The Fast Track to Plastic Surgery with Dr. Shikhar Tomur

We're like human beings, we're not perfect people. And like, you know, you can do plastic surgery and still make really bad mistakes. And I've seen lots of plastic surgeons make like really ugly, you know, results.

So, so hi everybody and welcome to the podcast. This is Generations MD. My name is Stephanie and I'm joined here by my colleague Dr. Sarah Davis, who's also my mother. And today we have a very special guest, Dr. Tomar.

Thank you, thanks so much for having me.

Yeah, well, we're so happy you're here. It was a long journey for you to get into the studio today, obviously.

Yeah, I walked a total of like, what, 8, 9 steps? So yeah, it's perfect. We're like neighbors. I mean, we literally are neighbors.

So yeah, yeah, yeah. So tell them, the viewers, a little bit about where you are now, and then we'll kind of back up and talk about where—

yeah. So I am a plastic surgeon in University Park, Park Cities area. I always get confused about what I should really say this area is.

A lot of different names for it.

Yes, I've been told that. I'm from Chicago originally, and so Dallas has now become home in last year, 2 years. But I'm a plastic surgeon. I work with Dr. Adams, and I joined him after I did fellowship at UT Southwestern last year. And it's been a fun, you know, path so far. I started back in July. I— my main interests are facial cosmetics. And so I do a lot of facelifts and rhinoplasties, eyelid, brows, anything on the face. But I also do a lot of things breast and body as well.

So that's awesome that you're here now doing all that. Backing up to before med school, maybe before college, did you see yourself being in the position that you are right now?

It's a great question. So in high school, I really did not. I kind of was always thinking like engineering or I honestly like engineering or business. And then I really started thinking about medicine probably like junior year, senior year. And I applied to a couple like straight med programs and I got into a 6-year program in Kansas City.

Okay. Yeah. Tell us a little bit about that. What's a 6-year program?

Yeah, so basically I think there was maybe at that time 2 programs in the country. There was one at Akron, Ohio, which was NeoMed, and there's one at UMKC in Kansas City. And basically you do 2 years of undergrad and then 4 years of med school. So like my undergrad experience was like super abbreviated. Because we do a lot of classes over the summer. So I think I was taking like 25, 26 credits and then I would stay over the summer and did like orgo and all these other classes as well. And then basically after a year and a half, I got straight into like the whole med school curriculum. So I took like, like systems-based stuff at that point. We called it like Human Structure and Function. And so then I must have been 19 years old when I started doing that. And I first remember seeing patients when I was like 17, 18 years old.

And so you just skip over the whole MCAT thing? Like, you don't even have—

did not take an MCAT. I was 20 years old. I turned 21, and then I— so I turned 21 in August, and then I started studying for Step 1 when I was 21 years old, like a month after.

Wow.

So it was fast. But then when I was done with Step 1, I was still 21. Took Step 2 when I was 22, and then I graduated at like 23 years old. Okay, so I'm 31 right now.

Wow.

Yeah.

So were you in Kansas City then for the whole time? Yeah.

Okay, so, so backing up, so I applied to all these different places. I got into like WashU for business, I got into Michigan for engineering, I got into like U of I for like chemical engineering, and then I got into UMKC for the straight med program. A lot of my obviously Indian family members are Indian, or like, are they obviously Indian, but they're also physicians right? But my mom's OB-GYN, my uncle is a pulmonologist, my grandfather was an anesthesiologist, and basically everyone was like, this will be— this is like the probably the best way of doing things.

Yeah, yeah.

If you know you want to do medicine, man.

Yeah. So I tell probably everybody that I meet that if you're like 51% of the way sure that you want to be a physician, then you should do this if you get into that program.

Yeah.

Um, nowadays I would say like, would I send my kid to UMKC? I mean, maybe we should not say this on, you know, I would, I would, I I would say like it just has to be like the right person. A lot of my friends, all their parents were physicians, and so they kind of knew what they were getting into. I think if you didn't know what you were getting into, then it would be really hard.

Yeah.

