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. My guest is plastic surgeon, Larry Fan, and he's in San Francisco, California. Welcome to the podcast.

Dr. Fan (00:39):
Thank you. It's wonderful to be here.

Eva Sheie (00:41):
I believe that I heard about you when I was very early in my career and I am trying to figure out why. But you're in San Francisco and I had a client, a very early client when I was back doing SEO a hundred years ago, and it was the hardest market I ever worked in, and someone told me at that time that there were something like 400 plastic surgeons in five square miles or some crazy number. And so you have to set yourself apart, and I am very excited to ask you how you've gone about doing that over the course of your career.

Dr. Fan (01:19):
Well, great. Well, I'll be excited to talk. And San Francisco, it's a wonderful place. Surprisingly, there are a lot of plastic surgeons here. When you look at the statistics, as you mentioned, there are several hundred plastic surgeons within the city of San Francisco itself, which is only seven miles wide by seven miles long. And so we have as many plastic surgeons here, roughly equivalent to Beverly Hills. But at the same time, there are lots of people who want and need all of our help. And so fortunately we have a very collegial group of plastic surgeons here locally, and I'm very thankful for that.

Eva Sheie (01:51):
Are you among other surgeons in your building or do you at least have your building to yourself?

Dr. Fan (01:57):
So I actually, I built a brand new office in a surgery center with a colleague of mine. So there are two of us plastic surgeons here in our building, but it's only the two of us.

Eva Sheie (02:07):
And you're friends?

Dr. Fan (02:08):
Yeah.

Eva Sheie (02:10):
So what do people find you for these days? You've been at this for a minute, and so I expect that you have a reputation for specific procedures or technologies. Can you tell us about that?

Dr. Fan (02:22):
Sure. So I've been practicing for about 20 years, and so I have been around for a while. As you mentioned, it has been a minute. And I think people come to see me first and foremost for the results. And I think I have a reputation for creating very nice and natural and beautiful results. I have a little bit of reputation as an artist, and I think that's first and foremost why people come to see me. I do have a broad-based practice. My specialty is cosmetic surgery, and so specifically facial rejuvenation, breast enhancement and body contouring. Those are really sort of the three biggest things people come to see us.

Eva Sheie (03:00):
And how did you land in San Francisco?

Dr. Fan (03:03):
So I came to San Francisco, gosh, 30 years ago. I came here actually for medical school. I actually grew up in the East Coast and born New Jersey, grew up in Pittsburgh, Pennsylvania, and then Los Angeles. I ended up going back east for college at Harvard and then came to San Francisco from medical school, fell in love with the area and ended up staying.

Eva Sheie (03:24):
Do you after 20 years find that you spend more time on faces or bodies or both? Is it really equal?

Dr. Fan (03:32):
It's actually both. It's about equal. Yeah. Amazing. I know I have some colleagues who end up specializing only in one sort of area of the body or one particular procedure, but I love all of plastic surgery and part of what brings me great joy is that every day I get to help people in very different ways and it keeps it sort of fun and fresh.

Eva Sheie (03:51):
Do you ever spend any time teaching, writing, studying on the other side of there's so many ways you can go in practice beyond taking care of patients? What else do you do?

Dr. Fan (04:05):
Yeah. Oh, absolutely. So first and foremost, my main focus is helping people, taking care of patients. But at the same time, I've always had a long interest in innovation. And so interesting story when I was in medical school when I came to San Francisco was actually the start of the internet, the main adoption of the internet. And I remember sitting in the computer labs of medical as literally a first year medical student and someone introduced me to Yahoo. I could think when the original search engines and I was just blown away. I was like, wow, this is so cool. And I was here in San Francisco in the epicenter. And so as I was going through my medical training, I had a second interest in technology and in innovation and doing new things. And so at one point, believe it or not, I actually had thought, gosh, do I want to be a doctor or do I want to be in technology?

