Plastic Surgery News, January/February 2025

January/February 2025

HARNESSING THE SPARK OF INSPIRATION

A closer look at some of the companies – and plastic surgeons – furthering innovation in the specialty through Society support.

Page 19

Face transplant restores life, hope for Michigan man Page 7

Remembering ASPS past President Norman Hugo, MD Page 9

PlastyPAC’s wins in 2024 elections Page 12

PERIODICAL POSTAGE PAID AT ARLINGTON HEIGHTS IL AND ADDITIONAL MAILING OFFICES Plastic Surgery News ISSN 1043-4119

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References: 1. Data on file, Allergan Aesthetics, March 2024; Aesthetic Monthly Tracker. 2. Gabriel A, Maxwell GP, Griffin L, Champaneria MC, Parekh M, Macarios D. A comparison of two fat grafting methods on operating room efficiency and costs. Aesthet Surg J. 2017;37(2):161-168. 3. Ansorge H, Garza JR, McCormack MC, et al. Autologous fat processing via the Revolve system: quality and quantity of fat retention evaluated in an animal model. Aesthet Surg J. 2014;34(3):438-447. 4. Data on file, Allergan Aesthetics, June 2022; Fat Grafting Final Report.

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January/February 2025

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ways to ease the awkward money talk

Financial conversations don’t have to be difficult.

Here are practical ways to smooth them out.

We know talking about cost is one of the toughest parts of cosmetic care— these conversations can feel uncomfortable or even intimidating. Check out these strategies for discussing flexible financing, which can help smooth communication and ease stress for all parties.

Tip 1

Tip 3

Before the Consultation Let patients know flexible financing is available when they call to schedule their consultation.

Addressing Concerns About Cost & Financing Remind patients that the CareCredit credit card can be used for copays, deductibles and out-of-pocket costs for surgery, as well as prescriptions, skincare products, and minimally invasive treatments.

Patient:

Patient:

“How much do you charge for breast augmentation?”

“I really want this procedure, but I just don’t have room in my budget right now.”

Practice: “Our cost ranges from $XXXX to $XXXX and varies based on your specific needs. We do accept the CareCredit health, wellness and beauty credit card to help you pay over time. You can ask questions and get an estimate for your procedure during one of our complimentary consultations. Would you like to schedule that today?”

Practice: “We want to help you look and feel your best, which is why we accept CareCredit. It’s a health, wellness and beauty credit card that can help you fit the procedures you want or need into your budget.”

Patient: “I already have a credit card. How is this different?”

Tip 2

Practice:

During the Consultation In addition to total cost, give patients an estimate of what their monthly payment could be with the CareCredit credit card. You can use the online payment calculator or patient financing brochure to show estimated monthly payments and disclosures to the patient.

Practice: “I’m glad you’re happy with the surgeon’s recommendation. You’re going to love the way you look and feel! The total cost for your procedure is $XXXX. With the CareCredit health, wellness and beauty credit card, your estimated monthly payment could be $XXX. Would you like to learn more about this option?”

“With the CareCredit credit card, promotional financing is available on purchases of $200 or more. If you’re approved, you can use it again and again to pay over time for additional cosmetic procedures at our office. Would you like to learn more about CareCredit or see if you prequalify?”

Tip 4 Handling Patients Not Yet Ready to Schedule If the patient says they need to think about the procedure, be empathetic and have a strong follow-up plan.

Patient: “I need time to think it over.”

The online payment calculator and patient financing brochure are available at carecreditprovidercenter.com.

Practice: “We understand this is a big investment. Here’s a printout of the surgeon’s full recommendation. If cost is a concern, we have a link to the CareCredit credit card application on our site so you can apply from home. Would you mind if we followed up in a few days to address any additional questions?”

Highlight Budget-Friendly Financing Make sure patients know CareCredit offers a way to help pay for the care they want or need. Display a window cling at your front door, stock brochures at the front desk, and place counter displays in waiting areas to highlight the CareCredit health, wellness and beauty credit card. Display your custom QR code in your office reception area and add your custom link to your website so patients can see if they prequalify and apply easily from their mobile device.

To order promotional items for your practice, log in at carecreditprovidercenter.com. Don’t have a custom link yet? Get one at carecredit.com/mycustomlink. Not yet enrolled? Start accepting CareCredit at carecredit.com/psn or call 855-860-9001.

PSN2025CA © 2025 Synchrony Bank

January/February 2025

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IN THIS ISSUE FEATURES

Plastic Surgery News

07 Mayo Clinic’s extensive face transplant work restores Michigan man’s life

January/February 2025 Vol. 36 No. 1

A 50-hour face transplant procedure led by ASPS member Samir Mardini, MD, gives man his life back.

The mission of the American Society of Plastic Surgeons is to support its members in their efforts to provide the highest quality patient care and maintain professional and ethical standards through education, research and advocacy of socioeconomic and other professional activities.

08 The significance of the MultiPlan lawsuit for plastic surgeons MultiPlan, Inc., faces a landmark antitrust lawsuit for allegedly orchestrating a nationwide price-fixing scheme.

ASPS PRESIDENT

09 Remembering ASPS past President Norman Hugo, MD, 1933-2024

Scott Hollenbeck, MD dr.scott.hollenbeck@gmail.com CHIEF MEDICAL EDITOR

Colleagues, mentees remember Dr. Hugo’s leadership and commitment to the specialty.

B. Aviva Preminger, MD, MPH premingermd@gmail.com

10 ‘Unmatched in his leadership of The PSF and beyond’

ASSOCIATE MEDICAL EDITORS

Richard Baynosa, MD richard.baynosa@unlv.edu Paige Myers, MD, MPH paigelm@med.umich.edu

The PSF past President Nicholas Vedder, MD, discusses his path to the specialty and national leadership roles.

11 Takeaways from the 2024 AMA House of Delegates Interim Meeting

ADVERTISING EDITOR

Anu Bajaj, MD anukbajaj.mac@mac.com

The November meeting in Orlando, Fla., placed focus on Medicare payment reform and surgical standards.

EXECUTIVE VICE PRESIDENT

14 YPS Perspective: Navigating stress, failure and job searches

Michael Costelloe mcostelloe@plasticsurgery.org STAFF VP OF COMMUNICATIONS

ASPS members share insights on a variety of topics – and pressures – that face young plastic surgeons.

Mike Stokes mstokes@plasticsurgery.org

19 COVER: Pushing innovation further

MANAGING EDITOR

A look at some individuals and companies advancing technology and technique for plastic surgeons around the world.

Paul Snyder psnyder@plasticsurgery.org SENIOR NEWS EDITOR

Jim Leonardo jleonardo@plasticsurgery.org CONTRIBUTING EDITORS

Enrique Fernandez, MD; Rebecca Knackstedt, MD, PhD CONTRIBUTING WRITERS

Erin Finnegan; Frances Hackler; Stella Hiltzik; Matt Lavin, JD; Kaibrea Schoning; Alex Walton COVER DESIGN

Paul Snyder

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DISPLAY ADVERTISING SALES

Michelle Smith, (646) 674-6537 michelle.smith@wolterskluwer.com, Wolters Kluwer Health CLASSIFIED ADVERTISING

Jeanne Embrey, jembrey@plasticsurgery.org Plastic Surgery News (ISSN 1043-4119) is published eight times per year: March, June, September, December single issues – and combined January/February, April/May, July/August and October/November issues – by ASPS. Phone: (847) 228-9900; Fax: (847) 228-9131

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COLUMNS 06 President’s Message 06 Editor’s Message 12 Legislative Update 23 Book Review

24 Late-Career Perspectives 25 Calendar 27 Classifieds 30 The Last Stitch

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PRESIDENT’S MESSAGE

The PSF is the engine that drives the future of plastic surgery

By Alan Matarasso, MD The PSF President

W

hen The PSF – then known as The Plastic Surgery Educational Foundation – was seeded by a $5,000 U.S. Savings Bond in 1948 by founder Jacques Maliniac, MD, the directors deemed the purpose of the new organization was to “support research pertaining to congenital and acquired deformities; promote high standards of training, practice and research in plastic surgery; confer prizes and establish scholarships; and promote lectures, seminars, and medical and public meetings to educate the lay public in matters pertaining to the field.”

Then and now, these aspirations improve the quality of life of our patients through education, research and development.

More than three-quarters of a century later, The PSF still adheres to many of those original designs, while also having evolved into an engine for our entire specialty and providing more than $1 million per year through a variety of grant opportunities. It serves as a hub for the Plastic Surgery Registries Network (PSRN), an umbrella under which rests the PROFILE registry, the National Breast Implant Registry (NBIR), Tracking Operations and Outcomes for Plastic Surgeons (TOPS) and the General Registry of Autologous Fat Transfer (GRAFT). These registries collect critical patient, device and procedural data to improve safety and fortify clinical evidence on an array of procedures and products.

ASPS and The PSF work in concert – and perhaps because of the vast array of activities that fall under The PSF’s purview (or any number of other factors), I still hear members ask a common question: How is what The PSF does different from ASPS?

For a technical start, ASPS is a 501(c)6 and The PSF is a 501(c)3 organization, which distinguishes The PSF’s operations as exclusively for charitable, educational and scientific purposes. Your annual membership dues directly fund ASPS – not The PSF. The PSF is sustained through gifts, which you can make by checking a separate box on your dues statement. Donations support The PSF Annual Fund, a variety of specific programs and grants and the National Endowment for Plastic Surgery, which was started by ASPS past President Norman Cole, MD, in the 1990s. These generous gifts continue to seed the research and innovation that drive our initiatives – and the entire specialty of plastic surgery – forward.

The mission of The Foundation is to advance plastic surgery through innovative research, to develop scientific leaders and improve the quality of life of our patients. Our expansive registry network allows us to trace, analyze and promote data regarding the plastic surgery procedures, patient safety and quality outcomes.

We’re always building on The PSF’s platform to partner with plastic surgeons, patients, industry and others to increase access to safe, effective and affordable plastic surgery care that meets the needs of individuals and populations. The grants that we provide advance research and the career development of plastic surgery residents and our plastic surgeon-scientists, as well as support emerging innovators and leadership collaboration. Groundbreaking research has both taken root and advanced thanks to the funds generated through our grant programs – a continually vital option for plastic surgery researchers who might not be able to otherwise secure funding through NIH offerings.

The PSF selects and funds individuals for the Visiting Professors program, International

Scholars and various international programs that enable plastic surgeons to engage in bidirectional exchange such as Surgeons in Humanitarian Alliance for Reconstruction, Research, and Education (SHARE) and Global Advancement for Academic Plastic Surgeons (GAAPS). It continues to provide valuable opportunities for young plastic surgeons to come to the United States to train with and learn from our leaders.

The three ‘C’s

I personally believe that The PSF – and, frankly, plastic surgery itself – is anchored by the three “C”s: collegiality, collaboration and contribution. One needs look no further than the hallways of any state, regional or international meeting to see firsthand the collegiality that plastic surgeons share with each other and how that spirit fosters any number of networking connections and opportunities for plastic surgeons at various stages of their careers.

As many of my predecessors in the presidential line have noted, a spirit of collaboration is also necessary to keep the life blood pumping through our specialty. We all recognize that several procedures innovated by plastic surgeons have been co-opted (if not outright hijacked) by other specialties. Trying to exist on our own specific island, however, will only put us in a demonstrably weaker position. We should continue to collaborate with each other and other specialties to advance patient care and research.

The common denominator to everything The PSF does is contribution. Each of us can and should contribute in some way to organized plastic surgery. Whether you contribute your time volunteering, teaching, assisting a colleague, performing research or through providing financial gifts, the specialty continues to stand as a bedrock of innovation from this ongoing spirit of giving back. When you look forward or reflect on your career, I think we can

all agree that an essential, fulfilling component of your professional life has been enhanced and enriched by the contributions to the profession to which you’ve devoted your education and life.

The PSF seeds the future of plastic surgery and advances all of our innovation. This issue of PSN highlights some of the plastic surgeon innovators within our ranks who are making gains from the partnership ASPS forged with MedTech Innovator to pull great ideas off paper and into the O.R. (see story on page 19). Many of the most important and routinely incorporated operations we perform were born decades ago from research grants seeded by The PSF. Furthermore, over the past 50 years plastic surgery has incorporated hand surgery into our repertoire, initiated microsurgery techniques and used them all over the body for an entire arsenal of reconstructive procedures. We’ve pushed microsurgery from what landed Joe Murray, MD, his 1990 Nobel Prize in Physiology or Medicine for transplantation, to now microsurgically performing full face transplantation (see a news story on the latest example of this on page 7).

Plastic surgeons essentially created liposuction surgery, revolutionized breast reconstruction, spurred the evolution of aesthetic medicine, helped establish techniques for gender surgery and more. We can only continue to make these prodigious advances through your voluntary, generous contributions to and participation in The PSF. We owe it to our patients, ourselves and the future of plastic surgery to continue to fuel this machine that drives the specialty. PSN

EDITOR’S MESSAGE

Plastic surgeon and mother: The impact of wearing two hats

By B. Aviva Preminger, MD, MPH PSN Chief Medical Editor

M

y first conversation about wanting to be a plastic surgeon took place when I was 14 years old. I was so excited to finally meet a female plastic surgeon. The conversation, however, was disappointing. She told me – in no uncertain terms – that I “just shouldn’t do it.” My kids would resent me for it, and I would miss out on all of the important moments.

I never forgot her words.

At my own peril, I somehow disregarded her recommendation. Ten years later, I found myself in the burn unit paired with a plastic surgery resident from another program. She introduced herself, and her last name immediately rang a bell.

“Is your mother a plastic surgeon?”

I asked.

“Yes,” she replied.

“Your mother warned me not to do this,” I said.

“Yeah – she told me the same,” she laughed.

Yet, there we were – two female plastic surgery residents who eventually completed their Editor’s note: The views expressed in the “President’s Message” and “Editor’s Message” columns are those of the author and do not necessarily reflect the opinions of ASPS.

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training and went on to raise children who are now teenagers. In the years since my training, of course, there have been notable changes made by the ABPS and academic institutions to better facilitate a balance between becoming a plastic surgeon and starting (or growing) a family. The Women Plastic Surgeons Forum also provides a vital network of colleagues who

can share their own experiences with women who might have concerns about the impact of issues ranging from changing practice types to chasing a new opportunity somewhere across the country – or even simply wanting to be a plastic surgeon – might have on their kids.

These remain valid concerns and conversations that still need to be had.

Close to two decades later, I have decided to go to the source (my daughter, Stella) to get a better understanding of the impact of the decision I made, in the hopes of providing young plastic surgeons – or maybe not-soyoung plastic surgeons – with some insight into the impact of being a plastic surgeon and a mom. PSN

Growing up with a plastic surgeon mom: A teen’s perspective

By Stella Hiltzik

W

hen I tell people that my mom is a plastic surgeon, I usually get a wide-eyed reaction.

“Wow,” they’ll say. “That is so cool!”

They’re not wrong. Growing up with a mom who’s a plastic surgeon definitely shaped my view of the world, body image – and even how I think about beauty and confidence.

But it’s not exactly what most people imagine.

First, I think it’s important to explain that my mom’s job is not like an episode of some flashy reality show. People often think plastic surgery is all about glamour, quick fixes and vanity, but what I see every day is far from that stereotype. My mom’s work is meticulous, complex and deeply meaningful to her and her patients.

For example, she doesn’t just help people “look better” – she helps people feel better.

Some of her work is reconstructive surgery for patients who’ve been through tough situations, such as accidents or illness. She always talks about how her goal is to enhance what’s already there and to help people feel more like themselves, rather than someone they’re not. This has made me understand that plastic surgery, when done with care and purpose, can be about healing and empowerment – not just appearance.

I’ve seen how she spends hours in surgery – completely focused – knowing that her work will help someone reclaim their confidence or sense of normalcy. Even when it’s exhausting, she genuinely cares about each person who walks into her office.

When she comes home though, no matter how tired she is, she changes hats and is in full “mom” mode, asking about our day, prepping dinner and helping with homework.

One of the things that shaped me most is

how my mom talks about beauty. Growing up, she taught me that confidence doesn’t come from fitting into a certain mold or achieving a specific look. She always emphasized that beauty is individual and that true confidence comes from feeling comfortable in your own skin. Ironically, being a plastic surgeon gave her a unique perspective on natural beauty and self-acceptance. I don’t feel pressured to look perfect, but I do feel a sense of responsibility to take care of myself. My mom taught me that taking care of your body is a form of respect for yourself.

So, while having a plastic surgeon mom might sound glamorous, it’s actually taught me a lot about empathy, resilience and self-acceptance. What matters is finding a path that helps you feel true to yourself.

Having a mom as a plastic surgeon has also shown me that I can accomplish anything I put my mind to. For that, I’m grateful to have such an incredible role model in my life. PSN

January/February 2025

‘Extensive’ Mayo Clinic face transplant gives man his life back the related function. It was an effort that was greatly aided by technology – and concerted effort.

“To a great extent, what led to the success of Derek’s procedure was all the prep work and virtual surgical planning,” Dr. Mardini says.

“One part of the virtual surgical planning was ‘guide creation.’ You print the model of the donor and the recipient and have them to look at.

We had a CAT scan of the donor and the recipient, which allowed us to work with biomedical engineers to do a simulation of the surgery.”

Dr. Mardini estimates that between the two procedures at Mayo, he and his teams spent more than 300 hours with virtual planning and in the cadaver lab.

For Derek, now age 30, the surgery achieved even more than he had hoped.

“It exceeded my expectations,” he tells PSN. “I have a face. I have a nose. I have lips. I can wear my glasses, which I couldn’t do for the last 10 years.

Dr. Mardini and the entire team did a great job. As far as undergoing the surgery itself, it was pretty easy. The toughest part was knowing that my parents had to wait while I was having the surgery.”

By Jim Leonardo

T

he technique and scale of facial transplantation have advanced so rapidly and greatly since the first successful partial face transplant – performed on a French woman in 2005 – that one of the most extensive full-face transplants, completed in February 2024 at Mayo Clinic, Rochester, Minn., could almost be considered routine. Almost.

Approximately 85 percent of Derek Pfaff ’s face was replaced by donor tissue – everything below his eyebrows and part of his forehead – including his upper and lower eyelids and intraorbital fat on one side; upper and lower jaws; teeth; nose; cheek structure; hard palate; parts of his soft palate and the entire skin of the face and neck. Thanks to hundreds of hours toiling in a cadaver lab and countless additional hours of virtual planning and 3D modeling by ASPS member Samir Mardini, MD, Derek’s 50-hour procedure concluded without a hitch.

