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 back to Meet the Doctor. My guest today is Steven Goldman and he's a plastic surgeon in the Cleveland area of Ohio, which is one of our favorite states here at Meet the Doctor. Welcome to the podcast.

Dr. Goldman (00:44):
Thank you very much, Eva.

Eva Sheie (00:46):
Now I think we were supposed to meet in person in Miami. Were you in Miami for the meeting?

Dr. Goldman (00:52):
Yeah, I was at the meeting.

Eva Sheie (00:53):
Yeah. And we couldn't connect. So I'm very happy to have you here today. And I'd like to start with, uh, the toughest question, <laugh>, which is actually the easiest one, which is to tell us about yourself.

Dr. Goldman (01:05):
Okay. So I am a, I guess you could say triple boarded plastic surgeon. I'm based in Beachwood, Ohio, which is in the Cleveland area. I practice an almost exclusively cosmetic practice, but of the face and body. I went to college at Dartmouth College. I went to med school at the University of Pittsburgh. I did an otolaryngology, which is ear, nose, throat residency there. So I'm board certified in E N T. And then I did a plastic surgery residency at Case Western in Cleveland. So I'm board certified in that. And then I did further board certification in facial plastic surgery. But I've been in practice for over 20 years. I have a great team of over 25 people, aestheticians nurse injectors or staff. Um, we have a, an onsite two room accredited surgery center at my main office. And I loved doing reconstruction and hospital stuff, but, but a few years back went out on my own and it evolved really into an entirely cosmetic practice, but surgical, non-surgical, face and body. But love medicine, medicine's a great field.

Eva Sheie (02:14):
I look at your website and I see the whole team on the homepage. You actually have them all. So how hard is this to update every time someone comes or goes from the team?

Dr. Goldman (02:24):
Okay, <laugh>, if you're looking at the main picture where, where there's a whole bunch of people, it's a composite. So we're not really deceiving anybody, but as, uh, as you add people, you can't bring everybody together easily. They've all got lots of work to do. So you take a picture and then you add it to the main picture.

Eva Sheie (02:43):
How long are you gonna keep this up?

Dr. Goldman (02:45):
As long as I can <laugh> God, God willing, if my, you know, it's all, it's all about health and uh, happiness and so hopefully many years yet.

Eva Sheie (02:54):
And uh, we may need a wider screen at some point because it's quite a team looks great.

Dr. Goldman (03:00):
No, they're great people, right? So the most important part of any medical practice is the people, it doesn't matter how nice the hospital or the facility looks on the outside, they used to talk about the three A's in medicine, availability, ability and affability. And I think all the people who work for me really embody the three A's, right? So they, they make themselves available to the patients. They're very able, capable, competent, skilled, and they're friendly, communicative, genuinely good people. So it's the team, they're a great team.

Eva Sheie (03:32):
It's unusual to run into someone who has three board certifications and usually it means that you really like going to school, <laugh>

Dr. Goldman (03:41):
Hate school. <laugh>

Eva Sheie (03:41):
But what does it mean <laugh>? What does it mean for the patient that you have gone through that process three times?

Dr. Goldman (03:51):
I think it means a couple things. One is there is some legitimacy to having uh, real board certification going through real training going through rear real schools. And the legitimacy derives from not just the education in terms of book learning, but also from the clinical experience. So in a hospital, in an operating room, seeing patients in an office. And while I think accolades only really mean so much because once a patient meets a doctor, then they'll make a decision as to whether or not that doctor makes sense when they're talking about medical issues. You know, seems to be genuinely interested in giving them a good result and taking good care of them and is communicating well. But honestly that's just a foundation, right? So three boards I think show that you have a legitimate foundation. But I think in reality, patients care more about your recent history, you know, what are your results, what's your reputation, who do you keep around you? So if a doctor's a great doctor but their staff, you know, isn't responsive or their website is out of date, then it calls into question their executive functioning, their their organizational skills, right? So, so I think recent history matters more than the boards and the education, but for sure the boards and the education are very important.

