MedEsthetics Magazine May/June 2015

May/June 2015 $5.00 Volume 11, Number 4 medestheticsmagazine.com

Best of Medical Aesthetics

CALL FOR NOMINEES New FDA Guidance on

AUTOLOGOUS TISSUE

H.L. Greenberg, MD

Makes a Name for Himself in Las Vegas

H.L. Greenberg, MD

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Contents

May/June 2015, Volume 11, Number 4

SURGICAL AESTHETICS 56 Cutting Edge The latest in cosmetic plastic surgery

58 Reducing Pain

by Keith Loria Pain management protocols for aesthetic surgery

66 Te Virtual Consult

by Annemarie Mannion Video and email communications benefit cosmetic practices

TOOLS & TECHNIQUES 20 Best of Medical Aesthetics Call for nominees

22 Chain Reaction

by Linda W. Lewis The science behind the top peptides in antiaging skin care

46 PRACTICE MANAGEMENT

16 Legal Issues

by Andrew S. Ittleman, Esq. FDA regulation of autologous tissue

38 Continuing Education

30 Vanishing Vessels

by Laura Beliz Treating varicose and spider veins

84 Newsmakers

by Linda W. Lewis Nutraceuticals and aesthetic dermatology

by Karen Appold The best advanced training options for aesthetic providers

46 Shooting for the Stars

by Keith Loria H.L. Greenberg, MD, builds a booming dermatology practice in Las Vegas

IN EVERY ISSUE 10 Best Practices 12 Introductions 72 Product Reviews 76 News & Events 82 Advertiser Index

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30 38 COVER: H.L. Greenberg, MD • PHOTOGRAPHY: Jim K. Decker

MedEsthetics (ISSN 1937-2140 & USPS 024-336), Volume 11, No. 4, May/June 2015 is published monthly except in February, June, August and December by Creative Age Communications, Inc., 7628 Densmore Ave., Van Nuys, CA 914062042, USA, Phone 818.782.7328, Fax 818.782.7450. Basic annual subscription rates are: $48.00 in the U.S., $65.00 in Canada, and $70.00 in other international countries. Periodicals Postage Paid at Van Nuys, CA and additional mailing offices. POSTMASTER: Send all UAA to CFS; NON-POSTAL AND MILITARY FACILITIES: send address corrections to MedEsthetics, P.O. Box 1072, Skokie, IL 60076-8072. Canadian distribution publication agreement no. 40798037.

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Shooting for

The Stars How an astronaut, a legendary comedian, a hometown doctor and a cardiologist father helped guide H.L. Greenberg, MD, to a career in dermatology.

By Keith Loria Photography by Jim K. Decker AS A CHILD, H.L. GREENBERG, MD, lived next door to Apollo 15 astronaut James Irwin, the eighth man to walk on the moon. His Colorado Springs, Colorado, neighbor motivated him to do something great with his life. “I always thought that if he could walk on the moon, I could do anything,� says Dr. Greenberg.

medestheticsmagazine.com | MAY/JUNE 2015 47

SHOOTING FOR THE STARS

As the owner and founder of Las Vegas Dermatology in Las Vegas, Dr. Greenberg practices general and cosmetic dermatology, serving a patient base that includes some of Las Vegas’ biggest names. But the journey to private practice success was not paved with gold.

and it’s easy to travel elsewhere. It’s a great home.”

He was recruited by the largest dermatology practice in the city and worked with them for a year. “But the whole time I knew what I really wanted to do was start my own practice here,” says Dr. Greenberg.

His first step in achieving The Road to that goal was a meeting with Dermatology Keith Borglum, a medical The son of a respected cardimanagement practice consulBy offering patients great results with minimal bruising and downtime, ologist, Dr. Greenberg always tant out of Santa Clara, CaliforLas Vegas Dermatology has been able to multiply its patient base. looked up to his father. “When I nia, who taught him the basics was in the seventh grade, my science class went to a carof launching a successful medical practice. diac cath lab and watched him perform an angioplasty on Feeling he was ready to step out on his own, he left a patient. Afterwards, the patient turned to my father and, his position, took a part-time job at the VA Hospital, and in front of all my little friends, said, ‘Thank you doctor for forged ahead with fulfilling his dream. He rented a small saving my life,’” he remembers. “I was in awe and I knew space in Las Vegas and admits he nearly went bankrupt in that’s what I wanted to do. I wanted to save lives.” those first few months.

