Tyler McElwee, MD - Facial Plastic Surgeon in Houston, Texas

Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision, and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Today on Meet the Doctor. My guest is Tyler McElwee. He's official plastic surgeon in Houston, and his dog is with us too. And your dog's name is? 

Dr. McElwee (00:41):
His name is Apollo. 

Eva Sheie (00:43):
Apollo. After Apollo Creed?

Dr. McElwee (00:46):
Actually, it's a mix between the fact that I'm a big history nerd and my wife wanted something Texas themed for our dog. We weren't living in Texas at the time, and so it was a good blend of the NASA Apollo program as well as something at least, I guess, more mythology than true history. My initial name was Julius and I was shot down pretty hard on that one. So we settled for Apollo. 

Eva Sheie (01:10):
Oh my g,oodness. Yeah. Do you know about the test? You're going to have to try this when you're naming your children where you go to the playground and yell their name 10 times loud in a row and see if it feels annoying. Do you know about that? 

Dr. McElwee (01:22):
No, but I think now we have to do that. We literally just decided on names I think the other day. And yeah, we haven't made blankets yet though, so I guess it's not technically set in stone. 

Eva Sheie (01:35):
I invented this test because I was at the playground once and I heard these parents yelling Oliver, Oliver over and over and over, and I wanted to kind of tell them to nicely be quiet. And ever since then, whenever we hear someone yelling Oliver, I'm looking at my husband. 

Dr. McElwee (01:55):
So the best part is that's one of our kids' names. <laugh? 

Eva Sheie (01:58):
No, no, no.<laugh>

Dr. McElwee (02:00):
 So it's funny. So I love the book Oliver Twist. Love the book, Oliver Twist, and it's like, actually ironic. Charles Dickens is not a favorite author by any stretch, but I've always loved the name Oliver, and now it's popular. But I was like, well, you know what? I've loved it, this long. My wife was like, yeah, I like it enough. And we also wanted to name names that we could turn into nicknames, like Ollie, stuff like that. And, so. 

Eva Sheie (02:30):
Yeah, Ollie's good. <laugh>

Dr. McElwee (02:32):
But I do totally get, 

Eva Sheie (02:34):
I"m sorry. 

Dr. McElwee (02:34):
No, don't apologize. I hear you. But now we're looking at 

Eva Sheie (02:40):
What are the chances? <laugh> 

Dr. McElwee (02:42):
I know. Well, so it turns out Oliver's actually one of the most popular names today. And as I was actually kind of annoyed to hear that, I was like, I've liked this name long before it was popular. Come on guys. It just so happens that the trend caught up to me and now I look like I'm caught up in the trend. But se la vie, I know. <laugh> What are the odds? As soon as you said that, I just had to start laughing. Don't worry about it. Don't worry about it. I hear you. 

Eva Sheie (03:11):
Oh, this interview is off to an excellent start. 

Dr. McElwee (03:13):
<laugh> 

Eva Sheie (03:14):
I've already insulted you. 

Dr. McElwee (03:17):
No, no, it's good. It's good. 

Eva Sheie (03:20):
Be serious for real. 

Dr. McElwee (03:21):
Okay. Okay, for real. 

Eva Sheie (03:24):
You ran home from work in the middle of the day to talk to me, which I really appreciate. Tell me a little bit about work and what that looks like for you these days. 

Dr. McElwee (03:35):
So work has been wonderful. So I joined Memorial Plastic Surgery as their facial plastic surgeon. They were so busy with body, and they were so good at body that they had a hard time incorporating face because it would take them a little bit longer. They're used to their routine and body, and so they wanted to bring on somebody to do face, and that's me. And I joined them because I am somebody who I know what I'm good at and I know what I'm not as good at. And I think I'm good at surgery. I think I'm good with patients. I am not good at business and marketing and that side of things. And so I wanted to join a practice that already had those kind of mechanisms in place to help me get where I want to be. They are helping me get patients in the door, and I am having the time of my life operating and meeting new people. And so it's been kind of a very good match so far. 

Eva Sheie (04:26):
So what kinds of things are you doing every day? Rhinoplasty, facelift, everything? 

Dr. McElwee (04:30):
Pretty much. I tell patients everything from the collarbone on up. So necklace, facelifts, blephs, which are eyelid lifts, brow lifts, forehead reductions, rhinoplasties, nose jobs, ear pinnings or otoplasty and the word scar revisions, and then even laser resurfacing for skin, and then injectables, your fillers, your Botox to sports stuff. So if it's above the collarbone, I am not afraid to tackle it. 

