September 2, 2025 • 39 mins
In this episode, Dr. Jonathan Sherwyn, a board-certified plastic surgeon, discusses the evolving landscape of plastic surgery, focusing on facelifts, the role of fillers and Botox, and the importance of lymphatic drainage. He emphasizes the distinction between cosmetic and reconstructive surgery, particularly in the context of the 'mommy makeover' and its benefits for women's health. The discussion also covers the significance of proper timing and preparation for surgery, as well as the importance of choosing a qualified surgeon. Wellness Unmasked is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Tuesday & Friday.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Welcome to Wellness on MASS I'm doctor Nicole Saffire and
today's episode is an interesting one and I'll tell you why.
As a woman, there is no escaping perimenopause and menopause.
I'm sorry, ladies, but everyone is going to go through it.
Is there a manopause, Yes, there absolutely is a manopause,
but that is for an entirely different episode. So men,
(00:24):
listen to this one because you may be able to
learn some things. But ladies, this is for you. One
of the things that I find, honestly a little bit
comical is we have so many things to make us
feel better, and right now, if you're not wearing a
weighted vest as you walk outside, you're not part of
that perimenopause menopause club. Apparently I have yet to purchase one,
(00:46):
but it's certainly on my list. People love it, and
I do want to be a part of that club,
I guess. But here's the question I have. Yes, I
know that taking our life into our hands with some
wellness stuff, changing our diet, exercising wear, wearing weighted vests,
weightlifting and all these other things can be really good
(01:09):
for us. It doesn't just make us look better, feel better,
but it actually makes us healthier and improves our quality
in life, may even help us live longer, healthier and longer.
But one of the things that is less talked about
is that there are actually some surgical interventions that might
be able to help women get to the place where
(01:29):
they feel better as well. And yes, I'm talking about
plastic surgery, but I'm not talking about plastic surgery kind
of as you traditionally think about it. One of the
things that we don't talk about as much is, yes,
there are all these things that we can do to
look better, feel better, but there's a lot of stigma
around some of it. Okay, there's not a lot of
stigma around you know, weightlifting, for women eating healthier, wearing
(01:53):
these weighted vests. They kind of go in that fool
of acceptable things we can do to make ourselves feel better.
But what about plastic surgery. Now, I'm not talking about
cosmetic plastic surgery, and you know that traditional sense where
it's like, oh, I have an Italian bump on my nose,
which I do if you ever seen me from a
profile shot. I want to get rid of my bump.
(02:14):
That's going to make me feel better. Okay, that's fine.
I mean, whatever you've got to do to make yourself
feel better. You know, making changes to yourself on the
outside doesn't necessarily help the person on the inside. But
anybody who ignores the fact that it can make you
feel better on the inside, they're being dishonest. So whatever
actually makes you feel better, I'm all for.
Speaker 2 (02:35):
Do.
Speaker 1 (02:35):
I think people overdo it with plastic surgery, undoubtedly, but
there are some things that you can actually do, specifically
for women like myself who have had children. Our bodies,
God bless our bodies because we are able to hold
these children, create these children, grow these children, birth these children,
(02:55):
and then raise these children. But yes, pregnant to see birth.
It takes a toll on our bodies. And one of
the things we keep telling women you have to be exercising,
you have to keep a strong core, you have to
do all these things if you want to be healthy
for your children as they grow up. Okay, well, for
some of us, you know, we can get some conditions
(03:17):
that leave muscles incredibly weak and make it very difficult
to do some of those exercises. So I am very
excited to have on Wellness en Mass today. A friend
and colleague doctor Jonathan Sherwin, who is a board certified
plastic surgeon in the New York City area. Plastic surgeon
to the stars. I know many people that he has
(03:38):
worked on. I've referred many people to him. He does
an excellent job, and he is all about trying to
make a woman feel better functionally, and he is here
to talk all about mommy makeovers. And I am on
a mission to get rid of the stigma behind these
mommy makeovers because it's not just about getting rid of
(03:59):
excess skin and fat. It's about so much more than that,
and it's about setting us up to a place where
we can get back to the gym, get back to
feeling stronger and healthier and really living that life that
we want to live and throwing on a weight to
vest if that's what we want to do. So let's
bring in doctor Sherwin. Okay, Well, I am very excited
(04:21):
to have on today a friend of mine but also
a colleague and someone I admire very much, Doctor Jonathan Sherwin.
He is a board certified plastic surgeon in Manhattan and
Greenwich area, and he is just a wealth of knowledge
and excited to have him today because I have a
lot of plastic surgery questions. Doctor Sherwin, thanks for being on.
Speaker 2 (04:41):
It's a pleasure and a privilege.
Speaker 1 (04:43):
Okay, so I just have to I have to talk
about the elephant in the room. Although this is not
the big thing I really want to talk to you about.
I'm more interested in the functional aspects of plastic surgery,
but inquiring minds want to know. If you look at
social media or I've had to talk about it on TV,
people are starting to pop up with what they're calling
(05:05):
these subtle facelifts. I think Chris Jenner, who's the matriarch
of the Kardashian family, is recently looking mightily refreshed. People
have questioned whether Lindsay Lohan and some other people, what
do you make of this?
Speaker 2 (05:21):
Well, I think that a lot of the popularity and
facelifts today are a reflection of use of GLP ones,
social media, also FaceTime and zoom. Some individuals refer to
(05:41):
it as the zoom boom because people are seeing themselves
on camera. What I would say in respect to the
subtle facelift, The first thing I would say is that
the beautiful thing about plastic surgery is that everybody is
an individual. Their needs are individual, their requirements are individual,
and so each procedure has to be has to address
(06:06):
that individual's needs and requirements. So that's the first thing
I would say. Plastic surgery, particularly when it addresses facial rejuvenation,
reflects a targeted approach, So you have to address the
areas of concern the patient's goals. To that end, I
think that more and more procedures are being done at
(06:29):
a younger age.
Speaker 1 (06:31):
They're young is too young?
Speaker 2 (06:33):
Like you?
Speaker 1 (06:33):
What are you seeing?
Speaker 2 (06:34):
Well, I've seen patients in their late thirties come in,
believe it or not, patients that have lost a significant
amount of weight. I have even been very, very surprised
at the amount of laxity that some younger individuals maintain
for a variety of reasons. And as much as I
try to ask these patients to wait or try to
(07:00):
delay their procedures, they're very very dogged. They keep coming
back and they really pushed to have the procedure done.
But I've been personally very surprised pleasantly by the great
rejuvenation that you can accomplish. Some individuals refer to this
early in event intervention as pre juveniation, if you will,
(07:24):
But I think I want to emphasize too, that it
is a targeted approach. I think that techniques today are
emphasizing more hidden incisions, in conspicuous closures, in conspicuous incisions,
minimal incisions. I think that's been very, very greatly emphasized
(07:49):
even in the literature today. And the other thing that
I would emphasize as well is that the procedure and
the outcome must be esthetic pleasing, tastefully done, not over corrected.
And the results have been I think much improved in
(08:10):
that regard.
Speaker 1 (08:11):
Well. So when I think of kind of traditional facelifts,
to be honest, someone who I saw all the time
always saw the scars was former President Joe Biden. I
mean that was, you know, he had a very obvious facelift.
You saw the scar kind of going periuricular around his ear,
and he always just looked a little bit too surprised.
