Aesthetic Society News - surgery.org

Quarterly Newsletter of the American Society for Aesthetic Plastic Surgery Volume 11, Number 3 Summer 2007

INSIDE THIS ISSUE:

PhysiciansCoalition forInjectable Safety

See page 4

Aesthetic Society News

Candidate’s CornerPrimer on Media Relations

See page 12

Continued on Page 14

Thirty years ago it seemed like a goodidea. Try to stem the tsunami of risinghealthcare costs by providing individualswith a menu of healthcare services and alimited number of providers through a per member per month program, an alternative to their existing fee for serviceinsurance plans. Make coverage cheaper.Promise providers from hospitals to phar-macies an inroad to hundreds of thousandsof patients (for a discounted fee, of course).Identify the top catastrophic diseases andcreate standards of care to treat them. Tryto eliminate the most fragile and highestacuity members through implementationof pre-existing condition clauses andadverse selection.

The result? An industry that tookhealthcare decisions out of physician’s

hands and into the hands of bureaucraticadministrators. A healthcare system that, according to the ACRQ: “spends alarger share of its gross domestic product(GDP) on health care than any other

Managed Care for the AestheticSurgery Practice?

From April 19 to 24, 2007, New YorkCity was the scene for one of the bestattended educational events in the 40 yearhistory of the Aesthetic Society. “TheAesthetic Meeting 2007, Be a Part of It!”attracted more than 2300 plastic surgeons,including 629 international plastic surgeons;in addition exhibitors, guests and alliedhealth professionals associated with thespecialty brought our total attendance toover 5,000. On behalf of the EducationCommission, I would like to thank ASAPS

President Dr. Foad Nahai for his insightfuland strong leadership in developing ouroutstanding educational venue. The mostpopular sessions at the Meeting included:

Optional Sessions S13, Hot Topics, aperennial favorite attracting 195 attendeesthis year, 613, Breast Augmentation with121 attendees, S11, Gel Breast Implantswith 119 attendees, S7, Fillers Course with113 attendees, and 421, Macs Lift with113 attendees. A special thanks to all these

The Aesthetic Meeting 2007More than 2,300 board-certified plastic surgeons attendseminal educational event in New YorkBy Jeffrey Kenkel, MD

Continued on Page 6

Plastic Surgeon AwardedCancellation FeeBy Bob Aicher, Esq.

The Problem When your patient cancels, you still want to

be paid. If there’s enough notice, you can get yourmoney by rebooking, but if it’s on short notice,you can only charge if you include a Cancellationand Refund Policy in your contract. If you don’tlike legal background and are really in a hurry,skip to “It Gets Better” 4 paragraphs down,because one of our members sued—and won!

Legalese Cancellation clauses are either an unenforce-

able penalty or valid liquidated damages, and thefirst test is whether the policy is clearly stated. Don’tbury the clause inside another paragraph, never useprint smaller than the rest of your document, and the closer the clause to your patient’ssignature, the better.

The second test is whether the amount of theliquidated damages is a reasonable approximationof your anticipated losses. Lost patient income isalways difficult to calculate, so liquidated damagesare often used to enforce non-compete clauseswhen you buy or sell your practice.

If the amount is small enough, then all of uspay liquidated damages without a fight, such aswhen we switch cell phone providers before ourcontract is up.

The final test to determine whether the policyconstitutes a penalty or liquidated damages iswhether the parties understand and intend that liquidated damages will be triggered by a breach.For instance, parents often find themselves liablefor their child’s entire year’s tuition when they cancel beyond a clearly stated written deadline (AR

Continued on Page 7

News from the Aesthetic SurgeryJournal

See page 16

Aesthetic Society NewsThe American Society for Aesthetic Plastic Surgery

The Aesthetic Surgery Education and Research Foundation

PresidentFoad Nahai, MD

EditorJulius W. Few, MD

Communications CommissionerMark Codner, MD

Director of Marketing and Public EducationJohn O’Leary

Marketing ManagerKristin Murphy-Aviña

Manager, Media RelationsAdeena Babbitt

ProductionErika Ortiz-Ramos

Janet Cottrell

DesignVia Media Graphic Design

Statements and opinions expressed in articles, editorials and communications published in ASNare those of the authors and do not necessarilyreflect the views of ASAPS or ASERF. Publishing of advertisements in ASN is not a guarantee, warrant or endorsement of any products and services advertised.

Send address changes and membership inquiries toMembership Department, American Society forAesthetic Plastic Surgery, 11081 Winners Circle,Los Alamitos, CA 90720. Email [email protected].

Co-sponsored/Endorsed Events 2007–2008

August 22-25, 2007

22nd Annual Breast Surgeryand Body ContouringSymposiumEl Dorado HotelSanta Fe, NMCo-sponsored by ASAPS/ASPS/PSEFContact: PSEF 800-766-4955

September 7-8, 2007

Cosmetic Medicine: The Bottom LineNew York HiltonNew York, NYCo-sponsered byASAPS/ASERF/ASPS/PSEFContact: PSEF 800-766-4955

September 27-28, 2007

BAAPS 2007 Annual MeetingLondon, UKContact: [email protected]

October 27, 2007

Surgical and Non-surgicalFacial Rejuvenation SymposiumBaltimore, MDCo-sponsored by ASAPS/ASPS/PSEFContact: PSEF 800-766-4955

November 14-17, 2007

Aesthetic Surgery of theAging FaceWaldorf Astoria, New York, NYContact: Francine Leinhardt212-702-7728

November 30-December 2, 2007

QMP Third Aesthetic SurgerySymposiumHyatt Regency, Chicago, ILEndorsed by ASAPSContact: Andrew [email protected]

January 18-20, 2008

24th Annual Breast SurgerySymposiumEndorsed by ASAPSAtlanta, GAContact: Susan Russell 678-773-3224 [email protected]

