Kyoto, Japan – November 2016

The International Society of Aesthetic Plastic Surgery (ISAPS) held its biannual meeting in Kyoto Japan in November. I was asked to be a part of a group of international experts on facelifts to talk about High SMAS Facelift technique with simultaneous fat. This technique addresses both the effect of aging due to gravity in addition to the loss of fat that occurs to the mid-face as we age. My presentation was extremely well-received.

I spent the day following my presentation with Dr. Shinja Yamanaka, the 2012 Nobel Prize winner in Medicine for his pioneering work on stem cells. Dr. Yamanaka showed the world how one could create pleuripotent cells out of any tissue in the body including scar, thereby bypassing the need for using embryonic stem cells.  At the University of Kyoto there is three large buildings with state-of-the-art world-class laboratories directed by Dr. Yamanaka exploring the use of stem cells for treatment of many diseases including cardiac and degenerative neural disorders.

Prior to the meeting, I spent two wonderful days in Nara with Dr. Keisuke Imai, the chief of plastic surgery at the Osaka General Hospital. Dr. Imai and I share the same love of craniofacial surgery, the procedure of changing a child who is born with a dysmorphic skull by going through the skull, moving the brain away and breaking facial bony structures to restore them to normalcy.  We had fun both socially and professionally sharing ideas in addition to the extraordinary food and hospitality of our Japanese colleagues.


Dr. Bryant A Toth with again be hosting a course in Vienna in September, 2016 at one of the most famous anatomy laboratories at the University of Vienna on Advanced Aesthetic Surgery of the Face. This two day symposium is taught to 50 surgeons who come from all over the world to learn the newest techniques in cosmetic surgery.  A series of lectures is given by Dr. Toth followed by surgical procedures done by him on a fresh cadaever which is filmed for all of the students to follow.  The attendees then have their own cadaever on which to practice these techniques supervised by Dr. Toth and a group of respected European Surgeons.


Vienna Cadaver Course PDF

September, 2015 – I have developed many great friends over the years in Italy and have been a visiting professor in nearly all of the major universities, whether it be Rome,  Milano,  Bologna, Firenze, or even in Sicily. A regular trail of young Italian surgeons come to visit me on an annual basis and many stay for 3 to 6 months to learn my surgical techniques. As a product of this I am regularly asked to give a Keynote Address at the Italian Society of Plastic Surgeons Meeting. This past September  the meeting  was in Milano and my topic again was on dealing with the aging face, Facelift with Simultaneous Lipofilling. This is a procedure that I have helped pioneer through the years, in addition to having performed untold numbers of clinical cases. I also have produced two videos on the topic, one filmed during live surgery benefiting the SavaneroRoselli Foundation.  Two years ago my two volume textbook of cosmetic surgery co-edited with Professor NicoloScuderi from Rome was published first in the Italian language.

My experience 11 years ago rejuvenating the face of the then Prime Minister of Italy has made me the facelift expert in Europe and beyond. When one operates on a high-profile patient not only does the outcome for that individual ride on your shoulders, but also riding on your shoulder is the perception of plastic surgery throughout the world. My patient was extremely pleased, he has become a very close friend, and we have spent time together on many occasions throughout Italy and beyond. This experience in addition to my many surgical friends has only fueled for my love of this beautiful country.


Plastic surgery residents nearing the completion of their training or even newly minted plastic surgeons in today’s world seem to be more focused on positioning themselves in social media on the internet rather than using their immense skills and making a difference. Things like public relations and SEO positioning appear to be much more important to them rather than focusing on how to give back to society with the enormous skills they have acquired.

As one looks through the Internet it appears as though every young surgeon, regardless of how long they have been in practice, is world-famous in some cosmetic procedure, whether it be in breast augmentation, liposuction or facelift surgery.

