9th Annual Winter Symposium on the Latest Advances

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					            9th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery
                        in conjunction with the American Society of Dermatologic Surgery and the
                            American Society of Ophthalmic Plastic and Reconstructive Surgery

Course Description                                                                           Faculty
This multidisciplinary course is designed to provide comprehensive didactics on the          Co-chairs:
latest advances and techniques in facial plastic surgery and aesthetic management            Devinder S. Mangat, MD, Cincinnati, OH, AAFPRS
of the face. It is held in conjunction with the American Society of Dermatologic             Stephen W. Perkins, MD, Indianapolis, IN, AAFPRS
Surgery (ASDS) and the American Society of Ophthalmic Plastic and Reconstruc-                William Nunery, MD, Indianapolis, IN, ASOPRS
tive Surgery (ASOPRS). Each day, separate sessions will address the latest                   Neil Sadick, MD, New York, NY, ASDS
techniques in facial plastic surgery to include topics such as: the difficult rhinoplasty,
cosmetic and reconstructive blepharoplasty, facelift and mid-face lifting, skin              Peter A. Adamson, MD, Toronto, ON, AAFPRS
resurfacing, minimally invasive aesthetic rejuvenation techniques, and implants.             Edward Bedrossian, MD, Philadelphia, PA, ASOPRS
Each session will have a panel discussion focusing on complications, successes,              Kimberly Butterwick, MD, LaJolla, CA, ASDS
what technique(s) works best, and how to avoid problem cases.                                Mark Cepela, MD, Edgewood, KY, ASOPRS
                                                                                             Ted A. Cook, MD, Portland, OR, AAFPRS
Who Should Attend                                                                            Sue Ellen Cox, MD, Durham, NC, ASDS
                                                                                             Roger A. Daily, MD, Portland, OR, ASOPRS
This symposium is presented to enhance opportunities in continuing medical
                                                                                             Jeffrey S. Dover, MD, Chestnut Hill, MA, ASDS
education for practicing physicians (with MD and DO degrees) at all levels of
                                                                                             Wallace K. Dyer, II, MD, Atlanta, GA, AAFPRS
experience in the specialties of facial plastic, oculoplastic, plastic, or dermatologic      Robert G. Fante, MD, Denver, CO, ASOPRS
surgery.                                                                                     J. Charlie Finn, MD, Durham, NC, AAFPRS
                                                                                             Robert A. Goldberg, MD, Los Angeles, CA, AAFPRS
Learning Objectives                                                                          Kriston J. Kent, MD, Naples, FL, AAFPRS
At the end of the course, participants should be able to:                                    Robert C. Kersten, MD, Cincinnati, OH, ASOPRS
W Evaluate and treat difficult nasal tip problems in primary and revision rhinoplasty        Russell W.H. Kridel, MD, Houston, TX, AAFPRS
W Have a multidisciplinary approach to cosmetic and reconstructive blepharoplasty            Corey S. Maas, MD, San Francisco, CA, AAFPRS
    with ancillary peri-orbital procedures                                                   William Mack, MD, Tampa, FL, ASOPRS
W Learn alternative face lifting techniques, SMAS, deep plane and endoscopic                 Steven Mandy, MD, Aspen, CO, ASDS
    surgery                                                                                  Ronald T. Martin, MD, Indianapolis, IN, ASOPRS
W Have an overview of resurfacing techniques and pitfalls                                    Seth Matarasso, MD, San Francisco, CA, ASDS
W Be familiar with minimally invasive aesthetic rejuvenation techniques using                Harry Mittelman, MD, Menlo Park, CA, AAFPRS
    injectables, fillers, pulsed light devices and life enhancing pharmaceuticals            Rhoda Narins, MD, White Plains, NY, ASDS
W Thoroughly discuss Alloplastic implants for aesthetic facial rejuvenation                  Christine Nelson, MD, Ann Arbor, MI, ASOPRS
                                                                                             Jeffrey A. Nerad, MD, Iowa City, IA, ASOPRS
                                                                                             Thomas Romo, III, MD, New York, NY, AAFPRS
Accreditation                                                                                John Shore, MD, Austin, TX, AAFPRS
The AAFPRS Foundation is accredited by the Accreditation Council for Continuing              James Swinehart, MD, Denver, CO, ASDS
Medical Education (ACCME) to sponsor continuing medical education for physi-                 Jonathan M. Sykes, MD, Sacramento, CA, AAFPRS
cians.                                                                                       Ralph E. Wesley, MD, Nashville, TN, ASOPRS

