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 the Meet the Doctor podcast. My guest is Dr. John Mesa. Welcome Dr. Mesa.

Dr. Mesa (00:37):
Thank you Eva, for inviting me to this podcast.

Eva Sheie (00:40):
Tell me a little bit about yourself.

Dr. Mesa (00:42):
I am a board certified cosmetic plastic surgeon. I have three locations. I have a office in New York City, Manhattan and another one in New Jersey and another one in Miami. And I specialize now in uh, facial procedures. I'm basically, people know me because of the buccal fat removal and chins and facelift and neck lift under local anesthesia. Those are my fortes.

Eva Sheie (01:06):
There's a lot to unpack there. Let's start with uh, local anesthesia. So most surgeries is not done under local anesthesia and sometimes there's some controversy about this. Why are you doing mostly local? All local?

Dr. Mesa (01:21):
Hundred percent.

Eva Sheie (01:22):
Hundred percent.

Dr. Mesa (01:23):
I'm proud to say that for the last two years I haven't brought anybody to the hospital to get surgery on general anesthesia. I do everything in my office on the local anesthesia.

Eva Sheie (01:33):
And was that out of necessity or preference or how did you end up there?

Dr. Mesa (01:37):
No, that it started when I was doing my third fellowship in University of Alabama. Uh, my professor was doing facelifts on the local anesthesia, local anesthesia quotation. But the patients were in a lot of pain and I told, my professor said, look at, that's not right. Patients should be painless because I did a fellowship the year before in Korean surgery that is reconstruction of the face. I said, look, I can numb the nurse and all the stuff and he and I can help you with that. He said, look, if you can improve the technique, let's do it. And I started to do it to the point that now I do almost everything on the face, completely awake on the local anesthesia with zero pain, which is, I like it because first of all, eliminates all the risk of going to sleep. So all a hundred percent of the risk of general anesthesia or eye visitation are waived. Secondly, nowadays that people, it's more convenient for the patients because now you don't have to have a chaperone or a component to come to get surgery or less. It's the eyes you can get like a, you can't get the surgery done by yourself and then you live by yourself. So which is more comfortable for the patient in addition of being more safe,

Eva Sheie (02:46):
It sounds like it's less invasive or less serious than going to the dentist.

Dr. Mesa (02:51):
Correct.

Eva Sheie (02:52):
Okay. This is really interesting. So go back to three fellowships. You sound like someone who loves to go to school.

Dr. Mesa (03:00):
Yes. I trained for 18 years.

Eva Sheie (03:02):
18 years <laugh>. Uh, so you started when you were 10. What were your three fellowships?

Dr. Mesa (03:08):
The first one was in plastic surgery research at Harvard. The second was a craniofacial surgery at University of Michigan and the third one was about aesthetic surgery of the face at the University of Alabama.

Eva Sheie (03:22):
And were you continuing through these fellowships because you weren't sure what you were going to do or just?

Dr. Mesa (03:29):
No, the first one was, uh, the price that I had to pay to get into plastic surgery cuz I'm foreigner. I am born in Colombia, so as a foreigner to get into plastic surgery in America is very difficult. So I had to pay my dues and that's what I had to do. Five year fellowship in research to get into plastics. The second one was because I always wanted to specialize in the face, so I wanted to be a reconstructive surgeon. Then I wanted to improve my reconstruction from the aesthetic side. So that's why I did the second clinical fellowship, third one in total. And then after that I decided to do cosmetic surgery because ultimately is what I liked the most.

Eva Sheie (04:11):
So let's go backwards again. You came from Columbia. 

Dr. Mesa (04:15):
Yes. 

Eva Sheie (04:15):
Certainly there are medical schools and plastic surgeons in Columbia. But why did you want to come to the United States for that instead?

