Dr. Arthur Swift on non-invasive plastic surgeons and crossing lines

Author: Pavel Hilbert, CEO Estheticon

"I do often combine treatments that are non-invasive with my surgcal procedures to results. It’s equivalent to expanding your artistic palette affording you the opportunity to 'paint in' some very fine details.”

IMG 1436

Dr. Swift, thank you for finding the time for a short interview. What would you tell your colleague, physicians who attend conferences in order to enter the very competitive aesthetic field, especially since the costs for  entry level marketing are  ever increasing?

Most Physicians, when they go through their medical school training, have had to dedicate so many hours to focus on their studies, that they lack the refining of the as business and marketing skills. Their concentration is on their career, and it would be prudent in most instances to delegate this aspect to professionals experienced in marketing and practice build-out. I personally have found that social media exceeds classic media (TV, radio, print billboards, etc.) in return on investment. Most importantly. Your "billboard", your "advertisement", are the result and experience you offer patients. The best ambassador you can have, is the happy patient who provides you the  word of mouth exposure that you need. 

Physicians attending conferences must further understand that the so-called expert in the field who present and demonstrate injection techniques are not gods. They're words are not written in stone. They're just sharing their experience on how they evolved within their practices. My advice would be that. If what you hear makes sense for your practice, embrace it. If it doesn't make sense, reject it...

Don’t drive a car the way somebody else drives it. Drive it the way that you’re comfortable. But be open-minded to learn from everybody in life, as seemingly unrelated thinkgs can be a boost to your practice. i have learnt some of my most advanced techniques from people who aren't in my profession - techniques-, that I adapted from other areas.

 And the most important thing that you can do as a young physician focusing on aesthetics is to apply your doctor's craft of systematically diagnosing and treating responsibly. Vhy are you choosing a specific technique or product? Every patient is an aesthetic journey. That is his/her starting point? What is your destination, and above all, how you get the patient there in the safest way? Safety is paramount, which is why I dedicate so much time to teaching anatomy and safe injection techniques. if somebody opens up across the street from me and charges less than I do, will I lose patients? Yes, maybe a couple of patient - but, most of them come back. What insulates you against the competiton is. Not getting into a price war, because there will always be somebody who will be comfortable to charge less than you. It's giving the patient a superior result, and experience that will protect your practice.

Many plastic surgeons are not crossing the line over into non-invasive aesthetic treatments believing that these treatments remain in the dermatology arena. I’m not a doctor, but my feeling is that in the very near future that will not be possible, and that plastic surgeons will have to understand and be skilled in non-invasive procedures.

You’re absolutely right. Plastic surgery  since its inception has been considered an exalted profession. It old guard elite believed that anything non-invasive was unbefitting the surgical profession. It’s time to wake up, my plastic surgery colleagues. I was a trained plastic surgeon. I still am a trained plastic surgeon, performing two or three days of surgery a week. But non-invasive treatments haves become a significant part of my practice. Surgical and non-surgical approaches are not mutually exclusive. I do treatments that are non-invasive and combine them with surgery to get even better results. It’s painting with a little brush and painting with a big brush. If all you do all day is paint with a big brush, you’re going to miss out on the opportunity to create some very fine details.

There is nobody better specialist positioned than a plastic surgeon, who understands anatomy, and is trained in aesthetics, to do these minimally invasive procedures. When I started doing liposuction in 1984, nobody was doing it. And people said, that’s not surgery, it’s sucking fat. It has repeatedly top the surgical list in North America as the number one plastic surgical procedure. When I started doing toxin and fillers, in the 1990s, my colleagues questioned my approach implying that I was "frustrated dermatologist"? There's more non-invasive procedures than invasive procedures being perfomed yearly. If you want to survive today as a plastic surgeon, you have to adopt this into your practice. It means a major change. Because from seeing 20 patients a week for surgery and operating on 10 or 15 a week, now you’re seeing 50 patients a week and you’re injecting them on top of the 20 that you’re operating on. So you have to have the right administrative system in place. But the injection patients then convert to surgery feeding your surgical practice. Alternatively, the surgery patients can have their results improved by injections. It’s a marriage, and it works well. So I think it’s foolish to not accept this by saying – it’s beneath me. Really? Whether I use a scalpel or I use a syringe, if you look at the features of beauty – there are 10 features of beauty that I talk about – eight and a half out of those 10 can be affected by syringe therapy. It doesn’t always have to be the scalpel.

Where do you see fillers in 3 – 5 years? What will change?

What is going to change with fillers? Well, we know for sure that what patients want is something that is non-invasive and quick, so they can get back to their lifestyles. People nowadays don’t want to take off a week or two or more to have treatments done. They want to have lunchtime procedures. So we find the fillers, especially in combination with toxin, have been working very well to slow down the visual aging curve. It doesn’t stop it, but it can flatten it out. And these products are going to continue to expand. I have a feeling we are going to see fillers pushing into the realm of medicine as well as into aesthetics. They’re going to be combining fillers most probably with vitamins and agents that can replenish the skin at a slow rate. This is what I see four or five years down the road.

I think we’re understanding much more about the safety of fillers as well. It’s such a fast-growing profession, people were very quick to adopt it, but we have to slow down and look: what is the safe way to do it, what is the proper way to do it? So education is extremely important now and will be even more important in the future.

There are so many individuals who want to perform these type of treatments, that as key opinion and thought leaders, we have to accept the responsibility to make sure that newcomers are well trained. Education is key to that, again something that the leading pharma companies takes very seriously. So the fillers are getting better and better, they’re integrating better into the tissue, they’re lasting longer. We’re hitting the sweet spot on that golf swing - we just have to make sure we don't overswing.

Updated: 2016-12-07

Pavel Hilbert, CEO Estheticon

Discussion to topic

Other patients' procedures