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. My guest today is Amir Ghaznavi. He's a plastic surgeon in Herndon, Virginia, which is the DC area. It's good to see you. Thank you for coming to the show today. Will you just tell us a little bit about your practice and what you're doing up there?

Dr. Ghaznavi (00:47):
Yeah. Thank you so much for having me on the show. Very excited. I am a plastic and reconstructive surgeon. I've been in plastic surgery for almost 10 years now, but in private practice for a little over a year and a half here. I focus on breast and body, so I offer the whole spectrum of both reconstructive and cosmetic procedures, and of course I do non-invasive facial fillers and neurotoxins and whatnot. But yeah, excited to be on and talk about my practice and talk about taking care of people here.

Eva Sheie (01:29):
So 10 years, but just a year and a half now on your own, what took you so long to get out of wherever you were?

Dr. Ghaznavi (01:37):
Yeah, I was an employee physician, a lot of docs who've graduated from school. I did an advanced fellowship in microsurgery and I focused on breast reconstruction, so I'm still doing a lot of breast reconstruction, but the best space for that is really in a big enterprise. So went from a university setting to a big enterprise hospital system and took care of a lot of people and just got to a point in my career where I thought that I needed to be a little closer to my folks live in Pittsburgh, so in the Northern Virginia area, closer to them and closer to family. Then it's just time to break out.

Eva Sheie (02:19):
Can you actually drive to Pittsburgh easily from DC?

Dr. Ghaznavi (02:24):
Yeah, you can. It's about three hours.

Eva Sheie (02:27):
Oh.

Dr. Ghaznavi (02:27):
I'm going to be making that trip for Thanksgiving, so very much looking forward to doing that again. But yeah, the drive is not bad. The kids with a couple of iPads done. Easy peasy.

Eva Sheie (02:41):
I know that trick well. So breast reconstruction is a really pretty challenging space, and I think one of the things that always surprised me once I figured this out was that you are just a small piece of that journey for the breast reconstruction patient, and it's not that you're not important, but there's other doctors in that environment for that patient that are much more important in the grand scheme of things, right?

Dr. Ghaznavi (03:13):
Absolutely, absolutely.

Eva Sheie (03:14):
How does that look in your current practice? I guess what I'm really trying to ask is what system are you in now and what does that look like for those patients? And then we'll kind of switch and talk about aesthetic too.

Dr. Ghaznavi (03:26):
Yeah, I think for me, I've had a long history of breast reconstruction. I've been doing breast reconstruction for a long time. I started my career in breast surgery. I was a general surgeon and then transitioned to more breast reconstruction, so I felt very comfortable with that patient population, have seen their stories, they've experienced the journey with them, but yeah, you're absolutely right. Breast reconstruction is just one small piece of the whole journey that a patient goes through, and for me it's about the collaboration with the other team members, talking to the breast surgeons, planning out, okay, what are we going to do here? How are we going to approach this? Talking to the oncologist, the radiation oncologist, of course, that's my arch nemesis. So what they do, I try,

Eva Sheie (04:16):
They can really mess up your stuff.

Dr. Ghaznavi (04:17):
So what they do, I try to undo with my reconstruction, but all of those at the end of the day is really trying to put a perfectly healthy woman who was going about their life with no other thing, just put 'em all back together, put all the pieces where they belong, and just kind of make them whole again. I think for me, that just being a part of that journey from where they come in without really distraught about what may have happened, a diagnosis or they've lost all their hair or they just found out that they're going to have this bilateral mastectomy back to playing golf and going and doing yoga and Pilates and just living like their lives. They've closed that chapter and it's just one small chapter in their life. So just to be a part of that is really the best part.

Eva Sheie (05:12):
We hope it's a small chapter.

Dr. Ghaznavi (05:14):
Yeah, absolutely. Absolutely. I always encourage patients to look at the whole spectrum of all the challenges that they've gone through and that this is one other challenge that they'll be able to persevere, and the fact that they've entrusted their care in me is the best part, that they know that I'm going to be there for them and as they go through that journey.

Eva Sheie (05:38):
How has your experience with breast reconstruction informed and supported the way that you approach aesthetic breast surgery where there is no underlying condition that needs to be addressed?