(04:53):
And I had to go through a little bit of a internal dialogue with myself, but ultimately I realized there's a way for me to combine my interest in wanting to help people also with technology. So I've been working with medical device companies particularly for many years. And so I've worked as an advisor, a consultant and investigator, and I've been lucky enough to be part of some really, really wonderful projects and worked with some really wonderful people and companies and a couple of them maybe known to people in the industry, you know, Miradry for example. That's a noninvasive treatment for excessive underarm sweating a condition that's a lot more common than you might think. But I've actually helped the people who invented it from the time it was an idea on a napkin. We talked about it and helped them develop it. And so that's something I'm very proud of, that is something that's really gone on to help lots of people. I've also been an investigator with Allergan and the biggest names in our industry, and I've also helped develop new treatments for cellulite and all sorts of things. So I do do some research and development and innovation work. I do do some speaking and have taught some other surgeons as well. Definitely without a question, do something in addition to taking care of patients.

Eva Sheie (06:06):
It's fascinating to think about you being growing up in San Francisco as a surgeon while tech is also growing up right around you. I'm curious how the city has changed around you since you've started working there.

Dr. Fan (06:21):
Sure. San Francisco has always been a wonderful and a beautiful place, and it still is. And if there's one constant about San Francisco that's having a history of change, every generation fondly recalls the old days when things were a little bit different and maybe for the older people a little bit better. But new things come in and particularly since I've been here, number one, San Francisco used to be a combination of a tech hub, but also a little bit of a sleepy town, and it's become more and more developed in the technology. And one of the old mayors really changed the local landscape by bringing in a lot of the big tech players like Google and Uber and Twitter and all these companies. And so the tech presence is only increased. But one of the things I've always loved about San Francisco though, it's such a diverse and vibrant place where there's so much energy and people are always wanting to do really interesting and new things, and people also want to just live differently.

(07:15):
So I joke that San Francisco is the place where any person can be whoever they want to be, and that's okay. And that's something that's really has always spoken to me. And I think it relates to plastic surgery. It's interesting, and some parts of the country people, one thing that bothers me about our industry is that there are some very unrealistic standards of beauty, and there are some conversations around beauty that I don't think are the most healthy. But one thing about San Francisco, it is about sort of embracing your unique self, about embracing authenticity. And I think that's something that rings true here in life in general, but I think it relates to plastic surgery. My own philosophy, I really believe that everyone deserves to feel great in their own skin, but everyone is beautiful as they are, whether or not they want or choose to do any enhancements for themselves. But ultimately it's about living your best life, embracing your own unique beauty and be damned what society says.

Eva Sheie (08:13):
At least from your perspective, do you think that you see more male patients than your colleagues might in other parts of the country just because of the way San Francisco is?

Dr. Fan (08:21):
Oh yeah. Yeah, absolutely. And my own, I guess internal data reflects that compared to normally I think plastic surgery, cosmetic surgery is probably about 85 to 90% women, so much smaller percentage of men in my practice. I do have a higher percentage of men. It is still more women than men, but it is a higher percentage. And I think it speaks to two things. Number one, with San Francisco being a very developed sort of place that a lot of people who really want to live well and all aspects, and part of that includes taking care of their bodies, their appearance, wanting to look good, wanting to look and feel young. And so I have a surprising number of men in technology, for example, who really just want to live quality lives. And so they will take the time and the energy to make those investments in themselves, take care of themselves. And then second, San Francisco has always been one of the meccas for the gay population, and obviously gay men particularly do tend to take care of themselves better than the average heterosexual person. So they will also spend more time and energy investing in cosmetic services.

Eva Sheie (09:23):
Good observations. Yeah. What kinds of things do men come in asking for?

