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In this episode of the Plastic Surgery Practice podcast, host Alison Werner interviews Babak Azizzadeh, MD, FACS, a double board-certified facial plastic and reconstructive surgeon and director of the Facial Paralysis Institute in Los Angeles. They discuss the nuances of plastic surgery and aesthetic procedures for younger patients, focusing on rhinoplasty and lip fillers.
Overview of Topic
Azizzadeh elaborates on the increasing demand for aesthetic procedures among younger individuals. He provides insights into the physical and social factors influencing the decision to undergo procedures like rhinoplasty and lip fillers, emphasizing the importance of timing and psychological readiness.
Key Takeaway 1: Considerations for Rhinoplasty in Young Patients
Azizzadeh highlights that rhinoplasty is most popular among teenagers and young adults, typically between the ages of 16 and 24. The physical readiness for surgery depends on the individual's growth and development, with girls often being ready around 15 or 16, and boys a bit later. He stresses the importance of ensuring that the septum and facial growth are complete to avoid stunting facial development.
Key Takeaway 2: The Social Dynamics of Surgery
The social aspects of plastic surgery for minors are complex. Azizzadeh points out that both the patient and their parents must be aligned in their decision-making. Effective communication and mutual agreement are crucial. He also addresses the significant psychosocial impact of nasal deformities, noting that timely intervention can prevent bullying and improve social interactions.
Key Takeaway 3: The Psychological Evaluation Process
Azizzadeh explains that the initial consultation with young patients and their parents is thorough, often lasting up to an hour. During this time, he assesses the psychological readiness and maturity of the patient, as well as the family dynamics. He emphasizes the importance of realistic expectations and continuous evaluation to ensure the suitability of the procedure.
Key Takeaway 4: Timing and Recovery for Surgery
Timing the surgery is critical, with Azizzadeh preferring to schedule procedures early in the summer to allow for ample recovery time. He explains that while the initial recuperation from rhinoplasty is quick, the final results can take longer to manifest, necessitating a more extended recovery period to achieve optimal outcomes.
Key Takeaway 5: Lip Fillers in Younger Patients
Lip fillers are increasingly popular among young adults, particularly those in their 20s, driven by social media influence. Azizzadeh advises a conservative approach, starting with small amounts of filler to achieve a natural look. He warns against overdoing lip fillers, which can result in unnatural appearances and necessitate correction.
Key Takeaway 6: The Impact of Social Media
Social media has profoundly changed the landscape of plastic surgery, making younger patients more informed and opinionated about their desired procedures. Azizzadeh acknowledges the challenge of managing expectations but finds that younger patients are generally open-minded and receptive to professional advice.
Conclusion
Azizzadeh appreciates the enthusiasm and satisfaction of younger patients when procedures are done correctly and conservatively. He emphasizes the importance of education and realistic expectations, ensuring that both physical and psychological factors are considered before proceeding with any aesthetic procedure.
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Introduction
In a recent episode of the Plastic Surgery Practice Podcast, hosts Alison Werner and Keri Stephens welcomed Stuart Mohr, Vice President of Marketing and Clinical at Jan Marini Skin Research. The discussion centered around the integration of clinically-backed skincare products to enhance practice procedures, results, and return on investment (ROI).
Stuart Mohr’s Background
Stuart Mohr shared his extensive background in the aesthetics industry, spanning nearly 25 years. Initially a biomedical and electrical engineer designing lasers for ophthalmology and dermatology, Mohr transitioned to marketing after obtaining his MBA. He has been with Jan Marini Skin Research for 15 years, bringing a unique perspective to the intersection of clinical results and business operations in aesthetics.
The Role of Professional Skincare in Aesthetic Practices
Mohr emphasized the importance of incorporating professional skincare into aesthetic practices. He highlighted that while patients visit for specific services like laser treatments or peels, their daily home care regimen significantly impacts the overall results. According to a New Beauty Magazine survey, over 80% of patients desired product recommendations from their practices to achieve better results.
