COSMETIC CONFERENCE SPRING. 111thst Glance: AMERICAN SOCIETY OF COSMETIC PHYSICIANS Cosmetic Education Without Boundaries

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1 Network With Us MARCH/APRIL 2016 VOLUME 2 NUMBER Your Link, Your Voice, Your Society INSIDE THIS ISSUE: 111thst Glance: Annual Recipe for Success Kevin Johnson, MD, FACS COSMETIC CONFERENCE PracticeWing Mara Shorr, BS Jay Shorr, BA September th - 11th Confidence Through YOUR Member Benefits SHAPING for SPRING 2016 The Natural Trend Autologous Fat Grafting I.D.E.A.L. Breast Augmentation At a glance Workshop with Ted Eisenberg, DO AMERICAN SOCIETY OF COSMETIC PHYSICIANS Cosmetic Education Without Boundaries

2 Are you an ASOCP MEMBER? Why not? ASOCP is proud to have faculty, members, and healthcare professionals from all specialties who are open to sharing their knowledge and expertise. Membership in the ASOCP has seen constant growth and now consists of over 00 members from different countries. Certificate of Membership Don t just say you re a member, show them you re a member Completion Certificate on Workshops Receive a certificate that shows you have completed CME accredited educational events on a particular subject CME credit on all ASOCP sponsored events Every ASOCP event or sponsored event will be offered with CME s Use of the ASOCP logo Members will receive free access to the use of the ASOCP logo Social Media Collaboration between members and the community through Facebook, LinkedIn, Twitter and Instagram Updates on Upcoming Events Receive s and mailers on upcoming workshops and events so you can stay informed MEMBERSHIP TIER LEVELS Partner (MD, DO, DDS, DMD) $5,000 -has fulfilled the fee schedule for lifetime membership -holds a genuine interest in maintaining and encouraging the mission of the ASOCP -holds a license that is current and unrestricted -performs or is interested in cosmetic medicine Physician (MD, DO, DDS, DMD) $500 -holds a genuine interest in maintaining and encouraging the mission of the ASOCP -holds a current and unrestricted license -performs or is interested in cosmetic medicine Aesthetic Professional $250 -holds a genuine interest in maintaining and encouraging the mission of the ASOCP -performs or is interested in offering services related to cosmetic medicine -non-physician Resident No Cost -holds a current and unrestricted license -currently participating in a residency or fellowship program-holds a genuine interest in maintaining and encouraging the mission of the ASOCP Discount on all ASOCP sponsored education Because continued education is important, stay informed for a discount on all workshops and our annual meeting. Clinical Case Review Submit difficult cases for advice or typical cases for review and critique Member Directory Your name and practice listed in our member directory

3 ASOCP For YOU ASOCP It s Our Mission "The American Society of Cosmetic Physicians is an organization which encourages the open exchange of ideas, techniques, patient safety, technological advancements and complications."the above sentence is easy to read and follow but when we take a closer look at the meaning, we key in on 2 words, "open" and "exchange". By themselves, these 2 words can have many meanings, but together, they mean un-abided. This is exactly what the ASOCP strives to provide. Benefit of Confidence Clinical Case Review is our NEWEST BENEFIT offered to Members of ASOCP. This benefit allows members to submit a clinical case for expert panel review. The submissions will be anonymously reviewed by the panel to provide you with specific (opinion or suggestion only) information that you are asking for. Whether your submission is seeking clinical advice, or a case result review, take advantage of the experts and facilitate your clinical growth. Outside of the clinical review, the goal for this benefit is to show that your fellow ASOCP members genuinely support each other and the advancement of the society. To submit your cases, visit our Members Section on the ASOCP website. PCustomize your practice to match your interests, capabilities and desires of your patients. PHave a resource to search and explore the possibilites. PReceive support and guidance for your office and staff. YOU CAN: PComplement your existing practice by adding elective, office based procedures. PDiversify your income with pay-for-service medical procedures. PHave access to others within your specialty to gain from their experience and profit from their advice

