Brazilian Academy of Anti-Aging and Regenerative Medicine
May, 2012
Leonard A. Rubinstein, M.D., F.A.A.C.S., F.A.A.Oto-HNS/F
Medical Director – Gulf Coast Cosmetic Surgery Center, Sarasota, Florida, USA
Medical Director – Center for Integration in Cosmetic Surgery and Rejuvenation Medicine,
ENT, Allergy and Skin Wellness, Sarasota and
Bay Harbor island (Miami), Florida, USA
Medical Director- Allergy Clinic of Sarasota, Florida, USA
Visiting Professor – Dept. of Plastic and Cosmetic Surgery,
Zunyi College of Medicine, Zunyi, Guizhou Province, P. R. of China
Clinical Faculty – Lake Erie College of Osteopathic Medicine
Visiting Faculty- East/West College of Natural Medicine
Integrative Medicine: Combining Allopathy, Homeopathy, Oriental Medicine
Provides for a holistic approach to patient treatment.
May include aspects of aromatherapy, acupuncture, nutrition, massage, energetics, informational
medicine, herbal medicine, osteopathy, reflexology, etc.
Provides a more complete and more realistic approach to the problem at hand than relying on
merely conventional Immunotherapeutic “messaging” to the Immune system.
Proposed Team Approach
A more complete paradigm for assessing and treating the patient should include a team:
Cosmetic Surgeon, Nurse, Oriental/Homeopathic Medicine, Age Management, Dietary and
Exercise Counseling.
Our Approach to the Cosmetic Patient
“Cosmetic” = “Self-Image Enhancement”
An Integrated approach including Allopathic, Homeopathic and Oriental/Chinese Medicine
components.
Utilization of a team approach: Doctor of Medicine (Cosmetic Surgeon), Doctor of Oriental
Medicine, Age Management physician, Nurse, Esthetician, Massage, Dietary and Exercise
Counseling.
The goal is to achieve a maximal natural-appearing result with self-esteem enhancement and
WELLNESS with the least recovery time.
An Integrative (East-West) Approach to Skin Care, Rejuvenation Medicine and
Cosmetic Surgery
Evaluation:
Patient Expectations and Family Expectations (realistic?)
Readiness: Schedule, Work, etc., Social History
Habits: Drugs, Smoking, Chewing Tobacco, Alcohol, etc.
Past Medical and Surgical History
Education and Culture
Medications/Treatments in Progress/Nutriceuticals/Dietary Habits/Exercise Regimen
Allergies and Endocrine Factors
Financial Capacity
The Concept of Beauty
What is the patient’s concept?
This is the most critical assessment that you as a Cosmetic Surgeon must make…..
If you don’t know where you need to arrive, you’ll never understand which “road(s)” to take
and you’ll rarely get there!
What obstacles are in your way?
The patient is often unaware of the issues……they are being highly influenced by the media.
The culture of the patient…..you must understand the influences of those around the patient
because it is to that culture that the patient will return after you have begun your involvement in
their care!
Age Management Assessment
Hormone levels: requiring supplementation?
Habits that may affect results.
Dietary issues that may affect results.
Exercise regimen that may affect results.
Breast Enhancement?
It is not fair to the patient to provide a single regimen, tool or treatment when there are so many
options and considerations that should be taken into account.
A sculptor uses many different tools to achieve the end result….
Anti-Aging Medicine
Bio-Identical Hormones are replaced if found to be abnormal – test saliva, blood, 24 hr. urine
Testosterone, Estrogen, Progesterone
Human Growth Hormone/Sermorelin
Thyroid
What good is surgical and skin rejuvenation without endocrine regulation/rejuvenation?
Our approach is “Beauty Inside and Out!”
Achieve Beauty and Wellness together!
What’s New In
Cosmetic Surgery?
The buzz words are:
*No down time*
*Lunch Time Procedures*
*Minimally Invasive*
*Quick Recovery*
Body Contouring by Breast Augmentation
Alternatives in the Traditional Approach to Breast Augmentation to prevent scarring of skin…
The Intra-Areolar Multi-W-Plasty approach to Breast Augmentation
“No Skin Scar” Technique
Developed by
Leonard A. Rubinstein, M.D., F.A.A.C.S..
The Intra-Areolar Approach
Multiple advantages to previously described techniques
No skin scar results because incision is not made on the skin
Small accordion shaped incision is made in the natural wrinkles of the pigmented portion of the
breast immediately surrounding the nipple.
No loss of sensation
Direct and accurate placement of implant to maximize a natural-appearing result
Cosmetic Surgery Times
April 2003
“Relative to other approaches for Breast augmentation, the intra-areolar technique also offers
advantages for avoiding loss of nipple sensation and implant hardening.”
“…also minimizes a number of factors that have been associated with implant hardening,
including inadequate hemostasis, excessive tissue trauma and bacterial contamination”
Cheryl Guttman
Staff Correspondent
Breast Augmentation in Teenager
Breast Augmentation in Teenager
The Intra-Areolar Approach
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Body Contouring by Breast Augmentation
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Breast Augmentation
Breast Augmentation
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-Z-Plasty
Intra-Areolar Multi-W-Plasty
The Art of Achieving a Natural-Appearing Enhanced Body Image
Breast Enhancement
Consider a New Definition of Beauty….
Our approach = “Beauty Inside and Out!”
Our goal: To Achieve Beauty and Wellness together!
Brazilian Academy of Anti-Aging and Regenerative Medicine
May 2012
Leonard A. Rubinstein, M.D., F.A.A.C.S., F.A.A.Oto-HNS/F
Medical Director – Gulf Coast Cosmetic Surgery Center, Sarasota, Florida, USA
Medical Director – Center for Integration in Cosmetic Surgery and Rejuvenation Medicine,
ENT, Allergy and Skin Wellness, Sarasota and
Bay Harbor island (Miami), Florida, USA
Medical Director- Allergy Clinic of Sarasota, Florida, USA
Visiting Professor – Dept. of Plastic and Cosmetic Surgery,
Zunyi College of Medicine, Zunyi, Guizhou Province, P. R. of China
Clinical Faculty – Lake Erie College of Osteopathic Medicine
Visiting Faculty- East/West College of Natural Medicine