Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using...
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using his passion for the intricacies of the face to give them confidence.
Committed to transparency, Dr. House helps his patients make informed decisions by educating them on anatomy and the different types of surgical techniques that may help them reach their goals.
Nominated to the Global Smile Foundation to do cleft lip and palate surgery, Dr. House’s rich knowledge of nose anatomy has helped him see how much the procedure affects the nose from both a functionality and aesthetic standpoint. Realizing that facial surgery on children can be life-changing, he loves helping young patients be seen for their personality rather than distracting facial features.
To learn more about Dr. Adrian House
Follow Dr. House on Instagram
Learn more about Global Smile Foundation
ABOUT MEET THE DOCTOR
The purpose of the Meet the Doctor 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.
When you head into an important appointment more informed and better educated, you are able to have a richer, more specific conversation about the procedures and treatments you’re interested in. There’s no substitute for an in-person appointment, but we hope this comes close.
Meet The Doctor is a production of The Axis.
Made with love in Austin, Texas.
Are you a doctor or do you know a doctor who’d like to be on the Meet the Doctor podcast? Book a free 30 minute recording session at meetthedoctorpodcast.com.
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using...
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using his passion for the intricacies of the face to give them confidence.
Committed to transparency, Dr. House helps his patients make informed decisions by educating them on anatomy and the different types of surgical techniques that may help them reach their goals.
Nominated to the Global Smile Foundation to do cleft lip and palate surgery, Dr. House’s rich knowledge of nose anatomy has helped him see how much the procedure affects the nose from both a functionality and aesthetic standpoint. Realizing that facial surgery on children can be life-changing, he loves helping young patients be seen for their personality rather than distracting facial features.
To learn more about Dr. Adrian House
Follow Dr. House on Instagram
Learn more about Global Smile Foundation
ABOUT MEET THE DOCTOR
The purpose of the Meet the Doctor 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.
When you head into an important appointment more informed and better educated, you are able to have a richer, more specific conversation about the procedures and treatments you’re interested in. There’s no substitute for an in-person appointment, but we hope this comes close.
Meet The Doctor is a production of The Axis.
Made with love in Austin, Texas.
Are you a doctor or do you know a doctor who’d like to be on the Meet the Doctor podcast? Book a free 30 minute recording session at meetthedoctorpodcast.com.
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using...
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using his passion for the intricacies of the face to give them confidence.
Committed to transparency, Dr. House helps his patients make informed decisions by educating them on anatomy and the different types of surgical techniques that may help them reach their goals.
Nominated to the Global Smile Foundation to do cleft lip and palate surgery, Dr. House’s rich knowledge of nose anatomy has helped him see how much the procedure affects the nose from both a functionality and aesthetic standpoint. Realizing that facial surgery on children can be life-changing, he loves helping young patients be seen for their personality rather than distracting facial features.
To learn more about Dr. Adrian House
Follow Dr. House on Instagram
Learn more about Global Smile Foundation
ABOUT MEET THE DOCTOR
The purpose of the Meet the Doctor 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.
When you head into an important appointment more informed and better educated, you are able to have a richer, more specific conversation about the procedures and treatments you’re interested in. There’s no substitute for an in-person appointment, but we hope this comes close.
Meet The Doctor is a production of The Axis.
Made with love in Austin, Texas.
Are you a doctor or do you know a doctor who’d like to be on the Meet the Doctor podcast? Book a free 30 minute recording session at meetthedoctorpodcast.com.
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using...
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using his passion for the intricacies of the face to give them confidence.
Committed to transparency, Dr. House helps his patients make informed decisions by educating them on anatomy and the different types of surgical techniques that may help them reach their goals.
Nominated to the Global Smile Foundation to do cleft lip and palate surgery, Dr. House’s rich knowledge of nose anatomy has helped him see how much the procedure affects the nose from both a functionality and aesthetic standpoint. Realizing that facial surgery on children can be life-changing, he loves helping young patients be seen for their personality rather than distracting facial features.
To learn more about Dr. Adrian House
Follow Dr. House on Instagram
Learn more about Global Smile Foundation
ABOUT MEET THE DOCTOR
The purpose of the Meet the Doctor 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.
When you head into an important appointment more informed and better educated, you are able to have a richer, more specific conversation about the procedures and treatments you’re interested in. There’s no substitute for an in-person appointment, but we hope this comes close.
Meet The Doctor is a production of The Axis.
Made with love in Austin, Texas.
Are you a doctor or do you know a doctor who’d like to be on the Meet the Doctor podcast? Book a free 30 minute recording session at meetthedoctorpodcast.com.
