Redefining Beauty and Longevity with Dr. Cory Goldberg

Welcome to the Living to 100 Club Podcast. Here's our host, Dr. Joseph Casciani.

Well, hello to everyone joining us today. You're listening to the Living to 100 Club Podcast, and I'm your host, Joe Casciani. I'm passionate about helping people embrace the principles of psychologically healthy aging, staying positive, finding purpose, and making the most of all the years we're given, no matter the challenges along the way. Each episode, we bring you conversations that educate and inspire, guiding you to age with resilience, optimism, and a positive mindset. I also invite you to explore our Club Insider membership by visiting my website, livingto100.community, and signing up there. You'll gain access to exclusive content, resources, and a supportive community focused on successful aging. And if you're a professional working with older adults, be sure to check out my Better, Longer, and Happier card deck series at livingto100.solutions. These 12 modules offer valuable insights and activities designed to promote positive aging and personal growth. Thank you for being a part of this journey with us. Now let's dive into today's conversation. On today's episode, I welcome Dr. Corey Goldberg, a dual board-certified plastic and craniofacial surgeon with a mission to align aesthetics and healthy longevity. Drawing from his 17 years of experience in plastic surgery and craniofacial reconstruction, Dr. Goldberg shares his insights into the transformative power of aesthetic surgery, not as a pursuit of vanity, but as a means to restore self-esteem, self-image, and vitality. Join us as we redefine beauty, embrace a holistic view of aging, and learn how science and compassion converge to improve lives. First, a little background. Dr. Corey Goldberg completed his plastic surgery residency at the University of Toronto, which included the surgeon scientist program, earning him a Master of Applied Science in biomedical engineering. He subsequently completed a pediatric craniofacial fellowship at the University of Southern California and is a dual board certified in plastic surgery in both Canada and the United States. His private plastic surgery practice is in Toronto, Canada, and he volunteers with Operation Smile doing cleft lip and palate surgery around the world, including missions to Cambodia, Egypt, Honduras, and Bolivia. He earned an Executive MBA in International Business from Cornell and Queen's Schools of Business. Dr. Goldberg's mission is to align aesthetics and healthy longevity through BeautySpan by leveraging AI, artificial intelligence, data analytics with lifestyle and evidence-driven therapeutic interventions. Dr. Goldberg, welcome to our program today.

Hey, Joe, it's a pleasure. Thank you so much for the introduction, and, uh, and thank you for, uh, for chatting. I'm looking forward to our conversation today.

Yeah, you're most welcome. I'm looking forward to it as Well, I always like to open by asking our guests to tell us a little bit about the journey that brought you to where you are today. You've covered a lot of ground, you have a lot of impressive credentials, and maybe tell us the highlights or the pivot points that brought you to where you are today.

Sure. Well, you know, I guess the first pivot point for me was going into medicine in the first place. And my father was a vascular surgeon in Toronto, Canada, and that certainly helped to shape my interest and desire to go into medicine and surgery. But, you know, I found when I got into, into medicine and was going through my clinical training, it just, you know, I realized that the healthcare system that I was working in and that was true, you know, both during my training in Canada and in the United States, it really, it felt me, it left me feeling like something was missing. You know, we really seemed to be managing things after the fact. People would come in with, with advanced cancers or, you know, diseases that, you know, there was a celebration of making a diagnosis or a label. But in the end, patients were already far along their disease process and cure was challenging. And I realized in my training that there was just, you know, the healthcare system we're working in is what we would now call sick care.

Yes.

It really is responsive. It waits for things to be broken. And so, you know, through my training, I kind of recognized that there was a need to shift or pivot how we approach people. In my practice as a plastic surgeon, you know, I realized in the aesthetic industry we treat things similarly. And, you know, don't get me wrong, there is a role for, you know, treatments and injectables and surgery, and I do those things. But I feel like our industry has become completely, you know, focused on only those things and really lacks insight into how to prevent people from aging and how to help people be the healthiest, most beautiful they can throughout their life. And that includes, you know, preventive care and addressing, you know, people individually, not just waiting for a wrinkle to show up and inject something into it to make it go away. So, you know, through my practice, I have adopted more and more healthy alternatives. I try to help my patients address diet-related issues. I do my best to help my patients manage oxidative stress and, and things that are resulting in aging of their skin and their whole body. And in so doing, I, I've kind of bridged over between my aesthetic practice and a healthy longevity practice, and I try to bring those two things together. And, and, you know, you use the term that I really like, is, is the concept of beauty span, which, which I think is analogous to the concept of healthspan or healthy longevity.

