My Thoughts

Dr. Marc Salzman Explains Louisville, KY Plastic Surgery Trends

Plastic surgery is an evolving science, with newer and safer methods for enhancement being developed yearly. At Salzman Cosmetic Surgery and Spa in Louisville, KY, plastic surgery trends follow the latest safe and effective technologies. Dr. Marc Salzman dedicates his time to staying up to date with medical research so his patients have access to the latest technological advances. We spoke with Dr. Salzman about the latest developments in plastic surgery, breast implants, and how his patients benefit from access to more options for enhancement.

Why Choices Are Important In Plastic Surgery

We asked Dr. Salzman why he offers a wide variety of plastic surgery options, including the newest breast implant, the IDEAL IMPLANT® Structured Breast Implant. Dr. Salzman is one of the exclusive surgeons in the Louisville, KY area to offer IDEAL IMPLANT among other new technologies. 

Dr. Salzman explains, “I’m always surprised when I read online or patients tell me they’ve been to other places and physicians are giving them one choice or is telling them, ‘Don’t worry, honey, I’ll pick your size, you’re going to look fine,’  And I’m aghast when they tell us, ‘Well, doctor so-and-so didn’t say anything about that.’ You can still do a tummy tuck like they did in 1975, that’s fine, but there have been some advances. There are some newer ways of doing it. The same thing with the IDEAL IMPLANT. If you’re not willing to accept the fact that something’s new and present that as an option just because you think it’s no good or you don’t want to do it, that’s probably not a great thing. You can say, ‘I choose not to’ for whatever reason, but I really don’t like when the physician poo-poos something that they don’t have because it either costs money to do or it takes time to learn. They say, ‘Oh, that you don’t need. That’s an advancement that doesn’t matter.’ And that’s not really true because some of these things do matter.”

Louisville, KY Plastic Surgery Trends And Breast Implant Options

Since Dr. Salzman does not approach cosmetic surgery as “one size fits all” we asked him how he helps women pick the best breast implants for their bodies. Every woman is different, so Dr. Salzman takes his time with each patient to find out exactly which breast implant will give her the results she wants.

According to Dr. Salzman, “We’ll start out the conversation saying there’s a right implant for you, but there’s also probably a few right implants for you. We’re going to show you on a three-dimensional image of yourself, so that really there’s no guesswork. This is exactly what it’s going to look like. 3D imaging has been around for eight years or so. We had it when it first came out. The primary thing that we do is to try and get a feel for what the patient wants. And I think it’s helpful if the patient brings in a photo. Almost every patient will bring a few photos of what their goal is, what they want to look like, and then that kind of starts the ball rolling.”

After learning about his patient’s cosmetic goals, Dr. Salzman provides information about breast implant options, Louisville, KY plastic surgery trends, and the new technologies he offers. He explains the process of looking at these options, “What kind of implant are we looking at? High profile, extra high profile, more of a modest, rather than just say, “this is what you need.” We have all the implants lying on the table. And I say, there is a reason to use every single one of these.

“I present the option of the IDEAL IMPLANT. It’s the most expensive one, it’s the most modern one, it’s really the only new type of implant that’s been introduced in years. And we show them the implant underneath the little cloth. It feels just like a silicone gel implant. Yet it has some sizing interoperability that you don’t have with a fixed volume silicone gel. The incision is a little bit smaller, the warranty is really as good or better than anything else that’s out there. My patients ask, ‘well, what’s the negative?’ It costs more, and my patients say, ‘you get what you pay for.’ And a lot of times the patients will select the IDEAL IMPLANT, never having heard of it before they come in.”

When talking to his patients about Louisville, KY plastic surgery trends and the benefits and compromises of the IDEAL IMPLANT, Dr. Salzman says “I think the only downside that I’ve seen is it takes longer to put the thing in. You have to pump all the saline, both lumens, where for me it takes me 15 seconds to put in a silicone gel implant. But, I think patients like the fact that this is the newest, latest, and greatest state-of-the-art implant. There really hasn’t been any big changes in silicone gel implants in a long time, other than the consistency of the gel. So this is revolutionary. I think the patients understand that you have something that feels like a silicone gel implant, which is why we like the silicone gel implants. That doesn’t wrinkle like a silicone gel gel implant, which this does not. That has the longevity that’s as good or better than most of the silicone gel implants. That has a warranty that’s as good or better than all of the silicone gel implants. And it has a smaller incision because you roll it up like a cigar and stuff it in a smaller hole. What are the negatives? Well it costs more. So my patients understand that and say, ‘well that’s why it costs more.’”