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using...
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using his passion for the intricacies of the face to give them confidence.
Committed to transparency, Dr. House helps his patients make informed decisions by educating them on anatomy and the different types of surgical techniques that may help them reach their goals.
Nominated to the Global Smile Foundation to do cleft lip and palate surgery, Dr. House’s rich knowledge of nose anatomy has helped him see how much the procedure affects the nose from both a functionality and aesthetic standpoint. Realizing that facial surgery on children can be life-changing, he loves helping young patients be seen for their personality rather than distracting facial features.
To learn more about Dr. Adrian House
Follow Dr. House on Instagram
Learn more about Global Smile Foundation
ABOUT MEET THE DOCTOR
The purpose of the Meet the Doctor 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.
When you head into an important appointment more informed and better educated, you are able to have a richer, more specific conversation about the procedures and treatments you’re interested in. There’s no substitute for an in-person appointment, but we hope this comes close.
Meet The Doctor is a production of The Axis.
Made with love in Austin, Texas.
Are you a doctor or do you know a doctor who’d like to be on the Meet the Doctor podcast? Book a free 30 minute recording session at meetthedoctorpodcast.com.
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using...
Facial plastic and reconstructive surgeon Dr. Adrian House is fascinated by the complexity of anatomy and the ability to manipulate the features people use to convey their emotions. He loves getting to know patients from all walks of life and using his passion for the intricacies of the face to give them confidence.
Committed to transparency, Dr. House helps his patients make informed decisions by educating them on anatomy and the different types of surgical techniques that may help them reach their goals.
Nominated to the Global Smile Foundation to do cleft lip and palate surgery, Dr. House’s rich knowledge of nose anatomy has helped him see how much the procedure affects the nose from both a functionality and aesthetic standpoint. Realizing that facial surgery on children can be life-changing, he loves helping young patients be seen for their personality rather than distracting facial features.
To learn more about Dr. Adrian House
Follow Dr. House on Instagram
Learn more about Global Smile Foundation
ABOUT MEET THE DOCTOR
The purpose of the Meet the Doctor 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.
When you head into an important appointment more informed and better educated, you are able to have a richer, more specific conversation about the procedures and treatments you’re interested in. There’s no substitute for an in-person appointment, but we hope this comes close.
Meet The Doctor is a production of The Axis.
Made with love in Austin, Texas.
Are you a doctor or do you know a doctor who’d like to be on the Meet the Doctor podcast? Book a free 30 minute recording session at meetthedoctorpodcast.com.
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's 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 Today my guest is Dr. House, which is actually Dr. Adrian House, not the Dr. House from tv, although that is one of my favorite shows and I'm sure he gets asked something about that every single day. Welcome Dr. House to the show..
Dr. House (00:47):
Thank you for having me.
Eva Sheie (00:49):
So tell us a little bit about yourself.
Dr. House (00:51):
So I'm a facial plastic and reconstructive surgeon, um, in the, uh, San Francisco Bay area. And this is where I grew up. You know, my friends and family are still around here and it's arguably one of the most beautiful and scenic places in the world. So I've always had a dream of coming back here and starting my practice. So, um, I've been fortunate to live all over the country for training from Boston to Los Angeles and, uh, which has been exciting and even frightening at times since I was the first in my family to go to college. But, uh, it's really nice to be back.
Eva Sheie (01:18):
Tell me more about that.
Dr. House (01:20):
In which sense?
Eva Sheie (01:22):
Well, you're the first in your family. Why, why hadn't anyone in your family gone to college before you?
Dr. House (01:27):
Well, my, so my mom was born in Italy. She came from a small town there and moved to Canada when she was young and ended up going to like through a nursing program up in Canada, which is a direct program. And, uh, so she's a, or nurse actually it's probably <laugh> a lot of how I got to where I am. And my dad's from a small fishing village in eastern Canada, Newfoundland, and he also left home at 17 and paid his whole way through helicopter training and became a pilot. So that was kind of the background. But you know, the generations before that were fishermen and kind of working on small villages in, in Italy. So it's been a really nice opportunity.
Eva Sheie (02:06):
There's always a, a fascinating story behind that, that kind of background. And I, I'm glad I asked <laugh>. So they, they made their way, they met in Canada Yeah. And then moved to San Francisco together or how'd that happen?
Dr. House (02:20):
Yeah, so I was actually born in Canada with um, my little brother's five years younger. He's up here in San Francisco too. He's a lawyer. And we uh, we moved when I was, I don't, maybe 12 years old or something like that, to the San Francisco Bay area for my dad's job. And I've been here ever since.
