Best Plastic & Cosmetic Surgeons | December 2013 Plastic Surgery Practice
A Compassionate Visionary
Emilio M. Justo, MD, Board-certified ophthalmologist
By Amy Di Leo
Imagine referring a friend to your doctor because you’re thrilled with him and your procedure results, and a few weeks later in the mail, you get a handwritten thank you note from him and a gift card. If you’re a patient of Emilio M. Justo, MD, that’s exactly what is likely to happen.
Little touches like these make it simple to see why Justo’s Arizona Eye Institute & Cosmetic Laser Center has been a fixture in the suburban Phoenix community of Sun City West for nearly a quarter century.
Handwritten thank you notes aren’t the only personal touch you’ll find from the offices of this board-certified ophthalmologist. Just about every part of the experience here says “home.”
“We do try to care for our patients like an extended family because we know that, ultimately, our practice depends on our patients continuing to see us over time and hopefully referring us new patients,” Justo says.
And refer they do. Justo’s thriving ophthalmologic and cosmetic surgery practices are equally busy and popular with patients who want to see better and look better.
Justo performs more than a dozen cataract surgeries per week, and lately, he says he’s had to carve out an additional day in the operating room to accommodate the needs of all his cataract patients.
The field of cataract surgery is growing, with new products and technologies to make the procedure faster, simpler, and more precise. Justo says one of the new breakthroughs enables him to give his cataract patients better vision along with the cataract removal.
“Ours was the second practice in Arizona to introduce a new technology called ORA (Optiwave® Refractive Analysis), a laser-guided intraoperative diagnostic device,” he shares. “After you remove the cataract and before putting in the lens implant, you use this machine, which takes a series of about 40 refractions (very fast measurements) to measure the eye before the implant is placed.”
Even though he has always taken preoperative measurements of the eye, which is industry standard, Justo says now he can also do evaluations during cataract surgery, which makes the outcomes even more accurate. Most patients recover with better, in addition to clearer, vision.
“Quite often, maybe 40 to 50 percent of the time, we make small changes in our selection of implant power based on those measurements,” Justo adds.
He also has a fix for people with cataracts who have astigmatism. Along with the cataract surgery, he can place a toric lens. The toric intraocular lens (IOL) is specialized so it can correct pre-existing astigmatism at the same time it corrects cataracts. The combination of the ORA with the toric lens translates into improved-quality distance vision. Most patients who wore glasses before the surgery no longer need them to see clearly far away.
“With the toric implant, the correction is built into the implant. For this procedure, it’s not just a matter of putting in the implant; it has to be oriented according to a meridian and axis. Before the toric, we would just mark the eye at the beginning of the case how a clock is, doing our best to line it up as close to that meridian as we’d think it would be. But now our outcomes are within 5 degrees, which is pretty tight,” he explains.
Depending on the density of the cataract, it takes Justo just 10 to 15 minutes to perform the entire procedure. The technology, technique, operative, and recovery time all translate into better results, as well as increased comfort and a better experience for his patients.
“My procedure was done using the latest technology,” says Joyce, one of Justo’s cataract patients. “I had no pain, and my anxiety was minimized by the support and care of Dr Justo and his staff before and during the procedure. Dr Justo gives you his complete, uninterrupted attention when he is working with you. You are treated with respect, and all questions you may have are answered in a no-rush manner,” she shares.
Adds another patient who did not want her name used, “Regardless of why I may have made an appointment, or what time of day the appointment is, Dr Justo always greets me as if he’s just been waiting all day just to see me.”
Respect and attention are common themes when patients and staff alike talk about Justo.
“The patients love Dr Justo because he spends a lot of time with each and every [one of them],” shares Stephanie Morlock, CPCP, COA, Justo’s main scrub assistant and a certified permanent makeup artist in the practice. “He will answer all of their questions, definitely does not rush them, and gives them all the information they need. He truly cares for each and every one of his patients,” she adds.
