Many aesthetic plastic surgery patients fear going under the knife a lot less than they fear anesthesia. They’ve gotten to know the plastic surgeon through the consultation and planning process, so they’re comfortable with him or her. But the anesthesiologist? Never met the person—and probably won’t until shortly before the surgery.

Because the anesthesiologist by custom enters the picture at the last minute as a complete stranger, there’s no opportunity to build a relationship and gain the patient’s confidence. In the Beverly Hills, Calif, office of plastic surgeon Linda Li, MD, FACS, things don’t work that way. During the initial consultation, prospective patients also become acquainted with the anesthesiologist: William E. Fulcher, MD, MS.

Says Li, “Patients find this very reassuring.”

Doubly so because Li happens to be married to him. Patients usually figure that if Li had trust enough in Fulcher to allow him to slip a ring on her finger, they in turn can trust him to keep them safe on the operating table.

Surpassing Expectations

Li and Fulcher co-own Aesthetic Perfection, which she started as a solo practice 5 years ago. They offer facial rejuvenation, facial enhancement, breast enhancement, body refinement, and reconstructive surgery services.

The couple had wanted to practice side by side since before Aesthetic Perfection was launched, but it was only earlier this year that their dream came true. The key was Li’s case volume: It had to reach a sufficiently high level to allow Fulcher to come aboard as a full-timer.

“Previously, we could afford to work together only occasionally,” he says. “Now, except under rare circumstances, I no longer work with any surgeon except my wife.”

Li and Fulcher recently opened an outpatient surgery center. Within its 1,800 square feet is enough space for their private offices and consultation rooms. It’s an attractive facility and, because of its unique floor plan, it is surprisingly airy.

Constructing the facility within the boundaries of Beverly Hills wasn’t exactly a walk in the park. The city boasts some of the strictest building and safety codes in the West. To win approval for their project, Li and Fulcher found that they had to jump through quite a few hoops, which included working with nitpicking inspectors who all but wore white gloves to check for dust whenever they paid a visit.

The pair began to look at prospective sites well before Li’s practice was financially ready for such an endeavor. What they lacked in capital they made up for in optimism.

“In 2002, we forecast where we thought the practice would be in mid-2005, and then based our decision to build the outpatient surgery center on that prediction,” says Fulcher. “Not the most conservative approach, but, as it turned out, we were right on the money.”

Actually, their projections were off—they underestimated the growth of the practice. They had no way to anticipate the volume of cases that would cascade through their door when they became television celebrities. In 2004, they began to appear regularly on a nationally aired television program called Dr. 90210.

Lights, Camera, Action!

Dr. 90210 is a reality series that airs during prime time on the cable television channel E! Entertainment Television. Cameras tag along behind an ensemble of a half-dozen Beverly Hills plastic surgeons, chronicling the ups and downs of their individual practices and private lives. Viewers are treated to the action inside the operating room, as well as the consultations leading to surgery and the follow-ups afterward. It’s compelling to watch, as evidenced by the fairly sizable audience that tunes in each week.

The show is beginning its third season; Li and Fulcher joined the “cast” during season two. They were “discovered” by being in the right place at the right time (no, it wasn’t at Schwab’s drug store, à la Lana Turner). As it happened, during the premiere season, Fulcher was providing anesthesia services to one of the then-featured surgeons. This inevitably resulted in an introduction to the show’s executive producer.

After pleasantries were exchanged, Fulcher asked about who else from the Beverly Hills community of plastic surgeons had been booked to appear. Upon hearing the names, Fulcher pointed out to the producer the one glaring deficiency: no women. The producer asked Fulcher if he could suggest a female plastic surgeon to inject a bit of balance into the all-male lineup. Without missing a beat, Fulcher volunteered his wife.

“I told him he’d love her—she’s young and hip and would be great on TV,” he recalls saying. A meeting (not a screen test) was arranged, and the rest is history.

“The producers really liked the fact that we work as a husband-and-wife team,” says Li. “For them, that was unique and opened up lots of interesting story possibilities.”

