Aesthetic Society News...San Diego Marriott Hotel and Marina Tel: 800.486-0611 May 1, 2008 The 13th Annual Meeting of The Rhinoplasty Society Manchester Grand Hyatt San Diego, CA Contact:

Quarterly Newsletter of the American Society for Aesthetic Plastic Surgery Volume 12, Number 1 Winter 2008

INSIDE THIS ISSUE:

The Aesthetic Meeting 2008Joins Gen X

See page 14

Aesthetic Society News

Notes from Healing the Children

See page 9

During the Aesthetic Society Board ofDirectors Meeting held in Baltimore, October,2007, a resolution was unanimously passedregarding Silicone Breast Implant postapproval studies. It reads:

“Since restrictions on silicone breastimplants were lifted and the FDA approvedfull return to market with a post-market surveillance requirement; the Society and itsmembers wish to assure their patients and thepublic of the safety of these devices; and so asto reach enrollment targets as soon as possible,the Aesthetic Society urges it’s members tofully and actively participate in the SBI postapproval studies as mandated by the FDA.” Continued on Page 10

The Society’s Peer-ReviewedPublication introduces changes inJanuary—February Issue:

In an editorial published in theJanuary-February issue of the AestheticSurgery Journal (ASJ), Editor -in-ChiefStanley A. Klatsky, MD, announced severalseminal changes to the Society’s peer-reviewedpublication. Among them are:• A new cover design, reflecting the scien-

tific nature of the publication. The newcover includes a Table of Contents andthe new subtitle, “A Peer-ReviewedInternational Journal” that reflects thepublication’s position in the internationalcommunity of aesthetic surgeons. ASJ iscurrently the official English languagepublication for nine plastic and aestheticsurgery societies throughout the world.

FDA Issues PublicHealth Advisory on Chantix

See page 19

The Aesthetic SurgeryJournal Revises Look,Composition andReinforces Academic Ties of Editorial Board

Silicone Implants and Post Market Surveillance:What Members Should Know

In order to help members fulfill thisrequest, we have assembled the followingquestions and answers. What exactly is the post-market surveillance requirement?

According to the FDA website, condi-tions given to the manufacturers for approvalof Silicone Breast Implants include thefollowing:

Conduct a separate 10-year largepost-approval study that will: • Involve a large number of silicone gel-filled

breast implant patients (approximately40,000)

Continued on Page 11

Countdown: The Aesthetic Meeting 2008By Jeffrey Kenkel, MD and Jack Fisher MD

This year, the Aesthetic Meeting 2008, Sailing into the Future of Aesthetic Surgery,promises to exceed our own expectations for being the most important event in plasticsurgery education. Among the highlights:• More than 200 technical and scientific exhibits• The perennial favorite “Hot Topics/Emerging Trends in Plastic Surgery”• The opportunity to earn up to 54 CME Credits• Special pre-meeting cadaver courses, including Endoscopic Technique in Facial and

Forehead, Barbed Sutures: Theory and Use, Open and Closed Precision Rhinoplastyand Facial Rejuvenation by MACS Lift

• The Research and Technology Luncheon, your opportunity to glimpse into the future!It’s not too late to register online by going to www.surgery.org/meeting2008. Also,

please find our “week at a glance” on pages 12 and 13 of this issue!Drs. Kenkel and Fisher are Chair and Vice Chair of the Aesthetic Society’s Education

Commission.

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 2008

March 4 – 9, 2008

11th Annual Dallas CosmeticSurgery Symposium and 25thAnnual Dallas RhinoplastySymposiumRitz-Carlton Hotel, Dallas, TXContact: Jennifer Leedy Tel: [email protected] by ASAPS

April 30 – May 3, 2008

Society of Plastic Surgical Skin CareSpecialists 14th Annual MeetingSan Diego Marriott Hotel and MarinaTel: 800.486-0611www.spsscs.org

May 1, 2008

The 13th Annual Meeting ofThe Rhinoplasty SocietyManchester Grand HyattSan Diego, CAContact: Rhinoplasty SocietyTel: 904-786-1377Jointly-Sponsored by ASAPS

May 1-6, 2008

The Aesthetic Meeting, 2008San Diego Convention CenterSan Diego, CAContact: ASAPSTel: 800-364-2147www.surgery.org/meeting 2008

June 27 – 28, 2008

Cosmetic Medicine: FromBusiness Strategy to ClinicalMasteryBeverly Hills, CAContact: ASPS Tel: 800-766-4955 Co-sponsored by ASAPS/ASPS

August 13 – 16, 2008

23rd Annual Breast Surgery &Body Contouring SymposiumEldorado Hotel, Santa Fe, NMContact: ASPSTel: 800-766-4955Co-Sponsored by ASAPS/ASPS

November 13 – 17, 2008

Advances in Aesthetic PlasticSurgery: The Cutting Edge VIIThe Hilton New York, New York, NYContact: Francine LeinhardtTel: 212-702-7728Endorsed by ASAPS

ASAPSCalendar

© 2008 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 American Society forAesthetic Plastic Surgery

2 Aesthetic Society News • Winter 2008

Skin Care 2008

Catch the New Wave in Skin Car

e

FOAD NAHAI, MD

President’s REPORT

The Family of Plastic SurgeryPlastic surgery has been very good to

me. It has provided me with a career andvocation that enables me to help peoplewith issues that go to their very core; selfesteem, self image, and confidence. It has given me the opportunity to meet colleagues that have become a fraternity ofdear friends the world over. Most importantly,it has provided me with a platform to giveback and serve a vibrant and exciting medical specialty that has provided mewith so much.

Many of us started in academics andall of us are firmly grounded in the principalsof reconstructive surgery even if our prac-tices are primarily aesthetic. Reconstructivesurgeons are very much a member of thefamily, as are our colleagues in hand, micro,and burn surgery. All of the AestheticSociety members I have spoken to feel verystrongly about this family; that is one ofthe reasons we have joined our colleaguesat ASPS in the Cosmetic Surgery Alliance.This group is dedicated to pursuing manyissues of common interest, but is primarilyserving one purpose: solidifying andstrengthening our ties to the entire plasticsurgery community.

There is one particular member of thefamily I would like to celebrate in thisissue of ASN.

Many of you knew Dr. Steve Mathes,perhaps as an outstanding reconstructivesurgeon, prolific author or brilliant educator.To me, he was all of these things—and adear friend. Steve had many outstandingqualities; honor, humor, generosity andkindness. His great love of adventure andconnoisseurs palate for wine is legendary.

Punctuality, however, was another legendary quality of Steve’s—and not oneof his better ones!

He served our plastic surgery commu-nity well. He was a bridge builder who wasable to bring together “town and gown” in San Francisco to the benefit of all, hisresidents and the local community.

Thank you for allowing me thisopportunity to thank Steve and his wife,Dr. Mary McGrath for years of deepfriendship and to celebrate the great con-tributions this man made to our specialty.

Aesthetic Surgery: The newCommodity?

No one has to tell any ASAPS member that the increased attention toour specialty has resulted in unscrupuloustactics that run the risk of turning ourmedical specialty, our personal service toour patients, into a commodity. Big corpo-rations have commercialized our services.Contests, give-aways, and free breast implantsare just a few of the ridiculous gimmicksthat are taking our medical education,commitment to patient safety and dedica-tion to the best possible outcomes andattempting to trivialize them, ultimatelyresulting in besmirching our family name.We cannot sit back and allow this to continue. I plan to assemble a Task Forceto examine this disturbing trend and askthem to provide recommendations to theAesthetic Society Board of Directors.

Aesthetic Surgery andAcademia

Many of us in Aesthetic Surgery work in solo or group practices, no longer in daily contact with our colleagues in academia. However, we all have strong anddeep roots in the academic communityand are well aware that the residency andtraining programs our colleagues run arethe foundation of the specialty. We welcome the participation of the academic

community in the Aesthetic Society andhope that our Annual Meeting will bebeneficial to them.

Probably no where is the involvementof academic medicine more important tous as an organization than on the pages ofour peer reviewed publication AestheticSurgery Journal. Today, ASJ has 30 of its 38 Editors, International Editors,Senior Scientific Editors, Clinical Editors,Technical, Statistical and InterspecialtyConsulting Editors holding active academicappointments. We thank them for theircommitment to learning and education.

The Aesthetic Meeting 2008 I look forward to seeing as many of

you as possible at the Aesthetic Meeting2008 in San Diego, May 1–6, 2008. Thisis not only the premier educational eventfor our specialty; it is also a chance to connect with colleagues the world over aswe learn, discuss and debate the latest intechnique and science. Please join us!

This year, for the first time, TheAesthetic Meeting joins the Gen X’ers!Education Chair Jeff Kenkel, MD, isintroducing iPod downloads of ScientificSessions, providing you with a vehicle to revisit the Meeting. Jeff discusses theinitiative on page 16 of this issue.

This is a great time to be a plasticsurgeon. Thank you for your contributionsto the specialty and I hope you enjoy thisissue of ASN.

Aesthetic Society News • Winter 2008 3


The burgeoning aesthetic medicalmarket offers unprecedented opportunityto today’s cosmetic patient. The downsideof having a plethora of options is the confusion such an array of services andproducts presents to consumers. PlasticSurgeons whose specialty includes cosmeticmedicine are in a uniquely advantageousposition from the standpoint of practicebranding.

