What is your philosophy on aesthetic enhancement and its purpose?
People often assume that those people who have aesthetic surgery are doing it to look better towards, or for, other people. However, by far the majority of my patients tell me that they are doing it for themselves. Although they may have good self esteem to begin with, there may be an area that has always bothered them, and when they have this area improved, they often tell me how something so small made them feel so much more self confident about who they are and how they look.

What would you say to a woman who is worried she is being too vain?
Vanity is all relative. This is a surgery about self esteem and self confidence. This should be happy surgery. If there is some area that you can improve with cosmetic surgery that will make you happy, then go for it.

How do you handle a patient who may be self-conscious about meeting with you?
Occasionally I have a patient who is very nervous about the examination. We might be looking at a body area that bothers them that they have never let anyone else see for years, sometimes not even their spouse, and that can be very intimidating. When I sense that a patient is self-conscious or nervous, I tell them that it is my job to make them feel very comfortable by the end of the consultation. In fact, I have made a bet to many many patients that if they don't feel completely comfortable by the time we are done, I will give them $5. I have not lost a bet yet.

How has the plastic surgery industry changed. and how do you stay on the cutting edge?
The two biggest changes is the explosion of non-surgical treatments for aging such as Botox, Restalyne, Juvederm and laser skin tightening. The other change over the past decade is the influx of doctors trained in other specialties such as Otolaryngology, Dermatology, Opthamology, Gynecology and even internal medicine that are performing procedures traditionally performed by Plastic and Reconstructive Surgeons. It is difficult for the public to understand that a 'cosmetic' surgeon is very different from a 'plastic surgeon', but it can be extremely important to know that difference when choosing someone to operate on themselves.

How do you stay on the cutting edge?
To stay on the cutting edge means daily, yearly, and lifelong learning and self critique. I am always evaluating my results to find ways to improve even if a patient thinks their surgery turned out wonderful. The cutting edge, however, does not mean performing the latest technique reported in the media. My staff knows to tell those calling in about a surgery they read about in Vogue that I do not readily adopt a technique until the safety and efficacy has been proven. Being the first, and being the best are two different things.