Obtaining a beautiful and vibrant youthful appearance is seen and understood differently by everybody. For some people, aesthetic beauty comes naturally. For others a quick visit to a cosmetic surgeon can make the world of difference. In this interview with Aesthetic Insider™, Dr. Walter Tom, a Cosmetic Surgeon who practices in Santa Rosa , CA, discusses how he and his staff use a broad array of advanced aesthetic technologies, products, treatments and procedures to safely deliver natural and beautiful looking results to all of his patients. It is Dr. Tom’s unique, educational and collaborative style of consultation with his patients that helps him develop realistic and reasonable expectations which ultimately deliver excellent results and happy patients. Read on to learn more about Dr. Tom’s approach to cosmetic surgery, as well as the most current and up-to-date trends in aesthetics. To learn more about Dr. Walter Tom, visit www.drwaltertom.com.
How long have you been practicing cosmetic surgery?
I was always drawn to the cosmetic surgery world and realized that dream when I created the Aesthetic and Laser Vein Centers initially in Santa Rosa, California just over eighteen years ago. I now also have an office in Napa Valley, California and two years ago opened up a practice on the island of Maui, Hawaii.
Have you seen a growth in cosmetic surgery procedures?
Yes I have. Not just in the number of new cosmetic surgery patients to my practice, but also in the demand for both surgical and non-surgical procedures. Over the past eighteen years there have been many new developments especially in terms of fillers, injectables and technology as it all relates to aging. When we started in 1999 we had a laser for laser hair removal, an IPL (intense pulse light) for facial rejuvenation or what we call photo facial treatments, but then we began to see many new developments driven by consumer demand and by our patients. What we saw was an evolving array of techniques that became less invasive and delivered better results with no downtime and little in the way of recovery. Surgical skills and procedures also advanced bringing in better and safer breast implants, tumescent liposuction techniques and much more. There’s been a movement towards less invasive procedures or if you do need surgery, techniques that will hasten the recovery for a patient. It’s been very impressive.
Why is patient education important to you?
Education of all kinds is key for me. It is important to me to spend time and to educate all my patients on the procedures they select, and I believe in educating my colleagues and peers, as well as myself. As a former President of the California Academy of Cosmetic Surgery, it was very important to me to learn as much as I could from colleagues in all aesthetic specialties, and to share as much of my own knowledge with others as I possibly could. It is my belief that educating patients is the best thing we can do for them, and ourselves. I generally spend a good hour or more with each patient at their initial surgical consultation with me. The more a patient understands about their chosen procedure, the better experience they will have and ultimately the happier they will be with their result. Giving a patient a great result and making them feel happier about themselves is of utmost importance to me.
What can a new patient expect when they consult with you for a procedure?
First, an understanding that there’s no one perfect solution for any particular problem, so the first thing I do is listen to the patient and find out what are their concerns, where they are in their life, and why are they requesting an alteration or an improvement in their cosmetic appearance. If we listen to the patients and fully understand their motivation, we have a better chance of being able to help them to achieve that. My new patient consultations generally last about one hour, I look into the patient’s eyes, look at their general health via their skin condition and then look at the overall appearance of their face, or body, and examine them depending upon what procedure they are requesting. I will discuss all of the procedures available to address their particular issue, provide any necessary reading material, show them before-and-after photos or videos if the procedure they are requesting requires a video description and answer any questions they may have. We review photos to show them what they might expect and, in some cases, may actually refer them to another surgeon for a procedure we may not offer. The most they can expect is a thorough and educational consult that will hopefully answer all their questions and leave them confident about the solution they have chosen.
How do you approach facial aging and facial rejuvenation?
That’s a challenging question as we have patients in all age groups so facial rejuvenation to a person in their 20s is different than that of a patient in the 60s or 70s. However, my base approach is the same in terms of evaluating their eyes, their skin health and their ultimate objective. How we treat each patient is where the variance comes in. Younger patients generally have good or adequate facial volume, while the aging patient often experiences loss of fat in the face which decreases their overall volume and the face looks deflated. One of our first approaches with facial aging is to restore volume via facial fillers and/or fat transfer to the face. Fat transfer is one of my niche procedures and something I lecture on frequently. It is a procedure wherein we take fat from another area of the body, possibly the abdomen or inner thigh where it will not be missed, process it and reinject it into areas of the face showing loss of volume. This is my preferred method as it is natural to the patient, is long lasting and rarely develops any complication. My main approach to facial aging and facial rejuvenation is a non-surgical approach that includes botox and fillers, fat transfer, and skin restoration for which we offer a variety of options including lasers and IPL, hydrafacial, topical skin treatments and at-home skin-care solutions. For me, less is more and many times a patient might need a few minor treatments to obtain a phenomenal result.
Can you help a patient that has neglected their face and has sun damage?