Dr. Mesa (04:22):
Because it was easier for me to become a plastic surgeon in America, even though it's so difficult than in my country. And the reason is different to America, in South America, when you go into a residency, you either have to pay to be in a private university or you are, you don't have to pay. But my family was very poor, they couldn't support me. So I needed some help to pay for my bills, my meals, my housing, uh, books, everything. And I find out in America, when you are a resident you get paid. It's a basic salary. So for me it was more easier to get into one of the most difficult residences in the world that are in my country. <laugh>.

Eva Sheie (05:03):
Okay. So I I'm starting to to see a pattern here with you that you like to do things that are very, very difficult.

Dr. Mesa (05:10):
Correct. 

Eva Sheie (05:10):
Okay. 

Dr. Mesa (05:11):
And that nobody has done before or very few.

Eva Sheie (05:14):
<laugh>. What other things have you done that no one has done before?

Dr. Mesa (05:19):
Uh, I mean the procedures I do my face lifts, uh, and neck lifts completely awake on the local anesthesia. People don't believe me and they concern doctors do what is called local anesthesia and sedation. They give you pure IV sedation. No, my patients are fully awake talking to me. We are talking the other day I did a director, a movie director from Hollywood and I have an assistant that used to do a lot of movies for shooting and all this stuff. And they were talking all the surgery while I was doing the face. So people tell that I'm a little bit crazy about that. And another thing is that after my last fellowship I ended up doing a book textbook about, uh, reconstruction of the face. It's a big book that trains, uh, plastic surgeons and is a official book of two societies, American Society of Craniofacial Surgery and the American Society of Maxillofacial Surgeons. And I'm the lead author of that book and nobody has done anything like that.

Eva Sheie (06:16):
How many years does it take to write a textbook of that size?

Dr. Mesa (06:20):
Uh, it took me like a six years.

Eva Sheie (06:24):
And who was helping you? Other doctors?

Dr. Mesa (06:26):
I invited some other doctors to write the chapters, but you know, when you are the main at the end you end up catching up with the incomplete work, eh, all the everything. So it was a lot of work.

Eva Sheie (06:37):
So you're also the project manager.

Dr. Mesa (06:38):
Correct. 

Eva Sheie (06:40):
That's actually harder than the writing sometimes? 

Dr. Mesa (06:43):
Yes. 

Eva Sheie (06:44):
Is research still a part of your everyday life at work now?

Dr. Mesa (06:49):
Right now, no, because I am no longer doing academics and right now what I'm doing is more like a clinical work and marketing work.

Eva Sheie (06:58):
If you had an unlimited time to do whatever you wanted to do on the research side, is there something that you would study?

Dr. Mesa (07:09):
Yeah, I will continue my research that I did at Harvard when I was doing uh, tissue engineering that I was uh, creating cartilage graft through injections. That's something that I really passionate, I was very passionate. I did five years of research and I would like to continue to do that. But for that you need a basic research lab.

Eva Sheie (07:27):
Do you think you'll get back to that someday?

Dr. Mesa (07:29):
Yes. At some point, yes. When I kind of grow a little bit more my practice, I have like a roadmap of what I want. When I, everything is in standby, then I will kind of contact a couple, one or two universities to become like an associate professors and then start doing a little bit more of that.

Eva Sheie (07:46):
That'll be exciting. Okay. So at the beginning you told me that you are practicing in both New York, New Jersey and down here in Miami where we are today. 

Dr. Mesa (07:56):
Correct. 

Eva Sheie (07:57):
How often are you traveling back and forth?

Dr. Mesa (08:00):
My office in New York and New Jersey are close. It's like a 45 minutes in between. So depending on the day I kind of commute to to either one. And the one here in Miami right now I'm coming only once a month. I operate on Saturdays the first Saturday of the month. I fly on Friday, Saturday I operate all day. Sunday I go to the beach and do brunch with my friends here in this, in Miami. And then Monday morning I fly back.

Eva Sheie (08:22):
So this, this Miami office was a plan to be able to go to the beach once a month?

Dr. Mesa (08:27):
That was the excuse to force me my <laugh> to go to the beach. 