Eva Sheie (02:35):
And so that must have been pretty different moving from Canada to California.
Dr. House (02:39):
Yeah, I mean there's a lot of similarities and differences, but you know, the weather is probably the, the nicest difference.
Eva Sheie (02:44):
It is actually better. Some people would complain about San Francisco weather.
Dr. House (02:47):
Oh, I love it. This is like a, you know, hoodie and shorts all year long. It's nice.
Eva Sheie (02:52):
Mm-hmm. <affirmative>. Yep. Gotta have a sweater with you all the time.
Dr. House (02:55):
That's right.
Eva Sheie (02:56):
Yeah. So then you took off for college and went from San Francisco to where?
Dr. House (03:04):
So I say kind of close by, I wanted to go to a, you know, uc in, in California. So I went to UC Davis, um, studied microbiology there, thought I'd be uh, a beer brewer for a while. <laugh>, um, even interviewed for a job at Sierra Nevada and didn't get the job. And I said, well, maybe I'll go into med school. So, and then I ended up going to the East coast to Boston BU for, for medical school and then decided that was a little too cold and I'd paid my dues with my Canadian upbringing. So moved back to the area you did U C S F for, uh, residency, then LA for fellowship.
Eva Sheie (03:40):
I think once you realize there's better weather out there, you just can't go back. <laugh>. That's true.
Dr. House (03:44):
I've been spoiled.
Eva Sheie (03:46):
Right. So do you still enjoy micro brew?
Dr. House (03:50):
I do, yeah. We did a little micro brew, home brew stuff when I was in college and even in med school. So that's nice. Breweries are a nice place to hang out.
Eva Sheie (03:59):
Was there a moment when you knew you wanted to move towards surgery?
Dr. House (04:04):
Yeah, you know, it's, I dunno, I look back on my life and there's a lot of major things that have happened, like decision to become a surgeon and, and I can't really pinpoint when exactly that was. I feel like it's just kind of organic. I think a lot of it was my mom's an OR nurse and so doctors to me were surgeons and that was kind of went hand in hand. So I think when I decided I wanted to be a doctor that was kind of a surgeon was always a part of that. And I think there's also a lot of similarities with aviation. You know, my dad's a pilot. There's a lot of technical skills and you have other people's lives in your hands and, and whatnot. So I think those things together just led me to be interested in surgery. And I tried to keep an open mind through medical school and there's a lot of amazing rotations and there's so much to learn. And, you know, radiology was a big interest of mine cause the technology. Um, but uh, I kept coming back to, to surgery and really enjoyed my surgery rotations, particularly head and neck and head and neck anatomy. And that's kind of what probably led me in doing head and neck surgery and ultimately facial plastics.
Eva Sheie (05:03):
That's interesting. Radiology. I, I had a chance to meet an IR an interventional radiologist this year, which I didn't even know that was a thing. And I found them to be very similar to plastic surgeons.
Dr. House (05:15):
Yeah.
Eva Sheie (05:15):
In temperament and personality, you know, they like to put stuff together and take it apart.
Dr. House (05:22):
Exactly.
Eva Sheie (05:24):
So there's lots of parts to the head and neck. Is there anything in particular that you enjoy the most?
Dr. House (05:31):
I mean, I think the anatomy in general is very like, complex. There's tons of different nerves and muscles and there's a lot of like intricate relations between those. Um, so I think it's something that, uh, has always been interesting to me. Like it's kind of similar to hand anatomy. I was really interested in hand anatomy too. Cause there's so many intricate nerves and, and it gives you, you know, the ability to use your hands and to be able to make things. And the same thing with the face. I mean, there's all of your five senses are through your face and we convey a lot of our personality with each other and emotions and things like that. So I, I've always found it interesting and, uh, to be able to, you know, manipulate those, those things and make changes. It's very interesting to me.
Eva Sheie (06:14):
And so are you completely in private practice or do you see patients in other places like hospital or?
Dr. House (06:21):
My main practice is in Menlo Park. Uh, it's private practice, but I do also, um, I'm a clinical instructor at U C S F, so about, you know, two days a month or so, I'm, I'm up there teaching the residents and going through surgeries and uh, you know, I spend some time even at the VA helping some patients there. And so I try to kind of not spread myself too thin, but keep a nice balance between private practice and it's lonely in private practice. You're just by yourself. I kind of miss the whole team environment as a resident. You've got a team of, you know, five, six residents and attendings and a bunch of patients to see. And it's, it's exciting. But when you're by yourself, you're by yourself.
