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It's a Matter Of... Beauty

Holistic Approach of Person Before Procedure with Dr. Shirley Madhere

June 24, 2020 BeautyMatter
June 24, 2020

With a vision of holistic plastic surgery - person before procedure - Doctor Shirley Madhere knows what beauty means in both theory and practice. Beauty is a heady topic that incorporates the physical, emotional, spiritual, psychological, and, in the case of plastic surgery, medical. Anti-Aging as a term is out, and Self-Care as a concept is in. Kelly Kovack talks with Dr. Shirley about how she has become an authority in the field on her own terms, and how the implication of a shift in the consumer mindset opens the borders of the conventional beauty landscape.

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.

Kelly Kovack                                 We sort of touched on kind of the taboos of plastic surgery and how it was sort of thought, not so long ago, to be something that women of a certain age did, kind of in secret. But, you know, all of the sudden, we live in this social media, selfie-obsessed culture that’s created this desire to look filtered in photos and in real life, and the result has been sort of this rise – meteoric rise in injectables and procedures that people are getting at a really young age, and so I’m curious to get your thoughts on that, and then maybe a little provocative, and I don’t know how comfortable you’re going to be having an opinion on this, but wherever there’s sort of that big of a spike in anything, businesses crop out of it. So, we now have the equivalent of dry bars for Botox, and so what do you think about this level of accessibility, for like, I mean, it’s still a medical procedure.

Dr. Shirley Madhere [00:28:40]: Agreed. So, yes, I’m comfortable talking about it. I will gauge my words somewhat carefully. Dry bar of Botox. Let me first say that yes, plastic surgery used to be taboo and hush-hush, and sort of done secretly, less so now, and I believe that that’s a result of social media, a result of the demographic where people are undergoing procedures, and they’re more open about some of the procedures that they’re having. Some celebrities are quite open about it. I think people are more open about the non-surgical procedures than the actual surgical procedures. There’s something still a bit taboo about, “Wow, you actually underwent the knife to change something about yourself.” I still think people may judge that, unfortunately. So, is it still taboo, less so, but surgical operations I believe still are a bit secretive, to most people, as they should be, it’s nobody else’s business. Dry bar of Botox, okay, let me just say this: I applaud having options and I applaud accessibility. I think anyone who wants to be able to change something about them, get a little tweak, they should be able to do that, and sometimes the barrier to entry is cost, and I fully understand that. So, I applaud that, and I’m happy that there are such institutions, organizations, that allow that to happen for some people. I will say, however, that that is, personally, those are not places that I would get my treatments. Aside from being a physician where I can do it myself, but even if I were a non-physician, those would not be places where I would have my work done, because in my opinion, the cost is not just – the fee is not just about the procedure, it isn’t just about the cost of the Botox or the cost of the filler, it isn’t just about the syringe and the supplies and everything that you use. I like to think that my patients come to me understanding that inherent in my fee is yes, of course, the cost of the supplies, but also my time, my expertise, my care and compassion, my sense of artistry, and my devotion to doing the procedure as best as I can to give them the best result I can without complications, but if a complication does occur, that I am well-trained to handle that as well. So, I think there’s a level of expertise and care and compassion and artistry and understanding of anatomy and physiology that I believe ought to be honored.

Kelly Kovack [00:31:22]:               I mean, I agree with you. I think on the one side, I’m kind of in awe, I mean, I read something recently where – it’s in the U.K., there’s actually something called the “Kylie Jenner Package.” It’s a Kylie Jenner Package, and I think it’s like £299. It is literally packaged, you know, and it’s sort of the equivalent of getting hair extensions. So, I kind of wonder if as a beauty industry, do we have a responsibility to educate, because having something injected in your face is not the same as getting hair injections.

Dr. Shirley Madhere [00:32:06]: Agreed 100%, and keep in mind, it’s something taken from the outside going into your body, and that then translates into the whole health and wellness and how do you really feel about yourself and self-care? And, also inherent in that is time: do you really want to go someplace where every 10-15 minutes you’re being cycled through for something? So, I take my time. I’m pretty slow, but I think that’s really important to what I do, and it’s the aesthetic and it’s the high touch that is valuable not only to me if I were a patient, but I hope to the patients that come to me.

