Dr. Martin Jugenburg

Written by Niki Stad

Toronto Cosmetic Surgery

Since I can remember, I have always been curious about how our looks represent us to our friends and society. Growing up, watching TV or looking at magazines has always created a certain image in my head about beauty, and it is these images that have set the standards for me. People always think about the option of plastic surgery, but rarely do they think about the reality of these surgeries or the surgeons who preform them and what kinds of things that these doctors actually do. Recently I got a chance to sit down and talk to one of the best plastic surgeons in Toronto, Dr Martin Jugenburg. I must admit it has changed my whole perception of what plastic surgery is, but I will let this interview speak for itself.

-Niki Satel

1) What made you to become a specialist in plastic surgery?
2) Where did you get your education and training?
3) How much spare time do you find for friend and family?
4) What is it like to be a plastic surgeon?
5) Do you think plastic surgery can be an art form, and do you feel or do you call yourself an artist?
6) What kind of services do you offer in your clinic?
7) What would you say is your specialty or favorite surgery to perform?
8) What types of surgery procedures are common in your office? And what’s the usual age group like?
9) Can you tell us one of your most memorable procedures?
10) How do you think Canadian plastic surgeons and techniques compare to the rest of the world?
11) What is the difference between cosmetic surgery and reconstructive plastic surgery? Some people think it’s the same and some don’t know the difference?
12) What types of procedures do you have for men and women who are thinking about a breast reduction?
13) You look so young to be a surgeon, have you had any procedures done yourself? And are you looking forward to having one in future?
14) Have there been any instances where you have refused to perform surgery? Is there a line you don’t cross?
15) What is the best way for your clients & patients to learn about you?
16) What kind of message, if any, do you think plastic surgery is sending to the general public?
17) What do you predict will be popular in the near future?
18) How do you describe beauty?
19) Recently Etalk featured your Brazilian butt lift, one curious question we have is, if you go on a diet, how will this affect this procedure?
20) What other procedures do you offer men?

1) What made you to become a specialist in plastic surgery?

I wanted to be a plastic surgeon since I was a little kid, my dad was a plastic surgeon so i saw his work and I was inspired by it. I think plastic surgery is by far the best surgical speciality. In plastic surgery you create form and function, which is by far the most fun, and as a plastic surgeon I get to work on the entire body. I do everything except for the brain, the heart and the lungs. Most other surgeons just focus on one area, so I like the diversity.

2) Where did you get your education and training?

I did my undergraduate and Medical School at the University of Toronto, my plastic surgery residency training at University of Manitoba. Furthermore I received my Speciality Plastic Surgery Fellowship in Microsurgery and Cancer Reconstruction in New York at the Memorial Sloan Kettering Cancer Centre, the world’s largest and most prestigious cancer treatment centre.

3) How much spare time do you find for friend and family?

Spare time is always hard to find, I try really hard to make time for friends and family, especially my wife and kids. I'm lucky to have an incredibly understanding and supportive wife who works very hard to accommodate and find ways for me spend more time with the kids, and keep a bit of a balance. It takes a Huge effort because it’s a pretty busy life style, looking after patients is a 24/7 job. Patients and illnesses don’t have weekends and evenings off!

4) What is it like to be a plastic surgeon?

It's a lot of fun though, just because the type of work that I do is so diverse plus it’s nice to see people that are happy with the results. A lot of the work that I do makes a huge difference in their self esteem and lives. For example; in breast cancer patients I do breast reconstructions and they are just so appreciative, and if you do an exceptionally good job they’re just beaming with happiness! Using the latest fat grafting techniques has helped and allows me to rebuild some cancer patients breasts where implants wouldn't work.

5) Do you think plastic surgery can be an art form, and do you feel or do you call yourself an artist?

There is definitely an artistic aspect to plastic surgery. That’s another thing I like about it. Unlike other surgical specialities, for example an appendectomy, there is one way to do it and you do it over and over. In plastic surgery the same procedure can be done in a million different ways and each surgeon has their own touch on how they do things. There is tremendous variety between different surgeons.

6) What kind of services do you offer in your clinic?

We offer pretty much everything from head to toe, both surgical and non surgical. Our non-surgical treatments include injectables such as HA fillers, Restylane, Juvederm and Teosyal, Botox Cosmetic and medical grade skincare treatments including Obagi. The surgical procedures include facial cosmetic surgery, breast and body surgeries.

