SPSSCS Central Office • 11262 Monarch Street, Garden Grove, CA  92841 • www.spsscs.org562-799-0466 or 800-486-0611 • Fax 562-799-1098 • email: info@spsscs.org

Official Publication of the Debra Yates, Editor • Shari Friedman, Co-Editor Winter 2012S O C I E T Y O F P L A S T I C S U R G I C A L S K I N C A R E S P E C I A L I S T S

SPSSCS MissionThe Society of Plastic Surgical Skin Care

Specialists is a voluntary, non-profit organization dedicated to the promotion of education,enhancement of clinical skills and the delivery ofsafe, quality skin care provided to patients withinthe office of a Plastic Surgeon certified by theAmerican Board of Plastic Surgery or the RoyalCollege of Physicians and Surgeons of Canada.

Stephanie Holden, RN, BSNPresident

Karen DavisPresident-Elect

Abbey Helton, BSN, RN, CPSNVice President

Elena Reyes, RMA, RSTSecretary/Treasurer

Angela Frazer, RNMember-At-Large

Jill NeibaurMember-At-Large

Claudio Pinto, MMAMember-At-Large

Bea Hunter ErdmanParliamentarian

Susan M. Wells, RN, MSImmediate Past President

Richard A. D’Amico, MDASAPS Advisor

Renato Saltz, MDASAPS Advisor

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SPSSCS Board of Directors 2011–2012

From the Editor’s DeskDebra Yates

decided it was time to brushup on my product knowledge andingredients, so I attended a vendorseminar in Philadelphia. I was delightedto run into a few of my SPSSCS friendsthat were attending. While at theseminar, I was given the opportunity totalk about our Society, what it means tome, and how it has helped my business.Although many at this meeting werenot members or working for a boardcertified plastic surgeon, I believe it isimportant to spread the word. Iemphasized that you do not need to bea member to attend our annual meetingand provided flyers and newslettersfrom our organization. Having skin carespecialists from different specialtiesknow that we are the premier, “Go To”organization is a two-way street: tohelp them strive to be the best and forour Society to prosper. ▲

Specialty SkinCare

he importance of skincare in facial aesthetics hasnever been more important orclear than today. The “holyTrinity” of facial aging isvariable skin atrophic change,volume lost, and ptosis(drooping) of deeper tissue. Anattempt to treat all three issueswith isolated surgery or fillerwill likely result in incompleteaesthetic results or worse, over treatmentleading to unnatural results.

Skin care not only preserves the benefitof other treatment modalities, it has adramatic potential to primarily limit thesigns of aging. In present day, the aestheticplastic surgeon should consider all patientscandidates for comprehensive skin care.

What are the key components? A cleanser,moisturizer, sunblock, and some form ofexfoliation/cell turnover stimulation. At TheFew Institute, we recommend a cleanser andmoisturizer regimen that is without harshdetergents, fragrance, or additives. Thereare a variety of offending agents found inproducts that can be avoided, alcohol andartificial fragrance to name a few.

The sunscreen can be physical orchemical. We tend to use the physical,

Dynamic Skin Care in Modern Facial Aesthetics

Julius W. Few, MD

either powder or crème, forsensitive skin or peri procedural—after laser procedures or surgery.We prefer to place patients onretinal serums for skin stimulation/exfoliation effects, combinedwith strategic use of chemicalpeel and laser resurfacing. Butit is crucial to eliminate use atleast one week before and afteran invasive skin resurfacing.

Finally, there is clear growth in the numberof patients that have skin of color, accordingto the American Society for AestheticPlastic Surgery 2010 statistics. There is alesser tendency towards sun related damageand wrinkle formation in skin of color, thatcan reduce aged appearance. At the sametime, darker skin will be more susceptible todyspigmentation and sensitive to scarring. Asa result, it is even more important to usejudicious skin care and avoid potentialirritants, and yes, darker skin often benefitsfrom sun protection. Just because darker skinis more resistant to actinic (Sun) damagedoes not mean skin care is unnecessary inthis population. The reality is every skin typecan benefit from skin care and having clear,healthy skin requires support in most cases.

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help support our Society. We need toincrease our annual membership, increasethe number of attendees at our annualmeeting and solicit the involvement andsupport of more exhibitors. The Board isworking hard to identify and implementideas that will drive membership. As I havebecome more involved with the Society, Ihave realized that many simply don’t knowabout us. We all need to help get the wordout to our colleagues about the SPSSCS,sharing that it is a great source of educationand information for the skin care specialist.

Karen Davis and her Program Committeehave been busy putting together a greatprogram for our 2012 Annual Meeting inVancouver. She has a nice mix of topicsincluding 5 educational pre-meetingcourses, information on the hottest topicsin skin care and a panel on practicemanagement and marketing. There willtruly be something for everyone. Claudio

Pinto and his Exhibits and Goodie BagCommittee have been hard at worksoliciting exhibitors and making ourGoodie Bags the best ever. We will truly“Go for the Gold in Vancouver.” Don’tforget to get your passport ready and helpspread the word about our Society and thisamazing meeting.

