Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision, and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There is no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome to Meet the Doctor. My guest today is Paul Afrooz. He's a plastic surgeon in Miami, actually Coral Gables. Welcome to the podcast.

Dr. Afrooz (00:43):
Thank you for having me. It's great to be here.

Eva Sheie (00:46):
So tell us a little bit about your practice and what you're doing today and then maybe we'll go backwards and kind of talk about where you came from.

Dr. Afrooz (00:55):
Sure. So I'm a board certified plastic surgeon and my practice, I specialize in plastic surgery of the face and nose. My passion is really facelift, facial rejuvenation, surgery and rhinoplasty and revision rhinoplasty.

Eva Sheie (01:17):
How long have you been in Miami now?

Dr. Afrooz (01:19):
Since 2017. So what is that, six years now?

Eva Sheie (01:24):
Six years. So when you landed here, did you start out on your own or did you join a group? How did that

Dr. Afrooz (01:28):
No, I was actually recruited and I joined another plastic surgeon and several months into that I realized that I really wanted to be in solo private practice and I pursued that. And since 2018 I've been in solo private practice.

Eva Sheie (01:48):
Did you go into that partnership thinking you were going to eventually leave or was that something you had hoped would

Dr. Afrooz (01:55):
No, I went into it with a very open mind because I knew that just like anything else in life, your ideas change, your goals change, your priorities change, and I realized that for me to really sort of express myself through my profession, I really wanted to do it my way and I think that was the best move I could have made.

Eva Sheie (02:23):
There's a funny sort of marketing fallacy I think among people who work in plastic surgery marketing that it's hard to market a young surgeon for facelifts and noses because they look like too young to know anything. So how would you argue against that?

Dr. Afrooz (02:42):
I've have to thank my mentors for my training, but I came out of my training extremely confident in my ability to deliver perhaps a little bit overconfident because as you might imagine, these surgeries are challenging, very nuanced, and there's nothing like experience to understand the nuance and understand the challenges and be able to predict and deal with challenges and complications. So despite having a tremendous amount of confidence and many thanks to my mentors for that, there were definitely some situations that were big growing points in my career. So there was some humbling, and this is a very humbling specialty. At any point in anyone's career, you put your life's work and training and put your best effort forward, and sometimes things don't necessarily go as you may have planned. A lot of that is due to the working material, working with human flesh and bone. There's a lot of variability in that. But with experience and great training and passion for what we do, we can really mitigate and decrease that degree of uncertainty, but that uncertainty will always be there.

Eva Sheie (04:12):
You mentioned your mentors a couple of times now. Is there anything that you can remember working with them during that time that helped you approach those challenges later?

Dr. Afrooz (04:25):
Gosh, yeah. There's so many instances, but my greatest mentors were so passionate and all of them are still in practice and they continue to be so passionate about what they do and that passion and dedication and devotion to their patients was so contagious, and I'm so grateful that I essentially caught that passion through them and found something that I love and it's truly a gift and I'm so grateful for that. But to answer your question, it's really that passion and dedication that they had that it was the greatest gift that they passed on to me.

Eva Sheie (05:13):
What does that dedication or devotion look like in everyday life? What kinds of behaviors come along with that?

Dr. Afrooz (05:22):
It's borderline pathologic, but it's preparing the night before surgery, really looking at your patient's photos, understanding what moves are going to get you to that final endpoint. And it's kind of like coaching a football team. I love football. I'm a big football fan, and you can have a game plan, you can study the scouting report, you can study the other team and have a good game plan in place, but a lot of times you have to make changes in the first quarter at halftime, whenever that game plan is going to have to be malleable if necessary. So to answer your question, it's a lot of planning. The day of surgery is really executing a very well formulated plan. But again, sometimes you run into some issues that you may not have foreseen and you've got to alter your game plan, but most of the time the day of surgery is executing a very well thought out plan.

Eva Sheie (06:35):
How much time does it take you to come up with that plan?

