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Quarterly Newsletter of the American Society for Aesthetic Plastic Surgery Volume 16, Number 1 Winter 2012

INSIDE THIS

ISSUE:

Aesthetic Society News

News from theMarketing Task Force

See Page 6

Continued on Page 20

Online ReputationManagement

See 6

My Checklist Manifesto

See Page 21

An Extraordinary Life:Dr. Sharadkumar Dicksheet



On November 14, 2011, the plastic surgery discipline lostone of its finest physicians, asunsung hero Dr. SharadkumarDicksheet passed away at age 80.Throughout his life, Dr. Dicksheetworked tirelessly, performing corrective facial deformities to over 200,000 children in India, all for free. And he did so despitehis own physical challenges.

In 1978, a serious car accident led toDr. Dicksheet’s right side being paralyzed.

In 1982, he was diagnosed withstage 4 cancer of the larynx.And in 1994, Dr. Dicksheetsuffered a severe heart attack,which necessitated a triplebypass surgery. Given thesechallenges and wheelchairbound, many urged Dr.Dicksheet to quit, but he resisted, saying “As long as I

have head, eyes and hands coordinated,I’m okay.”

Aesthetic Surgery Journalnow indexed withThomson Reuters (ISI)

We are proud to announce that AestheticSurgery Journal has been accepted by ThomsonReuters for inclusion in their Science CitationInformation Expanded (SCIE) and Journal CitationReport (JCR) editions, beginning with the 2009issues. This listing is commonly referred to as ISI(or Institute for Scientific Information) indexingand is the service that assigns journals an impactfactor. The ISI maintains a list of over 14,000 journals in both the sciences and humanities.

Applicant journals must meet a rigorous list of criteria that include timely publication, high-quality

On behalf of The AestheticSociety’s EducationCommission andScientific ProgramCommittee, we areproud to announcethat Registration is now open forThe Aesthetic

Meeting 2012—Focusing on the Future:The Changing Landscape of AestheticPlastic Surgery.

It has long been the goal of TheAesthetic Society, as well as the AestheticSurgery Education and Research Foundation(ASERF), to bring you the highest level ofaesthetic education possible, and we’veworked diligently to deliver sessions thatare more exciting, interactive, and inspiring

The Aesthetic Meeting 2012: Vancouver, B.C., May 3–8By Jack Fisher, MD

than ever, helping you to both build your practiceand enhance your technique.

In Vancouver, you’ll meet the experts you trust,armed with the knowledge you need. Thought and Opinion Leaders from around the world willshare their knowledge via panels, papers, special

MAY 3–8, 2012V A N C O U V E R, B. C.C A N A D A

TheAesthetic Meeting 2012TheAesthetic Meeting 2012

11262 Monarch StreetGarden Grove, CA 92841

PresortedFirst-Class Mail

US PostagePAID

Carol Stream, ILPermit #1096

Aesthetic Society NewsThe American Society for Aesthetic Plastic Surgery

The Aesthetic Surgery Education and Research Foundation

PresidentJeffrey M. Kenkel, MD

EditorCharles H. Thorne, MD

Associate EditorJulius W. Few, MD

Communications CommissionerDaniel C. Mills, II, MD

Director of Marketing and Public EducationJohn O’Leary

Products and Services Marketing ManagerKergan Edwards-Stout

Director of Public RelationsAdeena Babbitt

Communications ManagerJian Sun

Marketing AssistantJanet Cottrell

DesignVia Media Graphic Design

Statements and opinions expressed in articles, editorials and communications published in ASNare those of the authors and do not necessarilyreflect the views of ASAPS or ASERF. Publishing of advertisements in ASN is not a guarantee, warrant or endorsement of any products and services advertised.

Send address changes and membership inquiries toMembership Department, American Society forAesthetic Plastic Surgery, 11262 Monarch Street,Garden Grove, CA 92841. Email [email protected]

Co-sponsored/Endorsed Events 2012

March 7–8, 2012

15th Annual Dallas CosmeticSurgery SymposiumDallas, TXContact: Veronica MasonTel: [email protected]://dallascosmeticsymposium.com/announcements

March 9–11, 2012

29th Annual DallasRhinoplasty SymposiumContact: Veronica MasonTel: 214-648-2154Email: [email protected]://dallascosmeticsymposium.com/announcements

April 20–21, 2012

42nd Aesthetic Plastic SurgerySymposiumToronto, ON, CanadaContact: Dr. Jamil Ahmad905-278-7077jamilahmadprs@yahoo.comwww.torontoaestheticmeeting.ca

May 1–5, 2012

Skin Care 2012 Society of Plastic Surgical Skin CareSpecialists 17th Annual MeetingVancouver, BC, CanadaContact: SPSSCS Tel: 562-799-0466Email: [email protected]

May 3–8, 2012

The Aesthetic Meeting 2012 Vancouver, BC, CanadaContact: ASAPS Tel: 562-799-2356Email: [email protected]/meeting2012

May 3, 2012

The 17th Annual Meeting ofThe Rhinoplasty SocietyVancouver, BC, CanadaContact: Rhinoplasty SocietyTel: 904-786-1377www.rhinoplastysociety.org

August 22–25, 2012

The Breast & Body ContouringSymposiumSanta Fe Convention CenterSanta Fe, New MexicoContact: ASPSTel: [email protected]

ASAPSCalendar

© 2012 The American Society for Aesthetic Plastic Surgery

ASAPS Members Forum: www.surgery.org/members

ASAPS Website: www.surgery.org

ASERF Website: www.aserf.org

®

The Aesthetic Surgery Education and Research Foundation

The American Society forAesthetic Plastic Surgery

2 Aesthetic Society News • Winter 2012


Aesthetic Society News • Winter 2012 3

Update Your Passport and“Meet me in Vancouver”

Perhaps you’ve seen the messages from the Aesthetic Society asking you to“Update your passport and meet me inVancouver,” the site of the AestheticMeeting 2012. Many members of ourEducation Commission and leadershiphave given excellent reasons for attendingthis year’s meeting, from the innovativeeducational offerings to the excitement andfun of the city. However, in this issue ofASN, we have asked several members togive us their personal reasons for attendingthe Meeting. Among them are:

Robert Whitfield, MD “As a smaller Society, I feel that it is

easier to attend the meeting and interactwith the Speakers if I am so inclined. Theinteraction with colleagues is the mostrewarding part of physically attending themeeting, and I always learn something atthe Aesthetic meeting that I incorporateinto my practice.”

Julius Few, MD“At The Aesthetic Meeting I value the

state of the art exposure to aesthetic plasticsurgery topics, and enjoy meeting withrespected friends and colleagues. I alsoenjoy the exposure to exhibitors with newtechnology to offer.”

Laurie A. Casas, MD“The energy from the educators, my

colleagues, and the thoughtful interchangeof ideas has been incredibly valuable. The Teaching Courses have always beenone of the most educational experiences of the annual meeting. Learning throughevidence-based medicine and exchangingideas is critical for both me to stay competitive and for our specialties’advancement.”

So please, join us in Vancouver May3-8. But don’t think it’s all work and noplay. This year, the presidential dinner danceis open to all members and our theme is70s disco. For anyone who remembers Rufus,Chaka Khan, and Donna Summer (orwishes they did) this should be a fun party.Go to the back of your closet and dust offthose platforms, gold chains, and polywear.Suzanne and I will be in full 70s regalia. Ifyou’d like to join the fun, here’s a link to acostume shop in Vancouver that can haveyou the next Bianca Jagger or Rick James:www.surgery.org/microsite/meeting2012/generalinfo-dinnerdance.php. This can befound on our meeting site /general info—dinner dance.

Introducing the AnzuReader

The Aesthetic Society has entered intoan arrangement with a company that manyof us feel will change the way Societymembers reference educational material,read our scholarly publication ASJ andchange the way we save and index infor-mation for clinical use. Called the AnzuReader, this software is much more than asimple tablet reading device. Now, usingyour iPad, you can form your own virtualbookshelf, saving articles, videos, webinars,and a host of other information availablethrough the Society. The Anzu Reader willlet you make notes, save video, annotatewith text, annotate with audio, annotatewith video, annotate with image and ahost of other options. All you need is aniPad—the service is a benefit of dues to allASAPS members. The editorial directionfor this new and exciting project is led byWilliam P. Adams Jr., MD with colleaguesJohn Gross, MD; J. Peter Rubin, MD; JoeGryskiewicz, MD; Christine Hamori, MDand me. To quote Dr. Adams: “The

possibilities are endless... it can clearlyreplace all standard (available) educationalplatforms.” Watch for this innovative newplatform to be launched at The AestheticMeeting 2012 in Vancouver.

Update on the MarketingTask Force

Help in marketing your practice and showing the value of your ASAPSmembership has been discussed with memore than any other issue in my time asAesthetic Society President. During ourExecutive Retreat last summer, a group wasappointed to look at all aspects of market-ing, practice development and help in anextremely competitive landscape. Headedby our Vice Chair of the CommunicationsCommission Sanjay Grover, MD, a selectgroup of members have been looking atthese vital issues, making recommendationsfor the immediate future and implementingchanges that can influence your practicetoday. I urge you to read his progressreport in this issue of ASN.