What's different about what he had done versus I mean,
(08:34):
I'll be honest, Chris Jenner, she looks amazing. Now. I
get it if you have hundreds of millions of dollars
and and have a lifestyle that is I don't want
to say she lives a stress free lifestyle. But we
probably live different lives. That may have something to do
with it. But why does she look so refreshed and
Biden always looked like he was scared or surprised.
Speaker 2 (08:57):
Well, you know, a lot depends on the individual surgeon
and their approach. I do know the individual surgeon who
did her procedure. I know exactly what her procedure entailed
because I know the surgeon's particular technique. I just think
that it is the approach and how the procedure is executed.
(09:20):
I think that you know that factors very importantly to outcome.
Placement of incisions, how the incisions are concealed, on the
the procedure itself, and what it addresses, whether it addresses
the neck, the submentum, or the area under beneath the
(09:41):
chin cheeks only the vector of the left, meaning the
direction of the lift, and how every soft tissue is
redraped those are It's a very very multi factorial procedure
and each factor has to be corre directly addressed in
order to have a successful outcome. I agree with you
(10:04):
in terms of former President Biden. I think it's pretty
obvious to the person who's observant that he had worked
one and I don't think that his incisions were particularly
well placed or concealed, etc.
Speaker 1 (10:23):
But really it's about the surgeon.
Speaker 2 (10:25):
It is about the surgeon. It's about their technique. It's
how fastidious they are, how particular they are, how exacting
they are. It's not just the technique, it's also how
the individual surgeon performs that individual specific technique that makes
the difference, and that is plastic surgery. It's not just
(10:49):
a hernia of repair or removing an appendix. A lot
more goes into the procedure.
Speaker 1 (10:56):
When you find people who are coming for facelifts, I mean,
they tend to be older, but as you're saying, with
the weight loss from the GLP ones, maybe people are
wanting these a little bit earlier. Most of these women,
I have to assume, have probably done botox and fillers
in their face. I mean usually, I mean that's kind
of the progression. You start out with botox, maybe they
(11:16):
move on to fillers, and then I guess facelift for people,
does that cause any issues for you? Like, do you
feel any of those fillers that are in the face.
Speaker 2 (11:26):
Well, not infrequently when you're performing a facelift, And this
has happened to me. I know it's happened to other
surgeons as well. You'll come across old filler. It'll still
be there. As you're performing the facelift elevating the layers,
you'll come across old filler. Now, if there are occasions
(11:49):
when a patient is over volumeized that we will dissolve
the filler. We all know that.
Speaker 1 (11:56):
Look right, that's a big monk cheeks kind of like
pushing in their eyes.
Speaker 2 (12:00):
Sometimes we will recommend that the filler be dissolved prior
to procedure. I have done that on several patients who
are so heavy with volume. There's such distortion that we
will recommend dissolving filler prior to procedure. On other occasions,
when the filler may not be that evident, you'll just
(12:22):
be you performing your procedure in the middle of procedure
and you'll come across old filler. That doesn't create a
problem per se, unless it's done to such a degree
that it generates scar tissue. Not to digress too much,
(12:43):
but there are other procedures which generate a fair amount
of scar tissue. Threadlifting is one of the procedures that
are out there that can generate a fair amount of fibrosis,
and the surgeon just has to work through that scar
tissue or fibrosis is in order to successfully perform the procedure.
(13:04):
But fillers per se, they don't, they don't really compromise
the procedure. But again, I think the factor is whether
to dissolve before or not. The surgeon just has to
be aware and that's part of taking a very very
(13:25):
thorough history and physical on your patients. I always ask, do.
Speaker 1 (13:30):
You think women tend to lie?
Speaker 2 (13:32):
It's like, you know what, not only not not only
do they lie, but you know, frankly, some women are
very poor historians. So you don't know prior to procedure
certain things. And then once you're in the heat of
battle as I call it, you come across various things.
And then when you query the patient after procedure, oh,
(13:55):
by the way, we found X y Z, and then
jobs their memory.
Speaker 1 (13:59):
Speaking for women everywhere, I'm going to push back on
the women are poor historians. I think we're selective historians
because I think when women, we tend to think that
we know better, and we just tell our doctors what
they think is important for them to know.
Speaker 2 (14:14):
Okay, I don't I don't mean to make a blanket
statement about being a poor historian. Some some patients in general,
male or female, are poor historians. But you know, it's
it doesn't really compromise procedure. It's just nice to be aware,
that's all.
Speaker 1 (14:32):
Well, I guess that's good to know. I really do
hate that look of the overfilled face, just that chipmunk love.
I absolutely start to look the same.
Speaker 2 (14:42):
After what absolutely absolutely agree. I think when it comes
to botox or injectables, as we say, I'm a huge
fan of botox. Fillers have to be done very very judiciously,
very careful, very cautiously, because once you cross that line,
(15:05):
it becomes a negative not a positive.
Speaker 1 (15:07):
Well, you know what's I think? What I have a
little chuckle at these days you have so many of
these wellness people online and on TV, and they're like, oh,
I only eat clean and I only do loose sleep teeks,
I'm avoiding microplastic, and now I'm on my way to
go get my bochy light box and injected in my face.
It's like, all right, Picker chrees your battles. That's fine, right.
(15:28):
I digress. One thing that I talked about on TV
recently on Fox and Friends, we did a segment. It
was all about the fact that one of the Kardashians,
Kim Kardashian, came out with this device that you sleep
in that strangles you. Essentially, it's like a compression device
but for your chin and neck and just to try
(15:49):
and have like a chisel jawline when you wake up
in the morning. And I guess the overarching theme there is,
you know, compression almost like corset work of the abdomen,
but maybe on the neck and the jaw, which again
I thought again was a little cheeky in the sense
that her mother just displayed this beautifully done face. But yeah, no, no,
the rest of us, We'll just wear this corset on
(16:11):
our neck while we sleep. Sounded like a terrible idea
to me, But that got me doing a lot of
research on the benefits of lymphatic drainage of the face,
something that I kind of have doing myself personally. But
I'm curious, what's your thoughts on lymphatic drainage.
Speaker 2 (16:26):
So lymphatic drainage, just a little historical perspective, believe it
or not, was first described in the nineteen thirties by
a gentleman by the name of E. Meal Botter and
since that time, so that's about one hundred years ago,
believe it or not, that it's been in existence. There
have been about three modifications of that original description, but
(16:51):
manual lymphatic drainage definitely has significant benefits for a variety
of reasons. It's, first of all, it represents one of
the adjunctive therapies that plastic surgeons healthcare professionals use for patients.
Initially it was couched in reconstructive surgery, if you will,
(17:18):
or following reconstructive surgery, it's now progressed into body contour
surgery in terms of lifting techniques or excisional procedures, liposuction,
revision surgery. It has a multitude of very definite benefits.
It reduces swelling and bruising, diminishes pain and discomfort, promotes relaxation, sleep,
(17:48):
It accelerates the recovery process.
Speaker 3 (17:51):
It boosts the immune system too. It helps, yes, it
absolutely does. It eliminates those circulating toxins which are a
byproduct of surgery and surgical procedures, and improves circulation. So
it has a multitude of benefits and it's actually become
(18:11):
more much more mainstream these days. A lot of patients
will come in and even ask about it. They'll volunteer
in terms of, well should I look into lymphatic manual
lymphatic massage or drainage after my procedure, And we actually
provide a number of location centers practitioners who do this
(18:35):
procedure for.
