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THE DESCENDANT 58 MARCH 2016 | Med Esthetics Dr. Weiss became the fi rst member of his family to pursue higher education, graduating from Columbia University and then the Johns Hopkins University School of Medicine in 1978. "You get exposed to everything in med school. Of all the different rotations, the two that appealed to me were radiol- ogy and dermatology, because they were both visual," he says. "After one year of internal medicine, I did a year of radiology but found that hours of standing and reading chest X-rays was not as fascinating as I thought it was going to be. Fortunately a slot opened up in dermatology at Johns Hopkins, so I applied for it, got it and switched from radiology to dermatology." Building His Practice After completing a research fellowship in immunologic diseases at the National Institutes of Health, Dr. Weiss initially planned to go back to Johns Hopkins as a full-time junior faculty member. When he realized he was less than enthusiastic about the type of research he was assigned, his plans shifted. "It was then I decided to open a practice and be part-time faculty at the same time," he says. "It was 1985 and, at that time, there were none of the constraints or regulations that graduating doctors now have to put up with—it was kind of the norm to start your own little independent practice rather than join a group practice." Dr. Weiss admits that a lack of patients in the beginning was worrisome, but he knew it would take time to build a solid patient base. In fact, it took about a year before the practice, then called Dermatology Associates, was able to book 5 to 10 patients a day. "I grew into it. As the practice got busier over the fi rst two to three years, I started cutting out clinics at Johns Hopkins," says Dr. Weiss. "I did not have an offi ce manager and had to do everything myself at fi rst. Within a year or two of establishing the offi ce, my wife Margaret also joined the practice. That's when it started to grow, and we were able to hire more employees." A Golden Era One of the unique attributes that helped the Weiss' build their practice was Dr. Weiss' interest in laser medicine. He was at the forefront of using laser technologies for dermato- logic concerns, acquiring a small CO 2 device in 1986 and an argon laser a year later. "I had a strong interest in devices—I had worked a little bit with the machines in radiology and decided that was the direction I wanted to go. Of course there were no laser fellowships—they didn't exist," he says. "Even the pulsed dye laser hadn't been invented yet. The only things available that were compact enough to be installed in an offi ce were argon lasers for treatment of vascular lesions and CO 2 lasers. These were not the sophisticated ones we have today with ultra pulsing. It was a longer pulsed CO 2 that could be used to burn off warts." By 1989, Dr. Weiss had transitioned to the Hexascan, a device that was attached to the argon laser and allowed you to do a scan across an area to treat larger vascular lesions. He became the go-to physician for that procedure in his region. In the 1990s, new technologies began to appear. "The fi rst major advances came with the pulsed dye laser, which had only one pulse duration—in the microsecond range. Everyone would bruise and there was no cooling. In an effort to avoid bruising we worked on developing a new device called intense pulsed light (IPL), and that was in 1995. We had no idea how to use it," says Dr. Weiss. "We would exchange our settings with other practices and fi nally fi gured out the pulse duration, what fi lters to use and how much cold gel we needed to use to actually get it to work." After that, laser technologies developed rapidly with the introduction of the ultra-pulsed CO 2 , followed by ablative resurfacing, then nonablative resurfacing, Q- switched lasers with nanosecond pulsing, as well as Through the décor and lighting, Dr. Weiss wanted to create a relaxing environment where patients would feel comfortable.