Julio F. Gallo, MD, FACS, and Stephen Watson run a comprehensive practice and medical spa in a swanky Miami hotel.

An enormous amount of time, energy, and money went into the first-class build-out of the relatively young MIAMI Institute for Age Management and Intervention. Co-owners Julio F. Gallo, MD, FACS, and businessman Stephen Watson will not disclose just how much they spent, but, given that their state-of-the-art, 10,000-square-foot facility in­cludes a full-service medical spa and a pair of accredited, hospital-type operating rooms (ORs), their dollar investment in all likelihood was huge.

It is surprising, then, to discover that they are only leasing the space they occupy, rather than opting for the security of outright ownership.

Risky? Perhaps—except that Gallo and Watson, through their legal team, negotiated a fairly difficult-to-break long-term lease.

Unwise? No—considering that leasing was the only way they could obtain floor space at their prestigious downtown Miami location: the third-floor lobby of the Four Seasons Hotel and Towers, a chain renowned for ultraposh lodgings that are a favorite of the rich and famous.

“Our location is one of the keys to the success of this venture,” says Watson, who serves as the MIAMI Institute’s president and CEO. “Our presence in a multiuse building of this stature gives us an enormous advantage in terms of consumer appeal.”

The part of the building occupied by the MIAMI Institute is shared with several retail shops and commercial establishments. However, the institute is the only medical practice among them. Worth noting too is that no cobranding or cross-promotion occurs between the hotel and the MIAMI Institute; indeed, Gallo and Watson take pains to ensure that patients understand that the hotel neither sponsors nor endorses the enterprise.

“We’re a serious medical facility, not a resort,” Watson says. “As such, we don’t position or market ourselves as having anything to do with the hotel, other than the fact that we are located in it and that this choice of location affords certain conveniences and comforts to our patients.”

Emphasis on Privacy

One of the comforts is the patient’s ability to luxuriate in a five-star guest room following discharge from surgical recovery—even though fewer than 15% of MIAMI Institute patients elect to do so.

“We tell our patients that an overnight stay in the hotel with a nurse to attend them is advisable,” Gallo says. “Such a stay isn’t required, since all our patients are ambulatory. But checking into the hotel afterward is good for those who may not have anyone at home able to assist with the various needs they will likely have during the first 24 hours or so after discharge.”

Although the Four Seasons Hotel and Towers is a big place, it is not difficult to find your way to the MIAMI Institute. But the institute’s facilities are purposely situated where scant foot traffic is encountered.

“This is in part how we can better ensure the privacy of our patients, which is crucially important considering that we’re dealing with celebrities and VIPs. In fact, the facility has a private side entrance accessible from the garage that allows patients to be dropped off and picked up with discretion,” Gallo says.

Another privacy-protection tactic used by the MIAMI Institute: no central waiting room. “We have only individual, private consultation rooms,” Watson says. “As soon as the patient arrives and checks in with our reception staff, he or she is escorted directly to a consult room. If a consult isn’t necessary, then the patient is taken directly to a preassigned treatment area.”

It is perhaps appropriate for the location that the patient coordinators at the MIAMI Institute function much like concierges. “The patient coordinator takes care of all the patient’s needs, including travel arrangements and lodging,” Watson says. “Each patient is assigned a coordinator, who will always be the same one from visit to visit so that the patient has a steadily familiar contact to interact with.”

A Team Approach

Beyond the premier surroundings, every bit as central to the success of the MIAMI Institute is its interdisciplinary approach to the delivery of care and the provision of ancillary services.

“We felt that the best way to manage the aging process and to help our patients achieve lasting wellness would be with a comprehensive team of multispecialists,” says Gallo, who is one of two facial plastic surgeons in the institute. “We have full-time, board-certified practitioners from the fields of body plastic surgery, endocrinology–internal medicine, cosmetic dentistry, psychology, pharmacy, anesthesia, nutrition, and occupational therapy. For example, our internal medicine physician handles the programs involving wellness, pre- and postmenopausal hormonal modulation, growth hormones, nutrition, weight loss, and smoking cessation.

