Hakim Said, MD - Plastic Surgeon in Seattle, Washington

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 .Today on Meet the Doctor. I'm proud to introduce Dr. Hakim Said. He's a board certified plastic surgeon in Seattle. Welcome to the podcast. It's nice to see you.

Dr. Said (00:39):
Eva, thank you for having me on. I'm happy to chat with you.

Eva Sheie (00:42):
Now, I'm going to do a gotcha right out of the gate because

Dr. Said (00:46):
Uh-oh.

Eva Sheie (00:47):
I coincidentally was speaking to someone who knows you before we got on the podcast today and he called you a surgeon scientist.

Dr. Said (00:55):
Yeah, I've always been a problem solver, puzzle solver, and I was at the university for 15 years and I kind of like to take on tough challenges and if there's a puzzle to solve, I like to solve it. So I use data. I'm very analytical and so I don't know, people who know me know that I am kind of relentless about that.

Eva Sheie (01:14):
Was it the University of Washington?

Dr. Said (01:17):
Yep. I was at University of Washington for 15 years. I was the director of the Reconstructive Microsurgery program, which means I had to take on ferocious stuff and fearsome stuff from all over. People don't always realize the University of Washington covers one quarter of the land mass of the United States, so anything from literally one quarter of the United States service area comes to University of Washington. All the weirdest of the weird stuff would kind of come to us, come to me, and I had to kind of deal with rebuilding it, fixing it, and making it look good.

Eva Sheie (01:50):
So that's like Alaska, Canada?

Dr. Said (01:53):
No.

Eva Sheie (01:54):
I mean, I'm sure, no Canadians. Okay.

Dr. Said (01:56):
No, Canadians, not even, we'd say we see some people trickle in from there, but no, it's Wyoming, Montana, Idaho, Oregon, Washington, the whole, it's a five state area all around us that would come, but Alaska is the big one and they just fly in for that care.

Eva Sheie (02:14):
What kinds of patients were you seeing in that time of your career?

Dr. Said (02:17):
Early on I covered everything, but eventually I kind of ended up just in mostly doing cancer reconstruction and a lot of the cancer reconstruction was breast cancer. That's sort of the biggest, if you look at the numbers of it, ends up being breast cancer for women, and then that essentially is an aesthetic endeavor. In other words, it's not like brain cancer or something. Literally the goal is to make you look right, right, feel right, feel good about how you look. And so that's an aesthetic. And so on the one hand there are things to fix, but other things, the other ways, it's really about getting the form to be beautiful. So I spent many years sort of secretly trying to turn reconstructive patients into aesthetic patients, and that was actually one of my goals is that I wanted them to look too good to be an average example. I had sort of examples of patients of how they look afterwards and I would secretly try to get every patient to look so good that I wouldn't want to show everybody that example. So you're too good to fit in the book. We can't put you in the book because you look too good. We don't want to make that a standard expectation for everybody that you could get there.

Eva Sheie (03:24):
Can't set the bar too high.

Dr. Said (03:25):
That's right. It was kind of poignant. Sometimes people would come in and they'd say, oh, I want my sister, she'd bring her sister in and she'd say, I want my sister look as good as me. And I'd say, oh my gosh, she had this done 20 years ago and I'm not sure we can get her to the point that we have today. The technology today is better. So it's like not everybody could reach that point, but I certainly worked hard at it.

Eva Sheie (03:48):
So after 15 years there, you made the leap to a hundred percent aesthetic. Is that what you're doing now?

Dr. Said (03:53):
That's right, yeah.

Eva Sheie (03:55):
What precipitated that?

Dr. Said (03:57):
Actually, it was someone who retired, Dr. Souder, if you've ever interviewed her, she was amazing and she was in aesthetic practice, but a lot of the time took care of patients who'd had implants and would kind of fix them up after implants. And so she retired and they asked me to join here and it's really a wonderful, for me, a wonderful transition and it gives me the chance to essentially leverage all of the skills, all the things I did to rebuild people in the aesthetic world essentially. And so a lot of the tools I had were, I mean I was experienced obviously with implants and all sorts of different tools for reconstruction, natural tissue reconstruction, reshaping people using microsurgical reconstruction, which of course is a big deal, moving tissues around the body in order to use the areas you have that are extra to fill in the areas where you don't have enough, and making it shapely at the same time. All of those tools are almost immediately applicable to the aesthetic world. So that's, I sort of showed up and I have all these tools I can use and I'm happy to put them to use on your behalf.

