William Lao, MD - Plastic Surgeon in New York City

The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision, and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome to Meet the Doctor. My guest today is William Lao.

Thank you very much for inviting me. It's my pleasure.

He's a plastic surgeon in Manhattan on Fifth Avenue in particular. Thank you for joining us on the podcast.

Thank you again for inviting me, <laugh>.

So let's just start by talking about you. Let tell us about yourself a little.

Sure. So I'm a board certified plastic surgeon. Been practiced for about 10 years now. And then, uh, I originally grew up in Taiwan and then uh, it's, you know, a small island in Asia. And then, uh, came to actually, I went to Canada for high school first, and then I came to US for college and also medical school at Johns Hopkins. And then did my residency Wisconsin. Came to New York for uh, fellowship in cosmetic surgery fellowship.

So you only like to go places where the weather is cold or?

Well, Taiwan's pretty hot. And then Vancouver actually is very beautiful weather.

It is very mild.

Yeah. Yeah, very mild. Yeah, it's like four season and very distinct cause it's very beautiful.

I spoke too soon because, I used to live in Seattle, so it's kind of the same.

Right, yeah. But it doesn't rain rain as much as Seattle maybe. Yeah.

You think it rains more in Seattle or Vancouver?

Probably Seattle more.

Yeah, I agree.

Yeah. Yeah. Yeah.

It rained the most at my house.

Oh, <laugh>.

It's actually true because I lived next to a mountain and the clouds would get stuck on the side of the mountain and just sit there.

Oh wow. Okay.

And I left, I had to go.

Yeah. Have you ever drove to, uh, Vancouver then?

I have in fact. I think, were you there for that, I think it was an ASPS meeting in Vancouver.

Uh, I left Vancouver like more than 20 years ago.

Oh yeah. Well this was maybe 10 years ago.

Yeah. They're gonna have ASPS again next year in Vancouver.

If you have to go to Canada.

Yeah. Vancouver is the place. Vancouver is the place. Yes, that's right. Most Beautiful.

And you can fly to Seattle and just drive over there too if you need to.

Right, right, right. Yeah. Well it's a beautiful city.

Yeah, it is. And it's shocking how much, it's not like the United States, like it really is like a going, I mean it is a foreign country. That was my biggest surprise was like, it wasn't just an extension of Washington state.

Yeah. Yeah. Well, Canada, interesting country, you know, they, they're a little different, but they grew up watching all the American shows and very in tune with the American culture. So yeah. It's kind of interesting place. Yeah.

So you immigrated from Taiwan?

Yeah.

To Vancouver.

Canada first and then came to us for, you know, college, medical school, residency, fellowship, all my, I did all my educ, like I guess higher education here. Yeah, yeah, yeah.

Yeah. And so when you landed in Canada, did you already speak English?

No. I have to, you know, start everything on scratch. I learned, learned from like, you know, from something like this is a table, you know, something like that. Yeah.

Um, were you with your whole family when you did that?

Uh, no. My, I came with my younger sister and

Just the two of you?

Yeah, just two. I was like 13. My sister was 11. My parents at that time was kind of a trend for, uh, families in Asia to send their kids to study abroad, even at a younger age. So my parents kind of did that. And

So was it a boarding school or something like that?

No, we stayed with our aunt for like four years in high school and our grandparents. Yeah. So we do, we did have some relatives, so that was helpful.

Do you remember missing your parents?

Yeah. Of course. Yeah. In the beginning. Yeah. And then eventually you get kind of used to it. It, it is kind of an opportunity for you to become more independent too, you know? But you're forced to at an early age. Yeah.

And how had your aunt and uncle and your grandparents already moved over here?

They moved to Canada like many more years before, so, yeah. So they're kind of used to that place already? Yeah.

Do you remember what it was like going to high school and

Yeah. In the beginning you kind of just couldn't understand anything, what everyone else is saying, you know, but, but as a kid, you know, you learn the language pretty quickly and then you kind of a, like a sponge you just absorb. And then I was in some ESL class, which is like English as a second language class. And then, uh, study hard, you know, apparently, eventually, you know, I graduated number one from high school. Yeah. You know

Well that didn't take you long.