Credit Designation                                                                           Disclaimer
The AAFPRS Foundation designates this continuing medical education activity for              Registrants for this course understand that medical and
up to 23 hours in Category 1 of the Physician's Recognition Award of the American            scientific knowledge are constantly evolving and that the
Medical Association.                                                                         views and techniques of the instructors are their own and
                                                                                             may reflect innovations and opinions not universally
                                                                                             shared. The views and techniques of the instructors are
Needs Statement                                                                              not necessarily those of the Academy or its Foundation
New advances and technologies are entering the arena of facial plastic surgery at a          but are presented in this forum to advance scientific and
staggering rate. This course is designed to keep experienced facial plastic                  medical education. Registrants waive any claim against
surgeons abreast of the latest development in technique and technology, to ensure            the Academy or its Foundation arising out of information
                                                                                             presented in this course. Registrants also understand that
that they can bring the most knowledgeable care to their patients.                           operating rooms and health-care facilities present inherent
                                                                                             dangers. Registrants waive any claim against the
                                                                                             Academy or Foundation for injury or other damage
                                                                                             resulting in any way from course participation.

2
          9th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery
                     in conjunction with the American Society of Dermatologic Surgery and the
                         American Society of Ophthalmic Plastic and Reconstructive Surgery

Sunday, March 10, 2002                     4:45pm Cosmetic Orbital Surgery:            SOOF and Mid-Facelift
6:30am Continental Breakfast/Exhibits             Dealing with Prominent Eyes          3:30pm Liposhaving: Is it Safe and
7:00am Welcoming Remarks                          Ralph E. Wesley, MD                         Effective?
       Devinder S. Mangat, MD              5:00pm Ophthalmic Complications of Facial          Ted A. Cook, MD
                                                  Plastic Surgery                      3:45pm Mid-Facelift and SOOF Lift
Rhinoplasty                                       William Mack, MD                            Robert A. Goldberg, MD
7:05am Nasal Tip Support                   5:15pm PANEL: Blepharoplasty                4:05pm Mid-Facelift: Indications and
        Wallace K. Dyer, II, MD                   Moderator: William Nunery, MD               Personal Technique
7:15am Vertical Lobule Division                   Panelists: Robert A. Goldberg,              Stephen W. Perkins, MD
        Peter A. Adamson, MD                      MD, Robert C. Kersten, MD,           4:20pm Mid-Facelifting with Rhytidectomy
7:30am Structural Revision Tip                    Ronald T. Martin, MD, Jonathan              Kriston J. Kent, MD
        Rhinoplasty                               M. Sykes, MD, Ralph E. Wesley,       4:35pm Mid-Facelift Through Lower Lid
        Ted A. Cook, MD                           MD                                          Blepharoplasty
7:45am Correction of Valvular Collapse     6:00pm Welcome Reception/Exhibits                  Ted A. Cook, MD
        Using Porous Batten Graft          7:00pm Adjournment                          4:50pm Limited SOOF Lift in Reconstructive
