“The litmus test for me is: ‘What would I tell my cousin or my brother?’”

Dr. Roth has become known as Vegas’ “post-fight Plastic Surgeon.” He stitched up boxing champion, Manny Pacquiao’s deep gash that was down to the bone, after the Pacquiao vs. Juan Manuel Marquez fight. Besides administering thousands of stitches to boxing’s best, he has stitched up trauma wounds incurred from car accidents to gunshot wounds during his seven years in a Philadelphia Emergency Room. 

A Las Vegas native, Dr. Roth graduated from Chaparral High School, and then received his medical degree from the University of Nevada School of Medicine and his Plastic Surgery residency at University of California. Returning to Las Vegas to open his own private practice, he says: “Basically the plan was always to come home to my hometown to give back to the city and the state that really nurtured me and helped me with my education.” 

A Washington, D.C. research organization chose Dr. Roth as one of “America’s Top Surgeons” in 2012. He was named again as a “2013 Top Doc” from more than 3,500 doctors in Southern Nevada. Another “Top Doc” for 2013 title was bestowed on Dr. Roth when the Consumer’s Checkbook of Washington, D.C. contacted the doctors on the AMA mailing list in Vegas, asking each doctor whom they would consider “most desirable for care of a loved one?” To be honored by your peers in your own hometown is quite an honor, and Dr. Roth says: “I try to give back to the community. It was always my dream to come back and make a difference here in my hometown.”

