Ep.112: Interview with Dr. Andres Gantous

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Welcome to "Beauty and the Biz", where we talk about the business and marketing side of plastic surgery.

I’m your host, Catherine Maley, author of "Your aesthetic practice - What your patients are saying", and consultant to plastic surgeons to get them more patients and profits.

My guest today is Dr. Andres Gantous. He's a double-board certified facial plastic and reconstructive surgeon, in private practice in Toronto, Canada. ​

​He specializes in revision and reconstructive rhinoplasty as well as incisionless otoplasty.

Dr. Gantous is an Associate Professor and Head of the division of Facial Plastic and Reconstructive Surgery at the University of Toronto where he has earned their“ best teacher award” nominations year after year.

​He also speaks at medical conferences all over the world and that’s how our paths crossed.

​Welcome to Beauty and the Biz Dr. Gantous. It’s a pleasure to have you.

TOPICS OF DISCUSSION:

BUSINESS:

​✅ Let me start by asking if you are enjoying the surge of cosmetic patients like we are experiencing in the states?

​ ​✅ Why facial PS?

​ ​✅ Journey from academia to private practice

​ ​✅ Buying another surgeon’s practice:

• Why that practice?
• How was it valued?
• Transition period
• Do differently?

​​ ​✅ Private SX facility at The Cumberland Clinic in Yorkville, Toronto (how far from your practice?)

​ ​✅ Staff – manage & motivate

​ ​✅ Business Mistakes

​MARKETING:

​ ​✅ How do you differentiate yourself?

​ ​✅ Your Website shows art instead of models? Your Art?

​ ​✅ 3D imaging – PTS upload photos + virtual

​ ​✅ $175 consult fee displayed

​ ​✅ % of Face vs rhino – Different target markets

​ ​✅ Surgical vs non-surgical

​ ​✅ Tweak-ments

​ ​✅ Marketing – What’s Working? = Social Media

​ ​MINDSET / PERSONAL:

​ ​✅ What’s DRIVING you?

​ ​✅ Mentors, books, courses?

​ ​✅ Hobbies include painting, drawing, martial arts, reading and fluent in Spanish, Italian and French.

​ ​✅ Dog Arthur

​ ​✅ Words of wisdom for other practices?

​ ​✅ Something interesting about you?

​
To contact Dr. Gantous, or to learn more about his practice, visit his website at:

www.TorontoFacialPlastic.com

Transcript:

Interview with Dr. Andres Gantous

By Catherine Maley

August 4, 2021

Catherine Maley, MBA

Hello, and welcome to Beauty and the Biz, where we talk about the business and marketing beside of plastic surgery. I'm your host, Catherine Maley, author of Your Aesthetic Practice - What your patients are saying, and consultant to plastic surgeons to get them more patients and more profits.

I have a very special guest today. It's Dr. Andres Gantous, and he's a double board-certified facial plastic and reconstructive surgeon in private practice in Toronto, Canada. And he's also the associate professor of head oh, professor and head of the division of facial plastic and reconstructive surgery, at the university of Toronto, where he has earned their “best teacher award” year after year.

Now, Dr. Gantous also speaks at medical conferences all over the world, and that's actually where our paths met. I think we were in a few places. I remember Vegas. But welcome to the podcast. Welcome to the Beauty and the Biz podcast, Dr. Gantous. How are you?

Dr. Andres Gantous

I am well, Catherine, it was very nice to be here with you and seeing you again after, you know, not having any conferences for a while, but it's a pleasure, pleasure to be here and to see you and to talk.

Catherine Maley, MBA

Thanks so much. So of course, before we get started, I have to ask, are you enjoying this same cosmetic patient surge that we're enjoying here in the states? Are you enjoying that also in Canada?

Dr. Andres Gantous

Absolutely. We also have the same surgeon, Canada, at least in the larger cities, as far as I know. I think all my colleagues in the field have noticed it and it's been great.

So, of the bad things of the pandemic, that's been one of the good things for us, at least, and hopefully for the patients as well.

Catherine Maley, MBA

Isn't that amazing. I mean, I've been through recessions with the plastic surgeons because I've been at this for a long time. And usually, plastic surgery was one of the first.

You know, the first industries to get hit. And this time it looks like all the money went over to cosmetic rejuvenation rather than travel and restaurants, I assume.

Dr. Andres Gantous

I think, I think we can owe it all to this, to this media, which assumed

Catherine Maley, MBA

thank God. Okay. So, I hope it lasts too. So, Dr. Gantous., let's just start at the beginning.

How did you end up in facial plastic surgery versus any other specialties?

Dr. Andres Gantous

Yeah, good question. I you know, Even before I went to medical school, I want you, I want it to be a doctor since I was a little kid, but I come from a family of architects on both sides on my dad's side, on my mom's side. So, I was always very, very in tune with, with the arts and with design and things like that.

And as a matter of fact, when I finished high school, we had to do mandatory vocational testing and you know, I had. I wanted to go to medical school. And in Latin America, you go to medical school straight from high school. You don't do a pre-med degree. And I already was accepted. So, the, the lady who, the psychologist who did my test and he told me, well, You know, and the only reason I'm going to recommend for you to go to medical school is because you score the highest on, on BI examinations.

But you know, you really should consider going into graphic designer architecture. So, I've always had that artistic side to me. So, once I was in medical school, that didn't take very long for me to realize that I wanted to be a surgeon. I really. Needed to express things with my hands, with that.

