Dr. Sheila Nazarian

Guy Kawasaki:
Hello. This is Guy Kawasaki, and this is the Remarkable People Podcast. Today's remarkable guests is Sheila Nazarian. She is a plastic surgeon in Beverly Hills, California. She was born in America and then returned to Iran with her family. When the Iranian revolution occurred, she was smuggled out in a vegetable truck through Pakistan. She attended Columbia University in New York. She graduated with a BA in economics and a pre-med concentration. Then she studied medicine at the Albert Einstein College of Medicine at Yeshiva university. Her plastic surgery residence was at the University of Southern California. She also earned a masters in medical management at USC's Marshall School of Business. She operates a medical practice called Nazarian Plastic Surgery, and she markets a line of organic skincare products. In short, she's both a doctor and entrepreneur. In this episode, we cover topics such as how to pick a plastic surgeon, who should and who should not get plastic surgery, and the relationship between confidence self-esteem and beauty.
This episode of Remarkable People is brought to you by reMarkable, the paper tablet company. Yes, you got that right. Remarkable is sponsored by reMarkable. I have version two in my hot little hands and it's so good. A very impressive upgrade. Here's how I use it. One, taking notes while I'm interviewing a podcast guest, two, taking notes while being briefed about speaking gigs, three, drafting the structure of keynote speeches, four, storing manuals for the Gizmos that I buy, five, roughing out drawings for things like surfboards, surfboards sheds and office layouts, six, wrapping my head around complex ideas with diagrams and flow charts. This is a remarkably well thought out product. It doesn't try to be all things to all people, but it takes notes better than anything I have used. Check out the recent reviews of the latest version. I'm Guy Kawasaki, and this is Remarkable People. And now here's the remarkable Sheila Nazarian. Do you identify as Persian, Iranian, Jewish or American or all of the above?
Sheila Nazarian:
I think all of the above. Persian Jew is typically like when people ask me, "Where are you from? Where do you come from?" I was born in America, I was an anchor baby. My mom came here when she was nine months pregnant and had me.
Guy Kawasaki:
I was going to say it. Yeah.
Sheila Nazarian:
Yeah. Duh. She just literally flew, and I think I was like a month late being born, but they just wanted a US citizen.
Guy Kawasaki:
So wait, your mom comes to America, you're born, and then they go back to Iran-
Sheila Nazarian:
Yeah.
Guy Kawasaki:
... and then the regime changes-
Sheila Nazarian:
The revolution started. Yes, I was born in [crosstalk 00:02:58]
Guy Kawasaki:
The revolution started.
Sheila Nazarian:
Mm-hmm (affirmative).
Guy Kawasaki:
And then you're smuggled out in the back of a truck covered with corn into Pakistan.
Sheila Nazarian:
That's right. That's right. Yeah. So we went to a bazaar and they put us in the back of a truck. And I remember there was little stakes coming out like little metal stakes, because I guess that's what they would tie the rope to whenever they had to transport vegetables. And so I remember one of the stakes was going up into my ribs and I was 6, 7 years old at the time, and I told my mom and she was like, "Shh. You have to be very quiet." So they got us over the border in that way. And then we made a stop where we transferred to a pickup truck. But we went to this, almost like a clay shack, where that was that toilet, there was a big hole in the ground and you basically had to straddle it. So I was too small, my mom had to hold me over it to go to the bathroom.
Guy Kawasaki:
Or you'd fall in.
Sheila Nazarian:
Yeah. You'd fall in. And while we were in that bathroom, she told me, "Now we're going to America." And I just remember being like, oh my God, we're going to meet Michael Jackson. Because she didn't tell me before that because I would have told my friends and that was dangerous. That could have been life or death. So she didn't tell me until we'd actually made it across the border.
Guy Kawasaki:
How do you feel about the current relations between Iran and the US?
Sheila Nazarian:
I think the people of Iran aren't very happy. I think that's clear. I think the government is not what's best, and I think taking a heart stake on that government is probably the best way to go.
Guy Kawasaki:
If an American were to fly into Tehran today, would you feel like there's anti-American sentiment or is it just our two governments?
Sheila Nazarian:
No. They love America. It's the government. Yeah. I know the people of Iran love America. And-
Guy Kawasaki:
I've heard that.
Sheila Nazarian:
Yeah.
Guy Kawasaki:
Yeah.
Sheila Nazarian:
Yeah. It's beautiful there too. It's beautiful. It's such a shame.
Guy Kawasaki:
So if we could just get the governments together, the people are fine?
Sheila Nazarian:
Yeah.
Guy Kawasaki:
Isn't that always true?
Sheila Nazarian:
It's so true.
Guy Kawasaki:
Yeah. So, plastic surgery. First question, is it accurate to say that plastic surgery more or less got its start because of wars?
Sheila Nazarian:
It is, actually. It's been happening for a very, very long time. Like the ancient Indians, there's actually evidence that they were doing those jobs, and there's a picture of a guy, it's like an old, old painting, a picture of a guy holding to the post of a bed while some guy's coming at him with a chisel. So I think beauty and that sort of body modification has been a thing for a very, very long time. But I think modern day plastic surgery, yeah, it got its origins from reconstructing soldiers. Who'd been injured in war.
Guy Kawasaki:
And do you think today just statistically, is most plastic surgery, reconstructive or cosmetic?
Sheila Nazarian:
I think the majority is probably still reconstructive. But being a good reconstructive surgeon means understanding aesthetics, and being a good aesthetic surgeon means having training in reconstruction and knowing that you can fix anything, any complication. Or if you've reconstructed a breast from scratch, doing your breast augmentation's not going to be as difficult. And vice versa, knowing what a nice breast looks like after it's been aesthetically modified allows you to make a better reconstruction after cancer mastectomy, things like that. So I think the two go very much hand in hand and have very similar effects on people actually.
Guy Kawasaki:
Does it irritate you to think that people think of you as a "Beverly Hills plastic surgeon" and that it's all about giving stars treatment as opposed to reconstructive and changing people's lives?
