enhance skincare

32 elevate | july+august .12 elevatemagazine.com elevatemagazine.com july+august .12 | elevate 33

ph

ot

o:

th

ink

st

oc

k

e.ja12.enhance_Just the facts.3-0.indd 32 12-06-18 3:17 PM

32 elevate | july+august .12 elevatemagazine.com elevatemagazine.com july+august .12 | elevate 33

WHAT YOU NEED TO KNOW WHEN YOU’RE CONSIDERING A COSMETIC TREATMENT OR PROCEDURE. BY BONNIE STARING

FACTSJUST THE

Whether you’re opting for a procedure for the fi rst time or exploring a revision surgery, there are a number

of factors you need to consider to determine which professional, which location and, most importantly, which treatment approach is ideal for your needs. We’ve enlisted the help of fi ve cosmetic enhancement professionals to guide you through the essentials.

DETERMINE YOUR GOAL Establishing your esthetic goal will make your search for the ideal professional, procedure and treatment location easier. Surgeons, physicians and other professionals have di� erent specialties and expertise, so knowing what type of results you’re looking for—permanent or temporary, a reduction or an enlargement, etc.—will help guide you through the many options patients have available. Your goal will also guide you when evaluating research and referrals. “Your friend may have had a terrifi c

breast augmentation from Dr. Jones, but if you are looking to have a facelift, that doctor may not be very good at face procedures,” advises Dr. Peter A. Adamson, MD, FRCSC, FACS, an otolaryngologist-head and neck surgeon, practising in facial plastic surgery in Toronto and author of Fabulous Faces: From Motivation to Transformation through Facial Plastic Surgery. “You want to fi nd someone who is recognized as having a lot of experience in what you want to transform.”

GET SPECIFIC“For example, if you’re considering rhinoplasty, you should spend some time looking at your nose and specifi cally determining what changes you want,” explains Dr. Robert Mounsey, FRCSC, FACS, an Otolaryngologist-Head and Neck Surgeon practicing in facial plastic surgery in Toronto. The more specifi c you can be, the better. Instead of determining a somewhat-vague goal, such as wanting a nose to look smaller, Dr. Mounsey recommends prospective patients use photos and identify certain characteristics they’d

like to change. In the case of the smaller-looking nose, some patients may want a bump on the bridge reduced, while others may want the length of the nose to be shorter. “It’s important for patients to be able to articulate exactly what it is that they would like to achieve,” adds Dr. Mounsey. “Once they do that, then we can then tell them if this is possible, or how we can achieve this goal.” Having a surgical procedure is more complicated than asking for the hairstyle of a certain celebrity, which is why you need to invest the time in determining your goals and consulting with professionals.

FAST FACTThe more specifi c your goal, the easier it is for a professional to determine how to achieve it.

“IT’S IMPORTANT FOR PATIENTS TO BE ABLE TO ARTICULATE EXACTLY WHAT

IT IS THAT THEY WOULD LIKE TO ACHIEVE. ONCE THEY DO THAT, THEN WE CAN

TELL THEM IF THIS IS POSSIBLE, OR HOW WE CAN ACHIEVE THIS GOAL.”-DR. ROBERT MOUNSEY, FRCSC, FACS, AN OTOLARYNGOLOGIST-HEAD AND NECK SURGEON

e.ja12.enhance_Just the facts.3-0.indd 33 12-06-19 4:10 PM

AS SEEN IN

ENHANCE SKIN CARE

34 elevate | july+august .12 elevatemagazine.com

FINDING A PROFESSIONAL

Surgeons and physicians and estheticians, oh my! We’re fortunate to have a wealth of cosmetic enhancement professionals from which to choose. And having such a wide range of choice may mean you could spend more time fi nding the ideal professional than receiving the actual procedure or treatment. Here’s what to look for and what to expect when exploring your options.

DR. ADAMSON, FRCSC, FACS, an otolaryngologist-head and neck surgeon, practising in facial plastic surgery

FURTHER CREDENTIALS

MEDICALDESIGNATION

PRIMARY SPECIALTY

SPECIAL INTEREST

LET’S USE DR. ADAMSON’S CREDENTIALS AS AN EXAMPLE:

CREDENTIALS 101Doctors’ credentials need to be stated in a particular way to designate his or her educational background, training, primary specialty and area of special interest. “Right o� the top, the patient should look and see how a doctor describes him or herself,” says Dr. Adamson. “This disclosure of specialty and area of practice information is required of all medical practitioners to ensure that the public is specifi cally aware of their specialty qualifi cations.” In the case of plastic surgeons, this information distinguishes surgeons whose practices involve the entire body, rather than those who focus exclusively on the head and neck.

