Irvin Wiesman, MD, believes a good plastic surgeon should always expect the unexpected, no matter how routine the procedure—and be prepared to respond as necessary when the unexpected occurs.
A recent example of this philosophy in action occurred not long ago when Wiesman welcomed to his downtown Chicago office a tummy-tuck candidate who had some years earlier delivered a baby by emergency Caesarian section. While discussing with Wiesman her medical history, she mentioned that her ureter was inadvertently pierced during the birthing procedure. This puncture initially went undetected and leakage ensued, giving rise to multiple complications, each requiring surgical intervention of its own. The problems eventually were resolved, except for a ventral hernia.
Even with that hernia, Wiesman decided she was an appropriate patient for a tummy tuck. He then devised a surgical plan that anticipated performing the tummy tuck and repairing the hernia during the span of a single operation by himself. However, as the surgery commenced Wiesman discovered much adhesion surrounding what turned out to be a hernia worse than foreseen. “I went in thinking it was going to be a simple repair,” he recalls. “By the middle of the case, I ended up also having to initiate a laparotomy as well.”
Wiesman was dealt a difficult hand. “I went in expecting the unexpected and wasn’t disappointed,” he says. “Consequently, I was ready to respond to the changing circumstances of the moment. As such, in the end, her surgery went well and a good result was obtained.”
SAFETY IN NUMBERS
Having the right frame of mind allowed Wiesman to go on unfazed by what he encountered on the operating room table. Having the right training and credentials were pivotal, too. In addition to being board certified in plastic surgery (and board certified in hand surgery), Wiesman is board certified in general surgery.
“One of the advantages of being triple-boarded is I can go right in and address a great many more of the problems I encounter,” he says. “For instance, one of my colleagues here in the city referred to me earlier this year a carpal tunnel case that had nothing to do with either reconstructive or cosmetic plastic surgery.”
PRACTICE AT A GLANCE
Name: The Practice of Gary Weisman, MD, Irvin Wiesman, MD, and Associates
Location: Chicago with a satellite office in Highland Park, Ill
Specialty: Cosmetic surgery of the face and body
Years in practice: Father, 25; son, 6
Patients seen per day: 25
New patients per year: 500
Days worked per week: 6
Days surgery performed per week: 4
Number of employees: 9
Office square footage: 8,000
However, the carpal tunnel patient was impressed enough by the outcome to also stick around for a facelift. “It’s nice to be able to offer different services, because one thing feeds the other,” Wiesman adds.
It also just happens to be a sound business strategy in today’s roiled economic climate. “I’m getting referrals for cases that I wouldn’t otherwise were I specialized in just cosmetic plastic surgery,” he says, “By being triple boarded, I’ve ensured myself a much wider stream of referrals. There’s safety in numbers.”
A very safe number for Wiesman is 8,000. That happens to be the square footage of the spectacular new building he owns with his father and practice partner, Gary G. Wiesman, MD, FACS. “We’ve erected a state-of-the-art building that’s airy, bright and inviting,” Irvin Wiesman says.
The building is home to the Wiesman’s plastic surgery group, officially known as Drs Gary and Irvin Wiesman and Associates. It also shelters Wiesman Medical Spa (aka Natural Beauty Med Spa), an outpatient surgery center, as well as large studios occupied by nutrition counselors, personal trainers, hairstylists, and massage therapists. A bariatric surgeon may soon take up residence there as well.
“The practice, the medical spa, and the operating rooms each occupy a separate floor and are separate business entities,” Wiesman says. “My dad owns the operating rooms, while I own the spa. The other providers are independent operators who lease space from us but are positioned as part of our team, and we cross-refer all the time.”
The independent providers, with their particular service lines, help give the Wiesman’s’ building the feel of a wellness center. “That’s certainly how we like to characterize it, because a wellness center is our goal,” he says. “We want to go in the direction of a wellness center for the reason that we believe it’s the future of health care.”
|Wiesman’s family practice has become an upscale wellness center, with other specialists in addition to aesthetic practitioners.|
The Wiesman family has deep roots in the Land of Lincoln. Gary Wiesman was born in Granite City, Ill, while Irvin Wiesman is a native Chicagoan.