A Safe Place to Seek ClinicalAdvice and Share Mistakes

To help physicians learn from eachother, check out Wimed.org/asaps, a confidential, Federally-protected space for sharing highly-sensitive “near miss”information. As other plastic surgery-related bulletin boards such as surgery.organd plasticsurgery.org are not federally protected, with all posts being discoverableand admissible in Court, ASAPS membersshould use wimed.org/asaps to post abouta problem that has the capacity for patientharm—whether the problem reached thepatient or not. There is also a Wiki feature,where you can invite colleagues and team members to a private, completely

JEFFREY M. KENKEL, MD

President’s REPORT


Active members of the AmericanSociety for Aesthetic PlasticSurgery (ASAPS) will hear reportson Society business, vote on pro-posed amendments to the Bylawsand elect new officers for 2012-2013 during the ASAPS/ASERFAnnual Business Luncheon. Allactive members are invited toattend on Sunday, May 6, 2012.

PresidentLeo R. McCafferty, MDPittsburg, PAAutomatically ascends toPresident

President-ElectJack Fisher, MDNashville, TNPrivate PracticeCurrent Board Position: Vice PresidentASAPS Committee Work: EducationCommission (current Commissioner),Program Committee (current Chair),Finance and Investment CommitteeNational Affiliations: AMA, ASPS, ACS,ISAPSTraining: George Washington UniversityMedical Center Washington, DC; GeneralSurgery, Emory University; Plastic Surgery ABPS certification: 1981

Vice PresidentMichael C. Edwards, MDLas Vegas, NVPrivate PracticeCurrent Board Position: Member at LargeASAPS Committee Work: Finance andInvestment Committee (current Chair),Leadership Development Committee,Publications Committee, FellowshipReview Committee, Medical StudentCommittee, Industry Policy CommitteeNational Affiliations: ASAPS, ASPS, ASERF Training: David Grant Medical Center, TravisAFB, CA; General Surgery, Wilford HallMedical Center, San Antonio, Plastic SurgeryABPS certification: 1998

TreasurerJames C. Grotting, MDBirmingham, ALPrivate PracticeCurrent Board Position: Treasurer (oneyear term)ASAPS Committee Work: EducationCommission (current Vice Chair),ASAPS/ASPS Co-Sponsored SymposiumCommittee, Perioperative Task Force,Program Committee (current Vice Chair),Symposium Committee, LeadershipDevelopment Committee.

National Affiliations: ASAPS, ASPS, ACS(Fellow)Training: University of WashingtonAffiliated Hospitals, General Surgery,University of California, San Francisco,Plastic SurgeryABMS Certification: 1987

SecretaryDaniel C. Mills, II, MDLaguna Beach, CAPrivate PracticeCurrent Board Position: Member-at-LargeASAPS Committee Work:Communications Commission (currentChair), Project Beauty Task Force (ad hoc)(current Chair), Patient Safety Committee,Aesthetic Training Task Force, MarketingTask Force (ad hoc), ASJ TechnologyEditor, Finance & Investment CommitteeNational Affiliations: ASAPS, ASPS, ACSTraining: Wright State University, GeneralSurgery, Medical College of Ohio, PlasticSurgeryABMS Certification: 1990

Members to Vote on Slate of Candidates

Continued on Page 5



Members at Large

John E. Gross, MDPasadena, CA(3-year term)

Sanjay Grover, MDNewport Beach, CA(3-year term)

Herluf G. Lund, MDSt. Louis, MO(3-year term)

Those continuing in positions:

William P. Adams, Jr., MDDallas, TX(3-year term)

Al Aly, MD Orange, CA(3-year term)

W. Grant Stevens, MDMarina del Rey, CA(2-year term)

Richard J. Warren, MDVancouver, BC, CA(3-year term)

Society members will also vote onthe following candidates for office:

TRUSTEE(3-year term)

Robert Singer, MDLa Jolla, CA

APPLICATION REVIEWCOMMITTEE: (3-year terms)

Midwest Dennis Hammond, MDGrand Rapids, MI

Northeast Gary Brownstein, MD Cherry Hill, NJ

Far West Margaret Skiles, MDYuba City, CA

Canada Wayne W. Carman, MDToronto, ON

Continuing their terms:

Southeast Onelio Garcia, Jr., MDMiami, FL

New York City Lawrence S. Reed, MDNew York, NY

South CentralWilliam D. Leighton, MDScottsdale, AZ

Members to vote on Slate of CandidatesContinued from Page 4

Since our group was formed last summer, the Marketing Task Force hasbeen hard at work producing tools andopportunities to improve your practicemarketing and bring even more value toyour Aesthetic Society membership. The following is a brief synopsis of ourprogress to date:

New arrangements to increasethe reach of surgery.org andexpose your practice to morepatients

The Task Force, with approval of theASAPS Board of Directors, has enteredinto several agreements to increase the eyeballs seeing surgery.org content and our “Ask a Surgeon” and “Find a Surgeon features. They include:

A partnership with EmpowHER,the Award-winning Social HealthCompany for Women with morethan 1.5 million viewers perweek

This partnership, a non-compensatoryagreement, highlights an exchange of content, including relevant articles, videosand user-generated pieces on bothEmpowHER.com and ASAPS’ sites: surgery.org and projectbeauty.com.

The site is also replicating the “find aSurgeon” function on their website,

increasing the reach and audience for yourpractice. “Ask a Surgeon” questions arerouted to our site surgery.org with answersbeing posted on both properties. “TheAesthetic Society works hard to provideclinically-approved, accurate, and relevantcontent to our audience enabling them tomake the most informed decisions aroundplastic surgery options,” says Jeffrey M.Kenkel, MD, President of ASAPS.“Partnering with a leading, credible com-pany like EmpowHER helps us not onlyextend our reach to EmpowHER’s over18M women that visit their site annually,but further spreads the message about plastic surgery in a safe, and legitimateenvironment. It is the perfect, high-quality,complementary platform for our educa-tional content to a highly influential community of decision-making women.”

A Revised and expanded agreement with RealSelf.com

Many Society members are familiarwith the RealSelf, and its founder andCEO Tom Seery. RealSelf has emerged asone of the leading social media propertiesin aesthetics with over 2 million visitors permonth. We have enjoyed a long-standingrelationship with RealSelf, which onlyinvites participation from Board-certified,core group physicians.

Over 1,000 ASAPS members areanswering questions on plastic surgery andcosmetic medicine topics and many surgeonssee RealSelf as a tool for reputation management. They recommend RealSelf topatients as an ethical place to post reviewsand opinions.

Our new agreement leverages Tom’sconsiderable knowledge and expertise inall aspects of social media to specifically:• Serve as editor of a social media mono-

graph and offer suggestions on contentas well as expert commentary. This ToolKit will be introduced at The AestheticMeeting 2012.

• Provide promotional space for ASAPSbrand marketing campaigns in 2012

• Collaborate with Project Beauty on stories and social media outlets

Cooperative efforts with thePlastic Surgery Channel

This video site produces high qualityinformation on a wide range of plastic surgery and cosmetic medicine topics. Weare partnering with them on video sharing,link building and social media efforts.

Enhancements to surgery.org toincrease your referrals and leverage our content

Under the expert guidance of EtnaInteractives’ President, Ryan Miller, anumber of improvements have been madeto our main site surgery.org. Theseinclude:• Local Locator Pages: Now, your listing

on the find a surgeon function can besearched at the local levelSay a potential patient is looking for aboard-certified plastic surgeon inMissouri. New back-end enhancementsto surgery.org now allow visitors to oursite to drill down to the local level asillustrated on the screen shot at right.This means that your listing on surgery.org can now be recognized bythe Google “spiders,” allowing your listing to appear on a local Googlesearch.

• Activity TrackingSurgery.org is now capable of trackingthe following web site activities andmetrics; find a surgeon impressions, profile views, phone number requestsand website click throughs. These metrics are available to all purchasers of an Enhanced Profile Page.

News from the Marketing Task ForceBy Sanjay Grover, MD


Continued on Page 7

• Recent traffic increasesAs a result of these new, behind thescenes enhancements, surgery.org hasexperienced a 25% increase in overalltraffic and a 38% increase in new visitors since December of 2011.Surgery.org has had a 100% increase in traffic since January of 2011.

New Branding, new consumeroutreach, a new consumer-facingsite for Aesthetic Society members

The Task Force, under the experttutelage of branding firm Noe &Company, has been working on develop-ing new tag lines, value propositions and aconsumer-facing brand for the AestheticSociety. To date, we have engaged in thefollowing activities:• A full day branding session with Task

Force members and leadership to get tothe essence of what it means to be anASAPS member

• Testing of these hypotheses among consumers in our target group

• Discussing an additional site to ourexisting brands surgery.org and projectbeauty.com that would becomethe “consumer face” of the Society andeliminate any information that is notgermane to consumers

• Creation of a consumer campaign tospread the word about ASAPS and itsmembers training and expertise in aesthetic plastic surgery.

Member tool kits

You have told us loud and clear thatunbiased information on social media, mediarelations and Search Engine Optimizationwould be very beneficial to your practicemarketing efforts. Launching at TheAesthetic Meeting 2012, these three newdocuments will provide insights and practicaltools for these vital communications mediums.

We are also in the final stages of producing a monthly Online PracticeMarketing Resource. Are you wonderinghow to take videos, news articles and hottopics about plastic surgery and createengaging content on your newsletters,blogs or Facebook page? Let ASAPS makeit easier for you. Every month we’ll be

sending you print, video and Twitter andFacebook-ready media from the AestheticSociety’s extensive library that you can use for your own social media effortsimmediately.