Sheila Nazarian:
No. Not at all. I think that's why Instagram's there. And I think that's why I've been so focused on branding myself. And the show that we put out on Netflix really, I think spoke to the fact that it's not just about stars and the reason why the majority of people, not to their own fault, I think that's just what's been put out on media. A sort of this sensationalized view of plastic surgery, about people looking like clowns or really just exaggerated results. Where I think what I always tell my patients is you don't realize that people that look good. If you saw somebody walking down the street, they might've had plastic surgery from head to toe, but if it's natural, you would never know, you'd be like, "Oh, they're so lucky," or "Wow, they age so well."
But no, I think these things, Beverly Hills plastic surgeon, and putting people in that box is for people who just haven't learned enough about it. And I think that was the major things that I wanted to accomplish with the show, is showing people that no, plastic surgery is for everyone. And whether you're getting a breast reconstructed or a mommy makeover, the results can be equally as gratifying and improving quality of life for people. It can have ripple effects to everyone that person comes into contact with.
Guy Kawasaki:
Why do people come to you? Is it for making something good even better? Or is it making something that's bad acceptable? Or what's in their brains when they come to you?
Sheila Nazarian:
I think it's a little bit of both. And I don't think there's any shame in either. People come to be optimized, and people come to be their best selves, whether that's mental health or emotional health or becoming a better leader or looking and feeling your best. I think all of those things go hand in hand. So what we've put out on our branding and marketing online is very secure woman or man who has their together, to be honest with you, and this is just one thing that they've been working on, that they can accomplish on their own and they just need a little bit of help. The way that I look about it, it's no different than a life coach, it's no different than a therapist and it's no different than eating better. It's all self-care.
Guy Kawasaki:
And what do you think is the relationship between beauty and self-esteem?
Sheila Nazarian:
The relationship with beauty and self-esteem have gone hand in hand forever. There's like [inaudible 00:08:55] rubbing olive oil on herself back in the day. There has been studies, I remember seeing like a 60 Minutes maybe 15 years ago, that this teacher walks in to a kindergarten class and says the same line in the same tone of voice but she looks a little disheveled, she leaves, same actor comes back, repeats the same lines in the same tone, but she looks well put together. And they asked the kindergarten students, "Which teacher was nicer?" And they said, "The second one." "Which teacher did you like better?" "The second one." So there's definitely these relations. We're built like that, we're hardwired like that. And I always tell people, and I was just speaking to somebody else about this, beauty on the inside and the self-esteem on the inside matter. If you're getting surgery to make you happy when you're not already happy, it's not going to work. You have to be happy. You have to be grounded. You have to know who you are and that you just need help with this one little thing.
Guy Kawasaki:
Do you think that self-esteem causes beauty or beauty causes self-esteem?
Sheila Nazarian:
I think they go hand in hand. It's like saying work-life balance. You know, Guy? Is there a work-life balance?
Guy Kawasaki:
No.
Sheila Nazarian:
You spend more severe time at work, so you better love your work if you want to love your life. So it's the same thing.
Guy Kawasaki:
So if I were to ask you, what is your product? Is it beauty or self-esteem?
Sheila Nazarian:
No, it's confidence.
Guy Kawasaki:
It's confidence. And the confidence comes because of the physical looks?
Sheila Nazarian:
I think the confidence comes about how you feel about yourself in many aspects. I think if you have a totally messed up life and you look completely beautiful, you're not going to be confident. And it's vice versa as well. And beauty can mean different things for different people. The way that we put ourselves out there has natural results always. We always put out a powerful vibe, we always put out a confident vibe and natural results above everything else. So for example, in my practice, Guy, we never get people walking in with a picture of a celebrity ever, ever. Our breast implants are the smallest size always. So it's always just people wanting to look natural, but optimizing something that they can't work on themselves.
Guy Kawasaki:
So you probably don't think that plastic surgery can "fix somebody" and make them happy, right? It starts within?
Sheila Nazarian:
Of course. Yeah.
Guy Kawasaki:
So what happens if you meet somebody who's not happy within and says, "Give me plastic surgery so that I can-"
Sheila Nazarian:
I send them to a therapist.
Guy Kawasaki:
You do?
Sheila Nazarian:
Yeah. I do.
Guy Kawasaki:
You turn them down and send them to a therapist?
Sheila Nazarian:
100%. And I've only had one person in my entire career get upset about that recommendation. Everybody else says, "Oh my God, thank you so much. You're right. That's what I should be spending my time and money on." And when they're ready, they'll come back. But if I don't think they're happy, I want to sleep well at night too, I want to go to bed ... I want happy patients. I want patients that are writing those five-star Yelp reviews. So if I don't think that I could deliver that because that person has issues beyond my control, I will turn them down.
Guy Kawasaki:
Would you say that that attitude is typical of plastic surgeons or is just a Sheila thing?
Sheila Nazarian:
I think it's becoming more typical, but for a long time it was a Sheila thing.
Guy Kawasaki:
Yeah. Yeah. Do you think of yourself as a life coach, a therapist or an artist?
Sheila Nazarian:
All of the above. All of the above every day.
Guy Kawasaki:
Every day?
Sheila Nazarian:
Yeah.
Guy Kawasaki:
If you go to Santa Monica Mall or something, and when you look at people, do you think, oh my God, what I could do for you? Or can you ever turn it off?
Sheila Nazarian:
I can turn it off.
Guy Kawasaki:
Yeah?
Sheila Nazarian:
Yeah. I can turn it off.
Guy Kawasaki:
Or what do you say to detractors who think that plastic surgery is superfluous and a poor use of medical expertise and resources?
Sheila Nazarian:
Everyone, Guy says that until their kid falls and hits their head and needs stitches, and guess what they ask for when they're in the emergency room.
Guy Kawasaki:
Okay.
Sheila Nazarian:
They asked for the plastic surgeon.
