March 2018 Facial Plastic Times 1

TRENDS RELEASED: SELFIES REMAIN

POWERFUL, UP 13 PERCENT

March 2018Vol. 39, No. 2

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The annual AAFPRSmember survey resultsfor 2017 are out, with fewsurprises. From selfies

and prejuvenation to rhinoplas-ties and combination treatments,consumers continue to embracetheir options to look and feel theirbest. Overall, the average numberof procedures performed bymembers has increased 25percent since 2012.

For the third consecutiveyear, “selfie-awareness” is adriving factor for patients to seekyour assistance. Fifty-five percentof facial plastic surgeons sawpatients who want to look betterin selfies, which is up 13 percentfrom 2016. As the trend contin-ues to gain steam, it is transform-ing the facial plastic surgeryindustry.

People have become moreopen about sharing their en-hancements, aesthetic edits, andthe road to renewed self-confi-dence. “More and more of ourpatients are using social mediaas a forum to gain a sense ofsolidarity whenundergoing amajor, potential-ly life-changingprocedure.Consumers areonly a swipeaway from find-ing love and anew look, andthis movementis only going toget stronger,”says William H.Truswell, MD.

The tables are turning onwhat it means to look and to feelgreat, with a focus on health,vitality, and empowerment. This“prejuvenation” shift is creating ageneration of educated consum-ers who are taking control of theaging process. More than half (56percent) of our members saw anincrease in cosmetic surgery orinjectables with patients underage 30 last year.

This emerging segment isknowledgeable about high techskincare and sun prevention andstarts with facial injectablesbefore they turn 30. “As moremillennials come of age and gaindisposable income for aesthetictreatments, our members haveseen steady growth in the de-mand for cosmetic procedures,”says Dr. Truswell.

Regardless of treatment, anatural-looking outcome isparamount for patients, with33 percent stating a fear oflooking unnatural as their topconcern. See Prejuvenation, page 8

CHICAGO HOSTS

FACIAL REJUVE-

NATION MEETING○

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Join your esteemed col-leagues in Chicago, April12-15, 2018, for FacialRejuvenation: Master the

Techniques. The Planning Com-mittee and Advisory Board havesecured renowned experts toshare their methods, procedures,and personalized approaches. Notonly will you receive exemplarytraining, but there will also beseveral opportunities for partici-pants to interact and share withmultidisciplinary faculty.

Many interesting and engag-ing sessions will cover the gamutof the latest techniques andprocedures for browlifts, facelifts,implants, blepharoplasties,combination surgeries, laserresurfacing, skin tightening, fillerinjections, and more.

A breakout session on prac-tice management will share howto grow your practice by 20percent, meet prospective pa-tients’ needs, address legalissues, simplify human resources,and handle lifestyle choices. See Prerecorded Surgeries, page 8

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2 Facial Plastic Times March 2018

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

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Executive Editor: Steven JurichMedical Editor: Steven H. Dayan, MDManaging Editor: Rita Chua MagnessFreelance Writer: Lynnette SimpsonFacial Plastic Times is published by theAmerican Academy of Facial Plastic andReconstructive Surgery (AAFPRS)310 S. Henry St., Alexandria, VA 22314;Phone: (703) 299-9291; Fax: (703) 299-8898E-mail: info@aafprs.org; www.aafprs.org.

March 2018Vol. 39, No. 2BOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORS

William H. Truswell, MDPresident

Fred G. Fedok, MDImmediate Past President

Phillip R. Langsdon, MDPresident-elect

Theda C. Kontis, MDSecretary

Harrison C. "Chris" Putman, III, MDTreasurer

Richard E. Davis, MDGroup VP for Education

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

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

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

Humanitarian Programs

David W. Kim, MDGroup VP for Education-elect

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

Humanitarian Programs-elect

Jamil Asaria, MDCanadian Regional Director

Theresa A. Hadlock, MDEastern Regional Director

Benjamin C. Marcus, MDMidwestern Regional Director

Anthony E. Brissett, MDSouthern Regional Director

Travis T. Tollefson, MDWestern Regional Director

J. David Kriet, MDDirector-at-Large

Scott James Stephan, MDYoung Physician Representative

Steven J. JurichExecutive Vice President

INCLUSION AND DIVERSITY IN THE AAFPRS

“Isn’t it amazing that we are all made inGod’s image, and yet there is so muchdiversity among his people.” - Desmond Tutu

W e are on the map. We are well positioned in the smaller sphere of organized medicine and the larger universe of the public and

the world. We are the face of and de factorepresentative of facial plastic surgeons inthe United States and our specialty; thanksto our International Federation of FacialPlastic Surgery Societies partner, it isgrowing around the world.

As your elected representatives, westrive to promote and advance the core elements of the AAFPRS, whichwas formalized as our representative body over half a century ago. Inthe past, the core elements of our specialty’s goals have been to edu-cate, advocate, support research, work with industry, and sponsormedical missions in needy corners of the world. We have refined andexpanded those goals over the course of five decades to meet the evolv-ing demands of the science and technology. But, alongside our evolu-tion, the culture mores, folkways, and appearance of western societyhave all changed, grown, and expanded. Have we?

In my message in the last issue of Facial Plastic Times, I discussedthe challenges we uncovered in the Academy’s office, structure, andculture; and how, under the new leadership of Steve Jurich, we haveexperienced tremendous improvements in these areas. We are a veryproud organization—proud of our educational opportunities, of ourresearch, and proud of the work we do. Now, however, I think it is timefor us to turn inward and examine who we are and who we represent.