Speaker 2 (18:37):
Those persons who are a candidate or inquire about it
and really wish to go that route. But it's definitely
very very beneficial. It has to be performed, certainly by
qualified practitioners, Certified therapists have to do.
Speaker 1 (18:56):
There's some things you can do at home as well.
You can have a therapeutic lymphatic drainage massage, absolutely and
there's nothing better than that. But you know, for people
every day, I mean you can wake up and you know,
do some massages on your face or on your legs
that can kind of help.
Speaker 2 (19:12):
Absolutely. Literature even points to providing at when it's done
on the face, providing more of a glow, improving the
skin the look of the skin. Even acne believe it
or not, there are reports in the literature that it's
beneficial in that regard as well. So you're absolutely correct.
It does not have to be at a center or
(19:34):
a with a certified therapist. It's becoming very very mainstream,
and I do think that it's very very advantageous on
many levels.
Speaker 1 (19:47):
Put some videos up on my social media after this launches,
just to give some technique on the face so we
can all save a couple of dollars and try and
get that beautiful level.
Speaker 2 (19:57):
Absolutely, definitely, it's it's certainly stood the test of time,
and it definitely has very very tangible benefits. I've seen
it many many times in my practice.
Speaker 1 (20:09):
So I really thank you so much. I wanted to
get into that. But what I really want to talk
to you about as I get older and older by
the minute, it feels like and I've entered my perimenopause
menopause era obviously, you know in medical school a couple
decades ago. Now I don't want to age myself. But
you know, we don't really talk much about what happens
(20:32):
to our body after pregnancy and the hormones and the
mental and physical effect the toll of pregnancy and just
being an aging woman has on the body. There's a
lot of stigma around plastic surgery. As you know, people
you know are kind of whispering like, oh, did she
have something done, she looks different, and in fact, people
(20:55):
sometimes it's hard for people to even compliment on a
woman after she's had work done. Times that's because the
work can be just so over the top that it's like, whoa,
we've gone too far. I feel like the goal should
be where you almost don't even realize that they had
plastic surgery. Absolutely, I want to ask you what's really
the difference about, you know, functional or reconstructive plastic surgery.
(21:18):
Now I'm not talking about, you know, like war victims
or trauma victims. I'm more talking about for like a
woman who's you know, getting a little bit older. What
are some things that classic surgery offers. While it's thrown
in the bucket of being cosmetic, it's actually a lot
more towards the reconstructive.
Speaker 2 (21:38):
Well, I think there are a number of procedures that
fall into that category. Certainly, then the first that comes
to mind would be restoration of a woman's core, as
performed in tummy talk or abdominoplasty. How we refer to that,
(22:02):
I think that's one of the most significant.
Speaker 1 (22:05):
And so what is that is just removing a bunch
of excess skin from.
Speaker 2 (22:09):
Well, yeah, it's it's correcting what's called the diastasis. Technically
it's referred to as diastasis recte abdominance worthy a.
Speaker 1 (22:21):
Canyon that forms down a woman's when the muscles it'll
come back together all the way.
Speaker 2 (22:27):
Exactly so, prior to pregnancy, your younger years, the muscles
are more anatomically aligned, and with pregnancy they separate and
that can represent a significant compromise to somebody's core. And
(22:48):
the core is really defined as the level from the
diaphragm all the way including the pelvic floor, and as such,
restoration of a woman's core can be extremely significant to
a patient. Many times patients will come in with back
(23:09):
pain or back instability or discomfort that's very very resistant
to core training as we call it, and they come
in very compromised. And this particular procedure where there is
restoration or correction, I should say, of the diastasis, is
(23:31):
very impactful. As a matter of fact, there was a study,
a very excellent study published in the British Journal of
Surgery in twenty twenty one. It was a retrospective three
year study out of Sweden, and it was actually republished
by the National Institutes of Health and It was an
excellent study and it listed the myriad benefits of correction
(23:56):
of the diastasis and providing or stability stability of the
abdominal muscles, the back muscles. It even found objectively, I
might add that there was correction of urinary incontinence, improvement
of bowel function basically because of stabilization of the pelvic four.
(24:16):
So the first thing that would be on my list,
if you will, would be the abdominal plasty which works
to correct the core. And the other thing I would
mention is many many times incidentally or discovered and diagnosed preoperatively.
A lot of patients will come in with ventral hernia
(24:37):
either that are.
Speaker 1 (24:38):
Found or fat well, yeah, goes through the aboun I.
Speaker 2 (24:42):
Mean, and the ventral hernia consists of a number of
different types of hernia. Could be an epicastric hernia, it
could be an umbilical hernia, or an incisional hernia from
prior procedures, even laparoscopies that are found incidentally during procedure.
All of those corrective measures are extremely significant for patients
(25:03):
in terms of functional restoration. Really, in addition to that,
I mean, there are other procedures that we categorize as
reconstruction if you will. Breast reductions are categorized by plastic
surgeons as reconstructive, not aesthetic, even though there is certainly
an esthetic component to the procedure. Many times it's categorized
(25:29):
as more reconstruction. Whether a patient comes in with neck pain,
upper back pain, shoulder discomfort, rashes beneath the breasts, all
of those things can become manifest perimenopausally or postmenopausal or postpartum.
That's one of the procedures that's very commonplace in the
(25:51):
so called MOMMI make ver if you will. But these
all provide for functional improvement, restoration, recovery for women who
present with these issues.
Speaker 1 (26:08):
So I almost wonder because even that term mommy makeover
in itself that kind of seems like frivolous to a
woman that it's not. I mean, you just laid out
many reasons why women should absolutely consider this. Increasing their
core strength, increasing their pelvic floor. Many women after having
(26:28):
children have some urinarian continence. And no, that doesn't sound
very sexy, but try jumping on a trampoline with your
kids after having those kids. Sometimes that's a little bit
tricky because there's actually something that can be done to
improve that. We should be normalizing a little more. I
mean you see women walking out on the streets with
their weighted vests every day, now, I mean that is
(26:49):
like the hallmark sign of I'm in perimenopause metopause and
I'm working on my core. Well, that's great. You want
to be exercising, you want to be eating right, you
want to I guess, be wearing your weighted best and
lifting weight and all these other things that women are
being told we should do. But how can we remove
that stigma of this quote unquote mommy makeover? And maybe
it should just be given a new name to kind
(27:10):
of help.
Speaker 2 (27:12):
Yeah, I really don't think it should be stigmatized at all.
I mean I tell the moms that come into my
office that you know, having children is a wonderful gift
and it's a great thing, and you know this is
just part and parcel, sometimes not for every woman, but
(27:33):
for many women, part of that journey, if you will.
And I find tremendous satisfaction and gratification for turning back
the clock or allowing women to have that restoration functionally
and bringing them back to a better place. So I
(27:56):
hope it's you know, not stigmatized. It shouldn't be stigmatized.
If anything, I think women should be lauded for what
they've what they've been able to do in life and
that you know, giving birth and having children. I think
it's just a wonderful, wonderful thing, and I feel very
(28:18):
very happy to just be a part of that journey,
if you will.
Speaker 1 (28:22):
I've heard many women talk about improved energy posture and
just being able to exercise again after they've gotten you know,
they've had their the abdominal plasty or the tummy tuck
or mommy make over, wherever you want to call it.
From your experience, how transformative do you see in your
patients on their day to day quality.
