WEBVTT - Plastic Surgery Trends We'd Pass On 0:00:04.240 --> 0:00:07.560 Okay, we're back to part two between us doctors. I'm 0:00:07.600 --> 0:00:09.760 doctor Terry debro and you are. 0:00:10.480 --> 0:00:12.680 I'm doctor Robert Schwartz, my buddy. 0:00:13.960 --> 0:00:20.080 Too crazy wild and crazy boards certified plastic surgeons. Okay, 0:00:20.120 --> 0:00:23.480 we have some really actually I think, very good and 0:00:23.600 --> 0:00:28.720 relevant and useful listener questions. Okay, so when we go ahead, 0:00:29.120 --> 0:00:32.320 we talked about the Leanne Rhimes deep Jaw release video 0:00:32.360 --> 0:00:35.839 that's gone viral. Okay, don't do it. It's a scam 0:00:35.880 --> 0:00:37.440 to give me a break. 0:00:37.440 --> 0:00:40.440 And it's dangerous. Yeah, more than anything else, it's really 0:00:40.720 --> 0:00:42.040 really danagerous. 0:00:42.040 --> 0:00:46.080 Okay. Do you think Marco Robbie's slimmer face is more 0:00:46.200 --> 0:00:49.199 likely from buckle fat removal or weight loss for mozambic 0:00:50.080 --> 0:00:52.760 or just normal aging? So have you seen a recently, 0:00:52.800 --> 0:00:56.880 I mean extraordinarily beautiful woman obviously, you know, genetically gifted 0:00:57.760 --> 0:01:01.720 and a very good actress too. Obviously I have noticed. 0:01:01.760 --> 0:01:03.920 I did look at that. I did look at that. 0:01:05.280 --> 0:01:09.480 So I don't think Margot Robbie has had buckle fat removal, 0:01:09.480 --> 0:01:11.560 which is a procedure. By the way, it takes like 0:01:11.640 --> 0:01:14.440 twenty minutes. You make incisions on the inside of the 0:01:14.520 --> 0:01:17.120 upper part of the mouth, right across from the second molar, 0:01:17.480 --> 0:01:20.560 and you dissect into this compartment of the face that 0:01:20.640 --> 0:01:23.720 has this sort of little extra pad of fat that's 0:01:23.760 --> 0:01:26.720 below the muscle, you know, that's on the other side 0:01:26.760 --> 0:01:29.600 of the muscle, the deeper side, and it can make 0:01:29.640 --> 0:01:32.360 your face if it's round, thinner. And I think we 0:01:32.480 --> 0:01:37.840 both agree that it's rarely indicated in patients only in 0:01:38.080 --> 0:01:41.800 very specific situations. Should you even consider it in a 0:01:41.840 --> 0:01:44.759 young patient because you may pay for it later when 0:01:44.760 --> 0:01:48.080 you look much older. So how often do you do 0:01:48.120 --> 0:01:49.120 buckle fat decision? 0:01:50.400 --> 0:01:53.080 Very rarely. Yeah, I get people coming forward and I 0:01:53.320 --> 0:01:56.120 usually talk them out of it, right, Yeah, I usually 0:01:56.160 --> 0:01:57.680 talk them out of it. It's just that's one of 0:01:57.720 --> 0:02:00.080 those things. I don't have an object. That's not one 0:02:00.080 --> 0:02:03.160 of those things that I'll go like, oh, never do this. 0:02:03.840 --> 0:02:07.280 But it's not on my you know, a list. I 0:02:07.320 --> 0:02:12.560 think it's it's mildly effective at best. And frankly, you 0:02:12.680 --> 0:02:15.120 got to think about some of these procedures long term, 0:02:15.200 --> 0:02:18.799 because fat in your face is a valuable commodity as 0:02:18.840 --> 0:02:21.280 you get older, right, and you don't just want to 0:02:21.360 --> 0:02:24.760 like wantonly remove it. It's a bad idea. 0:02:24.840 --> 0:02:26.640 So my first five years when I came out. It 0:02:26.680 --> 0:02:29.560 was the hottest procedure. We did it on everybody. Every 0:02:29.600 --> 0:02:32.040 guy wanted it gave them more of a terminator kind 0:02:32.040 --> 0:02:34.960 of jawline and a little bit yeah. 0:02:35.000 --> 0:02:37.280 I mean, it really creates that little hollow below your cheek. 