Guy Kawasaki:
Is that literally true? That's-
Sheila Nazarian:
It's literally true. Everyone pooh-poohs plastic surgery until they need it.
Guy Kawasaki:
So that woman in the Netflix series who was shot nine times. Okay.
Sheila Nazarian:
Katrina. Mm-hmm (affirmative).
Guy Kawasaki:
Yeah. So Katrina. That was miraculous. That has to be an extreme case, right?
Sheila Nazarian:
Yes and no. Once you hit a certain level of people knowing who you are, you start getting cases that are more difficult. And I just did a lady who had had nine abdominal surgeries for a perforated diverticulitis that had to leave her abdomen open. She had all these scars on her belly going up and down, underneath that were placed there over the years to save her life and no plastic surgeon would operate on her because they said it was too risky the skin's going to die. And she's this young, single woman who's just like, "I can't live my life like this." So helping people like that is actually really gratifying. Or the extreme weight loss patients that just have tons of skin hanging everywhere, they can't even do a plank without their belly skin rubbing on the floor. Those types of cases are so gratifying because you just took someone who is completely non-intimate, won't get naked even in front of their husband and you just gave him a second chance.
Guy Kawasaki:
So I obviously watched the Netflix, and-
Sheila Nazarian:
Did you cry?
Guy Kawasaki:
I got to tell you, first of all, I had to avert my eyes. Sometimes when ... Wasn't there a scene where you said, "Okay, this is like two and a half pounds of fat we took off this person." Oh man.
Sheila Nazarian:
Yeah.
Guy Kawasaki:
Geez. And that's what it's like? You just go in there and ...
Sheila Nazarian:
Yeah. I think in training, you're kind of made into a little bit of a robot in the sense that you have to shut empathy off a bit in order to be able to cut people. But at the same time, if I don't cut them, they're not going to get better. I think that 2020 gave me a little bit of a pause and gave me the time to feel again and to look around and see the hurt that other people are going through. Whereas up until 2020, I think I was so laser focused on success and goals and achieving, that I had shut everything out other than what I had the emotional capability to take on at that time, which was like my kids and my husband basically. So I think now I feel a little bit more and I take time to look at my surroundings a little bit more rather than just being focused on my patients, my family and my practice.
Guy Kawasaki:
Do you ever maintain contact with your patients later?
Sheila Nazarian:
I do. I actually give all my patients who operate on my cell phone number. Because I want them to not Google something and do something dumb, I'd rather just have them text me and I tell them what to do.
Guy Kawasaki:
In the case of Katrina, obviously she had plastic surgery before, and why was it so botched? I mean, what-
Sheila Nazarian:
It wasn't plastic surgery, actually. The procedures she had before were to save her life. It's not botched. And I hate that word. Oh, I hate that word. It's just because now everybody's using it and it's like, listen, a surgeon tried their best and this was the result. That doesn't mean you're botched. It's just the priorities were different at that time, they had to stop the bleeding. They had to stop and save her life.
Guy Kawasaki:
Okay. Fair enough. But what about the woman with the acne? Didn't you and your nurse undo a lot of stuff?
Sheila Nazarian:
No. So what happens a lot of times, Guy is that there are a lot of very expensive devices on the market. So one laser may cost me anywhere between 100 to $400,000 to purchase. So a lot of doctors, what happens is that they'll get one laser because that's all they can get and they'll apply that, everyone's a nail and that's their hammer. And what happens is there's lasers that are better for lighter skinned people, and there are lasers that are better for ethnic and darker skinned people. And when you use, I call it like a White person laser on an ethnic person things can go wrong.
Guy Kawasaki:
This is good to know.
Sheila Nazarian:
Yeah. Yeah. Yeah. So in my practice we have about 30 devices, and we apply the correct device to the goals, the ability to have downtime and the skin type of each individual.
Guy Kawasaki:
Wow. Who knew there are 30 different kinds of lasers.
Sheila Nazarian:
Hundreds of different kinds of lasers, but we just try all of them and keep the ones we like.
Guy Kawasaki:
Tell me about body dysmorphic disorder.
Sheila Nazarian:
Yeah. What would you like to know?
Guy Kawasaki:
What is it? How prevalent is it? What do you do when you encounter it?
Sheila Nazarian:
When I was a resident at Albert Einstein in the Bronx, I did psych rotation at Bronx Psychiatric. So it was the type of lockdown facility that the door would close behind you before the door opened in front of you. And the lanyards with our IDs would break apart at multiple area so nobody could choke you with it. So my project in med school was body dysmorphia actually on that rotation. And this was, God, probably 15 to 20 years ago. At that time, there was an article that had come out that said 70% of plastic surgery patients have some level of body dysmorphia. And that was then, and I think it's probably hopefully a little bit better now. I would say, if I sense that a patient has body dysmorphia, I'll just send them to a therapist. But I think it's changed a bit. I think plastic surgery has become a little bit more mainstream. The patients that walk into my office aren't like, "I hate myself. This is so disgusting." Usually when they say this so disgusting, it really is bad. I don't get patients that come in with a normal nose and they're like, "My nose is huge." I just don't attract that type of person. I'm not seeing that. But at that time 20 years ago, that was the level.
So body dysmorphia is defined as when someone looks at a body part and they see it wildly exaggerated than what it would look like to anybody else. So somebody comes in with like a two millimeter hump and they say, "My nose has a big camel hump," and all that. That's body dysmorphia. So again, if we see anyone that we think is unreasonable ... and I have seen it, I've seen people come in and they literally bring in a file of what they looked like before they put filler under their eyes and what they look like now. And this is from every angle, and they have micro selfies of every part of their skin. I'm just like, "You know what? You are traumatized right now. You are not in the position to undergo even the downtime. Even if you get bruised, you're going to get further traumatized. And I don't think this is a good time or that you're in the right state of mind right now to undergo this procedure. And I really think you should take a step back and analyze why you're doing these things and maybe get a little professional help to help you understand." And that's my talk.
