Q. You founded your practice, concentrating in facial plastic surgery with emphasis on the nose, in 1993. Through the years, you have built a very successful practice and you yourself have become a very highly regarded and sought-after plastic surgeon. To what do you credit this success – what makes you and your practice stand out in the highly competitive field of plastic surgery?

A. First of all, let me say that during these years, it has been my privilege and my joy to be able to have earned the trust of the countless patients for whom I have cared. It has always been my goal, my mission to establish a premier facial plastic surgery center in The Texas Medical Center, a practice devoted to enhancing and improving people’s lives through facial plastic surgery. We have accomplished that goal and we’re moving even further with that mission – more about that in a minute.

My success comes from deep within. My passion for the face and the benefits of plastic surgery is innate. I have a love and unique understanding of the face, and the nose. I have reached a point in my career where I can focus on aesthetics and artistic balance because I have such a finely tuned understanding of the surgical process and what surgery can accomplish.

The complex technical aspects of the face are second nature to me. I have developed certain patterns and pathways that can be individualized to each patient, and that way, I can focus on the very subtle and refining nuances that are critical to facial balance and harmony.

I have also been blessed with opportunities and have made many right decisions. For one, our location within The Texas Medical Center. Here, the institutions that surround us – St. Luke’s, Methodist, Baylor – are truly on the cutting edge of medicine. My interaction with fellow physicians and techniques and technologies is invaluable. The institutional framework within which I practice is unequaled anywhere in the world. Of course, this proximity to the world’s best medical facilities also puts me in touch with the best surgeons and physicians – and medical school facility, students, fellows.

And my staff. I truly believe that my staff is the best anywhere. Years of experience, compassionate, caring. When anyone comes for a visit or a consultation, the difference is evident from the very first step in the door.

Q. Throughout the years that you have been in practice, your undeniable talent and proficiency as a facial plastic surgeon have not gone unrecognized. You have always been reluctant to talk about awards and accolades, but just for a minute, share with us some of your accomplishments.

A. My patients and their successes and happiness are truly my greatest rewards, and seeing the positive reinforcement that plastic surgery brings to their lives is satisfaction of the highest degree. But, yes, I have received some honors of which I am particularly proud.

I have dual teaching appointments at Baylor College of Medicine, serving in both the Department of Surgery, Plastic Surgery division and in the Department of Otolaryngology. This dual appointment, in itself, is a unique honor, as I believe I am the only dual faculty voluntary member.

Recently, at the June graduation ceremonies for residents of Baylor College of Medicine’s plastic surgery residents, I was very surprised, and very pleased, to be honored with the 2008 Outstanding Clinical Faculty Award. This award is voted on by residents and members of the Baylor faculty, so I am deeply honored to be named as the recipient.

Another honor of which I am particularly proud is my presidency of the Houston Society of Otolaryngology-Head and Neck Surgery. During my tenure in 2007-2008, the Society has become more active and I believe that my role set a new tone, enhancing the sense of camaraderie and increasing the emphasis on education.

I am also very pleased that in 2008, I have been named – for the fifth year in a row – as a Texas Top Doctor in Plastic Surgery by Texas Monthly magazine. I have also received accolades from Texas SuperDocs and from H Magazine.

Q. That’s quite a resume. Congratulations.

A. Although not an award, but I want to also mention that I am quite pleased to have been participating in fellowship program and resident training over these past years. I have physicians who are with me observing and training in rhinoplasty and nasal surgery, and also I accommodate, as mentors, several residents in my practice.

The residents and fellows with whom I work create a very challenging environment, and I enjoy doctors who are with us, learning and observing techniques and surgeries that we are able to share.

Q. You hinted at some exciting news for your practice. Can you tell us about what the future holds?

A. We are very pleased to have established The Bressler Center for Facial Plastic Surgery and Skin Care. This is an idea that I have had for several years, and I am pleased to see it come to fruition.

Our mission is still the same – a center dedicated to the face – but The Bressler Center makes the process of learning about surgical and non-surgical options easier and more efficient for patients.

The Bressler Center will be the center of excellence for facial plastic surgery and skin care. The unique factor that we bring to the table is that we have very special, very focused experience with the face, the facial structure and the skin.

The underlying philosophy is that, when it comes to the face, and particularly the nose, it is important to be in an environment where the emphasis is only the face. We don’t deal with body issues. At The Bressler Center, people are studied in facial characteristics and dedicated to learning more and more.

The Bressler Center is not like any facility. The experience patients enjoy here is not like any experience in the medical field. We have always been exclusively dedicated to the face, and now we are taking the focus even further.