Eva Sheie (06:57):
There's a really nice photo of you on your website holding a little a baby with a cleft lip.
Dr. House (07:02):
Oh yeah.
Eva Sheie (07:03):
Yeah. Can you talk about, uh, what you've done around the world?
Dr. House (07:07):
So, as part of my fellowship, one of my fellowship directors is Babak Azizzadeh and he is, uh, an amazing surgeon in person and he is part of this organization called Global Smile Foundation. So through that I was able to kind of be nominated to a position there. And last year went to Trujillo, Peru and we were doing a lot of cle lip and palate surgery. And, and even like from a, you know, facial plastic standpoint, we deal a lot with the nose. And I think a lot of people don't realize that like cleft pals and cleft lips really affect the nose, both from a breathing and aesthetic standpoint. So it was really great to help like little kids and babies early on. But then we're also seeing teenagers and doing, you know, cleft rhinoplasties with them. And that's super rewarding cuz they're able to actually emote and, and share the, you know, how happy they are with the results. So it's, it's a great organization and certainly steps I'll keep doing for a long time.
Eva Sheie (08:01):
When is your next trip planned for that? Do you have anything on the calendar?
Dr. House (08:05):
Uh, probably next year. It hasn't been finalized yet, but I really enjoyed Peru. They, they go to a lot of, I mean, they're all over the world in Lebanon and Ecuador and everywhere else, but I really enjoyed Peru. Like I love the people and the food and everything else, but I'll branch out as the years go by, I think.
Eva Sheie (08:20):
Do you ever see kids in San Francisco these days? Do you run into patients like that at home? Ever? Does that happen?
Dr. House (08:29):
Yeah, not so much from a cleft standpoint. Uh, most of those patients go to like larger, you know, university institutions and things like that. But you know, even in my own clinic, we have patients that even rhinoplasty, I mean they, the, there's a lot of kind of debate on how early a rhinoplasty can or should be done. And, uh, you know, wrote a paper on that last year where the, the age is not necessarily that important, but it's, it's how much of like an emotional impact that it has on their lives. And we had a patient last year who had, I mean, she was very kind of quiet and subdued and, and had this objectively, you know, her nose did not look that great. And, uh, we got teased at school and things like that and we were able to do her surgery and, you know, within a couple months her whole personality changed.
(09:13)
Even the colors were clothes or, I mean, it was just like life changing for her. So that's, that's a big part of it. And, and then there's other kids too have, have, have had special needs kids with moles or things like that on their face that they're bothered by and they kind of get fixated on and, and it's, you know, an easy procedure to, to do. But the, the reward is, I mean, they're just beyond happy. So it's, uh, so I still do, you know, the majority of my patients are probably twenties through seventies, but I still do some, some teenagers and even younger.
Eva Sheie (09:43):
What was your paper about? Were you arguing for younger or older or what was the premise of that?
Dr. House (09:49):
The argument was really looking at, you know, the age of rhinoplasty is, some people argue like 16 or whenever the facial skeleton is fully developed and that taking the septum out or, or changing that things can, can affect the craniofacial growth. But that's not really necessarily the case. And I think, and you gotta kind of weigh the pros and cons when you have patients who are just affected so emotionally at such a critical point in their lives. Uh, you know, going through early high school and things like that. Gotta kind of weigh those pros and cons in the side if it's something that that is worth doing. And, uh, you know, in her case it was definitely,
Eva Sheie (10:28):
I try not to talk about myself on this podcast because it's supposed to be about you, but my first exposure to classic surgery was our neighbor and I grew up in a regular middle class Minnesota, you know, suburban Minneapolis neighborhood. Not rich people at all, you know, moms who stayed home, but my parents were teachers and everyone, our, our neighborhood was like that. But our, my brother's best friend had ears that were like perpendicular to his head and that's how he was known from the time he was basically, you know, a toddler until he was, I think he must have been an early adolescence when they got his ears fixed. And I'd never thought about it until much later that, that when I thought back on it that it must have been extraordinary for his parents to pay for that. And after that he was, I'm not gonna say his name, but he became a person instead of his ears.