Irvin Wiesman also can claim title as the family’s third generation to practice plastic surgery. “You could say I’m genetically predisposed toward this field,” he jests. “But there’s no question that I’ve always been fascinated by the functioning of the human body, as well as its health and beauty.”
A 1991 alumnus of the University of Wisconsin at Madison, Irvin Wiesman received his medical schooling from the University of Illinois in Chicago. In 1995, he began 5 years of general surgery residency at St Joseph’s Hospital, an affiliate institution of Northwestern University in Chicago. In his final year at the university, he was chief surgical resident. From there, Wiesman complete a hand and microvascular surgery fellowship at Washington University in St Louis. Summa Health Systems in Akron, Ohio, was the scene of his training in plastic surgery from 2001 to 2003.
Wiesman entered private practice in 2003 by joining his father’s successful practice. “Our business relationship is that we’re associates with separate practices under one roof,” he says. “However, we perform some of our surgeries as a team and frequently bounce ideas off one another.”
|Wiesman is board certified in plastic surgery, hand surgery, and general surgery.|
Several years ago, Wiesman was befriended by Steven Bloch, MD, of Highland Park, one of the most well-known plastic surgeons in “Chicagoland.” Today, Wiesman rents space in Bloch’s office and uses that as a Northern suburbs-based satellite. “Being there in Dr Bloch’s office exposes me to many different techniques and ways of thinking. I’ve learned a lot in the course of our friendship,” he says.
Wiesman devotes Tuesday, Wednesday, Thursday, and Friday mornings to OR procedures, leaving the afternoons open to consult with patients. “This routine allows me to more easily divide my time between our downtown building and the satellite office.”
He and his father—separately and as a team—offer plastic surgery procedures that include rhinoplasty, breast augmentation/reduction, otoplasty, facelifts, facial implants, tummy tucks, and liposuction.
As an adjunct to liposuction, the Wiesmans use SmoothLipo, a modality sold by Elemé Medical Inc. “A big advantage of SmoothLipo is the way it delivers constant heating to the underlying subcutaneous tissue in the dermis, which produces better skin tightening,” Wiesman says. “But it does require good technique. For example, you have to be meticulously careful about the positioning of its heating fiber, and you must remember to maintain constant movement. Failure to do either can cause the problem of heating up too quickly or too much the area you’re working on. One way I minimize the possibility of overheating is by keeping one hand on the skin to give me a sense of the temperature changes that are occurring while I work. This is a good trick to remember in case you become distracted and are not able to keep as tight a watch on the manufacturer-recommended external temperature monitor.”
|The Wiesman family insists upon pursuing the highest-possible quality of work.|
The best candidates for SmoothLipo divide into two categories, Wiesman claims. The first is the patient who has a small degree of skin laxity and is perhaps slightly overweight—someone who could benefit from liposuction or, alternatively, a tummy tuck, but not both.
“I can offer liposuction and SmoothLipo at the same time in order to improve skin contractility and maybe avoid having to do an abdominoplasty and a large incision,” he says.
The second type of patient is the one who possesses a scant amount of fat but has poor skin tone and needs some skin contractility. “For this patient, SmoothLipo can be offered as a stand-alone treatment, without any type of liposuction,” he adds.
Another modality used by Wiesman is SmoothShapes (also from Elemé). This noninvasive product is primarily meant for patients with a minor degree of skin laxity who want the benefits of liposuction but hope to avoid undergoing a surgical procedure.
“SmoothShapes is the only indicated modality currently available for the treatment of cellulite,” Wiesman says. “According to the manufacturer, the system helps with cell permeability. It improves the appearance of cellulite and may even contribute to slight volume reduction.”
Wiesman adds that he likes to use SmoothLipo in concert with SmoothShapes. “I offer SmoothShapes treatment before liposuction and SmoothLipo, followed two weeks later by additional treatments with SmoothShapes to help improve the results of the liposuction, specifically the tightening and contractility,” he says.
|Wiesman believes the future of health care lies in creating a practice that treats the whole person|
ALL IS WELL
The wellness aspect of Wiesman’s practice is paramount to him. “Ultimately, I want ours to be recognized as one of the premier wellness centers in the nation,” he says.