“Our cosmetic dentistry team provides veneers, crowns, implants, periodontal work, and clear orthodontic braces. Their work is supported by an oral surgeon and a periodontist who come in as needed. Our two psychologists are available to help patients with stress management, lifestyle coaching, and behavioral modification. Patients who need lymphatic-drainage massage following liposuction and certain other procedures in which swelling is an issue receive it from our occupational therapist. And we have a physician assistant in charge of laser treatments.”

Before they joined the MIAMI Institute, these pro-viders for the most part had thriving practices of their own. It was necessary to recruit only the first few of them; the others approached the institute after word spread about the kind of facility Watson and Gallo were putting in place.

“For our clinician partners, the attraction was an opportunity to practice in a synergistic environment that would enable them to be even more successful than they already were,” Gallo says, adding that the team was lined up by the time the MIAMI Institute opened 1 year ago.

A Total “Care Package”

The development of the MIAMI Institute concept can be traced back to 2002, when Gallo and Watson met and agreed to become business partners. Gallo at the time was celebrating 10 years in facial plastic surgery practice, but was looking to expand into wellness and age-management services, which he believed to be the wave of the future.

Meanwhile, Watson—owner of a marketing agency that specialized in health care—was eyeing the potential of wellness and age management as a business-investment opportunity. He had convinced a Los Angeles age-management physician to participate with him in a proposed project along those lines, but the partnership fizzled before anything substantive could emerge. A medical-spa consultant (Cheryl Whitman—see page 46 of this issue) who was aware of Gallo’s interest in wellness and age management, subsequently introduced the two men.

“Our first meeting went exceptionally well,” Gallo recalls. “We each had our own separate ideas about how to structure and operate an age-management institute.” But, Watson says, “when we put our thoughts together, we ended up with something far greater and more sweeping than either of us could have imagined.”

Central to their resultant mutual vision was a medical spa of sufficient scope to permit an entire continuum of care for wellness and aging. Thus, anyone who comes to the MIAMI Institute today for facial plastic surgery is automatically accorded access to the facility’s medical-spa services and amenities.

“It’s part of the total package of care we offer,” Watson says. “For example, we routinely have the preoperative patient come into the medical spa to receive facial treatments that will help better prepare his or her skin for surgery. Postoperatively, the patient comes back to the institute for additional facial care, which further enhances the results of the surgery—and leads to greater satisfaction with the entire experience at the MIAMI Institute.”

Lasers and More

The medical-spa services feature a tunable erbium-YAG (yttrium–aluminum garnet) laser for resurfacing work—everything from superficial micropeels to deep resurfacing performed in the OR—plus a variety of other lasers for removing tattoos, unwanted hair, and varicose veins. The spa also features laser systems for face, chest, and hand rejuvenation.

Skin tightening is accomplished with radiofrequency technology, whereas ultrasound instruments are used to smooth postoperative skin irregularities and to aid the healing process. A red- and blue-light-emission di­ode machine has also been installed: red for skin healing and rejuvenation; blue for treating acne.

The institute’s photographic complexion-analysis system is exceptionally useful. This technology assesses the face with respect to age, skin-pore size, wrinkles, UV damage, and overall skin quality. Coupled with a physician’s analysis, the machine provides insights sufficient to develop a customized skin-care regimen for each patient. That program includes the use of the MIAMI Institute’s private-label skin-care dermaceuticals, which are pharmacist-formulated to suit each patient’s unique requirements. The in-house dermaceuticals are called MIx—short for MIAMI Institute Compounds.

“Because we have such an extensive array of ingredients to draw upon, and because each product is wholly customized, there is an almost limitless number of combinations we can come up with for our MIx line,” Gallo says. “And we can easily reformulate the products as often as necessary in re­sponse to changes detected in a patient’s subsequent analyses.”

The institute, which em­ploys a staff of 24, can accommodate up to a dozen patients at a time—not including surgery patients. “Let’s say a patient comes in for cosmetic dental work,” Gallo proposes. “While the patient is in the dental lab, he or she might receive a hand and foot massage by medical-spa personnel. This would be provided as part of our efforts to make sure the patient is kept comfortable, no matter which service he or she is utilizing in this facility.”

