How The Doctor Started

Dr. Javad Sajan  00:01

Ever wondered what motivates people to get plastic surgery? Did they regret it? What can we learn from the stories of plastic surgery patients I'm Dr. Javad Sajan and this is the plastic surgeon podcast.

Dr. Javad Sajan  00:30

Hello, welcome to the plastic surgeon podcast where we listen to real plastic surgery stories of triumph and pain from real patients and providers to further understand the motivations why they would risk their life under the knife. I'm Dr. Javad Sajan and this is our first mini episode. Today I'm excited to talk about a topic that really relates to questions we've been getting. Since we've launched the podcast. A lot of people have been asking me so Doc, why do you do transgender surgeries? What's all that about? How did you get into it? I wanted to share with you a little bit, my background, why I got into it, what I do, and why do I keep doing it. So I was born in England, I grew up in East Africa. I am and was raised Muslim, fairly conservative family, but modern at the same time. To transgender community is a group of people I was never really exposed to. When I grew, I grew up in Milwaukee, my family immigrated there from Africa. And in Milwaukee, it was sort of isolated from a lot of the current day events you hear now about when I was in Milwaukee, I did medical school there that I went to residency in Minnesota, and then I decided to come to Seattle to do my fellowship. The fellowship is what you do after residency, which is your specialization. They perform transgender surgeries. I was happy to learn it, but I thought it was something I was never going to do because it was my plan to always go back to Milwaukee. So I was setting up my career too. Go back to Milwaukee during the end of my fellowship, and I'd actually even got an office space there. While I was doing that things were getting set up in Milwaukee, I ended up finishing my fellowship. When I finished my fellowship, I decided to stay in Seattle and work out a little medical spa where they did Botox and fillers and do some of that Ron Milwaukee was getting set up, because I had to secure the space and I was getting bids from contractors and I was going to open my own little office there. I wanted to go back to Milwaukee because that's where my family was. So while Milwaukee was in the works, I stayed in Seattle. I was doing the Botox and fillers to make ends meet. And while I was doing that, I was gaining some popularity. A lot of patients were liking it, they were coming to me, they're asking me for more and more so I was just doing it and it was growing and I was getting the contractors and everyone in Milwaukee to get that project you have to build my own little office there. While I was in Seattle, a few patients approached me to do their surgery. They had heard About me through my fellowship and different patient referrals. Now I didn't have a surgery center or anything at that time, but the patients wanted surgery. I was still here. So I decided, let me see what I can do. One of the patients that approached me was a transgender patient in this patient came to the medical spa asked for a surgical consult. And I was a little bit surprised because I really wasn't trying to market or get any surgeries. I was just the Botox and filler guy temporarily at the Medical spa while my office was getting set up in Milwaukee. So this patient came in I didn't say no, I like people. I love meeting people and talking to them. So that patient scheduled a consultation with me. I saw them and during the consultation, I was curious, why are you here to see me so the patient told me I'm here to see you because I want transgender surgery. The patient told me I was assigned female at birth a transition to male and I'm ready to make me a male chest. The patient told me I have boobs. I don't want boobs in this restricting my life. And I was like, tell me how you know why you want more? Why do you want the surgery? In the patient he degenerated gender identity is male now said I want this because this chest tissue gives me dysphoria. I'm a chef, I own my own restaurant. I can't dress the way I want and it's very uncomfortable. So I was like that happened to help us but I told them. And then my next question to the patient was after I understood what they were looking for, was Why me? So the patient looks me in the eye and tells me my fortune teller chose you. And I almost chuckled when you said this. I was like your fortune teller. You got to be serious, right? I asked him I said, No, come, why'd you choose me? Tell me tell me. And he said my fortune teller. You know, and I was like, Okay, how did that work? How did your fortune teller know my name? Because I was like, Well, you know, is this patient on the right wavelength? And he said I printed the picture every doctor Who I'd heard of who does this operation I put them in front of the fortune teller. The fortune teller looked at it and picture your name and your picture.