Guy Kawasaki:
But don't they go next door and find another plastic surgeon in L.A.?
Sheila Nazarian:
They can but then that's on that plastic surgeon. I don't have to bring on that baggage into my practice. Because I'll tell you, Guy, the last thing you want to do is have 1% of your patients take up 99% of your staff's time.
Guy Kawasaki:
You're saying that in a business sense?
Sheila Nazarian:
Yeah. On a business sense, you want your staff happy. You want your staff to be focused on delivering quality care to all of your patients and not just spend a 100% of your time or 99% of their time on 1%. So we try to ... It's funny, like when I'm doing consults, I do a lot of virtual consult, so every Wednesday I'm doing virtual consults. I will take advice from my staff, if they say this person was rude to me, if this person was mean to my employees, we will not accept them as patients. And people think that they're interviewing me, but in reality, I'm interviewing them to see if they're ready and if they're a good fit, and if they're above all, capable of happiness.
Guy Kawasaki:
So just step me down this path a little bit, you do a virtual consult. So let's say you and I are doing a virtual consult, I say, "Oh Sheila, I just hate these age spots here. It makes me look so ugly, and it's affecting my self-esteem. And I speak a lot. I need to look better." Do you tell me, "Guy, fricking don't worry about it." Or do you tell me-
Sheila Nazarian:
No.
Guy Kawasaki:
What is it?
Sheila Nazarian:
I always tell people if it's something that's safe and you think about more than a few times per week, then why not fix it? Life's short. Why would you spend your mental energy worrying about something that can easily and safely be taken care of? So if it's something that you're thinking about more than three times per week and it's safe and you're in the right mental status, why not?
Guy Kawasaki:
I'm not really asking you because I'm thinking about it. But so you look at this, you see these brown spots and you say, "Guy, my nurse can take care of that in an afternoon," and what kind of seriousness is this? Just as a data point for me.
Sheila Nazarian:
We will put you on a hyperpigmentation skin regimen, just to get your skin prepped. And also what we want you to do is do the work at home a little bit as well. So I always tell people, what you do at home is like exercising by yourself, what you do in my office is like exercising with your trainer. We're going to push you a little bit harder than you would have pushed yourself with the right devices and the right equipment but that doesn't mean you can't take care of it at home. So for example, if you tell me, Guy, "I like to surf. I like to be outdoors and I never wear sunscreen, and I hate doing that." I'll be like, "You know what Guy? Live with your sun spots." Because whatever ... Yeah. It's like going to your dentist for a cleaning and not brushing your teeth at home. What's the point?
Guy Kawasaki:
Okay. Okay.
Sheila Nazarian:
You have to gauge your level of commitment as well.
Guy Kawasaki:
Okay. So if I tell you I surf and I do put on sunscreen, then what do you telling me?
Sheila Nazarian:
We'd probably use a laser on you or a series of peels, depending on your ability to have downtime and how quickly you want it taken care of. But yeah, it can be taken care of.
Guy Kawasaki:
And what does downtime mean?
Sheila Nazarian:
So downtime is like peeling or flaking. And during that, like week of peeling, you can't have any sun exposure. So I would have you like stop surfing during that week, or we'd do it in the winter time if there's downtime or we engage it with your life.
Guy Kawasaki:
Forget it. There's never a week where I will not surf so that eliminates me. And honestly, I don't think about these spots three times a week. In fact, you haven't thought about it till today. So I guess-
Sheila Nazarian:
Yeah. I always tell people, Guy, like, "This isn't a first appendix." Nothing we do is an emergency. You take care of it if it bothers you, you don't if it doesn't.
Guy Kawasaki:
Okay.
Sheila Nazarian:
I had this lawyer be sent in by his wife, because he had these lines in between his eyebrows. He said, "Yeah, my wife sent me here. Everybody says I look angry, but I am angry." "But it doesn't bother you. Leave." And so you left.
Guy Kawasaki:
If he was a divorce lawyer, he should look angry, that ups the settlement. Right?
Sheila Nazarian:
There you go.
Guy Kawasaki:
Do you think that the, perhaps a misperception or probably misperception of plastic where you can achieve the perfect body, does that create unrealistic expectations? Just like I could make the case that TikTok and Instagram perpetuates unrealistic expectations. So how do you address this?
Sheila Nazarian:
I actually post about it. So if there's like a TikToker who's doing a hundred squats into the camera and I can clearly tell she's had plastic surgery to make her butt that big, I will post about it. I will say, "You know what? This is what your favorite influencer is doing. And if you don't see these dips in her hip, on the sides, that's not from doing squats because there's no muscle there." And I will post about it and I'll educate the public because I have two daughters too. And the reason why I went on social media and grew my following, because I don't want my kids looking to Instagram, that's where they live, that's where they're consuming information, so I don't want them to just be on Instagram seeing YouTubers, and who I love, I treat a lot of YouTubers, but I wanted them to have an alternative role model. If something like, what was it? 87% of kids in the US now when you ask them what they want to be when they grow up, they say they want to be a YouTuber. It's not like doctor.
Guy Kawasaki:
No. No.
Sheila Nazarian:
It's not CEO. It's a YouTuber.
Guy Kawasaki:
Yeah.
Sheila Nazarian:
And so I think it's our responsibility to be on there and give positive messaging and educate and say, "This is real, this is not real. This is what they're doing. This is what ... If you don't see this, or if you see this, this is what the surgery that was done." Just to let people know what realistic expectations are. Also in the consults. Realistic expectations are so important. They always say, what you tell the patient before surgery is education, what you tell the patient after surgery is an excuse. So you have to spend that time educating the patient before they have a procedure and let them know what the risks are, what the possible downtime is going to be, what the expectations, what realistically they can achieve with this device or with the surgery. And if those things can't make them happy beforehand, don't do it.
Guy Kawasaki:
Yeah. I noticed on the Netflix series that you are definitely lowballing Katrina.