Eva Sheie (05:07):
Is there ever a need to use microsurgery in aesthetics?

Dr. Said (05:10):
That's sort of a frontier and it's tricky. I think the place where it's going to happen the most is in the transgender world. And so that's sort of on the cusp of it and we'll see what happens in the next year, a couple of years to see whether those, they're labor intensive, you have to spend some usually ICU time, a lot of surgery time to try to do that, to transfer tissues from one area to another. And it has been described, actually one of my trainees years ago now, does that offers that service, but whether that's a routine or not or whether that's sort of an experimental thing we'll have to see in the future, but almost everything shy of that, shy of the actual tissue transfer is applicable. Rebuilding folds and the envelope and the skin replacing areas and reshaping the areas that came from all of those efforts basically translate directly into aesthetic practice especially. And some people don't need all of those tools, but if you do, it's nice to have that on tap to be able to offer those a little more advanced techniques.

Eva Sheie (06:14):
So are you mostly doing body stuff, breast stuff or are you doing any face surgery? What does your practice look like today?

Dr. Said (06:24):
Yeah, I do all of those things. I do a lot of body reshaping, but I also do facial. I love the process of aging is such a fascinating puzzle for me. And one thing that I love is not just seeing one part of it, just the face, but also seeing how the body changes with age as well. There are a lot of changes that people don't realize come with age specifically your hormones have dictated the shape that you are, whether it's feminine or masculine. And as you get older, your hormones kind of vary in their effect. And so people discover that doing the same thing, eating the same number of vagals, same amount of exercise, your body will kind of change its shape distribution. People don't really understand that very, very deeply. Usually people don't understand that fat is a regulated resource within your body and if you just do liposuction in one area, it doesn't just vanish, your body's regulated and it will put fat back in other areas to compensate for the missing reservoirs.

(07:27):
And so that's a hormonally distributed. It's regulated and it's kind of smarter than you are so you can starve or exercise more and your body's kind of a couple steps ahead of you. And so what happens is as you get older, your hormone levels diminish and your hormones we're protecting certain areas of your body and giving you a shape that we recognize really instantly. You can kind of see someone's age through their shape. So what happens is as your hormones diminish, your body starts to pack on padding in places that you don't necessarily want to see it. I call it the scuba belt. The scuba belt is a very practical, it's a practical way to talk about it. If I had to give you 10 pounds to carry, what's the place that you could carry 10 extra pounds as ballast? You'd literally pack it around your waistline so that you could run and do scuba and everything.

(08:16):
So it's a very functional reason that you carry it there. It seems to me it's closest to your center of mass, but it's not necessarily a graceful reason you don't like it. People don't like carrying 10 pounds extra weight. They'll say, my weight is about the same, but now I have it in a different place. And I'd say, ah, yes, that is because you're transitioning to a little different phase of your life. And one of the things that I find is a fun puzzle is to kind of, when I see people, I meet people, I try to imagine where they were at different phases in their lives. In fact, for facial aesthetics, I actually asked them to bring in pictures of past 10 years, 15 years, 20 years, so that I can see what has changed in them over time. And then that's what I bear in mind. That's what I'm keeping as my goal as I'm working on getting someone's shape back to where they were and they don't realize the degree to which they just don't feel like the same person because their shape looks different and we can turn that shape back to an earlier time in their lives. So I kind of think of it like you pick up a coin off the ground and you kind of want to polish it into its original form. How can I get this to be as polished as once it was? Right.

Eva Sheie (09:23):
Yeah. It seems like there's parallels to losing a lot of weight between the aging process on the weight loss process that sound really similar.

Dr. Said (09:34):
Well, that's for sure true that you have deflationary changes as well, and then you have to manage the deflationary changes and that buys you extra skin or extra fabric and you have to figure out how, not just to get rid of fabric, but to create one graceful shape from the excess that you have. You have to turn it into something that looks younger, that looks like a younger version of yourself. So I think that's really fun. That's a fun challenge both in facial aesthetics and also in body aesthetics. People think I have extra tummy because I have a kid, so just get rid of the extra tummy. But really what's happening is you have a different age shape, and so we're turning the shape back in time essentially. And we want to think of what would you look like earlier in your life and what transmits a younger age? We recognize it right away. There's actually a South American group that studied the most impactful thing, the thing that our eye catches the most, and it's usually the proportion of the body much higher than whether you liposuction one spot or another spot or whether the breasts are larger or smaller. Just the waist shape and sort of the proportions, something that our eyes go to. It's really the most impactful place to reshape people.