4 ADDRESSING PRACTICE DEVELOPMENT: It s a fact: without a staff and team that s excited and motivated to help the practice succeed, nothing else matters. Having great services and excellent care mean NOTHING if your staff isn t excited to perform, sell and market them, or if a patient spots an unhappy staff and set of unfriendly faces the second they call your office or walk in the door. As simple as this sounds, nothing else matters. So, how can you MOTIVATE your team to success for the practice? c Start by leading from the top. If you re looking for a staff that smiles when they answer phones and greet patients, make sure that you re not only doing so with your patients, but with the rest of your team as well. Make sure that you re smiling at THEM, and check any frustrations you may have had over breakfast or your morning commute at the door. (Looking for more information on this? We personally love Dr. Richard Castellano s book The Smile Prescription. Dr. Castellano gave an amazing lecture at the 2015 conference on the power of smiling as well!) c Incentive them financially. If you re pushing for your staff to upsell patients on additional procedures and skincare, make sure that you give them goals... and rewards for meeting them. Each staff member, including providers, patient care coordinators and the person checking patients in and out, should be part of a group goal and/or individual goal. However, be sure to check with your state laws about how to financially reward patients and avoid fee splitting violations. c Work with your vendors. Most vendors are happy to offer your staff incentives in terms of free product when it comes to incentives. After all, the more of THEIR product your staff sells, the bigger your sales rep s order and commission check. Let one hand wash the other so the incentive doesn t always come out of your pocket. T E A M W O R K c Give each staff member their own business cards and list their photos, titles and biographies on your website. This serves two purposes: not only does it make your staff members feel important, but the cards arm them with the tools needed to get out into the community and promote your practice. Listing their information on your website allows your patients to feel like they know your practice before stepping foot in your door. These are incentives that act as a marketing tool as well! c Look at non-monetary rewards as well. Think of some standard things, like healthcare benefits, retirement savings accounts and paid time off. In addition, consider an employee of the month program, staff birthday/holiday/ appreciation parties and covering the cost for additional education. We have one client who has two offices a considerable distance apart from each other. So that employees who live close to one location didn t have to make 1.5 hour (each way) drive to their annual holiday party, he sent for a limo to pick them up and take them home. Certainly not a huge expense, and it showed his team that the night was about them being able to enjoy themselves! Authors Pick: The Smile Prescription by Dr. Richard Castello, Speaker at the 2015 ASOCP Cosmetic Conference Contributing Authors Jay Shorr, BA, MBM-C, CAC I-VI (ASOCP Faculty) Mara Shorr, BS, CAC II-VI (ASOCP Faculty) Have any questions, comments or concerns? Contact us at (520) or via info@cosmeticphysicians.org