Sheila Nazarian:
What do you mean?
Guy Kawasaki:
Well, you are not promising that she'd come out perfect.
Sheila Nazarian:
Yeah.
Guy Kawasaki:
And also the woman with the acne, you guys were definitely a lowballing her too about how much you could really do.
Sheila Nazarian:
Yeah.
Guy Kawasaki:
But is that typical in your business? There's so many stereotypes in my brain about Beverly Hills plastic surgery.
Sheila Nazarian:
I know. I can tell. I can tell you have a lot of stereotypes happening. No. I think it's becoming more typical, yeah. Because what happens if you don't do that is at the end of it, you get a very unhappy patient, and unhappy patients go online. So I think it is becoming a lot more prominent, letting people know exactly what it is that you can and can't achieve.
Guy Kawasaki:
Off plastic surgery for a second here.
Sheila Nazarian:
Thank God.
Guy Kawasaki:
Listen, when I interviewed Jane Goodall, I asked her about chimpanzees. I'm sorry. What do you want me to ask about?
Sheila Nazarian:
There's so much more.
Guy Kawasaki:
Okay. So now let's talk about your business.
Sheila Nazarian:
Let's do it.
Guy Kawasaki:
So you're the evangelist of thinking big. What does that mean?
Sheila Nazarian:
Yes. So what I realized is I went to business school too, and I was an economics major at Columbia. And I've always been fascinated by how creative marketing is and how it's ever changing. Now there's this app, there's that app. People look at me and they're like, "Plastic surgery is so creative." Well, it was, for the first five years. But then after you've done a thousand breast augmentations, yeah, every anatomy is a little different, there's definitely nuances, but it's lost its thrill. Do you [inaudible 00:27:16]
Guy Kawasaki:
Now that's a quote. After you've done a thousand breast augmentation, it's lost its thrill. I'll have to ... That's going to-
Sheila Nazarian:
Print that out and stick it on your [crosstalk 00:27:26]
Guy Kawasaki:
I'm going to make a, what do you call one of those?
Sheila Nazarian:
A bumper sticker?
Guy Kawasaki:
No, that too. But the Instagram little coat gram or whatever they call those things. Yeah.
Sheila Nazarian:
A meme. Yes.
Guy Kawasaki:
Yes, that's right. That's going to inspire me for quite a while, Sheila. No kidding.
Sheila Nazarian:
There you go. I'm so glad I can do that for you.
Guy Kawasaki:
Go on. All right.
Sheila Nazarian:
No. But-
Guy Kawasaki:
Back to thinking big.
Sheila Nazarian:
Yeah. No. So I just started looking outside of medicine and a lot of my patients are CEOs and super successful, outside the box thinkers. And whenever I'm in there doing their Botox or whatever, their skincare, I sit down, I talk with them for an hour. I'm like, "What are you thinking about now? What's your company doing? What's the tax planning. What are we doing? Where are we buying a house? Where are we going?" And I realized that everything's almost been done outside of medicine. And I'm a speaker on social media, they invite me all over the world to speak on social media. And I'm like, "Why are they asking me? I have 500,000 followers, they should be asking that person with 10 million followers."
Guy Kawasaki:
Right.
Sheila Nazarian:
So I decided to create this conference where we bring people from outside of medicine to learn from each other, almost like a think tank. The more diversity in the room, the better. And that was the impetus to creating the ThinkBIG conference where it was bringing a meeting of the minds and the people in medicine that are ready to grow and ready to think that way will self-select and they will be the ones to attend, which means they're the ones that are going to help each other grow as well. And that's what happened, it became like camp. And the first day we really focused on business and branding tips. The second day we focused on imposter syndrome. What is it about you that's holding you back? I just gave you all the tips, but you're still not going to post because maybe lighting was bad. Or what are your colleagues going to say about you? And all of these things we put on ourselves to cage ourselves in, prevent us-
Guy Kawasaki:
Wait, wait, wait. Time out for a second. So the people in the audience, they're all from the medical profession or this is just-
Sheila Nazarian:
Most of them. Most of them are.
Guy Kawasaki:
Who ever pays?
Sheila Nazarian:
No. My dream for it, Guy was for it to be lawyers and hotel owners and business owners. Because I just think the more diversity in the room, the more creative the ideas get. But what happens is most of the people who were following me were from the medical space and looking to learn from what I did and maybe they can apply it to their spa or maybe they can apply it. So I ended up being, most of the people in the audience were from the medical space. But we've certainly had lawyers, we've had boutique owners.
Guy Kawasaki:
This may seem like a dumb question, but are you saying that doctors need a brand? Why does a doctor need a brand?
Sheila Nazarian:
Of course. Let me tell you.
Guy Kawasaki:
I said it was a dumb question.
Sheila Nazarian:
No. No. It's not a dumb question. A lot of doctors still feel that way, "Why do I need a brand?"
Guy Kawasaki:
Right.
Sheila Nazarian:
But the thing is if you don't have a brand, if you don't control the conversation around what people think and feel about you online, then you're giving all that power to Yelp. If people know you online, you're that quote that says, "Live your life in such a way that if people speak badly about you, nobody will believe it." So the onus is on you to control your image online because if you don't other people will.
Guy Kawasaki:
And do you think that people pick their plastic surgeon based on Yelp?
Sheila Nazarian:
A lot of people do. Yeah.
Guy Kawasaki:
Really?
Sheila Nazarian:
Yeah. A lot of people do. Yeah, yeah, yeah.
Guy Kawasaki:
Is that good or bad?
Sheila Nazarian:
It's a double-edged sword. And it's not just Yelp. I think the thing that we found is people take a circuitous path to picking their doctor. They will look at Yelp. They will look at Instagram. They will look at your website. They will look at Google reviews. They'll look at your Facebook. And then they'll call.
Guy Kawasaki:
Wow.