January 25-27, 2008

12th Annual New Horizons inCosmetic Surgery SymposiumCo-Sponsored by ASAPS/ASERF/ASPS/PSEFRancho Las Palmas Resort & SpaRancho Mirage, CAContact: PSEF: 800-766-4955

February 7-9, 2008

42nd Baker GordonSymposium on CosmeticSurgeryEndorsed by ASAPSHyatt Regency Miami, Miami, FLContact: Mary Felpeto at 305-859-8250

February 10-13, 2008

19th Congress of ISAPSFoad Nahai, MDRenato Saltz, MDEndorsed by ASAPSMelbourne, AustraliaContact: Catherine B. Foss at603-643-2325Email: [email protected]

ASAPSCalendar

© 2007 The American Society for Aesthetic Plastic Surgery

ASAPS Members Forum: www.surgery.org/members

ASAPS Website: www.surgery.org

ASERF Website: www.aserf.org

®

The Aesthetic Surgery Education and Research Foundation

The American Society forAesthetic Plastic Surgery

2 Aesthetic Society News • Summer 2007

FOAD NAHAI, MD

President’s REPORT

Becoming President of an organiza-tion like the Aesthetic Society is more thana great honor. To me, it is an exciting andchallenging opportunity that I approachwith much pride and enthusiasm.

Our Society is currently in a positionof financial health and stability; it is thepowerhouse organization for AestheticSurgery Education and positioned as oneof the most honorable and transparentsocieties in organized medicine.

We have all our past leaders to thankfor this enviable position. However, I wouldlike to call special attention to our ImmediatePast President James M. Stuzin, MD.Jimmy is not only one of the foremosteducators in plastic surgery today but isalso a tireless advocate for the specialty andfor advancing the safety and innovation ofthe work we do every day.

Education, of both members and thepublic, has always been the cornerstone ofthe Aesthetic Society and that traditioncontinues today.

On the member education front, we recently enjoyed, through our AnnualMeeting in New York, one of the bestattended programs ever with more than2300 plastic surgeons participating. Iwould like to publicly acknowledge thefine and dedicated work of our EducationCommission, now headed by JeffreyKenkel, MD and Jack Fisher, MD. Jeff,Jack, and their Committee are already hard at work for our 2008 meeting in San Diego which I’m sure will bear theirunique stamp and develop into a thoughtprovoking and stimulating event.

Of course educational opportunitiesare not limited to the Annual Meeting.Our platform of co-sponsored, endorsedand other meetings covers subjects rangingfrom surgery after massive weight loss todeveloping your own medi-spa. Some of

the educational opportunities available toASAPS members over the coming monthsincludes: the 23rd Annual Breast and BodySymposium in Santa Fe August 22–25,Cosmetic Medicine: The Bottom Line,September 7–8, the Surgical and NonsurgicalFacial Rejuvenation Symposium inBaltimore, October 27.

On the public education front,patient choice and safety continue to bethe bedrock of all consumer and patientoutreach efforts. Over the past severalmonths we have issued patient advisorieson injection lipolysis, fat grafting of thebreast, and on fat melting treatments suchas Smart Lipo.©

Another patient safety initiative thatis a unique one for our Society is thePhysician’s Coalition for Injectable Safety;www.injectablesafety.org. This group, ofwhich the Aesthetic Society is a leadorganization, was formed for two reasons:to inform the public and physicians of the dangers and legal pitfalls of obtainingoff-shore, non-approved FDA products and the need to educate the public thatinjections should be performed by qualifiedproviders in appropriate settings. This isthe first time we have collaborated withcolleagues from other specialty groups;The American Academy of Facial Plasticand Reconstructive Surgery and TheAmerican Society of Ophthalmic Plasticand Reconstructive Surgery. Watch for newdata and press coverage on this importantsafety topic.

I can’t think of a harder working volunteer organization than the AestheticSociety. All members who serve on committees or are voted into leadershippositions do so for two reasons: love of the specialty and the development of neweducational, practice management andresearch tools for our members.

This tradition of philanthropy is particularly important as the landscapechanges. The public’s apparently insatiableappetite for plastic surgery news, regardlessof the source, new competitors to our specialty coming from all directions andunscrupulous individuals promoting themselves as “expert” all point to the needfor us to maintain our position as the goldstandard of care.

There is no better way to prove thisthan through complete disclosure andtransparency of all ASAPS leader’s relation-ships. All members of the ExecutiveCommittee, Board of Directors, CommitteeChairs, and Journal Editors are nowrequired to disclose any real or perceivedconflicts that could affect the way we servethe Society.

Our standards for membership are veryhigh and applicants undergo a rigorousevaluation process which includes a reviewof their website and advertising to ensurethat they are within our standards andcomply with our code of ethics. I believethat our members should be held to thosesame standards. In that spirit I have asked past President Dr. Dan Morello, and he has graciously accepted, to chair asubcommittee to regularly review ourmembers’ websites for compliance and toremind those who may have relaxed thosestandards since becoming members. Thecommittee has a huge task ahead to reviewas many as 1100 websites and to that end Dr. Morello is looking for volunteersfor this project. He can be reached at [email protected].

Speaking of the good of our specialty,I would like to update you on the CosmeticSurgery Alliance and some of the collabo-rative activities with our sister society,ASPS.

Aesthetic Society News • Summer 2007 3

Strength, Disclosure and Collaboration

Continued on Page 7


Last year at this time, disturbingreports were appearing in the nationalpress concerning unqualified cosmeticinjectors using substances ranging from thedangerous, such as product purchasedfrom off-shore sources, thus lacking FDAapproval, to the macabre, such as womenbeing injected with cooking oil and liquidsilicone. The Aesthetic Society immediatelyissued patient advisories, press releases andmember advisories warning of these issuesand advising patients on how to locate andchoose a qualified provider. Since the moreextreme cases were targeting immigrantcommunities and non-English speakers, weproduced a Spanish Video News Releaseand ensured that information in Spanish

was provided on the Society website tohelp consumers make informed choices.