Yeah, I like that. I like that model too. So, you've kind of come through the traditional Western medicine approach, and you've seen some of the shortcomings, of course, and focusing instead on the whole person, holistic care. That's a topic that's used a lot, but I think there is some meaning to it. And looking at what's, what's beyond the traditional diagnosis and treatment. And let's understand what's going on with this person and how can we help them grow and, and kind of flower in many ways. Yeah, interesting. So, um, your 17 years as a plastic surgeon, um, how did that shape your approach today in helping patients? I mean, with all the surgeries that you did, how does that inform your practice today?

Well, you know, I guess when it comes to body contouring, for example, I've recognized the importance of helping patients manage their lifestyle around those kinds of procedures. So, you know, when someone comes to me asking for a body contouring procedure such as a liposuction or a tummy tuck abdominoplasty, I really spend the time to talk to them about lifestyle. You know, I try to look at their diet and nutrition. I, you know, conversation with them about exercise. And I really make an effort to help patients address those things because I know very well that if I, if I do some liposuction on a patient and they're still following an unhealthy lifestyle, that I'm, you know, I'm doing nothing better than putting a Band-Aid on and really not helping them in the long term. So I really work on helping my patients with their weight management. And I'm really excited that my practice is actually going to be moving in the next year to a place where I'm actually going to have body contouring and weight loss clinic integrated into my practice. And, you know, this is where my practice is evolving to, is the opportunity to really give patients those tools to modify their lifestyle, to achieve the best result, to maintain it, and moreover, achieve the sort of healthiest and least risky kind of surgery. I mean, surgical recovery really depends on having a healthy patient. So those are the things that, as you know, with regards to body contouring. With regards to facial aesthetics, a lot of the things that I manage are about rejuvenation and, you know, facelifts and eyelid surgery like blepharoplasty. Those things have a place. But again, you know, the idea of trying to help someone manage their aging, whether it's through management of their sun exposure or management of their diet to try and maximize the thickness or the resilience of their skin, What you eat is very much related to your skin. There is a very close relation between your gastrointestinal microbiome, the bacteria in your intestine, and your skin. So helping someone to manage their diet and their lifestyle actually very directly impacts their skin and their facial aging. So again, this is an area where I'm very passionate and I try to help my patients achieve those healthy outcomes to try and minimize the types of surgical interventions that they're going to have, stave them off as long as possible. And then again, also achieve the best possible results and maintain them for as long as possible.

Yeah, that's really lifestyle medicine in many ways, isn't it? I mean, you have the specialty of plastic surgery, but lifestyle medicine seems to be this umbrella term where we're looking at so many different aspects of the person's functioning, day-to-day functioning, diet, exercise, attitudes, outlook, and all of that. And I mean, how do you How do you address the question that plastic surgery has this vanity connotation? And I'm sure it comes up a lot for you, but, you know, people are in pursuit of vanity in many ways. So how do you counter that?

Well, you know, I think the first thing is, you know, let's look at that word vanity. It's, you know, it's a word that I have patients— patients come to me and often one of the first things they'll say is, you know, I know that this is vain, or I told my family I was coming in and they told me that I'm being vain, that this is just vanity. And it's a funny thing, but there are not a lot of words in the English language that have a definition and a judgment attached to it. But vanity is one of those words, right? I mean, you think about vanity and it means that it's a person who is aware of or concerned about their appearance or their presentation to other people. And additionally, that that's somehow bad or harmful. It's a judgment about that. And I completely disagree with the premise. We are animals, and animals interact with each other based on their appearances. Social interaction between animals is very much dependent on how you appear, and we, we all present ourselves to others in, in a way that we choose, whether it's putting on makeup or not, or the type of clothes that we wear, or getting a haircut. Everything that we do is about our interaction in society, and everyone chooses how they want to do that. But you can't judge somebody for wanting to present themselves a certain way, or in the best way possible. So to me, to me, this is not vanity. This is about social interaction. And another thing that you hit on briefly in the introduction, which I thought was very appropriate, was the concept of self-esteem. I mean, as we age, there is most certainly a component of, of degradation of self-esteem, whether it's a feeling that you're not as vital or energetic or not as capable as, as you were in your younger years, or that you physically don't appear as fresh or as young as you used to. Those things very much impact somebody's self-esteem. And so I think it's very important to people maintain their activity, exercise, endurance so that they can be as active as, as they are, you know, throughout their life. However, I also think it's really important to help people maintain their appearance and make them feel like they look good, because that feeling of self-esteem is very important to your own psyche, and it's also very important with how you interact with people around you. And so that psychosocial component of your appearance is actually very impactful as far as your overall health, and it does impact longevity and it does impact healthspan. So it's not just skin deep, it's not just vanity. Looking good, feeling good about yourself actually changes your health and your social interactions.

