Plastic Surgery Discussions with Dr Aisha White

Send us a text

Episode Transcript

Chris (00:00):
Welcome to pulse check, Wisconsin.

(00:42):
Good morning.
Good evening.
Good afternoon.
Whatever it is for you.
This is Dr.
Ford from pulse check,Wisconsin, and we got a good
episode here for you today.
We're going to start it offagain with one of our cases to
help highlight the topic thatwe're going to discuss.
And with that being said, let'sgo ahead and get started.

(01:06):
Patient is a 23 year old femalewho is presenting to the
emergency department with achief complaint of abdominal
pain.
The patient arrives and on firstlook her vital signs look
concerning.
She's got an elevated heartrate.
She's tachycardic, as we say,with a heart rate of about 120.
She's also known to be febrile.
Her fever is 102 degreesFahrenheit.

(01:29):
Before I went to see thepatient, I took a look at past
records that I often will do inthe cases of patients who
present and I'm not seeing anyhistory of any significant
presentations to the emergencydepartment.
No past medical history, thepatient is otherwise healthy.
And so I went back to see thepatient and the patient looks to

(01:50):
be incredibly uncomfortable.
She's reluctant to move.
And on first look, I see thatshe has some bandages over her
abdomen.
The patient later tells me thatshe recently had surgery.
She had reconstructive surgerythat was performed.
She told me that she had a tummytuck and a Brazilian butt lift

(02:13):
or a BBL.
The patient states that thesurgery was performed not at any
of our facilities here in thestate of Wisconsin, but rather
she sought care out in theDominican Republic.
She tells me that she's beendiscussing her symptoms with her
surgeon, and she says that shedoes this via WhatsApp, which is

(02:34):
a communication application thatI'm sure a lot of folks here in
the Pulse Check audience arefamiliar with.
She shows me some of themessages, and in this message
log I can see that the surgeon,who the patient was working
with, has told her to seek carein the emergency department
today.
Before this, she tells thepatient in some of these

(02:55):
messages to go to the ER to haveher stitches removed, as well as
to have her drains removed.
So I removed the binder from thepatient's abdomen to get a
better look and I see a couplethings.
First off, the patient's abdomenis very tender.
She's what we call peritonetic,meaning that Any slight touch to

(03:16):
the abdomen or any movementcauses an extreme amount of
pain.
And it's often reflective of aprocess or an infection that's
going on in the abdomen.
She also has the drains that arestill intact that the surgeon
wanted her to go to the ER forto have removed.
And it looks to show signs ofinfection around the drain site.
And there is purulent or somepus like drainage into the

(03:40):
drainage bulbs.
With the patient looking to beseptic and to have an infection
in the belly, the decision wasmade to start the patient on our
sepsis protocol, which includedfluids, which included blood
cultures, as well as to starther on antibiotics.
And I walk the patient to the CTscanner in order to get a better

(04:02):
picture of what's going on inthe abdomen.
The patient's abdomen revealsseveral pockets of infection, as
suspected.
And at that point I knew thepatient needed to go to the
operating room.
So I contacted several surgeons.
I contacted a couple plasticsurgeons in the network that I
was working as well as generalsurgery.

(04:22):
And there was reluctance fromsome of our general surgeons to
treat the patient or to take thepatient to the operating room.
Because classically they aren'ttrained in plastic surgery and
don't know the specifics of thesurgery that the patient
underwent.
At the time some of the plasticsurgeons that were at the
hospital that were on call didnot have any privileges in house

(04:45):
at the hospital to do surgery.
And so as such I made thedecision to contact one of the
level one centers in the area toget the patient to an OR as fast
as possible as I thought thather condition would turn dire
and could potentially turndeadly.
I was able to get in contactwith the outside facility who

(05:07):
accepted the patient.
Then the patient was transporteddirectly to the operating room.
The patient was thenhospitalized in the ICU
following as she had a recoverythat took a couple of weeks
given the extent of theinfection.