Dr. House (11:27):
Right. Yes. Now that's actually one of my favorite surgeries. I did one last month on a gentleman who's a, an engineer here in the Bay Area. And he'd always kind of felt like, you know, people would kind of look at him like he wasn't intelligent or teased him when he was growing up and things like that. And with a simple, you know, in-office procedure, it completely changes, you know, and I mean that kind of, I think goes back to noses too, like how I look at them, is that a good rhinoplasty or any real surgery on the face, it shouldn't really be noticeable. So like if you have a distracting nose or distracting ears or things like that on even eyelids and ptosis and all those kind of things that people tend to focus on those rather than you as a person or, or, you know, other features. So a good rhinoplasty and, and good otoplasty, the focus of everybody else's view should be your eyes and your personality and everything else. So it's kind of nice to be able to take away the distractions. Mm-hmm. <affirmative> and really, I mean it's, it's helping people feel normal, for lack of a better term, I mean, to feel like they, they fit in and, and that they look like their peers and restoring that sense of normalcy is, is really rewarding.
Eva Sheie (12:36):
I agree. What is your favorite kind of case or person to help?
Dr. House (12:42):
Favorite kind of case? I mean, I think that every case is a little bit different. I mean, I do, probably the majority of my cases are facelifts and, and aging face. I do a lot of oculoplastic stuff too, like blepharoplasties and things like that. And each of them have their own kinda intricacies that they enjoy. I think with the eyes for example, is it's very, it's almost like watchmaking, right? It's very like intricate and detailed and, and with the face there's a lot of finesse and geometry and we're dealing with facial nerves when we're down in the deep plain. So it's, you know, it's a little bit tedious and, but those things are, are all kind of exciting to me. And then the nose, for example is, is very complex. You know, most noses open the same way, but every single time it's different. The reconstructive part, the what, what sutures, what maneuvers are gonna use.
(13:28)
So it's always like a little puzzle piece of, of getting things, you know? Exactly right. So all those really exciting. As far as patients, I mean, I just love to get to know patients in general, kind of all walks of life. I think it's really nice restoring people's confidence, whether it's somebody like that for no autoplasty and they're a little bit younger or, um, you know, a little bit of an older patient who doesn't feel like they've had the confidence they did when they were younger and kind of making them, giving them the ability to look on the outside as they feel on the inside. Within reason of course,
Eva Sheie (13:59):
Of course. When someone comes to see you for the first time, they're sitting in front of you at their consultation, what can they kind of expect from that appointment?
Dr. House (14:09):
Yeah, I find that the, the most important part of the initial consult when the patient first comes in is really like educational. I think that there's so much information out there from Instagram and podcast and everything else that, that patients are listening to and, and it's hard to really synthesize that information and know what's real and what's fake and what's being sold and whatnot. And so I think the big part of that initial visit is, well, one, obviously to get to know the other patient and f figure out what their goals are and everything else. But big part of it too is educational. Like I have put together a couple different presentations that I, I can show based on whatever their concerns are and I go over the anatomy and I go over the surgical techniques and, you know, I my patients to understand what is a mini facelift, what is a deep plane facelift, which one's best for you and why.
(14:56)
And I think that the days of going in and saying you want a rhinoplasty and then going to surgery and taking the cast off and it's over kind of behind us. I think patients like knowing things. They like being educated and uh, so I go over a lot of those things, the anatomy and even the kind of sutures I use and why, and the kind of reason through all those things so that they have an informed, uh, can make an informed decision, whether that's with me or another surgeon. I think it's very important that they, that they feel educated, you know, that teaching education has always been a passion of mine. So I definitely bring that to the, to the clinic too.
Eva Sheie (15:29):
Do you use any technology or tools to help people visualize what they might look like when they're done?
Dr. House (15:36):
Yeah, there's, I mean there are great technologies out there that, that will do 3D cameras and that you can morph and I think it's most helpful for noses. But, you know, I tend to kind of keep it simple. I use something like Photoshop or even Face Tune has got like a good, uh, morphing tool that's in it. And so it's kind of a, a nice way and I morph right there in front of, of the patient and kind of get their feedback on things too. So things like the ears and nose and things like that, it's kind of easier to, to morph. But for, for the rest of it, you know, I, I have a mirror in every room, that handheld mirror, I have the patient hold it and I kind of lift or use a Q-tip to kind of give, give an example of where their eyelids would be or where that, you know, the face would end up if they're worried about their jowls, how it would look and the the vector that we lift in and things like that. So by the end of it, I hope that they have a good understanding of, of what the end result's gonna be like.
Eva Sheie (16:29):
These presentations that you built, are they just slides that you use to kind of help illustrate what you're talking about with patients?