Yeah, yeah. Looking the best we can. I, I agree with that. I, I really appreciate that description. But there's also the trap that people fall into sometime when we equate our self-esteem with our physical appearance. Our self-worth, our value as a person is equated to our physical appearance. And I think that's unfortunate because that means people that are the best looking, the most attractive, are entitled to feeling better about themselves. And if you're not that way, maybe— or anyway, that's a trap. I think there's a— we get caught in that because our value doesn't diminish if we have some some facial scarring, for example, or some surgery or something that results us in looking less than we used to. Our value doesn't change, right? Our value as a person doesn't change. But what you're saying is that we can still have that self-esteem and still feel good about ourselves.

I agree. And, you know, I think the way you phrase that is, you know, it's a trap. It's absolutely true. You know, the, you know, I don't, I don't necessarily believe everything in moderation. But I believe that certain things in moderation are important. And I think this is one of those things. If you are completely focused on your appearance and that's the only way you value yourself, your life will not be very fulfilling. And so, you know, it's very important when I think of what I do with regards to surgery, it's sort of I can change how somebody appears, which then helps them to perceive themselves differently. But in the end, the important thing is how someone perceives themselves. And so when patients go down that trap, that bad path where really that's all they're focused on. Um, I think that as an industry, the aesthetic world needs to, to be able to rein that in and address the underlying issues with the patient, um, and, and, and help put the brakes on that. Because there have been a lot of really overdone people. And, you know, I've been asked to look at Hollywood celebrities and some of the really terrible things that have happened to them. You know, people go down that bad path, but our industry is partially responsible for that. We drive that. And partially out of greed. I mean, there is a financial benefit to, you know, practitioners who do these things. And if a patient comes and asks for something, to just go down that path and do more and more and more. I think that there's an incumbent responsibility on us as clinicians and to our industry to know when enough is enough and stop that path and help patients reflect on themselves and get them help as they need it to really learn how to appreciate themselves and value themselves for more than just how they appear. But this is, you know, that's also part of the holistic approach to a patient. I mean, if you can really help someone be healthy, then their cognition is going to be optimized, their physical abilities, their strength, their endurance also will be optimized. So, you know, the beauty part kind of comes from that. But it also means that a patient, you know, an individual is going to have the sort of best overall outlook on life because they're going to be healthy and capable from all dimensions. So I think that that beauty piece fits in the holistic world, but it can't be isolated. You can't look at just the one thing because that is a bad trap. You're absolutely right.

Yeah. Yeah. And as you say, these different dimensions, complement one another too. I mean, they're, uh, as one improves, the others kind of improve as well. So, you know, it reminds me of a patient I had once who was a, in a nursing home, and he had to have a leg amputated because of his advanced cardiovascular disease. And he was a professional boxer, right? And he said he prided himself on his physical appearance his whole career. And then here, now he's facing the loss of a leg and within a couple of months he had to undergo the amputation of the second leg. And, you know, that's, that's a drastic assault on our appearance and, you know, feeling of physical prowess. And here he was now saying, how could I look in the mirror? I used to be so proud of my body and my, you know, physical stature. And again, I brought up this example because it reminded me of this I think important concept, and you touched on it as well, that his value as a person doesn't diminish because he has two legs amputated. His value and worth. So it's, as you're describing this, helping ourselves to really appreciate that we're doing the best we can. This is— this— I'm at my best, and I'm going to continue to work at myself and maintain my healthy lifestyle no matter what's going on to my body, right? I mean, it's— yeah, yeah, yeah.

