As a child, Ashkan Ghavami’s parents always encouraged his education and to pursue a professional, yet creative career. Both parents are very artistic, with a love of art, music, and design, Ghavami says.
As such, Ghavami has been involved in art and music his entire life, including a love of the guitar and poetry. Growing up, he was taught that creativity is truly one of the unique displays of intelligence.
When Ghavami was 8 years old, he accompanied his mother to visit a plastic surgeon for a rhinoplasty consultation. “This did not seem like an ordinary doctor visit,” he says. At that point, Ghavami was hooked. “Plastic surgery is the only field in medicine that allows for this much creativity. Every patient is different, and I am constantly able to create and use my imagination,” he says today. “It’s never mundane or repetitive.”
Ghavami, currently one of the up-and-coming surgeons in Beverly Hills, Calif, started his practice in the heart of Tinseltown shortly after completing the residency program at the University of Texas Southwestern Medical Center in Dallas. Entering such a competitive market might have seemed risky to some, but Ghavami isn’t one to shy away from a challenge. He credits his driving force to the top-notch training he received under some of the top aesthetic plastic surgeons. “Most residency programs are not strong in cosmetic plastic surgery. I was very fortunate,” he notes.
His pathway to aesthetic plastic surgery began with an undergraduate degree in biology at the University of California in Irvine. From there, he earned his degree in medicine at the University of Wisconsin School of Medicine in Madison. In addition to completing his plastic surgery residency at UT Southwestern Medical Center, he also completed advanced fellowship training in hand and reconstructive microsurgery at the same institution. “My early mentors were Michael Bentz, MD, and Ed Luce, MD, for whom I am forever grateful. Without them, I wouldn’t be where I am.
“The training I received has really allowed me to accelerate early in my career,” he continues. “When you learn from experts like Rod Rohrich, Jack Gunter, Fritz Barton, Bahman Guyuron, Steve Byrd, Jeffrey Kenkel, and John Tebbetts—among many others—you are not only learning cutting-edge techniques, but you also obtain the type of confidence that enables you to trust your instincts and try new things right off the bat. Our weekly conferences were like the ‘who’s who’ of aesthetic plastic surgery—like mini-society panels. The discussions and intellectual exchanges that occurred were powerful and always insightful.”
While Ghavami calls himself a “calculated risk-taker” both in business and in his surgical approach, he says the key is to always perform with the goal of improving patient outcomes in mind. “I believe that’s the only way to really advance the cosmetic plastic surgery field,” he says. “There are a multitude of subtle aesthetic nuances available that can provide unique results without causing harm to the patient. I am constantly trying new concepts and techniques, which really don’t feel like risks to me. It seems to come naturally.”
Ghavami describes his practice and his philosophy as “fresh,” with an energy that is adaptable to the needs of any patient. He embraces opportunities to apply new concepts and to conduct detailed evaluations of his patients in order to provide a truly “customized” approach. These evaluations, combined with the expertise he gained during his residency and in his practice, allow him to formulate a series of calculated moves—like a chess champion—that create the kind of results his patients desire.
“Technique is like art—many believe that it is a natural talent,” he adds. “Learning from experts is like an artist learning from the masters. That education, and the experiences that grow from it, enhance your natural abilities exponentially.”
During his residency, Ghavami had a high volume and variety of surgery cases which became the catalyst for future creative freedom. “The kind of experience and knowledge you gain while performing surgery under the eyes of an aesthetic industry leader is incredible,” he says. “It really opened my eyes and allowed me to think about each patient as an individual work, not as just another nose job.”
His patients reap the benefits. In Ghavami’s consultative approach, he explains and draws the details of each procedure, and why each step is a critical part of their “custom” surgery. “Patients will tell me that they haven’t heard this kind of explanation before and, to me, that is key to establishing their expectations and aiming for the results they want,” he says.
EDUCATION BUILDING BLOCKS
Ghavami’s strong educational foundation has further strengthened his commitment to continued learning. Not only does he regularly attend conferences to take advantage of educational opportunities, but he also serves on the faculty of these meetings, like the annual Dallas Rhinoplasty Symposium. At this meeting, he has served as a member of the adjunct faculty and presented considerations in ethnic rhinoplasty titled, “The Middle Eastern Nose.”