As we all move into a new year, Ichallenge each of you to focus on theblessings and positives we have in ourpersonal lives and our Society. We are allfortunate to have the training and talent tohelp make our patients look and feel betterabout themselves. The new year can be atime of renewal and fresh beginnings. Iwish each of you success and happiness inyour lives and hope you will go into 2012with a renewed dedication to the SPSSCS.Help us make our Society the best it canbe. I look forward to seeing you inVancouver to “Go for the Gold.” ▲

o kick offthe New Year2012, I want to make ourmembership awareof how hard ourBoard has beenworking to

promote the SPSSCS. Through theirdedication, the SPSSCS is getting the wordout that we are a great organization withmuch to offer the skin care specialist. TheSPSSCS has a momentum of visibility thatis growing and is impressive. I was honoredto give a greeting from the SPSSCS at theASPSN fall meeting in Denver. As I waspreparing my slides, I began to realize allthat we had accomplished in the past twoyears. We have: restructured our Board toimprove function, completed the executivesummary of our 3-year Practice ProfileSurvey, launched “Notes from a Skin CareSpecialist” on the Project Beauty website,launched an interactive Facebook page,developed a “Novice Course” that has beenaccepted by ASAPS, expanded collaborationwith ASAPS and ASPSN, developed andpresented courses at the American-BrazilianMeeting and the Multi-DisciplinarySymposium, volunteered at the PhoenixSociety’s World Burn Congress and continuedto publish this amazing newsletter. Duringour fall Board meeting, we had wonderfulparticipation, ideas and lots of buzz andexcitement. I am honored to have such a dedicated Board to work with. AsPresident, I have been so proud to share the accomplishments of the SPSSCS withother organizations.

This past year, we focused on “ServantLeadership,” challenging ourselves tocommit to our patients, practices and theSPSSCS. Now is the time to realize thatthe SPSSCS needs your commitment—now, more than ever. Hopefully, all of youresponded to the e-mail survey asking whatthe SPSSCS could do to ensure that youcontinue your membership annually. Manyof our members join only during the yearsthey plan to attend the annual meeting.Our annual meetings are the main source ofrevenue that keeps our Society functioning,but we need steady membership numbers to

THE PRESIDENT’S MESSAGE

Stephanie Holden RN, BSN

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Brought to you by

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Member Profile:

Chotsie Adney

here wasn’t much skin careavailable growing up in the 1960s and ‘70sin a small, rural community outside LittleRock, Arkansas. All my life, I’ve fought

acne and rosacea—a daily struggle that made me passionate aboutworking in the beauty industry to help others feel better aboutthemselves.

My first aesthetics experiences took place in Oklahoma City and Boston, where I conducted post-op makeup sessions on burnvictims and reconstruction patients. Because my mother was a nurse,I became more interested in working in the medical side of thebeauty world.

In Boston, I worked at a skin care clinic, where I met a younggirl born with an abnormal growth on her nose and without any lips.She was treated by a plastic surgeon, and I helped her through theprocess. I remember putting makeup on her for the first time afterher reconstruction. After seeing the happiness on her beautiful face,I was hooked. I knew that working in the plastic surgery field wasfor me. When I returned to Arkansas in 1989, I began searching fora surgeon who shared my passion.

I met Dr. Kris Shewmake, a professor and Chief of Staff at theUniversity of Arkansas for Medical Sciences, in 1992. That led tomy initial education at UAMS in lasers for skin care. It was awonderful time, with new advances in non-surgical procedures likelaser hair removal, chemical peel procedures, skin care products,laser treatments, IPL and microdermabrasion.

Dr. Shewmake eventually joined with two other surgeons, Dr.Gary Talbert and Dr. David Bauer, and started his own plasticspractice called Arkansas Plastic Surgery. These three doctors havebecome my greatest mentors, supporters and teachers. After 20years, we remain colleagues and friends, and they continue toprovide oversight for my practice.

I am passionate about this field and what it can do for thepatients, but I refuse to risk a patient’s outcome on risky proceduresor products. I expect patients to follow my instructions, and I thinkthey appreciate my attitude and know that my motivation is to findthe best outcome in their care. I am scrupulous in my personal andprofessional ethics, and I will not compromise in either area.

In March of 2006, I purchased Advanced Aesthetics of Arkansasfrom Arkansas Plastic Surgery with the dream of expanding andoffering the best in non-surgical procedures and skin care. My sister,Cindy Steele, a member of SPSSCS, joined the practice in 2005,and my long-time friend Vicki Vick is our makeup artist and ClinicDirector. In 2008, my step-daughter, Laura Turner, joined thepractice. Laura is also an SPSSCS member. I’m proud to say that I’vebeen with the SPSSCS from its inception.

The most rewarding part of my job is seeing a happy patientwho becomes more confident and healthy under our care. I also amhonored to be a part of SPSSCS, an organization that reinforcesthese ideals and holds members to the highest industry standards ▲

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Become a Fan

Search “Society of Plastic SurgicalSkin Care Specialists” to find us.

May 1–4

Hyatt Regency

VancouverBC, Canada

64

BRUISING—ECCHYMOSIS THAT IS VISIBLE ON THESKIN WITHOUT CONCEALER• Essentially no bruising: no ecchymosis/

bruising, but patients may have someimmediate change in skin tone

• Minimal bruising: ecchymosis thatresolves in less than one week

• Moderate bruising: ecchymosis thatresolves in one to two weeks

• Significant bruising: ecchymosis thattakes more than two weeks to resolve

REDNESS—SKIN DEMONSTRATING INCREASEDREDNESS WITHOUT CONCEALER APPLIED• Essentially none: skin returns to “normal”

(pretreatment or improved) coloring inless than 24 hours, but patients may havesome immediate change in skin tone

• Minimal: hyperemia that resolves in oneto three days

• Moderate: hyperemia that resolves infour to seven days

• Significant: hyperemia that takes morethan seven days to resolve

SWELLING—OBVIOUS SWELLING IN THE TREATEDAREAS• Essentially none: swelling that resolves

in less than three days • Minimal: swelling that resolves in three

to seven days• Moderate: swelling that resolves in eight

to 14 days• Significant: swelling takes more than 14

days to resolve

PAIN—SIGNIFICANT DISCOMFORT/PAINASSOCIATED WITH TREATMENT• Essentially none: no pretreatment

medication, local anesthesia duringtreatment, or posttreatment painmanagement is required; over-the-counter medications may be used

• Minimal pain: requires pretreatment oralmedications (prescriptions), topicalagents and/or skin cooling duringtreatment, and/or post treatmentprescriptions for pain management

• Moderate pain: same requirements as“minimal pain,” but with pretreatmentlocal anesthesia needed to obtainanticipated results

• Significant pain: same requirements as“minimal pain,” but with pretreatment IVsedatives or general anesthesia needed toobtain anticipated clinical results.