Sheila Nazarian:
Yeah. So everything has to be consistent and everything has to be on brand. And when they walk into your office, if you have a brand that's screaming, luxury and elevation and optimization, and they walk in and your office is crappy and your front office girl's wearing UGGs and a Bon Jovi T-shirt, that's not good. So everything has to be consistent. So I always tell people, once you define your brand, everything you do as far as customer facing, has to be consistent and on brand. Whether it's your office furniture, who you hire, how they speak, how they answer the phones, your website, what your Instagram looks like, everything has to be consistent so that you don't attract everyone, you attract the people that are really vibing with you and are going to be in your tribe.
Guy Kawasaki:
I'm glad that UGG is not a sponsor of my podcast, but-
Sheila Nazarian:
I love UGGs but just not in the office.
Guy Kawasaki:
Okay. Now, could you just define therefore your philosophy and how you use social media?
Sheila Nazarian:
I use social media mainly to inspire.
Guy Kawasaki:
Inspire what you could look like or inspire what?
Sheila Nazarian:
No. Inspire women, young women, especially on men to let them know that once you're a doctor, that doesn't mean that's the only thing that defines you. You can have other interests. You can be a mom. You can be an entrepreneur. You can be an activist. You can be fashionable. You can look good. If you want to, you can be whatever you want to be. And that's, I think why the following has grown, is because I'm giving people permission to be themselves and be authentic.
Guy Kawasaki:
I did not anticipate going to this direction, branding and doctors, that's kind of a new subject for me. It's fascinating.
Sheila Nazarian:
It's very ... No, that's incredibly important. Because when they're choosing a doctor, and it's so cool to look at, Guy, in a medical school, they always tell you, "Write down at the top of the chart their dog's name and their kid's name. And every time they come in, ask them, "How's your dog? How's your daughter? What grade is she in now?"" But when you have opened up your life a little bit, and what you're about on Instagram, your patients constantly feel connected to you. So when they come in, they're like, "Oh, how was Tehran?" "Oh, I saw your daughter's getting so big. She looks so beautiful. She's learning Korean? What?" So I think it's a way to stay connected. And at this point, when people call for a virtual consult with me, they've already made the decision that I'm their doctor. It's just-
Guy Kawasaki:
Oh really?
Sheila Nazarian:
Yeah.
Guy Kawasaki:
Because of social media?
Sheila Nazarian:
Because of social media.
Guy Kawasaki:
But you have not yet made a decision if you're going to take them?
Sheila Nazarian:
Correct.
Guy Kawasaki:
Huh.
Sheila Nazarian:
Correct.
Guy Kawasaki:
Wow. Wow.
Sheila Nazarian:
Well, how is it like in your business? How is it? You do to take every client? No, you just have to see if they're a good fit, and if you can fulfill what they're envisioning in their head, and whether they're ready to take the next steps. It's the same thing.
Guy Kawasaki:
I guarantee you that you put more thought into who you take as a patient than I do.
Sheila Nazarian:
But your clients don't have your cell phone number, Guy, mine do.
Guy Kawasaki:
Well, no. They're not sitting beneath me and I have a $400,000 laser in my hand either. Now, for people listening to this, I think a lot of people are learning so much about plastic surgery they never did before. Which is good, that's the whole point of a podcast. So now can you give the advice to these people saying, okay, so if you're thinking of plastic surgery, this is what you do. This is your thought process.
Sheila Nazarian:
I have literally made 300 YouTube videos, some of them are along that exact line, how do you choose your plastic surgeon? What mental state should you be in before considering plastic surgery? And it's a lot of the things that we've talked about. I think there's so many fake plastic surgeons out there now, because they might be an emergency room doctor, or they might be a general surgeon, or they might be a dentist, but they're going to pick up that Botox needle, or they're going to pick up that laser, or they're going to pick up the knife and tout themselves as a plastic surgeon. So I think there's a few questions you should ask your plastic surgeon to make sure that they actually trained in plastic surgery. And one of those questions is, could you perform this procedure in a hospital? Because hospitals will not allow people who have not trained in a specialty to perform those procedures in a hospital. Okay?
Guy Kawasaki:
Wait, wait, wait. Say that again.
Sheila Nazarian:
So let's say that ... I'm telling you if you want a real plastic surgeon, who actually trained in plastic surgery, these are the questions you ask, could you perform this procedure in a hospital? That's number one. Number two, what did you do? Your residency training in? Okay.
Guy Kawasaki:
Uh-huh (affirmative). Okay.
Sheila Nazarian:
And are you board certified in plastic surgery? And it has to say the word plastic in it. Not cosmetic, plastic. So those are your three questions if you want a real plastic surgeon. Because a lot of times it's frustrating for us too, there'll be like this person dies getting plastic surgery. Well, guess what? That wasn't a real plastic surgeon.
Guy Kawasaki:
Wait, wait. So-
Sheila Nazarian:
Because a real plastic surgeon would refuse that patient.
Guy Kawasaki:
And what's the difference between plastic and cosmetic?
Sheila Nazarian:
So plastic surgeons actually went through a plastic surgery training, cosmetic surgeons might've done like a one year fellowship, but they actually trained in OB-GYN or they actually trained in emergency medicine or general surgery.
Guy Kawasaki:
So you're telling me that if I'm not certified plastic surgeon, a hospital somehow checks to see how I'm certified, it says, "Nope, you can't do breast augmentations here, Dr. Smith"?
Sheila Nazarian:
That's right.
Guy Kawasaki:
And this is some kind of rule in the medical world that-
Sheila Nazarian:
That's right.
Guy Kawasaki:
And you can't go to one of these surgery centers and they'll say yes? Everybody will say no?
Sheila Nazarian:
No. The surgery center will say yes.
Guy Kawasaki:
Oh.
Sheila Nazarian:
That's what I'm telling you, you need to ask, "Could you do this in a hospital?"
Guy Kawasaki:
Oh, because the surgery center and a hospital or different? [crosstalk 00:36:56]
Sheila Nazarian:
That's right.
