For many doctors, surgery can be one of the most stress-inducing aspects of their job. After all, surgery is serious business — and in some cases, a matter of life and death. But for Luis Macias, MD, double board-certified plastic surgeon in Marina del Rey, California, surgery is more of a meditative act.
“It's funny — the operating room tends to be my place for de-stressing,” he explains. “There's a little machine that has this sound that's the heartbeat, and it's got this tone that’s just so calming.” Dr. Macias uses the time in the operating room to reflect. There’s often no distractions, only the surgery at hand. “It's a fluid motion, and you're just in the zone.”
I spoke with the 45-year-old while at The American Society for Aesthetic Plastic Surgery® meeting in New Orleans this year. Similar to his demeanor in the operating room, he arrived to our interview calm and rather jovial, asking me about myself and joking with his wife about their day. His wife, who also acts as the office manager at his practice, was incredibly kind upon meeting her for the first time. As the last interview of my day, chatting with the couple was a pleasant note to end on.
It turns out Dr. Macias is a professional at connecting with people and putting them at ease — especially before they undergo a procedure with him. He values a strong relationship with his patients. “I try to gain a rapport with all my patients, to try to get to know them,” he explains, when asked how he earns his patients’ trust. “Then, if they have concerns about whatever procedure we're talking about — a surgery or something — I ask them what their concerns are, what their questions are, and then I have an honest discussion with them so they can get past those fears.”
Dr. Macias’s bedside manner isn’t the only thing that helps reassure patients — his remarkable career history does, as well. Before heading into medical school, Dr. Macias joined the United States Marine CorpsTM; and reached the rank of sergeant. Then, he used the G.I. Bill® to get his undergraduate and medical degrees from UCLA®, and completed a residency in plastic and reconstructive surgery at the Mayo Clinic®. Now, Dr. Macias runs his own practice, treating patients with both surgical and non-surgical procedures.
Naturally, I was ecstatic to pick Dr. Macias’s brain on all things aesthetics. Here, he reveals his most-requested procedure, his passions outside of operating, and the best skincare advice he has for your thirties.
Spotlyte: You have a very interesting background. How’d you end up in the field of plastic surgery?
Dr. Luis Macias: I was a general surgery resident, and there were two surgeons that really inspired me because they were amazing technical surgeons. They treated patients very well. They took care of them. They were just amazing doctors, and they were mentors. I thought about either becoming a cardiac surgeon or a plastic surgeon because of them. But when I saw the breadth of what plastic surgery had to give, as far as the reconstructive side all the way to the aesthetic side, that was very inspiring for me. I would be trained on [treating] the whole body. And I could operate anywhere on the body. I thought that would be very fun to do, and it would be amazing to be able to provide that for patients. So, that was one of the things that led me to plastic surgery.
Spotlyte: What do you think is going to be the biggest trend in the aesthetics world in the future?
LM: The future is definitely moving towards noninvasive or less invasive, nonsurgical [treatments]. We've already seen it happen with injectables, lasers, and skin-tightening products that are on the market. And with body contouring, such as CoolSculpting®, too. If we find something that can treat cellulite, or if we find something to treat stretch marks well, those would take off dramatically, too. I know that there's already things on the market [for those], but they don't work really great. But, the day that we find [those solutions] that will work amazingly, I think [that’ll] be the future.
[Editor’s note: The CoolSculpting treatment is a non-invasive fat-freezing treatment that effectively reduces fat in certain self-proclaimed “problem spots” in the submental and submandibular areas, thigh, abdomen, flank, and upper arm, along with bra fat, back fat, and underneath the buttocks (you know, those bulges that just won’t go away, regardless of how much you sweat it out on the treadmill). While it isn’t a weight loss solution, fat-freezing can reduce pouches of fat. As with any procedure, there are risks and side effects, so talk to a licensed provider to see if it’s right for you.]