Q. What is the incentive for The Bressler Center for Facial Plastic Surgery and Skin Care?

A. Through the years, the field of facial plastic surgery has gotten more and more sophisticated, and nowadays there are multitudes of options for individuals. I felt it was time to enhance the concepts that I had already established in my plastic surgery practice.

We have always been a patient-center facility. Individuals come to us and tell us that they enjoyed the visit with me, the nurse consultants, the aesthetician. We pride ourselves on fostering a compassionate, caring environment where the patient is our most important consideration.

The Bressler Center was a natural progression as we refined the practice to better serve individuals who seek our care.

Q. Describe what will define The Bressler Center – what kinds of services?

A. The Bressler Center for Facial Plastic Surgery and Skin Care focuses on three areas:

	The face itself and its structural characteristics
	The nose with its unique properties
	The skin and its enhancement

Our concentration on the face, the facial structure and particularly the nose will remain, and we will maintain our dedication to being the leaders in this field.

I am pleased to say that Dr. Etai Funk has joined the practice, enhancing our ability to serve more patients. Dr. Funk is a uniquely qualified physician and surgeon, and a scholar. It was recently announced that he earned the highest marks on the 2008 ABFPRS examination, which names him as the winner of the Jack R. Anderson Prize. This is quite an accomplishment and a significant achievement in the field of plastic surgery. And, perhaps more importantly, Dr. Funk shares my philosophy about the practice of facial plastic surgery. He brings an excellent caliber of skills and professionalism to our practice of facial plastic surgery.

Q. Expand on The Bressler Center’s focus on skin care.

A. My practice has had a skin-care component for many years. The enhancement realized by The Bressler Center derives from the belief that if you have achieved a beautiful, in-balance facial structure and then, your skin is sallow or sun-damaged or unhealthy, the effort has been wasted.

Now, expanding The Center with a full-service skin spa, we are able to provide our patients with the best technology, the best aestheticians – the best of everything when it comes to treatments before surgery, after surgery, even without surgery.

What’s also unique at The Bressler Center is that our patients enjoy the services of licensed aestheticians and nurse consultants who are able to provide skin treatments. And, additionally, when it comes to medically oriented treatments such as the injectables or the fillers such as Botox, Juvederm or Restylane, the patient has the services of a physician.

The Bressler Center is not like a retail or storefront spa. We combine the best medical clinic with a private, patient-center environment. It is comfortable for anyone interested in improving his or her appearance.

The aestheticians and consultants will be able to address the surface issues and complaints with the very latest technology. Unlike other practices, we have the freedom to only invest our efforts in investigating the best technology and also to find treatments that are the most successful.

Our patients have enjoyed excellent results with the Syneron™ medical aesthetic system that simultaneously harnesses the power of radio frequency and light energy for unprecedented precision and safety. It’s effective and there is little or no downtime. We can address a variety of skin complaints from skin rejuvenation, wrinkle reduction, skin tightening, skin rejuvenation, pigmented lesion lightening and more.

As well, The Bressler Center uses photo facials, microdermabrasion and other treatments to help with acne, skin redness, excessive hair and other issues.

Q. It sounds as if this patient-center approach makes it easier and more efficient for patients.

A. Yes, absolutely. Basically, patients come to us needing an evaluation on three levels. The Bressler Center for Facial Plastic Surgery and Skin Care put into place a system where treatments and options overlap and decisions are easy. Basically, it’s a layered approach:

	The first layer is surgical, where physicians can evaluate surgical issues and recommend techniques that are appropriate,
	The mid layer is for advanced skin care that requires a physician’s knowledge and expertise, and
	The third and final layer is on the surface, which addresses sallow skin, surface wrinkles, skin tightening.

We have reached a point where we can really address a patient’s concerns. We can accommodate the issues of an individual whose face is out of balance and requires rhinoplasty, or another who needs chin augmentation or similar reconstructive surgery to restore harmony to his or her face. As well, we are able to address the needs of someone who is combating wrinkles or who needs to correct blemishes and age spots.

It’s all here. We have simplified the process for our patients. The Bressler Center for Facial Plastic Surgery and Skin Care makes sense medically, it’s doable financially and provides answers that fit comfortably into a person’s lifestyle.

Q. You grew up in Houston, attended college at Tulane in New Orleans and returned to the city for medical school. You then completed a fellowship in Toronto. What is the draw to come back to Houston?