Dawn Vanmeter, COA, who has been with Justo for more than a dozen years, concurs. “Dr Justo spends a lot of time with his patients. If he’s in there with a patient and she has questions, he won’t leave until all of the questions are answered. He’s not going to rush them through an exam. That’s what I think makes him stand apart from other offices.”
Both Stephanie and Dawn have been a part of Justo’s practice for more than a dozen years each. Because many of his staff have been with him for a decade or longer, longevity among his employees is clearly one of the keys to his success.
“I do my best to treat my staff with respect. I value everything they contribute to my practice because they’re all my right-hand people, whether they’re the front desk—and that’s where the first impression comes from—the back office, or the nursing staff. Without each and every one of them, we wouldn’t have been able to succeed the way we have for 24-plus years,” Justo explains.
That success doesn’t only come from performing vision corrective surgery, managing eye disease, and the more medical side of ophthalmology. It also comes in the form of cosmetic enhancement procedures that Justo offers his patients as well.
Justo performs a dozen or more corrective eyelid surgeries each week—upper lids, lower lids, and a combination of both procedures using the CO2 laser exclusively since 1997. He performs the upper bleph procedure to repair upper eyelid abnormalities for aesthetic improvement and functionality. Blepharoplasty helps improve peripheral vision, brow strain, and visual fatigue, and though for many people eyelid surgery is a cosmetic procedure, Justo and his staff work tirelessly to get it covered by Medicare and other insurance because the condition causes medical issues. Two-thirds of his upper eyelid cases get covered by insurance.
His blepharoplasty technique is simple; his results speak for themselves. On the lower lids, which are never covered by insurance, Justo routinely uses transconjunctival incisions hidden inside the lower eyelid to remove fatty pouches. Justo also combines the surgical procedure with the use of a CO2 laser to perform periocular laser resurfacing. The procedure rejuvenates the eyes by reducing fine lines and wrinkles.
Justo’s practice also offers a vast array of nonsurgical services, such as permanent cosmetic makeup, tattoo removal, laser hair removal, sclerotherapy (spider vein removal), microdermabrasion, and skin rejuvenation, much of which is performed by Stephanie, as well as Roxanne Seale, RN.
Noninvasive and minimally invasive options are also available. Either Justo himself or Roxanne, who is specially trained, administer dermal fillers and neurotoxins like Botox.®
Today, Justo’s team of optometrists, ophthalmologists, technicians, opticians, and medical staff serves the greater Phoenix area in three convenient locations. The offices in Sun City and Wickenberg offer straight medical ophthalmology and optical services, while the Sun City West office offers medical, optical, and cosmetic treatments.
Justo became the full owner of the Sun City ophthalmology practice when he was just 27 years old. He says it sits at one of the busiest intersections in the area. The flagship Sun City West location also houses an Arizona state-licensed, Medicare-certified, AAAHC-accredited outpatient surgery center, which was opened in 1999. It’s where Justo performs all of his surgical procedures.
“From a practical standpoint, my patients like the idea that they’re coming to our office. They’re already familiar with the surroundings,” Justo shares. When you walk in the door, you don’t see a surgery center. The surgery center is tucked away in the back, so you already have a comfort level. The patients see the same staff of familiar faces. They like the comfort and warmth of being in the same environment that they’re used to. Practically speaking, that’s probably more important to the patient than the accreditation.”
A PRACTICE THAT HUMS
Roxanne is Justo’s director of nursing for both the surgicenter and the offices. She wears many hats as one of Justo’s right hands as a registered nurse and a certified aesthetic laser nurse.
Most surgeons are happiest in the operating room, but for Justo, it’s a little more obvious. “Dr Justo hums,” she shares.
Seale, who has been with Justo for 7 years, manages patient satisfaction surveys as part of her responsibilities. She says patients who are awake comment after their procedures, and “always mention the singing and humming that they hear from him as he does during surgery.” In fact, they say it’s their favorite thing about the surgery. “As someone who has worked with him for many years, we know when he starts to hum that he’s really in the zone.” The patients say that the humming provides a sense of comfort for them.