Eva Sheie (10:54):
What are your thoughts on keeping the fat, if you take fat out with liposuction, do you like to move it around and put it somewhere else so we don't use it?

Dr. Said (11:02):
That's exactly right. So the key is if you take it out and you throw it away, guess what's going to happen? Your body will decide where it puts it back on. And so if you have let's say five sites and you get rid of the first, it's going to go on to the second. If you get rid of the first and the second, it's going to go to the third and fourth and fifth, et cetera. Whereas if you put it back in, you get to choose you and your patient, get to choose what you would like to have, what shape you would appreciate. And then it also is more sort of future-proofing because what tends to happen over time is things are progressive, so your body will put more fat on, but if you put the fat back into another place, that will help to stabilize your shape over time.

Eva Sheie (11:44):
I want to go back to technology for a second because it seems like we go for a while without anything big or new happening and then all of a sudden it's coming from every direction. So there's a couple things I'm curious for your thoughts on. One would be AI and are you looking at how AI is going to impact the way that aesthetics are done? And then the other is not really technology and the computer sets, but maybe in the device sense. I want to make sure that I get your thoughts on the new Motiva implants.

Dr. Said (12:16):
AI has a tremendous potential to take away some of the parts that take so much work and effort and just turn them into just a millisecond worth of we come up with a plan or solution. For us, it's transformative for our practices. Instead of needing, say, nurses to call in, you can have it just an automated set of directions or instructions. Plastic surgery is uniquely tailored and so it's very hard to see how AI will take that on. In other words, demonstrated that they can use robots and sort of robotic intelligence to do things like appendixes take out appendixes, but it's still pretty tough for it to come up with. I think something as subjective as an aesthetic assessment like a cleft lip for example. Repairing a cleft lip would be tough to say, I'm just going to have the AI decide what to do about this.

(13:13):
So there's a lot of plastic surgery that I like to call irreducible. In my former life, by the way, I was a computer scientist, a master's degree in computer science, and I studied algorithms and I'm big tech, you might say a tech nerd. Friends know me as a tech nerd. A lot of things I can tell are reducible to an algorithm or a plan so that you could have it be standardized and automated. And interestingly, I kind of fled from all of those things that I could see, well, this just needs to be measured and bones need to be assessed. And the CT scan, you get farther and farther from that when you get into this sort of more and more subjective realm of plastic surgery. So actually now I'm kind of almost in the irreducible, the parts that are not reducible to that, the question is, now AI can do things like you can tell it to paint you a picture, which is very creative.

(14:01):
So the question is whether it can get into that subtle space of helping people look right or that kind of guidance is tough because so far AI doesn't makes people look weird and wrong. You have a dancer with three legs, that's how good are they at that? We'll see. I think there's tremendous transformative potential to enable us to do things, to make everything streamlined and to make drudgery much easier, especially for doctors where there's documentation issues, just getting it all so we can spend our time talking to our patients instead of charting and doing insurance and all of the administrative stuff can go away and just becomes the pure field of caring for a person, person to person, which I think is wonderful. I'm excited for that. In terms of the Motiva implants, I'm so excited about that because honestly the implants have not been very good substitutes for a breast.

(14:59):
And I can tell you firsthand, I've tried to use them to rebuild breasts and I see all the limitations of 'em. And so for many years they just were not the right device. They were just all these limitations we tried to work around and tried to deal with. And finally someone has gotten to the point where they can make substantial leaps forward and overcome FDA restrictions and just pre-thought preconceived notions and just trying to break everything down and start over again and make devices that are dramatically better. I mean, actually a colleague of mine was asking me just recently, is it really worth a new implant? And I said, I dunno if you understand how much of a leap this is. Right. So the last leap forward we had was in 2012 really we had a fifth gen implants went from, it kind of went about three x improvement in the ruptured rates went from 24% to 8%. So then you basically have a tripling of the reliability of the implants in 2012.