BUYER BEWARE–very few young surgeons have been trained in and skilled in cosmetic surgery since most training programs do not focus on this aspect of our specialty. In reality it requires years of training after residency in order to develop the technical skills and judgment for a surgeon to be able to distinguish his or herself in cosmetic surgery.

Without question the best cosmetic surgeon is the one who does reconstructive surgery throughout their professional career. This was true when I trained 30 years ago and is ever truer today where resident experience is much abbreviated. As I look back on those people who I consider the greatest of the 20th Century, ALL continued to challenge themselves with reconstructive surgery. Whether it be the great Mexican surgeon, Fernando Ortiz-Monasterio, who took care of children with facial deformity, to my mentor Daniel Marchac, arguably the greatest plastic surgeon in France of the 20th Century, all were great surgeons who continued to challenge themselves dealing with the poor and underserved.

Even Ralph Millard, the master surgeon who practiced in Miami and left a lasting impression in cosmetic surgery, continued up until the end to deal with children with clefts and building noses when they had been traumatically lost.

I would like to see young plastic surgeons give back to the community in which they practice, not just take away from it. Rather than going on one trip so they can appear compassionate on their “holy” website and never do it again, I would like to see them start something that they can sustain over their professional career. The surgeon who continues to stimulate himself technically is the one who continues to push the limits in their surgical career allowing the integration of many of the reconstructive talents acquired into their cosmetic surgery. It avoids the burnout one frequently sees in the cosmetic surgeon.

I have been fortunate that during my surgical training at Harvard and the Massachusetts General Hospital I was surrounded by outstanding attending surgeons who taught us that medicine meant more than doing a technically perfect operation. They instilled in us a sense that we had to be of service to our community whether that be local, nationally or internationally. This has stayed with me throughout my career.

I have continued this commitment by doing craniofacial surgery two days per week at the UCSF Benioff Children’s Hospital in Oakland. I am the Co-Director of the Craniofacial Department that I started over 30 years ago. My commitment to these children with facial deformities has not wavered.

In my first years in practice, I, along with one of my mentors, Dr. John Constable from Massachusetts General Hospital and a close friend, plastic surgeon, Dr. Michael Moses in New Orleans, started the Indochina Surgical Educational Exchange (ISEE). This enabled us to travel to Vietnam and Cambodia, the poorest two countries in the world at that time, to operate on facial clefts and correct some of the casualties left from the Vietnam War.

This was during a time when there was no support from the US government. We knew that to be effective we needed to have the surgeons come here to the U.S. to stay for six months to a year to train with us and they could then go back to their respective countries and train their colleagues. ISEE has always believed, “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.” Our organization has sponsored physicians from all over Southeast Asia that have ultimately resulted in the training of hundreds of surgeons. This continues today.

I have never considered giving up my reconstructive work to focus entirely on aesthetic surgery. My training in reconstructive surgery has made me a better cosmetic surgeon. I continue in the footprints of the great plastic surgeons that I admired and mentored me.

“If I have seen further than others, it is by standing upon the

shoulders of giants.”

—- Isaac Newton 1676

I am pleased to announce that Dr. Anne Warren Peled has joined our office. Dr. Peled is a graduate of Harvard Medical School and received her surgical training from the University of California-San Francisco. Her plastic surgical training was followed by an Oncology (Tumor) fellowship focusing on breast cancer and the treatment of melanoma. She is the first true oncoplastic surgeon in the Bay Area. Anne is able to do both the tumor removal as well as the reconstruction. She will focus on treatment of breast cancer and melanoma and the reconstruction it will require as well as developing her own cosmetic surgical practice. My 30 year experience with breast reconstruction dovetails nicely with Anne’s practice in the treatment of breast cancer.

Not every patient that comes to see me is a candidate for surgery and frequently many of the aspects that the patient is concerned with can be dealt with non-surgically utilizing fillers and Botox® (botulinum toxin type A).

If, for health reasons, the patient cannot undergo a surgical procedure or the patient is on blood thinners that would preclude one, commonly, one can improve their appearance by adding volume via fillers to the cheek area, upper and lower lip and temple region.