Eva Sheie (04:56):
I've been thinking a lot lately about why you should find somebody extremely qualified just for something simple like Botox or filler. Do you have any thoughts on that that you can share? Am I right? I just really want to know if I'm right.

Dr. McElwee (05:09):
You are a thousand percent right, and so I actually have very strong feelings about this. And the reason I have strong feelings about this is because if you can go online on Google images and see where do I get Botox injected? And some picture will show inject here, here, here, and here. And there's a very big difference about knowing unquote what to inject versus why to inject. The knowing why is a dramatic difference. The number of people who hate their forehead wrinkles, but they come in and they say, well, why went to so-and-so and my eyebrows came down? Well, the only muscle that elevates our eyebrows is the same muscle that causes these wrinkles. And so knowing why you inject that and knowing what can happen is a major factor. Now, luckily for Botox and Dysport, you can't hurt somebody with it permanently. 

(05:58)
It all wears off. It's the best and the worst thing about it. But then you start getting into filler territory and you see all these places doing liquid rhinoplasties and stuff, and that becomes a very dangerous game because if you don't know what you're doing there, you can potentially blind somebody. There can be very serious consequences if you don't know why you're doing what you're doing and what really lies underneath. It's not just putting filler to put filler there. There are structures underneath that are important and can cause problems if damaged. And so I think it's very, very important to vet whoever's working on your face. 

Eva Sheie (06:33):
When you're in training to be a facial plastic surgeon, what kinds of things do you do to learn what's underneath the surface of the face? 

Dr. McElwee (06:42):
So I have operated on places in the head and neck that I hope to never see again, to be quite honest with you. And what I mean by that is I've done a lot of head and neck cancer and reconstruction there all over the face. If it's an anatomic structure in the head and the neck, I have seen it firsthand. It's a blessing and a curse because some areas when you're dealing with cancer, you have to get that deep. You got to cure the disease. That's the point of doing the surgery. But it does give you a very, very, very good understanding of all of the anatomy and how it interplays. I've seen the structures that I'm worried about injecting. It's not just this mythical thing underneath the skin. To me, I have seen it live. I've seen it in every which way, every confirmation. And I think that gives me a good understanding of why I'm doing what I'm doing. 

Eva Sheie (07:31):
How many faces do you think you've seen the inside of? 

Dr. McElwee (07:36):
I can go back and look at my case logs, but it's going to be in the high three to low four digits at least just from training alone. And so it's a lot of faces, a lot of necks, a lot, lot of anatomy. 

Eva Sheie (07:50):
And then do you think there's injectors out there who've never seen it? 

Dr. McElwee (07:54):
Absolutely. I do. Pretty much anyone who isn't a surgeon has probably never seen the anatomy outside of maybe a cadaver lab. They've never seen, I'll be honest, I've done a good number of cadaver labs. They're great training tools, but they never replace the real thing. Structures are so much more variable in the real thing than just a cookie cutter cadaver. And so there's nothing that replaces surgical training. 

Eva Sheie (08:22):
And is there variation between people under the surface? Is everyone's face the same or completely different? 

Dr. McElwee (08:28):
It's not completely different, but there's variables and those are things to know about. For faceless, great example, one of the most important parts of surgery is protecting something called the facial nerve. The facial nerve comes out just in front of our ear, in the middle of that big spit gland called our parotid gland, and then it displays out into five branches. Now generally speaking, those five branches go the same trajectory. There's little anatomic markers that us facial plastic surgeons all know about that approximates the course, but that's exactly what it's, it's an approximation. So you can't just assume that it's going to fall perfectly on that line that you've drawn out. The marginal branch that comes down, most of the time it doesn't come back up over the mand some, but 10 to 15% of the time it does. Just knowing that is a possibility and not just assuming, oh, well in this generic textbook it said, it just goes this course. That must be the course that always goes. That's the kind of stuff where those are the pitfalls that you can run into if you haven't done this enough times. 

Eva Sheie (09:26):
So tell us a little more about your training and where you did have the privilege to see underneath roughly 400 faces. Where were you doing that and what was that like? 