Managing your brand is to deliberatelychoose a position you are uniquely qualifiedto provide and then consistently promotingand publicizing this unique attribute. Toactively manage perceptions about yourpractice is brand management at its finest.Many surgeons and their practices neglectto communicate amazing things aboutthemselves which are interesting andengender loyalty from patients: compellingbooks that have been written by the physi-cian, devices and products that have beendeveloped to address specific issues, andhumanitarian work which improves thelives of those less fortunate. Unfortunately,these accomplishments are rarely commu-nicated effectively despite the real valuethey could have in solidifying the practicebrand. Branding can seem daunting in the medical community, because mostphysicians are humble and self-effacing.The idea of “tooting their own horn” isrepugnant to many, and self promotion isoften considered bad form. However, in thisincreasingly crowded field, plastic surgeonsneed to be positioned and promoted differently than nontraditional cosmeticpractices and spas in order to continuallyremind the public of who you are and whatmakes you special. As a strategic defenseagainst competition, the practice of managing patients’ perceptions becomes apowerful tool when employed effectively.

Savvy ConsumersToday’s patient is typically a savvy

consumer adept at filtering out extraneousmarketing messages in order to make wisedecisions. The goal of a successful brandingstrategy is to focus on the needs and wantsof patients and then to communicate theability to meet those needs in a meaningfulway. To define your branding advantage, it is critical to begin with a firm under-standing of the unique attributes that distinguish your practice and services from others in your community. Start witha practice assessment that analyzes the following:• Staff• Doctors• Equipment• Schedule(s)• Location

When analyzing practice attributes, itis essential to stand in your patient’s shoes.As a “patient/consumer,” ask yourself thefollowing questions.• Do your staff and your facilities reflect

the image you want to project? • As a patient am I able to effectively

communicate my needs and do I feelunderstood?

The outcome of this exercise shouldbe a meaningful list of strengths andunique attributes which together form thebasis for the practice culture. Memorializingthe results of this analysis into a simple list,a mission statement, or practice philosophycan serve as a guide in developing “branding”messages for communication both withinand outside the practice. In addition, thislist can provide direction in the develop-ment and incorporation of the practicemessage or “tag line” into collateral materials.The list can serve as discussion points forphone contact with interested prospectsand in the development of the focus point

in conversations during the consultation.Because overhead costs frequently are

higher in plastic surgery practices—withmarketing budgets as much as 3% to 5%of gross revenue—questions about how to drive top-line revenue and still be profitable are very much on the minds of practice managers and physicians.Traditional marketing may soon becomeobsolete as savvy practices dare to challengetraditional thinking with more time andresources committed to branding theirpractices. Patient retention in the futurewill require a sharper focus. With this goalin mind, building a strong patient/practicerelationship is critical.

Branding BenefitsThere are a number of benefits to

branding your practice, including:• Patient retention and referrals;• Marketing dollar mileage;• Increased pricing power and profit

margins;• Ability to leverage brand across products

and procedures; and• The ease of new product introduction.

Ours is a baby boomer-driven market(ages 43 to 61) with 78.2 million people,50.8% of whom are women. According tothe 2006 US Census Report, a staggering7,918 people turned 60 each day in 2006or 330 every hour. In addition, “echoboomers” (pre-teen through 25 years of age) make up one-third of the US population and are strong supporters ofthe aesthetic medical market. The youngmedical aesthetic industry is going to serveits patient base for a very long time. Peoplewant to feel good about themselves bothinside and out, and finding the “right”provider and practice is very important tothis group. Effectively branding your

Branding: Who You Are and What Makes You Special

Continued on Page 5

GLENN MORLEY

Glenn Morley


practice provides a much-needed shortcutto understanding who you are and howyou may be important for the patient.Much time and energy is devoted to grow-ing a brand in corporate America. Strongbrand loyalty is developed by providingconsistent, sustainable quality and thencommunicating that fact to your cus-tomers. For instance, if I buy a Starbucks latte in Boston, it will taste just like theStarbucks I may order the next day in New York (or Los Angeles or Hong Kong).Customers use this understanding of consistent quality as a short-cut, and astrong brand is thus rewarded by strong-brand loyalty. For a loyal customer, itbecomes an unacceptable risk to stray from“their brand.” Developing your practicebrand requires that you provide consistent,sustainable quality.

Building BrandRelationships

A brand relationship is the mélange ofall thoughts, feelings, associations, andexpectations that a patient may have about

your practice. These perceptions are basedon what your customers or prospects experience when exposed to your practicename, individual providers, procedures,products, your website, staff, and practicecommunications. In fact, when you consider that everything you and your staffdo and say is making an impression, youmust acknowledge that every practicedetail is important and influences yourbrand identity.

One of the first challenges when considering who you are and how youwant to be perceived is to ask yourself how you would articulate your practice’sinternal character or unique identity. Whatdifferentiates you and makes your loyalpatients return over and over again? It maybe the way you partner with patients inaddressing their skincare needs; it may bein the expertise that you bring to the community after years in the academic setting; or you may be a part of a father-daughter practice bringing generations of expertise and a heritage of caring for

your community. When you are able toarticulate your practice’s unique identity,your next job will be to analyze how wellyou communicate this identity to yourstaff, patients, and the broader communityas a point of practice differentiation.

You are in a position to actively manage how you are perceived by staff,patients, your peers, and the broader community. A strong brand relationshiprequires that a customer know the brandintimately. Starting internally, it is prudentto analyze how the practice is perceived. A staff survey is a relatively inexpensiveand efficient tool to understand how yourpractice is perceived by one of your mostimportant “stakeholders”—your internalaudience. No matter what the results ofyour survey tell you, it is vital that youenlist support from staff in building a distinctive, well-perceived identity. Let’s examine what constitutes a strong brand and why brands are important to consumers.

Common characteristics ofstrong brands:• High customer involvement. How

good is your practice at retainingpatients? Do your patients book forrepeat procedures as recommended?How many of your Botox® patients arealso filler patients? Laser patients? Peelpatients? Chances are you have at least afew patients that are in your office formultiple services. Developing this relationship is critical for a practice.Each encounter does not need to bewildly profitable for value to exist. There is enormous value in becoming a destination versus a pit stop. Yourpatients will reward you for developingthis relationship with increased referralsand increased loyalty.

BrandingContinued from Page 4

Continued on Page 6

ProcedureOutcomes

CustomerService

BrandPersonality

Product performance

EmotionalBenefits

Social Influences

AllCommunications

The Brand

The Consumer


• Real, continuous product/service/procedure quality. If Starbucks latteswere not reliably the same in all cities, Iwould soon begin to look elsewhere foran easy coffee fix. Likewise, patients need to know that the skincare productsyou recommend are based on theirunique needs and will help them. Patients need to be able to depend on consistent aesthetic treatments thatmake them look and feel as good on theoutside as the inside.

• Market involvement and sustainedpresence. Many physicians are highlyinvolved in their respective medical societies; in research; in drug and devicestudies and development; and in non-profit and humanitarian organizations.Patients are very interested in knowingall of these things. They are interested informing a relationship with you, and allof this information is of value in therelationship-building process.

Why brands are importantto consumers:• As a shortcut. Consumers have to make

thousands of decisions every day, andstrong brands make these decisions easier. Satisfied patients are the strongestsource of new patient referrals. If you do a good job branding yourself in the patient’s mind, you are providingthem with a short-cut in making astrong recommendation to a friend,family member, or colleague. Becominga patient’s “shortcut” occurs as theirunderstanding and knowledge of you deepens and the patient/practicerelationship grows strong.

• As a badge. Brands have social value.Consumers say a lot about themselves—and learn a lot about others—from the brands they choose. For women, carrying a Coach bag is perceived a certain way. An equally strong yet different perception may occur if thatsame woman carries a Prada bag. Formen, it may be the car they drive, i.e.,Range Rover versus Porsche, Ford versusHonda. Similar perceptions exist in the

patient community regarding aestheticmedicine. You are in a position to manage these perceptions (or not).

• As a safety valve. Patients want toreside with a practice they can dependupon to partner with them in a wholeand healthy way. When new antioxi-dants emerge, consumers turn to theexperts for solid advice regarding sciencebased evidence versus marketing hype.Likewise, when a patient notices a newfacial line, wrinkle, or undesirable fold,we want their questions to come to us.

Powerful StoryA successful plastic surgery practice is

an exciting business to “brand,” becauseexceptional practices with accomplishedphysicians have a very powerful story totell. In the ever-expanding world of aestheticmedicine, you must take a stand in practice

identity and understand what this meansrelative to patient care. Taking the time toanalyze how well you currently manageperceptions about your practice is the firstcritical step in communicating yourunique qualities. Proactively using yourself-assessments to target and implementpositive change will pay dividends forever.

Glenn Morley is a management consult-ant with the Allergan Practice ConsultingGroup of Allergan, Inc., a specialty pharma-ceutical company based in Irvine, California.