Kelly Kovack [00:32:42]:               Well, you know, I think on the topic of wellness, I know wellness is kind of massive, and how you live your life and how you sort of practice, but you know, I think one of the most interesting things to me is what we’ve seen is this merging of beauty and wellness, so all of the sudden, we’re seeing ingestibles on the shelves of Sephora, and there’s almost – I don’t even know that there’s a distinction, I think the two categories have merged, and I think what we’re beginning to see is that same sort of disruption happening in healthcare, particularly when it comes to women, and I’m really interested in your perspective, because why do you think that it’s taken so long for the medical community to realize that women and men have significantly different needs when it comes to their health? I mean, we have different plumbing, we have – we go through kind of these fundamental changes in our lives, childbirth, when you become a woman, going through menopause, and all of these taboos are like being knocked-down, kind of at the same time the plastic surgery taboos are being knocked down, but it’s taken so long for how medicine is being practiced, both sort of in the approach, but also the physical environment, and so why do you think it took so long, and what are your thoughts about it, and where do you think it’s going to go?

Dr. Shirley Madhere [00:34:14]: Well, firstly, it’s about time! Oh my gosh, it’s about time. I think one of the reasons why it took so long was because in the past, medicine was – the rules of medicine, the regulations of medicine, how medicine should be practiced, really were dominated by men, and there was also some thinking that oh, we’re all humans, and yes, men and women are different in fundamental ways, but we’re all humans, and health-wise, we all need the same things. We all need our plumbing to work, even though we’re different. We all need to have mental health, we all need to have physical health, medical health, etcetera, and because the systems are the same, everyone has a liver – most people have livers, gall bladders, intestines, and therefore, because the physiology or the anatomy is the same, then perhaps medicine should be the same for men and women. But, as of late, thank goodness, there’s more realization that women do need different things, and we think about our bodies differently from the way men think about their bodies, I believe. We think about our appearance differently, maybe we know or inherently understand that how we are on the inside really does manifest on the outside, and therefore, we’re taking more stock in that, and feeling better and investing in our inner health as well as our outer health. So, I think that it took a long time, because of those reasons, but finally, we’re all coming around, thank goodness.

Kelly Kovack [00:35:34]:               I know, I think concepts like Parsley Health and slow living, functional medicine, I think this rise of…you know, it was probably like ten years ago I went to kind of a functional medicine doctor.

Dr. Shirley Madhere [00:35:49]: You were ahead of your time too!

Kelly Kovack [00:35:50]:               I guess so. It made so much sense to me, but it was also kind of considered one of those things, “woo-woo,” you have way too much money, more money than sense.

Dr. Shirley Madhere [00:36:01]: Right, because they do not accept insurance.

Kelly Kovack [00:36:03]:               They do not accept insurance. And, I still think it’s…you know, I think there’s also – there’s a lot of women behind these concepts, which I think is very interesting, and we’ve talked about this, where there are still female doctors that don’t prescribe to the functional thing at all.

Dr. Shirley Madhere [00:36:17]: A lot of doctors don’t.

Kelly Kovack [00:36:19]:               And, I think I shared with you that I went to a doctor and there was sort of an issue, and the first thing she wanted to do was prescribe something, and that’s always my personal choice, but my last option, and I told her that I was going to try acupuncture instead, and she literally looked at me and said, “That’s for neurotic people, and you’re not neurotic,” and I was like, “Okay, but I’m still going to do it.” So, I kind of feel like…do you think that that kind of old school approach – and this is like on Madison Avenue, in New York, you would think kind of a more open-minded, evolved, but do you think that’s changing, and is it changing sort of in how medical schools are sort of teaching the next generation?

Dr. Shirley Madhere [00:37:14]: I believe it is changing, but it isn’t so old school. I think that attitude is prevalent. I do understand the push for functional medicine is definitely increasing and gaining momentum, but it is expensive, for the most part, those physicians do not accept insurance, functional medicine, integrative medicine, alternative medicine, the fact that it’s called “alternative,” it should be complimentary medicine, but because it is so expensive, not everyone has access to it.

Kelly Kovack [00:37:42]:               But, it would cost, ultimately, it would ultimately cost less money, because it’s preventative rather than sort of…

Dr. Shirley Madhere [00:37:49]: I agree. It would take time, that cycle would take time, but I agree, it would cost less. Prevention, right? Prevention is I think the key cornerstone to health. I believe in functional medicine because it makes sense to me.

Kelly Kovack [00:38:03]:               It’s just common sense.

Dr. Shirley Madhere [00:38:04]: Before it even – it’s part of my culture, it’s part of how I was trained, it’s part of how I trained myself, it’s why I learned Reiki. I know this is going to sound really crazy, it’s why I learned homeopathy. These are not things I learned in medical school. I had, I think, one semester of nutrition in medical school, I then took a year of integrative nutrition, because these are things that are important to the way I practice. So, I am interested in functional beauty, because I think beauty and wellness are along the same spectrum.

