Dr. Natalie Plana: A Dancer's Path to Facial and Craniofacial Surgery in New York

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. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Well, welcome back to Meet the Doctor. I'm so excited to bring you Dr. Natalie Plana out of New York City today. Welcome to the podcast.

 

Dr. Natalie Plana (00:32):
Thank you so much, Eva. It's a real honor to be joining and I'm excited for a good discussion.

 

Eva Sheie (00:38):
So you found the podcast on your own. Was there something that I was doing that made you think, I want to be on Meet the Doctor? What was that?

 

Dr. Natalie Plana (00:48):
I had actually found you on social media and there was just something personal and raw and authentic about not just the conversations you were having, but the content being discussed and your ability to bring providers and physicians into a screen that sort of demystified all this sort of curtain and facade of what a doctor is. And you really present doctors as people who are just trying to take care of people. And that drew me and I wanted to be a part of that as well.

 

Eva Sheie (01:22):
So this is why I brought you on the show to give me a bunch of compliments. Just kidding. No.

 

Dr. Natalie Plana (01:28):
That's the authenticity.

 

Eva Sheie (01:30):
Thank you for seeing that because that is definitely what we've been trying to do. And I appreciate you because you got me off of a long break from doing episodes because there's just no shortage of content that we want to make. And so we've been doing lots of other things. But you're like, I'm going to officially declare you to be season two of Meet the Doctor and we're going to get going again with you.

 

Dr. Natalie Plana (01:54):
Great. I'm happy to be the pilot episode.

 

Eva Sheie (01:57):
Wonderful. So New York City is famous for having hundreds, if not thousands of plastic surgeons, probably not thousands, but definitely hundreds. And I once talked to a surgeon who said, "I am the only plastic surgeon on my block." And that really represented how competitive it is there. So describe for us what your environment is like. Another fun fact about New York, at least in my memory, was I lived in Texas pretty much my whole adult life, except for a minute in Seattle. The first time I ever went to a doctor's office in New York, having come from Texas, I thought, "Is this how everyone's office is? They're like the size of a small closet." So paint the picture for us. Where are you? What does it look like? What does it feel like?

 

Dr. Natalie Plana (02:51):
Sure. Well, it's actually funny that you talk about much of your adult life being in Texas and you sort of become a product of your environment. And so that's what New York City was for me. I moved to New York a week after I turned 18. It was an interest in art and dance and a very lucky and special recruitment to a cool dance company in New York City that had an affiliation with a college that I was accepted to. So I moved to New York eager and enthusiastic and New York City sort of matured me into adulthood, into womanhood. And it was the birthplace where I became a physician. And it was the birthplace of my plastic surgery career. And so I am a product of New York City training. I'm a product of New York City thinking. And so I very biasedly will say that New York City is one of the best cities in the world.

 

(03:43):
But what's unique about me too is that I was born and raised in Miami, which is a very different kind of attitude, a different culture. So in practice and in my life, I like to blend those two elements together. So New York City sort of offered me this great invitation to ambition. And you want to, at least for me, I want to be in the presence of the greatest plastic surgeons among the top in the country, a top and top of the world so I can learn from them. I can train under them. I can learn alongside them, practice alongside them. And then hopefully one day as I mature, mentor those younger than me too. So for me, the tight closets, that's just a matter of space, but that's a signal to me that I'm practicing where everybody or where many people want to be.

 

(04:32):
New York City will always recruit great talent. And in New York City, you're sort of walking down the street or taking the subway. You're amongst the highest of every industry. Music, restaurants, finance, fashion. So to me, it encourages me. It pushes me. It keeps me humble to know where I am still in my career and in my life, but always with a vision upward and onward.

 

Eva Sheie (04:57):
Go back to the dance part for me for a second.

 

Dr. Natalie Plana (05:01):
Yeah. So I grew up trained in classical ballet and modern dance. I entered dance just as an extracurricular activity as a hobby. And it turns out I wasn't half bad at it, but more than raw talent, I just had a really great work ethic that was instilled in me from my parents, my family, my dance teacher, and my friends. So I participated in competitive dancing for most of middle school and high school. And then when it came time to pick a college, I was looking around in different areas and my mom, we had in the mail gotten a whole bunch of brochures to audition for different places. And my mom found the brochure for the Alvin Ailey American Dance Theater School. And she said, "Natalie, why don't you audition?" And I said, "No way. There's no chance I'm going to get it. That's silly, mom." And she said, "No, this is what you should do." So she actually, as a graduation gift, gifted me a trip to New York City.