Eva Sheie (16:01):
Are you talking about when we went to gummy bear?

Dr. Said (16:03):
Gummy bear.

Eva Sheie (16:04):
Is that when gummy bear came along?

Dr. Said (16:05):
That's right. Yeah, you're right, exactly.

Eva Sheie (16:07):
I'm old.

Dr. Said (16:09):
So the gummy bear has improved our quality of what we put in. But the new ones today, the Motiva's now have a 0.6% rupture rate at 14 years actually. So that's about a 40%, 40 times 40 times improvement. So you went from a three x improvement to a 40 x improvement. And the only example I can give you that's the same is it's like if you had oil changes and oil changes on your car and you said, I'm going to make it so that your oil change can get 10% longer, the oil lasts a little longer, and then somebody says to you, we're going to get an electric car and you don't need oil changes anymore, it's going to go away. There's no more oil changes. And you say, what is that possible to have no oil changes?

(16:52):
I say, yes, but you have to have a different model. Things have to be different and you're going to have a leap forward. Less than 1% implant complications at 14 years is just shocking. That is a huge difference. And so that's one difference. And the other difference, which I'm trying to get out to my patients is that it's been designed to be biocompatible. So it is like a lot of the issues we have are, is it okay to put an implant inside a person's body? And silicone has so far has been the mildest thing we can put in and they just took the mildest thing and they made it more than 10 times more hypoallergenic. So they have an implant that now if you are worried it was going to cause you problems 10 times less reactive, your body sees the pattern on the surface of it and says, that looks totally like an organic pattern. Fine, we can leave this alone. So you have something that's simultaneously more than 10 times better, more reliable, and then also 10 times less inflammatory. That's actually a huge leap forward.

Eva Sheie (17:55):
They have 14 years of data because they've been using them in Europe that whole time? Is that why we know that?

Dr. Said (18:02):
Yeah. So people say, is this new? Is it new here? It is new here in the US but 85 other countries have tested it out. And that's one of the, I would say the downsides and upsides both for the FDA, our FDA is so restrictive that we can't get new implants and we spend years and years trying to work around the limitations of super old implants that have not been changed. So we have to become better surgeons to manage that. But at the same time, we also, everybody else in the world has been testing these for us before they get to us. And so there are a number of just awful implants in the world that we've never seen because they never made it into our country that other people in the world had to suffer and deal with and try out and say, oh, maybe we shouldn't go down that road. And so we didn't have to, but so these implants come to the US and they've already been tested extensively, 14 years worth of testing elsewhere.

Eva Sheie (18:52):
Have you been using them for a while then?

Dr. Said (18:55):
Yeah, basically since they were introduced in the US I think my partner and I,

Eva Sheie (18:59):
October.

Dr. Said (18:59):
Have been putting 'em in since, yeah, October. I think we were the first on, I want to say the first on the west coast. So we have definitely been using them and there's some interesting different things you have to do to use them. So there's a little bit of a learning curve, but it's a welcome one.

Eva Sheie (19:15):
Are there differences for the patient in that process? I feel like most women who've been thinking about breast augmentation really know how that works. What's different if you've been considering that you might not know about Motiva?

Dr. Said (19:30):
Yeah, great question. So in about 20, I want to say 2012, I started doing breast reconstruction above the muscle instead of below the muscle. And I had a number of patients who all things said just felt better when it was above. And I thought, why am I putting it under the muscle at all anymore? Just is this the right thing to do? And patients just responded so glowingly, when you put the breast where the breast should be. There's so many things I've learned from my patients. Sometimes a 6-year-old tells you the truth. Sometimes someone will tell, you'll say, can't you just do this? And you'd say, initially maybe the medical field would say, oh, I'm sorry. No, we can't do that, of course. And then five years later they say, oh, that patient was right all along five years ago. She said, can you just take my love handles and put it in my breast? At the time we said, no, that's not possible. And then finally we catch up to them. So I had a patient who was like, shouldn't we put the implant where the breast is? Yes. Right. That was simple truths, right? Yes, you, you're correct. We probably should put the implant where the breast is. If you're trying to make it into a breast, then you should put it where the breast is, and that's not under the muscle.

Eva Sheie (20:41):
We were putting it under the muscle. Why? So it would stay still and not fall down.