STRIPLV: What made you decide to get into Plastic Surgery? 
DR. ROTH: I think Plastic Surgery is a really nice marriage of art and science. I think we’re able to take our scientific knowledge of anatomy and physiology and then take a little bit of our artistic sensibility and try to put it together. I think things really cross apply. For example: The way the training program is run, is you do lots of reconstructive and you also do aesthetic, so when you’re used to dealing with a cancer nose or a trauma nose, you know what the principals are and you know what it’s supposed to look like in the end. You also have the other side of it, which is the aesthetic side, so while you’re putting this nose back together, you have this aesthetic sensibility to try to make it work well and also look nice. That’s a nice challenge that I saw, and I thought I had a talent for that or something in my wheelhouse that I can apply to that. For me, it’s just fascinating. 
STRIPLV: You all get similar training, so what makes one Plastic Surgeon have more beautiful outcomes than another? 
DR. ROTH: I think you’re right that Board Certified Plastic Surgeons all get trained well. It’s a long process, but it’s a long process for a reason – so you can recognize problems before they start, so you can see the different possibilities of what’s going on with the face or any other body part that you’re working on. As far as what makes one doctor better than another, that’s tough. It’s a matter of where you trained, your personal experiences; I think it’s a matter of what your particular interest is. There is one guy that has become the world-renowned expert in ears. There are other guys that like to do faces or other ones who like to do breasts. I think it’s where your particular interest lies, and then there are some who like to do all kinds of Plastic Surgery. By Plastic Surgery, I mean microsurgery, hand surgery, reconstructive surgery, cleft lips and palates, as well as the aesthetic stuff. It’s amazing that, as a Plastic Surgeon, we can operate on the head and the toe on the same day. We can work on the skin and we can also be called upon to work in abdominal or chest cavities. For me, it’s always been fascinating and challenging. To answer your question: It’s just a matter of that particular Plastic Surgeon’s journey, as to where they want to wind up, as well as what they find their niche in. 
STRIPLV: Do you have a special forte or what you consider is your best talent? 
DR. ROTH: When I very first started out, I did basically all that I could. Then, as most folks go on, the practice evolves, and so now we primarily do the aesthetic surgery. I think the kids that go to a dedicated center for cleft lips and palates (where you have pediatric anesthesia and pediatric orthodontia, and speech pathologists working as a team) will get better results. I have no problem sending patients to where they’ll get the best treatment. The litmus test for me is: “What would I tell my cousin or my brother?” That’s the answer I tell my patient. I’m not going anywhere, so when people come in, I want them to have the best experience possible. 
STRIPLV: When people shop for a Plastic Surgeon, what tools should they use?
DR. ROTH: It can be very confusing out there. I tell my aesthetic patients that they have time, and that they’re “the boss.” The patient can go ahead and see two or three different Plastic Surgeons – and they should. I believe that Board Certification by the American Board of Plastic Surgery is important, because then you know they’ve gone through an arduous, rigorous training program. That’s a basic starting point. From there, I think it’s important to research the Plastic Surgeon (on our website, there’s a box that says: “Check credentials.”) Then I would check out their website to see the “before-and-after” pictures, and then when you get it down to about three folks, go and see them. It’s important to like the doctor and what the doctor is saying and you’re also going to be dealing with the office staff. Remember: You’re the boss, and you get to decide who will do the procedure. 
STRIPLV: Do you ever say “no” to someone? It seems as though nobody said “no” to Michael Jackson.
DR. ROTH: He’s another whole story. We talk people out of Plastic Surgery all the time. About 10% of the people who come in here are turned down for a variety of reasons. Some want surgeries that aren’t anatomically possible or appropriate, some need a doctor who is an expert in that particular situation, and again, my litmus test is: “What would I tell my cousin?” Sometimes a person comes in and wants liposuction. I tell them to go to the gym and look at what you’re eating and we’ll see you back in 90 days, and we can discuss doing any touch-ups, because some people do have genetic fat that just won’t go away. That’s the fun liposuction: It’s me against the genetic fat and the genetic fat is going to lose. (laughter) Oftentimes people think they need one thing and they really need less surgery, and I’m always happy to tell them that. Sometimes you do need to go ahead and put the scar on somebody, which is unfortunate, but you want to do the right operation, too. You want to make sure the patient has the best shot of getting their expectations met when it’s all done. 
STRIPLV: Besides one’s genes, (which are incredibly important), not smoking, sun damage, abusing drugs and alcohol, is there something besides surgery that will improve our faces? Are there miracle creams? 
DR. ROTH: There’s no miracle cream. If there was, I would be selling it 24/7 as much as I could, and if I had invented it, I’d win the Nobel Prize! You’ve hit on a lot of things and #1 is to be a healthy person. Eat some form of protein, vegetables, and don’t abuse yourself with too much sun exposure and smoking. Smoking is an absolute killer. 
STRIPLV: How does someone prepare for surgery?
DR. ROTH: Try to be as healthy as possible and have a good attitude. I’ve found that people who are really prepared for surgery know that before, during and after, there’s going to be a healing process that they’re going to go through. Most people who have a good support system, whether it’s family or friends, tend to come through much more smoothly. 
STRIPLV: Besides a rhinoplasty (nose) or an otoplasty (ears), what is the youngest age you would recommend for plastic surgery?
DR. ROTH: We do cleft lips and webbed hands on babies. We see a lot of rhinoplasties before adolescents go off to college. Typically we don’t do aesthetic breast surgery on girls under eighteen. There are also federal guidelines that we’re not supposed to put silicone implants in patients under age 22. Sometimes I will see patients that are 16 or 17 for breast reduction surgery. Sometimes they need a white coat to tell them: “No, you’re completely normal, and this is within normal limits, and you don’t need surgery. We will see you back when you’re 18 and see if you’ve grown into things a little.” I tend to take a holistic approach as much as I can.
STRIPLV: What do you consider to be the telltale sign of someone’s age?
DR. ROTH: It depends on the society you’re in. Here in the United States, people will judge by a person’s neck and hands. In China, they look at earlobes. When I talk to some of my colleagues at meetings, they’re doing fillers to the earlobes, face and hands. In Vegas, we do quite a bit of hand rejuvenation, because there are a lot of dealers out there and their hands are in the public and they’ve been at these casinos for 20-30 years. We can do fillers and a hand care program. 
STRIPLV: How long do fillers last?
DR. ROTH: It depends. There are different classes of fillers and the one we use will last about a year, depending on the area. The lips break down a little faster than in the face, because people talk and chew. The folks that are in the gym twice a day, or trainers, tend to break down the fillers faster. It really depends on that individual patient and the experience of the injector. 
STRIPLV: What’s on the horizon?
DR. ROTH: There’s always something new in Plastic Surgery. I had an old professor tell me once: “Son, if you’re getting bored in Plastic Surgery, you’re not reading enough.” On the reconstructive front, the microsurgery front, they’re attaching smaller and smaller vessels and moving bigger pieces of tissue around. With Angelina Jolie’s prophylactic mastectomies, it’s becoming more in vogue, because now with the breast reconstruction, the options are so good. Plastic Surgeons are always challenging the limits for our patients. 
STRIPLV: Are you inclined to use something the minute it’s out there or do you wait a little to see the results?
DR. ROTH: I’m a little conservative by nature. I’m very much a doubting Thomas. I torture the reps that come in here. They’re in the business of selling something, but you have to take your scientific training and your surgical training and ask: “Does the basic science behind this make sense?” It could be a new gizmo or machine or skin cream, but if it’s going to be in my office, it better work. I’m conservative by nature and I don’t apologize for that. There are some guys that will push the envelope and they live in bigger houses than I do, and drive fancier cars than I do, and that’s okay, because I like to think I do the absolute best for my patients and I can sleep at night. 
STRIPLV: Do you do a lot of repair work from other physicians?
DR. ROTH: We get our fair share, mostly folks from out of town. Here in Vegas, there are a lot of really good Board Certified Plastic Surgeons. I think also, over the past few years, the Plastic Surgeons here in Las Vegas have really fostered a spirit of collegiality, which I haven’t seen in other towns. Quarterly, we all try to get together, have a scientific presentation, have dinner, and share what’s new and exciting in Plastic Surgery. You wouldn’t think that’s true in such a competitive town, but we do, and I think that’s very important. 
STRIPLV: What procedures do most men come in for? 
DR. ROTH: We’ve actually been seeing a lot of men lately. They’re about 10% of our practice, which is the national average. They want rhinoplasty, liposuction, and facelifts. I’ve been seeing a lot of cops and firemen lately for liposuction, especially as they get into their forties and fifties. The gun belts on the policemen start digging in and the firemen don’t want spare tires when running up and down ladders. We’ve also been seeing a lot of facial stuff because of the economy. We have 50-year-olds competing with 20-year-olds, especially for sales jobs. They come in and get their Botox and fillers, so they look less tired and feel more confident, and oftentimes, they’re selling twice as much as the 20-year-old guy. With just little tweaks, we’re able to get these guys in a little more confident position. Vegas is an aesthetically-driven town, because there’s that glitz and glamour that people expect. People come off the plane and they expect to see a grand entrance when they walk into a hotel. They expect to see the gorgeous cocktail waitress, the handsome host, dealer or Maître d’, and that’s Vegas. Even when I was working down in Hollywood, you had the red carpet girls and they knew that was their currency. A funny story about the red carpet girls is that we had a lot of them coming in for Botox in their armpits, because they don’t want to sweat in a $10,000 Valentino gown. In L.A., it’s 80 degrees plus 10 degrees more with the lights. We do it here in Vegas, as you can imagine, since it’s so hot. We’ve had both guys and gals patients, but especially the guys that have to wear suits. 
STRIPLV: Isn’t that painful?
DR. ROTH: It’s not bad. Here in Vegas, we cater to cowards and chickens. That’s our specialty!

Las Vegas Plastic Surgery • 9280 W. Sunset Rd. Ste. 236 • Las Vegas, NV 89148
702-450-0777 •

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