Key Takeaway 1: Integration of Professional Skincare
Practices should recommend clinically proven skincare products to patients for use between office visits. This approach ensures superior results, faster patient satisfaction, and continuous engagement with the practice.
Selecting the Right Skincare Products
When selecting skincare lines, plastic surgeons should prioritize products backed by scientific data and clinical studies. Mohr discussed a non-hydroquinone hyperpigmentation product from Jan Marini Skin Research that outperformed 4% hydroquinone in a split-face study, demonstrating the importance of evidence-based choices.
Key Takeaway 2: Evidence-Based Product Selection
Products should be chosen based on their proven efficacy in delivering results, as demonstrated through rigorous clinical studies.
Enhancing Results and Profitability
Mohr illustrated how combining skincare products with in-office treatments can enhance results and profitability. For example, using home care products in conjunction with laser treatments for rosacea showed statistically significant improvements compared to laser treatments alone. This not only improves patient outcomes but also increases practice profitability.
Key Takeaway 3: Increased Profitability
Integrating professional skincare can double the profitability per hour in practices, with zero added room or staff time.
Maintaining Patient Engagement
To maintain patient engagement, Jan Marini Skin Research offers an e-commerce solution that allows patients to purchase products online. This ensures continuous product availability and ties the patient’s purchases back to the practice, providing ongoing revenue.
Key Takeaway 4: Continuous Engagement and Revenue
Providing an easy way for patients to purchase recommended skincare products online ensures continuous engagement and additional revenue streams for the practice.
Conclusion
The podcast concluded with Mohr highlighting the dual benefits of incorporating professional skincare products: enhanced patient results and increased practice profitability. He encouraged plastic surgeons to select skincare lines based on scientific evidence and to leverage these products to build stronger, longer-lasting relationships with their patients.
Stuart Mohr's insights offer a roadmap for aesthetic practices aiming to optimize both clinical outcomes and business success through the strategic use of professional skincare products. -
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In this episode, Dr Gregory Keller, a board-certified facial plastic surgeon with offices in Beverly Hills and Santa Barbara, Calif, and full clinical professor and member of the medical staff at UCLA, talks about what it means for your practice and patient relationships to offer retail skincare products in office and what stands out to him about the Defenage line of skincare and haircare products.
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This week, we revisit our conversation with Terri Ross, a well-known aesthetics practice management consultant. She talks about how a med spa can benefit the plastic surgery practice financially and improve patient outcomes and the lifetime value of a patient to the practice.
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In this episode, Max Stock, founder and CEO fo Epicutis Skincare, joins the podcast to talk about the company's products, how they were developed, why they're ideal for plastic surgery patients post procedure, and how Epicutis works with plastic surgery practice to build better patient relationships.
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In this podcast episode, Dr Alex Zuriarrain is back to talk about the surgical and non-surgical neck lift options, who’s a good candidate for what, and setting realistic expectations with your patients.
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In this episode, Leah Garcia and Dr Felipe Jimenez of Nulastin, the hair care brand focused on elastin replenishment, on why hair care products should be part of a plastic surgery practice’s retail offerings and its line of products featuring its patented Elastaplex technology.
