Dr. Shirley Madere [00:00:22]: Hello, I’m Dr. Shirley Madhere, plastic surgeon in New York City who approaches beauty from a holistic perspective, and I’ve been giving this some thought, and to me, it’s a matter of beauty.
Kelly Kovack [00:00:39]: Beauty is a heady topic that incorporates the physical, emotional, spiritual, psychological, and in the case of plastic surgery, the medical. I’m Kelly Kovack, founder of BeautyMatter, and beauty is our business. As the consumer perception of aging morphs from changing the elusive fountain of youth to aging well, and as millennials focus on prevention rather than repair, the focus has health at the center of the conversation. This shift is the result of the merging of wellness and beauty, and the evolution of the beauty lexicon. Anti-aging as a term is out, and self-care as a concept is in. The implication of this shift in the consumer mindset opens the borders of the conventional beauty landscape. Dr. Shirley Madhere, Dr. Shirley as she’s known, has a clear vision of what beauty means in both theory and practice. In the male-dominated, macho world of plastic surgery, Dr. Shirley has become an authority in the field on her own terms. Unabashedly feminine, utterly graciously, and fiercely intelligent, she’s paved a path in her own way, led by her vision of holistic plastic surgery: person before procedure.
So, Dr. Shirley, thank you for coming and talking about all things beautiful today. I want to talk a little bit about your background, because you have a very interesting approach to kind of a very traditional field. Your education is sort of a very traditional, western medical path: you graduated from Brown University and then went to Dartmouth Medical School and Brown Medical School, followed by a residency at the University of Connecticut in the Montefiore Medical Center, and then a fellowship beyond that, so it’s a very sort of traditional path, yet your practice is anything but traditional. I think everything from the fact that your practice is in Soho instead of sort of on the Upper East Side somewhere, and you also describe your practice as sort of a holistic approach to plastic surgery. What does that mean exactly, and is that something that you kind of had in your mind on the outset, or is it something you’ve kind of grown into and it’s evolved?
Dr. Shirley Madhere [00:03:06]: Firstly, thank you so much for having me here. I am honored to be in your presence. I have so much love and admiration and respect for you, so I am grateful. You know, holistic plastic surgery and my background, for me, yes, I had a very traditional path toward becoming a plastic surgeon, but at some point, I really had to think about myself and putting myself in my practice, and I had to think about my culture and the values that I was brought up with, and then there was also a point during my first year of practice where I thought, “Okay, it isn’t just about this one part of the body that I’m operating on,” so let me explain a little bit more what I mean about that. I am of a multicultural background, and in my culture and in my family, whenever we had an illness or we were sick, weren’t feeling well, we actually turned to nature.
Kelly Kovack [00:03:57]: Because you’re Haitian, right?
Dr. Shirley Madhere [00:03:59]: Yes, so I was born in Haiti, right, my father is Spanish and Italian, my mother is from Haiti, so it’s a lot of madness. It’s beautiful madness.
Kelly Kovack [00:04:06]: A lot of passion.
Dr. Shirley Madhere [00:04:07]: It’s a lot of passion. So, I had all these cultures that influenced me, and so when I think about beauty and healing and health and wellness, I had to incorporate all of these teachings and values into my practice, and so what really solidified it for me, because the whole idea of holistic plastic surgery, yes, I made that up, but it wasn’t something I was thinking about all along, it was a seminal point in my first year of practice, where I saw one of my first patients, and he came in because he wanted liposuction, and he was working out and eating right, but eh, it was just a little something extra that he wanted.
Kelly Kovack [00:04:43]: It’s interesting that it was a male, too.
Dr. Shirley Madhere [00:04:45]: Yes, right, very trendy, right, even way back then. But, he just needed a little bit extra. So, I was very happy to perform plastic surgery and liposuction and I was really prepared and excited because I did not only a plastic surgery training, but cosmetic plastic surgery training in addition to that, so I was excited to get going and deliver my best for him. So, we went to the operating room, I explained risk, limitations, potential complications, we went to surgery, everything went well, beautifully, swimmingly, no complications, he’s recovering beautifully, and yet, on one of the first post-operative visits, him and his wife came to see me for follow-up, and when I moved the bandages, the garment, etcetera, I was thrilled, because I saw my results coming into being even though there was some swelling and some bruising. But, what was the seminal point and moment for me was that he really didn’t look as excited as I was, and his wife pointed to the lowest part of his torso and his trunk, in his groin area, and she looked at me with some concern and asked, “Is that still going to work?”