Dr. Fan (09:30):
Men come in asking for a couple of main things. So number one, men are just like women that they want to look good and look good for their age. And so men will come in requesting facial rejuvenation treatments, things like Botox and lasers and skin treatments, ways to just help them age gracefully. Second men also, they want to be fit as well, and sometimes they need a little bit of help. So they will come in and get a body sculpting treatments like CoolSculpting and Emsculpt NEO and liposuction. And then the third bucket is that some men also are just, they have physical features that bother them, whether it's just the way they were born or getting older. And so men will get things done like nose reshaping, chin augmentation, those sorts of things. And then the last thing, I'll also say that I do do some wellness and hormone optimization. And with that question, there is a whole group of men who are getting older and their testosterone levels are falling and they're feeling that. And so they'll come in and also get a boost.

Eva Sheie (10:34):
You said Emculpt NEO. Is that different from Emsculpt?

Dr. Fan (10:39):
Yeah, so Emsculpt NEO is sort of the next generation treatment of Emsculpt. So the original Emsculpt was focused solely on doing the muscle toning and strengthening. And with Emsculpt NEO, they added another sort of energy modality. And so it doesn't just strengthen muscle, build muscle, but it also reduces fat. And so you end up getting a combination completely noninvasive, build muscle, lose fat treatment, and that's one of reasons why it's become so popular.

Eva Sheie (11:09):
Someone told me yesterday that it helped, Emsculpt helped with back pain because it strengthened the muscles in the front.

Dr. Fan (11:17):
Absolutely, it can. And so one thing that's very interesting about when you think of traditional aesthetics and plastic surgery, things like Emsculpt NEO and tummy tuck for that matter, they can help to strengthen the core. And one thing that people don't spend a lot of time talking about, but I know my own patients have told me that by, for example, having a mother having a tummy tuck and getting that abdominal core tightened up, it can actually help fix the body mechanics that I've had more than a few mothers tell me after having kids, my body felt so weak, I couldn't even do a sit up or hold a plank. And after they have their tummy tucks, they're like, wow, it's made my body much stronger. I can do those things again. And others who said, I started having some back trouble, but after having the tummy tuck, it actually helped my back feel better. So strengthening the core can have a big impact on back pain as well as general strength as well as overall body mechanics.

Eva Sheie (12:09):
It was funny, it was the first time I said, oh, I should do that. I never really cared about it. I never cared about it for the other reason much. But back pain, now we're talking.

Dr. Fan (12:20):
Yeah, absolutely. One other tip that if anybody's struggling with having back pain, particularly after having kids, also Pilates and yoga and really, really focused core training can also help. There are some people who specialize in helping mothers through this, and I've had some mothers who started with that avenue and they told me it really did actually help make a difference. For some of them, it didn't do quite enough where they said it's made it better, but at the same time, I think I need more. And they ended up needing to have the surgery. But Pilates, yoga, core training can absolutely help.

Eva Sheie (12:52):
Now, Emscupt can't do anything to improve if you have diastasis recti or things that can only be fixed with surgery that doesn't exist yet, does it?

Dr. Fan (13:01):
So amazingly with diastasis recti, it potentially can help some. And with a caveat of, so I've had some mothers who have had pretty significant diastasis who've pursued non-surgical treatment including Emsculpt NEO cul sculp, NEO including specialized Pilates, and they've actually been able to get some help. I also had a patient who had Renuvion, which is the plasma tissue tightening and also got some help with the diastasis. But at the same time, if you have a wide significant diastasis, the nonsurgical treatments can probably help to a partial degree but not likely to cure the diastasis. And so ultimately surgery typically still the best option, the most effective option.

Eva Sheie (13:44):
So interesting. There's so many of these devices that take something that was already great and make it even better like Renuvion, and it seems like it's just my impression, but that you've kind of always thought about it this way because the technology was there and so interesting to you from the beginning. Can I ask you a funny one?

Dr. Fan (14:07):
Absolutely, please.

Eva Sheie (14:09):
How many of your technologies over the years turned into coat racks? Were there any good coat racks in there?

