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Nigar Ahmedli Of Montefiore Einstein Advanced Care: 5 Things You Need To Create A Successful Career…

Nigar Ahmedli Of Montefiore Einstein Advanced Care: 5 Things You Need To Create A Successful Career As A Plastic Surgeon

An Interview With Jake Frankel

Be available: We need to be available for our colleagues and patients. Last week, one of my dermatology colleagues reached out to me to assist in an ear reconstruction after the removal of a skin cancer in the ear. We all ask for help at some point in our careers so we should offer our help to others.

As a part of my series about healthcare leaders, I had the distinct pleasure of interviewing Dr. Nigar Ahmedli.

Dr. Nigar Ahmedli is a Board-Certified Otolaryngologist (Head & Neck Surgery) specializing in Facial Plastic & Reconstructive Surgery. She is an expert in the use of injectable fillers and neurotoxins, face procedures, primary and revision rhinoplasty as well as congenital, post-traumatic and Mohs reconstructive procedures. She has shared her work in peer-reviewed journals, focuses on resident education and sees patients at Montefiore Einstein Advanced Care in Westchester.

Thank you so much for joining us in this interview series! What is your “backstory”? What led you to this very interesting career?

Thank you for including me! I knew I wanted to be a doctor when I was 6. I was in first grade, didn’t speak English, and fell on the first day of school (and skinned my knee). My teacher asked me what happened, and I couldn’t explain, but I remember not being scared of the blood or pain or the big band-aid. Anytime we learned about the body (the different bones and organs), I was fascinated. I carried this fascination with me as I grew older. When I was 18, I applied to a combined 8-year college-medical school program at Brown University and was accepted! I was able to go to college without needing to take the MCAT (Medical College Admission Test) or apply to medical school afterwards because I already had been admitted to medical school. Early on in medical school, I decided I was not going to be a surgeon because of my preconceived notions about surgeons (no bedside manner, aggressive attitudes, no work-life balance), until I did my surgery rotation and absolutely loved it. I had a resident mentor early on who was so passionate when talking about facial plastic surgery that his passion rubbed off on me. It was around that time I was introduced to otolaryngology/head and neck surgery. The anatomy of the face and neck is beyond intricate, delicate and elegant. It was then I decided to apply for this 5-year surgical residency. In my 3rd year of residency, I decided that facial plastic and reconstructive surgery was going to be the focus of my career because it gave me the opportunity to restore function to the face and neck in an aesthetic way and improve the way people feel about themselves and increase their confidence. I therefore completed an extra year of training (fellowship) after residency to learn the intricacies of cosmetic facial surgery. Now, I’m practicing the medicine and surgery that interests and excites and pushes me the most. My patients’ results and happiness bring joy to my life. I am so grateful to be able to do this.

Can you share the most interesting story that happened to you since you started your career?

When I was a 2nd year resident, I saw a patient in the emergency room who had recently undergone sinus surgery with one of my attendings (fully trained otolaryngologist). He was bleeding from the nose and was concerned. Bleeding is common after sinus surgery, so I examined the patient and told him this was a normal amount of bleeding. He disagreed. He demanded I put gauze in his nose to stop the bleeding. I tried to explain that I could not due to the recent surgery, but he would not listen. I called the surgeon, who also explained this to the patient. The whole encounter was very uncomfortable because the patient was clearly unhappy and upset with me, and to be honest, I was quite frustrated with the patient. Fast forward 5 years, and this same patient was referred to me for a revision rhinoplasty following 3 prior rhinoplasty surgeries because he still could not breathe from his nose. I walked into the room, and he said, “I knew it was you! You’re the same lady who didn’t help me in the emergency room!” I was shocked. I recognized who he was immediately. Then he said, “You know what? Let’s give it another chance. I heard you are great at what you do, so let’s start over.” He underwent a rhinoplasty with me, is breathing easily, and cried happy tears at his most recent appointment with me because I “finally fixed his nose.” I love this experience because it started so negatively and yet, turned out to be one of those cases that challenged me both surgically and as a doctor and made me better.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

In residency and fellowship, the sutures that we close incisions with were always chosen by the attending (fully trained surgeon) in the room. I didn’t pay much attention to the types of needles that sutures are attached to because they were always the correct ones. When I became the attending in the room, I asked for the sutures I wanted but didn’t pay too much attention to the needles until one specific day. I was suturing in a skin graft and used the same stitch as I always do. This one came with a different needle that cuts or pokes the skin with the front edge instead of the back edge. While I was suturing, I cut through the skin. It happened a few times until I realized what was going on. I felt really dumb and silly at that moment because it was a basic mistake that I shouldn’t have made. After that, I put together a whole lecture about suturing for my residents where we also review needle types. It was such a humbling experience because even when you get to the end of training, you are still learning so much.