MEDICAL DESIGNATIONThese abbreviations refer to the education and training a doctor has received as well as their overall area of expertise. Here are the most common ones, what they mean and an example of the type of professional that has earned this designation. FRCSC, FRCPC, BOARD CERTIFIEDThe Royal College of Physicians and Surgeons of Canada oversees the certifi cation of medical specialists. “To be certifi ed in plastic surgery, doctors must successfully complete a fi ve-year Royal College residency program after receiving their medical degree,” explains Dr. Robert Sleightholm, MD, FRCSC, a plastic surgeon practising in cosmetic surgery in Brampton, Ont. “The doctor must have the exact FRCSC designation to be certifi ed as a surgeon.” The FRCPC designation indicates a physician with a medical specialty. The United States, unlike Canada, does not have an all-encompassing board that certifi es all physicians and surgeons. There are a number of American boards, including the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Medical Specialists.

FACSFACS stands for Fellow, American College of Surgeons. This designation

MD MEDICAL DEGREE

8 years of training, on averageEXAMPLE:

a family doctor

OR FRCSCFELLOW OF THE

ROYAL COLLEGE OF SURGEONS OF CANADA

5 to 6 years of training, on average

EXAMPLE: a plastic surgeon, a facial plastic

surgeon

FRCPCFELLOW OF THE ROYAL COLLEGE OF PHYSICIANS

OF CANADA5 to 6 years of training,

on averageEXAMPLE:

a dermatologist

+ +

is awarded to surgeons who have their respective board’s certifi cation, completed two years of practice and provided a list of at least 100 completed cases, along with letters of reference from individuals of stature in the applying surgeon’s community.

SPECIALTY AND INTEREST“Not all plastic surgeons do cosmetic surgery,” says Dr. Adamson. “Some may focus on burn surgery, such as performing skin grafts, or reconstructive surgery, such as reconstructing a breast after a mastectomy.” The Royal College stipulates that surgeons and doctors clearly state their primary specialty and specifi c interest to help prospective patients better understand a doctor’s training and expertise. For example, a dermatologist may be practising in laser treatments, or a family doctor may be practising in cosmetic medicine.

“RIGHT OFF THE

TOP, THE PATIENT

SHOULD LOOK AND

SEE HOW A DOCTOR

DESCRIBES HIM OR

HERSELF. ”-DR. PETER A. ADAMSON, FRCSC, FACS, AN OTOLARYNGOLOGIST-HEAD AND NECK SURGEON

FAST FACTNot all plastic surgeons do cosmetic surgery.

PH

OT

O:

TH

INK

ST

OC

K

e.ja12.enhance_Just the facts.3-0.indd 34 12-06-19 2:12 PM

elevatemagazine.com july+august .12 | elevate 35

THE CONSULTATION

“The consultation allows both the patient and the surgeon to align their goals with realistic expectations,” explains Dr. Mounsey. “It starts and defi nes the entire relationship.” The professionals interviewed agree that the more prepared a patient is, the more time both parties have to evaluate various procedures and discuss areas of concern. “Review procedures online beforehand,” advises Dr. Sleightholm. “Knowledge of the procedure is benefi cial for discussion during the consultation.”

WHAT TO EXPECT“Some people are surprised that the appointments can be quite detailed, depending on want they want,” says Dr. Mounsey. A consultation can take anywhere from 15 minutes to an hour. The consultation is your opportunity to get to know the surgeon and decide if he or she is a person you want to work with. “The doctor may be a good surgeon, but you may not gel with him or her on a personal level,” explains Dr. Sean Rice, MD, M.Sc., FRCSC, a plastic surgeon practising in cosmetic surgery in Toronto. Dr. Adamson agrees: “Patients need to have that sense that the doctor really is caring about them, and making their life better.” In some cases, a surgeon may refer you to another professional more suited to performing the procedure you desire. It all depends on the case, the aesthetic goal and the expertise of the surgeon. “And you should never feel pressured to have an operation,” says Dr. Adamson. Professionals expect that you will need some time to decide before booking a surgical procedure.

THE CONSULTATION“The consultation allows both

to align their goals with realistic

Dr. Mounsey. “It starts and defi nes the entire relationship.” The professionals interviewed agree that the more prepared a patient is, the more time both parties

procedures and discuss areas of concern. “Review procedures online beforehand,” advises Dr. Sleightholm. “Knowledge of

THE CONSULTATION APPOINTMENT WITH A SURGEON SHOULD COVER✓ Introduction and confi rmation of the surgeon’s credentials✓ Your detailed medical history✓ A detailed physical examination✓ Recommendation of procedure(s) and alternatives✓ Discussion of expectations and what can realistically be done✓ Disclosure of complications✓ The cost of the procedure(s)✓ Available dates.