And then a lot of us, like my main friend group, one of them is a dermatologist, went back to California. Another friend joined his dad's practice, who's an orthopedic surgeon. I have another friend who's an orthopedic surgeon, um, another friend that's a general surgery, and then another friend that's internal medicine in Alaska. So we kind of all knew what we really wanted to do. And this was just like the fast-track way of getting to what we wanted to be. I never knew I wanted to do plastics until I worked with Gwyneth Paltrow's plastic surgeon in Chicago. And so that was like a huge eye-opening situation for me because he works in like the John Hancock Tower on the 38th floor. We would go and meet all these, you know, really cool, exclusive people that you would never have thought that you would ever talk to. And then basically when I was Right when I got done with that rotation, I was like, I want to be a plastic surgeon. And so then I studied super hard and then did well on my Step 1, and then that kind of opened up a lot of doors for me.

Yeah, well, that's awesome. I mean, other countries do the 6-year program.

Yeah, it's super popular in Europe and India and all these other countries for sure.

And I don't think that— I think in college you do— on the education front, I feel like waste a lot of time just doing a lot of stuff. But at the same time, you have those 4 years. I went to Clemson, like a small college town, and I did have—

I did not do a study abroad. I, um, I unfortunately like was really compartmentalized into what I'm doing now, right? And so I think I did give up a lot of things, and I saw a lot of friends that, you know, were experiencing college and figured out what they wanted to be. I kind of was like pushed in a good direction, and it worked out because I really like plastic surgery. Yeah, but I definitely do feel the level of burnout for my friends, especially the ones that didn't do any specialization, is quite high.

Yeah. Yeah.

Because like I said, we've been doing this for like— I'm 31, so this is my 14th, 15th year doing this. And I think a lot of friends have at this point just been like, I don't want to be in the hospital anymore. I love doing surgery. And so like, I see it as a sport that I'm going to keep getting better. It's almost like golf. Like, I don't even play golf, but I play tennis. And I think like every year I get better at it. So that's a lot of fun. But I do think that sometimes for people that they didn't go into it knowing that they wanted to do medicine and they just kind of pushed their way through it. Probably wasn't the right choice.

Yeah. And I mean, it's hard to figure that out when you're 17.

Yeah. No one knows.

Yeah.

You know, you don't even know what it's like to be a physician yet.

Yeah.

Until you start doing it. It's so crazy. I'm like, this is like my realistically, like my realest year of doing it. I'm really happy. But there are good days and there are bad days, right?

Yeah, which would be true in anything, but I think there is that kind of growing up that happens during college that you'd like, you just kind of scoot on past.

Yeah.

When you were in rotations and you're 20 or 21, did you feel like behind at all in that way, or were you just like, well, this is what everyone else is doing?

I think everybody grew up really quickly in like a weird way. I mean, you know, you can run a code when you're like 18, 19 years old. That's pretty wild. I saw like one of the first patients I remember had pancreatitis from alcohol, and it's just like, oh, we're going to go out this weekend too. And it's like, oh, you know, it like really changes your opinion about all of these different things. Like, I mean, you could— learning about benzodiazepines, and then, you know, like there's the drug dealer down the hallway that sells benzos, and it's like you're learning as much as you can probably at that stage. Yeah, I think I probably did CPR probably for the first time like 20 years old, 21 years old, which definitely is unique. But at this point, you know, I feel super comfortable and I feel like I'm very good at talking to patients because I kind of have felt like I've been doing it for so long. I definitely think a lot of the med students I met recently have sometimes a really difficult time and they're not as mature. And I do think that the The students that wait, have lived life a little bit, then went to med school, probably doing a lot better than the ones that did like the 4 years of undergrad, then they went to med school and things like that. And that's like, you know, not every person just clumping them together, but that's kind of just stereotyping things.

Well, you're like baseline must have like maturity level must have been higher.

Sometimes people are just like that. Yeah. But, you know, I'm just— I was kind of saying like, oh, you didn't really have a college experience. But there's people who go to college but still don't have the college experience because they're just studying the whole time because they want to get into med school. You're already in.

Mm-hmm.

