In a cosmetic plastic surgery office, achieving the right atmosphere can be every bit as valuable as having the right management systems. For example, Daniel Man, MD, has added much allure to his Boca Raton, Fla, office by filling it with beautiful art.

"To visit my office is almost like walking into an art museum," he says. "There are paintings and sculptures everywhere."

The abundance of art in Man's office accomplishes several things. First, for new patients, it helps them relax and puts them in a proper frame of mind to easily discuss their needs with the doctor. Second, because the art is of human bodies, it provides a reference point for Man's descriptions of the surgical procedures being contemplated.

All of the displayed art pieces were produced by none other than Man. Once patients become aware of this, the paintings and sculptures subtly convey the reassuring message that anyone capable of creating such lovely works on canvas and in clay will be able to do likewise with the human body in the operating room.

"Patients, I have observed, prefer to have cosmetic procedures performed by a plastic surgeon who is more than a skilled clinical technician," Man insists. "They want someone who also has an artist's soul"

The Man, The Artist

Although a mainstay on the lecture circuit and having received national media attention, Man still garners most of his patient referrals from word of mouth.

Man finds certain similarities between surgery and painting. Both, for instance, require careful planning.

"Like a successful surgery, art does not just happen spontaneously," he says. "You have to map it out in detail before making that first brush stroke."

Man's art portfolio previously emphasized lifelike statuary, until he became intrigued with paintings of faces and bodies using watercolors and acrylics.

"1 am influenced by two schools of art-the contrast-heavy realism of the old Dutch masters and the vibrant colorations of the French impressionistic painters," he says. "1 like realism all by itself, but I feel that realism in paintings cannot compete with today's photography. So, gradually, I began to temper my art realism with strains of impressionism, which is a style I also like by itself. Today, I am blending the two in ways that are pleasing to the eye and to the emotions."

How good an artist is Man? Good enough that one of his paintings hung in the White House during the final 3 years of the presidency of Bill Clinton.

"It was a very large painting depicting the peace handshake that occurred on the White House lawn between [Israeli Prime MinisterYitzhak] Rabin and [Palestine Liberation Organization Chairman Yassir] Arafat, a handshake that came about because of Clinton's efforts," he says. "1 produced this painting as a way of commemorating the historic event and to thank Clinton for attempting to bring peace to the Middle East"

Crafting such a painting was an exercise freighted with meaning for Man, who comes from war-torn Israel.

Man arrived in America in the late 1970s to study medicine at the University of Louisville in Kentucky. He liked it so much that he decided to remain in the United States after completing his medical training in 1982. Wanting to live someplace with a warm climate reminiscent of Israel, he decided to settle in south Florida, an area with many affluent, beauty-conscious adults with a built-in readiness to use cosmetic plastic surgery services.

Pushing the Envelope

Man has discovered that displaying fine art in his office soothes patients, allowing for open discussions of their plastic surgery needs.

Another indication of Man's stature as an artist is the book he authored, The Art of Man: Faces of Plastic Surgery, now in its third printing (revised and under the title, The New Art of Man: Faces of Plastic Surgery). Add to that the number of prestigious gallery shows in which Man has participated, and his devotion becomes evident

Still, Man-who is a purely self-taught artist-is his harshest critic. "1 feel that I still have much to learn about art," he demurs. "1 am constantly striving to improve my technique at the easel, constantly trying new things and adding to my repertoire."

As an artist, Man works from a studio at home. He only has time for, perhaps, 1 solid day each week in his garret, where he likes to have as many as four different pieces in progress at once. Somehow, he manages to allow for an annual excursion to an artists' conclave held in Tuscany, Italy.

Lately, though, Man's interest has returned to sculpting, this time using metal as his medium.

"1 am completing work on a life-sized sculpture of two dancers made from large copper and small ceramic pieces welded together, and I am starting a life-sized horse that will carry a Lady Godiva-type rider also in metal," he says. "1 do not sculpt in stone at all. I like clay, but I find clay has limitations as a medium - limitations that directly correlate to the size of the kiln in which it is fired. With metal, however, I have a lot more freedom in terms of how big I can make the work. I also like the effects that can be created with heated metal, especially when it is fused with clay."