Kelly Kovack [00:38:33]:               And, do you think the beauty industry is sort of – either needs to evolve along those lines, do you see it happening?

Dr. Shirley Madhere [00:38:40]: I see it happening, and it’s coming. I know of a few companies, I’ve consulted with a few companies who actually are taking swabs of DNA, we talked about DNA earlier, and then they’re plugging that into their algorithms to determine the best serums or the best creams for somebody’s skin, so that is coming. Not only is functional beauty, functional medicine is having an impact, and also, I think personalized, customized health, wellness, and beauty are absolutely key. They are the way to the future.

Kelly Kovack [00:39:10]:               There is – I can’t remember the name of it, but there is a…it’s a medical practice in Seoul that is like super, super high-end, and you have to pay a yearly sort of…it’s concierage medicine, but it’s also beyond kind of the concierage component of it. It is like highly customized, and it’s sort of head-to-toe, so it’s everything from sort of a GP to plastic surgery, and there’s a gym there. It’s really fascinating. Do you think that that is kind of the future, or is that just sort of going to be for the one percent?

Dr. Shirley Madhere [00:39:48]: I think initially – I do think it’s part of the future, and I do think initially it probably will be prohibitively expensive for most people, maybe myself included, I’d have to work there, I’d be like, “Hey, can I have a job?” But, I do think models of that nature are for sure. I think they’re going to be here. They may not be coming soon, but I think they’re the wave of the future, I think they’re the next generation or the next generation after that, because personalization, customization, everyone wants that feeling. Everybody wants that “old school” feeling, which is too bad that it’s old school, of having your doctor, your practitioner, your caretaker spend the time with you to really try to understand you.

Kelly Kovack [00:40:29]:               And, not only like – you know, sometimes I find when you go to a doctor, you’re talking about really uncomfortable things sometimes, and so if you have a doctor that doesn’t really know you, they can’t really pull out of you what you might be saying, right?

Dr. Shirley Madhere [00:40:45]: Right. Although, listen, I don’t have a problem saying exactly what’s on my mind and then being a physician, I’m like, “Okay, listen, here’s what’s going on with me,” and I have to be careful when I’m a patient, because then I don’t want to tell the doctor what to do, but I have gone in and said, “Hi, I want this test. Please test for that.”

Kelly Kovack [00:41:01]:               Right, but you have a little bit of background, you’re not like…it’s not like me going on Web MD and self-diagnosing.

Dr. Shirley Madhere [00:41:07]: Everybody’s got an internet MD. But, listen, it makes me a difficult patient. Yes, I know that – you asked a question earlier about the future – the training of future doctors. I do think that medical schools are incorporating not just soft skills and bedside manner type of courses, but they are incorporating how to use technology, how to use AI, how to use different innovations in medicine, how to work with these devices, and using that information as a compliment to how you will interact with a patient and not just cure the illness or the disease or the condition, but actually make their lives better, and lean more towards longevity and a long life, a long beautiful life, free of not just disease, but dis-ease and feeling ill at ease.

Kelly Kovack [00:41:55]:               It’s also sort of optimizing.

Dr. Shirley Madhere [00:41:57]: It’s optimization. Why else would we be going through all of this, right?

Kelly Kovack [00:42:04]:               Exactly, exactly. So, there’s one last sort of topic.

Dr. Shirley Madhere [00:42:07]: Last?!?

Kelly Kovack [00:42:08]:               Well, you know, because I think it’s sort of, there are two big topics.

Dr. Shirley Madhere [00:42:14]: Heavy, okay, I’ll be serious.

Kelly Kovack [00:42:16]:               I mean, I think serious, and it’s the “isms.”

Dr. Shirley Madhere [00:42:20]: Oh, those three-letter words.

Kelly Kovack [00:42:22]:               The “isms.” So, you know, medicine, in general, has been sort of a male-dominated field, and surgery, plastic surgery, is particularly macho. Have you had to deal with sexism? I think I know the answer to that question.

Dr. Shirley Madhere [00:42:37]: Am I sitting here?

Kelly Kovack [00:42:39]:               Yeah, like how did you deal with it? Is it still as male-dominated as it was?

Shirley Madhere [00:42:47]:         Okay. I can say that things have gotten better, because I read some recent statistics that in medical schools, the ratio between male and female medical students is just about equal, so 48/50, 50/51, etcetera, equal to 100%, obviously. So, that is better. The numbers of women entering into surgery, while mildly increased, is still relatively low, obviously in comparison to men going into surgery. I cannot speak…

Kelly Kovack [00:43:15]:               Why do you think that is?