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In this podcast, we look at facial paralysis, facial reconstruction, and the role of the plastic surgeon, Babak Azizzadeh, MD, FACS, a double-board certified facial plastic and reconstructive surgery, specializing in the field. In this episode:
Founder and director of The Facial Paralysis Institute and associate clinical professor at the David Geffen School of Medicine at UCLA, Azizzadeh shares how it was a family friend’s experience with facial paralysis while he was doing his residency that sparked his passion for this subspecialty.Most of the time, Azizzadeh explains, we don’t think about the 17 muscles on either side of our face—the ones that allow us to express ourselves and control how our mouth for eating and speaking and opening and closing our eyes. The brain and the facial nerve work together seamlessly. But when there is an injury, virus, inflammation, infection, or tumor that interrupts that nerve, the face can stop working normally—and that is when facial paralysis can set in.Azizzadeh explains the role of the facial plastic surgeon in managing facial paralysis. He talks about how most plastic surgery is about creating some improvement in symmetry or static procedures, like face lifts. Facial paralysis, on the other hand, requires more dynamic reconstructive efforts to allow the patient to, for example, “smile more naturally, emotionally, and more instinctually, according to Azizzadeh.In his breakdown of the procedures in his armamentarium, Azizzadeh explains that no two patients present the same. Facial paralysis, however, can be broken down into two categories which come down to zero activity and some activity. He explains how length of paralysis affects surgical choices and how muscles from other parts of the body can be used introduced where facial muscles have atrophied.For patients experiencing facial paralysis caused by Bell’s Palsy, Azizzadeh explains how he is using Botox and physiotherapy to improve patient’s facial movement.And then, Azizzadeh talks about his own pioneering work in the field, including his surgery called selective neurolysis to help patients regain the ability to produce natural facial expressions. PSP -
In our latest podcast episode, hosts Alison Werner & Keri Stephens speak with Dr. Constance M. Chen from New York, is a leader in microsurgical breast reconstruction. They discuss the nuances of DIEP flap breast reconstruction, a topic clouded with misconceptions, especially regarding slimmer patients.
Dr. Chen addresses the common belief that thin individuals aren't suitable candidates, pointing to alternative grafting methods. With growing concerns around breast implant illnesses, she highlights the advantages of the DIEP flap method, outlining its recovery process in comparison to implants.
The conversation also touches upon who might not be the best candidate for this procedure, with insights from Dr. Chen on natural tissue breast reconstruction. Join us for a comprehensive and insightful discussion. -
In this podcast, Plastic Surgery Practice Co-Chief Editors Alison Werner and Keri Stephens interview James Beckman, MD, founder and CEO of Therapon Skin Health. They talk about the company’s Theraderm Clinical Skin Care line, its proprietary peptides, and how Theraderm grew out of Beckman’s works to develop a product to improve the skin of burn victims with skin-grafted hands. They also talk to him about where skin care is headed.
Beckman, who spent 20 years in private practice as a plastic and reconstructive surgeon and has a degree in biochemistry, shares his journey to creating a commercial product with active peptides for skin showing the signs of aging. The product grew out of his work with patients who had suffered burns or lost skin that resulted in skin grafts to close the wound and with patients who were just experiencing extremely dry skin as a result of their working conditions.
Working with a local pharmacist, he created his first product: Beckman’s Dry Skin Therapy. The product caught on with fellow plastic surgeons and he soon had his first company. From there, he sought to develop a product that restored elasticity and collagen of aging skin.
Today, the Theraderm Clinical Skin Care line has three product systems—an anti-aging, a skin renewal, and a revision clear skin system. As Beckman puts it, “Those three systems developed out of one system, and that one system developed out of one product that restored the oil depletion in dry hands.”
When looking to the future for the skin care company and its products lines, Beckman shares his philosophy on product development overall—and it centers on helping the consumer actually solve a problem. “I think the key for skin care product manufacturers is to—with any product—go out and see what the consumers are suffering with and try to find an answer that solves that problem rather than an advertising campaign that sells more of your product.”
In this interview, Beckman takes the listener through his career journey as a plastic surgeon in rural Arkansas and shares how word-of-mouth marketing is so much more valuable than having a huge advertising budget. After all, that’s how he found success with Beckman’s Dry Skin Therapy, and that pattern continues today with Theraderm's skin care product lines. PSP
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Join PSP co-chief editor Keri Stephens as she sits down with Alexander Zuriarrain, MD, FACS, a board-certified plastic surgeon and owner of Miami-based Zuri Plastic Surgery, to delve into all things rhinoplasty.