7) What would you say is your specialty or favorite surgery to perform?

My main interest is in the breast and the body, which is what I do the most work on. I’m becoming known in the media for the Brazilian Butt Lift and sculpting, but my breast surgery work is equally as popular in my practise. I use the NEWEST breast augmentations and breast lift NEWEST techniques which offer pretty amazing results which my patients are very happy with. I also do a lot of post weight loss surgeries which can require a total body lift, in some cases. Those cases are usually done at the Humber River Hospital which is the main centre for bariatric weight loss surgeries.

I also work at The Plastic Surgery Clinic in Mississauga, which is the main centre or the biggest centre for the Lap-Band (gastric band) surgery. So I get to see a lot of massive weight loss patients and I do a lot of body contouring. They are a group of patients that are tremendously grateful because they have just lost 100-200 pounds, and they are left with all this extra sagging skin so although they are thin, they often have a lot of access skin that hangs so i do tummy tucks, leg and butt lifts, and sometimes the under arm tightening!

8) What types of surgery procedures are common in your office? And what’s the usual age group like?

My age group goes from 18 years old up to, my oldest patient, who is in her 80’s. I really have a wide spectrum, the majority of my patients tend to be younger but I don’t limit my practise to any age group.

The most popular procedures in my practise are: Liposuction, breast reduction, aug and lift, tummy tuck, body sculpting and butt enhancement and lift. For mothers who just want their bodies back after having kids we do a tummy tuck and breast aug (or lift) combo that is very popular. Even though they live a healthy lifestyle and work out, there are areas that don't always bounce back after having kids. And exercise is not always enough for getting the shape you want. One of my female patients is a body builder who wanted a larger and more defined back side so had the Brazilian Butt lift. Her results can be seen on the b/a below. The photos speak for themselves.

We also have teenage patients with extremely large breast requesting breast reduction surgery. This is an issue that can cause not only physical discomfort and pain but also emotional and social problems. No young female teen wants to gain attention because of her overly large breasts. We spend a lot of time with these patients to make sure they are both physically and mentally mature enough for the procedure. We also make sure that it's the teens idea not the mothers. These are some of my happiest patients, post surgery. They are mostly happy about fitting in socially rather than eliminating the physical discomfort. The Globe and Mail recently interviewed me on this very topic. "Teens and Plastic Surgery".

We also have an increasing number of teen and early twenty year old male patient, requesting breast reduction. They just want to be able to wear a bathing suit and not feel uncomfortable in the locker rooms. We are one of only a few clinics in Canada that offer a NEW surgical technique that leaves no visible signs of surgery.

9) Can you tell us one of your most memorable procedures?

There are so many. To say that there is one, not really. I have a lot of cases that pop into my mind, but there’s not one that blows all the others away. There are several patients that I can think of that have had some phenomenal results where even I surprised myself. When people get injured I do a lot of trauma surgeries and hand injuries are very common. When people mangle their hands you know you will be able to restore function to them and it is very important.

10) How do you think Canadian plastic surgeons and techniques compare to the rest of the world?

I trained in Winnipeg and the stuff that I did there and the things that we do as a Canadian plastic surgeons is phenomenal. I think we are among the best in the world. The things that we did there very few people do it in the world. It is surprising because when you train in the system, you always think, oh there is the US, and there are all these other countries that are famous for plastic surgery. Then you go to these international meetings and you see these world authorities present and you kind of laugh. It’s all the same stuff we do, and we do it better. The Canadian Plastic Surgery training programs are known for their quality. Whenever a Canadian graduate applies for a a job or training position anywhere in the world, they almost always get it. Plastic Surgeons around the world recognize that our training is formidable. In Canada, pretty much every single training program is world class.

Botox Cosmetic and facial fillers all started in Canada, before they were available in the US. Botox, was actually discovered, for cosmetic use, by a Canadian physician. Most of the fillers originate in Europe then launch here before going to the US. At the American meetings, it's always Canadian doctors presenting and speaking about the key experiences and new techniques they have devised.

11) What is the difference between cosmetic surgery and reconstructive plastic surgery? Some people think it’s the same and some don’t know the difference?