Speaker 2 (28:41):
Well, I appreciate your bringing up the exercise factor because
I think that's very significant. Many many women are very
exercise driven today. And to your point, in that particular
study that I cited a month moment ago, quality of
life was one of the factors that they studied, and
the significant significant improvement of it was statistically significant and
(29:07):
very very to a very great percentage. But I find
that the quality of life in terms of every activity,
whether it's activity of daily living or exercise, or just
overall function or even discomfort if you will, the back discomfort,
the lower back discomfort. I've been very stricken by the
(29:30):
fact that women who have come in with very significant
back discomfort after procedure, they're markedly improved. So I think
the procedure is hugely beneficial. I'm not happy about any
kind of stigma. It should not be stigmatized at all.
(29:51):
I think that this is just an opportunity to help
women regain a better quality of life and fund better
on a daily basis. Whatever that means, whether it's activity
of daily living, exercise, et cetera, or just being symptom
free or pain free or discomfort free.
Speaker 1 (30:10):
What's the ideal timing for women who are considering having
the mommy makeover? Like how long after pregnancy? Should they
wait until they've finished having babies?
Speaker 2 (30:19):
Like?
Speaker 1 (30:19):
What do you think?
Speaker 2 (30:20):
So great question? First and foremost. I always tell women,
please wait until you're finished child bearing. I had a
patient come in recently who really was pushing to have
a procedure, but then in the same breath was saying, well,
I'm thinking about having another child in a year or so,
(30:43):
and I really recommended that she wait that being said,
I've had the opportunity to go back in on patients
who became inadvertently pregnant after having a procedure done.
Speaker 1 (30:58):
You still can get pregnant and have a baby if you.
Speaker 2 (31:01):
Have absolutely absolutely yes, it does not compromise pregnancy and
women can do that. So to answer your question, I
recommend waiting until child bearing is complete. If there is
a breast procedure involved as part of this procedure, the
(31:23):
factor that becomes important there is breastfeeding, whether a woman
is still you know, there's still milk letdown. Typically we
ask women if they're about to have a breast procedure
after child bearing or breastfeeding, we ask them to wait
a minimum of six months so that there is no
(31:45):
additional letdown which can take place during procedures. So I
would say with respect to breast procedures, we typically ask
a minimum wait time of six months.
Speaker 1 (31:57):
Generally, Really, after having your children, you can consider the
surgery kind of whenever you want. I mean, would you
recommend that they try to get in like the best
physical shape possible, get their muscles as strong as they
can before surgery, or should they have the surgery and then.
Speaker 2 (32:10):
Work on it well I would say after childbearing is complete,
I would tend to weight three months minimum. But in
terms of weight time in general, if a woman is
anticipating or thinking about weight loss or reaching more of
(32:34):
her goal weight, we encourage that. Certainly, if somebody is
thinking about a five or ten pound fluctuation weight, that's
not much of a factor or much of an influence
or impact on outcome. But if somebody is considering a
fifteen pound or twenty pound weight reduction, we encourage that.
(32:58):
Prior to procedure, and so yes, exercise weight loss, we
haven't really yet touched upon nutrition or diet. I think
that's also very very important important consideration as well. So
(33:19):
there is, as I mentioned a moment ago, this multi
factorial approach to improve outcome and result. And I do
think that trying to approach goal weight, exercise, good nutrition,
they all are important considerations when it comes to this procedure.
(33:41):
It definitely affects outcome. And my best results, really, when
I reflect on my outcomes, have been a combination of
not just the procedure, but exercise and diet and good nutrition.
Those are the most stunning results that I've ever or
experienced in my career.
Speaker 1 (34:02):
Truthfully, so for anyone listening. Is there anything else that
we should kind of know about in the realm of
plastic surgery. I want to mission out to destigmatize tummy
tucks for women who have had babies. I think the
data is clear that it's not just about cosmesis. I
think functionally it makes you look better, yes, but it
(34:24):
makes you feel so much better and stronger. And as women,
it's hard enough as it is as we go through
perimenopause and menopause, and I think it's something you want
to consider.
Speaker 2 (34:33):
You should. I couldn't agree with you more. And the data,
the research, the literature substantiates that unequivocally. Uncategorically, I don't
think that it's conjecture at all. So to your audience,
I would just advocate, if you are considering embarking on
(34:56):
this journey, consider this multi factorial approach. If you will
of good nutrition, healthy eating, exercise, it will enhance your outcome.
And to your earlier point about stigma, I don't think
(35:18):
anybody should feel stigmatized about wanting to have better quality
of life, whether it's as you say, cosmesis or even
functionally well.
Speaker 1 (35:31):
And you said we talked about this earlier. It's really
also about yes, all of that matters, you know, I'm
a huge advocate of that RF junior in Maha. Everyone's
talking about it, but it's also the surgeon and you,
being a board certified plastic surgeon. You know, you want
to make sure you do your due diligence. Make sure
the person that you go to is does this often.
(35:52):
I recommend not leaving the country like some people do,
trying to find better rates, but work with the doctor's office,
your HSA funds, whatever you got to do to make
it work.
Speaker 2 (36:02):
I would echo that I think credentials matter. I'm not
a fan of travel surgery many I've seen a number
of problems with that. Do your due diligence, as you suggest,
do your homework, investigate, explore. I always encourage patients to
(36:25):
come in with questions or even submit follow up questions
via email or even via virtual visits. I encourage patients
to do that, come in with having done your research
and your homework. It's an important consideration for patients. It's
an important step that patients take, and I appreciate the
(36:49):
significance of it. So I wholly endorse patients to do
their research. Homework, ask the hard hitting questions, the more
the her, for.
Speaker 1 (37:02):
Sure, And thank you so much for being on Wellness
Unmasked Doctor Jonathan Sherwin, friend, colleague out of New York City.
Appreciate having you on.
Speaker 2 (37:10):
It's a pleasure and a privilege to be with you
and your audience today. Thank you so much for this opportunity.
I really appreciate it.
Speaker 1 (37:17):
You're listening to Wellness and Mass. We'll be right back
with more. All right, that's it. That's my mission. We
are getting rid of the stigma associated with mommy makeovers.
The first thing we have to do is get rid
of that name, because there's something about that name that
just drives me bananas. Maybe it should be like Stronger Together.
(37:39):
Oh no, that sounds like a political slogan. How about
for her or the Core makeover? Oh I like the
core makeover or bringing it all together, because that's what
we're doing. We're bringing those muscles back together, whatever it is,
whatever you want to call it. If you have a
friend who's talking to you about maybe wanting to do
(38:00):
one of these procedures to really just start feeling better,
support them. If you're thinking about it yourself, I encourage
you to go talk to a doctor about it. It
may not be for you, but it doesn't hurt to ask,
especially if you find yourself having limitations or something that's
keeping you from getting back to the gym. Maybe it's
an abdominal hernia, Maybe it's very weak stomach muscles or
(38:21):
a weak pelvic floor. Maybe you're dealing with urinary incontinence.
You heard me kind of joke about jumping on a
trampoline with kids. Yeah, that's a real thing. It's hard.
Bottom line, we only have one life to live, so
do what you have to do to feel better, and
don't let anyone out there hate on you, and don't
take the fact that you're talking to a plastic surgeon
(38:43):
make you feel any less, because this is your body,
this is your health, and we need to get rid
of the stigma when it comes to some of these
plastic surgery procedures. Thanks for listening to Wellness on Mass
on America's number one podcast network, I Heart. Follow Wellness
on Mass with doctor Nicole Snaffire and start listening on
the free iHeartRadio app or wherever you get your podcasts,
(39:03):
and we will catch you next time.