 

(06:00):
So I went up to New York with my sister, my two closest friends, and I auditioned for the Ailey School. And I still have my number from my audition. And to my amazement, I was amongst, again, people top tiered in their element. And auditioning for the school isn't just. The entry isn't just for 18 year olds. You can sort of come in and participate at any stage. So I was auditioning against people in their early and mid 20s and they saw something in me. And whether it was erroneous or selective, I made it and I wasn't going to lose that opportunity. So I moved to New York. And Alvin Ailey has, they're on 9th Avenue and 55th Street. And they have an affiliation with Fordham University, which has a campus on 9th Avenue and 60th Street. So I was getting my BA, Bachelor of Arts at Fordham while simultaneously training at the Ailey School.

 

(06:58):
I went up and down those five blocks, probably four or five times a day, every day for the three years that I danced at Ailey. And then my senior year of college, I retired from my dance career.

 

Eva Sheie (07:12):
Was that hard to do?

 

Dr. Natalie Plana (07:14):
No, it was actually an easy decision because I recognized that I had pushed dance as far as I could and as I wanted to. I knew that a career in dance wasn't what was going to fulfill me in the long run. And I left nothing on the table. I pushed it as far as I could. I reached a level that I didn't anticipate I would. And I was very happy and proud of that. And not just for what I did in dance, but also what dance did for me. Dance gave me a lot of opportunity for discipline, for consistency. And interestingly, even though dance is not necessarily seen as sort of a team based activity, a lot of dances are individualized. That was not my experience. I had wonderful classmates, wonderful peers, very talented people who I learned a lot from and they pushed me every day.

 

Eva Sheie (08:06):
Well, at what point did you know that you wanted to head into medicine?

 

Dr. Natalie Plana (08:11):
I get asked that question a lot. And I don't know if there was necessarily a single inflection point. When I was in high school, I sort of was straddling two ends where I had a lot of fun in my dance world. But academically, certain subjects came pretty easy to me, math and science. And so I knew in the long term I wanted to do something in that arena, but dance was something that I just couldn't let go. It was more than a hobby, and it was a passion, but it wasn't necessarily a lifelong career for me. I was very fortunate. My father is in healthcare entrepreneurially, not practicing medicine. But he had always sort of encouraged me, "What do you think about being a doctor? What do you think about this?" And as I started to learn a little bit more about medicine, it became very clear to me rather quickly that I was a surgeon.

 

(09:00):
There's sort of like two paths in medicine, sort of medical doctors and surgeons. And whether that is because dance is a physical art, but I was just always good with the physical, with something visual, with something pretty immediate. And so I knew that I wanted to be a surgeon. I didn't realize that plastic surgery was the path for me until I was in my third year of medical school.

 

Eva Sheie (09:25):
Was it a specific event or something that happened in your life or was it gradual?

 

Dr. Natalie Plana (09:32):
No. So medicine and surgery was a slow buildup, but plastic surgery was a very specific time point for me. And it was serendipitous, but I don't know, maybe it was just meant to be. So in my third year of medical school, I. The third year of medical school is when you go through all these different rotations and you start dabbling into these different specialties. And very fortunate for me around that same time point, the plastic surgery department at NYU, which is the school that I had trained at, had just recruited its youngest ever chairman of plastic surgery. And that was a gentleman by the name of Eduardo Rodriguez. Eduardo Rodriguez, who I had never met before, turns out to, the new chairman of NYU is a Cuban gentleman. My parents are Cuban, who grew up in Miami just like I did, who went to a high school in Miami that's the brother school of the high school that I went to just many years before.

 

(10:33):
I sort of alluded to this earlier, but a lot of my upbringing, being the daughter of Cuban immigrants, there's this sort of big chase towards the American dream and really sacrificing so much that you can for this great ambition. In the blink of an eye, I saw that in action with Dr. Rodriguez. So he was sort of living out the dream that I had thought, okay, maybe I can do this, but now someone familiar to me, familiar to my sort of background and my upbringing was living that dream. So I rather courageously, as a medical student, just emailed the chair of a department.