We quickly found that more actionwas needed and self-funding these effortswould be prohibitive for the Society. Wealso found that colleagues in other special-ties were facing the same safety issues andhad an interest in collaborating with us ondisseminating important safety messagesthrough a wide range of mediums andensuring that the public and their mem-berships had the most factual and usefulinformation on injectables available.

With the above concerns in mind, thePhysicians Coalition for Injectable Safetywas born. Funded through unrestrictedgrants from Allergan Medical, Artes

Medical, BioForm Medical and MedicisPharmaceutical Company, our program waslaunched with a press event at the ASAPSAnnual Meeting in April. Inaugural membersof the Coalition included The AmericanAcademy of Facial Plastic and ReconstructiveSurgery (AAFPRS), The American Societyof Ophthalmic Plastic and ReconstructiveSurgery (ASOPRS) and the AmericanSociety for Dermatologic Surgeons (whohave since resigned from the program).Representing the Aesthetic Society areRenato Saltz, MD, Julius Few, MD,Felmont Eaves III, MD, Mark Codner,MD and myself.

To date, we are pleased to haveaccomplished a great deal in a short periodof time. The first of these accomplishmentsis the coming together of specialties thattraditionally have been competitive; how-ever, the common goal of patient safety isstrong glue and has enabled us to developthe following patient and physician tools:• A comprehensive website:

www.injectablesafety.org, that is buildingto become the “go to source” for patientinformation,

• A Memorandum of Understanding, stating the principles and mission forthe group,

• The beginnings of an injectable curricu-lum that can be considered for inclusionin the educational meetings and fortraining of supervised clinical injectors,

• Information for members via a membersurvey that will pinpoint your issueswith injectables and where you feel public and member education is needed,

• A comprehensive media program,informing the public on critical safetyand capability issues.

I would like to thank my ASAPS colleagues as well as AAFRPS President Ira Papel, MD and ASOPRS ImmediatePast President Roger Daily for their hardwork and collaborative spirit on thisimportant initiative. Look for future devel-opments on the program in upcomingissues of ASN

Mark L. Jewell, MD is an aesthetic surgeon in private practice in EugeneOregon, and was president of the AestheticSociety for the 2005-2006 term.

Focus on:The Physicians Coalition for Injectable SafetyBy Mark L. Jewell, MD


Cosmetic Medicine is a moniker wellknown to everyone involved in AestheticSurgery. What members might not knowabout is the Cosmetic Medicine Task Force,a joint effort of the Aesthetic Society andthe ASPS. The group, Co-chaired by Drs.Richard D’Amico and Renato Saltz, ischarged with digging deep into the so-called“new care paradigm” to see what vision it suggests for plastic surgery and whatactions the group can suggest to memberswishing to enter the arena. Below is a briefsynopsis on the Task Force’s findings andplanned actions:

Richard D’Amico, MD onthe Current Landscape:

Cosmetic medicine can be defined as medical and surgical treatments or procedures which enhance or restoreappearance. With that broad definition,what is the state of the art of cosmeticmedicine and where does it fit in to thepractice of plastic surgery and aestheticskin care?

The industry growing around cosmeticmedicine is already a multi-billion dollarentity. The Cosmetic Surgery Alliance,which brings together the leadership of theAmerican Society for Aesthetic PlasticSurgery and the American Society ofPlastic Surgeons, has convened a specialTask force on Cosmetic Medicine inJanuary of this year.

A scan of the industry reveals that it is expected to grow by at least 9% per year over the next decade. Non-surgicalprocedures account for 82% of all cosmeticprocedures with the most rapidly growingareas in laser and light therapy, injection oftoxins and fillers and non-ablative skinrejuvenation. Medical spas also represent arapidly growing segment of this industrywith approximately 2500 facilities acrossthe country. This alone is a one billiondollar market. The industry, however, is in

its infancy and is relatively unproven interms of revenue. This presents a significantset of challenges to plastic surgeons andtheir staffs. In this regard, two teachingcourses will be offered this year on the subject of medi-spas; the first in Los Angelesheld during the first week of June and thesecond scheduled for September 7 and 8,2007 at the New York Hilton

While cosmetic surgical procedureswill always be at the heart of cosmeticmedicine, the significant growth of non-invasive procedures has caused a rush ofboth core and “non-core” medical specialtiesinto this area. Core specialties such as dermatology and facial plastic surgery havelong been involved but the so-called non-core specialties, such as gynecologyand family practice, are clamoring to participate as well. There has been intenseindustry marketing and many companieswill market to any physician regardless oftraining. This should be of great concernto plastic surgeons who represent the highest level of training in this area. Therehas also been industry lobbying againstscope of practice limitations, which is alsodisturbing for those of us concerned aboutpatient safety and outcomes.

The plastic surgery profession is passionate about patient safety and qualityoutcomes and implementing best practices.We are determined to set the standards andset them high. The task force has engageda consulting firm to help us to reach out toboth our plastic surgeon members and tothe public. We believe it is important forthe public to be reminded that plastic surgeons are the only physicians who havethe core training to provide all cosmeticmedical and surgical procedures. We willalso be the entry portal at any age of lifeand we will generate the data to substantiateoutcomes and provide for patient safety.Plastic surgeons will become the “go-to”resource for information, referrals and

decision making tools. Our regulatory andlegislative outreach will emphasize patientsafety and quality outcomes.

Through the efforts of the task forceand the profession, we will keep plasticsurgery and related skin care services at thecore of cosmetic medicine and remain adriving force providing patients withunmatched expertise, safety and value.