Welcome to Wellness on MASS I'm doctor Nicole Saffire and
today's episode is an interesting one and I'll tell you why.
As a woman, there is no escaping perimenopause and menopause.
I'm sorry, ladies, but everyone is going to go through it.
Is there a manopause, Yes, there absolutely is a manopause,
but that is for an entirely different episode. So men,
(00:24):
listen to this one because you may be able to
learn some things. But ladies, this is for you. One
of the things that I find, honestly a little bit
comical is we have so many things to make us
feel better, and right now, if you're not wearing a
weighted vest as you walk outside, you're not part of
that perimenopause menopause club. Apparently I have yet to purchase one,
(00:46):
but it's certainly on my list. People love it, and
I do want to be a part of that club,
I guess. But here's the question I have. Yes, I
know that taking our life into our hands with some
wellness stuff, changing our diet, exercising wear, wearing weighted vests,
weightlifting and all these other things can be really good
(01:09):
for us. It doesn't just make us look better, feel better,
but it actually makes us healthier and improves our quality
in life, may even help us live longer, healthier and longer.
But one of the things that is less talked about
is that there are actually some surgical interventions that might
be able to help women get to the place where
(01:29):
they feel better as well. And yes, I'm talking about
plastic surgery, but I'm not talking about plastic surgery kind
of as you traditionally think about it. One of the
things that we don't talk about as much is, yes,
there are all these things that we can do to
look better, feel better, but there's a lot of stigma
around some of it. Okay, there's not a lot of
stigma around you know, weightlifting, for women eating healthier, wearing
(01:53):
these weighted vests. They kind of go in that fool
of acceptable things we can do to make ourselves feel better.
But what about plastic surgery. Now, I'm not talking about
cosmetic plastic surgery, and you know that traditional sense where
it's like, oh, I have an Italian bump on my nose,
which I do if you ever seen me from a
profile shot. I want to get rid of my bump.
(02:14):
That's going to make me feel better. Okay, that's fine.
I mean, whatever you've got to do to make yourself
feel better. You know, making changes to yourself on the
outside doesn't necessarily help the person on the inside. But
anybody who ignores the fact that it can make you
feel better on the inside, they're being dishonest. So whatever
actually makes you feel better, I'm all for.
Speaker 2 (02:35):
Do.
Speaker 1 (02:35):
I think people overdo it with plastic surgery, undoubtedly, but
there are some things that you can actually do, specifically
for women like myself who have had children. Our bodies,
God bless our bodies because we are able to hold
these children, create these children, grow these children, birth these children,
(02:55):
and then raise these children. But yes, pregnant to see birth.
It takes a toll on our bodies. And one of
the things we keep telling women you have to be exercising,
you have to keep a strong core, you have to
do all these things if you want to be healthy
for your children as they grow up. Okay, well, for
some of us, you know, we can get some conditions
(03:17):
that leave muscles incredibly weak and make it very difficult
to do some of those exercises. So I am very
excited to have on Wellness en Mass today. A friend
and colleague doctor Jonathan Sherwin, who is a board certified
plastic surgeon in the New York City area. Plastic surgeon
to the stars. I know many people that he has
(03:38):
worked on. I've referred many people to him. He does
an excellent job, and he is all about trying to
make a woman feel better functionally, and he is here
to talk all about mommy makeovers. And I am on
a mission to get rid of the stigma behind these
mommy makeovers because it's not just about getting rid of
(03:59):
excess skin and fat. It's about so much more than that,
and it's about setting us up to a place where
we can get back to the gym, get back to
feeling stronger and healthier and really living that life that
we want to live and throwing on a weight to
vest if that's what we want to do. So let's
bring in doctor Sherwin. Okay, Well, I am very excited
(04:21):
to have on today a friend of mine but also
a colleague and someone I admire very much, Doctor Jonathan Sherwin.
He is a board certified plastic surgeon in Manhattan and
Greenwich area, and he is just a wealth of knowledge
and excited to have him today because I have a
lot of plastic surgery questions. Doctor Sherwin, thanks for being on.
Speaker 2 (04:41):
It's a pleasure and a privilege.
Speaker 1 (04:43):
Okay, so I just have to I have to talk
about the elephant in the room. Although this is not
the big thing I really want to talk to you about.
I'm more interested in the functional aspects of plastic surgery,
but inquiring minds want to know. If you look at
social media or I've had to talk about it on TV,
people are starting to pop up with what they're calling
(05:05):
these subtle facelifts. I think Chris Jenner, who's the matriarch
of the Kardashian family, is recently looking mightily refreshed. People
have questioned whether Lindsay Lohan and some other people, what
do you make of this?
Speaker 2 (05:21):
Well, I think that a lot of the popularity and
facelifts today are a reflection of use of GLP ones,
social media, also FaceTime and zoom. Some individuals refer to
(05:41):
it as the zoom boom because people are seeing themselves
on camera. What I would say in respect to the
subtle facelift, The first thing I would say is that
the beautiful thing about plastic surgery is that everybody is
an individual. Their needs are individual, their requirements are individual,
and so each procedure has to be has to address
(06:06):
that individual's needs and requirements. So that's the first thing
I would say. Plastic surgery, particularly when it addresses facial rejuvenation,
reflects a targeted approach, So you have to address the
areas of concern the patient's goals. To that end, I
think that more and more procedures are being done at
(06:29):
a younger age.
Speaker 1 (06:31):
They're young is too young?
Speaker 2 (06:33):
Like you?
Speaker 1 (06:33):
What are you seeing?
Speaker 2 (06:34):
Well, I've seen patients in their late thirties come in,
believe it or not, patients that have lost a significant
amount of weight. I have even been very, very surprised
at the amount of laxity that some younger individuals maintain
for a variety of reasons. And as much as I
try to ask these patients to wait or try to
(07:00):
delay their procedures, they're very very dogged. They keep coming
back and they really pushed to have the procedure done.
But I've been personally very surprised pleasantly by the great
rejuvenation that you can accomplish. Some individuals refer to this
early in event intervention as pre juveniation, if you will,
(07:24):
But I think I want to emphasize too, that it
is a targeted approach. I think that techniques today are
emphasizing more hidden incisions, in conspicuous closures, in conspicuous incisions,
minimal incisions. I think that's been very, very greatly emphasized
(07:49):
even in the literature today. And the other thing that
I would emphasize as well is that the procedure and
the outcome must be esthetic pleasing, tastefully done, not over corrected.
And the results have been I think much improved in
(08:10):
that regard.
Speaker 1 (08:11):
Well. So when I think of kind of traditional facelifts,
to be honest, someone who I saw all the time
always saw the scars was former President Joe Biden. I
mean that was, you know, he had a very obvious facelift.
You saw the scar kind of going periuricular around his ear,
and he always just looked a little bit too surprised.
What's different about what he had done versus I mean,
(08:34):
I'll be honest, Chris Jenner, she looks amazing. Now. I
get it if you have hundreds of millions of dollars
and and have a lifestyle that is I don't want
to say she lives a stress free lifestyle. But we
probably live different lives. That may have something to do
with it. But why does she look so refreshed and
Biden always looked like he was scared or surprised.
