March 11, 2026 • 45 mins
Do not go under the knife until you hear this episode! Dr. Dubrow recruits his old pal and world-renowned plastic surgeon Dr. Robert Schwartz for an operating room tell all.
Find out how to tell when it’s time for a facelift, and the consultation red flags you should watch for!
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Episode Transcript
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Speaker 1 (00:05):
My man, what Alan, how are you?
Speaker 2 (00:08):
I'm good?
Speaker 1 (00:09):
This week on between Us, I have a very special
guest and a co host instead of Heather, she's busy
doing the housewife thing. Okay, my best friend of over
forty years, doctor Robert Schwartz. Doctor Schwartz, how are you.
Speaker 2 (00:26):
I am so excited to be here doing this with you.
It is the culmination of forty years of friendship.
Speaker 1 (00:34):
Yeah, it's a long time coming.
Speaker 2 (00:35):
You know.
Speaker 1 (00:36):
It's funny. When I told i Heeart that I wanted
to do this with you, they looked you up. And
you're known as the best breasts, best boobs in Dallas,
and you are. You're a very gifted plastic surgeon and
a phenomenally smart guy. I just want to spend a
couple of minutes talking about how I know you are,
(00:57):
friendship in our background, and a little bit about what
we're going to talk about today. Okay, so very briefly,
if you've ever met anybody who's a true genius, you
know that they're different than the rest of us. Okay,
and doctor Robert Schwartz is a true genius. I met
him at Yale where I was which is a joke.
His mcat instructor when he was a junior at Yale
(01:21):
Buckunn apply to med school, and I'm teaching him how
to take the missions test for medical school. When you
think about it, it's such a joke. And you I remember
him asking me a question that was kind of a
complicated physics question because this guy graduated summa cum lauti
from Yale University in physics. Okay, and he's a true genius.
You asked me a question. I went, what the hell
(01:42):
is he? Tom? Thinking, what the hell is he talking about?
And I and you to this day, you remember how
I sort of answered in kind of this filibuster, like
I have no clue. Do you remember that?
Speaker 2 (01:52):
I remember that. I don't remember exactly what the questions
are what you answered, but I remember sitting there thinking, no,
that's not right. So anyway, remember do you remember what
you said in the first five minutes of that class?
Speaker 1 (02:04):
No?
Speaker 2 (02:06):
Okay, So you started you introduced yourself when we started
talking about the MCAT and how it works and how
you know there's six sections each is out of fifteen
and then so the total is ninety, and so you
know you can get a maximum score of ninety, and
that you want to get. You know, a sixty would
be considered a good score on that and will make
(02:27):
you very competitive for med school. And then there's like
the standard Terry pause where you just go.
Speaker 1 (02:33):
I got to something too, What did you get? Come
on eighty three? Oh my god, which is of course
ninety nine PERCENTA anyway, left Yale and then we both
went to Ucilly Medical School. I was a year ahead
of you, and we caught up again.
Speaker 2 (02:47):
You got me to go to UCLA.
Speaker 1 (02:48):
I know he could have gone anywhere obviously, and he
decided to go to sile A. And the cell was
look at this weather, look at these chicks. Yeah, was
that pretty much the cell.
Speaker 2 (02:59):
Yeah. We walked outside and it was I don't know
what December, I don't even remember what it was, and
you look up at the sky and it's like seventy
five degrees and you just go huh. And then we
walked to the edge of Westwood and you go and
then you go one more thing, and you walk me
back to the BioMed library.
Speaker 1 (03:21):
Oh yeah, across from Sorority Row.
Speaker 2 (03:23):
Yeah, the physically closest library to Sorority Row. And so
it's just filled girls with girls, and you just go,
so Okay.
Speaker 1 (03:35):
Plus it was like the third or fourth best med
school of the world at the time, so that wasn't
you know, that wasn't bad either. But anyway, very easy, Yeah,
very easy. So you came out and we both graduated
medical school and then we don't need to get into
the details of the whole general surgery thing, but we
went through the very traditional way that we used to do.
(03:57):
Before you could be a plastic surgeon in our era,
you had to complete a full general surgery training, which
is the most difficult by far and away training that
you can go through after med school. It's like seven
years long. Every other night, you're awake all night, tons
of independent operating between and we're both chief residents. Between
(04:18):
midnight and six am. You are the doctor, the boss
of the hospital doing nothing but trauma. You're awake all
night doing trauma. It was the most intense and let's
be honest, awesome training that they don't get today because
they have a lot more controls over you're not allowed
to sort of operate independently anymore. The way we did, right,
it was really the wild wild West. Yeah, So we
(04:40):
graduate a super difficult general surgery program and we're both
in the same laboratory doing research and reconstructive surgery and
plastic surgery. And I went onto UCLA's Plus surgery program,
and you went on to one of the, if not
the top plastic surgery program in Dallas, right, yeah, ut.
Speaker 2 (04:59):
Southwest, Yeah, okay, I mean both super high level.
Speaker 1 (05:03):
Yeah, super high level. Yeah. And so we then were
chief residence in plastic surgery and we graduate and you'd
weirdly decided decided to stay in Dallas to practice plastic
surgery and raise your family. Well, it's weird when you
consider who you were going to Dallas and who you became. Okay,
(05:23):
Dallas changed you completely, and I stayed here in Los
Angeles that open up my practice and the rest is history.
But we've remained. Truly, You're my closest friend for all
these years, and you everybody has their person they go
to when they're in trouble, Okay, like if I have
an extraordinarily difficult case or even in my my life
in general, something threatening or I'm very worried about it,
(05:45):
that you call, you know, is your sort of your
go to chat tee GPT person human And You've always
been that guy for me because your advice is not
only brilliant, but sound and reasonable and moral and ethical.
And you know, we've just remained and we we're like
a couple of sorority girls the way we talk on
(06:06):
the phone even to this day.
Speaker 2 (06:07):
Right, well, let me let me throw those back at you, okay,
and then we can get the sentimentality out of this.
We could stop asking each other another yeah, another episode.
You are, unquestionably to me, the older brother I never had.
You are that guy. To me, you are the guy
I've always since I was twenty years old, basically my
(06:30):
entire adult life. You're the guy I've always looked up to.
You're the guy I've always gone to for advice. You
are the guy who has never once given me bad
advice of any significance on anything that I can think of.
And in fact, the times that I ignored your advice have
which we don't need to go into right now, have
(06:51):
cost me dearly.
Speaker 1 (06:52):
Right, but you've done well despite that. Yeah, Well, I
appreciate you saying that. And what's great about you is,
you know, you have such an amazingly intact ego that
even you know you're not everybody's great with when their
friends become successful, and you've become very successful. I've obviously
done okay, and you know we're happy for each other.
Speaker 2 (07:15):
Yes, I believe you've done okay.
Speaker 1 (07:17):
Yeah, we've done okay. But I can I can tell
you this is going to be a very different podcast
than just two plastic surgeons talking about health, wellness and beauty, okay,
because Rob and I are very different kinds of doctors.
First of all, we're at advanced stage of our career
and very successful, and we really don't need to operate anymore.
And we operate because we're it's interesting and we still
(07:38):
like to do it. But we're just I think, extremely honest.
Speaker 2 (07:43):
We want to just sort of I think tell this
like it is because I think you would agree with
me that we're blessed to be in this specialty. There's
a lot of great things that, you know, as plastic
surgeons we get to do. There's a lot of it's
really I'm still excited about doing this every day I
(08:06):
come to work. I'm still I still enjoy operating, I
still enjoy interacting with patients. And I don't think many
people get that in life. But they get to be
excited about their jobs and still want to do it,
you know, decades into it. The problem though, is that
plastic surgery is these little beautiful nuggets of gold that
(08:27):
are unfortunately buried in like just a mountain of bullshit.
And so I think what we're going to do in
this podcast is show you what the gold is and
scrape away everything else. Well, that's what my hope is
for this.
Speaker 1 (08:41):
Well, I think I want to also put a bright
light on the bullshit, right because when you typically see
two plastic surgeons on a podcast, it's really just a
thinly veiled marketing tactic to get patients in their practice
and talk about how wonderful plastic surgery is, and to
put down the competitors, the cosmetic surgeons or the dermatologists
(09:02):
who may take away from some of their business. We're
going to put it all down that we feel deserves
to be put down, and I think we're just going
to be extraordinarily honest. And I really want us to
talk about, you know, what the red flags are when
you go to meet a plastic surgeon and what you
should really look out for, but what they're really trying
(09:22):
to do. I think the first example in my mind,
and I of course want to hear what you say
is when we attach these cute little advertising labels to
things like ozambic face right, or other things nanotechnology, other
things that we sort of put out there that you
and I both know is a load, right, And I
(09:45):
think one of the first things that comes to mind
that's really out there is the deep plane base lift. Okay,
let's talk about a little bit briefly, because you and
I could do this for four hours, right, Well, we
could probably do this for longer than that.
Speaker 2 (10:01):
But we could do a four part series on the
DP plane facelift. We could, but no one wants to
hear that.
Speaker 1 (10:05):
But the Chris Jenner of it all really amplified everyone's
interest in facelifts. In fact, it's driving younger people into
plastic surgeon's office to have facelift now, and they're thinking,
everybody thinks it's a deep plane face lift. Well, first
I can tell you she didn't have a deep plane
facelift because I know the surgeon who did it. Okay,
he did a very amazing job. She looks amazing, but
(10:28):
he didn't even have one. And the Beverly Hills guy
I know very well who does a lot of these
sort of higher end celebrities that everyone's heard of. He
doesn't do a deep plane facelift either. So what is
in your mind? What's the story with this sort of
advertorial term DP plane facelift, And how can patients sort
(10:50):
of avoid falling into the trap of trying to find
someone who does a DP plane facelift, which is in
fact a harder procedure with greater complications closer to the nerves.