“It was long and it was a lot of delicate work, but it went very smoothly,” says Dr. Mardini, who is the surgical director of the Mayo Clinic Reconstructive Transplant Program.

Dr. Mardini, professor and chair of the Division of Plastic Surgery, says face transplants are always the last and most drastic option for patients, and Derek, who hails from Harbor Beach, Mich., had undergone 58 reconstructive procedures since a shotgun blast destroyed much of his face in 2014.

“From an anatomic standpoint, Derek had exhausted all reconstructive options, and continuing to pursue reconstruction only would be deleterious to other, healthy parts of Derek’s body,” Dr. Mardini tells PSN. “Doing that would damage other parts of the body that are important to Derek – and make it much more challenging to perform a face transplant.

“He had several morbidities from donor sites for his ongoing reconstruction around his body that were affecting his function, including a bad contracture of his forearm from a radial form flap,” Dr. Mardini adds. “Doing more of

A clinical program

(Top) ASPS member Samir Mardini, MD, leads a surgical team work through a 50-hour face transplant procedure for Derek Pfaff; (bottom left) Pfaff with his mother prior to the transplant operation; and (bottom right) Pfaff poses with his new face after the successful procedure. Photos courtesy of Mayo Clinic. the same wasn’t going to give him the functional and aesthetic outcomes that he was looking for. So it was obvious very quickly that he was a good face transplant candidate.”

Once that had been determined, the wait for an appropriate donor began. The answer came nearly two years after Derek entered the face transplant program, with events moving rapidly from there.

ASPS members meet in Shanghai

“We learned of a potential donor for Derek on a Thursday,” Dr. Mardini says. “Following careful evaluation, we accepted the offer for the donor and our organ-procurement organization began discussions with the donor family.

We then began our process of virtual surgical planning and team preparation.”

Once all agreed to move forward, the organ procurement organization took over allocating the other organs – which meant the earliest the donor tissue would be available was the middle of the night Saturday. In light of that, he and the team instead decided to start the following Sunday morning. Dr. Mardini assembled the team for an early briefing and then made the initial incision around noon. Nearly 60 hours and no serious complications later, Derek left the O.R. with a new face – and hope for the future.

Preparation and effort

Several ASPS members attended the Ninth World Congress for Plastic Surgeons of Chinese Descent in Shanghai, China, which was held Dec. 13-15. The event took place in at Tongji University in Shanghai and was combined with the 2024 Oriental Aesthetic and Plastic Art Conference. From left to right, Ernest Chiu, MD; Lee L.Q. Pu, MD; June Wu, MD; David T.W. Chiu, MD; ASPS past President Gregory R.D. Evans, MD; Angela Cheng, MD; and Haiyan Cui, MD, who is chairman of the Ninth World Congress. PSN January/February 2025

Dr. Mardini’s team counted more than 80 medical professionals, including surgeons, anesthesiologists, nurses, various medical technicians, assistants and others that preceded that Sunday trip to the O.R. This also wasn’t the Mayo Clinic’s first face transplant procedure; in 2016, Dr. Mardini led a team at Mayo that performed the procedure for another gunshot victim, with that experience paying dividends for Derek.

“Between the two face transplants, we spent more than 85 evenings and weekends in the cadaver lab, trying to make sure we understood every step of the operation,” Dr. Mardini says.

“We were determined to avoid unexpected outcomes and intraoperative surprises – and there were few, if any, surprises after we took Derek into the O.R.” Planning for Derek’s February procedure entailed detailed facial nerve mapping of the donor and recipient, in order to match nerves between the two and allow the donor to gain

Dr. Mardini, who trained and spent more than five years in Taiwan under renowned reconstructive microsurgeons Fu Chen Wei, MD, and Hung-Chi Chen, MD, PhD, as well as craniofacial surgeon Yu-Ray Chen, MD, at Chang Gung Memorial Hospital, says that unlike other transplantation efforts nationwide, the Mayo Clinic program was not built as a research program.

“We started our program as a clinical program, making Mayo the first in the country to offer facial transplantation as a clinical program,” Dr. Mardini says. “We did this because we felt, including our research IRB team, that the surgery itself had been done several times before; therefore, it didn’t need to be a program under the research umbrella. We also realized there would be some research protocols coming through, such as dealing with psychosocial matters and long-term outcomes – so research would still be served.”

Dr. Mardini says Derek’s story is the latest success in the program that he helped launch as the first of its kind in the nation.

“There was a lot of excitement over the years as we tried to get the Mayo program approved,” Dr. Mardini recalls. “Once the institution said, ‘Go ahead,’ I felt a massive weight on my shoulders. I had to think about how to execute this and make sure that the patient survives the face transplant while also ensuring that the patient achieves their goals. It’s quite a daunting feeling. That’s why we started going to the cadaver lab, and we went there probably more than we needed to. You’re in good shape if you over-prepare, but you could be harmed if you’re underprepared. And you never know when you’re fully prepared for something you’ve never done.”

After having been through so much over the past decade, Derek’s recovery is remarkable.

“He’s doing amazingly well,” Dr. Mardini says. “He’s back to life, he’s connecting with old friends and he’s doing well from the surgery.

He’s got some facial function. He’s strong. One thing that was very, very meaningful to me occurred about a month ago when he sent a family photo to my phone. In the photo is Derek – just one of the guys standing there. And the text message that followed it read: ‘The first family photo in 15 years. We’re so grateful to you and the Mayo team for giving us this gift.’

That was more touching than I’ll ever be able to describe.” PSN

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Understanding the MultiPlan lawsuit for plastic surgeons stepped in to fill the void. MultiPlan’s pricing tools are now alleged to serve the same function that Ingenix once did, suppressing out-ofnetwork rates and harming providers.

By Matt Lavin, JD

M

ultiPlan, Inc., faces a landmark antitrust lawsuit for allegedly orchestrating a nationwide price-fixing scheme, with major insurers – including Aetna, Cigna, UnitedHealthcare and Blue Cross Blue Shield affiliates – named as co-conspirators. The litigation challenges MultiPlan’s systematic reduction of out-of-network healthcare payments, a practice that could fundamentally reshape reimbursement standards. For ASPS members who rely heavily on out-of-network billing, this case represents a critical opportunity to address systematic underpayment issues that threaten the sustainability of plastic surgery practices.

In short, the suit alleges that MultiPlan systematically decreased reimbursements to providers for important healthcare services, while the company – along with its insurer co-conspirators – kept the difference as profit.

Understanding the case

Moving forward as multi-district litigation in federal court in the Northern District of Illinois, the lawsuit accuses MultiPlan and insurance companies of coordinating since 2015 to systematically suppress payments for out-of-network services. The lawsuit alleges that MultiPlan and major insurers violated the Sherman Antitrust Act by operating as a “huband-spoke” business model. In this case, MultiPlan allegedly acted as a central hub to facilitate coordination among multiple competing companies (the “spokes”) without the competitors ever speaking to each other.

More specifically, the scheme’s mechanics allegedly center on MultiPlan’s repricing practices

Evidence of impact

that allow insurers to standardize artificially low payments while eliminating competition among themselves. MultiPlan’s fee structure incentivizes this underpayment, with the company receiving compensation based on the difference between initial claim amounts and final payments, according to the lawsuit. In other words, the company’s profits increase as provider reimbursements decrease, the suit reads.

It’s alleged that MultiPlan’s explosive growth – from $23 million in revenue in 2012 to $709 million in 2021 – has come at the expense of healthcare providers, who frequently receive payments below their operating costs.

A pattern of behavior

This current situation echoes previous industry

practices. In the late 1990s, UnitedHealthcare created a subsidiary called Ingenix and acquired independent databases to control “usual, customary, and reasonable” (UCR) rates.

Major insurers – including Aetna and Cigna – contributed claims data to Ingenix and used it to determine out-of-network payments.

Investigations by the New York Attorney General and the U.S. Senate revealed that these databases were manipulated to artificially depress reimbursement rates by 10 to 28 percent.

This led to substantial settlements, with United paying $350 million and insurers agreeing to shut down the Ingenix database and fund the creation of FAIR Health, an independent database designed to ensure accurate UCR rates.

However, after insurers’ obligations to use FAIR Health ended in 2015, MultiPlan

Evidence of systematic underpayment emerged in an April 2020 study by the Office of the New York State Comptroller (“An Analysis of Reasonable and Customary Out-of-Network Reimbursement Rates for Medical/Surgical Services in the New York State Health Insurance Program”), which found that payments using MultiPlan’s repricing methodology were anywhere from 1.5 to 49 times lower than traditional out-of-network calculations. The lawsuit argues these actions violate the Sherman Act by eliminating competition among insurers and depriving the healthcare market of fair pricing practices.

The impact on healthcare providers has been severe – particularly affecting smaller medical practices. Many have been forced to reduce services, cut staff or close entirely. This consolidation has restricted patient access to specialized care and created a healthcare landscape with fewer options for both patients and providers.

Why plastic surgeons should care

ASPS members face unique challenges in the current reimbursement landscape. The specialty’s high volume of out-of-network claims – combined with the complexity of procedures such as reconstructive surgeries after trauma or cancer – makes practices particularly vulneraContinued on page 26

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January/February 2025

IN MEMORIAM

A professor and leader: Remembering Norman Hugo, MD

By Paul Snyder

P

lastic surgeons are paying tribute to ASPS past President Norman Hugo, MD, who passed away on Dec. 9 at age 91.

“He was always ‘The Professor’ to us,” recalls ASPS past President Richard D’Amico, MD, who trained under Dr. Hugo at Columbia-Presbyterian Hospital in New York. “He was a leader. He took on tough tasks and never backed down from his principles. He made us better people and better surgeons. He taught us about leadership – not just in the O.R., but in society and in our Society.”

His passion for medicine was the specialty’s gain, as Dr. Hugo’s stature and athletic prowess could have set him on a different path. Richard Peinert, MD, past president of the Massachusetts Society of Plastic Surgeons and a friend of Dr. Hugo’s for more than 40 years, says Dr. Hugo turned down a scholarship to the University of Kentucky to play basketball for Adolph Rupp so that he could attend Williams College. Basketball wasn’t his only athletic forte, either.

“He was a larger-than-life character – both physically and in how he acted,” Dr. Peinert says, noting that Dr. Hugo was also an all-scholastic baseball player in Massachusetts and would tell the story of how he once hit a towering fly ball off of Bill Monbouquette, who would find fame in the major league as a member of the Boston Red Sox, Detroit Tigers, New York Yankees and San Francisco Giants.

“This was in a field that didn’t have a fence,” Dr. Peinert says. “So Norman would talk about how he just stood there admiring his hit. He forgot to run, so he only ended up with a double. He was mad that he couldn’t say he homered off Bill Monbouquette.”

Dr. Hugo completed his general and plastic surgery training at Cornell Medical School, training at New York Hospital with The PSF past President Herbert Conway, MD, who Dr. Hugo counted as his most important mentor.

He held true to Dr. Conway’s mantra that “If you do not write, it did not happen” – and Dr. Hugo was a frequent contributor to several medical journals throughout the course of his career.

Following his residency, Dr. Hugo served as professor at Indiana University in 1966-67, when he was drafted into the U.S. Army (he ultimately served as a major). He suspended his private practice and was stationed at Walter Reed Hospital from 1967-69 as assistant chief of plastic surgery. The experience during the Vietnam War had a lasting effect on him, and he would speak at various events to honor American veterans and pay tribute to those who suffered lasting effects from the wounds sustained in battle.

Following Dr. Hugo’s discharge from the Army, he relocated to Chicago, where he served as associate chief of plastic surgery at Michael Reese Hospital in 1969-71, and then as associate chief of plastic surgery at Northwestern Hospital in 1971-82. In 1982, Dr. Hugo was named chief of plastic surgery at Columbia Presbyterian Hospital in New York – a role he maintained until his retirement on Dec. 31, 1997.

“He might be tough on us in a closed room – but in a positive way, because he always wanted the optimal outcome and wanted us to become the best surgeons we could be,” notes ASPS Trustee Jeffrey Ascherman, MD, who trained under Dr. Hugo and is now site chief of the Division of Plastic Surgery and professor at Columbia University Irving Medical Center.

“Outside of that room, he would protect and

ASPS past President Norman Hugo, MD support you any way he could in the hospital.

He considered us family. I have fond memories of him taking us to Army/Navy football games and to the best steakhouses around, so that we could rate the top ones in New York. Being the department chief wasn’t just a job to him – he invested all his time in that role to help us become the best possible doctors.”

Dr. D’Amico remembers starting rounds at Columbia Presbyterian Hospital with his fellow resident John LaManna, MD, at 6 a.m.

“One evening, Dr. LaManna and I were leaving at 6 p.m.,” Dr. D’Amico recalls. “The elevator door opened and he was standing there.

He looks at us and goes, ‘Half a day, boys?’ You definitely had to toe the line with him.

“But when I was his chief resident, we’d also have long talks at the end of the day,” Dr. D’Amico adds. “To the point where his fabulous wife, Gerry, called me and implored me to let him go earlier because it was such a long drive back from New York to his home in New Canaan, Conn. But those are the times I cherish, because that’s when the real learning took place.”

During his time as ASPS president in 1988, Dr. Hugo encouraged the Society to become more involved in political and economic activities. He also began the work of providing standards of clinical care for the specialty – a years-long effort that ultimately included input from several ASPS members. The result of their combined work, the Society’s first “Clinical Practice Guidelines,” was published in 1994.

Dr. Hugo also served as ABPS vice chairman.

“I was honored to follow him by exactly 20 years as ASPS president,” Dr. D’Amico notes.

“He sent me on my first committee assignment in 1988. He lived leadership, understood leadership and taught leadership. He was always there for you, and whenever I had my own questions or struggles with leadership, I always had his example to look to.”

After retirement, Dr. Hugo continued to maintain an active schedule – both as a nationally ranked squash player and in auto shows around the country where his Morgan (a handmade British automobile crafted from wood and steel) took home no fewer than 15 first-place awards. He enjoyed traveling around the world with his wife, Geraldine, family and other friends.

“My advice to young surgeons is to stay true to your ideals and work hard,” he told PSN in 2007. PSN

Tribute to a pioneer and a friend

By Richard Hamilton, MD

O

ne of the great pioneers of microsurgery in Scandinavia died Oct. 19 in Gothenburg, Sweden, after a short battle with pancreatic cancer. He was 83.

Ingemar Fogdestam, MD, was born in Blekinge, Sweden, on Sept. 29, 1941, and maintained his connection with the region for his entire life. His father was an engineer in the Swedish Air Force, and Ingemar attended school in Ronneby and proceeded to gymnasium in nearby Karlskrona.

Ingemar gained admission to medical school in Gothenburg in 1961. His early surgical experience was in Eskilstuna, Sweden, and he soon discovered an affinity for plastic surgery. He gained a residency position at the Sahlgrenska Hospital in Gothenburg in 1970, where he worked under clinic chief Prof. Bengt Johanson, a larger-thanlife character in the Swedish plastic surgery scene and a contemporary of Tord Skoog, MD. Bengt encouraged Ingemar to undertake a research project on wound healing and sent him to Aarhus, Denmark, from 1974-76, where he studied delayed primary closure under the supervision of Prof. Andrus Viildik, ultimately obtaining his doctorate degree in 1980.

Bengt Johanson recognized the importance that microsurgery would play in the future of plastic surgery, which prompted him to recommend Ingemar join the fellowship program of Bernard O’ Brien, MD, and Wayne Morrison, MD, in the microsurgical unit at St. Vincent’s Hospital, Melbourne, Australia. During the year he spent there, we first crossed paths, when I was chief resident in plastic surgery. Together in Melbourne, we carried out anatomical studies on the blood supply of the lower abdominal wall.

At the end of this time, Ingemar invited me to work with him at Sahlgrenska, where we built Scandinavia’s first microsurgical unit. During this period, in 1978-79 we carried out the first clin-

January/February 2025

ical cases for free abdominoplasty flap (now known as the DIEP flap) for breast reconstruction. The operation is now mainstream and has improved the lives of tens of thousands of women suffering from breast cancer Ingemar Fogdestam, MD around the world.

Other groundbreaking microsurgical procedures done by Dr. Fogdestam at Sahlgrenska included lower-limb reconstructions with the osteocutaneous groin flap; free-fibular transfer for congenital pseudarthrosis of the tibia; vaso-epididymal anastomosis for male infertility; and unique cases such as scalp replantation in a young girl and hand replantation in a young boy. He published numerous articles on these and other microsurgical works.

Ingemar was admired for his clear thinking, his absolute care and dedication to his patients and his willingness to undertake challenging cases. Dr. Morrison wrote to me recently and shared his fondness for Ingemar, saying he “thought he was one of the most genuine and honest fellows that we had at St. Vincent’s.”

In the final years of his professional life, Ingemar applied his skills to aesthetic surgery at Art Clinic in Gothenburg. Outside of surgery, he was an officer in the Swedish Air Force Reserves, and he had an encyclopedic knowledge of military history and an extraordinary memory. We remember him as a faithful, fine friend and he will be greatly missed by his family, friends and colleagues in Sweden, Denmark, Australia and the United States.

Despite all his professional commitments, Ingemar found time for and was dedicated to his family. He’s survived by his three daughters, Ilona, Ellen and Hanna, and six grandchildren. PSN

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The PSF Distinguished Service Award

Becoming the ‘consummate role model’ for plastic surgery

By Paul Snyder

P

lastic surgery was not even a blip on the radar of The PSF past President Nicholas Vedder, MD, when he graduated from medical school at Case Western Reserve University and began his surgical residency at the University of Washington (UW). Fortunately for the specialty, Dr. Vedder was left uninspired by his original path of cardiac surgery.

“As a resident, I realized cardiac surgery was pretty boring,” he says. “They did the same operation again and again. I got interested in vascular surgery for a while, but it wasn’t until I was a fourth-year resident in surgery when a new plastic surgery faculty member came in and performed microvascular surgery. It just blew my mind.”

