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More Than Skin Deep

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LEXINGTON Self image, like chronic pain, is felt, not seen. Poor self image and low self esteem that are debilitating can sometimes be reversed by a skillful and intuitive plastic surgeon.

As a plastic surgeon, David S. Kirn, MD, FACS, knows that there is more to cosmetic surgery than meets the eye. At his Lexington-based practice, Kirn sees many patients for whom cosmetic procedures mean so much more.

“What people who only see us on the outside don’t understand is that the cosmetic patient experience can be very powerful,” Kirn says. “There are applications that are absolutely life transforming. It may not make patients live any longer, but it certainly can make them live happier.”

Kirn grew up in Pikeville, Ky., and the couple next door happened to both be physicians, piquing his interest at an early age. He graduated from the University of Kentucky (UK) with a degree in physics and then attended the UK College of Medicine. He worked as a computer programmer for the division of plastic surgery between his second and third years of medical school. He quickly fell in love with plastic surgery and ultimately accepted a position with the aesthetic surgery practice of William Dowden Jr., MD, FACS, in Lexington. The two practiced together for 13 years before Kirn started his own practice in 2011.

The majority of Kirn’s current practice involves surgeries, but he also performs injections and laser treatments and works with the Aesthetic Skin Care Center, in the same building. He estimates that half of his practice is facial surgery and the other half is a mixture of breast and body contouring.

Kirn serves as the medical director of the Lexington Surgery Center, is certified by the American Board of Plastic Surgery, and is a member of the American Society for Aesthetic Plastic Surgery. He estimates that 90 percent of his patients are female but says cosmetic surgery is becoming more common in males. The most common procedures men seek out are for their eyelids or necks. “For career reasons, many individuals want to look youthful,” Kirn says.

One of the challenges in meeting patient expectations is determining the best method of treatment. With a large spectrum of options and new treatments emerging almost daily, there is not always a clear choice. Kirn says his patients tend to be well-educated and well-informed about their options before they arrive for a consultation.

“Our patients are really smart,” says Kirn. “A great example is Botox in the late 90s. A patient brought me an article about it and it was counterintuitive. You’re telling me I’m going to paralyze muscles … on purpose? But we got a vial, and it was miraculous. So we were doing Botox years before it started becoming very popular.”

Cryolipolysis is a newcomer generating a lot of buzz. The fat-freezing procedure is being marketed as a non-surgical way to get the results you want, but Kirn warns that even if it works, it might not be the best solution. “It probably does work,” he says. “I saw a report that indicated a result of about a 40cc of fat per area reduction in each zone of treatment with the cryolipolysis system. But if you were doing that area with liposuction, you would have probably taken 400 cc’s out. So does it work? Yes. Is it genuinely effective and will it make you a happy patient? Maybe not.”

A more impactful, recent addition is Exparel, a long-acting numbing medicine used on breast augments and tummy tucks. The numbing effect lasts about 72 hours, reducing the amount of narcotic pain medication that Kirn’s patients need during their recovery. Also new is Kybella, a fat-dissolving treatment used to eliminate double chins. “I’m intrigued by it, and we will stay on top of it to maintain our position on the cutting edge,” Kirn says.

Doctor, Inventor, and Tinkerer

Kirn also stays on the cutting-edge in his machine shop. There, the self-proclaimed “lifelong tinkerer” has invented a number of medically-related items, including arm rest boards for operating room tables and a skin cooling device for pre-injection cooling.

Kirn proudly claims that his most successful product is a bridle system to hold feeding tubes in place. Kirn developed the AMT Bridle™ over a decade ago after being inspired by a patient who came to him after being injured by an improperly taped feeding tube. Kirn’s bridle holds the feeding tube in place with magnets instead of taping it on the nose.

He stresses that his inventions are completely separate from his practice. Any testing is done adhering strictly to the highly regulated standards for medical devices.

High standards drive Kirn’s practice as well. He strives to reduce appointment wait-time without sacrificing the time it takes to understand a patient’s desired outcomes, explain their options and select the optimal treatment plan.

“I absolutely refuse to cut corners in the consult time to increase work flow,” Kirn says. “It’s that relationship with the patient that matters. Each surgery is very customized to the patient.”

And just might help them live happier.

The thought of Botox in the late 90s was counterintuitive. You’re telling me I’m going to paralyze muscles … on purpose?

Board Certified Plastic Surgeon devoted to advanced techniques in cosmetic surgery of the face, breast, and body

DAVID S. KIRN, MD, FACS 2376 Alexandria Drive Lexington KY 40504-3229 859.296.3195