And if you happen to find a surgeon who's just
sort of learning, which most of them are, how to
do a deep plane, you could be on their learning
curve and really be complication rather than a good result.
Speaker 2 (11:14):
Well, first of all, I think we need to define
what a deep plane facelift is, and to me, what
a deep plane facelift currently means. It's the term you
use to describe whatever facelift you've been doing for the
last twenty years, which is now suddenly a deep plane.
(11:35):
The idea that all these guys are suddenly doing the
deep plane facelift after having done something different their entire lives.
Suddenly everyone is the master of the deep plane. By
the way, by the way, it's the same plane.
Speaker 1 (11:51):
No, no, no, no, I'm going to go I'm deep. Okay,
I'm gonna turn I'm gonna turn the volume to eleven.
Speaker 2 (11:59):
Yeah, it's it's so deep you're coming out the other
side of the face. It's it's ridiculous.
Speaker 1 (12:05):
I think the TAKEO message here is, you know, let's
not fall into the I must find someone who does
a deep plane facelift, and I must go to a
surgeon who's telling me that they do a deep plane
facelift and it's the only facelift to have, because it's
just not true. And one person's deep pain facelift is
another person's more superficial facelift or skin only or smass.
(12:27):
I think the takeo message there is you want to
go to someone who does facelifts all the time?
Speaker 2 (12:32):
Yeah, you want to do someone who's a good Go
to someone who's a good facelift surgeon.
Speaker 1 (12:36):
Yeah.
Speaker 2 (12:36):
Period. Because it's not so much what name you give
the technique. I mean, all these techniques have pretty much
a lot of the same things in common. There's sort
of variations on a theme, and what matters the most
is the skill in judgment of the surgeon that's doing it,
absolutely far more than it, and the care that they're
going to take in doing this because, particularly if someone
(12:59):
is truly doing what is accurately described as an extended
deep plane face, which by the way, it's really very
few people truly doing that, you got to understand that
what you're doing to do that is you're separating the
layers of the face, where if you go half a
(13:20):
millimeter too deep, you're cutting the nerves that move the
muscles in your face, right, And so yeah, it's it's
you know it. Yes, a good surgeon can do this consistently.
Although even the very best guys at this will tell
you that they get at least five percent temporary nerve
injuries with this. Yeah, and by the way of plastic
(13:41):
search are telling they get five percent temporary nerve injuries.
They get more like fifteen percent temporary nerve injuries. Just
know that because there's no studies of this, right, any
studies of this is what some guy reported about his
own work historically.
Speaker 1 (13:55):
But well, that's a good point. This is a question
I get asked all the time. When's too young to
have a facelift? When's a proper time to be considering
a facelift. It really has nothing to do with age.
It's more of anatomy. Let's be honest, because a thirty
(14:15):
eight year old who lost one hundred and fifty pounds
may be a perfect candidate for a facelift, and a
fifty year old who's got minimal laxity is not really
a good candidate for a facelift. But what do you
think about this whole emphasis and enthusiasm or face of
driving people at younger ages when it's just starting to
(14:37):
loosen up into our offices for a facelift. What do
you say to your patients?
Speaker 2 (14:43):
Well, you know, I don't. I'm not, at least in Dallas,
I'm not seeing people in their twenties or early thirties
coming in for this yet. But I can tell you
what I tell patients who are even older than this,
where you're looking at them and they have very fairly
early changes of facial aging. I always look at this
(15:04):
as sort of a risk reward ratio in that we're
doing surgery, so there's guaranteed to be some risk involved. Now,
you know, in well performed surgeries on appropriate patients, the
risks are really low because they sort of have to be,
because if you had a procedure in cosmetic surgery that
was highly risky. No one in their right mind would
(15:24):
ever do it.
Speaker 1 (15:24):
What about the Brazilian budlift.
Speaker 2 (15:27):
No one in their right mind. Whatever, No, that's not
really true. I mean the way some people do it. Yeah,
the way sometimes that's performed. It's insane.
Speaker 1 (15:37):
But remember in the old days, for years and years
and years, over a decade, we were instructed to do
it the proper way, which was the dangerous way, injected
into the muscle. Remember that, until after what was it, ten, twelve, thirteen,
fourteen years we figured out, m, maybe we don't want
to inject the fat into the muscle because it's going
(15:58):
to get into those short, big blood vessels of the
buttock muscle and get into the vena kiva and go
to the lungs and oh, it's over, And that happened all.
It turns out to be the most fatal elective procedure
in all of surgery, A cosmetic procedure done to make
your butty bigger. It took Margue that.
Speaker 2 (16:17):
With the science of plastic surgery is after years of research,
we concluded that no matter how great your buttocks end
up looking, if you're dead, it's not probably worth it.
Unless they're gonna do an open casket, face down funeral.
It's just, you know, not to be glib about this,
but it's like too late. This is okay, this is okay.
(16:40):
There you go, there's plastic surgery science for you. We're
doing something that is you know, not entirely rarely killing people. Ergo,
we should stop doing this. Wow, wow, Nobel prize material
stuff there.
Speaker 1 (16:55):
I know, well, I remember do you remember when, Okay,
so fat transferred to the butt to the bread is
a thing now, right, it's an acceptable thing to do,
just like fat transfer to the buttock is an acceptable thing,
although now there's some sort of new ways to minimize
the chance it goes to the lungs and knocks you off.
Speaker 2 (17:11):
Yeah, not putting in a blood vessel.
Speaker 1 (17:13):
Right, But do you remember how our society and plast
Survey felt about the dermatologists doing fat They called it
a Bambi procedure, doing fat transfer to the breast. We thought,
that's dangerous, never should be done. That's fat's gonna calcify,
and they're gonna think it's breast cancer and you're gonna
have a mestectomy for dead fat. And then all of
(17:34):
a sudden, the dermatologists started to take business away from
plastic surgeons and breast augmentations using silicon with fat transfer,
and we went, maybe we should start doing that one.
Speaker 2 (17:47):
You know what, maybe we should I don't know, check
with radiologists and see if it's causing them to overread
on mammograms and it looks like cancer. And it turns
out they said, no, Now there's other issues with fat
trans yes, like that. It ends up that that's not
really an issue. But for years, based on nothing, plastic services,
(18:09):
oh never do this.
Speaker 1 (18:10):
Well, I remember, I go back far enough in the game.
I remember when it went from liposuction was being done
by dermatologists and we plastic surgeons thought it was dangerous
and shouldn't be done. To all of a sudden we went, uh, oh,
they're taking away our tummy tucks. They're taking away a
lot of our operations. We better learn how to do
(18:32):
this lep bo suction thing. Because it was really popularized.
Despite what you might say about iloise in Brazil or
Prance or whatever, it was really popularized by a dermatologist
in this country.
Speaker 2 (18:43):
True, Yeah, it was. Yeah, he went I think it
was developed in France and he went over there and
learned it. Yeah, and started doing.
Speaker 1 (18:52):
It, and we criticized the heck out of it, saying,
oh my gosh, why are dermatologists operating? What's this? Putting
this tube underneath the skin and sucking fat Out's so dangerous.
They're going to get fat enbaloie. It's horrible. And then
we went, oh, gosh, we better really learn how to
do that. Other words, we're going to miss out on
all that surgery.
Speaker 2 (19:14):
Yeah, it's like that. You could sneeze at the American
Sydio Plastic Surgery meeting and missed the moment where we
went from liposuction is terrible, terrible, terrible, terrible, terrible, terrible.
Speaker 1 (19:26):
Great exactly, and this is how you do it, and
this is how you do it, and listen to us
because we're board certified plastic surgeries. Now, you know, a
couple of board certified plastic surers like you and me
typically would get on a podcast and say, only go
to someone who's certified by the American Board of Plastic Surgery.
And of course we do feel that way. But being
being board certified the American Board of plast Surgery in
(19:48):
and of itself, what does it mean to you.
Speaker 2 (19:50):
It's a very low bar to set. It's like saying,
you know, so the guy who drives your for Formula
one race car should have a driver's license. It's that
It's like, yeah, okay, but that doesn't exactly necessarily mean
you're a great driver. It's the minimum. Yes, it means
(20:13):
you've been properly trained, you've gone through the right programs,
taking the test, you're taking the tests. Yeah, it should
be a minimum threshold. But if you think that all
board certified plastic surgeons are of equal standard, no, right,
it's still a bell shaped curve. It shifts the bell
shaped curve a little bit to one side. Right, so
(20:36):
you tend to get better people than those who didn't
even bother with the training, obviously, but there's still a
wide dispersion of ability in this and then so you
can still get a horrible surgery. There's a lot of
bad surgery done by board certified plastic surgeons.
Speaker 1 (20:52):
I always tell people if you pulled back your face
with two fingers on each side, you know your middle
finger and your thumb, and look remarkably better. Yeah, I
think you might be a canon no matter what your
age for a facelift. To me, that's a good starting
point to figure out, because if you go in for
a facelift to a cosmetic or facial or regular plastic surgeon,
(21:17):
they're probably unless they're very busy, they're probably gonna want
to do a facelift on you. Would you agree with that?
Speaker 2 (21:23):
Yeah, sadly, yes. I can tell you. What I tell
patients and consultations, okay, is that there's a risk benefit
analysis to this, okay, And the risk is always going
to be there to some degree. The question is what
is the benefit? And if you have very minimal early
facial changing, you can only get so much better, and
so if there's barely anything going on, yeah, it might
(21:47):
be you might notice something, But do you really want
to undergo a surgery and spend tens of thousand dollars
to get an end result where you go like, yeah, look,
you don't want to wait until it's horrible, right, because
you can only get so much better, and you know,
as you get past a certain age, the skin loses
its elasticity, nothing works quite as well. So you want
(22:09):
to have enough visible that there's a meaningful change to make,
and that's that's the time. If you're before that point,
it's just silly to do it, and certainly someone in
their twenties, you know who has other than massive weight
laws or something, or just horrible genetics or early thirties,
come on, there's very little that can be a changing.