Are you working on any new or exciting projects now?

I am working on a social media project about physician profiles. Many plastic surgeons have social media accounts to highlight their results, share patient stories, and share their own lives. Many patients use social media accounts to help determine with whom they will seek a consultation. The few studies that exist currently state that potential patients look for before and after images, patient testimonials/reviews, and research/publications. However, most surgeons share their personal lives on social media in an effort to engage potential patients and followers. This is done to show that surgeons are normal people and are relatable, but is it necessary? Would a patient not seek a consultation with a surgeon who did not post personal content if the surgeon had wonderful results? And if this is not the case, sharing personal life details on a public and professional social media account may limit the privacy of a surgeon, who is also a person. My project will assess through patient surveys the most important characteristics of a social media account and how important personal content is for patient recruitment.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

When I was a 2nd year resident, one of my older co-residents was applying to facial plastic surgery fellowships and exposed me to all that these surgeons do. Prior to that, I really didn’t know much other than they performed rhinoplasty surgery. This co-resident was so incredibly passionate about the field: his eyes literally sparkled every time he talked about a surgical technique or the latest innovative publication. He pushed me to shadow successful facial plastic surgeons in the New York City area (even on my post-call days where I had worked a 24-hour shift) to see the breadth of the specialty. I was able to meet my future mentors and colleagues who helped me during my fellowship application process and after. I am forever indebted to him for guiding me and allowing me to realize what was the passion in my career.

Is there a particular book that made an impact on you? Can you share a story?

The Confident Mind by Dr. Nate Zinsser. This book defines, shows and teaches what confidence is. I think most people assume that plastic surgeons are automatically confident because of the surgeries we perform and how we carry ourselves professionally. It’s difficult to maintain this confidence when you have complications or results that could have been better or just a tough day professionally. In the last several years, social media has become ubiquitous. All successful plastic surgeons are expected to have this social presence. This comes with great pressure because there is a certain style and image you want to portray but still be authentic to yourself. There is so much effort that goes into this, and the process of establishing yourself is slow. As a surgeon, I set definitive goals for myself. Recently, I felt like I was really dedicating myself to social media (which is time away from patients and my family), but not necessarily seeing the results. It was very discouraging. I did lose confidence in myself to obtain success in the social media domain. However, overall confidence is the belief you have in yourself that you can achieve a certain goal one day and be successful in the various facets of your life.

How have you used your success to bring goodness to the world?

When my patients tell me that they can finally breathe through their nose for the first time in a long time after their rhinoplasty surgery, I know I have done good that day. The “biggest good” that I can do is to pass along the lessons and techniques and knowledge that I acquire to the future generation. All the tiny details that I didn’t know when I started out, I’m sure to teach to my residents so they are not in a similar position one day. Or if they are, they will remember my experience, which will help them navigate their own particular experience. Mentoring is a huge part of medicine because it helped shape my career and my successes, so I must pay it forward.

Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant to you in your own life?

“Be grateful, be humble, be decent, be human.” Day to day, work and life can sometimes be overwhelming or you can become immersed in the details and forget the big picture. I saw this quote in an art studio during a surprise birthday weekend for the most important mentor in life, my fellowship director. This quote takes me out of the specific moment and reminds me why I do what I do and lead the life that I do.

Here is the main question of our interview. What are your “5 Things You Need To Create A Successful Career As A Plastic Surgeon’’ and why? (Please share a story or example for each.)

