This interview is with David Hill, MD, Plastic Surgeon & Medical Director, Fulcrum Aesthetics & Surgery.
David Hill, MD, Plastic Surgeon & Medical Director, Fulcrum Aesthetics & Surgery
David, welcome to Featured! Can you tell us a bit about yourself and your journey to becoming an expert in your field?
Thank you for having me! My journey to becoming a plastic surgeon has been quite an eclectic one. I started with a strong foundation in medicine and science, but my passion for aesthetics was influenced by my interests in performance magic, film, and the arts. These fields taught me the importance of precision, creativity, and the art of illusion, which are all vital in cosmetic surgery. Running, hiking, and camping have kept me grounded and connected to nature, enhancing my appreciation for natural beauty and balance. This diverse background has given me a unique perspective on anatomy and aesthetics, driving me to perfect the art and science of enhancing the human form with elegance and precision. My goal is always to help my patients feel confident and empowered through their transformations.
Your career path, transitioning from general surgery to specializing in aesthetic and cosmetic surgery, is fascinating. Could you share a pivotal moment that solidified this decision for you?
Absolutely, I’d be happy to share! The pivotal moment for me was during a reconstructive surgery for a patient who had breast cancer, resulting in a mastectomy (removal of the breast). As a general surgeon, I was trained to restore function, but I found myself captivated by the artistry involved in restoring not only form but also beauty. This experience highlighted the profound impact that aesthetic surgery could have on a person’s self-esteem and overall well-being. Realizing that I could combine my surgical skills with my passion for art and design to help patients feel whole again was a bit of a revelation. It was at that moment I knew I wanted to specialize in aesthetic and cosmetic surgery, merging precision with creativity to enhance both appearance and confidence.
You’ve spoken about the importance of pharmaceuticals in aesthetic surgery. What’s one specific advancement in pharmaceuticals that you’re particularly excited about, and how has it changed your approach to patient care?
One advancement in pharmaceuticals that truly excites me is the use of exosomes for drug delivery in aesthetic surgery. Exosomes, which are tiny vesicles released by cells, have the ability to modulate therapeutic agents like proteins, lipids, and RNA directly within cells. This approach enhances the effectiveness of treatments and minimizes side effects. For instance, in skin rejuvenation, exosome therapy can upregulate growth factors directly within skin cells, promoting collagen production and tissue repair more efficiently than traditional methods. This breakthrough has transformed my approach to patient care by allowing for topical treatments that yield improved and enhanced results. The potential of exosomes in drug delivery is vast, and their integration into aesthetic medicine is a game-changer for achieving optimal patient outcomes.
The use of 3D imaging technology like the LifeViz camera is revolutionary. Can you share a memorable patient experience where this technology played a key role in achieving their desired outcome and boosting their confidence?
One memorable experience involved a patient who underwent a facelift and fat grafting. After her surgery, we used the 3D imaging camera to capture detailed photos from the same angles as her before photos. By comparing these, we could clearly demonstrate not only volumetric changes but also improved facial contours. Reviewing these images together allowed us to recap the specific enhancements and show her the precise results of the procedure. This visual evidence of her transformation not only validated her decision but also significantly boosted her confidence. The ability to use 3D imaging to vividly illustrate the outcomes has been invaluable in enhancing patient satisfaction and trust.
You emphasize the importance of patient education for successful outcomes. What’s one creative or unexpected method you use to ensure your patients fully understand their procedure and post-operative care?
I find that providing a custom-illustrated post-operative care sheet specific to each patient’s surgery is incredibly effective. These sheets include detailed illustrations that outline important aspects such as drain management, medication schedules, garment usage, and showering instructions. By tailoring these visual guides to the individual procedure, patients can easily follow the care plan and understand each step they need to take. This method not only helps demystify the post-op process but also ensures patients feel more confident and informed, leading to smoother recoveries and better overall outcomes.
Many individuals struggle with the decision to undergo cosmetic procedures. What advice would you give to someone who is considering aesthetic surgery but might be hesitant or unsure about taking the first step?
When considering aesthetic surgery, it’s important to start with thorough research and a consultation with a surgeon who feels like the right fit for you. I advise my patients to list their goals and concerns, and then bring those to the consultation. This allows us to have an open, detailed discussion about what they hope to achieve and what the procedure entails. Additionally, patients should consider how the results of the procedure will age over time, the realism of their expectations, and the type of maintenance and recovery required, including various support systems.
Understanding the risks of surgery and comparing them to the benefits is crucial. Reviewing before-and-after photos of real patients can help set realistic expectations. Lastly, trust your instincts—choose a surgeon who makes you feel comfortable and confident in their care. The decision to undergo surgery is deeply personal and should be made for yourself, not to meet someone else’s expectations.
The integration of multidisciplinary collaboration is crucial for patient care. Can you share an example of how this approach led to a particularly successful outcome for a patient at Fulcrum Aesthetics?
We recently treated a patient who had undergone a mastectomy and breast expander placement elsewhere, but unfortunately developed skin necrosis and a severe multiple-organism infection. This complex case required the expertise of a multidisciplinary team. I led the debridement and removal of the infected expanders, while a wound care specialist helped to manage the temporary wound vac after discharge to promote healing. An infectious disease expert was crucial in selecting the right antibiotics to combat the infection, and a physical therapist was utilized to ensure the patient regained full functionality and movement. After the infection was cleared and the tissues had sufficiently healed, we proceeded with delayed reconstruction. This collaborative approach ensured the patient’s safety and ultimately led to a successful and satisfying reconstructive outcome, demonstrating the power of multidisciplinary teamwork in patient care.
Looking at the future of aesthetic and cosmetic surgery, what emerging trends or technologies are you most excited about, and how do you see them shaping the industry?
Two key areas in aesthetic and cosmetic surgery that I find particularly exciting are preservation rhinoplasty and deep-plane facelifts. Preservation rhinoplasty focuses on maintaining the natural structures of the nose. This technique minimizes disruption to nasal anatomy, resulting in faster recovery and more natural-looking results. Deep-plane facelifts are another area that is shaping the surgical landscape, as they lift and reposition deeper facial tissues, providing a more naturally structured and long-lasting appearance compared to more superficial facelift methods. In step with the deep-plane facelift, fat grafting continues to show promising benefits, not only for volume restoration but also for the regenerative properties associated with adipose stem cells. These techniques are all setting new standards in the field, allowing for continual refinement and improvement in surgical techniques.
Finally, what is one piece of advice you would give to aspiring healthcare professionals, particularly those interested in surgery or aesthetics, based on your own experiences and insights?
One piece of advice I’d give to aspiring healthcare professionals, especially those interested in surgery or aesthetics, is to embrace lifelong learning. Medicine and technology are always evolving, so staying updated on the latest advancements is crucial for providing the best care. For me, lifelong learning means attending conferences, visiting leading surgical colleagues, and honing related skills like drawing, sculpting, and hand-eye coordination. These activities have helped me better understand beauty, form, and proportion, leading to more natural and harmonious results in my work. By improving both my technical expertise and artistic vision, I’ve been able to elevate my practice and truly excel in the field of plastic surgery.
Thanks for sharing your knowledge and expertise. Is there anything else you’d like to add?
One final thought I’d like to share is the importance of empathy and communication in our field. No matter how skilled you are technically, connecting with your patients or colleagues on a personal level and truly understanding their goals and concerns can make all the difference. A successful outcome is not just about the aesthetic result, but also about how it impacts the patient’s confidence and overall well-being. Always take the time to listen, educate, and support your patients or peers throughout their individual journeys.