About

Advanced Aesthetics Medical Spa is a division of Advanced Cardiac Surgical Associates PLLC, the parent company of The Vein Treatment Center and The Center for Excessive Sweating.

Mission Statement

Our mission here at Advanced Aesthetics Medical Spa is to uphold an atmosphere of professionalism, personal attention, and excellence in care. We strive to do this through utilizing the highest quality and most advanced technology, as well as using the best therapeutic and medical quality aesthetic services available. We focus on educating our clients on maintaining health, wellness and beauty and to treat and prevent the signs of aging.

Health Care Providers

Dr. Hratch Karamanoukian

Dr. Hratch Karamanoukian, MD is a Board Certified Cardiothoracic surgeon who specializes in minimally invasive cardiac surgery, thoracic surgery, robotic surgery and vein disorders.

He obtained his training at UCLA, the University of Southern California and the University at Buffalo. He completed his residency training in general and thoracic surgery with highest honors at the University at Buffalo.

Dr. Karamanoukian has performed NIH sponsored research at the Childrens Hospital of Buffalo in the fields of pulmonary hypertension, inhaled nitric oxide and surfactant physiology. His work, under the leadership of Dr. Philip Glick, has improved the survival of critically ill infants born with congenital diaphragmatic hernia.

Dr. Karamanoukian is former Director of the Center for Less Invasive Cardiac Surgery and Robotic Heart Surgery at Kaleida Health.

He is a pioneer in beating heart surgery and robotic heart surgery. He was one of the first surgeons in the United States to perform robotic coronary artery bypass surgery and robotically assisted thoracic surgery.

He is a member of Advanced Cardiac Surgical Associates, with offices at the Buffalo General Hospital and the Georgetown Plaza in Williamsville. NY. He also shares an office with Dr. Raffy Karamanoukian, a plastic surgeon in Beverly Hills, California. Dr. Karamanoukian has performed the VNUS Closure procedure in several dozen Hollywood notables in the last 12 months.

Dr Karamanoukian also specializes in robotic surgery for diseases of the lung, esophagus and chest. He has authored more than 125 scientific articles and written 12 textbooks in the field of cardiac and thoracic surgery.


Dr. Raffy Karamanoukian is an extremely talented surgeon with a phenomenal aesthetic eye. In his practice, he has earned a reputation for his expertise in facial and body rejuvenation. He believes it is crucial to complement minimally-invasive aesthetic techniques with the latest advancements in plastic surgery.

Dr. Karamanoukian is a native of Los Angeles and is fluent in English, Armenian, and conversational French.

He received his undergraduate and medical education at UCLA and consistently ranked at the top of his class, where he received multiple accolades, including Departmental Honors, Latin Honors, Deans Honors, and Phi Beta Kappa Honors. After completing another four years at the UCLA School of Medicine, he completed four additional years of postgraduate training in general surgery at the UC San Diego Medical Campus. There, he acquired training in all aspects of general surgery including surgical critical care, burn reconstruction, and shock-trauma.

Thereafter, Dr. Karamanoukian completed an additional three years of postgraduate specialty training in Plastic & Reconstructive Surgery at UC Irvine Medical Center.

There, he obtained additional expertise in microsurgery, breast reconstruction, limb replantation, and craniofacial plastic surgery. During this period, Dr. Karamanoukian traveled internationally to one of the largest microsurgical centers in the world in order to obtain further training in microsurgical cancer reconstruction. This experience has allowed him to devote part of his time to breast reconstruction in patients who have undergone treatment for breast cancer.

In his current practice, Dr.Karamanoukian balances his time between aesthetic and reconstructive plastic surgery. His expertise lies in utilizing minimally-invasive techniques to perform cosmetic rejuvenation of the body and face. By employing a combination of non-surgical techniques with less-invasive surgical options, Dr. Karamanoukian maximizes results and minimizes surgical scars.

Dr. Karamanoukian is also an expert in secondary and tertiary reconstruction of patients who have undergone plastic surgery previously. Twice monthly, Dr. Karamanoukian accepts international patients, mainly from Asia and Europe, for aesthetic reconstruction of complicated plastic surgery scars and deformities. He has established himself as an international referral center for surgeries of the eyes and face.

Most notably, Dr. Karamanoukian has researched and developed unique skincare protocols in order to maximize skin rejuvenation in patients undergoing aesthetic surgery. These clinical programs have been formalized and adopted among physicians nationally and internationally. In certain patients, institution of an appropriate skincare program, as prescribed by Dr. Karamanoukian, can replace surgery.

From an academic standpoint, Dr. Karamanoukian performs original research in plastic and reconstructive surgery. He continues to present and publish research articles discussing innovative techniques in plastic surgery. Recently, Dr. Karamanoukian was the first in the world to describe the use of robots to perform complex microsurgery in cancer patients requiring reconstruction.

Dr. Karamanoukian is an extremely driven and talented aesthetic plastic surgeon who has been nationally and internationally recognized for his many contributions to plastic and reconstructive surgery. He is a recognized leader in the field of aesthetics and receives patients from around the world. Above all, he is a dedicated physician who is admired by his peers and patients alike for his com passion and professionalism.

Dr. Karamanoukian is available for consultation for aesthetic surgery of the face and body, cancer reconstruction, secondary and tertiary plastic surgery reconstruction, and for his established skin care protocols.