We are hopeful that both consumersand surgeons will find these expandeddefinitions helpful when considering orexplaining a light-based procedure. That’swhere we need your help.

Michael Kulick, MD is an aesthetic surgeonpracticing in San Francisco. He is Chair of the Lightand Energy Based Therapies Committee. ▲

or many of us, energy andlight-based devices are playing anincreasingly more significant role in ourpractices. However, the nomenclature canbe confusing to both surgeon and patient.To try and remedy this situation, the Lightand Energy Based Therapies Committee (adhoc) has established definitions for thefollowing commonly used terms. We willbe working with industry to encourage theuse of these definitions that, we hope, willbring a more balanced discussion andpatient expectation to the table.

DOWNTIME—INDICATES THE EXPECTED TIME AFTERWHICH A PATIENT CAN RESUME HIS ORHER “NORMAL” LIFESTYLE• Essentially no downtime: less than

24 hours• Minimal downtime: 24–72 hours • Moderate downtime: three to seven days • Significant downtime: more than

seven days

What’s in a Name?Plenty when you’re dealing with energy and

light-based devices.By Michael Kulick, MD

REPRINTED WITH PERMISSIONAESTHETIC SOCIETY NEWS, FALL 2011

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Pain

Swe

lling

Redness

Brui

sing

Moderate

Essentially None

SignificantMinimal

Downtime

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Micro-Focused Ultrasound:

A Worthy OptionAbbey Helton, BSN, RN, CPSN

he world of aesthetic technologyhas been in a rapid and constant evolution.Providers continue to put more tools in our tool box to provide a wider array oftreatments to our diverse patient population.The efficacy of our treatments is importantto us as professionals, not only to providetrue stimulation to our clients’ skin, but toassure that their hard-earned dollars arebeing put towards treatments that trulywork. In the past, many modalities havebeen brought into the market that havefallen short of providing the promisedresults—whether lifting, tightening, orretexturizing of the skin. But there is a newkid on the block now worth a look: deepmicro-focused ultrasound.

This technology is non-invasive but hasthe capability to treat and tighten theunderlying facial tissue—the superficialmuscular aponeurotic system—otherwiseknown as the SMAS. FDA approval for its“lifting” effect has given this treatmentvalidation for the many patients wanting topursue their interest in this new ultrasoundtherapy. Some surgeons are investigating itsefficacy on other territories of the bodysuch as breasts, arms, buttocks, thighs andabdomen. These efforts continue to openup new options to our patients.

This new technology has the ability tofocus the ultrasonic energy beyond theepidermis to the deep dermal structure andSMAS. The depth of ultrasound wave ordelivery can be visualized on a screen, thusassuring the level and accuracy of delivery.

The tolerance of the procedure is easilymanaged. Only one treatment is needed withthe majority of patients, with approximately20% needing a second treatment. A repeator maintenance treatment is suggested in 18to 24 months. Slight edema can be experiencedfor up to 48 hours and echymosis is rare butoccasionally reported. The lack of anysignificant immediate external effects makesthis truly a “no downtime” treatment.

Patients looking for a non-invasiveoption for lifting and tightening arecandidates for treatment as long as they donot present with severely damaged actinicskin, thin skin, severe laxity, marked fatexcess or scarring. If patients are lookingfor a subtle uplifting/ tightening effect,micro-focused ultrasound is a very soundoption. Educating patients (particularly forreasonable expectations) and assessing formild to moderate ptosis of the forehead/brow, face and neck are key in patientselection. As with many “minimallyinvasive” and “no downtime” proceduresand technologies, good patient selection isimperative for high patient satisfaction,since most patient results will be acompromise, not a total correction that a surgical option can offer. It does not

replace medical skin care, dermal fillers,neurotoxins or laser devices, but rather, iscomplementary to their use.

The ASPS and ASAPS continue tocollect data that indicate huge publicpreference for non-invasive rejuvenativeoptions. Deep micro-focused ultrasoundtherapy is now a valuable and worthycandidate. There will be more to discoveron micro-focused ultrasound at our 18thAnnual Meeting to be held in Vancouver,May 1-4, 2012.

Abbey Helton holds a Dual Certification inPlastic Surgery Nursing and Medical-SurgicalNursing with over 19 years of experience in themedical field, the last 12 years as Clinical Directorfor Joseph Banis Plastic Surgery. Her backgroundincludes Legal Nurse Consultant—reviewing andpreparing legal documentation for expert witnessing,development of Skin Care Solutions™, as well asaiding in the research of a nutricosmetic and geneticskin aging project with Dr. Joseph Banis. Abbey canbe contacted at 502.589.8000 or atahelton@aesthetics.com ▲

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s skincare specialists, we can really

make a difference when approached by acancer patient/client when it comes torecommendations for skin care and skintreatments to help improve the condition oftheir skin. It is really beneficial for us toknow how to read product labels for accuracyand to have an understanding of what thebenefits are from different ingredients indifferent products. This information putsyou out there as an expert in skin care andingredients. Most importantly, if workingwith patients/clients who are undergoingcancer treatment or are in the recoveryperiod—do you really feel confident thatyou know enough about ingredients thatwould be considered safe for this patient/client to use? Do you know which ingredientsare considered carcinogenic, toxic, and/orirritating to a skin that is compromised?

