May/June 2013 Vol. 34, No. 4 · MAY/JUNE 2013 Facial Plastic Times 1 May/June 2013 Vol. 34, No. 4...

MAY/JUNE 2013 Facial Plastic Times 1

May/June 2013Vol. 34, No. 4

FALL MEETING PRESENTS FACIAL PLASTIC SURGERY 2.0

Join the AAFPRS for FacialPlastic Surgery 2.0, ourFall Meeting in NewOrleans, October 19 - 21,

2013. This three-day meeting willfeature a new format with foureducational tracks: aesthetics,non-surgical, practice manage-ment, and reconstructive surgery.Co-chairs William W. Shockley,MD, and Steven H. Dayan, MD,have lined up expert speakersfrom various specialties to partici-pate on multiple panel discus-sions and over 80 masters semi-nars and instruction courses,which will provide expansivecoverage of topics in facial plasticand reconstructive surgery.

The Aesthetic Track willfocus on innovative techniquesfor facelift, browlift, and ble-pharoplasty. You won't want tomiss the panel discussion,Minimizing, Recognizing, andTreating Complications in FaceliftSurgery, moderated by William H.Truswell, MD. Stephen W. Perkins,MD, will moderate the panel, WhatWill Facelifts Look Like in 2025?

Dedicated sessions will alsocover fat transfer, hair transplanta-tion, and otoplasty. The AestheticTrack on Monday concludes withthe panel, Here Today, HairTomorrow.

The Non-surgical Track fea-tures speakers from the specialtiesof facial plastic surgery, plasticsurgery, oculoplastic surgery, andcosmetic dermatology. Sessionswill explore concepts of beauty,popular cosmetic procedures, scarmanagement, acne, and advancesin skincare. Panel discussions

throughout this track include:Why do we do What we do?; Meetthe Demand! Most Popular Cos-metic Procedures in America; MyPerspective May be Different thanYours; Rethinking Neurotoxins andFillers; Avoiding Complications andManaging Pitfalls; The New Wave-length; Emerging Technology; andFacial Plastic Surgery: A DifferentTranslation.

Learn about brand manage-ment, marketing, social media, andmore, in the Practice ManagementTrack. There are numerous practi-cal sessions to attend, in additionto the following panel discussions:O How do I Create a Luxury Brand?O Can I Provide the Ritz Carlton

Experience to my Patients?O Am I Getting the Most Out ofmy Staff?O What are the Warning Signs ofEmbezzlement and Fraud?O The Entrepreneurs: FromPatients to Pipelines, Promotions,and ProgrammingO Is it Possible to Retain 90Percent of my Current Patients?O Can I Reach an ExternalAudience Keeping Costs Low andReturns High?O What are the ROIs of SocialMedia?O How do I Protect Myself AgainstUpset Patients and BadReviews?O I Need to Increase MediaExposure, What Makes a GoodStory?O Do I Have my Patients at Hello?O Can I Get a Lawyer's Perspec-tive?

The Reconstructive Track willdevote an entire day to rhino-

plasty. Panel discussions will covernasal reconstruction, microtiarepair, reconstruction reimburse-ment, challenging cases in recon-struction and defects, and nasalvalve surgery. Esteemed speakersinclude Rod Rohrich, MD; BahmanGuyuron, MD; Gary Burget, MD;and Shan R. Baker, MD.

October is a beautiful time tobe in New Orleans, with the aver-age high temperature in the upper70s. Stroll along Bourbon Street tofind the perfect live-music venue.Check out St. Louis Cathedral inthe French Quarter and tour theGarden District. If you are a historybuff, the National World War II See New Orleans, page 16

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2 Facial Plastic Times MAY/JUNE 2013

PRESIDENT’S MESSAGE:

EXPERIENCE LEARN,

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

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

May/June 2013Vol. 34, No. 4

BOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORS

Robert M. Kellman, MD*President

Tom D. Wang MD*Immediate Past President

Edward H. Farrior, MD+President-elect

Stephen S. Park, MD*Secretary

Paul J. Carniol, MD*Treasurer

Fred G. Fedok, MD+Group VP for Education

Mary Lynn Moran, MD*Group VP for Membership & Society Relations

Edwin F. Williams, III, MD*Group VP for Public & Regulatory Affairs

Craig S. Murakami, MD+Group VP for Research, Development, and

Humanitarian Programs

Minas Constantinides, MD*Secretary-elect

William H. Truswell, MD*Treasurer-elect

Theda C. Kontis, MD*Group VP for Membership/

Society Relations-elect

Scott A. Tatum, MDDirector-at-Large

Harvey D. Strecker, MDCanadian Regional Director

David A. Sherris, MDEastern Regional Director

Harrison C. Putman, III, MDMidwestern Regional Director

Richard E. Davis, MDSouthern Regional Director

Sam P. Most, MDWestern Regional Director

Grant S. Hamilton, MDYoung Physician Representative

Patrick J. Byrne, MDEastern Regional Director-elect

J. David Kriet, MDMidwestern Regional Director-elect

David W. Kim, MDWestern Regional Director-elect

Stephen C. Duffy+Executive Vice President

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

So I had a chance to test drive the brand new educational portal of the AAFPRS Foundationa called LEARN: The Lifelong Educational

and Research Network, before it went live.Let me tell you; everyone who takes advan-tage of it will be in for a treat! It is an impressive accomplishment—and it should inspire those who supportedthe capital campaign to freely give more andthose who have not supported it to recon-

sider. The educational portal was one of three extremely important initia-tives identified as a need by our members that were to be financed fromcontributions raised through the capital campaign. The other two includethe implementation of a world class Research Center to educate memberson the process of conducting quality research while providing financialsupport to perform the essential research of the specialty, and the supportto take our FACE TO FACE programs to a whole new level. When you seethe educational portal, you will be impressed with how effectively the fundsdonated thus far (and of course there are still three years remaining onmost of the pledges) have been utilized.