        Thomas Romo, III, MD                                                                  Cosmetic Surgery
8:00am Lengthening the Short Nose          Monday, March 11, 2002                             Mark Cepela, MD
        Stephen W. Perkins, MD             6:30am Continental Breakfast/Exhibits       5:05pm Mid-Facial Contouring with
8:15am Tongue in Groove Technique for      7:00am Welcome Remarks                             Implants
        Tip Rotation and Hanging                  Stephen W. Perkins, MD                      Devinder S. Mangat, MD
        Collumella                                                                     5:15pm PANEL: Mid-Face Treatment
        Russell W. H. Kridel, MD           Reconstructive Blepharoplasty                      Alternatives
8:30am PANEL: Challenging                  7:05am Correction of Lower Lid Ectropion           Moderator: Devinder S. Mangat,
        Rhinoplasty Cases                          Wallace K. Dyer, II, MD                    MD
        Moderator: Harry Mittelman, MD     7:15am Ptosis Repair: Diagnosis and                Panelists: Ted A. Cook, MD, Mark
        Panelists: Peter A. Adamson, MD,           Technique                                  Cepela, MD, Robert A. Goldberg,
        Ted A. Cook, MD, Stephen W.                Robert C. Kersten, MD                      MD, Kriston J. Kent, MD, Stephen
        Perkins, MD, Thomas Romo, III,     7:40am Orbital Trauma and the Cosmetic             W. Perkins, MD
        MD                                         Rehabilitation                      6:00pm Adjournment
9:15am Morning Session Adjourned                   Ronald T. Martin, MD
                                           8:00am Laser Blepharoplasty and             Tuesday, May 12, 2002
3:00pm Apres Ski Break/Exhibits                    Periorbital Resurfacing             6:30am Continental Breakfast/Exhibits
                                                   Jeffrey A. Nerad, MD                7:00am Welcome Remarks
Cosmetic Blepharoplasty                    8:20am Browlifting Alternatives                    William Nunery, MD
3:30pm Surgical Anatomy of Eyelids and             Roger A. Dailey, MD
        Brow                               8:40am Botox Assisted Forehead Lift         Face Lifting
        Edward Bedrossian, MD                      Wallace K. Dyer, II, MD             7:00am Multivector 3-Layer Facelift
3:45pm Aesthetic Evaluation of the         8:50am Endoscopic Forehead Lift:                     Harry Mittelman, MD
        Periorbital Region                         Fixation Alternatives               7:15am Tisseel Assisted Low Morbidity
        Jonathan M. Sykes, MD                      Devinder S. Mangat, MD                       Facelift
4:00pm Upper Lid Blepharoplasty            9:05am Endoscopic Forehead Lift Using                Devinder S. Mangat, MD
        Christine Nelson, MD                       Long Term Fixation                  7:30am Facelift Utilizing Autologous Platelet
4:15pm Lower Lid Blepharoplasty:                   Thomas Romo, III, MD                         Gel
        Transconjunctival vs. Subciliary   9:20am Morning Session Adjourned                     Thomas Romo, III, MD
        Fat Repositioning                                                              7:45am The Aging Neck
        Robert G. Fante, MD                3:00pm Apres Ski Break/Exhibits                      Rhoda Narins, MD
4:30pm Lower Lid Blepharoplasty: A                                                     8:00am Extended SMAS – Deep Plane
        Personal Approach                                                                       Facelift
        Harry Mittelman, MD                                                                     Jonathan M. Sykes, MD
                                                                                                                                  3
          9th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery
                     in conjunction with the American Society of Dermatologic Surgery and the
                         American Society of Ophthalmic Plastic and Reconstructive Surgery