The biggest irritants in skin careproducts are fragrances and preservatives.These ingredients can cause allergies,sensitization and irritation on the skin. Mostskin care products contain fragrance invarying levels to make them euphoricallyacceptable to everyone. Fragrances are notsuitable for people considered to bechemically-sensitive individuals, as well asthose who are immune compromised and on acocktail of medications. Parabens, a commonlyused preservative which has received somuch publicity in recent years, is thebiggest concern according to the FDA sincethey can act similarly to estrogen. For thosehormone-related cancers, use of any skincare products with parabens is not advised.

All skin care specialists who considerthemselves an expert in their field need tobe knowledgeable about cancer treatment,the side effects on the skin and should becomfortable in their assessment with productsand be able to determine if they are suitableor not. This means knowing your ingredients,what testing the product has undergone andis it manufactured in a credible facility? Akey point is to determine the integrity of acompany by their product labels. Are theyrevealing all ingredients in the formula or

are they creating labels and claims formarketing value? Do these formulas containchemicals that are carcinogenic, irritating tothe skin or toxic with long term use?

The term ‘pinkwashing’ is used to describecompanies that position themselves as leaders in the fight against breast cancerwhile engaging in practices that may becontributing to rising rates of the disease.Many companies are unwilling to eliminatecarcinogens and other chemicals of concernfrom their products. There are many morecompanies now claiming that their productsare suitable for use on people that have avery compromised skin.

Working with any compromised skinrequires adjustments to a treatment and touch.Too much pressure can cause pain, bruisingand bleeding under the skin and possibletearing of the skin which may not be clearlyvisible. Working with someone whileundergoing cancer treatment, particularlychemotherapy, requires a light, gentletouch. Adjusting a treatment is necessary,according to each individual and most peopleon medications, such as chemotherapy, needadditional moisture and protection, as theskin cells are affected. The body is alreadybeing overloaded with toxic chemicals, sokeep the skin care regime simple. A lotioncleanser, and a good moisturizer with UVprotection are good recommendations whenthe skin is in its most fragile state. Oncecancer treatment is complete, allow the skin to recover and help it rebuild to itsoptimum of the ‘new normal’.

Broad spectrum sunscreens withphysical ingredients are safer, so avoidrecommending a sunscreen with chemicalsunscreens containing any ingredients thatare possible irritants or carcinogens. Skinsthat are undergoing chemotherapy or thatare immune suppressed are very susceptibleto sunburn from harmful UV radiation.

Mucous membranes can be affectedduring cancer treatment, and lips can be verydry during treatment. Hands and feet can beaffected with cuticles very prone to dryingand cracking. A dual purpose balm that canbe used on both cuticles and lips are valuefor money, especially if they are effective.

People with skin problems resultingfrom cancer treatment or medications are athigh risk of developing psychologicalproblems with depression being one of themain side effects resulting from chronic skindisorders. Other side effects are socialwithdrawal, anger, frustration, and lack ofconfidence.

Psychosocial distress is a natural, normalresponse to skin symptoms, especially in oursociety. Since it is far more than just vanitythat drives people’s desperation to lookgood, body image accounts to about one-third of a person’s self-esteem, which in turn has a major influence on overallpsychological health. So, when a persondevelops a skin disorder from medicationsor cancer treatment, their self-esteem andpsychological health will be affected.

Chemotherapy, radiation therapy andsome biological therapy drugs can be harshon the skin, and many products on themarket may not provide much healing orpreventative effects, however, the use ofselective, good quality, affordable topicalskin care products may provide patient/client comfort.

As a skin care specialist, we can definitelymake a difference when we are knowledgeableabout cancer, its treatments and side effectson the skin, together with credibleknowledge on reputable skin care productsand ingredients used in the formulas.

Mórag Currin has been a champion of the rightsof cancer patients in the spa environment—particularly their right to receiving a safe spatreatment. As the founder of Oncology Esthetics®,Mórag Currin is the author of “Oncology Esthetics:A Practitioner’s Guide,” and has 17 years ofaesthetic, product development and trainingexperience. She has been educating aestheticians onclinical Oncology Esthetics® throughout NorthAmerica since 2008. With a number of trainings,presentations and articles to her credit, Currin is a sought-after speaker, both nationally and internationally. She can be contacted atinfo@touchforcanceronline.com. Oncology Esthetics®

is a registered trademark of Touch For CancerOnline. ▲

Oncology Esthetics®:

Cancer Patient Skin CareMorag CurrinA

www.lovemybody.com

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s members of SPSSCS, Nancy Cheney, Susan Eldridge and I had the opportunity to volunteer at thePhoenix Society’s annual World BurnCongress held in Cincinnati in September,2011. They changed lives each day as partof the Image Enhancement Programcoordinated by Barbara Kammerer Quayle,a burn survivor, who uses the creativecosmetic techniques daily.

For so many of us working in plasticsurgical skin care, most of our days arespent trying to rid the world of wrinklesand sun damage. In a world that relies soheavily on outward appearances, take a

moment and think about how you might be affected after a traumatic burn injury.The stares at the grocery store, applying for a new job, insults on the playground,comments from strangers “Take off yourmask, Halloween is over,” or asking yourselfif you will ever date again, fall in love, getmarried, have children…

The loss of confidence can make these situations seem insurmountable andoverwhelming. As part of the ImageEnhancement Program, our goal is to notonly demonstrate but also educate. Imaginethe knowledge and experience that tookyou so many years to acquire and applying

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Changing Lives at the World BurnCongress 2011

Michelle Palcic

that to an entirely different population ofpeople…burn survivors. Each individual wastaught how to diminish skin discolorationand scarring, restore lip symmetry andcreate eyebrows. We worked to achieve anatural daytime look for each person. We worked with men and women, adults,and teens. It’s not just changing faces, it’schanging lives.

