What goes around…..comes around.

I had an interesting experience at the office today.  Not my first of this type, but a good one.  I went to a treatment room to see a patient that I have treated many times for Botox and small procedures.  I noticed that she would not make eye contact with me and thought that was odd. I asked her how her summer was and she said “terrible”, again while staring at the floor.  When I asked her why, she said she made a terrible mistake.  She went on to explain that she had consulted me months ago about a facelift, but on the recommendation of a friend, went to another surgeon and the result was a disaster.  I held her hand and reassured her that I am not offended and this happens to all doctors but I was sorry about her result.  Upon examination, she was correct, she had a poor surgical result.  Her incisions were improperly placed and noticeable, her neck still had much laxity, she had lost areas of tissue that healed with scars and had folds on her neck and chin from improper technique, to name the major problems.  She began crying and said she wanted to sue the other doctor.  I asked her who the other surgeon was and she told me.  She also told me that she should have know better than to go to him because when she told him that she had also consulted me, he “went off”.  She said this surgeon went into an embarrassing 5 minute diatribe about how I am unqualified to perform her facelift and many other degrading things about me.  She said that she already had paid a deposit and signed some papers so against her feelings she went ahead with the surgery.  She explained how disappointed she was and how much she suffered and how it ruined her entire summer.  She also reminded me that she asked me one time about this surgeon and I did not say anything negative about him and after his assault on me, she now sees the value of being a bigger person.  She stated “wow, you must really have taken a lot of this surgeons business for him to be that jealous, I am so sorry I did not choose you to begin with.” This was a good reminder of how astute patients really are. 

I again told her not to feel bad and that her actions were in the past and she can’t change that.  She spoke about suing the other surgeon which I totally discouraged, knowing that if the shoe was on the other foot, he would have relished in the process.  We began working on the scars and made a treatment plan to deal with the other problems and upon leaving, she gave me a hug.  I hope a lot of younger surgeons see this blog as there are a multitude of lessons to be learned in a case like this.  First of all, always speak with purpose and never lower yourself to the level of negative, insecure people.  You will always look bigger and patients can see right through an insecure surgeon.  Secondly, many doctors are victims of “competitive insecure bashing” and they should never let that bother them.  If a surgeon treats his or her patients like family and does good work, it will all catch up with the good doc and take away from the bad doc.  A Chinese proverb says “if you sit by the river bank long enough, you will eventually see the bodies of your enemies float by”.  It’s true.  Most doctors that talk trash are identifying themselves to that patient as insecure and intimidated by their competition.  If you can’t say something positive, then simply say “I don’t know anything about him”.  So today I wanted to thank Dr. X for his kind referral of this patient and all her friends.  I actually received patients without any marketing.  What goes around comes around.

To learn more about cosmetic facial surgery in Richmond, Virginia visit www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

Only Use A Board Certified Plastic Surgeon??

 

It seems that cosmetic surgery is one of the most popular topics to read about these days.  Pick up any magazine or paper and you will likely find an article on cosmetic facial surgery.  Same goes for TV and radio; cosmetic surgery is a popular topic.

We all know that there are a lot of different types of surgeons (and nonsurgeons) that perform cosmetic surgery.  We all know that some of these docs are really good and others may not be so good.  We also know that because of all of the many specialties that do cosmetic surgery that there is also a lot of competition among these groups.  Knowing all of the above, the question frequently arises on how to pick a competent surgeon.  Unfortunately, too often, you will read “only have cosmetic surgery from a board certified plastic surgeon”.  Let’s think about this for a minute.  It is like saying only buy a Lexus because it is the best car and all other cars are unsafe.  We know that there are many safe cars and if one company says that theirs is the best, it does not mean that all other car companies are no good.  With the transparency of this marketing hype it makes one wonder how the “only board certified plastic surgery thing” continue to be stated?  It is obvious that it is false marketing by the plastic surgery organization.  There is nothing wrong with them cheering for their team, but it is an opinion of their society, not a fact. I use the word false because there are not studies to support that ANY specialty of surgeon has better outcomes, happier patients, or fewer complications than another.  80% of cosmetic surgery is performed by non-plastic surgeons. Any organization or group can make statements to fool the public into thinking they are the best or the only choice.  This is exactly what organized plastic surgery has done.  I have many plastic surgery friends and colleagues and some of them received excellent training in cosmetic surgery and have great results.  Others plastic surgery friends, received very little cosmetic training as plastic surgery is not cosmetic surgery so they spent their training learning about burns, reconstruction and other important procedures, but not cosmetic surgery.  I have seen many outcomes from these people where the outcomes were not so great. It as a fallacy to think that plastic surgery is cosmetic surgery or that all plastic surgeons are good cosmetic surgeons.  Simply not true.  I have had numerous patients that came to my office because bought the hype of “only see a board certified plastic surgeon, and when they went there for treatment, it was done by a nurse!!  Not that there are not competent nurses, but doesn’t that contradict the mantra?

A recent in the Journal of Plastic and Reconsructive Surgery concluded that “Senior Residents (in Plastic Surery) felt deficient in facial cosmetic training” (see image below).  The article goes on to describe the average minimum cosmetic surgery case requiements for plastic surgery programs is 7 facelifts, 8 eyelid surgeries, six nose surgeires and 10 breast implants (see image below).  Obvisously, some residents get more training but the fact is that entering private practice with the experience of 7 facelifts or 8 eyelid surgeries does not make someone an expert or better than other specialties.  Again, just because someone is a plastic surgeon does no make them better than another specialty.

click on above to enlarge

click on above to enlarge

There are numerous specialties other than plastic surgery that perform safe and effective cosmetic surgery.  These include dermatologists, oral and maxillofacial surgeons, ENT’s, ophthalmologists as well as other specialties.  Given my personal training as an example, I have spent 10 years after college learning about the head and neck.  My expertise is in head and neck surgery and I understand the face and have had as much (if not more) experience in facial surgery as any specialty that exists.  I am also board certified in my specialty (oral and maxillofacial surgery) and limit my practice to cosmetic facial surgery.  Having said this, does it make more sense to have a facelift from a board certified oral and maxillofacial surgeon that only does faces or a board certified plastic surgeon that may do a handful of facelifts a year, but performs hundreds of body procedures?  I performed over 80 facelifts last year while the average plastic surgeon performs 26.

This blog entry is not meant to discredit plastic surgery as it is an impressive specialty with many talented surgeons and I am friends with many of them.  The only purpose of this discussion is to dispel the self-serving notion that patients should “only have plastic surgery from a board certified plastic surgeon” .  This in untrue, unfounded, is not proven and only serves to fool the public.  Who is a cosmetic surgeon?  A cosmetic surgeon is a surgeon that limits his or her practice to cosmetic surgery.  It does not signify a specific specialty. 

What is most important here is the success of any surgeon from any specialty.  That is measured very easily by looking for cosmetic surgeons with good outcomes, low complications, happy patients and a booming and successful practice.  Looking for the aforementioned traits is a much better indicator for a good doc than buying into specialty marketing propaganda.

To find out more about Dr. Niamtu and Cosmetic Facial Surgery in Richmond, Virginia visit www.lovethatface.com

 

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

www.lovethatface.com