I think you, you got it exactly right. I mean, people's worth comes from within, and, uh, and, you know, if you hang your hat on any one specific thing about yourself that you think is your only source of value, um, I mean, really, that's, uh, that, that's like having a portfolio that you're only invested in one thing. I mean, you want to diversify yourself. I mean, that's, that kind of satisfaction from being able to do multiple things or having multiple dimensions your person, I think is very valuable. And some people fall into a trap, whether that's about their aesthetic or something else. But you're right, you know, human value comes from within, and we all have the opportunity to create value in lots of different ways and feel satisfaction in different ways as well.

Yeah, yeah. Can you share an example or two of someone whose life changed so dramatically after your surgery?

Well, you know what, I'll, you know, I'll share two examples, one which I would consider aesthetic and one which I would consider cosmetic. And I'll draw the difference between between the two. So, you know, from a cosmetic point of view, the idea of what I do is about enhancing and sort of bringing someone closer to ideal from normal. And so there, you know, there's a patient that I did in the past year or so where I operated on her and I did a facelift and I did a chemical peel for her. And these were separated procedures by 6 months in between. And that combination is very potent as far as rejuvenation and anti-aging. And this is a patient who was 72 and very youthful inside, very healthy otherwise. But, you know, looking and speaking to her, I mean, she barely made eye contact. She had really terrible actinic damage. Her skin had aged poorly and it was a lot of sun exposure over many years. And her nutrition was, was not ideal. And she came to me looking to have this, this corrected. And I mean, she barely made eye contact with me in the conversation. She was very flat. And after I got her through these two procedures and I did the chemical peel with phenol, it's a very deep, aggressive peel. To refresh the skin. And then a facelift, the patient at the end of that, I mean, it was like a different person. I mean, her eyes glittered. Her best friend came to me and said, you know, this patient Diane, she used to stay inside, she never went out, and now she goes out all the time. She's very social. She's going out with friends and it's like a different person. And her best friend that came and told me this, then she came and had one of those chemical peels with me as well. So that was a cosmetic thing that I did that really changed a person's life. I think from an aesthetic point of view, you know, you mentioned I do work with Operation Smile, and I remember a patient that I worked on in Cambodia, and he was actually an adult patient. He was in his early 30s, and he had been born with a cleft lip that was just never repaired. He was never a resource available to him, and he came on this mission, and because he was an adult, actually, he was not prioritized. We usually prioritize children, so he actually was one of the last cases that we got to and I did it under a local anesthetic because the operating rooms were full. I had one, I had a minor procedure room that I had access to. So with a local anesthetic, like a dentist, I mean, I froze his lip, I repaired his cleft. It took me about an hour and it was like, I mean, he couldn't smile at the end because he was frozen, but I could see in his eyes, it was like looking in a mirror and it was the first time he saw himself with a repaired lip. And I mean, what was described to me through translator is this young man, I mean, he didn't date, he didn't go out, he couldn't get a job. And this restoration completely changed his life. And of course, I've never seen or spoken to him since. But, you know, I know now, like, his life has changed from that. So, you know, I feel a great honor that I'm able to provide these things to people, to give them tools to lead more fulfilling lives. And whether it's a cosmetic or aesthetic, either way, the way someone sees themselves is very, very fundamentally attached to how they interact with the world and their overall health. And so, I mean, I'm really grateful and honored to be able to do that with patients and be part of that journey. And it is, it is so satisfying to, to see that afterwards.

So is that the distinction that cosmetic is more personal preference and aesthetic is more functional?

Yeah, I think that's a good way of looking at it. Cosmetic is about taking someone who's in the normal range and trying to enhance, where aesthetic is about restoring and bringing someone closer to normal, whether that's from a deformity or scar or trauma. So, so, you know, cosmetic is more of a choice where aesthetic is about, you know, trying to restore. Um, and, and they're very, you know, they're related in that they're both about appearance, but the objective and the patient and what they're seeking is often quite different. So it's really important to have that distinction.

Sure. Interesting. And you've been doing Operation Smile for how long?