The Phoenix Society for Burn Survivorswas founded by Alan Breslau in 1977. Alan was extensively burned after acommercial airliner crash in 1963. Herealized, after visiting a boy in a burn unit, the importance of establishing peersupport for burn survivors.

People who suffer burn injuries oftenhave a challenging time getting back toliving. The Phoenix Society for BurnSurvivors helps them do exactly that. Formore than 30 years, the Phoenix Societyhas worked with survivors, families,healthcare professionals, the fire industryand donors to support burn recovery,improve the quality of burn care, andprevent burn injuries.

The Phoenix Society takes its namefrom the legendary bird that lives 500 yearsand is then consumed by flames. But it risesagain, reborn from its ashes to becomemore brilliant than ever.

The SPSSCS has been involved withthe Phoenix Society’s Image Enhancement

IN APPRECIATION

We would like to express our sincere gratitude to the following

companies for their generosity in providing products for this year’s

World Burn Congress ImageEnhancement Program:

NANCY CHENEY AND MICHELLE PALCIC DISPLAYTHE TOOLS OF THE TRADE AT THE WORLD BURNCONGRESS 2011.

BARBARA KAMMERER QUAYLE ASSISTS A BURN SURVIVORWITH CAMOUFLAGE MAKEUP.

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here is a new option for laserresurfacing with less downtime. Dealingwith 3-5 days of downtime with moreaggressive fractional resurfacing is difficultfor many patients. We have had manypatients ask for a gentler laser treatment torefresh their skin. We have started offeringfractional diode (1440nm) laser resurfacing.This is a gentle laser that refreshes the skinfrom the inside out. The laser energycreates millions of microscopic treatmentzones in the skin, replacing damaged skinwith healthy younger looking tissue. Thistreatment refreshes the skin, providing amore youthful appearance and makes theskin look clear and brilliant. Patients lovethe treatment and find that it really meetstheir needs.

Fractional Diode resurfacing is safe forall skin types. The treatment requiresminimal topical anesthetic prior to theprocedure and it is fast, effective andaffordable. Patients will experience slightredness and very minimal swelling for nomore than 24 hours after the treatment.They may wear make-up, return to work thenext day and carry on with their normalroutine. Patients are left with visiblyilluminated skin tone, smoother texture,reduction in the appearance of pores, and a

beautiful radiance. The treatments can betailored to the patient’s concerns. A series of4-6 treatments done 2-3 weeks apartprovides the best results, but improvementcan be seen with only 1 treatment. This isalso a great way to maintain moreaggressive fractional laser treatments.Patients of any age can benefit from thesetreatments. It is a great way for youngerpatients to start taking better care of theirskin and beneficial to older patients thatwant to reverse sun-damage without thedowntime. Fractional Diode laser treatmentshelp patients recover the glow, luminosityand smoothness of their skin. Aging skin isa fact of life, but now we have a new, easieroption to help turn back the clock.

Stephanie Holden R.N., B.S.N. is the currentPresident of the SPSSCS. She is the nurse managerof EpiCentre Park Lane, the laser and skin care centerfor the 9 physicians of Dallas Plastic SurgeryInstitute. She has 20 years experience in plasticsurgical nursing and loves to stay on the cutting edgeof new technologies. ▲

Program since 2005. Each year, SPSSCSasks for volunteers to attend the annualWorld Burn Congress. The SPSSCSvolunteers have a wonderful opportunityto provide one-on-one hour longconsultations using corrective cosmetics,color selection and choice to enhancethe survivors’ self image.

I met so many wonderful people onthis journey—some are children, someadults, some of their scars are visible,and some are hidden. Some are newscars and some are old. But the oneunifying factor is that each and everysurvivor I met is an inspiration. I’venever met a group of individuals withsuch spirit and heart and who are soappreciative of our help.

On a personal note, I have to tellyou that this was absolutely one of themost amazing, life changing experiencesI have ever been lucky enough to be apart of. There were laughs, tears, aweinspiring courage and hugs. Lots andLots of hugs.

I highly encourage all of ourSPSSCS members to consider becominga part of the Image Enhancement Teamwhen the annual World Burn Congresstakes place in Milwaukee in 2012. Youwon’t regret it !!! ▲

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What’s New in

Laser Resurfacing?Stephanie Holden, RN, BSN

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o menage as gracefullyas we think?While a mandoesn’t face thesame hormonal

changes with aging that effect a woman’sweight and muscle mass, his clock is stillticking. Whether he is constantly in thepublic-eye or an everyday delivery guy,most men want to maintain their healthy,youthful appearance just as much as awoman. And, with cosmetic surgery’sincreasing popularity, it is becoming moreand more acceptable formen to turn to cosmeticprocedures to continue tolook their best.

In the AmericanSociety of PlasticSurgeons 2010 Report ofPlastic Surgery Statistics,it was determined that outof the 12.6 millionsurgical and non-surgicalprocedures conducted,over 1.1 million wereperformed on men. Sowhich procedures are menundergoing? The chartsto the right illustrate themost popular surgical andnon-surgical proceduresfor men in 2010.

�After seeing thesenumbers men may bewondering, “What wouldbe an appropriate changefor me at this stage of mylife?” And that word“stage” is the word tozero-in on. Following myLife Stage PersonalEnhancement Philosophy,it’s the small changes thatare done over a period of

time that have more impact in the long runthan doing a dramatic reconstruction all atonce.

