Meet the NYAC Medical Director Specializing in Mohs surgery and reconstruction to the latest in laser procedures and liposuction, Dr. Ron Shelton, M.D., F.A.A.D., is a board certified dermatologist who is also certified in dermatologic cosmetic surgery by The American Board of Cosmetic Surgery. He served as the Chief of the Dermatology Service at Langley Air Force Base Hospital and studied cosmetic dermatologic and Mohs micrographic surgery at the University of California, San Francisco. In 1993 he created the Division of Dermatologic Surgery at the Mount Sinai Medical Center in New York City and served as its first Director. Dr. Shelton entered private practice in 1998 and co-founded The New York Aesthetic Consultants, LLP, a premier plastic surgery facility in Manhattan, where he serves as medical director. Quoted regularly by the print and television media, Dr. Shelton has been listed in both New York Magazine’s “Best Doctors in New York” feature as well as Castle Connolly Medical LTD’s “Top Doctors” New York Metro Guide” every year since 1996. www.thenyac.com Tell us a bit about yourself. What path led you to dermatology? When I was in medical school I was interested in pursuing the field of plastic surgery and forced myself to take a rotation in dermatology to learn the organ through which I would be working. I was fascinated to learn how much there was to learn about what had seemed to be a boring subject. The field was replete with large volume textbooks of skin pathology, and I never knew there was so much to learn about the skin. I saw that doctors were able to make a diagnosis, perform a biopsy, read the biopsy slide under a microscope and confirm the diagnosis, and then treat the disease. To me, that was performing complete patient care. The subspecialty of dermatologic surgery provided me with the ability to perform complex and intricate facial reconstruction after Mohs surgery for skin cancer and I love working with my hands. Cosmetically, I have been trained in this wonderful field to perform laser skin treatments and liposuction and fillers. What fillers and devices are you most excited about right now? The hyaluronic acids such as Restylane, Juvederm and Perlane allow us to do much more for our patients compared with what we used to do with collagen injections. I love working with Radiesse as a pan facial volumizer and the finer Restylane or Juvederm for finessing the smaller areas. What exactly is Zeltiq and who is a good candidate for this treatment? Cryolipolysis is a technique which freezes the fat. The adipocytes, or fat cells, actually die. They are then metabolized by the body. No surgery, no down time. There may be some bruising. It only takes one hour per body site. It is mostly done on abdomens and love handles. One treatment provides on average, 20% reduction in the fat thickness four months after treatment. Results can be felt in clothing as early as the first month to two. An ideal candidate is someone who is in good health, physically fit but can’t lose the last bulge in the lower abdomen or lovehandles and doesn’t want to undergo the risk and downtime of liposuction. Liposuction seems like an overweight person’s dream. In reality, who is a good candidate for this procedure? Liposuction is not a replacement for diet and exercise. If liposuction is done on an overweight patient who does nothing preoperatively to change their ways and stick to a diet and increase their exercise regimen, then they will have the same net caloric intake per day and gain the weight back. An ideal liposuction candidate is one who is healthy, physically fit, and has a stubborn bulge that just doesn’t go away despite exercise and diet. They may be 10 pounds overweight. They can’t be on blood thinners for medical problems or take certain medications during the liposuction that can interact with the tumescent local anesthetic. What cosmetic procedures and treatment are most requested now? Botox and fillers are still the number one and two requested treatments. Minimally invasive, natural appearing immediate results and minimal downtime, if any, are sought after by patients. Volumization of the face has become well established as being an excellent complement to a facelift if the patient has lost volume of fat. Lifting a thin face will not rejuvenate the face enough unless the convex surfaces of the cheekbones and mid cheek are replaced. How do you see anti-aging treatments evolving in the next three to five years? The increased lifespan, the competition in the workforce as we are trying to work longer while competing against the young, drives patients to seek topical and procedural ways in which to reverse the hands of time. Newer vehicles in which topical agents are mixed and delivered by application to the surface of the skin but then able to penetrate to the dermis and turn on collagen production and eliminate sundamaged proteins is something I hope to be seeing more of. Volumization and resurfacing will continue to increase in popularity, fillers and lasers, and lifting with less surgery but done more with non-invasive devices, with less down time than surgical lifts, will become the norm. This may take more than five years.