Today Dr. Sadati will be joining us to discuss Virtual Plastic Surgery and its impact on the industry and prospective patients. Dr. Kevin Sadati is a Board Certified Plastic Surgeon based out of Orange County, California and specializes in facial plastic reconstructive and cosmetic surgery as well as head and neck surgery. Dr. Sadati is an active member of the American Academy of Cosmetic Surgery and the American Association of Facial Plastic and Reconstructive Surgery.
ALEX: Dr. Sadati, thanks for joining me today Dr. Sadati to discuss Virtual Plastic Surgery.
DR. SADATI: My pleasure.
ALEX: Dr. Sadati, some people think that people who opt for cosmetic surgery are simply vain. Can you dispel that notion?
DR. SADATI: I disagree with that. The majority of the people that I deal with are people who are in work force or they are retired, yet with great amount of energy inside. They think that their face and neck look much older than how they feel inside, and this mismatch is what I believe drags them down. That is what they tell me. Their outside doesn’t match the way they feel inside.
By doing certain types of medical procedures, like a minimally invasive neck lift, they can feel more confident. Many of them just started dating, looking for a new job – it’s not just appearance (they are concerned with). Mentally, it helps them enormously to overcome some of the issues that they may have with themselves. I think that is what I see mostly in my patients.
ALEX: Doctor, as a facial plastic surgeon, what is your outlook on the industry – are you seeing any exciting advances or developments on the horizon?
DR. SADATI: Of course there are newer techniques and newer lasers and minimally invasive procedures that are on the rise. More and more in my practice, and many other practices as well we are getting away from the old methods of invasive procedures.
Continuous advancements in technology enable us to obtain excellent and long lasting results with less invasive surgeries. Since people who work cannot afford to have several weeks to recover from surgery, less invasive techniques combined with new technologies enhance recovery therefore, reduce the down time. For example, applying platelet rich plasma (known as PRP) to the surgical field will enhance (the speed of) the healing process, leading to less down time. PRP is rich in a variety of valuable natural growth factors such as PDGF (Platelet Derived Growth Factor), and TGF-β1 (Transforming Growth Factor β1). These Growth factors are known to be important in initiation and progression of wound healing.
At the time of procedure, a small amount of blood is drawn, and centrifuged to isolate the PRP from the blood. When ready, the surgeon will spray the PRP directly to the surgical field. This technique provides a very concentrated group of natural growths factors to accelerate the complex healing processes.
ALEX: Dr. Sadati, will you give us an example of a minimally invasive procedure that brings great results?
DR. SADATI: Facial dermal fillers such as Restylane® and Radiesse® are popular treatments for wrinkles and very effective treatment to enhance sunken cheeks, narrow lips, and even contouring the bridge of the nose know as non-surgical rhinoplasty. However they are not permanent solution and required repeated treatment and over time the cost can add up.
Fat grafting with PRP can be used as a permanent filler. This process allows the doctor to transfer some of the patients own fat tissue from other areas of their bodies where it is not wanted to replace the layer of support needed on their faces. In essence, you are simply replacing the missing fat tissue that was present when you were younger with other fat tissue from your own body. This is a very natural and successful approach for treating these cosmetic problems that can deliver amazing results.
Fat grafting with PRP also requires far less surgery with quicker recovery time and it is performed without the need of general anesthesia. I published a research paper regarding the effectiveness of fat grafting with PRP in the Journal of American Academy of Cosmetic Surgery. This research paper received the best scholarly manuscript research paper award in 2006 at the American Academy of Cosmetic Scientific meeting.
ALEX: There’s a buzzword going around right now doctor – Virtual Plastic Surgery. Would you explain to us exactly what that is?
DR. SADATI: Sure. Virtual Plastic Surgery takes place inside a software that can be downloaded as an app from an app store or even used as a web based application. Virtual Plastic Surgery enables patients to get a better idea of what surgical results to expect if they make the decision to go through with an actual operation.
For instance, if someone is interested in rhinoplasty – perhaps they have a small hump or deformity on their nose or maybe they have a small chin they don’t like – they can take a picture of their own profile and modify it with the Virtual Plastic Surgery software. This serves a few purposes. The patients can get a visual of the possible results of a particular procedure. It also enables them to better manage their own expectations with any procedure that they choose to undertake.
Patients are able to play around a bit with their own nose and know what types of results are possible. They can take the virtual image to the expert – in this case the plastic surgeon – and he/she can advise if the procedure is surgically feasible and whether or not it would be a good fit for their particular face.
If the patient goes live with me in a session of Virtual Plastic Surgery where we can both be involved at the same time, I can do the modifications for the patient. If we are doing a session of Virtual Plastic Surgery on the nose, I can show them exactly what will be the best fit for their face.
Virtual Plastic Surgery is a communication tool – it’s a way of creating a realistic expectation for the patients that can help them understand what is possible and educates them as well.
