Dr. Robert Leonard, founder and chief surgeon at Leonard Hair Transplant, is widely sought after for his soft touch, artistic eye and extensive knowledge about advanced hair loss. He is licensed in six states, including Rhode Island, Massachusetts, and Connecticut, and currently sees patients in seven offices – in Cranston, Rhode Island; Newton, Massachusetts; Braintree, Massachusetts; Hyannis on Cape Cod; Boston, Massachusetts; Worcester, Massachusetts; and Salem, New Hampshire. In addition to performing hair restoration surgery, he acts as a hair loss expert for ROGAINE®, educating others of the potential hair loss treatments hold.
Dr. Leonard is a past President of the International Society of Hair Restoration Surgery and was recently appointed to the American Society of Hair Restoration Surgery Advisory Council. He was also one of the early adopters of the innovative ARTAS ROBOTIC SYSTEM®, the first and only FDA cleared robotic hair transplant device.
He recently answered some questions about the evolution of hair transplantation for Beauty in The Bag.
How long have you specialized in hair restoration?
I began my training in hair restoration surgery in 1986 after I met my mentor, the late Dr. C. P. Chambers. This was during the days of the no-archaic “plug” transplant era. Transplants in those days required several sessions in order to provide a natural look.
What has been the biggest change that you have seen in your practice?
The biggest change in my practice was the revolutionary miniaturization of transplanted hair grafts. This occurred in a very few years beginning in the early 1990’s. Today’s transplants contain only one to four hairs, which provides hair loss patients a very natural result even after only one surgical session. There are two different harvesting techniques that I utilize today: strip harvesting and Follicular Unit Extraction Technique (FUE). Each method offers wonderful aesthetic results. It is very important, however, that patients know that it will take several months to achieve these great results.
What do today’s hair transplant really look like?
Unlike in the past where grafts were very large (about the size of a pencil eraser), today’s grafts contain only one to four hairs. In the past, these big grafts needed to be spaced significantly apart so they could grow properly; they also were planted in sort of a “corn row” configuration, providing a not-so-natural effect with only one surgical session. The whole world of hair transplantation has thankfully changed today—and, for the better—much better! We now transplant tiny grafts, very closely together, in order to provide patients with very natural results.
Do you treat many women, and can they benefit from transplants too?
I have welcomed women as patients from the earliest days of my career. I am asked by my colleagues throughout the world to speak about my approach to treating the female hair loss patient. Not all women are candidates, mostly due either to unrealistic expectations of results or because they do not have enough donor hair to provide a proper result. It is critically important that women do as much as possible to stabilize their progressive hair loss with minoxidil and/or low level laser therapy—I personally use the Capillus Laser Cap. If they have enough donor hair, women are excellent candidates for hair restoration surgery. I must say that these patients are the most appreciative of my care as it is not “normal” for women to lose hair or get bald.
What role does technology play in hair restoration today?
We are in a wonderful time in the history of hair loss treatment. The tools we have really work very well to both slow down the progression of male and female pattern hair loss as well as to regrow hair. However, the patients need to be willing to use them. For men, I treat hair loss with finasteride (Propecia), minoxidil (Rogaine, Keranique, etc.), and Low Level Laser Therapy (Capillus Laser Cap, etc.). For most women, I do not use finasteride; however, for some, it is a good option for them especially post-menopausal women. The more of these treatments the patient does at the same time, the better effectiveness. Two are better than one; three are better than two.
There are no other medically proven, scientifically sound therapies available yet to treat genetic hair loss. Some doctors are using purported “treatments” such as PRP (Platelet Rich Plasma), Stem Cell injections, and various lotions and potions. None of these have had proper scientific studies to prove that they are at all effective to treat hair loss.
To provide the latest in hair restoration treatments and offer our patients superior results, we have also added the advanced ARTAS® Robotic System to our line of surgical technology. This minimally invasive, outpatient procedure allows us to transplant the patient’s own hair without stitches or visible scarring. Recovery time is fast, we can achieve fuller, natural looking hair that will last a lifetime.
Tell us about your fellowship at the International Society of Hair Restoration Surgery?
The Board of Governors of the International Society of Hair Restoration Surgery (ISHRS) recently offered the “Fellow” designation in order to recognize members who meet its exceptional educational criteria. It is a great honor for a member to achieve the Fellow designation (FISHRS). This recognizes the surgeon who strives for excellence in this specialized field. To maintain this status, the surgeon must continue to meet established educational criteria over time. I am proud to be one of 61 Fellows of the ISHRS.