That's what, what, what guided me. And I think that's always the first divide for most medical students are doctors to be as whether you're going to be a surgeon or a medical person or a pathologist or radiologist or something. I'm like, wow. So, for me, surgery was, was the, the thing that, that really guided.

And then as I started doing my internship and I'm old enough that we had to do rotating internships. And so, on before you got into a specialty training, I realized that I liked plastic surgery and I thought I was just going to do a general plastic surgery residency. And then I started working. I wanted to train in the states.

I, you know, I grew up in Latin America and I, I worked with, I worked with a head and neck surgeon that had trained at Manhattan eye and ear, and he did a lot of facial plastic surgery. And I realized that I sort of liked that a lot. And I'll say one, two, when I went to train in LA, I decided, well, I'm I going to do either plastics or had a neck surgery, whatever I get into first.

And as I did my rotations, I decided I'd like had a neck better than general plastic surgery. I really didn't like a lot of the hand stuff and some other stuff, other stuff. And I like most of the stuff and had a neck. And that's why I ended up in that's in this specialty and always would be with the plan of doing facial plastic and reconstructive surgery.

So, it's kind of a long process, but I think it has to do just with my innate artistic bend that I've always had and the things that I, that I like. And that's the, you know, it ended up being the perfect fit for me.

Catherine Maley, MBA

Okay. So, did you start your career in academia? Or how, what, what did you do

Dr. Andres Gantous

next step after, after training, after training in the in the head and neck are involved, you had a neck program in Toronto.

I did a, I did a fellowship in cranial facial surgery with the plastic surgery department here in Toronto as well. And then the question was, you know, whether to go straight into full academia or have a combined community academic practice. I ended up, I ended up choosing the latter, so I've always had an academic appointment.

And, but I worked in a. Partially affiliated teaching hospital that became a full affiliated teaching hospital eventually. But I like to have, I ha I wanted to have a little bit more freedom than being a full, full academic, but with that, obviously teaching responsibilities were always set there about residents and, and fellows and things like that, all along medical students.

But at the same time, I was able to develop a little bit. Of a private practice on the side. Canada is a little bit different because, you know, we, we have socialized medicine in reality. So, so whatever it's not cosmetic is, is a government run. So, you know, we, we I've always had that opportunity to do a little bit of both.

And, but yes, my, you know, my academic appointments and my, you know, still exists. You know, gone through the ranks a little bit over time, but it looks combination of both since the beginning more academic and one at the start and then, you know, switching over with as I get older and a little bit more.

Great.

Catherine Maley, MBA

All right. So how much of your practice is private versus.

Dr. Andres Gantous

At this stage in my life, probably 80% is private and 20% is government right now. Very nice balance. I like it very much. I think I'll probably end up going to 90 10 and in the next couple of years and we'll see how that goes after that, but government practice.

Unfortunately, even though there's a lot of rewarding stuff in what I do there as, as usual bureaucracy gets in the way, and it makes things a little bit less pleasurable.

Catherine Maley, MBA

I get those calls quite regularly saying, I don't think I can take the hospital setting any longer. I can't do anything here. My hands are tied.

I feel so deported, you know, so but it's really tough. I can imagine to jump from. Peace of mind of having that salary and having that hospital backing to going out on your own. What, what kind of mindset did you have when you were saying to yourself? Like how long did it take you to say I've got to, I've gotta have more than just this equity.

Dr. Andres Gantous

Yeah, it took me a few years. I'll tell you about my chat took me a few years and it was, I did it slowly. Right? I did it slowly. I started building up my private practice, little by little, I ended up you know, ended up, you know, growing, growing that part of the practice a little bit more You know, trying to get a second space, a second office that I could, that I could work at and not combine it with a hospital practice too much.

And so, it probably, it was a transition period in my then the mindset part is a transition period that probably took, you know, anywhere, anywhere from five to 10 years to. To, to do that. Right. And until, until then I was kind of able to take a full jump. I think a lot of it, it has to do with that financial stability and other commitments.

Right. I mean, I didn't want to do a whole lot while I was what I had big financial commitments in terms of education of my kids, mortgages, things like that. I didn't want to sort of suddenly find myself, you know, not, not being able to pay that. So. That, that, that I think plays a big thing in the mindset as to how you do things.

For

Catherine Maley, MBA

sure. And, and eventually you have to decide and jump, you know, you have to make the best of it. There's that saying? You know, nothing happens until you decide. And then I don't know if there's some kind of saying for that, the part that here's the, the most interesting part that I know the audience will appreciate.

When I met you, you were You were speaking at some meeting and I was introduced to you by another surgeon. We both know. Well, and he said, oh, meet Dr. Again too. He, he just joined my practice or bought my practice. I can't remember now, but to give me that, because that's another huge one that it's another transitional time in your career where you say to yourself, okay, I have private practice, but what is this it or what's next?

And you happen to train. Yeah, so let's tie

Dr. Andres Gantous

that's. Exactly. And that's why really, really, that was the big leap. I had, I had rented a space and use the space in, in what is this office now from the other surgeon that we both know? It was a very well-respected academic and private medicine. A surgeon in Toronto, one of the fathers of facial plastic surgery in this country.

And you know, I use, I used to, I rented space from him that this was the, where, where I was developing that private practice. It was what worked the best for me. And you know, he, he basically informed me, you know, gave me a timeline for his retirement. He was going to close shop. And you know, he was putting his practice for sale and he asked me what I would be interested.