5 HELLO COLLEAGUES I hope this article finds you well and enjoying the early stages of spring and one of the busiest times of the year in cosmetic surgery. I ve been kindly asked to share my background and the story of my transition into the cosmetic surgery and medicine. I m KEVIN JOHNSON (ASOCP Faculty) MD, FACS a board certified General Surgeon specializing in cosmetic surgery and medicine. Medical School and General Surgery Residency training for me were both at the University of Washington in Seattle. I m in my 19th year of private practice. I have offices in Coeur d Alene, Idaho and Spokane, Washington and I have the pleasure to work with 7 great employees every day. We perform Smartlipo, Precision TX, Cellulaze, CoolSculpting, laser hair and tattoo removal, fractionated CO2, varicose vein procedures, Dysport, Restylane, Sculptra, and skin care. I now live with my wonderful family about 90 miles away from the wheat farm where I was born and raised. Advanced Aesthetics 60 Northwest Blvd., Suite 301 Coeur d Alene, ID After completing my residency, I joined a multispecialty clinic in Seattle. My practice involved teaching responsibilities as Clinical Faculty for the U of W and Swedish Hospital General Surgery programs performing a broad spectrum General, Vascular and Thoracic surgery in downtown Seattle. After 3 years of practice and 2 years of being a parent for the first time, my wife and I decided that we would move out of the city to a more rural setting to raise our daughter, and eventually a son. The thought process was to move out of the crowded city with bad traffic, rising housing prices and marginal schools, to create a better quality of life in a smaller community. But, after 4 years of every other night call for 3 rural hospitals and driving about 100 miles per day between these 3 hospitals for rounds, ER calls, operations, ICU emergencies, trauma and clinic it became apparent that this particular quality of life was not what we were looking for. When approached about the possibility of compensation for trauma 24/7 trauma call coverage to ease to pain of this burn out pace, the 3 hospital CEO s and Boards of Directors were insulted that we would even ask for what is now pretty much standard operating procedure around the country. This left us with an opportunity to make a life plan decision. That s when I discovered the magical formula of tumescent anesthesia. I went to the International Vein Conference in Miami, FL and listened to a lecture by Dr. Jose Almeida. He had a similar back story as a busy vascular surgeon. Surgical call, declining reimbursement, and deteriorating relationships between hospitals and physicians were his impetus to begin performing varicose vein procedures in his office-based procedure room. He was able to separate himself from the unpalatable side of surgical practice and start over fresh with a novel procedure using a LASER in his office with the assistance of tumescent anesthesia eliminating his reliance on hospital equipment, general anesthesia and the privilege of taking unassigned hospital call for AAA s and cold legs. Listening to this surgeon s story in Miami changed the course of my career. I moved to Coeur d Alene, Idaho and started over. We began by setting up our office-based surgery suite and began growing a varicose vein practice performing Endovenous Laser Ablation, microphlebectomy, sclerotherapy and cutaneous lasers for spider and reticular veins. We bought a platform device that could tighten skin, perform non-ablative rejuvenation with and IPL attachment. For the next few years, and hundreds of hours of conferences such as the ASOCP and the AACS, CME, independent study, observation and training, we slowly grew the practice. Professional relationships with colleagues were also developed and extremely valuable. Marketing was a new experience that was not emphasized in Medical School or Residency. In fact, it was frowned upon, because only inferior physicians who aren t very busy have to market. We learned that cosmetic patients aren t sent to us by other doctors through the usual, in-network, obtuse, random and/or politically motivated referral patterns. (Ask a Family Physician or Internist how they decide to whom they send their patients sometime, it s pretty entertaining.) We learned that marketing is hard. In 2016 my Shaping a Successful Practice best marketing advice is: the internet is important, the Yellow Pages are not. And, get help from the professionals who can develop and grow your website and brand. The current backbone of my practice is Smartlipo. We incorporated laser assisted liposuction into our cosmetic practice in 200. Liposuction remains the most popular cosmetic surgical procedure almost every year depending on the source of the survey. This holds true in our practice as well. 60 to 70% of our revenue is generated by LIPOSUCTION and those patients often cross over to other cosmetic procedures we offer. In spite of an economic downturn about the time we started performing liposuction; this procedure continues to hold steady and growing numbers every year. And, there is a tremendous amount of patient satisfaction when modern techniques are employed creating: jgreat results kminimal pain lan easy awake surgical experience mminimal downtime. Those 4 elements are the key to the popularity of any modern cosmetic procedure. I have also been granted the great privilege of teaching others. I regularly lecture on cosmetic medicine, and surgery and lasers. Additionally, we host a CME accredited tumescent laser liposuction training course in our CDA office monthly. These activities give me the opportunity to learn from other physicians and to share what others before me have passed on. It s a great sense of accomplishment to help a fellow physician enhance their skills and grow. Quality of life? It doesn t get any better than this.