Eva Sheie (08:31):
Uh huh. <affirmative> 

Dr. Mesa (08:32):
Because before I had the office I always wanted to come to Miami because it's a very Latin environment and the weather is nice. And I, as I said, with American, I like Miami and I always found an excuse not to come. But then now that I have patients I have to consult, there is no excuse about that.

Eva Sheie (08:49):
Makes sense. Someone's gotta do it. <laugh> Do you see any interesting differences between your patients, uh, in New York City and and down here?

Dr. Mesa (09:01):
Yes. One of the main differences is everybody arrives on time here. Even though there is a big pop Latin, I do because I speak Spanish, um, I would say 50% of my patients are Spanish speaking. And Latin culture by definition is arrives late everywhere. So in New York and New Jersey, all my, most of my patients arrive late. But here in Miami, especially the Latinos, they arrive on time or 15 minutes below, before, which is shocking to me. So that's why I'm able to pack my day with surgeries and go very efficient because everybody arrives on time. 

Eva Sheie (09:39):
Wow. 

Dr. Mesa (09:40):
Why is that? I have no idea.

Eva Sheie (09:42):
We're gonna have to figure that one out that that's really interesting. They clearly respect you very much and respect your time or maybe it's your staff and they're telling them.

Dr. Mesa (09:52):
No I mean, 

Eva Sheie (09:53):
No? 

Dr. Mesa (09:54):
it's the same staff. I have the same staff controlling the three offices. But here in Miami everybody arrives on time. Why? I have no idea.

Eva Sheie (10:02):
Are there aesthetic differences or are patients the same everywhere? 

Dr. Mesa (10:07):
Mm. In my practice I think they're very is they're actually the same because now I'm very specialized in certain procedures of the face. So because I'm very focused in basically like a seven procedures, basically what I do, all the patients are the same in even New York, New Jersey or in Miami.

Eva Sheie (10:26):
One of those procedures is the uh, buccal fat pad removal.

Dr. Mesa (10:29):
Correct.

Eva Sheie (10:30):
This procedure's been kind of hanging out on social media and uh, people magazine and it's popular.

Dr. Mesa (10:38):
It became popular like in December this year.

Eva Sheie (10:40):
Yeah. So it's everywhere. And now, now of course, you know, as soon as it becomes popular then you start seeing the bad results show up in the same places. And so I wonder if you can talk about that procedure a little bit and when I think what I'd like to know is when it goes wrong, what are they doing wrong?

Dr. Mesa (11:00):
Yes. I mean, buccal fat removal, why became interesting in when I finish all my fellowships of my trainings, I always, I always have been fascinated about the face. That's the reason why I became plastic surgeon. I wanted to make the face more beautiful. And I noticed that some always people in the movies in Hollywood, in tv they look very good compared with the regular people on the street. And then I started to do some research and then I hear, I found out about that procedure. But at that time, in the early two thousands, nobody talked about that. That's what I called right now the best kept secret in Hollywood. Cuz my hypothesis is that everybody in Hollywood does it. But nobody knew about that. So I started to do one or two, I researched about the technique. I was not trained in adults. I did buccal fat removals in kids.

(11:50)
In kids when they are, they have cleft lips and cleft palates. If they have a hole in the palate, you get the buccal fat pad and then you patch the hole. It helps to heal that. But it's not for aesthetic purposes. So I started to do some ones, and then there realized that patients started to look like celebrities. So that's why I started to do a lot to the point that now 50% of my practice is just buccal fat removal. So now with the all these years experience why things can go wrong, one is when you're not experienced in the procedure. Secondly, when the surgeon is not really well trained or does it have a good aesthetic eye? And third, when the patients are not well-informed or are not told, that the buccal fat removal is not just the solution to achieve their goals. For me it's very important.