 

(11:14):
It's not standard. I felt comfortable enough because of that familiarity, because of that cultural relationality. And Miami is a wonderful city as it is. The area that I grew up in Miami is very Cuban center. I grew up in a bit of a bubble in that way. And so he was someone from that same bubble at a very, very high stature. So I reached out to him and he gave me the opportunity of a lifetime to work under him as a research fellow for two years. The reason Dr. Rodriguez was recruited to NYU was because he was a big, big rising star in the field of facial transplantation. And so facial transplantation is a procedure of which they have been performed maybe 55, maybe 60 in the world, all by only a handful of surgeons. And at the time, he had already performed a transplant at his previous institution and was recruited to NYU to build a face transplant program.

 

(12:17):
So very quickly after he joined is when I had reached out to him and we connected. The timing could not have been better. And so I got to work under him and learn so much from him.

 

Eva Sheie (12:28):
I did want to ask you before you go too far with Rodriguez, and because I've never heard of this face transplant, what is actually being transplanted?

 

Dr. Natalie Plana (12:38):
Oh, sure. So it could be a part of a face or it can be an entire face. I was very lucky that in my first year of working in this role, I got to witness what was at the time the most extensive face transplant performed to date. So that transplant included, it was an individual who suffered severe facial disfigurement after a full face burn. He was a volunteer firefighter, went into a burning building. His oxygen mask caught on fire. And so his entire face and scalp was entirely burned. He had no ears. He had prosthetics through titanium implants. He had had about 15 procedures around his eyelids to close up his eyelids to protect his eyeballs. Without the ability to blink, our eyeballs don't get the proper lubrication that they need. And so he was at risk of losing his vision. So the face transplant included the entire face, the scalp, the ears, and down to the neck.

 

Eva Sheie (13:38):
Where would you get a donor for a face? The same way we get donors for everything else?

 

Dr. Natalie Plana (13:44):
Yeah. So donation for face transplant is really complex because we do ask families of loved ones who are brain dead to donate their organs. So the same way a person would donate their heart, their liver, their kidney, their pancreas. You would approach that family to ask, "Would you feel comfortable donating your family member's face?" That's a hard question to ask. And as a matter of fact, during my two years, we wrote up a couple of articles specifically on the topic of donation. And we found that even with just a short education, we could increase the donor pool by almost threefold, just by a short sort of blurb on what is face transplant and how can you completely change someone else's life from that. But selection is difficult because you have to match. It's not just matching the immune system to make sure the body doesn't reject it.

 

(14:34):
You're now matching facial features, skin color, gender, facial size. How big is the face? How small is the face? Overall sort of just smaller features because that's something that the recipient will carry on for the rest of their life. So donation is challenging and it's a whole other topic of discussion.

 

Eva Sheie (14:52):
We could probably talk for hours about this because there's so few people on earth who've been involved in that.

 

Dr. Natalie Plana (14:57):
Yeah. No, that's definitely true.

 

Eva Sheie (15:01):
Well, what a great opportunity.

 

Dr. Natalie Plana (15:03):
I didn't realize how career defining that was for me because face transplant is a phenomenal topic that, like you said, we can discuss it forever. But more than anything, my experience there was that's how I really learned about plastic surgery. That's how I learned what is plastic surgery? How do you connect to patients? How do you meet the patient's needs? How do we work with technologies that can be advancing, but sometimes can be limiting in what you can do? I received fantastic mentorship during my time there at every level, not just from the lead surgeon running the face transplant, but multiple surgeons within the department who took me in and taught me a lot and introduced me into craniofacial surgery, which is now my subspecialty residents and fellows. But also I had great friends and peers who are also within the research team who took me under their wing and I've learned so much from them.

 

Eva Sheie (15:59):
One of the things I try to do is talk about patients as people and not just buckets of patient populations because it's so easy for us to say, "Well, what about this group and that group?" They're all people. And in plastic surgery, it's really easy to focus on the cosmetic and not the reasons behind it. It took me forever to realize that this had such an impact on me, but where I grew up in Minnesota, nobody was rich. In fact, I would say it was like very low middle class. Just probably most of us in that neighborhood were on the verge of poverty, my own parents included. And one of my brother's friends had his ears pinned back at that time. And he was little. I mean, he probably was less than 10 years old. And I didn't realize that witnessing that stuck with me all the way through because once his ears weren't the thing that everyone noticed about him, he became a person.

 

(17:03):
And I still know him to this day. And he's great. But if his ears had stayed like that his whole life, he would've had a different life. Then this is my big lead into craniofacial because you must have had a lot of experience with kids too at that time in that training. Are you still doing anything with kids?

 

Dr. Natalie Plana (17:22):
Yes. Yeah. So craniofacial is sort of a subspecialty within plastic surgery that many people might have sort of different definitions, but my definition of craniofacial is blending reconstruction and aesthetics of the face. Cranial is sort of the skull, facial, obviously the face. But much of that is indicated for pediatric patients, like you said. So many children who are born with congenital differences that lead to changes in their face. And so some might ask, "Well, what does that look like?" And the most common congenital difference of the face is a cleft flipper palate. So that's something that many people might be able to recognize. And some might say, "Well, is that a reconstructive procedure or is that an aesthetic procedure?" And I get asked sort of questions about reconstruction versus aesthetics often. And to me, sort of the way that I was trained by many is that there's a functional component and there's an aesthetic component.

 

(18:25):
And those are not competing priorities. They are both very high level priorities that should always be considered without sacrificing the other. So a child who's born with a cleft lip, for example, meaning that their lip is sort of splayed open, it can be to different extents. There's huge functional concern for that newborn who may not be able to latch around a nipple or a bottle around the breast. So nutrition is critical for them at that point. They also, as they go on to develop, can have other sequela that might be able to affect their dentition or their oral hygiene. Certainly if the palate is involved, it can affect their speech. And then there's sort of the psychosocial component of a stigmata and it can really affect a child's self-esteem as they go into adulthood. So those I think could all be sort of categorized as functional, but the cosmesis is just as important.

 

(19:16):
So as you're repairing a three months old cleft lip, the alignment of the lip portions is critical. So if the red part of your lip has a step off of even one millimeter, it's noticeable to the eye. So if we're trying to improve a child's function or even an adult's function, if they've had a repair and we're trying to revise it, the aesthetic component is not a standalone element of that procedure. It is right there along everything else. So I do perform cleft surgery still, and I hope to and plan to for the rest of my career, but I don't necessarily categorize myself as a cleft surgeon. I like to sort of categorize myself as a craniofacial surgeon, meaning I do surgery to the face that is encompassing of both reconstruction and aesthetics across the board. So to me, I get just as excited about repairing a child's cleft lip and making sure the red part of the lip is just within that one millimeter level as I do for let's say that same patient's grandmother who's looking for a facelift and wants to regain her self-esteem that maybe has been lost over the last several years.

 

(20:32):
In my mind, that child's cleft lip is medically necessary. But I would argue that a 25 year old who is incredibly insecure about the appearance of their nose, for example, and it limits their social ability and their confidence to go out and get the job that they want or seek out into the romantic relationship that they're looking for and it inhibits their life, that may not be medically necessary, but it's pretty necessary for the growth of that individual's lifespan. So that's sort of my take on necessity. Necessity isn't something that should be determined by me as a surgeon. It should be determined by the patient. What is it that you're looking for? What are your goals? And then I as a surgeon can tell you, okay, well, this is my tool set. These are my resources. This is what I can do for you. And now let's see if those two things match.

 

(21:24):
It may not always match, right? I may not be able to give a patient what they're looking for, but for the most part, my goal is really to just talk to patients, hear them first. What is it that you're looking to achieve? And then I can explain, well, this is what I can do. Are we going to be able to get each other there?

 

Eva Sheie (21:42):
How did you get from your research fellow work to where you are now? Can you kind of take us through the steps that you've taken to your current practice?

 

Dr. Natalie Plana (21:54):
Sure. So that research time took place between my third and fourth year of medical school. So that was where I sort of implanted my interest in pursuit of plastic surgery. My last year of medical school was really dedicated to determine where I wanted to train. So plastic surgeons -

 

Eva Sheie (22:13):
You mean in New York?

 

Dr. Natalie Plana (22:14):
Oh yes, yes. Sorry. Sorry. That was in New York

 

Eva Sheie (22:17):
City. I mean, we have to stick to this whole, you were never leaving New York. Once you got there, you were done moving.

 

Dr. Natalie Plana (22:24):
Well, here's the fun part. I did leave New York actually.

 

Eva Sheie (22:27):
Oh.

 

Dr. Natalie Plana (22:28):
Yeah. So that's what's actually cool about this story. New York, I wasn't going to be gone for long. But for my residency, my plastic surgery residency, which is a six year extension, that's sort of where you learn how to be a plastic surgeon. I had a wonderful opportunity to train at the University of Pennsylvania, which also has an affiliation with the Children's Hospital of Philadelphia and also known as CHOP. And CHOP is a phenomenal place. I mean, I've never seen anything like it. It really is unbelievable. And CHOP is one of the largest cleft and craniofacial units by volume in the United States, led by some fantastic people. And actually the individual who founded the Cleft and Craniofacial and the plastic surgery unit at CHOP is a gentleman by the name of Linton Whitaker who was one of the first pioneers to perform craniofacial surgery on children.

 

(23:27):
And he was really pushing some boundaries. And so he trained my mentors. So I did spend six years in Philadelphia. I enjoyed my time there a lot. But after residency, I went out and sought out advanced training in craniofacial surgery. So I did a fellowship in craniofacial. And that's when I had to go back to New York. I had to go back to that same unit at NYU.

 

Eva Sheie (23:51):
To the same five blocks?

 

Dr. Natalie Plana (23:52):
I did. I did. But you know what? It's not just the same five blocks. It's the same people. The people who gave me the chance to begin with and saw something in me and took a chance on me, those were the people that I wanted to get that finesse from. So short stinch in Philadelphia, came back to New York, first opportunity that I could. And I've been in New York ever since.

 

Eva Sheie (24:18):
Certainly your dance background and the rigor and the discipline that it takes to train to be a professional dancer, it bakes something into your personality, into the way that you approach everything for the rest of your life. We are perpetual students. And so I imagine that really served you well as you kept going through other kinds of training. Training is training.

 

Dr. Natalie Plana (24:45):
Training is training. Yeah. But I think I've just been lucky in my life that the right people have come into my path. And some of that has been, I've sought some of these folks out, but others, not necessarily so. But what they've all sort of taught me is that you're really doing yourself a disservice if you lack the humility to continue to learn in life. And it doesn't matter if you're 95 years old. It doesn't matter if you've sort of reached the pinnacle of your field. The mind that isn't learning is the mind who's still, and that's not one who's going to really be able to contribute more to any kind of community. So I recently heard somebody say experience is expensive. And so I almost just got like the greatest deal of life because I've had very experienced people sharing their experience with me at no cost.

 

(25:42):
And so I haven't had to pay anything for that other than just having open eyes and open ears and the ability to actually incorporate that into my practice and start weaving in my own little path.

 

Eva Sheie (25:55):
Where are you today then? How would you describe your current practice?

 

Dr. Natalie Plana (26:02):
It has a lot of voice and a lot of color from my training, from my mentors. But what makes it unique is that sort of touch of how I've incorporated all of it. What I sort of strive in my practice, I sort of hinted at this earlier, is sort of focusing on facial surgery, whether that be reconstructive, whether that be aesthetic, but really melding all of this together and sort of understanding from a surgical or technical standpoint, looking at the face as a whole, not just the eyelids, the nose, the mouth, the cheeks, but really the craniofacial side helped me sort of incorporate the bony skeleton into all of it. And so I think when we're thinking about aesthetics or cosmesis, we sort of forget about the bone because everyone sort of looks at the curtain and the drapes of the face, the skin, the soft tissue, the muscles. But what I'm trying to do in my career is actually incorporate bony facial skeleton with the soft tissue side of it.

 

Eva Sheie (27:02):
The only other people I've ever heard say this, which probably won't surprise you, is the dentists all say this.

 

Dr. Natalie Plana (27:09):
I completely agree with you. Oral and maxillofacial surgeons who come from a dental background, they have a great understanding of the way that the bones and the facial skeleton is sort of the foundation and the scaffold. And then the skin and the soft tissue is a lot of the icing and the draping over top of all that. So I'm privileged in that I was, because of the craniofacial side, I'm very comfortable with bony stuff. But from the plastic surgery side, all the drapery comes quite easy to me and it's been part of my training for a long time. But the integration of both is really, really important.

 

Eva Sheie (27:48):
It's very common in facial surgery in particular for doctors not to do noses or only do noses. And I haven't heard you say whether or not you also do rhinoplasty as part of your overall approach.

 

Dr. Natalie Plana (28:03):
Yeah. I think rhinoplasty is a huge component of facial surgery. Rhinoplasty is important because the nose is the central point of the face. And it's oftentimes where somebody's eyes go to first before a face is animated, smiles or starts speaking. It's funny you mention rhinoplasty or nose because when I was interviewing for different positions, I was once asked the question, what is the most beautiful and harmonious part of the human body? And I actually said the nose for that exact reason. It's the center part of the face. If we look back to the earliest documentation of plastic surgery, it's actually nasal reconstruction back to sort of Egyptian times. And it's the procedure that's been most consistently performed across every era. And we're still figuring it out. We're still perfecting the procedure. It hasn't been the same for hundreds of years. It continues to evolve. And I think that we've reached a point where we can deliver good, consistent results.

 

(29:06):
In the same way that no two faces are the same, no two noses are ever the same. And even within the same nose, the left and the right side are often different. So rhinoplasty is a very fun procedure for me to take on because it feels, it invigorates that creative side while being foundationally set in structure and then making sure you have a good foundation, making sure the patient is breathing appropriately, making sure the nasal bones are well supported, and making sure that you can get the patient a result that's going to be lasting. Because you could get a good nose on the table that within three months of healing, heals in a very unpredictable manner. But I think with the right techniques and in the right hands, rhinoplasty is one of the most powerful procedures that can be done on the face.

 

Eva Sheie (29:51):
It's also that perfect marriage of function and aesthetics.

 

Dr. Natalie Plana (29:55):
Absolutely. Absolutely. Yeah.

 

Eva Sheie (29:57):
Well, let's talk about the future a little bit. What kinds of patients are you seeing today? What kinds of people are you seeing today?

 

Dr. Natalie Plana (30:05):
I see all patients who are in need or interested in facial surgery. So I see young children who have a facial difference, who are diagnosed with cleft, for example. Young kids who suffer from some sort of trauma to the face. This is the summertime and we're seeing that kids are much more vulnerable to injuries. So any kind of cut or laceration to the face, the nose is an often zone of injury for them. And I'm starting to see more and more kids with facial fractures. I saw a child just last week who had a baseball to the eye and had some broken bones from that. So you can't protect children from sports and fun. And sometimes you can't protect them from injury, but fortunately we have the tools to be able to help them and get them sort of back on track. The good news for any listeners is that most injuries that children suffer to the face before they're 18 don't need a lot of surgery because we need to let those kids grow before we start introducing any kind of scar.

 

(31:03):
Sometimes they need it, but not always. And then I see adults who are interested in changes to their face, whether that be from a reconstructive element. Some patients who had skin cancer to their face, for example, and they've been left with a little bit of a hole and they want to get that sort of patched up. I see a lot of patients who come in for rhinoplasty. I'm starting to see more patients who are coming in for facial rejuvenation. So that's just face lick, neck lift, eyelid surgery is something that I've done quite a bit over the last year. And the biggest sort of integration of all of that young, older, hard tissue, bony, soft tissue is jaw surgery. So we see it's prevalent among children with a cleft, but also in children who don't have a cleft who develop an overbite or an underbite.

 

(31:59):
And so what we do is we do corrective jaw surgery to actually line up their bite. So when they close, their teeth are meeting at the edge as they should. So it helps with their occlusion, it helps with their ability to chew. In some instances, it can actually help someone's ability to breathe if they have obstructive sleep apnea. Moving the jaws forward opens up that airway to a certain degree. And so now that sort of jaw surgery is sort of coined orthognathic surgery. And we're starting to see a shift from functional indications for jaw surgery to more aesthetic indications for jaw surgery. So someone who might have a normal bite and their teeth come together just fine and they chew pretty well, they might have a little bit of obstructive sleep apnea or they might have a little bit of an open bite, but what they're more interested in is the aesthetic benefit of moving their jaws forward.

 

(32:55):
So a lot of patients will initially come in because they say, "Oh, my chin's a little bit weak." But you can actually move the entire jaw forward and it can really augment the cosmesis of their chin. It can balance out their face. If their lower face is a little bit short or a little bit sort of deficient relative to the top two thirds of the face. By moving that lower jaw forward and down a little bit, it can completely harmonize the face in a way that is not achievable by any sort of soft tissue only kind of procedures. You were sort of hinting at what's sort of the future. We're kind of walking into it already. We're seeing a lot of patients that I've spoken to when they hear jaw surgery, they hear, oh goodness, you have to wire the mouth shut for six weeks and you have to drink a straw.

 

(33:42):
I don't want to do that. I mean, I wouldn't either, right? But we are now able to perform jaw surgery with Invisalign. So patients don't need to have braces, metal braces. They can have Invisalign, which makes it a little bit easier if you're sort of engaging in an active social life. And then after surgery, because we're able to customize the way that we do the surgery, there's greater stability to the bones. So we don't need to wire the jaw shut. In fact, we just put elastics and the elastics don't last for more than a few weeks. It depends on the surgeon. I like to do about two weeks of elastics. And so patients are able to have smoothies and purees and ground meat pretty quickly. So they're no longer on that sort of liquid diet that once was. And we can now start complimenting that with some minor soft tissue procedures.

 

(34:33):
So if someone wants to move their jaw forward and they want a really clean, sleek neck, we can do a little bit of a neck procedure with that. Maybe we can remove some of the buccal fat on the sides to give them a little bit more of sort of an edgy type of look. And what I hope to develop over time is combining the rhinoplasty with the jaw surgery because as especially the top jaw starts to move forward, it changes the appearance of the nose a little bit. So sometimes even just small rhinoplasty maneuvers can really improve the way that it all sort of starts to come together. I've given this analogy before and I really love it, but it's almost like when you start seeing these celebrities on the red carpet and they come in with these gorgeous dresses and these beautiful suits, but there's still some accessories that are still at play.

 

(35:19):
So you can add the purse, you can add the shoes and the jewelry, and then even little things like the makeup. Putting it all together is what really gives it sort of that glamorous look. And so I think that is really the future of plastic surgery. It's no longer being siloed into this one procedure or that other procedure, but really understanding what's the best approach that we can take and how do we take a little bit from all of these different areas to provide that patient exactly with what they need to reach their goals.

 

Eva Sheie (35:52):
That's very well said. Before we kind of wrap it up, and we probably are going to need to come back for part two with you. What do you like to do when you're not at work? Are you still dancing?

 

Dr. Natalie Plana (36:03):
Oh no. I've retired.

 

Eva Sheie (36:06):
Completely retired.

 

Dr. Natalie Plana (36:07):
I've completely retired. And so I let go of dance, but I let go of performing dance, but I really like being a consumer of dance. I love in the city going to different performances, seeing a lot of traveling companies come through. I really like the Joyce Theater. They have some great talent making their way around. And it's not sort of this big sort of elaborate place. It's relaxed. It really does a lot of justice to the art. So I enjoy watching dance. My family is in Miami, so I travel to Miami quite a bit. I very lucky I have a two year old nephew, a now almost one year old niece and a one month old niece. So spending time with them is a lot of fun. And watching my brother and my sister becoming parents is also fun. And then teasing them about it is the best part of it all.

 

Eva Sheie (37:02):
Yep. Yep. It is. If someone is listening to us today and they want to reach out and find you or talk to you more about what they're thinking of, where would you send them to reach out to you?

 

Dr. Natalie Plana (37:17):
The Instagram handle is @dr.natalieplana. And the website is www.planaplasticsurgery.com.

 

Eva Sheie (37:27):
I'll put them in the show notes to make them easy to find too.

 

Dr. Natalie Plana (37:29):
Cool.

 

Eva Sheie (37:31):
Thank you so much, Dr. Plana. I really appreciate your time today.

 

Dr. Natalie Plana (37:35):
No, thank you for having me. Thank you for a great chat. You make it so easy to talk to. And thank you to your listeners for tuning in.

 

Eva Sheie (37:46):
We'll do it again. There's no substitute for an in-person appointment, but we hope this comes close. If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links, including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at meetthedoctorpodcast.com. Meet the Doctor is made with love in Austin, Texas and is a production of The Axis, T-H-E-A-X-I-S.io.