Eyelid Surgery (Blepharoplasty)

Today I flew to San Diego for a 5-day stay. The Annual Meeting of the American Academy of Facial Plastic & Reconstructive Surgery (AAFPRS) begins on Thursday, but tomorrow is a full day of committee meetings and board meetings. Last year I was elected to the Board of Directors of the AAFPRS as Group Vice-President-elect of Awards, Research and Development by a national vote of the membership. I have been participating with Board activities in the “elect” capacity over the last year, and my official 3-year term begins at this meeting. This is a personal milestone for me, something that I had dreamed of since beginning my practice 15 years ago at NYU, but not really believing I could achieve at the relatively young age of 48. I consider a great honor to serve on the Board and representing our members, especially in this time of tremendous impending change in our health care system.

This meeting also marks my nomination to be on the Board of Directors of the American Board of Facial Plastic & Reconstructive Surgery (ABFPRS; www.abfprs.org ). This is the organization that administers the annual written and oral board examination in Facial Plastic & Reconstructive Surgery. The examination is another worthy endeavor that helps patients understand the competency of their doctors.

I will be again chairing the Fellowship Committee of the AAFPRS, where we help to improve the quality of the fellowship program administered by AAFPRS. I have been a Fellowship Director for 8 years, elevating facial plastic surgery to the next level at NYU Langone Medical Center. This year I hired my graduating fellow, Dr. Matt White, into my Division of Facial Plastic & Reconstructive Surgery, further expanding the services we provide.

I will also be attending numerous other committee meetings, among my favorite the Face To Face Committee, where I am senior advisor. We will be launching a new program: Face To Face Veterans Initiative. This program will couple volunteer surgeons with injured veterans from Iraq and Afghanistan. When armed forces healthcare and the VA system can no longer help these Vets, the AAFPRS program may, by making advanced expertise available at no cost to the Veteran.

Finally, I will be joining forces with Dr. Dean Toriumi of Chicago and Dr. Russel Kridel of Houston to teach a one-hour course on Open Rhinoplasty Finesse. To be able to share the podium with these two Past Presidents of the AAFPRS leaves me feeling giddy. It should be a lot of fun for all of us and for the course attendees.

Stay tuned for updates on the meeting, on this blog and on twitter.com @drconstantinide.

I have been writing about the Patient-Physician Relationship for facial plastic surgery journals lately, and wanted to share some of my thoughts with you. I believe that nothing is more valuable for my patients than helping them achieve their personal goals through surgery. However, how will surgery actually help each patient with achieving their life goals? I believe that I can be a better doctor when I know the answer for each of my patients. I start each consultation with a new patient with what Dan Sullivan [developer of The Strategic Coach (www.strategiccoach.com )] calls the R-Factor Question: “If we were to meet here in one year, looking back over that year that’s passed, what would have had to have happened for you to be happy with the progress in your life?” Notice that this question has nothing to do with surgery, but rather with my understanding my patient’s immediate life goals and dreams. During the consultation, I explore with my patient how surgery can help them meet their own goals, taking them to the next level in their life. I believe that we are all about 80% happy with our lives, but we are constantly looking for that next 20% that will make us reach the next level in our lives. When that includes surgery, then I can help my patients see what potential can be unveiled by successful surgery for them.

I also believe that no one can make any important decision in life if he/she is paralyzed by fear. Fear, in fact, is what keeps most of us from making needed changes. During our consultation, we explore what fears a patient has regarding surgery and progress in life in general. For each fear, I try to help them see a way past it. If it is fear of anesthesia, for example, I give them real facts about that risk, and also discuss how I have considered every risk and have minimized it for them. This has an amazing calming effect on most patients, so that this fear no longer stands in the way of their having surgery. After every fear is discussed, most patients feel empowered to take the step towards surgery. Our consultation doesn’t end there.

After fears have been discussed and eliminated, we talk about hopes. I ask my patient to imagine their life after successful surgery. What will it look like? How will it be different than it is now? What new opportunities will be unveiled for them? What personal strengths will be reinforced? What will this do for their personal and professional lives? A picture of life at the next level is even more empowering; few patients have trouble committing to surgery after such a vision is created by them of their future. This consultation process is what I call the Transcendent Consultation. It helps patients transcend their fears and reach for the opportunities that will be provided by surgery. This creates tremendous value in my patients’ lives. The consultation is not a superficial review of what surgery is like. It is a deep exploration of how surgery will improve all aspects of my patient’s life.

Its been too long, but my absence from the blog scene was for good reason. I’ve been busy traveling around Europe speaking about Functional Rhinoplasty, Cosmetic Rhinoplasty, and the Patient-Physician Relationship. Our trip spanned the two weeks between the last week of August and the first few weeks of September, with the Labor Day weekend as the middle weekend of the trip. Accompanying me were my wife Melissa and our son Dimitri. Our trip started in Paris, the only stop that had nothing to do with Facial Plastic Surgery. Dimitri loved the Louvre, where he was able to visit the Mona Lisa, who he had studied in school. I recently saw a History Channel segment hypothesizing the Mona Lisa was a self-portrait of Leonardo DaVinci. Kind of takes the wind out of one’s sail thinking about that. Whoever she was, she certainly captured a mysterious beauty that is more androgynous than feminine, but certainly not masculine.

After Paris, we flew to Porto, Portugal for the European Academy of Facial Plastic Surgery’s Annual Meeting. I gave lectures about Cartilage Grafting in Rhinoplasty and the Patient-Physician Relationship, and a one-hour course on Rhinoplasty: From Planning through Recovery. Porto is a beautiful city perched on a hill overlooking the Douro River and resting beside the Atlantic Ocean. Famous for the center of port wine production, it is an old, beautiful city with winding streets. It is also the musical and cultural center of Portugal. The closing dinner was a highlight of the trip, held in Taylor Wine Cellars where great food and wine was accompanied by a cabaret of Broadway show numbers. Portuguese wine is an amazing value for its price, with rich reds that stand up to the biggest meats. Fortunately they are becoming easier to find in New York.

Munich, Germany was our last stop. This was my first visit to Germany, and I was surprised that Munich, the capital of Bavaria, was a beautiful old city with numerous outstanding restaurants and the ever-present Bavarian beer. Our hotel, Tobrau House, was in the center of the old city having been built in 1490. Many of the buildings withstood the heavy Allied bombings that leveled most of the outer city during WWII, so Munich retains much of its old-world charm. It is an easy city to negotiate, and the locals are friendly and very proud of their heritage.

In Munich, I spoke at the largest Head & Neck training program in Germany at their annual Rhinoplasty Course. Day 1 included lectures by me on Functional Rhinoplasty, Cartilage Grafting in Rhinoplasty, Advanced Tip Techniques in Rhinoplasty, and the Patient-Physician Relationship. Day 2 was Live Surgery, where I performed a Functional Rhinoplasty on one of the most crooked noses and septums that I have seen in my career.

My patient was an Iranian immigrant who spoke only Arabic. He had a friend who spoke Arabic, German and Greek, so we were all able to communicate with only one level of translation. He had been a boxer and was known for his immense nose. I could imagine the young attending in the clinic seeing him and thinking, “Have I got a case for the famous visiting professor (ME!).” Surgery, piped in live to an auditorium of 50 course participants, was difficult and tedious and took 4 hours to complete. In the end, after extensive reductions of tissue volume while adding strengthening structural grafts, I left him with a nose that would work a lot better and look much straighter and smaller, though still masculine. The audience was impressed and I was confident that I had taught them something beneficial, thanks to this courageous Iranian.