These are just some of the effortswe’ve been working on since theMarketing Task Force was formed lastsummer. I would like to sincerely thank my colleagues on this initiative:Gary Brownstein, MD; Alan Gold, MD; Kent Hasen, MD; Herluf G. Lund, MD;Dan Mills, MD; Brian Reagan, MD;

Renato Saltz, MD; Robert Singer, MD; W. Grant Stevens, MD; and RobertWhitfield, MD. We will be regularlyreporting on our progress in ASN and rollout new initiatives as they are completed.

Sanjay Grover, MD is an aesthetic surgeon practicing in Newport Beach, CA.He is Vice-Commissioner of theCommunications Commission and Chair of the Marketing Task Force.


New back-end enhancements to surgery.org now allow visitors to our siteto drill down to the local level as illustrated on this screen shot.

Marketing Task ForceContinued from Page 6


There is never a more apparent needfor medical care than those crucial momentsfollowing a natural disaster, like the earth-quake in Haiti, or during wartime incountries like Iraq and Afghanistan. Dr. Kaveh Alizadeh, who is Chairman ofglobal medical charitable organization,Mission: Restore, recognized this needafter multiple trips to areas suffering theeffects of war, poverty and/or natural disasters.

After returning from a volunteer tripto Kabul in November 2011, he reportedthat there were only two self-trained plasticsurgeons in a country of 29 million. Dr.Alizadeh said to ABC, “These doctors havestayed in Kabul even when the Talibantook over the city. There have been multi-ple threats and they have been asked toleave, but they decided to stick it out. Wewant to help the local doctors who want tostay and help their people, but they justdon’t have the resources, education orinfrastructure.”

His organization, Mission: Restorefounded in 2010 focuses their efforts onbuilding the future. Along with providingimmediate relief by sending medical mis-sions to areas of need, their goal is to setup long-term, sustainable aid through clin-ical and educational support. They providelectures in medical and education centers,gather studies and reports on the latest

innovations to apply them in areas of needand promotes volunteerism in medicalschools and residency programs in thiscountry.

Mission: Restore worked on casesscreened by the Cure Hospital in Kabulranging from congenital face and bodydefects and malformations to burn andtrauma injuries due to war. They also provided a training curriculum for theAfghan fellows and began research on relevant topics, such as sexual trauma, warrelated deformities and acid burns.

Sending medical help and providingeducation is just a start to building a foundation in countries unequipped tohandle the demand. Alizadeh explains, “InAfghanistan, even though you have such alarge country, there’s a massive migrationof people that need help coming to veryfew health centers. Part of the conversationwas connecting with the Health Ministerto see if we can provide curriculums andprograms for major cities like Herat in the Western province, so we can create

long-term [solutions] for the Afghans toeventually take care of themselves and beindependent.”

Alizadeh himself was born in Tehran,Iran and fled the country right before theNovember 4th, 1979 hostage crisis. Hereturned to his country of birth for thefirst time on a volunteer trip during medical school.

“Initially, I had a scholarship to studypsychiatry at Cornell,” Alizadeh toldthe Iran Times. “While I was there, I did apublic health project looking into organi-zations like Doctors Without Borders andthe Red Cross. There, I connected with aplastic surgeon who became my mentorand turned me onto post-reconstructivesurgery.”

The impact from that trip and hisexposure to volunteer work has motivatedAlizadeh to continue charitable workthroughout his career. He explains, “Overthe past 18 years that I’ve been doing volunteer work, I’ve been interested in

Continued on Page 9

Dr. Kaveh Alizadeh on “Mission: Restore” and Volunteering

Dr. Alizadeh, H.E. Dr. Suraya Dalil, Afghanistan Minister of Public Health,Dr. Rick Perry, Director, Cure International Hospital, Kabul

FOCUS ON:Philanthropy


sustainable projects. So we establishedMission: Restore to provide clinical care,education and research to change the livesof a lot of people in war torn areas and totrauma victims in remote villages—manyof whom are female subjects of self mutila-tion and trauma. Some women are forcedinto marriage at a young age and engage inself-mutilation by burning. [Among manythings,] Mission: Restore hopes to gathervolunteers to help do post reconstructivework on these women.”

Volunteers are key to all missions,whether it’s to offer medical assistance, language translation or logistical help.“When I worked in Haiti after the earth-quake, volunteer students were a big helpwith organizing our efforts, matching uppatients with doctors,” explains Alizadeh.

Connecting with patients victimizedby the war is something Dr. Alizadeh doeshere in the US as well. In May 2008,Waad Burkan, a 7 year-old boy from Iraqwas walking home from school and kickeda bomb disguised as a bottle meant for UStroops, and ended up destroying the rightside of his face, eye, leg and arm. Thenearby US soldiers saved his life by bring-ing him to a hospital and then to the USthrough the non-profit charity, GlobalMedical Relief Fund (GMRF).

He first arrived at Shriner’s Hospitalin Philadelphia where he received prostheticlimbs. Then, in New York City, an ocular

prosthetics group, Kirszrot Prosthetic, provided a new eye. Finally, he came toNorth Shore-LIJ Hospital in Manhasset,NY where Dr. Alizadeh rebuilt Waad’s face.He is now back in Iraq with a new lease onlife.

Dr. Alizadeh finds hope in thesemoments and believes that there is a dutyto help not only our own soldiers but alsothe victims of war.

“On one end, we’ve been there for solong. It’s the longest war in US history.There’s been a lot of resources in terms oftroops, funds and time that has beenspent, but I’m sad to say that the primaryperception of America is not of a peoplethat are there to bring goodwill, but morein the context of war. We would like tochange that message,” he says.

Many ASAPS members like Dr.Alizadeh promote the message of goodwillby working through charitable organiza-tions and donating their time, money andmedical expertise. To get involved inMission: Restore visit their website atMissionRestore.org.

Dr. Kaveh Alizadeh is an AestheticSurgeon practicing in Garden City, NY. Hehas traveled abroad for volunteer missionsevery year since 1998 and acts as Chairmanfor Mission: Restore, a charity organizationhe helped found.

Mission: RestoreContinued from Page 8

Dr. Alizadeh with Afghan men at Cure Hospital

New JerseyRepeals Cosmetic Tax

In a move that finally stops the discrimination against plastic surgeons and the patients who seek their services,New Jersey Governor Chris Christierecently signed legislation calling for theelimination of the state’s six percent tax on cosmetic surgery procedures, which wasenacted in 2004. Assembly Bill 3646/Senate Bill 1988 requires the tax to bereduced to 4 percent in the first quarter ofthis year; to 2 percent on July 1; andrescinded completely on July 1, 2013.

The eight-year old tax nets the state$10.8 million in revenues per year, but itscritics argued that it inequitably burdenedpatients undergoing surgery, the medicalpractices that had to collect the extra fees,and the state revenue officials charged withenforcing the tax.

Dr. Christopher Godek, president ofthe New Jersey Society of Plastic Surgeons,is optimistic that if the repeal legislationpasses and lands on the desk of Gov. ChrisChristie, he will agree with the physicians’position that the tax is bad economic policy. Christie, “is very pro-business somy guess is that he will support” therepeal, Godek said.


As many of you are aware, the ASAPSMedia Relations Committee, workingtogether with the Society’s CommunicationsStaff has encouraged extensive media coverage about our specialty throughbroadcast, print and online publications.In 2011, The Society, ASAPS members,ASJ and ASAPS’ statistics were featurednationally and internationally thousands oftimes. The Committee and the ASAPSCommunications Office confirmed mediaplacements reaching an audience of over950 million consumers.

As Chairman of the Media RelationsCommittee, I am proud to highlight theaccomplishments of the Society and itsspokespersons that have been sourced multiple times in several of the nationsmost circulated publications such as: TheWall Street Journal, ABC News, Allure

Magazine, CBS News, The New YorkTimes, Cosmopolitan Magazine, Forbes,Fox Business, Los Angeles Times, NewsweekMagazine, The Miami Herald, The Doctors,The Dr. Oz Show, and USA Today.

ASAPS is determined to respond toinaccurate and irresponsible articles andbroadcasts about plastic surgery. Many ofyou read and commented on the Letter-to-the Editor written by the Society’s PresidentJeffrey M. Kenkel, MD, in response to anOp-Ed published in the Los Angeles Timesuggesting a ban on cosmetic surgery afterthe recent French PIP implant scandal.

The Society and our members haveappeared on many TV shows this past year,in November, I was featured on thenationally syndicated show “The Doctors;”and in December, Peter J. Rubin, MD wasa special guest on “The Dr. Oz Show” with

Susan Somers discussing a revolutionarysurgery to rebuild her breast after her battle with cancer.

In other news, The Aesthetic Societywas ranked as the number one plastic surgery social media influencer accordingto Klout analytics, a social media analyticscompany based in San Francisco. ASAPShad the highest Klout Score among plasticsurgery social media influencers. ASAPSnow has almost 5,000 followers on Twitterand over 3,500 “Likes” on Facebook.

In 2012, the Media RelationsCommittee is determined to reach moreconsumers through all news outlets andsocial media, and continue to promotepatient safety and the importance of aboard-certified plastic surgeon.

Dr. W. Grant Stevens is an aesthetic plasticsurgeon practicing in Marina Del Rey, CA.