For some time, there has been an undercurrent of dissatisfactionwith the way our meetings, courses, and symposia are presented.Attendees have talked openly and written in evaluations of too oftenseeing the same speakers, hearing redundant lectures, even viewingthe same slides. There has been a growing desire for fresh faces, newoutlooks, and a broader representation of the membership at thepodium. Membership has dropped, in part, as the meetings haveseemed as “more of the same” and other options for obtaining CMEsbecame available elsewhere. Two years ago, we sought to address thisconcern by creating a new meetings director position and appointedPhillip Langsdon, MD, to this post in 2015. We also hired Ada Phillipsas our new director of meetings and CME. Ada is a full time, in-houseAAFPRS employee.

For over two years, Dr. Langsdon, now our president-elect, workedwith meeting and course chairs to expand the number and diversity ofcontributors at these events. This was not an easy task at first, butgentle persuasion and persistence paid off. The reviews of recent meet-ings have been increasingly enthusiastic. Our last Annual Meeting wasa resounding success and highly praised. This was in great part due tothe wide range of topics, presentations, and, very importantly, thediversity of speakers at the podium. For present and future meetingplanning, we have taken Verna Myers quote to heart: “Diversity is beinginvited to the party, inclusion is being asked to dance.”

So, who are we? Who do we represent? Our Academy is more diversethan it has ever been—and that is a strength we need to fully harness!

Our members range in age and experience; and during any course,you can run into surgeons who have been in practice for only one year

March 2018 Facial Plastic Times 3

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and you can share tablespacewith surgeons who have been inpractice for 50 years. That is atestament to our specialty’sdedication to mentoring youngergenerations and cherishing olderones. We enjoy diversity of reli-gion, gender, and ethnicity.Practice settings include aca-demic and university-based,large multi-specialty groups,private groups, and solo prac-tices. We must understand thesedynamics and embrace thiswonderful group for their differ-ent experiences.

Over the last few years, theAcademy and the Foundationbegan strategic assessments ofour structure and mission. Weare now undertaking importantengagement initiatives to betterinvolve members over the entire,diverse spectrum of the member-ship in all aspects of the Acad-emy and the Foundation. As anearly result of these efforts, weinitiated steps in the last twoAnnual Meetings with the ap-pointment of program chairs towork with the meeting director,Dr. Langsdon, to handle thingsdifferently than in the past. Theyengaged a significant diversity ofmembers inclusive of all ages,genders, and ethnicities. Theoutcome of these efforts met withgreat success. That it is impor-

tant to leverage this diversity andinclusion from newer members tothe more seasoned and skilledsurgeons in our educationalefforts, meetings, and confer-ences was born out in our meet-ing in Phoenix this past fall.

Tapping into the knowledgeand expertise of the differentgenerational cohorts within themembership is essential forsustaining and ultimately grow-ing the membership. The oldermembers helped to forge thespecialty, facial plastic andreconstructive surgery, and itsAcademy, in the early days. Theywere critical in differentiating ourclinical capabilities from those ofplastic surgery, in both theoperating room and in the statelegislatures. Now, the youngermembers are poised to help usbetter leverage new technologiesand social media platforms todeepen our abilities and patientoutreach in new and evolvingways.

In my first presidentialmessage, I urged all members tosend me ideas for the enrichmentand improvement of the AcademyA number of you have done soand we are working to strategizethese suggestions to the better-ment of our organization. I alsoreached out to the youngermembers to join committees,

submit an abstract for a presen-tation, or participate in theworkings of the AAFPRS. Anumber of you have respondedenthusiastically.

At the Annual Meeting thispast October, I attended theWomen in Facial Plastic SurgeryCommittee and the Young Physi-cians Committee meetings. I wasdelighted to experience theenergy and enthusiasm of thesetwo groups. They are excited toparticipate and to be activeAAFPRS members contributing inevery way possible. This is astrong affirmation that theAcademy’s strategic initiative ofdiversity and inclusion is verymuch on target. We will continueour efforts for enhanced engage-ment with all existing membersand potential members based ontheir unique needs across themembership lifespan and spec-trum.

We are not Jacks of all trade.We are the master of one—facialplastic surgery! Today, we startcreating our future. We havebeen elected to this role. Today,we start embracing that role,pushing up our sleeves, puttingour minds together, and rightingthis ship of ours—fueled by thestrength of our indispensablediversity.

“Diversity is the magic. It is thefirst manifestation, the first begin-ning of the differentiation of a thingand of simple identity. The greaterthe diversity, the greater theperfection.” - Thomas Berry

William H. Truswell, MD

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PRESIDENT’S MESSAGE

4 Facial Plastic Times March 2018

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By Jason Bloom,MD, Chair,Emerging Trendsand TechnologiesCommittee

It is an honorto serve aschair of a committee I ampassionate about, the Emerg-

ing Trends and TechnologiesCommittee of the AAFPRS. This isa very exciting time for facialplastic surgery and aesthetic orcosmetic medicine. The marketcontinues to grow by leaps andbounds each year and facialplastic surgeons are at theforefront of innovation, clinicalpractice, and research withrespect to this industry's growth.It is increasingly important forfacial plastic surgeons to con-tinue to work with trusted indus-try partners to support both ourresearch and clinical efforts

because industry's novel tech-nologies and innovations arefueling advances in the profession.

Emerging trends in facialplastic and reconstructive sur-gery are occurring in three maincategories: (1) injectable thera-pies, (2) energy-based devices,and (3) improvements in surgicalprocedures and ancillary treat-ments. Accordingly, I would like toopen a dialogue via this forum ineach of these areas.