Speaker 1 (22:29):
Plus, I feel there's no science behind this, and we
all have our feelings about this. You know, anecdotal experiences.
But I feel if you start too young and then
you have too many facelifts, once you get past a
certain unknowable point, it starts to relax because they all
relax a little bit, and it relaxes in a potentially
(22:50):
unnatural way or angle or sweep. And once it does that,
now you're into altered. And once you get to altered
slash weird. No matter how good you look, if there's
a weirdness, it's kind of like a hair in your
salad or smell in the kitchen. It's just like, no
(23:12):
matter how good the food is, if there's kind of
this rancid something smell in there, it's over. The whole
meal's ruined, the whole face result is a disaster once
you get too weird. And by the way, even with
the best surgeons, we can have it heal even with it.
(23:32):
If it's not even without a complication, we can have
it heal in a slightly weird way. And I think,
I don't know if you agree with this. I think
if you have too many facelifts, your chance of getting
a slightly weirdness to your face is significantly elevated.
Speaker 2 (23:51):
Oh look, I think I don't even think it's like
it's almost guaranteed.
Speaker 1 (23:55):
Yeah, if you do too many, you.
Speaker 2 (23:57):
Only get But first of all, you know, with most
cosmetic surgers, but particularly facelifts, your first one is your
best one, and you want that one done properly at
the right time, because everyone after that is diminishing returns.
Because the things you can really affect with a facelift meaningfully,
you just can't do over and over again. Because you ye,
(24:22):
facelift is a simulation of youth. So when people come
in and they go, well, you know, then they're sixty,
they go, well, I don't want to look twenty again,
and I'm thinking, don't worry, it's not gonna happen. Okay,
So well, first of all, the first thing that is
that's not true, because you do want to look twenty again,
(24:44):
because if there was an operation that would make me
look like I look when I was twenty, I wouldn't
be on this podcast right now. I'd be getting it
done right, right, Yeah, I'd love to look twenty again. Unfortunately,
we can't do that. We can do a simulation of it.
We can move you in that direction, right. So it's
(25:09):
not a perfect simulation. It's like a virtual reality or something.
So it's not exactly right. And so every time you
do it, you're deviating a little more and more from
where you really were into something that never existed.
Speaker 1 (25:23):
Right.
Speaker 2 (25:23):
But the more you get into never existed, the more
it looks like a face.
Speaker 1 (25:28):
Look right, So I not to Let's switch gears a
little bit, because again, you and I we literally could
talk for two hours about anything in this field because
we love it so much. But I just did a
podcast which I guess is getting some there's some virality
to some of the things I said. And I was
discussing male plastic surgery on celebrities, Okay, yeah, and you
(25:49):
know why are the female celebrities looking so amazing and
the male's looking so weird? And you know they're being
done by the same surgeon. Okay. And I posited a theory, okay,
and the theory is this, and I want to see
if you agree with this, and I, well, the things
I love about you, besides effect your incredible genius, is
(26:09):
that you're completely honest. You'll call me out on any
bs and you won't agree with me just to you know,
just agree with me.
Speaker 2 (26:15):
Oh that's going to be half of this podcast. And
you're doing the same to me because you know.
Speaker 1 (26:21):
That's what we do for each other.
Speaker 2 (26:22):
Yeah, exactly.
Speaker 1 (26:23):
So I have this theory, and that is, if you
do the typical baselift that you would do on a
female on a male, it really only works with feminine males.
And that's why. And I don't know about any of
these people, whether they've had plasters or not. But they
talk about the Brad Pitt, I don't know if he's
had anything done. He looks great. They talk about Bradley Cooper.
(26:44):
I have no idea if he's had anything done. And
then they're asking me a lot when I walk out
of restaurants about Jim Carrey. So why are they sat
setting things aflame in terms of their results? And my
theory is this, if you're a feminine looking person, if
you're a pretty guy like a Brad Pitt, a John
Stamos or a Rob Low, you can pretty much have
(27:07):
more feminine looking, feminizing regular female plastic surgery, because you're
just making you look pretty. But once you go from
rugged okay, with heavy brows and putted upper eyelids and
maybe some wrinkles on the forehead to a sort of
feminized version of that, if that's your thing. You know,
(27:29):
like a Ryan Gosling could probably look good with feminizing plaster.
It's kind of a pretty dude, right. But you take
a George Clooney, although he's not not feminine, but he's
much more masculine looking, and you do that kind of
surgery on a George Clooney, it's gonna scream facelift. Don't
you agree with that?
Speaker 2 (27:47):
I think that's absolutely true. But I also think that
what you're saying really applies to every man in that
if I think part of what's going going on is
it's men or you know, plastic surgeons doing facelifts on
men and doing facial rejuvenation, filler, eyelid surgery, brow whatever
(28:11):
it is, doesn't matter, and they're doing it the way
they would on a woman. Yeah, and the aesthetic is
totally different because you know, I I'm not fascinated particularly
with celebrities, and I'm not fascinated by celebrity plastic surgery either,
but you know, my patients ask about it, so I
try to stay up with it, right, right, So you
(28:35):
get aggressive on any of these things. On a man,
it doesn't matter where they started off, and it's going
to look feminizing, and in some ways it's going to
look less handsome. Less is more on a man. A
male facelift is a very different surgery from a female facelift.
If you're gonna air one way or another, if you're
(28:56):
gonna air one way or another, and one obviously you
don't want to air at all. But if you're gonna
it's okay to maybe overdo just a little bit. It'll
be fine. Okay, it may take a little longer to
get there, but it'll be fine. If you're gonna air
one way or another. On a man, you should underdo it.
Speaker 1 (29:10):
You can always take.
Speaker 2 (29:11):
More anything well, and anything overdone starts to look feminized.
Speaker 1 (29:17):
Well. Remember, you know, it's funny people seem to plastic
surgeons now somehow seem to forget who Kenny Rogers was
or Robert Blake. Do you remember of course, I know
you know who Robert Blake was. He had clearly very weird,
feminizing plastic surgeon. And Robert Blake was a very handsome guy,
but a very rugged guy, and he was massively feminized.
(29:39):
And yet we still don't seem to understand the lessons.
But I think the scariest operation that a man can
undertake in plastic surgery is an upper eyelid blephoplastic, because
you just take a little too much skin and not
only is there no going back, but you're completely for
(30:00):
the looking person. And if you're a guy and you're
going to have your upryland is done, just tell him
to take one or two millimeters. You can always take
a couple more later, right, and you.
Speaker 2 (30:12):
Know what, you're not going to need to because you
don't want to look that refined as a man. You
just don't, you know. So look, Brad Pitt is obviously
a great looking guy. I think you could make the
argument that whatever he's had done, I don't know, he's
still great looking. He had good work done, whatever, he
(30:34):
looks great. Yeah, I don't think there was a problem
that needed to be addressed there. And whoever did it
obviously did subtle which is good, but you know, a
little craggy, the lines in the face in a man,
the aesthetics for him. That's the other thing is that
the aesthetics for a man and a woman are very
different as we age. It's fair, not fair, it's just
(30:57):
what it is. Let's just let's as they get older
and you know, more rugged looking, it just works in
terms of what society likes.
Speaker 1 (31:05):
It's true. Let's let's be honest. Brad Pitt never looked bad.
He never looked like he needed work done now the day.
Speaker 2 (31:13):
Honestly, he actually I think he looked even better as
he got older, which was just so painful to walk.
Speaker 1 (31:18):
I hate that that guy. Remember him in the Legends
of the Fall, Yeah, I mean he was the best
looking actor bar non female or male on the set
of that. I mean, he's just you know, it's.
Speaker 2 (31:31):
Like painfully good looking and like inglorious bastards and fury,
and you know, it's just he can't look bad.
Speaker 1 (31:39):
It's funny to get not to get too personal about this,
but you've embraced getting older with the beard and having
the gray. But you, let's be honest, you were a
very pretty slightly slightly as being generous to you because
you were more than slightly feminine, feminine looking guy. I mean,
(32:02):
you were a classic blue eyed, dark thick, black haired
model when you came to UCLA. It's funny because when
I knew you at Yale, you were kind of this
skinny I remember, not very tall, nerd genius. And then
a few years later I see US medical school and
you're like this super fashion model perfect. What the fuck
(32:26):
happened between Yale and ucllly medical School? Did you just
wake up and you were like this feminine, gorgeous looking
guy overnight? And did it mess with your head? And
I know we're getting way off topic here, but it
was weird.
Speaker 2 (32:38):
Yeah, there's a lot to reveal on the first episode,
but I don't know. I know we've talked about it.
I'm pretty sure we talked about this. I had a
very weird, like teenagehood. You know. Well, first of all, okay,
I went to Yale to become a physicist. Okay, okay,
let's let's be real here. Dork, seriously dork, right, So,
(33:01):
and when I started freshman year in September, how tall?
I was five ft four inches fall Wow?
Speaker 1 (33:07):
How tall?
Speaker 2 (33:08):
Chubby and chubby sixty. Yeah, sixty. I grew six inches
out of nowhere in my freshman year of college and
it completely changed my look, and honestly it was Yeah,
it did mess with my head because suddenly.
Speaker 1 (33:24):
Girls they paid it. They oh attention, dude, you were killer.
I remember you gave me to UC med school. We're
going med school ahead, you're going girls, and it was like, wait, wait,
that's a college thing. You're going now. And you took
a year off to go model in Europe?
Speaker 2 (33:40):
Yeah, yeah, not the best use of the year, but
I took a year off to model in Europe but
not model successful.
Speaker 1 (33:48):
Aren't you glad you did it? Though?
Speaker 2 (33:50):
Yeah, I'm glad because the modeling didn't really work out.