6 2016 Trending Naturally A procedure that has gained recent popularity despite being performed since the 190's, is that of Autologous Fat Grafting. Autologous Fat Grafting provides a natural way to augment and enhance the look of the patient's appearance in areas like the breasts, buttocks, face and even the hands- ultimately creating a more youthful appearance. As cosmetic procedures become more accepted in today s society, it s not surprising to see an increase in the total number of cosmetic procedures performed in 2015 from In a recent report by American Society of Plastic Surgeons, 2015 saw a 2% increase over BUTTOCKS In the past, Breast Augmentation using Fat Transfer was a cautioned procedure. As potential complications such as scarring, calcification and cysts still exist, new radiologic technology now allows examiners to better discern between benign and cancerous cells. These radiologic advancements have given confidence to physicians wanting to augment breasts using fat. Often times, women who receive breast implants have a "plastic" or "fake" look which can detract from the natural look they originally sought. The alternative to breast implants is that of autologous tissue. With the use of autologous fat, physicians are able to provide the patient with softer, more natural appearing breasts. A big advantage of Fat Grafting to the breasts is the same as that of autologous gluteal augmentation; the by-product of liposuction for harvesting and additional contouring of donor sites. Fat transfer to the breast is also being using in conjunction with breast implants. This method allows a majority of the volume to be achieved with the implants while the tissue is being used to contour and create a natural appearance. Additionally, fat transfer to the breasts is showing safe and promising results when used for breast reconstruction as a result of breast cancer surgery. BREAST HANDS Fat transfer to the face is perhaps the most popular area for transfer with primary sites being malar, lower eyelids and nasiolabial folds. In typical cases, 10-25cc injections are adequate to provide the additional volume and shape lost during the aging process. Fat transfer to the face is growing in popularity with many surgeons using this technique during facelift procedures. FACE Autologous Gluteal Augmentation, Brazilian Butt Lift and Natural Gluteal Augmentation are just a few terms used to describe autologous fat transfer for gluteal augmentation. With celebrities factoring into the recent popularity of this procedure, most notable Kim Kardashian, physicians are seeing a growing demand by patients. Additionally, ethnic influences from countries where curvy women are plentiful are playing a role in what is considered "beautiful". Patients are seeking more natural methods to augment their buttocks with the use of fat and one advantage of using the patient's own fat is that it has to be harvested from another area of the body. Lipo-harvesting creates additional contour and shape to the patient's abdomen, flanks or thighs as these are common donor areas. The physician will take into consideration both the contour change from the harvested sites and the gluteal augmentation from the transferred tissue for a more natural appearance. Many physicians have struggled with adding this procedure to their armamentarium due to high costs and time involved. Injecting between 400 and 1500cc into each side can be very time consuming. New technology now allows physicians to ditch the syringe method and use a machine that transfers the tissue to the recipient sites in a much more timely and safe method. Full results can take up to 6 months depending on the post-operative care and the survivable percentage of tissue- which is a current topic of debate. Fat Grafting as a whole is certainly trending upward with terrific results and minimal complications. As a fairly new procedure, many studies are currently underway by numerous institutions to evaluate the long term effects of using fat as an alternative means of augmentation. Societal influence on anti-aging extends beyond that of body shape and facial appearance. While a youthful face and aesthetic body shape are common factors when determining age, the hands are an area where many people feel age is most determinable. To address this aging area, physicians are performing fat transfer to hands more and more frequently. Physicians will make a small incision in the back of the hand and inject quantities from 15-20cc per hand. Procedure times are quick and full results, as with most cosmetic procedures, are seen between the 3-6 months. As a result, the patient is left with a more youthful and natural appearance. Contact Us For Fat Grafiing Workshops: or via info@cosmeticphysicians.org

7 One of the most-preferred methods for contouring is the use of RF energy it can be used for all skin types (Fitzgerald I-VI), and in all seasons. The gold-standard CORE (Channeling Optimized RF Energy) is Viora s proprietary bi-polar multi-rf technology. This has revolutionized RF treatments. CORE s three different RF frequencies, and a fourth channel incorporating all three frequencies allows the targeting of specific layers of the skin, controlling penetration depth, that lets the practitioner target both body and facial areas, for a variety of aesthetics treatments. CORE delivers non-invasive, painless and safe treatments for your patients. With the introduction of the V-FORM handpiece, available with the V10 RF technology platform line, Viora provides an even more powerful solution for contouring. V-FORM builds on the experience of CORE and delivers superior, clinicallyproven results, with shorter treatment times and less treatment sessions allowing you to achieve a faster ROI and more profit for your clinic. With V-FORM, you receive all the benefits of CORE, plus ABS (Anti-Burn System) blocks RF delivery if imperfect coupling, for more comfortable, safer treatments With the increase of electrodes in V-FORM, Multi-CORE is delivered for faster heating, faster treatments and better clinical outcomes Largest treatment area with 6 electrodes (97 mmx3 mm) for fast heating Shorter and easier treatments due to faster pre-heating and integrated temperature maintenance In addition to being available with V-FORM, CORE technology powers the Reaction device, as well as the V-ST handpiece available with Viora s V-Series multi-technology platform line (V20 & V30). Before After V-FORM Tx cm 15 cm Photos courtesy of Viora For more information about the V-FORM handpiece and how this can help your practice, contact Viora at today.