This, combined with utilizing Botox® for the forehead, in an effort to lift the brow, results in what I like to call a “pharmacological facelift.” No scars are left behind other than some mild, transient bruising at the injection sites. Any bruising resolves in 24 hours to a few days and usually can be masked by make up. The patient looks significantly younger because of the added volume and the recovery time is short rarely necessitating any time away from work.

plastic surgeon sf

Dr. Toth and his daughter with famed Egyptian Archaeologist Zahi Hawass

I am frequently asked by international plastic surgery societies to speak about cosmetic surgery and, in particular, I am asked to present my procedure of doing a HighSMAS facelift with simultaneous lipofilling. This is a procedure where I do my facelift tightening entirely in deep planes thereby placing no tension on the skin resulting in excellent scars, along with adding volume to the face utilizing one’s own fat. Patients are pleased with the concept of “RobbingPeter to Pay Paul” – losing some fat in an undesirable area in order to add volume to another area – in order to enhance facial beauty.



Dr. Taher Ishmail and Dr. Toth


This past November I was asked by the Egyptian Society of Cosmetic Surgery to be the Keynote Speaker at their annual meeting held in Luxor, along the Nile River where civilization existed 3000 years ago.I was asked to speak about my facelift technique where I simultaneously add fat for volume in addition to other facial procedures I perform. My Egyptian colleagues were welcoming and generous. It was fantastic to reconnect with Dr. Taher Ismail one of the most respected cosmetic surgeons in Egypt. We originally met during my training days at Harvard some 30+ years ago. Dr. Taher Ismail’s two lovely daughters; both trained plastic surgeons, are continuing their father’s work.



Touring the Great Pyramids


The Italian Society of Plastic and Reconstructive Surgery (SICPRE), Bergamo Italy

The annual meeting of the Italian Society of Plastic and Reconstructive Surgery was held

in Bergamo, Italy and I was honored to be one of the keynote speakers. I spoke about

high-SMAS facelift with simultaneous fat augmentation. As we age not only does our

skin lose its elasticity as gravity takes its toll, we also lose volume to our face. This new

way of dealing with the aging face has enormously improved the quality of outcomes.

During this visit I had an opportunity to get together with many of my former trainees,

young Italian surgeons, who are practicing in northern Italy, primarily Milan.

The annual meeting of the European Association of Plastic Surgeons (EURAPS) met in Antalya, Turkey in May. Antalya is a beautiful resort on the Gulf of Antalya in the Mediterranean Sea.  It was in this setting that I gave a talk entitled “Simultaneous Lipofilling and the High SMAS Facelift.”  In this presentation I reviewed 25 of my patients who at the time of their facelifts had their own fat transplanted into their face. This is a relatively new technique and it was well received. I attend the EURAPS meeting almost every year as it gives me the opportunity to spend time with my European colleagues to exchange ideas and discuss advances in plastic surgery. From there I traveled to Istanbul and left just days prior to the May 28th Turkish uprising in TaksimGeziPark.

I was honored to be the Invited Speaker at the 2013 Plastic Surgery Conference of the Australian Society of Plastic Surgeons in Melbourne. During this week long meeting I gave a total of eight hour-long lectures on aesthetic facial surgery that ranged from standard plastic surgical procedures to new technology like lipofilling, the procedure of taking one’s own fat and transplanting it to the face. My Australian colleagues were very interested in my 30 years of cosmetic surgery experience. Having never been to Australia, I was captivated by its beauty and how welcoming my local hosts were. I also participated in a pre-meeting symposium organized by Dr. Brian Mendelson in Melbourne. In addition, I was fortunate to be able to spend a few days in Sydney prior to my departure and found it to be every inch a cosmopolitan city like New York or London but the fact that it is surrounded by the magnificent Sydney harbor immediately relaxes the senses. I look forward to returning to Australia and exploring the outback.