The conversation kicks off with the impact of the so-called “Zoom Boom” on the popularity of rhinoplasty. As people spend more time on video calls, they find themselves scrutinizing their own appearances, leading to a surge in interest for nasal corrections. Zuriarrain explains how the advent of remote work has contributed to this phenomenon, with individuals seeking rhinoplasty to address nasal deformities and enhance their facial features.
Zuriarrain then discusses the evolution of rhinoplasty techniques and outcomes over the past few decades. From traditional methods involving chisels and hammers to modern innovations like ultrasonic rhinoplasty, the field has seen remarkable advancements, Zuriarrain explains. The use of sophisticated technologies, such as 3D imaging and computer-assisted surgery, has also made a significant impact. However, Zuriarrain cautions against relying solely on 3D imaging due to potential discrepancies between the generated images and the actual surgical results.
The podcast moves on to discuss patient selection, emphasizing the importance of identifying individuals who are genuinely good candidates for rhinoplasty. Zuriarrain shares his selective approach, highlighting specific patient populations, such as those exhibiting body dysmorphia or unrealistic expectations, who may not be suitable candidates. He further emphasizes the importance of ethnic considerations, as different geographic backgrounds have unique nasal anatomies that require specialized approaches.
Complications associated with rhinoplasty are also addressed in the podcast. Zuriarrain explains that swelling is a common concern, with patients often underestimating the recovery time needed for optimal results. He discusses potential complications, including “whistleblower” deformities, collapse of the tip, and issues with the nostril base, highlighting the need for skilled surgical techniques and patient education to minimize risks.
The episode concludes with a discussion on how surgeons balance patient desires for specific nose shapes with overall facial features and aesthetic goals.
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Medical tourism has been on the rise in recent years as people seek cheaper cosmetic surgery options in foreign countries. However, this trend has been associated with a range of risks and complications, as discussed by Alexander Zuriarrain, MD, FACS, a board-certified plastic surgeon and owner of Miami-based Zuri Plastic Surgery, in this podcast with PSP co-chief editor Keri Stephens.
According to Zuriarrain, patients seeking affordable cosmetic surgeries often consider traveling to the Dominican Republic, Venezuela, Colombia, or Mexico, where the costs are significantly lower than in the United States. However, there are a number of concerns associated with medical tourism, including the potential for patient exploitation, the risk of complications arising from long flights, and the difficulty of diagnosing and treating complications without in-person consultations.
One of the major worries associated with medical tourism is the potential for patient exploitation. Patients who seek cosmetic surgery in foreign countries may be unaware of the quality of care they will receive or may not have access to adequate post-operative care. This can lead to a range of complications, including infections, necrosis, and blood clots, which can be difficult to diagnose and treat remotely.
Another risk of medical tourism is the financial cost associated with undergoing cosmetic surgery abroad. Patients may believe that they are getting a better deal by traveling to a foreign country for surgery, but they may not consider the additional costs associated with follow-up care and complications. These costs can quickly add up, making the overall cost of surgery much higher than expected.
Overall, Zuriarrain advises patients to mull the risks and benefits of medical tourism before deciding to undergo cosmetic surgery abroad. Patients should be aware of the potential for patient exploitation, the risks associated with long flights, and the difficulty of diagnosing and treating complications remotely. Instead, patients should consider seeking surgery from U.S.-based board-certified plastic surgeons, who can provide them with high-quality care and adequate follow-up care at a reasonable cost.
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Plastic surgeons today face a unique set of challenges, from changing patient demographics to increased competition in the marketplace. In this podcast episode, Plastic Surgery Practice Editors Keri Stephens and Alison Werner talk to Nicole Chiaramonte, CEO of Advanced MedAesthetic Partners (AMP). Chiaramonte joins them to discuss how AMP can help plastic surgeons overcome these challenges and grow their practices. What’s more, she explains why AMP is an alternative to the private equity consolidation model sweeping the industry.
