Your Link, Your Voice, Your SocietYMAR/APR 2015 F VOLUME 1 F NUMBER 2

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ALIGNED WITH A PURPOSE Carla Phipps, MD

HORMONES: ANTI-AGING & REGENERATIVE MEDICINE

Robert L. True, MDPooja Malik, MD

IN THIS ISSUE

FACTS, TRENDS & IDEALS Ted S. Eisenberg, DO

MEMBER SPOTLIGHT Alex Kaplan, MD

TRANSITION FLAWLESSLY Gregory Crichlow, MD

QUESTION & ANSWER Gregory Laurence, MD

PRACTICE WING Jay Shorr, BA

Mara Shorr, BS

KISSABLE LIPSWalter Tom, MD

I always knew that I was drawn to missionary work and that someday I

would venture that way. 15 years ago, the stars aligned (shall we say it was time to

teach one of my teenagers how 98% of the world lives). Thus, my 15 year old

daughter and I found ourselves heading for Jamaica on a medical mission trip.

Being a family practitioner, I found my broad-based experience helpful in this setting. Needless to say, it was one of those life

changing experiences for both us. I got hooked on

going back frequently (2-3 times per year), and my

daughter, who swore she would never be a doctor to

that point, started soften-ing her negative attitude

towards medicine. We both do a healthy dose of discerning that difference

between a “need” and a “want.”The “need” for medicines and shelter was

great. The teams we worked with often consisted of construction crews, doctors,

nurses, and sometimes bible study and singing leaders. It soon became clear that

the cost of the trips with transportation and places to stay, plus medicines and

supplies, required a great deal of

fundraising,

lots of friends to beg from,

or we could quite

possibly dwindle away our children’s college funds. The

latter was not an option given that without education, the children might not leave home, so I started looking for ways to

augment trip funds without cancelling col-lege. My girlfriends actually suggested the idea of cosmetic medicine. Many of them were driving 40 miles to Kansas City for cosmetic procedures and suggested that

I should be offering those services in my practice. An idea was born that sounded

interesting, economically rewarding, and apparently needed.

Laser and Cosmetic Medicine, became a conduit for funding two

passions that help people in different manners. At first, I was very secretive about the fact that all profit was going

to fund missionary efforts, but as some of my close friends

pointed out, it becomes a way for others to feel good about the money they are spending

on themselves. As time has gone on, I have added other

charities to the list, including helping fund two missionaries that work

along the AIDS Highway for a group called, the Mufundi Orphans. I’m anxious

to add that one to my future missionary trips. I also love being able to say “YES” to the many local charities, such as Boy

Scouts, Girl Scouts, swimming teams, gymnastics events, etc. These organiza-

tions always seem to need extra dollars. It

is such a joy to look at the books each month and say, “how much money do

we get to give away?” My cosmetic business consists of just myself and

an esthetician. I still practice Family Medicine four days a week and do the majority of my non-surgical cosmetics

on Friday. I’ve met lots of people that I would not have normally met and enjoy the

happy atmosphere of well clientele after a busy week of colds, flu, and gynecology.Oh, that daughter who hated medicine, is

now an OB-GYN in Denver, Co. The other two children, who have also participated in

the missionary efforts, are also in the medical field.

“Thank you Cosmetic Medicine

for leaving college funds

intact!”

Aligned With a Purpose

“What we have done for ourselves alone dies with us; what we have done for others and the world remains and is

immoral.” -Albert Pike

By: Carla Phipps, MD

Dr. Carla Phipps (ASOCP Member) is a Board-certified Fam-ily Practioner. She graduated from the University of Kansas Medical School and completed her

residency at University of Kansas. She is the Director for the Laser and Cosmetic Center, whose mission is to help people feel their best at every age.

“An idea was born that sounded interesting, economically rewarding, and apparently needed”

Have you ever tried to cut your hair your-self? You trim a bit

from the left side and then little bit from the right side, using your ears as a guideline. Oops. It’s not even, so you go back and forth and back and forth. Before you know it, your hair is too short.Surgeons have similar chal-lenges during breast lift sur-gery when we strive to even out the breasts. For the first half of my ca-reer, I would rely on complex preoperative skin markings to address these challenges. I would draw the pattern , resect the marked skin on one side, and then tailor it back together to see how it looked. I would repeat the process on the other side and compare. If the breasts weren’t even, I’d go back and forth, trimming the skin until I was satisfied with the symmetry.After years of using this ap-proach, I had one of those ‘AHA’ moments, where I thought: What would happen if I reversed the procedure and tacked the skin together first on both breasts? I tried it. I invagi-nated and stapled the redundant skin, made a pattern around the staples, and then removed them.