Dr. Shirley Madhere [00:43:17]: For many reasons, rigorous, not that women can’t handle it, hours, hours, long hours, extensive mental/psychological/emotional/physical stress and drama, frankly, I’m just going to say drama, at a time when we are at our reproductive peaks. So, it’s a decision that has to be made. I made the decision to go into surgery because I loved what I was about to do, and even though I tried not to like it, I wound up loving it, and so I made that decision knowing that it would be at a time when some of my friends were getting married and having children. I clearly did not do that, I got married much later in life. It is a decision, and it’s unfortunate that modern, current, maybe even past upbringing of young girls, ladies, and women, is such that you have to choose one over the other, and I think that is bloody unfortunate, because both are still possible. Isms, in my plastic surgery training, now I know this is a bit more universal, but I’m going to be kind and I’m just going to keep it to my experience. My experience was not pleasant. My experience was traumatic. My experience was dramatic. Despite that, I was – one of the things that kept me going was because I loved what I did and do, and I was focused on it, and I feel that it’s truly part of my purpose and my mission to make the world a better place, a more beautiful place one person at a time, and to help educate or re-educate people about feeling empowered in their own bodies and their best version of themselves, and to find their own beauty, and also, I had a tremendous support system. I didn’t feel as if I had advocates in the programs where I was training, I didn’t really have too many, if any, mentors. I had mentors in other industries, so I was able to sort of translate other industry mentors and values to what I was doing, and I have a tremendously supportive family and friends. I remember coming home one afternoon after some surgical thing, and it wasn’t that there was a complication with a patient. Interestingly enough, throughout my surgical training, I learned how to deal very well with complications, with death, with other people’s trauma and drama, and yet internally, when I was exposed to the emotional and psychological trauma and drama of my own training, it was very difficult for me to handle, and I remember when I came home one afternoon, bawling, sobbing, in tears, you know, snot, everything, I couldn’t control it, it was ugly. It was not a pretty thing, and it just so happens that my mom called me, and I tried to get it together, my mom was a very strong woman, and like, “buck up!” So, rather than give away that I was having a hard time, she asked me how I was doing and she asked me some other question, “Well, how was your day today?” and I lost it. Again, the snot, the (crying noise). And so, I told her what happened, and finally she gave me a moment to pause, and then she asked me one simple question: do they know who you are? Oh my gosh. Every time I tell that story, it like warms me up. But, what she meant by that was, you have to remember who you are, and you have to remember that no matter what other people think about you and your abilities and capabilities, even though they’re judging you, they’re scoring you, whatever, you have to know that you’re here for a reason, and you can do it, that’s why you’re there, that’s why you were chosen, and you have to do it, because it’s what you wanted. So, that is a seminal – that was seminal for me, and through a lot of therapy, also, and spiritual healing, and that’s another thing that led me to spirituality and complimentary medicine and Reiki and stuff like that. I’ve had a lot of help getting over that drama and trauma, and it’s unfortunate that for a lot of women in those programs, that the psychological assaults and the emotional insults and the micro-aggressions, which very much sometimes can be macroaggressions, can hold some people back, but I’m here. I don’t know if that means I made it.

Kelly Kovack [00:47:38]:               I think you absolutely made it.

Dr. Shirley Madhere [00:47:40]: Thank you, but I’m grateful for, like I used to joke around and say, “I’m grateful for the haters,” because they taught me a lot about myself. And, I’m grateful for the challenges, because they taught me to persevere, and I’m grateful for the negativity because the negativity taught me to turn it around and be – and transform them into positivity and things I can learn from. So, it has been super-duper challenging, but I love what I do, and I don’t regret that I’m here.

Kelly Kovack [00:48:05]:               I think it kind of goes into something that we talked about over lunch a few weeks ago.

Dr. Shirley Madhere [00:48:13]: Yes, we did.

Kelly Kovack [00:48:13]:               And that’s sort of this idea of ageism, and is it sort of the last acceptable ism? And, you know, we also talked about how there was a generation of women before us that kind of started chipping away at the glass ceiling that allowed us to sort of be who we are and I know that you’re sort of big in sort of giving back, to kind of change for the next generation. But, you know, I guess, what do you think – hope will change? We’ve seen in the beauty industry that there’s this whole sort of group of women of a certain age that are being sort of given retirement packages, and what I find is interesting is these are a lot of women who sort of started, kind of as the secretary, so to speak, and have worked their way up to presidents of divisions, and you know, they turn a certain age, and they’re being transitioned out, yet if you’re a man, grey is good, and you’re being courted into the corner office. And, you know, I think we’re starting to see that, where business and corporations are actually making boards have more women and more diversity. What do you think is it going to take for it to really change?

