Cosmetic Surgery

Dr. Aaron Kosins holds a dual Medical Degree (M.D.) and a Masters degree in Business Administration (MBA) in Entrepreneurship. He is a highly credentialed expert on skin care, cosmetic dermatology, plastic and cosmetic surgery and medical aesthetics. He is also highly regarded for his expertise in Rhinoplasty and Breast & Body Contouring and frequently attends prestigious conferences around the world to speak about new techniques and technologies. In addition to operating a thriving surgical practice in Newport Beach, California, Dr. Kosins has trained extensively with acclaimed skincare pioneer, Dr. Zein Obagi and is a co-owner of ZO Skin Centre at Fashion Island, Newport Beach.  MSM caught up with Dr. Kosins for an in depth interview about plastic surgery, the dos and don’ts, the hype and the facts about non-invasive treatments and much more.   Why did you choose to become a plastic surgeon?  I chose to become a Plastic Surgeon because when I was a student, the Plastic Surgeons did the most incredible surgeries I had ever seen.  During the first surgery I ever watched, there was a patient that had a cancer of his jaw bone.  After it was removed, the guy had almost no jaw.  Then, I watched the surgeons transfer a patient’s leg bone to become their part of their jaw!  I thought, “How cool was that?  I want to be able to do that.” When women choose a plastic surgeon what are the key essentials to look out for? The number one essential is to look at your Plastic Surgeon’s reputation.  It is one thing to get a referral from a friend, but you want to make sure that he/she has a good reputation in the community AND in the medical community.  You can go online, look at reviews, view his/her website, etc.  Second, you want to make sure that the surgeon is a specialist in the particular procedure that you want.  In my practice, I specialize in rhinoplasty as well as breast and body contouring.  You can go on my website and look at hundreds of before/after photos.  The surgeon should understand your wishes, be able to communicate well, and then show you dozens of patients that he/she has worked on with your same issues. You are known as one of the best there is in the field of the so called “nose-job”. While the excellent ones can not even be spotted we see way too many bad ones or one that leaves the face more symmetrical but also more boring with no edge. What’s important about getting the right nose job and what is unique about your approach? Rhinoplasty is a true specialty within Plastic Surgery.  It is the most difficult operation that we do, and every single nose has different features that require a more sophisticated way of creating a beautiful result.  If you are interested in getting a rhinoplasty, you need to do your homework and go to a rhinoplasty specialist – a surgeon who devotes more than 50% of his/her practice to this operation.  Look at the doctor’s before/after photos and credentials.  Make sure he/she is board certified.  Look at the educational piece, meaning that you want a surgeon that is on the cutting edge of the specialty.  I spend one week out of every month either lecturing nationally or internationally.  I then spend time with the best surgeon in that state or country.  Learning and improving is the most important thing a rhinoplasty surgeon can do.  He/she should also be an active participant in forwarding the specialty.  As the editor of the rhinoplasty section of the Aesthetic Surgery Journal, I see all the news advances coming across the board.  This is hugely beneficial in making sure that I keep getting better and better. Two new things about my approach that are unique are Piezosurgery and the treatment of patients with difficult skin.  I no longer “break” my patients’ bones.  Piezosurgery is an existing technology that we have just now started to use in rhinoplasty.  Small saws are used that cut bone but not skin.  So I can move a patient’s bones (to narrow or straighten the nose) without trauma.  This is more accurate and causes less swelling and bruising.  Also this year I have been giving a lot of lectures on treating people who have thick and oily skin.  These patients often get suboptimal results because the skin acts like a thick blanket and little definition can be seen.  Using creams and sometimes medication I have been able to shrink the soft tissue/skin of the nose and this has been proven with ultrasound.  Both of these things are totally new and exciting to offer to my patients. What about the non-surgical nose job many doctors offer now which only uses derma fillers to shape the nose? I am not a fan of this for a few reasons.  First, the nose is full of blood vessels and in the wrong hands, filler can cause whole subunits of the nose to turn black and die!  At every rhinoplasty meeting I go to there is lectures on how to deal with filler complications.  Also, filler is soft and the nose consists of bone and cartilage.  The unique definition of the nose can’t really be achieved by injecting soft, gelatinous material.  Even in the best hands these procedures need to be repeated 2-3 times per year.  If you think about this, it is extremely expensive over time with suboptimal results.  Because of this, I have NEVER put filler in the nose.  In fact, I am seeing a whole new group of patients who need surgical rhinoplasty after having bad “non-surgical” or filler rhinoplasty.  I have to melt the filler (if possible) before surgery or remove it during surgery before I can create the ideal nose. We all see there is a great push by beauty docs to get more biz by pushing non-suriginal procedures, some of those patients then later stay with that doc for surgical procedures. What is your take on this? In general, I just don’t buy it.  The face ages in 3 ways – the skin ages,