Guy Kawasaki:
Yeah.
Sheila Nazarian:
That's correct. So a surgery center, if it's just an outpatient surgery center, you can do what you like, but a hospital will not allow someone to perform plastic surgery procedures if they weren't trained in those procedures in their residency.
Guy Kawasaki:
Wow. I'm learning so much. Okay. Now-
Sheila Nazarian:
Guy, I bet I'll be giving you a tummy tuck soon. We're going to-
Guy Kawasaki:
Oh. I have no esteem problems so you can ...
Sheila Nazarian:
No.
Guy Kawasaki:
No. Okay. So now we've figured out what to ask the plastic surgeon and all that, but now what do I ask myself? What mental state do you want me in?
Sheila Nazarian:
You have to be generally happy. In general, be grounded. And lead a healthy lifestyle. This surgery isn't going to make or break me. My husband's not going to stay with me if I get this surgery. Those kinds of things. It's, I'm happy, I'm settled, I'm cool, but this one little thing is something that's been on my wishlist for a while. That's the mental state you want to be in? Not, I'm really depressed, I'm unhappy, and the surgery is going to bring me happiness. Or my husband's going to leave me and is cheating on me, if I get bigger breasts he's going to stay. And we ask those questions. We ask those on our intake form, it'll say, "Did anyone make a comment, and that's why you want to get surgery?" "Are you hoping that the surgery will save a marriage or a relationship?" We actually ask those questions on the intake form.
Guy Kawasaki:
This is on the form?
Sheila Nazarian:
It's on the initial form before I even consult with a patient. Yeah. It asks about their medical history too, what medications are you on? What surgeries have you had? But the top right of the form has these questions, making sure that someone is doing this for the right reasons.
Guy Kawasaki:
And did you learn all of this in plastic surgery school? Or did you come to it as Sheila, the plastic surgeon maven?
Sheila Nazarian:
I think a little bit of both. I think a little bit of both. And every year, God, I learn something new. Every year, as a business person, as a physician, you come to a new realization and you're like, oh, I'm going to add that to my intake form. It could be anything. It could be, why would I say, cool sculpting, sculpture, light [inaudible 00:39:25] people don't know what they need, but they will check off that they need maybe fat reduction. So before we had the names of the devices listed, they don't freaking know what those are. So we changed it to, by concern. They know what their concerns are and that's something they might check off to discuss with me during their consultation.
Guy Kawasaki:
It's funny. This may sound like a bizarre application of this concept, but I interviewed someone named Colin Bryar, he was the chief of staff of Jeff Bezos. And the name of his book is called Working Backwards. And the concept here is that rather than working forwards from what you can make or do you work backwards from what the customer wants. If the customer wants bigger breasts, that's working backwards, but if you're saying, "Well, I have such and such laser, and that's what it does, that's what I'm going to do to you because I have a hammer and you are a nail," that's the opposite. And so you are working backwards, right?
Sheila Nazarian:
All the time. And we always do that. I love it when my patients ask me in the room like, "Oh, what skincare products should I get? I was looking for the one you posted about, I couldn't find it." I will literally grab their phone and go through the process of my e-commerce site to see what the limitations are. Is it misspelled? Maybe they're misspelling it, and I should use the misspelling somewhere in the description of that product so that when anybody else misspells it, they'll be able to find the product. Or maybe the page went inactive, and I didn't know. So I love it when patients give me feedback like that because I love seeing things from their perspective.
Guy Kawasaki:
Could you make the case that during the intake process, if the intake process does not have questions like what you just pose, that is a warning sign?
Sheila Nazarian:
Warning sign to the patient?
Guy Kawasaki:
Warning sign to the patient that this is-
Sheila Nazarian:
It's so interesting, Guy. People, I wish they would put a little bit more effort into thinking of things that way, but they don't. I wish they would. But I don't even think that's on most patients' radar. I think just honestly finding a real plastic surgeon, just taking it way back, even before you get to the form, just choosing who to pick up the phone to call. If I can make patients ask those three questions, we've already made massive leaps.
Guy Kawasaki:
The three questions about would you be able to do this in a hospital? Those questions?
Sheila Nazarian:
Yes, those questions. If I have just instilled those three questions into people, because doctors will be like, patients will call and say, "Are they board certified?" And the person's like, "Yes, they're board certified." Board certified in what? Board certified in brain surgery? Board certified in podiatry? Board certified in what? So patients ask these questions and they think they're doing their due diligence, and really, no, those are the questions you should be asking. And you could be going to a guy who literally did his fellowship in, I don't know, oral surgery and now he's putting breast implants in people.
Guy Kawasaki:
So if we're going to go down this path, just go down one more level, please define exactly what board certified means?
Sheila Nazarian:
So board certified means, after you've finished your residency training ... so you go to college, you go to medical school and then you choose a specialty, that could be GI doctor doing colonoscopies, it could be internal medicine, family medicine, dermatology, plastic surgery, ophthalmology, whatever, you choose, what kind of doctor do you want to be? And after you finish that training, whether it's four years or eight years, you have to take two tests, one of them is written and the other one is oral. So you actually fly into a place, it's the most nerve wracking thing that I've ever done in my whole entire life, and you sit in front of people and they test you. Older plastic surgeons or older, whatever you trained in will ask you these questions and if you don't answer correctly, you fail, and you're not board certified. And you have to-
Guy Kawasaki:
It's like a PhD thesis defense?
Sheila Nazarian:
There you go. Yeah.
Guy Kawasaki:
And this-
Sheila Nazarian:
So they could be board certified in something completely different. They could be board certified in cardiology. Do you want that person cutting you?
Guy Kawasaki:
Does each state have their own board? Where did you fly into? Does-
Sheila Nazarian:
No. So the board is national. So everybody, we had to fly into Scottsdale all of us. But like I know the dermatology board's in Florida. So there is one place you go and these older, senior or plastic surgeons will fly in to test the next batch of young budding specialists.