First, with respect to inject-able therapies, the entire marketwill continue to expand with theintroduction of new hyaluronicacid fillers and new indicationsfor previously approved fillers,both of which are occurring in2018. Also, new neuromodulatorsare in the pipeline that may bedifferent from current offeringsand bring about improvements inthe field. One of my goals is forthis committee to evaluate these

new fillers,injectables, andindications andreport back ontheir particularcharacteristics,benefits, andpotential areas ofconcern. Ideally,this group will haveregular emergingtrends updates byAAFPRS membersin the Facial PlasticTimes and presen-tations at theAnnual Meeting.The goal is to giveour membersexpert information,so that they canmake informeddecisions aboutwhether or not toadopt these newtechnologies ortechniques intotheir practices. Second, withrespect to lasersand energy-baseddevices, technology

is also moving at a rapid pace. In2018, we are seeing secondgeneration resurfacing systemsthat are producing great resultswith less downtime, as well asnew entrants into the space.Some examples of these includecombining microneedling withenergy to treat soft tissue laxityand acne scarring and percuta-neous energy-based devices totighten down the neck and jowlsoft tissue. The results from theseprocedures are excellent, which Ipreviously would never havethought possible without surgery.I am hopeful this group willprovide thoughtful commentsabout the myriad of devices,including the extent to whichthey are attracting new patientsto practices and their return oninvestment. Along the same lines,I hope this group will discuss andpublish tips for buying andleasing capital equipment.

The third group of emergingtrends that I mentioned—im-provements in surgical proce-dures and ancillary treatments—is more of a “catch-all” for anyand all types of other new innova-tions. Perhaps it is a new tech-nique in the operating room, anew implantable device to helppatients breathe, or even some-thing that you have implementedin your practice to simply improvethe care of your patients, reduceadverse events, or make it easierto deliver treatments. Some otherexamples would be advances insurgical nutrition options, meth-ods to reduce post-treatmentbruising, or a novel device that ishelping improve results in reduc-ing the bony nasal dorsum inrhinoplasty. These are the typesof things that should be dis-cussed and reported upon to thebroader membership.

Finally, I invite you to emailme at drjbloom@hotmail.com withany questions and concerns orany new innovations, technology,or emerging trends where youwould like more information. Allthe best! M

EMERGING TRENDS AND TECHNOLOGIES

March 2018 Facial Plastic Times 5

6 Facial Plastic Times March 2018

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This spring, take advan-tage of the Academy'squarterly, consumernewsletter, Facial Plastic

Surgery Today (FPST). This four-color, award-winning publicationis replete with the latest informa-tion on techniques, treatments,and procedures that will bringpotential and current clients intoyour office. Use as content foryour Web site, send to referringprofessionals, and provide toclients at the consultation ap-pointment.

On the cover of this springissue, “Selfie Awareness PrevailsAgain in 2017,” clients will dis-cover who had what and why,including the impact of socialmedia, prejuvenation, and stay-ing competitive in the workforceas a driving factor. Additionally,surgical and nonsurgical trendswill be shared, with predictionsfor 2018.

“Youthful Neck Solutions,” willbe the main article to addresshow to fade age spots, tightenturkey neck, and shrink thedouble chin. This article willcover the gamut from minimallyinvasive treatments to surgicalsolutions.

What is baby Botox? Consum-ers Ask the Expert and also wantto know who is a good candidate.The What's New section describeshow platelet-rich fibrin is beingused to treat the first signs ofaging. The Health Tip offers fourfactors to address before havingsurgery: motivation, expectations,communication, and preparation.

Seventy-two percent of Acad-emy members reported combiningnonsurgical procedures as arising trend. The final article, “I'llTake the Combo, Please,” willdiscuss choices, such as novellasers, hybrid lasers, andmicroneedling systems, and howfacial plastic surgeons are able totreat a wide range of facial rejuve-nation concerns in the span ofone appointment.

Be sure to order your digitalcopy—customizable with yourpractice information and photo-graphs—before April 15, 2018, toreceive the bonus of receiving thewinter issue. Refer to the en-closed subscription form fordetails. M

CONSUMER NEWSLETTER HIGHLIGHTS

TRENDING PROCEDURES

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SUBMIT YOUR ANNUAL SUBSCRIPTIONFOR FPST BEFORE APRIL 15, 2018, ANDRECEIVE THE WINTER ISSUE AS ABONUS.

WOMEN IN

FACIAL PLASTIC

SURGERY

In honor of Women's HistoryMonth in March, we're lookingback to highlight women in theAAFPRS’ history. One mile-

stone was the formation in 2000of the ad hoc committee, Womenin Facial Plastic Surgery. Chairedby Donna J. Millay, MD, andSuzanne Yee, MD, this committeewas created to encourage agreater leadership role for womenin the AAFPRS. The committee isstill active today with an annualluncheon at the Annual Meeting.The committee’s mission todayincludes: to provide support tofemale members; recruit andencourage women to pursuecareers in facial plastic surgery;and encourage participation byour female members in research,education, and leadership rolesin the AAFPRS and the medicalcommunity.”

We look forward to the rebirthof the Women in Facial PlasticSurgery column in the comingissues of Facial Plastic Times forsome invigorating and inspiringreads. M

March 2018 Facial Plastic Times 7

8 Facial Plastic Times March 2018

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From Cover Story, page 1A driving factor in the deci-

sion to have a cosmetic treatmentis to stay relevant and competi-tive at work, as reported by 57percent of members. Advance-ments in noninvasive and combi-nation technologies are allowingmen and women to refresh theirappearance with little to nodowntime.

Some of the most requestedprocedures were tailored tospecific lifestyle concerns. Eyelidprocedures to look less tired werereported as a rising trend by 73percent of members, along withcombined nonsurgical proceduresby 72 percent of members.

Predictably, Botox, Dysport,and Xeomin remain the mostpopular minimally invasivetreatments for both women andmen, followed by fillers and skintreatments.