BrandingContinued from Page 5

Branding “Perception” Survey

In our ongoing attempt to provide the highest quality care

and the best personal practice experience, we are asking select persons

such as you to participate in this important survey. You have been

selected to take part in this survey because we value your thoughts

and impressions. We are extremely grateful for your time and

consideration.

1. How is the practice perceived in this area?

2. If the practice were gone tomorrow, what quality(s) would you

attempt to find in another office?

3. Do you feel we have a “passion” for any particular service,

procedure, or product?

4. What three words best capture who or what we are to our patients?

5. How would you describe out practice to your best friend or a

sibling?

6. What could we do better?

7. What would you like us to “look” like in the next five to ten years?

8. How would you describe our practice to an acquaintance?

9. How do you feel after you have been to our practice?

10. What thoughts do you have about your time with us?

Please forward the completed survey in the attached addressed

and stamped envelope. Out of respect for your privacy and in hope

of eliciting complete candor, we have retained an independent

consulting group to compile the results of this small, select survey.

Thank you for taking the time to complete this survey.


Paid Media Opportunities: Are they right for your practice?

JULIUS FEW, MD

FOCUS ONPractice Marketing:

In today’s increasingly competitivemarket, many of us find that a solid marketing program of media relations, webpresence, philanthropic and communityinvolvement and, in some cases, advertis-ing, are essential elements to position ourpractices and our qualifications as Board-Certified Plastic Surgeons.

Several members have contacted ourCommunications Office for advice andinformation on so-called “pay for play”media opportunities; paid editorial place-ments on television, radio or print that arenot the usual public relations opportunitiesbut rather are “advertorials” or sponsoredprograms for which participants pay a fee.

Industry Pundits Weigh In:To find out more about these pro-

grams, we contacted several leading expertsin the field. Wendy Lewis is a veteran plas-tic surgery consultant and author with apractice based in New York and London;Karen Zupko is an accomplished practiceconsultant and has written extensively—both are frequent speakers at the AestheticSociety Annual Meeting. RussellLaMontagne owns a New York and LosAngeles-based Healthcare CommunicationsAgency, Corinth Group Communications,with a roster of pharmaceutical, not-for-profit and healthcare services clients. Here’swhat they had to say:

“Doctors are acommon strategic target for paid mediaoutlets to prey on” saidLewis. “Many of thesegroups (media outlets)can be questionableand before signing upand writing a check, I

would advise careful research, including

references checks and evidence of a proventrack record in your market.

You also want to find out who theprincipals are, and what other doctors areinvolved in the venture. Typically, the doctors who go for these deals have highvolume, heavily marketed practices, andare usually non-core cosmetic specialistsrather than board certified plastic surgeons.

The demographics and circulation figures may also be highly inflated, whichmakes it tricky to calculate the true returnon your investment, and fees can be staggering.

I am aware of doctors being asked for$25,000 and more for video recordings tobe broadcast on cable networks.”

Before considering paying for mediaexposure, which is no more than a subtletwist on advertising, each surgeon or practiceshould compile a marketing budget on anannual basis. Once you have set a budget,determine which outlets are going to giveyou the best return on investment, andplan accordingly. Budgets should bereviewed periodically to make sure you areon track.”

Karen Zupko hasbeen offering practiceadvice to physicians formore than 20 years.She advises membersnot to get caught up inemotional decisionsregarding practice marketing: “Scary

headlines about scary things like recession,slow-down and consumers with “walletfatigue” make some otherwise smart surgeons engage in some scary so-calledmarketing techniques. These techniquescan tarnish a brand and call into questionyour whole practice persona” she said.

“So called advertorials running at 3 am in between the infomercials for ginzu knives and teas that cure everythingfrom warts to baldness are one fine exam-ple. Sales staffs hit on plastic surgeons and sometimes leave out the importantdetails—like placement.

The same surgeon, who would neverrun an ad next to the obits or in the sportssection, may forget to ask the details aboutTV. Picking a print style is less complicatedand you can OK it. Being filmed withoutthe right makeup (yes, even for men) lightsand by a rookie camera man does not lend itself to a professional end productthat represents your practice in the mostappealing way.”

An Agency Perspective:“Placement and

credibility are themajor issues I havewith paid editorialopportunities” saidCorinth GroupFounder RussellLaMontagne. “Theshows (paid mediaopportunities on

broadcast outlets) generally air in time slots that are less than ideal. A show airingat 3:05 am is likely to miss its target audience.

Additionally, the paid segments do not possess either the benefit of a third-party endorsement on the editorialside or a specific well-targeted audience onthe advertising side. The public tend to correctly perceive them as advertorials.Ultimately the messages in these programsare diluted due to lack of trust by the


Wendy Lewis

Karen Zupko

Russell LaMontagne


Aesthetic SocietyMember Peter J. Rubin,MD, University of PittsburghMedical Center, is recipientof the 2007 PresidentialEarly Career Award forScience and Engineering

(PECASE). The PECASE is given to recognize and support researchers whoseearly work shows exceptional promise forleadership at the frontiers of scientificknowledge during the twenty-first century.Awardees are nominated by one of eightfederal departments, who provide theresearchers with up to five years of fundingto further their research. Dr. Rubin wasnominated by the National Institutes ofHealth, which has supported his researchgrant, “Injectable Engineered Tissue forCancer Reconstruction.”

Life Member andPast President ThomasRees, MD received aLifetime HumanitarianAward from the AfricanMedical, Research andEducation Foundation

(AMREF). According to the AMREF website: “Fifty years ago, under the trees ofMt. Kilimanjaro, three visionary surgeons—including the renowned American surgeon,Dr. Thomas D. Rees—had the idea to bringurgently needed clinical and surgical careto the most remote regions in East Africa.They called their organization the FlyingDoctors of East Africa—which is knowntoday as the African Medical & ResearchFoundation. Since then, AMREF has continued to create simple and cost effectivehealth solutions that transform the lives offamilies and communities across East Africa.”

ASAPS Vice PresidentRenato Saltz, MD, recentlyheld a funding raisingevent for the Image RebornFoundation, an organiza-tion for breast cancersurvivors founded by

Dr. Saltz. The event, held in Park City, UT,raised significant funds for the foundation,with the goal of finding a permanent homefor the group. Image Reborn provides apro bono retreat for women to revitalizeand renew after the ordeal of breast cancer.

Member News

Pushing the 2008Plastic EnvelopeBy Bob Aicher

It’s customary every December 31st to set goals for the coming year, usually toaccomplish something historically elusive yet desirable, such as more exercise and lessstress. I would like to suggest for 2008, rather than personal goals, a list of NewYear’s Resolutions for your practice to help keep you legally fit and stress free.

RESOLUTION NO. 1: I will double check my photographic consents. Why?Because when your patient calls you upset, only a written consent covering your specific use of her photographs will suffice. Keep in mind, invasion of privacy requiresthat the patient be recognizable, but unique jewelry, birthmarks and tattoos are neonsignposts to your patient’s identity. Also, in those states where privacy laws have beenmodified to mimic HIPAA, and in those cases where you are e-mailing forms toobtain insurance reimbursement, HIPAA’s privacy rules trump state rules, and privacyis violated whether or not the patient is recognizable, unless you have a written consent which follows the HIPAA form. For 2008: oral consent is no consent.

RESOLUTION NO. 2: I will not talk on my cell and drive. International Paper,$5.2 million; Dykes Industries, $20.9 million; State of Hawaii, $2.5 million, all paidin settlements or verdicts when their employees caused accidents while talking on theircell phones. The worst: a lawyer with Cooley Godward was convicted of felony hitand run for killing a 15-year old girl, resulting in a loss of her license to practice law,1 year in jail, $2 million in restitution, plus a $30 million lawsuit against her employer,who settled for an undisclosed amount. Five states and the District of Columbia banhand-held cell phone use while driving. For 2008: listen to CME instead.

RESOLUTION NO. 3: I will only take necessary photographs of my patients.One would think photographs for any reasons other than to augment the medicalrecord and deflect potential litigation would not require a reminder, but Dr. AdamHansen recently left his position as a Mayo Clinic chief resident surgeon when, priorto performing gall bladder surgery and after catheterization, he used his cell phone tophotograph his patient’s penis tattooed with the words, “Hot Rod.” Dr. Hansen willnot be prosecuted for the HIPAA violation, but faces a myriad of disciplinary scenarios.For 2008: another reason to turn your cell phone off.

RESOLUTION NO. 4: I will report unethical behavior appropriately. There’smore: two days later the Mayo Clinic was seeking to uncover which member of thesurgical staff reported the incident to the Arizona Republic, complete with thepatient’s name, because that person arguably exhibited even poorer judgment thanDr. Hansen by revealing the patient’s name and tattoo beyond the surgical suite tothe entire world. For 2008: remove “contact media” from your risk managementpractices and procedures.

RESOLUTION NO. 5: I will not blog myself into malpractice. Unknown to hisdefense counsel, pediatrician Robert Lindeman, MD was venting his disdain for thelegal system during his malpractice trial by blogging his lawyer’s advice under thepseudonym, “drfleablog.” When tipped off by another lawyer, plaintiff ’s counsel confronted Dr. Lindeman on the witness stand with breaching his attorney-clientprivilege and revealing his defense strategy on the internet; Dr. Lindeman settled outof court the next day, and his defense counsel had “no comment.” For 2008: respectyour patient’s privacy, your lawyer’s privacy, and your privacy.