Dr. Ghaznavi (05:52):
Yeah, I think for me it always starts with education. My breast cancer patients really come in, shook up and have a lot of input from multiple doctors. So what I try to do is distill down the surgery in this understandable terms for them and try to educate them on the stepwise process. That's going to happen. First we'll do this, then we'll do this, then we'll do this, and this is what you should expect. These are the risks, these are your options. I don't really approach patients in a very paternal way. I don't tell them what to do, and I try to do the same thing with aesthetics. With aesthetics, I try to identify or just talk to the patient and try to understand what's bothering them. Why are they sitting in that seat talking to me today? And then I give them a whole spectrum of options from minimally invasive to maximally invasive, and then we kind of come to an agreement, Hey, listen, so if you're trying to reach this, what's going to get you there? I consider myself an expert in the field, so I can give you a whole spectrum of all the different options and which of those I can do. I always say, I don't present an option to you if I don't think it's one safe and two something that I can execute and do for you. So that's how I approach it, and I do the same thing with breast reconstruction. I give them all the options. I go through all of the risks and benefits, and I try to educate them on what an informed consent would be.

Eva Sheie (07:22):
So you're actually making recommendations, but you're giving them choices and they're all good choices,

Dr. Ghaznavi (07:27):
Correct. Yeah, I would never make a choice or I never give them an option that I don't think is one safe for them or two, something that would be something that I could do if I had something that I can't do. I just wouldn't offer that as an option. I don't try to experiment on people. It's patients who I've done these procedures on. I think breast reconstruction has also given me the ability to say, okay, now I don't have to remake the entire breast. I have something of a breast melon to work with, and this is how I can aesthetically enhance the features that you may have or rejuvenate the changes that have happened in the breast or anywhere else in the body.

Eva Sheie (08:10):
So what happens when someone has decided what they want from Dr. Google and then it isn't something that you recommend? How do you approach that sort of conflict when somebody has a very strong idea about what needs to happen?

Dr. Ghaznavi (08:25):
Yeah, I mean, first off, it's just education. The patient goes to Google because they lack education about that, and part of my practice is really based on three E's, which I emphasize the most. One is education, the second is expertise, and the third is empathy. So for me, education is the first part and I try to educate patients on what they're asking for and why they're asking for that, and I give them the examples of, okay, this is what we're trying to do and this is how we can do it. I try to empathize with why they have attached their idea to that. Sometimes it's not reasonable, sometimes it's not possible. Then I just try to highlight my expertise and say, Hey, look, this is my expertise and this is what I can do for you. If it's something that I'm not capable of doing, I just decline surgery. I don't need to operate on every single person and I want to make sure I operate on patients who are going to be satisfied with what I can do. So I'm humble about what I can and can't do, and I try to align myself with those patients so that I know that I can achieve their goals.

Eva Sheie (09:39):
This year for the first time, I've started to see patients saying, I looked on TikTok for the answer to this and I couldn't find it, and I think to myself, why are you looking on TikTok? Have you seen this yet or are your patients old enough that they're still sort of impervious to thinking TikTok is a source of truth?

Dr. Ghaznavi (09:58):
No, I mean, I see that more in my cosmetic augmentation patients, and that's just because as a society, I don't think we have done a good enough job of grabbing social media and utilizing it for things that are not commercialized, but rather educational. All of the people that are really doing amazing work are board certified plastic surgeons that are really changing people's lives, but who wants to find time to make a video or make a blog post about, Hey, look, this is how this is done. It's sometimes easier to have someone who may not be an expert but is really looking for clicks or looking for eyeballs to grab their attention, and we've become, I think, a very short attention span sort of society where you want that answer in 10 seconds or less, and sometimes it's more nuanced. Sometimes you really need to understand the risks and benefits. You need to understand the body type to get a true sense of what the correct answer is.

Eva Sheie (11:03):
It's very well said. How much of your practice today is cosmetic versus reconstructive?

Dr. Ghaznavi (11:10):
About 50%. I still do a fair amount of breast reconstruction, both microsurgical and non microsurgical, and I do a fair amount of breast reductions, breast lifts, things of that nature.