At the time, Dr. Vedder had no idea how far his new fascination would take him. Born in Chicago and raised in Evanston, Ill., Dr. Vedder completed his undergraduate work at Stanford University – where he met his wife, Susan Heckbert, MD, on the first day, and they would ultimately go to Case together. It might be strange to consider now, considering the long and distinguished careers Dr. Vedder and Dr. Heckbert cemented in the Seattle area, but when they couple-matched to the University of Washington for residency, Dr. Vedder laughs that he thought it was the end of the world.

“It was my third choice, after University of California-San Francisco and Massachusetts General Hospital for surgery residency,” he notes. “But coming to UW turned out to be the beginning of my world. After my surgery residency, I did a two-year, NIH-sponsored trauma research fellowship here, too.”

Nevertheless, armed with an immediate interest in microsurgery and hand surgery – and citing The PSF past President (and then-UCSF Plastic Surgery Chair) Stephen Mathes, MD, as a personal hero, Dr. Vedder hoped to undergo his plastic surgery training at UCSF, landing an interview there one week and another at Mass General the following week.

“I called Dr. Mathes to tell him how much I loved UCSF and would really love to be there,” Dr. Vedder recalls. “He said, ‘Yeah, we really liked you, too. We’re going to meet next week, and we’ll let you know.’ So I got on the plane to Boston.”

At the time, the MGH plastic surgery department was run by James May Jr., MD, and Dr. Vedder was given a tour of the department from Rod Rohrich, MD, who was the hand surgery Fellow at the time.

“I remember it like yesterday,” says Dr. Rohrich, who would go on to become ASPS president in 2004. “Nick was young, brilliant and enthusiastic. He wanted to change the world and make a difference in plastic surgery and hand surgery. I told him the best place to do that was at MGH under the tutelage of Dr. May.” In addition to recruiting Dr. Vedder during the tour, Dr. Rohrich showed him how to K-wire a zygoma fracture (“Not something you typically do,” Dr. Vedder laughs). At the end of the day, Dr. May offered Dr. Vedder the job on the spot, which he immediately took.

At MGH, a veritable who’s-who of future specialty leaders – including Jeff Fearon, MD; Dan Del Vecchio, MD; and W.P. Andrew Lee, MD – were among his peers.

“Even back in surgery residency at UW, two of my senior residents were James Grotting, MD, and James Stuzin, MD, and all three of us went on to become chair of the ABPS,” Dr. Vedder notes.

Setting an example

Upon completion of his training, he returned to the Pacific Northwest to become UW’s first hand surgery Fellow. A decade later, he would

10

The PSF past President Nicholas Vedder, MD become the university’s chief of the Division of Plastic Surgery and begin the work of building a program that’s now one of the specialty’s national leaders in training. He’s also a professor, and the Jamie Hunter Endowed Chair.

“We now have more than 130 graduates from our combined orthopedic plastic surgery hand program,” Dr. Vedder tells PSN. “When I joined the plastic surgery faculty in 1990, there was only one other faculty member – Loren Engrav, MD. We hired two more, Richard Rand, MD, and Joe Gruss, MBBCh, from Toronto. Joe, in six years, took our craniofacial program from nothing to the top-volume program in the country. Tom Trumble, MD, and I took the hand program to one of the largest programs in the country. We now have 19 full-time plastic surgery faculty, 30 integrated residents and tremendous fellowships in hand surgery, combined with orthopedics, microsurgery and craniofacial surgery. I’m very proud to have been part of that growth.”

And then there’s the work that Dr. Vedder has performed in the O.R. over the course of his career. The excitement that made him seekout plastic surgery training all those years ago has never waned, and he’s helped shape (and reshape) the lives of countless patients.

“As reconstructive plastic surgeons, we are given a gift,” Dr. Vedder says. “That gift is the ability to use what we do to rebuild patients’ lives. Every day I get up is a day that I may have an opportunity to make a difference that will last a patient’s entire life. There’s nothing more rewarding on Earth.”

Now in the late stages of his career – Dr. Vedder will retire from practice in July – he acknowledges that the days of “career-defining” cases are behind him. However, he still has many to reflect upon. From performing microvascular replantation for a young woman who suffered a total-scalp avulsion in a fish processing plant and later tissue expanding the replanted scalp, to surgically replanting all five amputated digits on the dominant hand of an engineer at a Boeing plant, Dr. Vedder says that cases he’s handled have never ceased to cement his love for the specialty.

“There was a 7-year-old girl who had her feet nearly pulled off in a boating accident on Lake Washington, and we were able to replant those and reconstruct the defect,” he recalls.

“Just to be able to watch her have her life rebuilt

has been wonderful – she’s now a grad student at Cornell. There was another woman who had a severe crush injury to her hand, and I did a very low profile, free fascia flap and skin-grafted that. She got back to doing what she loves to do, which is playing piano. She sent me a video of her playing the piano, and although I haven’t seen her in 15 years, she just emailed me out of the blue, saying she’d like to come across the mountains and say hi to me and thank me for giving her life and avocation back.

“These are the kinds of things we get to do as plastic surgeons that no one else gets to do,” he adds. “It’s a special treat.”

Organizational leader

Concurrent with building UW’s plastic surgery program, Dr. Vedder also found himself helping to shape the specialty’s profile on a national level through his involvement with various organizations. However, he’s the first to note that he didn’t necessarily seek those roles.

“I kind of got dragged into many national leadership positions,” Dr. Vedder laughs. “But I’m very proud of the work – especially having been chair of the PSRC and the ABPS, because those are the two positions when you’re really selected by your peers.”

Nevertheless, Dr. Vedder’s leadership has fortified several organizations – he also served as president of the American Association for Hand Surgery and as a governor of the American College of Surgeons. His research techniques have been recognized by the NIH through the James A. Shannon Director’s Award, an R29 grant, and he’s the recipient of six Golden Scalpel Awards for best reconstructive case from the Washington Society of Plastic Surgeons.

Dr. Vedder’s involvement with ASPS and The PSF started shortly after he completed his residency, and while he recalls chairing various committees and moderating panels at annual meetings, he says he’s still surprised to see the amount of involvement he provided when he looks through his CV. All that work culminated in becoming The PSF president in 2013, which Dr. Vedder calls a highlight of his career.

“Plastic surgery doesn’t own any part of the human body,” he says. “The one thing that we own is innovation – and The PSF is the en-

gine for innovation in our specialty. To watch The PSF grow from what was a pretty small organization back when I first got involved to now giving out more than $1 million a year in research grants and truly being that engine for the specialty has been really rewarding. My wife and I are part of the Maliniac Circle, and we’ll always continue help The PSF grow – and watch proudly as it does.”

Dr. Vedder also helped play a critical role in advancing the ASPS/PSF governance restructure spearheaded by ASPS past President Joe Losee, MD, during his 2021 term.

“The idea of this bottom-up structure that raises the voices of so many members was just a wonderful idea by Dr. Losee, and I’m very fortunate that I got to be involved in the early planning stages of that,” he notes. “I think the restructure is already showing positive change and I believe the representation is going to benefit this organization in ways we can’t even see yet.”

Dr. Vedder’s commitment to not only furthering plastic surgery, but ensuring that more voices within the specialty are heard, earned him the distinction of receiving The PSF Distinguished Service Award, which was given to him by his 2013 counterpart, ASPS past President (and The PSF immediate-past President) Scot Glasberg, MD. “I was surprised that someone so dedicated to The PSF over all these years had not yet been given an award like that,” Dr. Glasberg says. “I’d always wanted to acknowledge him for his hard work and especially his partnership while we were presidents together – it was an honor for me to be able to bestow that award upon Nick.”

Dr. Rohrich says the enthusiasm he recognized in Dr. Vedder during his first tour of MGH manifested itself in myriad ways for plastic surgery.

“He has made such a difference for this specialty,” Dr. Rohrich says. “We became lifelong friends, served together on the ABPS – and especially on the RRC, where we changed the entire program structure and training for plastic surgery that remains in place to this day. Nick played a pivotal role in transforming plastic surgical training and education during his amazing academic career at UW. His focus, hard work and dedication to our specialty is unmatched in his leadership of The PSF and beyond. Nick is the consummate role model for all of us with his unique spirit and sense of humor.”

New horizons

With his career as a practicing plastic surgeon set to close this summer, Dr. Vedder says there are a few changes he’s already excited about.

“I’m looking forward to not getting up at 4:30 in the morning for conferences and meetings – and I’m looking forward to very few Zoom calls lasting late into the night,” he says.

“I’m also excited to do a lot more sailing, which is my passion, and traveling with my wife.”

Dr. Vedder is part of a group known as Sailing Plastic Surgeons, founded by Dr. Grotting, that consists of members from around the world – and who travel the high seas together.

“We travel around the world, either sailing on each other’s boats or chartering other boats.

Two years ago, we chartered a boat in French Polynesia and sailed from Tahiti to Bora Bora and other islands. Last October, we did a trip in Croatia with half a dozen couples, sailing from Split to Dubrovnik, stopping at islands along the way. So I’m always looking forward to the next Sailing Plastic Surgeons trip.”

Still, even with his eyes on corners of the world yet to explore, he’s proud to note that home is his third choice from all those years ago.

“As I said, what I thought was the end of the world was really the beginning,” he says. “At this point in my life, I couldn’t live anywhere other than Seattle.” PSN January/February 2025

Highlights from the 2024 AMA House of Delegates Interim Meeting

By Kaibrea Schoning

T

he American Medical Association House of Delegates (HOD) 2024 Interim Meeting was held in November in Orlando, Fla., with 20 plastic surgeons in attendance to represent their specialty through ASPS and its Plastic Surgery Caucus, along with the Section Council on Plastic, Reconstructive and Maxillofacial Surgery. In doing so, they ensured that the voice and values of plastic surgery were a part of the House’s consideration as it examined hundreds of resolutions and reports on many critical aspects of healthcare.

The meeting marked the first instance of ASPS past President Lynn Jeffers, MD, MBA, Oxnard, Calif., serving on the AMA’s Board of Trustees following her June election to the position during the Annual Meeting of the House of Delegates.

Dr. Jeffers’ service as a trustee left a gap in the Section Council on Plastic, Reconstructive and Maxillofacial Surgery, where she had previously served as the chair. To fill this gap, Michele Manahan, MD, Baltimore, was elected as the new chair of the Section Council, which consists of AMA delegates from ASPS and The Aesthetic Society, American Academy of Cosmetic Surgery, American Academy of Facial Plastic & Reconstructive Surgery, American Association for Hand Surgery, American Hernia Society, American Society of Maxillofacial Surgeons, American Society of Ophthalmic Plastic and Reconstructive Surgery, American Society for Reconstructive Microsurgery and International Society for Hair Restoration.

With this enhanced presence, ASPS played a key role in discussions on policies that resonate deeply within plastic surgery – and the most impactful policymaking came in the areas of pressing issues such as the highly anticipated Medicare payment reform, setting clear standards for surgical care and scope of practice.

developed by practicing physicians who understand the day-to-day realities of patient care. A reformed program would allow physicians to focus more on clinical excellence and innovation rather than on burdensome compliance tasks. The AMA’s support for this resolution aligns with ongoing efforts by ASPS to reduce administrative burdens, ensuring that time and resources are directed toward what truly matters – providing high-quality, patient-centered care.

Clear standards for surgical care

At the meeting, the years-long focus on scopeof-practice issues continued. ASPS supported a resolution introduced by the American Society of Ophthalmology that amended existing AMA policy on laser surgery standards. The

N

newly revised policy specifies that laser surgery should be performed only by those licensed to practice medicine and surgery, or by practitioners with proper training and licensure from the state to perform surgical services. Additionally, it emphasizes AMA’s support for legislation prohibiting optometrists from performing surgical procedures that fall under the AMA’s definition of surgery.

The resolution, which was adopted after amendment, marks a significant victory for patient safety. For plastic surgery professionals, it means that those performing delicate and complex procedures involving laser technology must meet stringent licensing and training requirements. It ensures a high level of expertise and aims to prevent unqualified individuals from performing surgeries that should be reserved for trained medical professionals.

Navigating crossroads

The AMA Medical Student Section introduced a resolution to address recent upheaval in the regulatory space following the Supreme Court’s reversal of the Chevron doctrine, a legal principle that historically required courts to defer to federal agencies when interpreting ambiguous laws. The court in June overturned this 40-year-old doctrine, leaving healthcare regulations in a state of uncertainty. The resolution proposed codifying Chevron deference, giving federal agencies the authority to interpret complex healthcare laws – including those impacting patient care and physician practice.

The debate surrounding this resolution is complex. On one hand, supporters argue that healthcare regulations, which require technical expertise, are best managed by agencies such Continued on page 26

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Medicare payment reform

Medicare payment reform was a central topic at the meeting. Delegates emphasized the specter of continuing cuts to physician reimbursement, which has not kept pace with inflation by a wide margin over the past two decades – and has actually decreased in recent years. The discourse focused on how these rates are unsustainable and particularly detrimental to small practices, which affects access to care in rural or underserved areas.

For plastic surgeons, the Medicare Merit-Based Incentive Payment System (MIPS) can be a double-edged sword. Although the system aims to improve the quality and cost-effectiveness of care, its administrative demands often detract from the time physicians can spend with patients. At the Interim Meeting, the HOD stressed the following shortcomings of the program: • MIPS is an administratively costly program that has failed to improve the quality of care.

• Mere compliance with MIPS requires a considerable investment in time and financial capital.

• MIPS operates in favor of physicians affiliated with better-resourced health systems, thus negatively impacting those practicing independently and patients in underserved areas.

The HOD passed a resolution, introduced by the New York delegation, that called for major reform of MIPS and urged the AMA to advocate for the repeal of this system, and for the establishment of a new, physician-designed program with a focus on outcome-based measures and reduced administrative burdens.

This resolution is a step toward a more streamlined system, where quality measures are

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LEGISLATIVE UPDATE

Celebrating PlastyPAC’s success in the 2024 elections

By Alex Walton

T

he weeks leading up to the 2024 general election were filled with uncertainty.

Polling for the White House, Senate and House of Representatives indicated that control of the federal government would come down to a small handful of states and districts.

By election night, polling aggregates suggested both the presidency and the House were virtual toss-ups. Amid this uncertainty, the Society’s affiliated political action committee (PAC), PlastyPAC, remained focused on supporting candidates committed to advancing plastic surgery’s priorities.

The PlastyPAC Board of Governors, which comprises 12 ASPS member surgeons from private and academic practices across the country, invested significant time and resources into identifying and vetting candidates. Their focus: A proven record of leadership on key issues, including fair physician reimbursement, congenital anomaly coverage, prior authorization reform and access to breast reconstruction.

Over the past 22 months, PlastyPAC contributed $228,000 to 78 congressional candi-

dates seeking election or re-election. Of these candidates, 72 emerged victorious, resulting in an impressive 92 percent success rate.

How we succeed

PlastyPAC’s success is no accident. The PAC

Advocacy in the states A quick look at some of the work ASPS did in November and December to advocate on behalf of the specialty at the state level.

employs a nonpartisan, evidence-driven approach to candidate selection, guided by a sophisticated scorecard system. This system evaluates candidates based on their track records, committee assignments, leadership roles and alignment with ASPS priorities. By focusing on objective metrics, PlastyPAC ensures that every contribution will support candidates who champion issues critical to plastic surgeons and their patients.

The scorecard also emphasizes the importance of relationships between candidates and ASPS members. These personal connections, paired with insights from ASPS advocacy staff and contract lobbyists, are key to advancing the Society’s legislative agenda and amplifying its voice on Capitol Hill.

Supporting physician legislators

• As part of the initiative to support microsurgical breast reconstruction, ASPS spoke with a member of the Arkansas Senate to discuss building support for his comprehensive bill to be introduced in 2025. Staff then met with the Arkansas Hospital Association to review recent modifications to the draft. ASPS also distributed state-specific legislation to 139 members of the North Dakota Legislative Assembly, requesting a champion to lead the same effort, while simultaneously communicating with representatives from the Arkansas Medical Society, the Medical Society of Delaware and the North Dakota Medical Association about the ongoing plans to improve breast reconstruction coverage in their states.

• ASPS met with staff from the American Academy of Dermatology and the American Society for Dermatologic Surgery Association to discuss issues regarding medical spa operations around the nation and opportunities to utilize the Medical Spa Safety Coalition to advance patient safety through regulatory frameworks.

• ASPS participated in a New Jersey Society of Plastic Surgeons Focus Group call to review the concerning medical spas landscape within the state and opportunities to enact legislation designed to tighten up their ownership and operation, thereby drastically improving patient safety.

• Supplemental information was provided by ASPS to the Alaska Medical Spa Services Work Group in preparation for its December meeting. The work group has been tasked with providing direction to the state’s licensing boards in determining the scope of medical spa services.

• The Society opposed legislation in Michigan that would increase the value of medical malpractice claims, raising the general noneconomic damages limit from $569,000 to $1 million and the exceptional noneconomic damages limit from $1,016,000 to $3 million, while also making earnings capacity damages available.

• ASPS communicated with staff from the Connecticut Society of Plastic Surgeons regarding scope-of-practice determinations being conducted for dentists by the state’s Department of Public Health (DPH). The DPH also received requests to review the scope of practice for other health professionals, including estheticians, dental therapists, naturopaths and physical therapists.

12

A critical component of PlastyPAC’s strategy is supporting physician-legislators, whose firsthand experience in healthcare uniquely positions them to advocate for policies that improve patient care and reduce administrative burdens.

In the 119th Congress, PlastyPAC helped increase the number of physicians compared to the 118th Congress. The PAC supported 12 incumbent physician candidates, 11 of whom won re-election. These physician-legislators include: • Sen. John Barrasso, MD (R-WY) • Rep. Neal Dunn, MD (R-FL-12) • Rep. Mark Green, MD (R-TN-07) • Rep. Andy Harris, MD (R-MD-01) • Rep. Ronny Jackson, MD (R-TX-13) • Rep. John Joyce, MD (R-PA-13) • Rep. Rich McCormick, MD (R-GA-07) • Rep. Mariannette Miller-Meeks, MD (RIA-01) • Rep. Greg Murphy, MD (R-NC-03) • Rep. Ami Bera, MD (D-CA-06) • Rep. Raul Ruiz, MD (D-CA-25) • Rep. Kim Schrier, MD (D-WA-08)

P

Additionally, PlastyPAC supported five newly elected physician-legislators: • Rep.-elect Maxine Dexter, MD (D-OR03) • Rep.-elect Bob Onder, MD, JD (R-MO03) • Rep.-elect Herb Conaway, MD (D-NJ-03) • Rep.-elect Mike Kennedy, MD, JD (R-UT03) • Rep.-elect Kelly Morrison, MD (D-MD03) As a result, the 119th Congress will feature more physicians than any Congress this decade.

