Dr. Lisa Lynn Sowder manages an accredited surgical facility and plastic surgery practice in Seattle, WA.

Name: Lisa Lynn Sowder MD FACS
Clinic: Seattle Plastic Surgery
Location: Seattle, WA
Website: sowdermd.com

That's interesting: Dr. Lissa Lynn Sowder is past president of the Northwest Society of Plastic Surgeons and the Washington Society of Plastic Surgeons, past chair of the King County Medical Society Grievance Committee and former Trustee of the King County Medical Society.

Your operating room is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF). How much benefit is there for a physician who owns their own surgical suite instead of using other facilities?

The headaches are staffing and supplying the operating room. Equipment needs to be maintained and replaced. Supplies need to be ordered. The floor needs to be mopped, etc. Employees need to be trained. There is a boat load of paperwork necessary for AAAASF certification. Just doing it all right isn’t enough – it all has to be documented and documented and documented. It’s expensive and time consuming.

Benefits include convenience and privacy for my patients, a cleaner environment than a surgery center or hospital (our surgical infection rate is very, very low), and a huge cost savings compared to the hospital. The hospital charges for routine cosmetic cases are about 5 – 10 times that of my operating room!  

Also, I’m always working with the same team and we “know the drill”. We are efficient with our time.    

One of the greatest benefits to running an O.R. is that I know what things cost. It helps keep me educated about health care costs. Many, many doctors have not a clue about costs. 

Last Thursday night, my beloved cat came home after being AWOL for 6 days. He had a HUGE abcess on his thigh from a cat fight. He needed emergency surgery in the middle of the night, IV antibiotics and rehydration, etc, etc. The bill came to $2,000. My husband about choked on a bill that I thought, or rather, I knew was reasonable based on the facility and the quality of care. Angelo, by the way is doing great and is almost back to his wonderful self. The husband, however, is still complaining about the bill.

You promote the fact that you're a female plastic surgeon. Does being a female plastic surgeon offer any advantages in appealing to potential patients?

Maybe 25% of my patients are coming to me based solely on my gender. And I have to say, that some of those patients have “issues” that can make caring for them difficult. 

I certainly understand many issues better than a dude every could – bra sizing for example and what a drag it is to try on a swim suit when the lighting in the Nordstrom dressing room makes you look like a blob of cottage cheese. I also have an advanced degree in motherhood and all of those issues. I have also had several procedures myself over the years and I really know what recovery is like. There are very few male plastic surgeons who go under the knife for cosmetic procedures. With dudes, money and power are enough. For women, looks matter a lot. 

I think I am a better listener than some, but certainly not all of my male colleagues. And if a patient is unhappy, I try very hard to keep my ego out of it and just work with the patient to try to get them to where they are satisfied with their results. I have had a few patients over the years come to me because their male surgeon said their result was as good as it gets and I really think the surgeon just did not want to admit that they could have done a little better.   

I also have the patience of Job which comes in hand for several procedures (fat grafting for example) but that is not really a gender related trait. 

I choose my own physicians based on their competence and communication skills, not on their gender. My family doc, my dentist, my plastic, hand and ortho surgeons (for various issues over the years) are all dudes. I haven’t had a female doctor for years. It’s not a big issue for me personally. 

I am, however, going to fire my male hair dresser. He’s just not into my hair anymore and it shows. I’m switching to a woman.

The CAST Liposuction seems to have a lot in common with other liposuction techniques. Have your results met your expectations?

CAST Lipo is really very technical in that only certain areas of the arms are actually suctioned and it is done, very, very carefully. Some on the arm circumference is just tunneled and this sets up contraction of the skin. CAST lipo is a technique that I was skeptical about but has overdelivered on results. The success of this procedure – like all procedures – is very dependent on patient selection and managing patient expectations. It doesn’t work on really saggy arms. It does work very well for fat, juicy arms.

Which nonsurgical technologies do you see being developed that might impact a plastic surgeon? What do you think of them? Are your patients inquiring about nonsurgical options?

I think Botox and the hyaluronic acid fillers – Restylane, Juvederm, Prevelle, etc – are fantastic. They allow facial rejuvenation with almost no down time and can provide very natural and lovely results. The HA fillers have allowed us to address the deflation of facial aging in a way that excisional procedures such as face lift and eyelid tucks cannot. 

I have started doing a lot of chemical peels to treat sun damage and am getting improvement that I can’t get any other way. A peel does not involve cutting but the recovery can be very, very difficult if the peel is deep.

As for things that don’t involve any down time – I think some of the new technologies have great promise. I am interested in Ulthera which may be a great way to tighten skin. I am not convinced that any of the non invasive treatments for fat are very worthwhile but I try to keep an open mind. The problem with all of these new technologies is that they are so expensive and usually the doctor cannot demo a machine for several cases and then say “no thanks” so once you have bought into it, you have to promote it and believe in it to get your return on investment. To me, it seems like one great big fat moral hazard. I’ve heard that 95% of “must have” gizmos are not even around after 5 years. That kind of says it all, doesn’t it?

I am personally waiting for the perfect non invasive method to slim fat, tighten skin and remove stretch marks. I’ll be the first in line for that treatment!

You've been successful in growing your practice, but what marketing mistakes have you made? What tactics didn't work?

Phone book ads are worthless now that everything is on the Internet. I have not spent a lot of time or money with SEO for my web site which is probably short sighted but all of this Google positioning reminds me of “Spy vs. Spy” in Mad Magazine.  It just escalates and escalates and eats up more and more time and energy. The best marketing is to do good work and be nice.

Where do you see the most competition from other physicians in your area? How do you position your clinic in order to compete with them?

I don’t mind going head to head with other plastic surgeons but it’s all the wannabe’s that drive me nuts. It’s just so crazy that all these non plastic surgery trained docs think that learning cosmetic surgery is so easy. They don’t know what they don’t know and that is very, very frightening. And the franchises like Sonabella and Liftstyle Lift and their misinformation about how easy it all is really gripes me. Both of those franchises have courted me but I have zero interest. I would not want someone coming to me for surgery because they thought I was the cheapest way to go or because they had been misled to believe that recovery from a facelift or lipo was a piece of cake. All of this is surgery, real surgery. I know. I’ve been on both sides of the knife!

What's the best advice you've ever received as a physician?

It’s nice to be smart but it’s really smart to be nice. And do good work.

About: Dr. Lisa Lynn Sowder  is a diplomate of the American Board of Surgery and the American Board of Plastic Surgery. She is a Fellow of the American College of Surgeons and a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the Washington Society of Plastic Surgeons, the Northwest Society of Plastic Surgeons, the King County Medical Society and the Washington State Medical Association.

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.