Eva Sheie (11:26):
Now, for those of us who don't really understand what microsurgery is, I think it means it's really tiny. Will you just give us the elevator speech on what microsurgery actually is?

Dr. Ghaznavi (11:41):
Yeah. Microsurgery is our operations in which you literally utilize a microscope or high powered magnification, and this is utilized to transport skin and tissue from one location to another by reconnecting blood vessels. We use suture that's as thin as a hair to reconnect the blood vessels that we take off from one place and put another. It's really utilized for breast reconstruction, for head and neck reconstruction, for lower extremity reconstruction, there's a lot of applications to microsurgery and it takes advanced training to do and just experience.

Eva Sheie (12:22):
Is that something that all plastic surgeons do or is it a subspecialty?

Dr. Ghaznavi (12:27):
Yeah, so you're exposed to it during your plastic surgical training, but in order to really gain expertise, people do a microsurgical fellowship, which is a year long fellowship you do where you just focus on doing advanced microsurgical cases, usually because of oncologic reasons, cancer reasons, someone's had a cancer, something removed or traumatic reasons they lost tissue on their leg or something along those lines.

Eva Sheie (12:55):
By the time you did this microsurgery fellowship though, you had already been in training for, I'm guessing well over a decade,

Dr. Ghaznavi (13:03):
So if you don't count medical school, I'd already done nine years of training before I did my microsurgical training. I did six years of general surgery, actually did five years of general surgery, a year of research, three years of plastic surgery, and then went and did a year of microsurgical also.

Eva Sheie (13:21):
Many doctors get to move all over the country while they're in this process. And I'm curious, where did you get to live while you were doing this? Meaning you didn't get to really explore it very much, probably?

Dr. Ghaznavi (13:32):
No, but my friends used to call me the Rust Belt Gypsy because I started in Pittsburgh. I lived in New York in Brooklyn for about 10 years, which was awesome. And then from New York, I traveled to Detroit, met my wife there, so lived in Detroit, and then from Detroit, I went to Ohio. I was in Cleveland, and then from Cleveland I traveled down to Boca Raton. So I was in south Florida for about five years, and now I'm here at the DMV in Northern Virginia.

Eva Sheie (14:10):
And are you planning to stay there?

Dr. Ghaznavi (14:13):
I am. This is it. No more. I've reached my max. I can't move anymore. I don't think my wife would let me move anymore, I think. No, I think the kids are ingrained now and they're growing up, so we want to stay here.

Eva Sheie (14:28):
The kids, it's the hardest on them. Adults can usually handle it. So which city did you have the kids in?

Dr. Ghaznavi (14:35):
We had them in Florida in Boca.

Eva Sheie (14:37):
So they're pretty little still?

Dr. Ghaznavi (14:39):
Yeah, there's still two little guys and we want them to stay in one place. Nieces and nephews are around. Grandparents are close by, so I think it's time. Stay put.

Eva Sheie (14:53):
What else besides the kids? I know when they're little, like mine are little also, they're pretty much all you do, but we did have lives before them and we will have them after them too, or when they're old enough to do stuff on their own. What do you like to do when you're not with your family or at work?

Dr. Ghaznavi (15:11):
I love to cook. I'm always cooking something dinner wise on the weekends, but I'm a pretty avid golfer. I play a lot of tennis. We got tennis lessons actually later on today, so we're looking forward to that. So I try to stay active. Used to do a lot of painting and art when I was younger, but just haven't found the time and the space to be able to do that. But something later on in my life that I'll pick back up.

Eva Sheie (15:39):
There's a painting behind your head right now. I know it's an audio podcast, but is there a story?

Dr. Ghaznavi (15:45):
It's a rising sun, Roy Lichtenstein, so I always look at my days, the sun is rising, so I always want to kind of remind myself that the sun is coming up, that you got to be positive, the sun is coming up, new day is starting as another day ends and new day starts. So's just a kind of positive thing for me to remind myself of that.

Eva Sheie (16:08):
We do get to start over every day.

Dr. Ghaznavi (16:11):
Yes, as bad as yesterday was, today is a new day, so you just start and try to make the best of it for that day. So

Eva Sheie (16:20):
What is in your future? Is there anything you're looking forward to?