Eva Sheie (05:14):
That's well said. We as consumers do not have the skills to evaluate surgeons for their surgical skills. So we end up substituting things that we do understand, which are things like the staff, which isn't always fair to the doctor, that we're judging you by the people who represent you. But the space, the environment, the location, the website, we take all the things that we do understand and we use those to make better decisions. So that's why they're important.

Dr. Goldman (05:46):
And you know, obviously today social media is a big part of it. I think social media has to some degree supplanted websites as far as patients sort of gauging legitimacy. And as we all know, you know, social media and the internet in general can be the source of misinformation. So you still ultimately need to interact with real people. You can interact virtually by the way, with real people as long as they're not AI generated. But you know, and that doesn't just include the doctor, that can be the doctor's staff, but you need to interact with real people in order to filter all that information cuz there's so much information and patients are smart and patients have common sense and they don't need a medical degree to see if something makes sense. And a lot of times by the time patients get to us, they've gotten great background information.

(06:40)
Sometimes some of it is incorrect, some of it, right. And there are even doctors out there who will say, hey, this technique is the, is the latest and greatest technique, but I may disagree with that. Right? So then my responsibility to the patient is communicating why I think that's not correct and another option is better. So that ultimately again becomes part of that whole educational process for a patient. So I think social media has made, and the internet research have made patients better patients, but you know, all you have to do is look at issues relating to vaccines or something to know that you still need some common sense guidance from people who have some, some sort of training.

Eva Sheie (07:24):
Mm-hmm. <affirmative>. Yep. Social media is tricky and I think people can be pretty forgiving, especially if what you're doing is authentic. And I, I've seen a line crossed from time to time where either a patient was posted without their permission or a patient was maybe gave permission but wasn't featured in the best light. And I wonder if you've seen that happen before? Do you have any thoughts on that?

Dr. Goldman (07:50):
No, no. For sure. So there was, you know, there was a doctor in Ohio that lost their license recently within plastic surgery. And one of the reasons was that patients were being presented on social media without their consent or in ways that they haven't approved of. And so I think ultimately it may work for a small niche of people in medicine to use social media almost as entertainment more so than as medical education and information. But I think most patients, even if they want some entertainment value out of their physicians on social media, I think they still want information the most, they still want education the most. And our philosophy is be friendly and accessible, but we're not gonna dance around while we explain a procedure or discuss a post operative result with a patient. And I also think patients want to hear from real people. They want to hear what the patient has to say lots of times more than what I have to say. So if somebody's a month out of a rhinoplasty and they're in our, and they've agreed to do a video to post, I probably don't do a good enough job letting them speak more than me because patients really want to hear what their experience was like and they wanna see their results.

Eva Sheie (09:07):
Definitely. Now how are your dancing skills?

Dr. Goldman (09:11):
Yeah, I grew up in Chicago, so they're pretty good. <laugh>

Eva Sheie (09:14):
Is that something people learn in Chicago <laugh>?

Dr. Goldman (09:17):
No, I dunno. So I, I it's, yeah, I mean I'm, it's something that my staff really doesn't get to appreciate from me that much, but I think they're pretty good.

Eva Sheie (09:28):
I think we could arrange something.

Dr. Goldman (09:31):
Yeah. Well maybe down the road.

Eva Sheie (09:33):
<laugh>, You have more training in, uh, the face than just about anyone I've ever spoken to and probably 20 years of experience on top of the training. Are you still focused on face procedures and nose procedures?

Dr. Goldman (09:51):
Yeah, what I enjoy about my practice and perhaps being in Cleveland versus, you know, Manhattan, I can focus on cosmetic surgery and the principles that apply to a rhinoplasty or a facelift overlap and are sometimes the same as the principles that apply to a tummy tuck or a breast lift. So by focusing on cosmetic surgery, I can do face and body and I definitely focus on the face, especially rhinoplasty and facelifts and you know, many of my well-trained colleagues who just work on the head and neck will do both reconstruction and cosmetic work as I used to do. But I think by focusing on cosmetic procedures, I can do face and body and, and get a lot of benefit out of kind of learning from the different procedures what I can apply to optimizing my procedure in any part of the body.

Eva Sheie (10:46):
Is there anything that you don't do?