Yeah. So that part was nice. I mean, every 2 weeks we would have like a really big test, but then after that we would all go have fun and like probably 6 or 7 of the people on my, like, my wedding groomsmen were all from my med school and they are like blood brothers to me. Like we had had the most fun parties ever. I think they're sometimes way crazier than even my other friends are. Yeah, I've been to a few of my friends' parties. I don't know if I just gravitated to that, but I mean, it was a lot of fun. I don't think I would have changed anything. I think there is just a sense of like the opportunity cost at the end of the day. You put so much time and commitment into something like this that when you come out of it now, you really have to be like, whoa, I'm— am I happy doing what I'm doing? It's hard to say that in that time. But even so, my wife's a dentist. I met her when she was starting dental school. And then I think when we first started dating, like, she didn't even know it. Oh, I'm dating a plastic surgeon, right? When I'm a plastic surgery resident. And now, like, this is year 8 and year 9 of it, and finally you start your practice. She has a whole new appreciation of when someone comes up to her ear. Like, she— we became friends with one of the interns, and they just got engaged, and she's like, oh my God, this person doesn't know what it's going to be like in the next couple years.

Yeah, yeah. Wait, and so tell me what your— what the what your residency path was.

And yeah, so I did, so I did the 6-year med program, and then KU is essentially like our home plastic surgery program. So they have an integrated pathway. And so my, um, I got into KU, or I matched into KU for residency. So they take 2 per year. I think it was like our year is like 160 people. So I know pretty much almost like more than half of my class at that point. Um, and then my co-resident was from University of Pittsburgh. Her name is Rachel. She's a hand surgeon now. She's at University of Nevada Las Vegas. Um, she, um, and I are obviously super close. We're like brothers and sisters at this point because like we just did everything together. Most programs take 2 people. The bigger programs like UT Southwestern take 4 people. And then residency in entirety for an integrated program is 6 years. So I was 23 to 29 when I was done with residency at 29, and then I did one year fellowship at UT Southwestern, which you don't have to do, but I thought that if I was going to break into a different location, then I think that would be super advantageous. And it worked out, and obviously I met Dr. Adams.

Yeah.

And so you kind of, you know, right place, right time things, and it kind of just led me this way.

So Yeah, well, talking about plastics for a second, um, I know you mentioned being in Chicago and, um, gravitating towards wanting to do plastic surgery, but I know there's so many different routes and different kind of subsets and niches, especially like in a market like Dallas, of, um, what different plastic surgeons do. Um, I guess maybe you're still kind of trying to figure out exactly what that is, or, or how have you decided like what specialties. Yeah, what interests you?

I think last year was super helpful. I mean, I think I had done a lot of facelifts throughout residency, and then last year I did a lot, even more. And then you do a lot of specific techniques. It's almost like, it's almost like working at like a French Laundry or like a super specific— like in Chicago, it's Alinea, right? So you're going to work with Greg Atkins and learn how he's going to make this specific pasta, and you're going to do do I like making dessert, right?

Yeah, yeah.

So I like making pasta, so that's kind of how I figured stuff out. Yeah, but it's funny because like I also am pretty good at making dessert, so like I can be with somebody that does something different than I do on a daily basis, but like it's all principles. And so like I can do cases that I've never done before because I just apply this one principle to it and then it works out really well. There's like a whole, and I'm never, I'm not an artistic person by any means, but I feel like I can kind of see patterns. And it's just because I've done residency and training for so long that you can see what things are supposed to look like. And then I try to get to that end result. It's very left side, like right-sided, when in fact, when I was growing up, I was very left-sided brain.

I've always felt that about plastic surgeons. There is just a lot more artistry to it than, as opposed to like orthopedic surgery, right?

Yeah, well, but orthopedics I think is also artistry too, but there are artists like the artistry component is just like getting a perfect X-ray, which I think is amazing. Like, that is like— they will put up all the X-rays in their room and be like, oh my God, look at that reduction, right? But for us, it's just like, look at that facelift result.

Yeah.

So there's all these diff— I think there is a sense of like perfect and a sense of beauty, which I mean, that's a whole conversation in itself of like, what are you trying to achieve? I think that is where I try to take the most time with patients nowadays, is just like, what do you think is like a perfect result? Yeah, because I can try to do all these different techniques, but then, you know, if someone has a really full face and then they have a sculpted neck, that doesn't look congruent. It kind of needs to fit everything together.

How have you, like, learned to navigate those sort of conversations with patients?