Dr. Fan (14:15):
Believe it or not, first, I'm a big believer in technology and maybe subliminally because I've been here in San Francisco, but I actually more than that believe that technology, it's a tool that can aid my ability to help people and the ability to help people achieve the most improvement with the least amount of invasiveness. To me, that's actually very powerful. I know it's something that patients want. It's something that I want for my patients. So I am very not even open, but I actually actively seek out technology. In contrast, I have some colleagues who really believe there's nothing better than surgery, and they will even, I'll hear them at the meetings kind of poo poo CoolSculpting and these things. But I know for a fact I've got thousands of happy patients who would never have ever considered surgery. And because there's something else that can help them, might not help them quite as much, but it really is a fit for them.

(15:03):
And getting back to sort of the original question, I look at technology with a very open eye, but also with a very critical eye. There are a lot of things that people have pedal that honestly I don't believe in. And I think most of us who are honest would say the same thing and they honestly don't work. And so I'm very selective about the technology that I will acquire and bring in. And so there's a lot of time spent researching and embedding any new technologies. And so out of all the things that I've acquired over the years, and there's literally been dozens of them, I've had zero coat racks. And I'll knock on wood and thank my lucky stars for a combination of good luck, but also putting in the research and also being lucky enough to have colleagues and sources of people that can help me also help sort things out.

Eva Sheie (15:49):
It's the hardest job in the world, being the rep, the rep for the technology, especially when they try to come talk to you. I think they're, well, maybe it's the easiest if they have the good stuff.

Dr. Fan (16:01):
Exactly. I think like everything in life, I think I have a lot of wonderful sales representatives that I work with closely, and the good ones are always there for the right purposes. They've got products that they know can help people, and they have a mission to help get that into the world. And so it's more than just making a sale, but it really is about being able to make a helpful impact. And when all of those things lined up, then by nature they're going to succeed in their job and have find good customers who can serve good patients with a good technology, then they'll naturally be able to earn some sales.

Eva Sheie (16:36):
What can patients who haven't met you yet expect when they come to see you for the first time?

Dr. Fan (16:42):
Where should I start? So many places to go, but what I think what might be helpful to understand is what is my philosophy of how I approach plastic surgery? And what I like to tell patients is that my philosophy of care is really grounded in the belief that each patient, their journey is unique and profoundly personal. And so what we do is, it's not just procedures, but we're actually about helping people and providing a holistic experience that prioritizes each person's wellbeing, their dignity and their aspirations. And to do that, I actually have a philosophy that has really six pillars, believe it or not. One is compassionate care, and it is understanding that people's concerns are very real and often very emotional. And so I want to approach every consultation with a lot of empathy, and I want to listen and understand what the real concerns are.

(17:36):
I want to understand the emotions behind things, and it's really important for every patient to feel heard and supported and respected throughout their journey. And then second, I want to give everybody a personalized treatment plan. So each person is unique individual, and I want to create bespoke treatment plans that really align with every person's goal and their own physical characteristics. And so it means it's not a one size fits all treatment. A lot of some clinics will treat every person with the same procedure in the same way. And I don't believe in that at all. And I think everyone's unique. And so we want to do unique procedures to be able to enhance each person their own beauty and also help make sure we're building out their own version of themselves. And then third thing is there is a huge commitment to safety. At the end of the day, safety always comes first.

(18:27):
And so we uphold the highest standards of safety in everything that we do. And that includes using technology, that includes staying abreast of the latest advancements in care, but it also includes very proactive safety measures. And then a fourth thing is a real focus on natural results in artistry and plastic surgery. There's a big part of it that's art. And I personally believe that plastic surgery should always look natural. It shouldn't ever be obvious that you've had something done. And so we want to achieve results that are not just an improvement, but stunningly beautiful, authentic to sort of each person's individuality and completely natural looking. And then the last couple of things, I also think integrity is extremely important. And so when I talk with patients, I try to be as open and honest as I can be, and I want everyone to be educated and informed and empowered, and I want everyone to have realistic expectations.