Among PlastyPAC’s supported candidates, several physician-legislators stood out for their contributions to healthcare policy. Notably, Dr. Murphy and Dr. Bera were key leaders in sponsoring H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024. This legislation prevents cuts to the Medicare Physician Fee Schedule in 2025 and includes an inflationary adjustment. By retaining their seats, these leaders will continue to bring vital medical expertise to health policy debates that affect plastic surgeons and their patients.

Building on success

PlastyPAC’s achievements go beyond election victories. Over the years, the PAC has been instrumental in helping ASPS secure legislative wins that directly benefit plastic surgeons and their patients. From expanding breast reconstruction coverage through the Women’s Health and Cancer Rights Act and patient education through the Breast Cancer Patient Education Act, to advocating for COVID-19 relief measures for medical practices, PlastyPAC delivered results.

Looking ahead, PlastyPAC remains focused on advancing policies that matter most to our specialty. In the next legislative session, priorities will include introducing new legislation to expand access to breast reconstruction, ensuring fair physician reimbursement and addressing administrative burdens that interfere with patient care.

Investing in our future

As we celebrate the successes of the 2024 election, we recognize the challenges ahead.

Opposing groups are ramping up their advocacy efforts, and the fight for sound healthcare policy continues. With the ongoing support of ASPS members, PlastyPAC is well-positioned to meet these challenges head-on.

Supporting PlastyPAC is an investment in the future of our specialty. Your contributions ensure that the voices of plastic surgeons and their patients are heard in the halls of power.

Visit plastypac.net to learn how you can get involved and make a difference. PSN

Thank you, PlastyPAC contributors

lastyPAC, the bipartisan political action committee of ASPS, works to educate and influence Congress on issues that directly affect plastic surgery. As the largest voice for reconstructive and cosmetic surgery, PlastyPAC is grateful for the support of the following people whose contributions during November help play a key part in the specialty’s success on Capitol Hill.

Alabama Christopher Park, MDu California Debra Johnson, MDI Florida Christopher Brooks, MDI Andrew Rosenthal, MDI

Massachusetts Theodore Calianos, MDI Carolyn Rogers-Vizena, MD New York B. Aviva Preminger, MD, MPHu Scot Glasberg, MDI

North Carolina Lynn Damitz, MDH

Pennsylvania Sean Li, MDs

Ohio R. Michael Johnson, MDI Christiane Ueno, MDI

Presidential Circle: $5,000 (max) L Congressional Circle: $3,500+ H Premier Circle: $2,000+ Chairman’s Club: $1,000+ u Patron: $500+ s Young Plastic Surgeons: $200+ n Residents: $25+ J

I

January/February 2025

The 2025 Plastic Surgery Coding Guidebook is Here!

Accurate Coding at Your Fingertips

Updates for 2025: Evaluation & Management • 17 NEW codes to report Telemedicine Services • Deletion of Telephone E&M codes

8 NEW codes for Skin Cell Suspension Autograft (SCSA) Expanded section for Hand, Digits, Wrist & Forearm Repair • Including NEW code for carpometacarpal (CMC) suspension arthroplasty • Updated guidelines and revised code descriptor to reflect this addition and new reporting guidelines

Expanded Section!

11010

WRVU 4.19

WRIST, FOREARM, HAND & DIGITS GLOBAL 010

DESCRIPTOR

4.94

010

20670

WRVU 1.79

GLOBAL 010

DESCRIPTOR (separate procedure)

of an open fracture and/or an open dislocation (e.g., excisional debridement); skin and subcutaneous tissues

11011

CPT CODE

Debridement including removal of foreign material at the site

performed alone or with other unrelated procedures/services it may be reported. If performed alone, list the code; if performed

See ASPS Coding Corner – September 2021

Debridement including removal of foreign material at the site

of an open fracture and/or an open dislocation (e.g., excisional

Surgical trays, A4550, are not separately reimbursed by Medicare; however, other third-party payers may cover them. Check with the

debridement); skin, subcutaneous tissue, muscle fascia, and muscle

11012

6.87

010

20680

5.96

090

See ASPS Coding Corner – April 2021, September 2021

Debridement including removal of foreign material at the site

Wrist, Forearm, Hand & Digits

CPT CODE

Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)

See ASPS Coding Corner – October 2018

of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone

(For debridement of skin, i.e., epidermis and/or dermis only, see 97597, 97598)

(For active wound care management, see 97597, 97598) (For debridement of burn wounds, see 16020-16030) See ASPS Coding Corner – April 2021, September 2021

see 20670.

20690

8.78

090

Application of a uniplane (pins or wires in 1 plane), unilateral,

20692

16.27

090

Application of a multiplane (pins or wires in more than 1 plane),

See ASPS Coding Corner – January 2008

Debridement associated with open fractures and/or dislocations may be reported separately when gross contamination requires

prolonged cleansing and removal of appreciable amounts of devitalized or contaminated tissue. When debridement is performed

fractures/dislocations, see 11042-11047. For debridement of skin only and/or active wound care, see 97597-97598. For debridement of burn wounds, see 16020-16030. Surgical trays, A4550, are not separately reimbursed by Medicare; however, other third-party

11760 11762

1.63 2.94

010 010

1.00

000

6.06

090

20694

4.28

090

63.09

090

anesthesia (e.g., new pin[s] or wire[s] and/or new ring[s] or bar[s])

Reconstruction of a nail bed with graft

Local anesthesia is included in this service. However, this procedure may be performed under general anesthesia, depending on the age and/or condition of the patient. Surgical trays, A4550, are not separately reimbursed by Medicare; however, other third-party

20527

20693 Repair of nail bed

Injection, enzyme (e.g., collagenase), palmar fascial cord (i.e., Dupuytren’s contracture)

(For manipulation of palmar fascial cord (i.e., Dupuytren’s cord post enzyme injection (e.g., collagenase), use 26341)

For manipulation of the palmar fascial cord following the enzyme injection, see 26341. For percutaneous palmar fasciotomy, see 26040. For open partial palmar fasciotomy, see 26045. For multiple injections performed into a single cord, CPT code 20527 may only

see 20690-20692.

20808

Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation

(To report replantation of incomplete hand amputation, see

be reported once..

New Codes, Updated Sections, Refreshed Look

Order Today!

January/February 2025

Scan the QR code to get your copy13

YOUNG P L A S T I C

S U R G E O N S

PERSPECTIVE WRITTEN BY AND FOR YOUNG PLASTIC SURGEONS

Managing the stresses that can affect any plastic surgeon

By Andrew McGregor, MD

YPS P e r s p e c t i v e

S

tress and anxiety are unfortunate parts of everyone’s life – especially as surgeons. As the transition from resident to attending occurs, many young surgeons feel that the stress of residency will diminish or go away completely. Although the transition can have its positive aspects, the stress of becoming an attending can prove to be much more pronounced than most young surgeons realize. Being fully responsible for your own patients can be daunting within the first years of practice. Stress and anxiety management during the first years of an attending’s career can help facilitate better overall well-being and better long-term performance.

Stress as a young surgeon can manifest itself in many forms. For most plastic surgeons in the first years of practice, stress emerges in a much different way than it might have during residency. For example, as a resident, stress might have resulted from managing a large patient load between multiple attendings, anxiety about in-service, fellowship matching and/or an intense workload. As a young surgeon, stressors often shift to the more detailed, technical aspects of surgery, preparation for boards, the pressures of ensuring patient satisfaction and making yourself productive in early years of practice.

Stress and anxiety in these years can have downstream effects. Weight gain, poor sleep patterns and depression are some of the effects

14

of poorly managed stress levels. These can then affect your work patterns, performance and productivity – as well as interfere with personal relationships.

Fortunately, there are ways to combat and manage both stress and anxiety as a young plastic surgeon. Exercise is great a way to help mentally reset your mind, especially from a stressful day or long case. It can be done through many activities – walking, jogging, biking, swimming, weight training or any combination of these. Engaging in activities that help you reset, review your thoughts and provide a break from the demands of surgery can help you not only perform better in the O.R., but also make you more efficient in day-to-day tasks. Exercise does not have to be an intense activity all the time, either. Moderate-level activity has been shown to be better for fat loss and maintaining weight, rather than constant high-impact activities that can also put you at risk for injury.

Another area that many people forget to focus on is carving-out time for hobbies outside of surgery. Residency can make you feel that your entire life is consumed with – and must be dedicated to – medicine. As you become a young surgeon, it’s important to realize the inherent need to have interests outside of practice. Whether playing an instrument, cooking or any of the other array of hobbies (Editor’s Note: Every issue of PSN highlights ASPS members’ non-clinical pursuits on “The Last Stitch” page at the end of

the magazine), it’s vital to have an outlet of stress relief that does not involve medicine. Indulging in these activities can sometimes make surgeons feel guilty that they’re not devoting enough time to the profession. Nevertheless, having an outlet to do something outside of surgery can prevent the burnout and fatigue associated with surgical specialties.

Fuel, focus

It’s also easy to forget that an important way to manage stress and anxiety is by taking the time to focus on what kind of fuel you are putting into your body. As a resident, many of us survived on a diet of graham crackers and peanut butter to get through a long day. The sustainability of limited nutrition during the day, however, leads to binge behavior. This then sends your body into a state of innate stress. One lesson I personally learned is that being a surgeon can, at times, be akin to being a professional athlete. To perform well, you must have fuel in the tank to execute a great surgery. Plastic surgeons often neglect to eat in order to push through tasks. In the long run, however, this can have a negative effect of weight gain and metabolism regulation as well.

Interpersonal relationships outside of your practice can also be a source of stress for young surgeons. Whether trying to navigate the waters of the dating world, working through issues with your spouse or trying to find the time

to focus on building a family, there are plenty of matters outside of the O.R. to exacerbate stressors in other facets of any surgeon’s life.

Many young surgeons had children in residency, which often cut into the limited free time that surgeons enjoy or anchor school and extracurricular commitments on your spouse. Stress and anxiety can be managed by communicating well with your partner. Whether you are trying to have a baby or commuting two kids to soccer practices, you and your spouse are a team – and a lack of communication will ultimately foster a sense of anger and resentment. It’s also important to remember that your children are only young once. If your schedule permits, be there for them. They remember more than you think.

The first years of developing your career in practice are a great time to not only build your technical wheelhouse, but also fortify the cornerstones of who you are as a person. Stress and anxiety will never go away – they are, unfortunately, an inbuilt part of our lives. Being able to manage them to make you more productive is a key part of any plastic surgeon’s growth and development. This will not only lead to becoming a better professional – and to becoming a better individual overall. YPS Dr. McGregor specializes in plastic surgery of the breast and body, and is in private practice in Melbourne, Fla.

January/February 2025

‘Temet nosce’ – or how The Matrix can help guide your job search

By Noah Saad, MD

A

tall, handsome man walks into a cramped kitchen, freshly baked chocolate chip cookies filling his nostrils. An elderly woman sits by the oven waiting for the cookies to finish, as she greets him. He’s hesitant and cautious, unsure of what to expect of his meeting with “The Oracle.” Neo has risked his life and the lives of the other rebels to find out if he’s “The One.” During this meeting, the Oracle points to a piece of art that says “temet nosce” and tells Neo it means “know thyself.”

After some time, the Oracle gives Neo the onceover and proclaims that while he has the gift, he’s not The One. (Spoiler alert: He is; he was just waiting for another life.)

Now some of you might be asking, “What the heck does The Matrix have to do with plastic surgery?” Even more to the point, “What does this have to do with whether I’m going to go into academics or private practice?”

Those are great questions, and the answer

lies in that Latin phrase: Temet nosce. Besides the fact it’s my favorite scene in one of my favorite movies, it has so much to offer in wisdom. In short: Nobody can tell you whether you should go into an academic practice or private practice.

Only you truly know where you will be happy, but to find your answer, you need to be honest with yourself. What drives you? What makes you happy? What is important to you? These are the questions you need to ask yourself before you make a decision. We’ve all spent years and decades of our lives training to weigh the risks, benefits, pros and cons of performing any procedure. In truth, there are no pros and cons when comparing an academic practice and a private practice. They each offer different things. One is no better or worse than the other.

When I was going through my own job search, I interviewed with both academic and private practices. After my interviews, I needed to sit down alone and weigh what each opportunity offered me. In the end, my path to becoming an attending informed my decision

that staying in academic medicine would provide me with the greatest sense of fulfillment.

I suppose I should lay out what each type of practice offers, seeing as how the idea for this column is to provide advice on forging your future path. When I’m asked by my residents why I chose academics, I tell them what it has offered me. I love watching residents progress through training. Seeing a once hesitant, uncertain intern become a confident, competent chief resident is fulfilling to me. It’s so much fun watching that lightbulb switch on for each resident. I love being a small part of their growth. I love the mentorship that I can provide. I was excited about the research opportunities and additional resources available to me – and the great mentors that could help me as I tried to focus on the type of research I wanted to pursue. Additionally, being in a larger academic institution provides opportunities to handle more complex cases with patients, which can be very exciting.

Nevertheless, when I considered private-practice opportunities, I was intrigued by

the potential to be my own boss (or one of them, when I became a partner). Private practice can also widen the geographic opportunities to consider. The partners with whom I interviewed all spoke of their lifestyle, built-in flexibility and the ability to have more free time. They also noted the financial benefits of being in private practice – as your salary can be significantly higher than in academics. Perhaps most importantly (at least to my own job search), going into private practice does not mean that teaching and educational opportunities will not be available or expected through academic affiliations.

At the end of the day, nobody can tell you where you will be happiest. The path to finding your own fulfillment is an individual process that requires no shortage of reflection and soul searching. So, temet nosce – and good luck! YPS Dr. Saad is a clinical assistant professor of surgery in the Division of Plastic and Reconstructive Surgery in the Department of Surgery at the University of Michigan, Ann Arbor.

By Hannes Prescher, MD

“Ever tried? Ever failed? Try again. Fail again.

Fail better.” – Samuel Beckett

T

he best predictor of failure in plastic surgery is inexperience. This is true no matter the subspecialty – microsurgery, craniofacial surgery, hand surgery or aesthetic surgery.

Moreso than the technique used, the severity of the injury or the complexity of the defect or deformity, the factor consistently associated with higher complication rates is the surgeon’s number of years in practice. Failure is a given and, in many ways, an enemy that only time can tame – though never fully defeat. The challenge then is to fail with style, to appreciate the process and learn how to fail better until the outcome consistently resembles something like success.

Failure in surgery feels personal and uncomfortable. In the late 1970s, Charles Bosk, then a graduate student in sociology at the University of Chicago, published a book called Forgive and Remember. He was interested in how surgeons behave in matters of uncertainty and how they deal with mistakes and failure. After spending 18 months shadowing the house staff and faculty of several surgical services, he surmised that surgeons differ from other specialties foremost in how they frame complications.

“When the patient of an internist dies, the natural question colleagues ask is, ‘What happened?’ ” Bosk wrote. “When the patient of a surgeon dies, colleagues ask, ‘What did you do?’ ” A morbidity and mortality conference highlights what you could have done differently.

Although this weighty personal responsibility for failure is what creates tension in early-career surgeons, there are also opportunities for growth that arise from mistakes. Importantly, there’s an inherent immediacy in the feedback and agency in making improvements. We have control over how we respond to failure. Failing with style January/February 2025

means taking ownership of mistakes and staying committed to the notion that the future surgeon we evolve into will benefit from them.

It’s important to recognize that compared to the future version of ourselves, every day is a failure in some sense – be it in efficiency, management or delegation of team members, setup

or technique. These factors might not always lead to the dreaded complication but staying alert and cognizant to how they affect and directly impact our practice will accelerate what we ultimately hope for, which is to arrive at a future version of ourselves that’s less prone to mistakes.

The famous cellist Pablo Casals, on being asked why at the age of 93 he still devoted three hours a day to practicing, replied: “I’m beginning to notice some improvement.” Improvement happens in small, incremental – and often invisible – steps. However, it only happens through failure.

The framing of failure matters. Atul Gawande, MD, an endocrine surgeon at Brigham and Women’s Hospital in Boston, and the author of several best-selling books, has written extensively about surgical complications and the process of betterment. He emphasizes the importance of systematically analyzing performance and being deliberate in practice. Elite performers, he writes, set themselves apart by having a talent not only for their craft, but more importantly, a talent to practice at it. He sees failure as an opportunity and identifies the character of the practitioner as the most important predictor of future success.

Most important, he argues, is to have people who are “conscientious, industrious and boneheaded enough to stick at practicing this one difficult thing day and night for years on end.”

In other words, much of the style in failure lies in the response and the willingness to engage with it and convert it into something productive.

That often requires seeking the advice of mentors and admitting one’s failings and mistakes.

It’s said that the best fellowship is the first year in practice. The intimacy of the failings during the preliminary years – when the expectation is that failure should be a thing of the past – make the lessons more profound. Failing with style means that these mistakes ultimately lead to improvement. The challenge is to try to live comfortably in the discomfort of constant failure – to put yourself in the same situation over and over again. To fail again, but to fail better. YPS Dr. Prescher serves as a clinical assistant professor in the Division of Plastic and Reconstructive Surgery in the Department of Surgery at the University of Michigan, Ann Arbor.

15

YPS P e r s p e c t i v e

Failing… with style: Taking lessons and encouragement from defeat

The PSF thanks all those who donated in 2024

T

he PSF’s excellence and leadership within the specialty depend greatly on the generosity of ASPS members. From annual gifts that make an immediate impact to endowed gifts that support future generations of plastic surgeons, contributions to The PSF serve as the catalyst of innovation for our specialty.

Last year, your generous contributions, professional achievements and selfless enthusiasm enabled The PSF to perpetuate its reputation as the most distinguished research foundation in the specialty. Thanks to your generosity, The PSF provided grant funding for investigator-initiated research projects, international scholars at U.S. plastic surgery institutions, distributed Breast Reconstruction Awareness Fund grants to U.S.-based charities and awarded Charitable Care Breast Reconstruction Awareness Fund grants to cover breast cancer surgical care costs for women who otherwise could not afford reconstruction. A total of 1,385 donations were made from Jan. 1 through Dec. 31, 2024.