Dr. Afrooz (06:38):
So early on in my practice it would be hours and hours, but with experience, I would say the night before a case, I'm typically spending 30 minutes to an hour planning.

Eva Sheie (06:51):
Is that true for faces and noses, it's not procedure specific?

Dr. Afrooz (06:55):
Absolutely. Yeah.

Eva Sheie (06:56):
I once took a surgeon out for drinks in the evening and that evening turned into closing the bar at 2:00 AM and he was calling,

Dr. Afrooz (07:07):
Hopefully he or she didn't have a case the next day. 

Eva Sheie (07:09):
He did. He did. 

Dr. Afrooz (07:10):
Wow. 

Eva Sheie (07:10):
He had a case the next morning in another state he had to get up and fly in the morning, and I remember being so disturbed that this is what he was doing the night before. It was a body lift. He's still pretty well known.

Dr. Afrooz (07:26):
Well, I think that's certainly wouldn't work for me. I mean, I know myself at this point in my life. I know what sort of rest I need. I know what sort of preparation I need before a big case like that. But we've all had friends who even in college could go out until the next morning and take a test and ace it. That was not me. I wish I could say it was, but it wasn't me. So you really get to know yourself in your late thirties and forties and what's necessary to show up the next day and be at your peak. And for me, just knowing myself, I know that that wouldn't work. I know that even after a second glass of wine, I'm not really my best the next day.

Eva Sheie (08:14):
Me either. I'm with you. You mentioned college, so it's a good place to ask where did you go to college and where did you grow up actually?

Dr. Afrooz (08:23):
I grew up in the Midwest in Youngstown, Ohio. Yeah, it's in the northeastern part of Ohio, almost exactly halfway between Cleveland and Pittsburgh. So I grew up a Browns fan. I trained at the University of Pittsburgh Medical Center, so I turned into a Steelers fan, but I went away to a boarding school for high school at age 14. It was in Ohio, but I was away from home and I went to college at Cornell University. I went to med school in Chicago at the Chicago Medical School, and I did my plastic surgery training at the University of Pittsburgh Medical Center, and I did a fellowship at the Dallas Plastic Surgery Institute.

Eva Sheie (09:07):
Isn't it an N F L team in pretty much all of those places, right? Except for

Dr. Afrooz (09:11):
Absolutely.

Eva Sheie (09:11):
Not in Ithaca.

Dr. Afrooz (09:14):
Yeah. I suppose people from Ithaca must be maybe Bills fans, Buffalo Bills fans or

Eva Sheie (09:22):
Seems logical. And who's your team today, now that you're in Florida?

Dr. Afrooz (09:27):
I love the Steelers. I think that's going to be a lifelong thing, but it's hard not to really love the Dolphins as well, living here in South Florida.

Eva Sheie (09:37):
So growing up in Ohio, in Youngstown, Ohio, it's kind of a blue collar place, right?

Dr. Afrooz (09:42):
Very much so.

Eva Sheie (09:44):
Tell me something good about Ohio.

Dr. Afrooz (09:46):
Gosh, there's so many great things about Ohio. It's just really a salt of the earth kind of place. Great people for the most part, warm Midwestern people, incredible seasons. This time of year in Ohio is really, or in the Midwest in general, is really my favorite time of the year. Summertime comes to an end. Things start cooling off a little bit. The leaves start changing colors, football's in session. 

Eva Sheie (10:19):
It smells like football. 

Dr. Afrooz (10:20):
Yeah, it smells like football and it's just really an incredible time of the year. So I really miss that about the Midwest and being in a part of the country with discreet seasons, but you got to take the good with the bad anywhere you live. And there's so much that I love about South Florida, but I definitely miss parts of Ohio.

Eva Sheie (10:43):
Did you always know you were going to be a doctor from the time you were a little kid, or did it strike like lightning?