For surgical trends, rhino-plasty leads the way year afteryear (performed by 97 percent ofsurgeons in 2017) followed byblepharoplasty (95 percent) andfacelifts (88 percent). The mostpopular treatment overall, Botox,was ranked first for womenfollowed by rhinoplasty. For men,however, it was reversed withrhinoplasty as the top procedurefollowed by Botox.

Botox and hair transplantsboth notably increased in thepast five years, with the numberof Botox procedures increasing by33 percent from 2012 to 2017.The number of hair transplantsin the sample jumped by morethan 538 percent in that timespan. Noninvasive fat reductionand platelet-rich plasma injec-tions are newer procedures thatfacial plastic surgeons are alsoseeing requested more often.

Trusting your face to a facialplastic surgeon remains a leadingfactor for consumers consideringfacial plastic surgery. Withmedical spas and centers con-tinually emerging, one in fourAcademy members expressedconcern about an increase in

non-medical staff doing proce-dures that result in sub-optimalresults.

What did our members predictfor 2018? The selfie obsession willcontinue, along with prejuvena-tion and the proliferation of non-invasive treatments. There will bemore flexible fillers that bend withfacial animation. Stem cell injec-tions will increase. Injectablerhinoplasty will become morepopular. You may also see moretransgender and feminizationprocedures and an increase inmillennial men turning to cos-metic maintenance.

Thank you to the memberswho responded to the 2017survey. Each year we rely on yourfeedback to deliver this informa-tion to the media—an integralpart of our outreach and market-ing efforts. M

PREJUVENATION, NONINVASIVE

Thank you to all participants whocompleted the survey. As anincentive, we promised prizes.Following are the winners:

Anthony Sclafani, MD, of NewYork, grand prize, free registrationto the AAFPRS Annual Meeting

Remy Nguyen, MD, of Montreal,Canada, set of patient brochures

Jeptha Cole, MD, of Jackson,Miss., your choice of five DVDs

David Holcomb, MD, of Sarasota,Fla., one copy of The Face Book

Jeffrey Spiegel, MD, of Newton,Mass., one copy of The Face Book

Jim Gilmore, MD, of Dallas, onecopy of The Face Book

William H. Truswell, MD, ofEasthampton, Mass., one copy ofThe Face Book

Louis DeJoseph, MD, of Atlanta,one copy of The Face Book

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From Cover Story, page 1There will also be CME injectionsessions covering hyaluronic acidfillers and neuro-modulators withlive demonstrations and paneldiscussions.

Six video sessions with thetheme, “How I Do It,” will include:Periorbital Rejuvenation: Non-Surgical, with Lisa Grunebaum,MD; Periorbital Rejuvenation:Surgical, with Fred G. Fedok, MD;My Approach to the Midface, withRoxana Cobo, MD; Facelift andNeck, with Phillip R. Langsdon,MD; and Perioral Rejuvenation,with Jeffrey S. Epstein, MD.

There will be three pre-recorded live surgeries withdiscussion. Stephen W. Perkins,MD, will perform the Perkinsendoscopic brow lift and lower lidblepharoplasty. The secondsurgery will be the Jacono deepplane face, with Andrew A.Jacono, MD. The third surgerywill feature full facial fat graftingwith Bruce VanNatta, MD.

This meeting would not becomplete without innovative andthought-provoking panel discus-sions. Some of the highlightsinclude, Assessment and Man-agement of Lower Lid and Cheek(nonsurgical and surgical);Comprehensive Facial Assess-ment and Management (nonsur-gical and surgical); NonsurgicalSkin Tightening of Face andNeck; Postop Management Pearlsand Complications of the Facelift;Postop Management Pearls andComplications of PeriorbitalRejuvenation; From Bruising toBlindness: Minimizing andManaging Filler Injection Compli-cations (delayed nodules, biofilmformation); and ComprehensiveFacial Assessment and Manage-ment (nonsurgical and surgical).

Finally, each morning andevening, we will have industry-sponsored lectures and livedemonstrations you won’t want tomiss. It is not too late to register:www.facialrejuvenationmeeting.org. M

PRERECORDED

SURGERIES

March 2018 Facial Plastic Times 9

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PR COLUMN: RIPPED FROM THE HEADLINES...

MAKING THE STATISTICS WORK FOR YOUR PRACTICE

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NOTE FROM KELZ PRThe AAFPRS is active on

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

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

Once again, the AAFPRSannual statistics aremaking a big splashwith the media.

Each year, we release ourstatistics to the media. Whatfollows is story after story basedon the trends that our membersare reporting, and this year is noexception. We have already seenarticles in Allure, Yahoo Style,MSN, New Beauty, and more. Howcan you get in on the action?

To start, look at the trends wespotted to see what resonateswith your practice population.From selfies and their undeniableimpact on aesthetics andinjectables among patients underage 30 (i.e., prejuvenation) toincreases in eyelid procedures tolook less tired and combinednonsurgical procedures, there isa lot to choose from this year.Once you have decided whichtrends you would like to focus on,the fun really begins.

Creative ideas for in-house eventsBreakfast clubs. Consider hostinga light breakfast for local report-ers, influential bloggers, or VIPsthat includes an informal discus-sion on the benefits of eyelidprocedures that help us all lookless tired than we are or #nofiltertreatments for “tech neck” andother selfie saboteurs. Offeringexpert tips on how to take theperfect selfie can sweeten the potfor all comers. A “Breakfast atTiffany's” themed event may bethe closest thing that your pa-tients get to the real thing, asreservations at Tiffany & Co’snewly opened Blue Box Café arehard to get. A raffle featuring apiece of signature Tiffany jewelryfor attendees is a sure crowdpleaser. Keep it short and sweetand offer discount codes toattendees.