So after about two months, my buddy and I who
we went over there, we just said, you know, screw it, and.
Speaker 1 (33:59):
We backpack through Europe and let's go back.
Speaker 2 (34:02):
He only stayed like another month or so, but I
stayed there like six seven months, right on my own,
backpacking through U and it.
Speaker 1 (34:07):
Was like, let's go back and be doctors. Let's leave
people with the what to look out for when you
go for a plastic surgery consultation? Can you go in
to a plastic surgery's office, and they've got all the
good looking furniture and the art on the wall and
(34:30):
the degrees hanging. Okay, so they have pretty offices. We
spend a lot of money in our offices to entice
people to have plastic surgery. All right, but what should
you look for that's good and not so good that
may be a red flag in a consultation?
Speaker 2 (34:44):
I think. Okay, so you know we said before, usually
this discussion begins and ends with look for a board
certified plastic circuit. And yeah, obviously, but the next thing is, Okay,
before you've even gone there, you should have looked at
their web and looked at them before and afters. Okay,
Now that is only so useful because anyone on their
(35:05):
website it's like their greatest Hits album.
Speaker 1 (35:08):
But just you know, by the way, if I can
add to this, just you know, it's now that's primarily
and more broadly replaced by Instagram. Now they're showing amazing
before and afters on Instagram, and that's the main catch
point for getting patients at their office. And boy, there's
no more bs than an Instagram before and after.
Speaker 2 (35:27):
Yeah, be really careful with that because I can tell
you what I've started seeing in the last year or so,
not so much on plastic surgeons in this country, although
definitely happening. It's results that have clearly been doctor right,
clearly altered, aside from the usual tricks of the you
know face of the before.
Speaker 1 (35:49):
Oh I know and they know that thing. So but okay,
so the patient comes in and you meet.
Speaker 2 (35:55):
So anyways, the photos I think are useful only in
the sense is if you look at their photos and
you go like on any of them.
Speaker 1 (36:00):
You're like, right done, because that's their best.
Speaker 2 (36:04):
If their best stuff is not meeting your approval, don't.
Speaker 1 (36:08):
Right, But what about what about the general demeanor, Like
how much time they spend with you? I think ten
minutes is not enough. You know, there has to be
a get to know you. You have to have a
cocktail with them first, and they have to learn. I
think it's important they learn a little bit about you,
to get to try to get a feel for you,
because you know, you may have red flags that they're
(36:28):
that they're not even looking for because they just want
to get you on the operating table. And you know,
for me, I say, my big thing is I want
to know why you're thinking about doing it now, like
you're forty three years old, coming for a breast augmentation. Why,
I'm very nice about it if I really want to
get at the why. Because if your marriage is failing
and you're doing breast implants, you can still do breast implants,
(36:51):
but it's good to know you're you know that you're
maybe expecting something that's going to really change everything about you,
and your expectations are overwhelmed by the results. So that's
what I do. I spend at least thirty forty five minutes.
I try not to spend an hour, but I'm willing
to if they want to talk that much. But I
want to get to know the person. I think your
(37:12):
plastic surgey should get to know you.
Speaker 2 (37:15):
I think your plastic surgery consultation should be done primarily
by your plastic surgeon and not by a coordinator or
a salesperson or right whatever it is. That's a red flag,
you know, it's total red flag. First of all, aside
from the fact that this is surgery. This is serious business.
You know, people forget that. You know, the second half
(37:35):
of plastic surgery is surgery. It's real, it's very real.
It's a real thing. It's real surgery. Yeah, and so
you should know the person who's going to be cutting
open part of your body and putting it back together.
Speaker 1 (37:49):
It's a good point of that because if you meant
the coordinator, it's almost like going in for the car.
The guy goes put a cigarette down and goes, let
me go talk to my manager. And the manager in
this case is the plastic surgery is going to come
in and do the clothes right.
Speaker 2 (38:03):
Right, right right. So yeah. So and second of all,
you're purchasing, aside from the fact that it's surgery and
it's your face or your body, and in some ways
there's no going back from this. You're purchasing a very
expensive luxury service, and you deserve to be treated like
(38:23):
someone who is receiving a luxury service. And that means
I have all the time in the world that you
need me to spend with you to make sure that
you're comfortable. I'm sitting there and we're chit chatting. And
we're chit chatting for two reasons. One because it's just
good manners to walk in and I ask people about,
(38:43):
you know, what they did or something that you know
has come up something that you know, I noticed what
they do for a living or whatever one because part
of what's a blessing about being a plastic surgeon is
we're not beholden to whatever Blue Cross blue Field is
going to pay us for the visit. So that's not
what it's about. And so I have that luxury. Right,
(39:04):
I can spend an hour with a patient if I
want to. You know, your intern is can't do that, right,
They can't make a living doing.
Speaker 1 (39:11):
Do you agree with this? They? Okay, So we discussed
they should take a januarine interest to you. Really, they
should try to understand you to determine whether they can
meet your expectation. Number one. Number two, I think it's
important that every procedure you talk about doing, they discuss
the pros and they all discuss the cons because every
(39:35):
procedure you're considering has cons. Like the first when a
patient comes in for a breastlift, first thing I say
to them, I go, let me ask you a question,
how do you feel about breast cars? Now I've started
with breast scars. That's not a good sales tactic because
now I've highlighted the thing that they would turn them
off to. Signing up for the procedure, right, the scars.
But if I can see right away whether they go scars, Oh,
(39:59):
you didn't know they were scars, let's talk about it.
And some people in the middle in the very beginning
of that consultation will go, I'm not doing it if
there's scars. You go, yeah, there's scars. There's scars for sure,
and they're permit, you're gonna see them. And they go, yeah,
I don't want that. You go great, I go, maybe
there's other things you can do, but I highlight and
you don't have to necessarily do this, but I think
(40:19):
it's important every single procedure they offer you should come
with various options, and they should highlight every one of them,
not necessarily all the risks, but the cons the cons.
The cons are a tummy tuck, for example, That is
a big recovery, big recovery, and it hurts, and it
(40:40):
has more risks than any of the other plastic surgery procedures.
I start with that. Now. I don't care if people
have surgery with me anymore or not. I don't care,
you know what I mean, And you don't either, because
you're you know, we both have these advanced practices now.
But I care that I've told them all this stuff,
and if anything untoward happens, I look at them and go.
But remember we did discuss this. But I know that
(41:02):
they made the decision based on having heard that they
can never say. My patients can never say. Boy, had
I known, I would not have done this. So I
think pros and cons. Would you agree?
Speaker 2 (41:15):
I one hundred percent agree, And I don't even look
you said. It's not a good sales tactic. It's not
a good sales tactic. But it is a good doctor tactic,
and aside from just the medical legal aspect of it,
it's just the right thing as a human being to do.
And so you know, I'd like to I try to
(41:36):
walk my patients backwards from what they're trying to get
out of this operation. And it took me a long
time in practice to really understand the psychological aspects of this.
What are we really doing with any of these operations.
We're taking a part of someone's face or body that
they feel self conscious about, rightly, wrongly, whatever, Okay, they
(41:57):
feel self conscious about it, and ideally want to move
it from a place where they feel self conscious, ideally
to a place where they feel proud of it, or
at least a place where they feel a lot better
about it. And so if you discuss something like a
breast lift without talking about the scars and without having
them in their head asking themselves, Okay, if my nipples
are in the perfect position, or my breast no longer
(42:19):
a hang down, but I do have some visible scars
around my nipple on the lower part of my breast,
do I feel better about my breasts or do I
feel worse about my breasts? Because unless the answer is
I truly feel better about my breast despite the scars,
shouldn't do it? I agree, because ultimately you're not going
to achieve what the goal is, which is feeling good
(42:39):
about your breast. No one's goal is to have nipples
that are twenty centimeters from their sternal notch, you know,
the things that often blasphic. No one comes in going
like I don't like my external notch to nipple distance.
They don't like their breasts. They don't always know why
they don't like their breasts, but they want to be
proud of their breasts again or maybe for the first
time in their lives. Right, And so if you can't
(43:02):
do that in a way. That's me. If you just
make them self conscious about something else, you've achieved nothing.
Speaker 1 (43:06):
Well, you and I could talk forever about this, but
I do want to make one final point. So people
have a practical red flag. I think if they've say
it's easy, if they use that's easy, that's a chip shot.
Oh my gosh, it's going to be so easy, that's
a red flag. I think. Don't you agree completely?
Speaker 2 (43:26):
This comes up a lot where PA goes this an
easy operation, and I always say, it depends what you
mean by easy.
Speaker 1 (43:31):
Yeah, Okay, A.
Speaker 2 (43:32):
Lot of things in plastic surgery, strictly speaking, not that hard.
It's not like taking a tumor out of the base
of the brain. You know, it's not the technical aspects
that aren't that hard. But it's hard in the sense
that you have to get everything exactly right right. So
it's easy in some sense to do breast implants. It's
(43:54):
hard to get the very best breast augmentation result time
after time after time, given all the differences between patients
and even between their own breast. That takes a lot
of work, a lot of judgment, and a lot of right.
Speaker 1 (44:08):
I mean, we have this thing we say, you know,
among us plastic surgeons in the lounge, the only easy
operations and operation done on somebody else. Yeah, right, well, listen,
I mean, there's so many more and we're going to
do this again. I loved doing this with you, and
we have so much more to talk about, and I
hope you'll do this again with me many more times.
(44:29):
And by the way, by the way, I just want
the audience to know that there will be a bonus
episode to look forward to, okay, where we'll talk more
about this. And I can't tell you how much I
appreciate you, know. I love you, you know, and you
know you're like one aside from my wife and my kids,
well some of my kids, you're like most important people
(44:50):
in my life, my life, and I adore you and
thank you for doing this. And I hope, I know
and hope that the audience will get to hear more
from you and me about this in the future. All right,
So thank you for joining me.