Kelly Kovack [00:05:56]: Oh my god.
Dr. Shirley Madhere [00:05:58]: Exactly, and I guess it was a little bit humorous, but it really wasn’t, and that’s when a light went off in my head, and I thought, “Oh my gosh, I was operating on this man’s chest and torso, it had nothing to do with his groin area; however, what I did affected not just the groin area, because gravitationally, things went down, but it also affected how he felt, how his wife felt, what they believed,” and I thought, “OMG, I’ve got to do things a little differently. Even though I’m operating on one or two parts of the body, this is a systemic experience.
Kelly Kovack [00:06:31]: Because that’s not really taught in medical school, is it?
Dr. Shirley Madhere [00:06:34]: No, we’re taught systems and isolation in medical school: reproductive system, hormonal system, endocrine system, you know, the muscular system, and sometimes the assumption is there that of course, everything is related and of course one thingleads to another, etcetera, but in the actual execution of the practice, either we tend to forget that, or it’s not as stressed, so it was that experience that taught me that yeah, I have to take a more holistic approach to not just the person or the body part in front of me, but the person as a whole, which then became my tagline: holistic plastic surgery for the discerning; person before procedure.
Kelly Kovack [00:07:11]: And so, how does that actually play out in your practice in terms of kind of mindset, motivation, aesthetics, you know, kind of the process, the consultative process with patients? Because I think it’s sort of very different, you have almost a very old school bedside manner, which is amazing in these days of clinics where you’re like in and out in 15 minutes.
Dr. Shirley Madhere [00:07:35]: Yes, because that’s important to me. I think that how someone feels about himself or herself and then them entrusting me with that kind of conversation, there’s some vulnerability there, which I honor, and I just don’t want to take it for granted. I meant, admittedly, some people think I’m “woo woo,” okay, and I accept that, I might be a little “woo woo.”
Kelly Kovack [00:07:55]: You may have been, like when you started doing this, but now people are like, “Oh, I know what she’s talking about now.
Dr. Shirley Madhere [00:08:02]: Yeah, “What is she talking about?” I actually had a patient ask me, “Well, what’s so holistic about your practice? Do you like put tinctures on your scalpel?” And I was just like, “Wow, no, but thank you for asking me that question, because this means I really need to do the work to explain what it is.” So, my consultative process takes anywhere from an hour to an hour and a half, so that’s long, but I feel that that’s the minimum I can do to really help the prospective patient understand where I’m coming from and see whether or not they’re in alignment with my philosophy. I’m not for everyone, and I accept that as well. So, we talk about from the start, right, we talk about what their needs are, what they’re looking for, what their desire(s) is or are, and from there, I sort of have this triangle or ladder of how I think about how the consultation should go. So, I’ll explain who I am, what I do, even though it’s obvious, it says “plastic surgery” on my door, but I do repeat it, and then I tell them what my philosophy is: I approach things this way, bottom-up, top-down, whichever way, because this is what I believe will help to contribute to your best outcome, surgery or no surgery. And so, I’ll take it from skincare, what are you using on your skin? I’ll take it to what are you eating? What’s your nutrition? What are your stresses? Do you exercise? Do you smoke? Do you do drugs? And those are a lot of basic questions that I believe all doctors ask, but then I will try to tie it in, and therefore create a prescription for healthful beauty that I like to leave them with, so whether it includes surgery or not, they have a plan for how they can achieve their goals, whether it involves me or not.
Kelly Kovack [00:09:40]: You know, I think it’s very interesting, because it kind of ties into…I don’t know that it’s a new trend, but people are talking about this whole…it’s not even a concept, it’s an actual practice of psychodermatology, which I find fascinating, because it is a thing, and you actually have to go through two residencies, both dermatology and psychology, and you know, I know that you also believe, because I’ve heard some other interviews that you’ve done, you really believe that procedures have an ability to heal in a way that goes beyond sort of the physical cutting, and I think it kind of ties into this, because there’s sort of a psychological component to making the decision, because a lot of people sort of, I think, chalk up cosmetic procedures or plastic surgery as insecurity or vanity, and it being very superficial, but I think you talk about it in a way that is probably more kind of the Hippocratic oath kind of actually transforming people and being sort of a cathartic healing process.