I was surprised to find that the area of skin to be removed (within the markings) was significantly larger than any area that was indicated by drawing a Wise or other pat-tern.I’ve been using this staple-first technique-based on the adage “measure twice, cut once” - ever since. It takes the guess-work out of breast lift surgery. It allows me to visualize the new breast shape and symmetry before I make a single incision. I know exactly how much skin needs to be removed for maximum tightening of the breast tissue without compromising tissue vascularization.

This approach is particu-larly useful for simultaneous

augmentation mastopexy for moderately to severely ptotic breasts, which is even more challenging because the surgeon has to tackle the opposing tissue forces neces-sary to make the breasts fuller (by stretching the skin with augmentation), yet firmer (by tightening the skin with mastopexy). This versatile stapling technique allows for the use of a wide variety of implant sizes and enables me to correct asymmetries. Subjectively, with this technique I’ve had consistently good results, regardless of the implant size used or the amount of skin to be resected by eliminating the need for multiple skin trimmings, operative time is reduced. I am looking forward to sharing my IDEAL Breast Lift technique with the ASOCP members at my April 16-17 Cosmetic Breast Surgery Workshop, because it has significantly simplified what was for me a challenging operation. It offers an extra level of confidence that the tissues will come together, that the vascular supply of the tissues won’t be compromised, that the breasts will be symmetric.

During augmentation mastopexy surgery, implants are placed and then the redundant tissue is invagi-nated and stapled.

IDEAL Breast Lift: Getting Even By: Ted S. Eisenberg, DO (ASOCP Faculty)

D The first modern breast augmentation took place on November 24, 1893, in Heidlberg, Germany, by Vincent Czerny.

D People between the age of 35-50 have the most Plastic Surgery, accounting for 44 % of the total.

D The first recorded “nose job” is found in Ancient Indian Sanskrit texts (600 BC).

COSMETIC SURGERY

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. For the first 13 years of his career, he performed general plastic and reconstructive surgery from head to toe. In 2003, Dr. Eisenberg created the I.D.E.A.L.® Breast Lift, a procedure for augmentation/lift surgery that maximizes the lift and minimizes the scar.

he fear of breast cancer has prevented many women from embracing the benefits of hormone therapy. Much of this fear stems from the media hype that occured due to the conclusions made by the Women’s Health Inititative (WHI) from 2002. However, if one evaluates this study and other studies that have been performed, one would come up with different conclusions.A 2012 study from Denmark dispels the cancer risk fear1. Dr. Schierbeck and colleague’s analyzed data from 1006 women who had recently gone through menopause were randomized to HRT

or no HRT. The study showed there was no increased risk of breast cancer or stroke over 16 years. Moreover, the group not taking HRT had almost a third the mortality from heart disease compared to the group on HRT. This decrease in mortality is depicted in this graph (on the right). The obvious conclusion from this graph is that the proportion of women who were alive at any one year was highter in the HRT group versus those not on HRT (Control group). Thus, these results strongly suggest that if women take estradiol aftter menopause, they will have less chance of dying overall than those women who do not take estradiol. The reduced risk is about a third (32.5%), mostly due to a decrease in cardiovascular disease, whis is the number one killer of women. The patients taking HRT used Estradiol and a progesterone, not a synthetic progestin as was used in the WHI study. In fact, progesterone seems to have a more beneficial effect on the cardiovascular system than do the synthetics.2 ,3Of note, the women who had a prior hysterectomy and only took estradiol with no added

progesterone showed a significant reduction in the risk of breast cancer, an observation also noted in the WHI study.4

The authors concluded that “In this randomized trial including 1006 women we found a significantly decreased risk of the composite endpoint of death, heart failure, or myocardial infarction when hormone replacement therapy was started early in post menopause” and there was no increased risk “of cancer, stroke, deep vein thrombosis, or pulmonary embolism.” The risk of developing breast cancer, in particular was the same whether HRT was used or not used.Thus, the WHI study conclusion may be incorrect. Women may actually live longer with hormone therapy, plus they may have a better quality of life since it also decreases hot flashes and makes sex more comfortable.