W. GRANT STEVENS, MD, CHAIR OF ASAPS MEDIA RELATIONS COMMITTEE

UPDATE ON: ASAPS Media Relations Committee

Headline News: The Aesthetic Society and the Media

According to a study by the American Society forAesthetic Plastic Surgery (ASAPS), adults between theages of 31 and 45 accounted for 43% of all cosmetic procedures in 2010, while baby boomers (ages of 51 and64), made up just 28%. Dr. Leo McCafferty, president electof the ASAPS, says the trend can be attributed to morereadily available information about products and cosmeticsurgery. Dr. Jeffrey Kenkel, says “I think the desire to lookbetter for both personal and professional reasons is moreprominent for Generation X. “But I do see baby boomerswho had to go look for jobs and wanted to do somethingthey thought would help make them more competitive inthe workplace.” Those seeking either invasive or non-invasive procedures should consult their local county medical society, or an organization like the ASAPS tocheck a doctor’s credentials beforehand

Generation X Leads Boomers In Cosmetic Surgery Procedures Fox Business

November 21, 2011

The new therapy that Suzanne Somers underwent is aminimally invasive method of restoring breast volumeusing fat moved from another part of the body, says Dr. J.Peter Rubin, Chair of the ASAPS/ASPS Joint Task Force onStem Cell/Fat Grafting. The biggest problem encounteredwith fat grafting is that fat can lose volume or beabsorbed by the body over time, leaving less of an affectfrom the original treatment. The first concern is whetherthe stem cells that are used to enhance the fat graftingwill stimulate the growth of breast cancer cells. An impor-tant question to answer is about the timing of this treat-ment relative to the breast cancer surgery. How long mustwe wait before administering this therapy to confirm thatpatients are free of disease? Another concern is whetherthis therapy will interfere with breast cancer screenings.

Stem-Cell Breast Reconstruction: Understanding the IssuesThe Dr. Oz ShowDecember 16, 2011

Media Notes and QuotesA sampling of current media coverage on The Aesthetic Society


Klout, a social media analyticscompany based in San Francisco,recently release their top 10 plastic surgery rankings for thepast 90 days. ASAPS was rankedat #1. According to the analyticscompany, “The American Societyfor Aesthetic Plastic Surgery—Theofficial Twitter account for theAmerican Society for AestheticPlastic Surgery post regularly on topics from its own website,as well as news outlets aroundthe world. The Society appears to also heavily “retweet” its surgeons and their commentsabout the industry.”

The Society is in good company,according to the reports.Rounding out the top ten “socialmedia influencers” are:

• The American Society of PlasticSurgeons

• The Journal of Plastic andReconstructive Surgery

• Jeffrey Kenkel, MD • Jennifer Walden, MD • J. Vicente Poblete, MD • Project Beauty • Jeffrey Roth • RealSelf • Elizabeth S. Lee, MD

The Klout Score is determinedbased on the ability to drive traffic, engage and influence others. The firm uses data fromsocial networks in order to measure Reach, Amplificationand Network Impact.

Klout does have its detractorswho argue that results don’tmatch up with the offline realityof one’s influence. However,according to the websitetechcrunch.com, “Klout continuesto roll with the punches becauseour online identities are frag-mented across different services.These different sites rank theirown users, of course, but typically

only factor inputs tied downwithin their own gardens. Themain forces, Facebook, Twitter,LinkedIn, certainly weigh theirown users’ activity for variousreasons, but Klout has built onesingle, unified score based on itsown independent algorithmacross these services.”

We think the numbers speak for themselves. With over 4700followers on Twitter and 3500likes on Facebook and increasingeveryday, ASAPS is a major socialmedia influencer in the specialtyof plastic surgery.

Want to check out your ownKlout score? More information isavailable at their websiteklout.com

The Aesthetic Society Ranked #1 of Top 10 PlasticSurgery Social Media Influencers

Headline News: The Aesthetic Society and the Media


The Center for Democracy andTechnology (CDT) recently filed a formal complaint with the Federal TradeCommission and various state AttorneysGeneral alleging that the company MedicalJustice has committed deceptive and unfairbusiness practices in violation of the FTCAct. We’ve written about Medical Justicebefore—they sell a suite of “reputationdefender” services to doctors and dentistsacross the nation.

One way that they claim to protecttheir clients’ reputation is by distributingform contracts for patients to sign thateither prohibit patients from commentingonline or posting reviews about the doctor,or assign a copyright interest in any onlinereviews to the doctor, so the doctor can getthem removed from the web at his or her discretion.

As a result, doctors can ban patientsfrom warning others about problems theymight have had, or have an uncheckedveto power to remove reviews they thinkare unfair or inappropriate. If a patientdoesn’t want to sign the contract, the doctorcan refuse to give medical treatment. (For more information and analysis ofMedical Justice’s contracts, check outDoctoredReviews.com, an excellent siterun by law professors Eric Goldman ofSanta Clara and Jason Schultz of Cal dedi-cated to calling out these bad practices.)

In our complaint, we allege that thesepractices aren’t just bad and unethical—they’re also illegal. Medical Justice’s prior restraints on patients’ speech areunconscionable and unenforceable undercontract law—typically, you can only contractually bind someone not to speakfreely if there’s a trade secret or other confidential information at stake.However, Medical Justice markets its

contracts as an effective solution for combating slanderous and fraudulentreviews, including by ex-spouses and competitor doctors (who never would havesigned the unenforceable contracts in thefirst place). Medical Justice also claims that their contracts offer extra “privacyprotections” for the patients that signthem—a fact that has no grounding inreality.

We allege that the contracts are“unfair” under FTC law as well. Theyharm current patients by threatening theirfree speech rights and future patients fromgetting valuable information about thedoctors to whom they’re consideringentrusting their medical care. Patients can’treasonably avoid this harm—after you’vetaken off two hours from work to see adoctor about that blinding toothache, areyou really likely to leave to try to findanother dentist who’ll see you next weekover a review that you don’t know youwant to write yet?

And finally, there’s no countervailingbenefit to these contracts—doctors whothink they’re being defamed already haveremedies under the law, and can sue tounmask (and receive damages from) commenters who make libelous state-ments. Medical Justice contracts are merelyintended to short-circuit the establishedlegal process for combating unwantedanonymous speech, and instead give doctors the chance to fraudulently curatetheir online reputation by pruning awayinconvenient statements.

In addition, we have asked the FTCto investigate claims that Medical Justice isalso deceptive by seeding consumer reviewsites with misleading positive reviewsabout doctors. Both RateMDs and Yelphave discovered uniformly positive reviews

being uploaded about doctors fromMedical Justice web servers. The FTC hasalready done excellent work in this area ofonline “astroturfing” with its updatedEndorsement Guidelines, but there is stilla lot of gray area for companies, especiallyas social media has dramatically expandedin importance even since the guidelinescame out two years ago. Can doctors pickand choose among the reviews they solicitfrom patients to put on their website? Canthey upload them to Yelp under assumednames? Can doctors require patients to“Like” them on Facebook before providingmedical treatment, or for a discount? Howdoes all this need to be disclosed?

Based on what we can see, we believethat Medical Justice’s tactics cross the line,but this case presents a great opportunityfor the FTC to craft strong injunctive reliefto give companies more clarity on to promote themselves through social mediawithout deceiving consumers.

Online reputation management isgoing to be an increasingly important issue for doctors, companies, and evenindividuals in the coming years. But managing your public image should not beachieved through trickery and abusivebehavior. Regulators need to stop badactors from gaming the robust reputation-based ecosystem that we have come to relyon everyday. We will all be much worse off if review sites become polluted by shillendorsements and deprived of honest criticism.

For tech policy updates, follow us onTwitter at @CenDemTech.

Justin Brookman is currently theDirector of Consumer Privacy at the Centerfor Democracy and Technology. You can visit the website www.cdt.org for more information.

CDT Files FTC Complaint Against Medical Justiceby Justin Brookman

Expert Legal Advice.

Exclusively for Members of The Aesthetic Society. With richlegal experience in the medical field, Bob Aicher, Esq., isuniquely qualified to provide free Member consultations in theareas of practice management, insurance, malpractice, scope ofpractice, ethics, and defamation.

To contact Bob Aicher, Esq., please email [email protected] or call via phone at (707) 321-6945.

This service is not intended to replace legal counsel.

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For More InformationToll-Free 800.364.2147 or 562.799.2356

www.surgery.org


CDT Files FTC Complaint Against Medical Justiceby Justin Brookman



presentations, courses and seminars. Notonly are some of your favorites returning,such as “Global Hot Topics,” which has beenredesigned to make it even more dynamicand fast-paced, but we have some excitingnew courses, each designed to deliver the latest in education from the experts you trust.

“Cosmetic Medicine 2012” has beenrevised, with the morning session devotedto Light and Energy-Based Technology,and the afternoon session focusing onInjectables. These sessions have also beenredesigned, offering more opportunities forinteraction with the instructors, to askquestions, and better viewing of the proce-dures. Attend one session, or register forboth for added savings.

Make sure to attend Tuesday’s session,devoted to the Business Side of AestheticPlastic Surgery. This event is free to thestaff of Aesthetic Society Members andCandidates. At this dynamic session, you’lllearn a variety of ways to ensure that yourpractice is operating to its maximumpotential, and is not to be missed.

At The Aesthetic Meeting 2012, wewill have over 200 technical and scientificexhibits, hands-on cadaver workshops, andlive demonstrations. Also, this year youhave the opportunity to earn up to 47.75AMA PRA Category creditsTM. Attend theentire 2012 Scientific Session to receive 8 patient safety CME credits, and up to10.5 patient safety CME credits by attending select Optional courses.

The Aesthetic Society’s EducationCommission and Scientific ProgramCommittee is committed to bringing youthe best in higher education, bar none, andthis year’s Aesthetic Meeting in Vancouveris shaping up to be one of our best yet. We appreciate your feedback, and look forward to meeting you in Vancouver.