Plastic surgeon Robin T.W. Yuan, MD, spends hours with each patient to get the best handle on what they want to change about their appearance, and develop the most appropriate action plan to achieve it. For these reasons, his Beverly Hills, Calif-based practice is not a factory. Far from it. Yuan is all about fostering the doctor-patient relationship. He doesn’t even have nurses or consultants that act as go-betweens. It’s his desire to provide patients with the best possible experience and outcomes that encouraged him to pen Behind the Mask, Beneath the Glitter: The Deeper Truths About Safe, Smart Cosmetic Surgery and another book juxtaposing relationships in cosmetic surgery and marriage, The Skinny on Marriage… A Plastic Surgeon’s Practical Guide.
Yuan received his medical degree from Harvard Medical School in Boston, and completed his internship at the University of California, Los Angeles. He did a residency in general surgery at UCLA and Cedars-Sinai Medical Center and a plastic surgery residency at University of Miami-Jackson Memorial Hospital. In addition, Yuan completed a Research Fellowship at the UCLA Division of Plastic Surgery.
He recently discussed his practice and what sets him apart from others in Beverly Hills with Beauty in The Bag. Here’s what he had to say:
Why inspired you to write Behind the Mask, Beneath the Glitter: The Deeper Truths About Safe, Smart Cosmetic Surgery?
First of all, I was doing a lot of reconstructive surgery early in my career. The choice of procedure was clear since most of the time I was trying to restore function or recreate normal from abnormal. Since I believed every patient was a unique individual, purely cosmetic surgery seemed to have limitless options. As I was referred more and more patients for cosmetic surgery, it was clear that there was often a disconnect between a patient’s goal and what surgeon’s perceive as the goal of cosmetic surgery. I saw too many unhappy or injured patients with unnatural results for such an elective endeavor. The book was the result of my trying to uncover the truths about cosmetic surgery and explain what the field is really about in order to increase the chance of success and safety.
How have the lessons in your book helped improve your consultations?
I am very focused on the patient’s perception of him or herself and resist the urge to operate until we have a mutually clear understanding of the goals and risks. The only way to ensure this understanding is direct one-on-one time with the patient so my consultations are comprehensive and performed on a number of office visits.
Explain how you apply the artistic concept of the Fifth Dimension to your surgeries?
The Fifth Dimension is the key to successful cosmetic surgery. It involves achieving a meeting of the minds regarding three dimensional space of anatomy, and the fourth dimensional changes of this three-dimensional anatomy over time. There is so much that goes into achieving the Fifth Dimension. It is what happens when an “artist” produces or performs a work that satisfies an audience that “gets” it. But it is not achieved by chance or force, but communication and customization.
Tell us about your approach to cosmetic surgery?
I do not look at what I do as anatomically limiting. Every part of the body is merely an anatomical structure built from all the same material of skin, fat, muscle, cartilage, vessels, bone, etc. As long as you know how to manipulate and use these tissues, you can modify any anatomical structure. I also explain to the patient how each anatomical area is connected to and influenced by other adjacent anatomy. For example, the peri-orbital region is connected to the brow and forehead, as well as the cheeks and midface, which in turn are connected to the chin, jaw, neck, and even peri-auricular area. So I look at things (w)holistically in an anatomical sense.In the end, it is the highly customized approach that is my specialty, not the body part. Anatomical specialization is somewhat artificial, either because of training, such as in ophthalmology or otolaryngology, or due to public demand for “super”-specialists. Of course, having said that, facial, breast, and body contouring surgeries are the most common.
What sets you apart from other surgeons in Beverly Hills?
I think I have a very unusual and personalized approach, having no consultants or nurses that interpose between me and my patients. I spend an inordinate amount of time with each patient (many hours versus tens of minutes) trying to achieve the Fifth Dimension. I have had a wide and extensive training with unparalleled mentors and a large experience in reconstruction that brings a varied and important fund of knowledge to cosmetic procedures. Cosmetic surgery is reconstructive in nature and reconstructive surgery should be cosmetically pleasing. It is a continuum.
What role do you think the plastic surgeon should have in treating patients with breast cancer?
My personal view is that there should be a paradigm shift in the team approach with the plastic surgeon at least on par if not at the head of the table. The basis for this is that in some ways breast cancer is a cosmetic disease as well as a oncological state. There should be a more complete evolution from the old days where cosmetic appearance was completely sacrificed for attempts at cure by radical surgery or radiation to a more cosmetic goal of not necessarily preserving, but enhancing (if desired) the breast without sacrificing potential cure. As opposed to the usual situation of the oncological team deciding on treatment and then inviting plastic surgical input if they deem it necessary, the treatment options should be outlined and then the plastic surgeon should decide with the patient as to the most optimal cosmetic plan. Quality of life should be as important as quantity. Plastic surgeons are uniquely trained to project into the future what cosmetic result could be obtained by various treatment options.
