Photo Credit: vipplasticsurgery.com
Everyone who sets foot on the Las Vegas strip tends to see themselves as a Very Imporant Person (VIP), but as many a weekend gambler or tourist soon learns, all that glitters isn’t gold. That said, there are still places in Vegas where VIP actually means something — including VIP Plastic Surgery. Christopher Khorsandi, MD is the chief plastic surgeon at VIP Plastic Surgery in Las Vegas and Los Angeles. He is board certified in plastic surgery, and trained in minimally invasive hand surgery and migraine relief surgery. “No matter if you just walked off the runway, run a family, or are running between jobs, we want our patients to feel like VIPs,” he tells Beauty on the Bag. Dr Khorsandi shared other insights about his practice and what people in Sin City are really looking for when it comes to cosmetic surgery — and some of his answers may surprise you!
Here’s what he had to say:
What is your practice mantra at VIP Plastic Surgery?
We do not have a factory mentality with anything we do. We believe in tailored treatments and an atmosphere that is never rushed or pressured.
Tell us what people in Las Vegas are looking for in terms of cosmetic enhancements. Is bigger still considered better?
Las Vegas is really a major hub for plastic surgery and making things bigger will always be a part of the plastic surgery landscape, but I believe the days of 1,200 cc breast implants and humongous trout pout lips are behind us. What we do hear from nearly all our patients is that they want to be bigger, but at the same time they want to look natural. It almost seems contradictory, but I do believe you can go big and still look good. So how do we accomplish this? We take a tailored approach to implant and filler selection. We use a 3D modeling system called VECTRA 3D to show patients what they will look like with different amounts of volume. That way we get just enough augmentation to satisfy even the most discerning patients. As a result, this creates the highest level of satisfaction in our patients which is reflected in our online reviews.
What is your signature procedure?
I pride myself on my rhinoplasties. I think it’s the top level of plastic surgery and it takes a keen eye and a skilled hand to deliver results. There are many plastic surgeons out there but very few of them excel at rhinoplasty. It’s a surgery of millimeters, and it takes an almost obsessive attention to detail to make it work well.
What are the biggest trends that you are seeing today?
In terms of trends we are seeing increasing numbers of women looking for Brazilian Butt Lifts and gluteal augmentation. I think this trend will continue for a few more years as the techniques have become safer and more predictable. The butt augmentation is like the new breast augmentation. Case in point: Sports Illustrated‘s Swimsuit Issue this year featured three derrieres. Women are embracing the idea that you can have a more shapely backside without having to do thousands of squats in the gym seven days a week. Our first choice for butt augmentation is fat. We tend to use fat for augmentation 8 to 1 in our practice because you get the added benefit of liposuction and body contouring. However, there are implants available for patients with little donor fat available. With the number of patients we are seeing, Butt Lifts are second in line for my signature procedure.
Tell us about migraine relief surgery, and how it is changing the way these debilitating headaches are treated.
Migraine relief surgery is a new field of plastic surgery that has developed in the last decade to address the issue of chronic migraine pain. We know that Botulinum toxin can significantly reduce the frequency and severity of migraine attacks. The mechanism of action is likely the paralysis of small muscles that surround and pinch nerves in the scalp and forehead. Surgery looks to reduce migraine attacks by releasing the muscle from around the nerve and allowing for decompression of the nerve. Studies performed at Harvard University in Boston and other notable institutions have indicated that these techniques have lead to improvement in 90% of patients. It’s a very exciting new field, and we are one of the few practices nationwide offering the treatment.
How would your patients describe you and your bedside manner?
I think they would say that I have a passion for what I do and that I enjoy my job which translates into a positive office environment. It’s a privilege to get to do the work that I do and be able to be part of so many peoples’ life journey. I enjoy the practice and the people. In other fields of medicine there is this need to see high volumes of patients in order to make ends meet. In my practice, I can spend quality time with my patients. It’s like the old days of medicine where your doctor actually knew who you were, and remembered you. Some patients tell me it’s the most interaction that they get to have with a physician. I often get the sideline: “Hey Doctor Khorsandi, can you take a look at something for me?” Or, “I have a family member who is undergoing this type of medical treatment, what do you think?” I think it’s a compliment to the amount of trust we have built with our patients.
Photo Credit: drmezrow.com
Board certified plastic surgeon Craig Mezrow’s career is impressive. He received a B.S. and M.S. from Emory University in Atlanta, and an M.D. from The Mount Sinai School of Medicine in New York City. He initially entered the field of cardiothoracic surgery, but after a decade, he found his true calling and trained for five years in plastic and reconstructive surgery at the Medical College of Wisconsin. Mezrow went on for additional training in Cosmetic Surgery at the prestigious Manhattan Eye, Ear & Throat Hospital in New York City. He is now in private practice in Bala Cynwyd, located on Philadelphia’s posh Main Line.
