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.