burnout and practice sustainability(because of bureaucratic red-tape and required over-documentation), to work for reasonable drug charges,to stop the opioid epidemic, to put patients beforepolitics, to help employed physicians, to preserveprivate practice and all modalities of health caredelivery, to work on liability reform.

Those who pay their dues are certainly gettingtheir money's worth from the AMA. Unfortunately,those who do not pay their dues are just getting afree ride and need to commit themselves to member-ship in the AMA. It is like belonging to a family and

not doing your chores. Membersmove medicine; 60 percent of AMAdues go directly to advocacy forphysicians and our patients.

Yet, very few AAFPRS membersare AMA members. Since we are sucha small specialty, we need to have thelarger and more politically powerfulAMA look out for our interests. Quitesimply, you need to join the AMA. Ourspecialty needs it. I am asking you to go to www.ama-assn.org/membership today. Our five-year memberreview will take place within the next several monthsand if you don't join, we are at risk of losing ourvaluable representation in the AMA; a critical num-ber of our AAFPRS members must belong to the AMAto meet the membership criteria for continuation inthe Association.

We need your help; please join or renew today.As the AMA states, “Together, we are stronger.” Let'shelp the AMA win our battles and give it the strengthit needs through our membership support. N

Editor’s Note: This article was written by Russell W.H.Kridel, MD, AAFPRS past president and member andcurrent Board member, AMA Board of Trustees.

TOGETHER, WE ARE STRONGER...LET’S WIN OUR BATTLES

Paul J. Carniol, MD, ofSummit, N.J., is thenew president of theBoard of Medical

Examiners of the State of NewJersey. The New Jersey StateBoard of Medical Examiners iscomprised of a select group ofphysicians and medical personnel from variousspecialties throughout New Jersey, all of whom areappointed by the governor. Their mission is to protectthe public's health and safety by determining qualifi-cations of applicants for licensure, establishingstandards for practice, and disciplining licenseeswho do not adhere to those requirements. In addi-tion, the Medical Board is responsible for overseeingthe licensing and certification process for alliedhealth care providers, including podiatrists, certifiednurse midwives, acupuncturists, athletic trainers,bioanalytical lab directors, physician assistants,electrologists, hearing aid dispensers, andperfusionists.

Dr. Carniol serves on the AAFPRS Board ofDirectors as the group vice president for membershipand society relations. N

IN BRIEF: CARNIOL’S

APPOINTMENT


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From Cover Story, page 1injections, practice management pearls, cutting-edgetechnologies, and more.

Besides the supreme learning and collaborativeexchange of ideas, there will be supplementaryopportunities for networking and sharing best prac-tices. Industry-sponsored sessions will add value toyour overall learning experience. Plan on attending abreakfast session daily as well as an evening recep-tion hosted by industry. The exhibit hall is sold outand exhibitors are waiting to show you their latestand greatest.

This educational event will exceed your expecta-tions, while also providing a wonderful city to explore.The host hotel, the Sheraton Grand Chicago, islocated in the heart of the city. Stroll down theMagnificent Mile, visit Navy Pier, or take an architec-tural boat tour. There are 29 miles of lakefront pathsyou may want to wander. Millennium Park offers art,landscape design, and architecture including themammoth stainless-steel Cloud Gate sculpture, TheBean. Be sure to bring the whole family to thelakefront Museum Campus where you can explorethe Field Museum, Adler Planetarium and AstronomyMuseum, and the Shedd Aquarium.

The restaurant scene will not disappoint. Youmay be asked your opinion on two classics that

Chicagoans take very seriously: pizza and hot dogs.In case of rain, consider traveling via the Pedway—Chicago's downtown pedestrian walkway system ofunderground tunnels and overhead bridges that linkover 40 blocks in the heart of the city.

Come to Chicago for the rejuvenation trainingand workshops, then stay to experience the city.For program updates or to register online, visitwww.facialrejuvenationmeeting.org. Take advantageof the early bird savings and register by March 5,2018. N

THE WINDY CITY OF CHICAGO AWAITS THE AAFPRS


Donna is instrumental in en-hancing all aspects of Dr.Pearlman's practice. Making sureyou look as amazing as you are, isher main priority. Her motto is“Age is just a number, beauty istimeless.” We are fortunate tohave her as our 2018 president.

