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Get to Know Sarmela Sunder, the Plastic Surgeon Who Combines Artistry with Medicine to Help Her Patients Feel Their Best

Many of us have preconceived notions about plastic surgery and the types of people who elect to “get work done.” It was a hurdle that even Sarmela Sunder, who is now a globally recognized double board-certified facial plastic surgeon, had to overcome during her medical residency. As a kid, Sunder was a top student with an aptitude for art, a skill that has become one of her most distinguishing talents as a surgeon.

As she looks back on her life and career, she tells us, “You have all these points in your life and when you’re experiencing each one, you don't know how things are going to work out. But when you look back you realize, oh, everything makes sense. This was what I was meant to be doing.”

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Let’s Start From The Beginning, Dr. Sunder. Where Did You Grow Up?

I was born in Sri Lanka, but my family moved to Miami when I was about eight years old. There was a huge civil war happening at the time, so my parents fled the country and we ended up in Miami, which is where I grew up.

Wow, Miami! What Was That Like?

Miami has a huge Caucasian population and a huge Latino and Hispanic population as well. My high school had about 4,000 students and of those 4,000 people, the entire Asian American population—including South Asians, Chinese, Japanese, Korean, Filipino, Vietnamese—came out to only 20 of us total in all four grades. At the time, I identified with Latino culture more than Asian culture, because I didn't know too many Asians.

It was one of those things where you went along with it, but in retrospect, I wish I had more South Asian friends growing up. That said, my parents did a really good job of infusing that culture at home, so I didn't feel like I lacked it in any other way other than wishing I had peers to do stuff with.

What Did You Dream Of Becoming As A Child?

I knew I wanted to be a doctor very early on. I actually found this drawing I made when I was either nine or 10 recently. The prompt was something like, “What do you want to be when you grow up?” And I had drawn a surgeon with what looks like a kitchen knife, but it was supposed to be a scalpel. Anyway, I thought I’d end up as a doctor, a chemist or an artist.

Did You Feel Any Pressure From Your Parents To Pursue A Certain Path When You Were Growing Up?

Not directly from them, but indirectly, knowing their story. They were immigrants and they both had very successful careers. My dad was an engineer, and my mom was a veterinarian, even though they came from this tiny village with absolutely nothing. They had to rise to the challenge to make a life for themselves. They were on a path to far exceed the expectations of the generations that came before them.

They knew what it was like to be in a war and what it was like to live in a society where there was a lot of discrimination against women. Knowing he had two daughters who were going to be discriminated against as they grew up, my dad wanted to get us somewhere where we could live to our potential, somewhere we’d at least have that chance. And, for our safety, right? My parents left everything behind to give us a chance to do well and so there was that indirect pressure in the back of my mind, where I was always thinking, “I can't let them down. I can't just slack off at school.” I knew my parents gave up so much to give me the opportunity to succeed.

How Did You Decide On Plastic Surgery And Dermatology Specifically?

In medical school and even during residency to an extent, I thought I wanted to do cancer related surgery, specifically removing tumors in the head and neck region. While I was training for that, I thought, well, it'd be really good for me to know the reconstructive aspects of this also because the two go hand in hand. Traditionally, what happens is one team goes in and does the resection and another team comes in and does the closure. There’s some conversation there, but it’s two separate teams. I thought that by learning the reconstruction part of things, it would make me a better surgical oncologist. During my training, the nurses in the OR would say, “You should really think about becoming a plastic surgeon,” because I would always take my time to close the incision and make sure it looked perfect, because in my head, if we just tried to help cure this person of their cancer, why leave them with a scar that constantly reminds them of it in a negative way, right?

So much of recon is just about putting things back together in a functional way because priority number one is to get rid of the tumor and give this person their life back. Priority number two is to give them a functional life back. This is especially important in the head and neck region because we want to make sure they can eat and speak again. Third, and very low on that list, is let's make it look pretty. I really thought the cosmetic aspect of this process was lacking and it still is in a lot of ways.

I was initially resistant to becoming a plastic surgeon though. I had this firm belief of, “I went into medicine to help people, not to make people look pretty!” Because back then, that’s what I thought as a judgmental 20-something-year-old. I didn’t understand why people sought out plastic surgery. I wanted to spend more time learning about that, so as part of my training, I met all these patients who were having facelifts and rhinoplasty and things like that, and I’d ask them, “What’s your motivation for doing this?”