A man’s cosmetic plan to maintain a life stage balance of his facial and bodyappearance remains pretty consistentthroughout his adult life. The following is aguide to help men look and feel their bestthrough their 30s, 40s, 50s and beyond.

Men in their 30s: A man’s circulatingtestosterone level begins to decrease afterage 30. Because of this, the most importantthing a man can do to keep himself lookingas youthful as possible is to continue to

work at building and maintaining hismuscle mass. A regular program ofcardiovascular fitness paired with weighttraining is essential to mitigate the naturalaging process of decreased muscle mass.

Men in their 40s: The use of Botox andfillers has become much more common formen in their 40s and 50s who are beginningto deal with the loss of skin elasticity in theface. Because a man’s face has a more robustblood supply than a woman’s face, anypersonal enhancement treatments orientedspecifically to the face must take intoconsideration factors such as the depth of

Do Men Really Improve with Age?Top Cosmetic Procedures for Men that Allow Them to “Age Gracefully”

By Robert T. Grant, MD, MSc

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BOTULINUM TOXIN TYPE A337,000

LASER HAIR REMOVAL

165,000

MICRODERMABRASION

158,000

CHEMICAL PEEL

90,000

SOFT TISSUE FILLERS

78,000

2010 TOP FIVE MALE COSMETIC MINIMALLY-INVASIVE PROCEDURES

9% FROM 2009

4% FROM 2009

-10% FROM 2009

-3% FROM 2009

10% FROM 2009

NOSE RESHAPING

64,000

EYELID SURGERY

31,000

LIPOSUCTION

24,000

BREAST REDUCTION IN MEN

18,000

HAIR TRANSPLANTATION

13,000

2010 TOP FIVE MALE COSMETIC SURGICAL PROCEDURES

-4% FROM 2009

4% FROM 2009

7% FROM 2009

6% FROM 2009

2% FROM 2009

ith allthe media attentionand recent reportsfrom various mediaoutlets onphysicians whohave been operating

outside their scope of practice, we needmore than ever to provide proper consumerand staff education. ANYONE with amedical license can call themselves a plasticsurgeon but ONLY those who are ABMSboard certified should be performingprocedures and care to our patients.

Unfortunately, with the economicsituation that we have been experiencing,everyone seems to want to cut corners. Oneplace neither you, nor your patients, shouldbe sacrificing is your health. Now, morethan ever, we need your assistance inpromoting Project Beauty—a project thatnot only educates but provides up-to-dateinformation you can trust.

Become a friend on facebook at http://www.facebook.com/?ref=tn_tinyman#!/ProjectBeauty and follow us on twitter@Project_Beauty

ABOUT USOur goal is to become THE beauty

site for all consumers interested in self-improvement. Project Beauty has thebacking of one of the leading medicalauthorities in beauty—The AmericanSociety for Aesthetic Plastic Surgery.www.surgery.org

BUT WHY DOES THE WORLD NEED MOREHEALTH AND BEAUTY INFORMATION?

With the plethora of information outthere, we have yet to find one source for allthings beauty that is vetted through one ofthe leading authorities in their field, thatpresents only safe and effective options, andanswers to 2,200 board-certified plasticsurgeons. That source is Project Beauty.Women and men have told us of theirconfusion: what treatments work? Whichdon’t? How can we tell if a product islegitimate or just marketing hype? ProjectBeauty cuts through the clutter.

Below are some of the topics that werecovered in Project Beauty during the monthof December:

RECENT VIDEOSwww.projectbeauty.comDecember 6th:Focus On Patient Safety: Pt I—Importanceof Board CertificationDecember 12th:Focus On Patient Safety: Pt II—Are QuickFix Brand Surgeries Worth It?December 19th:Focus On Patient Safety: Pt III—How ToChoose A Plastic SurgeonDecember 27th:Aging Hands

RECENT BLOGSwww.projectbeauty.com/blogDecember 5th:Raccoon Invasion On My Face: UndereyeCirclesDecember 8th:Doing Away With Death (In Your Lifetime)December 14th:Undo The Voodoo That You Do: How ToUndo A Beauty HangoverDecember 20th:Plastic Surgery: Let’s Face ItDecember 25th:Twas The Night Before Neck Cream: ACautionary Holiday Tale

We are working on revamping ProjectBeauty with current up-to-date informationand more videos were taped in the monthof November in New York and future videotaping is planned in California.

If there is a topic that your patientshave been requesting or that you would like to see, please kindly email me atclaudio10011@aol.com

We are often in need of your feedbackand testimonials on skincare products—the direct link to our giveaways is www.projectbeauty.com/skincare—Please emailme a testimonial on your favorite skincareproduct. Since the giveaways are maileddirectly to the patient’s home, it cannot be aprescription product. We want to make thisventure as exciting as possible but we needyour support—check us out online andemail your suggestions and testimonials tome. Have a wonderful winter and we willsee you all in the spring! ▲

skin peeling, energy levels for light basetreatments and frequency of topicalmedications applications. The mostcommon aesthetic procedure for men inthis age group involves rejuvenation aroundthe eyes. Eyelid surgery, or blepharoplasty,when done well, can help rejuvenate aman’s face without announcing to the worldhe had a cosmetic procedure performed.

Men in their 50s and beyond: Men inthis age group will typically experienceincreasing amounts of skin accumulationalong the jaw line in the neck that we oftenrefer to as jowls. Traditional approaches forface and neck lifts do not work particularlywell in men because the scars cannot behidden under the hairline as done inwomen. However, men can have theremoval of extra neck skin through ageometric pattern that hides the scar in thearea between the bottom of the chin andthe Adam’s apple.