(19:24):
And so we'll talk pretty frankly about what are the benefits of every treatment, but also what are the potential risks and what typically can be expected, and also what does someone need to go through? I don't like to sugarcoat things at all. And then the last part is for myself, unlike a lot of other plastic surgeons, I have a passion for aesthetics, but I'm also a big advocate for overall health and long-term wellbeing. And so in addition to helping people sort of on the outside, I have a dedicated program to help people on the inside with things like physiology and health and wellness. And so I have programs related to medical weight loss, to armon optimization to longevity. And then also something else I spend a lot of time talking to people about is mindset. A lot of your experience of being a patient, your experience of wanting to improve yourself, there's definitely a big internal component, and I believe it's as important as the external component. So I spend a good amount of time talking with people about that and trying to help them in that way.

Eva Sheie (20:22):
You mentioned weight loss and it's impossible not to notice what's going on with medical weight loss and the use of medications like Semaglutide and Tears peptide. When did you start seeing this have an impact on patients and what made you decide to bring it in?

Dr. Fan (20:39):
Yeah, so I think the Ozempic phenomenon started at this point, gosh, it's been probably a year and a half, two years ago. And as a citizen of this world, we started hearing and seeing stories of people being able to achieve these weight loss breakthroughs that they were never otherwise able to achieve. And I've always been interested in helping people, as I mentioned, just not only on the outside but on the inside. And so as I got older, maybe partly selfishly, I started learning and really becoming an expert hormone optimization. And I began to learn about and see how it was helping thousands of women and men live better and live more healthy. And so I became an expert in that and started providing that to my patients. And weight loss falls into the same kind of category that obviously being overweight and obesity is a huge problem in this country.

(21:31):
I think the statistics show that about 75% of adult Americans are overweight or obese. So that is almost everybody. And obviously when you're heavy, it is a health issue. It is a sort of self-esteem issue, but it also affects your appearance. And so a lot of patients who want to improve their physique without question, many of them can benefit from weight loss. And when semaglutide became available, and after really studying the data and understanding and seeing how, hey, it's the first time we've had a medicine that has a very strong track record of being both effective, safe, and tolerable, that I decided I wanted to make it available to my patients. And so I started offering not just the medicine, but with weight loss. It isn't just medicine, but there are health issues, there are support issues. And so I've developed a comprehensive medical weight loss program. The medicine is one foundation of it, but health evaluations and health optimization as well as support and accountability and lifestyle and behavior modification, those are also fundamental components. So that's how I ended up getting into medical weight loss.

Eva Sheie (22:39):
And what kinds of results have you seen from your patients?

Dr. Fan (22:42):
Oh, we've seen really, really wonderful results. I've had patients who have struggled their whole life with being overweight and after going through our weight loss program, they're able to lose, gosh, we've had someone lose 80 pounds and literally 40 years of struggling. And for the first time they've told me like, oh my gosh, I feel so amazing in my body. I've never felt this way. It's a wonderful thing. And I've had other patients tell me, gosh, you know what? I haven't felt this good and I haven't loved my body this much since I was in high school. And all sorts of stories like that at the same time, it's important for everyone to know. It is very helpful. I think semaglutide and the GLP ones are already saving lots of lives and adding years to people's lives, but at the same time, it's also not a magic bullet. It's not a cure all. It doesn't happen instantly. And so people still have to take care of themselves and they have to eat healthy and they have to get some exercise, and there's some other things to do, but biggest thing, it's important to know that it is changing the face of our, there's so many people who have been struggling with being overweight, and this is something that's really sort of given people a tool to be able to help overcome this obstacle.

Eva Sheie (23:56):
There are people who are able to get a prescription just fine, but then there's big shortages, or aside from the shortages, it's still even very cost prohibitive to get the prescription. And I think we're seeing a lot of people turn to the internet to try to find it or find another way, and I'm hoping that we can do a better job making people aware that plastic surgeons are a great resource in the middle that doesn't require choosing a dangerous online source for what you want.

