The U.S. wellness industry has a conservative estimated worth at more than $200 billion, a niche that will grow increasingly important as a way to combat chronic disease. With a renewed focus on preventive care, the medical community has melded wellness with medicine and surgery to create comprehensive services for discerning healthcare consumers who desire quality, convenience and a one-stop shopping experience.
Tapping into shared synergies are Peter Fodor, MD, FACS, and Glenn Marshak, MD, two Los Angeles-area physicians who collaborate to bring to their patients a non-surgical weight loss program coupled with surgical cosmetic procedures. Fodor operates from his practice, Century Aesthetics, while Marshak, an internist and certified nutrition specialist, is a staff physician at the Aspect Beauty medical spa. Together, they provide their patients with guidance and treatment at all points along their weight loss and plastic surgery journey.
“Among Aspect’s many spa services, we provide a medically supervised weight loss program on an outpatient basis for patients who want to lose weight through proper nutrition, dietary supplements and exercise,” Marshak explains. “Dr. Fodor is the plastic surgeon at Century Aesthetics who is performing medically indicated procedures, such as liposuction or other types of cosmetic procedures on patients who have had bariatric surgery and/or experienced non-surgical weight loss who have excessive skin that can cause significant discomfort, and medical conditions such as severe rashes, or skin which needs to be fixed cosmetically.”
Fodor says he has always believed in what he calls the ‘360-degree approach’ to wellness and cosmetic surgery: “If a patient comes to us for a facelift, we also have a medispa on the premises that will teach them how to ensure that their skin is in the best possible condition for the surgery. And after the surgery, we teach them how to care for their skin as they recover and heal,” he says. “It’s nice to have everything under one roof , but in the case of weight management, the collaboration with Dr. Marshak allows us to help patients ensure they are on the proper diet and exercise program both before and after a surgical procedure. Whether it’s bypass surgery or a lap-band procedure, Dr. Marshak will arm them with the right nutrition and everything they need for optimal recovery and uneventful wound healing.”
Following a patient’s weight loss, Fodor explains further, they must maintain their weight in order to be candidates for surgical removal of excess skin to help improve the look of their bodies and increase functionality as they engage in activities of daily living. “The collaboration begins again as those patients are prepared for their procedures and surgeries,” Fodor says. “Dr. Marshak is a great complement to the team because he gets patients ready from a nutrition and exercise standpoint so healing is optimal. It could be six months to a year between the time they have lost the weight and stabilized themselves, and the time they would undergo their surgical procedures, and we are there to provide the hand-holding they need.”
While Fodor and Marshak champion their patients’ needs, the economy has not been kind to healthcare providers offering these kinds of elective services. Making recent headlines was the news that the economic downturn has created a chilling effect on aesthetic procedures; according to the American Society for Aesthetic Plastic Surgery, there has been a significant decrease in plastic surgery business. While 11.7 million surgical and non-surgical cosmetic procedures were performed in the United States in 2007, the economy has caused many healthcare consumers to rethink that facelift or tummy tuck.
Fodor and Marshak acknowledge this downturn in patient volume, but both physicians say there are bright spots. Fodor says that even though plastic surgery has been impacted, he has observed a significant shift toward less complicated and expensive procedures that could eventually supplant lost revenues. Diversification of procedures and surgical services is an important way to not only recoup and build revenues, but to better compete in a crowded marketplace through differentiation.
“I like to be able to offer my patients a variety of aesthetic procedures,” Fodor says. “Oftentimes, a patient may come to you for a facelift but actually what would benefit them is what I call a ‘near facelift’ – you do their eyes, their nose, their neck, and if you were to look at a before and after photos you would think they had a facelift. With a near facelift the patient receives a group of smaller procedures that can give the appearance of a more expensive procedure.”
Century Aesthetics’ diversity of procedures and Aspect Beauty’s comprehensive programs is a business model that is successful for client wellness centers and medical spas, according to Robert Zasa, MSHHA, FACMPE, a principal of Woodrum Ambulatory Systems Development. For Marshak, this modality works “because it is a multi-disciplinary approach to taking care of weight-loss patients at different places during the course of their treatment period.” Marshak adds, “Not all patients fit readily into a box; we as physicians must offer different options. For each patient to be successful, you can’t just have one regimen or program or procedure, but rather offer an integrated approach.”
Innovation goes to the heart of any viable practice or program, and Fodor says that physicians must take advantage of the progress that has been made in every medical and surgical specialty. “One of the worst things you can do is to not be open-minded to new technology and techniques,” Fodor says. “The important thing is to make sure they compare favorably with the gold standard of whatever it is that you are doing. If you can do something via laparoscopic surgery, with a quicker recovery time and a smaller scar for the patient, you must be certain that it still produces superior results and is better than what is considered to be the gold standard. It’s the right thing to do for your patients.”
Marshak says he believes that medical spas, aesthetic surgical services and weight loss programs will remain fiscally viable for the future. “Wellness is key because the progression of disease leads to co-morbidities,” he says. “Having obesity leads to diabetes, hypertension, low levels of immunity and even some cancers, so I think there will always be a place for preventive medical programs and their related aesthetic surgical services.”
Cosmetic Procedures by the Numbers
According to data from the American Society for Aesthetic Plastic Surgery, there were more than 10 million surgical and non-surgical cosmetic procedures performed in the United States in 2008. Non-surgical procedures accounted for the most, making up 83 percent of the total.
- • From 2007-2008, there was more than a 12 percent decrease in the total number of cosmetic procedures. Surgical procedures decreased by 15 percent, and non-surgical procedures decreased by almost 12 percent.
- • Since 1997, there has been over 162 percent increase in the total number of cosmetic procedures. Surgical procedures increased by almost 80 percent, and non-surgical procedures increased by over 233 percent.
- • The top five surgical cosmetic procedures in 2008 were: breast augmentation (355,671 procedures); liposuction (341,144 procedures); eyelid surgery (195,104 procedures); rhinoplasty (152,434 procedures); and abdominoplasty (147,392 procedures).
- • The top five non-surgical cosmetic procedures in 2008 were: Botox injection (2,464,123 procedures); laser hair removal (1,280,964 procedures); hyaluronic acid (1,262,848 procedures); chemical peel (591,808 procedures); and laser skin resurfacing (570,880 procedures).
- • Women had more than 9.3 million cosmetic procedures, almost 92 percent of the total. The number of cosmetic procedures for women decreased over 11 percent from 2007.
- • The top five surgical procedures for women were: breast augmentation, liposuction, eyelid surgery, abdominoplasty and breast reduction.
- • The top five surgical procedures for men were: liposuction, rhinoplasty, eyelid surgery, breast reduction to treat enlarged male breasts, and hair transplantation.