Sapphire

R. Barrett Noone, MD Robert Ruberg, MD Randy Sherman, MD*

Platinum

Eugene Podsiadlo Sherwood Smith, MD

Diamond

Daniel Freet, MD C. Scott Hultman, MD, MBA Lindsay Nixon

Gold

THE PSF THANKS YOU

Daniel Careaga, MD Brooke Clark Mimis Cohen, MD Amber Leis, MD Babak Mehrara, MD Andrea Pusic, MD, MHS Christine Rohde, MD, MPH Justin Sacks, MD, MBA

Sterling

Frank Agullo, MD Ashley Amalfi, MD Jeffrey Ascherman, MD Nebil Aydin, MD Bruce Baker, MD Haven Barlow Jr., MD C. Bob Basu, MD, MBA, MPH Richard Baynosa, MD Michael Bentz, MD Gunnar Bergqvist, MD Steven Bonawitz, MD Earl Campbell, MD Angela Cheng, MD Jerry Chidester, MD Michael Christy, MD

Maliniac Circle

The Maliniac Circle was named for ASPS co-founder Jacques Maliniac, MD. Fellows of the Maliniac Circle have made an outright gift of $50,000 or more, or a minimum deferred gift of $100,000, advancing plastic surgery to a higher level through research, innovation and public service. The following is a complete list of Maliniac Circle members. We thank them for their commitment to the specialty.

Dr. Bruce Achauer* Dr. John and Candese Alexander Dr. Bernard and Susan Alpert Drs. Darrick and Elizabeth Antell 16

Mark Clemens, MD Michael Costelloe Lynn Damitz, MD Dina Eliopoulos, MD Heather Erhard, MD Peter Fayek Randall Feingold, MD Brooke M. French, MD Katerina Gallus, MD John E. Gatti, MD Lloyd Gayle, MD Gayle Gordillo, MD Amanda Gosman, MD Karol Gutowski, MD Josef Hadeed, MD William Y. Hoffman, MD Julie Holding, MD Karen M. Horton, MD, MSc Robert Howard, MD Kenneth C. W. Hui, MD Debra Johnson, MD Timothy King, MD, PhD Janice F. Lalikos, MD Danielle LeBlanc, MD Michele Manahan, MD, MBA Bernard Markowitz, MD Erik Marques, MD Timothy Marten, MD Alan Matarasso, MD Evan Matros, MD Gwendolyn Maxwell, MD Mark Migliori, MD Paul B. Mills, MD Andrea Moreira, MD Brian Novack, MD Linda Phillips, MD Melissa Poh, MD Samuel Poore, MD, PhD Peter D. Ray, MD Michael Reed, Esq. Loren Schechter, MD Dr. Stephan and Viviane Leao-Baker Dr. Mark T. Boschert Dr. Keith and Tina Brandt Dr. Garry Brody* Dr. Richard E. and Colleen A. Brown Dr. Brentley and Diane Buchele Dr. Rafael C. Cabrera Dr. Theodore and Sheryl Calianos Dr. John and Laurie Canady Drs. Andrew and Amy Chen Dr. Eugene and Ruth Ann Cherny Dr. Norman and Pat Cole* Dr. Sydney Coleman Dr. Mark and Charlotte Constantian

Dr. Mary Ann Contongiannis and Ralph E. Huey Dr. Robert N. Cooper Dr. James R. and Gayle Cullington Dr. J. Douglas and Barbara Cusick Drs. Richard and Brenda D’Amico Dr. Tancredi D’Amore Dr. Lynn Damitz Dr. Glenn and Maryann Davis Dr. Sara R. Dickie Dr. Sharadkumar Dicksheet* Dr. T. Michael Dixon Dr. Christine Dowbak* Dr. Sepehr Egrari Dr. Walter and Carolyn Erhardt Dr. Daniel J. Freet

Leigh Spera, MD David R. Stephens, MD Srinivas Susarla, MD, DMD, MPH Gregory Swank, MD Raj Vyas, MD

Silver

Todd Adam, MD Ahmed Afifi, MD Richard Agag, MD Carl Askren, MD Rafael Avila, MD Glenn Becker, MD Paris Butler, MD, MPH James Butterworth, MD M. Bradley Calobrace, MD Holly Casey Wall, MD Alexander Chase Castillo, MD Manuel Chacon, MD Edward I. Chang, MD James Clarkson, MD Brannon Claytor, MD Michael Curtis, MD Jorge de la Torre, MD, MSHQS Anne DeLaney, MD Sara Dickie, MD Vidas Dumasius, MD Themistocles Economou, MD Sean Figy, MD Ronald Ford, MD Paige Fox, MD, PhD Robert D. Galiano, MD Noopur Gangopadhyay, MD Patrick Garvey, MD Jannine Griese Meegan Gruber, MD, PhD O. Allen Guinn, III, MD Jeffrey Gusenoff, MD Steven Haase, MD Barry Handler, MD Melinda Haws, MD Drs. Heather Furnas and Francisco Canales Dr. Roberta Gartside Dr. John E. Gatti and Margaret M. Gatti, Esq. Drs. David* and Lisa Genecov Dr. Diane Gibby Dr. Scot and Alisa Glasberg Dr. R. Cole Goodman Dr. Gayle M. Gordillo Dr. Arun and Smita Gosain Dr. Gregory A. Greco and Daniel Ranger Dr. Richard and Robin Greco Dr. Matthew Greives Dr. B. Rai Gupta Dr. Subhas and Seema Gupta Dr. Geoffrey and Kathryn Gurtner Dr. Karol and Ellen Gutowski

Dr. Bahman and Lora Guyuron Dr. Dan and Mrs. Lynsi Hatef Dr. James* and Barbara Hoehn Dr. Scott & Julie Hollenbeck Dr. C. Scott and Rev. Suzanne C. Hultman Dr. Ron and Nancy Israeli Dr. Ronald and Virginia Iverson Dr. Jeffrey and Emily Janis Dr. John and Marcia Jarrett Dr. Debra J. Johnson Dr. Michael Kalisman Dr. Susan Kaweski Dr. Brian Kinney* Dr. Gurmander and Maninder Kohli Drs. Joshua and Siobhan Korman January/February 2025

Dr. William and Linda Kuzon Dr. David and Sherry Larson Dr. David C. Leber Drs. Bernard and Britt Lee Dr. Charles K. Lee Dr. Edward Lee Dr. Samuel Lin Dr. J. William Little Drs. Joseph Losee and Franklyn Cladis Dr. Dennis and Mary Lynch Dr. Sergio Pasquale Maggi Dr. Raman C. Mahabir Fred* and Mary McCoy Foundation Dr. Michael McGuire* Dr. Dan and Jan Mills Dr. Peter Neligan Dr. Michael W. Neumeister

January/February 2025

Nicholas Webster, MD Larry Weinstein, MD Libby Wilson, MD Michael Wong, MD, MBA Arthur Yu, MD

Bronze

Peter Aldea, MD Robert Allen Jr., MD Adam Angeles, MD Stephen Baker, MD Jo Barta, MD Michael Bernstein, MD Alicia Billington, MD, PhD Cristiano Boneti, MD Keith Brandt, MD Kristen Broderick, MD Alberto Calvo Quiroz, MD Chris Campbell, MD Ubaldo Carpinteyro Espín, MD Michael H. Carstens, MD Ernest S. Chiu, MD Carrie Kai-Cheng Chu, MD Derek Cody, MD Al Cohn, MD J. Douglas Cusick, MD Alexander Dagum, MD Anthony N. Dardano, DO Gloria de Olarte, MD Patricia Eby, MD Gregory Evans, MD Robin Evans, MD Erin Finnigan Alberto Gallerani, MD Lisa Gfrerer, MD, PhD Amir Ghaznavi, MD Cory Goldberg, MD, MSc, MBA Luis Gonzalez Fernandez, MD Gregory Greco, DO Geoffrey C. Gurtner, MD Anoush Hadaegh, MD Adam Hamawy, MD D’Arcy Honeycutt, MD Tara L. Huston, MD Laurene Isip Ronald Iverson, MD Sonu Jain, MD Surinder Kaur, PhD Shahrooz Sean Kelishadi, MD Kenneth Kim, MD Jason Ko, MD, MBA Mark Labowe, MD W. Thomas Lawrence, MD Mary E. Lester, MD Patricia Mars, MD

Dr. R. Barrett and Barbara Noone Drs. John & Katie Osborn Dr. Douglas Ousterhout Dr. and Mrs. Vasu Pandrangi Dr. Christopher Pannucci Dr. Janet Parler Dr. Ash Patel Dr. James and Diane Payne Dr. John and Susan Persing Drs. Linda and William Phillips Dr. B. Aviva Preminger Dr. Patrick Proffer Drs. Andrea and Martin Pusic Dr. Norman and Deborah Rappaport Dr. Debra Ann Reilly-Culver Dr. William Riley Dr. Luis M. Rios, Sr.*

Dr. Luis M. Rios, Jr. Dr. Rod Rohrich and Diane Gibby Dr. Stephen Ronan Dr. Michelle Roughton Dr. Robert and Cynthia Ruberg Dr. Robert and Anne Russell Dr. Justin Sacks Dr. Kenneth* and Luci Salyer Dr. Bernard* G. and Rhoda G. Sarnat Dr. Loren S. Schechter Dr. James D. and Kathleen Schlenker Dr. Petra Schneider-Redden and Mr. Curt Redden Dr. Paul and Barbara Schnur Dr. Ali Seif* Dr. Jack* and Anita Sheen

David Mathes, MD G. Patrick Maxwell, MD Tiffany McCormack, MD Patricia McGuire, MD Daniel A. Medalie, MD Charlotte Michaelcheck, MPH Taro Mikami, MD, PhD Raymond Mockler, MD Anita Mohan, MBBS, MRCS, PhD, MBA Adeyiza Momoh, MD Robert X. Murphy, Jr., MD Paige Myers, MD G. Neurohr, MD Marilyn Ng, MD Rajiv Parikh, MD Anne Peled, MD Alain Polynice, MD Ariel N. Rad, MD Sashank Reddy, MD, PhD Brian Reedy, MD Andrew H. Rosenthal, MD Stephanie Rowen, MD Moises Salama, MD George Sanders, MD Adam Schaffner, MD Christopher Shale, MD Makoto Shiraishi, MD, PhD Sachin Shridharani, MD Catherine Sommers Jeff Swail, MD Jordan Swanson, MD, MSc Shruti Tannan, MD Peter Taub, MD Jesse Taylor, MD Rudolf Thompson, MD Winnie Tong, MD Dawn J Wang, MD Jane Weston, MD Mark Wigod, MD Steven Williams, MD Kerri Woodberry, MD, MBA June Wu, MD Wayne Yamahata, MD Diana Yoon-Schwartz, MD, PhD

THE PSF THANKS YOU

Scott Hollenbeck, MD Henry Hsia, MD Gary R. Jacobs, MD Ellen Janetzke, MD Jay Arthur Jensen, MD Sang Yoon Kang, MD Christopher Killingsworth, MD Sugene Kim, MD Jeffrey Kozlow, MD, MS Aleksandra Krajewski, MD Gordon Lee, MD Sao Ieng Leong, MD Scott Lifchez, MD Samuel Lin, MD, MBA David D. Lo, MD Carl Manstein, MD, MBA, CPE Aaron Mason, MD Bruce Mast, MD Gina McClure Joyce McIntyre, MD Alexander Mericli, MD Charles A. Messa III, MD Louis Miller, MD Kerry-Ann Mitchell, MD, PhD Lisa C. Murcko, MD Jason Mussman, MD Minh-Doan Nguyen, MD, PhD Phuong Nguyen, MD Son Nguyen, MD Janet Parler, MD Elizabeth Peterson, MD Brett Phillips, MD, MBA Ashley L. Pistorio, MD, MS Julian Pribaz, MD Edward Ray, MD Edward Reece, MD Renee Robbins Carolyn Rogers-Vizena, MD Paul Rollins, MD Lorne Rosenfield, MD Malcolm Roth, MD Paul Ruff IV, MD Marc J. Salzman, MD Rajendra Sawh-Martinez, MD, MHS Wesley Schooler, MD Warren Schubert, MD Peter Schwartz, MD Reginald Sherrill, MD Lane Smith, MD Isaac Starker, MD Thomas Trevisani, MD Victoria Vastine, MD Christian Vercler, MD Natalia Vidal, MD Robert D. Wallace, MD

Giving levels Sapphire: $25,000+ Platinum: $10,000 - $24,999 Diamond: $5,000 - $9,999 Gold: $2,500 - $4,999 Sterling: $1,000 - $2,499 Silver: $500 - $999 Bronze: $375 - $499 Dr. Michele Shermak and Mr. Howard Sobkov Dr. Randy Sherman* Dr. Reginald L. Sherrill Dr. Geoffroy and Lauren Sisk Dr. Margaret and Stephen Skiles Dr. Sherwood and Judith Smith Dr. David H. and Janie Song Dr. Scott* and Cynthia Spear Dr. John (JT) Stranix Dr. Anne Taylor and David Heutel Dr. Kevin Tehrani Dr. Jacob Unger Dr. Karen Vaniver* Drs. Nicholas B. Vedder and Susan R. Heckbert Dr. Charles and Gale Verheyden

Dr. Amy Wandel Dr. Philip D. and Elizabeth L. Wey Dr. Linton and Renata Whitaker Dr. Thomas C. Wiener Drs Steven Williams and Anita Reddy Dr. Robert* and JoAnne Winslow Dr. Elvin* G. and Sharon Zook Anonymous (2)

*Deceased

17

PSF/DePuy Synthes Craniomaxillofacial Research Grant

Investigating a cell-free therapy for wound healing Dr. Lee: The upregulation of OPG may be attributed to the extended phosphate release and mechanical properties of the hydrogel, which likely create a microenvironment conducive to anti-osteoclastogenic signaling. This highlights the interplay between material composition and cellular responses, suggesting a novel mechanism of action for the composite material.

By Jim Leonardo

Editor’s note: The following is part of an ongoing series highlighting The PSF Research Grant Award winners, and research they’re conducting to improve patient safety and develop new technologies for plastic surgeons. These features examine research funding awarded prior to the current year, as projects to which grants were awarded this year may not yet have results ready to discuss.

THE RESEARCHER

FOCUS ON PLASTIC SURGERY RESEARCH

Justine Lee, MD, PhD Title: Professor and Associate Chief, Bernard G. Sarnat Endowed Chair, UCLA Division of Plastic Surgery Award: PSF/DePuy Synthes Craniomaxillofacial Research Grant Project: Phosphate-eluting Composite Biomaterials for Skull Regeneration PSN: What’s your objective in studying phosphate-eluting composite biomaterials?

Dr. Lee: The project seeks to assess the impact of a phosphate-eluting hydrogel (MCGPh) integrated with nanoparticulate mineralized collagen glycosaminoglycan (MC-GAG) on osteogenesis and skull regeneration. Specifically, it aims to evaluate how MCGPh enhances osteoprogenitor differentiation and mineralization compared to MC-GAG in vitro, and to determine its efficacy in promoting in vivo bone regeneration, biomechanical properties and safety in a rabbit calvarial defect model.

PSN: How far along are you in this work?

Dr. Lee: The project has successfully completed in vitro studies demonstrating that MCGPh significantly enhances osteogenic differentiation, late osteogenic gene expression and mineralization in human mesenchymal stem cells.

In vivo studies have shown that MCGPh leads

A costumed Dr. Lee (right of center, white-and-pink paw gloves) in her annual lab photo; a group selfie taken by Kelly Huang, BS, for Dr. Lee’s (powder blue shirt) lab graduation event; and 8-year-old Tiberius, named after Star Trek’s James Tiberius Kirk, lurks in the grass. to improved skull regeneration, radiographic bone formation and biomechanical properties compared to MC-GAG. The most promising variant, aMCGPh40, showed sustained phosphate release, upregulated osteogenic signaling, and superior integration and stability.

PSN: What do you see as the practical possibilities of your research?

Dr. Lee: This project has potential clinical applications in developing off-the-shelf materials for skull regeneration and other bone defects.

The findings could pave the way for more effective cell-free biocompatible scaffolds, addressing limitations in current bone grafting materials. Future possibilities include expand-

ing in vivo testing to other defect models and translating the material for human use.

PSN: Has anything unexpected surfaced, and how could it change your research?

Dr. Lee: An unexpected finding was the extent of osteoprotegerin (OPG) upregulation by aMCGPh40, which enhanced anti-osteoclastogenic activity. This suggests that MCGPh might not only promote osteogenesis but also modulate bone remodeling more effectively than anticipated. This could broaden the focus to explore its role in conditions with excessive bone resorption.

What are your thoughts as to what’s behind that development?

PSN: Who are the individuals who helped with this work?

Dr. Lee: I would like to thank my co-investigators, Youngnam (Emma) Kang, PhD, and Wei Chen, PhD. Dr. Kang is a young material scientist who has been instrumental in all of the synthesis, material characterization and design of in vitro studies of the MCGPh material. Additionally, she and Dr. Chen, one of our project scientists in the lab, performed the in vivo experiments in conjunction with Meiwand Bedar, MD, MSc, a former postdoctoral Fellow in the laboratory who is currently a general surgery resident at Harbor-UCLA. PSN: What did you want to be when you grew up?

Dr. Lee: Growing up, I aspired to be a pediatrician. Later, after completing my PhD, I thought I would become a pediatric hematologist-oncologist. When I finally encountered plastic surgery, I realized that I wanted to be a plastic surgeon. Ultimately, I merged the science side of my life with the medical side and became a surgeon-scientist.

PSN: What’s been your favorite research project besides this?

Dr. Lee: My favorite scientific project outside of my basic science work is understanding mental health quality-of-life outcomes for transgender and gender-nonbinary patients who undergo facial gender-affirming surgery. One of the most important aspects of this research is determining whether and how facial reconstruction improves symptoms of dysphoria, mental health and overall quality of life. Beyond improving patient outcomes, this research helps drive changes at the health policy and insurance coverage levels by providing rigorous data that was previously absent in the literature – an obstacle that has significantly hindered patient access to these surgeries.

PSN: How do you spend your time away from the lab?

Dr. Lee: I enjoy yoga, Pilates, hanging with my peoples and walking my skunk dog.

PSN: What sounds are most often heard in your lab?

Dr. Lee: I love ’90s hip-hop, especially West Coast. I detest angst.