Dr. Fan (24:25):
Oh, absolutely. I couldn't agree with you more though that so many people can benefit from the medicine, but without question, access right now is still very limited. The medicine, it's specific patient populations are getting some insurance coverage, whether a lot of people could use the medicine that are not, and even if you do get some coverage, it is supply is very limited, so people are not able to get the medicine in their hands. Fortunately, there are some other potential avenues to be able to get some help. And going to reputable medical doctors where, and getting medical supervision, that's probably really the biggest message. This isn't something you want to just find and treat yourself, that having supervision is really important, both so that you can stay out of trouble with the medicine, but also because there are other factors that can contribute to weight gain. And if you don't have things properly evaluated and addressed, semaglutide, for example, can help you, still help you, but to a limited degree. And a lot of people will have trouble achieving success if they don't really have the right care.

Eva Sheie (25:28):
I also like to point out that you're going to have an elevated experience at a plastic surgery office that you may not have at another kind of office.

Dr. Fan (25:37):
Yeah. Well, I'd like to say that I know in my office we do care quite a bit about providing a great experience. So it isn't just, let's see how much we can help you, but at the end of the day, we want to sort of deliver as much improvement as we can. Beautiful natural results. We want to keep people safe, but we also want to make it an empowered and an enjoyable experience.

Eva Sheie (26:01):
The future is very bright here. Okay, so last question. What do you like to do when you're not at work?

Dr. Fan (26:11):
Well, I am a family man, so I have a beautiful wife and two amazing children, and they're probably the center of my world. And then if I'm not hanging out with them, I'm playing basketball. Probably the one thing that I do for myself is I'm not a young man anymore in basketball as a young man's sport, but I still play at least what I call playing and I love it, and it's my one outlet for being on the get that stress relief and to get some endorphins and also to be able to get some exercise.

Eva Sheie (26:43):
You have sharp elbows?

Dr. Fan (26:47):
Some people might say that, but honestly, no. I like to say I'm not afraid of playing hard, but without question, it's important to play fair.

Eva Sheie (26:57):
Well said. Very nice. I'm so grateful for your taking the time to talk to us today, and I really enjoyed meeting you and hearing about you. If someone is listening and they would like to reach out and find out more about you or your practice, where should they look for you online?

Dr. Fan (27:13):
Absolutely. So you can find me at www.77plasticsurgery.com. So the name of my clinic is 77 Plastic Surgery. And so one thing, I have a special gift for anybody listening. So a lot of people ask me, gosh, how do I find a good plastic surgeon? And I actually wrote an entire book about this subject. It's something that's very honest and very real and it's fairly deep. So if it's something that you're curious about and you really want to know, how do I really figure out who's the right surgeon for me and who's good and who's maybe a pretender or something, go to the website www.77plasticsurgery.com. That's the number 77, and you can find the complimentary ebook on how to find a great plastic surgeon.

Eva Sheie (28:00):
This is one of my favorite topics, Dr. Fan, and I'm going to read it myself.

Dr. Fan (28:05):
Please do. I really did write something a little bit more in depth and a little bit real, because it honestly is a hard question. And even when you Google it, you got a lot of basic answers, but there's a lot more detail in there, and so there's a lot of insight. And so please, I invite you and I hope you find it valuable.

Eva Sheie (28:20):
We're going to have to have another conversation about that. And I mean, I really do love that topic and I've spent my life trying to help people do the same thing. So let's do that.

Dr. Fan (28:29):
Absolutely. I'd be delighted to talk anywhere, anytime. I love plastic surgery. I love talking about it. I love talking with people who care about people, patients as well. And the more we can promote healthy conversations, provide honest, valuable information, I think we can help make the world a more beautiful place.

Eva Sheie (28:49):
I completely agree. 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.