Being super honest and, like, not looking at your ego and saying, like, I'm gonna make a mistake, and just putting it all out there. And if they choose to have you as their surgeon, then you're like, I'm good to go, right? I think at this point I feel like I have nothing to lose. Kind of a lot of things worked out like for me, and I got super lucky to be in the positions that I did. Like, I don't think this always happens to everybody that comes throughout this process. And so I've just been like, I'm just gonna try to do the right thing, and if it doesn't work out, at least I tried my hardest, and that's it. I can kind of go to sleep and live by that. So it's just, you gotta always just critically look at saying, how can you better at what you're doing.

Mm-hmm.

It's truly that in itself. And if you're not critically looking at it, then it's like, what's the point of doing this? Then go do something else. Yeah, right.

Yeah.

And I guess it's exciting to be in something that you are excited about improving.

Yeah.

Yeah.

And I didn't have that the first year too. I definitely would think like I was depressed my second year studying for Step 1 and all these different things. But like, yeah, what I got excited about is like what my life could be in the future. And I thought that was like a big driving force into like what I like doing. And that's what made me work really hard on Step 1 and Step 2 and things like that.

Yeah, I was kind of thinking about that as you were talking just about the 6-year accelerated program is that, I mean, so much of medicine in this journey is delayed gratification. But talking about your program, taking 20, 25 credits a semester and then just having to like put your head down and just hope that there's kind of light at the end of the tunnel. I guess like there's obviously something to that, 'cause we're looking at you now and you're so successful and doing all the right stuff. But then at the same time, it's like in med school now, I know there's gonna be hard points, but at the same time, I'm trying to like not have such a delayed gratification mindset. 'Cause I wanna like enjoy life.

Yeah, so like I'm Hindu and I don't eat beef. And so like, I really don't even know what like steak tastes like or stuff like that. So when I started med school, I didn't know what like a normal college experience was. That's the only thing I experienced, right, was like 26 credits, right? So I do think when I first started, like, Instagram wasn't what it was. All these other things, outlets of just comparing yourself to other people, it's not there. And so for the first couple of years, it was actually really easy to like, I'm just going to go and study and hang out. I only compared myself to my friends and we all were doing the same thing.

Yeah, true.

Same thing was just like, you know, if nowadays it's so hard because you can be super profitable, super young, and you'll see that on Instagram. And you compare yourself instantly to 10,000 people that you can follow, and you're just like, why am I behind? But reality is you're probably on your own path and you don't have to think that way. Yeah, it's all mind games.

Yeah, yeah. But it's just the thing of like putting your head down and working hard now for the idea of being happy later. But that is so much of this path. Yeah, but that is so much.

Yeah, for sure. I do have all these weird sensations when I know a medication that a patient says and I'm like, well, I got that from step one, right? So like, it is a weird— like, I love Inception and I love like Interstellar. And there's all these little moments of your life. You're like, wow, this was actually like important.

Yeah.

And like somebody is somewhere out there is looking out for you. Maybe it was yourself that was like, you should read this really hard.

Yeah.

Because all of it's important.

Yeah.

Like it weirdly enough. Is important. And I love AI. I mean, I can talk about, like, I'm getting my MBA. I started my MBA too during residency.

Wow.

So I have 8 classes left, and I just took an AI real estate course. But there's all these little tiny, like, Easter eggs I feel like I find out, and all these things that, like, help me make my notes better or be more efficient or do something here and there. It's all just lifelong learning.

Mhm. Well, let's talk about that for a second, because I did kind of want to talk about— I think plastic surgery, or I assume, I don't know that much about it, but I, uh, from what I've seen, it seems unique in the way of business and having to, um, kind of market yourself and, um, just kind of the, the marketing aspect of also just like being a part of a private practice too, in any specialty. Um, what has that been like learning more about that?