Dr. House (16:38):
Yeah, for the most part I put together kind of PowerPoint presentations. I use Keynote cause I'm a Apple guy and I love their aesthetic <laugh>. But, but yeah, I put together presentations that they're really kind of modeled after, you know, like, like academic presentations. But I kind of try to simplify things and not use too much jargon and, and a lot of like the technical things and, and kind of keep it simple cuz in the end, I mean it's, the concepts are fairly straightforward and understanding them is pretty simple. Executing them is, you know, another thing. But I think the most important thing for patients is that they get a good picture of if they're concerned about their jowls, why do they have jowls? Why does it stop here? There's a ligaments, there's ligaments in the face that we need to manipulate, and why do we pull in a vector the old way of doing a face of his pull, you know, straight back like a wind swept and only dealing with the skin.
(17:25)
And, and now that we have a better understanding of the SMASer and deep plane and all that stuff, the aging vectors, there's also a lot of great papers out. But, um, but Sebastian Koana, he's another essentially an anatomist where he's, he's looked at a lot of different patients and, and how they age and the vectors that change in facial movements and what parts of the face move and which parts don't, and all that kind of stuff that, that's given us a lot of better understanding of dynamic anatomy. You know, the understanding of cadaveric anatomy, we've known for a while, but, but this kind of dynamic anatomy and how things change in the glide planes, I think have kind of revolutionized how we look at and treat the face.
Eva Sheie (18:03):
A friend, um, yesterday was asking me, she was telling me that a year ago she had Sculptra and she actually thinks that she looks worse because, neither one of us could come up with a plausible theory. And I was, you know, I've been thinking about it since yesterday. What, what would cause her face to actually fall instead of what it was promised, which was that her cheeks would be fuller and
Dr. House (18:30):
I can answer it.
Eva Sheie (18:31):
Yeah. Well just tell me now why, because you made that face, like I know what you're talking about.
Dr. House (18:37):
Yeah, so Sculptura is essentially, so it's a P G L A, it's micronized, essentially dissolvable suture that we use in the operating room. And then that's, uh, injected under the skin in certain layers that those small little beads of PGLA get dissolved and your body kinda reacts to them. And in that reaction inflammation process, you end up building collagen. So you get these little pearls of collagen. And so when it's kind of dilute, put in certain areas of the face, then you can naturally build more collagen, takes several months really to get the results from that, but it can last, you know, four or five years or longer. But in that process, wherever those little beads, I guess you could call 'em, end up, your body can build more collagen in that area. So if it was injected in a different layer or if it's injected a little bit lower, or if it was maybe really dilute, so there was a lot of fluid in there so it spreads a little bit more, you know, those areas can end up building a little bit more collagen than, than you'd want or, you know, than, than you'd initially planned.
Eva Sheie (19:36):
Oh, interesting. I see what you're saying. I'm gonna clip this and send it to her.
Dr. House (19:41):
Yeah, a lot of these things, I mean, it's just like fillers or Botox, I mean Botox is a great example. I mean, you're, you're injecting Botox most, there's a lot of injectors all over the country and over the world that, that do it. And yet people get different results and a lot of that comes down to the technique, the reconstitution, you know, value that. So like for myself and how I learned in Fellowship is we kind of use what's called the actors dose, which is a, it's reconstitute with more saline than typical. So it's not diluted, it's the same number of units, but it's over a, you know, larger volume. So that tends to give a much softer look to the Botox. It's not kind of like bullet point of areas not moving, it's much more smooth. You still have some movement, but not a lot. And so I think it looks a lot more natural and a lot of people debate me on that and think I'm crazy. He's that, uh, that much saline. But I think the results that I get are gonna speak for themselves. And, but it's like that with everything like Sculptura and fillers, what plane you're in, if you use a cannula versus needle, there's just so many variables and really just comes down to experience to to know exactly what to do.
Eva Sheie (20:42):
Do you have any perspective or advice on whether we should maybe look for facial plastic surgeons to do our injections versus injectors at the mall?
Dr. House (20:53):
<laugh>, I'm a, I have a biased view on that, obviously.
Eva Sheie (20:56):
I know <laugh>
Dr. House (20:56):
Uh, but watch
Eva Sheie (20:57):
I walked you right into it.
Dr. House (20:59):
I mean, it comes down to like understanding of anatomy more than anything. I don't think that just because you're a plastic surgeon means you have a steady hand more than somebody else who's doing Botox. But I think it comes down to like, do you really understand the anatomy? And you can look at textbooks and you can look at cadavers and you can train with people who are very, you know, world class injectors. But I find that if you actually operate on live living patients, your understanding of anatomy every single time gets better. Every single time I do a facelift or a bleph or anything else, there's my understanding of anatomy gets that much better. And so I think that for doing things that are, like Botox for example, you probably tend to get a better result with somebody who has a better understanding of anatomy. I'm not saying you have to be a surgeon to do that. Uh, I know some great dermatologists who are better than most surgeons at these injectables, but they just have a gift really to have almost x-ray vision. Like their understanding of anatomy is maybe they don't need to operate to, to learn that stuff. But, but yeah, I find the results from facial plastic surgeons tend to be better, just probably based on the anatomy understanding.