0:02:37.600 --> 0:02:41.399 It can and now, of course, like everything else, we've 0:02:41.480 --> 0:02:44.600 learned when it's a good idea and when it's really 0:02:44.639 --> 0:02:46.320 not a good idea. And I think it's someone like 0:02:46.320 --> 0:02:49.880 a Christy Tiagan who has a very round face that 0:02:49.960 --> 0:02:52.960 it can be useful. Particularly she's sort of over forty, 0:02:53.080 --> 0:02:55.040 so we sort of know what she's going to look 0:02:55.160 --> 0:02:59.320 like in the future. I think that's pretty safe. But 0:02:59.400 --> 0:03:01.040 I think if you do it in sort of a 0:03:01.120 --> 0:03:04.440 Margot Robbie situation, it's probably a really bad idea. I doubt. 0:03:04.440 --> 0:03:08.200 I actually don't think she's had. My suspicion is that 0:03:08.760 --> 0:03:11.280 she's just a little thinner, you know, I think actresses, 0:03:11.280 --> 0:03:12.840 I mean, you know, I talked about this, We talked 0:03:12.880 --> 0:03:17.200 about this ozempic anarex anorexy ozempica thing where you know, 0:03:17.720 --> 0:03:20.600 we're basically able to shut off her appetites now using 0:03:20.600 --> 0:03:23.400 these GLP one drugs. And I just think some people 0:03:23.400 --> 0:03:26.440 are just taking a little too far and maybe maybe 0:03:27.320 --> 0:03:29.160 maybe she's just a little thin right now. And that's 0:03:29.200 --> 0:03:31.240 not to say that Margot Robbie's on a GLP one. 0:03:31.320 --> 0:03:32.919 I doubt it, but who knows. 0:03:33.200 --> 0:03:35.120 Yeah, I don't look. I think she looks a little 0:03:35.200 --> 0:03:38.720 leaner overall. And buckle fat doesn't do that. Bubble fat 0:03:38.840 --> 0:03:41.960 removes a little bit of fat from a very specific area. 0:03:41.960 --> 0:03:43.880 It doesn't make you look it doesn't make your face 0:03:43.880 --> 0:03:45.600 look thinner overall. It doesn't do that. 0:03:45.680 --> 0:03:51.240 So a deep plan necklift with sub mandibular land shaving. 0:03:51.920 --> 0:03:55.960 So the submandibular gland it's located sort of halfway between 0:03:56.000 --> 0:03:59.000 the tip of the chin and the angle of the 0:03:59.120 --> 0:04:02.760 jaw back there, okay, and it's it's just below the 0:04:02.760 --> 0:04:06.160 bone and it can bulge a little bit. And there 0:04:06.160 --> 0:04:09.160 are some well known surgeons who actually get in there 0:04:09.160 --> 0:04:11.640 and they have a device and they they shave it up. 0:04:12.000 --> 0:04:15.680 Some guys actually remove it. They take it out of 0:04:15.680 --> 0:04:18.640 a capsule and they cut it up, and I you know, 0:04:18.680 --> 0:04:21.719 you can get The main side effect, of course, is 0:04:21.880 --> 0:04:25.679 zero stomia. Right is the dry mouth if you bugger 0:04:25.720 --> 0:04:27.560 it up too much, because. 0:04:27.360 --> 0:04:29.760 It's really called a syalys eel where you get a 0:04:29.800 --> 0:04:33.960 fluid pocket of saliva in your neck, that's right, or 0:04:34.839 --> 0:04:39.159 or major nerve injury that can paralyze part of your face. 0:04:39.320 --> 0:04:42.480 Right. So there are some surgeons though, who get in 0:04:42.520 --> 0:04:45.599 there and they use a shaving device and they take 0:04:45.640 --> 0:04:48.680 sort of the outer edges of it off. I think 0:04:49.720 --> 0:04:53.120 I think it's rarely indicated. I think it's you know, 0:04:53.279 --> 0:04:56.080 the risk outweigh the benefits. I know there's a couple 0:04:56.080 --> 0:04:57.640 of guys out there who are well known to do 0:04:57.720 --> 0:05:02.320 it routinely, and and I have seen because I always 0:05:02.320 --> 0:05:05.039 see everybody's mess ups. So I get to see they're 0:05:05.080 --> 0:05:07.640 old records and they charge. They probably some of those 0:05:07.640 --> 0:05:10.240 guys who do it routinely charge you know, eighty five 0:05:10.360 --> 0:05:13.279 ninety thousand for a procedure that probably takes four minutes 0:05:13.920 --> 0:05:14.520 on each turn. 0:05:14.720 --> 0:05:16.279 Eighty five ninety thousand just for that. 0:05:16.520 --> 0:05:22.279 Yeah. Yeah, it's an addisle. Yeah yeah, and uh nice. 0:05:22.680 --> 0:05:27.719 I think mostly it's probably not a good idea in 0:05:27.800 --> 0:05:31.640 my opinion. Now, that's the thing about plastic surgery. I'm caring. 