Regardless of their age, I ask that mentake a realistic approach in their ideal bodygoal. Less favorable male cosmetic surgeryoutcomes, such as in Bruce Jenner, MickeyRourke and Burt Reynolds, have taught usthat too much is simply too much. I leaveyou with the same adage I advise my patients with when deciding on a cosmeticprocedure: “moderation is key.”

Dr. Robert T. Grant is Plastic Surgeon-in-Chief for the combined Divisions of Plastic Surgeryat New York-Presbyterian Hospital/ColumbiaUniversity Medical Center and New York-Presbyterian Hospital/Weill Cornell Medical Center,the University Hospitals of Columbia and Cornell, aposition he has held since April of 2006. Board-certified in general surgery and plastic surgery, Dr.Grant is a member of the American Association ofPlastic Surgeons (AAPS), the American Society forAesthetic Plastic Surgery (ASAPS) and theAmerican Society of Plastic Surgeons (ASPS). Heis included in the annual Castle-Connolly Guide ofAmerica’s Cosmetic Surgeons and Dentists and hasbeen named to New York Magazine’s list of BestDoctors in New York. ▲

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Project Beauty UpdateClaudio Pinto, MMA

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howants to workswith YOU? Yes. Iasked that question.When is the lasttime your physicianstold you they’re

glad you work with them... or how valuableyou are as a staff member? How about yourfellow employees or area colleagues? Everheard someone say they would love towork with you?

I believe that it’s vital in analyzing yourbusiness, that you take time to analyze yourpersonal performance. I’m not referring tohow much money you produce. I amspecifically referring to analyzing yourpersonality, your relationships and yourcontribution to the office as a human being.

Brian Tracy writes in his book MaximumAchievement, “Most of your happiness andunhappiness in life comes from yourrelationships with others, as it is yourrelationships with others that truly makeyou human... The very essence of yourpersonality is demonstrated in the way youget along with others, and the way they getalong with you.” It’s very simple. Greatpersonalities have an abundance of greatrelationships. If you are lacking anabundance of truly great relationships atyour office or in your life, there’s room forimprovement.

Here are reasons I’ve personally failedin the past in relationships as well asreasons I’ve seen others fail:

ENTITLEMENT ASSUMPTION. “They (hired, supervise) me, therefore,

they should be providing me with the (pay,benefits, gifts, etc.) to keep me happy.” Thisassumption is pretty much a failure in anyrelationship, yet people burden themselvesand others with it.

If you need something, ask for it. If youdon’t get it, ask why rather than create yourown story. And, as I tell my staff, if you’recapable of getting it yourself, do so. It’s astrange phenomenon that the more I’vedone for myself, the more I get when I ask.

Our seven-surgeon practice is home to

a surgicenter, clinical area, billing centerand administration in addition to the skinclinic. So, although we produce well, otherareas may be in more critical need ofavailable resources. Sometimes, it’s aboutother people.

AVOIDANCE ASSUMPTION. “It’s better to avoid a person who seems

to have an issue with me than confrontthem. It may make it worse.” I understandsome employers can be intimidating intimes of tension. I’ve learned it’s better toconfront the person, let them know I wanta great relationship with them and workthrough whatever issues are preventing it.

All of my surgeons know I want a good working relationship with them. As I tell them, “If I make a mistake, it wasn’tintentional, as I always want to do my bestwith each of you.” Imagine someone walkingup to you and saying, “I want to have agreat working relationship with you. Tellme how I can make that happen.” I’ve doneit and it works well.

I MAKE A LOT OF MONEY FORTHEM MYTH.

“I generate so much money, there’s noway they’d let me go.” I’ve seen a couple ofcolleagues fall victim to this myth. It doesn’tmatter how much money you produce, ifpeople don’t like working with you, they’llbe glad to have a reason to remove youfrom their workplace.

And, while we’re on the topic of money,if you want a raise, the first aspect of yourjob performance you should analyze is yourattitude. Would you want to give a raise toan employee with a sour disposition?

Jack Canfield writes “It’s time to meetthe person responsible for the life you live

right now. This person created your income,your debt, your relationships, your health,your fitness level, your weight, your attitudesand your behaviors. Who is it? To introduceyourself, walk to your closest mirror andsay hello! This person is you! A popularmyth circulating is that external factorsdetermine how you live, the truth of thematter is that you are in complete controlof the quality of your life.”

It took me a long time to realize it wascompletely in my power to create therelationships with the physicians and officestaff I wanted. And if a problem arises, it’san opportunity to have an even betterrelationship! People will respect you fortaking responsibility for mistakes and goingthe extra mile to repair any damage it caused.

There have been many books writtenon relationships, personalities and manage-ment. If you’re having issues, go buy a fewand take action. In the meantime I leaveyou with this ONE rule for creating greatrelationships in the office.

“Do Unto Others As You Would HaveThem Do Unto You.” Yes, it’s simple. TheGolden Rule is “GOLD.” Always treating others the way you want to be treated creates great relationships. Become the model of the workplace your want. If you want people to smile and greet you, then greet them with a smile everyday. If you want support and generosity, then be supportive and generous. If you want appreciation and recognition, then appreciate and recognize.

So, I ask you again, who wants to work with YOU? Go now and get the relationshipsyou want! ▲

W IT’S TIME TO MEET THE PERSON RESPONSIBLE

FOR THE LIFE YOU LIVE RIGHT NOW. THIS

PERSON CREATED YOUR INCOME, YOUR DEBT,YOUR RELATIONSHIPS, YOUR HEALTH, YOUR

FITNESS LEVEL, YOUR WEIGHT, YOUR ATTITUDES

AND YOUR BEHAVIORS. WHO IS IT?