Dr. Shirley Madhere [00:10:54]: I totally believe in that. But, first off, let me say something about the psychodermatology situation.
Kelly Kovack [00:10:58]: Yeah, what do you think about that?
Dr. Shirley Madhere [00:11:00]: I mean really?
Kelly Kovack [00:11:02]: I know, but it also totally makes sense because I feel like having been in beauty so long, and I can remember being on the sales floor talking to people, and they would say, “Oh, but my dermatologist prescribed this,” and they would look literally like their face went through a meat grinder, and I think for so long, doctors have this, and they should, credibility, they go to school, whatever, but we live – have lived in this time of almost like cause and effect, and so you’re treating, oh, you have a pimple, I’m going to put this drying lotion on it, rather than saying, “Okay, what’s the source?”
Dr. Shirley Madhere [00:11:49]: Or, what caused the pimple?
Kelly Kovack [00:11:50]: What caused the pimple? So, I think – that’s why I think the whole, what do they call it, psychodermatology or whatever, and there is this connection between, you know, I’ve seen people with – and, I think it’s one of those moments for me when I worked at Dennis Groves skincare and we had this peel, and we could literally transform people’s skin, and so people who have acne are incredibly self-conscious, and so the ability to do or give someone something that can give them confidence is so rewarding and powerful. So, there is that kind of - and maybe they’re making it to be a bigger thing than it is, but I think we can’t like discount the psychology. But, can you talk about sort of this healing that you’ve seen happen?
Dr. Shirley Madhere [00:12:37]: Of course. Well, I don’t know about the term psychodermatology and the new study, but really, is there – there’s psychology in everything that we do, particularly in beauty, all forms of beauty, and you can speak to that with your beauty experience, and most definitely with plastic surgery. There is psychology in everything that we do, and I think the psychology of beauty is particularly complex because I think that beauty is something that we are innately, it’s fundamentally human, it’s in our DNA, I think it’s something, as humans, we are innately attracted to, so the pursuit of it, the maintenance of it, the going forward and doing what it is we feel we need to do to feel beautiful and attractive should not be discounted. And, I think that it is transformative. Not only is beauty, or if you perceive – when you perceive yourself to be beautiful, not only is that transformative, but it’s also empowering. So, for me, I think that one of the things that led me to this field, or why I think I’m aligned with it, is because I think that that’s part of my mission, to help each person bring out their best version of themselves, and it just so happens to be that I do it through the language of beauty and procedures, but I think it’s transformative, I think beauty is empowering, and if I can help by performing a procedure or letting someone know about a skincare product or anything else that is beauty-related, where they feel like they can bring their best foot forward, and frankly put their best face forward, confidence can increase, a better sense of self can increase, and I think that reverberates: boy, if you’re feeling beautiful and confident, maybe you smile to the person walking down the street, and maybe that smile just changes that person’s mood. I think the reverberations and the ripple effects from what beauty can do for a person and other people, I think it’s phenomenal. It was Fyodor Dostoevsky in one of my favorite books who said, “Beauty will save the world,” and I run that quote from here to eternity. I’m not really sure what he meant, but I think it makes a lot of sense.
Kelly Kovack [00:14:45]: I one hundred percent agree.
Dr. Shirley Madhere [00:14:47]: Right? It’s transformative.
Kelly Kovack [00:14:48]: It’s such a smart quote.
Dr. Shirley Madhere [00:14:49]: Such a smart quote, and why is it, in a negative way, that in some countries that perhaps women do not have as many liberties and freedoms, when someone wants to make a statement about anger or retaliate against a woman, they throw acid in her face, they take away that thing that they believe is her power, right? They’re not chopping off a finger, god forbid, these are all grotesque things, but they’re throwing acid in her face. So, that, to me, says a lot, it’s deep.
Kelly Kovack [00:15:21]: Yeah, you know, I mean, beauty is really powerful.