Michael Edwards, MD, FACS, is a board certified plastic surgeon who has an unmatched comprehensive understanding of the medical profession. Not only does he hold two board certifications—general surgery, in addition to plastic surgery—he was an RN before obtaining his medical degree,
He recently formed a new group practice in Las Vegas with plastic surgeons Dr. Goesel Anson and Dr. Terry Higgins, which offers a full range of facial and body procedures and treatments. Dr. Edwards specializes in breast revision surgery, a focus he feels very fortunate to address. Anson, Edwards, Higgins Plastic Surgery Associates also includes a board-certified dermatologist and a fully trained skincare team.
Here, Beauty in the Bag talks with Dr. Edwards, who is also President Elect of the American Society for Aesthetic Plastic Surgery (ASAPS), to get his tips for getting the results you seek from a surgeon.
Tell us a bit about your background. How did you come to choose plastic surgery as your specialty?
There aren’t many jobs in the medical field I have not worked at. This includes working as an EMT, ER technician, nursing assistant, and house orderly. I then became a registered nurse not knowing exactly what lay ahead. Thanks to a very understanding and supportive wife, I pursued medical school while working nights as an RN. Once in medical school I knew early on that I was bound to be a surgeon and really enjoyed the wide variety of surgical procedures the plastic surgeons were performing. I was hooked once I rotated in my fourth year of medical school. I decided to follow the more common general surgery route and completed five years of general surgery training and I still maintain my board certification. Plastic surgery was all I had hoped it would be. Our surgical cases are virtually head to foot with microsurgery, hand surgery, and incredible reconstructive techniques. I have never looked back and draw on my medical and surgical training almost daily as I care for my patients.
You recently joined a new group practice in Las Vegas. What is the group’s objective and what types of services/treatments does it provide?
I recently merged with Dr. Goesel Anson and Dr. Terry Higgins (Anson and Higgins). We have an 11,000 sq. foot office with three board-certified plastic surgeons, a board-certified dermatologist, two RN nurse injectors, four medical grade aestheticians, a highly organized and efficient practice manager, and a great staff of medical assistants, surgical technicians, and front desk personnel. We are able to provide our patients a complete range of state-of-the-art surgical and non-surgical procedures allowing each of the surgeons to focus on a specific area of expertise. Our goal is to provide a comprehensive approach where our patient’s experience, safety, and satisfaction come first. We are committed to coordinated, personalized aesthetic care for life, not just a single procedure.
What is your signature procedure?
Over the years I have been fortunate to focus my talents primarily on breast surgery, more specifically breast revision surgery. We, as plastic surgeons, all want our patients to be happy with their surgical results and we strive for that. Sometimes results don’t meet expectations as well our bodies go through changes from weight loss or gain as well as pregnancy. The breasts do change and sometimes benefit from revision. I would say my signature procedure is removing implants from above the muscle, placing new ones partially under the muscle for better coverage and prettier result, followed by a breast lift.
What is the best way to minimize scaring with a breast lift or augmentation?
With any surgical procedure there are incisions and scars. Our job, as plastic surgeons, is to plan and conduct our procedures with gentle tissue handling, tension free closure, and compulsive post-op wound care. I prefer topical silicone therapy for most of my healing incisions but on occasion there may be a need for local steroid injections or laser therapy.
Are there any new developments in surgical or non-surgical body contouring procedures that you find particularly promising?
There are always promises of new, wonderful modalities on the horizon. Unfortunately many of them fail to live up to their expectations. We, as plastic surgeons, try to look deeper at the science, to see if using evidence-based medicine, these are worth bringing into our practice. Surgical innovation is a great aspect of our specialty and we are willing to share our newly developed techniques with other board-certified plastic surgeons. Non-surgical devices are abundant and some appear to give better results in one set of hands than another. External body contouring techniques using freezing, radiofrequency, or ultrasound are promising for the right patient. They are not a means of weight loss but body contouring.
What questions should a prospective patient always ask their plastic surgeon during a consultation?
1. Are they a board-certified/eligible plastic surgeon?
2. Do they have hospital admitting privileges to perform the same procedure they are proposing to perform in an out-patient setting?
3. What are the potential risks/benefits/alternatives to the proposed procedure(s)?
4. How much experience do they have in the procedure you are seeking?
I could go on and on….