For more information about the many research studies funded by The PSF or to support our current and future research initiatives, please go to ThePSF.org. PSN

18

January/February 2025

Furthering innovation

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By Paul Snyder

January/February 2025

ince its inception, plastic surgery has been a specialty built on a foundation of innovation – one which continually pushes the field of medicine toward new horizons. Whether these are groundbreaking medical advancements – such as Joseph Murray, MD, winning the 1990 Nobel Prize for Physiology and Medicine for the world’s first successful kidney transplant – or seemingly minor upgrades to O.R. equipment that made work incalculably easier for the generations that followed, the innovative spirit still burns brightly within the specialty.

Now further fostered by ASPS offerings such as the Innovation Challenge at Plastic Surgery The Meeting or through the ASPS/MedTech Innovator Accelerator program, which helps plastic surgeon innovators to get their ideas in the marketplace, the Society continues to actively support innovation in techniques and products that can change how plastic surgeons practice. The following are introductions to six companies that are toiling to advance medicine through an array of products and technologies.

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Company: Akeyna Location: Boston edle hanced injection ne celerator Product: Sensor-en tor Plastic Surger y Ac va no In ch Te ed /M PS Presented: 2024 AS

stic surgeons’ ideal way to get pla and develan s wa led tai oads ng a de ack and make inr keyna isn’t providi a patient’s feedb ing relationships with the ASPS of on ati loc the of rk map op wo l – but it might ys. “We gained every blood vesse community,” she sa on the kinds mco e Th . ng xt best thi rspective be providing the ne blood vessel-detec- valuable pe with ons that happen ed ati lop lic ve mp de co s ha of e pany tur that s nia ue mi iss a r of the form s, and large tion technology in that dermal filler th fat-transfer procele ed ne a of tip the in wi sensor embedded ect doctors face erful to receive they are about to inj dures. It was wond ration of the warns physicians if od vessel. bo lla co d blo the insight an dermal filler into a o met with us objective,” says wh the ns y eo all rg re su is c “Safety r of plasti de un -fo co d g Plastic Suran rin O du CE in San Diego fKaren Cronholm, o sa the ng idi out prov ting 2024 and wh Akeyna. “This is ab e for their patients, gery The Mee htec r ou r fo ity fin nc af rie an est and best expe kept expressed benefit to mind. One thing I y. They see a clear log no r but also peace of fo l tia ten actices.” po pr the ir is the s d an an ici their patients hearing from phys inse the gy has m olo fro lications The Akeyna techn catastrophic comp and is ” ht.

GH M nig m at fro up d jections keeps them ced needle is de - been license Cronls. preclinical tria The sensor -enhan fastened now in the product has underbe n ca d an tile signed to be versa nee- holm says ringe. Should the testing and Akeyna to any standard sy with a blood vessel, gone animal ct ing clinical studies. dle tip come in conta a flashing red light. is now plann to see ance will be needed the physician will green FDA clear d a , an , ea ns ar ma n hu tio ec on t inj uc use the prod If they’re in a safe de the anticipates light is displayed. n, but Cronholm be eo d rg su an c ce sti an pla ar a cle t Cronholm is no in vice will gain next couple years’ experience in the market in the a scientist with 30 ed rk wo s ha o wh try us the life sciences ind of multiple medical of years. ditional nt “If patients see ad they on the developme both dert , or ce pp pla su in to ts es ur uc fety meas devices and prod y. The Akeyna sa feel a greater sense of er rg su c sti pla d an matology chu- will veloped at Massa dergoing these technology was de and Cronholm says comfort in un l she says. “The ita sp ,” es Ho l ur ra ed is not setts Gene ASPS/ proc the in on s product is that it ati cip rti ou key thing ab t thi – it’s lthe company’s pa ce ion lut Ac y so er a r rg fo Su g c lookin r Plasti MedTech Innovato specialty’s interest in a technology problem that doctors are the an answer to a erator highlighted e. cing today.” the devic ASPS/MTI cohort fa “Being part of the

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Company: Avance Innovations Location: London, United Kingdom Product: ORASIS Presented: 2024 ASPS/MedTech Innovator Plastic Surgery Accelerator

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hen London-based plastic incre asing autonomy, reducing stress and surgery resident Ankur Kha- maki ng the whole process much more effijuria, MD, went to India to do cient .” lab-based microsurgical training with rats, The device was the runner-up in the it didn’t take long for him to recognize an ASPS Innovation Challenge in 2023 and issue that’s faced microsurgeons for year s. got a further boost in being part of the 2024 “It was a pretty challenging task – conASPS/MedTech Innovator Plastic Surg ery necting vessels in a live rat model – and Accelerator. there was active bleeding and fluid pool “To meet and interact with other plasing,” he says. “Without any assistance , I tic surgeons and other innovators really was having to clear the field and then try seemed to fast-track my process and allow to stitch, and I thought: ‘There needs to be a me to better anticipate potential prob lems better way of doing this.’ ” with bringing the product to market,” Dr. Reaching out to contacts who had a Khajuria says. “Within the ASPS/MTI co3D-printing facility and partnering with hort, we created a community where we World Society for Reconstructive Microsur - reach out and talk to each othgery President-Elect Joon Pio Hong, MD, er, make introductions – it’s all PhD, MBA, the wheels were quickly put in been great.” motion on ORASIS, a 3D-printed devic e Dr. Khajuria says he plans for vascular anastomosis with autonom ous to begin clinical trials for ORA irrigation and suction that cuts operative SIS, which is already on the time, enhances vessel clarity and redu ces FDA register, this year. After costs for plastic surgery practices. that he hopes for a limited mar“I really think this will be a major disrupket release in some key hospitals tor in the space and transform the way we throughout the United States. do microsurgical anastomosis,” Dr. Khajuria “We’re starting with plassays. “It’s typically done with an assistant, tic surgery, but I can see appliand there are many interruptions that caus e cability in lymphatic surgery, psychological stress and other burdens.

It head-and-neck surgery, sarcoma also can prolong operative time and caus e surgery and more macrovascular patient safety concerns through poss ible applications, as well,” he says . damage to the vessel. With ORASIS, you’ re “Once the device gets more wide spread use, I think that will broaden the adoption into other hospitals and enable some strategic partnerships with large distributors to scale the product.”

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January/February 2025

Company: Fasciotens GmbH Location: Essen, Germany Product: Fascial traction device for complex hernia surgery Presented: 2024 ASPS/MedTech Innovator Plastic Surgery Accelerator

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n the three years since fasciotens and bigger. We didn’t set out brought its fascial traction device to treat with the idea of using this deabdominal wall defects to market, it has vice for complex hernias or inbecome available in more than 30 coun - traoperatively – it all just came tries throughout Europe, Asia, Australia to light after we used it on the and Africa – and been part of more than first few cases.”

2,500 successful procedures.

The company also has two “The ultimate goal is to bring this to the other devices in the European United States,” says Clemens Winkler, MD, market for open abdomen prothe company’s head of medical and scien - cedures and to repair congentific affairs. ital defects in pediatric patients.

That’s why Dr. Winkler says the inter The company says the data it facing with U.S.-based surgeons in the received from use in the Euro2024 ASPS/MedTech Innovator Plast ic pean market is very convincSurgery Accelerator proved invaluable.

It ing, and that plastic surgeons provided the opportunity to connect with who took part in ASPS/MTI experts and mentors who shared insig hts cohort were enthused by the on what’s needed to gain FDA approval. device’s possibilities.

The company would like to have its her“Many experienced plasnia device available in the U.S. market by tic and general surgeons 2026. know that large abdominal The product in question provides on-dewall defects require multimand lengthening of the abdominal wall ple techniques for closure,” for complex hernia surgery. The typic al Dr. Winkler says. “Beyond approach to closing complex ventral hern i- a certain defect size, closing as without bridging involves extensive re- them becomes extremely constructive procedures. These procedur es challenging, even with all the often lead to higher complication rates available surgical techniques. and a weakened lateral abdominal wall.

Our device is another tool in the box.

It’s The hernia device applies standardiz ed a completely new approach that can help vertical-diagonal traction to the abdomiyou overcome these hurdles. The big and nal wall. By using diagonal traction on the unique advantage is it stretches the ablateral abdominal wall, it enables myofasdominal wall in a controlled and repro cial lengthening and the possibility of direc t ducible manner. The data we’ve alrea dy fascial closure. gained from European studies show that, The prototype of the device, Dr. Winkler in most cases, we can lower the complicanotes, emerged from a private project. tion and recurrence rates. This is an impo rt“We just wanted to see what was ant step to make abdominal wall recon achievable,” he says. “Then it grew bigg er struction easier and bette r.”

Company: ImageAssist Location: Nashville, Tenn.

Product: Clinical photography mobile app Presented: 2023 ASPS Innovators Challenge (Winner)

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and the 4D-EMR system mageAssist was born from a “pain point” medical software member Robert Pollack, ASPS by ed develop MD, , Golinko l Michae r that ASPS membe and export features search tag, Easy MD. noticed in his Vanderbilt University medation of photos organiz ss seamle provide raphy photog patient h Althoug ical practice. . Dr. Golinko options sharing g securin and ns’ is critical to his – and most plastic surgeo video of particutake can app the says also in mainta to trying that says – work, he nt range of motion and consistency in those photographs was a lar areas to docume t deformities. Imagedifferen with ion animat ge. constant challen tes no matter where templa body has Assist “It’s great that ASPS created photoor extremities. torso face, – operate you notes.

Golinko Dr. ds,” graphic standar even though that add pers develo The if , “The problem is that, as a plastic surgeon with your phone, the taken are photos the ately immedi it it, do to nurses you’re training content secure behind a can interrupt your workflow. If you’re a busy app keeps that cloud, meaning that pant complia HIPAAa clinic in s patient 30 have you practice and show up when you not will photos tient day, it can be hard to get consistent photos. show a friend recent to phone your out pull of but critical so are back get The photos we Security is also photos. n vacatio or family such variable quality – and we’re making ric login. biomet through ed enhanc If photos. those on based s medical decision The product was first launched in VanI see a patient in the clinic, I depend on that Epic platform in 2021, and Dr. Goderbilt’s .” operate to time comes photo when it that since then, it’s been used on says linko With the Society’s patient photography 2,000 patients and put more than more teamed Golinko Dr. cue, a standards as photos into the sys5,000 than with coders at Vanderbilt, as well as Jon. ImageAssist is platform Epic tem’s 15 than more has who e– athan Sadlow anyone to use for le availab now years’ experience as an entrepreneur and store.

App Apple’s through of pment develo begin to – tech executive enjoyable ely extrem been “It’s an iOS mobile application that automaticaled develop are apps how seeing and frames ratios, rd standa ly provides the busireal very a also it’s but – to distances for any area that doctors need ness for me,” Dr. Golinko says. photograph for reference. that solved “The core idea stems from a mobile bank “It’s a cool project into turned and point pain a says.

Golinko deposit,” Dr. get We bigger. much ing someth the By using your phone to photograph hearing from tion satisfac of lot a ‘smart g pendin patentapp’s patient, the using it and frames’ use a color-coded system to let about other people practice, their helped it how say riateapprop is subject the you know when with ships relation ed improv ly aligned. The app also deletes the backthem saving also but – s patient industry an provide to photo ground of the and headaches standard blue background for all pictures overhead line.” the down Epic into ted integra ssly seamle and it can be

January/February 2025

tion Do you have an innova with that you want to share es? gu lea your ASPS col ng gi Email PSN Mana at er yd Sn Editor Paul g. .or ery rg psnyder@plasticsu

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Company: Lattice Medical Location: Loos, France Product: MATTISSE bioprothesis ator (Winner) Presented: 2024 ASPS/MedTech Innovator Plastic Surger y Acceler

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ory requirements, the prot’s been nearly a decade since Julien In terms of regulat documentation and clinding surroun cesses Payen, the CEO and co-founder of LatThe biggest difference similar. are trials ical a st, biologi a with met first l, tice Medica y is the costs to bring compan startup a for biochemist and a plastic surgeon to discuss are lower, so we’re Europe in market to it ous autolog asive less-inv a of the potential an launch first.

Europe a toward moving option for women undergoing breast retrials in Europe clinical the do will “We . construction surgery U.S. process our help to data this use and “We wanted to provide something that during the ASPS/ heard we what and – imbreast of facets best the would catch a lot of plastic surgeons plants and the best facets of autologous MTI track was that technology and want this in ed interest are says. surgery,” Payen clinical trials,” he further in ate particip to After years of research – and the adneous cansponta to open are “We adds. comthe – devices ting 3D-prin vancement of ators.” investig U.S. future the for es didatur pany developed the MATTISSE bioprothesis, ces might still clearan market h Althoug ngineer tissue-e rbable a 3D-printed bioreso years away, Payen says ing chamber. The implant is made from a be up to seven prospects that advances the by excited he’s that erial biomat ble resorba medical-grade in that time. fortify can printing 3D in tishas a porous base to fix the autologous clinical trial, we’ll the after that expect “I as well as rated, regene be to sue that needs product based the of version r anothe have a dome to provide the patient’s desired volplastic surgeons,” from receive we input on printing 3D of benefits The ume and shape. kind of input from surgeons allow the device to be developed into var- he says. “Any so we are very glad to reus, for crucial is alize individu help to shapes ious sizes and upgrade and adapt the will We it. ceive the patient’s reconstruction procedure. market. But as far as U.S. the for t produc Henri painter French famed Named for the only company also are we know, I for Matisse and doubling as an acronym developed our have to t segmen this in the ering, Engine TISSue for MAtrix Textile are not subwe – factory printing own the MATTISSE bioprothesis emerged as are doing all we g, anythin ting contrac the in final grand ge mid-sta winner of the ourselves. We want 2024 ASPS/MedTech Innovator Plastic the implant printing can make a reyou that strate demon to enthuthe says Payen ator.

Surgery Acceler t – with new produc ective cost-eff liable, siasm the product generated from plastic ped and develo be can that ns iteratio bewill ition compet the surgeons during the about thing The . quickly ted genera ny come even more important as the compa that every year, is y industr ting 3D-prin MATbring to process ong begins a years-l you have a new machine. The evolution TISSE to the U.S. market. is only going to work in our favor toward make to had we y, compan “As a French developing the highest-quality product apa choice,” Payen notes. “Do we seek over the next few years.” first?

States United the or proval in Europe

Company: ReConstruct Bio Location: Boston Product: Breast BioImplant Presented: 2024 ASPS/MedTech Innovator Plastic Surge ry Accelerator

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hen Luba Perry, PhD, co-found- building blocks.

These blocks are patterned er and CEO of ReConstruct Bio, into a network of interconnected channels and part of Harvard’s Wyss that template blood vessels within the tissue Institute’s 3D Organ Engineering Initiative, and incorporate suturable cuffs to ensure began working toward a medical break- that the implanted tissue has immediate and through in regenerative medicine, she ad- suffici ent access to the patient’s own vascumits she didn’t yet realize the perfect target lar netwo rk. patient group for her team’s innovation.

The team developed a small-scale hu“I did not know much about breast re- man tissue prototype and successfully valconstruction or the limitations with the pro- idated it in rats. cedure,” she says. “When I started talking “We have demonstrated the tissue stays with patients, I was stunned to learn how perfus ed and viable for nine days post imfrustrated and deeply overlooked they feel. I planta tion,” Dr. Perry says. “It was importcouldn’t believe that breast implants are still ant for us to get beyond seven days, which kind of held to the same standards that they is the critical time point for flap survival in were in the late 1960s or 1970s.” clinic.”

Most women who face a breast cancer ReConstruct Bio is actively raising a seed diagnosis undergo mastectomy to treat the round to fund large animal feasibility studies disease, and roughly 40 percent of those as a critical step toward clinical trials. ASPS women choose to undergo breast recon- memb er and clinical co-founder Samuel Lin, struction surgery. Artificial implants require MD, MBA, who has been provided consulmonitoring and should be replaced within tation to Dr. Perry’s team, says the product’s 10-15 years, and some implants’ associa- poten tial for plastic surgery could go tion with other kinds of cancer have come beyon d breast reconstruction. under FDA scrutiny. Beyond reconstruction, “I see this as a key to being able to artificial implants are also widely used for utilize and fabricate soft-tissue blocks breast augmentation. to place anywhere in the body,” Dr. Although autologous tissue flaps are con- Lin says.

“It could be head and neck sidered a more “natural” approach, not all for soft tissue defects after trauma, women have enough tissue for the proce- conge nital issues – people born with dure. The Breast BioImplant is a living, bioen- soft-tis sue asymmetries – or in the gineered free flap created from the patient’s trunk area. Just to be able to minimize own cells, obtained through liposuction and the donor site for these patients who designed to provide a safer, more natural otherw ise might require a large incision alternative to current standards. Dr. Perry’s somew here on their body. This allows a team at the Wyss Institute worked on a pro- more personalized approach to using cess in which a patient’s cells are extracted their own tissue. In our lifetime, someto create dense, vascularized adipose tissue one is going to be able to accomplish made of personalized pre-assembled organ this. Why not us?” PSN

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January/February 2025

BOOK REVIEW

A Continuing Review and a valuable educational tool Plastic Surgery: A Continuing Medical Education Review Editor: Gustavo Chavarria-Leon, MD ChavarriaPress, 2021

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lastic Surgery: A Continuing Medical Education Review is a comprehensive yet concise resource for all levels of plastic surgery learners, from trainees to veterans. Leveraging his wealth of experience, Gustavo Chavarria-Leon, MD, has artfully organized this book to inform readers of the ever-evolving techniques, technologies and ethical considerations within our specialty. It’s an excellent resource for students preparing for rotations, residents and Fellows preparing for board exams, as well as practicing plastic surgeons looking for a succinct update on a particular topic.

Each of the 58 chapters of this book is written by a different plastic surgeon, allowing for wide breadth of expertise and insight. The source materials for these chapters are from continuing medical education articles, Maintenance of Certification modules, peer-reviewed journal articles and the traditional texts of plastic surgery. The sources and suggested readings are also listed at the end of each chapter to allow for further reading on the topic if desired.

The material is arranged by each anatomic subspecialty of plastic surgery, including more broad chapters on fundamentals and aesthetics. The information is presented in a detailed, bulleted format for quick and clear understanding. Dr. Chavarria-Leon also included several high-quality and well-designed photographs, illustrations and figures to enhance both practical and deep understanding. The numerous graphics are a notable strength, depicting complex concepts in an easier-to-understand fashion.