Dr. Shirley Madhere [00:15:23]: It is. It’s deep.
Kelly Kovack [00:15:26]: You know, I think that one my – I love many things about you, but one of my favorite things is you have this like insatiable curiosity for all things beauty and wellness, and you also have a bit more than just wanderlust. If you have a chance to jump on a plane and go somewhere, does it even matter where it is? I think we share that. Is there a particular source or place that you go to for inspiration or information? And then, sort of as a follow-on, what is the strangest beauty treatment you’ve ever had?
Dr. Shirley Madhere [00:16:04]: Wow. So, inspiration and information, so I read a lot. I am a quintessential nerd. I subscribe to your newsletter, and I read it religiously, so thank you for doing that, because I think it’s valuable information, and highly entertaining, and it contributes, most definitely, to my life. So, I read a lot; I read the plastic surgery journals, I read the beauty magazines, the Vogues, the Allures, the Ls, I scour through them monthly. I make it my responsibility to read what my patients are reading so that I can answer questions. I have patients who come from abroad, and they bring me their newspaper articles about different procedures that they’re doing overseas that we don’t have the access to perform here, and I read into those. I have traveled, yes, extensively, to learn more about procedures, even though we may not be able to perform them here. I’ve gone to Paris, I’ve gone to London, I’ve gone to Asia, because I’m curious and wow, the world of beauty out there, global beauty, woo!
Kelly Kovack [00:17:01]: The world of beauty in Asia is fascinating, I know. It’s like plastic surgery is like the Vegas strip.
Dr. Shirley Madhere [00:17:10]: Vegas strip. I just read an article about how eyelid surgery is the surgery in Kazakhstan.
Kelly Kovack [00:17:19]: Oh, really?
Dr. Shirley Madhere [00:17:20]: Kazakhstan. I almost went to Kazakhstan to give a lecture, but I couldn’t get it together. But, anyway, yes, insatiable appetite for learning, because I love to learn. It helps keep me alive, it keeps my brain going, which, when you keep your brain very busy, is one of the best things you can do for anti-aging.
Kelly Kovack [00:17:35]: I agree. I agree. You know, talking about, I think there’s been such a transition, and I’m sure you’ve seen that, of 20 years ago, plastic surgery, or the practice of plastic surgery, was something sort of middle-aged ladies who lunch did, and they’d go on a vacation and they’d come back looking very refreshed. And, also, you had, there was this moment where you could look at someone’s boobs, nose, lips, and immediately identify who did the work, which is kind of like a weird branding exercise, but I feel like we’re kind of going away from that a little bit, and we’re sort of like going towards a more natural look. Can you talk about a little bit of kind of the evolution? I mean, at the end of the day, you’re an entrepreneur as well. You have your own practice. So, you also have to think of the business implication of sort of the changing aesthetics and times, and so are you ahead of the curve on those things? How does it actually play out in a business sense?
Dr. Shirley Madhere [00:18:46]: So, you know, my father is a corporate banker, and he often said to me, “You’re not a very good businesswoman.” I’m probably not. Am I entrepreneurial? Yes, I do have my own practice, and I think yes and no in answer to your question. So, let’s see, how it plays out in my practice. I think that the sort of return to a more natural look is not new for me. I actually have a bit of a reputation as if you want a natural, subtle look, outcome, result, go to Dr. Shirley. So, I think I’m known for that, and I have been doing that, but the fact that we’re sort of coming back around to that, I’m not sure that everyone will ascribe to that aesthetic, because there are certainly lots of people in this world who still like the extra, and still like that va-va-voom.
Kelly Kovack [00:19:33]: Well, you were actually doing the tweak-ments before they were a thing, right?