Notes from Healing the ChildrenBy Karl Wustrack, MD

Healing the Children is a national,non-profit volunteer organization dedicatedto providing medical care to needy childrenin our own community and around theworld. Foreign children are treated by volunteer medical teams in their homelandand other children are flown to the UnitedStates for donated specialized care.

So far, our medical teams have traveledto countries such as Uzbekistan, Guatemala,Pakistan, Vietnam and El Salvador. Thechildren who are brought to the US comefrom all over the world as well, withouttheir parents. They fly with a volunteerescort, usually from the airlines. Whilehere, the children stay with local host families. Our chapter also has a partner-ship with local homeless shelters where weprovide health and wellness education forfamilies and some donated supplies.

For the past four years we have beengoing to the same hospital in My Tho, aMekong River delta town about two hoursfrom Saigon.

The hospital is Tien Giang GeneralHospital, the regional hospital for TienGiang Province, fairly modern with about500 beds.

The first year we did a mix of cases—hand, clefts, burns, etc. but the last twotrips have been almost all cleft lips and

palates. The team is usually two surgeons,three anesthesiologists and ten or so nurses,translators, etc.

A few years go we had an interestingcase in a 30 year old Cambodian who hada scalp lesion about 15 cm in diameter,foul smelling, draining; it looked like aneglected skin cancer.

We excised and closed the scalp withflaps and the pathology was chronic foreignbody reaction. He had fallen out of a treeabout 5 years before and had a piece ofwood in his scalp. The best part was—hehad tattoos all over his back and I askedthe translator what the story was, and hereluctantly said he was a Khymer Rougesoldier! Great!

The people are great, the kids try to practice English when we jog by themon our morning runs, and the food is outstanding. This last trip I took the fellowfrom the plastic program at OHSU and hehad a great experience.

About the Organization:The National office is located in

Spokane, WA where Healing the Childrenwas founded 25 years ago. There are 13chapters nationwide.

The Oregon and Western WashingtonChapter of Healing the Children operateson a very low annual budget. For every$1.00 donated to our organization, we areable to provide more than $300.00 worthof donated medical care. This includes surgery, hospitalization, and medical supplies. For children outside the U.S. wealso provide donated airline tickets andhost family care. Medical team memberspay their own travel and lodging. Locally,we assist medically needy families whomight need equipment or medication notcovered by insurance.

Karl Wustrack, MD is an AestheticSociety member with a private practice inTualatin, OR



Silicone ImplantsContinued from Cover

• Involve a control group of saline-filledbreast implant patients

• Provide information about certain endpoints: • local complications; • rates of connective tissue disease and

its signs and symptoms;• rates of neurological disease and its

signs and symptoms; • potential effects on offspring of

women with breast implants;• potential effects on reproduction and

lactation; rates of cancer; • rates of suicide; • potential interference of breast

implants with mammography; • and patient compliance with MRI

recommendation and rupture rates• Survey patients annually using web,

mail, or telephone questionnaires• Have physician evaluations at years 1,

4-6, and 9-10 for Mentor and years 1,4, and 10 for Allergan (formerlyInamed) to collect local complicationdata.

• Continue its laboratory studies to continue to further characterize themodes and causes of failure of explanted(removed) devices over a 10-year period.

As a private practitioner, I don’t have the resources of an academicmedical center available to me. Arethere resources available from themanufacturers for assistance withthese studies?

Yes. The following information wassupplied to ASN by Allergan and Mentor.

From Allergan:www.BIFS.us is the home site for our

Breast Implant Follow-up Studies (BIFS)program. Here our customers can reviewthe mission of BIFS and review the proto-cols and informed consent documents.

We are happy to help each of ourdoctors complete the investigator applica-tion process and we have a dedicated BIFSclinical team at Allergan that is expert inthe IRB approval process. They can bereached at 800.862.4426 ext 4658.

Once our doctors have IRB approval,we’ll set up special in-service appointmentsat their convenience to review the programwith the office staff and offer suggestionson how to incorporate BIFS into the prac-tice flow. To further support the process wehave clinical field specialists who are com-mitted to working with the office, helpingthem develop customized solutions to

ensure the office is able to enroll all theireligible patients.

We have developed these resources toensure the doctor has as much support ashe or she needs and wants. We knowstudy conduct can be intimidating butthrough close collaboration with societyleadership we are confident we’ll meet ourgoals and thus ensure continued availabilityof silicone for generations to come.

From Mentor:Mentor is uniquely positioned by

having considerable experience with studiesof this size and scope.Adjunct Study facts:Over 14 years in durationApproximately 3,500 investigatorsApproximately 160,000 patients enrolled

Mentor is committed to making participation in the PAS as smooth and asleast burdensome as possible. Mentor has:• Created a protocol that is manageable

for physicians and patients whichincludes only two cohorts:Augmentation and Reconstruction

• Reduced the workload for physicians toinclude a one page operative form andone page follow-up form to complete

• Assembled a “user friendly” enrollmentkit that contains an instruction DVD,procedures manual, subject enrollmentflow-chart, subject tracking log and incision rulers

• Created a streamlined patient packetthat contains all the study forms neededfor each subject with business replyenvelopes to return the forms

• Created duplicate patient forms so thephysician’s office does not need to makephotocopies and offer online form com-pletion for subjects to use.

The essential design of the PAS is thatof a longitudinal study for which there is asmall (1,000) concurrent control group.Where appropriate, national norms for thediseases and conditions to be studied areused as the control group. The study eval-uates patient health over 10 years throughannual patient questionnaires and threephysician visits. An experienced clinicalteam is available to assist with enrollment,



IRB applications, consent modifications,contracts, questions and all other PASitems.

The PAS is progressing well with over3,200 physicians participating and over23,000 patients enrolled so far. Mentor iscommitted to meet the FDA post approvalconditions for this study.

I see that one of the FDA require-ments is “to further characterize themodes and causes of failure ofexplanted (removed) devices over a10-year period.” Is a pathologyreport from my hospital necessary tomeet this requirement?

No, according to Lenore Carleton ofAllergan. She says: “There is no FDArequirement regarding pathology reportsfor any explanted device. However, ourinternal procedures require us to attemptto collect any and all information thatmight assist in an investigation of anadverse event. So if a hospital routinelycultures explants or does any kind of gross pathology, we try to obtain a copy tofacilitate our investigation. Frequently ourinternal procedures have requirements that are designed to help us comply with

expectations that we know FDA has, butthat they don’t document in the form of amandatory requirement.”

I know that explantation is financial-ly the responsibility of the patient.However, my hospital requires apathology report for identification ofevery explanted device. Who isresponsible for incurring this cost?

Several members have contacted theAesthetic Society with this question. Itappears to be a local issue, dependent onthe risk management protocols of yourlocal hospital. The ASPS and ASAPS areconsidering the development of a WhitePaper on radiologic examination ofremoved implants to help members dealwith this issue.

Why should I participate in theadjunct studies?

When women finally were given theright to silicone implants after a 14 yearhiatus, adjunct studies were a condition of approval. Your participation will helpensure that the patient safety is documentedand evidence based medicine will again triumph over anecdotes.

• An elimination of the distinction betweenthe Practice Forum and Scientific Forum.As article submissions increase, theJournal is strengthening its requirementthat all papers uphold the highest standards of research and evidence-basedmedicine

• The elimination of the poly bag andlabel carrier. This mechanical adjust-ment solves two concerns; making ASJmore environmentally responsible andproviding your label directly on thecover with your member number, providing easier access to the ASJ onlineversion

• A listing of all academic or other significant affiliations for ASJ EditorialBoard members and the expansion ofthe Board to include more internationalthought and opinion leaders and outstanding contributors from outsidethe Specialty.

“These changes reflect where ASJ isgoing while still honoring our traditions,”said Editor-in-Chief Stanley A. Klatsky,MD, Associate Professor of Plastic Surgeryat the John Hopkins University ofMedicine. “We have always strived to be a useful and important educational tool for the practicing aesthetic surgeon,” hecontinued. “Our editorial changes reflectthe growing scientific reputation of theSpecialty and our dedication to bringingyou the best content available.”