Speaker 2 (08:57):
Well, you know, a lot depends on the individual surgeon
and their approach. I do know the individual surgeon who
did her procedure. I know exactly what her procedure entailed
because I know the surgeon's particular technique. I just think
that it is the approach and how the procedure is executed.
(09:20):
I think that you know that factors very importantly to outcome.
Placement of incisions, how the incisions are concealed, on the
the procedure itself, and what it addresses, whether it addresses
the neck, the submentum, or the area under beneath the
(09:41):
chin cheeks only the vector of the left, meaning the
direction of the lift, and how every soft tissue is
redraped those are It's a very very multi factorial procedure
and each factor has to be corre directly addressed in
order to have a successful outcome. I agree with you
(10:04):
in terms of former President Biden. I think it's pretty
obvious to the person who's observant that he had worked
one and I don't think that his incisions were particularly
well placed or concealed, etc.
Speaker 1 (10:23):
But really it's about the surgeon.
Speaker 2 (10:25):
It is about the surgeon. It's about their technique. It's
how fastidious they are, how particular they are, how exacting
they are. It's not just the technique, it's also how
the individual surgeon performs that individual specific technique that makes
the difference, and that is plastic surgery. It's not just
(10:49):
a hernia of repair or removing an appendix. A lot
more goes into the procedure.
Speaker 1 (10:56):
When you find people who are coming for facelifts, I mean,
they tend to be older, but as you're saying, with
the weight loss from the GLP ones, maybe people are
wanting these a little bit earlier. Most of these women,
I have to assume, have probably done botox and fillers
in their face. I mean usually, I mean that's kind
of the progression. You start out with botox, maybe they
(11:16):
move on to fillers, and then I guess facelift for people,
does that cause any issues for you? Like, do you
feel any of those fillers that are in the face.
Speaker 2 (11:26):
Well, not infrequently when you're performing a facelift, And this
has happened to me. I know it's happened to other
surgeons as well. You'll come across old filler. It'll still
be there. As you're performing the facelift elevating the layers,
you'll come across old filler. Now, if there are occasions
(11:49):
when a patient is over volumeized that we will dissolve
the filler. We all know that.
Speaker 1 (11:56):
Look right, that's a big monk cheeks kind of like
pushing in their eyes.
Speaker 2 (12:00):
Sometimes we will recommend that the filler be dissolved prior
to procedure. I have done that on several patients who
are so heavy with volume. There's such distortion that we
will recommend dissolving filler prior to procedure. On other occasions,
when the filler may not be that evident, you'll just
(12:22):
be you performing your procedure in the middle of procedure
and you'll come across old filler. That doesn't create a
problem per se, unless it's done to such a degree
that it generates scar tissue. Not to digress too much,
(12:43):
but there are other procedures which generate a fair amount
of scar tissue. Threadlifting is one of the procedures that
are out there that can generate a fair amount of fibrosis,
and the surgeon just has to work through that scar
tissue or fibrosis is in order to successfully perform the procedure.
(13:04):
But fillers per se, they don't, they don't really compromise
the procedure. But again, I think the factor is whether
to dissolve before or not. The surgeon just has to
be aware and that's part of taking a very very
(13:25):
thorough history and physical on your patients. I always ask, do.
Speaker 1 (13:30):
You think women tend to lie?
Speaker 2 (13:32):
It's like, you know what, not only not not only
do they lie, but you know, frankly, some women are
very poor historians. So you don't know prior to procedure
certain things. And then once you're in the heat of
battle as I call it, you come across various things.
And then when you query the patient after procedure, oh,
(13:55):
by the way, we found X y Z, and then
jobs their memory.
Speaker 1 (13:59):
Speaking for women everywhere, I'm going to push back on
the women are poor historians. I think we're selective historians
because I think when women, we tend to think that
we know better, and we just tell our doctors what
they think is important for them to know.
Speaker 2 (14:14):
Okay, I don't I don't mean to make a blanket
statement about being a poor historian. Some some patients in general,
male or female, are poor historians. But you know, it's
it doesn't really compromise procedure. It's just nice to be aware,
that's all.
Speaker 1 (14:32):
Well, I guess that's good to know. I really do
hate that look of the overfilled face, just that chipmunk love.
I absolutely start to look the same.
Speaker 2 (14:42):
After what absolutely absolutely agree. I think when it comes
to botox or injectables, as we say, I'm a huge
fan of botox. Fillers have to be done very very judiciously,
very careful, very cautiously, because once you cross that line,
(15:05):
it becomes a negative not a positive.
Speaker 1 (15:07):
Well, you know what's I think? What I have a
little chuckle at these days you have so many of
these wellness people online and on TV, and they're like, oh,
I only eat clean and I only do loose sleep teeks,
I'm avoiding microplastic, and now I'm on my way to
go get my bochy light box and injected in my face.
It's like, all right, Picker chrees your battles. That's fine, right.
(15:28):
I digress. One thing that I talked about on TV
recently on Fox and Friends, we did a segment. It
was all about the fact that one of the Kardashians,
Kim Kardashian, came out with this device that you sleep
in that strangles you. Essentially, it's like a compression device
but for your chin and neck and just to try
(15:49):
and have like a chisel jawline when you wake up
in the morning. And I guess the overarching theme there is,
you know, compression almost like corset work of the abdomen,
but maybe on the neck and the jaw, which again
I thought again was a little cheeky in the sense
that her mother just displayed this beautifully done face. But yeah, no, no,
the rest of us, We'll just wear this corset on
(16:11):
our neck while we sleep. Sounded like a terrible idea
to me, But that got me doing a lot of
research on the benefits of lymphatic drainage of the face,
something that I kind of have doing myself personally. But
I'm curious, what's your thoughts on lymphatic drainage.
Speaker 2 (16:26):
So lymphatic drainage, just a little historical perspective, believe it
or not, was first described in the nineteen thirties by
a gentleman by the name of E. Meal Botter and
since that time, so that's about one hundred years ago,
believe it or not, that it's been in existence. There
have been about three modifications of that original description, but
(16:51):
manual lymphatic drainage definitely has significant benefits for a variety
of reasons. It's, first of all, it represents one of
the adjunctive therapies that plastic surgeons healthcare professionals use for patients.
Initially it was couched in reconstructive surgery, if you will,
(17:18):
or following reconstructive surgery, it's now progressed into body contour
surgery in terms of lifting techniques or excisional procedures, liposuction,
revision surgery. It has a multitude of very definite benefits.
It reduces swelling and bruising, diminishes pain and discomfort, promotes relaxation, sleep,
(17:48):
It accelerates the recovery process.
Speaker 3 (17:51):
It boosts the immune system too. It helps, yes, it
absolutely does. It eliminates those circulating toxins which are a
byproduct of surgery and surgical procedures, and improves circulation. So
it has a multitude of benefits and it's actually become
(18:11):
more much more mainstream these days. A lot of patients
will come in and even ask about it. They'll volunteer
in terms of, well should I look into lymphatic manual
lymphatic massage or drainage after my procedure, And we actually
provide a number of location centers practitioners who do this
(18:35):
procedure for.
Speaker 2 (18:37):
Those persons who are a candidate or inquire about it
and really wish to go that route. But it's definitely
very very beneficial. It has to be performed, certainly by
qualified practitioners, Certified therapists have to do.
Speaker 1 (18:56):
There's some things you can do at home as well.