To register, or for more information,please go to www.surgery.org/meeting2012.Take advantage of Early Bird Registrationpricing, now through February 22nd,including special Four or More Coursepackage savings.

Dr. Jack Fisher is an aesthetic plasticsurgeon practicing in Nashville, TN, andserves as Vice President of The Aesthetic Societyand chair of the Education Commission.

“I am a proudMember of theSociety, as it provides me with a wealth of educational opportunities that

I simply can’t get anywhere else. I am incredibly excited about The Aesthetic Meeting 2012, asattending a meeting allows meto ask questions directly to theexperts. It facilitates interactionwith my peers about importantthings in my practice, and I love learning, discussing, and socializing with my colleagues in person.”—Jeffrey M. Kenkel, MD

“The energy fromthe educators, mycolleagues, and the thoughtfulinterchange ofideas has beenincredibly valuable.

The Teaching Courses havealways been one of the mosteducational experiences of theannual meeting. Learningthrough evidence-based medicineand exchanging ideas is criticalfor both me to stay competitiveand for our specialties advancement.” —Laurie A. Casas, MD

“The AestheticMeeting is a fabulous educa-tional and collegialexperience, year inand year out. The educational

content is formidable and thereis a cutting edge approach to the meeting that makes it worthcoming back every year.” —Richard A. D’Amico, MD

“This year, I ammost looking forward to TheAesthetic Meeting’songoing emphasison bringing evidence (EBM) to

aesthetic surgery. We are targetedby relentless advertising fromvendors and hear wild claimsthroughout the year. What isreal? What really works? ASAPShelps me figure that out so Iknow how to grow and changemy practice in the best way. It isoften the discussions with my colleagues or with speakers inthe hallway that really bringpoints of clarity to me and helpsme make sense of where a technique, procedure, or conceptfits into my practice.”—Felmont F. Eaves, III, MD

The Aesthetic Meeting 2012Continued from Cover

Meet Us in Vancouver!The Aesthetic Society asked just a few of our esteemedMembers what value they gain from attendance at The Aesthetic Meeting and their thoughts on the

upcoming Aesthetic Meeting 2012 in Vancouver, B.C., May 3-8. Registration is open now, with Early Bird Savings

available only through February 22, 2012, atwww.surgery.org/meeting2012.



“Although there istremendous benefitto online and DVD-based educationalprograms, there isno replacement forgathering with

fellow plastic surgeons to listen andlearn about what the thoughtleaders are saying. I always enjoycatching up with friends to seewhere they are with their familiesand practices and to pick up practice pearls from them. I amreally looking forward to ourannual meeting in Vancouver. Itis a beautiful city and it shouldbe a tremendous meeting.” —Michael C. Edwards, MD

“At The AestheticMeeting I valuethe state of the art exposure toaesthetic plasticsurgery topics, andenjoy meeting

with respected friends and colleagues. I also enjoy the exposure to exhibitors with newtechnology to offer.” —Julius Few, MD

“The AestheticMeeting focuses onaesthetic surgerypresented byboard certifiedplastic surgeons,and we enjoy

hanging out with old friends and making new ones. At boththe Hot Topics Symposium andthe Research and TechnologyLuncheon, the energy is palpableand helps me to separate the newtechnology hype from reality, givingme opportunities to discuss newmodalities for enhancing mypatient care. And at the ASERFResearch Luncheon, I can seefirsthand how our research dollars are being spent.” —Joe M. Gryskiewicz, MD

“I joined TheAesthetic Societyto improve my aesthetic surgerypractice by learningfrom The AestheticMeeting. I value my

interaction with colleagues, aswell as the courses and exhibits.”—Elizabeth Hall-Findlay, MD

“What I value mostabout The AestheticMeeting is theinteraction withother physicians,nurses, and fellowprofessional which

occurs at the meeting. Thesecould occur during a session, in ahallway, or in an exhibit hall, andthat in-person experience is onewhich no webcast or DVD canreplace. The experience of ‘beingthere’ is invaluable.” —Leo McCafferty, MD

“I recall Foad Nahaionce telling methat becoming anASAPS Member was one of his most memorable accomplishments

and I certainly feel the same way.” —M. Mark Mofid, MD

“I remain an ASAPSmember becauseof the value thatmembership inASAPS brings tome. Beyond theeducational

opportunities, I have made somewonderful friends and have had the opportunity to meet colleagues from all over theworld. I am moderating a panelon the role of volume in lowereyelids and my goal is to bringout the latest in the treatment of this area.” —Foad Nahai, MD

“In my opinion, nowebinar, DVD,stream surgery, norany other virtualtechnology canreplace either thelearning gained

through personal participation,nor the interaction I enjoy withmy colleagues and their staff.” —Renato Saltz, MD

“The AestheticMeeting has terrificscientific informa-tion, with the latest updates onwhat is being doneand new trends.”

—Lina Triana, MD

“As a smallerSociety, I feel thatit is easier toattend the meetingand interact withthe Speakers if Iam so inclined. The

interaction with colleagues is themost rewarding part of physicallyattending the meeting, and Ialways learn something at the Aesthetic meeting that Iincorporate into my practice.” —Robert Whitfield, MD

The Aesthetic Meeting 2012Continued from Page 14

V A N C O U V E R


Because of vast and growing internetreach and influence, online reputation isincreasingly important in defining yourprofessional identity and growing yourbusiness. What others say about youincreasingly matters. Online reviews influence purchase decisions. Web technology is moving toward a numericalreputation score for businesses, and possibly individuals.

Offensive StepsBecome PROACTIVE and CONSIS-

TENT. Solicit favorable reviews from satisfied and articulate patients. Establish a system to accomplish this. Your staffshould be able to email a user friendlyinterface to patients allowing them toquickly and easily post an online review.Incorporate this into their daily routine.Regularly check the system, and verify thatfavorable reviews are actually being posted.Consider motivating and rewarding stafffor achievements with your online ratings.Enlist vendors and business partners tosupport your credibility and professionalreputation online for using their productsand services. Review sites include Google,Bing, Yahoo, Yelp, Realself, Healthgrades,Vitals, RateMD, Wellness, Angie’s List,and many others.

Build and maintain the highest quality professional character, integrity,and customer service. Underpromising and overdelivering is important. You must fulfill every one of your promises and claims. Excellent patient care andcommunication with patients is critical.Treat patients with respect and aggressivelyserve the dissatisfied patient to correct distasteful situations. Avoid confrontationsand adversarial interactions with patients.Be on their side!

Video testimonials should be postedthroughout your web presence, including

your blog, your website, YouTube, andsocial networking sites. These videos canbe posted instantly to Facebook from theFacebook application on your mobiledevice, and to multiple sites from applications such as UStream.

Engaging your patients and gettingthem to participate in your practice’s socialnetwork is important. Having yourpatients endorse your practice to theirsocial network is powerful marketing.

Post educational material online. Press releases, publications, and an activeoriginal blog increase your web visibilityand online positive presence.

Defensive StepsMonitor your online reputation to

quickly discover a negative review. GoogleAlerts and sites such as reputation managementconsultants.com, reputation.com, andothers police the internet for mentions ofyour name and add content about you thatpushes down unfavorable reviews. MedicalJustice, Inc. also offers to help physicianswith their online reputations.

Never should a patient post an onlinereview while still in your office. Never criticize another surgeon’s work to apatient. If that patient posts a negativereview quoting your words, retaliation isincentivized.

Improve the customer experience inyour office, including courtesy of frontoffice staff, attentiveness to patient needs,parking, duration of waiting, cleanliness,and billing process.

Diligent risk management. Avoidoperating on patients who spend their lastdime on their cosmetic procedure, or heavily finance with no reserve. If theyneed a revision and cannot afford it,they’re likely to criticize you online as aneasy route of expressing their frustration.Listen carefully to patients for signs of

instability, unrealistic expectations, dissatis-faction with other surgeons, disagreementwith your treatment plan, poor under-standing of risks, vindictiveness, and avoidthose you believe have a greater chance oftheir vision being unfulfilled, or of difficultcomplications. Avoid patients you justdon’t have a good feeling about.

Keep good company online, be professional, and NEVER disclose privatepatient information. Increasingly, youronline activity and associations will be followed.

Steve Laverson, MD, is a plastic surgeon practicing in Encinitas, CA, and is aMember of the ASAPS Product Developmentand Market Research Committee.

References:Leonardo, Jim: Don’t be a sitting target when yourreputation comes under fire online. Plastic SurgeryNews, ASPS, December 2011.

Finn, Holly: How Google & Co. will rule your rep.Wall Street Journal, 14 Jan 2012.

Kruse, Kathi: Why you can’t automate your onlinereputation. http://www.krusecontrolinc.com. 5 December 2011.

Burling, Stacey: Doctor’s feel helpless over patients’online slams. Philadelphia Inquirer, Jan 6, 2012

Online Reputation Management For ASAPS MembersSteve Laverson, MD

V A N C O U V E R

www.surgery.org/meeting2012


F O C U S I N G O N T H E F U T U R E —The Changing Landscape of Aesthetic Plastic Surgery

Annual Meeting of

THE AMERICAN SOCIETY FORAESTHETIC PLASTIC SURGERY, INC.