(05:28):
So in that case, it highlights acouple of things that we'll talk
about with our special guesttoday, Dr.
Ayesha White, who is a boardcertified plastic surgeon out of
Austin, Texas.
But what that case highlights ismore so some of the pitfalls
that folks can run into when youare seeking surgery in an

(05:49):
environment that is not typicalof plastic surgery.
One thing that we harp on a lotin medicine especially here at
PulseCheck Wisconsin is that allsurgeries should be considered a
major procedure.
So even if it's an aestheticsurgery, even if it is not an
emergent surgery.
Those procedures have longstanding effects on your body,

(06:11):
and it is a major undertakingthat you should consider.
And so, what we need to do is tomake sure that you're doing your
homework, make sure that youhave a surgeon who is board
certified, that'll be ourrecommendation, and also to make
sure that your aftercare isallotted for.
You want to spend just as muchtime researching your surgeon

(06:32):
and and making sure that thataftercare is there too, because
a lot of time, a lot of patientsthat we're seeing around the
city of Milwaukee, when they goto other places to have these
surgeries, they go overseas oreven go out of state.
A lot of times they're relyingon the emergency departments to
take out sutures or take outdrains.
When in a lot of cases, I cantell you in my emergency

(06:53):
department, a lot of providersare not doing this.
You're not going to be able tohave that done.
And also you're increasing yourrisk for infections, things like
complications of the surgery,and you may even need to have
surgery again.
And so for a lot of folks whoare seeking this type of
surgery, and more so kind ofbudget shopping on your surgery,

(07:14):
we would highly recommendagainst this, and Dr.
Aisha White can speak a littlebit more, on this subject as
well.
So with that being said, I wantto introduce Dr.
Aisha White.
Again, she is a board certifiedplastic surgeon.
She is currently practicing inAustin, Texas and has extensive
training and experience inplastic surgery.

(07:36):
She's a fellow of the Americancolleges of surgeons and a
member of the American societyof plastic surgeons as well,
which are very prestigiousorganizations to be a part of.
So she knows the stuff she knowswhat she's talking about.
I wholeheartedly was veryexcited to do this interview
with her, not only to discusssome of the things that we
talked about in this case, someof the things that are part of.

(07:58):
The dangers and pitfalls thatsome folks fall into with
plastic surgery, but also likedher interpretation and her
approach to plastic surgery.
And this is a direct quote fromher website.
She says, I do not subscribe toa cookie cutter model of plastic
surgery.
For some plastic surgery isabout beauty.
For me, it's about strength.
When you're comfortable in yourown skin, you are empowered.

(08:20):
She also states, She stronglybelieves that beauty shouldn't
fit a mold and that there is notjust one standard of beauty.
with that being said, I want tointroduce my friend, Dr.
Aisha White.

(08:48):
So my name is Dr.
Ayesha White.
I'm a board certified plasticsurgeon practicing in Austin,
Texas.

Aisha (08:54):
Currently my practice is mostly cosmetic surgery, but in
the past I've donereconstructive and cosmetic
surgery.
My undergraduate degree is fromHoward University.
And then I went to medicalschool at Northwestern, have an
MBA from the Wharton School, andthen did both.
General surgery and plasticsurgery residencies at SUNY

(09:14):
downstate and the University ofIllinois at Chicago,
respectively.

Chris (09:18):
Yeah, so and you've had like we talked a little bit
before this but you know You'vehad the ability and the
privilege to kind of practice ina lot of different locations in
the United States including myhometown of Chicago Which I love
You were actually cross pathswith Dr.
Callie on the south side who wasmy first introduction into

(09:40):
Medicine in general to

Aisha (09:42):
wait.
Crazy thing.
I swear.
I didn't play in this funnything.
That picture in the background.
I'm like in my office area.
That's me and Dr.
Kelly Muthu scrubbed in a case.

Chris (09:50):
All the listeners to Dr.
Kelly is a plasticreconstructive surgeon on the
South side of Chicago.
He is like right off of, let'ssee, that would be Western and
95th.
I'm going to say, yeah, so butit has been practiced for him
for a number of years.
His partner, somebody he went toresidency with and fellowship
with Dr.
John Newkirk was my firstintroduction into medicine down

(10:12):
in South Carolina.
When I came back home fromundergrad, he said, Hey, you
should go see this guy.
Dr.
Kelly.
I haven't seen him since theseventies, but it would be great
for you to kind of, you know,continue over the summertime,
keep you out of trouble.
And so Dr.
Kelly is amazing.
As well as Gina, Nancy everybodyover there.