LEARN is "Your Gateway to Educational Excellence in Facial Plasticand Reconstructive Surgery Worldwide," and it will provide our memberswith a valuable and user-friendly way to navigate through their educa-tional needs in facial plastic surgery. You can track purchases and CMEsthrough your account. There will be post-tests available so that CMEcredits can be obtained for online study; LEARN will provide the capabilityto print certificates and personal transcripts directly from the portal.Access articles, journals, and even virtual workshops. There will even beopportunities to watch videos from the John Dickinson Memorial VideoLibrary online (and the quality of the video and the audio was very impres-sive indeed). And this is only the beginning.

With the transition to time-limited certificates that are now offered bythe certifying boards, everyone will need mechanisms to work their waythrough the maintenance of certification (MOC) process. The educationalportal will provide ready access to learning modules that will make theMOC process so much easier, and it will assist our members as they worktheir way through their continuing education efforts.

The educational portal will also make it possible to access other educa-tional activities more easily, including course and meeting registrations.The opportunities are almost endless. The Academy is maturing in theInternet Age; it is taking advantage of the many opportunities that theInternet provides for reaching out to and providing its members with thetremendous benefits that the Web can provide. Access to digital mediamakes content not only easier to access but also to store. This is truly agreat advance for the Academy and its members; and I must congratulateall of those who have contributed to this amazing series of accomplish-ments. I must commend Karen Sloat and the members of the EducationalPortal Committee that was led with vigor, enthusiasm, and perspicacity byM. Eugene Tardy, MD, one of our past presidents and devoted leaders.Many thanks to the members who spent hours of their time to assist withthe selection of a vendor, identification of business requirements, design,and testing of the portal, including Ted A. Cook, MD; Theda C. Kontis,MD; Sachin Pawar, MD; Peter A. Hilger, MD; and Tom D. Wang, MD. OurCME and meetings consultant Caryl Bryant has played a critical role inassuring that all CME regulations are being met and that the CME


OUR NEW EDUCATION PORTAL

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offerings will meet the needs of ourmembers.

In addition, the committeeengaged a number of Academymembers in the overall testing ofthe portal to ensure that thefunctionality was operating asexpected and that the tool was userfriendly.

I have to come back to thecapital campaign. I am so im-pressed with how quickly thisfundraising success has beentranslated into meaningful andmeasurable accomplishments. It isa testament to the commitment ofthis organization, its leadership,and its staff to provide real value toits members. We had 231 membersand 12 companies pledge supportto these initiatives. I have been toldthat member support was unprec-edented and I commend those whohad the vision and the foresight tomake this dream a reality.

The research subcommitteeshave been similarly conscientiousin working to create opportunitiesthat will advance our purposes andenhance the standing of ourorganization and its members. Aseries of meaningful grants de-signed specifically to encourageand support the types of researchactivities that will lead to long-termprojects are now planned, andagain, due to the capital campaign,there are now funds to underwritethese important efforts.

Unique opportunities are beingcreated that will help foster re-search success among our mem-bers and help our organization toprovide leadership in areas thatwill hopefully lead to furtherongoing support, particularly fromour partners in industry. Sam P.Most, MD, as committee chair andBenjamin Marcus, MD, and LisaIshii, MD, as subcommittee chairsworked diligently with committeemembers to make sure that thenew Research Center is a reality in2013. The first grants and scholar-ship will be made available tomembers for application by year-

end. They include a$30,000 ResearchScholar Award in-tended to providefinancial support toAAFPRS memberswho are planning toconduct research thatwill make a signi-ficant contribution tothe profession offacial plastic and re-constructive surgery;a $2,500 ClinicalInvestigation Awardintended to providefunding to AAFPRSmembers who don'tnormally participatein research projectsbut demonstrate aninterest in furtheringthe professionthrough research;and a $15,000 FacialPlastics Clinical Re-search Scholarshipintended to providefinancial support toAAFPRS members to pursueacademic training in the principlesof clinical research design, datamanagement, statistical analysis,and manuscript and grant prepa-ration. It is the intent of theFoundation and the Academy toexpand clinical and basic scienceresearch to provide high qualityevidence to identify best practices.You can read more about theseopportunities on page six of thisissue of Facial Plastic Times.

Finally, the FACE TO FACEprogram is being evaluated andpossibilities for major growthanalyzed. This committee, chairedby Dr. Cook, is working to achievethe vision to provide physicianswith the operational support andleadership for focused trips, toincrease the number of referralsreceived for FACE TO FACE: TheNational Domestic Violence Projectand FACES OF HONOR, and toencourage members to participatein one or more of the programs. To

accomplish this objective, anindividual has been assigned bythe Foundation to help achieve ourgoals. With dedicated fundsallocated for this purpose, thereare numerous ways that theprogram can be expanded, andthese are being carefully assessed.

Your Academy is doing won-derful and important things onbehalf of us all. As I indicated inmy acceptance speech, we are amembership organization, and wedepend upon the generosity andsupport of our members to makeus strong and meaningful. I wantto congratulate you, our members,for doing just that.

Robert M. Kellman, MD


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PR TIPS: HOW TO EARN LOCAL MEDIA COVERAGE

This column is provided toyou by Melissa Kelz Commu-nications, the Academy’s newpublic relations firm. Have anews worthy story, Melissaand Patty Mathews are avail-able to you—reach out to themat [email protected].

Media outreach hasbecome a vital aspect ofAAFPRS members'practice growth strategy.

Your ability to convey your messageto your targeted audience candirectly impact the success of yourmarketing program. There are twotypes of traditional media—paidand earned. Paid media you pur-chase, e.g., ads in magazines,online, radio, and television.Earned media you gain throughoutreach to media outlets, pressreleases, press conferences, andevents. Paid media is usually veryexpensive; it has less credibility orimpact than earned media becauseyour target audience knows that itwas purchased. Earned media alsoenhances your position as anexpert in your field, and elevatesyour profile in your geographicarea.

Following are some key earnedmedia tactics that can help takeyour practice to the next level.

1) Send out or post pressreleases on your local newswires toannounce major milestones, newtechnologies you have brought on,key staff members who have joinedthe practice, clinical research youare involved in, published articles,

and speaking engagements atprofessional meetings.