We would like to congratulatePenny Cappel on receiving the2017 Member of the Year award,presented byCare Credit.Penny couldnot attendthe Phoenixmeeting dueto healthissues, andshe is in ourthoughts. DevinderS. Mangat, MD, of Cincinnati,states, “Penny Cappel has been adedicated, hardworking, and mostloyal employee of our practice forthe past 18 years. During my 38years in practice, I have neverhad an employee who was sopassionate about her job and soengaged in doing all she can tosee the practice succeed.” Way togo, Penny!

We look forward to yourmembership and to interactingwith you this year. Plan to be inDallas for our next annual meet-ing, October 15-18; it will beanother great meeting withexceptional speakers and pre-senters.

If you have any questionsabout the OFPSA program, pleasefeel free to email your officers. N

We hope everyoneenjoyed the Phoenixmeeting last October.A survey was sent out

to attendees to gather yourfeedback for improvements;please send your responses if youhaven’t done so already. We areeager to further enhance yourOFPSA meeting experience.

It is membership renewaltime. If you're new to the OFPSA,welcome. The cost is $180 for theentire office to join. New andreturning members will gainaccess to our private Facebookgroup. In this group, memberscan share ideas and seek guid-ance from other industry profes-sionals in facial plastic surgery.This is a great way to networkwith other OFPSA members andgain insight on what others aredoing both locally and nationally.

The OFPSAhas a new presi-dent. Meet DonnaFay, The BeautyExpert USA, anindependentexpert in the,cosmetic surgeryand beautyindustry, and recognized as the“go to” person when consideringcosmetic procedures.

Donna has been in the indus-try for over 27 years as an educa-tor and consultant for doctorsand various laser and skincarecompanies. She works closelywith men and women nationwidewho want to undergo plasticsurgery procedures and areseeking qualified, ethical, andskilled surgeons. Donna hashelped many patients find theright surgeon, and has been anadvisor to med spas, cosmeticdentists, and plastic surgeons.

In 2014, she started workingwith Steven Pearlman, MD, inNew York City. Donna wearsmany hats and is the practicemanager, patient care coordina-tor, and medical aesthetician.

MAKE 2018 THE

YEAR YOU JOIN

Call for Abstracts and Presentations12th International Symposiumof Facial Plastic Surgery

You are invited to submit an abstract for ascientific paper/poster or for a generalpresentation at the 12th InternationalSymposium of Facial Plastic Surgery,October 15-18, 2018, in Dallas. This is thepremier education and networking eventfor the facial plastic and reconstructivesurgery community.

The International Symposium bringstogether practicing physicians, fellows,residents-in-training, medical experts,students, and allied health professionalsfrom around the globe to collaborate,share best practices, exchange ideas,discuss scientific research, and learnabout innovative techniques that willadvance the profession and enhancesurgical outcomes and patient satisfac-tion.

Abstracts are being considered forthe following presentation types:O Scientific postersO Scientific paper presentations (5 mins.)O Lecture/podium presentations, solo orpanel speakers (5 to 15 mins.)

The AAFPRS Foundation strives toensure its clinical education activitiesoffer engaging and informative contentand provide pertinent, thought-provokingand high-quality training for its culturallydiverse audience. We also encouragelectures that are inclusive, feature a widerange of perspectives and topics, as wellas a diverse mix of both novice andseasoned presenters.

The schedule will be designedaround the following programmatic tracks:O Congenital /craniofacial abnormalitiesO Emerging technologyO Facial reconstructionO Facial rejuvenationO Minimally invasive and nonsurgicalproceduresO Practice managementO Rhinoplasty

If you have knowledge in any ofthese areas, please consider submittingan abstract. Whether you're a youngphysician or have been in practice forover 30 years, we strongly encourageand welcome your contribution to thisone-of-a-kind event.