0:05:31.680 --> 0:05:33.400 I want to hear your opinion. Plus surgery, you get 0:05:33.440 --> 0:05:36.279 ten good plastic surgeons, you're going to get seven different 0:05:36.360 --> 0:05:38.080 kinds of opinions. What do you think about it? 0:05:40.720 --> 0:05:45.039 I think I always look at these things from a 0:05:45.160 --> 0:05:51.320 risk benefit perspective, and so I think, with very very 0:05:51.440 --> 0:05:54.120 rare exceptions, the difference you're going to get in your 0:05:54.160 --> 0:05:57.760 result of the facelift in terms of how overall much 0:05:57.839 --> 0:06:00.960 younger or better the patient looks. I think anything you 0:06:01.080 --> 0:06:03.839 do to the sub mandibular gland, no matter how aggressive, 0:06:04.960 --> 0:06:09.279 it's at best the sprinkles on the frosting on the cake, 0:06:09.440 --> 0:06:11.279 it's definitely not the cake. 0:06:11.640 --> 0:06:11.880 Right. 0:06:12.000 --> 0:06:15.240 And if it were a completely benign procedure that we 0:06:15.360 --> 0:06:16.720 all do, you know, take off a little bit of 0:06:16.720 --> 0:06:21.039 the submanadbuta it is not that. Though it is a potent, 0:06:21.200 --> 0:06:24.360 it is a procedure that is going to add little 0:06:24.400 --> 0:06:27.960 to your result, if anything, and is exposing you to 0:06:28.040 --> 0:06:31.400 some pretty significant risks. And so for me, that's a 0:06:31.440 --> 0:06:33.919 bad idea. Okay, just a bad idea. Why are we 0:06:33.960 --> 0:06:37.240 going to add potential significant risks to a procedure for 0:06:37.480 --> 0:06:38.240 very little better? 0:06:38.279 --> 0:06:40.320 Okay, So if we were doing a smasher pass, it 0:06:40.320 --> 0:06:41.960 would be a pass. If you noticed this thing that 0:06:41.960 --> 0:06:45.799 they're doing an Instagram smasher pass, Okay, you pass? Okay. 0:06:45.960 --> 0:06:48.680 I watched the whiskers podcast. Have you ever seen the 0:06:48.680 --> 0:06:49.800 Whiskers podcasts. 0:06:49.839 --> 0:06:52.080 We have very different feed I know it's. 0:06:51.880 --> 0:06:57.640 These two AI cats because I love cats that are 0:06:57.680 --> 0:07:01.680 talking to each other, and one atisode. I know in 0:07:01.720 --> 0:07:05.280 one episode they show they go, okay, guys, it's okay, 0:07:05.480 --> 0:07:08.400 time for a smasher pass. And they show this cat 0:07:08.560 --> 0:07:11.840 you know, sitting there and they go, ooh, I would 0:07:12.000 --> 0:07:14.800 throw her out of bed for eating crackers. That's a smash. 0:07:15.400 --> 0:07:16.280 They show another one. 0:07:16.560 --> 0:07:18.640 Yeah, I think that's what they're referring to in smash 0:07:18.680 --> 0:07:21.480 or pass. I don't think they're referring to your submandibular glass. 0:07:21.640 --> 0:07:23.440 And then then oother ones again, they show another cat 0:07:23.480 --> 0:07:27.920 licking its butt and when one goes, okay, okay, that's 0:07:27.960 --> 0:07:30.960 the thing we do. But it's still a smash. 0:07:31.640 --> 0:07:33.040 We so have to get you off. 0:07:33.640 --> 0:07:36.520 I know, I really I recommend you. 0:07:36.640 --> 0:07:41.280 What are you doing with your time? You're watching talking 0:07:41.520 --> 0:07:45.640 cat videos talking about licking their buttoles. This is what 0:07:45.840 --> 0:07:51.800 you are doing. Whatever amount of lifetime we have left, 0:07:52.320 --> 0:07:53.400 you're doing this. 0:07:54.600 --> 0:07:58.840 Really, it's what I'm into, Okay, two own all right, 0:07:59.480 --> 0:08:04.080 all right, no, no, no, I'm into AI generated cats 0:08:04.080 --> 0:08:06.040 licking their babbles. Okay, that's my thing. 