Breast Augmentations And Louisville, KY Plastic Surgery Trends

In addition to offering the latest breast implant options Dr. Salzman approaches breast augmentation surgery in a new way. His methods typically lead to less downtime and reduced pain during recovery. Dr. Salzman explains, “I’ve been doing pectoralis muscle blocks for two and a half years now. That’s under high-resolution ultrasound, putting a long-acting numbing medicine. We use ropivacaine, and we put that in between the pectoralis major and pectoralis minor muscle, where the nerves that supply the muscles come out of the underarm, and that’s the spasm that you get when you create this pocket. Three years ago when I would go back to the patient in the recovery room and say, ‘How are you feeling?’ the thinner patient with bigger implants would say, ‘I feel like an elephant is on my chest and I can’t breathe.’ That’s the response of the muscle tightening and having this implant underneath it. Well, when you paralyze it, so to speak, by using the long-acting numbing medicine, we don’t get that rapid tension and the patients don’t feel like an elephant sitting on their chest. I’ve also noticed that because of that block, we don’t see implants way up in the underarm. All these massage things and special bras and all that, we don’t have any of those things. Patients can pretty much do what they want the next day.”

Salzman Cosmetic Surgery And Spa

We asked Dr. Salzman how his practice, Salzman Cosmetic Surgery and Spa, compares to other practices around Louisville, KY. Plastic surgery trends are just one aspect of a cosmetic surgery practice. Safety, efficiency, and personalized care are also needed to give patients lasting results and the best experience possible.

Dr. Salzman tells us, “I think our office is a little bit unique in most parts of the country. We have a AAAASF, nationally certified operating room. We use board certified anesthesiologists and certified registered nurse anesthetists. We practice under the guidelines of the American Society of Plastic Surgeons and American Aesthetic Society. So it’s a state of the art operating room. We have ultrasound, we’ve got up to date things for liposuction. We’re doing BBLs, Brazilian butt lifts, under ultrasound. We’re doing tummy tucks with no drains, a painless, drainless tummy tuck. I do my own tap blocks, putting in numbing medicine in between the muscles of the abdominal wall, which really has helped for patients because it lasts for three days, it revolutionized their post-op care. We’re doing some state of the art things that not everybody’s doing and we have a beautiful facility and fantastic staff that is there to cater to our patients. And we have nurse practitioners taking care of our patients. It’s just a different type of practice.”

Considering breast implants in Louisville? Contact Dr. Marc Salzman today to discuss your options. Simply call 502-425-5200, or visit Dr. Salzman’s office is located at 4702 Chamberlain Lane Louisville, KY, 40241. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Be Aware of Imposters

I recently read an article in USA today that got my immediate attention. The link is provided here.Cosmetic Surgery Dangers. Apparently, according to this article the 8 years of residency training that I did to become a cosmetic surgeon may be of some benefit in providing safe and predictable outcomes for my patients. The article mentions that, as economic pressures have increased on medical doctors, some have sought to bolster their income by providing cosmetic services. Weekend courses, slick advertising, practicing outside the confines and regulatory practices of hospitals and ambulatory surgery centers have allowed this new crop of “cosmetic doctors” to peform aesthetic services like surgery, lasers and injectables without the oversight and regulation of other physicians. This article also discusses the importance of Board Certification. Plastic Surgeons, ENT’s and advanced fellowships in Dermatologic Surgery all have training during their residency that incorporates the principles and practice of cosmetic surgery. These training programs are often after a general surgery or ent residency that is 5-6 years of surgical experience. A weekend course is just not enough. Often, the Boards these wannabees say they are a member of are issued to doctors like themselves with limited training. At our office, I oversee everything. All nurse and cosmetologist providers have been trained by me and practice within the scope of their ability, training and licensure.We consider safety first and foremost and use only the very best of equipment, materials, photography and staff. Our fees may be somewhat higher than at the mall. Like anything in the US, you get what you pay for. The immediate gratification of a lower price can sometimes be far outweighed by long standing pain of a poor outcome or the added cost of a repeat procedure.

