Dr. John Mesa epitomizes the American dream. Born in Medellín, Colombia, Mesa moved to the United States during his college years, where he became a triple fellowship-trained, Harvard-educated, and board-certified plastic surgeon. He is regarded as one of the best doctors for buccal fat removal and innovator of surgeries performed under local anesthesia. Here Mesa talks about plastic surgery and his coming out.
Taking it back to the beginning, where did you grow up?
Dr. John Mesa: I grew up in Medellín, Colombia. I did live part of my childhood in Venezuela.
How was your experience growing up in both countries?
JM: It was interesting. I was born and raised in Colombia; however, when I was seven my family moved to Venezuela for work reasons. It was a shocking experience because, at the time, racism against Colombia was high in part due to Pablo Escobar. I had to suffer due to this. I was even rejected from middle schools because I was Colombian. In the end, I got to experience the similarities and differences of both countries. After high school, I moved back to Colombia for college and medical school.
Even at a young age, you lived a very worldly life. When did you come to the United States?
JM: I came to the United States when I was 23. It was when I was completing medical school. I received a scholarship to complete my last three months of medical school at Harvard University. Only the two best students of the entire med school were chosen — including myself and my best friend. After Harvard, I decided to relocate to the U.S.
Can you elaborate on your medical education?
JM: I am a Harvard-trained, triple-fellowship plastic surgeon. In total, I have 19 years of training. Medical school in Colombia is different than America. In America you go to college then you go into medical school. In Colombia after you finish high school you go straight to medical school. I spent seven years in medical school in Colombia. I did a fellowship in plastic surgery research at Harvard University from 2001 to 2005. Thereafter, I went into residency. During residency I did three years of general surgery at Harvard followed by two years of plastic surgery at Penn State University. I did a second fellowship in craniofacial surgery at the University of Michigan in 2010-2011. Upon completion I realized jobs were scarce due to the economy. Thus, I did a third fellowship in aesthetic surgery at The University of Alabama.
That is a wealth of training and education. As a patient, you desire a doctor who is educated and experienced. You went into the business knowing more than your peers due to all of your training and made advances in performing surgeries under local anesthesia. You have presented at national and international events held by The American Society of Plastic Surgeons. How did you perfect performing so many procedures under local anesthesia?
JM: In my third fellowship I was training with one of the pioneers of facelifts under local anesthesia. I started to realize patients were in a lot of pain. I was surprised because the procedure was supposed to be painless yet was extremely painful to the patient. I told the doctor I trained in craniofacial surgery, I know where all the nerves of the face are, and I could inject all of the nerve blocks of the face to make the surgery painless. The doctor gave me a chance, and during the surgery I was able to create a painless surgery, however the process of nerve blocking was still painful. There was still a challenge.
In Canada there is a doctor who does hand surgery under local anesthesia, which was revolutionary at the time, and I began attending his conferences. I obtained his knowledge and was now able to create nerve blocks and perform surgery completely painlessly. I am fortunate I am able to perform all of my surgeries under local anesthesia with my patients being completely awake. I perfected this technique in 2013.
You have made many advances in plastic surgery. Can you elaborate on the risks of performing surgery under general anesthesia? Why is it better to get these surgeries under local anesthesia?
JM: Even though anesthesia is safe these days, risks still remain. What is the chance of you winning the lottery? It is small yet once you win, it is big. The same applies to risks associated with general anesthesia. When you go to sleep, anesthesiologists need to give you medication via blood which can affect your heart rate. You also need a breathing tube, which could only inflate one lung. The risks go on. However they are all erased when you are able to get quality surgery under local and without pain. Why not? Even when recovering from general, you feel weaker, your bones and muscles are more delicate, and so on. You also need a companion with general, another hindrance.
You are regarded as the top doctor for buccal fat removal surgery. This is such a unique surgery. Why did you pursue this?
JM: My first buccal fat removal surgery was in 2014. At the time no one was aware of this. I became interested in plastic surgery because I like to make faces more attractive. I noticed there was always a difference in how people in Hollywood look versus common people. At the time of my training, buccal fat surgery was not even in the standard curriculum of plastic surgery. I began to study this extensively. My first patient took 2.5 hours whereas today the surgery takes me 20-40 minutes. It became Hollywood’s best kept secret. This is what everyone in the entertainment industry has gotten done for years because it gives a chiseled, more defined appearance. It did not become somewhat mainstream until over the past year.
How difficult is the surgery?
JM: Buccal fat removal is a very difficult surgery. I make it look easy however it is difficult for a variety of reasons. It is quite difficult to locate the buccal fat pads. Plus the buccal fat pads are located very close to the nerves which control your lower face especially your smile. If you do not get it done by someone who specializes in the surgery, you risk damage to the face nerves, and in turn a crooked smile.
You have expanded to three offices.
JM: My first office and home office was established in Livingston, New Jersey. Thereafter I expanded to Manhattan, which was always a dream of mine. I love Latin culture, which led to my third practice in Miami. My next target is Dubai.
What are the most popular procedures patients are coming to you for today?
JM: My number one surgery is buccal fat removal. Over 50% of my practice is buccal fat removal. Second, chin-neck-jaw liposuction. This combo removes a double chin, tightens the neck, and provides a more defined jawline. Third, face lifts and neck lifts. As for cosmetics, filler enhancement is my most popular.
Recently there have been a lot of social media attacks on plastic surgery including shaming those who get it. What are your thoughts, and moreover, do you feel plastic surgery is more socially acceptable for women while still being a scarlet letter for men?
JM: What is the problem with plastic surgery? There is a lot of bad plastic surgery out there from doctors who either do not perform well or who say yes to whatever the patient wants even when they should say no. If there is something which bothers you that you want to change, why not change it? You can do as much exercise as you want, be fit, have a six pack, yet the face will always age faster, especially in relation to the mind. This is where plastic surgery comes in. If it will make you feel more confident, and if it is done well, you will feel more in harmony with yourself. If you can get a haircut, you can get plastic surgery. The key is to find a surgeon who will give you quality results.
There are also times, as a doctor, you need to redirect a patient. For example, recently a patient wanted buccal fat removal surgery, but after analyzing the face I explained the problem was cheekbones, which could be easily fixed with filler. If you do not need it, I will not sell it to you.
When did you come out?
JM: I came out seven years ago when I turned 40. It was a very horrifying experience. I was raised Catholic in a very conservative culture where being gay was the worst thing ever. It was better to hit your mother than be gay. I was struggling because I was in the closet for a long time in an effort to make everyone else happy. I felt enslaved and jailed because I was living life making everyone happy while I internally suffered. At one point I was engaged to a woman. I was going down the path to be married until I broke the engagement.
I did a lot of introspection and at 40 I decided to come out. My biggest fear was being disowned but I could not continue suffering. I came out to my friends first. I accidentally came out to my colleagues via a text to my nurse I meant to send to somebody else (laughs). I planned to come out during Christmas in Colombia where I brought my boyfriend with me. I worked myself up so much only for it to go far better than I anticipated. Nothing out of left field. The uncle I was most horrified [of] was actually super inquisitive, as opposed to putting me down. I could not believe I suffered 40 years thinking my family was going to hurt or disown me, only for none of my fears to become reality.
Often times we build up worst-case scenarios in our mind, which direct our decisions and the moves we make. It is 2023 yet many men are still in the closet. I advise you to come out now before you make life more complicated by trying to appease everyone around you.
Are you on the market?
No, I am still with the same boyfriend I was with when I came out seven years ago. He is going to be my partner for life!