Dr. McElwee (09:38):
Fortunately, and unfortunately a little bit more than 400, it was closer to four digits. But I'm from southern Louisiana and I really wanted to go back there to train because I knew I'd probably never settle down back home. But I wanted to live there one more time when I was young enough to enjoy it. So I trained at LSU in New Orleans and it was phenomenal. One of the perks there is that there's a lot of, it's not really, it's a perk from a training standpoint, but it's a sad ordeal. There's a lot of indigent patients that can't get care elsewhere, so they come to you with problems that are generally farther gone than the average person is going to present to a physician with. And so it was no shortage from a patient population standpoint. And because the supply of patients outweighs the outweigh the demand of the doctors, even as early as intern year, you're kind of thrust into the situation in a lot of ways. And it got me a lot of great operative experience that I don't think I would've gotten in a lot of other training programs, to be quite honest with you. Again, just you're kind of thrust into the picture because everything's on fire and there's only so many firefighters. You know what I mean? So it was a great experience. 

Eva Sheie (10:53):
And this is in New Orleans? 

Dr. McElwee (10:54):
Yes. 

Eva Sheie (10:54):
So you're working like, and you were a resident here? 

Dr. McElwee (10:58):
Yes, resident. Yeah, I was a resident there. 

Eva Sheie (11:00):
So you're basically living at the hospital and you're drowning or trying not to drown probably in patient volume most of this time , right?

Dr. McElwee (11:13):
Patient volume was sky high. 

Eva Sheie (11:14):
So for how long did this go on? 

Dr. McElwee (11:17):
So residency is five years, and then I did a fellowship after that for a year specializing in just cosmetics. So all the facelifts like rhinoplasties, the cosmetic side of things. And so fellowships, it's a tough year, but residency is the toughest. I mean, and it's not even just tough on me, it's tough on spouses, it's tough on family. You're never around, like you said, it's called residency because you live at the hospital basically. But it's a very worthwhile endeavor. Now I can say that now that I'm on the other side of things. 

Eva Sheie (11:45):
Sure, yeah.

Dr. McElwee (11:46):
It's like I said, the experience is unparalleled from a training standpoint. It really is. 

Eva Sheie (11:53):
Was this when you figured out that you wanted to head towards aesthetics was during this time? 

Dr. McElwee (11:57):
It was because like I said, we dealt with a lot of cancer and we will kind of take assistive to a lot of skin cancer. And that indigent population, they really didn't have a mo surgeon that could make tiny defects in the face and kind of repair tiny defects. So we did all of our own excisions and repairs. And so these repairs are pretty complex, reconstructing eyelids, reconstructing lips, reconstructing noses. And so that's what started gearing me into the aesthetic side of things because you take people who have been just fine their whole life and you give them this disfiguring defect and you got to make it look nice. People don't want to walk around with missing half an eyelid. They can't either. But again, it's a cosmetic thing and you give these people confidence back. One of my favorite patients in all of my training as a gentleman who had long punk rocker s hair, he's like in his late fifties and he had a very large squamous cell on his scalp, and his only request was, I don't want a bald spot there. 

(12:56)
He's got this long hair. And then he just didn't want just a giant bald spot right there where it was. I was like, all right, I got you. And through a couple little rotational flaps and things like that, you could never tell anything happened. And the defect was probably a good six and a half centimeter diameter, maybe seven centimeter diameter. It's a pretty good size and you can't tell anything happened. And he's the most ecstatic person in the world over it. It's just giving people that confidence that their look that I do a big believer in, you look good, you feel good. If you think you look good, you feel good. And so he's not going to want to walk around with a bald spot like this giant disfigured spot right there. And is it something that's kind of silly? They think about, okay, it's just a bald spot, but we all have little insecurities that bother us whether they bother other people. And so that's the only human, and so he worried about it and I'm happy to be able to give that confidence back to him. 

Eva Sheie (13:50):
So you said earlier you went back to Louisiana. So you grew up in Louisiana and you came back to Louisiana, but what did you do in between those two Louisianas?

Dr. McElwee (14:01):
Moved to Houston just before high school. My dad got a job in the oil and gas industry after going back to college when I was a kid. 

Eva Sheie (14:10):
But he made you leave in the middle of high school? 

Dr. McElwee (14:13):
No, no, no, just before high school. It was before school. 

Eva Sheie (14:15):
Oh, just before. 

Dr. McElwee (14:16):
Yeah, it was a good time to transition, and so I ended up staying in Texas for undergraduate at Texas A&M, graduated summa cum laud there. Then went to Baylor College of Medicine, my med school. That's where I met my wife, who is a Houstonian born and bred. So it's probably a foregone conclusion that we were going to come back to Houston at some point. But I did want to live in Louisiana one more time before settling down wherever we settled down, which of course so happened to be happy wife, happy life Houston. 

Eva Sheie (14:45):
So you've never lived north of I 10? 

Dr. McElwee (14:48):
No, I guess College Station technically, but I mean 

Eva Sheie (14:51):
I guess technically. 

Dr. McElwee (14:52):
Well outside of that, no, a little bit. I used to joke that I 10 is like the wall from Game of Thrones. It's northern, this northern border that no one dare cross. 

Eva Sheie (15:04):
It's cold up there. You don't want to get past it. 

Dr. McElwee (15:07):
Exactly. 

Eva Sheie (15:11):
That's good. So you're at Memorial now and how long have you been there? 

Dr. McElwee (15:17):
So we just moved to Houston a couple few months ago, so I've been there for two months now. 

Eva Sheie (15:23):
Okay. So you have a brand new team around you, new staff, new everybody, new patients. Are they starting to get to know you and how do you think they would describe you? 

Dr. McElwee (15:33):
So it's actually funny because just today one of them told me that this is just really gratifying to hear, and I'm not somebody who likes to compliment myself, but they should have told me they were super happy I joined because I'm very easygoing, I'm fun to work with and just enjoyable to be around. And I thought that was the most heartwarming thing I think I've ever heard in my life, but I try to be that way. We've all been on teams in any capacity work related that don't fire on all cylinders together, and it's pretty miserable for everybody involved. And I believe when everything's firing on all cylinders and the teams are working, other teams are happy to be there, that's when you get your best results. Because everybody wants, they're not just trudging along to get to the goal. They want to get to the goal. And so even back in training, I was the chief resident, I'd always, I was never one to yell at people. I was never one to be like that kind of personality. If somebody makes a mistake going to do about it, you can't go back in time and make sure doesn't happen. All you can say is listen, move forward for the next time. And so I always try to be easygoing and it was just really heartwarming to hear that they notice it and feel that way too. 

Eva Sheie (16:41):
My mentor always says when the staff are happy, the patients are happy. 

Dr. McElwee (16:45):
mm-hmm.

Eva Sheie (16:45):
And it sounds like your staff's pretty happy. 

Dr. McElwee (16:49):
I would say so. They're all great. I love the people I work with. 

Eva Sheie (16:53):
Do you think the patients can tell? 

Dr. McElwee (16:56):
Yes. Yes. I think it's the same way. Sometimes this Gen Z, as this might sound, the vibes are sometimes off. You can just tell when you walk in a room that there's some tension, there's some, you don't even have to know what's going on, but people can just tell that kind of stuff. I really believe that people are very good on picking up on the little hidden clues and hidden signals that are going on, whether they know what it means or not, they just know something's off. 

Eva Sheie (17:22):
There's an office where I used to go all the time and I love the provider and that was why I went there, but every time I went, the front desk had a bench right in front of where you would check in, so you'd walk up to the front desk and then they'd have it this stupid bench right in front. So you'd sort of be like, do you really want me here or are you trying to tell me something with this bench? And I thought, I think about bench a lot because sometimes we do things in our offices because we forget what it's like to be scared or to be nervous or to feel vulnerable coming somewhere like a cosmetic surgery office for the first time and all they had to do was move the bench like six feet to the left and it would've felt a lot better. 

Dr. McElwee (18:09):
It's funny you mentioned that. I'm a big believer in that the patient experience is what matters just as much as a result. Back when I was interviewing for fellowship, remember talking to one of the fellowship directors, big guy out in Salt Lake City, and he was saying that he charges X amount more for his rhinoplasty, his competition. He goes, do I think I'm better than them? I do. Do I think I'm that X amount better than them? Probably not. But the experience I provide patients believe it. And I always think about that because there's a lot of great surgeons at Houston. I'm not going to pretend that I'm this mecca of surgeon. I think I'm a very good surgeon, don't get me wrong. But what differentiates it is the patient experience. I want to roll out the red carpet for these people. I want my patients to be happy in all facets. I don't want them to have a single hiccup, whether it's administrative or what and shouldn't. No one else in my family's in medicine. And so I keep that in mind because I've never been just on the medicine side of things. I've been on the other side of things plenty too, and I just keep in mind what it's like to be a patient. There are trials and tribulations with their clinics and stuff like that, and I think it's very, very important to provide that perfect patient experience. 

Eva Sheie (19:22):
Can you give us some examples of how you do that for your patients? 