The ASJ Revises Look Continued from Cover

Silicone ImplantsContinued from Page 10

Visit the ASAPS web site for on-line physician registration, hotel reservations and course updates www.surgery.org/meeting2008

The Aesthetic Meeting 2008 • Week-at-a-GlanceThursday, May 1, 2008 Saturday, May 3, 2008

6:30am – 4pm Registration Open—San Diego Convention Center Hall F

ASAPS Board of Directors MeetingManchester Grand Hyatt

ASERF Board of Directors MeetingManchester Grand Hyatt

Special Pre-Meeting Cadaver Workshops7:30am – 1pm S1 Endoscopic Technique in Facial and Forehead—A Cadaver Workshop

Instructors: Renato Saltz, MD, Grady B. Core, MD, Felmont F. Eaves, III, MD,Kiya Movassaghi, MD, & Richard A. Warren, MD

7:30am – S2 Barbed Sutures: Theory and Use 11:30am Instructors: Gregory L. Ruff, MD & Malcolm D. Paul, MD2pm – 6pm S3 Open and Closed Precision Rhinoplasty—The Complete Basic Steps of

Rhinoplasty: A Cadaver Workshop Instructors: Joe M. Gryskiewicz, MD, Paul H. Izenberg, MD, Robert M. Oneal, MD, & Daniel Sherick, MD

S4 Facial Rejuvenation by MACS Lift—A Cadaver Workshop Instructors: Mark L. Jewell, MD, Patrick L. Tonnard, MD, & Alexis M. Verpaele, MD

6:30am – Registration Open—San Diego Convention Center Hall F6pm

Special Seminars7:30am – S5 Cosmetic Medicine—The Importance of Non-Surgical Options in Your5:30pm Practice—Featuring “Live” Patient Demonstrations

Co-Chairs: Jeffrey M. Kenkel, MD, Clifford P. Clark, III, MD, & Steven Fagien, MDEducational grants provided by Allergan, Artes Medical, BioForm Medical, Canfield Imaging Systems, Dermik Aesthetics, Medicis Aesthetics, Mentor Corporation, Obagi Medical Products, Palomar Medical, and Sciton, Inc.

7:30am – 5pm S6 Conjoint Symposium: Technique and Artistry in Rhinoplasty—A Joint Presentation of the Rhinoplasty Society and The American Society for Aesthetic Plastic Surgery, Inc.Co-Chairs: Jack A. Friedland, MD & Mark B. Constantian, MD

8am – 5pm S7 Advanced Cardiac Life Support (ACLS) Provider CourseInstructor: Charles Bortle, M. Ed.

8am – 2pm R Residents & Fellows Forum Co-Chairs: Julius W. Few, MD & Clyde H. Ishii, MDSupported by Allergan

8am – 12noon S8 Anatomical Drawing & Sculpture of the Face Instructors: Grant A. Fairbanks, MD & Grant R. Fairbanks, MD

S9A AAAASF Inspector Training Workshop Instructors: James A. Yates, MD, Alan H. Gold, MD, Gary M. Brownstein, MD, David D. Watts, MD, Harlan Pollock, MD, Geoffrey R. Keyes, MD, Jeff Pearcy, Theresa Griffin-Rossi, Pamela Baker, John D. Newkirk, II, MD, & Gerald H. Pitman, MD

S10 Gel Breast Implants: Use, Efficacy and Safety Chair: Richard A. D’Amico, MDEducational grant provided by Allergan

S11 Strategies for Re-Designing Your Practice Co-Chairs: Mark L. Jewell, MD & Robert Singer, MD

12:30pm – S12 Hot Topics/Emerging Technology in Plastic Surgery4:30pm Co-Chairs: William P. Adams, III, MD, Joe M. Gryskiewicz, MD, & V. Leroy Young, MD

1pm – 5pm S9B AAAASF Medicare Inspector Training Workshop Instructor: Michael F. McGuire, MD

1pm – 6:30pm S13 Cosmetic Rehabilitation of the Post-Bariatric Patient Co-Chairs: Al Aly, MD & Mark L. Jewell, MD

2pm – 6:30pm S14 Basic PowerPoint® and Basic Patient Imaging Instructors: Samuel J. Beran, MD & Joshua Greenwald, MD

2pm – 6:30pm OPTIONAL COURSES6:30pm – Residents & Fellows Forum Reception7:30pm

6am – 5:30pm Registration Open—San Diego Convention Center Hall F

Scientific Session7am Aesthetic Society Welcome

Foad Nahai, MDASERF WelcomeAlan H. Gold, MDCanadian WelcomeBrian Peterson, MDASPSN Welcome

Program Chairs’ WelcomeJeffrey M. Kenkel, MD & Jack Fisher, MD

7:15am Panel—Are Aggressive Facial Procedures Worth the Risk and Recovery?Moderator: James M. Stuzin, MDPanelists: Patrick L. Tonnard, MD, J. William Little, MD, Fritz E. Barton, Jr., MD & Sherrell J. Aston, MD

8:30am Special Presentation: A Retrospective of My Career in Aesthetic Surgery Bruce F. Connell, MD

9am Panel—Cosmetic Medicine—Embracing the FutureModerator: Robert Singer, MDPanelists: Renato Saltz, MD, Richard A. D'Amico, MD, Roxanne J. Guy, MD, &Rod J. Rohrich, MD

10am Coffee Break in the Exhibits

10:30am Papers

11am Special Presentation: Lower Lid BlepharoplastyModerator: Foad Nahai, MDPresenters: Clinton D. McCord MD & Steven Fagien, MD

11:45am Special Presentation: The Evolution of the Modern Facelift Daniel C. Baker, MD

12Noon Interactive Video—Aesthetic Refinement in Upper Lid BlepharoplastyPresenter: Glenn Jelks, MDModerator/Discussant: Mark A. Codner, MD

12:30pm – 2pm Lunch in the Exhibits

12:30pm – 2pm S17 Research & Innovative Technology Luncheon (Page 17)Co-Chairs: William P. Adams, Jr, MD & Joe M. Gryskiewicz, MD

12:30pm – S18 Women Plastic Surgeons’ Luncheon (Page 17)1:45pm Co-Chairs: Roxanne J. Guy, MD & Carolyn L. Kerrigan, MD

Supported by Mentor Corporation

12:45pm – OPTIONAL COURSES1:45pm2pm Panel—Aesthetic Breast Enhancement with Fat

Moderator: Jack Fisher, MDPanelists: Sydney R. Coleman, MD, Scott L. Spear, MD, Grant W. Carlson, MD, & Roger K. Khouri, MD

3:15pm Panel—Innovations in LipoabdominoplastyModerator: Jeffrey M. Kenkel, MDPanelists: Jean Francois Pascal, MD, Claudio Cardoso de Castro, MD, & Renato Saltz, MD

4:15pm Coffee Break in the Exhibits

4:45pm Papers

5:15pm Corporate Sponsorship AwardsLawrence S. Reed, MD, Alan H. Gold, MD & Foad Nahai, MD

5:30pm Panel—The Forehead—A Continuum of CareModerator: Sherrell J. Aston, MDPanelists: Steven Fagien, MD, Richard J. Warren, MD, R. Bruce Shack, MD, &James M. Stuzin, MD

6:30pm Adjourn

7pm – 8pm New Member Meet and Greet ReceptionManchester Grand Hyatt – Mohsen AB

7:30pm Welcome ReceptionManchester Grand Hyatt – Elizabeth Ballroom

9am – 4:30pm Special Seminar for Patient Coordinators OnlyS15/S16 Skills for the Successful Patient CoordinatorInstructors: Karen Zupko & Isabel Stoltzman

Friday, May 2, 2008

Visit the ASAPS web site for on-line physician registration, hotel reservations and course updates www.surgery.org/meeting2008

6:30am – 5pm Registration Open—San Diego Convention Center Hall F

Scientific Session A 7:30am Panel—Strategies in Ptosis Management

Moderator: Mary H. McGrath, MD Panelists: Laurie A. Casas, MD, Jack Fisher, MD, Dennis C. Hammond, MD, & Barbara B. Hayden, MD

9am Interactive Video—Cohesive Gel Implants: Patient Selection and Technical DetailsPresenter: Per Heden, MDModerator: Bruce L. Cunningham, MDDiscussant: Michael Scheflan, MD


10:30am Papers

11am Special Presentation: MOCert: What it Means to Our SpecialtyR. Barrett Noone, MD

11:15am Panel—Animation Deformities Following Breast Augmentation: Should We Be Concerned?Moderator: Gustavo A. Colon, MDPanelists: Loren Eskenazi, MD, G. Patrick Maxwell, MD, & Scott L. Spear, MD

12Noon Lunch in the Exhibits—or ASAPS/ASERF Business Luncheon

Scientific Session B7:30am Panel—Fractional Resurfacing—A Critical Assessment

Moderator: Barry E. DiBernardo, MDPanelists: Jason Pozner, MD, E. Victor Ross, MD, & Jeffrey M. Kenkel, MD

8:30am Papers

9am Panel—Hyaluronic Acid—Does Size Matter?Moderator: Alan H. Gold, MDPanelists: Mark G. Rubin, MD, Z. Paul Lorenc, MD, & Clifford P. Clark, III, MD


10:30am Papers

11am Panel—Effective Management of the Nasal Labial FoldModerator: Jack A. Friedland, MD Panelists: Miles H. Graivier, MD, Bruce F. Connell, MD, H. Steve Byrd, MD, & Victoria A. Vitale-Lewis, MD

12Noon Lunch in the Exhibits—or ASAPS/ASERF Business Luncheon

2pm - 6:30pm OPTIONAL COURSES6:30pm – Women’s Martini Hour—Manchester Grand Hyatt—Mohsen AB7:30pm Supported by Mentor Corporation

9am – 11am Special Seminar for Patient Coordinators OnlyS19 Advanced Discussions for Patient Coordinator Course Alums Instructors: Karen Zupko & Isabel Stoltzman

1pm – 7pm S22 Nurse Injector Competence Training—Course 1Instructors: Jeffrey M. Kenkel, MD & Clifford P. Clark, III, MD