In addition, Ghavami has been a faculty member of the biannual Hawaii Plastic Surgery Symposium, which he will co-chair in 2012. He also serves as a voluntary assistant clinical professor at the UCLA David Geffen School of Medicine (Division of Plastic and Reconstructive Surgery). Ghavami says, “Assisting in the training of residents keeps me humble and on my toes. They inspire me.”
“Being visible and active in a variety of educational venues is critical to advancing the aesthetic plastic surgery field as a whole, by collectively improving our own practices,” he says. “While taking time out from a growing practice in a challenging economy is tough, the sharing of information and ideas is part of how we as professionals can improve aesthetic techniques. I enjoy hearing from experts in the field, and I appreciate the opportunity to participate and create dialog with other physicians who share my challenges and philosophy.”
COMPETING IN THE CITY OF STARS
When the Los Angeles native decided to return home after a long journey away at school, Ghavami decided to establish a niche in the highly competitive Southern California aesthetic surgery market. He has focused on rhinoplasty and ethnic rhinoplasty, as well as fat transfer to shape the buttocks (what he has termed the “S-Curve Buttock Lift” to illustrate the goals of creating “s-curvilinear lines”) and quick recovery breast augmentation. He also has had the opportunity to perform many revision rhinoplasties for which there is a growing demand. “I enjoy the challenge and mystery of taking the nose apart and starting over,” he says.
Some of the unique techniques he learned during his training have provided Ghavami with a competitive advantage. “While in Dallas, I learned techniques that allow for much faster recovery in breast augmentation, and I am one of the few surgeons to offer that advantage in this market,” he says, referring to the busy LA breast augmentation scene.
Other procedures offered include fat transfers and liposuction. In a good month, “I perform between three and four fat transfers to the buttocks per week,” he says. “In this area, there aren’t many doctors who perform this kind of procedure, and those that do have just recently started to see the value in buttock shaping. I saw the value and importance of buttock shaping from day one in my practice, and it has been a phenomenal aspect of my practice.”
He describes the procedure as a kind of “sculpting exercise,” making sure that the shapes are natural, balanced, and in proportion to the patient’s overall physique. By focusing on the whole body rather than just the buttocks, Ghavami sculpts tissue in a way that gives new “S-curves” throughout the body without synthetic implants.
In the unique Southern California market, many plastic surgeons don’t perform complex nose jobs (that is, ethnic and revision rhinoplasty), and many consumers seem to primarily go to ENT physicians for nose jobs, Ghavami says. His training, incidentally, included learning from some of the world leaders in rhinoplasty, “So I do not understand the LA trend,” he adds.
The competitive landscape in the Los Angeles area creates other challenges. “I feel that many physicians are hesitant to refer patients to other physicians, for fear of losing business.”
For example, Ghavami recalls a local ENT physician who referred a patient to him for liposuction. This physician had previously performed a rhinoplasty for the patient, who wasn’t completely satisfied. The patient asked Ghavami to do a revision rhinoplasty after seeing his work, but he declined. His reasoning? One goal in his practice is to keep relationships in the LA medical community intact and to create trust and collaboration among peers. “I think a strong connection between facial plastic surgeons—ENT-trained—and plastic surgeons is imperative to preserve and strengthen the legitimate cosmetic surgery market, and differentiate us from the numerous inadequately trained physicians offering cosmetic surgery services.”
Ghavami’s Web site has been a catalyst for his practice’s growth. He personally oversees the content and technical aspects of the site. Making sure the site is current is critical. Having numerous before-and-after photos that show a variety of patient types, as well as his academic and media accomplishments, has increased his relevance with potential patients.
“I have spent a lot of time building an online presence that is informative and easy for patients to navigate. Whether we like it or not, the Internet has become a critical part of plastic surgery business-building, and as such I take personal responsibility for maintaining the content and making sure the information I post is timely, accurate, and meaningful,” he says.
However, over the past 4 years, word of mouth continues to be the key component in his practice’s growth and is the most powerful indicator of longevity. Trusting patients are another key. Once they get to know him and understand the depth of his training and expertise, and then see the results firsthand, they become advocates in the community, he claims. Referring friends and family members for consultation follows naturally.
THE NOSE KNOWS
“I really prefer open rhinoplasty versus closed,” Ghavami says. While many physicians cite a scarring concern with the open method, Ghavami doesn’t see the issue. “Any scarring is really hard to see. When I hear people talk about scarring in open rhinoplasty procedures, it sounds more like a marketing tactic than a medical concern to me.”