AESTHETIC SURGERY EDUCATIONAND RESEARCH FOUNDATION

®

MAY 3– 8, 2012Vancouver Convention & Exhibition Centre

Register Today• Interactive and Informative, with the Latest in Evidence-Based Medicine

• Global Perspectives, Dynamic Panels, Thought-Provoking Papers

• Hot Topics: Compelling and Controversial

As co-authors of “For Doctors Only:A Guide to Working Less & BuildingMore” and advisors to physicians through-out the country, we are often asked to helpdoctors to protect assets against future lawsuits. From this experience, we oftenlearn what misconceptions physicians haveregarding how to protect their assets frompotential lawsuits. In this article, we hope to dispel some of the incorrectassumptions that you may have, and shedsome new light on opportunities for further asset protection.

Personal vs. PracticeProtection

The first misconception that mostphysicians have is that they should onlyprotect their personal assets from potentiallawsuits. Nothing could be further fromthe truth. In fact, the practice’s importantassets are the most vulnerable to lawsuits,especially in a group practice. That isbecause any malpractice claim or employeeclaim (sexual harassment, wrongful termination, etc.) against any of the doctorsthreatens all of the assets of the practice. Inother words, if you are in a group practice,you are underwriting all of the acts andomissions of all of your partners, to theextent of your practice assets.

What are the most important practice assets?

Certainly, your cash flow and incomeis most important. The good news is thatthe tools that protect your cash flow alsotypically help you save on income taxesand build retirement wealth. These include qualified retirements plans (including defined benefit plans to 401(k)sto combination plans and more), non-qualified plans, fringe benefit plans, captive insurance arrangements and more.While we have written extensively on thesetopics, we drill down on them a bit later inthe article.

Beyond your cash flow, the practice’s accounts receivable(AR) are typically animportant asset.Your AR iswhat you, in fact, workfor. What mostphysicians don’t realizeis that a lawsuit againstthe practice itself, created bya wrongful act of any of thepartners, threatens all of the AR ina typical practice setup. Certainly,there have been cases where physicianshad to work for free for a number ofmonths because of the lawsuit judgmentresulting from the act of one physician created a loss of the AR for the entire practice. Don’t let this be you.

Other important practice assetsinclude the practice real estate, if any, andvaluable equipment. If your practice hasvaluable real estate or equipment, it mustseparate these assets from the main practice. While the details of advancedstrategies go beyond the scope of this article, suffice it to say here that there are anumber of tactics we can use to protectreal estate and valuable equipment frompotential lawsuits against any of the physicians or the practice itself.

Personal Protection: A Matter of Degree

The most common asset protectionmisconception that physicians have regardstheir personal asset protection—shieldingtheir personal assets from potential lawsuits. In this endeavor, asset protectionattorneys approach a challenge much inthe way a physician approaches being apatient. Like physicians, we asset protec-tion professionals first will try to get aclient to avoid “bad habits.” For a medicalpatient, bad habits might mean smoking,drinking too much or a poor diet. For aclient of ours, bad habits might include

owningproperty in their

own name, owning itjointly with a spouse, or

operating any medical practice withbusiness assets exposed (see above).

In fact, we use an asset protection rating system for a client’s overall situation:from -5 (totally vulnerable) to +5 (superiorprotection). Exposing business assets, owning property in your own name, etc...these are examples of -5 situation.

In this way, before we implement anysophisticated asset protection planning, wewant to move the client from a -5 to atleast a low negative or neutral number.This means eliminating any of the “badhabits” named above, and others. If yousee yourself as a physician who has business assets exposed and owns personalassets in your name or jointly with aspouse, you should talk to an asset protection advisor immediately. You don’twant to linger too long in the -5 category, as it’s only a matter of time until you get “sick.”

Basic Asset ProtectionAgain, using the sick patient analogy,

if you see a patient with a particular condition/disease, you try to treat it. Forus, we try to treat physicians to solve theirlawsuit vulnerability. In this endeavor, weuse particular structures to protect a physician’s assets.

If you are in such a situation, whereyou want good basic asset protection, butdo not want to pay more advanced tools,


Asset Protection: A Matter Of DegreeDavid B. Mandell, JD, MBA



then basic asset protection tools like familylimited partnerships (FLPs) and limitedliability companies (LLCs) should be used.Essentially, these tools will provide goodasset protection against future lawsuits,allow for maintenance of control by you(the client), and can provide income andestate tax benefits in certain situations.

Specifically, these tools generally willkeep a creditor outside the structurethrough “charging order” protections.These protections typically allow a physician to create enough of a hurdleagainst creditors to negotiate a favorablesettlements. For these reasons, we oftencall FLPs and LLCs the “building blocks”of a basic asset protection plan. We mayalso layer in domestic irrevocable trusts,such as life insurance trusts or charitableremainder trusts.

In essence, these tools will provideadequate asset protection relating to anasset protection score of +2. Obviously,their asset protection benefits are reliantupon proper drafting of the documentation,proper maintenance and respect for formalities, and proper ownership arrangements. If all these are in place, thephysician can enjoy basic asset protectionfor a relatively low cost.

Ultimate Asset Protection:Advanced Strategies

For many physicians, a basic assetprotection plan, which has some potentialvulnerability, is not good enough. A +2 ontheir asset protection score is not enoughto give them the psychological comfortthat they want. Other clients realize thatthe best protection comes from tools thatactually can help clients create wealth. Forthis reason, these clients use advancedstructures to put themselves at a +4 or +5,the ultimate asset protection score. Like aphysician giving the ultimate medicine ormost effective surgical procedure, assetprotection consultants rely on a number oftools to provide ultimate asset protection.These include:

A. Qualified Retirement Plans:The term “qualified” retirement planmeans that the retirement plan complieswith certain Department of Labor andInternal Revenue Service rules. You might

know such plans by their specific type,including pension plans, profit sharingplan, money purchase plans, 401(k)s, or403(b)s. Under federal bankruptcy law,and nearly every state law, these plans aretotally protected against lawsuits and credi-tor claims—enjoying +5 protection status.

B. Non-qualified and fringe benefitplans. Non-qualified plans and fringe benefit plans allow a physician to putfunds away at the practice level and enjoythem in retirement. Also, these types ofplans can be used in addition to qualifiedplans. In many states, these can be fundedby exempt (+5) asset classes. Even in thestates where there is no (+5) exemption, a(+2) LLC can typically be used to providea solid level of protection.

C. Captive Insurance Companies(CICs): In this technique, the owners of amedical practice actually create their ownproperly-licensed insurance company—toinsurance all types of risks of the practice.These can be economic risks (that reimbursements drop), business risks (thatelectronic medical records are destroyed),litigation risks (coverage for defense ofharassment claims or HCFA audits) andeven medical malpractice (keeping somerisk in the captive and reinsuring the rest).To maximize the protection of the CIC,many physicians establish trusts to own the CIC.

Funding of exempt assets: Each statelaw has assets that are absolutely exemptfrom creditor claims, thereby achieving a+5 status. Many states provide unlimitedexemptions for cash within life insurancepolicies, annuities, and primary homes.Make sure you seek an expert on this tofind out the exemptions in your state.

ConclusionAsset protection planning, like any

sophisticated multi-disciplinary effort, is amatter of degree. Nothing in life is 100%certain (except perhaps death and taxes—subjects of other articles). For asset protec-tion planning, this adage holds true. Inyour asset protection plan, make sure youunderstand the cost and benefits of thevarious tools you employ. It will help younot only protect the wealth you havealready built, but may assist you in build-ing greater after tax wealth for your retire-ment and beyond.

Special Offer: For a free (plus $5S&H) copy of “For Doctors Only: A Guide to Working Less and BuildingMore,” please call (877) 656-4362.

David Mandell, JD, MBA is a principalof the financial consulting firm OJM Group.He can be reached at 877-656-4362.

Disclosure: OJM Group, LLC. (“OJM”)is an SEC registered investment adviser with itsprincipal place of business in the State of Ohio.OJM and its representatives are in compliancewith the current notice filing and registrationrequirements imposed upon registered investmentadvisers by those states in which OJM maintainsclients. OJM may only transact business inthose states in which it is registered, or qualifiesfor an exemption or exclusion from registrationrequirements. For information pertaining to theregistration status of OJM, please contact OJMor refer to the Investment Adviser PublicDisclosure web site (www.adviserinfo.sec.gov).

For additional information about OJM, including fees and services, send for ourdisclosure brochure as set forth on Form ADVusing the contact information herein. Pleaseread the disclosure statement carefully beforeyou invest or send money.

This article contains general informationthat is not suitable for everyone. The informa-tion contained herein should not be construedas personalized legal or tax advice. There is noguarantee that the views and opinions expressedin this article will be appropriate for your particular circumstances. Tax law changes frequently, accordingly information presentedherein is subject to change without notice. Youshould seek professional tax and legal advicebefore implementing any strategy discussed here-in.

“We often call FLPs and LLCs the

‘building blocks’ of a basic asset

protection plan. We may also layer

in domestic irrevocable trusts,

such as life insurance trusts or

charitable remainder trusts.”

Asset ProtectionContinued from Page 18

Each year, he traveled throughMaharashtra, Tamil Nadu, Gujarat,Chattisgarh, Madhya Pradesh, Delhi, Uttar Pradesh, Karnataka and Rajasthan to perform the surgeries. He performedsurgeries so quickly and accurately thatmedical students would record them andplay them back, zooming in and studythem in slow motion, in order to learnfrom his techniques. Speed and efficiencywere his two mantras and he performed100-150 surgeries a day.

With precise moves and extremelyneat sutures, it would take him less than30 minutes to perform a cleft lip surgeryon a one-month old child. “In 30 minutes,he corrected my son’s cleft lip and did notcharge anything for it,” said a gratefulmother, Banitha Venkatagiri.