Yeah, I mean, I kind of, you know, I've been told a thousand different things about how to do stuff. But I kind of was just like, I just need to be by my— like, be myself as a person. And it's interesting too, like, Dr. Adams has a very prominent, like, advertising department with Plastic Surgery Channel and all these different things. Um, but it's something that I've kind of taken a step back at and be like, I really want to be thoughtful about how I do things. And so I don't advertise. I don't put myself on Google Images, like Google, um, sponsored ads. I don't post any befores and afters. Like, if you want to come and see me, then like, that's when I'll show patients like what my fours and afters look like, which I'm always happy to do that. Um, but I just kind of think like just being a little bit more myself. I never had a Facebook growing up. I really never had Instagram until last year. So like none of this stuff is like stuff that— why would I change?

Yeah, yeah, right.

And I don't really think at the end of the day the biggest thing that I can do is just make a patient really happy and they tell 10 friends.

Yes.

Yeah, I mean, you know, it's true.

Like your mom's a testament. Like no one does internal medicine and like a concierge practice and like for you to do this in this super competitive atmosphere, that's more impressive than what I do.

Well, yeah.

And it just, you know, I mean, I started this practice so long ago, it's like at that point you don't even know what you don't know. But same thing. I just always— I'm not a salesperson. And when I bring in a potential new patient and I talk to them, I never try to sell them of like, you need to be a patient. I'm just like, I'm going to explain to you who I am and what I do. And then if that sounds good to you, then You know, yeah, you can be a patient as long as I like them too. But that's key.

And that's what I'm really getting into is just like, it's not a consultation for them as much as it is a consultation for me for them. And there will be things that I will start picking apart and be like, this person, it's not, it's not going to work. Yeah, this is not, this is not conducive to making me go home on a Friday and not getting phone calls and text messages I share my phone number to every single patient I operate on. I do not want to get a text message and I really don't get text messages by anybody because I know what I'm having sifted through the clinic is people that I really like and I really want to operate on. And then they have cool friends because they're a cool person and they will bring their cool friends.

It's a big difference. Yeah.

Yeah.

That's when, when a potential new patient calls, I always want to know, how did you hear about me? And if they were referred by somebody, I'm like, oh, It's going to be great.

Yeah, I learned that, like, the mentor that I had was Dr. Bortnik in Kansas City, and like, literally the same thing. If someone said, oh, we got your information from Google, he's like, God, like, because I think they don't really know the whole vibe. They've already been— they're already positive about the encounter before they walk through the door, right?

Yeah.

Um, you want to— I think when you look at— and it's a really big lesson too, is like looking at You know, the Hermès Birkin bags, they put advertisements up. No, they don't. Right. But everybody, everybody knows about it. Right. You want to make yourself something that people talk about by just doing good things. And it takes time. Like, were you super busy your first year?

It does. It takes a long time. It takes honestly way longer than you even think that it will. But yeah, I think you just have to have realistic expectations.

Yeah. Yeah. I think that's a really good point. Just you can do all the marketing and all of this, but I mean, just being a good doctor and having your patients like you is key. Yeah.

Yeah. Just be good at what you do. My mom and I— my mom loves sports, and so, like, I learned a lot of sports and, like, I love athletes and everything like that. At the end of the day, we always joke around and be like, LeBron James is still an exceptional basketball player at the end of the day, but now he's invested in this and that and that, you know? But it all just stemmed from being a good basketball player. Like, I would always talk to my plastic surgery attendings and be like, how can I make money in the stock market? What can I do? And he's like, You're going to make more money being a good plastic surgeon than you ever will being a good stock market predictive person, all these different things.

It's funny you say that. There's these different Facebook groups, like one called Physician Side Gigs.

I'm obsessed with the Facebook groups.

Oh, really?

Well, I just happen to get on these things and see. But a lot of these people are like, they're doctors and they're always like, okay, I want to start a business doing this or that. And I'm thinking, you're a doctor, just be a doctor.

That's what you trained for.

You can make more money doing that. Just do that really well instead of spending a bunch of money and time trying to build up some other business that you know nothing about.

Correct. I think everybody has the sense and we always learn is just like the grass is greener on the other side. But it's so funny, like getting my MBA, I've learned a lot about starting businesses and basically whenever you start a business, like the first couple of years are like like you're not profitable, right? And then your third or fifth year, you're finally there. But like during those, like that exponential growth phase, so many people quit because they want to go to somewhere else. But then you start the same thing where you're like going up, going up, and like, this doesn't work, so then I'm gonna go do something else. So that's the whole like just being okay. And that's the same application to like dating people. Like, you know, I'm— oh my God, I met this girl, I love her so much. First 3 years are like amazing, or maybe like something bad happens, right? And then you're like, I'm going to go date somebody else and you start this all over again.