Renato Saltz, MD: TheCosmetic Medicine ActionPlan

Dr. D’Amico and I are very fortunateto have a “who’s who” lineup of some ofthe brightest minds in plastic surgery working with us on this Task Force. Membersof the group include Drs. Robert Singer,Brian Kenney, Rod Rohrich, Monte Eaves,Phil Haeck, Mark Jewell and Alan Gold.We thank them for their insights and sageadvice.

Before proceeding on an action planfor cosmetic medicine, the group thoughtit was vitally important to gather as muchdata as possible. In July of this year, a comprehensive survey of consumers wasconducted through our consultant,Reingold Communications. Data pointsinclude: who a preferred provider is for cosmetic injectables, what key pointspatients look for in choosing a provider,what qualities make for an optimal patientexperience, and what sources to patientsand potential patients most trust in seek-ing invasive and non-invasive treatments.We are in the final stages of tabulatingthese results: look for updates in futureissues of ASN.

We also needed to know your experiences in this area. Reingold is in the process of completing member surveysand interviews to ascertain your needs inthis area and your interest in making cosmetic medicine part of your practice.

Update from the Cosmetic Medicine Task Force

Renato Saltz, MDRichard D’Amico, MD



Managed Care for the Aesthetic Surgery Practice?Continued from Cover

major industrialized country. Expendituresfor health care represent nearly one-seventhof the Nation’s GDP, and they continue tobe one of the fastest growing componentsof the Federal budget. In 1960, for exam-ple, health care expenditures accounted forabout 5 percent of the GDP; by 2000, thatfigure had grown to more than 13 percent.

For physicians, the results have changedthe very paradigm of what it means to pro-vide quality patient care, as reimbursementlevels shrink, patient platforms grow, andsecond guessing of care and treatmentplans by non-clinical persons is the normrather than the exception.

Now, the threat of “managed care” ormedical commoditizing, is knocking at the plastic surgeon’s door. Here, are some reasons not to answer:

1. Medical decisions shouldnot be price-based.

Entering into a Preferred ProviderOrganization for aesthetic surgery proce-dures certainly has an appeal, particularlyfor those just starting in practice. However,

before signing up, consider a few realitiesof our profession:

Aesthetic procedures are not medicalnecessities. The majority of our patientsare seeking our services for self improve-ment, to bolster self-esteem or for otherpersonal reasons that are far removed fromdisease treatments or medical prevention.

Because of this, the pool of aestheticpatients is miniscule compared to peopleseeking treatment for diabetes or heart disease, for example. Putting your nameinto a managed care pool will positionyour practice on price, not on quality,qualifications or outcomes.

2. What are the contingenciesif complications arise?

Today, patients are personally respon-sible for aftercare if surgical complicationsoccur. Would that be the case if the patientbooks a consultation from a managed carepool? What exactly would your liability be,and what would the reimbursement be fortreatment of complications? Most purelyaesthetic practices do not have the burdenof seeking third party reimbursement;could your business handle the additionaladministrative and financial burdens associated with it?

3. How is the reimbursementlevel determined?

As we all know, the time it takes to perform a lipoplasty versus a body contouring after massive weight loss variesconsiderably. How is the managed careplan determining reimbursement for indi-vidual procedures? If income doesn’t covercosts, will you have to be “up-selling”other procedures or services in order tomake a living? Facility fees, office expenses,staff salaries and benefits, and malpracticeinsurance will all still be necessary. It isunlikely to impossible that a discountedfee structure will allow you to maintain thequality standards and customer service yourfee for service patients have come to expect.

4. What will being part of aPPO do to your currentpatient platform?

Everyone loves a bargain, even thosepatients you’ve nurtured through minimallyinvasive procedures or skincare to theirfirst facelift or other surgical procedure.These patients return to your practicebecause you offer a particular value proposition; for example, exemplaryresults, broad-ranged cosmetic medicineand surgical options, and an interactiveand strong doctor-patient relationship. Inthe tight confines of aesthetic surgery, itwill not be long before all your patientsfind that you are providing discounts. Thisis usually not a good strategy for the longrun and may actually alienate your existingpatient base who are paying your usual andcustomary prices.

5. What we practice is a science, but it’s an art, too.

Surgical procedures in general aretechniques learned in the operating room,not through bench science or classroomlearning. This is particularly true of aesthetic surgery and the main reason theAesthetic Society was created 40 years ago.Managed care, by definition, manages the medical process both clinically andadministratively in order to get the maxi-mum number of procedures for the lowestcost. This so called “cook book medicine”does not take into account the countlessnumber of hours we have spent perfectingand refining our craft.

In conclusion, Preferred ProviderOrganizations are not the answer forincreasing census or loyalty in the aestheticsurgeon’s practice.


1955 $1770, NY 1969 $1100, OH 1993$6440, CT 1993 $4000). Similarly,lawyers often find themselves liable underan expert’s written policy when they cancela doctor’s deposition at the last minute(DE 1999 $1200, OH 2001 $600 [1hour], IL 2001 $1200 [2 hours], AZ 1999$1400 [2 hours]).

It gets better. Thanks to our ownASAPS member, Kenneth L. Arsham,MD, we now have a reported appellatedecision, http://www.sconet.state.oh.us/rod/newpdf/8/2007/2007-ohio-1715.pdfwhere a plastic surgeon was awarded hiscancellation fee against a patient (a lawyer,

no less, and Dr. Arsham represented him-self ) who rescheduled less than two weeksprior to surgery.

Dr. Arsham included in his patientcontract a Cancellation and Refund Policydirectly above the patient’s signature which

required her to prepay the surgical fee of$3250; if she cancelled between 7 and 14days in advance, she would be assessedone-half the fee, or $1625, and if she cancelled less than one week in advance,she would be assessed the full fee. She cancelled 8 days prior, so Dr. Arsham kept$1625, and she sued for a refund.

