A blemished career
William Birnbauer
May 18, 2008
Page 1 of 6 | Single page
Once considered among medicine's best and brightest, driven cosmetic surgeon Cynthia Weinstein is again facing allegations that she has botched procedures.
FITNESS nut Ron Silverstein was running hard along Kew Boulevard early one morning when he heard footsteps zeroing in behind him. He hurried along, only to see "this person fly at enormous pace right past me. (She) whizzed past just like the wind," he recalls.
She was slight â€" a wisp â€" but clearly a very determined athlete, he thought as she disappeared ahead in the dark. Soon after, he spotted her at his gym, in the middle of a punishing workout. With blonde hair pulled back, she exercised crazily, pushing herself, lifting impossible weights. Competing. Lifting more. She was so fragile-looking, he was sure she would snap.
He discovered that Cynthia Weinstein doesn't snap physically or mentally. She ran every morning, even once when she had stress fractures in her foot. She worked out in the gym after her run, and again at night after work.
Silverstein, who befriended and trained with Weinstein for several years, says: "Even though she's got a very light frame, Cynthia's mind tends to rule the rest of her body. She has more strength and determination than anybody I've seen … an unbelievable degree of perseverance."
Run, Cynthia, run.
NOTE: REGULAR EXERCISE INDEED KEEPS THE BODY IN TIP TOP CONDITION.
Weinstein, 53, in her third appearance before the Medical Practitioners Board of Victoria, faces serious allegations of unprofessional conduct that could result in restrictions on her practice, suspension or deregistration as a doctor.
The hearings, adjourned pending a decision in the Court of Appeal, centre on her treatment of six patients, including one said to be left with significant "facial asymmetry", swelling and "extensive puckering" of her skin. In another case, she allegedly breached conditions imposed on her registration by injecting a patient with silicone. Separately, she allegedly repaid a dissatisfied patient $3300 on the condition she did not make complaints against her.
NOTE: MEDICAL MALPRACTICE IS PUNISHABLE BY LAW... IRREGARDLESS IF THE DOCTOR IS FAMOUS OR NOT.
Silverstein, a lawyer, is one of several acquaintances and colleagues who have seen Weinstein, Australia's most notorious and peculiarly recognisable cosmetic surgeon, push boundaries in ways that are often brilliant, but can also be disastrous.
The frantic, adrenalin-fuelled energy is not confined to exercising. A general practitioner once recalled that in her early years in practice she was "hyperactive to the extreme, to the point of almost being manic".
Silverstein saw her juggling eight patients at once; rushing here and there, often working weekends. In her surgery, recalls a former bookkeeper, "everybody was going in all directions". She saw 26 patients a day. There were also overseas conferences, scientific papers to write, drug company representatives to meet.
Silverstein noticed, too, her intense irritation if the doors to the gym opened even a minute late; her intolerance of people she felt did not live up to her standards.
NOTE: QUALITY SERVICE IS MORE IMPORTANT THAN QUANTITY SERVICE.
Whatever she has performed on her patients, it is her own appearance that causes most comment, even alarm. Only Weinstein and her cosmetic molders, said to be mainly in the United States, know precisely what she's had done to her face. Local experts guess it includes cheek implants, facelifts, nose and chin jobs, injections of dermal fillers, and probably more. Rumours abound she injected silicone into her own face.
Silverstein avoided asking his training buddy about her oddly-sculpted face. "I think she's done a lot of work, but you know over all the years I never discussed it with her. It's probably too personal …"
Asks a plastic surgeon: "Why do people persist in going to see her? I've had patients say, 'I had a look at her and I just left'." Another plastic surgeon says: "She's the most bizarre looking specimen that you can see. That just makes you wonder what sort of mindset she has."
Once, she was considered medicine's best and brightest. Now, once more facing serious allegations before the medical board, any support she had from Melbourne's wealthy, close-knit circle of plastic surgeons, dermatologists and cosmetic doctors has evaporated.
Says a specialist who treated a number of Weinstein's former patients: "I defended Cynthia for the first 10 years that she was mucking up people, but I just can't do it any more. I just can't do it any more."
The medical board in 2000 heard allegations about Weinstein that appeared to be totally at odds with a medical specialist who was once so highly regarded. The allegations included this: "You did not advise your patient that the brow lift would involve inserting metal screws into her head."