All over again. Yeah.

Everything. I think everything in life truly gets better over time, but it just takes you being determined and committed to, like, seeing it through.

Yeah.

Yeah.

Talking about business and starting a business, what was the— your experience being exposed to private practice through medical school and training? We're kind of only exposed to big academic institutions and academic medicine. How were you able to meet Dr. Adams and what made you interested in kind of—

Yeah, so this UT Southwestern fellowship is interesting because it's not really academics. It's— I only worked with people in private practice, but they have like a strong alliance with the academic center. And so it's a good combination of a hybrid portion of it. Cosmetics unfortunately doesn't make sense in a facility such as UT Southwestern because it's billed off of RVUs. And so the whole structure of that, actually, like billing patients doesn't equate. And so the biggest thing that I do is I don't make a facility fee at the end of the day. So any quote that I have has a surgeon's fee, a facility fee, and anesthesia fee. Anesthesia is going to make their portion, but the facility fee usually is like an allocated amount for a specific case. The question is for the hospital, is it worth it to have a lot of cosmetic plastic surgeons or a lot of orthopedic surgeons that can have facility fees way higher than our cases? It's always going to be orthopedics or urology or ENT or cardiac, right? That's why you have like a cardiac building. That's why you have an orthopedic building. The facility fees on screws and hardware is 1,000 million times more than anything that I would do with a facelift or a rhinoplasty or things like that. So basically what ends up happening is that you kind of get pushed out because our time is not generating as much money for the hospital system as if I did reconstructive surgery. So if you want to do cosmetics, you have to almost do private practice.

And when did that— when was that decision made to do cosmetics rather than reconstruction?

I had more fun doing cosmetics.

And then was that in fellowship or—

That was my fourth year, right?

Okay.

Yeah. So I worked with— I had done 3 and a half years, and then we go on the VA, and the VA is usually always like a light rotate. We call it VASPA, right? Like, and so you always are going to have a lighter rotation. So I worked Monday, Tuesday, and then like Wednesday, Thursday, Friday, I would go hang out with a cosmetic surgeon in Overland Park who was like one of the main attendings in Kansas City. And so I just learned so much from him. And then basically, I think by doing like 4th, 5th, 6th year, whenever I'd finish a case at the main campus, I'd go hang out with him afterwards. By the time I got to fellowship, they were very impressed. I was like, I thought I was going to show up and not, you know, be as highbrow as UT Southwestern was, but I felt like very comfortable doing a lot of different things, um, probably just because I just spent a lot more time operating. So it's like a sport. It's nothing like if you shoot a lot of basketballs, like in a hoop, like a lot of free throws, you'll get better at it if you do a lot more reps. But if you do only a couple of you won't be that good, you know.

So, well, yeah, that's— yeah, I think that that's important for people to hear too, um, especially don't get good like not doing stuff.

Yeah, that's the saddest thing now I think about all of med school is that you just watch a lot of residency when you first start out. You lot, like, you watch, and then I think you have to start seeing like, what are they doing? Up to a point that helps you when you get the opportunity to do something to like be successful. Yeah, it's, it's weird, but like the more you do the one same task every day, you start noticing. It's like magic tricks. Like if you start watching somebody do a magic trick, you start realizing all the other things that are going on and you're just not looking at their hands.

Mm-hmm.

Yeah.

So, oh, my, my question is just about your day, like how— or about your week. How much time do you spend? Talking to patients, consulting them, and how much time in the operating room?

Yeah, I mean, honestly, probably the girls would probably agree that like I spend way too much time talking to patients, but like I think at this point I really like doing that. And so I try to maximize as much time as I can. Um, in the OR, I usually, depending on like cases, they're usually booked weeks in advance and then You know, the shortest cases are going to be about an hour. The longest cases could be about 6, 7 hours. Yeah, I know.

You got to really like doing something to do it for 6, 7 hours.

Yeah, it's like taking Step 1.

I didn't have the stamina to sit there and take a test for 8 hours.

