Miami has a reputation as a city for beautiful people, and Co Louth sisters Sidhbh and Neasa Gallagher are working in at the core of this idea with their plastic surgery business.
Sidhbh has lived in the US for almost two decades. She trained as a plastic surgeon in the midwest, a speciality unavailable to her after medical school graduation in Dublin.
When she moved to Miami in 2020 to set up her own private practice, she was joined by her younger sister. Neasa, a trained primary schoolteacher, had been working in Dubai and moved across the Atlantic to become the business office manager.
Sidhbh loves the work’s ever-evolving variety: “I am very lucky there is always something new.” The explosion in GLP-1 use is one of those new factors, with an estimated one in eight people in the US having taken the drugs for weight loss.
“Weight-loss drugs have changed the face of the practice a lot. People with loose skin have become a huge part of the practice, getting a tummy tuck or an arm lift.”
Lifts and tucks had a standout year in 2024, a trend accelerated by the use of GLP-1s, according to the annual report of the American Society of Plastic Surgeons.
Rib-remodelling is another big growth area in the business, the Irish doctor says. The procedure involves repositioning a person’s ribs to give them a slimmer waistline. But the demand is growing even among “cis-gender patients” (women assigned their sex at birth), who “are never going to have a waist because of where their ribs are”, says Sidhbh.
With about half of Sidhbh’s surgeries related to gender reassignment, having her own centre is particularly important. “You are able to hand-pick the crew; we work with people we have known for years,” she says.
Clients travel from all over the United States for these procedures. But how has this aspect of their work been impacted by a raft of Trump administration policies reversing protections for transgender people? “For all the stuff in the media, we are still able to offer the same services. So it hasn’t affected us day-to-day. But it’s unfortunate how polarised things are,” says Sidhbh.
Miami is a big hub for cosmetic surgery thanks to its strong flight connectivity. However, Sidhbh has noticed a decline in international patients, including from Ireland, in recent years: “People are afraid to travel and seeing that is sad.”
The use and availability of Botox and fillers has exploded. Sidhbh welcomes such cosmetic procedures becoming more mainstream, describing them as the “gateway” to surgery.
“I believe in the product, it makes people happy. There is a stereotype that it’s for deeply miserable people.” But in her experience, patients just want to fix something that has bothered them and get on with their lives, she says.
Life in Miami, with its subtropical weather and white sandy beaches, stands in sharp contrast to her former life in agricultural Indiana: “It was all work, no fun allowed,” she says, telling of how she has just got her boating licence for her paramotoring hobby.
The diversity in Miami is something she finds particularly appealing. More than half of Miami’s population were born outside the US, and in 2024, 71 per cent of residents were Hispanic, mainly from Cuba, Haiti and Colombia. “It doesn’t feel like a lot of America,” she says.
Younger sister Neasa has embraced the good life on offer in Miami and seems to have had a positive influence on the doctor’s work-life balance.
“We have a pretty easy life. There was a lot of drudgery in my training,” Sidhbh says. Typically they work four days a week, with operations on two (long) days.
Neasa says she prefers to schedule their appointments on office days for a 10am start “after pilates”. And when the former primary schoolteacher “blocked off the month of August … it gave me chest pain”, jokes Sidhbh.
Miami Beach is “a little bit different” and “the hustle culture here is not very strong”. When they are up at 7am many others in the neighbourhood are still in bed, but the gym is packed at 1pm on a Tuesday, says Neasa.
Neasa has quickly adapted to the Miami Beach way of life, with her two dogs. “I’ve two Pomeranians, Angel Baby and Baby Love.” She laughs as she explains that she brings them to the supermarket in their stroller. “When I got here I thought that was crazy (dogs in strollers), but then Angel Baby broke his hip,” she says.
While they gush about their life in Miami Beach, there is one missing ingredient (and that is not just the Irish food and bread, for which they long): their family and friends in Ireland. But the sisters are hopeful this will soon be partially resolved, with plans afoot for their parents to move over and embrace the Miami lifestyle.
Sidhbh and Neasa Gallagher’s story will air on Escape to Florida, Channel 4 on Monday May 11th and Tuesday May 12th at 4pm.channel4.com/programmes/escape-to-florida.