Speaker 2 (45:06):
I would love to do this again and again. At
the risk of us sounding maudlin, I love you like
the older brother you've always been to me. Thank so,
thank you for having me on at anytime. Thank you
My man, what Alan, how are you?
Speaker 2 (00:08):
I'm good?
Speaker 1 (00:09):
This week on between Us, I have a very special
guest and a co host instead of Heather, she's busy
doing the housewife thing. Okay, my best friend of over
forty years, doctor Robert Schwartz. Doctor Schwartz, how are you.
Speaker 2 (00:26):
I am so excited to be here doing this with you.
It is the culmination of forty years of friendship.
Speaker 1 (00:34):
Yeah, it's a long time coming.
Speaker 2 (00:35):
You know.
Speaker 1 (00:36):
It's funny. When I told i Heeart that I wanted
to do this with you, they looked you up. And
you're known as the best breasts, best boobs in Dallas,
and you are. You're a very gifted plastic surgeon and
a phenomenally smart guy. I just want to spend a
couple of minutes talking about how I know you are,
(00:57):
friendship in our background, and a little bit about what
we're going to talk about today. Okay, so very briefly,
if you've ever met anybody who's a true genius, you
know that they're different than the rest of us. Okay,
and doctor Robert Schwartz is a true genius. I met
him at Yale where I was which is a joke.
His mcat instructor when he was a junior at Yale
(01:21):
Buckunn apply to med school, and I'm teaching him how
to take the missions test for medical school. When you
think about it, it's such a joke. And you I remember
him asking me a question that was kind of a
complicated physics question because this guy graduated summa cum lauti
from Yale University in physics. Okay, and he's a true genius.
You asked me a question. I went, what the hell
(01:42):
is he? Tom? Thinking, what the hell is he talking about?
And I and you to this day, you remember how
I sort of answered in kind of this filibuster, like
I have no clue. Do you remember that?
Speaker 2 (01:52):
I remember that. I don't remember exactly what the questions
are what you answered, but I remember sitting there thinking, no,
that's not right. So anyway, remember do you remember what
you said in the first five minutes of that class?
Speaker 1 (02:04):
No?
Speaker 2 (02:06):
Okay, So you started you introduced yourself when we started
talking about the MCAT and how it works and how
you know there's six sections each is out of fifteen
and then so the total is ninety, and so you
know you can get a maximum score of ninety, and
that you want to get. You know, a sixty would
be considered a good score on that and will make
(02:27):
you very competitive for med school. And then there's like
the standard Terry pause where you just go.
Speaker 1 (02:33):
I got to something too, What did you get? Come
on eighty three? Oh my god, which is of course
ninety nine PERCENTA anyway, left Yale and then we both
went to Ucilly Medical School. I was a year ahead
of you, and we caught up again.
Speaker 2 (02:47):
You got me to go to UCLA.
Speaker 1 (02:48):
I know he could have gone anywhere obviously, and he
decided to go to sile A. And the cell was
look at this weather, look at these chicks. Yeah, was
that pretty much the cell.
Speaker 2 (02:59):
Yeah. We walked outside and it was I don't know
what December, I don't even remember what it was, and
you look up at the sky and it's like seventy
five degrees and you just go huh. And then we
walked to the edge of Westwood and you go and
then you go one more thing, and you walk me
back to the BioMed library.
Speaker 1 (03:21):
Oh yeah, across from Sorority Row.
Speaker 2 (03:23):
Yeah, the physically closest library to Sorority Row. And so
it's just filled girls with girls, and you just go,
so Okay.
Speaker 1 (03:35):
Plus it was like the third or fourth best med
school of the world at the time, so that wasn't
you know, that wasn't bad either. But anyway, very easy, Yeah,
very easy. So you came out and we both graduated
medical school and then we don't need to get into
the details of the whole general surgery thing, but we
went through the very traditional way that we used to do.
(03:57):
Before you could be a plastic surgeon in our era,
you had to complete a full general surgery training, which
is the most difficult by far and away training that
you can go through after med school. It's like seven
years long. Every other night, you're awake all night, tons
of independent operating between and we're both chief residents. Between
(04:18):
midnight and six am. You are the doctor, the boss
of the hospital doing nothing but trauma. You're awake all
night doing trauma. It was the most intense and let's
be honest, awesome training that they don't get today because
they have a lot more controls over you're not allowed
to sort of operate independently anymore. The way we did, right,
it was really the wild wild West. Yeah, So we
(04:40):
graduate a super difficult general surgery program and we're both
in the same laboratory doing research and reconstructive surgery and
plastic surgery. And I went onto UCLA's Plus surgery program,
and you went on to one of the, if not
the top plastic surgery program in Dallas, right, yeah, ut.
Speaker 2 (04:59):
Southwest, Yeah, okay, I mean both super high level.
Speaker 1 (05:03):
Yeah, super high level. Yeah. And so we then were
chief residence in plastic surgery and we graduate and you'd
weirdly decided decided to stay in Dallas to practice plastic
surgery and raise your family. Well, it's weird when you
consider who you were going to Dallas and who you became. Okay,
(05:23):
Dallas changed you completely, and I stayed here in Los
Angeles that open up my practice and the rest is history.
But we've remained. Truly, You're my closest friend for all
these years, and you everybody has their person they go
to when they're in trouble, Okay, like if I have
an extraordinarily difficult case or even in my my life
in general, something threatening or I'm very worried about it,
(05:45):
that you call, you know, is your sort of your
go to chat tee GPT person human And You've always
been that guy for me because your advice is not
only brilliant, but sound and reasonable and moral and ethical.
And you know, we've just remained and we we're like
a couple of sorority girls the way we talk on
(06:06):
the phone even to this day.
Speaker 2 (06:07):
Right, well, let me let me throw those back at you, okay,
and then we can get the sentimentality out of this.
We could stop asking each other another yeah, another episode.
You are, unquestionably to me, the older brother I never had.
You are that guy. To me, you are the guy
I've always since I was twenty years old, basically my
(06:30):
entire adult life. You're the guy I've always looked up to.
You're the guy I've always gone to for advice. You
are the guy who has never once given me bad
advice of any significance on anything that I can think of.
And in fact, the times that I ignored your advice have
which we don't need to go into right now, have
(06:51):
cost me dearly.
Speaker 1 (06:52):
Right, but you've done well despite that. Yeah, Well, I
appreciate you saying that. And what's great about you is,
you know, you have such an amazingly intact ego that
even you know you're not everybody's great with when their
friends become successful, and you've become very successful. I've obviously
done okay, and you know we're happy for each other.
Speaker 2 (07:15):
Yes, I believe you've done okay.
Speaker 1 (07:17):
Yeah, we've done okay. But I can I can tell
you this is going to be a very different podcast
than just two plastic surgeons talking about health, wellness and beauty, okay,
because Rob and I are very different kinds of doctors.
First of all, we're at advanced stage of our career
and very successful, and we really don't need to operate anymore.
And we operate because we're it's interesting and we still
(07:38):
like to do it. But we're just I think, extremely honest.
Speaker 2 (07:43):
We want to just sort of I think tell this
like it is because I think you would agree with
me that we're blessed to be in this specialty. There's
a lot of great things that, you know, as plastic
surgeons we get to do. There's a lot of it's
really I'm still excited about doing this every day I
(08:06):
come to work. I'm still I still enjoy operating, I
still enjoy interacting with patients. And I don't think many
people get that in life. But they get to be
excited about their jobs and still want to do it,
you know, decades into it. The problem though, is that
plastic surgery is these little beautiful nuggets of gold that
(08:27):
are unfortunately buried in like just a mountain of bullshit.
And so I think what we're going to do in
this podcast is show you what the gold is and
scrape away everything else. Well, that's what my hope is
for this.
Speaker 1 (08:41):
Well, I think I want to also put a bright
light on the bullshit, right because when you typically see
two plastic surgeons on a podcast, it's really just a
thinly veiled marketing tactic to get patients in their practice
and talk about how wonderful plastic surgery is, and to
put down the competitors, the cosmetic surgeons or the dermatologists
(09:02):
who may take away from some of their business. We're
going to put it all down that we feel deserves
to be put down, and I think we're just going
to be extraordinarily honest. And I really want us to
talk about, you know, what the red flags are when
you go to meet a plastic surgeon and what you
should really look out for, but what they're really trying
(09:22):
to do. I think the first example in my mind,
and I of course want to hear what you say
is when we attach these cute little advertising labels to
things like ozambic face right, or other things nanotechnology, other
things that we sort of put out there that you
and I both know is a load, right, And I
(09:45):
think one of the first things that comes to mind
that's really out there is the deep plane base lift. Okay,
let's talk about a little bit briefly, because you and
I could do this for four hours, right, Well, we
could probably do this for longer than that.
Speaker 2 (10:01):
But we could do a four part series on the
DP plane facelift. We could, but no one wants to
hear that.
Speaker 1 (10:05):
But the Chris Jenner of it all really amplified everyone's
interest in facelifts. In fact, it's driving younger people into
plastic surgeon's office to have facelift now, and they're thinking,
everybody thinks it's a deep plane face lift. Well, first
I can tell you she didn't have a deep plane
facelift because I know the surgeon who did it. Okay,
he did a very amazing job. She looks amazing, but
(10:28):
he didn't even have one. And the Beverly Hills guy
I know very well who does a lot of these
sort of higher end celebrities that everyone's heard of. He
doesn't do a deep plane facelift either. So what is
in your mind? What's the story with this sort of
advertorial term DP plane facelift, And how can patients sort
(10:50):
of avoid falling into the trap of trying to find
someone who does a DP plane facelift, which is in
fact a harder procedure with greater complications closer to the nerves.
And if you happen to find a surgeon who's just
sort of learning, which most of them are, how to
do a deep plane, you could be on their learning
curve and really be complication rather than a good result.