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10 ASOCP Events 2016 Cosmetic Breast Surgery Workshop APRIL EISENBERG 7:00am :00am 1 April 2-29, 2016 Pre-Operative Evaluation of Breast Augmentation/ Mastopexy Patient -Anatomy -Markings and photographs Live Surgery: The I.D.E.A.L. Breast Lift Staple-first technique for bilateral breast augmentation and mastopexy Post-Operative 11:30am Recovery Room Management for Breast Augmentation 12:00pm Working Lunch with Q&A 12:30pm PowerPoint Presenatation: The Staple-First Technique for Bilateral Breast Augmentation and Mastopexy 1:15pm Hands-On Stapling with Surrogate Model 2:30pm Mock Breast Augmentation Consultation -Including risks of surgery for both saline and silicone implants 3:30pm Q&A 4:30pm Review of Pre and Post Op Patient Photo Books -Non-ptotic -Ptotic -Hypomastia and Ptosis -Aysmmetry -Secondary operation to go bigger 5:30pm Marketing, Office and Patient Management with Office Staff 6:30pm Adjourn 7:00am :00am 2 Pre-Operative Evaluation of Breast Augmentation/ Mastopexy Patient Including anatomy, markings and photograph Live Surgery: Staple-First Technique for Augmentation/ Mastopexy 11:30am Post-Operative Recovery Room Management for Augmentation/Mastopexy and Pre-Operative Evaluation for Breast Augmentation 12:00pm Working Lunch with Q&A 12:30pm Live Surgery: Inframmamary Submuscular (dual pane) Bilateral Saline Breast Augmentation (exchange saline to silicone) 2:00pm Post-Operative Recovery Room Management for Breast Augmentation 3:15pm PowerPoint Presentation: Augmentation Complications and Their Management Review of over 5000 patients PowerPoint Presentation: The Buck Stops Here Patient selection 4:00pm Q&A; Course Wrap-Up 5:00pm Adjourn Your name and practice listed in our member directory Complement Your Practice Connect with us Follow us now on Instagram! #MySocietyASOCP Member Discount Because continued education is important, stay informed for a discount on all workshop and annual meeting. Member Directory Your name and practice listed in our member directory Save the Date 11th Annual Cosmetic Conference at the OMNI Montelucia Resort & Spa in Scottsdale, AZ September -11,2016. I am looking forward to sharing my I.D.E.A.L. Breast Lift techniqe with the ASOCP members at my April 2-29 Cosmetic Breast Surgery Workshop. Ted S. Eisenberg, DO, FACOS, FAACS, director of the East Coast Center for Cosmetic Breast Surgery in Philadelphia, PA has over 25 years of experience as a plastic surgeon.

11 ASOCPMainstay CALENDAR Test YOUR Knowledge Upcoming Workshops From the Desk of: h h COSMETIC BREAST SURGERY April 2, April 29, 2016 Eisenberg, Ted, DO, FACOS, FAACS Evergreen Towers: 2375 Woodward St, Ste 102 Philadelphia, PA AMA PRA CME Credits ADVANCED COURSE IN LIPOSUCTION May May Sharma, Sanjeev, MD, FAAFP FACGS, MACEP Destination Beauty Medical Spa, 1319 Worcester Road Framingham, MA AMA PRA CME Credits LASER LIPOSUCTION AND FAT GRAFTING 2016 Tom, Walter, MD Aesthetic Laser and Vein Center, 70 Stony Point Road Suite G Santa Rosa, CA AMA PRA CME Credits Dr. SANJEEV SHARMA The helical root arises from which of the following external ear structures Please select the ANSWER from the following choices: A Antihelix B Concha C Inferior crus D Scaphoid fossa E Triangular fossa Please submit your answers on our website: for a chance at free registration to the 11th Annual Cosmetic Conference at the OMNI Montelucia Resort & Spa in Scottsdale, AZ September -11,2016. Register online now at:

12 American Society of Cosmetic Physicians 040 South Kolb Road Tucson, AZ 5756 cosmeticphysicians.org PRSRT STD US POSTAGE PAID TUCSON AZ PERMIT NO. 44 AMERICAN SOCIETY OF COSMETIC PHYSICIANS Cosmetic Education Without Boundaries SAVE THE DATE September -11, th ANNUAL ASOCP COSMETIC CONFERENCE OMNI Montelucia Scottsdale, AZ Join Us 2016