Managing Your Physicians 101: Who Wants to Work With You?

Michelle Turley

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Welcome NewMembersLinda N. Babgian—Westford, MAJennifer Eve Derry—Pittsburgh, PAJennifer Eve Dowling—Paramus, NJSara Dunlap, RN—Anchorage, AKSheri Goldman, CST, CLS—Boca Raton, FLHelen Gonzalez—Miami, FLRobyn J. Hofmann—Cancun, MexicoAmy McCulley—Philadelphia, PATeesha Northcutt—Anchorage, AKFarnaz Onsori—Paramus, NJJean M. Posillico, RN—Huntington, NYMendy L. Pridemore, RN—Lexington, KYLina Solarte—Wall, NJ

Elena Reyes, RMA, RST Chair, Membership/Mentor Committee

Go for the Gold in VancouverScience, Technology and Skin Care

SOCIETY OFPLASTIC SURGICAL

SKIN CARE SPECIALISTS

18TH ANNUAL MEETING

May 1–4, 2012Hyatt Regency Vancouver

Vancouver, BC, Canada

Get Your Passport!

www.spsscs.org

“Attendance at the SPSSCS Annual Meeting has been essential for my aesthetician’s professional growth. Because she functions at the master aesthetician level and works solo with my practice,

the professional peer-to-peer opportunities at SPSSCS are unparalleled and available in almost no other place.”

Richard A. D’Amico, MD FACS—Englewood, NJ

DYNAMIC SKIN CAREContinued from Cover

With skin care, whether you are juststarting to utilize it in your medical settingor are a seasoned veteran, remember toreinforce the basics to all of your patientsand realize the benefit that both you andyour patients will see!

Dr. Julius Few is a board certified plasticsurgeon who specializes in advanced cosmetic surgeryand cosmetic medicine. He is the director of the FewInstitute for Aesthetic Plastic Surgery, as well as aclinical associate at the University of Chicago. Dr.Few has more than 50 publications and serves as aclinical editor for the Aesthetic Surgery Journal,commissioner of cosmetic medicine/board of directorsin the American Society for Aesthetic Plastic Surgery,and medical advisor for ABCnews.com. Julius Few isa reviewer for Plastic and Reconstructive SurgeryJournal and Aesthetic Plastic Surgery Journal,while being an active scientific investigator/principleinvestigator in clinical research. He currently serveson the editorial advisory board for Medscape byWebMD and New Beauty magazine ▲

SpecialtySkinCareSOCIETY OF PLASTIC SURGICAL SKIN CARE SPECIALISTS11262 Monarch Street, Garden Grove, CA 92841-1441 • www.spsscs.org

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garments can be an advantage as well, in thesupport of larger scars.

Hydration of the scar surface is beneficialand can be accomplished with topical oils,lotions, creams, silicone sheeting and gels, whichhelp with transepidermal water loss. A marketingmyth perpetuated for years relates to the benefitsof Vitamin E in scar care. A 1986 study of burnpatients randomly selected over the course ofone year utilized Vitamin E cream and differenttopical creams to their scars. Those who usedVitamin E showed no noticeable improvement intheir scarring. In a 1999 study, Vitamin E was

compared with a placebo cream in patients with minor surgery scars,no difference was found in the scars at the completion of the study.Not only had Vitamin E not made a positive difference in the scarsbut one third of the patients had an allergic reaction, contactdermatitis. In our practice, we have had patients experience allergicreactions to the onion extract preparations as well. The quicker a scarmatures, the less chance there is of hypertrophy.

Inflammation is a necessary sequence in all wound healing.Excessive inflammation results in exaggerated scars, so we strive tocontrol inflammation in scar management. The topical application ofolive oil compounds produces a significant degree of anti-inflammatory and antimicrobial effects. One of our local health foodmarkets does carry emollient creams containing Oleuropein. In ourpractice, we have noted that the faster our patients begin topicaltretinoin as part of their scar treatment regimen the maturationprocess appears to progress more rapidly, resulting in a shorterperiod of wound hypertrophy.All items mentioned in the above submission are for informational purposes only. ▲

Saunda (Sam) Wolfersberger, RN • Plastic Surgery Center, Ltd.

he economy has so impacted ourpatients that many will visit our practice lookingfor something to make them feel better and endup leaving with our formulation of topicaltretinoin mixed with an emollient. (Dr.Kligman’s recipe). It is something, combinedwith strong admonitions regarding sunscreensthat can be that baby-step that many patientsappreciate and can lead them a little further intoa skin care regimen with our aesthetician and onto dermal fillers and the neurotoxins. Somepatients will even venture into the realm of non-ablative lasers, because most of these arefinancially possible. I have not heard that excited query, “IS THEREANYTHING NEW?” for a very long time.

Resveratrol seems to be the new magic topical, studies areunderway and look promising for the treatment of acne.

New biologic data on scar management states that the answer isa multitargeted approach as with so many aspects of our specialty.The publication, “Advances in Skin & Wound Care,” December2011, elaborated on the theory that just hydrating a scar is notenough. It is best to target hydration, support, inflammation, andcollagen remodeling simultaneously.

Scar support has been familiar to plastic surgeons for years inthe form of extended taping of incisions with micropore tape. Alinear taping length-wise of an incision ensures that support isconsistent and not intermittent. Also, allowing the tape to remain inplace until it separates spontaneously or becomes worn or frayedand can be replaced for extended periods of 6 to 8 weeks. Prematureremoval can result in skin stripping, which aggravates inflammationand adverse effects on the scar. Silicone sheeting and compression

T“An aged, degraded skin is uncomfortable to live in” —Dr. Albert Kligman