AMP works as a management service organization, coming in, as Chiaramonte describes it, as a consulting firm of sorts to take care of the business side of running a medical practices—specifically those aspects doctors often don’t want to deal with or don’t feel they have the knowledge to handle effectively and efficiently. According to Chiaramonte, AMP takes care of HR, IT, marketing, and overall day-to-day management, including inventory systems and data management for its partner practices. As she explains, AMP allows “physicians to do what they love without the headache of the business side of medicine.”
In this episode, Chiaramonte talks about how private equity is changing the playing field, and how she wanted to create a model that protects private plastic surgery practices. As she explains it, Advanced MedAesthetic Partners partner practices retain their public-facing identity. AMP’s goal is optimize the business side, investing heavily in marketing and training, while allowing the plastic surgeon to focus in on what he/she knows best: clinical treatment.
As Chiaramonte explains it in this podcast, for plastic surgery practices looking to partner with Advanced MedAesthetic Partners, the key characteristics include a commitment to patient satisfaction, a willingness to adapt to changing market conditions, and a desire to grow and scale their business over the long term. She also explains how this model can be just as attractive to mid-career plastic surgeons as those at the beginning and end of their careers.
From there, Chiaramonte shares how AMP has helped partner practices scale up their business. That has included adding additional surgeons to fully book out the practice to building out a practice’s non-surgical recurring revenue opportunities. Chiaramonte also shares how AMP can help practices struggling with staffing—a problem affecting all of healthcare.
To close out the episode, Chiaramonte and PSP’s editors talk about trends and how the industry is evolving. And Chiaramonte explains the role she sees Advanced MedAesthetic Partners playing in the future.
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Join Plastic Surgery Practice Co-Chief Editors Alison Werner and Keri Stephens as they talk to ELEVAI Labs Founder and CEO Jordan Plews, PhD, to talk about the company's ELEVAI E-series post-procedure aftercare products featuring a proprietary exosome technology. ELEVAI Labs is a biotechnology company developing regenerative skincare applications. The company is focused on physician-dispensed products that can work to support patient skin health following a range of procedures, from microneedling to laser resurfacing.
Plews, who has a background in biochemical engineering, shares how his work in stem cell research related to regenerative medicine brought him to aesthetics. He developed a proprietary technology centered around exosomes and the role they play in the cellular repair process of the skin. These exosomes are ultra-small, nanoparticle compartments packed with growth factors known to support skin health. The proprietary ELEVAI Exosomes are the key ingredient in the company’s post-treatment aftercare system, the ELEVAI E-series, launched in 2021, which includes ELEVAI empower and ELEVAI infinity.
In this episode, Plews not only provides a deep dive into how exosomes in skin care work, but also explains how the ELEVAI E-series products can be used for post-treatment aftercare for procedures including microneedling to laser resurfacing. As he says, these products work well where “you’re causing a low level of damage and you want to give the patient something that’s going to really supercharge their recovery.”
ELEVAI empower is a concentrated serum, designed specifically for single-use in office application post-procedure. ELEVAI enfinity is a daily serum that can then be sent home with the patient to support their skin health post procedure. According to ELEVAI, both products aim to help activate the skin’s natural healing process; reduce the appearance of fine lines and wrinkles; improve the appearance of uneven skin tone, skin texture, and laxity; and reduce the appearance of pigmentation and redness.
This podcast episode sees Plews talk about the ingredients in these post-procedure aftercare products that work with the ELEVAI Exosome technology, and what both plastics surgeons, their staff, and patients can expect with use. He also explains why these products are only available for sale from authorized providers, for instance, physicians and their trained staff, and why it is important for ELEVAI to work with plastic surgeons and staff like this. PSP
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Join Plastic Surgery Practice Co-Chief Editor Keri Stephens as she talks to Michael Tantillo, MD, MBA, a board-certified plastic surgeon and founder of Clareo Centers in Massachusetts, about the popular trend of buccal fat removal. The conversation covers what the procedure is, how it works, and its benefits and risks.