One of the story lines for the upcoming season revolves around Li’s and Fulcher’s travails and triumphs in building their outpatient surgery center. That could prove to be an audience-pleaser, but it’ll have to go some to top last season’s grabber, in which Li discovered that she’d become pregnant. The baby is due in November; the mother- and father-to-be have sneaked a peek at the ultrasound image and know that it’s a boy, who they intend to name David Alexander.

Not All Glitz

For Li and Fulcher, the show hasn’t been all glamour and glitter, adoring fans, and the best table at Spago. Their involvement comes at a price, namely the forfeiture of time that otherwise could be devoted to their practice. However, because of the tremendous public-relations value gained from having their faces beamed coast to coast and border to border, Li and Fulcher consider Dr. 90210 to be a key part of the practice’s business, and thus time well spent.

Then there’s the matter of privacy, or lack thereof. Not a problem, Li guarantees.

“The camera crew that follows us around, they’re relatively unobtrusive,” she says. “And they’re not constantly taping us—they show up only for significant events. For example, when we announced my pregnancy to family, the crew was there, but we had to invite them.

“To be honest, though, we’re glad we’re being recorded. Years from now, we’ll be able to relive these moments over and over.”

The presence of a television camera normally causes people who are not trained professional actors to behave differently, to cease to be real. However, Li and Fulcher have been largely unaffected by the bright lights that flash on whenever tape is rolling.

“Who we are on camera is who we are in real life,” vouches Li.

Not that they weren’t supplied abundant advice on who to be.

“Before the first taping, we heard from all our friends and relatives, suggesting ways to behave and things we should say or not say,” Fulcher reveals. “None of them had ever been on a show themselves, yet they all sort of knew how we should conduct ourselves for maximum positive effect.”

Li and Fulcher decided the best course was to ignore the helpful hints and simply pretend the camera wasn’t there.

“We figured the one thing we could do consistently well during the months of taping would be to be ourselves—but we do watch what we say about politics, religion, and sex,” Fulcher adds with a laugh.

Beauty Speaks

On Dr. 90210, patients get into the act as well. However, none of the cases spotlighted by the show are setups arranged by the producers to achieve a predetermined story outcome.

“They’re all patients who come to me of their own accord,” says Li. “Essentially, as I consult with each new patient, I keep an eye open for cases that might be of interest on Dr. 90210. When I spot a possibility, I ask the patient for permission to share his or her story with the producers. Only after permission is granted do I tell the producers about that particular case. The decision as to whether they want to follow the patient is then entirely up to them.”

Li and Fulcher say they have no regrets about appearing on Dr. 90210, save for one. Fulcher is disappointed that his wife’s technical skills aren’t depicted in ways that do them justice: “She’s so dexterous that, when she dials a phone, you can’t even see her fingers landing on the keypad. But, seriously, she has a sureness in her hands, a sureness of her surgical decisions, that I’ve never seen in any other surgeon—and I’m not just saying that because I’m biased toward her.”

What comes clearly through the tube is the product of Li’s labors. On television, beauty speaks for itself, loud and clear.

Beauty speaks too for Li. She’s television-photogenic, as is Fulcher. Each has a keen sense of humor, and they play off each other well. Together, they make an attractive pair, both on the small screen and in real life.

Northwest Native

Originally from Richland, Wash, Li was drawn to the plastic surgery profession by the appealing opportunities it presented for interaction with patients. “You have a relationship with your patient that’s very different from the forms it can take in other fields of medicine,” she contends.

Li undertook medical school at Boston University as part of a 6-year program that began while she was an undergraduate there. Her internship and general surgery residency work were performed in Los Angeles at the University of Southern California.

It was in her second year of general surgery training, during the plastic surgery rotation, that she decided to specialize in this discipline. That led her to enter plastic surgery residency at New York Presbyterian Hospital; this was followed by a fellowship at Cornell University Medical Center, also in New York City.

Certified by the American Board of Plastic Surgery, Li is a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, and the California Society of Plastic Surgeons, as well as a fellow of the American College of Surgeons. She ended up with a practice in Beverly Hills as fulfillment of a promise she made to Fulcher when she was about to start her training in New York: She vowed that, if the California-based anesthesiologist would relocate with her to Gotham, he could pick the city they would call home afterward.