That might not be beyond the realm of possibility, given Wiesman’s insistence upon pursuing the highest possible quality of work—that aspect of the practice “is an entire strategy all by itself,” he explains. “Quality is why we’ve gone to the time and expense of having our operating rooms Joint Commission-accredited. Quality is why our medical and clinical providers possess relevant certifications. Quality is why we insist on having a review of all our cases for the previous month. Quality is why we invite every patient to complete and return a satisfaction survey. [It] is why we have regular employee meetings in which the staff is able to offer their thoughts about where improvements are needed and what can be done to achieve them.”
Wiesman correctly points out that the reason plastic surgery practices are hurting at the moment is not because recession-worried consumers have no money to spend. In fact, they do.
“It’s just that they’re being much more frugal right now,” he says. “People are trying to pay off their debts and build up savings rather than engage in discretionary spending at the levels they did earlier in the decade. As a result, elective surgeries are down wherever you turn. The big exception is the noninvasive procedures. They’re still very much in demand because people haven’t stopped wanting to look good. They’re willing to pay for noninvasive work, as long as what they’re purchasing is seen as affordable and having value.
“Even though these are difficult economic times, I feel that the broadness of our practice makes us well-positioned to ride out the storm,” he says.
This is what Wiesman expects. He does not expect that the storm clouds will quickly part, leaving a behind gorgeous rainbow and a pot of gold.
Rich Smith is a contributing writer for PSP. He can be reached at [email protected].
The Iron Man
It sometimes is said of plastic surgeons that they need to be made of iron in order to bear up under the exhausting strain of long, long days in the operating room.
In a way, Irvin Wiesman, MD, is made of “iron,” and he has the trophies to prove it.
Wiesman, a triathlete, participates in those famed Iron Man events. The most recent such competition took place in Canada. “It started with a 2.5-mile swim, then a 112-mile bike ride, and wrapped up with a 26-mile run, all in the span of about 12 hours,” he says. “It was fun, but I wish I’d had more time to train. It’s tough to train for one of these things when you have a career to worry about first and foremost.”
Not to worry: Wiesman contends that he did not participate with a first-place finish in mind, and despite this lamentation he performed well. “I finished an hour faster than when I entered this same event 10 years ago. I couldn’t believe it,” he says. “I also couldn’t believe that I was still able to walk the day after. I was just out there to basically compete against myself and no one else. I wanted to see how I could handle it.”
He handled it well enough that he will be going back for more—he signed up to participate in at least one additional Iron Man contest later this year.
Wiesman got into triathletics because of the varied elements that go into a single event. “I’ve entered marathons, but those are just long hours of nothing but running. I like the change of pace that you get with a triathlete event. Having different things to do challenges my mind as well as my body.”
Some of the elements of triathletic competition correlate with life in daily plastic surgery practice. “In the operating room, you never know what you’re going to be confronted with, and the same is true of getting out in one of these Iron Man contests. So, mental focus and the ability to respond quickly to the curves thrown at you are imperative in both types of endeavor,” he says.
Boxing is another of Wiesman’s interests. “I get in the ring once a week for some friendly contests,” he says, noting that his approximately 160 pounds qualifies him as a Middleweight by American amateur boxing rules. “But I don’t participate in formally sanctioned matchups. I only box for recreation, and at that only with friends.”
Wiesman also enjoys skiing, bicycling, and rock climbing, and confesses to knowing that there is some element of risk to each of his chosen sports. However, he insists he is not a risk-taker and—above all—not a thrill-seeker. “Maybe when I was younger I was a little bit of that,” he says. “I was the guy with the motorcycle and into skydiving. But I’m married and have three kids now, so it’s important that I live my life a lot less out on the edge and stop pushing the envelope quite so much.”
The children—two boys and one girl—are young still, so it may be some time before any of them express interest in working with Wiesman, as he does with his own father. However, a challenge inherent to having parents and children work together is the inevitable emergence of intergenerational conflict.
“That’s actually not something my dad and I find ourselves confronting,” Wiesman says. “In fact, what we have is synergy more than anything else. We each bring something vital to the table, and we play off one another especially well. My dad’s years have given him experience. He knows what works, what doesn’t work, what’s likely to work, and what isn’t so likely. My youth gives me energy along with an enthusiasm for innovation that keeps driving the practice onward and upward.”