Sashi Munoth, Dr. Dicksheet’s coordi-nator, noted that “He preferred small children as well as young men and womenof marriageable age for surgeries, as hedoes not want them to live with theignominy of a disfigured face.” He neverturned a child down.

In 2001, Dr. Dicksheet was honoredwith both the Kellogg’s Hannah Neil“World of Children Award” and the WorldCongress of Cosmetic Surgery’s “LifetimeAchievement Award in Aesthetic andRestorative Surgery,” given his dedicationto children, his ethics, and his lifetime ofsustainable work. He was also honored toreceive a Padma Shri award, which is thefourth highest civilian award in theRepublic of India. Plastic Surgery Newsnoted that “Dr. Dicksheet was reportedlynominated five times for the Nobel PeacePrize for his work with India’s indigent.During his 1998 nominating speech in theU.S. House, his Nobel sponsor, then-U.S.Representative Michael Bilirakis (R-Fla.),called Dr. Dicksheet ‘the essence ofhumanitarianism.’”

Dr. Dicksheet would spend half of theyear in New York, where he lived, with the rest of the year traveling in India, performing surgeries for cleft lips, squinteyes, facial scars, ptosis, and birthmarkremoval. “My troubles are nothing whencompared to the problems of children whocome in for surgeries and the stigma theyface in life because of their disfigurement.

My sole aim in life is to give them a betterlife,” said Dr. Dicksheet.

Through his impressive legacy andreconstructive skills, thousands are now living free from pain and ridicule. Dr.Sharadkumar Dicksheet will be greatlymissed, and our field owes him a debt ofgratitude for his generous spirit and dedication to others.

For donations in his memory, pleasemake checks out to “Dr. Dicksheet’s India Project,” which can be sent to Dr.Dicksheet’s India Project 135 OceanParkway, 17-C Brooklyn, NY 11218. Adocumentary film telling Dr. Dicksheet’samazing story is available for online viewing at http://vimeo.com/32189802.

An Aesthetic SocietyMember Remembers Dr. Dicksheet

Aesthetic Society Member, LarryWeinstein, MD, first met Dr. SharadkumarDicksheet at New York’s Kings CountyMedical Center. At the time, Dr.Dicksheet was an instructor and Dr.Weinstein was completing his residency,and Dr. Weinstein was impressed by Dr.Dicksheet’s perseverance despite debilitiesof complete Laryngectomy, back problemsthat kept him in a wheelchair, and cardiacproblems. Dr. Raj Lalla, Dr. Barry Citronand Dr. Weinstein all appreciated histenacity, technical skill, and humanisticapproach to medicine. Dr. Weinstein considered Dr. Dicksheet a mentor andfather figure.

Preparing for his boards, with thestress and strain that entails, the young Dr.Weinstein sought out Dr. Dicksheet’sadvice on the best way to tackle his boards.Dr. Dicksheet encouraged him to join in atrip to India, to both refocus himself andprepare himself mentally. Thus began anongoing commitment, inherited throughDr. Dicksheet, from Dr. Weinstein to thepeople of India.

Dr. Weinstein has now made sevenmissions to India, most recently just following Dr. Dicksheet’s death. At the

Sharadkumar Dicksheet Continued from Cover


Aesthetic Surgery JournalContinued from Cover

of the journal’s editorial content, interna-tional diversity of the journal’s authors andboard members, and the journal’s overallcontributions to the subspecialty. Accordingto the Thomson Reuters website, the company’s editorial staff reviews over 2,000journal titles each year, but selects only 10-12% for inclusion in the database.Indexing with this service is a great honorfor Aesthetic Surgery Journal—one thatbuilds upon our previous achievement ofPubMed/MEDLINE indexing in 2008.

Perhaps most importantly, indexingwith Thomson Reuters’ ISI and inclusionin the SCIE and JCR databases will even-tually provide Aesthetic Surgery Journalwith an impact factor. As described byThomson Reuters, “The annual JournalCitation Reports impact factor is a ratiobetween citations and recent citable itemspublished. A journal’s impact factor is calculated by dividing the number of current year citations to the source itemspublished in that journal during the previous two years.” It is basically a measure of the frequency with which theaverage article in a journal has been citedin a particular year or period and it reflectsthe influence of a journal’s contributionson the “state of the science” in a particularsubspecialty. While ASJ will not have anofficial impact factor until at least 2014,early research has shown that it will becompetitive with other ISI-indexed journals in the field of aesthetic surgery.

This designation reflects our commit-ment to continuous improvement in publishing quality articles that provide aperspective on the research, science, andclinical practice of aesthetic surgery. We arehonored to be a part of Thomson Reuters’annual listings and hopeful that theincreased visibility brought by this designa-tion will help us publish ever-stronger articles for the benefit of our readership.

As always, we invite you to submityour manuscripts to Aesthetic SurgeryJournal, where they will receive a timelyand thorough peer review. Particularly withour newly-approved inclusion in theThomson Reuters databases, you can trustthat any article you publish with ASJ willreach a wide audience of cosmetic surgeonsand practitioners.


Sancheti Hospital in Pune, India, Dr.Weinstein was expecting to find 100 people needing help, but was instead metby a crowd of over 500 people, sufferingfrom a variety of deformities, includingseverely cleft palates, congenital ear deformities, cleft noses, eyelid deformities,ptosis, macrostomias, double lips, andmany scar deformities. He both began andclosed his time there with ceremonies honoring his mentor.

At the time of his very first trip, Dr.Weinstein’s then-young son couldn’t understand why he was not able to travelwith his father. Recently, his son, havingnow graduated film school, traveled withDr. Weinstein to India and was able to follow and film Dr. Dicksheet for manymonths, resulting in the documentary,Flying on One Engine, which celebratesthe life and efforts of Dr. Dicksheet tohelp those in need.

As Dr. Weinstein notes, Dr. Dicksheetwas a “like a father” to him, and he isgrateful for their connection and theimpact it has had on his life. Despite Dr.Dicksheet’s passing, there is comfort inknowing that his work lives on, both inpeople like Dr. Weinstein, who carry onthis legacy of compassion, and in his son’sfilm, which forever captures an extraordi-nary man and his efforts to better the people of India. Together, these allow others to bear witness to Dr. Dicksheet’slegacy, for which we are all grateful.

Dr. Larry Weinstein is an aesthetic surgeon at Weinstein Plastic Surgery Center,located in Chester, New Jersey.

My ChecklistManifesto

With the recent introduction of the secure, web-based forum calledWimed.org, we as Aesthetic Society members are truly witnessing arevolution in information sharing. Compared to the unilateral,inherently “belated” print journals, this endeavor represents a verypowerful harnessing of all that the web is and should become.Where else can we air our surgical challenges and exchange reparative solutions…this close to as it happens? It is for this reason that I am penning these words as a “call to arms” to ourmembership to embrace this very real revolution. As plastic surgeonsthis should come easily: it is in our DNA, after all, to forever strivefor “better”.

I have forged my own journey in this regard by persistently notaccepting the status quo, whether it be my own or our profession’s.That is, in order to get better, one has to be willing to questioneverything; particularly those things that do not go as well as wewould like…such as our surgery.

One path that I have taken has been the inception, constant nurturing and now, proselytizing, of a surgical checklist. Its beginnings were both humble and humbling: 3-M sticky notesplaced on the patient’s chart. They read: “Do not forget to injectMarcaine before closing the wound” (in a submuscular breast augmentation); “Don’t forget to conduct abdominal scar revision”(at time of facelift); “Do not forget to call patient’s husband duringsurgery” (to inform that all is well). I say humbling, because the seminal event which ignited my checklist passion was all too avoidable and potentially fatal (and might I add, forever memorableeven 15 years later!). After a six hour bilateral breast reconstruction,I wearily pulled the drapes off the patient only to find that thesequential pumps had mistakenly not been placed on the patient’slegs! After writing my post op operative orders, a formal checklistbecame my next writing assignment. And from then on the checklisthas continued to grow in clarity and efficiency both in its applicationand efficacy. That is, a day does not pass that both my operatingroom staff and myself comment on the checklist’s power at preventing the “silent” errors of omission. Please pause for amoment and consider both utilizing and contributing to theWimed.org initiative as well as your own Checklist Manifesto!

Dr. Loren Rosenfield is an aesthetic surgeon practicing inBurlingame, CA. and a member of the ASAPS Patient SafetyCommittee

Sharadkumar Dicksheet Continued from Page 20

LOREN ROSENFIELD, MD

FOCUS ON: Patient Safety

The Aesthetic Society’s Board ofDirectors has recently approved the signing of an agreement with New Beautymagazine to become the anchor endorserof a new ExpertInjectorTM program slatedto launch in the spring issue of the magazine and at the Aesthetic Meeting in Vancouver. We feel that this is anexcellent opportunity for ASAPS membersurgeons to position their expertise in theburgeoning injectables through a nationalad campaign.

The program consists of advertisingin New Beauty, a free listing on the publi-cations website for all ASAPS members(you will have the ability to opt out ofthe program if you prefer not to utilize it)and the opportunity to purchase anenhanced listing at additional cost.

The ExpertInjectorTM program isdesigned as a consumer education program,enforcing the training and expertise of“core” specialty injectors as being themost qualified to administer the producesdue to advanced training and extensiveknowledge of facial anatomy.

