Wendy Lewis talks to some of the leaders of the American Society for Aesthetic Plastic Surgery about their triumphs over half a century

The sunny city of San Diego played host to the 50th anniversary of the American Society for Aesthetic Plastic Surgery (ASAPS) in April 2017. This momentous occasion was marked by a grand celebration of this forward-thinking society that was founded in 1967 and now boasts over 2,600 members in the US and Canada.

The event was a fitting tribute to this prominent group of board certified plastic surgeons. The 50th anniversary conference celebrated the many accomplishments of ASAPS and its members, who are at the forefront of the ever-expanding variety of aesthetic procedures available to patients today.

What makes ASAPS tick?

A SAPS is widely recognized as the world’s leading professional organization of board-certified plastic surgeons who specialize in aesthetic procedures of the face, nose, body and breasts. The Aesthetic Society has been at the forefront of innovation in aesthetic plastic surgery and medicine since its inception. Their overriding goals are to promote medical education, consumer education, and patient advocacy. The Aesthetic Society’s stated mission is to advance the science, art, and the safe practice of aesthetic plastic surgery and cosmetic medicine through education, research, and innovation.

It should be noted that as a prestigious specialty organization, plastic surgeons are elected to become members, must be sponsored by two ASAPS members, and there is a lengthy vetting process. At the time of this printing, approximately 1,200 plastic surgeons are enrolled in the ASAPS Candidate Program or the International Candidate Program. Candidates must be certified by the American Board of Plastic Surgery or certified in plastic surgery by the Royal College of Physicians and Surgeons of Canada, and be in at least the third year of practice following board certification. They also need to meet the CME requirements and perform sufficient cosmetic cases during a 12-month period.

Among their major initiatives is the ASAPS Cosmetic Surgery National Data Bank that releases annual statistics to the public. Working with an independent research firm, ASAPS has compiled national data for procedures performed and detailed statistics on consumer trends since 1997. In 2016, Americans spent an all-time high of over $15 billion dollars on combined surgical and non-surgical aesthetic procedures, marking an 11% increase over the past year. Surgical procedures accounted for 56% while non-surgical procedures were 44% of the total. This was the largest amount spent on cosmetic procedures since ASAPS began releasing statistics 20 years ago¹.

Established in 1996, Aesthetic Surgery Journal is an official publication of ASAPS considered to be the most widely read clinical journal of cosmetic plastic surgery in the world. It is the ‘go to’ peer reviewed journal in the specialty, and has a rich history of breaking new ground. Under the editorial direction of Atlanta plastic surgeon and ASAPS Past President Foad Nahai, ASJ has charted new territory. ‘Just as aesthetic surgery itself has changed, the Aesthetic Surgery Journal of today is a different “animal” than it was in the past—certainly a more formidable one. We continue to maintain a focus on the “meat and potatoes” of aesthetic surgery, but we have not lost our willingness and ability to tackle the controversial and the new. A number of years ago, who would have thought ASJ would have an entire section devoted to cosmetic medicine or a “virtual issue” on genital rejuvenation?’

Sue Dykema has served as the organization’s Executive Director since 2009. ‘Celebrating the 50th Anniversary of the founding of The Aesthetic Society reaffirms the need for ongoing education specific to aesthetic plastic surgical procedures. The Founders were true visionaries of the specialty and I am honoured to be serving as Executive Director during this milestone in the organization’s history,’ says Ms. Dykema who is universally respected as the heart and soul of ASAPS, having been with the organization since 1996.

Reflections on ASAPS’ 50th

Many presidents, past presidents, and board members had much to say on how their experiences with ASAPS has impacted their careers.

‘From its very humble beginnings in 1967, ASAPS has become the leading organization of board-certified plastic surgeons dedicated to aesthetic surgery and cosmetic medicine. It was a great honor for me to assume the presidency of this distinguished organization during our 50th anniversary meeting in San Diego.  Even with the build-up prior to this monumental event, the meeting exceeded everyone’s expectations from senior surgeons to residents,’ says Dr. Clyde H. Ishii in Hawaii, the current President of ASAPS. One of the standout sessions of the 50th anniversary meeting was Past President Dr. Robert Singer’s presentation on the history of The Aesthetic Society and how it paralleled the evolution of aesthetic plastic surgery.

According to immediate past president Daniel C. Mills, MD, ‘Being in San Diego we had perfect weather and wonderful social events to commemorate the 50th. The huge wall that displayed the ASAPS timeline of our 50 years was also a huge hit. We had many new initiatives, which is what The Aesthetic Society is known for. We were able to work with other organizations, such as ASPS and ISAPS, to have a better working relationship with them on the breast implant ALCL issues. We are also looking at the potential complications of fat grafting with Brazilian butt lifts. Everyone who talked to us said that the meeting was the best educational experience that they had ever had bar none for aesthetic surgery. I wish I could take credit for that but it truly is from our Educational Commissioner Dr. Charlie Thorne and program directors Drs. Bill Adams and Jamil Ahmad with our Program Committee. They did an outstanding job on the education front.’