So, I obviously, you know, was interested, although I was very, a little bit reluctant and, you know, economically and financially, I was trying to serve, figure out what was this going to be a good thing or not? And, you know, make a long story short. I mean, we, we met, we, we agreed on terms. I got the financing that I needed and I.

You know, just jumped on board. Right? So that, that was really the best decision I've made. And you know, most of my professional career in terms of how things turned up out, but it could have gone either way. Right. But I had the confidence that it was going to work well. And it, it was just the way we did this, that made the huge difference.

Catherine Maley, MBA

So how long had you been in that practice before this house?

Dr. Andres Gantous

I had, I had been, I had been in this situation, you know, working in, in this office that we were, we weren't working together. We're not as soldiers right there that I just rented space. I paid him for, for space, for secretarial work and Swan.

I had my own practice coming here right on the days that he was in the door. I could be here because nobody would know what he was using the office. And probably, I probably had been doing that for about 10 years.

Catherine Maley, MBA

Oh, okay. So, the big question is how do you value this practice? What are you buying? Because that becomes a very big question.

When it comes time for money to change hands, you know,

Dr. Andres Gantous

Yeah. So, so that, that, that's a, that's a good question because medical practices, as opposed to the United States and Canada are never sold, right? Because you know, the government practice that says you don't need selling, you can, you can hang up your shingle and you're going to be busy in two seconds.

You know, with, with government covered things. Whereas, you know, cosmetic practices that are private are not often put up for sale symptoms or disclosed. There's not some market that, that hasn't been, it really hasn't been tapped into too much. Right. Most of the surgeons that I know will have just retired, some have tried to sell at exorbitant prices and nobody bites.

So, what happened in this case is that The, the value of the practice was based on not the surgical practice, because to me buying a surgery practice doesn't make much sense because. You know, how, how do you, how do you, how do you assure that people are going to come and have surgery with you? Right.

But the new, the other surgeon and most of those people had already had had their operations. So, it doesn't make much sense. So, this surgeon had a very, very big filler and a neurotoxin practice. So, there was, it generated quite a lot of money a year in terms of that, it was a big, big practice with that.

He did all his injectables himself, had a nurse and that helped him with that. So that is something that we agreed that had value, right? Because he, we thought that probably a good 80% of the, of that patient population would come and still come and have their injectables done because that's something a little bit easier too, to have confidence in somebody else.

So, so that was about that. That was how we value that practice and how we made the purchase with certain agreements, of course, of how that was going to happen, which are very important.

Catherine Maley, MBA

Did you, did you take over the lease? Did you buy a building? Did you buy the furniture? Did you buy the patient?

Dr. Andres Gantous

Yeah. So basically, what we did is I took over the lease of the of the office space.

I made you know, we made a commitment that he was gonna stay on for, you know, at least six months. And he did have stopped his surgical practice. So, the agreement in general was I was going to take over the, lease the salaries of the employees, or I wanted to retain. And I retained all the employees except for the esthetician who had decided to retire as well.

So, I hadn't re I didn't replace her until very recently. And basically what, what we did was that he stayed on and, you know, he paid me rent, right. And he paid me from work for the consumables and stuff like that. And he paid. So, we, we, we switched, you know, complete opposite as to the arrangement that we had exactly the same.

Right. So, he gave me a small percentage of what he was building to cover for, you know, secretarial and, and, and rent. And but. And on top of that, the agreement was that he dreamed that six months he was going to introduce me to the patients that I sent Jack. So, I would take, yeah. And that was, that was the key element, right?

So, the days that, you know, at least once a week or two half days a week, I would come over and I would meet. And he would introduce me to his patients as he was you know, I got to meet them. I got to see how he injected them, how he did things a little bit different than what I did, how I did things.

And but I got to know, I got to know that people with that came the Goodwill part and the Goodwill part was the surgery. So, he had a busy surgical practice. I didn't buy his surgical practice, but there were patients that are still coming and calling the office. So, You know, in that, in that in, in that first six months I operated on, on.

You know, probably 50 patients that were not patients of mine, but there are patients of his that were coming back and, and he said, now Dr. has taken over. I'm not doing any surgery and there you go. So, so that was an incredible asset to me. Right? Because you, you know, that is something that I, that I, that I was able to monetize very easily to take that transfer that amount of Goodwill into something that was concrete.

And in the meantime, getting to know his long-term patients that were coming, you know, on a fairly regular basis for injections, and these are the type of patients that do keep, keep on coming back, we had estimated about 80% retention, and I think it was more like 95% retention. I think we've had over the three years since I took over, I think we've had two or three patients that have requested their charts to go elsewhere.

Okay. Good for you too, Ben. Fantastic. Yeah.

Catherine Maley, MBA

That Goodwill piece is not talked about enough and not focused on enough, but it's transference of credibility. His patients have to know that you are the next best thing to him. So, I highly recommend when during our transitional period, I would even get it in writing that you'll do videos together.

He'll do Instagram together. You'll he'll, he'll introduce you in creative ways to just constantly. From him to you, you know, because you really need those patients to stay put. Did you like his kind of patients or did you want a different demographic? Was there any,

Dr. Andres Gantous

yeah, I, I truly like his patient. I mean, he, he had, he had the perfect patient population, right.

He had patients well-established or Antonians with a lot of old money elites of every sword. Right. So, it's the type of patient population that he built a life. Building being a native Torontonian, being from, you know, the right circles. He built this practice over, over a lifetime. And so, I was very lucky to be able to keep that type of practice.