0:08:06.520 --> 0:08:09.600 All right, all right, all right, I guess okay, fair enough, 0:08:09.640 --> 0:08:15.520 that's the hobby. 0:08:18.960 --> 0:08:22.320 Hey, hey you yeah, you you're sitting there wondering what 0:08:22.440 --> 0:08:25.440 podcast do I want to listen to? Are you thinking yourself? 0:08:25.640 --> 0:08:28.920 So many podcasts? Which one do I want to pick? 0:08:29.080 --> 0:08:31.320 We can answer that for you. Listen if you want to. No, 0:08:31.440 --> 0:08:33.200 we're not saying listen if you want to. We're saying 0:08:33.240 --> 0:08:36.319 that's the podcast. Listen if you want to. We talk 0:08:36.360 --> 0:08:38.600 about everything you're gonna want to hear, your favorite celebrities, 0:08:38.600 --> 0:08:40.439 pop culture, what to watch on TV, what music to 0:08:40.480 --> 0:08:42.360 listen to, what games to play, what clothes to wear, 0:08:42.559 --> 0:08:44.840 where to go, what to do. It's called listen if 0:08:44.840 --> 0:08:47.160 you want to, you say something. 0:08:47.240 --> 0:08:49.400 You're doing so good, keep going. 0:08:49.120 --> 0:08:49.840 And keep going. 0:08:50.360 --> 0:08:53.400 Okay, guys, Listen if you want to. Is available on 0:08:53.440 --> 0:08:54.720 the iHeartRadio. 0:08:54.160 --> 0:08:57.840 App, Apple Podcasts or wherever you listen to podcasts. 0:08:58.360 --> 0:09:02.120 Let's talk about fat transfer to the bread US. Very interesting. Okay, 0:09:02.320 --> 0:09:05.720 So what we're talking about is there's essentially two ways 0:09:05.720 --> 0:09:08.680 to do a breast augmentation right now. There actually there 0:09:08.760 --> 0:09:11.320 may be more because there's no other things like alo clay, 0:09:11.520 --> 0:09:14.520 and you can inject other kinds of injectibles. But then 0:09:14.679 --> 0:09:15.800 you know, okay, run. 0:09:15.640 --> 0:09:17.600 It wallow Clay is processed fat. 0:09:17.640 --> 0:09:20.400 If I remember it's cadaver fat, cadaver fat, Yeah, okay, 0:09:20.440 --> 0:09:23.280 it's better. Yeah, I know, all right, so. 0:09:23.280 --> 0:09:25.440 Weird how it's how much more appealing it sounds when 0:09:25.440 --> 0:09:29.200 you call it Alo Clay's are calling it fat from 0:09:29.200 --> 0:09:34.600 a dead person? I know, right, good, Hey, nice job 0:09:34.679 --> 0:09:36.119 marketing team on the renaming. 0:09:36.280 --> 0:09:38.240 Right way to go. But what are we going to 0:09:38.280 --> 0:09:40.640 call this some dude dead dudes fat that we're putting 0:09:40.679 --> 0:09:41.360 in people's press. 0:09:41.760 --> 0:09:44.400 Yeah, I know, fat fat into corpse. 0:09:44.480 --> 0:09:48.960 So no, I've got the idea. It's called it. By 0:09:49.000 --> 0:09:51.040 the way, it's it's weirdly similar to the way they 0:09:51.120 --> 0:09:57.439 named drugs. I mean, who thought of turzeppetite or moncharo? 0:09:57.520 --> 0:09:59.400 How about way to hold on Moonjaro. 0:10:00.200 --> 0:10:03.840 They basically took Killimunjaro and took the kill out, which 0:10:03.880 --> 0:10:04.440 was a good move. 0:10:04.480 --> 0:10:07.959 Where did zep bound come from? Who thinks of the 0:10:08.600 --> 0:10:09.280 zep bound? 0:10:09.440 --> 0:10:10.839 But by the way, look at look at just look 0:10:10.840 --> 0:10:15.040 at the way they name our implants. Right, The softer 0:10:16.200 --> 0:10:21.520 allergan implant is the responsive implant, right, and the firmer 0:10:21.520 --> 0:10:22.760 one is the soft touch. 0:10:23.080 --> 0:10:25.800 Yes, okay, how does that make right? Yeah? 0:10:25.840 --> 0:10:27.160 Well done? Boys, Yeah, well done? 0:10:27.200 --> 0:10:27.440 I know. 0:10:27.640 --> 0:10:30.640 Or what about the people who named I don't mean 0:10:30.640 --> 0:10:33.400 to call this, but what about the people who named Zeman? 