But like, I don't think I could be in the operating room for that long. But I also look back and be like, you know, taking a long test is just seeing how well you can concentrate for that long of time. For me, I can't think of anything like outside of me operating during that time. And so like, I just get into a zone and I love it. Some people probably hate it and just be like, what is happening? But it's almost like therapeutic. It's fun. It's for sure a lot of fun when you can do something super well. I think it's a lot of fun.

Yeah, I think that's also, I don't know, encouraging to hear you talking about this, like what you do, so positively, and that you love it and that you're interested in it.

And like, it's a love-hate relationship.

It's—

there's days that I put a stitch in, it looks and I cut it out and I do it again, it still looks terrible. So like, you know, the third time I do it, finally it's like I'm happy with it. There's a lot of cases that you do though that you're like, I wish this looks better, but you can try so hard. And like, probably to a lot of people they're like, wow, that looks great, you know? But in my head I'm like, how can I get this better? It's like golf. You can never play a perfect round of golf ever, right?

Coming back for more.

Yeah, yeah.

But I think it's fun for sure.

Do you feel like you've always had like a perfectionistic mindset or—

no.

Yeah, no, I definitely didn't fit the mold for plastic surgery early on. And I still think like, I don't know, 50% of the plastic surgeons I meet are the coolest people I've ever met, 50% are the worst people I've ever met. And so like you have to find who you really gravitate to and like. And I was not a perfectionist nothing like that. But now I feel like I just like getting better at what I do, and now I can kind of see where I have those tendencies. But it's so funny, like, I am in love with my wife and she is OCD about teeth, and we are both OCD probably like when we go home and like clean our apartment and all these different things. So like, I have tendencies that probably I just don't even know that I have. Yeah, right.

Yeah, that makes sense.

Does your wife have great teeth.

She has wonderful teeth, but it took her a long time to get to that point. Yeah, very long time to get to that point. She had like headgear and all these things. So she just comes from another side of just like, I really like doing this for patients. She's even more passionate about what she does than I do.

So yeah, does she do cosmetic dentistry? Okay, yeah, that's awesome.

You can interview her next time too.

Yeah, dentist. Yeah. Um, so I guess you're at kind of, I guess, the beginning of your career, where do you see, where do you see things going?

Hmm.

I think, I mean, hopefully just keep growing. It's funny that you ask that question because like I put this into ChatGPT one time. There's 365 days in a year. You take out weekends, you take out holidays, there's like 250 days and then you pretty much only operate 3 days a week. You probably can only do 2 cases per week. And then you— I don't know, so let's say there's 200 days times 2 cases, so like 400 cases probably in a year that you can do. I think I just want to maximize those 400 cases and get like the best result out of those 400 cases rather than trying to make it to like 500, 600. And so I would rather have like the best of the best, like a French Laundry or Alinea, And that's probably all that I would like to do.

Like, that's enough.

That's enough.

I have to do more than that.

The happiest people I know— the best advice I got is this guy that does rhinoplasty in Newport Beach, and he takes the entire month of September off. He doesn't have children. So he said his mentor, who did like exceptional rhinoplasty, basically was just like, I would say take more time off, take more time off for vacations, like just live. Live like in the moment. So he takes the entire month of September off, and he takes every 6 weeks off 1 week. And so I don't know, I think it's probably like 16, 17 weeks of vacation. Um, but during the time that he's back, he's working really hard, and then the time that he's out of the OR, he's like living life as much as he can, which I think that's awesome. You gotta find a balance between both of it.

Yeah, quality over quantity.

Yeah. Which I think our generation is doing a great job pushing that boundary for sure.

Mm-hmm. Do you feel like that's such a shift from what you've been doing the past couple of years, just going straight through from medical school?

I miss weddings, I miss funerals, I missed all these different things. This was last year. I was long distance and then with my fiancée, now married. So like, there's stuff that like, you know, Friday, 4 p.m., I'm done. Like, I'm not going to think about stuff. I mean, obviously, if patients text me or call me, then I will respond. But I don't want to try to think about work on Saturday. Saturday is usually like my free day. And then Sunday I usually do my MBA stuff and then catch up with notes and I start it all over again. So I think that's the best way of trying to be sane at it.