Cosmetic surgery is a sub section of plastic surgery. Plastic surgery is plastic and reconstructive surgery. The term plastic comes from the Greek term “plastikos” not plastic as in plastic materials, but plastikos as in Greek word for “molding”. That’s what plastic surgeons do, they mould tissues. So we take existing tissue and create something new.

Plastic surgery was born in during the war as a speciality that helped soldiers recover after tremendous injuries, and from this ability to reconstruct function and form slowly involved the cosmetic aspect. So now plastic surgeons do reconstructive surgery…where you try to correct an injured deformed body part, and cosmetic surgery is when you take something that is otherwise normal but you make it better.

12) What types of procedures do you have for men and women who are thinking about a breast reduction?

For men with enlarged breasts there are two types. They either have a fatty breast or the an actual glandular breast like a female breast; so there are 2 different treatments for that. The procedure that I use is a unique technique that only a few physicians are trained to do which leaves no visible scarring. The traditional technique can leave a scar around the aureole area which fades slightly over time. What I do is hide the incision line in the armpit where nobody ever sees it. Female breast reduction is different, but the technique I use is also the NEWEST technique available. The benefit of my technique is that the scar is so minimal, it is much less obvious and the scar looks much nicer and the shape of the breast ends up a little nicer then the original technique. Last summer I was invited to New york City to teach this new surgical technique because of the interest it has generated.

13) You look so young to be a surgeon, have you had any procedures done yourself? And are you looking forward to having one in future?

I think I benefit from some good genes and minimal sun exposure. (And of course he has a healthy life style, he works out, he eats properly.) There is a lot of stress around me but I don’t let it get to me.

Sun exposure is a major ageing factor which some don't realize. A good example that I often mention to patients is to look at your grandmothers face in comparison to her belly, which hasn't had sun exposure, it will look like baby skin and her face will show she is 80 years old.

14) Have there been any instances where you have refused to perform surgery? Is there a line you don’t cross?

Absolutely, there are basic things that you want to look at. First the patient needs to be physically healthy to undergo a surgical procedure, and they need to be mentally stable to understand what they are doing and how they will benefit from it. So no psychological issues, and finally they need to have realistic expectations. If someone comes into my office and expects that I can create miracles, I tell them right away that I'm not miracle worker, I can make them better but I can not make them perfect.

15) What is the best way for your clients & patients to learn about you?

It's always best to come into the clinic, meet me, and talk to me in person. I think one to one contact is the best, I find most people who come to my clinic and meet me, seem to immediately feel comfortable. I'm often told by my patients and staff that I'm very down to earth and approachable. I also do my best not to use medical mambo jumbo. I explain what I can offer and what their options are without over promising.

When you go through medical surgical training you learn what is the ideal way of doing things, what is the best thing, what is the ideal shape and form and function. But I learnt very early on, that instead of telling the patient what I think is the best thing for them; I listen to what they want. When they ask me what I think, I ask what bothers them about their appearance and what they would like to change. I then guide them to what is reasonable and possible.

16) What kind of message, if any, do you think plastic surgery is sending to the general public?

I think the plastic surgery organizations of both the American, and the Canadian sides have done a really great job. Trying to spread the message, that it’s important that patients understand what plastic surgery is about and that they understand that this is a real surgery and not to be taken lightly.

There has been some misconception created by TV shows like “Nip Tuck” and “Doctor 90210” that make plastic surgery look like a joke as if it's as quick and easy as going to the hair salon. The show starts at 8 o’clock and by 9 they wake up brand new people. You need to understand that this is real surgery; there are real considerations that need to be taken into account.

As a patient you need to understand that you have to do your research. Make sure that your doctor is a board certified plastic surgeon with the appropriate experience. People call themselves cosmetic surgeons. There is no such a thing as cosmetic surgery, cosmetic surgery is a made up term. Plastic surgery is an official term that is recognized by the Royal College of Physicians and Surgeons of Canada.

People that call themselves plastic surgeons have passed the rigorous training program and have passed rigorous exams. People that call themselves cosmetic surgeons, you don’t know what their training is, if any. They could be plastic surgeons, they could be family doctors, they could be dermatologist, they could be a psychiatrist, they could be an endocrinologists, there are no regulations, and no certifications that you can really rely on.

The other thing is there are a lot of organizations out there that for a fee, provide a diploma, and these are organizations that do not require you to prove your training, you simply become a member and that’s about it. They can call themselves (I’ll make up a name) such a name as “the cosmetic society for liposuction.” It sounds very official but anybody can be member as long as they pay their dues.