FAST FACTThe consultation is an integral step in evaluating a professional.

OTHER PROFESSIONALSNo matter what type of procedure or treatment you plan to have, check the credentials of the professional who will be treating you and the amount of experience he or she has. “Certifi cation would imply training in the procedure but not necessarily the level of competency,” explains Dr. Sleightholm. “In general, the longer time the person has been doing the procedure, the more patients treated, the better the result.”

MD, DERMATOLOGIST OR SURGEON?Deciding upon going to a doctor, a dermatologist or a surgeon depends on the treatment or procedure you’re looking to have done. Medical doctors, who have 11 years of medical training, may o� er non-invasive cosmetic treatments such as fi llers, Botox and light chemical peels, but they do not have the training necessary to perform surgical procedures. “If you have a skin condition, a skin disease, a rash, acne, rosacea, a mole or anything else a� ecting the skin, hair and nails, a dermatologist is the expert in all these things,” explains Dr. Benjamin Barankin, MD, FRCPC, FAAC, a dermatologist specializing in medical, surgical and cosmetic care of the skin in Toronto. Board-certifi ed dermatologists receive the most formal training in laser technology, fi llers, Botox and other skin treatments in comparison to other physicians. “Many dermatologists perform skin surgery and have training in plastic surgery, so a dermatologist is a great starting point for treating any lesion or skin condition,” adds Dr. Barankin. “And a dermatologist can refer a patient to a plastic surgeon where appropriate.”

“THE DOCTOR MAY BE A GOOD SURGEON,

BUT YOU MAY NOT GEL WITH HIM OR HER ON

A PERSONAL LEVEL. ”-DR. SEAN RICE, MD, M.SC., FRCSC

CONSULTATION FEES “Consultation fees are at the discretion of the physician,” explains Dr. Sleightholm. “With most consult fees, if the surgery is booked, the fee goes toward the cost of the surgery.” Fees for consultations usually start at $50 to $75 and can range higher, depending on what’s involved.

DETERMINING THE IDEAL PROCEDURE During the consultation process, most patients discover that there may be more than one procedure or treatment that can be used to achieve an esthetic goal. Both surgical and non-invasive options can be employed to reduce the appearance of aging, increase volume and rejuvenate skin. “It’s not uncommon to have patients thinking they want ‘X’, and leaving realizing they need ‘Y,’” says Dr. Rice. “A surgeon’s objective is to help you reach those goals and expectations, realistically.”

e.ja12.enhance_Just the facts.3-0.indd 35 12-06-19 3:57 PM

elevatemagazine.com july+august .12 | elevate 37

or delegating the treatments. Speak to the medical director on site to verify the credentials and training of those supervising and performing the procedure. “If there’s no medical or clinic director or manager, that’s not a good sign,” advises Dr. Rice. “Professionals at reputable locations, whether in a doctor’s o� ce, a clinic or a medspa, are able to determine an appropriate treatment and handle an emergency if necessary.” You may also want to research the type of equipment and/or product being used for the treatment. “Non-surgical treatments have risks too,” explains Dr. Rice. “You want to make sure the person who’s giving you the treatment asks you about allergic reactions, skin sensitivity, if you burn easily, etc., to ensure the treatment strength is appropriate.” As mentioned before, an incorrect use of a laser or too strong a peel may result in serious skin damage. “Ensure the doctor is available while the procedure is being done and is on hand in case complications occur,” adds Dr. Sleightholm.

BEFORE AND AFTER Even after doing your homework and evaluating your options, there are additional items to consider, once you’ve decided to proceed with a treatment or procedure.

EXPECTATIONSDuring the consultation process, the professional you are meeting with will be paying close attention to what your expectations of a procedure are. “What a patient wants changed may only be noticeable to them, like a small depression on the nose no one else can see,” explains Dr. Mounsey. “If they say they’re spending four hours a day looking at this ‘problem’ that no one else—like friends or family—views as a problem, and they’re skipping social activities because of it, that’s a red fl ag that indicates there may be other things going on. And surgery might not be appropriate for them.”

FAST FACTBeing nervous and apprehensive before a procedure is normal.

Although patients should expect that a treatment or procedure will improve their appearance, some patients may have unreasonable expectations of the impact of a procedure’s results. “There are two aspects to any cosmetic procedure,” says Dr. Mounsey. “One is the actual physical surgery. But cosmetic surgery is unique because you’re using surgical techniques to obtain a psychological goal.” Professionals must constantly negotiate this careful balance, from the initial consult through to post-procedure care.

DOUBTS“Being nervous and apprehensive before a procedure is incredibly normal,” says Dr. Rice. If you are feeling uncertain, speak with the professional and explain your concerns. If necessary, book a consultation with another surgeon. “A second opinion in agreement with the fi rst could verify that the right procedure has been selected,” advises Dr. Sleightholm.

