October 14th, 2010
First and foremost, it’s nice to see that most of what the “experts” are teaching isn’t much different than what I am already doing in my practice. There were two rhinoplasty seminars with excellent talks by Drs. Bahman Guyron, Dean Toriumi, Ira Papel, Pietro Palma, Jack Gunter, Norman Pastorek and Peter Adamson to name a few. A few of the take-home messages that I got were tips on reducing pain for the patient in rib cartilage harvesting and techniques for straightening out a crooked nose, which is the most difficult skill for perfecting a rhinoplasty.
Facial fillers have always been a hot topic at recent meetings and still were in Boston. Of course, everyone has their favorite fillers. The fillers change with the volume and applications. For smaller volumes, hyaluronic acid fillers such as Juvederm and Restylane still rule. For fine lines, Prevelle Silk. As we get to larger volumes, Radisse takes over and for the most volume and longest lasting results, Sculptra is likely best. Dr. Rebecca Fitzgerald gave a 1 hour breakfast seminar on Sculptra that actually lasted for two hours. Sculptra is now injected deeper under the facial tissues, just on top of the bones in most areas of the face.
What new products did I discover? Finally PDS foil is FDA approved for use. This has been used very successfully for years in Europe for nasal support in very crooked deviated septum repairs, revision rhinoplasty and other areas of the nose as well. I was invited to attend a special meeting in St. Louis in early November to learn the nuances of this new product. I was fortunate to have received a sample, which I used to help repair a much deviated septum. This particular patient had two prior attempts at correction, but the nose was still very crooked. I will discuss this procedure next week.
As much as I have learned in my past 22 years of medical practice and teaching Facial Plastic Surgery, it’s still important to keep on learning and modifying my patient care techniques.
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October 4th, 2010
It’s been a few weeks since my last post. I have been quite busy, academically. I was lecturing in a course on Rhinoplasty in mid-September in St. Louis. The following week was the AAFPRS annual meeting followed by lecturing last week at the ENT (Ear Nose and Throat) annual meeting.
The week before last was the annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Over 800 facial plastic surgeons from around the world were in attendance. I really enjoy going to this meeting for three reasons:
- From attending and lecturing at 4 to 6 meetings and courses per year, I have made some great friends given our mutual interests and backgrounds.
- I get to lecture to peers and young physicians on surgical techniques that I have mastered such as rhinoplasty and revision rhinoplasty.
- I learn from my peers. If I pick up at least two pointers at a meeting, I deem it a success. The most learning is done in the hallways between lectures, when I can get the real scoop on the latest techniques and lasers right from the innovators.
As for social events, the past president’s dinner is always at a top restaurant. This is one group that no one can join, buy in or donate to attend. As a past president of the AAFPRS we are invited to a black tie dinner where we socialize and really discuss very little medicine. The next night was another black tie function, the founders club. This is always held at an unusual venue. This year it was in Fenway Park, a fun place to visit as a long time Yankee fan.
I gave three lectures and seminars. I taught a course in revision rhinoplasty. I pointed out the most common things I see that brings patients in to see me for revision surgery and discussed what likely went wrong. The best treatment is doing things right in the first place and avoiding the need for revision surgery. I also included a description of how I restored these noses to a normal appearance and function.
My second lecture was given with Wendy Lewis, who is a world authority on plastic surgery. She lectures to physicians around the world, advises potential patients about what and who is best for them to see. Wendy has written 11 books on cosmetic surgery. This seminar was on how to talk to patients and media in “non-medical” speak. Too many doctors address patients and writers/reporters in technical terms that leave heads spinning.
My third lecture was at the ENT (otolaryngology) meeting the following week. I went back to Boston for the day to teach a course on the nasal valve with Dr. Maurice Khosh. We discussed this important area of nasal anatomy and physiology, and how it is important to respect as well as sometimes strengthen the nasal valves in rhinoplasty.
Next week I will review what new educational pearls I picked up that I am going to use to improve my surgical techniques.
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