The Ohio Eighth Appellate DistrictCourt began with the general rule, supportedby the tuition cases, that parties are free toenter into, and must bear responsibilityfor, contracts which apportion damages incase of default. Since Dr. Arsham provideda variety of services, damages from a cancelled appointment would be difficultto determine, as would be filling the slotwith another patient with less than twoweeks’ notice. The Court found chargingthe patient one-half of the anticipatedincome was thus reasonable.

Looking to the format of the contract,the Court stated:

“Groedel is an attorney with overfourteen years of experience. The agreementis legible, written in plain English, and iscomposed of a single page with the cancel-lation and refund provision printed in the same print size as the other clauses.Furthermore, there is no evidence todemonstrate that Groedel was pressured intosigning an agreement, the terms of whichshe could not see or easily understand.”

Not mentioned by the Court, butnevertheless good practice, is that Dr.Arsham’s clause contained the heading,Cancellation and Refund Policy in under-lined, bold-faced type, thus further alertingthe patient to the policy.

Cancellation Policy PracticeTip: • Make your policy legible, plain, a single

page, and obvious;• Keep your liquidated damages

calculations reasonable; and• Call Dr. Arsham and thank him; this is

great precedent.

Plastic Surgeon Awarded Cancellation FeeContinued from Cover

ASPS and Aesthetic Society leadershipcame together three years ago with the goalof establishing a new spirit of collaborationdesigned to strengthen the Specialty andeliminate redundancies. Since that seminalmeeting, the CSA has been able to work onimportant issues such as fighting cosmeticsurgery taxation, working together on theapproval of silicone breast implants, andproviding our members with new practicetools and advocacy efforts. Today, we areworking on the Cosmetic Medicine TaskForce, Co-chaired by Drs. Renato Saltzand Rick D’Amico. This initiative will notonly define this new burgeoning field butwill also establish us at the center of theextensive array of cosmetic treatments.

With new surgical techniques, therespect of the public and the medicalestablishment and a burgeoning new fieldto claim, this is an exciting time to be anaesthetic surgeon. I thank you for the trustand confidence you have placed in me andwelcome any comments or suggestions onour Society or our specialty. Please feel freeto contact me at [email protected]

President’s ReportContinued from Page 3

When your patient cancels, you

still want to be paid. If there’s

enough notice, you can get your

money by rebooking, but if it’s

on short notice, you can only

charge if you include a

Cancellation and Refund Policy in

your contract.

Cancellation clauses are either an

unenforceable penalty, or valid

liquidated damages, and the first

test is whether the policy is

clearly stated. Don’t bury the

clause inside another paragraph,

never use print smaller than

the rest of your document, and

the closer the clause to your

patient’s signature, the better.

Medical News from theWire ServicesNote: First Call is the press service used bythe investment community

Product Approvals:(First Call News service)

Thermage(R), Inc. today announcedthat the Food & Drug Administration(FDA) provided a first-time-ever 510(k) clearance for the non-invasive treatment of periorbital wrinkles andrhytids, including upper and lower eyelids. Thermage’s proprietaryThermaCool(R) system, utilizing customized ThermaTip(TM) treatmenttips, is the only medical device in thenon-invasive skin tightening categorywith this clearance.

ASAPS recognizes

Allergan Medicalas an ASAPS Sapphire Triangle Sponsor 2007

for contributing over $150,000 from May 2006-April 2007

Allergan Medical, Vice President Facial Aesthetics, Bob Rhatigan receives the ASAPS Sapphire Triangle Award from

ASAPS Immediate Past President, James M. Stuzin, MD. (right) and Corporate Sponsorship Chair, Lawrence Reed, MD, (left).

ASAPS thanks Allergan Medical for its continued support and provision of resources to fulfill the Society’s

important educational and research mission.


ASAPS recognizes

Mentor Corporationas an ASAPS Platinum Triangle Sponsor 2007


Mentor Corporation, Vice President of Sales, Jason O’Hearnreceives the ASAPS Platinum Triangle Award from


ASAPS thanks Mentor Corporation for its continued support and provision of resources to fulfill the Society’s




ASAPS recognizes

NexTech, Inc.as an ASAPS Platinum Triangle Sponsor 2007


NexTech, Inc., President, Kamal Majeed, PE, PhDreceives the ASAPS Platinum Triangle Award from


ASAPS thanks NexTech, Inc. for its continued support and provision of resources to fulfill the Society’s



ASAPS recognizes

2007 Corporate SponsorsPresented by ASAPS Immediate Past President

Mark L. Jewell, MD

Einstein MedicalRobert Silkey

Chief Executive Officer

Medicis AestheticsJonah Shacknai


Coapt SystemsJohn KraczkowskySenior Vice President,

Marketing & Business Development

Ethicon, Inc.Allison London-

BrownUS Group Product

Director

Merck & Company, Inc.Photo Not Available

Artes MedicalDiane GoosetreePresident and CEO

BioForm MedicalSteven Basta


Dermik LaboratoriesPhoto Not Available

Gold Plussponsors contribute$75,000 to$90,999

Goldsponsors contribute$50,000 to$74,999

Bronze sponsors contribute$30,000 to$30,999

When I matched into an integratedplastic surgery residency back in 1998 Iknew that I wanted to be a surgeon, Ienjoyed the visible results, and I liked thesense of accomplishment at the end of theday after helping people improve upontheir appearance whether it was for recon-struction or cosmetics. That said, when Imatched into an integrated plastic surgeryresidency, I had no idea that the specialtythat I was joining would become such asource of entertainment, media inquiry, andhuman interest in pop culture as it is today.

I was asked to give input on dealingwith the media as a plastic surgeon who isrelatively new in practice. The other day I Googled “Plastic Surgery.” On this search engine alone there are 42,500,000listings. Among some of the more interesting ones are: awfulplasticsurgery.com,celebrityplasticsurgerypics.com, andmyfreeimplants.com… did you know thatthere is a site called myfreeimplants.com?Via an online community men can donatemoney to women who have signed up tohelp fund their breast augmentation proce-dures. The women participate by chattingonline, sending personal messages or gifts,and providing pre- and post-operative photos (kind of like eHarmony for thebreast augmentation patient if you will).