Quick Recovery Breast Augmentation

I know we talk about the way we do breast augmentation that minimizes patient discomfort and makes for a quick recovery but I wanted to share some patient comments from her return some 6 weeks after a silicone gel breast augmentation. She said she went out to lunch on the way home because she felt hungry. We operated on her on a Friday morning. She attended a dinner party on Saturday and went to church on Sunday. After two pain pills on Friday evening, she took only Tylenol. She then went to work on Monday as usual. Talk about quick recovery, that’s almost no recovery. While I believe her story is extraordinary, we have seen that our patients, when they compare their recovery experience to patients of other practices, seem to say that they have experienced less downtime than what they hear about from others. I do think that the attention to detail, gentle tissue handling, almost no bleeding all contribute to this kind of result. Malcolm Gladwell, in his prize winning book, Outliers, talks about having to put 10,000 hours into whatever your chosen area of expertise in order to be great at it. After 20 years and thousands of breast augmentations, I can see what he means. Breast augmentation in our office can be a weekend recovery for most patients. This makes for happy patients and a happier physician.

Another “Top Doc” Award

I was recently selected as a 2010 Top Doc for a Trade Magazine for our specialty. The interview really concentrated on what made our practice special and how it all started in Aesthetic Surgery for me. Here is a link: 2010 Top Doc in Plastic Surgery

Why We Do It

The enclosed letter I received the other day is reminder to me and my staff about how important our relationships that we build we our patients are. We fully understand that patients have many choices in providers of cosmetic services and we try to not only do it better, but also do it with passion, caring and compassion for our patients.

Today, its not enough to just have the latest and greatest technology or be able to deliver cutting edge procedures, we also have to deliver Ritz Carlton level of service. I have always felt that our practice, having been devoted to 100% cosmetic services for well over 15 years, had a distinct advantage over practices that did not specialize in cosmetic surgery. The relationship of the cosmetic patient and the plastic surgeon just seems different to me than for insurance based physicians.

We can take the time to make sure every patient has a clear understanding of the choices, risks, and benefits of everything we do from lasers, injectables to surgical procedures. It’s the thank you cards like this one that serve as  reminders of our success in that endeavor and that’s what makes it all worthwhile and it’s why we do it every day.


If it sounds to good to be true…..

Theses days I’m seeing more and more outrageous claims for cosmetic improvements mostly by non traditional aesthetic services providers.  By that I mean practitioners other than board certified plastic surgeons and dermatologists.  Injectable concoctions such as “lipodissolve” that can reduce the patient by several dress sizes and non invasive massage using ultrasound that removes inches of fat over 6 to 8 treatment sessions have both been recently touted in the media.  While our office has had some experience using Lipodissolve, our outcomes have been very modest and we use this method in a very few selected fashions for very small areas.  Focused high energy ultrasound is presently being evaluated in clinical trials here in the US.  Early reports have shown some fat reduction after 2 to 3 treatments.  No one in the Kentuckiana region has either of these experimental machines. We as board certified plastic surgeons, evaluate all new technologies very carefully.  Sometimes, the early claims of improvement can not be repeated by subsequent physicians.  New treatment modalities are tried and compared to the already existing standards and these outcomes are presented at our meetings and reported in peer reviewed journals. Not until the safety and efficacy (they work) are proven can these new breakthroughs be utilized by all physicians.  I have trouble with physicians who are new to the aesthetic arena recommending the newest technologies as being the greatest thing since sliced bread when they have had little or no experience in what this new technique will supposedly replace.  Unfortunately, it is a case of buyer beware.  Ask yourselves why, if this new machine, concoction, technique is sooo much better than the standard method that everyone doesn’t have it or do it.  Sometimes, when it sounds to good to be true maybe getting the opinion of an expert in the field would be prudent.  As it stands today, there is no machine that tightens skin like a facelift, no fat treatment that equals liposuction results and nothing that has been shown to be effective long term in treating cellulite.