7am – 5pm Registration Open—San Diego Convention Center Hall F

Scientific Session A7:30am Panel—Dorsal Augmentation—Personal Techniques

Moderator: Rod J. Rohrich, MDPanelists: Jack P. Gunter, MD, Bahman Guyuron, MD, Ronald P. Gruber, MD, & Miles H. Graivier, MD

9am Interactive Video—Primary RhinoplastyPresenter: Rollin K. Daniel, MDModerator/Discussant: Joe M. Gryskiewicz, MD


10:30am Papers

11am Panel—Tip Refinements—Grafts or Sutures? Moderator: Samuel Stal, MDPanelists: Onur Erol, MD, Jack P. Gunter, MD, & H. Steve Byrd, MD

12Noon Joyce Kaye Lecture—Patient Safety Outside of the Box: The Impact of Ethics, Systems, and Communications in Cosmetic SurgeryModerator: Felmont F. Eaves, III, MD

1pm Lunch in the Exhibits

Scientific Session B7:30am Panel—Rejuvenation of the Arm: A Treatment Algorithm

Moderator: Daniel C. Morello, MDPanelists: Peter B. Fodor, MD, Felmont F. Eaves, III, MD, & Lawrence S. Reed, MD

8:30am Papers

9am Panel—Treatment Options for the Aging HandModerator: Petra Schneider-Redden, MDPanelists: Barry E. DiBernardo, MD, Roxanne J. Guy, MD, & Danny Vleggaar, MD


10:30am Papers

11am Panel—Finesse in Lower Body Contouring Moderator: Mark L. Jewell, MDPanelists: Al Aly, MD, Dirk Ritcher, MD, & Sharon Giese, MD

12Noon Interactive Video—Thighplasty—Matching Procedures with the DeformityPresenter: Jean-Francois Pascal, MDModerator: Susan E. Downey, MDDiscussant: Osvaldo Ribeiro Saldanha, MD

1pm Lunch in the Exhibits

1pm - 2pm S21 Candidate Open Forum (Page 25)Chair: Michael E. Edwards, MDVice-Chair: Patrick K. Sullivan, MD

2pm - 6:30pm OPTIONAL COURSES6:30pm VIP Reception

7pm Presidential Cocktail Reception

8pm Presidential Dinner DanceSupported by Medicis Aesthetics

Scientific Session6:30am New Board of Directors Organizational Meeting

7:30am Body Contouring Research Foundation PresentationJean-Francois Pascal, MD

8am Award Presentations—Annual Meeting & Journalistic AchievementPresenters: Foad Nahai, MD, Alan H. Gold, MD & Mark A. Codner, MD

8:30am Panel—Speak Up or Forever Hold Your Peace—Facial Aesthetic Surgery(Member submitted presentations)Moderator: Jack Fisher, MD

9:30am Papers


10:30am Panel—Lower Lids and Troughs—Problems and SolutionsModerator: Mark A. Codner, MDPanelists: Sydney R. Coleman, MD, Robert S. Flowers, MD, Catherine Bergeret-Galley, MD, & Bryan C. Mendelson, MD

11:45am Interactive Video—Management and Avoidance of Eyelid Ptosis Presenter: Clinton D. McCord, MDModerator: Foad Nahai, MDDiscussant: Julius W. Few, MD

12:30pm Lunch in the Exhibits

1:30pm Panel—Raising the Bar in Breast Reduction/Shaping Moderator: Elizabeth J. Hall-Findlay, MDPanelists: T. Roderick Hester, MD, Frank R. Lista, MD, João Carlos Sampaio Goés, MD, & Constantino Mendieta, MD

2:30pm Papers

3pm The Best of Hot Topics Moderator: William P. Adams, Jr., MD

3:15pm Papers

3:45pm Panel—Breast Implant Pocket Selection—What's Best?Moderator: Charles H. Thorne, MDPanelists: Steven A. Teitelbaum, MD, James C. Grotting, MD, Frank R. Lista, MD, & Claudio L. DeLorenzi, MD

5:15pm Adjourn

Sunday, May 4, 2008The Aesthetic Meeting 2008 • Week-at-a-Glance

Monday, May 5, 2008

Tuesday, May 6, 2008

This year at The Aesthetic Meeting,2008 in San Diego, we will be offeringsame day downloads on more than 15 scientific sessions for your iPod. For thefirst time, you will be able to review,almost immediately, some of the best presenters in aesthetic medicine on topicssuch as Cohesive Gel Implants; PatientSelection and Technical Details, TipRefinement, Graft or Sutures?, TheEvolution of the Modern Facelift andmany more.

We are anticipating that these down-loads will be of particular value to ourinternational members, giving them theopportunity to review important scientific

sessions while traveling from our SanDiego meeting site. Details on pricing and availability will be distributed at, andimmediately prior to, the meeting.

“MP3 Technology has come a longway in the last few years and we are hope-ful that members will view downloads as avalue-added service whose time has come”said President-elect Alan Gold, MD.“Refinement in imaging and in the devicesthemselves lend themselves perfectly to aneducational application.”

Downloads will be available at theDVD Desk. Stop by to enter into a draw-ing for a free iPod!

In an effort to diversify its revenuestream, the Aesthetic Surgery Journal (ASJ)will be offering its subscriber list for rentto commercial and not-for-profit entitiesmeeting strict criteria. These include:• All organizations, commercial and

not- for- profit, must submit a sample of their mailing piece in advance. Allmailings must be approved by theSociety Executive Director or theDeputy Executive Director.

• Mailings can be rejected for any reasonat the discretion of the Society

• Email addresses are not available• Lists are available for one time usage

only; list is not available for sale• Subjects of mailings cannot compete

with Aesthetic Society initiatives• Request form for list rentals must be

submitted along with the sample mailing piece

“This is a pilot project that we hopewill be as successful for us as it has beenfor such well known journals as NewEngland Journal of Medicine, JAMA and Nature Publishing” said Michael F.McGuire, MD, Chair of the AestheticSociety Publications Committee. “Societymembers should note that the list availableis for ASJ, which includes members andnon-members who pay for the publication,accounting for roughly half of the list. TheBoard of Directors did not consider therental of the ASAPS member list” headded.

Members wishing to “opt out” of thelist rental program can do so by [email protected], and your namewill be immediately removed. You will,however, still receive emails from the publication with news or events of interest.

The Aesthetic Meeting 2008 joins Gen X: iPod downloads to be available for Select Scientific Sessions

AestheticSurgery Journalto Offer ListRental Service:


ASAPS FUTURE MEETING DATES

2009 May 2-9 Las VegasMandalay Bay

2010 April 22-27 Washington, DC

Gaylord National

2011 May 11-16 Boston

2012 May 3-8 Vancouver

Focus on Practice MarketingContinued from Page 7

audience and the lack of authenticity of editorial input. When it comes to paid editorial opportunities, the ‘pay’ outweighs the ‘play.’”

Advice for SocietyMembers:

The Aesthetic Society’s PublicEducation Committee offers the followingadvice for members considering “pay forplay” opportunities:• Make sure you know who you’re dealing

with, when the program will air, that the production company involved is of high quality and that the programenhances—and doesn’t detract fromyour over-all marketing program.

• Don’t fall into the trap of trivializingyour practice. We have all spent manyyears training, and providing patientswith the best and safest possible outcomes.This year’s marketing gimmick may notbe next year’s strategy.

• Position yourself and your practice as anexpert in your local market. One goodplacement in your local newspaper canoffer opportunities for re-purposing thatcan be used in newsletters, on your website, in patient emails and in manyother venues.

• Don’t give into scare tactics concerningthe market. These too shall pass.

Julius Few, MD is an aesthetic surgeonpracticing in Chicago, IL. He is Chair of the Aesthetic Society Public EducationCommittee. He can be reached at [email protected]

October 30, 2007

American Society for Aesthetic Plastic Surgery, Inc.11081 Winners CircleSuite 200Los Alamitos, CA 90720

RE: The article of trial for trouble in trendy times by Marie Czenko Kuechel.

Dear Editor:

Hoorah, Hoorah! Finally, an article that makes sense about the marketing ofPlastic Surgery. I have had the pleasure of giving a course over the past several yearswith Marie Czenko Kuechel and with Robert Singer and each time these topics havebeen briefly touched on in the course, but to see it in black and white certainly doesbring quite a deal of pleasure to me. Because I think that these facts needed to bebrought up to young plastic surgeons, we Plastic Surgeons tend to easily fall into the“trendy times” of aesthetic practice.

Having been one who opened a so-called skin care practice or as is now known a“medi-spa” back in the early 90s, I found that it created an interesting adjunct to mypractice. It turned out to be approximately 5% of my income and approximately 80%of my headaches. But when I stopped having that in my practice and concentrated onsurgery, I found that my practice increased.

At the present time, as a semi-retired plastic surgeon, I can look back at all thefoibles that I did in the past that I would not do again. I can tell you that each one ofthose subjects, which Marie talks about, are concepts that every young plastic surgeonshould look at very seriously. I think that the trends in plastic surgery whether it isinjectables, lasers, adjunctive aesthetic procedures, will pass in time and in what willultimately survive is the fact that we are outstanding surgeons and we do surgery best.I think surgery will never go away but trends will come and go. So, I applaud Mariein her advice and I think that everyone who reads it should consider it very, very seriously. Best Regards,

Gustavo A. Colon, M.D.