Right. I mean, I, you know, I, I, I like my own practice that I had, which. Blended it and folded in very nicely. You know, I have, you know, I had a little bit of a different demographic and I had and I still have patients from, you know, a little bit more multicultural in, in stream sense, but the patient population that I inherited for him was great.

They're very loyal customers. They. They come back. They, you know, they, once they like you, they like you, you can't do anything wrong. So, it's, and you know, and they have the means to, to purchase the services at a level that I wasn't used to.

Catherine Maley, MBA

That's what you get from that you see, you can, up-level your mindset.

Yeah. And your demographics, you know, when you hang around with somebody else who had done that, he showed you the way and you took it so good for you. Yeah. Did the staff, let me talk about the staff for a second because you say that you retain this. Which can be fantastic, but it can also be a train wreck when they start saying that's not how we used to do it.

That's not how we do it. Was there any of that or was that I at all?

Dr. Andres Gantous

It was great. It was great because he had put his stuff on contract for the last couple of years. Right. Just he had done everything. He had announced his retirement plan. So, he did it all legally the way it was. And then basically when, you know, I, I had a talk with all of them beforehand and I asked them whether they were willing to stay.

Right. And at that point, the esthetician sort of said, well, I, I, you know, I think I'm going to retire as well. And that was fine. Right. So, I didn't, I didn't ha I didn't replace her immediately because I, I wanted to have a little bit more comfort that this was gonna happen and it was gonna work the way I wanted it to work.

Right. So, I had a good chat with all with all of them. I, you know, and I knew them because I work here. Right. So, it's not like I was an unknown person coming in. They knew me and they knew they knew he did things a little bit different. So, it was no problem. I, I, you know, we, we did new contracts on them and it was, it was very funny because my, my our, our assistant, the office you know, I say the stent, you know, the receptionist, she still has feisty, you know, little Italian Argentinian woman and yeah, very young, very, very pretty.

And she. This one switch allegiances like this, like this, the moment, the moment. I signed; I paid her first paycheck. If I was, that was it you know, do I have to do that for him? She would ask me, I go, yeah, he's, you know, he cared for him for many years. You're still going to do that. So, so it was great.

And our nurse I've also known for a long, long time and she was great and, you know, she nicest person in the world. Right. So, so it worked out very well. I had no issues with staff. No issues with bringing in new ways of doing things. And I changed things right. You know, I brought my EMR into the practice, which, you know, he didn't have right.

We started switching things, doing little things like that. And, you know, so it worked very well. And then, you know, I brought a little bit more technology into, into the, into the practice that that was missing. So. Other than that, you know, our styles are not that different in terms of how we treat patients, how we do things, how we treat people.

There's not a whole lot of difference in that. I think I like to think we're both very nice guys, so

Catherine Maley, MBA

right. I think you are. So, when you look back at that whole period of transition, is there anything you would have done differently or recommend others do. If they're thinking about doing

Dr. Andres Gantous

something like that?

Not really. Not really. I mean, I it, it was so smooth and it worked so well that I had, I had no issues with that. Right. I, you know, I don't think I would have done anything different. It worked the way I expect it to work. The, the money that I paid for the, for the practice, I mean, And the first year.

Right. So, yeah, so it was not there was nothing that could have gone, you know, any better than, than what it did. I don't have any regrets whatsoever and I don't think I would've changed anything. I did. I did, again, I would've done the same thing. Right. Does it the same thing, you know, I just, I just want it to change.

I just wanted it to change the physical space a little bit. I wanted to tune it up a little bit and I really do. You know, I probably would have done that a little bit sooner, but I, I let the doctor stay in his office here for a little bit longer than I probably would've because he, he was, he was having some issues at home in terms of their youngest daughter, having some issues with w with renovations of her house and they had full house.

Couldn't move all the stuff out at the time. So, one, a little bit longer than expected, but I did not want to sorry about that. I did not want to start doing any renovations while he was still, you'd

Catherine Maley, MBA

have to close up shop while you renovated, or did you practice during the renovation?

Dr. Andres Gantous

She did.

I did. I did close. And it took me a while to do it and then COVID hit, I was kind of doing it a little bit earlier and then. You know, I just, I just wasn't able to, I, it took me a while to get the right contractor, then, you know, we have the design done and, and so on. And so that, that it's a process. It takes, it took about a year longer than I wanted to do stuff.

And then I close for three weeks. We got the place, but it was, my contractor was very good. So, I close for three weeks. I took a little space next door that was at dentist hat that they let me put some of my stuff. And I, I saw, I saw patients one week and then I just kind of closed the rest of the time.

I think that I was going on a trip someplace as well anyway, so it didn't make much difference, but yeah, yeah, they, you know, you, don't, it's impossible through our renovation of this magnitude without. Without closing shops or moving someplace else. Right.

Catherine Maley, MBA

For sure. So, let's talk about marketing. Is your practice, is it in a competitive, is Toronto as competitive as New York, Miami, Chicago?

Dr. Andres Gantous

Well, I mean, it's hard for me to say, right? I mean, it, it is, it is a competitive market, right? We have the same, the same competitiveness that Americans do in terms of. Facial plastic surgery, plastic surgery, dermatology, you know, now a little bit more, you know, oral maxillofacial surgeons and so on. Plus, all the, all the, you know, the family doctors and, you know, non-nonmedical personnel offering cosmetic services, you know, and, and injection injectables and fillers and so on.