The Kentucky Society of Plastic Surgeons annual meeting

This past week, as President of the Kentucky Society of Plastic Surgeons, I was responsible for arranging and running the yearly meeting here in Louisville.I spent a fair amount of time organizing a fun and informative learning opportunity for the residents of UK and UL as well as the academic and private practice plastic surgeons from around the state.I had visiting a plastic surgeon from my alma mater at Duke, a Ph.D. from Santa Barbara and practice consultant from Ohio all make outstanding presentations to a record crowd.It was so nice to hear many compliments from my peers about what a great meeting experience it was.One of the lectures that I devised was a panel where difficult plastic surgery problems were addressed by several surgeons from around the state.In our specialty, there is often many solutions to a given problem and that is where the “art” of plastic surgery lies.We did have a little scare for our dinner plans which were scheduled for a steakhouse near my office.Apparently, there was no power at that establishment.It was Ryder Cup week in Louisville and most restaurants that could accommodate large groups had been booked long in advance.Fortunately, for us, another steakhouse had a cancellation that morning.As some of our local patients may know, hurricane force winds had wreaked havoc in greater Louisville earlier that week. We were fortunate that another group had to back out at the last minute.

It’s all about the patients.

Today I saw a patient that exemplifies some of the positive effects we as plastic surgeons can have on our patients. A few weeks ago a very nervous teenager came in with her mother to be evaluated for small breasts. She seemed shy and was quite hesitant to let me examine her. Her mother said that her daughter hated summertime because she refused to be seen in a bathing suit. She had more than just small breasts. She had a breast deformity that we see quite often called tubular breasts. In this condition, the base of the breast does not form correctly leaving the nipple and areola pointing downward. I will usually not do breast surgery on a teenager but in these situations of deformity at an age where body image is vastly important to the psyche, I think it is warranted. About a week ago, she had expandable breast implants placed so that we could gradually increase her size over several months and she could determine the final size before the port is removed. What a change a week made. She came in all bubbly and excited. Her mother states she can’t keep her out of a bathing suit. The same girl who several weeks ago was hesitant to be examined had to be reminded that we have finished looking at her and she could replace her robe. While I don’t cure cancer or return trauma patients to health anymore, it’s days like these that remind me why I choose to be a plastic surgeon in the first place. Happy patients.

ABCS Denied Bid

Plastic surgery and all of organized medicine celebrated a major victory on April 28 when the California Court of Appeals denied a bid by the American Board of Cosmetic Surgery (ABCS) to gain specialty equivalency to the American Board of Plastic Surgery (ABPS). I feel strongly, as do all real Plastic surgeons, that these “Bogus Boards” are an attempt to confuse the public and gain market share in the cosmetic surgery marketplace. The ABCS does not require a residency in plastic surgery. Residency is where, after medical school, a young physician trains under a consummate, board certified physician in a University setting to gain the knowledge and skill required to safely and successfully practice plastic surgery. This physician is then rigorously tested, with a review of a years worth of cases, that they have the skill, integrity and knowledge base to be a board certified plastic surgeon. Without a formal training program requirement, the ABCS recipient has either been self taught or attended a weekend seminar to learn these skill sets. My residency was 8 years. Five years in General Surgery and three in Plastic Surgery. Either I’m an idiot, or there is clearly more to be learned than a weekend course can satisfy. I welcome the time when all states will only allow claims of board certification by boards recognized by the American Board of Medical Specialties (ABMS). The ABMS contains the boards that we have all heard of: American Board of Surgery, American Board of Pediatrics, American Board of Obstetrics and Gynecology among many others. I’m not against a career change by any physician. Just get the proper training first. Any physician in Kentucky can call themselves a plastic surgeon. They may also say board certified in their advertisements. Which board they are certified by may not be stated. If you have questions check the ABMS website.

Why should a plastic surgeon have a blog?

I love what I do and keep up with all of the new technology, treatments and procedures. Unfortunately, with vast media coverage of these same new materials through the internet, magazines and TV, I believe lots of misinformation is passed on to the public. This is my opportunity to comment on what’s happening out there and interpret the good and bad for my patients.  I also plan on relaying poignant stories that happen daily in our office.  I will, without breaching patient confidentiality, relate to other patients how plastic surgery and its wonderful possibilities have impacted my patient’s lives.So here it is:  Plastic Surgery – Louisville Styleby Dr. Marc J. Salzman.

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