2) Host an open house event ormedia breakfast in your office tointroduce a new procedure ortechnique, to educate editors, andto position your practice as a "goto" source of up-to-date informa-tion. Invite media to watch ademonstration of a procedure, ortalk to a patient who has had itdone and is an advocate for yourpractice.

3) Pitch stories to mediaoutlets (regional newspapers,magazines, Web sites) that have arelevance to your local community;for example, a patient who under-went a procedure that was lifechanging, or a trend story abouthow girlfriends are having facialrejuvenation treatments donetogether.

4) Plan outreach to localbloggers who write about beauty,aesthetics, anti-aging, and cos-metic surgery to share informationabout what consumers wanttoday, and interesting advance-ments in the field of facial plasticsurgery. Share components of theAAFPRS 2012 statistics.

5) Celebrate any media place-ments your practice receives by

integrating these into your market-ing program and social mediacampaigns. For example, post anymentions or broadcast appear-ances on your practice Facebookpage, Twitter, blog, and in youreblasts to patients to get the wordout. For high impact placements,such as glossy magazines, have thecover and the passages thatinclude a mention of you or yourpractice framed professionally fordisplay in the office. N

Andrew A. Jacono, MD, of NewYork City, recently returned fromhis mission to Quito, Ecuador,where he performed facial plasticsurgery on children with microtia.Dr. Jacono and medical volunteersfrom HUGS Foundation spent aweek in Ecuador, March 2 -9,2013, screening and operating onnumerous cases that involvedsculpting and creating ears fromrib cartilage. HUGS Foundation isa non-profit organization thatdelivers medical care to childrenfrom developing countries whosefamilies have lack of medical andfinancial resources. Dr. Jacono hasbeen helping children with cleft lipand palates, birth defects, burns,and other deformities for over fiveyears. His most recent missiontrips include Ecuador, Thailand,and Colombia. Dr. Jacono'sinternational philanthropicengagement includes volunteeringfor organizations such as BeyondOur Borders and Healing theChildren. N

IN BRIEF


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L ast fall at the 2012 Annual Meeting in Washington, DC, the AAFPRS Founda- tion and the Academy

celebrated the culmination of avision first proposed by the Acad-emy leadership several years ago.The Many Faces of GenerosityCapital Campaign, to which 231members and 12 companiesgenerously contributed over $4.1million, provided the funds tomake the dream a reality. Thesecontributions are now beingutilized.

The AAFPRS Foundation isexcited to announce that we arewell on the way to building aResearch Center that will educatemembers on the process of con-ducting quality research, whileproviding funding to perform theessential research that will meetthe needs of the specialty. Thisincludes supporting academictraining in the principles ofclinical research design, researchmanagement, and statisticalanalysis. It will also expandcapacity to conduct clinical andbasic science research to providescientifically based evidence tosupport treatment decisions andrecommendations. The goal is forthe AAFPRS Foundation to providea first-class Research Center formembers to further their trainingin conducting research, to providefunds to expand research efforts,and to provide opportunities formembers and industry to collabo-rate while discovering opportuni-ties to improve patient care.

We are pleased to announcethat a distinguished committee ofyour peers has outlined a series ofgrants and scholarships that willbecome available to members laterthis year. These opportunities willfollow the established guidelinesfor the Bernstein Grants with aJanuary 15 deadline of each yearstarting in 2014. These include:

1) The Research ScholarAward is a $30,000 grant pre-sented annually and renewable foran additional two years. TheResearch Scholar Award will be

WORLD-CLASS RESEARCH CENTER COMING SOON

given to the candidates thatdemonstrate the potential to makea significant contribution to theprofession of facial plastic andreconstructive surgery and willmake meaningful contributions tothe field.

2) The Facial Plastics ClinicalResearch Scholarship is a $15,000contribution intended to providefinancial support to AAFPRSmembers to pursue academictraining in the principles ofclinical research design, datamanagement, statistical analysis,and manuscript and grant prepa-ration. It is the intent of theFoundation and the Academy toexpand clinical and basic scienceresearch to provide high qualityevidence to identify best practice.The committee may approve morethan one scholarship based on theapproved annual budget for theResearch Center. In addition, anindividual may receive the scholar-ship for two years in a row if it is atwo-year degree program.

3) The AAFPRS ClinicalInvestigation Award will be pre-sented for smaller projects to beawarded to those surgeons whodon’t normally participate inresearch projects but have smaller,but meaningful projects that couldcontribute to facial plastic surgery.These grants are meant to fostercontinued contribution frommembers to the field of facialplastic surgery. A grant of $2,500is available.

Beyond the exciting newscholarship and grant program,the committee has been workingon developing course programsfor future meetings, both CMEand non-CME. Discussions havebeen taking place with industryto determine which companiesmay have an interest in sponsor-ing courses on the followingtopics:O Clinical researchO Conducting clinical trialsO Data managementO StatisticsO Getting ready for an auditO AND MORE!

Look for more informationwith the 2013 Annual Meetingmaterials. These sessions will bestructured in such a way that theyare appropriate for clinical coordi-nators and will be conducted bymembers of the corporate commu-nity.

Long-term goals includeexploring the feasibility of aResearch Center Forum. Theforum would provide selectedinvestigators with the opportunityto convene on a yearly basis topresent and discuss the findingsof each research project, to assessthe impact on the profession, andto ensure that members of theAAFPRS benefit from the studiesconducted.

In addition, the AAFPRSleadership feels there is value inexploring the viability of a separateentity as an arm of the Academy,whereby independent research canbe conducted with results beingmade available via the LEARNportal and through the proposedResearch Forum sponsored by theAcademy.

The entire Research CenterCommittee—under the guidance ofJonathan M. Sykes, MD, and VitoC. Quatela, MD, as chairs of thecapital campaign, and committeemembers: Sam P. Most, MD; LisaIshii, MD; Benjamin Marcus, MD;Michael Brenner, MD; Patrick J.Byrne, MD; Steven H. Dayan, MD,Paul Leong, MD; Amir Moradi,MD; Mary Lynn Moran, MD;Michael J. Sullivan, MD; andBrian Wong, MD—invite you towatch for future announcementsas to how you can apply for theseexciting opportunities. N

For more information aboutthe Research Center, or tobecome involved, contactKaren Sloat, Senior ProjectConsultant via e-mail [email protected] or by phone(703) 299-9291, ext. 230.