Back-to-work nights. Close to60 percent of facial plastic sur-geons reported that stayingrelevant and competitive at work

is a major driver for nips andtucks. Invite a local career coun-selor to come in and speak tomoms who may be interested ingetting back into the workforce.He or she can review resumes,chat about interview skills, andanswer pressing questions, suchas, how to explain a gap on aresume. As part of the event,provide an overview of some of theprocedures that can make asubtle but significant differencein appearance, with a focus onthose that have minimal down-time and maximum impact. Offerdiscounts or free consults toguests.

Monthly seminars on hottopics. Pick one night a month fora seminar that focuses on a hottopic such as platelet-rich plasma(PRP) injections. There is a lot ofconfusion about what PRP canand cannot do. Invite VIPs in toset the record straight. Make sureto promote upcoming events andthe entire series across socialmedia, via email blasts, and inperson when meeting with pa-tients. After a few months, reviewthe format and return on invest-ment to see how well it is workingout. Offer a code so that you cantell who books a procedure as aresult of these timely and infor-mative seminars.

More food for thoughtPithy pitching often starts withcrafting a local angle to a na-tional story.

Reach out to local media andinfluential bloggers to providethat hometown perspective onnational trends. Let them knowwhat you are seeing, and how itechoes our AAFPRS nationalstatistics and trends. If you havea patient who is willing to befeatured on television, let localnews and morning shows know,as this is great television mate-rial.

Use our statistics for socialmedia fodder and “did you know?”

posts across all your platforms.For example, “Did you knowBOTOX® (Allergan), along withDysport® (Galderma) andXeomin® (Merz), remain the mostpopular minimally invasiveprocedures for both women andmen, followed by fillers and skintreatments?” These posts performwell. Always include a call toaction such as, find out more orschedule your appointment today,to further drive engagement.

If you have the bandwidth,create an infographic on some ofthe trends we identified, e.g.,advances in eyelid rejuvenationor the anatomy of a nose thatdetails what rhinoplasty can andcannot address. These get greatpick up by the media and also dowell on social platforms. Sampleinfographics are on the AAFPRSWeb site.

With the proper outreach andallocation of resources, you willreap the dividends of our annualstatistics. M

This column is provided by theAcademy’s public relations firm,KELZ PR.

10 Facial Plastic Times March 2018

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FACE TO FACE NEWS: NEW SITE FOR CAMBODIA

In conjunction with NorthwestMedical Volunteers and SmileCambodia, a FACE TO FACEteam led and completed

another successful medicalmission trip to Cambodia, Janu-ary 8 - 12, 2018. The last severaltrips were in the capital city ofPhnom Penh; however, this year anew site was established in SiemReap. This is to provide betteraccess to patients in the north-west provinces of the country,many of whom previously traveledseveral days to seek medical carein the capital to the south. SamMost, MD, of Stanford University,and Craig Murakami, MD, ofVirginia Mason Medical Center, inSeattle, led the trip.

Twenty-five other volunteersfrom the University of Washing-ton, Stanford University, andother institutions, made up theteam: Jon Paul Pepper, MD, ofStanford University; Kathleen Sie,MD; Michael Nuara, MD; andAmit Bhrany, MD, of the Univer-sity of Washington; TravisTollefson, MD, of University ofCalifornia, Davis; Charles Shih,MD, of Kaiser Permanente, in

Oakland, Calif.; and ScottBevans, MD, of the U.S. Army.The team also had wonderfulpediatric support from ArashBabaoff, MD, of CincinnatiChildren's Hospital, and AndyStandish, a child-life specialist, ofthe Standish Foundation. Addi-tional supporting medical stafffrom the University of Washingtonand Stanford University providedanesthesia, nursing care, andadministrative assistance.

The Northwest Medical Volun-teer group worked closely withSmile Cambodia and local plasticsurgeon Theavy Mok, MD. TheCambodian staff, nurses, andmedical trainees were indispens-able in helping to successfullyscreen and provide preoperative,intraoperative, postoperative, andfollow-up care for patients. Thisclose partnership allowed forseveral opportunities to providemedical and cultural educationbetween the two teams as well.

During the 2017 trip toPhnom Penh, over 100 patientswere screened; the surgical teamperformed 43 operations, includ-ing 10 cleft lip repairs, seven

palatoplasties, one cleft rhino-plasty, nine microtia repairs andotoplasties, and 16 scar revisions.During the 2018 trip to SiemReap, over 70 patients werescreened; the surgical teamperformed 37 operations, includ-ing six cleft lip repairs, threepalatoplasties, four cleft rhino-plasties, seven microtia repairs,seven otoplasties, and 10 scarrevisions.

Some of the patients screenedalso underwent surgery by aconcurrent mission throughSmile Cambodia from a Malay-sian surgical craniofacial team,performing 13 operations. Some ofthese patients had been previ-ously seen on prior missions andreturned for second stage surger-ies, providing excellent continuityof care. In particular, one patientwith bilateral microtia underwenthis three previous microtiasurgeries with Dr. Most and theteam, and returned for his finalsecond stage microtia repair onthis mission. The boy and Dr.Most are pictured above.

On the final day of the mis-sion, volunteers participated inWalk for Smile-Angkor, a 20kmwalk to the beautiful temples justoutside of Siem Reap to raiseawareness and celebrate anothersuccessful mission in Cambodia.The group is already planningfuture trips to Cambodia, andexcited to collaborate with localmedical staff to continue provid-ing high quality and consistentsurgical services to the people ofCambodia. M

CALL FOR AWARDSIn an effort to present these prestigious awards to well-deservedfacial plastic surgeons, consider nominating your colleagues. EmailGlenda Shugars at the AAFPRS office, gshugars@aafprs.org, toreceive a nomination form or visit www.aafprs.org/research/awards/for more information.