‘In addition, the new ANN (Aesthetic Neural Network) is the only tool available to benchmark our members’ practices with their colleagues. ANN will help us get better practice management tools, and down the road it will greatly help us get better statistics and outcomes for our patients and our members so we can maintain our high position in aesthetic surgery and medicine,’ he adds. ‘This society is such a family with great out of the box thinkers who are creative, artistic and really care for their patients. I was so humbled and extraordinarily thankful that our members gave me the opportunity to serve as President. I feel like I did not let them down,’ says. Dr. Mills.

Dr. James Stuzin in Miami, a Past President, shares his thoughts on the rich history of ASAPS. ‘The 50th anniversary meeting celebrated the advancement and accomplishments of those plastic surgeons who committed their careers to improving the outcomes for patients undergoing cosmetic surgery. When the Society was founded in 1967, aesthetic surgery was felt to be an outlier by the national leadership of organized plastic surgery, a subspecialty that had little scientific basis and was supposedly not of benefit to patients. At that time, aesthetic surgery was not taught in plastic surgery residency, there were no textbooks on how to perform these procedures, and most cosmetic surgeons of that era were reluctant to share their ideas and techniques because they were afraid to train the competition. ASAPS, whose primary mission has not changed in 50 years — which is to promote aesthetic surgery education — brought credibility to cosmetic surgery and provided a forum for plastic surgeons to share ideas, innovations and promote patient safety.’

According to Dr. Tracy Pfeifer in New York City, a Member at Large on the Board, Editor of RADAR, Vice-Chairman of the Symposium Committee, ‘ASAPS founders were trailblazers who bucked the status quo and created the Society de novo.

This required courage, determination and a singular vision. They were leaders who withstood significant criticism by the other plastic surgery societies and this was truly a unique group of surgeons with a strong vision. This spirit of ingenuity and of broadening horizons, not allowing others to define them, permeates ASAPS today.’

The next generation

As ASAPS has grown up, they have added more specialized groups and sub-groups where plastic surgeons who are earlier in their practice are encouraged to participate. This has opened up the organization to new ways of thinking as the challenges facing younger plastic surgeons keep changing with the times and competition in the market is fierce.

Women constitute an emerging growth sector contributing to ASAPS’ ongoing success. According to Dr. Pfeifer, “Although the number of women is increasing, we still represent a small percentage of board certified plastic surgeons nationwide.  ASAPS’ leadership recognizes that we have an important role to play and they proactively seek out women to become involved at the highest levels. The leadership and staff have helped develop the Women Aesthetic Surgeons Committee which hosts a half-day session at the annual meeting that specifically addresses issues faced by women plastic surgeons. ASAPS is always thinking about how to leverage the talents of our women members and meet their specific needs. This is a far cry from when I was told by the male Chief of Surgery in my third year of medical school that he did not approve of women going into surgery, which created a possible career ending situation since the Chief of Service has to write a letter to be accepted into any residency program. While I had to fight my way into general surgery, it is so nice to feel that I am truly welcomed and respected as a woman aesthetic plastic surgeon by ASAPS. In fact, many male ASAPS members have said that they wish other women would become more involved. We have come a long way, baby, and I know the year of our first woman president of ASAPS is not far in the future.”

Another area where ASAPS excels is in its commitment to promoting their members’ standing through digital marketing and social media. “ASAPS has always meant being at the top of my craft to me. I saw membership in this society as one of the ultimate goals when starting my private practice. I am currently working with other active members of ASAPS to spread the word on social and traditional media that by choosing an ASAPS member surgeon, you are choosing the cream of the crop in cosmetic plastic surgeons.  Virtually all of the top cosmetic plastic surgeons in our field are members of ASAPS, so for me to ever be considered in the same breath as some of these giants in our field I needed to become an active member. Now I’m excited, as Chair of The Media Relations Committee, to hopefully play an integral role in expanding the public’s awareness of choosing an ASAPS surgeon,” says Dr. Anthony Youn in Michigan. “I feel privileged to help hold the banner of ASAPS with so many doctors I look up to and admire who have held it before me these past five decades.”

Communications Commissioner Dr. Jennifer Walden in Austin describes what attracted her to ASAPS early on. “I am committed to lifelong learning and being the best aesthetic surgeon as possible, which is what attracted me to The Aesthetic Society as a resident. The Aesthetic Meeting is an opportunity for me to stay up-to-date with surgical technique and innovation and the Aesthetic Surgery Journal supplements that on a day to day basis. I’ve been privileged to have become friends with many of those from whom I’ve learned, and my time volunteering on the ASAPS Board of Directors has allowed me to give back to the specialty, from which I’ve gained so much.”