0:10:33.960 --> 0:10:37.120 Yeah, that's it's one of the botoxes Zman. 0:10:36.880 --> 0:10:43.280 Suriously, really seriously, because when I first heard that, when 0:10:43.280 --> 0:10:47.080 I was like in my fifties, I'm not proud of this. 0:10:47.520 --> 0:10:48.480 I still would. 0:10:50.640 --> 0:10:53.040 Yeah really, okay, that's. 0:10:52.840 --> 0:10:53.880 What you're putting in your face. 0:10:54.000 --> 0:10:57.800 So currently the two ways and people are combining them. 0:10:57.800 --> 0:11:00.400 By the way to make your breast larger is either 0:11:00.440 --> 0:11:03.280 to use, of course, a breast implant, it's been around 0:11:03.280 --> 0:11:07.280 since the seventies, and or adding fat from sort of 0:11:07.280 --> 0:11:10.719 like a bbl of the breast fat transfer to the breast. Okay, 0:11:11.000 --> 0:11:15.679 and that is an acceptable way theoretically of adding some 0:11:15.800 --> 0:11:19.800 volume to your breast. Now, what's interesting is when we 0:11:19.800 --> 0:11:24.680 were young plastic surgeons, the dermatologists were doing that, and 0:11:24.720 --> 0:11:28.240 we ragged on them to no end. We thought that's 0:11:28.400 --> 0:11:32.720 so dangerous, and then, of course, thirty years later, it's 0:11:32.760 --> 0:11:36.120 now an accepted procedure in plastics. What you see a 0:11:36.160 --> 0:11:39.120 lot with fat transfer, which I think is really sort 0:11:39.160 --> 0:11:42.360 of doesn't make sense for me, people who've had multiple 0:11:42.400 --> 0:11:45.120 previous operations have a lot of scarring. We'll go to 0:11:45.160 --> 0:11:47.880 a doctor and the doctor will do liposuction from somewhere 0:11:47.880 --> 0:11:51.920 and inject it into that scarred up breast. Well, think 0:11:52.000 --> 0:11:55.600 about that. I mean, you're basically taking a potted plant 0:11:55.880 --> 0:11:59.680 from one soil bed and putting it, digging it up 0:11:59.720 --> 0:12:03.400 and put into another, depending upon how well irrigated the 0:12:03.440 --> 0:12:06.360 other soil bed get, you know, and whether it's a 0:12:06.400 --> 0:12:09.040 good environment for it to live and take. And if 0:12:09.040 --> 0:12:12.000 you injected into a breast that's had multiple previous operations 0:12:12.040 --> 0:12:13.720 and a lot of scarring, what are the chances it's 0:12:13.720 --> 0:12:16.199 going to get its own independent blood supply and live low. 0:12:16.559 --> 0:12:19.000 And if it doesn't, I mean, if you're lucky and 0:12:19.040 --> 0:12:22.560 it doesn't, it just gets absorbed. If you're unlucky and 0:12:22.600 --> 0:12:25.600 it doesn't get its own blood supply and absorb it 0:12:25.600 --> 0:12:28.000 can turn into what we call fat necrosis or oil 0:12:28.120 --> 0:12:31.720 cysts and be painful or granuloma's foreign body directions or worse. 0:12:32.360 --> 0:12:35.560 Right, Well, I think you hit the nail on the 0:12:35.600 --> 0:12:38.560 head with your soil analogy, because literally what you're doing 0:12:38.559 --> 0:12:41.600 in that case is you're taking some sort of tropical 0:12:41.640 --> 0:12:44.199 plant from Florida and tried to plant it in Arizona. 0:12:44.360 --> 0:12:46.079 That's a good and it's not. 0:12:46.559 --> 0:12:49.880 It's not going to work. I was the first person 0:12:49.920 --> 0:12:53.120 to do that procedure in Dallas really, so after it 0:12:53.200 --> 0:12:56.800 was you know, basically we got the ok that, oh yeah, no, 0:12:56.880 --> 0:12:58.920 it doesn't get mistaken for cancer. So I have a 0:12:58.920 --> 0:13:04.920 fair amount of experience doing this and it's an okay 0:13:05.040 --> 0:13:08.880 procedure at best. And so when someone comes to me 0:13:09.000 --> 0:13:11.360 for a breast augmentation, they want to know should they 0:13:11.400 --> 0:13:14.480 do fat or breast implants? The answer is never