Dr. Goldman (10:49):
So, you know, I do think you wanna focus on certain things. So like I'll do uh, gluteal augmentation, but it's not a focus. I don't do a lot of that, you know, at this point I don't really do any facial trauma and stuff anymore. I've done a lot of facial trauma and a lot of breast cancer reconstruction in my career and I love doing those things, but I don't really do those anymore.

Eva Sheie (11:10):
If an existing patient ran into an issue and had a facial trauma, they could still reach out to you though.

Dr. Goldman (11:17):
Yeah, that's the basic connection now is that if somebody who's either an existing patient or a friend or family member, then they'll reach us through those kind of roots and then I, I'm happy to help them if I can.

Eva Sheie (11:30):
What made you wanna be a plastic surgeon?

Dr. Goldman (11:33):
Hmm. So, you know, I went into medicine trying to keep an open mind, but thinking that I might want to do something in surgery, knowing that I definitely wanted to interact with patients and not be like a, nothing wrong with being a radiologist or a pathologist, but I wanted, I wanted to interact with patients. And so by the end of medical school I liked ear, nose, throat, head and neck because the anatomy was complex, the technology was really cool, cool instrumentation and there was a variety, you know, ears, ear surgery, pediatric surgery, nasal surgery, cancer surgery, um, there's even immunology and neurology in there. So by the time I was done with my E N T training, I gravitated toward the plastic surgery, both reconstructive and aesthetic procedures in the face. And as I looked at pursuing that, the options were to either stay in the head and neck or do plastics in the whole body and the head and neck. And I just felt like I didn't want to be limited to above the collarbones. So I did a second residency, but I still wanted to focus on facial stuff. So I also ultimately got board certified in facial plastics, but I, you know, now probably facelifts, rhinoplasty, anything, breast and tummy tucks are probably my four main niches. But I still, I feel like a variety keeps our brains young in plastic. So I like doing a lot of different things including non-surgical stuff.

Eva Sheie (13:01):
Isn't a residency like five years?

Dr. Goldman (13:03):
So ENT was five, plastics was two, and at that time you had the option of going right out of medical school or to plastics or from another residency like ENT to plastics. That still exists. But most plastics residents go outta medical school and do six years now.

Eva Sheie (13:20):
Got it. It's a long time. So you were saying you even like to do non-surgical and I, I recently have landed myself on the idea that probably just gonna let facial plastic surgeons do my Botox and injectables in the future.

Dr. Goldman (13:37):
So, you know, it is interesting because if you look at anything except surgery within the cosmetic field, there's been a huge proliferation of medical spas and there are constantly articles that come out to discuss whether or not, you know, these are, are legitimate and I think many of them are good people running them and involved, but there's a huge range of the degree of supervision by actual physicians and it really used to be a debate of like whether or not you'd have a facial plastic surgeon or a plastic surgeon or maybe an oculoplastic surgeon or a dermatologist do injections. Now it's like the debate is, do you do it in a strip mall with a nurse <laugh> or do you do it in a doctor's office? So I have a pa, a nurse practitioner and two nurses, all of whom who do injections and they all do a great job.

(14:28)
And I think the reason they do a very nice job is because they're well trained by me and we get them all sorts of other opportunities to get education and training and they educate each other. So we all, and I learn from them the same way they learn from me as soon as, as soon as they get good, but because they're adequately trained and that includes sort of surgical mentality, right? Watching out for complications, being really thorough with analysis, not overdoing it. There are all sorts of, you know, along with these questions of what is the degree of supervision in certain spas out there. Cuz again, some well supervised, some are not, is the way Madonna looks today, you know, is that aesthetic or not?

Eva Sheie (15:12):
Yeah. Whose fault is that?