Of course, although their results might not be as good as someone who is entering the world of cosmetic treatments at an earlier age, or someone who has refrained from sun bathing and smoking and not neglected their face. Many of the new laser and RF (radio frequency) treatments work wonders on the skin and can very effectively reduce fine lines and wrinkles leaving the skin looking brighter and firmer. Neurotoxins such as Botox® can help significantly with crow’s feet and wrinkles, and we are seeing exceptional results with fat transfer and PRP (platelet rich plasma) to restore volume loss.
What is PRP (Platelet Rich Plasma) and how do you use it?
PRP is serum from our blood and it contains various healing factors. It is the serum that occurs in a cut or a scrape and acts to heal the tissue. It is derived from the blood and processed and we often use it to help rejuvenate the skin when we do microneedling. With microdneedling little tiny tunnels are made in the skin and the PRP helps heal those tiny wounds and helps create collagen formation. I use it for fat grafting too because it improves the longevity of the fat and also improves the texture of the skin. We also use it in combination with fillers as it increases the life of fillers, and we use it in hair transplants too. Hair transplants are a very common procedure for both men and women and we soak the hair follicles in the PRP, or we can actually inject PRP in an area where there’s a lot of hair, and it can many times stimulate hair growth in that area.
Do you have any cosmetic ‘secret’ tips?
Ha ha. Well yes I do. With aging, the area underneath the eye sometimes loses fat and begins to look dark and hallowed. Patients think that their skin has changed color when in fact it is generally shadowing caused by loss of light bouncing off the skin under the eyes. Light from the sun or fresh light in a room would normally hit below the eye, but when the area under the eye is sunken the light goes straight to the floor missing the lower eye area completely. By simply restoring fat to the lower eye area, the light will hit the fat pad under the lower eye and bounce that light directly into the pupil causing it to shine brighter making the patient look happier and more youthful. Another secret to restoring youth to an aging face is to add a little fat to the cheek or malar area. A fuller cheek is a sign of youth and a simple way to refresh and lift an aging face, and when that patient smiles the cheek is lifted higher catching more light which again is reflected in the eyes causing them to sparkle even more.
What is your approach to aging of the body and is the Mommy Makeover a lasting trend?
I do think that being a mom is probably one of the most wonderful things in the world, but many moms do experience changes in their body due to pregnancy that they want to correct. I do think that Mommy Makeovers will be a lasting trend although in my practice they begin with women in their 20s and continue up to women in their 70s who are now grandmothers. For those patients, depending on how their body has handled the pregnancy, we would typically offer a breast lift or augmentation, liposuction and/or a tummy tuck. However, we do have non-moms who come in seeking breast augmentation, reduction or lifts, as well as liposuction and tummy tucks. My approach to aging is to help our patients achieve their desired look. For some patients this actually starts with personal changes in diet and exercise so they can reach a weight loss goal before having a surgical procedure. For others, it might be that they want a breast augmentation or a simple liposuction procedure only as they are perfectly happy with the rest of their body.
What procedure is the biggest confidence booster in a patient?
Breast augmentation has one of the highest satisfaction rates of all the cosmetic procedures that we do and continues to be within the top ten most desired cosmetic surgery procedures nationwide.
Are male cosmetic surgery procedures on the rise?
Definitely. For the gentlemen at my practice body contouring tops the list. Some of them have what we call a ‘muffin top’ of excess fat and skin that hangs over the back of their pants so liposuction of the back area, abdomen and flanks is very popular. We are also experiencing an increase in our male patients asking for facial procedures and we have to be careful not to feminize their faces in any way. Men differ from women in that some of them have very strong jawlines while others have heart-shaped faces. If you simply compare George Clooney to Brad Pitt you will see what I mean. Both are extremely handsome but their facial structure is very different and we have to take that into consideration when doing Botox® or filler procedures on the men.
What are the current top cosmetic procedures?
If we include surgical and non-surgical, I would say these are the current top cosmetic procedures:
- Botox® and Fillers
- Skin Resurfacing Lasers
- Microneedling with PRP
- RF Skin Tightening
- Breast augmentation
- Tummy Tucks
- Hair Transplants
What do your patients say about your practice(s)?
Our patients are generally bringing us something about themselves that they do not like and are actually very vulnerable. By recognizing that, my staff and I do our best to treat them how we would want to be treated and I think what they would, and they do say, is that we treat them nice, we show our care and concern for their well-being and are truly happy to say they are our patients. We strive to make them feel special and I think they would agree that we do.
For more information about Dr. Walter Tom or to learn his hours of operation in Santa Rosa, CA, Napa, CA and Maui, HI, visit www.drwaltertom.com.
To listen to Dr. Walter Tom’s interview on Aesthetic Insider™ Radio, CLICK HERE!