How Dr. Lara Devgan Is Changing Plastic Surgery
In ELLE.com’s series Office Hours, we ask people in powerful positions to take us through their first jobs, worst jobs, and everything in between. This month, we spoke with Lara Devgan, plastic surgeon and skin-care founder, whose fans include Jennifer Aniston, Bella Hadid, and Kim Kardashian. Known for her subtle, natural approach to her work, Devgan grew up near the old Getty Museum in Malibu and trained as an artist. Her study of the beauty of light and shadows, combined with her desire to help people, spurred her interest in plastic surgery. “It’s really the perfect combination of art and anatomy,” she says. “Plastic surgery is about adding, subtracting, and putting things back together. It’s like being a very technical and detailed carpenter, but for the human face and body.”
Devgan practices non-surgical and surgical techniques at her Upper East Side practice, and recently, she authored a paper examining the structural biases in surgical instrument design, finding that most tools were designed for male hands. In just one call for systemic change, she launched a set of surgical tools specifically sized for smaller and female hands (proceeds will benefit the Dr. Lara Devgan Golden Scalpel Award for the next generation of women surgeons). Below, the mother of six talks about her profound moments in the operating room, the difference between beauty and identity, and the gender gap in surgery.
My first job
In high school, I worked as an assistant junior counselor at a day camp in Santa Monica. It was fun to be outdoors in the summer. I also did a lot of tutoring jobs and some teaching in math, science, debate, and English.
My worst job
This was not my worst job, but my hardest job was being a Capitol Hill Senate intern. I was 16 years old and a young person who loved politics. I remember seeing this machine called an Autopen—it’s essentially a big signature robot. I felt genuine sadness that the senator wasn’t actually personally signing letters to constituents, which, in retrospect, was the most obvious thing in the world. But at the time, it represented the end of my innocence about the political process. I felt a little bit disillusioned by the bureaucracy of politics and seeing the inside of the hot-dog factory.
The surprising lessons I learned as a medical resident
As a surgery resident, you go from being a senior medical student and know-it-all to being at the very bottom of the totem pole. It builds a lot of resilience [and] character. You have to figure out how to make a full, balanced meal out of a vending machine. You have to figure out how to sleep on a mattress, with no sheets, for one hour. You have to figure out how to be the person who picks up candy wrappers that are on the ground and cleans up vomit and feces and bodily fluids one minute, and then in the next minute, breaks the news about a diagnosis or development to a family and resumes a position of authority.
It teaches you to not be too proud, but also to be willing to do anything in service of your overall goal. It really is like the sharpening of a knife. I loved it. I spent time taking care of patients who had gunshot wounds, facial fractures, car accidents, cancer, congenital anomalies, severe burns. It just really shows you the breadth and depth of the human experience, and the dignity of being able to offer people freedom from suffering. In the way, politics took away a little bit of my idealism, but training to be a surgeon helped restore my idealism.
My profound moment in the operating room
In medical school, I saw a person’s face being completely taken apart. The cancer and ENT (ear, nose, throat) surgeons took out a big carcinoma of the mandible, but the patient was left with a very disfigured hemiface. The plastic surgery team then came in and rebuilt it, using something called a free fibula flap, which is a bone borrowed from the leg and anastomosed to the tiny vessels of the face. It was so beautiful and artistic. There are many types of surgery that take things apart, but plastic surgery is about putting things back together.
On the gender gap in surgery
I came of age at a time when surgery was a very toxic culture and difficult place to be. With every progressive year and generation, it’s becoming more and more open. Approximately 90 percent of board-certified plastic surgeons are men, and 90 percent of patients are women. This creates a strange situation where we, as women, don’t always feel like we are controlling our own beauty narrative.
In my work, I feel passionately about the idea that beauty does not have to feel self-abnegating or like something somebody told you to do. Beauty can feel extremely empowering, because it’s an opportunity for a person to have the outside reflect the inside. If you’re born with a cleft lip and you want it to not be the first thing someone talks to you about, or if you hate your profile from the side, or if you want your body back after you have a baby, these are all things that are part of the human condition that sometimes feel awkward to talk about. I really enjoy creating a safe space for these things to exist.
Why it’s important to find multiple mentors
It’s hard to learn every single thing from just one person. My strategy was to find female and male mentors—people who I thought could give me good teachable moments about surgery and personal success. I certainly came of age at a time when I wished I had more women to look up to. I wished when I was younger that I had visible examples of role models who were successful women surgeons, who had families, happy relationships, were thriving, doing good work in the world, and hitting their professional and personal marks. There were examples here and there, but at various times, I felt like I had hardly anybody to look up to.
My call for change
Surgical instruments are typically standardized for an average-sized male hand. But, just like with clothing, when they say “one size fits all,” it doesn’t really fit everybody. I wrote a review article where we found that 85 percent of female surgeons report difficulty with standardized surgical instruments. My surgical instrument project was designed to bring attention to this kind of structural bias. Now, granted, there are some men who have very small hands and some women who have very big hands, and not everybody has the same kinds of issues. But in surgery, it can sometimes feel like we are living in a world that’s built by and for men.
As a woman in surgery who takes care of many women, I wanted to bring awareness to this idea and also to try to ideate some solutions for it. The conversation around this topic needs to be had, in the same way the conversation around inclusive sizing for clothing needed to be had, so that there can be more collaboration with manufacturers and instrument designers globally.
How I view beauty versus identity
Beauty and identity are distinct but related. In my work, one of my main goals is trying to preserve identity, while optimizing beauty. We all can think of examples of celebrities who had a procedure and lose their identity and don’t seem like the same person anymore. Maybe it’s what they want, but in many cases, people want to have that continuity of who they are. Plastic surgery is really a field of millimeters and not centimeters, and giving people an outcome that straddles this delicate line between identity and beauty is the ultimate goal.
This interview has been edited and condensed for clarity.
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