Dr. Said (20:46):
I mean, if I'm being technical about it, I could say, well, there are a number of challenges that we were, but the truth is, right, I mean, I could come up with our societal talking points of why the submuscular plane was the correct one for that implant. You know what I'm saying? But when you step back for a moment and you say, big picture, if I were a 6-year-old, I would say the only reason you had to do that is because there was something not right about the implant. You couldn't put the implant, the implant wasn't good enough breast to be able to put where the breast is. And so if it were more like a breast, if had more characteristics like a breast, then you should put it where the breast is. So essentially what I'm trying to say is when I made that journey in the reconstructive world of switching to, you win, if you put it where the breast is supposed to be, whether it's natural tissue or an implant or whatever it is, some combination of the two, a hybrid construct, it should be where the breast is.

(21:42):
And then the reasons we didn't do that were related to the implants. And if the implants get good enough, the capsular contracture rate is fine to put it above the muscle. The rippling is fine to put it above the muscle if you have a hundred percent fill, if the gel is soft enough and natural enough and its movement and it can sort of respond to gravity and look like a teardrop, then you can put it above the muscle. All of those are reasons the implant has gotten good enough that now we can put it where the breast should be. Right?So that's kind of a revolution too, to say, do we have an implant that's good enough that we can put it where it should go? And so that's transformative. So there are two things you get out of that. The first is you don't have to mess with people's muscles, so the recovery is much easier, but a lot of people say, I work out, or I'm a CrossFitter.

(22:30):
I don't want you to mess with my muscle. I say, great, you don't have to anymore. You're going to put it above the muscle. You can put it where the breast is, that's where the breast should be and that's where the implant will be. The recovery is easier when you do it that way. So you have something that is just less onerous, less difficult for your life. And so you'd say, well, I would like to do something that doesn't impact me negatively, and that's what the new implants promise to do. You don't have to say, oh, I'm sorry, we're going to have to put it under the muscle to compensate for the rippling and the fill volume and the gel and the capsular contracture rate and the infection rate and the soft tissue cover. All of these reasons that we sort of make up that really are head back to the main point that it's not a perfect breast yet.

Eva Sheie (23:15):
The other side is that breast reconstruction patient, they will benefit from these things maybe more than aesthetic patients.

Dr. Said (23:26):
In many ways. I think the more the less cover there is, that's sort of the extreme case where there's no cover at all and it can't just look like a breast. It actually has to be a breast. That's the highest test of is this going to be sufficient or not to make people feel fresh and young and they're restored, right? Restoration is a big deal. It's a mental thing. Plastic surgery is a mental thing. So we're really changing someone's self image. So to the surgery we're doing is to bring your self-image back up so it's not just physical architectural. I mean, I like the architectural side of it too. So I enjoy the architectural challenges of it, but also it's a very psychosocial challenge where you kind of changing, you do the same surgery on two different people and one will be happy and one will be unhappy. The architecture is not enough. You have to pair it to the person's desires and their feelings. So yeah, it's definitely psychosocial.

Eva Sheie (24:33):
So well said. Thank you. I want to go back through two little things. We know you were at UW for 15 years, but you said you were also a computer scientist.

Dr. Said (24:44):
Oh yeah.

Eva Sheie (24:45):
Go kind of in reverse and give us the path of your education backwards.

Dr. Said (24:50):
I kind of loved architecture and I loved computers and I kind loved art, and I wasn't sure which of those I would do. So it was kind of, and just to step back even before that, I grew up in Switzerland. My father is a diplomat and he was Middle Eastern, so I've got the Middle Eastern side and that accounts for my name. But my mother was blonde and blue-eyed and she was a mid-westerner who was on exchange in Europe when she met my dad. And so she was American and she was an artist, a sculptor, and an artist. And so I ended up, they got married, they had all of us, and we grew up in Switzerland. And Switzerland is a place of very much like Seattle actually. This is the closest I've been able to find a place that mimics my upbringing in Switzerland. It's little microclimates and mountainous and water. Switzerland, when you fly over Switzerland, you feel like it's a dollhouse. You're looking down on a dollhouse or something. And I definitely get that feeling when I come to Seattle that it's green, everything's lovely and green, and so they're definitely matched. Things don't work quite as well in Seattle as they did in Switzerland. Switzerland is kind of, there's a little clockwork sort of side to it, the trains. And I will say at the time growing up, I didn't appreciate how much that would rub off on me, but definitely some of that, I think precision is something that I liked. So my mother was artistic and then growing up in Switzerland, and that definitely helped to motivate me to, I liked something that was technical but then actually was creative and artistic, and that's kind of what I found. That's where I am now. I do something technical, but creative and artistic. But I also was introduced to computers at an early age, and I loved computers and I loved architecture, especially a form and shape of architecture I loved. And so I kind of didn't know what direction I was going to go, and it took me a while to figure that out. Anyway, so that's my foray into computer science. I was doing simultaneous, I thought I was going to go into medicine, but then I also was thinking about computers, and so I kind of did both.