But from a surgical point of view, it, it is a competitive market. There's no question about it. People shop. Shop around. They, they, they go, they see multiple surgeons and so on. The, so, so we are, we are we are in that, in that type of a market as well. It's, you know, it's the biggest city in Canada and, and the, and the most populous city in Canada.

So, so we, we would be you know, probably more the size of a Chicago. Right. But probably more, I think, I think we can compare more to Chicago than anybody else. Any others. What weather-wise and population wise and so on. What is the crime?

Catherine Maley, MBA

Oh, that's easy compared to Chicago. I'm actually from Chicago and I'm glad I'm from

Dr. Andres Gantous

there.

I love Chicago.

Catherine Maley, MBA

Then the news makes it look like it all burned down, but it used to be a lot of fun there. Yeah. I liked it a lot.

Dr. Andres Gantous

Yeah, exactly. Yeah.

Catherine Maley, MBA

So, when I was, when I was researching you to do this podcast, It looks like you like to differentiate yourself with revision, rhinos, and most doctors run for the Hills with the, with primary rhinos, let alone revision what that is a tough group. So how, why would you do that and how that.

Dr. Andres Gantous

Oh, that goes very well. I mean, the reason I've done it, the reason I did that is one I one, I mean, obviously I'm confident in my abilities. Right. But I understand the reason why doctors don't want to do it. Because, because of my academic background and the fact that I've done a lot of reconstructive nasal work and I still do, that's one of the few things I still do.

You know, very, very, very tough cases, paces with granulomatosis with cocaine gnosis accidents cancer, stuff like that. You know, I feel comfortable doing that, that type of difficult case. And then it happens that at the end of the day, If there's not enough people that are doing revisions in, in your community, somebody has to do them.

So, it is something that, you know, comes my way. A lot of my colleagues that are well-established just don't do them. They, some, some don't even revise their own noses. So, you know, it just, somebody has to do it in my opinion, and you know, this challenging it, it can be very gratifying. It can also be, you know, you pull your hairs and you wish you never had touched that patient.

That's a problem. Right. But you have to have a little bit of a thick skin and you'd have to know how to manage people. And you know, that's, that's one of the issues. That's one of the reasons I was slightly late today is I had a, a patient for a revision nose that wouldn't leave the office. We tried everything.

Catherine Maley, MBA

How many revisions will you do on one day?

I mean volume and say three or four already. And now I need Dr. Gunn to still take care of it. Where's your

Dr. Andres Gantous

country. I think, I think, I think what it comes down to really is, is what. Not so much the number, although the number is important, right. Because of the tissues. But I don't focus so much on the number of revisions they've had before us as to what the tissues look like and what the patient feels they want.

And whether I think I can help them right. With the necessary tools. So, you know, there are, gnosis where you just know you can't do anything for them, or they may have had only one operation or. Or to operations and what they want is not achievable. Right? So those are the ones that I will just stay away.

Whereas I've had patients that have had seven or eight procedures on their nose. Right. But you know, what they want is reasonable. Right. And there is a chance that we can achieve it. Right. And to be honest, I haven't regretted operating on those patients. I, you know, they, they don't, they may not turn out excellent or, you know, even very nice looking, but.

Just changing a few of the things that bother them, makes them feel like, you know, they have a new lease on life and, you know, they, maybe it's just breathing a little bit better and maybe it's just correcting one feature that was bothering them tremendously. And that's, that's, that's the thing. Now, when you have somebody that you've read that I have revised and.

Then they want a little touch up for something that I don't think I can get. I'm not going to do it. Right. I will just tell them that's enough. That's all I can do. So, so it, it is a problem for us, right? The number of operations that they had. But like yesterday I operated on a patient that I revise. I revised a few years ago and she had had already four operations and I revised my revision yesterday.

Right because she mostly, because what happened was that she had a mild infection and one of my graphs didn't survive as well as I want. And she had the effects of that. Nothing bad, but she shortened a little bit more and rotated a little bit more than that. Then she, and I want it. So, I just revised him and she did very well, but she was very reasonable as to what she wanted.

So, her tissues were in pretty good condition regardless. So, you know, I knew that we could, we could help her. So, I know I can do something that is going to help them. And, and we're on the same, on the same page, right. As to what the resources are going to be, I will, I will consider doing.

Catherine Maley, MBA

Well, your reviews are great.

So, you don't, you seem to be having an issue with that, but those patients can be tough when it comes to online reputation. They're the first ones to get on there and, you know, set up websites, you know, telling how awful you are. So, and you haven't had that. Congratulations. You're doing a good job.

I

Dr. Andres Gantous

haven't had, I haven't had a website against me, but I have had a lot of bad reviews.

Yeah. So not too many, but you know, you, you always have a patient that, and to be honest I, I've never had a bad review from a medic patient. I've only, you know, the people, some of the, the, the few bad reviews that I've had have been from. Cancer patients or reconstructive surgery. Patients are usually very grateful patients, but now, and then you get one that just doesn't get it.

Right. And but that's the, you know, it's, I've been a little bit lucky in terms of that compared to some of my colleagues in town.

Catherine Maley, MBA

Yeah, well, maybe you're selecting the right patients too.

Dr. Andres Gantous

Yeah.

Catherine Maley, MBA

Let me ask you about the non-surgical rhino that has taken over on social media for sure. And the younger people.

