We were delighted to catch up with Steven Dayan, esteemed Plastic Surgeon and US Scientific Director of AMWC.
Can you tell us a little bit about what led you into the field of plastic surgery and what have been the highlights so far?
I like to say that plastic surgery chose me, I didn’t choose it. I guess there is a bit of destiny involved in my trajectory as there is with most of us in the aesthetic fields. Those with a creative affinity are viscerally drawn to the aesthetics fields and those who enjoy working with their hands as well as enjoying the adrenaline of surgery are drawn to plastic surgery. But all physicians and healthcare professionals who fall into aesthetics seem to appreciate aesthetic medicine as the last bastion of medical care where the doctor patient relationship remains sacrosanct. A patient and doctor are at liberty to choose each other. Unlike many other medical fields where patients are sent to a provider based on an insurance plan or other third-party payors. In aesthetic medicine a patient searches for and finds the doctor that best fits their needs and desires. And a doctor has a responsibility to provide the best care and always treat the patient well or risk not being successful. There are market forces and trends that dictate and influence patient flow, industry innovation and treatment protocols. And success is measured both for the individual provider as well as the specialty on patient satisfaction more than any other parameter.
Aesthetics is a field devoted to improving patients’ lives and well-being. We make people happy; we use our efforts to infuse and stimulate self-esteem and confidence with our tools including surgical procedures, non-surgical treatments, skin care or at times… nothing more than a simple conversation. Our goal is not beauty per se but rather increasing a patient’s self-esteem and confidence. Following a treatment our patients stand taller, talk stronger and feel better about themselves. And we get the opportunity to participate in that transformation. I can’t think of a better field of medicine to be in.
What has been the best piece of advice that you have received in your career and what advice would you offer to those following in your footsteps?
“Know your position in space as it relates to yourself and others.” Basically this means know your biases and appreciate the views and thoughts of those around you, as well as how your point of view affects and influences theirs. And as an undergraduate student with a background in philosophy, I often refer to my favourite philosopher, Nietzsche, and his recommendation, “Amor Fati,” translated as love your fate but, more practically, meaning live the life you would want to live over and over again.
What have been the most exciting developments in your field in the last decade?
This is a complicated question that deserves a thoughtful response… and I think the answer is greatly dependent on who you ask. As someone who has been in practice for over 20 years and seen the explosion of non-surgical products and procedures there is no doubt the greatest impact and the reason for the massive explosion, as well as democratisation of aesthetics, is the introduction of botulinum toxin and soft tissue fillers. Historically aesthetic medicine was a field for the few wealthy who were vanity challenged or who wanted to showcase their privilege. They could afford the downtime and expense of plastic surgery procedures. But all this changed in the early 2000s with popularisation of botulinum toxins and fillers. Now aesthetics treatments are more affordable and can be done in an office visit with little to no downtime. And over the last 20 years both treatments have continued to get better results with less downtime (less bruising and swelling) and results continue today to get better as we learn what makes a face attractive and why. Non-surgical fillers and toxins also allow us to do studies that provide validated evidence-based medicine results which was impossible when we only did plastic surgical procedures.
Over the last decade with the introduction of patient-reported outcomes, we have begun to understand the impact these treatments have on the wellbeing and psyche of our patients as the field of aesthetics evolves into one that improves the mood and wellbeing of patients, and we attempt to better define how appearance and mood are related. In the last five years biostimulation and regenerative medicine have started influencing aesthetic medicine as we look to stop and or reverse the ageing process of the skin, soft tissues, and architecture of the face. From hair replacement to bone reformation, appearance detracting facial ageing doesn’t have to be a foregone conclusion. And the future is bright with a field that seems to be recession-proof and predicted to grow at 10% per year. More and more people from all walks of life are wanting to look and feel their best and physicians and providers from all fields and levels of medicine are meeting that demand. Expect an increased interest and participation from the general populous as well as multiple healthcare providers in the coming years.
You are one of the Directors of AMWC. Do you enjoy this role?
I absolutely love being the North American Director of AMWC. It gives me an opportunity to learn from the best of the best in my field as well as be on the cutting edge of new treatments and thoughts. AMWC is unique in that it attracts physicians and industry from all corners of the earth. And each year I come home even more stimulated and motivated to participate in pushing the field of aesthetics forward. I feel more knowledgeable, confident and complete when consulting with my patients and colleagues.
In 2023 AMWC will return to Monaco at the end of March. Can you tell us about the themes and potential highlights of the event?
Every year is exciting at the AMWC meeting but I feel like this year even more so. It is the first year where most people seem to feel Covid is behind them. More and more of the best will be attending and the enthusiasm to meet, explore, share, and learn from each other will be at an all time high. Also, there isn’t a more beautiful coast, venue and city to have a global meeting in than Monaco. This year I am very excited to direct a session on:
Diversity: We will be taking a deep dive into the aesthetic similarities and differences between culture and people from Africa to Asia to South America, North America, Middle East, and India. We will have experts from each of those locations to share their thoughts and techniques as well as provide sensitivities and the insights into the differences in social and cultural customs.
Other exciting sessions that are sure to generate a lot of buzz and excitement will be the sessions on:
Ultrasound imaging in aesthetics: This is a very important, current, and even somewhat controversial issue. Ultrasound enthusiasts are favourable on the benefits of mapping out dangerous areas of the face prior to injecting the face and the importance of ultrasound guidance to help quickly alleviate symptoms when complications happen after injecting fillers. Some seasoned injectors feel it may not be necessary especially in the hands of those who are experienced. A spirited debate is likely.
Limits of treatment with fillers: This is an important new way of thinking in aesthetics with greater attention on how to best avoid the overfilled ‘pillow’ face or unnatural appearances. A rash of pillow faces hurts all of aesthetics when patients look bizarre. This session will be focused on when enough is enough and when or how do you say, “no.”
Aesthetics and reality: Aesthetic medicine rapidly evolves and much of the latest trends are splashed on social media screens before even being tested in clinical trials. However, this means there are also many unproven and potentially unsafe treatments being promoted to consumers in an irresponsible manner. But on the other hand, clinical trials that provide evidence-based medicine can take years to complete and by the time the treatments get approved and to market, they may be irrelevant or outdated. Where is the balance and how to use critical thinking and reasoning when evaluating new data and practices?
Threads with focus on neck and eyebrow: Threads are one of the biggest raves in aesthetic medicine, whether they are reliable and deliver on their promise is still up for debate. The North American experience has not been as positive as the results seen in Asia. And a lot can be learned from the experience from physicians who have already figured out best practices with threads. Two areas which seem to give more consistent results are the neck and brow area. This session is sure to be filled to standing room only as everyone is looking for a procedure that offers an immediate lift with an office-based procedure that can be done in minutes with little to no downtime.
And finally, if you have any spare time, how do you like to relax?
Good question! I like to think about AMWC and all the fun things to do when I am in Monte Carlo!
Many thanks for your time!