Aisha (10:29):
Yeah, no, they're incredible.
The whole team.

Chris (10:32):
Yeah, so one thing that we do is we usually will talk to
a lot of our guests about Theirjourney through medicine just
because everyone's journey is alittle bit different in terms of
what brought you To plasticsurgery what brought you to
whatever specialty, that you areJust so folks out there can kind
of get an idea anyone interestedin medicine, etc tell me about
your journey and what broughtyou to plastic and

(10:53):
reconstructive surgery

Aisha (10:54):
So, you know, actually, I tell this all the time, when I
started medical school, I wasinterested in doing OB, and it
was actually my first clinicalrotation in medical school.
I absolutely loved it for like aweek.
And I think, you know, whenyou're, when you're young, I
think you don't think about allof the many things you need to

(11:15):
consider in terms of picking acareer.
And so OB was amazing.
I mean, it was a great feel.
I mean, it's kind ofquintessentially medicine,
you're delivering babies,there's happy, healthy people.
But I found it really monotonousand I think it was the first
time I had ever consideredanything other than like, I like
this in terms of, you know,determining whether or not I

(11:35):
wanted to do this as a careerand it was really an eye opening
moment for me because I waslike, I can't, I can't do this
every day.
Like, I can't do the same thingevery day.
But what it did crystallize forme.
is that I did want to dosomething with my hands, so I
knew at that point it would haveto be a surgical specialty.
And because I thought I wasgoing to do OB and plan that as

(11:56):
the first rotation and reallydidn't care about anything else
afterwards the rotations that Ihad afterwards, it was like
psychiatry, pediatrics, it was awhile before I actually had
Surgical rotation and then whenI got into surgery, I loved
everything and initially didn'tlike, commit 100 percent to
plastic surgery, which is why Idid the general surgery
residency 1st, but knew that Isort of wanted that variety.

(12:19):
I think for me, that arc has,evolved in, in terms of like why
I love plastic surgery.
So I probably chose plasticsurgery because of the variety
and the specialty.
But I think why I love plasticsurgery is this ability that you
have to transform people's livesreally make people feel whole
again, confident.

(12:40):
And particularly, you know,Especially on the cosmetic side,
or even for me on thereconstructive side, I did a lot
of breast cancer reconstruction.
This ability to like empowerwomen, particularly empower them
around their bodies and alsosimultaneously sort of combat
some of these like societal likepressures and kind of, you know,

(13:01):
accepted norms of like bodystandards and sort of, you know,
doing my part to sort of kind ofbreak that down.

Chris (13:07):
And I'm glad that you brought that up because that's
something I want to tease outduring this interview.
We're going to talk a little bitabout kind of those beauty
standards and those culturalperceptions that people take
with them into going into, youknow, making any changes to
their bodies or trying toenhance their beauty, et cetera.
But we'll get into it.
But before we do for some folkswho may not know, could you
explain to us a little bit aboutthe differences between like

(13:29):
reconstructive surgery and thedifference between plastic
surgery that way?
Okay.
Folks who may not be in the knowget a little bit more
information about it.

Aisha (13:37):
Sure.
So, you know It's actually alittle bit of a trick question
Whether you realize that or notbecause sort of what makes
something a reconstructiveprocedure Versus a cosmetic
procedure is the indication notthe actual procedure.
So for example if someone had alumpectomy, which is a procedure
where, as you know, part of thebreast is removed, but now it

(13:58):
leaves them asymmetric and youwanted to fat graft that breast
or even put a small implant into make it symmetric to the
other breast.
The procedure is fat grafting orthe procedure is augmentation
with an implant, but in thatsituation, it's a reconstructive
procedure versus if someonecomes to see me and they're
like, you know, I don't like mybreasts.
I want them bigger, you know,then putting in an implant to

(14:20):
make them bigger or moresymmetric.
Or a fat grafting in that case,it's now a cosmetic procedure,
but, you know, many times theway I do the procedure may be
the same.
Sometimes, obviously, in thereconstructive cases, what
you're dealing with is a lotmore difficult, you know,
because you aren't necessarilydealing with a normal situation,

(14:41):
but in terms of, you know, theprocedures, they, they, they're
more or less the same.
And what's making 1reconstructive and the other 1
cosmetic is the indication.