One of the strengths of this volume is not only its depth, but the effort made to manage such an array of content while staying current in an ever-changing field. Dr. Chavarria-Leon covers many topics, from fundamental principles, basic anatomy and pathology to advanced procedures and innovations within the head and neck, breast, trunk, upper extremity and aesthetic surgery. The

inclusivity makes the book accessible to a broad audience, catering to medical students, residents in training and practicing surgeons aiming for continuous professional development. Complex concepts are presented clearly and concisely, ensuring that readers at varying levels of expertise can benefit from the material.

As a residency program director myself, the information contained within Plastic Surgery: A Continuing Medical Education Review is the kind of resource I encourage my trainees to study as they prepare for exams and clinical challenges. It’s an essential educational resource and an indispensable guide for anyone interested in advancing their knowledge of plastic surgery and fostering a deeper understanding of anatomy, pathology and surgical techniques. Dr. Chavarria-Leon’s expertise and dedication to education are evident, making this book a valuable asset for patient care and exam preparation. This book is a tremendous resource for those pursuing excellence in plastic surgery.

– Paige Myers, MD, MPH Faculty, Residency Program Director, University of Michigan, Ann Arbor PSN Associate Medical Editor Ann Arbor, Mich. PSN

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January/February 2025

23

Society shares support, encourages donations for wildfire victims

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SPS supports our members, their families and staffs, patients and communities in Southern California as they cope with the devastating effects of the wildfires in their area. The thoughts of membership, leadership and staff are with all who have been displaced, experienced loss or are facing significant challenges during this difficult time.

ASPS has been in contact with the California Society of Plastic Surgeons, which encourages those interested in offering direct assistance to contribute to the American Red Cross (you can text the word CAWILDFIRES to 90999 to make a donation), which is on the ground supporting

Southern California residents, and the Los Angeles Fire Department Foundation.

“CSPS is here to support members in this crisis and its aftermath and work with our local and regional societies,” says CSPS Secretary Katerina Gallus, MD. Links to additional resources helping plastic surgeons affected by the devastation can be found at plasticsurgery.org.

“We admire the courage and dedication of all medical and emergency personnel as they continue to provide care in the face of extreme personal and professional adversity, and hope for a swift end to the destruction so that Californians can begin the process to rebuild their lives,” says ASPS President Scott Hollenbeck, MD. PSN

LATE-CAREER PERSPECTIVES

The transition from your practice: Essentials for success

By Enrique Fernandez, MD

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s you begin to plan the transition away from your practice, it’s important to deliberate, develop a strategy and conceptualize the tactics necessary to support it. It’s also essential to consider your evolving role in the context of the transition process.

You are the leader

Throughout your career, you’ve functioned as the leader of your practice. You’ve developed a supportive staff and delegated a variety of responsibilities. Over time, this has fostered a mutual trust between you and your staff, based mostly on shared values as well as excellent performance focused on the welfare and safety of your patients.

However, transitioning away from practice is an unfamiliar process for you and your staff – and it’s important to keep this unfamiliarity at the front of your mind. You need to ensure you communicate your vision to staff with clarity and conviction to encourage their support. Early on, the path may not be clear – but the objective must be.

Situational awareness

As the process evolves, it coexists superimposed over ongoing patient care. It will require that you ensure there’s adequate staffing to support

the transition process. This might necessitate reassignments, modification of job descriptions and, perhaps, additional personnel. These changes have the objective of supporting and facilitating more senior staff to assist you directly through the transition. As you think ahead, you should also recognize that this evolution also represents the first steps of developing staff that will be needed to support another surgeon.

As leader of the transition, it’s essential that you also undertake a management role whereby you ensure efficient and effective execution. A central element of success is excellent communication characterized by clarity, timeliness and productiveness.

Matter of perspective

broaden your outlook and strive to consider the other party’s perspective. When you begin discussions with a prospect, ask questions that will inform you as to their expectations and overall outlook.

A buyer will likely have a different point of view, and you need to be able to put yourself in their place. The buyer might be coming into a new community, perhaps with a family. Buying a practice entails a significant financial investment and other commitments. For these and other reasons, you can expect that the buyer and their advisors will undertake a diligent evaluation of you, your practice and community.

What to do?

At this stage in your career, if you had to provide a quick assessment of your practice, you’d probably suggest it’s functioning just fine. Yes, it may need some fine tuning, but in general, you are satisfied with its performance.

Nevertheless, an essential element of preparation is ensuring that its current performance and profitability are optimized so that it’s ready for a future associate or buyer. In this context, the process also serves as the initial step to promote practice growth.

Take time to re-evaluate the big picture.

Review your interests and think about the short- and long-term future as much as possible, but no further than you can see. Seek to

It’s important to be able to demonstrate that you have undertaken preparations to accommodate your new associate or buyer. You can address what you think is needed – as well as what you can reasonably anticipate from a buyer’s perspective. The due diligence put in upfront is often appreciated and will reflect upon you favorably.

It’s a good thing to “begin with the end in mind,” but it remains critical to know what needs to be done presently, and in a certain manner and order to achieve your goals.

The “what” can be summarized in one word: Preparation. This involves three specific goals:

1. To enhance the current function of your practice; 2. To increase the value of your practice by optimizing its profitability, and; 3. To prepare your practice to accommodate, support and promote a new plastic surgeon whether in a succession and/or sale.

To accomplish these goals, develop corresponding plans that are executed in sequence: 1. Optimize practice performance 2. Maximize practice profitability (and, therefore, value) 3. Prepare for a new plastic surgeon (via succession and/or purchase) The creation of these plans is extremely valuable. Timely, ordered execution provides you with a methodology to achieve your goals and the success of your associate. Without them, the chances of achieving your goals will be considerably diminished. As it’s been said: “Hope is not a plan, it simply does not work.”

The design and execution of your customized plans will help you create a clear path marked by tranquility, triumph and the success of your design. PSN ASPS Life Member Enrique Fernandez, MD, provides more retirement preparation insight online at enriquefernandezmd.com.

“Snow-Clad Evergreens, Grand Teton National Park, WY - 2010,” Photo by Enrique Fernandez, MD

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January/February 2025

CALENDAR For additional ASPS/PSF meeting information, visit the Meetings & Education page at www.plasticsurgery.org/meetings; e-mail registration@plasticsurgery.org; or call (800) 766-4955 / (847) 228-9900.

Dates, locations and program information are subject to change without notice.

JA NUA RY

Renew your ASPS Membership for 2025!

31-Feb. 2

Southeastern Society of Plastic and Reconstructive Surgery 40th Annual Atlanta Breast Surgery Symposium Atlanta Contact: (435) 901-2544 Web: sesprs.org

14-15

ASPS Coding Workshop

Online Contact: (847) 228-9900 Web: plasticsurgery.org/coding-workshop Directly provided by ASPS

15

Northeastern Society of Plastic Surgeons Spring Workshop New York Contact: (978) 927-8330 Web: nesps.org/workshop/

Benefit highlights: Subscriptions: • Plastic and Reconstructive Surgery Journal® (PRS) • Plastic Surgery News® (PSN) • ASPS Education Network (ASPS EdNet)

• Products and services to help grow your practice • Inclusion on Find-A-Surgeon feature on PlasticSurgery.org

5-6 LIMITLESS Leaders Summit

Boston Contact: (847) 228-9900 Web: plasticsurgery.org/limitless Jointly provided by ASPS, The Aesthetic Society and the American Hernia Society

The Aesthetic Meeting

Austin, Texas Contact: (562) 799-2356 Web: theaestheticsociety.org

6-8

APR IL

Women Plastic Surgeons Symposium Boston Contact: (847) 228-9900 Web: plasticsurgery.org/wps Directly provided by ASPS

20-23

12th Annual ACEPS Winter Meeting Las Vegas Contact: (978) 927-8330 Web: aceplasticsurgeons.org/Meeting/

• Member discounts on educational meetings and symposia

24-28

• Advocacy that focuses on public and private sector issues, so you can focus on your practice

Kigali, Rwanda Contact: +250 791 693 973 Web: panafricansurgicalconference.com

3-5

ASPS Presents: The Global Plastic Surgery Congress (GPSC2025) Buenos Aires, Argentina Contact: (847) 228-3330 Web: plasticsurgery.org Directly provided by ASPS

9-June 4

2025 In-Service Exam For Surgeons

Pan-African Plastic and Reconstructive Surgery Conference

Online Contact: (847) 228-9900 Web: plasticsurgery.org/ise Directly provided by ASPS

10-12

Diabetic Limb Salvage 2025

28-March 2

ASPS Spring Meeting

PlasticSurgery.org/Dues

20-23

Online Contact: (847) 228-9900 Web: plasticsurgery.org/springmeeting Directly provided by ASPS

Washington, D.C. Contact: (202) 451-6705 Web: dlsconference.com Endorsed by ASPS

11

Wisconsin Society of Plastic Surgeons Annual Conference

M A RCH

Brookfield, Wis. Contact: (920) 750-7721 Web: wisocietyplasticsurgery.com

6-9 Mountain West Society of Plastic Surgeons 10th Annual Meeting Olympic Valley, Calif.

Contact: (847) 228-3330 Web: mwsps.org Jointly provided by ASPS

6

2025 In-Service Exam For Residents Online Contact: (847) 228-9900 Web: plasticsurgery.org Directly provided by ASPS

January/February 2025

CALENDAR

Members-only Access:

FE B RUA RY

MAY 1-4

70th Annual Plastic Surgery Research Council Meeting St. Louis Contact: 978-299-4510 Web: ps-rc.org/meeting

25

AMA Meeting Continued from page 11

as the FDA or CDC. On the other hand, opponents worry that codifying Chevron deference could limit the AMA’s ability to challenge agency decisions that negatively affect healthcare providers, such as payment policies under Medicare – and that it would put too much power in vested political interests within agencies.

In other words, granting agencies more power could streamline healthcare regulations, but it also raises concerns about unchecked executive authority that might not align with physicians’ interests. The resolution was referred for further study, and ASPS will continue to track this issue closely, as its outcome could significantly impact the way healthcare policies are shaped moving forward.

Committed to physicians

From safeguarding surgical standards to reforming Medicare and examining the crossroads of medicine and the law, ASPS is committed to ensuring that the voices of plastic surgeons remain at the forefront of healthcare advocacy. The Society’s participation in the AMA is critical to ensuring that plastic surgery’s priorities are advanced in the House of Medicine. It’s imperative that ASPS members also join and take on active roles in the AMA to ensure the specialty is represented and plastic surgery’s voice is heard. To join the AMA or renew membership, visit member.ama-assn.org/ join-renew. PSN

MultiPlan lawsuit Continued from page 8

ble to unfair pricing practices. These specialized services require advanced skills, significant resources and lengthy recovery periods – all of which necessitate appropriate compensation.

Evaluating your claims

To determine if you should consider joining the litigation, review your practice’s out-of-network claims from 2015 onward, focusing on: 1. Claims processed by: • MultiPlan (primary claims processor) • Viant (a MultiPlan subsidiary specializing in medical bill review) • Data iSight (MultiPlan’s data-analytics platform) 2. Claims involving defendant insurers: • Aetna

• Cigna • UnitedHealthcare • Blue Cross Blue Shield affiliates • Centene • Humana 3. Documentation to gather: • Explanation of Benefits (EOBs) • Billing records • Communications with insurers or MultiPlan about reimbursements.

4. Consult a healthcare attorney: • A lawyer experienced in healthcare litigation can help you evaluate your claims and guide you through the process of joining the lawsuit.

A fight for the future

A master complaint has been filed in the litigation, and new plaintiffs now have a streamlined filing process that offers an efficient path to

join the lawsuit. Beyond the potential recovery of significant underpayments and damages, your participation carries broader implications.

By challenging these practices now, ASPS members are fighting for the future of specialized medical care. The outcome of this case could establish crucial precedents for how insurers handle out-of-network claims, ultimately affecting the sustainability of independent plastic surgery practices across the United States. This is about maintaining the integrity of the profession and ensuring continued access to high-quality plastic surgery services for patients who need them. PSN Matt Lavin is a Healthcare and Commercial Litigation partner in Arnall Golden Gregory LLP’s Washington, D.C., office, serving as court-appointed counsel for Direct Action Plaintiffs in the MultiPlan Health Insurance Providers Litigation.

2025 MWSPS 10th Annual Meeting Olympic Valley, CA | March 6-9, 2025

Join the Mountain West Society of Plastic Surgeons (MWSPS) for two days of educational programming in a snowy, fun and collegial atmosphere. The meeting is open to plastic surgeons, residents, medical students and plastic surgery office professionals nationwide!

Register Now! www.mwsps.org 26

January/February 2025

CLASSIFIEDS

OPPORTUNITIES

You Just Found It! Are you looking for the best opportunity to launch your career, and have a great quality of life for you and your family?

Thriving 100% Cosmetic Surgery practice with 30-year regional reputation is looking for aesthetic fellowship trained surgeon, or experienced aesthetic surgeon to join our team. Freedom to grow the niche practice that you desire with overflow of surgical consultations and patient flow from 5 very busy aestheticians. No hospital call or climbing your way up the ladder doing injectables for years while you grow your surgical practice. You deserve to be supported by our experienced clinical and administrative family so you can focus on being your best and have the time to enjoy your family. Salary guarantee with productivity bonus, full benefits and partnership opportunity in only two years. Our not so senior, not so greedy senior surgeon will treat you like an equal, actually share consults with you, and help you grow your practice. We want future partners, not employees! Complete office renovation and expansion underway to support our rapid growth with the addition of in-house surgical suite. Located in an award-winning suburb with excellent schools, low cost of living, pro sports and busy entertainment and restaurant scene.

So what are you waiting for? Call our director Lisa Greaves, RN at 317-848-5518, or email at lgreaves@myplasticsurgerygroup.com.

West Coast Florida Plastic Surgeon Well established 100% aesthetic surgery practice in Tampa Bay with accredited Office Surgery Facility seeks Board Certified / eligible Plastic Surgeon.

Submit CV and inquires to BPS500@aol.com.

Prime Location in Miami!

Are you a plastic surgeon seeking a modern, state-of-the-art practice space to share? We have the perfect opportunity for you!

Our brand-new office suite offers: • Two fully equipped operating rooms • Spacious, contemporary office space Contact us today to schedule a tour.

Info@EpicPlasticSurgery.com For Sale: Maui Hawaii Plastic Surgery Practice with AAAASF Surgery Center Exclusive, turnkey plastic surgery practice with state-of-the-art, AAAASF certified surgical center. Stand-alone facility includes 4,340 sq. ft.: pre-op, recovery, exam, skin care rooms, waiting areas and exclusive parking lot. Attached bonus spaces ideal for Med-Spa. Well-established practice with a 25 year top “Best on Maui” reputation. Located in Kahului, close to airport, in prime business district. Ideal for new or expanding surgeon or consortium seeking a lifestyle change and/or second location. Maui offers world-class beaches, great schools, caring community, low taxes, and a relaxed yet vibrant lifestyle. Contact: mpsMaui2025@gmail.com Office Sharing Opportunity Newport Beach, California A beautifully appointed office adjacent to Fashion Island area of Newport Beach, with onsite AAAASF operating room. Ideal for a second location, or someone building their practice.

The senior surgeon specializes in Facelifts and would refer most of the “below the neck procedures”. The prospective candidate must have impeccable skills and affable personality, BC/ BE. Please submit a brief Cover Letter and CV to ackerman92660@gmail.com

100% Aesthetic Practice in Dallas/Fort Worth Metroplex

Signing bonus, large guaranteed salary and the ability to make huge bonuses with proven track record of success for young surgeons.

• 100% aesthetic practice

Unique Private Practice Opportunity in NYC The ideal candidate is interested in performing breast reductions and top surgery for a small group practice in NYC specializing in these procedures. The practice is based in the Upper East Side of Manhattan, serves many patients who identify as people of color and/or LGBTQ, and takes pride as a health advocate for this demographic. A competitive pay structure with a generous productivity incentive, reasonable hours, and a routine schedule allow for a desirable work/life balance. The practice allows significant flexibility for surgeons to frequently work from home by relying heavily on telemedicine and physician assistants. Surgery and patient appointments are scheduled Monday to Friday, but not weekends. There is a call schedule for covering the practice, but no hospital call. Surgery is performed in an office OR, private ASC, or Lenox Hill Hospital, all within walking distance of each other. This position is only available for a full-time W2 employee, not a part-time independent contractor. Malpractice insurance is covered.

Health insurance and 401k benefits are included.

Applicants must be board certified/board eligible with the ABPS. Please email a cover letter and CV to: info@breastsurgerygroup.com.

For more information about the practice please visit breastsurgerygroup.com.

Big City Practice Stress?

Tired of the rat race of a big city practice and ready for a change? After 31 years, I want to hand over my healthy solo private practice in a charming Southeastern town. My hospital is working with me.

Info: https://dpspractice.com/ Contact: cheyenne.sanchez@dmhnet.org, (256) 973-2597

Premier Houston Plastic Surgery Practice Reduced Hours/Flexible Schedule Seeking a BC/BE plastic surgeon with microvascular/reconstructive surgery training looking for flexible and reduced hours and a great work/life balance. The candidate MUST have advanced training and proficiency in microsurgery with expertise in DIEP flap breast reconstruction.

Only experienced candidates apply.

Email: LBoden@Greatrecruitingworks.com Office Space Rental, San Francisco Shared office space to rent 4 days a week in historic 450 Sutter building near Union Square.

Great opportunity for plastic surgeon looking to expand or start their practice in the Bay Area.

If interested, please contact Chelsie at (415) 898-4161.

Desire to be your own boss in your own practice?

Seeking BC /BE surgeon desiring to assume ownership of established practice in America’s heartland, slower pace of life, no RVU pressure, physician-friendly state, metropolitan city with major university, active fine arts/music/ community.

Opportunity to purchase existing condo office, option of establishing offices in 2 states with different patient populations. Option to work with adjacent hospital, one office location has only one plastic surgeon in that area.

Opportunity to own and manage a private practice and make decisions independent of others.

For more information: http://pumc.com/aesthetic-practices-for-sale/

Pinsky Plastic Surgery is seeking a Plastic Surgeon to join our amazing team.