How is that fitting into your practice?

Dr. Andres Gantous

It doesn't really fit into my practice very much. I mean, I, I do very few primary. It's like non-surgical rhinoplasty side. I have a few Oriental patients. Find that they're reasonable and they're you know, they, they, they seem to be, seem to understand the risks and, and what they want is reasonable.

So, I I've done it, a few girls with big coms that are waiting to have surgery and, and I know their families or, you know, their families are patients of mine, so I've done it, but it's not something that I advertise. The reason is that you see too many problems. There are, there are complications.

There are. Issues with that. And doesn't mean that I don't use fillers in the notes. I do use failures, particularly on revision. Gnosis right. Sometimes there's mild imperfections that we can fix perfectly with that. And that can be my revision gnosis and my patients. And I will offer them little fillers to, to help camouflage some stuff.

And I think in that, in those circumstances, that very good choice as a primary thing, you know, some people do great job with it. They make the no slip. I I'd rather do surgery.

Catherine Maley, MBA

Gotcha. Okay. And what about the aging face? Rejuvenation. Are you I'm on your website? You're showing it, but it feels like you're still very much into the rhinoplasty world.

Do you do

Dr. Andres Gantous

both? I do. I do a lot of rejuvenation surgery. It's I like it. I like rhinoplasty the best. It's the most challenging operation. A real thinking man's operation. It never gets boring. They're all different rejuvenation surgery is sprayed at pace with pace. Well, it's patients are usually very happy.

They don't give you any grief, like rhinoplasty patients, right? So, it's, it's, it's great. I find it a little bit boring at times, right? Is there some, they can be tedious longer operations, right. And there's not a whole lot of creativity into it. But I do it. I mean, I, you know, I do we, we have obviously an aging population in Toronto, you know, the patient population that I, that I inherited into this practice is patients that have I've, I've done, I've done a lot of revision facelifts on patients.

Were done by the surgeon that I brought the practice from 25 years ago. Right. And they've come for their second or third, a facelift. So that's great. I don't mind doing that. And we do quite a bit. We do a lot of ice and things like that. So, browse and next and you know, submentoplasty so, so it's quite a lot of that.

I am, I am well-known for the rhinoplasty and that's why it's a big focus in, in. In, in my practice and this also something that distinguished me a little bit from a lot of my competitors.

Catherine Maley, MBA

Well, and that's the secret to marketing you externally market to be the specialist in something. And then you internally hang on to them for all sorts of other things, but getting well known for one procedure is the way to go in.

What about on your website, you've got the 3d imaging and I love, love, love your the way you have it set up. So, you have 3d imaging, you're encouraging the patient to upload their photos and then reserve a consult or a virtual consult with you. And do you, and you also charge 1 75 for that consult.

Is that, do you charge 1 75 for the virtual, the. Yeah,

Dr. Andres Gantous

it's the same price. It's same, same, same. I mean, you know, I, I prefer to do a live, in-person consultation. Right. And you know, We, we got better during, during COVID at doing virtual consultations. Right. And we all, we all had to learn. So, we, you know, people, people still ask about it, even though things are tying back to normal, people still ask about it.

But I do get patients from all around Canada. So that's why, you know, we do a lot more virtual stuff. With the with the 3d, you know, this part into, into the system that I have, they have the 3d virtual consultation on stone. So, you can do it. It works pretty well. It's fairly seamless. So, so we do offer it or, or we just do it in the office when people are here with them, we'll just do it.

The 3d or 2d in some cases, imaging, depending on what time constraints and what people want. Right. So, all technology has had limit, right? So 3d imaging is great when it works well, but it doesn't always work. Great. So sometimes we'll elect to do a 2d imaging and on my iPad on I'm pretty quick about doing that and works.

Sometimes it looks better than the 3d images as far as I'm concerned, but whatever the patient wants, right. That I'm fairly flexible.

Catherine Maley, MBA

But from a marketing perspective in today's world, when you're throwing yourself out into the universe. And trying to get sales leads from that, you know, it's just such a bag of tricks.

Like you're just, I, you, who knows what you're going to end up with. So, I love that you have put up gates. So, it's very on your website. It's very obvious that you love art. You don't use models, and I love that as well, use artwork instead. And then you let that a prospective patient upload their photos, schedule the consult.

They're going to pay the 1 75 that already you have set yourself up for. So much more success than had you just said, oh click here for a free consult. And now you've got everybody in their brother, so you can have 100 leads coming in. And maybe if you're lucky, one of them converted. Whereas in your case, I guarantee you're converting a lot of those or way more than you.

Having not put up those fences.

Dr. Andres Gantous

Sure. Yeah. Yeah, no, that's, that's very true. We do, we do have a fairly high conversion rate, which is nice. And yeah, I mean, I'm, I'm happy with that website and I mean, I'd find it to be a, a good reflection of who I am and how I do things and you know, so, so that's it works well and you know, every, every little thing like that, as you say, it helps, it helps create a.

Create a persona, create an online persona, create an image of, of what you're offering. And so on. At least you hope it does right.

Catherine Maley, MBA

Well, it's different. What else do you do to market yourself or, or do you not have to anymore? You're not resting on your laurels. I hope because world is changing very quickly.

I noticed you're not big on social media. What are you doing to keep this?

Dr. Andres Gantous

I don't do, I don't do a whole lot of social media. I mean, I do, I have my Instagram account. I have a personal one. I have applied practice. I'm not a big poster. Right. I, you know, I, I will post things when I think are important and Swan.