Chris (14:50):
Got it.
Yeah.
And, and, and that's, I feellike, especially as I would say,
when we're coming up inmedicine, it was a lot more
popularized in terms of theexposure to plastic and
reconstructive surgery, right?
Like in the seventies, eighties,nineties, you know, it was kind
of underneath the surface, butcome to two thousands, you got,
you know, Dr.
90210, all these things.
And so folks, you know, kind ofhad that expectation of what

(15:11):
plastic surgery was and, youknow, had some ideas in their
minds about what they wanted topursue and things of that nature
more so than before.
Yeah.
So.
One of the things that, that wetalk about too is kind of the
specific challenges that folkshave in walking that road in
order to become a plasticsurgeon or in order to become a
surgeon of any ilk.
You know, I don't know a lot offolks understand kind of the

(15:33):
road that you have to go and howintensive that, that, that
surgical residency is, thisfellowship, et cetera, et
cetera.
Are there any specificchallenges that you face as, you
know a trainee as a a blackwoman in plastic surgery?
Because I know, you know, By thenumbers, it's not many of us
period in medicine, but Icouldn't even imagine what the
numbers are in plastic surgery.

Aisha (15:54):
Yeah.
The numbers are small.
I mean, they're really small.
You know, it's funny.
Like obviously I know a lot ofplastic surgeons and I know a
lot of black female plasticsurgeons because I'm a plastic
surgeon.
And I mean, a lot is relative.
But I think sometimes whenpeople meet me, you know, I am
probably the only black femaleplastic surgeon, maybe any given
one person may have met and in alot of cities.

(16:17):
you know, there might be one ifthere's one at all.
You know, yeah, I think it'schallenging.
I think we all know surgery ispredominantly male and it's
predominantly white men.
And so, you know, there's, youknow, fitting into that whole
culture.
Also surgical training foranybody.
Whether you're male or female,you know no matter what your

(16:38):
ethnicity is, it's, it's not akind of warm and fuzzy
environment.

Chris (16:45):
Not at all.

Aisha (16:46):
Which is why

Chris (16:47):
Dr.
Cal was such a breath of freshair, right?
Yeah, no, no, no, no, no, he's

Aisha (16:52):
an exception.
Yeah, doctor, you know what,like, you know, that's almost, I
mean, Having the opportunity tomeet him and work with him is
incredible.
But it also, there's a part ofme that's like, I hope people
who want to be plastic surgeonsdon't meet him at the beginning
of their journey, because Ithink you will get lulled into
this false sense of what, youknow, that experience will be

(17:13):
like, what the mentoring will belike.
I mean, he is, he's truly anextraordinary person and
extraordinary surgeon, but justsuch a kind man.
And that is, That is not thenorm.

Chris (17:25):
That's a bonus.
Yeah, that's a

Aisha (17:27):
major bonus.
That's a unicorn bonus.
But yeah, I mean, I think it'shard.
Like, I think in any field, it'salways a challenge when you
don't see people who look likeyou doing something.
And being able to have thatlevel of mentorship, I think I
definitely relied heavily on mypeers for a lot of support and

(17:48):
mentorship, you know, people whowere in the same year as me as
residency, or even maybe peoplewho were just like, you know, a
couple of years above or belowbecause, you know, Yeah, I, I
didn't have a lot of females or,you know, black males.
There was definitely, like,almost no black women.
Definitely not in plasticsurgery.

(18:09):
There were maybe a couple in mygeneral surgery training.

Chris (18:11):
And a lot of that too, we had on Dr.
Jane Morgan during our lastepisode, our first episode of
the season.
And she was kind of talkingabout her experience as an
African American femalecardiologist being the only one
in her hospital and how thatreally trickled down to her
position on faculty.