1 Schierbeck, L. et al “Effect of hormone replacement therapy on cardiovascular event in recently postmenopausal women:randomised trial” BMJ 2012; 345, October 2012.http://www.bmj.com/content/bmj.e64092 Simoncini T, et al. “In vitro effects of progestins on vascular cells.” Steroids 2003; 63(10-13):831-6.3 Rosano GM, et al. “Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women.” J AM Coll Cardiol 2000;36:2154-9.4LaCroix AZ, et al. “Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy.” JAMA2011; 305:1305-14.

he field of Anti-Aging Medicine is the most rapidly growing specialty. Hormone replacement therapy forms a huge part of this specialty. Restoring balance means optimiz-ing the ability of our cells to do

what they do best. This involves correcting defi-ciencies of hormone nutrients, removing toxicities for clarity of mind, and a structurally sound and pain free body. All acute and chronic disease are a manifestation of imbalances in these areas. These lead to weight gain, insomnia, cognitive decline,

fatigue, skin aging, bone decline, etc.We are exposed to stress constantly. Our lives are busier and the world is more com-plex than ever. Being constantly in touch with cell phones and e-mail has its advantages, but also adds to the stress in our daily lives

(remember, any interruption is a small stress). Other stressors to our body include pollution, foods with poor nutrition content, lack of sleep, lack of exercise, and many of the medications we take (especially when they cause side effects). We age due to the fact that hormones decline. In women and men, hormones start to decline from the age thirty onwards. By the age of fifty we are at approximately fifty percent of hormone function for es-trogen, progesterone, testosterone, thyroid, DHEA, melatonin and growth hormone. Genetic make up and a healthy lifestyle, play an important role in optimizing cel-

lular function. However, at some point our organs will not produce hormones even with the healthiest lifestyle and best genes. Decline in these hormones in women can produce symptoms like anxiety, irritability, premenstrual syndrome, hot flashes, vaginal dryness, loss of libido and muscle loss.

Hence women get treated with antidepressants and anxiolytics medications, though the true deficiency is a steep decline in hormones. More and more of these women are being pre-scribed what are called bio-identical hormones which are not the norm. Bio-identical or bio-equivalent hormones are ones that are similar to

the chemical structure of hormones found in the human body.

So, whether we aim to cure or prevent a symptom or a disease, the basic areas must

be addressed: establish a healthy mind, cor-rect deficiencies of hormones and nutrients. By

re-establishing this balance we achieve optimal cellular function, so the cells of the body can best do what they do to keep us healthy. Hormone replacement provides primary prevention of cardiovascular disease, osteoporosis, Alzheimer’s disease, depression, skin changes, osteoarthritis, pain and improved quality of life.

Anti-Aging & Regenerative Medicine

Pooja Malik, MD

Robert L True, MD ASOCP Faculty

ASOCP: How long have you been in practice?GL: Well...about five years into a busy surgical family and obstetrics I made the commitment to

go “all in” for aesthetic medicine. This involved a separate staff and a separate location.

ASOCP: What is the most rewarding part of being a Cosmetic Physician?GL: Easy! A relationship that is fully focused on the patient and the patient’s desire for wellness and enhancement.

Many physicians will never know the great responsibility and thrill that comes from a doctor-patient relationship not encumbered by third-party entanglements.

ASOCP: What is your favorite procedure to perform and why?GL: Anyone that knows me, knows that it’s impossible for me to nail down my favorite procedure. For me a “perfect

week” would include several type cases. The week would include a complex consultation that required more than an hour of communication with a patient; this would include reviewing old pictures, capturing new photos, and digital consultation with colleagues. Transumbilical breast augmentation makes the list under the title “less is more,” it is an eloquent procedure that regularly profile a thrill for the patient. Also, like any surgeon, I sometimes have to “get my

suturing on.” Combined mastopexy augmentation gives the opportunity to precisely work with tissue flaps.

ASOCP: What specific technology or technique have you implemented in the last few years that has given you the best return?

GL: Over the years I have made a lot of capital expenditures. Maybe it speaks to my business acumen, but very few of these expenditures have been substantially profitable. Still, my patients have benefited greatly, and I have resigned my-self to the fact that leading aesthetic physicians must have these tools and the credibility that comes along with them. Interestingly, the satisfying “clinical return” was a $500 handheld red laser. It has been remarkable how effectively this

device softens breast capsules and helps avoid unneeded surgery.

ASOCP: Do you advertise your practice using social media?GL: I consider advertising to be outbound activities like print ads, radio and television spots. I look forward to the day

that I can effectively engage in these activities. An effective outbound advertising strategy requires an excellent inbound foundation. I am super impressed with the sophistication that has allowed some of my ASOCP colleagues to generate

close to 10,000 organic Facebook likes, I aspire to such!

ASOCP: When you need to get your mind off of your practice, what activities or hobbies do you participate in?

GL: Because of my commitment to medicine I gave up golf many years ago. I still find time to work in my garden, and I only spend time on plants that I can actually eat! Someday I will get a greenhouse, but a lot of research first! I try to limit my college football to 1 1/2 games per weekend. I catch the majority of every Memphis Grizzlies basketball game, and

I enjoy ESPN sports highlights. I get most of my news online, but occasionally watch both MSNBC and Fox news for dif-ferent mainstream perspectives.