I kept hearing story after story about how these people dedicated their lives to other people—whether it's their kids or their husbands or their work—and 20, 30, 40 years would go by and when they looked in the mirror, they no longer recognized the person staring back at them. They're like who is this person? I feel so energetic and full of life, and I look in the mirror and this person looks so exhausted. That’s when I realized that plastic surgery isn’t just about making people look pretty. It's about making people feel more aligned with their own self-perceptions.

Ok, We Have To Go Back To You Wanting To Be An Artist Or A Doctor As A Kid For A Second, Because I’m Starting To See Some Parallels Here Of Why Or How This Could Tie Into What You Do As A Surgeon.

Plastic surgery really is the perfect balance of art and engineering. There's a lot of vector and whatnot to consider, so it's the perfect marriage of the two. The specificity is especially important when you’re considering the differences in people’s facial structures, especially between races. For example, there are so many different types of noses and eyes, which is something we didn’t really talk much about until the last ten years, and we still don’t talk much about the differences in cheeks, which varies widely. I think that's why when people of color go to someone who doesn't understand their anatomy, they can sometimes end up looking distorted.

Have you been in a situation where you've had a patient request that their features be altered to fit a specific standard of beauty (i.e. Eurocentric), but you know that it would completely change their face in a way that they might not even anticipate?

You know that happens often, and it's a sensitive topic that has to be treated differently with each patient. Sometimes people don’t even realize there’s a certain look that’s been ingrained in our heads as the standard of beauty—like a tall sharp nose with a cute little tip. It's one of those things that when you say it out loud to someone, there can be a complete disconnect for them, which can be quite jarring. It’s touchy because I never want any of my patients to feel judgement for wanting a specific aesthetic.

Beauty Is So Subjective And Layered. But If You Had To Distill It Down To A Simple Definition, What Would That Be For You?

That's a great question. I think, for me, beauty is facial balance. Someone might have huge eyes and a big nose and big lips, but if they flow together in a balanced way, that's beautiful.

You’re a double-board certified surgeon, you founded your own practice, you're a master injector with Allergan, and the list goes on. Did you ever run into moments of self-doubt along your journey?

I experienced more self-doubt when I was younger. For instance, when I was applying to college, I didn’t think I was going to get in anywhere. Mind you, I was valedictorian of my class, and I don’t say that to brag, but to highlight why it made no logical sense for me to worry about not getting into a college. But there was always this doubt, where I thought, maybe I was just lucky and maybe this luck will eventually run out? And then in college, I thought, well, medical school is so hard to get into. I'm not going to get into med school or I won't get into the med school I want, and a lot of my friends didn't get into med school, so it was a very real fear this time.

Every step of the way I worried I wasn’t good enough. I’d think of my accomplishments as lucky breaks. In the years since, I’ve thought about where that might have stemmed from, and I think a lot of women, especially women of color, have this feeling. It’s subconscious, but when you hear people around you say that you only got this opportunity or that one because you’re a woman or a woman of color, you hear it enough times and you start to think, well, maybe they’re right?

Once I started working, things changed. I began to realize that these opportunities and accomplishments weren’t a product of chance. I actually worked really hard for these things to happen. So when it came time to start my own practice, I felt confident in that move.

Yes, I had some fears, because it’s financially risky and it was in the middle of the pandemic. It was the worst time to do something like this, but any fears or doubts I had were more about the uncertainty of the world and how it would change, and less about being good enough to start my own practice. By this point in my life, I don’t have doubts in my skills as a surgeon.

What Keeps You Motivated?

Since starting my Instagram a few years ago, I’ve gotten some really wonderful messages from teenagers and young women from all over the world. Young Latino women, young Asian women, young Middle Eastern women, women from all different backgrounds sharing things like, “You know my family always says that I shouldn't go into medicine because I can’t do that sort of job and be a mom at the same time. But I see you, with your kids and this career, and it makes me think that I can do it, too.” It’s the reason why I include my children in some photos but don’t post their faces.

People sometimes ask, “Well, why do you post them at all if you cover their faces?” and the reason is so these young women can see that I’m a surgeon who works full time, but I’m also a mom who is present for her children. I want to show young girls my daughter’s age and older that they can think past what they've been told they’re capable of doing.

Yes, being able to see what’s possible is so important when you’re growing up. Actually, I think this is true at any stage of your life—which leads me to my last question: Who are some AAPI colleagues that inspire you these days?

The first person who comes to mind is Vanessa Lee. She's a nurse in the aesthetic industry and I’m a huge fan of hers. Within a short period of time, she went from medical nursing to becoming an aesthetic nurse to owning her own business. On top of that, she’s a huge supporter of women and women of color. She’s incredible and I have such respect for her.

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