Speaker 2 (11:14):
Well, first of all, I think we need to define
what a deep plane facelift is, and to me, what
a deep plane facelift currently means. It's the term you
use to describe whatever facelift you've been doing for the
last twenty years, which is now suddenly a deep plane.
(11:35):
The idea that all these guys are suddenly doing the
deep plane facelift after having done something different their entire lives.
Suddenly everyone is the master of the deep plane. By
the way, by the way, it's the same plane.
Speaker 1 (11:51):
No, no, no, no, I'm going to go I'm deep. Okay,
I'm gonna turn I'm gonna turn the volume to eleven.
Speaker 2 (11:59):
Yeah, it's it's so deep you're coming out the other
side of the face. It's it's ridiculous.
Speaker 1 (12:05):
I think the TAKEO message here is, you know, let's
not fall into the I must find someone who does
a deep plane facelift, and I must go to a
surgeon who's telling me that they do a deep plane
facelift and it's the only facelift to have, because it's
just not true. And one person's deep pain facelift is
another person's more superficial facelift or skin only or smass.
(12:27):
I think the takeo message there is you want to
go to someone who does facelifts all the time?
Speaker 2 (12:32):
Yeah, you want to do someone who's a good Go
to someone who's a good facelift surgeon.
Speaker 1 (12:36):
Yeah.
Speaker 2 (12:36):
Period. Because it's not so much what name you give
the technique. I mean, all these techniques have pretty much
a lot of the same things in common. There's sort
of variations on a theme, and what matters the most
is the skill in judgment of the surgeon that's doing it,
absolutely far more than it, and the care that they're
going to take in doing this because, particularly if someone
(12:59):
is truly doing what is accurately described as an extended
deep plane face, which by the way, it's really very
few people truly doing that, you got to understand that
what you're doing to do that is you're separating the
layers of the face, where if you go half a
(13:20):
millimeter too deep, you're cutting the nerves that move the
muscles in your face, right, And so yeah, it's it's
you know it. Yes, a good surgeon can do this consistently.
Although even the very best guys at this will tell
you that they get at least five percent temporary nerve
injuries with this. Yeah, and by the way of plastic
(13:41):
search are telling they get five percent temporary nerve injuries.
They get more like fifteen percent temporary nerve injuries. Just
know that because there's no studies of this, right, any
studies of this is what some guy reported about his
own work historically.
Speaker 1 (13:55):
But well, that's a good point. This is a question
I get asked all the time. When's too young to
have a facelift? When's a proper time to be considering
a facelift. It really has nothing to do with age.
It's more of anatomy. Let's be honest, because a thirty
(14:15):
eight year old who lost one hundred and fifty pounds
may be a perfect candidate for a facelift, and a
fifty year old who's got minimal laxity is not really
a good candidate for a facelift. But what do you
think about this whole emphasis and enthusiasm or face of
driving people at younger ages when it's just starting to
(14:37):
loosen up into our offices for a facelift. What do
you say to your patients?
Speaker 2 (14:43):
Well, you know, I don't. I'm not, at least in Dallas,
I'm not seeing people in their twenties or early thirties
coming in for this yet. But I can tell you
what I tell patients who are even older than this,
where you're looking at them and they have very fairly
early changes of facial aging. I always look at this
(15:04):
as sort of a risk reward ratio in that we're
doing surgery, so there's guaranteed to be some risk involved. Now,
you know, in well performed surgeries on appropriate patients, the
risks are really low because they sort of have to be,
because if you had a procedure in cosmetic surgery that
was highly risky. No one in their right mind would
(15:24):
ever do it.
Speaker 1 (15:24):
What about the Brazilian budlift.
Speaker 2 (15:27):
No one in their right mind. Whatever, No, that's not
really true. I mean the way some people do it. Yeah,
the way sometimes that's performed. It's insane.
Speaker 1 (15:37):
But remember in the old days, for years and years
and years, over a decade, we were instructed to do
it the proper way, which was the dangerous way, injected
into the muscle. Remember that, until after what was it, ten, twelve, thirteen,
fourteen years we figured out, m, maybe we don't want
to inject the fat into the muscle because it's going
(15:58):
to get into those short, big blood vessels of the
buttock muscle and get into the vena kiva and go
to the lungs and oh, it's over, And that happened all.
It turns out to be the most fatal elective procedure
in all of surgery, A cosmetic procedure done to make
your butty bigger. It took Margue that.
Speaker 2 (16:17):
With the science of plastic surgery is after years of research,
we concluded that no matter how great your buttocks end
up looking, if you're dead, it's not probably worth it.
Unless they're gonna do an open casket, face down funeral.
It's just, you know, not to be glib about this,
but it's like too late. This is okay, this is okay.
(16:40):
There you go, there's plastic surgery science for you. We're
doing something that is you know, not entirely rarely killing people. Ergo,
we should stop doing this. Wow, wow, Nobel prize material
stuff there.
Speaker 1 (16:55):
I know, well, I remember do you remember when, Okay,
so fat transferred to the butt to the bread is
a thing now, right, it's an acceptable thing to do,
just like fat transfer to the buttock is an acceptable thing,
although now there's some sort of new ways to minimize
the chance it goes to the lungs and knocks you off.
Speaker 2 (17:11):
Yeah, not putting in a blood vessel.
Speaker 1 (17:13):
Right, But do you remember how our society and plast
Survey felt about the dermatologists doing fat They called it
a Bambi procedure, doing fat transfer to the breast. We thought,
that's dangerous, never should be done. That's fat's gonna calcify,
and they're gonna think it's breast cancer and you're gonna
have a mestectomy for dead fat. And then all of
(17:34):
a sudden, the dermatologists started to take business away from
plastic surgeons and breast augmentations using silicon with fat transfer,
and we went, maybe we should start doing that one.
Speaker 2 (17:47):
You know what, maybe we should I don't know, check
with radiologists and see if it's causing them to overread
on mammograms and it looks like cancer. And it turns
out they said, no, Now there's other issues with fat
trans yes, like that. It ends up that that's not
really an issue. But for years, based on nothing, plastic services,
(18:09):
oh never do this.
Speaker 1 (18:10):
Well, I remember, I go back far enough in the game.
I remember when it went from liposuction was being done
by dermatologists and we plastic surgeons thought it was dangerous
and shouldn't be done. To all of a sudden we went, uh, oh,
they're taking away our tummy tucks. They're taking away a
lot of our operations. We better learn how to do
(18:32):
this lep bo suction thing. Because it was really popularized.
Despite what you might say about iloise in Brazil or
Prance or whatever, it was really popularized by a dermatologist
in this country.
Speaker 2 (18:43):
True, Yeah, it was. Yeah, he went I think it
was developed in France and he went over there and
learned it. Yeah, and started doing.
Speaker 1 (18:52):
It, and we criticized the heck out of it, saying,
oh my gosh, why are dermatologists operating? What's this? Putting
this tube underneath the skin and sucking fat Out's so dangerous.
They're going to get fat enbaloie. It's horrible. And then
we went, oh, gosh, we better really learn how to
do that. Other words, we're going to miss out on
all that surgery.
Speaker 2 (19:14):
Yeah, it's like that. You could sneeze at the American
Sydio Plastic Surgery meeting and missed the moment where we
went from liposuction is terrible, terrible, terrible, terrible, terrible, terrible.
Speaker 1 (19:26):
Great exactly, and this is how you do it, and
this is how you do it, and listen to us
because we're board certified plastic surgeries. Now, you know, a
couple of board certified plastic surers like you and me
typically would get on a podcast and say, only go
to someone who's certified by the American Board of Plastic Surgery.
And of course we do feel that way. But being
being board certified the American Board of plast Surgery in
(19:48):
and of itself, what does it mean to you.
Speaker 2 (19:50):
It's a very low bar to set. It's like saying,
you know, so the guy who drives your for Formula
one race car should have a driver's license. It's that
It's like, yeah, okay, but that doesn't exactly necessarily mean
you're a great driver. It's the minimum. Yes, it means
(20:13):
you've been properly trained, you've gone through the right programs,
taking the test, you're taking the tests. Yeah, it should
be a minimum threshold. But if you think that all
board certified plastic surgeons are of equal standard, no, right,
it's still a bell shaped curve. It shifts the bell
shaped curve a little bit to one side. Right, so
(20:36):
you tend to get better people than those who didn't
even bother with the training, obviously, but there's still a
wide dispersion of ability in this and then so you
can still get a horrible surgery. There's a lot of
bad surgery done by board certified plastic surgeons.
Speaker 1 (20:52):
I always tell people if you pulled back your face
with two fingers on each side, you know your middle
finger and your thumb, and look remarkably better. Yeah, I
think you might be a canon no matter what your
age for a facelift. To me, that's a good starting
point to figure out, because if you go in for
a facelift to a cosmetic or facial or regular plastic surgeon,
(21:17):
they're probably unless they're very busy, they're probably gonna want
to do a facelift on you. Would you agree with that?
Speaker 2 (21:23):
Yeah, sadly, yes. I can tell you. What I tell
patients and consultations, okay, is that there's a risk benefit
analysis to this, okay, And the risk is always going
to be there to some degree. The question is what
is the benefit? And if you have very minimal early
facial changing, you can only get so much better, and
so if there's barely anything going on, yeah, it might
(21:47):
be you might notice something, But do you really want
to undergo a surgery and spend tens of thousand dollars
to get an end result where you go like, yeah, look,
you don't want to wait until it's horrible, right, because
you can only get so much better, and you know,
as you get past a certain age, the skin loses
its elasticity, nothing works quite as well. So you want
(22:09):
to have enough visible that there's a meaningful change to make,
and that's that's the time. If you're before that point,
it's just silly to do it, and certainly someone in
their twenties, you know who has other than massive weight
laws or something, or just horrible genetics or early thirties,
come on, there's very little that can be a changing.