Eva Sheie (22:08):
It makes sense. What would you like your patients to know about you if they're coming to see you for the first time?
Dr. House (22:17):
I think in general, I mean, as a a surgeon, I like operating. I think we all do. But when it comes to surgery, I, I'm actually fairly conservative, so I think there's a lot of places out there that will be paid enough, they'll operate on you. But every day I tell patients no. In my clinic, I never push surgery on anybody and I try to do the least amount that's gonna give you the best result of what you're looking for. Um, and sometimes that's not surgery. And I think also that I'm, I'm attentive, I truly care about my patients. You can ask my wife. I spend a lot of time laying awake at night thinking about my patients and how they're doing and what I've learned from them to help the next one. And every single patient that I operate on gets my personal cell phone.
(23:00)
I don't ever want them to feel like they can't get in touch with me or anything like that. So I really view it as like a, a team effort where we work together to find a good plan. I help educate them and I usually kind of give them some options of, you know, here's the surgeries or here's the injectables that I think would be good for you, or a laser or whatnot. And then based off of their desires and what their outcomes and expectations are, then we kind of come to a conclusion together. And then after I operate on them, they, they're mine for life, you know, and that's kind of how I see it. So I always have an open line of communication with them and, and keep them in my thoughts.
Eva Sheie (23:35):
Who else is on your team?
Dr. House (23:37):
Uh, in my clinic?
Eva Sheie (23:39):
Mm-hmm. <affirmative>
Dr. House (23:39):
It's, uh, me and one employee. <laugh>
Eva Sheie (23:42):
Just one.
Dr. House (23:43):
It's just me. It's just me and her. And she's, uh, she's kind of the Swiss army knife of the, of the office and she's kinda the office manager and she helps booking and billing stuff and yeah, I kinda, it's kind of a boutique practice at this point, right? It's a little early on in a stage, but, but I'm also, I mean I've been very fortunate in my life to have certain opportunities and, you know, one of them is I, I share an office with another facial plastic surgeon who was a mentor of mine when I was a resident. He's about 10 years ahead of me or so. And so I'm able to use, you know, his staff help me out at the very beginning and, and we kind of share a lot of our patients. He almost exclusively does rhinoplasties and so there's patients that need additional stuff. Sometimes we'll do combined cases and whatnot. So it's, it's uh, I try to keep it kind of like a team environment, but for now it's just, just me and Nicole <laugh>
Eva Sheie (24:33):
Go Nicole.
Dr. House (24:34):
Yeah, she's great.
Eva Sheie (24:35):
How did people find you initially?
Dr. House (24:37):
This, you know, can I, I grew up here and my friends and family around here. So I think initially a lot of it was word of mouth and kind of referrals from friends and family and you know, as those patients came in and they had a good experience, then they were, you know, they, they would refer their friends. And so I had a little bit more of an organic start than I think some other practices had. But then, you know, moving forward, there's obviously we live in a day and age where technology's everyday part of our life. So Instagram and putting a website, you know, and then it's hard right when you're starting out. I try to keep overhead low and try to keep costs low. And so I built my own website with my friend and try to kind of keep things simple and straightforward and educational but still functional. And so, uh, yeah, so I think my website and Instagram are probably the biggest ones for like new patients. But I also do some marketing with email marketing and Google ads. And again, not just trying to spread myself too thin but.
Eva Sheie (25:33):
Right.
Dr. House (25:34):
But word of mouth I think is the best because if patients have come to you, they've had a great experience, their word is gonna be worth more than any amount of money you could put into an ad to try to convince somebody to come give you a chance.
Eva Sheie (25:48):
Your Instagram, so that's all you, are you doing that all yourself?
Dr. House (25:52):
Yeah.
Eva Sheie (25:52):
Yeah. There's a cute picture of a, of a girl. Is that your wife?
Dr. House (25:57):
Uh, I hope so. <laugh>,
Eva Sheie (25:59):
You're kissing a girl in a car. It's gotta be your wife.
Dr. House (26:01):
Yes. Yeah. Yeah. That's my wife. These are uh, those are our engagement photos down in LA. So one of my other friends and mentors, Ben had uh, lent us his antique Mercedes and we took it out to Malibu at Sunrise. It looks like sunset, but it's that sunrise cuz you have unlimited amount of time as the sun goes up with sunset, once it's down it's dark.