Lillian, one of Justo’s patients, was awake when Justo performed her upper eyelid surgery. She explains, “I was given a local anesthesia and was awake for the surgery. I very much enjoyed the music that was playing; it was engaging and happy. I’m not sure if Dr Justo was humming or whistling.”
“I originally started going to Dr Justo for my annual eye checkups and always enjoyed him and his staff’s friendly, professional attitudes, explains Dianne, a longtime patient. “I loved the convenience of being able to get my checkup and my glasses all in one stop. A couple of years ago I went to get my driver’s license renewed, and I barely passed the peripheral eye test, so I went to Dr Justo for an upper eye lift. As always, everything went smoothly with no pain involved and very little downtime. My vision was greatly improved; my eyes looked great, and everyone involved was amazing.”
She adds, “Being a native of Arizona, my skin had been severely sun damaged over the years, and I noticed a brochure in Dr Justo’s office about laser peels for damaged skin. After discussing with him the pros and cons of the procedure, I decided to try it. I loved the result. Earlier this year, I had a facelift because I wanted my skin to look as young as I felt! Due to some existing health issues, Dr Justo first said he would not do the procedure, but I worked hard at getting my health and medication under control. It wasn’t until much research and discussion with my cardiologist that Dr Justo agreed to do the procedure. Only when he was sure my health was not at risk, he agreed to do the surgery. Everything went well, and I am so happy with the result.”
Justo credits his success to a combination of education and family influence. When he was 3 years old, Justo and his parents fled Cuba and settled in Indiana and eventually in a small town in Missouri. By the time he reached high school, Justo knew he wanted to become a physician, and he was selected to attend the University of Michigan’s prestigious Integrated Pre-medical/Medical Program, completing his BS and MD degrees at the age of 23.
He spent more than 3 years of postgraduate courses training in cosmetic surgery. During his residency at Washington Hospital Center in Washington, DC, Justo eventually chose to focus on ophthalmology and began to perform many oculoplastic surgeries. With a strong interest in plastic surgery throughout his educational career, Justo says it just made sense to focus here.
“Cosmetic surgery was just a natural evolution of my liking and affinity for the whole oculoplastic realm, taking it one step further,” he says. “Certain dermatologists were doing cosmetic procedures, and there are many ear, nose, and throat physicians performing them. But for ophthalmologists, there was really just a limited number of us, even though oculoplastics is part of our specialty.”
When he opened his practice, Justo was already performing many oculoplastic surgical procedures, such as blepharoplasties.
Family is an important piece of the Emilio Justo puzzle. As his patient, Dianne, notes, “When you walk up to the door of his Sun City West office, there is a tribute to his deceased father and grandfather, thanking them for making his career possible,” she shares.
These days, Justo’s family includes not only his wife of more than a decade, Allison, and their three young children, it extends to his staff family. Stephanie, who has been providing services for Justo’s patients for 13 years, says he’s a great person to work for.
“We definitely have a ‘family atmosphere’ in that we all like each other and even get together outside the office. We work together in great harmony to make sure the patients feel good about their visits and procedures. We appreciate the hard work that we all put into the office and with our patients. And we genuinely care for one another,” she explains.
Shares Justo, “Professionalism, compassion, empathy, our dedication to what we’re doing as a team, and trying to work together as a team, these are the cornerstones to our philosophy. I’ve always emphasized the highest degree of professionalism, and at the same time stressed being compassionate and empathetic to our patients’ needs, whether it be their medical needs or even emotional or financial ones.”
Emilio M. Justo, MD
Arizona Eye Institute & Cosmetic Laser Center
19052 RH Johnson Blvd
Sun City West, AZ 85375
10701 W Bell Rd
Sun City, AZ 85351
500 W Savage St
Wickenburg, AZ 85390