Speaker 1 (22:29):
Plus, I feel there's no science behind this, and we
all have our feelings about this. You know, anecdotal experiences.
But I feel if you start too young and then
you have too many facelifts, once you get past a
certain unknowable point, it starts to relax because they all
relax a little bit, and it relaxes in a potentially
(22:50):
unnatural way or angle or sweep. And once it does that,
now you're into altered. And once you get to altered
slash weird. No matter how good you look, if there's
a weirdness, it's kind of like a hair in your
salad or smell in the kitchen. It's just like, no
(23:12):
matter how good the food is, if there's kind of
this rancid something smell in there, it's over. The whole
meal's ruined, the whole face result is a disaster once
you get too weird. And by the way, even with
the best surgeons, we can have it heal even with it.
(23:32):
If it's not even without a complication, we can have
it heal in a slightly weird way. And I think,
I don't know if you agree with this. I think
if you have too many facelifts, your chance of getting
a slightly weirdness to your face is significantly elevated.
Speaker 2 (23:51):
Oh look, I think I don't even think it's like
it's almost guaranteed.
Speaker 1 (23:55):
Yeah, if you do too many, you.
Speaker 2 (23:57):
Only get But first of all, you know, with most
cosmetic surgers, but particularly facelifts, your first one is your
best one, and you want that one done properly at
the right time, because everyone after that is diminishing returns.
Because the things you can really affect with a facelift meaningfully,
you just can't do over and over again. Because you ye,
(24:22):
facelift is a simulation of youth. So when people come
in and they go, well, you know, then they're sixty,
they go, well, I don't want to look twenty again,
and I'm thinking, don't worry, it's not gonna happen. Okay,
So well, first of all, the first thing that is
that's not true, because you do want to look twenty again,
(24:44):
because if there was an operation that would make me
look like I look when I was twenty, I wouldn't
be on this podcast right now. I'd be getting it
done right, right, Yeah, I'd love to look twenty again. Unfortunately,
we can't do that. We can do a simulation of it.
We can move you in that direction, right. So it's
(25:09):
not a perfect simulation. It's like a virtual reality or something.
So it's not exactly right. And so every time you
do it, you're deviating a little more and more from
where you really were into something that never existed.
Speaker 1 (25:23):
Right.
Speaker 2 (25:23):
But the more you get into never existed, the more
it looks like a face.
Speaker 1 (25:28):
Look right, So I not to Let's switch gears a
little bit, because again, you and I we literally could
talk for two hours about anything in this field because
we love it so much. But I just did a
podcast which I guess is getting some there's some virality
to some of the things I said. And I was
discussing male plastic surgery on celebrities, Okay, yeah, and you
(25:49):
know why are the female celebrities looking so amazing and
the male's looking so weird? And you know they're being
done by the same surgeon. Okay. And I posited a theory, okay,
and the theory is this, and I want to see
if you agree with this, and I, well, the things
I love about you, besides effect your incredible genius, is
(26:09):
that you're completely honest. You'll call me out on any
bs and you won't agree with me just to you know,
just agree with me.
Speaker 2 (26:15):
Oh that's going to be half of this podcast. And
you're doing the same to me because you know.
Speaker 1 (26:21):
That's what we do for each other.
Speaker 2 (26:22):
Yeah, exactly.
Speaker 1 (26:23):
So I have this theory, and that is, if you
do the typical baselift that you would do on a
female on a male, it really only works with feminine males.
And that's why. And I don't know about any of
these people, whether they've had plasters or not. But they
talk about the Brad Pitt, I don't know if he's
had anything done. He looks great. They talk about Bradley Cooper.
(26:44):
I have no idea if he's had anything done. And
then they're asking me a lot when I walk out
of restaurants about Jim Carrey. So why are they sat
setting things aflame in terms of their results? And my
theory is this, if you're a feminine looking person, if
you're a pretty guy like a Brad Pitt, a John
Stamos or a Rob Low, you can pretty much have
(27:07):
more feminine looking, feminizing regular female plastic surgery, because you're
just making you look pretty. But once you go from
rugged okay, with heavy brows and putted upper eyelids and
maybe some wrinkles on the forehead to a sort of
feminized version of that, if that's your thing. You know,
(27:29):
like a Ryan Gosling could probably look good with feminizing plaster.
It's kind of a pretty dude, right. But you take
a George Clooney, although he's not not feminine, but he's
much more masculine looking, and you do that kind of
surgery on a George Clooney, it's gonna scream facelift. Don't
you agree with that?
Speaker 2 (27:47):
I think that's absolutely true. But I also think that
what you're saying really applies to every man in that
if I think part of what's going going on is
it's men or you know, plastic surgeons doing facelifts on
men and doing facial rejuvenation, filler, eyelid surgery, brow whatever
(28:11):
it is, doesn't matter, and they're doing it the way
they would on a woman. Yeah, and the aesthetic is
totally different because you know, I I'm not fascinated particularly
with celebrities, and I'm not fascinated by celebrity plastic surgery either,
but you know, my patients ask about it, so I
try to stay up with it, right, right, So you
(28:35):
get aggressive on any of these things. On a man,
it doesn't matter where they started off, and it's going
to look feminizing, and in some ways it's going to
look less handsome. Less is more on a man. A
male facelift is a very different surgery from a female facelift.
If you're gonna air one way or another, if you're
(28:56):
gonna air one way or another, and one obviously you
don't want to air at all. But if you're gonna
it's okay to maybe overdo just a little bit. It'll
be fine. Okay, it may take a little longer to
get there, but it'll be fine. If you're gonna air
one way or another. On a man, you should underdo it.
Speaker 1 (29:10):
You can always take.
Speaker 2 (29:11):
More anything well, and anything overdone starts to look feminized.
Speaker 1 (29:17):
Well. Remember, you know, it's funny people seem to plastic
surgeons now somehow seem to forget who Kenny Rogers was
or Robert Blake. Do you remember of course, I know
you know who Robert Blake was. He had clearly very weird,
feminizing plastic surgeon. And Robert Blake was a very handsome guy,
but a very rugged guy, and he was massively feminized.
(29:39):
And yet we still don't seem to understand the lessons.
But I think the scariest operation that a man can
undertake in plastic surgery is an upper eyelid blephoplastic, because
you just take a little too much skin and not
only is there no going back, but you're completely for
(30:00):
the looking person. And if you're a guy and you're
going to have your upryland is done, just tell him
to take one or two millimeters. You can always take
a couple more later, right, and you.
Speaker 2 (30:12):
Know what, you're not going to need to because you
don't want to look that refined as a man. You
just don't, you know. So look, Brad Pitt is obviously
a great looking guy. I think you could make the
argument that whatever he's had done, I don't know, he's
still great looking. He had good work done, whatever, he
(30:34):
looks great. Yeah, I don't think there was a problem
that needed to be addressed there. And whoever did it
obviously did subtle which is good, but you know, a
little craggy, the lines in the face in a man,
the aesthetics for him. That's the other thing is that
the aesthetics for a man and a woman are very
different as we age. It's fair, not fair, it's just
(30:57):
what it is. Let's just let's as they get older
and you know, more rugged looking, it just works in
terms of what society likes.
Speaker 1 (31:05):
It's true. Let's let's be honest. Brad Pitt never looked bad.
He never looked like he needed work done now the day.
Speaker 2 (31:13):
Honestly, he actually I think he looked even better as
he got older, which was just so painful to walk.
Speaker 1 (31:18):
I hate that that guy. Remember him in the Legends
of the Fall, Yeah, I mean he was the best
looking actor bar non female or male on the set
of that. I mean, he's just you know, it's.
Speaker 2 (31:31):
Like painfully good looking and like inglorious bastards and fury,
and you know, it's just he can't look bad.
Speaker 1 (31:39):
It's funny to get not to get too personal about this,
but you've embraced getting older with the beard and having
the gray. But you, let's be honest, you were a
very pretty slightly slightly as being generous to you because
you were more than slightly feminine, feminine looking guy. I mean,
(32:02):
you were a classic blue eyed, dark thick, black haired
model when you came to UCLA. It's funny because when
I knew you at Yale, you were kind of this
skinny I remember, not very tall, nerd genius. And then
a few years later I see US medical school and
you're like this super fashion model perfect. What the fuck
(32:26):
happened between Yale and ucllly medical School? Did you just
wake up and you were like this feminine, gorgeous looking
guy overnight? And did it mess with your head? And
I know we're getting way off topic here, but it
was weird.
Speaker 2 (32:38):
Yeah, there's a lot to reveal on the first episode,
but I don't know. I know we've talked about it.
I'm pretty sure we talked about this. I had a
very weird, like teenagehood. You know. Well, first of all, okay,
I went to Yale to become a physicist. Okay, okay,
let's let's be real here. Dork, seriously dork, right, So,
(33:01):
and when I started freshman year in September, how tall?
I was five ft four inches fall Wow?
Speaker 1 (33:07):
How tall?
Speaker 2 (33:08):
Chubby and chubby sixty. Yeah, sixty. I grew six inches
out of nowhere in my freshman year of college and
it completely changed my look, and honestly it was Yeah,
it did mess with my head because suddenly.
Speaker 1 (33:24):
Girls they paid it. They oh attention, dude, you were killer.
I remember you gave me to UC med school. We're
going med school ahead, you're going girls, and it was like, wait, wait,
that's a college thing. You're going now. And you took
a year off to go model in Europe?
Speaker 2 (33:40):
Yeah, yeah, not the best use of the year, but
I took a year off to model in Europe but
not model successful.
Speaker 1 (33:48):
Aren't you glad you did it? Though?
Speaker 2 (33:50):
Yeah, I'm glad because the modeling didn't really work out.
So after about two months, my buddy and I who
we went over there, we just said, you know, screw it, and.
Speaker 1 (33:59):
We backpack through Europe and let's go back.