Dr. Afrooz (10:49):
My dad's a doctor and I grew up really having a great deal of admiration for him and his dedication to patient care. I remember just hanging out with my dad on the weekends and if he would be on call and had to go in, sometimes he would say, why don't you just come along with me? And I would go and sit at the nursing station and sometimes the patient room would be pretty close by so I could hear him talking to patients. And so I developed that admiration and that intrigue for medicine and clinical care very early on at a young age. And I was good at math and science, and so I sort of had a hunch early on that that's the direction I would go. But I was fair to myself. I tried other things in college. I took a lot of econ and finance classes and explored some other interesting things that were definitely interesting. But in terms of pursuing a career and other things, everything I tried just kind of led me right back to medicine. And it fortifies your, it's great to do that because it fortifies your aspirations and it lets you know that this is the direction I want to go.

Eva Sheie (12:17):
Was there even a moment or did you just sort of meander there?

Dr. Afrooz (12:22):
I mean, I pursued other things. I had a summer internship in New York in finance, and so I really tried to open doors and see if anything captivated me. And the truth is, it really didn't. I didn't think anything that I tried was for me. I love music. I have many passions, but in terms of a career, I thought that medicine was the best fit for me.

Eva Sheie (12:53):
What kind of music? Are you still doing anything musical today?

Dr. Afrooz (12:56):
Not really. I absolutely love music. I can remember, I have an older brother and sister, and I can remember when I was probably about eight or nine putting on their Walkman and listening to Guns N Roses, paradise City for the first time, and just having my mind blown I was and still am a huge Guns N Roses fan.

Eva Sheie (13:21):
So you have an older brother and sister?

Dr. Afrooz (13:23):
I do, yeah.

Eva Sheie (13:23):
Are you the baby?

Dr. Afrooz (13:24):
I am, youngest of three.

Eva Sheie (13:28):
Did your siblings become doctors too?

Dr. Afrooz (13:30):
No. They are both attorneys and my brother is very entrepreneurial and has been that way since a very young age, but he pursued a very high level of education. He's a lawyer and got his master's in business administration. So at one point we would tease him that he was a professional student, but he's gone on to be very successful as an entrepreneur.

Eva Sheie (13:55):
Who's your mom's favorite?

Dr. Afrooz (14:00):
Oh boy. She loves all her children equally, but I come from a Middle Eastern family and everyone knows that in Middle Eastern families you want your children to be either a doctor or an engineer. And so I'm definitely not the favorite. I know that she loves us all equally, but I know that she's very proud that I went into medicine.

Eva Sheie (14:27):
She'll probably listen to this. Everyone's mom always listens.

Dr. Afrooz (14:31):
That's great.

Eva Sheie (14:32):
Hello to Dr. Afrooz's Mother.

Dr. Afrooz (14:35):
Hi Mom.

Eva Sheie (14:36):
<laugh> The first time I've ever done that on the show, it's kind of funny. Okay, let's go back to faces and noses. People have a lot of feelings about what they see in the mirror, and it's different for face than it is for your body. You can put clothes on, but you can't always cover your face with something. Although I think Covid, a lot of people actually found that to be the silver lining of the mask was hiding. What can your patients expect from you when they come to see you for the first time to talk about something like their face or their nose?

Dr. Afrooz (15:14):
Patients can expect that right off the bat. I'm really going to try to get to know them and understand their personality and what their hobbies are, what their interests are, where they grew up, because that's really going to give me a lot of insight into what their goals are. Patients don't necessarily have the vocabulary, the plastic surgeon vocabulary to be able to articulate what it is that they want. So establishing that rapport and having great communication just gives me a little bit more insight into what their goals are. So I take that very seriously because it's important that there's a congruency between what I think is going to be a great result and what they think is going to be a great result. So we've got to have that communication and the key to any good relationship is good communication. So that's very important. So I spend a lot of time trying to understand their goals, and then we talk about what's going to be necessary to get there.