Dr. Goldman (15:14):
Well, and it's, and there are people who cry misogyny and I think you can just ask without picking on anybody, even if they're a celebrity, you can ask what is the standard of beauty? And for sure there is not one standard of beauty and there's all sorts of variation in terms of individual variation, ethnic variation, personal choice, variation, age variation, right? So there is no one standard of beauty, but I don't think, you know, I think the average person doesn't wanna look conspicuous or what is normal. There's no normal, but they don't wanna look weird. Right? The average person wants to

Eva Sheie (15:50):
Well that's what's wrong with Madonna. She does, she looks weird. It's not just her face, it's her hair and those weird braids and her clothing. And I think what made it even worse was that 10 or 15 years ago she looked gorgeous and it, we all were debating whether she was using s sculptor 15 years ago because her face looked so great.

Dr. Goldman (16:13):
Well, you know, without picking on any one person, it brings up age, right? There are people who look great at a certain age and then as they age, they don't age well. And part of a good physician's responsibility, whether you're a plastic surgeon or whether you're an injector, is really trying to make someone look aesthetic. And part of that is trying to make them look youthful. But if you do too much paradoxically, you start making, look, people look old. If somebody has a tight facelift at a young age, they're gonna look older than they were before the facelift because they look like they've had a facelift instead of just looking refreshed. Right? So in the same is true of fillers, you pump somebody up with so many fillers that everybody knows that they have fillers in their face, whether or not they're consciously aware of it, they know that, that look, then that person paradoxically looks older, not younger. So, you know, that's part of the training that whether it's nurses or PAs or nurse practitioners or me in the office, you really, you really want everybody to, to have that kind of perspective. It's part surgical, it's part aesthetic, it's part ethical.

Eva Sheie (17:23):
What's your advice to us about how we can avoid ending up in that situation?

Dr. Goldman (17:29):
Okay, so one, one piece of advice would be to find a doctor or an advanced provider who you do feel is trustworthy and has a good aesthetic eye and not jump around too much because one of the things we'll find with people who end up looking overdone is if you tell 'em, Hey, this is enough. They may go somewhere else and anybody will inject or do surgery. There's always somebody who will do it for money, right? So not jumping around is often a good way to be consistent and have a good aesthetic look over time. And then the other piece of advice would be not to lose the forest for the trees, right? Not to, Hey, I'm gonna fill up my cheek because I see a wrinkle under my eye, right? So fill up the cheek, sure, but don't overfill it because the wrinkle hasn't gone away completely.

(18:23)
We have so many tools, whether it's skincare or lasers or injectables or non-surgical tightening or surgery, right? That that you really ought to be able to get a dramatic but natural result, right? A result that looks like, like it's you and people don't know, you, know that you've had something done. It's okay to have them wonder, right? Say wow, like does she have sculptor in her face because you know, she looks great for age or him, but to have them know, you know that wow, that's a lot of filler in your cheeks. And again, even if people don't know, they see that look and they know something's going on and it, it's not aesthetic. So not focusing on minutiae, not losing the forest for the trees and being consistent ideally with somebody who knows what they're doing, who guides them through the process because we, nobody knows how they really look. Everybody thinks they could be thinner, everybody thinks they, you know, their skin could be tighter, right? So nobody has accurate self-image.

Eva Sheie (19:23):
That's so true. And really all you need to ruin your self-image is a toddler with a phone standing way below you taking pictures of you from beneath.

Dr. Goldman (19:31):
Or wait till they say, boy you look tired today. <laugh> like,

Eva Sheie (19:36):
Yep

Dr. Goldman (19:37):
Kids, they're brutally honest, they're brutally honest.

Eva Sheie (19:40):
Yeah, I guess, yeah, that's one way of looking at <laugh>, that relationship is so important. And I love what you said about not jumping around.

Dr. Goldman (19:49):
Yeah. Not that people can't seek second opinions or you know, especially if they're contemplating surgery from someone they have only met once, right? Second opinions are great, I never discouraged that because you get more information and no doctor or injector should be afraid of people getting second opinions. But people bounce around when they don't get the answer they want. And they'll do this with non-cosmetic things. You know, if somebody wants some kind of medical workup or something ambiguous, they'll go find a doctor who tells them what they want to hear. And that may not always be the best thing for them.

Eva Sheie (20:20):
Maybe a tangent, but I was reading yesterday that there's a whole set of talks out there that if you want Adderall, they'll teach you what symptoms to say that you have in order to get the online prescriber to give it to you.