Importance of innovation

Despite how far it has advanced, the field of plastic surgery has unlimited developments yet to be pursued.

According to Dr. Stuzin, “The 50th meeting of ASAPS celebrated many accomplishments as well as noting the progression of safe and consistent outcomes in the wide variety of procedures available to patients today. These pioneers of cosmetic surgery had the foresight to understand the importance of aesthetic procedures for our patients and by forming a subspecialty society of plastic surgery, which is ASAPS, influenced the progression and practice of cosmetic surgery both in the U.S. and globally. 50 years later cosmetic surgery is now at the center of innovation for organized plastic surgery and is part of the core curriculum in residency training.”

For a specialty that has long embraced new developments, albeit with a healthy dose of skepticism, the rise of non-surgical and minimally invasive procedures underscores the ongoing need for evidence based medicine. For example, there has been substantial debate at ASAPS meetings about the safety, efficacy and science of stem cell therapies and regenerative medicine. The uber popular Hot Topics forum has delved into these areas and other controversial topics, and it ranks as my number one ‘go to’ session that I never miss year after year.

Promoting clinical research is one of the guiding principles of ASAPS’ raison d’etre. The Aesthetic Surgery Education and Research Foundation (ASERF) is the philanthropic research and education arm of ASAPS whose mission is to identify and pursue those issues relevant to the advancement, effectiveness and safety of aesthetic surgery through directed research and education to benefit patients, surgeons, and the medical field.

The new President of ASERF, Dr. Barry DiBernardo of New Jersey, is actively involved in education and research in aesthetic surgery and medicine. “My goals are to provide a means for ASAPS and ASERF members to conduct clinical aesthetic research in a non-biased way and to explore new opportunities for ASERF-supported research. Having spent over 25 years in education and research in aesthetics, I am honoured to be at the helm of this cutting-edge research group”, he says.

Dr. Michael Kulick in San Francisco, who has served as Chairman of the Light and Energy Based Therapy committee since 2009, and co-chairs the popular Cosmetic Medicine Course with Dr. Z. Paul Lorenc, is leading a new platform called Surgeons As Consumers (SAC). “ASAPS has taken a big step in helping physicians make important decisions regarding their practice. Historically, clinicians and their patients have relied upon the sales force of companies to provide information regarding the functionality and efficacy of light and energy based therapies. Unequivocally, such devices have provided significant improvements in the aesthetic realm. However, not all modalities work as expected. This year, ASAPS has implemented a feature where members can go onto the ASAPS.org website and add their experience with any device they utilize. They can also review the opinions of other members regarding efficacy, company support, training, return on investment and more regarding light and energy based therapies as part of the process to incorporate new devices into their practice.”

The future of Aesthetic Plastic Surgery

What will the future hold for the time-honoured specialty of plastic surgery?

“The early pioneers of cosmetic surgery had the foresight to understand the importance of aesthetic procedures for our patients and by forming this subspecialty society of plastic surgery, they influenced the progression and practice of cosmetic surgery both in the US and globally. Now 50 years later, cosmetic surgery is at the center of innovation for organized plastic surgery and is part of the core curriculum in residency training,” says Dr. Stuzin.

As Dr. Nahai wrote, “The important work being done by colleagues in related specialties and in far-reaching fields, such as genetics and biogerontology, will increasingly have implications for aesthetic plastic surgeons. As human beings are seamlessly changed from the inside, they will expect to be seamlessly changed on the outside as well. The more we steep ourselves in the latest scientific developments within our specialty and as far outside of it as we can go, the more exciting will be our possibilities for the future.1”

As membership continues to grow, the reach of ASAPS’ initiatives is expanding. “My membership in The Aesthetic Society is part of the core foundation of my ongoing surgical education, and I look forward to all I will learn in the future. 50 years is an important milestone, and I am excited about the journey ahead into our next 50 years,” says Dr. Walden.

“On the occasion of ASAPS’ 50th Anniversary, it is appropriate not only to recognize the past achievements of this Society and its talented members, but to renew our commitment to the future of aesthetic surgery as a scientifically-driven discipline. Only in this way can we realize its full potential to enhance our patients’ quality of life,” says Dr. Nahai.2

Dr. Ishii has a lot on his plate having taken over the reins in April. “As we embark on the next 50 years ASAPS is poised to continue as the standard-bearer for educating plastic surgeons around the world,” says Dr. Ishii

‘ASAPS is all about education. We are Aesthetics and our mission is Aesthetic Education and Patient Safety.  My first ASAPS meeting was in 1986 in New Orleans. I look forward to becoming the President of ASAPS next April in New York,’ says President-Elect W. Grant Stevens in Marina Del Rey.

ASAPS The Aesthetic Meeting 2018 will take place on April 26 – May 1, 2018 at Jacob K. Javits Convention Center in New York City. http://www.surgery.org