8:15am Inconspicuous Incisions in Facelift   Wednesday, March 13, 2002                   5:00pm The Future of Hair Transplantation
       Surgery                               6:30am Continental Breakfast/Exhibits              James Swinehart, MD
       Russell W. H. Kridel, MD              7:00am Welcome Remarks                      5:15pm PANEL: Discussion of Bovine
8:25am Combined Face-lifting and Full               Neil Sadick, MD                             and Human Cadaveric
       Face CO² Laser Resurfacing                                                               Collagen and Acellular Dermis
       Stephen W. Perkins, MD                Minimally Invasive Aesthetic Rejuvenation          Moderator: Sue Ellen Cox, MD
8:40am Endoscopic Facelift                   7:05am The Enigma of Beauty                        Panelists: Russell W. H. Kridel,
       Robert A. Goldberg, MD                          Jeffrey S. Dover, MD                     MD, Steven Mandy, MD, Seth
8:55am PANEL: Facelift                       7:15am Botox                                       Matarasso, MD, Neil Sadick, MD,
       Moderator: Peter A. Adamson, MD                 Seth Matarasso, MD                       James Swinehart, MD
       Discussions with Audience             7:30am Botox Techniques for Upper and       6:00pm Adjournment
       Participation                                   Lower Thirds of the Face
9:20am Morning Session Adjourned                       Harry Mittelman, MD               Thursday, March 14, 2002
                                             7:45am Myoblock: An Alternative to Botox    6:30am Continental Breakfast/Exhibits
3:00pm Apres Ski Break/Exhibits                        Neil Sadick, MD
                                             8:00am Full Face Fat Rejuvenation           Implants
Resurfacing                                            Kimberly Butterwick, MD           7:05am Use of Alloplastic Materials and
3:30pm Medium and Deep Chemical Peels        8:15am The Future of Fat                             Homologous Grafts
        Steven Mandy, MD                               Sue Ellen Cox, MD                          John Shore, MD
3:45pm Variable Strength Baker-Gordon        8:30am Restylene, The Latest Injectable     7:15am Importance of Facial-Mandibular
        Chemical Peel: A New Frontier                  Filler                                     Contouring
        Devinder S. Mangat, MD                         Rhoda Narins, MD                           Harry Mittelman, MD
4:00pm Caveats of Chemical Peeling           8:45am Subcision Dermal Grafting for        7:30am Pre-jowl Sulcus Effacement Using
        Seth Matarasso, MD                             Facial Scarring                            Gore Tex Wafers
4:15pm Dermabrasion                                    James Swinehart, MD                        Thomas Romo, III, MD
        Steven Mandy, MD                     9:00am Myoblock: An Ongoing Study           7:45am Lip Augmentation and Perioral
4:30pm Combined Resurfacing                            Corey S. Maas, MD                          Enhancement
        Techniques for the Face and Neck     9:15am Morning Session Adjourned                     Stephen W. Perkins, MD
        Stephen W. Perkins, MD                                                           8:00am Use of Gore Tex Sling in Facial
4:45pm Role of Platelet Gel in CO² and       3:00pm Apres Ski Break/Exhibits                      Rejuvenation
        Erbium Resurfacing                                                                        Wallace K. Dyer, II, MD
        Kriston J. Kent, MD                  3:30pm New Findings in IPL (Intense
                                                                                         8:15am Facial Plastic Surgery and
5:00pm Is There a Role for Laser                    Pulsed Light) Photo Rejuvenation
                                                                                                  Dermatology: An Interdisciplinary
        Resurfacing in 2002?                        Neil Sadick, MD
                                                                                                  Practice
        Jeffrey S. Dover, MD                 3:45pm Coblation: A New Technology in
                                                                                                  J. Charlie Finn, MD
5:15pm PANEL: Resurfacing                           Facial Rhytid Smoothing
                                                                                         8:30am Cosmetic Otoplasty
        Moderator: Steven Mandy, MD                 Ted A. Cook, MD
                                                                                                  Peter A. Adamson, MD
        Panelists: Jeffrey S. Dover, MD,     3:55pm Long Pulsed Dye Laser Treatment
                                                                                         8:45am PANEL: Facial Implants
        Kriston J. Kent, MD, Devinder S.            of Vascular Lesions
                                                                                                  Moderator: Russell W. H. Kridel, MD
        Mangat, MD, Seth Matarasso, MD,             Sue Ellen Cox, MD
                                                                                                  Panelists: Wallace K. Dyer, II, MD,
        Jeffrey A. Nerad, MD                 4:10pm Photorejuvenation: Protocol and
                                                                                                  Harry Mittelman, MD, Thomas
6:00pm Adjournment                                  Results
                                                                                                  Romo, III, MD, John Shore, MD
                                                    Kriston J. Kent, MD
                                                                                         9:15am Morning Session Adjourned
                                             4:25pm Alloderm and Cymetra
                                                    Russell W. H. Kridel, MD
                                                                                         3:00pm Apres Ski Break/Exhibits
                                             4:40pm Growth Factors in Facial
                                                    Rejuvenation
                                                                                         3:30pm PANEL: Open Forum with
                                                    Kimberly Butterwick, MD
                                                                                                Faculty
                                             4:50pm E-PTFE for Aesthetic Facial
                                                    Rejuvenation                         5:00pm Meeting Adjourned
4                                                   Corey S. Maas, MD
            9th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery
                        in conjunction with the American Society of Dermatologic Surgery and the
                            American Society of Ophthalmic Plastic and Reconstructive Surgery