• Five locations in DFW Metroplex • No insurance accepted • No ER call, no nights, no weekends • 4 full-time anesthesia providers

This is an exciting turnkey opportunity providing all that the beautiful Palm Beaches has to offer. In addition to:

• 5 medical spas

•Very competitive salary

• Technology focused practice with 3-dimensional imaging, HIPPA compliant texting apps, state-of-the-art lasers and body contouring equipment

•Full benefits program

• Dedicated 6 OR AAAASF accredited surgical facility

• Large dedicated social media team • Personal patient care consultant for each surgeon • 4 weeks paid vacation

•Excellent bonus incentive •Retirement plan •Excellent patient referral platform

•Established practice for over 30 years •Highly skilled support staff offering personalized care •Supported by corporate business expertise and insight

•Luxurious and state of the art office environment

• Additional paid time off for meetings If you dream of being a successful aesthetic plastic surgeon, we can make it happen! Please email CV to sandy@northtexasps.com. To learn more about our practice, please check out our website www.northtexasplasticsurgery.com.

January/February 2025

Explore an environment where expertise meets exceptional quality.

I F YO U W O U L D L I K E T O L E A R N M O R E Please email your CV to Rebecca Sale, rsale@aquadermatology.com or 904-333-2007

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CLASSIFIEDS

Plastic and Reconstructive Surgery Opportunity with Partnership Track in New York City and Long Island.

Fast growing, well-established, and innovative practice seeking BE/BC Plastic Surgeon.

• Top Salary Match • Immediate Bonus • Benefit Package • Personal Coordinator • Dedicated PA/NP • Devoted Staff • Modern Office • Private O.R.s • State-of-the-Art Facility Please email your CV to: drjnikfarjam@gmail.com executivedirector @thenewyouplasticsurgery.com

DM us @drjnikplasticsurgery

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Plastic/Reconstructive Opportunity with Partnership Track Long Island & NYC Excellent opportunity with partnership track.

Well-established cosmetic plastic surgery practice with locations in Long Island and Manhattan seeks a plastic/reconstructive board certified/board-eligible surgeon to join our thriving practice.

Modern offices, professional team environment, state-of-the-art and accredited facilities, knowledgeable and professional staff, competitive compensation and benefits.

Greenbergcosmeticsurgery.com

To apply, forward CV to docstg@aol.com or call 516-364-4200

Plastic & Reconstructive Surgeon Southern Maine Plastic & Hand Surgical Associates, the largest independent plastic surgery practice in Northern New England, seeks a BE/BC Plastic and Reconstructive Surgeon to join our group of 8 surgeons in South Portland, Maine in mid-2025.

This opportunity involves a broad-based practice encompassing all areas of plastic surgery including general plastic, reconstructive, cosmetic, hand and microsurgery, for a diverse patient population. The practice operates an in-house AAAHC ASC. Our surgeons also provide plastic and hand services and coverage for the two hospital systems in Portland, one being a level 1 teaching hospital.

We provide training to rotating residents from the Lahey Clinic plastic surgery residency program, general surgery residents from Maine Medical Center, and plastic surgery residents from Tufts University and Dartmouth-Hitchcock.

West Palm Beach, Florida Plastic Surgery of Palm Beach, an established, Board Certified, Plastic Surgery Group located in beautiful West Palm Beach, Florida is seeking a Plastic Surgeon to join our team.

The ideal candidate has experience in all aspects of plastic, reconstructive and hand surgery. A candidate with specific interest in microsurgery and breast free flap surgery is preferred. Fellowship trained proficiency is encouraged but not necessary. Excellent people skills and a strong work ethic are required.

If you wish to join a great South Florida team, please send CV and cover letter to mds@plasticsurgerypb.com.

Plastic & Hand offers a collaborative environment where work-life balance is valued. The support of professionals including physician assistants, clinical, administrative and billing staff is provided. On call coverage, including hand, is required. We offer a competitive, guaranteed salary with potential to earn a productivity based bonus to start; eventual partnership buy-in is anticipated. Full benefits including but not limited to health insurance, malpractice insurance and 401k profit-sharing are included.

Please email CV to jswain@plasticandhand.com Visit plasticandhand.com to learn more about our practice.

Make your home in South Florida where Palm Beach offers you beautiful beaches, water sports as well as the arts, culture and many outdoor events.

You are Board Eligible/Board Certified, confident in your surgical skills, patient oriented and have an outgoing personality. Must possess a great work ethic and be willing to do reconstruction as well as cosmetic surgery. Call shared/flexible.

We are looking for a long-term commitment that will lead to partnership for the right candidate.

We offer a skilled support staff and a marketing team. Salary with bonus incentives, full benefits package including malpractice, health, dental, vision and retirement plan.

North Texas Looking for a motivated surgeon to thrive in our state-of-the-art facility! Join a premier plastic surgery facility in North Texas, fully equipped practice with two operating rooms, offering patient comfort and privacy. Enjoy flexible terms, and comprehensive administrative support.

Email us at karina@drplano.com for more details.

NW Plastic Surgery Practice For Sale Sun Valley, Idaho, resort quality of life practice for sale; buy out or buy into 24-year practice and office building. Practice mostly outpatient cosmetic surgery and expanse of in office procedures. Letters of inquiry and CV to Tom Crais motsiarc@aol.com. 208 788 7700.

January/February 2025

CLASSIFIEDS Opportunity for BC/BE Plastic Surgeon to Join a Busy Private Practice in Houston, TX Memorial Plastic Surgery (MPS) is a leading aesthetic and reconstructive plastic surgery practice.

This is an excellent opportunity for a BoardCertified / Board-Eligible Plastic Surgeon, with a strong interest in microsurgery to perform DIEP flap breast reconstruction and/or cosmetic breast and body procedures, to join a well-established practice known to deliver unparalleled patient care and results.

MPS OFFERS: • Heavy volume of patient overflow for associate to build practice • Mentorship and hands-on training with premier group of board-certified plastic surgeons • Team-oriented staff for administrative and clinical support, including marketing and social media needs • Physician offices, spacious exam rooms, MedSpa area for non-surgical services • Private AAAHC accredited ORs located on-site • Multi-specialty ASC located directly one floor below with direct access to 4 additional ORs COMPENSATION: • Competitive compensation models • Benefits package - Medical/Vision/Dental Insurance & 401k plan • Partnership track opportunity QUALIFICATIONS: • Board Eligible or Board Certified in Plastic Surgery

• Active Texas Medical License • Aesthetic fellowship/training a plus, but not required • Must have a passion for delivering high-quality patient care and results Qualified applicants are encouraged to apply by submitting an updated CV & headshot photo to: APPLY@MEMORIALPLASTICSURGERY.COM Office Sharing Opportunity in Beautiful Portland, Oregon Amazing opportunity available now for a BC/BE Plastic Surgeon to share a medical office space with one established plastic surgeon. Suite is in a professional medical office plaza with outpatient surgery center in building, and connected to a busy hospital. Suite includes two doctors’ offices with mountain views, multiple exam rooms, and two separate reception desks to support separate practices. Outstanding opportunity for a surgeon starting a new practice or desiring a new or second location.

Please submit Cover Letter and CV to mia.skourtis@providence.org.

Long Island Plastic Surgery Practice For Sale Board certified plastic surgeon with over 25 years’ experience in same location looking to retire.

Practice is 100% cosmetic and well established located in beautiful Eastern Long Island. Practice is located in 3,500 sq. ft. turnkey suite with stateof-the-art medical equipment including 3 lasers.

Excellent location to raise a family and less than 2 hours from Manhattan. Owner willing to stay on during transition with option to finance sale.

Please email eeprhs@gmail.com.

Beverly Hills Office Space To Share This is a great opportunity for a BC/BE plastic surgeon to share a large, sunny office with an established plastic surgeon. The office suite is in one of the best-known medical buildings in Beverly Hills. There are multiple ambulatory surgery centers in the building, and is minutes away from the world-renowned Cedars Sinai Medical Center. The office space would include two dedicated offices for the surgeon and consultant, a reception desk, as well as the use of up to three exam rooms. This is an outstanding opportunity for a new surgeon starting out or an established surgeon who wants to relocate. Please submit cover letter and CV to drminniti@drminniti.com

inquiries to: Dung Nguyen, MD, Director of Microsurgery, Division of Plastic Surgery; Stanford University Medical Center; 770 Welch Road, Suite 400, Palo Alto, California 943045715. Jhernan9@stanford.edu.

MISCELLANEOUS Plastic Surgery Biller Specializing exclusively in Plastic Surgery billing with over 25 years’ experience. We check for correct coding for maximum reimbursement and review each claim before submission. Once the claims are submitted, we follow closely and appeal when necessary. We work remotely, off-site with excellent references. Call Ana at 239-541-9993.

TRAINING Stanford Microsurgery Fellowship A one-year position in Microsurgery is available beginning August 1, 2026, through July 31, 2027, at Stanford University Medical Center.

Individuals acquire expertise in comprehensive microsurgery and complex reconstruction, including reconstruction of the breast (TRAM, DIEP, Omental, SGAP, TUG, SIEA, PAP), lower extremity, peripheral nerve, facial reanimation, hand, brachial plexus, nerve transfers, and lymphedema (LVA, lymph node transfer, liposuction). Stanford is a Level I Trauma Center as well as a Comprehensive Cancer Center.

You will be appointed as a Clinical Instructor.

Opportunities are available for participation in global health, basic science, and clinical research projects, as well as medical device development.

Individuals typically perform over 150 microvascular cases each, and work with ten full-time microsurgeons.

Please apply through SF Match. Please direct

Classified Ad Policy

Rates for printed classified ads are based on word count and must be paid prior to publication. Logos, boxes and color enhancements can be designed for additional fee. The editors do not investigate positions of employment and assume no responsibility for them.

ASPS reserves the right to accept, reject or cancel any advertisements in its sole discretion.

Ad Rates ■ 1 to 50 words: $165 ■ 51 to 100 words: $305 ■ 101 to 150 words: $440 ■ 151 to 200 words: $555 ■ 201 to 250 words: $763 ■ More than 250 words: Contact jembrey@plasticsurgery.org for “designed” ad options

To place a classified ad, contact: Jeanne Embrey Advertising Coordinator jembrey@plasticsurgery.org

Directly Provided by:

2025 Earn up to

PLASTIC SURGERY SELF-ASSESSMENTS Test your knowledge and earn CME

37.5 credits

Earn up to

30 credits

Bundle Self-Assessment Exams to Save!

Early Registration is open now!

The ASPS In-Service Exam is designed to evaluate your knowledge of the most up-to-date and comprehensive content developed by experts in the plastic surgery specialty.

Your results will provide insight into your strengths and identify areas in need of further study.

The ASPS Life-Long Learning Exercise (L3E): 2025 Aesthetic In-Service is available to all plastic surgeons. This activity focuses on the cosmetic subspecialty with aesthetic-only surgery questions.

Testing Window: April 9 - June 4, 2025

Testing Window: June 11 - August 6, 2025

Register by Feb. 28 and save up to $100

Register by Feb. 28 and save up to $100

$495 members

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*Add-on the L3E test for just $224 more.

January/February 2025

29

SURGEON SPOTLIGHT Editor’s note: The bulk of PSN’s pages are devoted to specific elements of our mission statement – to keep members informed of the social, political and economic trends and educational opportunities that affect the specialty of plastic surgery.

KEEPING TIME INSIDE AND OUTSIDE THE O.R.

A

t age 77, and having played drums essentially all his adult life, Robert Gilman, MD, DMD, Ann Arbor, Mich., has seen plenty – as well as inhabited the same spaces of some of the greatest figures in rock ‘n’ roll.

Dr. Gilman comes from a musically inclined family – his mother and sister played piano, while his father was a professional saxophonist and a distant cousin was head of the Hart School of Music in Hartford, Conn. He found himself drawn to the sound of percussion over that of musical notes, and developed an affinity for the sounds of jazz – in particular, that of Joe Morello, who sat behind the kit during the recording of the Dave Brubeck Quartet’s Grammy Award-winning instrumental, “Take Five.”

“I saw him play in college at an outdoor venue in Connecticut, where the opening act was (piano great) Thelonious Monk,” Dr. Gilman tells PSN. “I sat in the first row, and in the middle a song, Joe broke a stick that came out to me – and I kept it. About 20 years ago, I attended a drum camp where Joe was a featured guest, and I told him the story about the stick. He turned to me and said: ‘Oh, that’s where it went. I’ve been looking for it. I want it back!’ It was fantastic.”

Dr. Gilman eventually became part a 12-piece band called the Dr. Gilman holds the tempo during a recent perRegressions. The breadth and formance by his band the Regressions. scope of their repertoire attracted musicians from all fields and levels, including Eddie Willis – one of the Funk Brothers of Motown fame. A one-off meeting between band members and Willis turned into a long-lasting relationship between the physician and musician – strong enough that he invited Dr. Gilman to be a guest at his Hollywood Walk of Fame induction.

He also had the opportunity to play with other drummers of note, including Jim Chapin, the father of the late singer-songwriter Harry Chapin. “I was at a drum camp with Jim, who was one of Buddy Rich’s teachers in the 1930s and 1940s – and he regaled us with numerous stories. What a phenomenal opportunity.”

But not all of his encounters have had a positive ending. Dr. Gilman and his wife, Chris, have made dozens of trips to Antigua for relaxation, dwelling in an area known for its celebrities – including Keith Richards of the Rolling Stones and Eric Clapton, whose house is just two doors away from the Gilmans’ usual rental. One night, an obnoxious man accompanied by a younger woman joined them in conversation at a bar pre-dinner. “He told us stories that he had just come from South America and had gotten sick, the food was terrible, everything was terrible. Then he started hitting on my wife, but it was actually pretty funny,” Dr. Gilman says. “I asked the owner later who the guy was, and we were told it was the guitarist from another legendary band.

My wife said: ‘I don’t care. He was an a------.’ ” Dr. Gilman says playing the drums and his work in the O.R. are related through repetition. “Being a good surgeon is having all the rudiments down, and when you’ve practiced for a long time, as I have, when you see something new, you know how to deal with it, just like playing drums.”

While the ASPS Active Member is planning his retirement from plastic surgery, Dr. Gilman has no such plans for his drumming, his lifelong love. “I’m gonna go until the day I die,” he says. PSN

10 YEARS AGO IN PSN With several major companies announcing security breaches and the theft of millions of consumers’ credit card information, the discussion on hackers and data breaches turned local after multiple plastic surgery practices had to inform thousands of patients that their personal information might have been compromised by cyberattacks. ASPS members, security experts and legal counsel provided insight and tips to plastic surgeons in the January/February 2015 issue of PSN: “We often encounter the belief that data security is an issue for the managed-care world and large healthcare providers that traffic in ‘big data,’ but not for boutique private practices or elective procedures. We regularly encounter plastic surgeons who don’t think this really matters. Successful plastic surgeons who plan to stick around are going to need to take the issue seriously and have a strategy for data security. ” – Harry Nelson, JD Managing Partner, Nelson Haridman LLP PSN

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PSN is pleased to take liberties with the “social” aspect of its mission statement by presenting a good-natured look at the lives of notable members who we believe are making significant contributions to the specialty.

In this issue, we present ASPS member Patricia Mars, MD, Tucson, Ariz., a solo practitioner, and creator and owner of Venus by Mars Cosmetic Surgery. Dr. Mars serves on the Emerging Trends Subcommittee, Women Plastic Surgeons Steering Committee and the Assembly of Member Sections.

She’s belonged to several additional ASPS committees, groups and panels over the past several years – and she was a quizzer for the PSN Presidents Forum held during PSTM24 in San Diego. Between hitting stores to gather the ingredients for her famous Christmas tamales, Dr. Mars found time to answer the following questions for PSN: If I had to start my career over, I would... Do the same thing. I love my job and have never regretted my choice of career.

The best thing about being a plastic surgeon is... That I actually get to spend a good amount of time and build well-established relationships with my patients – I think more so than other specialties. There are patients in my practice who’ve been with me from the beginning. I enjoy the loyalty and longitudinal relationships where you really get to know people.

The worst thing about being a plastic surgeon is... Dealing with patients with unrealistic expectations. This is one of the hardest parts of my job.

The best part of next weekend will be... Making Christmas tamales, which is a serious family tradition. My family has Patricia Mars, MD been making red chili tamales for generations and my children now love this tradition. The whole family is involved, and we drink margaritas and listen to mariachi music the entire day. The tamales still turn out delicious!

The best thing I ever purchased for my office was... Our fancy Nespresso machine, which makes delicious, frothy coffee, which I love. It’s a treat and an indulgence. If I had to pick a surgical device, it would be my power-assisted liposuction cannula. The work of liposuction is no joke, and this makes a huge difference in effort.

My all-time favorite movie is... Pride and Prejudice, the 2005 Keira Knightly version. I love historical and period dramas, and this one has amazing cinematography and a beautiful soundtrack.

An operation I no longer perform is... Rhinoplasty. I decided about six years ago to concentrate on the operations I really love doing. With rhinoplasty, I just don’t enjoy the difficult personalities and the stress of how particular these patients tend to be.

During the shutdown, something I worked on outside of medicine was... After a long break, I started doing yoga again with all that time available – and to reduce stress. Since then, I’ve become very dedicated to practicing at least three times per week. I also got more into gardening and built an in-ground raised garden box. I love how they significantly improve my quality of life.

The best vacation I ever took was... A week in Paris for a significant birthday (none of your business). We spent the whole week just indulging in all things French: food, fashion, art and wine – and it was all incredible.

I couldn’t operate without my... Music. My anesthesiologist (and best friend, who I went to medical school with) is usually the one picking the tunes. We listen to a few different playlists: all-female pop, 1980s, 1990s and alternative.

My biggest surprise in the O.R. was... Becoming pre-eclamptic while doing a mommy makeover and going into early labor three weeks before my due date. All ended well, but that was one serious surprise, as it was my first pregnancy.

Dr. Mars multitasks on the front patio of her Tucson home by nursing a margarita while assembling one of her traditional Christmas tamales.

The best thing a grateful patient ever gave me was... I’ve gotten some incredible pieces of jewelry. My two favorites are a beautiful silver flower pin that my patient, a jewelry designer, made by hand for me.

The other is a star-shaped pendant with little multi-colored pave sapphires embedded, given to me by another jewelry designer. I love them both so much.

The words I try to live by are... “Run toward your complications, not away.” I learned this from one of my mentors during general surgery training. We all have complications, but how you handle them is what sets you apart. Learning to handle these with grace, skill and perseverance makes for a very grateful patient. PSN January/February 2025

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