An Interview with Dr. Gregory Laurence

“I sometimes have to get my suturing

on”

Dr. Gregory Laurence is the Founder and Medical Director of Germantown Aesthetics. Having received his MD degree from the University of Texas at Houston Medical School in 1992,

Dr. Laurence fulfilled his residency at Saint Francis Family Practice at the University of Tennessee and completed a fellowship in Advanced Women’s Health, also at the University of Tennessee. Since 1995, Dr. Laurence has served as a diplomat of the American Academy of Family Practice

and the American Society of Cosmetic Breast Surgery.

If you’ve ever met Dr. Laurence you would agree that he definitely fits the description of a fellow comrade. His energetic persona and passion for his career make for quite a remarkable personality. He has the ability to educate effortlessly; people always seem to gravitate towards what he has to say. I had the pleasure of interviewing him for this piece, I asked, listened and learned. Take a moment and get to know Dr. Laurence. ~by Annette Estrella

The Essential Role of Office PersonnelLet’s face it: as a provider, you can’t be everywhere at once. Your focus should be, and needs to be, on treating your patients. While you’re busy performing surgery and otherwise treating patients, it’s your staff and office personnel serving as the face

of your practice, and as your practice grows, how they represent you is more important than ever.

So how do you make sure the brand you’ve built is being properly upheld? Let’s break it down in six easy steps:

Remember that “receptionist” you hired? Scratch that title and make sure s/he is represented properly as your Direc-tor of First Impressions, because when patients first dial your digits, that’s who they’ll be speakig with. Make sure the phone is answered with a smile that can be heard on the other end. (Don’t believe the theory? Test it: I guarantee you’ll hear the difference.)

Ditch how you used to answer the phone and replace it with this script:“Hello, (name of your practice here)’s office. This is (name of your Director of First Impressions). “I can help you.” Make it a bold statement, not a question. But more importantly, make sure the statement is true by educating your staff about each and every procedure and practice policy, remembering, of course, to instruct them to NEVER diagnose patients over the phone.

Instead, make sure they are including credentialling of the providers they’ll see, as well as positive personal experiences.

Make sure your staff works to get the patient an appointment time that works for their schedule, and collect as much contact information as possible in advance. This will certainly save time when the patient comes in for their first appointment. No one likes having to fill out all of that boring paperwork. Ask them how they’d like to be reminded of their appointment and note it in your system... and actually schedule the reminder. (Options to do this include a manual phone call/email/text-reminder or

scheduling the reminder through your existing EMR/EHR software). If your practice doesn’t have the capabilities, try outside software like Solutionreach, to make patient reminders easy on your team, preventing them from slipping through the cracks. Make sure to ask the patient how they prefer to be contacted, of course. Why the push for this? It drastically reduces no shows and ugly last minute holes in your schedule.

When your patient does come in for the appointment, your team should greet them with the same smile they’ve come to know and love and personally welcome them into your office. Whether it’s their first or fif-teenth visit, your staff should show them how grateful they are they’re

there, not slam a glass window in their face.

Finally, make sure your staff is rebooking your patients before they leave your office (we all know busy lives kidnap even the best scheduling intentions), and the patient’s current email address is in your practice management software to use with regularly scheduled

e-newsletters to stay top of mind.

ADDRESSING PRACTICE DEVELOPMENT AT THE:

Contributing Authors: Jay Shorr, BA, MBM-C, CAC I-VI (ASOCP Faculty)Mara Shorr, BS, CAC II-VI (ASOCP Faculty)

Practice Wing

u

Catch Up with Jay & Mara

v

w

x

y

z

Keep in mind the patient may have come in for one treatment and not be aware of other services you offer. Include plenty of practice-branded marketing in your reception area, including your custom brochures and photo books of Before and After collections, a

television monitor showcasing your services, framed signage promoting your gift cards and e-newsletter promotions, beautifully displayed retail products and more. Nix magazines on your end table and Judge Judy on your TV; they do nothing to promote your practice and educate your patient.

he mantra of the American Society of Cosmetic Physicians is “YOU CAN AND YOU SHOULD.” 5 simple words that echo the heart of legendary Surgeon, Dr. Richard Webster, who strongly believed that once willing, every doctor who wanted to learn the art, science and discipline of Cosmetic Surgery should have access to quality training and guidance, to assist them in becoming a competent and confident Cosmetic Surgeon. Cosmetic education without boundaries; this is what our society stands for. Making the transition from a non-surgical, non-cosmetic specialty to the cosmetic arena, especially Cosmetic

Surgery can be a nerve-wrecking experience. This experience can be galvanized by turf battles with other surgeons in your area, who may hold the opinion that you, for whatever bizarre reason, should not have the right to be trained and to diversify your practice; and to pursue the vision you have for your career and future.

TLEAD the pack; TRANSITION flawlessly

he Specialty of Cosmetic Medicine and Surgery is developing rapidly and has vast reach. It is also highly competitive and has sometimes volatile turf battles and competition issues. The world is recognizing that Cosmetic Medicine and Surgery are of too great an importance to dedicate anything short of a complete specialty to this discipline. Hence, doctors who are exclusively ded-icating their training and practices continually to this discipline are being sought out by the patient, to ensure the best outcomes. So let us continue to support our Society and become architects and articulators of the future. Finally, I want to encourage you to indeed join us on the journey. Let’s teach our hands to see, and let’s walk together in support of each other on the journey

towards being the best Cosmetic Surgeons on the planet.

T

MENTORSHIP: Beyond the CME

short courses, it is imperative to understand that surgery

is a “full-on” commitment. It

simply cannot be half done. The age-old, time-proven

best methodology to learn is through mentorship or ap-

prenticeship. Find a mentor. Someone who’s willing to

hold your hand and walk you through the process until you

can safely and effectively produce quality results. This has been the most important anchor point of my process.

Through proper guidance you will learn how to set up your

OR right, which procedures to begin with and how to choose patients correctly, especially

for your first procedures. Your goal should be to learn to

produce safe, excellent results and a quality patient experi-

ence. You don’t need machis-mo nor heroism at this stage; and probably not at any stage as a matter of fact. Some of the best friendships I have

established are with these fel-low surgeons who, with open

arms, have invited me into their practices and homes; and

for this I am grateful.

MANAGEMENT:You must manage your process. Set a clear map or

pathway and be willing to continually

invest in every skill, piece of equipment or mate-

rial you need to establish a safe

and sound surgical practice. You must be willing to invest. Invest in you first of all; then invest in everything neces-sary to produce safe, quality results and satisfied patients. Your first course should be to learn or re-learn basic surgical skills such as types of sutures, dissection techniques, OR protocols, choice of cannu-lae, indications for surgical intervention and infection control. Learning to manage complications associated with your procedures is also vital. You may also want to develop your surgical pathway into full training programs that offer a continuity of train-ing that is equivalent to a residency. You will have to go back to anatomy and cadaver dissections, but it will be worth it.

MOTIVATION: Stay connected with an orga-nization or group of fellow surgeons who are on the same

pathway. Read and feed your mind with outstand-ing results

you want to duplicate; and also

feed your mind with positivity and wisdom. Avoid negative conversations or materials that produce fear. Yes, we must always be aware of the possible complications and dangers of our procedures and the impact it can have on our patients and our practice, and yes we must do everything we can to avoid such things or to manage them correctly should they, God forbid, arise; But if your mind is inundated with negativity, in my opinion the likelihood of something negative happen-ing, increases. Develop your confidence gradually and feed from the power of association. Contribute whenever you can also, with integrity and with vision.

MOMENTUM: Keep moving. A surgical procedure may be defined as any iatrogenic procedure that breaks the skin. We must learn how to skillfully dissect tissue and put it back together again safely, healthily and with amazing aesthetic finish. As you receive guidance as to where to start, your abili-

ties in one area will ultimately prepare

you for the next level, and your skills will compound and

act synergistically to help you produce strong results with procedures of increasing degrees of diffi-culty. Keep moving and keep connected to your support organization.

“Your aesthetic eye will also develop with artistic finesse as time goes on. TRUST THE PROCESS.”

Gregory Crichlow, MD

As a qualified doctor, a

PHYSICIAN like you, who has

made that transition

and continues

up the often intimidating

learning curve, I offer

a few tips to help you

through your first year of

Cosmetic Surgery.

Tales of Beauty

Hello, I am Alex Kaplan and joined ASOCP in 2014 after finding out about the society during the American Academy of Cosmetic Surgery annual conference. I met Sean and others at the trade booth and instantly had a feeling that this would be my favorite cosmetic surgery group to belong to. I then attended the ASOCP conference in Tucson, Arizona in November and enjoyed it more than any other cosmetic conference that I have gone to so far. I made new friends and networked with colleagues from across the country. I particularly enjoyed meeting Drs. Tom, Sharma and Alouf. I look forward to attending this year’s conference in Orlando as well. My medical background is unique. I started out as a resident at the University of Chicago combined General Surgery/Plastic Surgery program. After my 5th year, I changed to Emergency Medicine. Meanwhile, I opened a medical spa, now called Celebrity Laser Spa & Surgery Center, after graduating from residency. The more cosmetic medicine I did, the more I enjoyed it, especially after adding on invasive procedures, such as liposuction, fat transfer and abdominoplasties. At this point, I work part-time in the emergency department and look at that as a way to stay up to date with General Medicine and to maintain my skills. My passion though, is in cosmetic surgery. I am constantly seeking ways to be the best at what I do and to learn new techniques and procedures. I believe that science, precision and loyalty to the patient are keys to success in this field. ASOCP has been my most beneficial cosmetic society membership to date. I have a training scheduled with one of the faculty members and look forward to others in the future. More than any other cosmetic society, ASOCP supports me and my practice allowing me to grow as a Cosmetic Physician!

MEMBERSPOTLIGHT BOTOX™ : Diamond in the RoughHave you ever wondered

who made the ageless discovery behind the toxin’s cosmetic properties? In 1987 two Vancouver Doctors, Jean and Alastair Carruthers, accidentally made the timeless discovery when they realized that the toxin normally used by opthal-mologists to treat blepharospasm also diminished wrinkles. The breakthrough surfaced when a patient being treated for blepharospasm noted that when her forehead was injected with the toxin; her wrinkles seemed to dissappear. After

treating their receptionist with Botox™ in attempts of erasing frown lines; they realized it did reverse the signs of aging.

Although the duo didn’t “coin” the dis-covery...their research definitely made a revolutionary mark by unearthing a cosmetic diamond in the rough.

AGELESS Quest

At the age of 53, the great

Spanish Explorer

Juan Ponce de Leon learned

of a Caribbean island called

Bimini, on which there were

rumored to be miraculous waters

that could rejuvenate those who

drank from it. This fascinating tale

quickly piqued his interest and in 1513

he led a private expedition to Bimini, in

search of the mythical “Fountain of Youth.”

Along his quest for eternal youth and

beauty he stumbled upon the land we

now know as Florida. He believed himself

to be on another island, not realizing that

what he had discovered was the main-

land of North America. His

discovery came at the time of Easter, thus

naming the region Pascua Florida which is

Spanish for “Floral Easter,” perfectly

suiting the lush and floral terrain.

REFER A NEW MEMBER, RECEIVE $100 OFF YOUR MEMBERSHIP RENEWAL call us (520) 574-1050 or visit our website cosmeticphysicians.org for more details

mark your calendars

CONFERENCE

AMERICAN ACADEMY OF DERMATOLOGY

March 20-24, 2015San Francisco, CA

ASOCP WORKSHOP LASER LIPOSUCTION

March 26-27, 2015Location: Coeur d’Alene, ID

Dr. Kevin Johnson

ASOCP WORKSHOP COSMETIC BREAST

April 23-24, 2015Location: Philadelphia, PA

Dr. Ted Eisenberg

ASOCP WORKSHOP LASER LIPOSUCTION

April 23-24, 2015Location: Coeur d’Alene, ID

Dr. Kevin Johnson

CONFERENCE ASLMS

AMERICAN SOCIETY FOR LASER MEDICINE AND

SURGERY April 25-26, 2015

Orlando, FL

CONFERENCE ACOG AMERICAN COLLEGE OF

OBSTETRICIANS AND GYNECOLOGISTSMay 2-6, 2015

San Francisco, CA

ASOCP WORKSHOP LASER LIPOSUCTION

May 21-22, 2015Location: Coeur d’Alene, ID

Dr. Kevin Johnson

ANSWER: b) RCA

Q) For several hours, which city dyes its river green on St. Patricks Day?a) Nashville, TNb) Chicago, ILc) Milwaukee, WI

Yes, for decades, Chicago has turned its river neon green every St. Patrick’s Day. The city uses natural veggie dye. The practice started in 1962 when city workers started using dyes to trace illegal sewage discharges and realized that the green dye would be a unique way to celebrate March 17th this very Irish city. During their first attempt, they released enough green vegetable dye (100 pounds) into the river to keep it green for a week. Today, with an eye towards environ-mental caution, only 40 pounds of dye are used, and the river turns green for only several hours.

Q) Which company introduced the first color television on March 25, 1954?a) Sharpb) RCAc) Toshiba

ANSWER: b) CHICAGO, IL

SCENT FULL FACT

The smell of “wet soil,” the one we often notice in the woods, is

actually caused by bacteria! Actinomycetes, a type of filamentous bacteria, grow in soil when

conditions are damp and warm. When the soil dries out, the bacteria produces spores in the soil. The wetness and force of

rainfall kick these tiny spores up into the air where the moisture after a rain acts as an aerosol (just like an aerosol air freshener).

EARTHLY EMOTIONSThunder and lightning reveal our planet’s fiercer side. A single stroke of lightning can heat the air to around 54,000 degrees Fahrenheit (30,000 degrees Celsius), according to educational website Windows to the Universe, causing the air to expand rapidly. That ballooning air creates a shock wave and ultimately a boom, better known as thunder.

“ALWAYS SEEK TO

EMBRACE THE EARTH AND ITS KNOWLEDGE,

LISTEN CAREFULLY

TO THE CALL OF OPPORTUNITY”

EARTH DAY APRIL 22, 2015

call us (520) 574-1050 or visit our website cosmeticphysicians.org for more information

Your lips are one of the most sensitive parts of your body. A large portion of the sensory brain is dedicated to your lips. Your lips sense any foreign item (usually food) passing into your mouth, on its way to the inside of your body. This is a defense mechanism to keep unwanted items out of your body. This heightened sensory awareness also explains why kissing is so enjoyable! Thank goodness!Visually the lips are considered a sign of health and sensuality. Youthful lips are full with smooth (vermillion) borders. In today’s culture they are also considered

sensual and a part of one’s sex appeal. We have all heard the phrase “Kissable Lips”!Our preoccupation with the “Kissable Lips” is demonstrat-ed by the large market demand for lipstick. Even during recessions, lipstick sales soar. The natural contour

of a youthful lip has several components.1. Plump volume, larger in the middle and tapering to the corners of the mouth.2. The lower lip vol-ume should be up to

50% greater than the upper lip.3. A distinct vermillion border should be present with smooth skin around the lips.4. The middle of the upper lip border is a concave curve aptly named ‘Cupid’s Bow’.Item #2 above is very important. In order to avoid the “fish lips” look, one must augment the lower lip from 33-50% greater than the upper lip. If the upper lip is augmented more than the lower lip the “Trout Pout” is produced. This is not a natural look. As one ages the lips lose volume and borders become less distinct. Only up to a point can lipstick hide these changes.Women turn to injectable fillers

and implants to reclaim a more youthful look.Some of the more popular fillers are hyaluronic gels under the brand names Restylane and Juvederm. The advantages of these fillers are that they are a natural biologic material that are soft, produce smooth contour

improve-ments and have no downtime. These fillers now have local

anesthesia mixed within the gel so a skilled injector can make a patient very comfortable with very simple maneuvers.1. Ice to the lips2. Gentle, slow injection technique3. The use of very tiny needles that should be changed frequently.The downside of hyaluronic gel fillers are that they are tempo-rary lasting up to a year. Bruis-ing can be a nuisance. Patients should avoid blood thinning medications such as aspirin, fish oil, NSAIDs, etc. for one week prior to the procedure.Are lip implants right for me?Some women want a more long lasting solution to deflated lips.

In the past the materials used were not ideal. Now there is a firm gummy like silicone lip implant that has several improvements.1. It is soft and natural feeling.2. Is a tapered implant that is thicker in the middle creating a natural look.3. It can be placed in both the upper and lower lips under local anesthesia.4. This implant does not react to surrounding tissues like implants of the past. Therefore if the patient no longer wants these implants it is straightforward to remove.So now there are several good options for our patients to keep maintain their youthful “Kissable Lips”!In Beauty and Health,Dr. Walter Tom (ASOCP Faculty)

. . . . . . . . . . .

Lips a more beautiful pout!

Where Does the Excess Fat Go?

TIPS ON LIPS AND HIPS

Have you ever stopped to wonder where

excess fat goes when you lose weight? Most people are under the popular

misconception that the missing mass is converted into energy or heat. Even 50 percent out of 150 doctors, dieticians, and personal trainers were under the

same beliefs. Despite this theory, a new study reveals that breathing is the major

underlying factor when examining the metabolic process of weight loss.

According to the study conducted by the

UNSW School of Biotechnolo-gy and Biomolecular Sciences, most of the mass is breathed

out as carbon dioxide. The study’s lead author Ruben

Meeman, a physicist and Australian TV science

presenter states, “it literally goes into thin air.” Ruben’s novel approach to the

biochemistry of weight loss was to trace every atom of the fat being lost. Accord-ing to Meeman, “if you follow the atoms

in 10 kilograms of the fat as they are lost, 8.4 of those kilograms are exhaled

as carbon dioxide through lungs. The remaining 1.6 kilograms becomes water,

which may be excreted in urine, feces, sweat, breath, tears and other bodily

fluids.” This recent discovery seems to be both a great advancement in

scientific research as well as a startling fact when associated to climate change.

As most of the earth’s population has begun to shift towards a healthier

lifestyle; the pounds have begun to melt off; even literally speaking . This

is a double edged sword; while obesity numbers decrease worldwide; increased

carbon dioxide levels are endangering the earth. Is the polar ice cap melting

due to pounds being shed?

~Annette Estrella

Test Your Tangram Skills HOW MANY TANGRAMS CAN YOU FIND IN THIS SQUARE? (answer below)

Skills Senses

DID YOU KNOW? The ASOCP Logo, known as the Tangram, was selected for a very specific reason! The Tangram is an ancient Chinese Puzzle that was created for entertainment purposes. Entertainment is afforded by placing 7 fixed geometrical shapes into as many different larger shapes as possible. The significance of our logo lies in the smaller shapes that are arranged to create a large square. The large square represents the Cosmetic Medicine Specialty while the smaller shapes represent the specialties that make up cosmetic medicine. Different medical specialties, like the shapes that make up the square, have different interests and sizes but all play an equal and integral role in Cosmetic Medicine. Not one piece is more important than another and all must be involved to configure the square.

AMERICAN SOCIETY OF COSMETIC PHYSICIANS

8000 S Kolb Rd, Ste 101 Tucson, AZ 85756

phone: (520) 574-1050 fax: (520) 545-1254

info@cosmeticphysicians.org cosmeticphysicians.org

answ

er: 5

EDITOR’S NOTE This issue

primarily focused on the essence and impact of education. As we expand our skillset, our chances for success increase exponentially.

Knowledge in action molds our future; every step we take somehow shapes both our planet and persona. Let your footprints be innovative and

purposeful. Lead the way to timeless discoveries this Spring!

Take the opportunity to Connect with us and be heard. Remember that

collaboration increases individual strength.

Warm Regards, Annette Estrella

ASOCP Editor-In-Chief

SAVOR THE FLAVOR a CREATE THIS CULINARY DELIGHT FROM

All of the information contained here within is printed in good faith and for general information purpose only. We do not make any warranties about the completeness, reliability and accuracy of this information. Any action you take upon the information is strictly at your own risk. All of the views and opinions expressed within do not reflect those of the ASOCP.

SALVADOREAN CUISINE is a style of cooking derived from the nation of El Salvador. El Salvadorean cuisine arises from Mayan and Aztec cook-ing traditions. Many of the dishes are made with corn. El Salvador’s most notable dish is the pupusa, a thick handmade corn flour stuffed with either cheese, chicharrón (cooked pork meat ground to a paste consistency), refried beans, and/or loroco (a vine flower bud native to Central America). Traditionally, pupusas are served with curtido. Curtido is a Salvadorean cabbage slaw that compliments pupusas and is eaten as a side dish similar to coleslaw. PUPUSAS (yield: 8-10)Ingredients2 cups corn flour (masa harina) 1 ¾ cups warm water2-3 cups shredded mozzarella cheese Vegetable oil for cooking InstructionsPut masa harina and 1¾ cups water into a bowl; stir to form a dough. Pinch off a 1 ½-oz. piece of dough; roll it into a ball. Pat dough into a thin disk. Squeeze 1 ¼ oz. cheese into a ball. Press cheese into center of dough; cupping dough, stretch edges of dough around cheese and seal. Pat dough to form a 3 ½”-wide disk. Repeat to make about 10 pupusas. Heat a 12” nonstick skillet over medium-high heat, drizzle with oil. Working in batches, cook pupusas, 6-7 mins each side, turning, until golden. Serve hot with slaw. CURTIDO (SALVADOREAN CABBAGE SLAW)Ingredients1 small cabbage, washed and shredded (about 3-4 cups) 1 cup carrots, washed, peeled and grated1 small red onion, thinly sliced 1 jalapeño, sliced into thick rings½ cup apple cider vinegar or distilled vinegar 3 teaspoons salt½ teaspoon oregano ½ – 1 cup warm waterInstructions1) Shred the cabbage, peel and grate the carrots, thinly slice the onion, and toss them with apple cider vinegar and jalapenos in a large bowl. Use your hands to toss in salt and oregano, then pour the mixture into a large jar and top it off with the warm water until just covered. Cover and refrigerate for at least 2 hours before serving, and enjoy leftovers for weeks to come. Curtido lasts for up to 2 months in the fridge.

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Foundation for the Advancement of Medical Education8000 South Kolb Road, Suite 101 Tucson, AZ 85756

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