Dr. Goldman (20:33):
Yeah.

Eva Sheie (20:34):
What are the trigger words?

Dr. Goldman (20:36):
No, it's hard. It is a tangent. But you know, the more data there is and as one potential benefit of AI would be to try to really as objectively as establish criteria for who needs Adderall, who needs a tonsillectomy, right? And for sure there'll be strides that can be made with chemotherapy regimens by taking thousands of data points and putting 'em together. But even, you know, something like Adderall, if we can try to make it objective because whether it's surgery or something like that, you go to two different doctors and you will get two different opinions and it's hard for patients. You ask a doctor who to go to in a different field and they often have trouble telling you, right? It's hard to find people that you really, that you really trust. But there are a lot of good people out there. There are a lot of good providers out there.

(21:24)
But as far as aesthetics, the emperor's new clothes is a great analogy for aesthetics. There are a lot of things that come out and people rave about them and then a short time later they're done. Whether it's a surgical procedure or a specific filler or especially especially a technology. And so data, you know, will really help that. So if you could really get everybody doing cool sculpting, everybody doing soft wave, which is an ultrasound skin tightening thing, everybody to accumulate their data, you could get very objective data about where this works the best, where it doesn't work, who's a good candidate, who isn't. Now doctors do that with their own big brains getting a sense of who really is a good candidate for a procedure, surgical or non-surgical and who isn't. And analysis and synthesis is a huge part of medicine.

Eva Sheie (22:15):
I'm picking up a theme here of honesty and also your, you seem very pragmatic to me and I wonder what else patients could expect from you when they come in to see you.

Dr. Goldman (22:28):
Well I mean, so first of all, when you have a consultation with a patient, the first part is communication, finding out what's bothering them, why are they here, right? Why weren't they here five years ago? What's changed? Right? So weight loss, couple kids now they have time. So the first part is getting a good sense of what's bothering them and sometimes patients are very clear on it and sometimes they're not as clear on it. And then the second part is analyzing their physical characteristics. If they feel like they're showing signs of aging in their face, are they bothered by their jowls? Are they bothered by their waddles, their submental neck, right? So and then analyzing, are those really the issues? And then it's coming up with a treatment plan. So if what they really have is sun damage and no waddle, then they're great candidates for skincare with a retinoid and other things like sunblock, like antioxidants, but laser resurfacing, right?

(23:24)
And within laser resurfacing, do we use co2, do we use erbium? Do we do something in the OR, do we do something in the office? Are we more or less aggressive? Even if you wanna be more aggressive, are they a good candidate for that? Even if you wanna be less aggressive, do they want more aggressive and is it legitimate to use that for them? So treatment plan or do they really need a facelift to correct their jawline and neck and midface? So it all those things. And because we do have so many non-surgical tools, the botulinum toxins, the fillers, the technological devices for tightening and fat reduction and stuff like that, then you know, it can get overwhelming for a patient to discuss everything. So you wanna focus on the things that are the right options for them. And then you don't want to talk anybody into anything. Like they if, especially if it's surgical, they have to be decisive, they have to want it, right? If they're not sure then try less aggressive things and see how they respond to that first. But a lot of analysis goes into getting a good result, not just the technical execution of the procedure.

Eva Sheie (24:34):
Is there anything you wish patients knew before they came to see you?

Dr. Goldman (24:39):
You know, we could <laugh>, we could do a better job always of getting them information before they come to see us, right? So one of my aspirations that I never quite really get done enough is putting out educational material for the patients so that they can learn about the options. Because there are times when patients come in and they've done their homework and they pretty much know what they want and they're accurate about choosing what they need. So that's probably what I, what I would do more. And of course to keep growing cuz we need a bigger picture of all the staff.

Eva Sheie (25:13):
Right? <laugh> That's right. Wider monitor. Yeah. What do you like to do when you're not at work?

Dr. Goldman (25:20):
So I'm big on family, right? So I have four kids, two dogs, a boss at home who's nice to everybody else, but she's really hard on me. <laugh>, no, I'm just teasing. No. So I love doing stuff with, with my kids who only one is still in high school and the dogs are not well behaved and they're a lot of fun.