Speaker 2 (34:02):
He only stayed like another month or so, but I
stayed there like six seven months, right on my own,
backpacking through U and it.
Speaker 1 (34:07):
Was like, let's go back and be doctors. Let's leave
people with the what to look out for when you
go for a plastic surgery consultation? Can you go in
to a plastic surgery's office, and they've got all the
good looking furniture and the art on the wall and
(34:30):
the degrees hanging. Okay, so they have pretty offices. We
spend a lot of money in our offices to entice
people to have plastic surgery. All right, but what should
you look for that's good and not so good that
may be a red flag in a consultation?
Speaker 2 (34:44):
I think. Okay, so you know we said before, usually
this discussion begins and ends with look for a board
certified plastic circuit. And yeah, obviously, but the next thing is, Okay,
before you've even gone there, you should have looked at
their web and looked at them before and afters. Okay,
Now that is only so useful because anyone on their
(35:05):
website it's like their greatest Hits album.
Speaker 1 (35:08):
But just you know, by the way, if I can
add to this, just you know, it's now that's primarily
and more broadly replaced by Instagram. Now they're showing amazing
before and afters on Instagram, and that's the main catch
point for getting patients at their office. And boy, there's
no more bs than an Instagram before and after.
Speaker 2 (35:27):
Yeah, be really careful with that because I can tell
you what I've started seeing in the last year or so,
not so much on plastic surgeons in this country, although
definitely happening. It's results that have clearly been doctor right,
clearly altered, aside from the usual tricks of the you
know face of the before.
Speaker 1 (35:49):
Oh I know and they know that thing. So but okay,
so the patient comes in and you meet.
Speaker 2 (35:55):
So anyways, the photos I think are useful only in
the sense is if you look at their photos and
you go like on any of them.
Speaker 1 (36:00):
You're like, right done, because that's their best.
Speaker 2 (36:04):
If their best stuff is not meeting your approval, don't.
Speaker 1 (36:08):
Right, But what about what about the general demeanor, Like
how much time they spend with you? I think ten
minutes is not enough. You know, there has to be
a get to know you. You have to have a
cocktail with them first, and they have to learn. I
think it's important they learn a little bit about you,
to get to try to get a feel for you,
because you know, you may have red flags that they're
(36:28):
that they're not even looking for because they just want
to get you on the operating table. And you know,
for me, I say, my big thing is I want
to know why you're thinking about doing it now, like
you're forty three years old, coming for a breast augmentation. Why,
I'm very nice about it if I really want to
get at the why. Because if your marriage is failing
and you're doing breast implants, you can still do breast implants,
(36:51):
but it's good to know you're you know that you're
maybe expecting something that's going to really change everything about you,
and your expectations are overwhelmed by the results. So that's
what I do. I spend at least thirty forty five minutes.
I try not to spend an hour, but I'm willing
to if they want to talk that much. But I
want to get to know the person. I think your
(37:12):
plastic surgey should get to know you.
Speaker 2 (37:15):
I think your plastic surgery consultation should be done primarily
by your plastic surgeon and not by a coordinator or
a salesperson or right whatever it is. That's a red flag,
you know, it's total red flag. First of all, aside
from the fact that this is surgery. This is serious business.
You know, people forget that. You know, the second half
(37:35):
of plastic surgery is surgery. It's real, it's very real.
It's a real thing. It's real surgery. Yeah, and so
you should know the person who's going to be cutting
open part of your body and putting it back together.
Speaker 1 (37:49):
It's a good point of that because if you meant
the coordinator, it's almost like going in for the car.
The guy goes put a cigarette down and goes, let
me go talk to my manager. And the manager in
this case is the plastic surgery is going to come
in and do the clothes right.
Speaker 2 (38:03):
Right, right right. So yeah. So and second of all,
you're purchasing, aside from the fact that it's surgery and
it's your face or your body, and in some ways
there's no going back from this. You're purchasing a very
expensive luxury service, and you deserve to be treated like
(38:23):
someone who is receiving a luxury service. And that means
I have all the time in the world that you
need me to spend with you to make sure that
you're comfortable. I'm sitting there and we're chit chatting. And
we're chit chatting for two reasons. One because it's just
good manners to walk in and I ask people about,
(38:43):
you know, what they did or something that you know
has come up something that you know, I noticed what
they do for a living or whatever one because part
of what's a blessing about being a plastic surgeon is
we're not beholden to whatever Blue Cross blue Field is
going to pay us for the visit. So that's not
what it's about. And so I have that luxury. Right,
(39:04):
I can spend an hour with a patient if I
want to. You know, your intern is can't do that, right,
They can't make a living doing.
Speaker 1 (39:11):
Do you agree with this? They? Okay, So we discussed
they should take a januarine interest to you. Really, they
should try to understand you to determine whether they can
meet your expectation. Number one. Number two, I think it's
important that every procedure you talk about doing, they discuss
the pros and they all discuss the cons because every
(39:35):
procedure you're considering has cons. Like the first when a
patient comes in for a breastlift, first thing I say
to them, I go, let me ask you a question,
how do you feel about breast cars? Now I've started
with breast scars. That's not a good sales tactic because
now I've highlighted the thing that they would turn them
off to. Signing up for the procedure, right, the scars.
But if I can see right away whether they go scars, Oh,
(39:59):
you didn't know they were scars, let's talk about it.
And some people in the middle in the very beginning
of that consultation will go, I'm not doing it if
there's scars. You go, yeah, there's scars. There's scars for sure,
and they're permit, you're gonna see them. And they go, yeah,
I don't want that. You go great, I go, maybe
there's other things you can do, but I highlight and
you don't have to necessarily do this, but I think
(40:19):
it's important every single procedure they offer you should come
with various options, and they should highlight every one of them,
not necessarily all the risks, but the cons the cons.
The cons are a tummy tuck, for example, That is
a big recovery, big recovery, and it hurts, and it
(40:40):
has more risks than any of the other plastic surgery procedures.
I start with that. Now. I don't care if people
have surgery with me anymore or not. I don't care,
you know what I mean, And you don't either, because
you're you know, we both have these advanced practices now.
But I care that I've told them all this stuff,
and if anything untoward happens, I look at them and go.
But remember we did discuss this. But I know that
(41:02):
they made the decision based on having heard that they
can never say. My patients can never say. Boy, had
I known, I would not have done this. So I
think pros and cons. Would you agree?
Speaker 2 (41:15):
I one hundred percent agree, And I don't even look
you said. It's not a good sales tactic. It's not
a good sales tactic. But it is a good doctor tactic,
and aside from just the medical legal aspect of it,
it's just the right thing as a human being to do.
And so you know, I'd like to I try to
(41:36):
walk my patients backwards from what they're trying to get
out of this operation. And it took me a long
time in practice to really understand the psychological aspects of this.
What are we really doing with any of these operations.
We're taking a part of someone's face or body that
they feel self conscious about, rightly, wrongly, whatever, Okay, they
(41:57):
feel self conscious about it, and ideally want to move
it from a place where they feel self conscious, ideally
to a place where they feel proud of it, or
at least a place where they feel a lot better
about it. And so if you discuss something like a
breast lift without talking about the scars and without having
them in their head asking themselves, Okay, if my nipples
are in the perfect position, or my breast no longer
(42:19):
a hang down, but I do have some visible scars
around my nipple on the lower part of my breast,
do I feel better about my breasts or do I
feel worse about my breasts? Because unless the answer is
I truly feel better about my breast despite the scars,
shouldn't do it? I agree, because ultimately you're not going
to achieve what the goal is, which is feeling good
(42:39):
about your breast. No one's goal is to have nipples
that are twenty centimeters from their sternal notch, you know,
the things that often blasphic. No one comes in going
like I don't like my external notch to nipple distance.
They don't like their breasts. They don't always know why
they don't like their breasts, but they want to be
proud of their breasts again or maybe for the first
time in their lives. Right, And so if you can't
(43:02):
do that in a way. That's me. If you just
make them self conscious about something else, you've achieved nothing.
Speaker 1 (43:06):
Well, you and I could talk forever about this, but
I do want to make one final point. So people
have a practical red flag. I think if they've say
it's easy, if they use that's easy, that's a chip shot.
Oh my gosh, it's going to be so easy, that's
a red flag. I think. Don't you agree completely?
Speaker 2 (43:26):
This comes up a lot where PA goes this an
easy operation, and I always say, it depends what you
mean by easy.
Speaker 1 (43:31):
Yeah, Okay, A.
Speaker 2 (43:32):
Lot of things in plastic surgery, strictly speaking, not that hard.
It's not like taking a tumor out of the base
of the brain. You know, it's not the technical aspects
that aren't that hard. But it's hard in the sense
that you have to get everything exactly right right. So
it's easy in some sense to do breast implants. It's
(43:54):
hard to get the very best breast augmentation result time
after time after time, given all the differences between patients
and even between their own breast. That takes a lot
of work, a lot of judgment, and a lot of right.
Speaker 1 (44:08):
I mean, we have this thing we say, you know,
among us plastic surgeons in the lounge, the only easy
operations and operation done on somebody else. Yeah, right, well, listen,
I mean, there's so many more and we're going to
do this again. I loved doing this with you, and
we have so much more to talk about, and I
hope you'll do this again with me many more times.
(44:29):
And by the way, by the way, I just want
the audience to know that there will be a bonus
episode to look forward to, okay, where we'll talk more
about this. And I can't tell you how much I
appreciate you, know. I love you, you know, and you
know you're like one aside from my wife and my kids,
well some of my kids, you're like most important people
(44:50):
in my life, my life, and I adore you and
thank you for doing this. And I hope, I know
and hope that the audience will get to hear more
from you and me about this in the future. All right,
So thank you for joining me.
Speaker 2 (45:06):
I would love to do this again and again. At
the risk of us sounding maudlin, I love you like
the older brother you've always been to me. Thank so,
thank you for having me on at anytime. Thank you
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