Lion Square Lodge and Conference Center                                     Vail Valley
Lion Square Lodge and Conference Center presents you with the               There’s no place like it anywhere else. The heart of Vail is comprised
premier year-round destination resort in the heart of the Colorado          of the Tyrolean-inspired Vail Village and the more contemporary
Rockies. Lion Square is just steps away from Vail’s new 12-passenger        Lionshead. Both are nestled between the mighty peaks of the Gore
gondola and the Born Free Express Quad. In addition, the famous             Range at an elevation of 8,200 feet with surrounding peaks soaring to
shops, restaurants and nightlife of Vail and Lionshead are an easy          heights of over 13,000 feet.
walk from the property.
   Unlike most typical hotels or condominium properties, Lion Square        A unique blend of American and European cultures, Vail is cosmopoli-
Lodge combines the comfort of a mountain lodge with the services and        tan yet relaxed. Picturesque, winding pedestrian streets feature
amenities of a hotel. With the addition of the $12 million Eagle Bahn       colorful shops and boutiques, an international potpourri of restaurants
Gondola right outside the door, Lion Square Lodge’s ski-in/ski-out          and cafes, a sparkling nightlife and breathtaking vistas at every turn.
location is more convenient than ever. Each of the spacious condo-
minium units includes a living room, full kitchen, fireplace, balcony and   Winter in the valley is also a perfect time for an exhilarating horseback
barbecue grill along with special touches such as a welcome gift, voice     ride through some of the area’s most pristine wilderness, or join a
mail, hair dryers, and daily newspaper delivery.                            group of new-found friends on a horse-drawn sleigh ride over the
   Amenities include: Welcome gift and coffee in unit, outdoor heated       new-fallen snow.
pool, three outdoor hot tubs, two saunas, privileges at the Cascade
Health Club and Spa, complimentary coffee in the lobby, free on-site        Then there’s that fabulous mountain! A skier and snowboarder
parking, 24-hour front desk, complimentary ski valet and storage,           paradise in the winter ... As the temperature drops and the snow
bathrobes and humidifiers, cable TV and HBO.                                begins to fall, Vail comes alive with winter activities, including: alpine
                                                                            skiing; snowboarding; ice skating; snowshoeing; Nordic/cross-country
Rental Car Discounts                                                        skiing; snowmobiling; sledding; ice fishing; hot-air ballooning; sleigh
Our official rental car company is Hertz. To obtain these great             rides; horseback riding; and ice climbing. Vail Mountain truly offers
discounted rates, you may either call Gateway Travel Management at          something for everyone.
1-(888) 661-2613 (toll free) and they will arrange for your car rental
(Group Code xxxxx), or you can call Hertz at 1-800-654-2240 and             The young, and the young-at-heart, will delight in Vail’s newest on-
give them our group code: xxxxx. The following rates are available          mountain playground. Adventure Ridge offers an eight-lane tubing hill,
from Denver.                                                                an outdoor ice skating rink, two snowboarding half-pipes, sled dogs,
                                                                            five unique restaurants, late-night dancing, and--one of the most
Car Class                 Daily Per Day Weekend Weekly                      exciting new sports to hit the slopes--guided snow biking tours.
                                        per day (5-7 days)
                                                                            Ski Rental Information
Economy 2DR               $34.99          $21.99        $129.99             To make renting your ski equipment convenient, we have arranged
Compact 4DR               $39.99          $25.99        $149.99             with Specialty Sports to have ski equipment available for you to rent.
Midsize 2/4 DR            $42.99          $27.99        $169.99             After you have registered to attend Latest Advances in Facial Plastic
Sporty 2 DR               $45.99          $32.99        $179.99             Surgery, you will be sent a reservation form which you can return to
Fullsize 4 DR             $49.99          $34.99        $194.99             Specialty Sports by mail or by fax. They will provide AAFPRS with
Luxury                    $65.99          $62.99        $274.99             reduced rates on five different packages: Sport, Performance, Demo,
4Wheel Drive              $65.99          $62.99        $274.99             Junior and Snowboard.
Minivan                   $69.99          $64.99        $289.99
                                                                            Group Ski Lift Tickets
                                                                            Group ski lift tickets will be sold at registration. For planning purposes,
                                                                            group ski lift tickets are priced as follows:
                                                                                                    Adult per day            Total
                                                                                1 day                $61                       $61
                                                                                2 day                $61                       $122
                                                                                3 day                $57                       $171
                                                                                4 day                $57                       $228
                                                                                5 day                $55                       $275
                                                                                6 day                $49                       $294
                                                                                7+ days              $49                                              5
           9th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery
                        in conjunction with the American Society of Dermatologic Surgery and the
                            American Society of Ophthalmic Plastic and Reconstructive Surgery