17) What do you predict will be popular in the near future?

I think fat grafting is the hottest trend right now, fat grafting has been around for a quite a while but it was very controversial for two reasons. One is nobody could really figure out how to do it properly to preserve the fat. Transferred fat dies unless handled properly. You have to be very careful in the way the procedure is performed to ensure optimal results. The other thing was when you transfer the fat, fat lumps and bumps can be concerning for people who worry about cancer.

The two things that have happened are that we now have new MRI technique that allows us to differentiate between fat and actual cancer so we don’t have to worry about having difficulty in detecting cancer. The other thing is the techniques for fat grafting have become refined, so now the fat transferred does not just die but it actually just stays there.

Another great thing about fat is that it also has some healing effects. It has been noticed in the breast cancer population that the fat which has been transferred into various areas seems to heal the tissues and they notice that stem cells, which are very early growth cells are able to differentiate into different body tissues.

The observation came from people who had breast cancer and had radiation. They had badly burn skin and tissue and when they have fat injected into these areas, the tissue seems to have improved and rejuvenated.

It’s also amazing how popular and the increased demand from patients for butt enhancement that is largely influenced by celebrities. Kim Kardashian and Jennifer Lopez have certainly helped set the TREND for curvaceous bodies. The Brazilian butt lift/enhancement not only makes your butt bigger but it creates a more curvaceous and slimmer waist and lower back area. When fat is removed from the lower back area it enhances a and shapes the butt. Again, it comes to the art; there are two types of surgeons, there are engineers and there are artists. Engineers are the ones who measure everything, they spend the hours on the drawings and there’s the artist, they look at you, get an idea and do it. I’m the artist type.

18) How do you describe beauty?

Beauty comes in several aspects. One of the key principles of beauty is symmetry not perfect, but similar. The left and right is never identical, but they should be pretty similar.

Smoothness of lines, smoothness of surface and nice curves. That’s what creates beauty. You don’t want to have a rough surface; you don’t want to have scars. Finally, everything should be in good proportion. There is something called the “Golden Ratio“ which is approximately 1.61 and is found all the most beautiful people in the world.

19) Recently Etalk featured your Brazilian butt lift, one curious question we have is, if you go on a diet, how will this affect this procedure?

Fat cells don’t multiply and they don’t die. Once they heal in a place they stay there, a fat cell is like container of fat. When you gain weight this container fills up with fat, when you loose weight it shrinks. So when you do the surgery you change proportions, we take fat cells from unwanted areas and transfer them to the area you want to enhance. So yes, if you were to loose weight your fat cells will shrink, your breasts get smaller but the proportions will remain the same. So the curves that I am creating will stay.

When you take the fat cells from the abs, for example, and put them into the butt or breast area and you later gain weight the fat goes to your breast not to the tummy where it was taken from. I liposuction fat from unwanted areas and re-inject into areas you want to enhance instead of throwing it out,. So it’s a great '2 for 1'. That’s why it is so popular, you're getting two procedures in one.

Men also request the Brazilian Butt Lift, but they are often too slim and don't have enough body fat. So there are some limitations on the breast and butt lifts, if you don’t have the fat you can’t have a Brazilian butt lift. In some of these cases we advise the patient to gain weight 15 to 20 pounds and then come back otherwise their only option is to use implants.

Using fat is much more natural looking and you don’t have the problems sometimes associating with implants such as leakage, rupture, infections, excursions. These issues rarely happen with breast implants which are a different type of implant than what is used for the backside.

20) What other procedures do you offer men?

As well as breast reduction, sometimes called "Moobs" by the media. we also do the regular facial rejuvenation like botox, filler and under eye fat removal (blephooplasty). We also eliminate double fatty necks using liposuctions which only requires a tiny incision under the chin so no scars and minimal downtime.

We also use peck and chest implants for where fat won't work to provide augmentation and a more defined chest area. Liposuction to eliminate tummy and love handles is still the most requested procedure for men. We also do huge weight loss body surgeries which may include tummy tucks and full body lifts.

For more information: www.plastica.ca

Plastica Cosmetic Surgery
Level A Fairmont Royal York Hotel
100 Front St W
Toronto, ON, M5J 1E3
tel 416-834-6640
fax 647-436-6969