Well, my first mission was in 2008. It was about— it was a year or two after I got into practice. And I try to go on a mission every couple of years as I'm able to take some time away from the practice and kind of close things down. But I'm excited. I'm hoping next fall to be heading on my next mission, my last one was to Bolivia. I went with my wife, actually. She ran the medical records department, and, and I did surgery. It was really amazing. It was such a wonderful experience, and, uh, we're, we're looking forward to our next opportunity to do that.

Well, good for you. That's great. And, um, I know the rewards, uh, they're far greater than we think from that, right? I mean, going off to the foreign country and undeveloped country and probably getting paid very little, if anything, but the rewards are so substantial. That's great.

Yeah, yeah, yeah, it's— it is, it is really soul-filling. And, uh, the, uh, the, uh, the group Operation Smile, I mean, it's, uh, they run an amazing mission, and there's a strong focus on education. So we actually spend a lot of time with local physicians and nurses teaching them how to do the surgery and look after the patients. So it's not just about, you know, showing up and doing things and leaving. It is about creating a legacy and an ongoing care, um, and eventually championing the— these surgeons to be able to do surgery on their own. So, you know, we are teaching, teaching people to fish. We're not just giving them fish. But it is really satisfying, and the teams that come together in these missions are just remarkable humans. I, I just, I love working with those people, and, and it is such a fulfilling thing both for the patients, the families, and, and also the, the colleagues and people that I meet.

Yeah, yeah. And, and BeautySpan is what? Tell us about BeautySpan.

Yeah, so BeautySpan is, is the concept, uh, you know, I have my website beautyspan.com and it is really about the, that premise of, uh, of, you know, bringing aesthetics and health together under, under one umbrella. Um, and, and in my practice this is what I'm trying to apply, which is, you know, precision medicine including, you know, genetic markers and testing, biomarkers, and, and also AI-driven, uh, you know, lifestyle coaches and, and ways of helping people will truly change their behavior for the best for their health. And so in this way, I'm trying to bring together, you know, my aesthetic practice and, and functional medicine and health. And so that's, you know, that's what I call BeautySpan. And so my website beautyspan.com has some information about that, and also a newsletter that we're going to be putting out with tips and tricks on how to do exactly what I'm talking about— try to maintain your beauty as much as possible throughout time, and at the same time maintain your health in the same, in the same ways.

So our listeners can go to beautyspan.com and get more information about you and your work and sign up for the newsletter. That sounds like a great resource. Yeah, thank you. How do you, how do you, um, how do you measure success in your practice? I mean, I'm sure there's the physical changes and improvements, but can you, can you get a sense of how positive your outcomes are Or how do you—

Yeah, you know, the measure of success, of course, the first one is safety, you know, making sure that I treat patients well and that, you know, they have safe outcomes. And the treatments that I do, I, you know, I know how to, you know, minimize risk. So, you know, safety is always number one, you know, but number two in this world, it's about satisfaction. You know, it really comes down to how somebody feels after their surgery. And, you know, sometimes the most minimal intervention will result in the biggest change in a person. But, but really, my measure of success is patient satisfaction. It's someone really feeling like they are, you know, they perceive themselves differently, that their self-esteem has really been changed. And if I can help somebody achieve that, that to me is a huge success.

So safety number one, and then satisfaction. Yeah. Yeah. Do you find some patients who are not satisfied, or maybe had unrealistic realistic?

Yeah, you know what, that's a, that's a great question. And the answer is, you know, there are some. It's certainly not very common though. And, you know, oftentimes it's something very small that's easily remedied. So, so, you know, the, the occasions where someone is truly not satisfied, those are very few and far between. And those are really, I mean, that's, those are hard ones for me. But usually what it comes down to is, is inappropriate screening, you know. And, and it was really earlier in my practice that I saw that from time to time. I, I, you know, I, I don't recall seeing that for quite a lot of years now, but, you know, choosing who to operate on, I would say, is the most important part of being a surgeon. You know, most people think about the technical skills of cutting or stitching. You know, those are important too. And my, you know, I have good hand-eye coordination, my hands are pretty steady. But, but having said that, you can learn those things. I mean, physical skills can be taught. Um, judgment as far as who to operate on and what to do for them and how to manage that person so that they have the right expectations and you achieve what they're looking for, all of that together, I mean, that's why they call it practice. This is, you know, you learn it as you go. There's no medical training that can teach that to you in one go. So, you know, as I went on in my practice, I definitely learned those red flags or people that I recognized I couldn't achieve what they were looking for, or they had the wrong sort of mindset, or they were following that bad trap of just chasing an aesthetic that wasn't possible for them, or that they were looking to do do it in a sort of surgical way, but without the personal effort involved in obtaining good health. All of those things, those are pitfalls that I've had. And I would like to say I'm a wiser and better surgeon now, but really it is very much about interpreting somebody and understanding when they speak to you what they're looking for. And that, I mean, communication is such a pivotal part, and I think the most important part of surgery. And that's how you get good, satisfied patients, and you avoid dissatisfied ones that you can't meet their expectations.