With the onslaught of websites likethese and television programs such asNip/Tuck, Dr. 90210, MTV’s I Want aFamous Face, and Extreme Makeover, ourspecialty is confronted with widespreadexposure, scrutiny, and misrepresentation.While it is not something we traditionallylearn in residency, knowing how to fieldquestions from the media is becoming anincreasingly important tool. I have puttogether a list of points that may be of useto the plastic surgeon building a practiceand establishing a reputation.

1. Avoid self-promotion. Speak mainly for the specialty of plas-

tic surgery as a whole, and avoid makingstatements in the first person. Speak ingeneralities. If someone were to ask aboutthe pros and cons of teenage plastic surgery,you might say, “Otoplasty and rhinoplastyare procedures that are known to benefitcertain young men and women with specificanatomical problems.” Sentences that beginwith the word, “I,” tend towards self-promotion. For example, “I am an artistand sculptor of the human body,” and, “Iam the one who developed and perfectedthis technique,” most likely are inaccurateand are in violation of ASPS/ASAPS ethical standards. As a matter of fact, the beautyeditor of one of the most popular andwell-respected women’s publications oncetold me that when she receives emails from doctors or their publicists touting thesurgeon as sculptor, genius, or above allothers, they promptly get deleted.

2. Do your homework on what the interviewer willask about the topic.

Avoid pieces that could ultimatelycast you (or the specialty) in a negativelight. Try to get an idea on the spin theinterviewer has on the topic ahead of timeand where they got their information.Think of all of the questions—good orbad—that might arise. If you get a gutfeeling that things may not go the way youwant them to, cancel the interview withample time for the interviewer to findsomeone else—it’s not worth the negativepublicity this early in your practice. If youhave questions about a particular topicregarding plastic surgery that is generatingbuzz in the news, the ASAPS press releaseson our website (www.surgery.org) are agood source of general information that are

relevant, timely, and often mirror what isgoing on in the media regarding cosmeticsurgery. Also, the ASAPS CommunicationsOffice is always available to help with anyinterview or public relations matter.

3. Contact the AestheticSociety CommunicationsDepartment.

Experts in all aspects of media relations are here to help: 800-814-7148;Adeena Babbitt; [email protected] or John O’Leary at the Central Office 800-364-2147; [email protected].

4. Educate the public.If you have the opportunity to edu-

cate the public on issues such as the safetyof silicone gel implants, the importance ofboard-certification of your plastic surgeon,or using caution when consulting withdoctors or paramedical professionals performing cosmetic procedures outside ofthe scope of their practice, then do so.

5. Don’t overdo it.Only participate in tasteful pieces or

segments. Contributing to every event, lead,or story that comes your way is personallyexhausting and doesn’t necessarily reflectwell on you. Are you really the expert on allof the techniques and procedures you arespeaking about? Make sure you don’t blowit up when you are doing well in yourpractice and trying to establish a reputation.

6. Review all material submitted to the media.

Review any material that someoneelse submits to the media on your behalfwhether it is your office manager, secretaryor a publicist. Their perception of whatsounds promising to say about you or thetopic may be different from your own.

JENNIFER L. WALDEN, MD

Candidate’s CORNER

Primer on Media Relations



7. Do not to speak negativelyof another doctor or medical profession.

Avoid doing stories on other doctors’problems. Plenty of gossip news showswant to do stories on “botched plastic surgery.” I recently saw a press release sentout by a local publicist whose client was aplastic surgeon. The headline referenced a malpractice suit filed against another doctor in the community. The releaseurged the recipients of the email to contactthe publicist so that the doctor could comment on the suit and describe how his techniques were superior. This is anextreme case, but standing to gain fromanother surgeon’s problems or misfortunesis not only unbelievably distasteful but isalso unethical.

8. Offer disclosures or biases. Stating, “I am not a consultant for the

manufacturer of this product, but I use it andhere’s how it works,” is an objective way oftelling about your experience with a product.


9. Offer objective facts.With new products, skin care lines,

and injectables, try to offer objective factsabout the product and any well-controlledresearch. Otherwise you may end up justsounding like salesman.

10. Follow the ASPS/ASAPSCode of Ethics

Do not set yourself apart from othersimilarly trained and qualified doctors basedon gender or other attributes; again, a directviolation of the ASAPS Code of Ethics.Saying that you have a unique perspectiveon things because you are a female plasticsurgeon is misleading. Avoid saying you arethe best in your community unless you areable to back it up; with outcome data orother statistical evidence.

11. Be careful with pieces that feature you and your personal life to the public.

As soon as you do this, you and yourfamily’s lives are exposed for anyone andeveryone to comment on, whether positively

or negatively. Leave a little to mystery!Focus on the practice of plastic surgery,technical aspects, and issues within thespecialty; philanthropic efforts are nice todiscuss if you are asked about any otherendeavors of interest.

12. Respect your patient’sprivacy.

If a member of the press wants tocontact a patient and include them in theirsegment, call the patient ahead of time, gettheir written permission, and reassure themthat if they are uncomfortable with the situation they don’t have to participate (orthey could change their name to protecttheir anonymity).

Primer on Media RelationsContinued from Page 12


course presenters for their hard work in developing outstanding and popularprograms.

The April meeting also provided anopportunity for members to vote on a newslate of leadership, recognize those whogave outstanding clinical presentations atlast year’s meeting and honor several members for their philanthropic service.

