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Daniel Cassuto, MD: World View, Intimate Approach

By: Abby Penning
Posted: September 1, 2010, from the September 2010 issue of
Plastic surgeon Daniel Cassuto, MD

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Somewhat ironically, offering patients the best results possible also involves Cassuto talking with his patients quite a bit. “Sometimes it is difficult to understand what a patient wants, because it is not always what they are asking me to do,” he says. “The only way I can find out what they are really hoping for is to talk and talk and talk with them. I prefer to speak with my patients myself.

“It is not always about trying to improve the way people look, but the way they feel about how they look,” he continues. “The only way to maintain a principle of real beauty is to create a symphony between what people are and how they feel about what they are.”

Cultivating that appreciation often involves discussion with patients, as well. “Sometimes, the most difficult part of working with patients is convincing them that they are OK and don’t need anything done. In fact, I’ve found two of the hardest lessons to learn are when to refrain from doing anything and how to convince the patient that doing nothing is the right thing to do,” Cassuto explains. “I want to try to take the aesthetic practice back to the practice of medicine. I have patients who see advertising about an injection product and come in and ask me for it—this is bad medicine. I need to know from my patients what is bothering them, not what they’ve heard. Once I am able to understand their desired outcome, I can more accurately make a proper diagnosis and pursue the appropriate course of treatment.”

Cassuto continues his explanation through an example of a patient complaining about upper eye lids, saying the traditional route would typically be to perform a blepharoplasty. “Now I question if this is really what the patient is looking for, what the patient needs, because she may just end up with a higher brow and the rest isn’t changed—she doesn’t necessarily look any better,” he explains. “It would be as if a patient came to my practice complaining of a headache and I just prescribed an aspirin. If she had a deeper problem, the aspirin wouldn’t address it. The headache isn’t the cause of the problem, it’s a symptom. We need to think more diagnostically like this in aesthetic medicine. Once I know the root of the problem, I can figure out more accurately what the patient is looking to achieve. And many times, minimally invasive treatments have a more natural look and cost less than a surgical procedure. This is what I mean by giving back instead of demolishing—this is the real medicine.”

Treating and preventing complications

Cassuto also helps train residents and is a professor at two universities in Italy—the University of Catania in Sicily and the University-Hospital, Policlinico of Modena—and helped open a center that treats complications from aesthetic procedures gone wrong, particularly filler injections. “I’ve been doing this in my private practice for the past six years, and have published papers about this,” he says. “I see it as a kind of a mission for myself—I don’t charge these patients, plus I volunteer to provide corrective services in the hospital once a month. It gives relief to those who could not otherwise afford it, and these are patients who nobody wants to treat because of the complications involved.”