After graduating with distinction from the University of “Truth is, I definitely didn’t have enough cash on hand Michigan in Ann Arbor, Dr. Greenberg headed to medical to start a practice. I had seen so many other practices— school at Wayne State University in Detroit, not entirely when I was a senior dermatology resident I did rotations certain what sort of doctor he would be. in Denver, New York and Dallas—and I could envision “I went to medical school wanting to save lives, and what I wanted my own space to look like,” he says. “The I spent two weeks doing cardiology with my dad in my problem is, I couldn’t do it all right away; it took eight senior year,” says Dr. Greenberg. “My mom said I should years to achieve the vision I always imagined.” try something different so I did another rotation with my For the past eight years, Dr. Greenberg has worked hometown dermatologist—Dr. Nate Trookman—and I hard to establish himself as one of Las Vegas’ most recwas hooked. I just fell in love with dermatology. I couldn’t ognized dermatologists. In the beginning, he was seeing believe you could do this many things in a specialty.” five to seven patients a day—now he sees an average of Dr. Greenberg completed an internal medicine resi40 patients daily and has expanded his facility from 2,500 dency at Georgetown University Hospital in Washington, square feet of space to 5,000. The practice boasts a staff D.C., then began his formal dermatology training as a of 12, including two estheticians. cutaneous oncology fellow and first-year dermatology resident at the University of Wisconsin, Madison. He continued his residency at Scott & White of the Texas A&M University Health System, where he took on the role of chief dermatology resident and gained specialized experience in Mohs micrographic surgery.

Viva Las Vegas Though he lived in several regions as he completed his education, Dr. Greenberg always knew he wanted to wind up in Sin City. “We took a family trip here when I was 12 and went to Caesars Palace, where I met comedian Rodney Dangerfield, so I always felt like it was an exciting town,” says Dr. Greenberg. “I wanted to meet famous people, I wanted to eat at great restaurants and I wanted to see fantastic shows. A lot of famous people come to town, the restaurants are great 48 MAY/JUNE 2015 | MedEsthetics

Professional networking helps Dr. Greenberg stay on the cutting edge of patient care and build his patient base.

SHOOTING FOR THE STARS

The Internet and social media have helped Dr. Greenberg (pictured with his staff) grow Las Vegas Dermatology. He regularly blogs under the pseudonym, Dr. Vegas.

“If you’re Michael Jordan and selling basketballs or Steve Wynn and selling hotels, it’s helpful, but really, who was going to know me by name?”

When he decided to open his own practice in 2007, Dr. Greenberg wanted a simple name that would alert patients to what he did and where he did it. Somewhat surprisingly, Las Vegas Dermatology wasn’t taken.

“I think physicians are somewhat an arrogant bunch, and they want to call a practice by their own name. But when you start out, people are going to look for the name of the city and what the practice is,” he says. “If you’re Michael Jordan and selling basketballs or Steve Wynn and selling hotels, it’s helpful, but really, who was going to know me by name?”

The choice paid off as the practice immediately became the No. 1 search result on Google and Yahoo for patients seeking a dermatologist or dermatology treatment in Las Vegas. But search engine results alone are not enough to create sustained growth.

“The secret to growth is being accessible and asking for business,” says Dr. Greenberg. “I literally introduce myself to everyone I meet, be it a cocktail waitress, fitness owner, chef or someone I meet at a social event like the Vegas Young Professionals. When I introduce myself, I don’t say ‘Dr. Greenberg,’ I say ‘H.L.’ and when people ask what I do, I tell them. Often that leads to a discussion about medicine or dermatology, but not always. I am interested in a lot of fields, and a lot of the time I will do business with someone else and in turn, they will do business with me.”