Tantillo explains that buccal fat removal has been around for decades but has gained significant popularity recently, particularly among Gen Z patients who are more open-minded to aesthetic procedures. He notes that the procedure is safe when performed by a properly trained surgeon and has minimal risks and downtime. The surgery involves a partial removal of the buccal fat pad, which lies in the mid-face between the muscles, through an incision inside the mouth. Patients can expect a quick recovery and high satisfaction rate, as the procedure results in a slimmed mid-face with reliable and reproducible results, according to Tantillo.
The episode also discusses the reasons behind the trend of buccal fat removal, which Tantillo attributes to a drive toward slimming down the mid-face and avoiding the “round face” look. The popularity of buccal fat removal has been driven by its virality on social media platforms like TikTok, Tantillo says. Learn more about the procedure in this informative podcast.
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Join Plastic Surgery Practice Co-Chief Editors Alison Werner and Keri Stephens as they talk to Los Angeles-based, board-certified plastic surgeon and inventor Gregory Mueller, MD, FACS, about a trending device in aesthetic medicine. A public speaker who educates surgeons about the minimally evasive MyEllevate procedure that he developed, Mueller discusses another technology in this podcast: the Sofwave energy-based device, which he uses in his practice. In December, the U.S. FDA cleared Sofwave to treat the appearance of cellulite, complementing its previous clearances to lift the eyebrow lax submental tissue as well as neck tissue. Here, Mueller reveals how Sofwave is different from other devices on the market, in addition to which patient population Sofwave benefits most. He also shares what the learning curve is like for using Sofwave, along with his advice about the device to his plastic surgeon peers.
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Join Plastic Surgery Practice Co-Chief Editor Keri Stephens as she talks to Anna Steve, MD, FRCSC, (or “Dr. Anna,” as her patients call her) about all things breast reconstruction. A breast specialist at the New York City-based Neinstein Plastic Surgery, Dr. Anna endorses an “elegant” approach to breast surgery—although she’s quick to point out that the reconstruction process can present unique challenges. In this podcast, Dr. Anna reveals why breast reconstruction is rarely a one-and-done procedure and why referring to post-mastectomy reconstruction as a “free boob job” is deeply erroneous. She also divulges what excites her most in breast reconstruction right now. (Hint: It involves nipple reconstruction.)
Finally, Dr. Anna shares one important aspect of medicine that surgeons are “not historically great” at—and why that should change.
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In this podcast, Alexander Zuriarrain, MD, FACS, joins Plastic Surgery Practice Co-Chief Editors Keri Stephens and Alison Werner to talk about ethics in plastic surgery—a subject Zuriarrian recently wrote about for Plastic Surgery Practice. The three discuss how social media and the way plastic surgeons are using it are raising some ethical questions. Zuriarrian—a board-certified plastic surgeon and owner of Zuri Plastic Surgery in Miami—talks about how he’s seeing plastic surgeons post altered and airbrushed images on social media platforms like Instagram and TikTok and how these posts raise concerns. He talks about how photos showcasing certain procedures are more easy to manipulate and give patients unrealistic expectations. When it comes down to it, Zuriarrian contends that this is one of the reasons patients should search out board-certified plastic surgeons. He points out that the American Board of Plastic Surgery certification process is not just about how good a surgeon’s technique is, but also about ethical behavior—and that includes the ethics around their marketing practices. Zuriarrian specifically points to board guidance on website content and how images are used to illustrate procedures. The fact is social media is a whole new frontier and there are ethical issues that need to be addressed. And while the conversation has started around the responsibilities of board-certified plastic surgeons, it’s going to take time to create guidelines. In the meantime, Zuriarrian reminds listeners of the four guiding principles of medical ethics and talks about why it’s important as a plastic surgeon to look to one’s conscience and always focus on what is in the best interest of the patient. PSP
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