fat. 0:13:14.520 --> 0:13:17.559 And the problem isn't because it's so risky. It's because 0:13:17.559 --> 0:13:21.200 it's so minimally effective, and there's a number of problems 0:13:21.200 --> 0:13:23.320 with it. The first is you can only put so 0:13:23.400 --> 0:13:26.160 much fat in the average female breast because you have 0:13:26.200 --> 0:13:30.079 to put the fat in as little micro droplets or 0:13:30.120 --> 0:13:32.560 it doesn't survive. You can't just go and squirt a 0:13:32.559 --> 0:13:34.440 big amount of fat in there. It just dies and 0:13:34.480 --> 0:13:36.840 it creates the problems you just talked about. So you 0:13:36.880 --> 0:13:40.040 can't do that. So there's only so many places you 0:13:40.080 --> 0:13:40.640 can put it. 0:13:40.679 --> 0:13:45.199 When is it useful for small augmentations at best? 0:13:45.280 --> 0:13:48.360 It's used in my book it's useful for a patient 0:13:48.360 --> 0:13:52.400 who comes in primarily for lipos suction and is of 0:13:52.440 --> 0:13:55.240 the feeling that, hey, instead of wasting the fat, let's 0:13:55.280 --> 0:13:58.120 get what we can in my breasts out of this fat. Okay, 0:13:58.200 --> 0:14:00.560 but got no issue with that. That's a great use 0:14:00.600 --> 0:14:02.640 of it. You'll get something, Okay. But here, I don't 0:14:02.640 --> 0:14:04.320 think I've ever done one where you can't tell the 0:14:04.320 --> 0:14:05.280 difference afterwards. 0:14:05.400 --> 0:14:07.760 Right. But here in Beverly Hills, the people who are 0:14:07.760 --> 0:14:10.360 trying to market their practice are doing combo platters. Now 0:14:10.400 --> 0:14:13.440 that's the big thing. Do a breast implant? Do a 0:14:13.440 --> 0:14:16.520 breast implant take fat from the stomach and inject it 0:14:16.559 --> 0:14:19.840 at the same time. I think it's not the greatest 0:14:19.880 --> 0:14:23.960 idea because you're lifting up the breast tissue radically reducing 0:14:24.000 --> 0:14:25.640 the blood supply to create a pocket. 0:14:25.720 --> 0:14:28.200 Yeah, compressing the breast tissue at the same time, right. 0:14:28.400 --> 0:14:31.360 And compressing it. And then just as you're sort of 0:14:31.480 --> 0:14:34.520 waiting for it to re establish its blood supply, which 0:14:34.560 --> 0:14:37.440 it will increase its blood supply as it's healing, you're 0:14:37.440 --> 0:14:40.520 now putting a vascular demand on it by asking it 0:14:40.560 --> 0:14:44.520 to give fat transferred into it its own independent blood supply. 0:14:44.520 --> 0:14:47.480 I think it's a mistake in addition to whatever risks 0:14:47.520 --> 0:14:48.760 there are of the breast implant. 0:14:48.840 --> 0:14:55.080 Okay, yeah, I call sham. Okay, so pass mostly on 0:14:55.120 --> 0:15:01.120 fat transfer, pass on combination implants and fat transfer, and okay. 0:15:01.760 --> 0:15:03.640 So I would say pass, I would say, I would 0:15:03.680 --> 0:15:08.160 say smash on fat transfer in the right patient. Okay, 0:15:08.200 --> 0:15:11.280 nothing wrong with it. I would say, pass on implants 0:15:11.320 --> 0:15:14.240 plus fat transfer. I can find no convincing argument that 0:15:14.280 --> 0:15:17.080 I've ever seen, or results that anyone has ever shown 0:15:17.440 --> 0:15:19.160 that would suggest to me that's a good idea. 0:15:19.160 --> 0:15:24.120 Okay, do surgeons take lung lunch breaks or pee while 0:15:24.160 --> 0:15:27.440 we have lung operations. So let's say you're doing a 0:15:27.480 --> 0:15:31.359 five hour operation. You're doing a breast augmentation, at breastlift 0:15:31.520 --> 0:15:33.240 and at tummy tuck. How long will that take you? 0:15:33.280 --> 0:15:34.800 Five five and a half something like that. 0:15:35.120 --> 0:15:37.000 You're talking about a breast dog, a breastlift, and a 0:15:37.000 --> 0:15:39.160 tummy talk. Yeah wait what. 0:15:39.480 --> 0:15:42.760 Master PETSI, tommy tuck og Master PEXI tummy tuck. 0:15:43.280 --> 0:15:44.520 Yeah, probably about five hours. 