Yeah, it took four years and then, yeah. And then uh, came to us for a college, medical school. Also interesting is after I finished all the training in the US I actually went back to work in Taiwan where my parents are, you know, for a few years before I came back to New York to set up my own private practice. So I would say another interesting thing about me is like, uh, there's probably no one I know that's both board certified in Asia and in US for plastic surgery. Yeah.

I, yeah, I think you're probably right about that.

Yeah. I don't, I don't know anyone in New York who is board certified in Asia and also in the US at the same time.

That's a new meaning to double board certified.

Yes. In different continent or different countries.

Is one harder than the other?

Similar. I would say the basic plastic surgeon knowledge is similar, but I had to take the exam in Chinese, which I took the, you know, American exam in English and I took the Chinese exam in Chinese.

Yeah. How much more time did it take you to do this in over there?

Like it wasn't hard. It was just a language thing. Like, it was just like if you have to know the language at such higher level language, you know, but the, is the same, right? Plastic surgery, how to do the surgery, how to take care of patient, like the patient management part, the knowledge part is exactly the same, but it's just, you have to know that language well enough that you can take a, you know, a board certification test in that language.

Did you miss anything on the test?

Uh, I'm sure I missed some. Yeah. <laugh>

You don't remember what though?

Yeah, it was like a many years ago.

Did they even give you the results? Like this is how you, did?

They basically tell you whether you passed or not. Yeah, but, but they don't really tell you exactly the score.

That's unfortunate. I, I remember everything I ever got wrong. Like it made me mad if I got something wrong, so it just was memorable. Right?

Right, right, right. On the American exam, they'll tell you what you got wrong and the score and everything. Yeah. Yeah, that's, yeah,

Yeah, that makes sense. That's very American. Yeah. <laugh>, here's where you screwed up.

Yeah, that's, well you can learn from those mistakes, you know, go back and see

And you're an optimist too, I see.

Yeah.

<laugh>. Okay. So these days, what is your practice like? What are you doing?

Yeah, so my practice is interesting. I do, I do everything, but I focus a lot. A lot of my, I would say 90% of my patients are come to see me for either eyelids, nose, breast and liposuction. Those four procedures. And then of all those procedure, because of my background, I kind of do something different too. Like, uh, eyelid, I do a lot of Asian eyelids, which is uh, a little different from the common sort of Caucasian eyelid surgery cuz you're trying to create a double fold, you know, whereas um, most Caucasian patients already have to double fold. And then rhinoplasty in a Caucasian rhinoplasty is more of a reduction, you know, because nose oftentimes too big. Most patient want to be smaller, but for Asians they opposite. They a lot of times the nose is too low, too small, too short and they wanna make a longer, little higher or you know, so more prominent.

(07:55)
So it's like a totally different direction. Breast augmentation, I do the transactory approach, which I go through the armpit using endoscope. So we can hide the uh, incision in the armpit, which is very different from the traditional approach of just making an incision and the inferior end of the breast, which the scar is more obvious I guess. Um, this is all also benefit from my experience working in Asia. So cuz the Asian skin tend to scar worse, same as black skin too, you know, they tend to scar worse. So the techniques are often developed in Asia to reduce visible scar. So these are all techniques to do the same procedure but to reduce visible scar.

Do you spend any time treating scars just by themselves or working on how to make scars look better?

Yeah, yeah, of course. So a lot of, a lot of patients don't know, like plastic surgeon are actually the scar expert. You know, if you, in a medicine world, medical world, if you have to go see a doctor for scar, I mean I recommend to see a plastic surgeon because we can handle scar from all spectrum. We can do laser for it, we can do injection for it, we can do excision for it. And usually plastic surgeon are the best specialty you wanna see for any kind of scar treatment or even like some kind of scar release. If you had developed some kind of scar contracture, you sh you have to see a plastic spur for it.

You mentioned lasers. Do you have a bunch of lasers in your office?

Yeah. We have a bunch of laser. We have laser for pigmentation, laser for lifting, laser for skin, tightening some pores. And we even recently just bought laser for active acne.

Just like the surgery is different for Asian patients. Is laser treatment also different?

Yes, uh, laser, you just have to be more careful about the energy and the number of passes because uh, Asian skin tend to hyper pigment more often than Caucasian skin. Meaning if you go too strong energy, they can really be darkened afterwards. So you have to be very careful and speci, and then there's a specific type of laser you should use versus, you know, the other different races.

So are you doing laser treats, treatments yourself or is there someone on your team who has expertise?

Yeah, so I, I'll do laser in my treat myself, but we also have a Japanese dermatologist in our office who would do the laser.

So are you known around town for being the place to go if you have Japanese skin?

I think so, yeah, probably. Yeah. Or Asian patient in general I think, yeah.

Forgive my ignorance, but there's, is there a difference between the Japanese skin and other Asian kinds of skin?

Yeah, there are, there are are some, you know, some minor difference of course everything, there's a spectrum, right? Yeah. But like I would say East Asian, like Japan, Japanese, Chinese, Korean usually little more, the skin's a little bit more fair compared to like say Southeast Asian, you know, like Filipino Malaysian or something. So there's a little minor difference, but there it is just like, you know, even compared to Caucasian skin, there's some difference between like East European, Western European, Northern European, you know, there's some minor difference.

Did you set out to want to treat Asian patients from the beginning? Was that a focus of yours?

Uh, not really. I guess. I think I focus on just doing good work for everyone. And then just in New York City there's not too, there are not too many doctors, plastic surgeons that I know who knows how to do all these procedures that I just mentioned. So eventually it becomes sort of a niche. But we also have a lot of Caucasian patients too that come and do all the regular stuff. You know, the IMF approach, breast sanitation. Yeah, the reduction rhinoplasty. But it just kind of slowly become a niche that, you know, we have a lot of Asian patient that really travel from across the states. Some not some inter, even international, we have a lot of patients from Seattle. We have to treat a bunch of patients who work in Amazon, in Seattle. Yeah. At least 20, 30 of them I guess. There's a lot of people in Amazon.

A few, yeah.

Yeah. It was the headquartered there right? In Seattle.

Yeah, I was just reading this morning. Yeah. That uh, people who don't work at Amazon are very angry that Jeff Bezos is making them return to the office because now the traffic time has doubled. Doubled again. They should be angry. <laugh>, that's a lot of traffic.

It can be as bad as in LA or you know, LA traffic's probably the worst.

<laugh> I used to, um, I used to stay downtown really close to the RealSelf office and I was always shocked because I would wake up at 4:30. Yeah. And the traffic would already be a hundred percent. Even that early, that early people work on an east coast schedule a lot. So, they just adjust and they get used to it. So they're driving from 4:30 to 5:30 and they start working at six and then they just go home at two.

Okay. But when they go home, they probably can avoid a traffic.

Yeah. They avoided coming and going.

Okay.

You've had a remarkable journey and uh, it's clear that you've worked very hard, but you're kind of just at the beginning still.

Yeah, I, I, I hope so. You've been I hope so. I'm not like too old in my no job yet.

Yeah, you certainly don't look too old. You, you've been at it by yourself at least for 10 years.

Right.

Where do you want your practice to go?

Well just want to continue to provide good and better service for patients. You know, that's why we always exploring more, more and new options. You know, like even, you know, in, in residency, oh we learn just how to operate, we learn some laser stuff but we never had too much chance to doing it. That's why we're developing. Cuz a lot of these things gonna go hand in hand. You know, like surgery can do so much but we can't really change that say your skin condition. So, you know, laser will add to it. So hopefully, well how I envision my practice is um, will continue to develop and we can provide a, like a whole service for every patient that comes in, you know, from skin treatment all the way to surgical treatment and continue to do well, you know, provide uh, the service we've been providing. Yeah.

I've been seeing a pattern lately where plastic surgeons are starting to say that people are asking them for about everything.

Yeah.

And it, I was really trying to figure out why is this happening? But it's because it's so hard to just get honest answers from a regular doctor. But you are unique, plastics are unique in that we can make appointments and see you and talk about pretty much anything. And are, are you seeing this with your patients too?

Yeah, of course. And then a lot of patients don't understand is, you know, when you talk about beauty or aesthetic, the two specialties that really receive core treatments in them is plastic surgery and dermatology. Okay. But there of course because of economy or finance, whatnot, there's many other specialists, specialty people, they after training actually you know, step into a cosmetic, nothing wrong with it, but it wasn't their training. Maybe they can learn afterwards but it wasn't their core training in the beginning. So sometimes they're even more I guess, bold than us cuz they're not trained to see, have seen the complication, the consequences of certain procedure. And they can be even more brave than board certified plastic surgeons in doing like cosmetic treatment or even cosmetic surgery.

Or dangerous.

It can be dangerous. Yeah. Cuz you never even seen what can happen. Right. Cuz it wasn't part of your training. Yeah. So if you don't know your boundary and it can be dangerous. Right. Right.

Yeah. People are unfamiliar with aesthetic practices really in this day and age and especially in New York. What do you think they can expect when they come to see you for the first time?

Yeah, so they can expect a very honest opinion from me. One thing I think is very important for every patient to understands they need to have a correct and realistic expectation. You know, there's oftentimes people always come with some celebrity photos before and after or something like that. But you have to understand that say nose, that nose look good on her face, that nose might not look good on your face. Right? So you have to have a correct expectation and we'll try to using what we have, like in our clinic we have a 3D simulation for rhinoplasty. So at least we can create a model to simulate what kind of change might look like on your face. And then we can discuss if that's possible or that's not possible and all the different materials we can potentially use. So I think number one thing is to get a correct and realistic expectation.

(16:34)
Number two things they have to understand. Many people they don't understand cosmetic surgery is still surgery. You know, when you talk about surgery there's always risk involved. So I'm always very honest to tell them in an experienced hand, like myself, the chance of happening any complications is very low. But if you want zero complications, not possible. Right? So you have to understand cosmetic surgery is still surgery. Those two things they have to understand. So in plain parents that the risk involved and also the potential benefits and what are the alternative treatments, right? There's not just one way to to do something, right. If they want to do a minimal invasive procedure for skin tightening, we can do some laser, some, some much, something like that. You wanna do more invasive, you can do facelift, you can do thread lifting, you know, there's many options. So that's why it's also always good to go to a board certified plastic surgeon. So you know, there are many options.

We touched on your team a little bit earlier in that you have other people with expertise in your office. Who's there that we could expect to meet if we came in?

So usually you meet our office manager and then uh, she'll sort of explain it to the basics about a certain treatment or procedure. And then if it's a laser kind of noninvasive treatment, usually our dermatologists take care of that. And if it's anything invasive then I kind of take care of it. But sometimes we kind of do a joint consultation between me and the dermatologist to both see the patient and then just give them and often the patient's curious about the recovery of each treatment. So that will help them to, you know, tailor which one is pseudo for their time schedule. Like say they have a wedding coming up in two days, then you won't do surgery, right. It be swollen, but you might do so very minimally noninvasive laser that's gonna only be red for two days or something, you know. So it, it depends on what kind of treatment and also recovery period they're looking for. Yeah.

Do you have a dermatologist that is part of your team? You work together every day?

Yes. Yes.

And what is that dermatologist's name?

Uh, Dr. Nao Tsuji.

When you're not at work, what do you like to do?

I love basketball. So I play a lot of basketball.

Basketball?

Yeah. Basketball.

And when did you start doing that?

Uh, I think my dad liked to play basketball and then when I was a kid I started playing basketball and then I always played just like club sports, club basketball and then also in college played like intramural, that kind of stuff. Also, you know, being very Asian, I played badminton too. Yeah. Yeah. I don't actually play ping pong much but

See now you just brought me back to grad school and I would go, I went to Rice for grad school and when I would go through the gym, all the Asians would be playing badminton.

Yeah, yeah, yeah. Badminton, badminton if you play at like in a professional level is actually very difficult. It's very fast, you know? Yeah. It's very fast paced. You have to have very good reflex. You know, most of the time you see them. People just rally that. That's not like real competitive badminton.

No, but it's fun.

Yeah, it's fun. It's fun. You'll sweat a lot. You'll run a lot.

It's really underrated. I think we should try to bring it back.

Yeah, well it's, it's very popular in Asia. It's just not popular in the US you know, sports is different by region, you know, like I say, American football is only played in US, right? It's no played, no not much elsewhere. Right. Rugby probably even played more countries than American football. And then soccer is the world's most popular sport. Right.

Unfortunately.

Popular sport, right? Yeah.

So are you a basketball fan here in New York? Do you go to games?

Uh, sometimes but you know, tickets are so expensive and also I have two small kids, you know, kind of hard to take them to a kids sometimes they go there, they don't, they get bored, you know, cause they're like, they don't appreciate four and five year old, you know, they're, yeah. They cannot sit there for two hours, you know? Yeah.

So they're four and five right now?

Yeah, four and five. Yeah.

Girls, boys?

Boys. Two boys. Yeah. Recently they kind of interested in basketball now, but before they're like, you know, it takes them to a game and they just cannot sit there for two and a half hours. Yeah.

<laugh>, I can barely do that.

Yeah, well they, well the good thing about going to the stadium, they can get up and go buy some french fries or something. <laugh>.

Do you guys have a neighborhood park where you can go play and shoot baskets?

Yeah, we live in the Upper East side of New York and they are many parks that have basketball hoops and then, uh, recently the weather's perfect so they can go. And then there's also, you know, the like the Y M C A nearby and all these places you can go if you wanna play indoor or basketball, but they're, they're kind of just starting to dribble, you know, a little bit. The basketball hoop is too high for them.

One of my children will gravitate to whatever ball is in the room. Like she just wants to play with the ball is very odd.

You know, people

Will encourage it. Yeah,

Yeah, yeah, yeah. Yeah. Maybe she'll be really good at uh, soccer or whatever.

No, not soccer. <laugh>.

You just don't like soccer, huh?

We're a lacrosse house. Dr. Lao.

Lacrosse. Well you know, I went to Hopkins then lacrosse is like I know number one sport almost in lacrosse in Hopkins.

That's right.

Yeah. The Blue Jays. Yeah. Yep. The homecoming for Hopkins is for lacrosse, not for football. That's, you know, mo most universities for football.

Yeah. So you get it. Yeah, we're a lacrosse house. We don't play soccer.

Oh, you were from Texas originally or

Actually originally New York. But then I grew up in Minnesota. And I got to Texas as fast as I could.

Okay. <laugh> Texas is big on lacrosse, probably not, right?

It's growing.

It's growing. Okay. And then, you know, the whole east coast is pretty big on lacrosse. It's kinda like the water polo on West coast. Mm-hmm. <affirmative>, you know, like Yeah. But Texas, I'm not sure what's big Football.

Football, yeah. Football is the, yeah.

Yeah, yeah, yeah.

Trumps it all. Yeah. Before we wrap it up, if a patient's listening to this, right, extremely helpful conversation about lacrosse and they want to come see you for, for any reason or your dermatologist. How should they reach out to you or learn more?

Right. So they can reach, always reach out to us by phone, you know, or email or, we actually use many, all the social media. There is, you know, uh, Instagram, TikTok, so uh, there's a Chinese app called WeChat. You know, you can also reach us on that. Yeah. So

It's the first time I've ever heard that. But it makes sense.

But it's easiest way to just Google my name, you'll be able to find all the information and on our website and everything.

I will put all the links in the show notes to make 'em easy to find too.

Okay, great. Thank you.

What are your plans for the rest of today?

So to pick up my kids, they went to some uh, Japanese language school for the morning and uh, may, well actually my wife might pick me up depending on what time we finish here and uh, we'll go eat some lunch together. Yeah. Yeah. Oh, and actually my older kid just turned six so we're planning on taking him to a little bank nearby. Just opened a kid's account cuz I think it's starting six year old. You can open an account.

Very smart.

Yeah. So I think he is, uh, looking forward to that. Yeah. Which is find probably will find some local bank nearby, like Apple Bank or something.

Yeah. They're probably gonna charge you a fee.

Yeah. <laugh>. Oh yeah, yeah, probably. But you know, it's just fun. Just wanted to start learning, you know, to save and stuff like that. Yeah,

That sounds great. Well, thank you for sharing yourself with us today.

Oh no. Thank you for inviting me again.

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