A. I have always called Houston home. I completed a year of cardiothoracic research in a DeBakey heart lab after college, followed by medical school at UT-Houston and residency in Otolaryngology - Head and Neck Surgery at Baylor College of Medicine. These 10 years exposed me to all the hospitals in the Texas Medical Center as well as many of its physicians. The experience made me realize what an amazing center we have in Houston with such an astounding level of prestige and excellence. The desire to work in the Texas Medical Center is comparable to when traders or investors want to work on Wall Street or politicians flock to Washington, D.C. The Texas Medical Center makes Houston one of the premier cities in the world to practice medicine.

Lastly, working in the Texas Medical Center will allow me to converse and correspond with colleagues easily about the most effective techniques and most recent technology. This keeps me abreast of new and exciting treatments which may be of great benefit to my patients.

Q. What lead you to spend a year Toronto?

A. I was very passionate about facial plastic surgery during residency and wanted to hone my surgical skills in this field with a yearlong fellowship. I was honored to have the opportunity to work with Dr. Peter A. Adamson, one of the most respected facial plastic surgeons in North America and past president of the American Academy of Facial Plastic Surgery. This highly coveted fellowship, in the glamorous Yorkville, Toronto area, concentrated on rhinoplasty and cosmetic facial surgery. Dr. Adamson’s experience and guidance sharpened my aesthetic eye, enabled me to understand the subtleties of the field, and refined my surgical techniques. The training was phenomenal and I think bringing this international experience back to Houston will be extremely beneficial to my patients.

Q. Why have you chosen to join Dr. Bressler’s practice?

A. Dr. Bressler and I met early in my residency. I was always spending time in his operating room watching and learning from his rhinoplasties. He had some research ideas and I began working diligently on a project spending countless hours in his office for about two years.

His office staff and I connected well, and as one can imagine, Dr. Bressler and I worked extensively together on this project. We quickly found that we had similar philosophies regarding cosmetic surgery and running a successful practice.

As a chief resident at Baylor, I would sometimes have him staff my rhinoplasty cases at the VA Medical Center and was always impressed with his devotion and dedication to furthering our field, educating, and mentoring physicians such as myself. He is highly regarded in the medical community and throughout our field.

During my fellowship, Dr. Bressler and I began conversing more seriously about my joining the practice. Although I had other offers, we already had developed a history, trusted one another whole-heartedly and agreed that the most important part of the practice would be to provide the best patient care.

The office is an aesthetic marvel, with extremely amiable, accommodating, and well-trained staff. This provided the perfect atmosphere in which I wanted to practice.

Q. What are your philosophies about cosmetic facial plastic surgery?

A. Facial plastic surgery enables a physician to create and shape the features of the face and neck in a more aesthetically pleasing fashion. It allows for artistic creativity while at the same time implementing the basic principles of surgery and medicine.

Over the years, I have been fascinated with society’s view of beauty, particularly with the face. I have always thought that our face is our social fingerprint.

In fact, the human eye can actually scan a face and analyze it in a sixth of a second. So, when someone walks into a room filled with 30 people, that person can identify everyone he/she recognizes within five seconds. Now, the human eye may go back for a second look at those it finds intriguing.

The next logical question is why are people intrigued by some faces and not others? What makes these faces attractive and alluring?

In effect, we are asking what defines beauty. Sir Francis Bacon said that beauty is harmony. Or, beauty is identified when different aspects of the face are in harmony, or in proportion with one another.

Others say that beauty is symmetry. However, studies show that the face has asymmetries in 95 percent of people. If one looks closely enough, he or she will notice that there are many beautiful faces with any number of asymmetries.

Lastly, people have been quoted stating that they cannot define beauty, but that they know it when they see it.

I feel that we cannot define beauty because it is always changing, particularly in the face.

Q. Beauty is changing? That’s an interesting idea. Can you explore this idea further?

A. Our society today has accepted that beauty is found in all cultures and races. When you look at the aesthetic features of Caucasians, African-Americans, Latins, and Asians, they are all different. The eyes, nose, cheeks, lips, and chin vary dramatically depending on a person’s ethnicity, culture, or origins.

Fifty years ago, we would have never seen Lucy Liu, Beyoncé, or Jennifer Lopez on the cover of Vogue or voted as People magazine’s most beautiful people. But, they are all beautiful women.

Beauty, I feel, has been accepted as a blend of all these features of different ethnicities and cultures.

This is defined as koinophilia, or a love of the average. It is an average of all these different facial features that has become the allure to the human eye. Beauty is always changing because we as people are changing. Our perceptions and acceptance of beauty within different cultures are constantly changing which leads to a continually shifting idea of what defines beauty itself.

Q. Can you discuss some of the different cosmetic facial plastic surgery procedures and your philosophies behind each? Let’s consider the rhinoplasty patient.