This: "As a result of the surgery, your patient developed a permanent palsy of the mandibular branch of the right facial nerve."
And this: "You failed to advise and/or warn your patient that she would still be left with a very large flap of skin that would hang down between her thighs."
The board suspended her for six months after finding she had engaged in serious professional misconduct in the treatment of two patients. In a deal hammered out between her lawyers and the board, allegations involving another six patients were adjourned indefinitely.
Weinstein undertook to restrict herself to the diagnosis, treatment and prevention of skin diseases. This meant she could use lasers for skin resurfacing and the treatment of facial and leg veins, tattoos and benign lesions, and could also perform chemical peels, hair transplants and administer fillers like botox. She was allowed to remove benign and malignant skin lesions. But she was prohibited from doing cosmetic and other surgical procedures.
After the case, the liposuction patient left with the skin flap between her thighs was disappointed that Weinstein had not apologised to her victims. "I don't think this is the last time that we will hear from her. She is beyond repair," she said presciently.
In 2004, Weinstein was convicted in the County Court of defrauding Medicare in 203 claims involving 15 patients. The medical board later found the offences involved dishonesty and a breach of trust and fined her $2000 as well as imposing conditions on her practice.
IN THE current hearings, the board alleges Weinstein breached the 2000 restrictions on her practice by performing cosmetic surgery, including 287 "skin stitch" procedures, excisions, incisions and "fat pad removals". She injected liquid silicone into patients without proper authority, the board says.
During a "skin stitch" procedure, the board says, Weinstein did not dispose of used syringes or needles as required, and a division two nurse, known as Ms TR, was pricked. "The needle that pricked Ms TR had been used on a patient who later tested positive for HIV." Last month a patient told the board Weinstein had failed to correctly cover her eyes while using a laser, resulting in her corneas being eroded on their surface. "I looked like I had been in a boxing ring," she said.
Weinstein is fighting the charges, asserting that the "skin stitch" and "fat pad" procedures were not surgical procedures. Her lawyers this month unsuccessfully went to the Supreme Court seeking to disqualify the panel due to it having an ostensible or apprehended bias. They have now appealed to the Court of Appeal, and the medical board's hearings have been adjourned pending the outcome.
Ron Silverstein exercised with Weinstein on Sunday mornings for seven or eight years and recalls that they spoke on the phone most nights. He confesses: "In the beginning, I found her very physically attractive …"
Silverstein is quite a character â€" he was once honorary consul for the West African republic of Liberia â€" and is currently fighting a $14 million tax bill he insists has been issued "without having received one dollar or being entitled to one dollar".
He believes Weinstein inherited her drive from her father, Michael, a postwar immigrant with his wife from Poland. Michael Weinstein was born in the northern town of Wloclawek, where many Jews died during the Nazi occupation in 1939.
"She's got this sort of survivor mentality which I think comes from her dad," Silverstein says.
Michael Weinstein is a key shareholder in Glenvill Pty Ltd, which owns Glenvill Homes, a well-known home builder. He is described as a tough, competitive businessman, but gained a higher profile in Melbourne in the 1970s and '80s for his enthusiastic promotion of soccer, then hardly visible in football-dominated Melbourne. He was chairman of the Victorian Soccer Federation and vice-president of the Australian Soccer Federation, which he helped create. Today, aged 86, he is a trustee and life president of the Football Federation of Victoria.
Michael and his wife, Josephine, had three daughters. Tragically, one of Cynthia Weinstein's sisters died after the taxi she was in was involved in an accident. Friends say Weinstein, who was in primary school, witnessed the death. Another sister, seven years Weinstein's junior, is a solicitor in Sydney.
Weinstein went to Mount Scopus Memorial College â€" she was school vice-captain in year 12 â€" and was active in the Ajax Maccabi Athletics Club where, while not exceptional, she tried out for most things.
In 1978, young Weinstein equal-topped clinical medicine in her final year exams, winning Melbourne University's prestigious Jamieson Prize and several other awards.
She completed her specialist medical qualifications as a physician and a dermatologist at the Austin and the former Prince Henry's hospitals and travelled to the United States in the 1980s to learn how to use lasers to treat skin conditions.