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By Peter A. Adamson, MD

From the moment the AAFPRS was founded,the excellence of its fellowship program waspreordained. This was because of theexceptional dedication to teaching that hasbeen the hallmark of our Academy’s leadersfrom the beginning. In 1964, Richard T.Farrior, MD; Jan Beekhuis, MD; Robert L. Simons, MD; Jack R.Anderson, MD; and Dean Lierle, MD, among others, debated thesalient issues regarding the creation of fellowship programs. Howlong should they be? Should they be observational or hands-on?Should they be for graduating residents or for surgeons inpractice? How should they be funded, and how should they beaccredited? Many of these questions have subsequently beenanswered, but some persist even to this day.

The first fellowship program began in 1968, with initialfunding organized by Dr. Anderson who raised funds throughappeals to his colleagues. Peter A. Hilger, MD, was one of thefellows of Richard C. Webster, MD, and remembers, “In the earlydays, fellows received no pay, and I had to cover my ownmalpractice insurance. So I took out a loan and lived off my wife!”And, Dr. Webster was a character, “I carried Dr. Webster’sparaphernalia around looking like we were on Safari, and referredto him as Bawana Webster! Dr. Webster was probably the firstdirector to introduce the San Diego classics teaching videotapesthat he created with Terry Davidson, MD, and Chuck Cox. Wewatched them while Dr. Webster did his consultations—alwaysalone.”

By 1972, the Educational and Research Foundation for theAAFPRS was created and funds from educational courses weredirected to fellowship programs, initially at $6,000 per year.Standards were established, and the AAFPRS Foundation appliedto the American Medical Association (AMA) for approval of theprogram so that a recognized certificate could be awarded. Thefirst official fellow was David A.F. Ellis, MD, from the Univer-sity of Toronto. Other early fellows included E. GaylonMcCollough, MD; Ted A. Cook, MD; John R. Dmytryshyn, MD;and Fred J. Stucker, MD. By 1973, there were eight rotationalfellowships with fellows spending three to six months at eachprogram. Early fellowship directors included Irving Goldman,MD; Trent Smith, MD; Sidney Feuerstein, MD; Morey Parks,MD; Wally Berman, MD; Richard L. Goode, MD; Dr. Simons;and Dr. Beekhuis.

Beginning in the 1970s, an international fellowship programwas established with Hugo Obwegeser, MD, and Claus Walter,MD, in Switzerland, and Lionello Ponti, MD, in Italy. These wereultimately discontinued as the fellowship program became moreregulated to match Accreditation Council for Graduate MedicalEducation (ACGME) standards.

Dr. Anderson was a powerhouse in the Academy and can becredited with at least three major initiatives related to thefellowship program. First and foremost, “Jack” was the consum-mate teacher, and unlike some others such as Dr. Goldman whowas rigorous in demanding others follow his technique, Dr.Anderson was geared to change. From initially opposing the openrhinoplasty approach, he ultimately became one of its greatest

proponents. As his fellow, I remember him excitedlysaying, “Peter, look at this, look at what's happeninghere.” If you wanted to learn, he wanted to teach.Secondly, Dr. Anderson was the first to push for a GraduateFellows Committee to bring fellows together to discusscases. At his behest in 1982, I created this committee alongwith Edwin A. Cortez, MD; Devinder S. Mangat, MD; andWilliam H. Beeson, MD; this group was ultimately laying thegroundwork for the creation of the Fellowship Committee.Finally, in 1988, Dr. Anderson donated $1.3 million to theAcademy from a successful lawsuit for the article, “When SkimMilk Masquerades as Cream.” This provided the funds for thecreation of the fellowship examination which ultimately led to thecreation of the American Board of Facial Plastic and Reconstruc-tive Surgery (ABFPRS).

In 1981, under the direction of Charles Gross, MD, G.Richard Holt, MD, began the thrust to create more facultypositions for facial plastic surgeons to enhance our academicengagement. He also developed courses in maxillofacial trauma,facial skin malignancies, and soft tissue workshops. In 1985, aschair of the newly formed Fellowship Committee, Dr. Holtconvened an historical retreat in San Antonio to strategize itsfuture. Young (at the time!) leaders participating included Shan R.Baker, MD; Lee Smith, MD; Donn R. Chatham, MD; Wayne F.Larrabee, MD; J. Regan Thomas, MD; and myself. Importantinitiatives included the development of the educational compen-dium, oversight processes for programs, the format of thefellowship examination, and an application for a Certificate inAdded Qualifications (CAQ) in facial plastic surgery for theAmerican Board of Medical Specialties (ABMS) and the Ameri-can Board of Otolaryngology (ABOto). As Dr. Holt said, “Themodern AAFPRS fellowship process was birthed at this retreat,amidst chicken fajitas, Lone Star beer, homemade ice cream, jetskiing, and long runs in the hot sun.”

Not unexpectedly, our application for a CAQ was resisted bymost of organized medicine including the ABMS, AmericanBoard of Plastic Surgery (ABPS), and even the ABOto. Thisrejection led the Academy to create its own certification process,and the fellowship examination being used as the foundation forthe creation of the ABFPRS.