Dress                                             Course Registration                                 Registration Categories and
Attire for this symposium is very casual. It is   The registration fee covers attendance to the       Instructions
not unusual to see attendees in ski clothes or    scientific session, exhibits, continental           Physicians
very casual warm clothes. Of course, be           breakfasts, Welcome Reception and apres             Physicians (with MD and DO degrees) who
prepared for either cold weather or sunny         ski breaks. The registration form and               wish to receive CME credit must register as
and warm weather.                                 payment must be received in the AAFPRS              physicians in the appropriate registration
                                                  Foundation office by February 8, 2002 in            category and designate their medical degree.
Exhibits                                          order to qualify for the pre-registration fee.      (Non-MDs and DOs will receive a certificate
All continental breakfasts, apres ski breaks,     After February 8, 2002, you will be charged         of attendance.)
and the Welcome Reception will occur in the       the on-site fee. Spouse and guests will be          ! Society Members: Members of the
exhibit area. The exhibitors are an integral      charged and ticketed for the Welcome                societies noted on the adjacent registration
part of this program and they benefit             Reception.                                          form who are current in membership
tremendously from interacting with attendees.                                                         requirements and dues.
Help us to continue this valued partnership       On-Site Registration                                ! Non-Members: Physicians who are not
by supporting and encouraging the                 On-site registration will be held at the Lion       currently members of the societies noted on
exhibition.                                       Square Lodge starting Saturday, March 9,            the adjacent form.
                                                  2002 from 3:00pm to 6:00pm. Please note             ! Residents: Member and non-member
Meeting Contact                                   that on-site fees will apply when you register      residents in training.
Questions on any of the information provided      after February 8, 2002.                             ! Fellowship Participants: Fellows
in this brochure may be directed to:                                                                  participating in an AAFPRS Foundation
Joanie Amorosi, CMP                               Cancellation Policy                                 Fellowship Program between July 1, 2001
Meeting and Exhibits Asst. Manager                Cancellations require a written notification. A     and June 30, 2002.


                                 #
AAFPRS Foundation                                 full refund, less a $75.00 cancellation fee will
310 S. Henry Street                               be made before February 8, 2002. After              Non-Physicians
Alexandria, VA 22314                              February 8, 2002, no refunds will be                ! Facial Plastic Surgery Assistants:
Phone: (703) 299-9291, ext. 237                   granted.                                            Members or non-members of the Organiza-
Fax: (703) 299-8898                                                                                   tion for Facial Plastic Surgery Assistants
Email: jamorosi@aafprs.org;                                                                           (OFPSA) who are medical assistants and
                                                  Meeting Site
Web site: www.aafprs.org                                                                              office personnel must register under this
                                                  Lion Square Lodge and Conference Center
                                                                                                      category to receive a letter of attendance,
                                                  660 W. Lionshead Place
                                                                                                      which acknowledges participation.