Poised to Grow

The MIAMI Institute is still a fairly young organization, but already Gallo and Watson are exploring expansion strategies. Specifics are few at this stage, but in general they hope to eventually add as many as six similar operations at sites at least as prestigious as the one they currently en­joy in the downtown Miami Four Seasons Hotel and Towers complex.

“We’re thinking about locations elsewhere in the United States, and perhaps be­yond,” Watson says.

Off to an auspicious start on that endeavor, the MIAMI Institute in late 2005 inked an exclusive deal with a company that operates high-end resort spas in Italy. Now, as part of a complete-care package, MIAMI Institute patients, after initial postoperative recovery, can be flown to Italy for a stay at one of several thermal-springs luxury spas run by Italy’s STB Natural Spa Resorts for even more intensive pampering.

Says Watson, “Age management and wellness is a growth sector of the health care field, and we’ve positioned ourselves right on the cutting edge of it.” PSP

Rich Smith is a contributing writer for Plastic Surgery Products.


Name: MIAMI Institute for Age Management and Intervention

Location: Miami, Fla

Specialty: Plastic surgery, cosmetic dentistry, cosmetic dermatology, medical-spa services

Year established: 2005

Patients per day: 30–40

New patients per year: 2,000

Days open per week:

Physician services: 5

Medical spa: 6

Number of employees: 24

Office square footage: 10,000

The Team

In addition to Julio F. Gallo, MD, FACS, the clinicians at MIAMI Institute are:

• Board chairman and nasal surgeon Robert L. Simons, MD

• Body plastic surgeon Leonard Tachmes, MD

• Cosmetic dentists Julio E. Hernandez, DMD, and Mark I. Gutt, DMD

• Health and wellness specialist Suzel M. Vazquez, MD

• Anesthesiologist Paul Crawford, MD

• Psychologists Vanessa A. Chartouni, PhD, and Julissa Senices, PhD

• Nutritionist Juliana Maggio, RN, LDN

• Lymphatic drainage specialist Lisa Morse, OTR/L, CWT, CLT

• Laser operator Jelena Petkovic, PA-C

A Caring Staff

In the operation of a medical spa, the most important ingredient for success—apart from clinical excellence—is the attention paid to patients, according to Stephen Watson, president and CEO of the MIAMI Institute for Age Management and Intervention in downtown Miami.

“All of our staff is focused on service and kindness for each and every patient who walks in through the door,” he says. “However, being kind is more than extending a pleasant hello to the patient and smiling. It’s about making sure the patient is comfortable from arrival until the end of the visit. It’s also about making sure the patient is never allowed to wait.

“You have to start with an awareness that the patient is electing to come here. He or she isn’t being forced to do so, and could just as easily choose to go someplace else. So, it’s incumbent on us to do all that we can to make sure the patient feels he or she made the right choice by coming here.”

The ability to be exceedingly attentive is a special talent that many people lack. Consequently, the MIAMI Institute strives to recruit spa personnel with a natural disposition to service-mindedness. But attitude alone is insufficient. It also takes proper training.

“Attentiveness and kindness are attributes that can be further developed through instruction,” says Julio F. Gallo, MD, FACS, medical director of the MIAMI Institute. “We put all our spa staff through an extensive training program that includes periodic refresher courses. They learn how to properly handle phone calls from people wanting information about the institute and how to schedule appointments. They learn how to use superior interpersonal-communication skills when they have a face-to-face encounter with the patient, and much more.”

How well the lessons of training were absorbed is assessed by periodically sending undercover observers to pose as patients. These “mystery shoppers” (as they’re known in the world of marketing) take notes of the good and bad they see during their visits, then report back to Watson and Gallo. The insights delivered allow the management team to modify future training sessions to address detected shortcomings in the quality of service and the level of kindness.


For more information on hiring and training medical-spa employees, see page 54 of this issue.—Ed.