You can have a therapeutic lymphatic drainage massage, absolutely and
there's nothing better than that. But you know, for people
every day, I mean you can wake up and you know,
do some massages on your face or on your legs
that can kind of help.
Speaker 2 (19:12):
Absolutely. Literature even points to providing at when it's done
on the face, providing more of a glow, improving the
skin the look of the skin. Even acne believe it
or not, there are reports in the literature that it's
beneficial in that regard as well. So you're absolutely correct.
It does not have to be at a center or
(19:34):
a with a certified therapist. It's becoming very very mainstream,
and I do think that it's very very advantageous on
many levels.
Speaker 1 (19:47):
Put some videos up on my social media after this launches,
just to give some technique on the face so we
can all save a couple of dollars and try and
get that beautiful level.
Speaker 2 (19:57):
Absolutely, definitely, it's it's certainly stood the test of time,
and it definitely has very very tangible benefits. I've seen
it many many times in my practice.
Speaker 1 (20:09):
So I really thank you so much. I wanted to
get into that. But what I really want to talk
to you about as I get older and older by
the minute, it feels like and I've entered my perimenopause
menopause era obviously, you know in medical school a couple
decades ago. Now I don't want to age myself. But
you know, we don't really talk much about what happens
(20:32):
to our body after pregnancy and the hormones and the
mental and physical effect the toll of pregnancy and just
being an aging woman has on the body. There's a
lot of stigma around plastic surgery. As you know, people
you know are kind of whispering like, oh, did she
have something done, she looks different, and in fact, people
(20:55):
sometimes it's hard for people to even compliment on a
woman after she's had work done. Times that's because the
work can be just so over the top that it's like, whoa,
we've gone too far. I feel like the goal should
be where you almost don't even realize that they had
plastic surgery. Absolutely, I want to ask you what's really
the difference about, you know, functional or reconstructive plastic surgery.
(21:18):
Now I'm not talking about, you know, like war victims
or trauma victims. I'm more talking about for like a
woman who's you know, getting a little bit older. What
are some things that classic surgery offers. While it's thrown
in the bucket of being cosmetic, it's actually a lot
more towards the reconstructive.
Speaker 2 (21:38):
Well, I think there are a number of procedures that
fall into that category. Certainly, then the first that comes
to mind would be restoration of a woman's core, as
performed in tummy talk or abdominoplasty. How we refer to that,
(22:02):
I think that's one of the most significant.
Speaker 1 (22:05):
And so what is that is just removing a bunch
of excess skin from.
Speaker 2 (22:09):
Well, yeah, it's it's correcting what's called the diastasis. Technically
it's referred to as diastasis recte abdominance worthy a.
Speaker 1 (22:21):
Canyon that forms down a woman's when the muscles it'll
come back together all the way.
Speaker 2 (22:27):
Exactly so, prior to pregnancy, your younger years, the muscles
are more anatomically aligned, and with pregnancy they separate and
that can represent a significant compromise to somebody's core. And
(22:48):
the core is really defined as the level from the
diaphragm all the way including the pelvic floor, and as such,
restoration of a woman's core can be extremely significant to
a patient. Many times patients will come in with back
(23:09):
pain or back instability or discomfort that's very very resistant
to core training as we call it, and they come
in very compromised. And this particular procedure where there is
restoration or correction, I should say, of the diastasis, is
(23:31):
very impactful. As a matter of fact, there was a study,
a very excellent study published in the British Journal of
Surgery in twenty twenty one. It was a retrospective three
year study out of Sweden, and it was actually republished
by the National Institutes of Health and It was an
excellent study and it listed the myriad benefits of correction
(23:56):
of the diastasis and providing or stability stability of the
abdominal muscles, the back muscles. It even found objectively, I
might add that there was correction of urinary incontinence, improvement
of bowel function basically because of stabilization of the pelvic four.
(24:16):
So the first thing that would be on my list,
if you will, would be the abdominal plasty which works
to correct the core. And the other thing I would
mention is many many times incidentally or discovered and diagnosed preoperatively.
A lot of patients will come in with ventral hernia
(24:37):
either that are.
Speaker 1 (24:38):
Found or fat well, yeah, goes through the aboun I.
Speaker 2 (24:42):
Mean, and the ventral hernia consists of a number of
different types of hernia. Could be an epicastric hernia, it
could be an umbilical hernia, or an incisional hernia from
prior procedures, even laparoscopies that are found incidentally during procedure.
All of those corrective measures are extremely significant for patients
(25:03):
in terms of functional restoration. Really, in addition to that,
I mean, there are other procedures that we categorize as
reconstruction if you will. Breast reductions are categorized by plastic
surgeons as reconstructive, not aesthetic, even though there is certainly
an esthetic component to the procedure. Many times it's categorized
(25:29):
as more reconstruction. Whether a patient comes in with neck pain,
upper back pain, shoulder discomfort, rashes beneath the breasts, all
of those things can become manifest perimenopausally or postmenopausal or postpartum.
That's one of the procedures that's very commonplace in the
(25:51):
so called MOMMI make ver if you will. But these
all provide for functional improvement, restoration, recovery for women who
present with these issues.
Speaker 1 (26:08):
So I almost wonder because even that term mommy makeover
in itself that kind of seems like frivolous to a
woman that it's not. I mean, you just laid out
many reasons why women should absolutely consider this. Increasing their
core strength, increasing their pelvic floor. Many women after having
(26:28):
children have some urinarian continence. And no, that doesn't sound
very sexy, but try jumping on a trampoline with your
kids after having those kids. Sometimes that's a little bit
tricky because there's actually something that can be done to
improve that. We should be normalizing a little more. I
mean you see women walking out on the streets with
their weighted vests every day, now, I mean that is
(26:49):
like the hallmark sign of I'm in perimenopause metopause and
I'm working on my core. Well, that's great. You want
to be exercising, you want to be eating right, you
want to I guess, be wearing your weighted best and
lifting weight and all these other things that women are
being told we should do. But how can we remove
that stigma of this quote unquote mommy makeover? And maybe
it should just be given a new name to kind
(27:10):
of help.
Speaker 2 (27:12):
Yeah, I really don't think it should be stigmatized at all.
I mean I tell the moms that come into my
office that you know, having children is a wonderful gift
and it's a great thing, and you know this is
just part and parcel, sometimes not for every woman, but
(27:33):
for many women, part of that journey, if you will.
And I find tremendous satisfaction and gratification for turning back
the clock or allowing women to have that restoration functionally
and bringing them back to a better place. So I
(27:56):
hope it's you know, not stigmatized. It shouldn't be stigmatized.
If anything, I think women should be lauded for what
they've what they've been able to do in life and
that you know, giving birth and having children. I think
it's just a wonderful, wonderful thing, and I feel very
(28:18):
very happy to just be a part of that journey,
if you will.
Speaker 1 (28:22):
I've heard many women talk about improved energy posture and
just being able to exercise again after they've gotten you know,
they've had their the abdominal plasty or the tummy tuck
or mommy make over, wherever you want to call it.
From your experience, how transformative do you see in your
patients on their day to day quality.