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

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

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

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

March 2018 Facial Plastic Times 11

By Donna Fay, OFPSA President

Although many elementsare at play in creating asuccessful practice, theadvice and counsel of a

business consultant can payenormous dividends for a practicethat is ready, willing, and able togrow. Steve Pearlman, MD, hasbuilt a successful facial plasticsurgery practice, PearlmanAesthetic Surgery, and hasbenefited from a long and produc-tive relationship with Ms. GlennMorley, a senior consultant atBSM Consulting.

Asked why he was interestedin a consulting firm, Dr. Pearlmanshares, “As a physician, I learnedhow to operate and take care ofpatients, not how to run a prac-tice and manage employees. Stafflearned their jobs throughcourses, working, and advancingin the industry or through train-ing with other employees. Inretrospect, this was not fair to myteam or the practice. Having a

consultant, like Glenn, is likehaving an extremely high-leveladministrator who can come inand help the staff and operationsfunction at a much higher level.”

In this Q&A, Dr. Pearlmanand Ms. Morley share some oftheir secrets to practice success.

Q: Dr. Pearlman, what wasthe catalyst for you reaching outto Ms. Morley for assistance?

Dr. Pearlman: I have alwaysfelt there are some things bettercommunicated by an outsideperspective. For me—and myentire team—Glenn has been ableto provide a valuable outsideperspective. Since she regularlyspends time with us every quar-ter, she can quickly answerquestions or analyze businessopportunities between visits. Ourgrowth over the past five yearshas been explosive—in a goodway. Since we started workingwith Glenn, our practice opera-tions have become smoother,individual roles and responsibili-ties are more clearly defined, and

our development plans areclearer for every single teammember in our practice, includingme! I really appreciate having ahighly educated person whounderstands practice manage-ment and operations inside andout to be able to observe the staffand how they function with anexternal objective eye.

Q: Ms. Morley, when youthink about practices that you’veworked with and have experi-enced growth, what have beenthe key success factors at play?

Ms. Morley: The ability toembrace and implement a ser-vant leadership mentality, at alllevels of the practice, is the mostimportant success factor. Tradi-tional leadership generally in-volves the accumulation andexercise of power. In my view, thisleads to lack of ownership andaccountability and sadly, a lot of See Servant Mentality, page 13

BENEFITS OF A BUSINESS CONSULTANT

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12 Facial Plastic Times March 2018

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MESSAGE FROM THE MEDICAL EDITOR: THE EVER-ELUSIVE

MALE MARKET

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

Here we goagain...Irecentlyfielded a

call from a budding reporter,“Dr. Dayan would you be willing tocomment about the upsurge inmen seeking cosmetic treat-ments? Don't you believe there isan increased sensitivity andvanity in the modern evolvedman? Isn't it true that today mencare more about their appearancethan ever before?” My uncomfort-ably long pause prompted her toreengage, “Dr. Dayan are youthere, Dr. Dayan?”

I was slow to speak becausemy answer was the same to thisreporter as it was to her ancestralbookend a decade ago. “Therereally hasn't been a significantchange in the number of menseeking cosmetic treatments inmy practice since I first went intopractice 18 years ago.”

Despite the fact I have madeconcerted efforts to appeal tomen, my practice patient popula-tion is 10 percent male andremains 10 percent male—it hasnever wavered. What am I doingwrong? I questioned myself. Am Ithe only one who is experiencinga similar stagnant male patientgrowth? After a bit of reflection,conferring with a few colleaguesand research, I stumbled acrosssome interesting tidbits.

According to the latest statis-tics published by the AmericanSociety of Aesthetic Plastic Sur-geons, 1.036 million (8.9 percent)of all those undergoing nonsurgi-cal aesthetic procedures last yearwere male, as opposed to over10. 6 million (91.1 percent) offemales. That is down from 2004,when the percentage of malesreceiving nonsurgical cosmeticprocedures was 10.6 percent, acontinuing downward slope from

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1997, when males made up 13.7percent of all aesthetic proce-dures. And while the male markethas increased 15 percent since2014, and 260 percent since1997, the female market hasincreased 33 percent and 506percent respectively. The femalemarket is growing at two timesthe rate as male and is 10 timesbigger.1

If my anemic percentage ofmale patients is substantiated bysimilar reports from friends, plusone of the most comprehensivestatistical analysis on the cos-metic seeking populous, why thenthe continuous talk and bom-bardment from a gesticulatingmedia and industry touting arapidly growing male market? Forthe media, could a public rela-tions manufactured, warm-hearted piece about the evolvingman be a welcomed narrative?For a wealthy, aesthetic industryconsumed primarily with onegender, quite obviously there isan untapped other half of themarket to develop.

But for a small businessowner who survives by beingpractical, I have to question ifdevoting precious resources,attention, and time to pursuing amale market of patients that is 10times smaller and growing at halfthe rate as the female market is aprudent decision. And even if Idecide to pursue the niche ofneglected males desiring beautifi-cation, is my office ready toreceive the enlightened modernmetrosexual male?

Our waiting room is decoratedwith fresh flowers, skin carepromotions, cushy couches,lighter colors, and almost alwaysthere exists a stylish woman ortwo accompanied by a designerbag with recently purchasedboutique clothing. Our guests aregreeted by a young female hostserving fresh berry-infused waterand offering the latest in tintedmoisturizers. Most likely, such an

environment would be uncomfort-able if not intimidating to adiscreet gentleman. I am sorry ifit seems as though I am general-izing, but I do believe there is adifference between men andwomen.

As a father of three daugh-ters, I can say with completecertitude my household is a lotdifferent than the Johanssen's atthe end of the cul-de-sac whohave three boys. As a student ofhuman behavior, there is nodoubt that appealing to primitivevisceral instincts in both menand women is a successfulstrategic tactic to altering behav-ior or stimulating action. And it ismy educated impression that menand women have different motiva-tions for seeking cosmetic treat-ments.