Abstract submission deadline isFebruary 28, 2018. Visit:www.aafprs.org/am2018/Abstract.Questions? Please send us an email [email protected].

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Current Officers:Donn Fay, PresidentEsthetic Coach & Patient CareCoordinator, New York, NY

Megan Persin, Vice PresidentPatient Care & Marketing Coordina-tor, Atlanta, GA

Amy Mladineo, Former PresidentPractice Coordinator, Stanford, CA


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It’s the time of year where weall take out our crystal ballsand try to forecast what is tocome. The American Academy

of Facial Plastic and Reconstruc-tive Surgery (AAFPRS), the world'slargest specialty association forfacial plastic surgery, sharedpredictions in cosmetic surgery.Here is what you can expect for2018.

“Bendable” fillers“We foresee new, more flexiblefillers that ‘bend’ when the faceanimates as well as longer-lasting filler options,” saysAAFPRS president William H.Truswell, MD. Stem cell injectionswill be refined and used more.Volumizers will be used more andmore for rejuvenation. Ageless isthe new anti-aging and patientsdemand a more natural result.

Prejuvenation gains popularity“The concepts of maintenance,prevention, and ‘prejuvenation’will bring younger patients to ouroffices for everything from skincare, injectables, neuromodula-tors (Botox, Xeomen, Dysport),laser treatments for hair removal,tattoo removal, brown spots, laserfacials, and light therapy,” sharesDr. Truswell. Face lifting tech-niques will continue to evolve forthe younger patient who wants to“tune up” without major downtime.

PR COLUMN: TOP PREDICTIONS FOR 2018

“I see more young patientsconsidering and asking forfacelifts, even in their 30s,” saysPatrick J. Byrne, MD, AAFPRSgroup VP for public and regula-tory affairs.

Selfie awareness, unstoppableYounger generations are flockingto facial plastic surgery thanks tothe plethora of non-invasivetechniques now available and anincreased awareness (or obses-sion) with our own image. A full42 percent of AAFPRS membersare seeing people who are re-questing facial plastic surgery tolook better on social media,according its 2016 survey.

Transgender/feminizationproceduresThe surgical community hasincreased its attention to provid-ing transgender support. Bothtransgender and feminizationprocedures are getting muchmore attention by academiccenters trying to build programs.“Procedures that change theunderlying bone structure or thesoft tissue of the face have theunique ability to help individualsto present themselves in themanner most consistent withtheir sense of self,” says Dr.Byrne.

Facial reanimationPatients now fear that frozen,expressionless result. Most wanta natural result that helps themlook as good as they feel—like thebest version of themselves. It'sabout confidence, not anti-agingthese days. “For patients whohave gone too far with surgeriesand injectables, we see explodinginterest in facial reanimation,”says Dr. Byrne.

Injectable rhinoplastyNose jobs have evolved consider-ably over the past decade. Tech-niques are becoming more reli-able, predictable, and less inva-sive thanks to non-surgicalcorrections with injectable fillers.

Non-surgical rhinoplasty isgaining popularity because it canbe performed in minutes and hasa fraction of the downtime, bruis-ing, and swelling typical of atraditional rhinoplasty.

Millennial “man”tenance is athingKen got a makeover, and modernmen are following suit. A surveyby the AAFPRS found that moremen than ever are turning tocosmetic maintenance to look andfeel their best. Thirty-one percentof men surveyed said they are“extremely likely” to consider acosmetic procedure—surgical ornon-surgical. Of those men, 58percent were between 25-34 yearsold while 34 percent were 18-24years old.

The bottom line? ”Trust yourface to a facial plastic surgeon,”says the AAFPRS. You'll come outlooking gorgeous and staying safeand healthy in the process.That's a win-win. N

Editor’s Note: This column waswritten by the Academy’s publicrelations firm, Kelz PR.

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NOTE FROM OUR KELZ PRThe AAFPRS is active on

social media. Remember to likeus on Facebook (AAFPRS) andto follow us on Twitter andInstagram @AAFPRS.