(27:04):
I got a concurrent bachelor's and master's degrees in biology and computer science and sort of picking which direction to go. Early on, I thought I'd be able to use CT scans and modeling and try to, how can I use my technical background to do medical work to really have an impact on people? But then ultimately, as I mentioned before, I really loved the irreducible parts of medicine, the parts where it's just creative and there's no way to take that out and hand it off to a CT scan, where it's literally just crafts, there's some craftsman side to it, which I think is just very fulfilling and rewarding for me.

Eva Sheie (27:43):
Was that at Washington or did you go somewhere else for your undergrad?

Dr. Said (27:47):
My undergrad was at Johns Hopkins. So I grew up in Switzerland, and then I came to the US for high school, and then I went to Johns Hopkins for undergraduate experience where I also did graduate my master's work. From there, I went to Ann Arbor for medical school, and from there I went to Northwestern in Chicago and I did my residency training, plastic surgery in Chicago. I met my wife in Chicago. I did a subspecialization in microsurgical reconstruction, so I kind of knew I wanted to be able to build, tackle the biggest challenges, and so I spent a year in Houston doing that microsurgical reconstruction, and then my wife and I kind of wandered across the countryside and ended up on the west coast, and so we're here. We love it here. I like to say sometimes she jokes we're the West Said, we're out here on the West Said. So we made our way from the east coast all the way to the west. So to go back to the point about computers,

Eva Sheie (28:54):
Yeah.

Dr. Said (28:56):
I'm kind of tech avid, so if there's anything I can add to my surgical, my treatment of people, if there's a new technology or new technique, usually I'm going to explore it. And so for example, the Motiva implants, I kind of needed the background and I can tell that it's next generation that I'm going to go into it, and that's been the case for years. Even while I was at the university, if there's a new technology or a new technique, we would adopt it right away. I brought long lasting numbing medications or new devices if there's something new or a new implant or some sort of matrix that we can use, that's wherein lies the future. So the difference between, and I always tell people the Civil War, they would just pull your teeth out today. Thankfully we have local and all these other things that we can use to make the experience as good as possible.

(29:50):
It used to be we didn't have antibiotics, now we have antibiotics. Now you have a problem from your antibiotics. So we give probiotics. So you give an antibiotic and a probiotic. You do a surgery, it's inflammatory, you should give an anti-inflammatory. And so as we get more sophisticated, we learn how to manage sort of the intervention so that it's controlled and all the tools that we can bring to bear we use on your behalf essentially. So that's kind of probably what Dr. Hayes was saying. I'm always thinking about how can we use everything we have to the benefit of our patients.

Eva Sheie (30:25):
Is there any other new technology or new advancements that you're digging into right now?

Dr. Said (30:31):
I mean, there are enough that it's hard to even get into them. Meshes, matrices. I'm giving a talk on how to fix the fold, which is something that really came from my reconstructive background, how to adjust the breasts using internal support systems. What else? I just think that just so much room for improvement in every part of our craft that I'm sort of pushing for all of it.

Eva Sheie (31:01):
It's so true. I mean, it's constantly changing and it's so interesting, all of it. And there's not a day that goes by that I don't learn something brand new that I've never heard before.

Dr. Said (31:13):
Yeah, it's exciting.

Eva Sheie (31:15):
Yeah, there's a lot going on.

Dr. Said (31:16):
There's so much room. And then if you think about ways we could say, how could AI accelerate this? We can use AI to develop the next generation. They're using it for everything for microchip, so using AI to develop the next microchip even so that would be a better microchip. So I could totally see scaffolding and all of the tissues, everything that we put in a tissue should be basically designed.