He chose Beverly Hills—a decision that had nothing to do with market conditions and practice-growth prospects. “I just loved the climate of Southern California,” says Fulcher.

World by the Tail

Fulcher had ample time prior to the move to New York to grow accustomed to the balmy temperatures of the Golden State. He attended medical school at the University of California, San Diego, graduating in 1987. Later, his internship and anesthesia residency took place at USC.

Interestingly, Fulcher started his career as an engineer, having obtained a degree in engineering mechanics from Virginia Polytechnic Institute in 1978. Before switching gears and heading off to medical school, Fulcher spent a couple of years performing advanced analysis of complex military and intelligence-agency systems. Midway through his medical residency at USC, he picked up a master’s degree in engineering mechanics from the California Institute of Technology in nearby Pasadena.

Fulcher completed his residency in 1993, at which time he became an assistant professor in USC’s anesthesia department. In 1996, he entered private practice in Los Angeles. In New York, he became an assistant professor at New York Medical College and an attending anesthesiologist at Metropolitan Hospital Center. Upon his and Li’s permanent return to Los Angeles, Fulcher accepted a staff position at Kaiser Permanente Hospital on the city’s west side. In 2002, he was named to the attending staff at Brotman Medical Center a few miles away in Culver City.

Today, Li and Fulcher pretty much have the world by the tail, what with the television show, the new surgery center, and the baby on the way. The big question for them right now, though, is how the stork’s visit will impact the smooth functioning of the practice.

“We think productivity will decline a bit at first,” says Li. “But we’ve got technology and systems in place to help us be as efficient as possible, so we should be all right.”

Adds Fulcher, “Eventually, we might opt to stay home on Mondays and take Friday afternoons off, which would allow us more time to be a family. On the days we have to be at work, we’ll perhaps use the services of a nanny.” To compensate for the loss of a full day and a half, the couple is toying with the idea of increasing the number of surgeries scheduled each day.

Li puts it in perspective: “For us,” she says, “it’s not a matter of choosing between professional success and personal satisfaction, but of balancing the two.”

By every measure, they appear to be doing well in that regard. PSP

Rich Smith is a contributing writer for Plastic Surgery Products.

Loving Their Work —
and Each Other

Normally, sparks in the operating room (OR) aren’t good. Unless, that is, the sparks are between two people and the only thing ignited is a romance. Take, for example, the enduring love of spouses Linda Li, MD, FACS, and William E. Fulcher, MD, MS.

Li and Fulcher met in the OR at County-USC Hospital in Los Angeles, where she was an intern and he was an attending anesthesiologist. This was at a time when rules about dating among staff were less strict than they are now.

Says Li, “I found him an incredibly well-rounded, interesting person. We became friends, discovered we had a lot in common, and one thing led to the next.”

The attraction was mutual, but it was left to Fulcher to play the part of the ardent pursuer. His initial ploy entailed arranging his schedule so that he kept “coincidentally” bumping into Li in the OR. Even at that, it was 2 years before things heated up to the point where either was ready to acknowledge the blossoming of a romance.

During that time, “I had a chance to observe the kind of surgeon she was,” says Fulcher. “She was very talented, very caring, and dedicated. I loved those qualities in her.”

Early on as he courted her, Fulcher found that one of the ways to Li’s heart was to talk to her about ballet. Ballet has been a passion for Li since she was 4—the age at which she took her first ballet lesson. Li continued training in that particular form of dance for the next 20 years, then began enjoying it entirely as a member of the audience (except for a brief period during medical school when she volunteered to conduct backstage tours of the Boston Ballet Company).

Although she pirouettes no more, Li keeps herself in shape by spending up to 90 minutes per day, four or more times per week, in the gym. Fulcher, meanwhile, gets his exercise mainly by biking.

“We’re both very health- and body-conscious,” says Li. “We believe that, because of our practice and what we’re promoting through it, it’s important that we look and feel our best.”