Calling all members. Wewould love to share yourawesome patient before andafter photos (with practicewatermarks, signed patientconsents, preferably full-faceviews, and no blacked-outeyes, please) on our socialmedia channels. Submit yourphotos today and help usshare the good work you do.(Photos are subject to ap-proval.) Contact PattyMatthews, of Kelz PR, [email protected] or(646) 450-KELZ.


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In partnership with FACE TOFACE, the Peruvian teamreturned to Lima, Peru, for thesixth time on November 6,

2017. The reach of the teamcontinues to grow each year.

During the one-week mission,130 surgical procedures wereperformed on 99 patients. Ninety-seven of the patients have cleft lipor palate. Many are babies, and itis truly miraculous how a 90-minute surgery can offer a child ahope at a normal life, as thesechildren are often bullied and notallowed to attend school in Peru.Over 50 speech therapy sessions,many from previous patients,were also provided.

The Peru team also offered aprogram to provide glasses andhearing aids. The local schooldistricts in Lima screened chil-dren for hearing loss and visionloss during the year. Children in

FACE TO FACE SIXTH MISSION TO LIMA, PERU

need were bussed to the hospital.The team of optometrists andaudiologists performed a detailedexam and fitted them. Hundredsof frames were donated; childrenpicked out a pair they wantedand were able to go home seeingbetter than they ever have.

“I was able to sit in on a fittingfor hearing aids for a child withsevere hearing loss and it wasvery emotional when his dadspoke to him and he turnedaround and said, ‘Papa, papa’because he could actually hearhis dad,” says team leader RyanF. Brown, MD. Eighty childrenwere fitted for glasses and 42 forhearing aids.

Even though Hospital 2 deMayo is the oldest medical schoolin South America, they havenever had a hearing aid programbecause of lack of training andtechnology. The team has been

able to provide them thecomputer software,training, and equip-ment, so now they canstart to treat their ownpeople with hearingaids. One memorable boythat was operated onwas Jeremias. He is 17years old. He was bornwith a cleft palate, buthas never had anopportunity to have itfixed and didn't know itwas possible. He isintelligent and hand-some, but given hiscomplete cleft palate, hewas unable to speakwell. This has severelyimpaired him in schooland socially. WhenJeremias was told thatthe team was going torepair his cleft palate,he couldn’t stop smilingand gave a little fistpump for excitement.His excitement to havelife-changing surgerywas visible to everyoneinvolved.

(Jeremias, left, is pictured herewith Dr. Brown.)

Between surgery, speechtherapy, glasses, hearing aids,and a new dental clinic, over 300patients were helped during theweek-long mission. With the helpof FACE TO FACE, the team plansto continue helping the wonderfulpeople of Peru in 2018. N

Editor’s Note: This article waswritten by Ryan F. Brown MD,FACS, medical director of Lima,Peru, mission and member ofAAFPRS.

SHOWN HERE IS ONE OF THE 97PATIENTS WHO RECEIVED SURGERY TOCORRECT A CLEFT LIP AND PALATE.


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MESSAGE FROM THE MEDICAL EDITOR: A JOURNEY WITH

By Steven H. Dayan,MD, Medical Editor,Facial Plastic Times

Friday morn-ing July23, 5:24a.m., I woke

to the wailing sirenscommonly heard along ChicagoAvenue, the main ambulancethoroughfare leading to North-western and Children's MemorialHospital. After living in the samelocation for the past five years, Ihave become accustomed to theloud city sounds. But this morn-ing, it couldn't have come at amore perfect time. I woke invig-orated to the fertility of the day.The thrusting rays of sun justbroke past the eastern horizonmerging within the crisp breezeoff Lake Michigan carrying thefresh scents of prairie blossoms.The forecast called for clear skiesand warm temperatures acrossthe plains.

