Plastic surgeon starts building sleep medicine practice: obstruction of airways could trigger more serious conditions.

MOST of Dr. Joseph Broujerdi's patients, turn to him for a little cosmetic nip 'n' tuck or a more extensive facial reconstruction following an accident. They may not realize that a growing side practice for the Beverly Hills plastic surgeon is working with a medical colleague in developing the relatively young field of sleep medicine.

Broujerdi, who hung out his own shingle this month with the opening of the Aesthetic Plastic Surgery Institute of Beverly Hills, has

ken the go-to surgeon for sleep apnea procedures at Advance Sleep Medical Center Inc. not far away in the Miracle Mile district.

Medical director Dr. Payam Shadi, an internist, opened the sleep disorder clinic three years ago to tap an underserved market for chronic poor sleepers for whom conventional behavioral and drug therapies weren't working.

"People with sleep problems are so often misdiagnosed and sim ply given medications," said Shadi. "They may even have more than one issue. A lot of what we do is working to get patients off the drugs and fix the underlying problem."

Sleep apnea is a disorder caused by obstruction of the airway or a disturbance in the brain's respiratory center. Both private and public health insurers are increasingly covering treatments as a preventative measure for more serious conditions such as high blood pressure, congestive heart failure and stroke, Shadi said.

There are noninvasive treatments for apnea, such as nose and mouth masks that deliver compressed air pressure to prevent a sleeper's airway from collapsing during sleep. When the cause is a structural problem, Broujerdi is called in to do everything from moving a jaw to realigning the base of the tongue. Around 15 percent of the surgeries he performs are sleep-related, a percentage that has grown since joining with Shadi.

"There are so few surgeons who have the (required) level of training both in oral and reconstructive surgery," said Broujerdi, who originally wanted to be a dentist. "Most plastic surgeons don't do a lot of reconstructive work like this. They complete their training and concentrate on the aesthetic end, hut this is certainly the kind of work I wouldn't want to give up."

The sleep clinic generally can only treat 20 patients per week, and there's been enough demand to start planning additional clinics. Plans are in the works to soon open a second one in the San Fernando Valley. Shadi declined to release revenues.