Dr. McElwee (19:27):
Sure. Every patient I operate on, I give them my cell phone number. I want them to call me. I want them to text me. I don't care what time of day or night it is. I actually just had a facelift text me earlier saying, Hey, I hate to bother you about this. It's probably fine. And it was fine, but it's like, I would much rather you let me know if you have any question whatsoever, I want to be there to answer for you. I do a ton of these. You do one. There's no such thing as a stupid question, no such thing as a silly question. Just fire away and ask. And so when patients get here, they're escorted everywhere effectively. I mean, you're not just going to say, oh, the exit signs over there. Like, no, we'll walk you to point A to point B. We are your buddy in this process. We are all in a team and we're going to treat each other like that. I want patients to feel as comfortable as possible in all aspects here, besides having great results. That's my goal. 

Eva Sheie (20:21):
Is it easy? I know Houston's a crazy big city and there's lots of traffic and lots of people and you're in a kind of a busy part of town, but is it easy to get in and out of the office once you're actually there? 

Dr. McElwee (20:34):
It is. We have a great location right off I 10, and so it's easy to duck right off and duck right back on. We're not nestled away in an obscure area. It's right off I 10. Our building is on I 10. 

Eva Sheie (20:46):
If you're coming from another part of town or even from outside of town, what's around the office that's fun to do. 

Dr. McElwee (20:54):
So we're just outside of inside the loop. Now for anyone who's not from Houston, inside the Loop has a different meaning because there are now three loops around Houston. It is just that big. And so we're just outside the innermost loop, which is like Houston proper. And so within five minutes of our office, there is any restaurant you could possibly want, parks, there's music venues. You are not that far from any major sports venue. I mean, if you're here getting surgery and recovering, there's still a lot you can do now. Don't overdo it if you're a post-op, don't get me wrong, but there's still a lot you can do in Houston and it's all right next to the office. 

Eva Sheie (21:34):
I can vouch. It's a great part of town. Well, outside of the office, you've mentioned your wife and your wonderful dog, Apollo. So I assume you guys like to take the dog places, but what else do you like to do when you're not at work? 

Dr. McElwee (21:49):
We do. We do. Outside of the office, you can find me either on a tennis court or in the kitchen. I love playing tennis. It's like my competitive outlet for better and worse. It also keeps me active. Other thing is I love to cook the latter's, a side effect of being raised in Louisiana. Being from Louisiana and knowing how to cook, it's as important as knowing how to swim. So I think I make a pretty good gumbo and a pretty good crawfish etouffee if I do say so myself. But I enjoy cooking. It's a ton of fun to me. But I guess outside of that, yeah, spending time with the wife and the dog. We like to do a lot of outdoorsy stuff, like farmer's markets, bring the dog along. We're both big hikers, but there's not a lot of hiking in Houston, so we just plan most of our vacations around hiking and national parks and all that jazz. 

Eva Sheie (22:35):
If we're interested in coming to see you or potentially schedule a consult and get to know you better, how should we reach out? 

Dr. McElwee (22:43):
So the best way is through an inquiry on the website, which is memorial plastic surgery.com with a couple little questions about what you're interested in, a little bit, medical, history wise, all that jazz. That's the easiest way because our patient care coordinators are pretty on the ball about getting those leads and getting back to people, getting you where you need to be. That's going to be the best way. I also, on my Instagram, Dr. Tyler McElwee, I respond to a lot of messages as well because I understand that's become an increasingly popular marketing tool effectively, but also way for patients to shop around. And so I know a lot of physicians just have somebody run their professional Instagram and knowledge jazz and whatnot, but I guess to me, I do too to some degree, but I have access to it. I get on it and I respond to messages as well. People are asking, Hey, do you do this? Hey, do you do that? I'm happy to talk to people. I went into medicine because I like interpersonal relationships, so where should I draw that line? To me, it's not a line to be drawn. 

Eva Sheie (23:47):
Agree very wise. Alright. Thank you for sharing so much of yourself with us today. And Apollo, I think he's the first dog that's ever actually been on the show.

Dr. McElwee (23:59):
Is he, because I'll let you know. This is 1, 2, 3, 4, 5, 6, 7, 8. He is toy number nine in his mouth.

Eva Sheie (24:07):
He has that many dog toys. <laugh>

Dr. McElwee (24:08):
So he is a persistent dog just like me for better or worse. But yeah. 

Eva Sheie (24:16):
Thank you. Thanks Apollo. 

Dr. McElwee (24:18):
Thanks bud. Thanks for cheering me on. 

Eva Sheie (24:25):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at Meet the doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of the Axis, t h e a x i s.io.