Excited, I knew my directionand what the day ahead meant.After a quick run along the park,an even faster shower followed. Iwas barely dried off as I put onmy favorite pair of ripped bluejeans, a v-neck white t-shirt, myWyoming boots, and of course,Raybans. I left the apartmentwith an overnight sac carryingthe minimalist of overnight gear,crossed the street to the DunkinDonuts and grabbed a large cupof coffee with one pump of creamand three sugars. I threw the sacin the trunk, hopped in the car,put the top down, placed the carin sport mode, and put on 99.5FM Chicago's Country Musicstation. I quickly screeched out ofmy garage, immediately turningsouth onto Lake Shore Driveaiming toward Highway 55, akaRoute 66. Where I was going wasstill yet to be determined and itreally didn't matter…it was thejourney I was more interested innot the destination.

Physicians are goal orientedand it starts early. Study hard to

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get into college, study harder toget into medical school. Thenstudy and work hard to get a goodresidency, impress to get a fellow-ship, impress even more to get agood job, and so on. Clinically, weare taught find the cure, cut outthe tumor, erase the wrinkle.Personally, we are encouraged tomake money, get a house, have akid, save for retirement…but holdon! Just one second!! What abouttaking a moment to reflect on thejourney?

There are few if any profes-sions that require so manycontinuous years of consistenthardwork and dedication as doesmedicine. We become pro-grammed to achieve goals anddeliver results. But we rarely ifever are taught the importance ofrecognizing, appreciating, andlearning from the moments alongthe way. The skills, disciplines,and friendships gained fromendless nights of studying, takingin house-calls, and working 36-hour shifts are priceless andlikely contribute to the core ofwhat makes us competent deci-sion makers. Clinically, we aretrained with an emphasis thatskips over managing the pathol-ogy in favor of quickly definingthe target, determining a solu-tion, and then shooting to cure.

In aesthetics, we are trainedto see a wrinkle, find a fold,uncover the fat deposit, andchoose the product toxin or devicethat will best achieve a two-pointimprovement. In all cases, we arepositioned to look past the patientand their needs. However, step-ping back for a moment allowsclarity to what we do, for whomwe do it, and why we do it. Itopens up space to think beyondthe spoon fed EMR guided diagno-sis and EBM treatment protocols.An equanimity ensues and a Jediphysician is the result.

After years of intense school-ing and goal oriented training,the imaginative and non-linearportion of our thinking canbecome dormant or even snuffed

out completely. Physicianstrained in a militant hierarchalmanner are encouraged to notchallenge conventional wisdoms.Along the way, character traits oftrustworthiness, competency,loyalty, and reliability are gained,all being necessary requisites tothe profession. But the yin to thatyang is loss of spontaneity,creativity, and a tendency towardrisk averse robotic thinking, andeventual burn out.

Many find their love formedicine rekindled during avacation. Time to relax, catch upon reading, or other interestsoften leads to creative insightsthat translates to career better-ment. But let's be honest, evenvacations today are greatly pre-planned, void of risk, and mappedout months in advance. All canrecount some of their greatestopportunities for learning, rela-tionship building, or professionaladvancement happened whenleast expected. It is during theunplanned situation or journeythat we are forced to be resource-ful and receptive. The challengeof the unknown combined with apush outside of our comfort zoneleads to an initial uncomfortable-ness followed by a presence ofmind and personal growth.

To allow myself better appre-ciation for the journey, eachsummer I choose a randomweekend in which I clear myschedule for a road trip. Theessential element though is that Ihave no particular destination inmind. I only know that I will wakeup on Friday morning, check theforecast, and drive in whicheverdirection the road and sun takeme. Last year, I found myself inNauvoo, Illinois, a place of impor-tance to the Church of Latter DaySaints. Following the murder ofJohn Smith, Brigham Young ledhis congregation's exodus acrossa frozen river on their way to theirultimate home in Utah. The yearbefore, I found myself listening tobanjo music on a paddle boatsteering down the Mississippi


NO PARTICULAR DESTINATION

River in Hannibal, Missouri, atown that still lives in the 1840s.It also happens to be the home-town of Mark Twain. The yearbefore, I found myself in Deward,a small ghost town in CentralMichigan, which at the turn ofthe century was one of the mostimportant logging towns in theMidwest. Other years, I haveended up on Kentucky's BourbonTrail, spent a night in MackinawIsland's famed Grand Hotel, roadthe Fenelon Place cable car inDubuque, Iowa, and so muchmore.