But first to understand mylogic, we are going to have to divedeeper into the male mind and itis not pretty, nor politicallycorrect. If you are easily offendedyou may want to stop readinghere.

A priori, humans are not asadvanced as we would like tobelieve. Homo sapiens split offfrom genus homo 150-250,000years ago. The first evidence ofculture was 50,000 years ago; thefirst cities were 8-10,000 yearsago. This means that humanshave been civilized for less thanone percent of their evolution!Human brains and behaviorshave been developing for eonswith a solitary mission to find anideal mate, procreate, and ensuregenetic reign. Humans think andbehave in a way that is meant tosurvive the harshest environ-ments of evolution. Humans areunique in that their primitivedesires can be tempered andcontrolled, but it would be naïveto deny that these visceral in-stincts of humanity exist. Thereare reasons that humans shyaway from a growling animal, See What Do Men Want? page 14

March 2018 Facial Plastic Times 13

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From Business Consultant, page 11blame when things do not go asexpected. By comparison, theservant-leader team sharespower, puts the needs of othersfirst, and helps those aroundthem to develop and perform ashighly as possible.

In every practice I consultwith, we work hard to understandwhat real accountability and ablameless environment looks andfeels like. A servant mentality is acultural norm in the most suc-cessful practices, and I seeseveral positive outcomes when itall comes together for a team,including: accountability at alllevels, owner happiness, staffhappiness, excitement andenergy for the work being done,patient satisfaction, and impres-sive revenue growth.

My own company works thisway, and I can say with completeconviction that every personworking at BSM Consultingabsolutely loves their job andfeels enormously privileged towork there. It starts at the top

and the energy of this type ofculture is infectious, tricklingdown to every employee. I wantthat for every client.

Q: Dr. Pearlman, do you feelyou have achieved a culture thatembraces a servant mentality?

Dr. Pearlman: When Glennstarted working with us, we allstruggled with the pressures ofNew York’s fast-paced, high-energy environment. She wasgentle with us, but never waveredin her belief that our team couldbe low-drama, high-energy ser-vant leaders. The difference in mypractice has been substantial. Ithas been an evolution as weimplemented one hundred little—but related—things. Today, Icannot say enough about thework my entire team does daily tomake this “culture” happen. Theyare real superstars, and I amgrateful to them.

Q: Ms. Morley, how does apractice start on the road todeveloping a servant mentalityand culture? Is there a bookavailable to help one understand

how a practice can create thiskind of positive culture?

Ms. Morley: I have a recom-mended reading list a mile longand would be happy to share it!To read about servant leadershipyou can’t do better than readingThe Question Behind the Question(QBQ), by John Miller. This bookis a very quick and easy read andis eminently suitable for a prac-tice seeking to strengthen theirculture of accountability andservant leadership.

Private practice owners areentrepreneurs by nature andtend to be independent risk-takers. For some, it can be diffi-cult to ask for external help.However, none of us knowseverything about growing andmanaging a business. Sometimesit makes sense to seek the coun-sel of others and knowing who isright for you and your business isvery important.

Next month, stay tuned forsimple, important guidelines onhow Dr. Pearlman’s office selecteda business consultant. M

A SERVANT MENTALITY, A CULTURAL NORM

14 Facial Plastic Times March 2018

From Medical Editor, page 12favor fertility, and desire thequick hit of energy found in apacket of sugar. Mother naturedoesn't make mistakes.

In a frequently cited study2

done at the University of Floridain the early 1980s, a male confed-erate in the quadrangle ap-proached a random female andasked three questions: 1) Wouldyou go out tonight? 2) Will youcome over to my apartment? 3)Would you go to bed with me?What percentage of women do youthink said yes to any of thosequestions? Then the situationwas reversed and a confederatefemale went into the same quad-rangle, approached a randommale with the same three ques-tions. What percentage of mensaid yes?

It may be no surprise to youthat zero percent of women saidyes to going to bed with a randommale. However, the reverse wasquite different, 75 percent of themen said yes to bedding anunknown inquiring female. Thestudy concluded that the gendersare wired differently when itcomes to carnal desires. If thestudy was repeated today, whilethe numbers may change slightly,I doubt it would be by much. Theprimitive male mind may bequicker to accept an offer, whereas a female conscious is morecalculating before selecting. Andin a strictly primitive sense, it isunderstandable. The conse-quence of conception is of greaterphysical and temporal burden toa female than a cruising male.Therefore, she is best off choosinga reliable, resource ample, geneti-cally well-endowed mate. But howis she to know when the courtingmale is her evolutionarilymatched Prince Charming?

Today, of course, there aremany facets that contribute to anideal male candidate, some ofwhich are much different fromour primitive ancestors. But froman evolutionary perspective, amale with a strong brow, chin,

and cheek would be at a selectiveadvantage to bring home a meal.Such a well-shielded hunterwould appreciate the eye andneck protection their facialskeleton would provide whenfighting off a foe or beast. And theprimitive decoders in the humanamygdala subliminally identifythese physical features as attrac-tive. It is not random that allheroes from Superman andBatman to Brad Pitt and Dwaynethe Rock Johnson project adominant facial skeleton.

Men not blessed with a strongaquiline jaw or chin can tempo-rarily compensate with facial hairor a goatee, or more permanentlyremedy with facial fillers andimplants. And the overwhelmingevidence points to them doing itfor good reason.