ALEX: Doctor, which patients do you feel would benefit the most from Virtual Plastic Surgery?
DR. SADATI: People who tend to get the most benefit and most enjoyment out of Virtual Plastic Surgery are the ones with realistic expectations.
ALEX: Once one of your patients decides to make the leap from the ‘virtual’ world of plastic surgery to an actual procedure, what are a few things for them to keep in mind? Can they really expect the same type of results that they are seeing with the software?
DR. SADATI: Well, Virtual Plastic Surgery is a tool for me to see what is in my patients’ minds. Based on the modification of patients’ own facial images and limitation of surgical procedures, surgeons are able to communicate the degree of improvements, as well as what is NOT possible. All of that is determined during our consultation and conversations. In that way, I can maintain a clear line of communication with my patients. I can tell them what is do-able and what isn’t do-able.
If we can come to terms and they agree with what my assessment and plans are we can move forward. If they are NOT in agreement, then I have avoided disappointing them an unexpected result and we can simply move on.
ALEX: Doctor, you bring up an interesting point. What about the people that walk into your office with extremely high expectations – expectations that simply can’t be met? Out of the individuals that meet with you and go through the entire process and consult with you, what would you say is the approximate percentage of people that decide NOT to go through with the procedures they had in mind once they have been fully informed and educated?
DR. SADATI: I would say about 10% of the people that I meet with – their expectations are unrealistic. I conduct a thorough 1 hour consultation. When I sit down with a patient I ask them: “What do you see yourself looking like after surgery? What are your expectations? What do you think this procedure is going to make you look like?”. If they say that they just want to look like themselves, but better, well that is a realistic expectation. If they bring in a folder (to the consultation) with pictures of 20 different models and they show you that, obviously you know that there is something wrong. The facial features of each individual are different and if they are trying to make a collage in their mind of 20 different supermodels, that is most likely an unrealistic expectation.
ALEX: Doctor, can patients expect permanent results from facelifts?
DR. SADATI: As I tell patients, nothing is ‘permanent’. The only thing a facelift does – the very best facelift in the world – is to take away the laxity of skin and muscle. It makes the face appear 10-15 years younger. After the surgery is complete, that patient will continue to aging again. In 5-10 years there is going to be some looseness again, but 10 years following that their appearance is going to be much better than if they didn’t have the procedure in the first place. Aging is a gradual process. Basically, a facelift turns back the clock10-15 years but does not stop it. After the procedure, the clock will start ticking again and the face will start the natural aging process.
ALEX: Would you suggest that patients of yours come back in 10 years or so for another ‘touch-up’?
DR. SADATI: Actually, it’s up to the individual. I don’t normally make this type of recommendation. This is how the conversation goes with my patients. I say “Listen. This is what I’m going to do for you now, if you like it and continue to be pleased with the results, you don’t need to do anything else. But in 7 or so years from now if you realize that you want to have the same firmness that you did after your first completed procedure, a touch-up can do exactly that.”
Please realize that there are some 70 year olds that still play golf, they run their own business, they are energetic – they want to look good too. For those people that want to look better, and stay firm and nice looking, why not? On the other hand, some people may say “You know what? I’m OK with what I look like and who I am.” For those individuals, I would most definitely NOT recommend another procedure.
ALEX: Very good doctor. To wrap this up, what are a few of the most important considerations that someone must take into account before choosing a plastic surgeon to work with?
DR. SADATI: First and foremost, I would say experience and results are absolutely the most important. The prospective patient needs to find out not only whether or not a doctor is Board Certified, that is a given, but what is the focus of their practice?
Beyond that, there are also some additional qualifications of a doctor that a patient will need to research for themselves. For instance, review a doctor’s before and after pictures. If they have 200 before and after photos of facelifts, you know that surgeon has done a lot of them. If, on the other hand, a doctor has just one in his archives, he obviously doesn’t have very much experience.
Go talk with the doctor, go see the staff. If possible see how the staff interacts with the doctor and with patients – if they are making them feel comfortable with everything. It’s like an investment they are making in their own body – this should never be taken lightly.
Patients should also take into consideration sub-specialties of a particular doctor. If someone is going in for rhinoplasty surgery, make sure that is one of the doctors major focuses so that they can get the absolute best results possible. A doctor who is experienced knows the ins and outs of every procedure so they can better inform the patient and create a realistic expectation, so at the end patient is happy with the outcome.
Dr. Kevin Sadati is a member of the American Academy of Facial Plastic & Reconstructive Surgery, the American Osteopathic Association and the American Academy of Osteopathic Otolaryngology/HNS/ Facial Plastic Surgery. Dr. Sadati operates a practice in Orange County, California focusing on facial plastic reconstructive and cosmetic surgery as well as head and neck surgery.