New Beauty has been consistent inits policies of encouraging consumers toseek the services of board certified plastic surgeons for plastic surgery of the faceand body. Its editorial board includesRobert Singer, MD (Chair); Julius Few,MD; Jason Posner, MD; and RenatoSaltz, MD. The magazine is sold at more than 42,000 newsstands across the country and has a total circulation estimated at 500,000.

confidential online conversation about any sensitive topic for which you prefer confidentiality and freedom from possiblediscovery.

Aesthetic fellowshipendorsement

I would like to introduce you to ournew Endorsed Fellowship Program. Thepurpose of the fellowship is to promulgatethe importance of training in aestheticplastic surgery among younger surgeonsand trainees. We would like to offer youassistance in academically strengtheningyour existing fellowship and in your offering of uniformity in advanced aesthetic surgery training to your postgraduate trainees.

The Aesthetic Society’s FellowshipCurriculum is available through the centraloffice: please contact Debi Toombs,Director of Education at [email protected] obtain a copy. You can also obtain ourChecklist which will provide the necessarysteps for your program to qualify forASAPS endorsement.

We have created a FellowshipOversight Committee which will periodi-cally visit your office and will review logdate and research experiences. There are noprogram directors on the OversightCommittee and we feel that the input theyoffer will be a mutually beneficial relation-ship for you and your staff.

On behalf of your Executive Committee,thank you for being an Aesthetic Societymember. We are working hard to bring you not only the best educationalexperiences available in the specialty but to help you market and grow your practiceas well.

President’s MessageContinued from Page 3


Aesthetic Society EndorsesExpertInjectorTM Program fromNew Beauty Magazine


The Aesthetic Surgery Education andResearch Foundation (ASERF) works diligently to select the best grant applica-tions and research projects to advance thesubspecialty of aesthetic plastic surgery.

With the help of our donors andsome conservative spending and fiscalresponsibility, ASERF has amassed over$1.8 million in cash reserve. However, assurgeons and researchers ourselves, weknow how expensive research is and how

overwhelming the emerging developmentsin our field are to our practice and patients.We have to stay ahead of the curve tomake sure our commitment to science andpatient safety remains paramount.

While every donation is appreciated,it is my proud honor to announce threenew members to the President’s Circle, adistinguished group of individuals who areplanning either a $50,000 cash or

$100,000 or more planned gift to thefoundation.

These members are an example ofhardwork, dedication and understand theneed of supporting the important research.If you have the same desires and wouldlike more information or have alreadymade a provision in your estate, pleasecontact Director of Development, TomPurcell at [email protected] or by calling562-799-2356.

BY V. LEROY YOUNG, MD

UPDATE ON: ASERF

ASAPS Members Make PlannedGifts to Secure the Future of Plastic Surgery Research

Luis Rios, Jr., MD Edinburg, Texas

Dr. Luis Rios, Jr. has pledged a$50,000 cash gift to ASERF for thepreservation of the field of plasticsurgery.

Aesthetic surgery has been veryimportant to the well being of my practiceand family. I have received countless benefits, so a cash gift that can have imme-diate benefits is the least I can do to giveback to my specialty.

As a board-certified plastic surgeonand ASAPS member, patients come to meseeking answers about new technologiesand looking to receive effective treatments.ASAPS has been a reliable resource for meto acquire the knowledge my patients needto help them achieve their goals.

Research is the cornerstone for devel-oping and analyzing these treatments andtechnologies. I am very proud to be part ofan organization that emphasizes evidence-based medicine. Right now, I’m doingresearch on the effect of the SIP (SurgicalInfection Prevention) protocols in my officeand comparing my culture results beforeand after implementing the protocol. Ihope to have the analysis completed forthe Texas Society of Plastic Surgeon’s meeting in the fall of 2012.

Evidence-based medicine distinguishesus from other specialties and it puts thefocus of research on patient safety. It allowsus to distinguish treatments that are drivenby marketing versus those that are reliableand effective. ASAPS and ASERF are true beacons of light in a world wheremarketing seems to be more importantthan the search for truth and knowledge.

The burden for funding of thisresearch is on us. How will our specialtymove forward without the generosity of itsmembership? If one takes a step back andconsiders the question: How did I findmyself as an Aesthetic Surgeon? It wasthrough previous research, funding andhard work from previous generations. Inorder to sustain our specialty, it is incum-bent on the current and future generationsto give back to the specialty.


BY V. LEROY YOUNG, MD

Sepehr Egrari, MDBellevue, WA

Dr. Egrari celebrates ASERF’s role inhis development as an aesthetic plastic surgeon through a $100,000planned gift.

Throughout the years I became keenly aware of ASERF’s commitment toresearch and its vital role in our specialty.Since aesthetic surgery is the primary focusof my practice and what I do, it’s impossi-ble not to have been affected by researchsponsored through ASERF. From the useof antibiotics or effects of lidocaine to theimpregnated mesh for capsular contrac-ture, we have all seen the benefits andresults of independent, science-basedresearch.

ASERF embodies the academic andresearch infusion that our specialty needs.My planned donation is meant to celebratethe role of ASERF in providing that keyelement and its importance to our specialty.Being involved in multiple clinical trials on

body contouring and keeping up-to-dateon research has always been a priority.

A planned gift allows me to be effective and put money aside for researchand plastic surgery education. It’s vital togive back to the Aesthetic community. Ifirst became involved with the MaliniacProgram at PSF and now giving to ASERFcompletes the circle of our great specialty:plastic surgery.

ASAPS Members Make PlannedGifts to Secure the Future of Plastic Surgery Research

James R. Payne, MD andDiane Payne, RNModesto, CA

Dr. and Mrs. Payne made a plannedgift to show their appreciation to thespecialty of plastic surgery with a$250,000.

What began as a review of my estateand desire to see to it that it was managedproactively while I was still healthy, becamea donation that I had always intended tomake to ASERF.

We chose a planned gift because I’mrelatively young and still in practice. Myestate will continue to grow. I am not in aposition to write a check for the full amountnow but am willing to consider early giftingto ASERF when I am older depending onmy financial needs at that time. The methodwe chose gives us maximum flexibilitywithout draining us financially now especially in these uncertain times.

My wife, Diane is an RN and directsour Spirit Laser and Skin Care Medispa.She partnered with me in this effort andhas done most of the research required onour end to establish this gift.

Plastic surgery has provided me with aprofession and life experience that I could

have never imagined as a young manbeginning a new career. I could neverrepay the people and institutions that havesupported me every step of the way. Noamount of money could every equal thelife I have lived because I was able tobecome a plastic surgeon.

There are so many important areas ofplastic surgery research that need furtheror ongoing support to help improve ourspecialty. Between post-incision scar devel-opments, cellulite, stem cell applications,fillers and lasers, there is a wealth of topicsthat require more investigation and research.

I am so proud to be able to live andwork surrounded by so many smart, hardworking, talented, resourceful, caring andethical people who make up the plasticsurgery world. I get up every day and go towork thanking my lucky stars for the privilege of being a plastic surgeon.


SOCIETY OFPLASTIC SURGICAL

SKIN CARE SPECIALISTS

18TH ANNUAL MEETING

Could Your Staff Benefit from Unbiased Plastic Surgical Skin Care Education?

www.spsscs .org

May 1–4, 2012Hyatt Regency Vancouver

Vancouver, BC, Canada

Go for the Gold in VancouverScience, Technology and Skin Care

“My medical skin care practice is a major driver to my surgical practice. I always make sure at least one of our master aestheticians attends the

SPSSCS annual skin care meeting. It’s the best ‘must attend’ event for any practice

in the cosmetic medicine world.”Renato Saltz, MDSalt Lake City, UT


President Joseph M. Gryskiewicz, MDEdina, MN Private PracticeAutomatically Ascends to President

President-Elect(one-year term)

William P. Adams, Jr., MDDallas, TXPrivate Practice Associate Clinical Professor of Plastic Surgery at UT SouthwesternMedical Center, Dallas, TXCurrent ASERF Board Position:Vice President National Affiliations: ASAPS, ASERF,ASPSTraining: Integrated General and PlasticSurgery; 1991-1996 University of TexasSouthwestern Medical Center, Dallas, TX

Vice President(one-year term)

Al Aly, MDOrange, CAClinical Professor, Surgery, School ofMedicineUniversity of California, IrvineCurrent ASERF Board Position:TreasurerNational Affiliations: ASAPS, ACS,ASERF, ASPSTraining: General Surgery: VanderbiltUniversity, Facial Plastic Fellowship:University of California Irvine PlasticSurgery: University of Miami.

Treasurer(two-year term)

Steven Teitelbaum, MDSanta Monica, CAPrivate Practice Assistant Clinical Professor of PlasticSurgery, David Geffen School of Medicineat UCLACurrent ASERF Board Position: DirectorNational Affiliations: ASAPS, ASERF,ASPS, ACS, ISAPSTraining: General Surgery: Harvard/BethIsrael Hospital, Boston, MAPlastic Surgery: University of SouthernCalifornia

Directors(2-year terms)

Scott Barttelbort, MDLa Jolla, CA

Barry DiBernardo, MDMontclair, NJ

Michael Cedars, MDOakland, CA

Bahman Guyuron, MDCleveland, OH

The ASERF Nominating Committee recommends thefollowing slate of candidates to be elected for 2012-2013:

The Premier Industry Partnership Program matches your professional goals

and the strength of the ASAPS organization, with the innovation of our

industry partners. Together, we are advancing the science, art, and safe

practice of aesthetic plastic surgery among qualified plastic surgeons.

Be the first to step out and introduce yourself to our partners.

ASAPS Partners—It is more than just business to us.

Founding Partners: Dermik, Medicis and Sientra

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