Editor’s Note: Dr. Colon is a past president of the Aesthetic Society

Letters to the EDITOR


The Physician’s Coalition forInjectable Safety, a project of the AestheticSociety, The American Academy of FacialPlastic and Reconstructive Surgery, andThe American Society of OphthalmicPlastic and Reconstructive Surgery, isentering a new phase in its Patient SafetyMission to protect consumers against illegal product and unscrupulous providers.

This year, at The Aesthetic Meeting2008, the Coalition, with generous supportfrom Artes, Bioform, Allergan and Medicis,will be sponsoring a special session specificallyfor nurse injectors. The course, titled: “NurseInjector Competence Training—Course 1:Understanding the Basics of InjectionTechniques with Botulinum Toxin Type Aand Dermal Fillers” is designed to provideparticipants a review of the treatmentrationale and clinical applications forBotulinum Toxin Type A and the manydermal fillers available today.

The importance of a thorough aesthetic analysis will be examined in detailwith a focus on facial anatomy includingmuscles, nerves and skin layers. Effectivepain management options are covered.While all products will be reviewed indetail and appropriate injection techniquesfor different areas of the face discussed, livepatient injections for Botulinum Toxin, collagen and hyaluronic acid fillers will bedemonstrated. Patient safety is discussedthroughout the course with an emphasison avoiding complications. The course willreview the importance of teamwork andeffective communication between thenurse injector and surgeon and how this

relationship can have a positive economicimpact on the plastic surgery practice.

Successful completion of this course isthe first of two requirements for nurseinjectors to receive a certificate of NurseInjector Course Completion. The secondrequirement is participation in a physicianpreceptorship consisting of 10 BotulinumToxin and 10 HA cases. The certificate is the property of the plastic surgeon’spractice; this should help to balance the non-core nurse who simply wants to open a day spa and do injections on his or her own.

Although the Aesthetic Society hasconducted similar courses in the past, thisis the first time we have collaborated withcolleagues from other specialties to ensureproper training of allied health professionalsand providing participating practices withan extra measure of commitment to qualitycare via a certificate of completion.

As both a representative of the Coalitionand Chair of the Aesthetic Society EducationCommission, I would like to thank mycolleagues Communications CommissionChair, Mark Codner, MD and PublicEducation Chair, Julius Few, MD for theirassistance with this course. I also thank IraPapel, MD, Past President of the AAFPRSand Roger Daily, MD, Past President ofthe ASOPRS for the opportunity to work with them on this important educationalendeavor.

Jeffrey Kenkel, MD is Professor andVice-Chairman Director, The ClinicalCenter for Cosmetic Laser Treatment, TheRod J. Rohrich, M.D. DistinguishedProfessorship in Wound Healing and PlasticSurgery Department of Plastic Surgery, TheUniversity of Texas Southwestern at Dallas.He is also Chair of the Aesthetic SocietyEducation Commission

The Physician’s Coalition for Injectable SafetyNurse Injector Competence Training Course to be held at The Aesthetic Meeting 2008

JEFFREY KENKEL, MD

UPDATEon:

This year, at The Aesthetic Meeting

2008, the Coalition, with generous

support from Artes, Bioform,

Allergan and Medicis, will be

sponsoring a special session

specifically for nurse injectors.

The course, titled: “Nurse Injector

Competence Training—Course 1:

Understanding the Basics of

Injection Techniques with Botulinum

Toxin Type A and Dermal Fillers” is

designed to provide participants

a review of the treatment rationale

and clinical applications for

Botulinum Toxin Type A and the

many dermal fillers available

today.



Educating the public about safe prac-tices and choices with cosmetic injectablesis a vital and viral part of the PhysiciansCoalition for Injectable Safety:• Vital: As complications from unqualified

injectors, inappropriate settings and elicitinjectables rise, consumer confidence in this growing category of cosmeticmedicine will be shaken.

• Viral: Spreading the word, with qualifiedinformation and simple messages ofsafety is essential to protecting publicsafety and enhancing the image and trustconsumers have in qualified physicians,like you!

Join us! These no-cost resources areavailable to all members of the AestheticSociety. They are positive educational toolsand also effective marketing tools for yourpractice:• Injectablesafety.org Icons: Three differ-

ent artwork styles, all pre-programmedto link your web site, or any web sitedirectly to www.injectablesafety.org, themost complete, unbiased, non-commer-cial, authoritative and dynamic websiteexclusively dedicated to the benefits ofcosmetic injectables with to up-to-the-minute safety information.

Place a link on your web site andencourage your referring physicians andother professionals, your hospital, yourcommunity media and women’s groupsto place a link on their web sites.

• Injectables are not Cosmetics Artwork:Contemporary, attention-getting, posi-tive and promotable, this artwork can becustomized to your practice and repro-duced into posters, tabletops, postcards,advertisements, public service announce-ments and more.

Whether a speaking engagement, asafety message to leave with local hairsalons and spas, or a public serviceannouncement for your hospital or localmedia to publish on paper or on-line,this message is essential to eradicatingunsafe practices with cosmetic injecta-bles.

• Beauty in the News: A consumerupdate from the Physicians Coalitionfor Injectable Safety. Have yourpatients heard the hype, and now havequestions about lipodissolve? Does your

public think a Botox Party is not urbanlegend, it’s a great time? Has your com-munity been affected by storefront injec-tion shops? This quarterly newsletter, online or in a PDF format (that can becustomized and printed at your localquick-printer), provides consumers allthe latest news on injectable safety, andincludes a consumer planning guide forthose considering injections.

• Cosmetic Injectable Planner: Whethercontemplating an injection, planning afirst time injection, or planning a repeatinjection, this planner is a must for anyconsumer. Outlining the safe choices in“Doctor,” “Brand,” “Beauty,” this plan-ner can be customized with your prac-tice name and contact information. A

great tool to have on your web site, togive prospective patients, and to provideyour referral networks, it actively edu-cates, promotes safe practices and leadsconsumers confident in their choice forcosmetic enhancement-to you!

Download Injectable Safety actively-linked icons and Injectable Safety artworkby accessing the August 2007 InjectableSafety Newsletter on the Physicians Onlylink at www.injectablesafety.org. You’ll alsofind a link to the consumer newsletter, anda PDF file of the newsletter and theInjectable Planner on the Physicians Onlylink at www.injectablesafety.org. If youhave questions or are looking for cus-tomization, please call the New YorkASAPS Communications Office.

Spread the Word: Injectables are Not Cosmetics


The Aesthetic Surgery Education andResearch Foundation (ASERF) held astrategic planning session at its InterimBoard of Directors Meeting in Baltimore,October, 2007. Many issues were discussedat this session and several initiatives wereproposed to strengthen the role of ASERFin the plastic surgery research community.Among them are:• Donors: Increase the number of donors

by keeping Members informed of up-coming ASERF opportunities, andpossibly soliciting members from outside the plastic surgery communityfor ASERF contributions.

• Research: Advance our relationship withIndustry through identification of newdevices, pharmaceuticals and modalitiespresented in our “Hot Topics” course,potentially building a bridge betweenASERF researchers and the corporateresearch community.

• Development: Hire a dedicated staffperson to work primarily on ASERFmajor donor, corporate donor and capital giving campaigns.

Another Planning session is scheduledfor summer, 2008.

Lipolysis Study BeginsPatient Recruitment:

ASERF’s study of injection lipolysisunder the direction of Dr. Leroy Young haspassed its final FDA hurdle and has begunpatient recruitment for this important study.My thanks to Dr. Young and all who stuckwith the project and brought it to life.

Bahman Guyuron, MD is Chairman,Department of Plastic Surgery, Case MedicalSchool and University Hospitals, Cleveland,OH. He is President-elect of the AestheticSurgery Education and Research Foundation.


BAHMAN GUYURON, MD

UPDATEon:


Editors Note:Many Aesthetic Surgery practicesconsider Chantix for their patientsneeding help with smoking cessation.The following advisory on the medication was recently issued bythe FDA:

The U.S. Food and Drug Administration(FDA) today issued a Public HealthAdvisory to alert health care providers,patients, and caregivers to new safetywarnings concerning Chantix (varenicline),a prescription medication used to helppatients stop smoking.

On Nov. 20, 2007, FDA issued anEarly Communication to the public andhealth care providers that the agency wasevaluating postmarketing adverse eventreports on Chantix related to changes inbehavior, agitation, depressed mood, suici-dal ideation, and actual suicidal behavior.

As the agency’s review of the adverseevent reports proceeds, it appears increas-ingly likely that there may be an associa-tion between Chantix and serious neu-ropsychiatric symptoms. As a result, FDAhas requested that Pfizer, the manufacturerof Chantix, elevate the prominence of this safety information to the warnings and precautions section of the Chantixprescribing information, or labeling. Inaddition, FDA is working with Pfizer tofinalize a Medication Guide for patients.This is an example of FDA working withdrug manufacturers throughout products’lifecycles to keep health care professionalsand patients informed of new and emerg-ing safety data.