Eva Sheie (31:44):
I was on the hunt for the practical applications of AI in our day-to-day world, and I heard one recently where they were using AI during tumor surgery when they're actually in surgery to remove it, that the AI was helping them remove the whole thing all at once instead of going back two or three times sometimes to get the rest because they didn't get it all. And so in the old process, you'll have to correct me if I'm off, but you had to send it off to pathology and wait, and then if you didn't get it all, you had to bring the patient back in and do it again. And that was really awful for the patients. But the AI is helping them actually capture the whole thing. How is it doing that? I don't know if I entirely absorbed that information.

Dr. Said (32:32):
There are a number of different projects like that. One of them is it used to be that you didn't know, and then there are other ways where you could do part, like a mohs resection is when they take off some tissue, but then they examine the edge of it. Sometimes it's hard to tell if it's healthy or not. So they're sort of fluorescent dyes that they can use to identify the boundaries or where the tissues look the same, they look normal, but they're not, they're cancerous. And if they have some kind of scanner to look at it and a fluorescent area, they can figure out if this area needs additional resection. So there are a number of technologies that sort of fluorescent or their indicators that will tell you that you have to kind go for more. That's really exciting.

Eva Sheie (33:17):
The other one I recently heard, which was I was at a meeting and this young female scientist won the whole contest. They were actually, it was like a startup contest, and she was basically growing new nipples for reconstruction with acellular dermal matrices. Which in her pitch, it was like a pitch competition, she said that that particular procedure hadn't been updated since the 1940s.

Dr. Said (33:47):
I think that's bright.

Eva Sheie (33:48):
She was a runaway hit. People were really excited for her.

Dr. Said (33:53):
Yeah, that's exciting if you could, especially because we have to decide whether we can preserve the nipples or not. I think one big advancement is just being able to preserve the nipples, and so if you can preserve them instead of removing them, then you don't have to rebuild them. You spare yourself a couple different steps.

Eva Sheie (34:11):
It's been a real privilege to get to know you today, and I'm so grateful. If someone's listening and they've made it all the way to the end, where should they look for you online or find out more information about you?

Dr. Said (34:23):
Hakim Said is my website. Said Plastic Surgery. You're welcome to look stuff up. I try to keep that up to date with the latest things, latest offers. That's great. I also post on my Instagram Hakim Said MD, so welcome to follow that. I try to let people know how important the next generation changes are that are coming.

Eva Sheie (34:44):
And you're in downtown Seattle?

Dr. Said (34:45):
Yeah, downtown in Seattle. Yeah. Happy to see people from all over.

Eva Sheie (34:49):
What's the parking situation there?

Dr. Said (34:53):
Parking's right on board, it's right underneath us.

Eva Sheie (34:57):
Oh, good.

Dr. Said (34:59):
We're in a high rise down in metropolitan Seattle, so sometimes people come in from the rural, from the suburbs, or they don't like to deal with the city, but the city has its ups and downs. So we're in a skyrise. You can see we have a few of Mount Rainier out the side.

Eva Sheie (35:18):
When you can see it.

Dr. Said (35:19):
Yeah, right, right. Inside our tower, so it's lovely up here. So we got a little bird's nest in the sky where we have all of our stuff. Parking's right downstairs. So pretty easy. We usually have, there are about three different places to stay within about a block or two. So people fly in, stay here, and then fly out afterwards.

Eva Sheie (35:38):
Do you have an OR right there in the office?

Dr. Said (35:40):
Yeah, right inside our office.

Eva Sheie (35:43):
Easy.

Dr. Said (35:44):
Yeah, it makes things really easy. It's like, I like to think of it after 15 years at the university, which is a huge sprawling airport, this is kind of like a small private walled garden. It's very easy to take care of people because it's one-on-one, me, a patient, one anesthesiologist, one nurse. Everything is very one-on-one. It's lovely.

Eva Sheie (36:05):
It sounds wonderful. Thank you so much, Dr. Said.

Dr. Said (36:09):
Yeah, thank you. A great chance to chat with you and talk about all this exciting stuff that we have coming.

Eva Sheie (36:18):
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 MeettheDoctorpodcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, theaxis.io.