In addition to social and professional networking, Dr. Greenberg has become a savvy social media marketer. He regularly creates videos for the practice’s 50 MAY/JUNE 2015 | MedEsthetics

YouTube channel, which has more than 1 million views to date; writes an online blog under the pseudonym “Dr. Vegas;” and he and his staff have an active presence on Twitter and Facebook.

“I’m very active in videography and I’ve done close to 90 YouTube videos. We have patients come in because they’ve seen a video of something like a microneedling procedure,” he says. “One of the videos won an award from the American Society for Dermatologic Surgery— it was about why you should see a dermatologist for skin problems. That attracted some patients as well.”

Dr. Greenberg lectures at venues across the country—and often posts those lectures to his YouTube page. In addition, he has written multiple journal articles and book chapters on topics including: lasers in the

Education is key to creating happy, satisfied patients at Las Vegas Dermatology.

SHOOTING FOR THE STARS

treatment of scars and striae; cutaneous T-cell Lymphoma; and the use of imiquimod in the treatment of basal cell skin cancers.

“I think when patients see you perform a procedure or talk about a topic, it lends credibility, and they feel more comfortable when they come to see you in the office,” he says. “People have come in for Botox or fillers because they have seen me speak.

“I posted a video of myself lasering a tattoo for Miss America and within three minutes of putting the post on Facebook, three people called wanting to come in for laser tattoo removal,” says Dr. Greenberg. “You never know what’s going to resonate on social media.”

In an effort to reciprocate the valuable training he received in medical school, Dr. Greenberg serves as clinical assistant professor in the department of internal medicine at the University of Nevada School of Medicine, where he lectures on dermatology, advises medical students interested in dermatology and has medical resident rotators in his office.

Building a Brand When patients walk into Las Vegas Dermatology, they enter a neat and clean lobby with a display case featuring the specials of the month and a sign advertising the practice’s latest promotions. Front and center is the company’s logo.

“I am very big on branding. I think everything has to have the brand on it,” says Dr. Greenberg. “The brand is on all our cards and pens, and when someone comes in for a procedure, they wear a headband with our logo on it.”

Cosmetic patients are directed to the VIP room

Branding is an important component of practice growth at Las Vegas Dermatology.

where a Keurig coffee maker is waiting in a warm, inviting green space. Music plays in every room and monitors positioned throughout the facility run images of the practice’s cosmetic offerings, including laser treatments, toxins and fillers.

The practice uses Smile Reminder to remind patients about upcoming appointments, and every patient receives a message on his or her birthday. As a treat to both new and returning patients, Las Vegas Dermatology offers “Filler Fridays,” where Botox and fillers are 10% off the normal price. There is also a multiple services discount.

The philosophy of the practice can be seen on all of its materials: “For a healthier and more beautiful life,” and that is Dr. Greenberg’s goal for both patients and staff.

Every Wednesday, he and his staff gather to discuss the practice, and they each share at least one positive thing going on in their lives outside of the office.

“Staff recruitment can be a tricky thing. I look for people who are happy and positive, know how to use a computer and maybe know dermatology,” says Dr. Greenberg. He finds that he can train new employees in the use of the computer system and the practice’s treatment offerings. “But if someone is negative or isn’t happy in the job, we can’t use them,” he says. “What I love about my job is that it’s a happy environment and a place I want to come to every day.”

His practice continues to grow through repeat patients and referrals, and he credits his dad’s advice. “My dad taught me never to lie to people; to be straightforward and honest,” says Dr. Greenberg. “The secret to making a practice strong is to be accessible, answer questions and make sure people are taken care of. I always ask if there are any questions before I leave the room. I want patients to be comfortable. I want them to be happy.”

Patients are invited to learn more about treatment offerings, special promotions and retail offerings in the practice’s reception area.

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Keith Loria is a freelance writer based in Oaktown, VA.