The importance of the fellowship program and its influenceon the development of the ABFPRS should not be underestimated.I, along with Drs. Chatham and Cortez, still vividly remember theday Dr. McCollough approached us and said, “I have an importantproject for you to do.” We all knew it was a huge undertaking, buteven we vastly underestimated the time and effort it ultimatelytook to create the highly reputable examination. From this, Icreated the blueprint for the ABFPRS certification exam thatremains essentially the same to this day. My committee requiredtwo years of effort by over 60 Academy members. Dr. Chatham isrecognized as the “father of the written exam” and Dr. Cortez asthe “father of the oral exam.” Jean Adams, MD; Lee Rowe, MD;Bill “Jake” Jacquis, MD; and Jim Denneny, MD, were all signifi-cant contributors of written examination questions. The creationof the board certification process provided recognition for andvalidation of the fellowship training programs and, indeed, our

Excellence Personified – The History of theExcellence Personified – The History of theExcellence Personified – The History of theExcellence Personified – The History of theExcellence Personified – The History of theAAFPRS Fellowship ProgramAAFPRS Fellowship ProgramAAFPRS Fellowship ProgramAAFPRS Fellowship ProgramAAFPRS Fellowship Program


specialty itself. Stephen W. Perkins, MD, a significant contributor to the development of the examination and the fellowship program throughout his career has said,“The Educational Research Foundation fellowshipprogram solidified the Academy's reputation, as well as

legitimacy, within organized medicine.” It should be notedthat, due to interspecialty competitiveness, it was not always easyto establish fellowship programs. As Ira D. Papel, MD, noted, “AtJohns Hopkins it was a significant undertaking due to complexpolitics and opposition from certain specialties.” Such was thecase for many programs.

In 1988, along with the development of the ABFPRS exami-nation, the fellowship program was standardized to meet AMAand ACGME criteria, these including fellowships being one, full-year long and mandatory sitting for the fellowship (now ABFPRS)examination which was based on a defined core curriculum. 29fellows took the first examination in Washington, D.C. in 1988.

Prior to the introduction of the computerized match processin 1998, selection experiences were often quite informal.Devinder S. Mangat, MD, remembers being interviewed by Dr.McCollough at a Western saloon/diner/pool hall! Richard E.Davis, MD, a former fellow and now director, has said, “Fellow-ship training served to hone my surgical skills and providevaluable insights.” Dr. Mangat shares the feelings of manydirectors in stating that it has been one of the most fulfilling partsof his life and he feels it is the single most important factor in theoverall success of the Academy. Numerous fellowship directorshave noted that this position has allowed them to maintain theirleadership, teaching, and surgical skills. Time and again, fellow-ship directors state how honoured and privileged they feel to be apart of this group.

Between 2005 and 2010, the role of fellowship co-directorswas defined; the core curriculum, video curriculum, and bibliog-raphy updated; and a review process for the fellowship programsestablished. All programs with ambulatory surgical facilitieswere required to have them accredited. In 2011, Jonathan M.Sykes, MD, spearheaded efforts to institute evidence-basedmedicine (EBM) into the fellowship programs. And, most

recently, steps are being taken once again to apply for ACGMEaccreditation status for those programs that wish to do so.

Today, the AAFPRS has 47 fellowship programs with 16having co-directors in the United States and Canada. In 2011, wewelcomed our first female fellowship director, Tessa A. Hadlock,MD, from Harvard. The average year sees 58 applicants fromeither otolaryngology-head and neck surgery or plastic surgery. Anew Domestic Observership Program has 23 mentors, and theInternational Observation Fellowship Program instituted by VitoC. Quatela, MD, has 41 mentors.

History has shown us the incredible success the fellowshipprogram has enjoyed. To date, 1,156 surgeons have completedfellowship programs, 1,528 fellows and non-fellows have takenthe examination, and 1,089 have been certified by the ABFPRS.Two distinguished awards, the John Orlando Roe Award and theSir Harold Delf Gillies Award recognize academic research andpublications completed during the fellowship year. The presti-gious Jack R. Anderson Award from the ABFPRS—whichrecognizes the highest standing on the examination—has beenwon by many fellows, as well as regular candidates for theexamination.

Any history of the fellowship program must also includeFatima Porter-EL. Fatima began her career with the AAFPRS in1991, becoming Fellowship Program Coordinator in 1992, andFellowship Program Manager in 1998. All fellows and directorsowe her a debt of gratitude for her commitment and contributionsto the program.

The AAFPRS fellowship program stands today as one of thelongest and strongest pillars supporting our Academy, ourFoundation, and the ABFPRS. It also supports each of us as facialplastic surgeons, whether fellowship-trained or not. Its history ofsuccess reflects the achievements of our Academy as a whole.Through the vision, idealism and determination of many histori-cal leaders, the integrity, stature, and value of our fellowshipprogram have been realized. No doubt, future Academy memberswill carry on this admirable program, evolving it as is necessaryto meet the needs of our members and our specialty for genera-tions to come.

Editor’s Note: In addition to those mentioned in the article, Iextend my appreciation to the following who have providedhelpful information: Fred G. Fedok, MD; Russell W.H. Kridel,MD; Mr. Stephen Duffy; and Ms. Laurie Wirth.

Taken in 1993, seen here are Dr. Adamson (third from the left)and his fellows (from left to right): Todd Morrow, MD; BeckyMcGraw-Wall,; MD; Mary Lynn Moran, MD; Ken Gwinn, MD;and Guy Tropper, MD.

Taken in Hollywood, FL, April 2010, during the Academy’s 10thInternational Symposium are Dr. Baker’s (second from the right)fellows: Jacob Steiger, MD; Brian Jewett, MD; and Jeff Moyer,MD. Jennifer Kim, MD (second from left) was the fellow ofMack Cheney, MD.


The winter ski meeting,endorsed by the AAFPRSFoundation, recentlyreturned to action after

a several year break. Facultyfrom facial plastic surgery,plastic surgery, oculoplasticsurgery, and dermatology, metJanuary 23 - 27, 2013, at theWestin Riverfront Resort inBeaver Creek, Colo. The meetingtitled, "Reaching New Peaks inFacial Plastic Surgery," broughttogether leaders from the variousfields to discuss the newest tech-niques in a casual, intimateenvironment. The ski meetingformat allows for generous interac-tion between the presenter andaudience that is not available atmany other meetings.

The educational sessionsbookmark the days, with collegial-ity on the slopes mid-day. Whilethe formal meeting times offergreat educational value, perhaps

Each quarter, the AAFPRSprovides an exceptionalmarketing vehicle for yourpractice—Facial Plastic

Surgery Today (FPST). This full-color, consumer newsletter isavailable in digital format; custom-ize the issue with your practiceinformation, before/after photo-graphs, and more. Your patientswill appreciate your dedication toensuring they have up-to-dateinformation—not to mention givingthem reasons to come into yourpractice for their next procedure.Mail FPST to prospective patients,distribute copies in your waitingroom, and post on your Web site.

