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The comprehensive approach to making patients more beautiful and healthier has been successful.

"I never have advertised, and I'm booked for cosmetic cases six months in advance--even in a small city like Virginia Beach. Every patient has been referred by another," he says. "It has changed my whole practice because I get healthy people in now, and patients always want to bring their friends to share the information about better aging and plastic surgery."

Many cosmetic surgeons will cringe with the time and effort Dr. Carraway puts into the anti-aging side of his practice. But the physician insists there is no other way to approach the plastic surgery patient. The practice philosophy is not just about cosmetic surgery. It also is about how to keep patients aging better--not just so that they look better with a quick operation but how to teach them to age so that they will look and feel better 10, 15, and 20 years in the future, he says.

Patients who book consultations are sent information and educational packets. In each is an extensive questionnaire, wellness information, tips and resources.

Dr. Carraway's questionnaire is more than a medical history. The eight-page piece asks intricate details about a person's lifestyle, including: How many meals do you eat in a day? What kinds of snacks do you eat? What is your body weight now and what was it five years ago? How much exercise are you doing? It also quizzes people about their exercise ability, anxiety, appearance of aging, sexual drive, sexual function and more.

Potential patients send these in before they come in for the consultation, so that Dr. Carraway can review them and discuss, at length, where these people can adopt healthier lifestyles.

Tips for a healthy future

The new patient folder features steps that patients can take for anti-aging and wellness. Dr. Carraway and his staff recommend regular medical checkups or executive physicals and suggest patients look into extensive cardiovascular testing, total body scans, growth hormone and other hormone level checkups.

The packet makes recommendations about ideal balances of carbohydrates, proteins, fats and nutrients. Patients learn about the numbers of fruits and vegetables they should eat, as well as what kinds of fats and amounts of carbohydrates they should consume.

"We also give them an appointment with our nutritional counselor. We have a Zone-trained, master's level nutritional counselor and trainer. We pay her salary so that she can be available for people," Dr. Carraway says.

There is a sheet of information on while carbohydrates, including myths and truths. In addition to learning the negative sides of eating flour and sugar, Dr. Carraway's packet features a list of foods to eat and avoid. Examples of low-glycemic carbohydrates to eat are: green vegetables, high-fiber whole-grain-cereals, whole-grain breads, small potatoes with the skins on, semolina pasta, brown rice, high-protein pasta, fresh fruits, nuts, dried beans, small amounts of sweet potatoes and plain yogurt. Foods to avoid would be mashed potatoes, white bread, regular pasta, quick oatmeal, bagels, muffins, doughnuts, cakes, candies, breakfast cereals, white or polished rice, cooked carrots and bananas.

The packet offers a list of recommended nutritional supplements, including multivitamins and minerals; vitamins C and E; selenium; calcium, magnesium and zinc in a combination pill; and two to three fish oil capsules a day. Dr. Carraway has also included a list of supplements patients can take in addition to those and explains on the sheets what each does. These optional supplements include garlic tablets, Coenzyme Q10, phytonutrients, green tea, human growth hormone precursors, melatonin, amino acids, human growth hormone replacements and more.

"Then we write about physical exercise: how much they should be getting and how they should train," he says. "We offer a phone number to call for a physical trainer appointment. We teach them about stress management because that is one of the things that promotes aging most. We refer them to our separate skincare center for a massage, facial, or medical skincare, and we talk with them about yoga and stress management techniques. We talk about spiritual needs and how spirituality enhances health and contributes to longevity. We suggest that patients go to a church, synagogue of mosque of their choice.

"We think spiritual matters are very important in the total aging process--it has been shown that Mormons live nine or 10 years longer than the average population in this country Good lifestyle habits accompany spiritual commitment."

The packet includes information about reducing risk factors, including decreasing alcohol consumption, wearing seatbelts, avoiding nonscheduled airline flights and not taking unnecessary risks.

It also gets into the importance of good skincare. "We have a skincare center across the hall so that people can go to it without having to go to the doctor's office," Dr. Carraway says.

According to Dr. Carraway, patients who engage in skincare will look younger and do things to perpetuate their feeling and looking younger. The program then takes the patient through the possibilities of advanced skincare, including the options of peels, lasers and injectables. Finally, the folder discusses the benefits of plastic surgery.

Dr. Carraway talks to patients about the importance of continued self-education and gives them a list of things to do:

* Read some anti-aging books. "I have a list of about 12 or 13 books written for the consumer by physicians," he says. "And each patient gets a free copy of the Barry Sears' book, 'A Week in the Zone.'"

* Read wellness magazines.

* Keep a notebook of new health information from newspapers and other sources because health information changes. "As patients become more knowledgeable, they teach others and become your disciples," he says.

* Visit a health food store and vitamin store and just look around each for a few hours. Ask questions and discover the options.

* Consider going to a wellness specialist for preventive care.

* Visit Dr. Carraway's anti-aging center to talk with the Zone trainer and learn more through the wellness library.

Dr. Carraway holds regular seminars in the office waiting room, which seats about 50. About twice a year, he hosts a crowd of 300 to 400 at a local hotel, where participants pay an admission for a day-long seminar on anti-aging. Dr. Carraway invites experts from around the country to speak.

"Then, we give them a phone number and e-mail address and, if they have any questions about supplements or diets or anything, we wit answer them," he says.

Better lives as a result?

Dr. Carraway is on a mission to help people reach life spans that he believes can go to 120 years. The time he puts into the program comes back many fold, he says, in that he has healthier, happier, more loyal patients and he, himself, is more satisfied with what he does professionally. Some plastic surgeons go on medical missions to help people in foreign countries, Dr. Carraway says.

"This is our medical mission and the many extra hours that we spend in the endeavor are very worthwhile. What I do is change the lives of families, and the many lives of my friends."

Dr. Carraway recommends that cosmetic surgeons learn how to counsel their patients about better aging. Patients will, in turn, see their cosmetic surgeons more as "real" doctors, who care a lot about the patients under their care.