The Dean of Plastic Surgery
Big personalities and a strong professional drive must run deep in Zarem genes. Most Savannahians know a thing or two about PR guru Bobby Zarem, but few may be as familiar with his brother, Dr. Harvey Zarem, although he stacks up quite nicely in terms of success—and interesting stories. An academic by nature, Zarem, a renowned plastic surgeon who just recently returned to his hometown to practice with Savannah Plastic Surgery, got his start in Andover, then progressed to Yale University, then to Columbia Medical School, The Johns Hopkins Hospital, Harvard, back to Hopkins and then to teach at University of Chicago School of Medicine and eventually UCLA. While enjoying the academic nature of plastic surgery, he eventually opened his own practice in Los Angeles and made quite a name for himself. After decades in the business, working with everyone from movie stars to cancer patients to the surgeons who worked on Michael Jackson’s infamous nose, here’s what he’s got to say about the business of plastic surgery—did I mention he also sat in on the very first liposuction surgery in the country?
PLASTIC SURGERY 101
• Plastic surgery is an interesting specialty unto itself. We joke that it’s basically surgery of the skin and its contents. It’s not a well-defined specialty and it varies from community to community.
• It evolved during and after World War II from all the war injuries, and it actually mostly started out in England with the RAF pilots that were getting injured. The planes then would catch on fire when they got hit and burn the pilots' faces and their hands. That was the beginning of what we know as plastic surgery today. So in the beginning we were all doing lots of reconstructive surgery.
OBJECTIVES AND ADVANCEMENTS
• Most of what I’m trying to do is trying to please the patient … The ultimate pleasure is when they come back and say they love it.
• I always tell the [medical] residents that if you’re not doing the latest thing, you’re probably doing the best thing for the patient. Technology and advancements are grossly overhyped. There’s too much of that in our specialty today. Commercialization has crept into our specialty to a terrible degree. And it’s something I fight all the time. New and improved isn’t as good as tried and true.
• The idea is they went around the country and found people with a good story; obviously they wanted it to be appealing. They found people suffering with injuries or various deformities that couldn’t afford to have the surgery. They went to communities without the resources.
• Myself and several other plastic surgeons would see patients as part of the show, and it was understood from the beginning that we were going to maintain a proper doctor-patient relationship. I wasn’t going to be a part of a public relations involvement or be pressured by them, and they honored that to the core. Subsequently there were other programs that didn’t do that at all. Unfortunately, Extreme Makeover gets lumped in with these other shows.
• It was a very gratifying thing. It gave the public a sense of what we can and can’t do. It stimulated a lot of interest in plastic surgery.
FACING THE CRITICISM
• There’s a lot of criticism of plastic surgery because there are a lot of examples of celebrities that look awful. The most classic example is Michael Jackson and his nose. I never operated on him, but the people who did are all people I trained. I’m intimately familiar with the situation. And the one thing I defended … let me put it this way, he went to an extreme and it was pretty obvious he wanted to look Caucasian … He wanted a Caucasian nose and he got it. It was the big criticism, but I tried to defend the person who did it; there were actually several different doctors who did it, all of whom I know. But they were saying, “This is what Michael Jackson wanted,” and they were giving him what he wanted, trying to please him—and they did. So when you see it from that angle, it’s a little different from, “Isn’t it terrible what they did?”
• That’s what we as plastic surgeons do; we try to please the patient. Now sometimes the patient might want things that we don’t think is in their interest, and there’s a spectrum of that. There are extreme cases, and I won’t do it because I don’t think it’s right. They may think they want it now, but in five years they’re going to regret it. And I also don’t want them going around town saying, “Look what Dr. Zarem did to me.” I yielded a couple times and regretted it each time.
Images by Greg Ceo