Her timing was perfect â€" major advances in laser technology were bumping up against a postwar generation that did not want to age. Lasers were a fast and effective response to exploding consumer demand for rejuvenated skin, free of wrinkles, acne scars and sun blemishes. Lasers not only cut but could also target blood vessels and pigmentation and stimulate collagen growth, acting as a non-invasive alternative to dermal fillers.
"We can now wind back the clock five to 10 years without requiring surgical facelifting," Weinstein said in 1999. "Although lasers hold the mystique of a magic wand, they are in fact extremely precise and complex tools that can selectively remove sun-damaged skin, allowing a newly rejuvenated skin to form."
NOTE: WEINSTEIN'S DETERMINATION DIDN'T AFFECT HER FOCUS IN SUCCEEDING. TOUGH TIMES NEVER LAST.
Weinstein rapidly gained an international reputation for laser skin resurfacing and became a regular on the global medical conference circuit, as well as publishing research findings in professional journals. Always up with new techniques, she also promoted the use of ultrasonic liposuction and laser eyelid surgery. She became chairwoman of the Australian College of Cosmetic Surgery's laser committee and was its director of medical training. Media appearances turned her into one of Australia's first celebrity doctors.
Critics concede she is highly intelligent … and yet there's this obsessive, abnormal drive, they say, that clouds her judgement. She strives to be the best but lacks empathy for the victims â€" and there are several â€" of her botched procedures.
"She's a driven person both physically and professionally and lacking in emotional insight … lacking in pathos and emotion," says a professional colleague who, like others, declined to be named due to her litigious reputation.
The same colleague says: "She will stand up in lectures … and say all the right things and give you all the contraindications and all the risks. She will list them and detail them and they're dead right. If you followed her protocols you'd be on reasonably safe ground. But what she says in that lecture and what she does in the privacy of her own setting … those two don't meet. When she gets into her own setting, she can't help herself."
A dermatologist says that in trying for a fantastic result rather than a reasonable one, Weinstein sets the energy on cosmetic lasers at levels that increase the risk of complications. "I think her judgement is faulty. (She has an) inability to pull back from pushing the boundaries in any particular procedure."
Her insatiable hunger to be the best has meant that her life revolved around work and the gym. Weinstein and her husband of 22 years, Marshall Segan, are fighting a protracted property dispute after the breakdown of their marriage. Their twins, a boy and a girl, are almost 19 and an older daughter is 21.
Segan was the practice manager of the surgery in Victoria Parade, East Melbourne, where Weinstein created a lucrative and aggressively promoted cosmetic surgery and dermatology clinic.
"He is totally different to her," Silverstein says of Segan. "In that relationship, I think he acted like the mother. She was working all the time. I think the husband probably found her very difficult to control, that's the way I see it. I think she'd be most difficult for anybody â€" you can't control Cynthia. Unless you fit in with her timetable and regime … you basically couldn't have any relationship with her."
A family acquaintance says: "They (Segan and the children) left her in a 90-square (metre) house (in Toorak) to live in by herself and they moved into this tiny little place in Hawthorn because that was still a whole lot better than living with Cynthia."
Weinstein moved several years ago from her East Melbourne day procedure centre to a swankier address in High Street, Armadale, and renamed her practice "Dr Skin". It is conveniently located across the road from the gym she frequents. The practice changed names again recently to CDC Clinics. Asian women are said to make up a high percentage of her clients.
In 2002, Preston dermatologist John Fewings died unexpectedly, leaving behind a wife and three children and a busy practice with a large mortgage. When his wife, Lynne Ahmad, appealed to dermatologists to help the practice survive, Weinstein responded and started working there a day or two a week. It was an act of kindness that saved the practice from closure, the medical board heard in 2004.
But such praise is rare. Silverstein notes that unlike the case of Professor Thomas Kossmann, the controversial trauma surgeon suspended by The Alfred hospital, there hasn't been any public support for Weinstein from peers or clients. What could have been a brilliant career looks as blemished as some of her patients, or indeed, as she does.
"Medicine is not about being the best," says a former associate. "Medicine is about being the safest, staying within parameters. Cynthia can't do that, she's a risk taker. She pushes envelopes because she is so psychologically desperate about her own inadequacy â€" she has to be better than others."
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