(16:26)
I absolutely love facelifts and neck lifts and facial rejuvenation surgery because many times patients come in in their forties, fifties, sixties, and even seventies, and they've got this incredible energy and vibrance to them. But one of the most common statements I get is I just look at myself in the mirror and I don't feel like I look like how I feel. That's a very, very common statement that I hear. And fast forward to three months after a face and necklace surgery and the energy and the vitality that these many patients come in with when they've gone through the recovery and they're really beginning to look great after surgery, that's really the most rewarding part of our profession. Being able to restore that self-confidence and that energy and just, for lack of a better way to say it, just someone really feeling themselves and I mean, that's really the most rewarding thing.

Eva Sheie (17:45):
Is there anything you use in these conversations, technology wise or images to help bridge the gap between what's in their head and what's in your head?

Dr. Afrooz (17:54):
When it comes to rhinoplasty? Yeah. I do a lot of morphing of images, and what I often tell patients to do is, since this is now something you want to pursue, I would encourage you to look at noses that you see. Look at noses on Instagram, look at noses in magazines, take photos of them with your phone, make a folder, and you and I will use those photos to communicate about what our goals are. I think in addition to the morphing, having patients, giving them a little bit of homework to look at noses and understand what it is that they want and what would look great on them, I think is a great tool.

Eva Sheie (18:38):
Do you ever turn people down?

Dr. Afrooz (18:40):
Absolutely. Absolutely.

Eva Sheie (18:42):
What are you looking for?

Dr. Afrooz (18:44):
I have a lot of patients that come in that are absolutely stunning, and there's just nothing that I can do for them, and it would be a disservice to both them and me to try to do something. And I tell those patients point blank, you're, you look fantastic, and I think that you need to wait five to 10 years for a facelift. Or if I had a patient who had a rhinoplasty in Turkey who wanted a revision, and she came in and the nose was stunning and there was nothing that I could do, and I told her that her nose was stunning and she looked incredible, and she should really do her best to try to enjoy it.

Eva Sheie (19:36):
You can't really touch a nose for what, 12 to 18 months after?

Dr. Afrooz (19:41):
Yeah, my threshold is 10 months, so that is my minimum before I'll do a revision.

Eva Sheie (19:48):
Before you'll even entertain it. Right?

Dr. Afrooz (19:50):
Well, we will start to have the discussions at around 6, 7, 8 months, and then if someone's really just getting very impatient, and I think it's appropriate 10 months, the short 12 months is ideal for me and my practice, but 10 months is the earliest that I'll do it.

Eva Sheie (20:11):
It's hard to wait when you

Dr. Afrooz (20:13):
It is. Yeah. I mean, it's right in the middle of your face, and I understand it. Many patients are unhappy and it truly affects their daily life.

Eva Sheie (20:25):
Before we go off and have a fun Saturday, well, I can't leave, but you can. What do you like to do away from work?

Dr. Afrooz (20:35):
Well, my wife and I have two and a half year old twins, a boy and a girl, Anna and Miles. So right now they're my greatest joy outside of work, and so I spend the majority of my time away from work with them and my wife. So it's really a beautiful chapter in our lives, and I'm doing everything I can to savor it.

Eva Sheie (21:00):
If someone's listening today and they want to find out more about coming to see you or check out maybe some of your photos, where should they go look for that?

Dr. Afrooz (21:09):
Instagram's a great place for that. The biggest challenge with specializing in facelift and facelift surgery, neck lift surgery and rhinoplasty is that anonymity is tough. So I would say the overwhelming majority of my patients choose not to have us share their photos, but we have a small percentage who are very open and willing to allow us to use their photos, and we love that. So for that fraction of patients that is willing to let us share their photos, their photos are on the website, they're on Instagram, and we do our best to really showcase all types of cases through social media and our website.

Eva Sheie (21:54):
Thank you for letting us get to know you today. It's been a pleasure.

Dr. Afrooz (21:57):
Oh, it's been a lot of fun. I really appreciate it. Thank you for having me.

Eva Sheie (22:05):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at Meet the Doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, t h e a x i s.io.