Part of it is just being busy and not having somebody doing it for me. And you're always gonna modeling. Should have you have somebody else do it. Right. Most of the marketing comes through the website and, you know, my, you know webmaster and they, they, they, they tend to do a little bit of stuff on, on Facebook and, and different media.

You know, we have a newsletter it's up come out. Right? Those, those attract a lot of patients, right. And they, we promote different treatments every month and introduce staff and, and new procedures or whatever we may be doing. So that, that seems to work quite nicely. And it's just a fairly non-intrusive.

We don't do too much. We don't send, you know, once a month that say it right. We let people. Sign in or sign out of that. And we respect that. So, so we're, we're very, non-intrusive we try to keep things as, as classy as possible without, you know, over-broad and people with information and unwanted emails or ads or things like that.

So that's mostly, mostly what I mostly what I do. Right. I don't talk, I don't, I don't put too much money into it. Right.

Catherine Maley, MBA

But there's such a challenge there because others are putting the money into it. PR marketing themselves with, with no shame, you know? So, you always have to think about

Dr. Andres Gantous

that. Absolutely.

I'm always thinking about it. I think, you know, at this stage of my career and so on and you know, I, you know, I have a reputation. I, I, you know, I have you know, not just Joseph with patients, but also with colleagues across disciplines and that helps. Right. And also sort of being still involved with the university and being head of the division of facial plastic surgery that carries, you know, a lot of pinash in some people's minds and inpatients and other doctors and so on.

So, I do get a lot of requests because of that. So, I'm, I'm lucky in that way. I mean, things have, have progressed to in a, in a good way. And sometimes I look at, I look at some of my colleagues who spend a fortune in advertising. Maybe they have a few more patients that's for sure. Maybe they have. But I don't know, at the end of the day, I look at what you're taking home.

Right. And, and how you live your life. Right. And if you have 20 staff versus three or four staff and if you're spending X amount of dollars a month versus a smaller X amount of dollars a month, It's going to affect your, you know, the bottom line. Right. So, advertising more and having more patients doesn't mean that you are actually more successful.

Right. And so, I I'm, I'm very happy with how things are. I, I can only do so much as well. Right. I can only do so much operating. I can only see so many patients, right. I'm happy where things are, right. We not, not Tom, you know? Sure. You always want to be a little bit busier. Maybe you want to have a, you know, a little bit more than, than this, but I sometimes just, when I, when I find myself thinking too much about that, I sit myself back and I just kind of think of what I, what I have, what I do and what I really want to do something very different than that kind of calms me down a little bit.

Catherine Maley, MBA

I think you just have to know yourself. Some I've watched surgeons building the castle, you know, and they've got the 30 plus staff and the overhead is killing them. Or. Or they're really good at it. And they have built, you know, a really smooth operation, not many have though you have to know yourself because I'm so certain surgeons have said to me, I was so much happier when I just had my wife, my nurse and my receptionist, you know, so, I mean, they wanted their life back, so there's no one way to do this.

And that's the good part. You can set it up any way you want.

Dr. Andres Gantous

I'm a surgeon. I'm not a businessman. So, you know, if I. I have, I have to dress my instance to do things that I think will work for me. And that's it. It's fun.

Catherine Maley, MBA

Well, and it's working for you. So, if you're happy, that's the most important thing. Is there anything in particular you study or like, I love talking about mindset.

Like what keeps you motivated or keeps you adaptable to change? You know, is there anything you read or watch or learn from.

Dr. Andres Gantous

Yeah. I mean, as you know, Katherine, I mean, I travel a lot for conferences, right. I I'm, you know, invited to speak at many conferences and courses you know, around the world. I have very good friends and colleagues from all over the world and, you know, because I speak several languages, I get invited to different places as well.

It, it comes, it comes with the territory and your background, right. So that, that is always, to me, one of the things that keeps me up to date with things, right. But listening to my colleagues, right. Chatting with them over a glass of wine or a beer or, or more, or more often a cigar on a scotch and you know, chatting and learning what they're doing, how they're doing things a little bit different you know, going to visit colleagues at times.

I mean, I'm. You know, I'm not ..., you know, even though I've been around a long time, I have a big practice. I still like to. See with some of my colleagues operate or do things a little bit different. I get on the phone. If I, you know, I see somebody doing something, I don't know how to do very well.

They'll send me a video right. Of how they do a procedure. Right. So, I want to learn how to do stuff like that. And then we're always, you know, even the, even rhinoplasty, which, you know, I consider myself an expert. I'm still changing. I'm still learning new things. I'm still trying new things because, you know, there's, there's, it's an, it's a, it's a, it's a lifelong study.

Right. So, I do that, you know, obviously I read, I read the journals I, you know, belong to, to some WhatsApp groups and Facebook groups in inter specialty and within the own specialty and of aesthetic practice that some of my colleagues have been fantastic about putting together and you know, kudos to them.

Right. They kept us all involved and created a group of people. Like-minded people to present things, to discuss things, to ask advice. And that, that has been very, very great on that'll happen during COVID right, where we all had a little bit of more time when we're shut down. And so that, that, that, that keeps my interest professionally.

Right. I have many, many interests outside of medicine, right. That keeps me keep me happy. And, and you know, they, they, they you, those are, those are just as important as just your medical and scientific endeavors.