Spotlyte: Are there any ways you like to de-stress when you’re outside of the operating room?
LM: I ride my bicycle. I live in the marina, so I used to get up, go out, and row there. That's a nice way to get away.
Spotlyte: Do you get injectables or any other in-office treatments?
LM: I get injectable wrinkle reducer in my forehead [lines], although right now, my wife keeps telling me I need it again. She's my injectable wrinkle reducer monitor. As far as lasers, I haven't gotten any yet, but I'm going to do a BBLTM; for some brown spots that I have on the left side of my face. I haven't had any fillers as of yet, but I'm getting to the point where I need filler in my cheeks. I'm 45 years old, and gravity gets us all.
[Editor’s note: Injectable wrinkle reducers temporarily smooth the look of moderate to severe wrinkles in certain areas of the face, including the forehead, frown lines, and crow’s feet; they should not be used more frequently than every three months. Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, both injectable wrinkle reducers and injectable fillers have potential risks and side effects. Talk to a licensed provider to see if they’re right for you. And learn more now by chatting with a trained aesthetic specialist.]
Spotlyte: In terms of skincare, do you have a lengthy routine or do you keep it simple?
LM: I am a simple kind of guy. I've been wanting to get into more skincare for myself, but I haven't yet. I do use SPF. That's important, but I haven't gone any steps further.
Spotlyte: What is the most requested procedure or treatment in your practice?
LM: The most requested procedure right now is a facelift. I often do lasers on top of it, too. So, we do [a patient’s] facelift, then a laser treatment, and then a skincare [regimen] is obviously important to add.
Spotlyte: What is the best skincare tip that comes to the top of your mind regardless of age?
LM: Retinoic acid! [Especially] for people in their thirties.
[Editor's note: Retinol shouldn't be used by women who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.]
Spotlyte: How do you calm first-time patients who are nervous to get a treatment done?
LM: I think there are very few patients that are that nervous. Appointments begin with them walking in and I meet them. [We start out] just sitting there and chatting about everything. It's all about discussion. You don't want to convince someone to have something that they don't want. So, having that discussion with them is very [important]. It's that discussion that helps get patients to understand whether or not [the treatment] is for them.
Spotlyte: Is there one question that you think all patients should ask their provider before getting a treatment done?
LM: Ask [your provider] if they know the protocols to follow in case there's a problem [with your treatment]. There are always risks with any treatment, and they should have the ability to [address most of] them. Going to a reputable practice that knows what to do in case there's a problem, obviously, is very important.
CoolSculpting® is an Allergan®-owned non-invasive fat reduction treatment.
CoolSculpting® Treatment Important Information
The CoolSculpting® procedure is FDA-cleared for the treatment of visible fat bulges in the submental (under the chin) and submandibular (under the jawline) areas, thigh, abdomen and flank (love handles), along with bra fat, back fat, underneath the buttocks (also known as banana roll), and upper arm. It is also FDA-cleared to affect the appearance of lax tissue with submental area treatments. The CoolSculpting procedure is not a treatment for weight loss.
Important Safety Information
The CoolSculpting procedure is not for everyone. You should not have the CoolSculpting procedure if you suffer from cryoglobulinemia, cold agglutinin disease, or paroxysmal cold hemoglobinuria.
Tell your doctor if you have any medical conditions including recent surgery, pre-existing hernia, and any known sensitivities or allergies.
During the procedure you may experience sensations of pulling, tugging, mild pinching, intense cold, tingling, stinging, aching, and cramping at the treatment site. These sensations subside as the area becomes numb. Following the procedure, typical side effects include temporary redness, swelling, blanching, bruising, firmness, tingling, stinging, tenderness, cramping, aching, itching, or skin sensitivity, and sensation of fullness in the back of the throat after submental or submandibular area treatment.
Rare side effects may also occur. CoolSculpting may cause a visible enlargement in the treated area which may develop two to five months after treatment and requires surgical intervention for correction.