Yanover: I’ve always admired your profession for repairing cleft palates, or reconstructing nasal passages, or helping burn victims, where the issues at hand are not just aesthetic, but come down to the quality and even the possibility of life itself.
Salzhauer: I’ve heard that my whole career. You should know that before they allow you to do cosmetic surgery, you have to operate on sick people, you have to go through general surgery. Then you have to operate on reconstructive cases, like cleft palates, etc. And then, after all that, you reach a level where you can operate on people that don’t necessarily need you for medical reasons, but you can greatly benefit their lives.
To operate on a healthy person, to put a scar on somebody who otherwise wouldn’t need it, but you can actually make them look better and feel better, that’s another level completely.
I’ve been through burn victims, I’ve been through cleft palates and so forth.
WHY DO CROOKED TEETH GET ALL THE BREAKS?
On the other hand, nobody looks askew at orthodontia, at a parent who takes an 11-year-old girl or boy to the orthodontist because they have crooked teeth. And they put this metal braces in their mouth, and the child is in pain, and it takes months and years, and they look deformed until they finally get them off and they have beautiful, straight teeth. And that, too, costs thousands of dollars.
Still, people don’t have a problem talking about it, and nobody says, Oh, she’s so vain, how could she do that to her kid, doesn’t she know that beauty is on the inside.
Meanwhile, the rest of the world that doesn’t have access to orthodontists, they all survive, they all eat, they all get married, they all do fine. It’s not like you need straight teeth to live. So there’s some hypocrisy there – if you have a crooked nose, you should live with that, but if you have crooked teeth, sure, go get the kid braces.
Yanover: Do you in your practice tell some patients they should not get a nose job, they’re just fine the way they are?
Salzhauer: Often. I would say, between 15 and 20 percent of all the people that come into my office don’t even get a quote for surgery. I just say, Look, what you have isn’t serious enough to require surgery – in other words, it’s some minor imperfection that only they see.
They may also not be psychologically good candidates for surgery for various reasons.
Some people think that surgery is going to suddenly cure all their life’s problems. But that’s just not true. So if I pick up on those cues in talking to patients, and I say, You’re just not a good candidate for cosmetic surgery.
Then there are patients who can’t have the surgery for medical reasons. I only operate on, essentially, young, healthy people. I don’t do a lot of facelifts. I don’t treat a lot of patients over the age of 50. The majority of my patients are between ages 15 and 50.
THE TALE OF THE HASIDIC REBBE AND THE PLASTIC SURGEON
When I was a general surgery resident, going through trauma training and cardiac surgery training and all that, and I’m frum, so I had a crisis of conscience – shouldn’t I do trauma surgery, which seemed much more lofty.
A chasidishe rebbe came to town, I think it was the Riminover Rebbe (Rabbi Chaim Wassertheil). I saw a sign – Tzadik ba la’ir (a righteous man has arrived in our city). So I went for yechidus (private audience), to ask about my dilemma. I had a few references from people who said he was “ish kadosh,” a holy guy.
So I went in, I was about 27 at the time, and I told him, I’m on this path, I was accepted in plastic surgery—which is a very competitive position to get because it’s considered a highly specialized field and it’s so lucrative. I told him, I have a lot of other choices, I can go into general surgery, I could go into business and medicine, and I had couched the question to him in a way that I was sure he was going to say, You should go into helping sick people. I was sure that’s what he was going to say, how could he say anything else?
So he looks down for a few minutes… By the way, this is a guy who, I’m sure, has not watched TV his whole life, I doubt he’s seen a movie, or knows who Madonna is, or anything like that. And he looks at me and in his very heavy accent he says, You must, you must continue – meaning plastic surgery.