Dr. Javad Sajan  05:09

So I was like, Okay, that sounds reasonable I guess or no no, why not? I'll do it. So then I did the patient surgery went amazing. And you know, I was like, Okay, I'm happy to do this one off surgery, no big deal. I did the surgery took two hours to do. I performed a double incision chest reconstruction with free nipple grafts. What that means is I removed a lot of the breast tissue like was called the chest to make a male chest or to move the nipples in the area, align, reattach them. surgery went great. And I thought it was going to be a one off surgery. Beijing came for their first post op, I took all the bandages off, things looked amazing. And I was still new here. So I was you know i spending a lot of time with my patients. I still do. But at that time, my schedule wasn't as busy so I did spend more time and I really enjoyed it and I still enjoy talking to all my patients a lot. So I walked him out to the elevator When we got to the elevator, he pushed the button, and that I was sort of standing there going to walk away. And he said, Doctor, I want to tell you something. And I was like, okay, Sure, go ahead. I thought maybe he was gonna ask me about his band aid or his diet or something like that. He looked me straight in the eye. And there was a pause. And then he said, Thank you for giving me a new life. And the moment he said that, something changed for me, I realized that within a two hour surgery, I had totally changed someone's life. I had made him feel much more comfortable the way he was. I had made him much more comfortable to live, how he wants to live. And I had help treat a disease that he had for a lifelong, that being gender dysphoria. And that was the moment I decided, you know, what I can change people's lives for the better with one operation. ration consistently, safely is something I'm amazing at. And I decided I'm going to do this operation. And after that more patient started coming to me, with gender confirming surgeries were still a good amount of what I did during that procedure, put my life in a different direction. Because many more people are coming to me for this operation because they heard of this first patient, it's better direction for me to settle in Seattle. Had I not done that first operation. I don't think I would still be here. I think I would likely be in Milwaukee doing what everybody else does. I I ended up staying in Seattle because of that patient, his fortune teller doing his surgery. And then my people just knowing of me and it growing and having a you know, thank god a snowball effect where more people might have come to me more and more. And the more I did the operation, the more I realized I could totally change someone's life for the better in a very dramatic way. At that moment, I realized this is my future. And I ended up settling and being in Seattle, in performing surgeries for transgender people and really having that privilege. I've learned so many things, so many things about myself and so many things about others. One of the greatest things that I learned about others is, on average, patients will say or do a lot of things. I don't want to say anything, but I sort of want to be close to that to have surgery done. I never realized how significant some people want change in their life. And as I started creating more and more change, I realized some people would put themselves at Jeopardy for that change. For example, just this morning, I had an amazing patient who was here for a gender confirming surgery. This amazing patient, blood pressure was in the high one seven days. Before I cancel the surgery. I went to talk to my patient and I told them I have to cancel your surgery, your pressure is very high. And what the patient told me is, Doc, I'll find anything. I don't care if I die, just get it done. And then I told him, you know, odds are we could do this and we can give you a blood pressure medicine and probably squeaked through this 8020 rule. I'll be fine 80% of the time. But I can take a risk of 20% of you dying. If your pressure isn't controlled after a surgery like it's not now, you could develop a hematoma and you could die from that you could have a stroke during surgery, you could have a heart attack during surgery. One of the greatest lessons that you learn about plastic surgery, the more you do it, is you have to learn when to say no. Oftentimes when you build up a stronger reputation and people know who you are, and they come expecting something from you. They'll say yes to almost anything you're going to say and you have to walk that boundary Giving them autonomy, giving them respect, while doing what's right.

Dr. Javad Sajan  10:06

And sometimes doing what's right requires, and not always, but sometimes taking a more parental role in telling that patient You know what, today's not the right day, this isn't safe. We can do this another day, we can do it better. We can do it safer. And we can do what's in your best interest. And sometimes in my field, and I see this a lot, especially when doctors are new. All they want to do is operate, operate and operate and operate on anybody, and they'll say anything. And whenever you do this, you always end up getting in trouble. Because your hearts in the wrong spot. You're acting for the wrong reasons. Sometimes when you hear no is the right way to go. If you're thinking about having surgery and you see hesitation from your provider, that's a big sign that maybe you shouldn't do it in medical school, rather Vinci fellowship when you're training. You're always taught problem x treat with y. Problem a treat would be sometimes saying no is the right answer and taking care of that problem or not taking care of it. Sometimes saying no is the right answer, and understanding that taking care of that problem Another day, another time, or even not taking care of it is the right answer. Thanks for listening to the plastic surgeon podcast. Tune in next week for my guest who has an amazing story from botched surgery in South America. She's a physician and she's going to share tremendous insight with us. Catch me on all social media at real doctor Seattle and watch my surgeries live on Snapchat. Bam