Speaker 2 (28:41):
Well, I appreciate your bringing up the exercise factor because
I think that's very significant. Many many women are very
exercise driven today. And to your point, in that particular
study that I cited a month moment ago, quality of
life was one of the factors that they studied, and
the significant significant improvement of it was statistically significant and
(29:07):
very very to a very great percentage. But I find
that the quality of life in terms of every activity,
whether it's activity of daily living or exercise, or just
overall function or even discomfort if you will, the back discomfort,
the lower back discomfort. I've been very stricken by the
(29:30):
fact that women who have come in with very significant
back discomfort after procedure, they're markedly improved. So I think
the procedure is hugely beneficial. I'm not happy about any
kind of stigma. It should not be stigmatized at all.
(29:51):
I think that this is just an opportunity to help
women regain a better quality of life and fund better
on a daily basis. Whatever that means, whether it's activity
of daily living, exercise, et cetera, or just being symptom
free or pain free or discomfort free.
Speaker 1 (30:10):
What's the ideal timing for women who are considering having
the mommy makeover? Like how long after pregnancy? Should they
wait until they've finished having babies?
Speaker 2 (30:19):
Like?
Speaker 1 (30:19):
What do you think?
Speaker 2 (30:20):
So great question? First and foremost. I always tell women,
please wait until you're finished child bearing. I had a
patient come in recently who really was pushing to have
a procedure, but then in the same breath was saying, well,
I'm thinking about having another child in a year or so,
(30:43):
and I really recommended that she wait that being said,
I've had the opportunity to go back in on patients
who became inadvertently pregnant after having a procedure done.
Speaker 1 (30:58):
You still can get pregnant and have a baby if you.
Speaker 2 (31:01):
Have absolutely absolutely yes, it does not compromise pregnancy and
women can do that. So to answer your question, I
recommend waiting until child bearing is complete. If there is
a breast procedure involved as part of this procedure, the
(31:23):
factor that becomes important there is breastfeeding, whether a woman
is still you know, there's still milk letdown. Typically we
ask women if they're about to have a breast procedure
after child bearing or breastfeeding, we ask them to wait
a minimum of six months so that there is no
(31:45):
additional letdown which can take place during procedures. So I
would say with respect to breast procedures, we typically ask
a minimum wait time of six months.
Speaker 1 (31:57):
Generally, Really, after having your children, you can consider the
surgery kind of whenever you want. I mean, would you
recommend that they try to get in like the best
physical shape possible, get their muscles as strong as they
can before surgery, or should they have the surgery and then.
Speaker 2 (32:10):
Work on it well I would say after childbearing is complete,
I would tend to weight three months minimum. But in
terms of weight time in general, if a woman is
anticipating or thinking about weight loss or reaching more of
(32:34):
her goal weight, we encourage that. Certainly, if somebody is
thinking about a five or ten pound fluctuation weight, that's
not much of a factor or much of an influence
or impact on outcome. But if somebody is considering a
fifteen pound or twenty pound weight reduction, we encourage that.
(32:58):
Prior to procedure, and so yes, exercise weight loss, we
haven't really yet touched upon nutrition or diet. I think
that's also very very important important consideration as well. So
(33:19):
there is, as I mentioned a moment ago, this multi
factorial approach to improve outcome and result. And I do
think that trying to approach goal weight, exercise, good nutrition,
they all are important considerations when it comes to this procedure.
(33:41):
It definitely affects outcome. And my best results, really, when
I reflect on my outcomes, have been a combination of
not just the procedure, but exercise and diet and good nutrition.
Those are the most stunning results that I've ever or
experienced in my career.
Speaker 1 (34:02):
Truthfully, so for anyone listening. Is there anything else that
we should kind of know about in the realm of
plastic surgery. I want to mission out to destigmatize tummy
tucks for women who have had babies. I think the
data is clear that it's not just about cosmesis. I
think functionally it makes you look better, yes, but it
(34:24):
makes you feel so much better and stronger. And as women,
it's hard enough as it is as we go through
perimenopause and menopause, and I think it's something you want
to consider.
Speaker 2 (34:33):
You should. I couldn't agree with you more. And the data,
the research, the literature substantiates that unequivocally. Uncategorically, I don't
think that it's conjecture at all. So to your audience,
I would just advocate, if you are considering embarking on
(34:56):
this journey, consider this multi factorial approach. If you will
of good nutrition, healthy eating, exercise, it will enhance your outcome.
And to your earlier point about stigma, I don't think
(35:18):
anybody should feel stigmatized about wanting to have better quality
of life, whether it's as you say, cosmesis or even
functionally well.
Speaker 1 (35:31):
And you said we talked about this earlier. It's really
also about yes, all of that matters, you know, I'm
a huge advocate of that RF junior in Maha. Everyone's
talking about it, but it's also the surgeon and you,
being a board certified plastic surgeon. You know, you want
to make sure you do your due diligence. Make sure
the person that you go to is does this often.
(35:52):
I recommend not leaving the country like some people do,
trying to find better rates, but work with the doctor's office,
your HSA funds, whatever you got to do to make
it work.
Speaker 2 (36:02):
I would echo that I think credentials matter. I'm not
a fan of travel surgery many I've seen a number
of problems with that. Do your due diligence, as you suggest,
do your homework, investigate, explore. I always encourage patients to
(36:25):
come in with questions or even submit follow up questions
via email or even via virtual visits. I encourage patients
to do that, come in with having done your research
and your homework. It's an important consideration for patients. It's
an important step that patients take, and I appreciate the
(36:49):
significance of it. So I wholly endorse patients to do
their research. Homework, ask the hard hitting questions, the more
the her, for.
Speaker 1 (37:02):
Sure, And thank you so much for being on Wellness
Unmasked Doctor Jonathan Sherwin, friend, colleague out of New York City.
Appreciate having you on.
Speaker 2 (37:10):
It's a pleasure and a privilege to be with you
and your audience today. Thank you so much for this opportunity.
I really appreciate it.
Speaker 1 (37:17):
You're listening to Wellness and Mass. We'll be right back
with more. All right, that's it. That's my mission. We
are getting rid of the stigma associated with mommy makeovers.
The first thing we have to do is get rid
of that name, because there's something about that name that
just drives me bananas. Maybe it should be like Stronger Together.
(37:39):
Oh no, that sounds like a political slogan. How about
for her or the Core makeover? Oh I like the
core makeover or bringing it all together, because that's what
we're doing. We're bringing those muscles back together, whatever it is,
whatever you want to call it. If you have a
friend who's talking to you about maybe wanting to do
(38:00):
one of these procedures to really just start feeling better,
support them. If you're thinking about it yourself, I encourage
you to go talk to a doctor about it. It
may not be for you, but it doesn't hurt to ask,
especially if you find yourself having limitations or something that's
keeping you from getting back to the gym. Maybe it's
an abdominal hernia, Maybe it's very weak stomach muscles or
(38:21):
a weak pelvic floor. Maybe you're dealing with urinary incontinence.
You heard me kind of joke about jumping on a
trampoline with kids. Yeah, that's a real thing. It's hard.
Bottom line, we only have one life to live, so
do what you have to do to feel better, and
don't let anyone out there hate on you, and don't
take the fact that you're talking to a plastic surgeon
(38:43):
make you feel any less, because this is your body,
this is your health, and we need to get rid
of the stigma when it comes to some of these
plastic surgery procedures. Thanks for listening to Wellness on Mass
on America's number one podcast network, I Heart. Follow Wellness
on Mass with doctor Nicole Snaffire and start listening on
the free iHeartRadio app or wherever you get your podcasts,
(39:03):
and we will catch you next time.
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