“Chantix has proven to be effective insmokers motivated to quit, but patientsand health care professionals need the lat-est safety information to make an informeddecision regarding whether or not to usethis product,” said Bob Rappaport, M.D.,director of the FDA’s Division ofAnesthesia, Analgesia and RheumatologyProducts. “While Chantix has demonstrat-ed clear evidence of efficacy, it is importantto consider these safety concerns and alertthe public about these risks. Patientsshould talk with their doctors about thisnew information and whether Chantix isthe right drug for them, and health careprofessionals should closely monitorpatients for behavior and mood changes ifthey are taking this drug.”

Chantix was approved by FDA inMay 2006 as a smoking cessation drug.Chantix acts at sites in the brain affected bynicotine and may help those who wish tostop smoking by providing some nicotineeffects to ease the withdrawal symptomsand by blocking the effects of nicotinefrom cigarettes if users resume smoking.

In the Public Health Advisory and aHealth Care Professional Sheet that wasalso issued today, FDA emphasized the following safety information for patients,caregivers, and health care professionals:

Patients should tell their health careprovider about any history of psychiatricillness prior to starting Chantix. Chantixmay cause worsening of current psychiatricillness even if it is currently under control.It may also cause an old psychiatric illness

to reoccur. FDA notes that patients withthese illnesses were not included in thestudies conducted for the drug’s approval.

Health care professionals, patients,patients’ families, and caregivers should bealert to and monitor for changes in moodand behavior in patients treated withChantix. Symptoms may include anxiety,nervousness, tension, depressed mood,unusual behaviors and thinking about or attempting suicide. In most cases, neuropsychiatric symptoms developed during Chantix treatment, but in others,symptoms developed following withdrawalof varenicline therapy.

Patients should immediately reportchanges in mood and behavior to theirdoctor.

Vivid, unusual, or strange dreamsmay occur while taking Chantix.

Patients taking Chantix may experi-ence impairment of the ability to drive oroperate heavy machinery.

FDA will continue to update healthcare professionals with new informationfrom FDA’s continuing review or if newinformation is received on Chantix andserious neuropsychiatric symptoms. FDAmay consider requesting further revisionsto the labeling or taking other regulatoryaction as the agency’s continuing reviewsand conclusions warrant.

For more information:http://www.fda.gov/cder/drug/infopage/varenicline/default.htm

FDA Issues PublicHealth Advisory on ChantixAgency requests that manufacturer add new safety warnings for smoking cessation drug

Media Notes and QuotesA Sampling of current media coverage on the Aesthetic Society

Dr. Mark L. Jewell, a plastic surgeon in Eugene, Ore.,who is a past president of the American Society forAesthetic Plastic Surgery, said he warns his patientsthat breast augmentation surgery automatically guarantees a second operation at some future date.He added that many patients in clinical studies hadelected to have follow-up operations to changeimplant type, size or position.

Do My Breast Implants Have a Warranty? New York Times

January 17, 2008

Consumers’ ever increasing appetites for aestheticprocedures have clearly outpaced state medical boards’ability to keep up. The number of “nonsurgical cosmetic procedures” performed annually skyrocketedfrom 1.1 million in 1997 to 9.5 million in 2006,according to the American Society for AestheticPlastic Surgery.

The Truth About Medi SpasMarie Claire

November 2007

Injection lipolysis is “scientifically unproven, lackingany objective data on safety and efficacy,” theAmerican Society for Aesthetic Plastic Surgery (ASAPS)cautioned in an advisory last May…The first placebo-controlled, independent research of lipodissolve on humans (led by Leroy Young and overseen by abranch of ASAPS) will begin this November in St. Louis, where 20 patients will receive the shots,every four weeks, in one side of their abdomen and a placebo in their other. They will be tracked for 46weeks, and a report is expected by April 2008.

Fat ChanceAllure

November 2007

If you are considering a cosmetic tweak your docoffers, remember, “It’s buyer beware,” saysNorthwestern’s Julius Few, MD, a leader of thePhysicians Coalition for Injectable Safety. “If you go outside the classic specialty group, there is noguarantee that you’ll get someone who has any experience,” he says.

Gynos Removing WrinklesHealth

January 2008

These days, you have as many options for upgradingyour looks as you have for upgrading your computer.And the number of men availing themselves of a nip here and a tuck there keeps growing: TheAmerican Society for Aesthetic Plastic Surgery reportsa 47 percent increase in male procedures in 6 years,from 640,000 in 2000 to 940,000 in 2006.

Custom Body WorkMen’s Health

November 2007

Not that there’s anything wrong with a littleupkeep—most women today have moderate views on cosmetic surgery. In 2006, the American Society for Aesthetic Plastic Surgery (ASAPS) revealed that 63 percent of women in this country approve of it, though just 34 percent would consider it for themselves…”Most of these patients aren’t awarethat they look artificial,” says Dr. Foad Nahai, president of the ASAPS.

How much is too much?Marie ClaireJanuary 2008

Dr. Foad Nahai, president of the American Society forAesthetic Plastic Surgery (ASAPS), says he’s seen a similar increase at his practice in Atlanta: men madeup between 15 and 20 percent of the patients he sawin 2007. “It’s just in the last year that we’ve reallyseen that change,” says Nahai, who attributes muchof the growth to aging boomers and the acceptanceand array of nonsurgical wrinkle remedies. “Evenfour years ago, I could recite the names of every manwho came in for Botox. Not anymore.”

What Wrinkles?Newsweek

January 3, 2008

Numbness after breast surgeries of any type is themost common. Loss of sensation in the nipple in particular occurs anywhere from 10% to 70% of the time, says Dr. Nahai, president of the AmericanSociety for Aesthetic Plastic Surgery (ASAPS) depending on the type of procedure. What’s worst?Breast reductions, where the nipple and areola aretotally removed and reattached as skin grafts.

Ten Plastic Surgery Risks You Need To KnowForbes

October 10, 2007



The following courses have been approved by The American Board of Plastic Surgery and qualify for its designated Cosmetic Module for MOC-PS™

Tracer Procedure Course # Cost Credits CME/Patient Safety

Blepharoplasty DAM07-405AB $236 4/0.4

Augmentation/Mammaplasty DAM07-S11AB $236 4/1.0

Augmentation/Mammaplasty DAM07-111 $118 2/0.2

Lipoplasty DAM07-424 $118 2/0.2

Face Lift DAM07-515 $118 2/0.25

Patient Safety DAM07-522 $118 2/2.0

Abdominoplasty DAM07-705 $118 2/0.2

2007 DVDs and MOC CME DVDs

The theme of the 2007 AnnualMeeting in New York City, “Be a Part ofit: An Interactive Educational Experience,”lives on in the recorded sessions that areavailable now on DVDs. Watching thesevideos is the best way to study new procedures, learn innovative techniques, or study for the new Maintenance ofCertification in Plastic Surgery, MOC-PS™.

Viewing the DVD is as close as youcan get to the surgical techniques withoutactually being in the OR. The picture is assharp as any TV programming you watch.The DVDs are recorded “live” at the annualmeetings. They capture the presenters’ on-screen pointer showing specific detailsas they are explained. Furthermore, theyare guaranteed to play on any set top player.

Have a favorite speaker? A surgeon’s

outcome you admire? Want to examine Dr. Constantian’s closed rhinoplasty [DVD #DAM07-18], or observe a livelypanel discussion regarding divergentapproaches to the blending of thelid/cheek junction [DVD #DAM07-4]?Watch them all on the DVDs and enjoycrystal clear, sharp images.

The annual meeting DVDs are consistently appreciated by the member-ship, and are dedicated to continuing education. If you missed the meeting,here’s the best way to bring safe, reliableand accurate information home in a mostconvenient format.

There is a lot to discover! Purchase anindividual DVD for only $68 or get a setof your favorite ten for only $579. The

Aesthetic Society films the entire ScientificSession and key optional courses that havethe most interest. Patient safety credit has been assigned to help you fulfill yourtri-annual requirements.

Maintenance of CertificationNew this year: ABPS-approved

MOC-PS™ courses. Category 1 CMEcredits required for Part II-IV (Life-LongLearning and practice assessment modules)of the MOC-PS™ are earned by partici-pating in designated DVD CME activities.Satisfactory completion is achieved byscoring a minimum of 75% on the post-activity exam. This satisfies the CMErequirement for the assessment module.Additionally, Patient Safety Credit hasbeen assigned.

All category 1 CME credits earned for MOC-PS™ will be reported, on aquarterly basis, directly to the AmericanSociety of Plastic Surgeons for recording inthe combined plastic surgery database. Formore information about this new program,

visit the American Board of Plastic Surgery’swebsite: https://www.abplsurg.org/ModDefault.aspx?section=DipMOCPS

Add to your existing library, or startone today. Order now while supplies last.The complete list of available DVDs from

the 2007 Annual Meeting was recentlymailed to you. Complete the order formincluded in that mailing, log onto the sur-gery.org/shoppingcart website, or call theoffice at 800-364-2147 to place yourorder.


Documents

Aesthetic Society News...San Diego Marriott Hotel and Marina Tel: 800.486-0611 May 1, 2008 The 13th Annual Meeting of The Rhinoplasty Society Manchester Grand Hyatt San Diego, CA Contact: