Plus:❖ Noninvasive

Skin Tightening

❖ Laser PlumeSafety Protocols

Sheila Nazarian, MDOn the Power of Social Media in Plastics

Putting Back the Good: Probiotics and the Skin Microbiome

April 2018 $5.00Volume 14, Number 3

medestheticsmagazine.com

Set New Hires Up For Success

MedEsthetics (ISSN 1937-2140 & USPS 024-336), Volume 14, No.3, April 2018 is published monthly except in February, June, August and December by Creative Age Communications, Inc., 7628 Densmore Ave., Van Nuys, CA 91406-2042, USA, Phone 818.782.7328, Fax 818.782.7450. Basic annual subscription rates are: $48.00 in the U.S., $65.00 in Canada, and $70.00 in other international countries. Periodicals Postage Paid at Van Nuys, CA and additional mailing offi ces. POSTMASTER: Send all UAA to CFS; NON-POSTAL AND MILITARY FACILITIES: send address corrections to MedEsthetics, P.O. Box 460159, Escondido, CA 92046-0159.

CONTENTSApril 2018, Volume 14, Number 3

TOOLS & TECHNIQUES28 Blemish ControlProducts addressing acne and pigmentation concerns

30 A Healthy Balanceby Inga Hansen

How skin microbiome research is changing skin care

36 The Heat Is Onby Linda W. Lewis

What’s working in noninvasive skin tightening

48 Collagen BuildersAntiaging skin care for patients

60 Aesthetic TechnologiesAesthetic devices for your practice

64 Newsmakersby Inga Hansen

A new treatment for SKs

PRACTICE MANAGEMENT20 Business Consult by Cheryl Whitman

Onboarding for new hires

24 Legal Issuesby Alex R. Thiersch, JD

Trademarking your brand

42 Up In Smokeby Karen Appold

How to protect against laser plume

50 The Social Practiceby Keith Loria

Sheila Nazarian, MD, on growing a new practice

IN EVERY ISSUE

12 Best Practices

18 Introductions

58 Advertiser Index

62 News & Events

COVER: Sheila Nazarian, MD PHOTOGRAPHY: Armando Sanchez

50

42

36

30

Born in New York City while her

mother was on vacation, unrest in her home

country of Iran brought board certifi ed plastic

surgeon Sheila Nazarian, MD, back to the

States earlier than expected. “My mother

wanted me to be the fi rst U.S. citizen in the

family,” says Dr. Nazarian, who spent her

early years in Iran where her father worked

as a pathologist at the Shah’s Heart Hospital.

When the revolution began, the family

prepared to fl ee the country.

By Keith Loria

Photography by Armando Sanchez

50 APRIL 2018 | MedEsthetics

Sheila Nazarian, MD, harnessed the power of the internet to grow her plastic surgery practice.Sh il N i MD h d h f h i h l i i

Th e Social Practice

THE SOCIAL PRACTICE

52 APRIL 2018 | MedEsthetics

“We were Jewish so it was not good for us there,” Dr.

Nazarian recounts. “In 1985, my father left my sister’s,

mother’s and my passport with the government and

said he was going to Vienna to do some research. My

mother, sister and I escaped to Pakistan on the back of

a pickup truck, following the same route portrayed in

the movie Not Without My Daughter.”

The family reunited in Vienna and made their way

to the United States, setting up a home in Los Angeles.

Dr. Nazarian, who was 6½ at the time, quickly learned

English and excelled in school, earning a Bronfman

Youth Fellowship in her teens that allowed her to

travel to Israel for six weeks of leadership training.

Early on, she knew that she wanted to be involved in

the medical profession in some way. “My father was

a big part of that,” she says. “But also, when I was

16, my mother was diagnosed and passed away from

breast cancer.”

Initially, she wanted to become an orthopedic

surgeon because she liked constructing things with her

hands. Wood shop was her favorite class in school and,

while traveling from Pakistan to Vienna, she became

adept at making things out of whatever objects were on

hand, including a suitcase made of discarded paper bags

and duct tape.

“When I was in college, I started following an orthopedic

surgeon, but it became boring and cookie-cutter to me.

Someone suggested I look into plastics because it’s more

artistic, so I did and I never looked back,” she says. “It was

perfect for me, and all of that building and making stuff was

really good training.”

Dr. Nazarian attended Columbia University in New

York and graduated with a BA in economics, then matricu-

lated into Yeshiva University’s Albert Einstein College of

Medicine. She completed a plastic surgery residency at the

University of Southern California. “I had three kids during

residency, but I wasn’t the type who was trying to leave

and go home to my kids; I was always the fi rst there and

last to leave,” she says.

With an eye on one day opening her own practice, Dr.

Nazarian earned a master’s in medical management at

USC’s Marshall School of Business between her general

surgery and plastic surgery training. “I didn’t think it was fair

to my family to do another year of fellowship or be em-

ployed where I would miss more recitals. I wanted to be on

my own schedule so I could be a better mom,” she says.

Preparing for Practice OwnershipShe took a few months off after completing residency

training to spend time with her family, but was eager to

get back to her career. In July 2013, she found a location in

Beverly Hills and began building out Nazarian Plastic Sur-

gery. The practice opened in October of the same year.

During her fi rst year in practice, she perfected her pro-

tocols and established a presence both on social media and

in the community. “I couldn’t just sit and wait,” she says. “I

wrote the content for my website. I started social media

accounts. I made sure my before-and-after images were

really good. I made sure my offi ce was presentable and the

“Little by little, we have upped our game

and the patient experience.”

Dr. Nazarian spent her fi rst year in practice perfecting protocols and the interior of the offi ce.

THE SOCIAL PRACTICE

54 APRIL 2018 | MedEsthetics

consents were on point—everything that needs to happen

to make yourself successful,” she says.

Her biggest challenge: “Being patient,” says Dr. Nazar-

ian. “I remember noticing that the phones were ringing in

December 2014. It took that long for people to start call-

ing regularly.”

Then the fl oodgates opened. “It all happened at the right

time. Once everything was in place, the people started to

come,” she says. “Now, I just want an afternoon off!”

Keys to SuccessNazarian Plastic Surgery offers a range of aesthetic surgical

and nonsurgical procedures, including breast augmenta-

tion, liposuction, tummy tucks, vaginal rejuvenation, buccal

fat pad removal, lasers, noninvasive body contouring proce-

dures, Cellfi na cellulite treatments, toxins and fi llers.

In addition to doing good work and taking outstanding

care of patients, Dr. Nazarian fi nds that the secret to main-

taining success in the industry is to have a strong team and

utilize social media, videos and your

website to educate patients. “I have

seen over and over again that thanks

to social media and the videos on our

website, the patients who come in

to the offi ce have already decided I

am their surgeon. There’s not a lot of

selling that has to happen during the

consultation,” she says.

To keep her online reviews popu-

lated and timely, staff members are

trained to recommend that happy

patients share their stories online.

“It used to be that the person who

picked up the phone was a patient’s

fi rst point of contact, but today that is

the third or fourth point of contact,”

she says. “The fi rst point might be

Google, then social media or Yelp,

and then the receptionist. The fourth

point of contact is the experience of

walking into the offi ce.”

In order to meet patient expec-

tations, Dr. Nazarian put a lot of

thought into that fi rst experience with

the physical offi ce. When patients ar-

rive, they are greeted by staff, offered

a Fiji water or Pellegrino, and given a

tour of the practice. “They are taken

into a relaxation room to wait so they

are not waiting in front of anyone else

who may have just walked in,” she

says. “We don’t have anyone answering phones up front.

They are all in the back of the offi ce so waiting patients

don’t have to listen to people talking. It’s very quiet and

tranquil. Little by little, we have upped our game and the

patient experience.”

The practice has nine full-time employees and two part-

timers, and Dr. Nazarian’s management philosophy is to

exemplify and encourage a strong work ethic. “Our persona

on social media is laid back and fun; our offi ce is quite seri-

ous,” she says. “We have a game plan every day. There are

goals to meet and protocols to follow. We may be playful

with the patients but we are quite serious about our work.”

The Power of Social MediaSocial media remains an important part of Dr. Nazarian’s

business plan. She has four accounts on Instagram, including

@drsheilanazarian, @hautedoctor, @themodelsurgeon

and @theskinspotbeverlyhills totaling 160,000 followers

with more than one million impressions per week.

At Nazarian Plastic Surgery, the patient experience is just as important as patient outcomes.

THE SOCIAL PRACTICE

56 APRIL 2018 | MedEsthetics

“I think plastic surgeons are fi nally catching on

that if they’re not engaged in social media, it’s kind

of like not having a website,” she says.

Last year, she spoke at 17 medical conferences.

In 2018, she will host her own event called the

Nazarian Institute. “I will give a talk on how to

get a return on investment with social media, and

we’ll have great speakers throughout the event,”

she says. They include social media successes

from the worlds of dentistry, medspas, dermatol-

ogy and plastic surgery; a practice consultant who

will talk about offi ce fl ow and how to train your

staff; and a luxury brand CEO who will speak on

the importance of the customer experience.

Expanding Her Infl uenceWith a busy practice and more and more offers

for speaking engagements, Dr. Nazarian is fi nding

new ways to balance career and family time. She

is taking her husband (a neurosurgeon) and three

children to Paris for an upcoming event. Travel-

ing, she says, is one of their favorite things to do.

“I also like going to temple. It’s great family time,

where we can pray together and remember

what’s important in life,” she says. “It’s really the

only place I can calm my brain so I try to go as

often as possible.”

She is also focused on new projects. A few

months ago, Dr. Nazarian started an online ecom-

merce site for skincare called theskinspot.com,

and it already has more than 100 members. “It’s

a curated website, so instead of having 200 dif-

ferent types of sunscreens, for example, I pick my

favorites and make a video about them,” she says.

“If you have oily skin, this is the sunscreen for you.

If you have super-dry skin, this is the one for you.

It looks at skin types and the aesthetic goals of the

end user.”

Because she specializes in—and would like to be

known for—providing natural results, Dr. Nazarian

created a hashtag, #NaturalByNazarian, that she

includes on all social media posts. “We offer every-

thing here from the completely noninvasive, includ-

ing skin care and lasers, all the way up to surgical

procedures. It’s a one-stop shop,” she says. “The

goal for 2018 is to grow The Skin Spot, have two

Nazarian Institute conferences and gain a whole lot

more infl uence on social media.”

Keith Loria is a freelance writer based in

Oaktown, VA.

“Plastic surgeons are

fi nally catching on that

if they’re not engaged in

social media, it’s kind of

like not having a website.”

Dr. Nazarian uses social media and online videos to educate prospective patients on her practice and procedures.