Among those voted into leadershippositions this year include:

Executive Committee:Foad Nahai, MD, PresidentAlan H. Gold, MD, President-ElectRenato Saltz, MD, Vice PresidentFelmont F. Eaves, III, MD, TreasurerJeffery M. Kenkel, MD, Secretary

Member-at-Large:Julius W. Few, MDCharles H. Thorne, MD, Paul D. Faringer, MD

Trustee:Jeffery Lang, MD

Ethics Committee:Claudio Delorenzi, MD—Canada and NorthBrandon Kallman, MD—Southwest

Judicial Committee:Lorne Rosenfield, MD—West

Membership Committee:Richard Baxter, MDOnelio Garcia, MD Susan Downey, MD

Scientific Awards for presentations at theMeeting 2006 included:The Walter Scott Brown AwardJose Abel De La Pena, MDBEST VIDEO, 2006 MEETING

Autologous & Prosthetic GlutealAugmentation

Tiffany Award: Best ScientificPresentationLeo J. McCafferty, MD209 Consecutive Primary BreastAugmentations: Pearls to Reducing theRisks of Reoperation?

Simon Fredricks Award: Best PanelistFelmont Eaves, III, MDPatient Safety—What Can Go Wrong andHow to Prevent It

Best Scientific Exhibit Award: Peter B. Fodor, MDBiochemical Changes in Adipocytes andLipid Metabolism Secondary to the Use ofHigh Intensity Focused Ultrasound for Non-Invasive Body Sculpting

Sherrell J. Aston Award: BestPresentation by a Candidate or ResidentHisham Seify, MDQuantification of Ptosis Repair with aThree-Step Technique—A Review of 144Consecutive Aponeurotic RepairProceduresThis award is made possible through anASERF grant from Shradakumar Dicksheet,MD

Raymond Vilain Award: BestPresentation by an InternationalPhysicianArturo Ramirez-Montanana, MDAn Easy Way to Harvest Rib Cartilage toRestore Dorsum Nose and How to AvoidCurvature Deformities

Best Panel ModeratorJack Fisher, MDThe Greatest Challenge—Primary &Secondary Augmentation MastoplexyAward Funded through the generous contribution of Barbara and Dr. Peter Fodor.

Additionally:In Chul Song Award: PhilanthropicServiceFernando Ortiz-Monasterio, MDMade possible by an ASERF grant fromShradakumar Dicksheet, MD

Ted Lockwood Award: Excellence inBody ContouringPeter B. Fodor, MD

Outstanding Volunteer of the YearKenneth E. Salyer, MDGiven in Great Appreciation of YourTireless Work on the World CranialfacialFoundation

Planning is already underway for theAesthetic Meeting 2008—Sailing intothe Future of Aesthetic Surgery. Themeeting will be held in San Diego,May 1–7. Scientific Sessions andExhibits will be held May 3–7 withmorning dual sessions on Sunday andMonday. Drs. Kenkel and Fisher serveas the Program Chairs. Teachingcourses will be held May 1– 6. Wehope to see you there!

The Aesthetic Meeting 2007Continued from Cover

Attendees fill the room for one of the Scientific Sessions held at the recentAnnual Meeting.

The Aesthetic Meeting 2008

A N N U A L M E E T I N G O F A S A P S & A S E R F

Sailing into the Future

of Aesthetic Surgery

The Aesthetic Meeting 2008

May 1–6, 2008 • San Diego, CaliforniaSan Diego Convention Center

May 1–6, 2008 • San Diego, CaliforniaSan Diego Convention Center

Early Bird Registration Discounts AvailableRegister On-line at www.surgery.org/meeting2008 (beginning January 2008)

Call for AbstractsSubmit Your Abstracts on-line by Thursday, November 1, 2007www.surgery.org/abstracts• Scientific Session including International Papers• Residents & Fellows Forum (deadline January 11, 2008)

• Cadaver Labs on Thursday, May 1• Optional Courses on

Friday, May 2 – Monday, May 5• Residents & Fellows Forum on Friday, May 2

Scientific Sessions & Exhibits on May 3 – 6• Interactive Video Presentations• Panel & Paper Presentations


At the Aesthetic Surgery JournalEditorial Board Meeting, on April 23 inNew York, Editor in Chief Stanley A.Klatsky, MD, announced the addition often new ASJ editors, bringing the totalnumber to 38. “We are pleased to add a number of exceptionally qualified individuals to the Editorial Board,” saidDr. Klatsky. “These physicians bring notonly a wealth of clinical experience butalso significant strength in terms of academic affiliations, which is important as our journal seeks to attract an evenbroader range of high quality articles.”

The new additions to the Editorial Board are:

ASSOCIATE EDITORFoad Nahai, MD

Clinical Professor of SurgeryEmory University School of Medicine

SENIOR SCIENTIFIC EDITORBahman Guyuron, MD

Kiehn-DesPrez Professor and Chief, Division of Plastic Surgery

Case Western Reserve University andUniversity Hospitals Case Medical Center

CLINICAL EDITORSFritz E. Barton, Jr., MD

Clinical Professor of Plastic SurgeryUniversity of Texas Southwestern

Medical Center

A. Jay Burns, MDAssistant Professor of Plastic Surgery

University of Texas Southwestern Medical Center

Dennis J. Hurwitz, MDClinical Professor of Surgery (Plastic)

University of Pittsburgh Medical Center

Jeffrey M. Kenkel, MDProfessor and Vice-Chairman, Department of Plastic Surgery

University of Texas Southwestern Medical Center

Berish Strauch, MDChairman

Department of Plastic and Reconstructive Surgery

Albert Einstein College of Medicine

Luis Vasconez, MDProfessor and Director

Division of Plastic Surgery, Department of Surgery

University of Alabama-Birmingham School of Medicine

Michael J. Yaremchuk, MDProfessor of Surgery, Division of Plastic and

Reconstructive SurgeryHarvard Medical School

INTERSPECIALTY CONSULTING EDITOR

Seth Matarasso, MDClinical Professor

Department of DermatologyUniversity of California School of Medicine

ASJ Seeks Submission ofSubstantial Research andReview Articles

In preparation for submitting ASJ tothe National Library of Medicine (NLM)for consideration of inclusion in theMEDLINE database, submissions of articles in several specific categories arebeing encouraged. “Our goal is to submitthe journal to the NLM possibly as early as fall 2008,” says Dr. Klatsky. “We areprepared to fast-track the peer-reviewprocess for articles that meet certain criteria identified as helpful to our journal’s chances for acceptance by theNational Library of Medicine.”