Catherine Maley, MBA

For sure. I know you are like you paint, draw you're into martial arts. You and your fluent did Spanish, Italian and French.

Yeah. What do you do in your free time? That's awesome.

Dr. Andres Gantous

That's some of the stuff that I do, you know, the martial arts boxing, all that stuff has been, has been pretty much going to hold for the last year. They're just this week, they were reopening my boxing gym. So., I haven't really done it in over 12 months or more.

And you know, so I like, I like to exercise. I mean, I like to start trying to stay in shape. I do like, you know, art painting and drawing and, and I you know, we had a chat briefly about this before we started and I wish I had a little bit more time and I'm going to; I'm forcing myself to do it.

I read a lot, I read a lot and on nonmedical stuff, I am always been a big reader. And so that, that always something that happens and I like spending time with friends, so I like I like you know, socializing like, you know, having. My kids w when, when they're around, come over and, and I like to cook.

That's why I do like to entertain at home. So, and I like to go out and eat and restaurants and all that stuff. So, like, you know, nothing, nothing, you know, out of this world, but those are things that keep me going, you know, I'd like to travel. I like to travel for work and like to travel for leisure. Those are the things that are important to me.

What's one

Catherine Maley, MBA

of your favorite meals to cook?

Dr. Andres Gantous

Well, that's a, that's a, that's a, that's a hard one. Say it, right? I mean, there's lots of stuff that I do. And I think it probably, it probably changes it probably changes you know, with time, but based on, based on my background there's, there's several things that I like to cook.

My, my, one of my grandmothers was Italian and a fabulous book. Right. And I learned how to make gnocchi from her. So, I liked, I like to make pasta and I'll make my own pasta and I'll make stuff. Boston I'll make gnocchi, which is really, truly not a pasta, but a dumpling. But, but I, you know, you know, I still remember her with both hands rolling silkies and like a speed that, that I can't, even as a surgeon, I can manage to do stuff the way she did.

And then on my back side of the Lebanese side, I, you know, there's lots of stuff in, in the, in that middle Eastern type of food that I like to do. And You know, I mean, I go, I go, you know, one of the things that I've been cooking, you know, that that I've been trying to perfect a little bit is I make a pretty good seafood bite.

Yeah.

Catherine Maley, MBA

Oh, wow. All right. I'm available for dinner.

Dr. Andres Gantous

Don't

Catherine Maley, MBA

worry. I have never learned how to cook myself, but I sure like it, you know, I like to eat it. I just don't. So just to wrap this up, do you have any words of wisdom, especially for the younger guy coming up or the one who's dying to transition? Who's dying to jump any words of wisdom for them?

Dr. Andres Gantous

Yeah, I mean, for, for the latter, for the one who's dying to jump in transition. I mean, my advice, they said, it's something that you really want to do, just do it. It'll work out. Right. It'll work out, just do it, you know, just make sure that, you know, your finances or financial arrangements are, you know, doable, even if things don't work out that it's not going to put you in the poor house.

Right. You know, I don't think one has to go big. I don't think you have to build, you know, a $20 million surgery center. Right. You just need to. Take the plunge and, and, and, and change how you do things. So just my advice on that is just do it, be smart about it, you know, do your homework, and then you bite the bullet and you do it.

I think, I don't think anybody's going to regret it right once for that, for the younger surgeon, for the, you know, the, the fellow transition. I, you know, my advice and I tell this to my residents and I tell this to my fellow stripes. You know, find, find what you like to do. Find something that makes you happy and do it and try to become good at it.

Right? Keep an open mind. Don't get, don't get stuck in, in how you learn something. And in residency, that's the only way you're going to do it. Always learn how to do new things, right. Always to learn how to do a new procedure, even though nobody taught you how to do it. And I think, I think if you, if you have that frame of mind, you're going to succeed in a surgical career.

You know, if you, if you're doing something you love to do, you're going to be happy doing it. Rather whether you make a lot of money or not that much money in, in our field, nobody's going to go hungry. Right. And you know, if you, if you, if you do things for the right reasons and you make patients happy and you take care of people, Because that's where in the business, we're in the business of taking care of people.

So always remember that you're, you're taking care of people, you know, whether you're doing a cosmetic rhinoplasty or you're taking the thyroid out or you're, you know, putting tubes in a year and a kid, right. You're taking care of people. You're trying to make people better. Right. So, I think that's the important thing is, remember, remember where, what, what brought you to do what you're doing?

Right. I doubt very much that there was money for it. You know any of us, right? I, it comes afterwards, right. It comes with success and you know, there's time to do it so long career.

Catherine Maley, MBA

Wow. And with that, we are going to conclude. Now, if you did want to learn more about Dr. Gantous, you can check out his website.

It's www.TorontoFacialPlastic.com. Is that correct?

Dr. Andres Gantous

That's correct. www.TorontoFacialPlastic.com.

Catherine Maley, MBA

Thank you so much for joining me. I really appreciate you being on Beauty and the Biz, Dr. Gantous.

Dr. Andres Gantous

It's been absolutely. My pleasure, Catherine.

Catherine Maley, MBA

Thank you. Okay, everyone. That's a wrap for us, so please. If you feel so inclined, head over to subscribe to Beauty and the Biz at iTunes and leave me a review if you want.

You can also give me some feedback or questions. Anything you have, you can leave me a message on my website at, www.CatherineMaley.com or you can DM me on Instagram @catherinemaleymba. Thanks so much. And we'll talk again soon.

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