The summer issue is theperfect time to feature brides andthe procedures they are having;the cover article is titled, WeddingSeason brings Brides in for FacialPlastic Surgery.

This article will explore the

SEEN HERE FROM LEFT TO RIGHT ARE: EDBUCKINGHAM, MD; DOUG SIDLE, MD; SAMMOST, MD; DAWN BUCKINGHAM, MD; EDWILLIAMS, MD; IVAN WAYNE, MD; TOMWANG, MD; AND STEVE SMITH, MD.

efforts brides are making to looktheir best on their wedding day—noninvasive skin treatment,contouring, plumping, or frown-line treatments can be the perfectcomplement to all of the prepara-

CONSUMER NEWSLETTER FEATURES WEDDING WISHES

AND FACIAL PLASTIC SURGERY TRENDS

tion that goes into making thebride look her best.

Inside on pages two and three,consumers will be intrigued by themost recent findings from theAAFPRS trend survey. Everyonewants to know what the mostpopular procedure is and who ishaving what and when.

In Ask the Expert, a patientinquires, "What is a face-freezingtreatment? I've heard it treatswrinkles." The answer will describea technique called cryoneuro-modulation—also referred to asFrotox—an injection of cold liquidnitrogen that reduces the appear-ance of wrinkles, much like Botox.

The What's New? section willhighlight the latest advancementsfrom Cornell bioengineers andphysicians in creating an artificialear using 3-D printing and inject-able molds. It looks and acts like anatural ear, giving new hope tochildren born with microtia.

The Health Tip will cautionpatients to avoid celebrity-inspiredfacial plastic surgery. Recent buzzabout Kate Middleton's nose haspatients bringing in pictures andtalking about getting a nose justlike her. Doctors advise to choosean optimal you instead of copycatfeature that may not be flattering.

Finally, on the back cover,Tune-up or Overhaul: What is YourPreference? will compare twodifferent treatment paths. Somepatients prefer to have severalminimally invasive techniques,while other patients want toschedule a combination rhino-plasty, eyelift, and facelift. Whatare the advantages of havingseveral minor procedures versus acombination of major procedures?Disadvantages? The article willexplain options and will encouragethe patient to take the path thatfeels most comfortable for them.

Don't miss out on an opportu-nity to lure brides and otherinterested clientele into yourpractice. Refer to the enclosedorder form. N

WINTER SKI MEETING REDUX

even more information passeshands on the ski lift! The skimeeting will take place every otheryear, alternating with theCaribbean facial plastic meeting,which offers a similar casualmeeting environment in a tropicalsetting. N

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By David Reiter, MD,DMD, Medical Editor,Facial Plastic Times

Every physi-cian is a greatcommunica-tor—just ask him or her.

Yet hundreds of clinical studiessuggest that this is not true. Theeffect of poor physician communi-cation on adherence to treatmentand on outcomes is known to bereal and significant. And thesubjects most ignored by doctorsin their communication withpatients (or, at least, perceived bypatients to have been ignored) areof great importance to facial plasticsurgery patients.

The manner in which a physi-cian communicates information toa patient is as important as theinformation being communicated.Patients who understand theirdoctors are more likely to acknowl-edge health problems, understandtheir treatment options, modifytheir behavior accordingly, followtheir medication schedules, etc.Multiple studies have shown thateffective patient-physician commu-nication can improve a patient'shealth as quantifiably as manydrugs—perhaps providing a partialexplanation for the powerfulplacebo effect seen in clinical trials.

Similar benefits of strong andopen communication apply to riskmanagement, where it is wellknown that patients who perceivetheir doctors as having been openand forthcoming are much lesslikely to allege negligence in theevent of a suboptimal outcome.

Unvalidated information abouteverything is now readily availableto everyone, and the entire countryis focusing on health care safety,efficacy, cost, etc. As a result,barriers to effective communicationbetween physicians and patients orpotential patients are growing innumber, density, and effect. TheInternet is a fountain of conflictinginformation about health care, andrampant misinformation affectspatients regardless of the nature of

MESSAGE FROM THE MEDICAL EDITOR: IMPROVING OUR

their problems or the specialty oftheir physicians. This makes itmore important than ever forphysicians to have a full range ofknowledge about health care,including the political and eco-nomic issues surrounding andaffecting it. We must educate ourpatients, which means that wehave to counter myth and rumorwith fact and good judgment.

We might do well to considerthe pioneering work done by theAmerican Academy of OrthopedicSurgeons (AAOS) in physiciancommunication, a group similar toour own that established a Com-munication Skills MentoringProgram (CSMP) to help membersimprove. From John Tongue, MD(chair of the AAOS' CSMP), "Whilewe all like to think we're goodcommunicators, our survey re-vealed that many members wereless charitable about their col-leagues' communication skillsthan their own. And the public'sperception of us matched ouropinions of our colleagues."

Dr. Tongue's group uses thebest available evidence to guidetheir programs. For example,studies have shown that mostorthopedic surgeons interrupt apatient within 19 seconds of thatpatient's first word to the doctor.But further research also showsthat most patients will finishsaying what they wanted to saywithin two minutes if allowed toproceed uninterrupted from theirfirst words. Research also showsthat most patients form an opinionof most doctors in the first 30seconds of interaction, manywithin five to 10. And that initialimpression can seriously impactthe efficacy of all subsequentcommunication.

AAOS teaches a "4E" approachto communicating with patients:engagement, empathy, education,and enlistment. They've trainedabout 40 of their members asmentors for the program and havealready taught over 4,000 mem-bers and residents in over 200workshops. From Terry Canale,

MD, an AAOS member who hasbeen very active in this program foryears, comes this summary of theAAOS approach:

"Engagement involves theinitial meeting with the patient.When you walk in the room, youhave only five seconds before he orshe forms an opinion of you. Startout by knocking on the door,smiling, and addressing thepatient professionally, in particularif that person is older. Dressprofessionally, maintain eyecontact, sit down in order to be onthe same level with the patient,and touch the patient briefly inorder to connect. Don't say, ‘Areyou doing well?’ because thisperson may feel like his leg isfalling off. Just say, ‘How can Ihelp you today?’