Of particular interest to the journal atthis time, says Dr. Klatsky, are substantialclinical research articles, basic scienceresearch articles and comprehensive reviewarticles.

Dr. Klatsky emphasizes that ASJ’s firstpriority remains to provide readers withtimely information on clinical techniquesand relevant science that has practicalapplicability to their aesthetic practices.But he adds, “We also need to make surethat we are adequately represented as a scientific and scholarly journal in order tobetter satisfy general indexing criteriaestablished by the National Library ofMedicine.”

“ASJ’s exclusion from MEDLINE has not hampered it from becoming theworld’s most widely read clinical journal of cosmetic surgery,” says ASAPS Presidentand ASJ Associate Editor Foad Nahai,MD. “ASJ articles are indexed in a numberof other important databases and are soonto be searchable through Google.” Headds, “The prestige of being indexed byMEDLINE is still a highly desirable goal,and it can only enhance the national andinternational reputation of our journal.”

ASJ Announces New Board Members, New Editorial Initiatives


ASJ Call forManuscripts

Aesthetic Surgery Journal is seekingmanuscripts in the following categoriesfor fast-tracked peer-review and, ifaccepted, rapid publication:

• Substantial clinical research articles• Basic science research articles• Comprehensive review articles

Contact Editor in Chief StanleyKlatsky, MD ([email protected]);Associate Editor Foad Nahai, MD([email protected]); or Managing Editor Paul Bernstein([email protected]).

Submit manuscripts online atwww.aestheticsurgeryjournal.com.

ASAPS members, candidates and plastic surgery residents are invited to contact Dr. Klatsky ([email protected]),Dr.Nahai ([email protected]) orManaging Editor Paul Bernstein([email protected]) with information oncurrent research or ideas for manuscriptsthat could be considered for submission toASJ, particularly within the next sixmonths.

For easy online submission of manuscripts to ASJ, go to the journal website at www.aestheticsurgeryjournal.com.For assistance with online submission, contact the journal Editorial Office, [email protected].

ASJ Announces...Continued from Page 16

The Aesthetic SocietyNominating Committeeneeds your help.

Our organization has a plethoraof young, talented and visionarymembers who are changing thecourse of our practices everyday. We need your help in identifying and tapping this talent as we look to the futureand strive to maintain the excellence and vitality of ourorganization.

We invite you to submit nominations for the followingposts to be vacated in the2008–2009 term. The leadershippositions available are:

Vice President (one-year term)

Treasurer (one-year term)

Secretary (one-year term)

Members-at-Large (3-year terms)

Three positions will be availablewith 3-year terms. Members currently in these positions arealso qualified to serve anotherthree year term:

Dr. James A. Matas, Current Member at Large

Dr. Brian Kinney, Current Member at Large

Dr. Leo McCafferty, Current Member at Large

3 Trustee (3-year term)

Ethics Committee (3-year term)

Northeast:West:

Judicial Council (3-year term)

Central: Northeast: Dr. Sumner Slavin. Dr. Slavin has only served a partial term. He is eligible fornomination.

Membership Committee(3-year terms)

South Central:Southeast:New York City:

All Active Members in theAesthetic Society are encour-aged to submit nominations nolater than November 30, 2007.Please send your nominations,including position and a briefparagraph explaining your reason for choosing this member to:

[email protected]

Nominations will be tallied andpotential candidates will be contacted to ascertain theirinterest. Finalists will be askedto submit a CV, disclosures, andoutline past ASAPS Committeeinvolvement.

Thank you,

Rod Rohrich, MDChair

Send your nominations to:[email protected]

The Aesthetic SocietyCall for Nominations


This committee is looking for volunteers to monitormember websites for breaches in our advertising and promotion code of ethics.

Estimated time required is about 2-3 hours monthly. Thegoal of this subcommittee’s work is to review every member’swebsite (as is done for candidates’ websites already) at leastevery two years.

This is a vital undertaking for the Society. New scope of

practice issues, blatantly misleading advertising, and theincreasing sensationalism surrounding our work calls for members to be particularly diligent in reviewing their ownpromotional efforts and calls for our organization to help anymembers whose standards might have inadvertently slipped.

Interested members please respond to Dan Morello [email protected]

C A L L F O R V O L U N T E E R S :The Ethics Committee

Member Website Sub-Committee

The Task Force has an aggressive timeline. All research and analysis will becompleted by the end of August: Reingoldwill be giving us strategic recommendationsfor public communications and potentialmember tools at approximately the sametime. Our goal is to have strategies and tactics in place no later than November ofthis year.

As Dr. D’Amico mentions, plasticsurgeons should be perceived as the ‘go to’physicians on any matter concerning cosmetic enhancement. With that in mind,we need to decide what portions of thisvast business are most complimentary toour practices and what segments are moredesirable as continuum of care or ancillaryservices to be providing our members.

As Aesthetic Surgeons our first concernsare always patient safety and optimal outcomes. For these reasons, both Rickand I feel that the Cosmetic MedicineTaskforce has a charge that goes beyondfinancial or practice concerns to ones thatare firmly rooted in the wellbeing and satisfaction of our patients. As our Groupprogresses will we supply you with regularupdates on our findings and suggestedvision for the future.

If any ASAPS members have questionsabout this project please email either Dr.D’Amico or me at [email protected]

Update from the Cosmetic Medicine Task ForceContinued from Page 5

Documents

Aesthetic Society News - surgery.org