(12:42)
Anybody that is gonna get the procedure to have high cheekbones, because everybody say, oh I wanna look like Bella Hadid. And you say yes to look like Bella Hadid, you will need a buccal fat removal. But for that you need to have the Bella Hadid cheekbones. You need to have the Bella Hadid jawline, you need the Bella Hadid chin. And that's when things grow wrong when you do a buccal fat removal in somebody that don't have those features and then the results are bad. So that's why, and I learned that early in my career and I tell all the time I had a patient, I knew she needed to have cheekbone fillers to get a good result. She convinced me not to do it. I did a surgery. She looked a little bit aged because that's the problem. If you do buccal fat removal with no cheekbones, you are gonna look aged.

(13:24)
She wrote a nasty review in Real Self. If you go at the bottom of my reviews, that review is there. I was devastated and I had to bring her back. I had to do fillers, I fixed her, but she never revised the Real Self review. That's the way that I learned. So that's the point, like when you do the procedure in somebody that doesn't have what is needed to have a good result. And now, right now I'm very strict. I say look at you have no cheekbones unless you don't do cheekbone fillers. I won't do your surgery cause I don't want you to have a bad result.

Eva Sheie (13:54):
Oh, I wish we didn't have to learn the hard way. 

Dr. Mesa (13:57):
But you know, that's, um, I learned in a book or somewhere, I don't remember the source, the world expert, the definition of expert. And they say expert is somebody that has done every single mistake in the past. And that's how you become an expert. Cuz you know, from mistakes, what not to do in the future.

Eva Sheie (14:20):
I love that.

Dr. Mesa (14:21):
So it's a, it's a way to see negative things in the past as a positive way in life.

Eva Sheie (14:28):
Is there anything that you wish your patients knew before they came to see you?

Dr. Mesa (14:34):
Yes, I would like them to be certain of what they want because sometimes what they have in mind is not what they are truly, truly want. And it's very important for patients to kind of do a little bit of internet search and try to figure it out. Be a little bit more informed. Cause I, I hate when patients come and say, oh, I want Dr. Mesa, I want to improve my face. What can you do for me? I said like a no. I mean, as a plastic surgeon and I can do everything I can do, but no, my job is not to sell you surgery and make money out of that. And my, in my practice or the way that I practice my plastic surgery is to make you feel better. And for that you need to know exactly what is what you want. So that's why I tell the patient, no, tell me what bothers you and then I can tell you how can I help you to improve that area that bothers you.

Eva Sheie (15:24):
Are people finding you now for the things that you're known for?

Dr. Mesa (15:27):
Oh, yes. Yes.

Eva Sheie (15:29):
So are you actually known for being the buccal fat pad guy?

Dr. Mesa (15:33):
Some people tells me, I mean, my colleagues, I just run into a couple of friends here and everybody that I met, they, and if they have with another friends and they want to introduce me, they say, oh, let me introduce, this is my dear friend John Mesa, Dr. Mesa, he's the king of buccal fat removal <laugh>. So that's what the people calls me, the king of buccal fat removal.

Eva Sheie (15:52):
Now I know the king of buccal fat pad removal and the, the king of the bbl. I know, I know both kings. Both cheeks.

Dr. Mesa (16:02):
Yeah. 

Eva Sheie (16:02):
Okay. This is a great day. If someone is interested in finding out more about you or reaching out to possibly schedule a consultation, where should they look?

Dr. Mesa (16:13):
The first, since we're in RealSelf, the first place to go to realself.com and search my name John, j o h n. And last name Mesa, it means stable in Spanish is m e s a. And the second one is the website is dr mesa.com. And then on Instagram, Dr. Mesa 2, and that's where they can find information about me. And I also own the buccal fat removal and buccal fat pad removal handles on Instagram.

Eva Sheie (16:41):
Excellent. And I, I will put all of those in the show notes so they're easy to find on, on the podcast.

Dr. Mesa (16:46):
Thanks. That's very kind of you. 

Eva Sheie (16:48):
Thank you for sharing yourself with us today, Dr. Mesa.

Dr. Mesa (16:50):
No, thank you Eva, for your invitation to this amazing podcast.

Eva Sheie (16:54):
Thank you. 

Eva Sheie (16:57):
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.