Eva Sheie (26:21):
Are you sure it wasn't cuz he just wanted you to drive, drive it before there was any cars on the road. <laugh>,
Dr. House (26:28):
It was my decision for the timing.
Eva Sheie (26:29):
Oh, okay. <laugh>
Dr. House (26:30):
Poor, poor guy, I had to pick up the car super early in the morning from him. But
Eva Sheie (26:33):
That's beautiful.
Dr. House (26:34):
Yeah. Great photos. And uh, that's the thing with being an aesthetics and a photographer myself, it was kind of hard finding the right person. But uh, shout out to Ian cuz he does a great job.
Eva Sheie (26:45):
And then also I see that you were Bane for Halloween, which <laugh>
Dr. House (26:49):
That's right. That was a bit of a last minute costume decision, but it worked out well. She was Ivy.
Eva Sheie (26:54):
Trying to get people to go follow you on Instagram. So I'm calling out your greatest hits here, <laugh>. It's good, it's good. My husband would approve.
Dr. House (27:03):
I appreciate that. Thank you.
Eva Sheie (27:04):
He has his professional Bane voice.
Dr. House (27:07):
Oh does he? I wish I did. I tried. I won't try for your podcast here and embarass myself.
Eva Sheie (27:12):
No, don't do that. <laugh>. So your Instagram is House MD Plastics and what's your website address?
Dr. House (27:20):
House MD plastics.com.
Eva Sheie (27:22):
Same thing. It's so memorable. You, you couldn't have picked a better name. <laugh>.
Dr. House (27:29):
I went to a, uh, conference at, I think it was down at Stanford, there was facial plastic surgery conference and somebody gave a lecture. This was a resident, I think it was an intern or something, second year. And somebody gave a lecture on social media and how it's affecting, you know, aesthetic surgery and whatnot. And uh, and I said, if you are considering this, like go out and get, save whatever handles that you can right now cuz somebody else could pick it up. So right then and there I decided it was like, well last name's house. I got that TV show that's so famous how somebody plastics will be great. So I saved it for years and then finally ended up deciding, I didn't even know that I wanted to do aesthetic surgery, facial plastic surgery.
Eva Sheie (28:05):
Wow.
Dr. House (28:06):
And uh, I was like, wow, good thing I saved this. And I I didn't even save the website domain at that meeting so it worked out well. Although now I feel like it's kind of, uh, I didn't think it through all the way because if you Google House MD all comes up as the TV show. I'm like on page six or something like that. So it's probably hurting my marketing a little bit, but, but I like it.
Eva Sheie (28:26):
They'd have to put in your first name.
Dr. House (28:28):
Yeah. Or plastics then it'll pop up.
Eva Sheie (28:30):
Yeah, it's probably okay. I think you're gonna survive.
Dr. House (28:35):
I think I'll be fine.
Eva Sheie (28:36):
<laugh>
Dr. House (28:37):
My dream is to meet Hugh Laurie though the, the actor for house. I just, I gotta take one photo with him. A patient asked me if I was related to him, which is kind of funny. <laugh> Dish's character. <laugh>.
Eva Sheie (28:48):
But that's pretty cute. I'm sure it'll serve you well for like jokes and uh, memes for, for many, many years to come until people don't remember the show anymore.
Dr. House (28:59):
Until they forgot the show. That's right.
Eva Sheie (29:00):
But it's one of the few shows that I actually go back and watch again. Like, I don't have anything to watch. I'm gonna put some House on cuz it's always good.
Dr. House (29:08):
Yeah. Oh, it's, it's a great show. It was, yeah. I watched it in high school almost religiously. Which maybe that also affected my decision to go to medicine, but, and then when I went to med school, the one of the writers from the show came and gave a lecture.
Eva Sheie (29:20):
Oh.
Dr. House (29:20):
And there's, I mean I've rewatched several episodes now and they're pretty accurate. I mean they kind of played up and dramatized a little bit, but for the most part, I mean the medicine behind is that is spot on.
Eva Sheie (29:32):
That's good to know. They're usually, uh, terrible and nobody will watch except for non, non-medical people.
Dr. House (29:40):
That's right.
Eva Sheie (29:40):
Yeah.
Dr. House (29:41):
No, it's held the test of time.
Eva Sheie (29:43):
A ringing endorsement from Dr. House for Dr. House. <laugh>. Uh, thank you. Thank you so much for telling your stories today and I'm so grateful to have gotten to know you a little bit.
Dr. House (29:57):
Thank you. It was great.
Eva Sheie (30:02):
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.