REVISION PROCEDURESEven when due care is taken to minimize risks, in some cases optimal results are not achieved with the fi rst procedure. “Discuss the unsatisfactory result with the professional who performed the procedure,” advises Dr. Sleightholm. “Ask if they’ve seen this complication before and, if so, what is the recommended treatment.” Sometimes a patient needs more time to heal before the results can be properly evaluated. Other times an adjustment or revision may be necessary—especially with complex procedures such as rhinoplasty. Still unsatisfi ed? “Patients can call the

“ENSURE THAT THE LOCATION HAS A

SKIN EXPERT LIKE A DERMATOLOBIST ON

SITE, OR A PLASTIC SURGEON IF YOU ARE

SEEKING A SURGICAL PROCEDURE.”-DR. BENJAMIN BARANKIN, MD, M.SC., FRCSC

“DISCUSS THE UNSATISFACTORY RESULT

WITH THE PROFESSIONAL WHO PERFORMED

THE PROCEDURE, ASK IF THEY’VE SEEN THIS

COMPLICATION BEFORE, AND IF SO, WHAT IS THE

RECOMMENDED TREATMENT.”-DR. ROBERT SLEIGHTHOLM, MD, M.SC., FRCSC

College of Physicians and Surgeons of Canada and register a complaint,” explains Dr. Sleightholm. “The physician is obligated to respond and, through the college, resolve the complaint.” Taking the time to determine your esthetic goal at the outset is paramount. Dr. Mounsey explains why: “The fi rst procedure is always your best chance to get your best result. Any cosmetic procedure is ruled by a law of diminishing returns. The more times you have a revision, the less likely it is to improve things and get the results that you want.” After all the basics have been revealed, one thing is clear—having all the facts before making a decision on a treatment or procedure is essential.

e.ja12.enhance_Just the facts.3-0.indd 37 12-06-18 3:17 PM

ENHANCE SKINCARE

36 elevate | july+august .12 elevatemagazine.com

COVERING COSTS You can avoid delaying surgery due to cost concerns by using

a fi nancial company such as Medicard (medicard.com) to provide fi nancing for a portion of or the

complete cost of a cosmetic surgical procedure. Medicard provides fi nancing to patients through

a network of more than 6,000 a� liated doctors across Canada. By opting for Medicard fi nancing,

patients can take advantage of low monthly rates, choose the terms that work best for their needs and

pay o� their balance ahead of schedule without penalty.

OHIP, in essence, covers any procedure that’s reconstructive in nature, such as a condition that’s

congenital in nature (you’re born with it), a post-trauma injury (within two years of the accident), a

breast reduction procedure or a post-cancer reconstruction. However, OHIP will not cover procedures

that are purely cosmetic, esthetic or elective. Check with your doctor about your specifi c situation.

VISUALIZING POTENTIAL RESULTSShowing before and after photos has been a standard practice to help patients visualize results, but now more and more surgeons are taking advantage of technology to create customized images of a patient’s potential results. The Vectra 3-D System, which Dr. Rice uses as part of the consultation, takes a simultaneous photo of a patient from six di� erent cameras and combines them to create a 3-D image. The image can then be manipulated to demonstrate the results of one or multiple procedures,

or a change in angle or volume—on the face or body. “You get a very close representation of what you would look like rather than what you think you would look like,” says Dr. Rice. “If you have an image in your head of what the ideal nose or the ideal breasts are, usually you’re picturing that on someone else. The Vectra System takes that other person out of the equation altogether.”

LOCATION, LOCATION, LOCATION

Patients not only have a wide selection of professionals to choose from, but they also have a choice of treatment locations. Many doctors now have medical facilities on site, and clinics, hospitals and med spas may all o� er similar treatments—fi llers, other injectables, laser treatments, peels, etc.—which can make determining the ideal location harder than ever before. “Ensure that the location has a skin expert like a dermatologist on site, or a plastic surgeon, if you are seeking a surgical procedure,” advises Dr. Barankin. Recent news stories have documented cases of patient injury and, in one case, death due to practitioners being ill-equipped to properly administer procedures. “Laser treatments, unfortunately, is an unregulated area of medicine, but that will soon change,” he says. “With non-surgical procedures, the choice of where to go may not be as obvious,” says Dr. Sleightholm. No matter what the location, the decision should

NOTE: There’s no additional charge for Vectra 3-D System; it’s included in the consultation fee

FAST FACTNon-surgical treatments have risks too.

PH

OT

O:

TH

INK

ST

OC

K

e.ja12.enhance_Just the facts.3-0.indd 36 12-06-19 2:14 PM