Along with breast enhancement, tummy tucks, and liposuction, Mezrow offers a comprehensive nonsurgical menu of BOTOX, fillers, skincare, Intense Pulsed Light (IPL), and lasers. He was one of the first plastic surgeons in the U.S. to offer the UltraShape focused ultrasound device for body shaping, and is also a big proponent of VelaShape to target cellulite and dimples.
He talked to Beauty in the Bag about his love for lasers and light-based devices, the body contouring revolution and where he thinks this field is headed. Here’s what he had to say:
As a board certified plastic surgeon, how and why have you embraced lasers in your practice?
I believe that lasers as well as radiofrequency and ultrasound devices are becoming essential tools in an aesthetic surgical practice. To illustrate this, consider the face and neck lift patient, whom not only has hanging jowls and loose neck skin but also has wrinkles and sun damaged skin. To only perform a face and neck lift without addressing the wrinkles and/or skin dyschromia (pigment discoloration) would be incomplete. Only with a comprehensive approach using light and/or energy-based devices can a complete rejuvenation be achieved. On the other hand, some patients do not wish to have any surgery but instead desire non-invasive treatments to improve their skin color, texture, firming and possibly even reduce regions of excess fat. We now have the ability to address their concerns without employing invasive treatments.
What is new and exciting in the world of body contouring?
Each year, hundreds of the thousands of patients undergo surgical body contouring procedures such as abdominoplasty and/or liposuction. Many desire additional refinements such as reduction of fat deposits without further surgery. For the aforementioned and for those patients who won’t consider surgical modalities, we now have non-invasive treatments. During the last decade, multiple non-invasive fat reduction therapies have been introduced into the United States. Some of these technologies include radiofrequency heating devices such as VelaShape, Venus Freeze, Venus Concept Legacy, and Vanquish. Other devices “freeze” the fat such as Coolsculpting by Zeltiq. Lastly, there are devices that employ ultrasound to destroy fat such as the Liposonix device and the most recently FDA-approved UltraShape device, which is the only non-thermal device in the U.S. market place.
I am very excited about the introduction of UltraShape to the U.S. because this technology uses pulsed, focused ultrasound that is not “cold” or “hot” to selectively destroy fat cells without injuring nerves, blood vessels, muscle, and surrounding tissues. The area to be treated can be individualized, customized, designed to each patients needs. UltraShape is comfortable since it is non-thermal thus not requiring any type of anesthesia. It has no down time, as there is no swelling, bruising, induration, or soreness. With a series of three abdominal treatments performed every other week, a three to six centimeter circumferential reduction can be achieved with visible results as early as two weeks. I also expect to use UltraShape in the near future to treat fatty arms, necks, thighs, etc.
What do you use as your ‘go to’ techniques for turning the clock back?
The most important is the patient’s concerns. After a complete history and examination, we have a discussion about whether the patient desires a combination approach of surgery and nonsurgical modalities or only desires non-invasive treatments. Significant non-invasive rejuvenation and patient satisfaction can be achieved when a combination of treatments are employed using multiple modalities. The treatments may incorporate a combination of lasers, IPL, radiofrequency, and ultrasound devices to achieve aesthetic goals. It would not be uncommon for non-invasive facial and body procedures to be performed on the same day in conjunction with injections of hyaluronic acid-based fillers, polylactic acid and/or botulinum toxins.
Does anything work well for acne scars, stretch marks, and cellulite?
When treating acne scarring, it is imperative to first evaluate the degree of scarring, the patient’s skin type, and the patient’s desires of a single treatment with significant downtime or multiple treatment sessions with little or no downtime. If the patient has a lighter skin type (Fitzpatrick I-III), and accepts downtime, I will perform a single treatment of fractional CO2 laser resurfacing. I have obtained excellent results with Syneron Candela’s CORE CO2 laser. I am very fond of this system because I can perform full ablation and/or fractional ablation with varying settings without changing the hand piece. Full ablation is the complete removal of the skin’s top layers, while fractional ablation involves a controlled wound healing process. The laser places tiny holes or micro channels in the skin which cover a fraction of the total treatment area. This activates the body’s wound healing response, and stimulates the production of new collagen.