Guy Kawasaki:
You may have noticed that in recent episodes, I've asked my guests where they do their best and deepest thinking. The reason I do this is because our sponsor, the reMarkable tablet company makes the product that fosters great and deep thinking. It's the reMarkable Tablet 2. The reason why it fosters great and deep thinking is because it is single purpose. You use it to take notes. This is unlike an iPad where you're checking email, checking social media sites and generally being de-focused. So now here comes advice about how to do your best and deepest thinking, sponsored by the reMarkable tablet company. Where do you do your deepest and best thinking?
Sheila Nazarian:
It's either organizing my closet or doing laundry.
Guy Kawasaki:
That's where you do your best thinking?
Sheila Nazarian:
Yes. I need productive meditation. I can't sit there and meditate, I'm so bad at it. And it doesn't matter that people are like, "You have to practice it." But I actually get my best thoughts and thinking done when I'm doing some sort of thoughtless work, like I don't have to use my brain power to work, but I'm accomplishing something. So I call it productive meditation. And it's funny, at my conference last year, we had Chris Jenner as the keynote, she does the same thing. And I was like, "Girl, we got this. We should have our own closet organization/deep thought show." What about you, Guy, where do you do your best thinking?
Guy Kawasaki:
I recently interviewed Julia Cameron.
Sheila Nazarian:
I love her.
Guy Kawasaki:
Yeah. And she talks about writing every morning. Right? And she also talks about, I forget the term she used, about taking yourself on this sort positive, emotional date and it can be anything. And I really do think that I do my best thinking driving a German, manual shift car. How's that for a rationalization?
Sheila Nazarian:
No. Is it brain ... What makes you think better in that car? Why that car?
Guy Kawasaki:
Well, I'm trying to rationalize getting a German, manual shift. But besides that, I don't know, I just enjoy driving. I would drive for the sake of driving. Greta Thunberg is going to hear this and condemn me for causing climate change, but I love to drive. And my closet is a mess.
So now you learned something, you can do your best and deepest thinking while doing laundry, driving a German, stick shift car or using a reMarkable tablet.
Now, I lied, so the absolute last question is I interviewed a New York times Pulitzer Prize-winning, investigative reporter, and I asked her for tips about how to interview people. And she said, always end your interview with the question, is there anything I didn't ask you? So I'm asking you, Sheila, is there anything I didn't ask you that you feel that people should learn?
Sheila Nazarian:
There's a lot. As an immigrant ... There is. There's just so much. I should write a book and talk about it.
Guy Kawasaki:
Are you saying I'm an incompetent interviewer?
Sheila Nazarian:
No. You're an amazing interviewer. The background work you do is just inspiring to me. No. I think what people don't see a lot is the amount of work and energy that goes into getting to the place and thought and intentional strategy that goes into becoming successful. I think I've gotten so much backlash a little bit, "Oh, you're successful because you're on Instagram," and, "Why are you posting yourself in a dress?" And especially from my colleagues who tend to be a little ... So I think the thing that I'm grasping with right now is, when will my accomplishments get me the same amount of respect that a man would get with less? Even from the people in my daily life, if I speak to my employees in a very direct way, like, "Hey guys, the numbers were a little off yesterday," they might go cry. Whereas if a man said that, "Oh, the numbers were off? I'll look into it." And it's, at what point have I reached the level of success that I will be seen the same way as a man and responded to the same way. And the answer is never.
But that's something that I've been giving a lot of thought to. And the amount of intensity and work that has gone into becoming who I am and where I am today since the age of seven, coming to this country, not speaking language, being an ESL, the amount of teasing for being a nerd, the amount of commitment, sacrifices. Having my kids during residency and pumping at four in the morning as I'm driving into the hospital and in between cases all day at the county hospital, in a closet. All of those things. It's like, what more do I have to go through to achieve that level of respect? And that's the things that I'm thinking about now and what I think needs to be explored a little bit.
I think people, especially with plastic surgery, try to box people in. And I think also within plastic surgery, once they've given you the privilege of obtaining that profession, you die with a scalpel in your hand. And as soon as you start to pivot and maybe say, you know what? I'm also interested in fashion. Pivot, I'm also interested in business. I'm also interested in philanthropy. It's almost like, "How dare you? We took the time to train you, why are you not just obsessed with operating all day?" And I think that's why physicians burn out because that's the expectation. And we're conquerors, we're achievers. We want to be challenged. We want to constantly be growing. And when we're told that this is the only thing you can do, "You graduated, you're board certified now go in your office and work all day long." Yeah. And so I think that there's so much more to everyone and everyone has a story.
Guy Kawasaki:
And you're a woman doing all this, which just makes their heads explode.
Sheila Nazarian:
It does.
Guy Kawasaki:
I think it's good to see some exploding heads on the side of the road. Well, Sheila, thank you very much. And if I ever really start thinking about [crosstalk 00:50:33] thoughts more than three times a week, you will be the first person I consult.
Sheila Nazarian:
You know where to go.
Guy Kawasaki:
I do. I have a friend in the plastic surgery business.
Sheila Nazarian:
You do.
Guy Kawasaki:
Yeah. And I can fill out that intake form, no problem, so ...
Sheila Nazarian:
Flying colors, Guy.
Guy Kawasaki:
To put it mildly, I began this interview with some stereotypes about "Beverly Hills plastic surgery". Let's just say a lot of those stereotypes were destroyed by Sheila. In fact, you can make the case that plastic surgery is a lot more constructive, no pun intended, than I ever imagined. I'm Guy Kawasaki, and this is Remarkable People. I'm backed up by two remarkable people, Jeff Sie and [Paik Fitzpatrick 00:51:18] who always make my podcasts come out beautifully. Until the next episode, remember vaccines are on the way, but still, still wash your hands, wear a mask, don't go into crowded places, get vaccinated when you can. And this applies, especially to people in Texas. Mahalo and Aloha. This is Remarkable People.