Within six hours of Chicago, Ihave explored state parks, caves,rock, and the boyhood homes ofPresidents Grant, Lincoln,Reagan, Harrison, and othernoted dignitaries with midwestroots. Most years, I travel alone;some years, I invite another whoshares my romanticized passionfor the journey. But all years, Iam greeted on the road withwarm welcomes and friendlywaves. I've grown to love countrymusic, buttered grits, and bot-tomless cups of coffee from dinersin one-stop towns. Barbequecompetitions, state fairs, fire-works, and listening to musicwhile sitting on the hood of mycar are fairly routine. But mostimportantly, I gain an apprecia-tion for the journey; it is pregnantwith potential and teased by theunknown.

Another benefit to driving theopen road is the inherent incom-patibility with social media. Themobile phone is down. It forcestime to think, gain inspirationand perspective on a career andlife. And if with another—whetherit be spouse, child, friend, cousin,or budding romantic interest—you are in a closed, no way-outsituation, the ideal set up forcommunicating through anydilemma, project, or inspiringdream together. And as a by-product, two people can really getto know each other.

While road tripping may notbe for everyone, each has an

opportunity to set up their ownversion of a journey without adestination experience. Perhapsgo to the airport with bags packedand choose where to go aftergetting to the airport. Or if livingin a city, begin a trek followingthe little green man in the light,never stopping. See where thewalks lead to. If in the suburbs,how about taking one road till itends and then making alternativeright and left turns till finding aninteresting place? Or consider abookstore, closing your eyes andpointing to a random book toread; similarly with music, pick agenre never before appreciated. Ifwith a group of friends, each go toa non-traditional grocery store,randomly choose ingredients forone another, and see whatunique gustatory delight eachcan create. There are endlessways, whether alone or withothers, to foster a milieu of spon-taneity, fun, and openness to newopportunities and thinking. Thekey is that there is no pre-planned destination just a jour-ney and a willingness to explore.

The brightness of life is builtduring the shades of the journey.Try it; see where it takes you. N

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From President’s Message, page 3to the health and advancement ofthe Academy.

Steve, our new EVP/CEO, hasinitiated significant financial,operational, and team correctionsthat he will continue to imple-ment over the ensuing years tocome. Our investments aregrowing. The inner workings ofthe Academy office are runningfar more smoothly, and theculture of the office continues toevolve in productive directions.

A new director of operations,Jenn Waugh, has brought herconsiderable experience and skillset to effect operational andfinancial changes that will ulti-mately assure we attain anefficiently running business. Themeeting planning is once againin-house under the tutelage ofour new director of meetings andCME, Ada Phillips. Our long-standing employee, Rita ChuaMagness, has been engaged in anew position as director of indus-try relations and communica-tions. She has already madegreat strides in strengthening ourrelations with our valued busi-ness partners.

In closing, it seems appropri-ate to share an anonymous quotethat I like to repeat to myself on aregular basis: “Even though thereare days I wish I could changesome things that happened in thepast, there’s a reason the rear-view mirror is so small, and thewindshield is so big. Where you’reheaded is much more importantthan what you’ve left behind.”

The AAFPRS is definitelyheaded in the right direction, myfriends. With your encourage-ment, suggestions, and support, Isee a new and exciting tomorrowfor our beloved Academy.

William H. Truswell, MD

MAKING

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CLASSIFIED AD

The Alaska Center for Ear,Nose, and Throat is searchingfor a BC otolaryngologist/facialplastic surgeon to join ourprivate practice. Two of our fourwell-respected physicians, bothFP fellowship trained and boardcertified are winding down theirpractices, opening a uniqueopportunity for an otolaryngolo-gist/facial plastic surgeon tocontinue this portion of thepractice. In addition to a busy,well-rounded practice, weprovide full otolaryngologyneeds for the Anchorage com-munity of 300k. Contact Kim byemail at [email protected] tolearn more.


