Confessions Of A Real Housewives Plastic Surgeon

illustrated by Anna Sudit.
Dr. David Shafer, MD, is a celebrity plastic surgeon in NYC. He has worked in the industry for 12 years, and specialises in liposuction, facelifts, breast enhancements, and injections. The following story was told to Kelsey Castañon and edited for length and clarity.
I've always been interested in sculpture and the mechanics of putting things back together. When I was a little kid, I would take apart TVs or VHS tapes just to fix them, and in high school, I spent summers studying architecture. That's essentially why I decided to go into plastic surgery. As I went through my training in medical school, one of my favourite parts of being in the operating room was closing the skin — stitching everything back together. The incision is what patients are more concerned about after surgery, so that is what I put my heart into and ultimately found the most rewarding.
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Early on in my career, I was seeing some patients in the fashion world. I was in the audience at a New York Fashion Week show and ended up sitting next to the mother of a very famous musician, who's also kind of famous herself. I can't say who she is, but we ended up going to a party and she was in my office a few weeks later wanting a facelift. Later, she ended up inviting me to another party, with other celebrities, and I got more patients that way. A lot of appointments come from word of mouth.
Giving — & Getting — The Royal Treatment
About a year after graduating from my aesthetic surgery fellowship, I got a call that a Saudi royal family wanted me to come to Saudi Arabia to perform surgery on five or six members. The person said, 'We've done our research, and I need you to go to the consulate by the U.N. to fill out some paperwork and get a temporary medical license. Whatever you need, just tell us your fee and we'll make all the arrangements.' I thought it was one of my friends playing a joke on me! But the next week, my team and I were on a flight to Saudi Arabia.
When we got there, we were treated like rock stars. They put me up in a room that was bigger than my New York City apartment! I didn't know what to expect, but when I walked in to the operating room, it looked like something out of Star Trek — there was state-of-the-art equipment, all this amazing lighting. What was really interesting was that the women were fully covered, so I didn't even know what they were getting done until 20 minutes before surgery. Some got facelifts; others got liposuction, breast implants, or an abdominoplasty [tummy tuck], but they only exposed the part of the body I was operating on. It was a very different experience for me, because I'm used to meeting with the patient ahead of time and talking through the plan.
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Some of the family members have become regular patients and will fly in to New York to see me. They've referred me to their friends in other countries, who refer me to their families. Very quickly, about 50% of my patients became international patients who travel abroad for surgery.
Real Talk With The Real Housewives
A lot of women on the show don't have any shame or embarrassment when it comes to plastic surgery. When friends have had the same work done, it's easier to talk about openly. I've known Jules [Wainstein, formerly of RHONY] socially for a long time through friends and just being in the New York scene, even before she was on Housewives. One day, I got a call from her that she was on her way to the emergency room. She was going out of a window to smoke a cigarette, tripped, and injured her labia. I always joke that I've never had a vaginal emergency, but when I rushed to the hospital, sure enough it was a true emergency. If you Google the genital injury, hers was one of the worst cases I've seen.

I've been at many dinners where I've operated on half the people sitting at the table, but I can't say anything because of the confidentiality you have with your patient.

Dr. Shafer
We can look at the humour of it now — and it made for very good TV. They couldn't film the scene in the hospital, so producers shot some of her appointments at my office. When they came to film, they transformed my office to look like a movie studio. They took out a lot of the furniture, put up all this special lighting, installed the microphones — it was really funny.
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The Most Requested Procedures
In the non-invasive realm, Botox (to decrease wrinkles) and fillers (to enhance the lips or cheeks) are incredibly popular. As much as I hate to admit it, the Kardashians have so much influence on the plastic surgery industry. It's crazy. Every single day, someone comes in asking for Kylie Jenner's lips or Kim Kardashian's butt. On the flip side, there are also patients who use them as a reference for what they don't want: ''I don't want them to look like Kylie's, I want them to look natural." So they're definitely used as a benchmark either in a positive or a negative way.
As far as surgery, what I call "the mommy makeover" — body work for those who've just had kids or lost a lot of weight — is really big with my celebrity patients, and can be transformative both physically and in terms of how they feel.

The Kardashians have so much influence on the plastic surgery industry. Every single day, someone comes in asking for Kylie Jenner's lips or Kim Kardashian's butt.

Dr. Shafer
Keeping Secrets
What happens a lot in plastic surgery is you become friends with the patients who come in a lot. You'll go to the same charity auctions or dinners or benefits. I've been at many dinners where I've operated on half the people sitting at the table, but I can't say anything because of the confidentiality you have with your patient. You have to be careful and let someone say something to you first.
A lot of celebrities don't want people to know the work they've had done. So in our office, we have our main entrance and then we have a back door, where we sneak them in through the freight elevator. The nice thing — not just for celebrities, but all patients — is after the surgery, you can choose to go home or to a hotel to recover. I can come to the hotel so the appointment is in a private setting. If they live in New York, it's so easy for me to swing by their apartments to check on them so they don’t have to keep coming in and being inundated by the public.
I always say the best patients are the ones referred by somebody else. They trust you. It's amazing to look back and trace who the primary "big deal" patient was. It's kind of like a tree with branches — you can see how the first patient helped grow your practice.

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