0:15:44.560 --> 0:15:47.840 Okay, So five hours. So that's you know, and it's 0:15:47.880 --> 0:15:50.320 gruss you're crossing. It's your second case. You're going from 0:15:50.320 --> 0:15:55.360 ten to two thirty it's crossing past lunch. What do 0:15:55.400 --> 0:15:58.000 you typically do? Do you take a break, do you pee? 0:15:58.000 --> 0:15:58.560 What do you do? 0:15:59.840 --> 0:16:04.080 I would rarely do either, so I would certainly not 0:16:04.320 --> 0:16:08.160 break for lunch. But I think it's acceptable to itself. 0:16:08.440 --> 0:16:09.680 But I think it's I think. 0:16:09.560 --> 0:16:12.080 It's acceptable to it's to step out and look, it's 0:16:12.120 --> 0:16:15.560 acceptable step out and p Obviously I'm not quite at 0:16:15.560 --> 0:16:17.960 that stage that I need to go that often, so 0:16:18.320 --> 0:16:20.960 usually I try to remember to go before we get 0:16:20.960 --> 0:16:24.560 in the car or whatever. So you know, it's generally 0:16:24.600 --> 0:16:27.320 it just doesn't happen. I don't like hydrate heavily on 0:16:27.360 --> 0:16:29.840 the morning of serge okay, so that's rarely an issue. 0:16:29.840 --> 0:16:31.640 But I don't see anything wrong with it. Nor do 0:16:31.680 --> 0:16:34.080 I think there's anything wrong with stepping out and like 0:16:34.200 --> 0:16:37.240 having a protein bar or protein shake, but like no 0:16:37.400 --> 0:16:40.000 a half hour lunch, clocking out and clocking No. 0:16:40.040 --> 0:16:43.520 It's not so. Having said that, I would I surmont. 0:16:43.640 --> 0:16:47.160 I think that most surgeons, when they do an operation, 0:16:47.320 --> 0:16:51.960 even as long as seven to eight hours, never scrub out, 0:16:52.200 --> 0:16:55.640 never eat anything, and never pee. Wouldn't you agree with that? 0:16:56.520 --> 0:16:59.160 Yeah, I'll say this. There's a lot of operations that 0:16:59.200 --> 0:17:02.320 you're doing Okay. Operations in plastic surgery run that long 0:17:02.440 --> 0:17:05.160 is because people are doing multiple right right, and very 0:17:05.200 --> 0:17:07.720 often when that's happening, there's some point where you need 0:17:07.760 --> 0:17:09.880 to reprep and rate. 0:17:10.000 --> 0:17:12.320 Then you have a natural break, and then there's a 0:17:12.440 --> 0:17:14.480 natural break because you have to scrub back in, you know. 0:17:14.680 --> 0:17:16.960 While the nurses are doing that, where I could step 0:17:17.000 --> 0:17:18.760 out and go to the bathroom or have a little 0:17:18.760 --> 0:17:23.120 snack or something. But if it's just we're going continuously 0:17:23.160 --> 0:17:25.560 and there's an extraneous reason why I should do that, 0:17:26.480 --> 0:17:28.959 very rarely, I think think it's wrong as long as 0:17:29.000 --> 0:17:30.280 it's limited in scope. 0:17:30.359 --> 0:17:32.560 I think in the nearly thirty years that I've been 0:17:32.600 --> 0:17:38.560 doing this, I think I've probably scrubbed out from an operation, 0:17:38.920 --> 0:17:44.240 any operation, maybe twice con And what's weird is you're 0:17:44.280 --> 0:17:47.320 so focused and so into it that you would literally 0:17:47.560 --> 0:17:51.200 never have to pee. But the moment, it's the weirdest thing, 0:17:51.280 --> 0:17:55.160 isn't it. The moment you take your gown off. It's 0:17:55.160 --> 0:17:55.840 all of a sudden you. 0:17:55.760 --> 0:18:02.640 Go, oh, bladder reflex or whatever it is. I don't 0:18:02.680 --> 0:18:09.840 know what it is. Yeah, no, Look, honestly, the anesthesiologist. 