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

APRIL 18-22COMBINED OTOLARYNGOLOGYSPRING MEETINGS (COSM)(AAFPRS April 18-19)National Harbor, MDCo-chairs: Travis T. Tollefson, MD, MPHand Sydney C. Butts, MD

FACIAL PLASTIC TIMES

JANUARY/FEBRUARY 2018

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JUNE 23-24ABFPRS EXAMINATIONWashington, DC

AUGUST 3-5*PORTLAND RHINOPLASTY COURSEPortland, ORCo-chairs: Tom D. Wang, MD; MichaelKim, MD; and Myriam Loyo, MD

OCTOBER 15-1812TH INTERNATIONAL SYMPOSIUMOF FACIAL PLASTIC SURGERY ANDAAFPRS ANNUAL MEETINGDallas, TXCo-sponsored by the InternationalFederation of Facial Plastic SurgerySocieties (IFFPSS)Co-chairs: John L. Frodel, Jr., MD; MaryLynn Moran, MD; and Krishna Patel, MD

CLASSIFIED AD

FOR SALE BY OWNER: Physi-cian injector owned, full-servicemedical spa in beautiful,rapidly growing tax advantagedWestern state. Build yoursurgical practice from thehundreds of well-to-do patientsseen each month while generat-ing huge cash flow from inject-ing and the myriad other spaservices performed by yourstaff: Coolsculpting, fractionalRF, CO2, IPL, Ultherapy, LHR,tattoo removal, and more.Annual $2M gross (all cash),$600k net (Ebitda). Fully staffedbusiness, just hang up yourcoat and go to work. Ownerfinancing considered forqualified buyer/s. Asking$1,750,000. Interested partiesshould send contact informa-tion to [email protected].

CLASSIFIED AD

Well-established plastic surgeonfocused on body contouringseeks facial plastic surgeonassociate to join growing team.The successful candidate willbe board certified/board eligiblein ENT, plastic surgery, orOMFS. We are looking for anenthusiastic surgeon interestedin being part of a team andhelping build the premier multi-specialty cosmetic surgerypractice in the country. NorthTexas Plastic Surgery has twolocations, Southlake and Plano,which are affluent suburbs ofDallas. The practice has a fullyaccredited AAAASF, twooperating room surgery centerand a large established patientbase. Please visit our Web site at:www.northtexasplasticsurgery.com.All inquiries are confidentialand can be submitted onlinevia email to Linsey [email protected] or byphone at (817) 416-8080.

Enclosed in this issue ofFacial Plastic Times is the

Facial Rejuvenation Meeting brochure.

*Endorsed by the AAFPRS Foundation

REMINDERSThe deadline for applying for afellowship is February 1. Appli-cants can apply for the latedeadline, which is March 1. If youneed information regarding theFellowship Program, pleasecontact the fellowship office,[email protected].

Fellowship directors will bereceiving notification soon regard-ing the current 2019-2020 fellow-ship applicants.

Fellow members looking to applyfor ACPSE accreditation of theirfellowship program should con-tact the fellowship office forapplication information. Applica-tions are due in the fellowshipoffice by April 1. Applications arereviewed and discussed forapproval during the AnnualMeeting.

Membership dues invoices weresent out earlier this year. TheAAFPRS headquarters officeappreciates your prompt remit-tance. For questions about yourdues, please contact Maria Atkinsat [email protected].

2018 Membership DirectoryYour copy of the 2018 MembershipDirectory is on its way. Use this form ifyou would like to order an additionalcopy for your office.

( ) Send me _____ copy(ies) at $45each.

Payment:

Card #___________________________

Exp. ___________ Security Code ______

Name on Card _____________________

Ship to:

Name ___________________________

Address _________________________

_____________________________________

____________________________________

Email ___________________________

Phone __________________________

Please allow two weeks for delivery.Questions? Contact Glenda Shugars at(703) 299-9291; [email protected].


Canfield, oick up Aug2016

January/February 2018 Vol. 39, No. 1 · 2020. 3. 12. · January/February 2018Facial Plastic Times...

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Transcript of January/February 2018 Vol. 39, No. 1 · 2020. 3. 12. · January/February 2018Facial Plastic Times...