Male cadets at West Pointwith dominant facial featuresachieve higher military rank intheir senior year and in theirprofession.3 Furthermore, theprofits of the top 25 and bottom25 companies on the Forbes 1000can be correlated to the facialappearances of their CEOs.4

Additionally, better lookingattorneys are more likely to makemore money.5 We like our maleleaders tall, dominant appearing,and with a full head of hair. Theman looking for a competitiveedge at the workplace may beopen to undergoing a chin, cheek,or jawline cosmetic treatment ifhe knew it contributed to anincrease in his employmentstatus. However, at the extreme,too prominent of a brow, chin, orjaw creates a Frankenstein likeappearance. It likely will strikefear, detracting a casual observer,and negatively impacting theresponse in actions and behav-iors. Men born with these fea-tures may benefit from softeningor masking fear-provoking physi-cal traits.

Facial symmetry, evolution-arily speaking, is an outward signof health and parasite free. Whilean important denominator to the

attractiveness calculus for bothgenders, males in particular withsymmetrical facial features mightbe treated to more sexual encoun-ters with multiple women.6, 7, 8

While the fleshy benefits ofsymmetry are good fodder for acocktail conversation, it also mayhelp to explain the motivationof young, recently divorced or aflirting male population of pa-tients seeking aesthetic services.

Of course, I am just scratch-ing the surface of the malepsyche and oversimplifying. Notall males are the same; butgeneralizations are a componentto develop markets and to appealto the majority of those seeking aproduct or service. And if we treatmen and women the same, appealto them with the same advertise-ment, assume that they areinterested in the same things,and use the same techniques andproducts on them, then itshouldn't come as any surprisethat many men leave aestheticoffices appearing feminized alaKenny Rogers. This likely turnsoff many more men and contrib-utes to the stagnant relativegrowth in the male market.

Men who seek out cosmeticsurgery do it for three reasons: 1)increase attractiveness for mateselection; 2) temper aggressivelycharacterized facial features;and, 3) youthful appearance tocompete in the workplace. Ifaesthetic practices are beingpressured by a persuasive mediaand industry to cater to the malepopulation, then it will require ameaningful investment in time,energy, and resources to restruc-ture offices, marketing materials,and thinking.

As a few colleagues who havesuccessfully built a male-domi-nated practice have told me, theiroffices look more like a barbershop then beauty shop. To culti-vate a male market, we are betteroff appealing to the primitiveevolutionary preserved corners ofthe male mind—which is rathersimple in theory, but arduous

WHY DO MEN SEEK OUT COSMETIC SURGERY AND WHAT

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March 2018 Facial Plastic Times 15

2018MARCH 16-17*10TH ANNIVERSARY SYMPOSIUMON VASCULAR ANOMALIESCharleston, SCDirector: Marcelo Hochman, MD

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

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

FACIAL PLASTIC TIMES

MARCH 2018

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APRIL 25-27*FIRST BOGOTA HANDS-ONRHINOPLASTY COURSEBogota, Colombia

JUNE 23-24ABFPRS EXAMINATIONWashington, DC

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

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

CLASSIFIED ADFOR SALE BY PHYSICIANOWNER: Cosmetic medicinepractice and full-service medicalspa in beautiful, rapidly grow-ing, tax-advantaged Nevada.Build your surgical practicefrom the 600 patients seen eachmonth, while generating hugecash flow from injecting and themyriad other spa servicesperformed by your staff:Coolsculpting, fractional RF,CO2, IPL, Ultherapy, LHR, tattooremoval, and more. $2M gross(cash), $600k net (Ebitda) thispast year. Fully staffed business,just hang up your coat and go towork. Owner financing consid-ered for qualified buyer/s.$1,750,000. Interested partiesshould send contact informationto buyamedspa@yahoo.com.

Enclosed in this March issue ofFacial Plastic Times is theFPST Subscription Form.

*Endorsed by the AAFPRS Foundation

and expensive in practicality.Likely, it will take more than justa few brochures in the front officeand a beautifully producedmarketing campaign from anindustry partner.

If you have been unsuccessfulbut desiring to grow a malemarket of patients don't fret; itwill take a while, along with atransformation in thought andaction. In the meantime, however,there is a rapidly expanding andever-present female populationjust waiting to be wowed by animpressive, reliable, and honestsuitor. M

Sources:1. American Society of AestheticPlastic Surgeons2. Clark, R. D., & Hatfield, E.(1989). Gender differences inreceptivity to sexual offers. JPsych Hum Sex, 2, 39-55.3. Mazur, A. Mazur, J. Militaryrank attainment of a West PointClass. Am J Sociology, 1984;90:125-150.4. Rule, N. Ambaday, N. The faceof success: inferences from chiefexecutive officers’ appearancepredict company profits. Psycho-logical Science, 2008 19: 109.5. Biddle, JE. Hamermesh,DS. Beauty productivity anddiscrimination: lawyers’ looksand lucre. J of Labor Economics,1998;16: 172-200.6. Gangstead, S. Thornhill, R.Yeo, R. Ethol Sociobiol, 15;73-85;1994.7. Grammar, K. Thornhill,R. J Compar Psychol, 108;233-242; 1994.8. Rhodes, G. Proffitt, F. Grady,JM. Psych Bull Rev, 5;659-669;1998.

DO THEY WANT?

CLASSIFIED ADWell-established plastic surgeonfocused on body contouring seeksfacial plastic surgeon associate to joingrowing team. The successful candi-date will be board certified/boardeligible in ENT, plastic surgery, orOMFS. We are looking for an enthusi-astic surgeon interested in being partof a team and helping build thepremier multi-specialty cosmeticsurgery practice in the country. NorthTexas Plastic Surgery has two loca-tions, Southlake and Plano, whichare affluent suburbs of Dallas. Thepractice has a fully accreditedAAAASF, two operating room surgerycenter and a large established patientbase. Please visit our Web site at:www.northtexasplasticsurgery.com.All inquiries are confidential and canbe submitted online via email toLinsey at linsey@northtexasps.com orby phone at (817) 416-8080.

16 Facial Plastic Times March 2018