Dr. Fix It

by Liz Finch (Plastic Surgery Products)

As long as he can remember, Melek Kayser, MD, FACS, wanted to be a surgeon. In the third grade, he read a book on the heart. After that, he was hooked.

“That was it for me,” he says. “I thought, ‘This is cool,’ and I’ve never had a desire to do anything else.”

Of course, as a third grader Dr. M Kayser did not know the difference between surgery and other specialties, he was merely interested in fixing things.

“I wanted to pursue something that would allow me to work with my hands, because I was always building things. That was my desire. If I could fix it, let me do it, “ he says.

The desire to “fix it” lead Dr. M Kayser to the University of Texas at Dallas, where he completed his undergraduate work, and then to St. John Hospital and Medical Center in Detroit, where he completed five years of general surgery. During this time he became particularly intrigued with pediatric surgical patients. He finished up at Wayne State University/Detroit Medical Center in a two year plastic surgery residency.

“Plastic surgery became an opportunity to have the best of both worlds,” he says. “I got to work with kids and yet specialize in plastic surgery at the same time.”

His interest in that area lead Dr. M Kayser to do an extra year in fellowship training in craniofacial and pediatric surgery at UT Southwestern Medical School in Dallas. He has received awards from the Michigan Cleft Palate Association Research Competition and the St. John Hospital Annual Residents’ Practice Day Research Competition. Dr. M Kayser is certified by the American Board of Plastic Surgery and is also a member of the American Society of Plastic Surgeons, the American Cleft-Palate Craniofacial Association, and the Christian Medical and Dental Society, among others.

Dr. M Kayser now practices in Roseville, Michigan. Pediatric groups in the area know of his extra training and interest in that area, and generate a number of referrals.

“The wonderful thing about seeing children who are born with a congenital deformity is that I can participate in enhancing their quality of life,” he adds. “Children whose parents are devastated when they’re born have new hope when I am able to restore their deformities. The patients are pleased, and I have heard that many pediatricians have been, too.”

Those positive patient and physician recommendations have really helped Dr. M Kayser’s business get off the ground. When he first began practicing plastic surgery in the Michigan community almost four years ago, Kayser did so in a time-shared office space because that was all he could afford.

“They supplied a telephone, an exam room and a staff person to put the patient in the room with a chart,” he says. “That was about it. They were very humble beginnings.”

From those humble beginnings has risen Image By Design, Dr. M Kayser’s private practice, which is located directly across the street from what he refers to as “a very good, very competent plastic surgery group.”

“I have the utmost respect for them, and it does create a competitive atmosphere. I don’t think that it is to my detriment, however,” Dr. M Kayser says. “I have a good working relationship with other surgeons in the area, and since I know they are good surgeons, I would have no problem referring patients to them. I think there is enough cosmetic and plastic surgery available to all of us in the area.

“We all want to grow our practices, and we all area aware of other plastic surgeons in the area. That creates certain challenges sometimes,” he continues.

Dr. M Kayser meets those challenges by working hard to earn the respect of referring physicians who are allowing he to see their patients, as well as achieving the best surgical results he can and establishing an excellent rapport with his patients, who range from children to adults, and from cosmetic to reconstructive patients.

Among the services offered at Image By Design are face lifts, endoscopic forehead and brow lifts, eyelid surgery, nose reshaping, chin and cheek enhancement, body contouring, microdermabrasion, facial peels, Botox injections, and laser hair removal. He also performs breast enlargements, reductions, reconstruction and lifts. Dr. M Kayser does some hand surgery as well for local hospitals and is chief of the department of plastic surgery at St. John Macomb Hospital Center.

“Dealing with a varying clientele gives me a broad perspective,” he says. “I wouldn’t want to do just one thing all the time. I like the diversity, and every day is a challenge. It keeps it interesting.”

One of the most interesting areas of his practice, in addition to the cleft work he performs, is breast surgery, which he says is definitely one of his favorite areas of plastic surgery.

“I like trying to restore a part of a woman’s body that has been taken from her,” he says. “That type of procedure carries not just the physical aspect, but sexual, social and emotional aspects as well. It is very gratifying to both the patient and myself.”

A new breast lift/breast reduction technique called the SPAIR (short scar periareolar inferior pedicle reduction mammoplasty) technique, which reduces scarring by up to 50 percent, has made his breast surgery even more gratifying. Dr. M Kayser became enamored of the technique two years ago when he saw it presented at a national meeting.