Eva Sheie (25:39):
So you've launched three of them and are they all still around, around home?

Dr. Goldman (25:44):
No. So only one is still in Ohio right now and he's got one where you're of high school. So we're trying to get him to skip that so we can have peace and quiet. No, he's good kid. And then, you know, as far as other stuff, I like physical activity, right? A little bit of that ADD thing going probably, but I like to be outside.

Eva Sheie (26:05):
Any plans to go back to school for anything?

Dr. Goldman (26:08):
Nope. No. I mean, so school, I mean I, I joke that I hate school. I honestly think there's too much school. I think we're making doctors spend too many years in school and not just doctors, pretty much everybody. I think if you look at college, right, like why do we do it like that? I'm not sure we should be doing it like that. I think public service should be part of the process of going from childhood to adulthood and I think that would save people money, it would give them life experiences that would help them make better career decisions but also help improve the world a little bit. So school is absolutely valuable and education is critical and everybody should be literate and everybody should be well read but

Eva Sheie (26:49):
And play outside.

Dr. Goldman (26:50):
Yeah. But I'm not sure if school is, is hasn't been overemphasized. It's too much of a hurdle. Right. And we're having, we're having kids stay in school too long. Yeah, that's not plastic surgery information though. We, we digress. But it's fun to digress.

Eva Sheie (27:07):
It's fun to get to know you a little bit too.

Dr. Goldman (27:09):
Sure. I appreciate that.

Eva Sheie (27:11):
Any sports teams that you love there in the Cleveland area?

Dr. Goldman (27:15):
You know, so I did grow up in Chicago so I have a little bit of loyalty to like the Cubs, but I really like The Guardians, which is the Cleveland's baseball team now. And I really like the Cavaliers. They're a lot of fun to watch. And the Browns, I mean I still probably do more bears than Browns actually I have in Pittsburgh for nine years training, so I'm probably more of a Steelers fan than any other football team. But I think people should do sports, not just watch sports, right? Like they should get out there and it doesn't have to be necessarily even like playing football. They should be out there in the woods hiking and stuff.

Eva Sheie (27:47):
Tell me your favorite thing about Ohio.

Dr. Goldman (27:49):
The people. I was just talking to somebody who, whose neighbor just moved here from big city and she had to get used to like waving to her neighbors. But now that now she really likes how people say hello to each other. I mean I walked, I got out my car this morning and my neighbor was getting into his car and we had a pleasant little chitchat and both went off to work like in the movies. But I think it's hilarious because people think like even when I was in like in college, people thought that Chicago was full of people walking around in overalls, right? <laugh>, Like my do my daughter's in, in Philadelphia and like people are like, you know, like just picture all of Ohio including the bigger cities being farmland, right? Like 2% of America is farmers now. It used to be like whatever it was during the Revolutionary War, 90%. But so it's just funny cuz people do think of Ohio as like it's all farms and we love farms. I love hiring anybody who grew up on a farm from whatever state they grew up cuz they all know how to work hard. But no, Ohio's mostly cities, just like every state.

Eva Sheie (28:55):
If somebody's listening today and they wanna come see you, where should they look for you online?

Dr. Goldman (29:00):
Our website is dr goldman.com, so you know, www dr goldman.com. That's probably the easiest way to start and from their phone numbers, contact forms. But, uh, we love virtual consults. I mean, honestly, virtual consults are a totally legitimate way to initiate the plastic surgery process. So I do think if somebody comes from out of town for surgery, the hardest part of that is long-term follow up. And I'm not a big fan of assembly line plastic surgery, you know, these, these strip mall places in in Florida have, and California have been, uh, regulated heavily by the states because of complications. And I'm really not a fan of people leaving the country for plastic surgery, not just because of, I don't think it's a big percentage of people. So it's not competition I just worry about about complications, but at any rate, hit the website and virtual consults are a great way to go.

Eva Sheie (29:54):
I will make sure I link that in the show notes and I really appreciate you taking the time to share yourself with us today.

Dr. Goldman (30:01):
Thank you Eva.

Eva Sheie (30:06):
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.