“Empathy, while hard to defineand teach, is the most importantelement of the interview. A roughdefinition would be 'how thepatient perceives you thinkingabout him or her and whether ornot you care.' Your goal here is toget the patient on your team. Themost important part is your abilityto listen to the patient, because apatient doesn't care how much youknow until he knows how muchyou care. Listening is not definedas ‘waiting to speak.’

“Education is what we do best.But it's easy to overwhelm apatient with a lot of medical terms.So it's important to use plain, clearlanguage to ensure that the personunderstands what you are saying.And you also want to understandpatients' preconceived notions, asmany times they come in with [apredetermined idea of what theyneed or want]. Patients should bechecked throughout the educa-tional phase of the interview toassess their understanding of whatis being discussed. Patient ques-tions should be encouragednow, not just at the end of theinterview.

“Enlistment techniques includesummarizing your salient pointsbefore you leave the room, writingout your instructions, and not

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COMMUNICATION SKILLS

leaving the room without ensuringthat the patient understandseverything you have said. Saysomething like, 'Mrs. Jones, let'smake sure you and I are on thesame page. Can you tell me whatexactly you will tell Mr. Jonesabout what I said today?' Thatway, the patient feels like you care,and you know you won't have tospend extra time reviewing infor-mation at a later appointment."

A 2011 study of 276 patientsby Nelson, Gay, Berman, et al(Cancer 117: 5212-20) found thatthe topics about which physicianswere rated to have communicatedpoorly or not at all (after hospicecare, life support, living wills, andmedical proxies, all relevant tofacial plastic surgery but not likelyto be held as concerns by most ofour patients) were emotionalsymptoms (56 percent), practicalneeds (71 percent), and spiritualconcerns (80 percent). No one canargue that the former two areimportant in facial plastic surgery,and spirituality in the broadest

sense is more of a factor in patientoutcomes than we generallyrealize. I've had more than a fewpatients over the years chose theirdoctors and dates of surgery on thebasis of their star charts. Whetheror not it was fortunate for me thatour signs were compatible is stillopen for discussion, but I waschosen as a surgeon by a surpris-ing number of patients over theyears because of my birth datealong with (one hopes not in lieuof) more traditional qualifications.Truth be told, it was only because Iunderstand fully that things ofgreat importance to patientscannot be dismissed as foolish orfrivolous by their doctors that I wasable to discuss these issues in amanner that let me assess thelikelihood that such patients poseda greater-than-baseline liabilityrisk to me and manage themaccordingly.

Effort spent on improvingcommunication skills will berewarded many times over. Theevidence says so. N

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You may have forgottenabout this, although itwas very popular when itwas released back in

September 2008 under the direc-tion of then president Vito C.Quatela, MD. The Academy’spublic relations package formembers is still available and verymuch up-to-date to further our on-going national campaign, Trustyour face to a facial plastic sur-geon. Reinforce to current andpotential patients—and theirfriends and family—to come toyour practice for cosmetic andreconstructive surgery.

The package contains anadvertorial with three versions(each one with a different focus:eyes, nose, facelift) in digitalformat. There is also a tip sheet onhow to maximize and get theadvertorial placed. There are three,high-quality images/posters tohave in your office, which you willalso receive in digital format so youcan customize with your own logoand practice information. And,finally, five, ready-made advertise-ments in color and black and whiteare included in the package. Allthree come in a PDF and werecreated in Adobe Photoshop, whichyou must have to be able to cus-tomize them to suit your practice.

The goal is to expand aware-ness and increase exposure withconsistent messaging. This will inturn promote our specialty, in-crease your name recognition, andbuild confidence with consumers.

Media coverage throughadvertorials, posters, and newsstories can translate into actualnew patients and assure currentpatients that they made the rightchoice by choosing you.

The PR Package is an easy-to-implement solution to getting morepatients through your practicedoor. An affordable $500 gets youthe entire package, while supplieslast. N

ADVERTISING

PACKAGE FOR

AAFPRS MEMBERS

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The image to the left is one of thethree posters that you can displayin your waiting room.

The image below is one of the fiveready-made ads that you canpersonlize with your practice logoand information.

Refer to the enclsoed formto order your PR packagetoday. For questions,contact Rita ChuaMagness at the Academyoffice at (703) 299-9291,ext. 227 or by e-mail [email protected].


OFPSA CORNER: TECHNOLOGY--

IT’S THE BEST, OR IS IT?

Jack Anderson Portraitby Eugene Bortnick, MDWm. Russell Ries, MD

Photograph of Irving B.Goldman, MDFrank I. Marlowe, MD

Candid photographs throughthe yearsWilliam H. Truswell, MD

"Best Memories of Wuerzburg"photographs, certificatesProf. Claus Walter, MD

"Paint the Town" invitationsand auction booksDr. and Mrs. Thomas Romo

Legal material from 1986William E. Silver, MD

1950s drawings/paintings byJerome A. Hilger, MDPeter A. Hilger, MD

We are looking for more submissions toadd to the Archival Center. Please mail/ship your archival materials to:Ann Holton Jenne at the AAFPRS office,310 S. Henry Street, Alexandria, VA22314

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Historical documentsE. Gaylon McCollough, MD

Various photos from Goldman’sTheaterMark E. Krugman, MD

Various watercolors of our pastleadersEugene Bortnick, MD

Historic photosRobert L. Simons, MD

Submissions for Archival Center

By Debbie Carlisle,OFPSA Vice President

Isn't technologygreat? The advan-ces we have seenare amazing;

whether it is in the operatingroom, advertising, or even some-thing as simple as having a patientask if we can text confirmation oftheir appointment time. At times,our brains seem to be overloadedwith information—are we not ageneration of information—yetalways desiring to learn more!