Yeah, yeah, yeah.

Great.

Mm-hmm. Well, we won't take up too much more of your time, but— Oh yeah, you're good. But I always ask everybody on the podcast this, uh, what advice would you give to a student who's early on on their medical school journey, like me?

Yeah, uh, it's a great question. I always think don't be critical of yourself because you're learning and it takes time to get good at what you're supposed to do. It would take me an hour before I did like a good deep dermal stitch. And I got so nervous and I would just beat myself up and I'd just be like, I'm never going to do good at this, like be good at this. And now I can throw stitches in 2 seconds and I'm 1,000 times better. But I think like in the past I got so nervous and anxious about everything that I was just so hard on myself that it probably just caused more anxiety and grief and frustration than it probably needed to be. We're like human beings. We're not perfect people. And like, like, you know, you can do plastic surgery and still make really bad mistakes. And I've seen lots of plastic surgeons that make like really ugly, you know, results. So, and so I won't say that for my results, but, uh, I, yeah, you think that, oh my God, everything has to be exact, but it's not. You can do so many other things and still be super happy about it.

Yeah, I like that a lot. I, and yeah, just the remembering that you're a learner, not— yeah, yeah.

I think that's true for you going into clinical rotations coming up, and I think that's a— it's a— it's such a shift from what you've been doing with all this kind of book learning. And then you start doing rotations, and they're, you know, and you're trying to do, you know, trying to present to the attending and the residents on rounds. And, um, but, and, you know, you're not going to be perfect at it for a while. It's going to take a while to get good, to figure out what's important when you're interviewing a patient. All of that. But don't, don't beat yourself up when you don't know the answers to the questions that the attending's asking you, which is gonna happen.

And that's the thing, like, it's so funny when you— it's— I always think this is like a Rubik's Cube. Like, the first time you do a Rubik's Cube, it's really complicated, you don't know how to do it. And then you do it 100 times, you're like, I know how to do this. Attendings have done Rubik's Cubes for like 1,000 times. So like, you're figuring out all the different bells and whistles, and it just takes time to learn it. And I think it just takes time to like digest stuff because your brain is growing. And so don't be hard on yourself. I mean, it's easier said than done, but that's what I would say.

I like that. Also, any specific advice on— I think I'm going to do my specialty surgery in plastics. So, really? Yeah, yeah, yeah.

I think realistically being yourself, like, I think takes you way farther in every rotation. And I don't remember, like, the kids that knew every single question, like, cool, great, that's awesome. But like, I really wanted to hang out as a resident with med students that were a lot of fun and like were fun and bubbly and talked about lots of fun things and like new current events and, you know, what great restaurants are in Dallas or in Houston or anything like that. That takes you way farther. We're all normal people. Like, you don't have to overthink it as much.

I like that.

You know, you also just like people that want to work hard, you know. If you're a student and you're doing stuff to help out your residents, I mean, that means way more to them than knowing the answer to every little question.

I— you will go so far in life by just saying like, hey, I suck at this, can I like— how can I get better at it? You go so— like, people immediately are gonna be so much kinder to you. Like, I still say it, like, hey, I'm an idiot, I don't know what I'm doing, and like everybody laughs. Like, no one is ever going to be mean to me that says that.

That's just— yeah, putting your ego aside.

I like putting your ego aside and just be like, I messed up. Anything that you can, like, really self-deprecating. I learned this from one of my co-residents. Like, if you're massively self-deprecating, be like, I suck at this, I'm stupid. Or not— don't be hard that much, but like, you know, just like within reason, people will immediately drop their, you know, defense.

That's good.

Yeah. Okay.

Yeah, you can get out of any patient encounter really well and just be like, I messed up, you know?

Yeah, yeah, yeah, yeah.

And then it's just like, you know, they kind of like, oh, I'm not going to be mad at him anymore, right? Um, it helps a lot.

I like that. I like that a lot. Um, well, you guys know where to find us at generations.md on Instagram and TikTok, and you can find my mom at Dr.

Davis PGY30 on TikTok.

And if you have any questions, uh, you can email us at askgenerations.md. Questions.md@gmail.com, and we will talk to you guys soon.

Bye!

Bye!