  1. Be affable: It is much more enjoyable to work with someone who is kind, warm and approachable. Colleagues feel more comfortable to reach out to you if they know the reception will be welcoming. There are several physicians who refer patients to me because of a one time in-person interaction we shared. Recently, another surgeon asked to shadow me to watch my suturing technique in the operating room because she asked for my advice on a specific patient and found it to be helpful without being authoritative. When my patients meet me for the first time, they often say, “You’re not what I expected. You’re so nice.” One skill I learned from my mentors early on in my training was the importance of rapport and bedside manner. As a surgeon, I ask my patients to put their faces in my hands and to trust me. They give up control of their bodies and hope I take care of them. How can I ask them that if I don’t show courtesy and respect for them?
  2. Be available: We need to be available for our colleagues and patients. Last week, one of my dermatology colleagues reached out to me to assist in an ear reconstruction after the removal of a skin cancer in the ear. We all ask for help at some point in our careers so we should offer our help to others.
  3. Have sound technical ability: The most important characteristic of a successful surgeon is to have great technical, surgical ability. This produces the results that patients are seeking. We spend a long time in surgical training to learn and master facial anatomy. I recently attended a facial plastic surgery society meeting where multiple surgeons debated a specific surgical technique used in brow lifting. To be able to participate in this discussion was a bit of a surreal moment for me because I realized how specialized our knowledge and abilities truly are.
  4. Be humble: As plastic surgeons, we have the ability to make profound facial changes. However, we are still human. We have complications of surgery too. A few years ago, I performed a large reconstruction of the nose and cheek on the loveliest patient. During the operation, she had an arrythmia (irregular heart rhythm), which jeopardized the blood flow to the flap (the local skin that was elevated to cover the defect) I used for the reconstruction. The skin necrosed (died) in the weeks that follow. We spent about 1.5 years together getting her through the immediate healing process, a second surgery, healing after surgery to where she is today. It was quite a journey that taught me about healing, patient counseling and expectations, and to follow your instincts as a surgeon. The tough experiences are usually the most altering ones. Even after all this, when I had my baby, she knitted him a blanket.
  5. Continue to change, refine and improve: As a plastic surgeon, I need to evolve my surgical technique and my medical knowledge constantly. There are new devices and techniques that are introduced at every conference. To be able to provide the best care for my patients, I need to understand the latest advances. The way I perform rhinoplasty and facial reconstruction now are quite different that how I did them 2 years ago. I use different grafts (pieces of cartilage) to re-shape the nose. I learned from my outcomes and fine-tuned how I close incisions on the face.

What are the “myths” that you would like to dispel about being a plastic surgeon? Can you explain what you mean?

Myth: Plastic surgeons are vain. It is not vain to want your outside to represent how you feel on the inside. It is not vain to want to feel confident in your body.

Myth: Plastic surgeons analyze your face. It is our job to assess the face when planning an intervention. However, in our daily lives, we look at people we know or meet as a whole person. We don’t pick apart their features and decide how to make them better.

If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?

The Transparency Movement: in our daily lives, we hold so much to ourselves. In our careers, family life, personal health, there are so many details we keep to ourselves. Situations in which we share some of those details can be so liberating. We often find out that others have similar issues and concerns and that we are not alone. For example, in residency training we make little mistakes here and there, but oftentimes, we do not tell our co-residents because we are ashamed. In the instances that we do, we hear about their version of the same mistake that they perseverate over for so long. Similarly, after I had a baby, my body and emotional state went through many changes. Some I was expecting, but some I wasn’t. I was so grateful to my friends who had shared their stories with me before I had my baby because they helped me understand some of those changes. The ones I didn’t hear about, I told my friends in case it happened to them. In modern media, there is almost a game-like quality to guess what procedures or interventions celebrities have had on their faces. The celebrities that share what they have undergone are often applauded for their honesty because their transparency allows non-celebrities to understand expectations and possibilities they have for their own faces.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why?

Natalie Portman. She has been in the limelight since childhood but has maintained normalcy in her life in regard to her education, family life, and privacy. Even with media being as intrusive as it can be for celebrities, she maintains a presence while protecting certain aspects of her life. Power and fame can cause so many issues in a person’s life, but she seems to have found a way to remain grounded. I’d love the chance to talk to her and understand how she is able to do this.

What is the best way our readers can follow you online?

My Instagram: @dr_ahmedli!

Thank you so much for these wonderful insights! We wish you continued success.

Nigar Ahmedli Of Montefiore Einstein Advanced Care: 5 Things You Need To Create A Successful Career… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.