Most practices have seen thebenefit of expanding what a Website offers and the many differentaspects of social media. It's so easyto get caught up in the reports,i.e., number of hits, how many e-mails, how quickly we reply, whichareas/procedures are hit the most,how many seconds/minutes arespent at each area/link, etc. Ouradrenaline gets so pumped on thepossibilities. Yet, how good it is forour brain and our heart when weactually talk to the prospectivepatient!

Let us not overlook the firsttime we actually speak—usuallywhen we schedule the consulta-tion—and, ultimately meet withthe patient in an actual officeconsultation by listening to whothey are, what they want, whattheir desire is. We are connectingwith the patient as a person, notjust a number or statistic.

We hear so much about prac-tice growth. Different practicesseem to grow for different reasons:a well-known surgeon, the bestprices for injections, a convenientlocation, a caring staff, an informa-tive Web site, thousands of fans onFacebook...to name just a few.However, we all know a practiceisn't going to consistently thrive ifthey don't have a surgeon ofexcellence and staff who cares.

So what are the needs ofour patients? What can we doto improve the quality of our care?

This brings me back tohuman nature—caring, one ofthe most important needs of ourpatients. I'm sure our practice isn'tthe only one whose patients focustheir comments in surveys, cards,and e-mails on our level of care.This is what our patients see,want, and desire: to have a profes-sional relationship with genuinecare.

How do we show our patientswe genuinely care about them?First, we must block out anythingthat is preventing us from focusingon the patient during the consulta-tion. As hard as it may be, youmust block out the patient/consultyou just met with 20 minutesearlier, or the surgery you forgot toput on the schedule, and, dare Isay it—looking at the clock andthinking, I have somewhere to bein an hour! Second, once thepatient leaves, record your notesinto their chart including possiblesurgery dates, their travel sched-

ule, their thoughts, needs, andconcerns. No one expects us toremember three back-to-backpatients without notes. Third,follow up with a phone call or evene-mail if the patient prefers. Thesearen't suggestions on how to "do itright," but rather to get ourmindset in order: thinking of thepatient, one patient at a time!

Can this be a goal for prac-tices—that we see beyond thestatistics—beyond the monetarybenefit? See the patient as aperson we genuinely care aboutand may our patients see thepassion we have for our career! N

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For more information aboutthe OFPSA program and tobecome a member, please e-mailOFPSA president Kristi Fritz,[email protected].


2013MAY 8-11ADVANCES IN RHINOPLASTYChicago, ILCourse Directors: Peter A. Hilger, MD;Minas Constantinides, MD; andDavid W. Kim, MDEndorsed by ASAPS

JUNE 22-23ABFPRS ExaminationWashington, DC

AUGUST 2-4Portland Aging Face Course(Endorsed by the AAFPRS Foundation)Portland, ORCourse Directors: Tom D. Wang, MD andMichael Kim, MD

OCTOBER 19-21FALL MEETINGNew Orleans, LAChairs: William W. Shockley, MD andSteven H. Dayan, MD

FACIAL PLASTIC TIMES

MAY/JUNE 2013○

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2014FEBRUARY 5-8REJUVENATION OF THE AGING FACESan Diego, CACourse Directors: Sam P. Most, MD;Keith A. LaFerriere, MD; andH. Devon Graham, III, MD

MAY 27-3111TH INTERNATIONAL SYMPOSIUMNew York, NYSymposium Chair: Jonathan M. Sykes,MDProgram Chair: Anthony P. Sclafani, MD

JUNE 14-15ABFPRS ExaminationWashington, DC

SEPTEMBER 18-21FALL MEETINGOrlando, FL

May 27-31, 2014New York, NY

50th Anniversary CommitteeRobert L. Simons, MD, Chair

Peter A. Adamson, MDDonn R. Chatham, MD

Fred G. Fedok, MDGrant S. Gillman, MD

Grant S. Hamilton, III, MDSamuel M. Lam, MD

E. Gaylon McCollough, MDWilliam E. Silver, MDFred J. Stucker, MD

Ivan Wayne, MD

Enclosed in this issue of FacialPlastic Times are the Fall MeetingBrochure, FPST and PR PackageOrder Form, and Annual Fundenvelope. All ads that appear inthis publication are paid ads.

CLASSIFIED ADGreat opportunity to take posses-sion of an all cosmetic facialplastic surgery practice on theWest Coast of Florida. This is aturnkey transaction for a physi-cian or non-physician owner.High profile practice that ispoised for an incoming owner totakeover. Salaried staff surgeonand PA in place who couldremain if desired by new owner.Contact Emery Ellinger by phone(727) 639-4716 or by e-mail [email protected].

From Cover Story, page 1Museum should not be missed.From interesting cemetery tours tosouvenir and antique shopping,there is something for everyone.

The Fall Meeting brochure isenclosed in this issue of FacialPlastic Times for your review andregistration. Take note that theAAFPRS Fall Meeting will not beheld alongside the AAO-HNSFAnnual Meeting as in the past. Wewill be at the beautiful SheratonNew Orleans Hotel and you areencouraged to make your reserva-tions early to get the special roomrate. And as always, register beforethe pre-registration deadline ofSeptember 20, 2013, to avoid theon-site fees. N

UNIQUELY NEW

ORLEANS

CLASSIFIED ADThe Williams Center Plastic Surgery Specialists in Latham, NYPosition available for a board certified facial plastic surgeon in a growing,dynamic, multidimensional practice/business that has an emphasis onworld class outcomes, a staff culture of winning and accountability. Appli-cants must be driven and possess core competencies and have a genuineinterest in trauma, reconstruction, hair restoration, clinical research andteaching, including non-surgical/surgical facial rejuvenation, and a spiritof entrepreneurialism.

Guaranteed salary and benefits package with an incentive base modelis being offered for the first year, followed by a generous performance basedmodel for subsequent years. Partnership will be offered at 18 months toindividuals who show great work ethic and performance in addition to thepractice and business culture being a good fit.

Interested parties, please e-mail [email protected].

May/June 2013 Vol. 34, No. 4 · MAY/JUNE 2013 Facial Plastic Times 1 May/June 2013 Vol. 34, No. 4...

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