0:18:08.920 --> 0:18:12.040 Sometimes does that, but you know, yes, they do it. 0:18:12.119 --> 0:18:14.440 They're not serge. And by the way, when they when 0:18:14.440 --> 0:18:16.560 when they come back from that, please tell me you 0:18:16.600 --> 0:18:18.200 relentlessly mock them for it. 0:18:18.480 --> 0:18:21.679 I said, it must be nice. They said, did you 0:18:21.680 --> 0:18:25.040 bring a new playlist? Just let's face it, they're they're anethesiologist. 0:18:25.119 --> 0:18:25.840 Last DJs? 0:18:26.280 --> 0:18:29.520 Was that? Was that very satisfying for you? Remember to 0:18:29.640 --> 0:18:30.160 wash your head? 0:18:30.200 --> 0:18:32.879 Did you have a little sneak? Do you have a sneak? 0:18:34.520 --> 0:18:35.320 Do you feel better? 0:18:35.359 --> 0:18:35.560 Now? 0:18:36.119 --> 0:18:37.000 Feel better? Now? 0:18:37.119 --> 0:18:39.840 It's still be I still hear the beep, beep beep. 0:18:39.960 --> 0:18:41.680 You're good. Don't worry about it. 0:18:42.320 --> 0:18:44.120 By the way, nothing happened in your absence. 0:18:45.560 --> 0:18:46.280 I watched the. 0:18:46.320 --> 0:18:59.160 Screen No Bachelorette season, No problem. Hey, it's Ben Higgins and. 0:18:59.200 --> 0:19:02.879 Ash Like from the almost famous podcast Even on the 0:19:02.920 --> 0:19:06.400 fate of Bachelor Nation is a giant question mark. We're 0:19:06.400 --> 0:19:10.480 not going anywhere because the Bachelor Universe has expanded. 0:19:10.200 --> 0:19:13.800 We're still bringing you great reality TV show recaps that 0:19:13.920 --> 0:19:17.640 your favorite Bachelor Nation alum are a part of interviews 0:19:17.680 --> 0:19:21.760 with your favorite cast members. News and did we mention 0:19:21.960 --> 0:19:25.679 our very own Ashley is a cast member of Bravo's 0:19:26.119 --> 0:19:30.000 The Real Housewives of Rhode Island. We're breaking down every 0:19:30.040 --> 0:19:33.320 episode in giving you the behind the scenes details only 0:19:33.800 --> 0:19:35.159 our podcast can give you. 0:19:35.640 --> 0:19:39.680 Listen to Almost Famous on the iHeartRadio app, Apple podcasts 0:19:39.760 --> 0:19:41.439 or wherever you listen to podcasts. 0:19:42.920 --> 0:19:47.359 What is the best way to remove a scar? And 0:19:47.440 --> 0:19:49.760 of course the answer is it depends, right. 0:19:49.720 --> 0:19:52.639 Yeah, it really depends. So if we were talking about 0:19:53.880 --> 0:19:56.760 it depends why we're removing the scar, right, Let's see, 0:19:56.960 --> 0:19:59.440 let's say it's least or thickened or way you cut 0:19:59.480 --> 0:20:02.639 it out? And Rea, Yeah, sometimes you inject some steroid 0:20:02.680 --> 0:20:03.880 at the same time you do that. 0:20:03.960 --> 0:20:06.240 What about if it's a flat scar that just could 0:20:06.320 --> 0:20:11.800 be better, like too wide, too wide, irregular something. Some 0:20:11.920 --> 0:20:14.200 areas of it are slightly you know, you're. 0:20:14.040 --> 0:20:16.640 Basically essentially what you're doing is you're recreating the wound 0:20:16.680 --> 0:20:17.639 and closing it better. 0:20:17.840 --> 0:20:21.320 Right, But there is a role for PRP micro needling, 0:20:21.440 --> 0:20:24.240 I mean, I you know, and some laser. It's a thing, 0:20:24.440 --> 0:20:26.680 and it's a big thing here in Beverly Hills. Lots 0:20:26.680 --> 0:20:30.600 of PRP microneedling and laser and actually, you know it 0:20:30.640 --> 0:20:34.359 can remodel the scar. I know what you're thinking, let's 0:20:34.400 --> 0:20:36.920 eat because we're surgeons, give me a break. Let's just 0:20:36.920 --> 0:20:39.720 cut it out, give me ten minutes and restart block 0:20:39.880 --> 0:20:41.720 and it'll be better. Right. 0:20:41.760 --> 0:20:43.480 I think those things are better. I don't. I don't 0:20:43.520 --> 0:20:46.400 discount that there that they have a role. I think 0:20:46.440 --> 0:20:48.399 the role is limited, and I think they tend to 0:20:48.400 --> 0:20:50.359 be more effective when the issue with the scar is 0:20:50.359 --> 0:20:52.720