                                  !
No Smoking Policy                                 Vail, Colorado 81657; 1-(800) 525-5788
The AAFPRS Foundation                                                                                 ! Allied Health Professionals: Individuals
has a no-smoking policy                                                                               who are nurses, physician assistants,
                                                  Room Rates                                          surgical assistants must register under this
prohibiting smoking during sessions and
                                                  Room rates are: Lodge room: $269.00; one            category to receive a letter of attendance,
social events.
                                                  bedroom condominium $429.00; One                    which acknowledges participation.
                                                  bedroom plus loft condominium $589.00; two          ! Spouse/Guest: Individuals accompany-
Welcome Reception                                 bedroom condominium $645.00. The hotel              ing a registered physician either as a guest
All registrants are invited to attend the         cut-off date is January 23, 2002. There is a        or spouse. Registration will permit entrance to
Welcome Reception on Sunday, March 10,            four-night minimum stay for reservations. A         the exhibits and Welcome Reception.
2002 at 6:00pm. Guests and spouses may            credit card number or a check must
purchase tickets to attend the reception. See     accompany individual room reservations for
registration form for fees.                       an amount equal to two night’s stay to
                                                  guarantee a reservation. The cancellation
                                                  fee is 50% of the deposit if the reservation is
                                                  cancelled 42 days or more prior to arrival.
                                                  The deposit is fully forfeited if the reservation
                                                  is cancelled 29 days or less prior to arrival.
                                                  Check-in time is 4:00pm. Check-out time is
                                                  10:00am.
6
            9th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery
                        in conjunction with the American Society of Dermatologic Surgery and the
                            American Society of Ophthalmic Plastic and Reconstructive Surgery
                                                                                   +You may register as a Society Member if you are a
  Please use a separate form for each registrant.                                  member of any one of these societies (please check
                                                                                   all that apply):
  Registration Fees                           Pre-reg.             On-site         m AAFPRS
                                              Before Feb. 8        After Feb. 8    m American Society of Dermatologic Surgery (ASDS)
  m SocietyMember+                            $695                 $745            m American Society of Ophthalmic Plastic and
  m Non-Member                                $845                 $895                Reconstructive Surgery (ASOPRS)
  m Resident Member*                          $425                 $475            m Australasian Academy of Facial Plastic Surgery
  m Non-Member Resident*                      $495                 $545            m Brasilian Society of Rhinology and Facial Plastic Surgery
  m OFPSA Member                              $245                 $275            m Canadian Academy of Facial Plastic and
  m OFPSA Non-Member                          $275                 $305                Reconstructive Surgery
  m Allied Health Professional                $425                 $475            m Colombian Society of Facial Plastic Surgery and
  m Member in AAFPRS Fellowship $100                               $100                Rhinology
  *Registration must include written verification from program director            m European Academy of Facial Plastic Surgery
  Welcome Reception tickets                                                        m The Mexican Society of Rhinology and Facial Surgery
      Adult                                   $35 No. of tickets _____
      Child over 5 years of age               $20 No. of tickets _____             How did you hear about this meeting?
                                                                                   m Journal AD m Brochure Mailing m Internet/E-mail
  TOTAL ENCLOSED $________________ (U.S. Funds)                                    m Repeat Registration
Type or Print Clearly



Last/Family Name (as it will appear on badge)                  First Name                                        MI                Degree


Business Mailing Address


City                                                           State     Zip/Postal Code               Country


Business Phone (include appropriate area/country code) Facsimile


Spouse/Guest                                                                                E-mail Address

Payment Method
Payment must accompany registration. Payment (in U.S. funds) can be made by personal check (payable to the AAFPRS Foundation) or
charged to the cards indicated here. [ ] Check [ ] Visa [ ] American Express [ ] MasterCard [ ] Diners Club [ ] Carte Blanche


Card Number                                                                       Print Name on Card


                                                                                      AAFPRS Use Only
Exp. Date                         Authorized Signature
Complete this section if billing address is different from above.                     Date Received ________________________________________
Billing Address ___________________________________________________                   Check # _____________________________________________
                                                                                      CC app. _____________________________________________
_______________________________________________________________                       Conf. Date ____________________________________________
Please mail or fax this form to: AAFPRS Foundation                                    Ref. Date _____________________________________________
310 S. Henry Street, Alexandria, VA 22314; Fax (703) 299-8898.

				
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