Board-certified dermatologist Dr Ava Shamban talks to AMP about signature feature, self-esteem and the importance of forming partnerships with your patients from the very first consultation.

AMP: In your book Heal Your Skin: The Breakthrough Plan For Renewal, you provide readers with ‘the freedom to look their best even when they may feel their worst’. Clearly this is fundamental to your approach with clinical patients.

AS: It has been said people want to look as good as they feel, but the truth is everyone wants to look better than they feel. When people are going through a stressful event in their lives such as a divorce, the death of a parent or major medical illness, no one wants to be pitied. Everyone wants to be complimented on how great they look while they go through their traumatic event.

AMP: You and your associates practise a philosophy called Signature Feature, where, instead of trying to ‘ x’ a person’s appearance, you work with each patient to determine the focal point of their individual beauty and take steps to enhance that feature.

AS: There is a clear movement in the aesthetic industry to provide patients with a natural look. The idea of Signature Feature takes this concept to the next level by creating a look suited to each individual.

If everyone were to look like a Kardashian we would be creating a planet full of identical people. How would your date or your business associate ever remember who you are?

The aesthetic work is designed to enhance the feature as well as increase the signal by reducing background noise. In dermatology, background noise is lines, wrinkles and brown spots, for example.

AMP: Would you agree you work with patients’ self-esteem as much as their appearance?

AS: We know from psychology literature that self-esteem is intrinsically tied to our appearance. We have no choice in the matter – it is hardwired into our sub- cortical brain.

AMP: Could you describe a typical rst consultation and progressive consultations with a patient? For instance, what kind of questions do you ask and what do you look for without asking questions? Why is the initial consultation so important?

AS: Of course I want to understand each patient’s individual concerns.

So, I start with those questions, then enquire as to any previous work that has been done, educate the patient about the role genes play in the change in their looks, as well as their exposure to ultraviolet rays.

I examine the patient while their face is at rest and also while they are speaking because any work I do should look natural at both rest and during animation. The consultation takes approximately 30 minutes and we design a treatment plan. At this point, I have decided on a combination of modalities including injectables, lasers, radio frequency devices and, of course, at-home skincare.

When this initial consultation is done properly you have formed a partnership with the patient on their journey to restore their looks so they can look the best version of themselves for their age. By the end of the consultation they realise that this is not a one or two visit process but that it can take anywhere from four to 12 months to achieve their goals. And, after that, there’s maintenance that needs to be done to preserve the results.

AMP: As you point out, the majority of patients’ goals aren’t achieved in one visit. How do you not only plan their treatment program, but engage and enthuse them to take ‘the journey’ that may last months or even years? Also, the cost factor is an ever-present obstacle to many people. How do you manage this with your patients for a mutually satisfactory outcome?

AS: We encourage patients to understand that these treatments are an investment in the most precious belongings that they have – themselves.

Appearance is important in so many ways both in terms of a positive facial feedback loop as well as non-verbal communication to the rest of the world. Once my patients understand this idea, they are more than willing to invest the time, energy and nances required. AMP


Board-certified dermatologist Dr Ava Shamban graduated from Harvard University and earned her medical degree from Case Western Reserve University School of Medicine in Ohio. She completed her dermatology residency at Harbor-UCLA Medical Center in 1989 and is currently a member of the ASDS as well as the AAD and also serves on the editorial board of The Journal of Clinical and Aesthetic Dermatology.

In addition to heading her practices in Santa Monica and Beverly Hills, California, she recently launched her new skin concept space, SKINxFIVE, in Pacific Palisades and presently serves as Assistant Clinical Professor of Dermatology at the UCLA Ge en School of Medicine. As well as lecturing nationally and internationally and serving as principal investigator on many clinical and FDA trials, Dr Shamban makes regular television appearances on US TV network CBS’ The Doctors, is the skin maven on the US ABC network’s Extreme Makeover and is a frequently quoted expert in fashion and beauty glossies all over the world.

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