Dr. Shirley Madhere [00:19:36]: Yes, I was totally doing the tweak-ments before they were “a thing.” When I first read that, tweak-ment, I thought, “Okay, that’s interesting.” That’s what I do, that’s what I’ve been doing, I like tweaks. How it plays out in business, good ways and not so good ways. I guess good ways is that in terms of branding, I never intended to brand myself as the natural plastic surgeon type of thing, it just sort of happened because those were a lot of the results that I was getting, and that’s what people talked about amongst their friends. How it doesn’t work out, at least in my practice, is that I sometimes say no. I sometimes say no to patients when I think that there’s a result that I cannot deliver or will not deliver for them. I have had patients walk in and show me photos of celebrities and they’re looking 180 degrees different from the celebrity, and that’s not work that I feel comfortable I can do for them. I have actually had patients fill out a questionnaire, and when I ask, “What are your previous procedures or what have you done?” and if they say only one thing, and it’s quite obvious to me that there are multiple things that have been done, I mean, there’s a trust and an integrity there that’s lost, and therefore, I do not work with that patient. So, how it plays out in my practice is in very interesting ways. I still read a lot, I still go to conferences and conventions and learn about new inventions and innovations, but I’m very cautious about bringing them into my practice.
Kelly Kovack [00:20:59]: What are some of the advancements that you think we’re going to see in not only procedures, but also sort of technology and you know, that will impact kind of how you practice medicine?
Dr. Shirley Madhere [00:21:11]: Absolutely. Well, there are innovations that are coming, such as I definitely think there’s going to be more devices in the world of aesthetics. I’m interested in a few of them, not excited about all of them. I think technology will play a huge role – technology is already playing a huge role in medicine and health and wellness as they are, and then they will definitely extend into aesthetics. Some of the innovations that I know are coming and that are currently being worked on that I’m excited about are DNA. I think using your DNA as much as you can, some snips here, some proteins there, and incorporating that into health, wellness, and aesthetics based on my DNA or based on some of my genes or proteins, what’s the best moisturizer for me? I think that’s super exciting, and innovations in cellulite, I mean, that’s coming, really exciting.
Kelly Kovack [00:22:01]: You know, one of the most interesting things that I hadn’t really thought about it, I went to a conference recently and there was a lot of conversation about AI, which is like fascinating and scary all at the same time. And, you also have these sort of people who are sort of proponents of the good that it can do, and then you have sort of the conspiracy theory, like robots are going to take over the world, but someone had a really interesting application for machine learning and AI for medicine, and they actually said that there could be a time in the future where it would be considered malpractice to not have sort of an AI component to the diagnostic process, and I was like, wow, that makes…it doesn’t remove the human from the equation, but it sort of compliments, and I was just like, that’s really fascinating, or where you could have a robot be taking care of people sort of as they get older, and doing sort of the self-care things that it’s hard for a caregiver to do. So, I think it’s kind of…when you think about it in that context, it’s really, really interesting.
Dr. Shirley Madhere [00:23:13]: Yeah, fascinating, interesting, scary at the same time. Robotic surgery, there’s nothing new in robotic surgery. Machine learning, residencies now are using machines, devices, machine learning to help residents to sew better, to stitch better, etcetera, and in surgical practice and training, so that isn’t anything new, but the incorporation of AI into diagnostic medicine is also very interesting. I agree, it doesn’t remove the human from it, so we’re still going to have obviously doctors who go to medical school, etcetera, and maybe collaborate with AI, but also be able to still add that human component, and say, “Wait a moment, the machine may be based on these algorithms, but the machine was not touching the patient or feeling the abdomen, or really pinching how much fat there is,” and therefore, the human touch will always be important.
Kelly Kovack [00:24:01]: And also, for what you do, there is also an art to it, because you know, you’re taught kind of the symmetry and the mathematics of what the perfect face is or whatever, but there’s also a lot about sort of kind of ethnicity and those quirks that make people kind of who they are that a machine learning robot, call it what you will, those nuances won’t…
Dr. Shirley Madhere [00:24:23]: Right, right, but who programs the machines? Who programs the AI? If someone programs the AI and programs the algorithm, but that person perhaps never interacted with many people of different ethnic backgrounds…
Kelly Kovack [00:24:36]: Right, they’re programmed with inherent bias.
Dr. Shirley Madhere [00:24:38]: They’re programmed with inherent bias, and therefore, they’re not for everyone. So, we have a ways to go.
Kelly Kovack [00:24:44]: Exactly. So, I think this is the perfect segue to kind of talk about a little bit about sort of the evolution of not only sort of medicine and beauty, but also I think being female entrepreneurs, and that’s up next.
