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Lunch at The Four Seasons with: Dr. Paula Moynahan

Published by The New York Sun on 2005-11-02

Paula Moynahan, plastic surgeon to CEOs and celebrities, fixes minds.


"Yes," said Dr. Moynahan, who's among only a handful of women in the world to have achieved double board certification from the American Board of Surgery (ABS) and the American Board of Plastic Surgery (ABPS). "I realized long ago that if you correct a defect in the body, or a face, you're really correcting a defect in the mind. People feel better about themselves afterward."

"So in that sense, I'm a fixer of the mind," the Connecticut-born Dr. Moynahan said, with a smile. "Plastic surgery brings about a transformation of the mind."

Americans in growing numbers are seeking such transformation. Last year, they spent $12.5 billion on cosmetic procedures, a record. The number of surgical and nonsurgical cosmetic procedures in America increased by 44% to a total of nearly 11.9 million, according to the American Society for Aesthetic Plastic Surgery (ASAPS). Men accounted for 10% of this figure.

The number of surgical procedures increased 17% last year from 2003, and the number of nonsurgical procedures increased 51%. The most frequently performed procedure was Botox injection, and the most popular surgical procedure was liposuction. The number of cosmetic procedures performed on men increased 306% from 1997 to 2004, according to the New York-based ASAPS.

"The big gratification for me is when someone says, 'Doc, you changed the way I feel about myself,'" Dr. Moynahan said.

She is one of 2,500 physicians in America - out of a total of 800,000 - who practice plastic surgery. Of these, barely 200 are women. And 30 years ago, when Dr. Moynahan started practicing, only 17 women in the world were certified by the ABS and ABPS, the authoritative global bodies that issue these mandatory certifications.

"There used to be a definite bias again women in surgery," Dr. Moynahan said. "The arguments against them were that they had periods - that PMS caused instabilities that no surgeon could risk. In 1975, only about 3% of students in America's medical schools were women. Now there are slightly over 50% in some medical schools. Women surgeons carry no more risk than their male counterparts. As to the natural female functions, there are always ways to work around that."

Dr. Moynahan concedes, however, that being a surgeon requires her to deny herself one female passion - nail polish.

"There's a chance that bacteria can form within the crevices of the nail polish," Dr. Moynahan said. "So in surgery, at least, women need to do as the men do."

She starts her surgeries at 7 a.m. Most days, she will perform at least two major surgeries, and another eight minor ones. And because patients who undergo plastic or cosmetic surgery need what Dr. Moynahan calls "maintenance," she is virtually assured of return visits.

The effects of Botox, for example, last about four months. Sculptra lasts about four years. It is the newest, most advanced and longest-lasting of the injectable facial fillers. Sculptra originated in Paris under the name, "New Fill," and has been successfully used on more than 150,000 patients in 33 countries. Dr. Moynahan was among the first surgeons in America to use Sculptra.

Then there's collagen, whose effects last just three months. And Restylane, a clear gel cosmetic dermal filler made of hyaluronic acid - and which is popular among teenagers because it enables them to have Angelina Jolie-type pouty lips - lasts six months. A typical face lift - usually sought by men and women over 51 - lasts seven years.

However, Dr. Moynahan refuses to do liposuction, which is the most popular form of cosmetic surgery for both men and women in America for the obese.

"People who are obese should engage in a program of diet and exercise," she said.

Why, beyond vanity, do her patients seek plastic surgery?

"Genetics may explain why certain parts of the body or face age more rapidly, or don't respond to other interventions," Dr. Moynahan said. "Some children are born with ears that look as if the doors of a taxicab are open. But cosmetic surgery is very subjective. Unless there are specific medical reasons, it all depends on the patient's wishes. But will a 50-year-old person ever look like a 30-year-old through plastic surgery? Not with the techniques we have available today."

Those techniques include laser - particularly the non-ablative kind that doesn't leave scars - and injectables. Dr. Moynahan said that although researchers in Paris - where she studied after getting her medical degree from the Medical College of Pennsylvania in Philadelphia - may claim otherwise, the cutting-edge research in plastic surgery is being done in New York.

She is virtually assured of never running out of patients. America needs to train 3,000 to 10,000 more physicians a year -- up from the current 25,000 -- to meet the growing medical needs of an aging, wealthy nation, according to a recent study by Harvard University's Dr. David Blumenthal. Writing in the New England Journal of Medicine, Dr. Blumenthal said that because it takes 10 years to train a doctor, the nation will have a shortage of 85,000 to 200,000 doctors in 2020 unless action is taken soon.

Dr. Moynahan agrees, citing the fact that as nearly 80 million baby-boomers edge past 60, they will want the services of not only physicians for medical ailments.

"The quest for looking young and fit has always been with us," she said. "It's an eternal quest. I'm just a lady doctor who tries to please her patients."

Pranay Gupte,
Senior Writer and Global-Affairs Columnist

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