Yeah. And you take into account their motivation to maybe change or improve lifestyle or diet or physical activity. Is that part of the initial evaluation assessment?

It is, it is. And, you know, it's not, um, it's not so much for me to judge why, you know, what their motivation is, whether it's good or bad. Although, you know, I've definitely had some people, you know, bring up some maybe not the best reasons. But having said that, you know, understanding someone's motivation is important because it does sometimes change the, the plan. It does change my approach to them, and it helps me to understand what, you know, what keeps them going. You know, when it comes to healthy longevity, the most important thing by far is motivation. It is, it is a— that the psychosocial status that somebody has and the motivation that they have every morning when they get up to do something, to go out to achieve That motivation, the thing that moves them, that is the most important part of somebody's healthy longevity. And so, you know, the motivation that brings them to see me to seek out an aesthetic change in their, you know, appearance or their life, that to me is a part of their overall motivation. And so it's really important to me to understand my patients, and that's a part of selecting the right people and, you know, achieving the right results so that they can have, achieve what their reason for presenting is and achieve the thing they're motivated to achieve.

Sure, sure. Makes sense. Great information, Dr. Goldberg. This is really important, important education, I think, for my audience. What's the takeaway? What do you hope our listeners remember from this conversation? What do you think is most valuable to remember?

Well, you know, I would say the first thing is that you're beautiful the way you are, and you should appreciate your beauty and enjoy it. And if there are things about your appearance that don't fit, that don't, you know, doesn't seem like the outside and the inside, you know, are matched, then do something. And doing something doesn't necessarily mean go get surgery. It may very well mean just, you know, start putting on some moisturizer, take on a skincare routine, start protecting yourself in the sun. There are things that you can do every day, and very simple things like diet, exercise, and the sort of core pillars of healthy longevity are the same things that you can do to, you know, look and feel your best. So, you know, my take-home message is, you know, your health and your appearance are linked. And while you should feel beautiful as you are, if you're not feeling that way, I think the first thing to do is to, you know, try and enact that healthy lifestyle. Lifestyle that is going to help you achieve that beauty and be the healthiest that you can be. And past that, if there's still something that doesn't feel right, then there are practitioners out there who can help you to, to achieve those things and, and, you know, feel and look your best.

Yeah, great, great information, because as you say, all of these elements complement one another. And as we kind of become responsible in one area, it spills over into the other, and we continue to shine. Yeah, I love that. I love that. Yeah. Well, looks like we're, um, about out of time for today, uh, Dr. Goldberg. But before we wrap up, I just want to remind my listeners to visit my website, livingto100.club, and sign up as a club insider. You'll enjoy many benefits, including a free copy of my 9 Tips to Make Living Longer Enjoyable, 100 inspirational quotes, live discussions, and participation in our private group forum. And if you're affiliated with a senior living community, be sure to explore our Better, Longer, and Happier card deck series at livingto100.solutions, a powerful resource designed to promote positive aging and engagement. Dr. Goldberg, thanks so much for being a guest on our show today, and your website is beautyspan.com.

You got it, beautyspan.com. And, uh, Joe, it's been a real pleasure. Thank you so much for your time. I've enjoyed our chat very much, and, uh, uh, you know, I'll, I'll keep you posted as, as things unfold with, uh, with my practice and, uh, and getting BeautySpan out to the world.

Well, that's great. I'd enjoy that. And thank you so much for being a guest on the program. I know our listeners will get a lot out of it. And thanks to all of our, our audience for tuning in today. Hope to see Next time.