A. Most of us become acutely aware of our facial appearance and develop a heightened sense of body image around the time of puberty. So, as you might imagine, many of my rhinoplasty patients are of a younger age group. However, I do have many older patients who state that they have never liked the appearance of their noses.

Patients may wax and wane over their concerns about their noses or faces, but ultimately, that anxiety or unease about a particular feature will always be there.

People may comment on a lovely smile, beautiful hair, or alluring eyes, but rarely do you hear someone mention a beautiful nose. The people who do notice noses are those who are more vigilant or aware of them because of their own inherent anxieties about their noses.

The nose should easily blend into the face and actually not be noticed. This is interesting considering the nose sits directly in the center of the face.

Patients frequently look in the mirror or in photographs and tell me that they feel as though this is not their nose– not the nose they should have been given.

My goal is to shape and create a nose that blends easily into a patient’s face with a natural unoperated appearance. I want people to approach my patients and say, “Wow, I never noticed how beautiful your eyes are or you have such a wonderful smile.” It is said that a good rhinoplasty is not seen in the nose, but actually in the eyes.

But most importantly, I want my patients to look in the mirror or at a photograph, and say, “Yes, this is nose I should have had.” This allows their objective outer appearance to reflect those inner subjective feelings they have always had about the way their nose should look. It has also been my experience that a patient almost always forgets what his/her nose used to look like and develops a new, healthier body image in time.

Q. What about your patients who are interested in facial rejuvenation?

A. My patients who are interested in rejuvenation surgery (such as facelift, browlift, or blepharoplasty) almost always present stating that they saw a recent photograph or looked in the mirror and did not feel as though this image reflects their inner self. They still have this inner vitality, vigor, and energy, yet this feeling is not apparent externally.

The objective with these patients is not to change the appearance of the face, but simply to shape and adjust different aspects of the face and neck. I am not interested in changing a patient's visage or identity.

My goal is for my patients to enjoy a natural, unoperated image – a refreshed, rested, less tired look, where the outer appearance reflects a person’s inner spirit and vitality.

And it works. Time and time again, my patients tell me that after the rejuvenation procedure friends often comment or ask if they have recently returned from vacation, changed their hairstyle, or lost weight.

Q. Any thoughts for individuals who are considering plastic surgery but can’t decide?

A. Patients frequently convey to me that their family members or friends say that their nose or face is fine and not to worry about appearances. However, these well-meaning individuals are not the ones that have to wear that face or nose every day.

Facial features are unique, personal, and ultimately only related to how one feels about his/her features and how they affect that person.

People may say that cosmetic surgery is superficial or that we should accept what we have been given. If it were not for patient confidentiality, I would love to invite those people to my clinic and have them meet young rhinoplasty patients or rejuvenation patients and see what a change surgery has made on their lives.

With the young rhinoplasty patients, there is more self-confidence and a more gregarious nature. In fact, parents tell me that many demonstrate better behavior, increased motivation, and improvement in schoolwork simply because they have one less thing to worry about. My facial rejuvenation patients feel beautiful and attractive once again. Their inner spirit and vitality is now reflected by their outer appearances.

I truly believe that we are changing people’s lives for the better, which is why I love my work.

Q. What are your thoughts on the less invasive or non-surgical aspects of facial rejuvenation?

A. I believe there is a large role for preventative measures in regards to aging. Most importantly, individuals should avoid prolonged sun exposure, wear sunscreen, and quit (or don’t start) smoking.

Non-invasive or minimally invasive procedures such as BOTOX®, fillers, and non-ablative resurfacing procedures are becoming quite popular. If an individual is interested in any of these treatments, it is important to obtain medical services from a trained professional.

In the near future, BOTOX® and fillers will not be considered an elective procedure, but a form of maintenance for women and men. Just as women today receive manicures and facials, I believe individuals will maintain youth and beauty with injections and resurfacing techniques.

Although these procedures are becoming more commonplace, they cannot replace cosmetic surgery. A person will never obtain as dramatic a result with a non-invasive procedure as with a surgical option – which is precisely why I believe a person is wise to seek these non-invasive services at a facial plastic or plastic surgeon’s office.

Non-surgical treatments administered in this setting provide excellent opportunities for a patient to become familiar with their plastic or facial plastic surgeon. Is he/she honest and amiable? Is he/she punctual with appointments? Is the office staff receptive and accommodating? How is the aesthetician? How is the facility? Does it appear to be a professional practice?

Obtaining this information through periodic visits for non-invasive procedures enables a patient to become familiar, comfortable, and confident in a surgeon and his/her practice. Therefore, if the patient elects to pursue a surgery at a later date, the surgical consultation becomes a delightful, non-stressful, and enjoyable experience.