Dear Doctor: Anita Kulkarni

Capsule
Capsule
Jul 23, 2020 · 6 min read

The founder of DC Plastic Surgery Boutique on helping her patients reclaim their sense of self, changing the stigma around women and plastic surgery, and adapting to the new healthcare landscape.

By Maya De La Rosa-Cohen

Since its recent reopening, walking into the waiting room at DC Plastic Surgery Boutique still feels more like entering your best friend’s living room than a medical office. All of the little details, from the chandelier in the front to the fridge stocked with La Croix sparkling waters, were designed to make the practice’s female clientele feel at home. It’s all part of the vision of founder Dr. Anita Kulkarni, who started the boutique practice under a “for women, by women” philosophy. Yes, the staff is all-female and 99% of their patients are women. In a field still dominated by male surgeons, Dr. Kulkarni has created a place that belongs to women. Read on to learn how she and her staff work passionately to help their patients reclaim their dignity and sense-of-self and to ultimately change the stigma around women and plastic surgery.

What drew you to plastic surgery?

Initially, I was drawn to plastic surgery to take care of breast cancer patients. When I was in medical school at the University of Chicago rotating on the plastic surgery service, I met a number of young women undergoing mastectomies. It was the first time that I was involved with a patient population that looked so much like me. These were young women in their 20s and 30s facing this potentially really disfiguring surgery. And the plastic surgeon involved in their care was the one that got to reconstruct them, build them back up and make them feel whole again. That had a profound impact on me. I felt like, because I too was a young woman, I intuitively understood the things they worried about that might seem frivolous when you’re facing a cancer diagnosis. Things like, are my scars going to show in a two-piece swimsuit, or, can I still wear a halter-top dress? The idea of helping these women reclaim their dignity and sense-of-self was what propelled me to plastic surgery.

After this experience, I trained in plastic surgery at the University of Michigan and did a fellowship in breast reconstruction at Memorial Sloan Kettering Cancer Center. So working with breast cancer patients has always been an important part of my practice, but the other big part of my practice today is taking care of moms after they’re done childbearing. I do a lot of breast and belly surgery, which is called post-pregnancy body contouring or “mommy makeover surgery.” Again, this is a population that I identify with intimately, since I have two young children of my own. As a woman and a mother, I have this organic connection with my patients, which is the basic philosophy of my practice — connect with the patient first.

How do you combat the challenges in changing the stigma around women and plastic surgery?

I work with a lot of moms in my practice, and one of my biggest challenges is helping to absolve my patients of their mom-guilt. When a mom is deciding to do something for herself and her body, there’s a lot of guilt associated with that decision. She feels selfish, wonders about what other people will think, or worries that she hasn’t worked hard enough on her body after pregnancy. By the time a woman comes to my office to talk about surgery, she’s often ashamed and deeply frustrated because she’s tried everything possible to reclaim her body — whether it be undergoing exhaustive HIIT workout classes or strict Paleo or Keto diets — and nothing has worked.

That’s when I explain that there are some real, anatomic changes that happen with pregnancy that can’t be undone with diet and exercise. I tell her that it’s not her fault, and that every woman’s body changes with pregnancy. Helping her understand that it’s okay for her to care about how she looks and feels in her skin is an important first step. Once we get over that hurdle, it seems to lift a weight off her shoulders. These conversations don’t always lead to surgery. Sometimes a woman just needs to hear that she’s not alone.

What about the mental health benefits of restorative surgery?

As many of us are aware, there are two main arms of plastic surgery: cosmetic and reconstructive. Where those two Venn diagrams meet is where my post-pregnancy procedures live, what I call restorative surgery — since it’s both cosmetic and reconstructive. Finding this language came from years of my patients post-surgery telling me that they finally feel like themselves again. In fact, I hear that phrase, “I feel like myself again,” a couple of times a week.

I think these procedures have a profound impact on my patients because when a woman starts to have babies, there’s a five-to-ten year period where her body is not her own. First, she’s pregnant, then delivering, then nursing, and if she has more than one kid, soon she’s pregnant again and the cycle restarts. When a woman completes this journey of childbearing, sometimes she looks in the mirror and doesn’t recognize the woman standing there. It can strip women of their sense of self because they’ve been focused on their sense of motherhood for so many years. When these women have restorative plastic surgery, they feel like themselves again. It’s very powerful feedback for me to hear. Plus, it makes my job fun!

Are female surgeons still a minority in the field?

It’s clear that the tides have turned for the better since I finished medical school in 2006, but the upper levels are slower to change. For example, my medical school class at the University of Chicago in 2006 was 50% women, but my plastic surgical residency at the University of Michigan had only four women out of twenty-one total residents. This past year, the hospital’s plastic surgery residency was 50% women. So we’ve seen enormous progress in the past ten-to-fifteen years. It’s really important for me as a female surgeon to mentor women who are just starting out, and to show them what’s possible for a woman in this field. As Marian Wright Edelman said: “You can’t be what you can’t see.”

What do you believe are the most exciting technological advances on the horizon?

Nonsurgical treatments are getting better all the time. While there’s a lot of snake oil that gets sold in the cosmetic realm, there are also real developments. It’s refreshing to see new technologies in the cosmetic space that actually do work. A few exciting examples are recent nonsurgical fat removal devices, like CoolSculpting or Sculpsure.

How has COVID-19 and incorporating virtual care impacted your practice?

We pivoted to virtual consultations pretty early in the process, which allowed us to be primed for a full schedule when we reopened. The virtual consultations have been so popular that we decided to keep them as an option even after reopening our office. I imagine this may be a permanent way to deliver care from here on out.

How do you see your practice, and healthcare in general changing post-COVID-19?

Virtual visits will likely become a permanent fixture. I also think we have to be ready for rolling shutdowns for the next couple of years, so we have to stay lean and flexible at all times.

What advice would you give to other doctors navigating this uncertain time?

This is probably good advice for any time, but particularly in light of recent events, you have to be able to pivot quickly to recover quickly. Because we were able to switch to virtual visits early on, I could continue seeing a large number of patients even when we were closed. Those patients scheduled surgery for June, so my June surgery schedule ended up being busier than usual. This allowed us to recover really fast from being closed.

Vital Signs

What’s one healthful habit you’d love to see patients adopt? Drink more water.

Any phobias? Bugs, I really hate bugs.

What would you be in another lifetime? A writer or journalist. I’ve always loved to write, and my mom is a writer. In fact, I have a book proposal that we’re shopping to publishers now called The Essential Guide to Your Body After Babies.

What’s the best advice you’ve ever received? I have so many to choose from because I listen to this brilliant podcast, No Limits with Rebecca Jarvis. She interviews female founders and leaders about their paths to success, and I jot down inspirational advice and quotes from the show. One of my favorites was from Rent The Runway founder Jennifer Hyman: “If you try to change who you are, you’re never going to be successful and you’re never going to be happy.”

Know a great female doctor in NYC? We’d love to meet her, introduce us here!