For the patients whom do not want significant downtime, I have been extremely pleased with fractional radiofrequency Sublative treatments using Syneron’s Matrix RF. What’s fabulous about this system is the rapid healing, minimal downtime, and the fact that it can be performed on all patient skin types including African American patients. The treatments to improve stretch marks are more complex. It is important to assess if the stretch marks are red, immature scars as compared to lighter, mature scars. While in my opinion, there are currently no reliable treatment options, I have had success using fractional radiofrequency Sublative treatments.
Cellulite continues to be concerning for millions of women. My view is that the technology is improving and hopefully one day, we will have a permanent treatment modality. Syneron’s VelaShape technology has had the longest track record, totaling nearly a decade with four generation of machines to decrease cellulite. Their latest model is the 150 watt VelaShape III, that now has a three treatment regimen protocol. That is reduced from their earlier 20 watt machines requiring sixteen treatments. Another promising newcomer to the marketplace is the Venus Concept Legacy that combines multipolar radiofrequency with electromagnetic energy.
What are your East Coast patients looking for most often and how has that changed in the past decade?
What has changed the most in the aesthetic industry over the last decade is the patient demand, desiring non-invasive, nonsurgical options without downtime for facial rejuvenation and body contouring.
In your view, what is the future of aesthetic surgery?
My opinion of the future of the aesthetic industry is going to be the obvious future demand of non-invasive, nonsurgical, no downtime treatments. I also believe that more physicians are going to incorporate non-surgical modalities with their surgical aesthetic practices.
Photo Credit: aafprs.org
Even the balmy weather and threats of storms didn’t detract from the excitement as facial plastic surgeon Stephen S. Park, MD, became the new President of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) at the group’s annual Fall meeting in Orlando, Florida.
Representing more than 2,700 facial plastic and reconstructive surgeons throughout the world, the AAFPRS is the world’s largest specialty association for facial plastic surgery. In addition to taking the helm of the AAFPRS for a one-year term, Park remains the director of the Division of Facial Plastic and Reconstructive Surgery at the University of Virginia Medical Center in Charlottesville.
Despite a full dance card at the meeting, Park sat down with Beauty in the Bag to discuss his practice, the direction the specialty is heading, as well as what he believes are the three things that can help put the brakes on aging.
Here’s what we found out:
Tell us about your practice.
It’s about 50% reconstructive including correcting congenital deformities such as microtia, a condition where the external ear is underdeveloped. The rest is aesthetic and includes aging face surgery, facelift, and rhinoplasties. My biggest niche, however, is nasal reconstruction, often following trauma or skin cancer.
How does reconstructive facial plastic surgery differ from cosmetic facial plastic surgery?
The lines are becoming blurred and that’s a good thing for patients. For many years, aesthetic surgery was one bucket and reconstructive surgery was another. As such, surgeons put a focus and expectation into the procedure according to which bucket it was in. The thought was ‘at least your cancer is gone, you can live with the deformity.’ Now, however, the two disciplines or approaches have blended. Skin cancer reconstruction has changed based upon what we know about aesthetics. Cosmetic rhinoplasty too is intimately related to functional nasal surgery. We are pulling tricks and nuances from our aesthetic practices into our reconstructive cases and producing a more cosmetically pleasing outcome after reconstructive surgery.
One of the Academy’s main messages to patients has been to ‘trust your face to a facial plastic surgeon’ because these are the experts who are most qualified. Are today’s patients heeding this call?
I very much think this message is resonating. Today’s patients are so unbelievably sophisticated largely because of technology and social media. They can do a lot of homework before they ever meet you and are making more informed choices about surgeons and procedures. The result is that patients are now asking us the hard questions during consultations.
What doe the future of facial plastic surgery look like to you?
Stem cells and tissue engineering will be big. I genuinely believe that in the lifetime of our younger members, so much of what we do and use today in facial plastic surgery will become obsolete. The big nasal reconstructions will be of historical interest only. In the future, a bright engineer will figure a way to use stem cells from a person and seed a perfect, biodegradable, 3-dimenional scaffold and grow a new nose. It may be first grown in an incubator and later implanted into the patient. Once that gets going, we will also begin to use stem cells mixed with growth factors to make new collagen for more youthful skin. We are on the cusp of a revolution.
Is 50 really the new 30 and if so, what does 50 look like in 2014?
I’m 52 and don’t feel old at all. I am shocked at how youthful and energetic so many people can be today.
What is their secret or yours?
In addition to the obvious, such as not smoking, the three things that make a huge difference are: regular exercise, hydration and moisturization. They say eight cups of water a day, but it is really as much as you can drink throughout our crazy days. I always recommend moisturizers to all patients and a sun block with at an sun protection factor (SPF) of 30 or higher.