Dr. Shirley Madhere [00:49:38]: Again, I think it’s getting better, but we still have a long way to go. No ism is acceptable. No form of subtle misogony is acceptable. I applaud the women who came before us, because they did open the door. Even though it’s a crack, the door was previously closed, and I do applaud the women who have the seat at that table, even though albeit, their numbers might be small or low. So, we’ve made progress, we’ve made headway, and if there’s any way I can be a part of that, I’m going to do it, because it’s important. I can’t imagine a future where the world is amazing, better, fantabulous, oh my gosh, phenomenal, without women and our contribution. We must be here, we must be at the table, we must be allowed to have – not just allowed to have the conversation, we must be invited to have the conversations, and have our contributions be valued.

Kelly Kovack [00:50:37]:               I think one of the positive things that I’m seeing sort of happen is you know, before, so say you chose to sort of stay at home and raised children, and your children go to college and you know, women have always gone through sort of the empty nest, and I think one of the cool things I think is happening is that both women who have sort of chosen that path, and women who are sort of being sort of shown the door, are having almost this, “What’s next” moment, and having second careers, and I actually think it’s those women who are going to kind of change the next generation, because they’ve already proven – they’ve already proven themselves, and now they’re kind of doing things on their own terms.

Dr. Shirley Madhere [00:51:24]: That’s right. Yeah, I love that sort of – it’s the art of the pivot, right? It’s the art of the pivot, and inherent in that pivot is transformation. They’ve proven to themselves, I’ve done this, I know I can do that, so why not? I love that. I think it’s very exciting, and I don’t know what my pivot will be, if I will have one, but I look forward to that. I hope no one is showing me the door and offering me a package. I mean, I’m self-employed, so…

Kelly Kovack [00:51:49]:               Well, I know, so just show yourself the door.

Dr. Shirley Madhere [00:51:53]: I know, I’ll show myself the door? I don’t think so. But, I plan to, and hope I can keep doing what I’m doing with modifications and enhancements and stay on course with my mission for a very, very long time, and maybe by then either AI, Amazon, Google, or somebody else, Apple, will figure out a way for me to live to 120, and even look better.

Kelly Kovack [00:52:16]:               So, one last question.

Dr. Shirley Madhere [00:52:18]: Yes.

Kelly Kovack [00:52:19]:               If there was one piece of advice that you could give to that young girl thinking about sort of a career in medicine or that girl sort of in medical school or in residency that could make a profound impact on sort of her way forward, what would it be?

Dr. Shirley Madhere [00:52:39]: Stay true to yourself. Stay absolutely true to yourself, because there will be so many situations where you doubt yourself, where you are not sure what you are doing or what you want to do, and that’s okay, to doubt and to question, but going back to center and knowing who you are, and knowing what you want for yourself, I think that’s invaluable advice.

Kelly Kovack [00:53:01]:               Thank you, Dr. Shirley.

Dr. Shirley Madhere [00:53:04]: Thank you, Kelly, so much for having me on your amazing podcast. This has been beyond fantastic. Thank you so much.

Kelly Kovack [00:53:14]:               For Dr. Shirley, it’s a matter of beauty. Her philosophy embodies the idea that aging gracefully may involve needles and scalpels, but it also involves nutrition and self-care. For her, being a plastic surgeon is a constant challenging dynamic to provide service, be of service, to educate and teach, to listen, and to perform. Wellness has disrupted the world of beauty almost beyond recognition. In order to look good, you have to feel good. No longer is the focus only on external measures to enhance beauty, there has been a shift to a more holistic approach, a movement from artificial to organic, from cosmetic repair to ongoing prevention, from topicals to ingestibles, along with scientific validation that beauty changes everything. Given the shift in beauty towards wellness, owning your beauty, and all things natural, Dr. Shirley was way ahead of her time. While the industry and consumer preferences may have caught up with her holistic approach, she remains a role model. Dr. Shirley is evidence beauty and brains are not mutually exclusive. So, in the end, it’s a matter of beauty. I’m Kelly Kovack, see you next time.

Dr. Shirley Madhere [00:54:40]: Hello everybody, my name is Dr. Shirley Madhere, plastic surgeon in New York City, and to me, what matters most is a beautiful life, and what I mean by that is I know you’re probably thinking, “Oh, of course, she’s a plastic surgeon, so of course beauty matters to her.” Yes, it does, but not just beauty in the way that you would think about it, but truly, holistic, beautiful life. So, beauty on the inside, beauty outside of you, beauty in all of its forms, and living the best life you can, for me, is a beautiful life.