“After comparing it to other different methods, I found it to be a tremendous technique,” he says. “It incorporated a lot of concepts already used in breast surgery with minimal scarring, such as the periareolar techniques that Europeans are know for, and it was reproducible and easily learnable. I’ve been able to incorporate it in my practice quite well, and I have seen results that I think are better than results with traditional breast reduction techniques.”

Dr. M Kayser also has begun to combine the SPAIR technique with augmentation, and says that he used it recently on a male patient with gynecomastia.

“It kept the scars completely confined to the areole instead of extending them vertically and horizontally,” he says. “It’s a wonderful technique, and I don’t see myself going back.”

Dr. M Kayser’s patients are likewise extremely happy with the SPAIR technique, and he sees their positive experience as key to the success of his practice.

“It is important that once the work is completed or even during patient care, they experience a very positive relationship,” Dr. M Kayser says. “A number of my patients are absolutely delighted with the office. I hope that word of mouth gets back to friends, family and the referring physicians so that they are comfortable in continuing the referral process. My goal is to allow patients to feel they have received the utmost in care and surgical expertise available.”

Dr. M Kayser says he also is striving to achieve and pursue a relationship with his patients that is deeper than just surgically fixing them.

“It’s important to look into why people chose to have a certain thing done,” he says. “With mastectomy patients, we understand there will be an emotional impact. It is a given that they will have sustained emotional trauma from having a part of their body removed and coming to realize that they have cancer. We all expect that they are going to have to struggle, and we want to be supportive, but cosmetic patients are often overlooked. I also want cosmetic patients to know that when they leave this office after a procedure is done, they are still as much a part of this practice as before we did surgery.”

Dr. M Kayser also looks out for his patients before they become patients, making screening for psychological and emotional issues a priority.

“Expectations effect perception and the degree of satisfaction after surgery, he says. “If I suspect a woman with implants wants to be twice as big and I think that’s an unrealistic perception of proportion and beauty, I may screen her out. We are the gatekeepers of what beauty is, and it is incumbent to define and explain to our patients why a breast is attractive or unattractive, why a certain size and shape is aesthetically attractive. It is not unusual for patients who are educated to change their ideas about what they wanted. People would rather have someone say, ‘You look good,” not “Who is your plastic surgeon.’”

He cites another case of a patient who came in with her husband for a consult for augmentation, only to reveal that she was really struggling with self-esteem issues.

“We ended up talking for another hour after the first consultation about personal issues. I may never see her again, but if I have contributed to her making better choices in life, to finding an identity that is stronger than when she came in here, that makes my week,” he says. “Those special moments don’t come everyday, but when they do it’s great, and you can really feel good about what you’re doing.”

“It’s amazing how many people don’t really have an understanding of the concept of self-esteem,” Dr. M Kayser says. “Personally I believe if we understood who God made us to be, then we wouldn’t struggle with self-esteem. I also would probably be out of business. But if a customer believes surgery will solve their problems, they may be disappointed to find out that their life doesn’t change afterward. It’s important to know each patient personally and find out their motives, expectations and goals.”

“People are willing to pay cash to look better, and that is an easy temptation to succumb to,” he continues. “All of us are vulnerable, but we need to keep our guard up and remind ourselves what we are really here for. If a patient is well-motivated and realistic in their expectations, then we will have a happy patient after the work is done.”

“This is about a relationship, which is an intangible thing I am convinced not every physician and patient has,” he says. “From the first time patients call and talk to our staff, they receive confidentiality and experience a memorable, positive consultation.”

Adding to that experience is the practice’s purposeful small size, the fact that patients are never kept waiting, and the “non-doctor’s” office environment of Image By Design.

“There are no fluorescent lights or glass,” he says. “My wife and I worked to create a warm home environment featuring French doors, individual suites and nice art work.”

Dr. M Kayser considers himself blessed by his wife, a certified public accountant who works out of their home while she cares for the couple’s 15-month-old baby.

“I really like her being as involved as she can be,” he says. “I am not a business man, and I have no desire to be one. I just want to treat my patients. I’ve been blessed with having God provide me the patients that I have, as well as my wife and my daughter. I have a sense of gratitude about that. The most difficult thing I can be challenged with is realizing that this is not about me, but about how I can be of service. That’s my ultimate desire.”

Though he has no immediate plans for expanding Image By Design or adding a partner, Dr. M Kayser says he will consider it if the time comes when he cannot handle all the work by himself.

“I want to continue to grow, but there are advantages to being by yourself,” Dr. M Kayser says. “A 20-man practice just offers you the chance to have 20 people in the office and 300 staff members. Here I know every patient personally and that is an important aspect of my work.”