His preference stems from the ability to open up the nasal area and see with accuracy, allowing for direct sculpting of the area and solving difficult anatomical challenges. “There really isn’t a substitute for being able to see a direct, three-dimensional view and how the changes made impact the patient’s appearance,” he notes. And he says an increasing number of surgeons are converting to the open method, as well.
Ghavami’s most common procedure is rhinoplasty, and he adds there is a growing market for ethnic rhinoplasty in particular. Patients come from all over the world to see him for this specialty—Ghavami has built a strong referral network in this area. In general, patients are well-educated on ethnic considerations in rhinoplasty and understand that they need a physician with specific expertise in this area. “They are scared of looking weird,” he claims.
Ghavami has continued to improve upon approaches to the evaluation and treatment of ethnic patients. For example, he has been developing new grafting combinations and cartilage-shaping techniques that effectively strengthen and shape the ethnic nose. These techniques help to prevent unpredictable soft-tissue healing, and blend the tip and the nostril rims in an aesthetic manner. This helps alleviate some of the issues associated with working with thicker ethnic skin.
All of Ghavami’s techniques are built upon his strong rhinoplasty training but are not necessarily what he was directly taught. They are, rather, a continuous evolution of his surgical foundation. Ghavami continues to write and share his thoughts in book chapters and articles.
As Ghavami is of Persian descent, he is often sought out by patients of Middle Eastern ethnicity. “Tehran, Iran, is the rhinoplasty capital of the world, where patients are both male and female, and there is an extremely high demand,” he says. “High demand means there are a lot of doctors performing rhinoplasties, but not all of them have been trained properly. Similarly, in Los Angeles, the demand has translated into motivation for physicians to enter the aesthetic field for solely monetary reasons.”
This motivation has the effect of cheapening the aesthetic surgery industry as a whole, he adds. Fortunately, fewer physicians venture into rhinoplasty in the United States because of its difficulty and steep learning curve. As a result, board-certified plastic surgeons and facial plastic surgeons who perform rhinoplasty are somewhat protected.
QUICK RECOVERY BREAST AUGMENTATION
One of the most popular plastic surgery procedures, breast augmentation, has a reputation for forcing the patient to endure an uncomfortable recovery period. Ghavami offers an innovative technique and concept, originally developed by Dallas-based surgeon John Tebbetts, MD, that reduces the traditional recovery period to less than 24 hours. Ghavami, who brought the technique to Los Angeles as a result of his training under Tebbetts in Texas, is one of the few physicians on the West Coast to offer the procedure.
In the procedure, the bleeders have already been mapped out, which allows bleeding to be controlled pre-emptively, by using a precise and systematic cautery dissection sequence (instead of blunt dissection) that opens the breast pocket for placement of the implant. In addition to maintaining a dry surgical field, this method also reduces the length of time required for the procedure. The elimination of bleeding and trauma to tissues caused by blunt surgical instruments (or finger dissection) eliminates bruising in the rib area, which has a great impact on the level of pain experienced by the patient, postsurgery.
“In most cases, patients don’t need surgical wraps, drain tubes, or even major pain medications after a Quick Recovery procedure,” Ghavami says. “Most patients can go home with a surgical bra, and I encourage them to carry on with normal activity as long as they are comfortable.” Ghavami has revamped the terminology, naming this the Flash Recovery Breast Augmentation in order to more effectively market it in the Southern California area. “Clever marketing is a reality of today, so long as what we are providing patients is legitimate and improves outcomes,” he notes.
THE S-CURVE BUTTOCK LIFT
Ghavami performs what he calls the S-Curve Buttock Lift (fat transfer to the buttocks) procedure as a result of a demand for more sensual, proportional curves. “Patients who undergo body contouring are now more often requesting a more comprehensive approach that provides curvaceous proportions and silhouette lines,” he says. “The term Brazilian Butt Lift says nothing about the goals of the procedure, in my mind. It is not important what one calls it; rather, that it is performed effectively.”
The S-Curve procedure uses liposuction to remove unflattering fat in the hips, arms, stomach area, flanks, and even shoulders. Ghavami then sculpts the patient’s own fat cells into the buttocks or other desired areas in a way that enhances their results. He does not simply enlarge the buttocks but firm and shape them.
“The preoperative analysis and patient markings are really key to the effectiveness of this technique,” he says. “[You] have to decide how much fat to take and exactly how much and where to leave it behind to get the best results.”
Schae Kane is a contributing writer for PSP. She can be reached at firstname.lastname@example.org.