Dr. Ghaznavi (16:26):
I mean, for me it's just learning to be a small business owner. It's just something that we weren't really trained on and it's a learning process. I decided when I was training that I was going to get my MBA, so I spent two years on the weekends to my wife's chagrin, getting my MBA.

Eva Sheie (16:46):
Why doesn't this surprise me.

Dr. Ghaznavi (16:48):
So I'm an overachiever. I always love to learn, but even with that, I think that there's so many life lessons about managing people and just getting the ins and outs of business, talking to vendors and things of that stuff that I think you just only get with experience and making mistakes and asking your friends and colleagues. For me, it's just learning business, learning on the ground level business, that's the hardest thing, and it's been the thing that every day I think about how is this going? There's so many aspects to it, stuff that when you're an employee physician, you're not really worried about what's the marketing sell this week or how are things going with our inventory and things of that nature itself.

Eva Sheie (17:39):
I think my own opinion is deciding what you're going to do every day is the biggest and most difficult decision is like where are you going to spend your time because there's only so much of it and you already know three days of it is in the operating room or two, and the other two is where you have to decide how are you going to use your time and how much of it are you going to give up that you could be with your family. And so those challenges will make you feel like you're being torn in half or in three parts even. I don't have any patience. I only get torn in half. I had a CEO once who said, I got my MBA so you guys don't have to, and all you need to know is incentivize what you want, so I will never go get it. I already know what I need.

Dr. Ghaznavi (18:25):
Yes,

Eva Sheie (18:25):
What I need from him.

Dr. Ghaznavi (18:26):
There you go.

Eva Sheie (18:27):
Yeah, it's a lot and it's admirable. She must have known what she was getting when she married you that you were going to keep going to school as long as you could.

Dr. Ghaznavi (18:38):
Yeah, yeah. She knew that I was an overachiever and that a lot of the study, but there was a lot of weekends on the beach that I gave up to sit in a classroom to talk about finance or marketing, and that was not because I wanted to open a business just because I just felt like that was something I always wanted to learn and I never really got a chance to do it. So it just kind of one thing led to another.

Eva Sheie (19:05):
Well, if a patient is coming to see you for the first time, can you share with us a little bit about what they can expect that visit to look like?

Dr. Ghaznavi (19:14):
Yeah. For me, I think I try to hang my hat on being very approachable and being very down to earth. I'm not going to walk in with a white laser without a shirt on, something outrageous. I want someone to really be able to talk to me like we've known each other for a long time and really tell me and empathize me to try to empathize with them to why they're there, what I can do to help their confidence or what I can do to make them feel better about themselves. I think once I'm able to get to the core of that, that's when I really am able to help them and say, okay, so here are what your options are and this is what I can do for you and this is what I can offer you. If I can't, I just say, Hey, that's not something that I can do, but maybe this is something you may want to try. So I think just having that dialogue and having the time knowing that I'm going to sit there with them and talk about all of the things that are bothering them and give them options and what's possible and what's not.

Eva Sheie (20:18):
If someone is interested in coming to see you, where can they find out more information about you?

Dr. Ghaznavi (20:23):
They can go to our website@amgplasticsurgery.com. They can fill out online requests or you can follow us on Instagram at AMG plastic surgery. You can always Google me. I'm the only Amir Ghaznavi MD I think out there. But yeah, the website is usually the best place to go to get a hold of us.

Eva Sheie (20:43):
If we can spell it, we can Google it and I will put all the links in the show notes so they're easy to find.

Dr. Ghaznavi (20:49):
Awesome.

Eva Sheie (20:50):
And your Instagram too? Yeah, it looks great.

Dr. Ghaznavi (20:53):
Thank you so much,

Eva Sheie (20:54):
And I agree you do seem extremely approachable and open and warm and you're not rushed and just all the things that I think we expect from that kind of experience. So thank you for sharing so much of yourself with us.

Dr. Ghaznavi (21:09):
Yeah, no, this was great. I really appreciate it. Hopefully this will start the new podcast from here on in.

Eva Sheie (21:16):
Stay tuned.

Dr. Ghaznavi (21:17):
Stay tuned. Awesome.

Eva Sheie (21:26):
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.