Man stresses, however, that his paintings and sculptures are no substitute for a good digital imaging system.

Imitating Art

Man describes Niite, a wrinkle reducing laser treatment, to a patient.

"The imaging system I use," he says, "is meant only to document patients' reality. It is not used to show them what they will look like after surgery. I do not believe that doing prognoses of any sort is productive."

Man's conservatism in that regard is believed by his willingness to push the envelope and test boundaries, which he does often in his role as an innovator of cosmetic plastic surgery techniques and tools. His first best-known innovation was a facelift expander.

"When I first began practicing, patients would tell me they wanted a facelift but were reluctant to do so because they knew people who had facelifts that ended up looking pulled and unnatural," he recalls. "1 subsequently designed an expander that would combine both stretching and expansion. In testing, I observed that this approach permitted a more natural-looking result."

Over the years, Man kept refining his device, which he called the Man Facelift Expander, a balloon-like insert that allows the elevated skin section to be draped back into place without the introduction of an unacceptable amount of tension.

"When I do a wide undermining of the skin, I put the expander in place and it pushes the corner of the mouth toward the center of the face," he explains. "That way, rather than merely pulling the skin toward the ear, there is a circumferential relaxation that occurs. The whole area of the flap is being stretched. The expander is then removed. The flap is trimmed, and the closure is under minimal tension, thereby achieving creep and stress relaxation."

With further experience, Man discovered he could attain the Silme effect from the use of ordinary gauze pads in place of an expander device.

Man of the Year

Ensuring that he and his staff understand patients' expectations and needs up front is Man's biggest challenge.

Also looming large in Man's life is his dedication to charity. He supports the Association of Victims of Domestic Abuse (AVDA). He recalls his introduction to AVDA: the group sent him a woman for reconstructive surgery; her out-of-control boyfriend had bitten off her nose during the course of the attack.

"I took the case, and charged nothing for my services," he says. "The young lady left my care with a beautiful, restored nose. It was extremely satisfying to see her smile again, and to know that I had done something to give her back at least some of her self-esteem, to put her on the road to a new and better life away from abusive relationships."

That act of charity-and others just like it-prompted Palm Beach County Victims' Services to honor Man as Humanitarian of the Year, and no doubt factored into south Florida magazine's decision to single him out for recognition in a feature about the region's finest physicians.

In addition to facelifts, Man's practice is focused on skin rejuvenation, cosmetic laser surgery, and liposuction. He performs surgery at an accredited facility he owns adjacent to his office, and also at Boca Raton Community Hospital, which is directly across the street. Man is on staff at two other local institutions: West Boca Medical Center and Delray Community Hospital.

Man travels extensively on the lecture circuit, having garnered a sterling reputation for informative presentations on topics ranging from his facelift expansion technique to decreasing postoperative swelling. He has spoken to medical societies across America and in parts of Europe, Africa, and the Middle East.

Not surprisingly, Man encounters scant difficulty attracting major national media interest in his practice. He has appeared on "Good Morning America," "ABC Evening News With Peter Jennings," American Health Network's "Ask The Doctor," and CNN. He has also been written about in Vogue, Allure, Newsweek, and Omni Magazine.

The publicity is helpful, Man confirms; however, most of the new patients he attracts come by way of referral from previous patients.

Meanwhile, the most daunting challenge Man must confront in his practice is making sure patients' needs and wishes are fully understood up front.

"I have devoted a lot of time and energy to learning how to be a good listener," he says. "I have found it is relatively easy to be a good listener to patients who are articulate and have no trouble conveying their desires. But listening skills are most essential with patients who are not able to articulate [their words] about what they want to accomplish with plastic surgery."

Looking ahead, Man says he plans to find more creative ways of providing the services he offers.

"It is my nature to be innovative and on the cutting edge," he says. "Yet, it is more than that. One of my overriding goals is to deliver the best possible result every time. I am, after all, an artist as much as I am a plastic surgeon. Sometimes, it is hard to tell where one ends and the other begins." III

Rich Smith is a contributing writer for Plastic Surgery Products.