By Denise Mann

On any given evening, Paramus, NJ, plastic surgeon Gary Breslow, MD, can be found scrolling through “before” photos from potential patients on his tablet or smartphone, evaluating their anatomy, goals, expectations, and answering any questions they may have about a procedure.

It’s called Zwiveling, and it is made possible with Zwivel, a new online platform that aims to make in-office consultations that much more productive and cost-effective for all-comers.

Yes, it’s an abstract term, but it’s proving to be a sticky one. So far, 750 plastic surgeons (and counting) are on board, and the Zwivel team has grown to include 25 staffers. In recent months, the privately funded company teamed up with CareCredit and Prosper Healthcare Lending to streamline the financing part of the conversion process. They are also rolling out Zwivel Premium—an upgraded version of the platform—to a select group of beta testers, and three national commercials are slated to begin airing on Bravo and E! during prime time.

All in all, 2015 has been a pretty good year for this newbie company.

Breslow and his team officially launched the platform in January 2015, and to date the greatest challenge has been explaining exactly what Zwivel is and what it isn’t to plastic surgeons and their practice managers. “It can take a while for doctors to have that ‘a-ha’ moment, but it’s so cool when it happens,” says Breslow, the medical director of The Breslow Center for Plastic Surgery, and Zwivel co-founder and chief executive officer.

So exactly what is Zwivel?

Think of Zwivel as a for plastic surgeons and patients. “It enables the patient to get to know you before they come into the office,” Breslow explains. “You both want to know if it is worth it to take the next steps.”

There have been many notable success stories on or other online dating platforms, but there have also been some fails. In the dating world, the fails may link back to a lack of chemistry or truthfulness. Expecting a 6-foot-1-inch suitor with a full head of curly hair, for example, and instead meeting a balding 5-foot-4-inch gentleman can be a deal breaker.

Honesty and candor are key on dating sites and Zwivel. “You need to answer questions as though the patient is sitting right in front of you, quote accurate numbers, and also let them know if you think they are a good candidate for the surgery they are interested in,” he says.

It’s a two-way street. Patients, also, need to be forthcoming about what they want and can afford, he says. As in dating, there are many “do not pass go”-type fibs or red flags that can be vetted by Zwivel and Zwiveling.

Zwivel doesn’t discourage plastic surgery patients; it arms appropriate ones with knowledge, says Scott Kera, Zwivel’s chief operating officer. “The goal is to give the patient all the information they want before they come into the office—so when they do come in, nothing is a shock. Nobody wants to go through an hour consultation to find that they are not a good fit,” he says.

“It’s not a lead generator, but a lead qualifier, that can then become a generator,” Breslow adds.

Instead of reserving a full day or more for consultations, most of which historically do not convert to surgeries, Zwivel is open and accessible 24-7. “It only takes a few minutes. I Zwivel between cases, I Zwivel before bed, I Zwivel while waiting for a valet to bring me my car or when I am in the car if my wife is driving,” Breslow says.

“I would rather see fewer patients who are more likely to book than dozens who are not serious or good candidates,” he continues. “With Zwivel, consultation time is cut in half and my conversion rates have doubled.”

Barry DiBernardo, MD, a plastic surgeon in Montclair, NJ, agrees. “I pride myself on being an early adopter. When I see a new technology that I think has merit and can make my practice work better or make my patients’ experience easier—I want to try it out. I am also extremely analytical, so I want to look at the metrics and see if the promise lives up to the hype,” he says. “I have been impressed with Zwivel.”

Problem Solved

Innovation in today’s high-tech world can come in broad strokes—a seismic change in how we do things, such as the creation of the “information superhighway”—or it can also come in smaller, more measurable, ways as a direct response to a very specific problem.

Zwivel was born of the latter. Breslow and colleagues have all spent hours consulting with prospective patients who were not appropriate candidates for cosmetic surgery. Stumbling blocks may be financial, and other times they can be physical or emotional or even just bad chemistry. “More than 60% of people who come in to see a doctor don’t have a procedure with that doctor,” Breslow says.

“This was a problem that was frustrating to both patients and doctors,” he adds. Zwivel is the solution.

Despite the early success of his start-up, Breslow identifies as a plastic surgeon, not a businessman or tech guru. “I view myself as a problem solver,” he says. Like most surgeons, he wants to spend more time in the OR—and Zwivel is helping him to achieve this objective.

What’s In a Name?

Zwivel may sound trite at first mention, but as Breslow points out, “What did Twitter mean before Twitter?” Another iconic term—Google—also means nothing. “A googol is the large number 10100, but Google had no meaning before it became a household name associated with the search giant,” he says.

“I wanted something that has the connotation of going back and forth from patient to doctor and doctor to patient,” Breslow explains from Zwivel HQ. “My staff came up with words like boomerang and sling shot, but we know from Zappos and Zoc Doc that things that start with the letter Z are catchy,” he says. “Swivel—to turn or rotate on an axis—with a Z is Zwivel.”

Like Google, Zwivel can be a noun or a verb: “Are you on Zwivel?” “Is this a Zwivel request?” or “I Zwiveled last night.”

Zwivel 2.0

And with a host of new bells and whistles, Zwivel Premium is likely to secure Zwivel’s place in the plastic surgery vernacular. “It’s a significantly enhanced version that allows plastic surgeons and staff to create and save replies so they can be repurposed, reused, and recycled,” Breslow says.

“Every prospective patient wants to know about time back to exercise and time back to work, among other concerns, so I can make a video with this information that will be saved and can be added on to a request in the future,” he adds.

Zwivel requests can be answered with customized templates that allow users to attach all sorts of important information about a procedure, its risks, its costs, and the surgeon who will be performing it. “You save your best pitch in the cloud and can use it every time,” he says. “It makes it easy to say, ‘This is what we can do for you, and this is about what it would cost.’?”

To sweeten their pot, Zwivel doctors can assign injectors and practice managers to create video content that answers some of the more common questions and/or addresses other issues such as financing or downtime.

Zwivelers can play the field, but it isn’t a bidding war, Kera says. “We know patients often meet more than one plastic surgeon before making a decision.”

The group is also launching Zwivel Connect, a HIPAA-compliant forum for doctors to text, email, or videochat with existing patients. Another new Zwivel feature applies mainly to potential advertisers. With trigger-targeted advertising, vendors bid on search terms on so that their product will pop up on the screen when a Zwiveler Zwivels a specific condition or procedure.

“The vendors can target the doctor and/or the patient with this program,” Kera says. There is, however, an ad-free version for patients who go through a Zwivel widget on a particular doctor’s site, not

“Zwivel is not telemedicine. It’s not a doctor directory, and now that people are beginning to understand that, we are growing rapidly,” Kera says.

Now it’s time to step up awareness efforts, and that is where Breslow’s wife, Loren, an attorney, comes in. She serves as the VP of operations and is responsible for direct-to-consumer advertising initiatives as well as professional outreach, and she is on it. She is working behind the scenes to help raise Zwivel’s online profile, and has just given the official green light to three national commercials, which will start airing on E! and Bravo from 6 pm to 12 pm, 5 days a week.

“Our objective is to sign up doctors, but consumers drive demand in this market,” she says. The plan is also to increase local outreach efforts in plastic surgery-centric locales like Orange County, Calif; Miami, Palm Beach, and Boca Raton, Fla; Westchester and Nassau County, NY; and Bergen County, NJ. There are also several events planned to introduce beauty bloggers and media to the Zwivel concept, and without giving too much away, an A-list reality star may be involved.

Stay tuned.

Denise Mann is the editor of Plastic Surgery Practice. She can be reached at [email protected].