(18:32):
Things that she would be able tosay by having the seat at the
table, etc And also theirexperience in working with
patients as well How that howthat kind of colors that that
that interaction and how you canbe an advocate and in some cases
You know, she brought up a goodpoint to a fault Sometimes we
stay at you know as africanamerican providers stay in a bad
situation too long because it'slike I have to Like I have to be

(18:52):
that person.
Yeah

Aisha (18:54):
100

Chris (18:55):
Yeah, exactly.
How has your experience been,you know, especially in being
that advocate and working withpatients, African American
patients.
And how has your approach andkind of your experience kind of
coming up?
How does that affect yourpatient care?

Aisha (19:07):
Yeah, I mean, I think it, you know, it affects my patient
care in small ways and big ways.
I mean, I think it's like Youknow, very exciting for, you
know, women and women of colorto often have a doctor who who
looks like them treating them,who understands their needs.
I mean, on a very deep level interms of like how you approach

(19:30):
consultations and just yourinteractions with patients.
I mean, I think, you know, a lotof women in health care of all
ethnicities, Often feel unheardand dismissed.
And so I think, you know, thiswhole notion of like, I wasn't
heard.
They didn't listen to me.
You know, I spend a lot of timewith my patients in my practice,
listening to them, also tryingto figure out what they want.

(19:53):
And helping them achieve thething they want, if it's
possible, not pushing my ownpersonal aesthetic agenda, you
know, trying to, like, put mybiases aside, like, you know,
for example, like, I'm not a bigfan of big implants, but, you
know, all of my patients get theimplants.
You know that they want as longas it's something that's going
to be reasonable for theirbodies, you know But you know

(20:15):
again, I think that that cansometimes be different from what
you may get with anotherencounter I'll tell you others
also other little small thingslike, you know, when I I had a
facelift earlier this year Andat the end of the case when you
did a facelift, a lot of timesthere's blood and other things
in the hair and you want to washthe hair.
And I was doing this face as ablack woman and I remember

(20:36):
saying to her when I was in theprep era, I was like, Okay, I'm
going to rinse your hair but I'mnot going to wash your hair.
I was like, so I'm going to makesure I get the, the blood out of
your hair.
I was like, but when you gohome, you're going to want to
wash your hair because I'm notabout to like wash this woman's
hair.
with Hibiclens, and it's goingto strip her hair and dry her

(20:57):
hair in a way that it's notgoing to dry somebody else's
hair that has a differenttexture or isn't permed.
And so, you know, but again, youonly know what you know.
And so, you know, if you don'thave that perspective of what
it's like to like, you know,wash your hair with a bar soap
and know that that's just notgoing to work for your texture,

(21:18):
then you're not going to make adifferent choice for that
patient because you just don'tknow any better.

Chris (21:22):
You don't know you don't have that context.
Right.
And that's why it's so acrossthe board representation has
only been seen as a benefit,right?
As compared to, you know, somecommon perceptions from people,
especially as things get theclimate gets a little bit more
political as a good thing,right?
We want more representation.
We want more points of views atthe table.
Otherwise, we're going tocontinue to fall in the same

(21:43):
pitfalls.
But like you said, you havingthat context, right?
And having that lived experienceto say, okay, if I put myself in
my patient's shoes, these arethings that are going to affect
her down the road if I do this.
Right.
And like you said, if you don'thave that context, you're not
going to be in that position tomake that decision.
So one of the things that Iwanted to talk about here and

(22:04):
we, we kind of discussed this alittle bit.
Here in the state of Wisconsin,I would say myself, as well as a
couple other ER doctors haveseen a rash of patients who have
pursued elective surgery more soaesthetic surgeries, and they've
done that on a travel basis,right?
And so in Milwaukee here is moreword of mouth.
You see folks that are goingover, you know, they say that

(22:28):
they're going to Miami, butthey're really going to, you
know, Puerto Rico or wherever,um, in order to pursue these
plastic surgery procedures.
The problem that we run intothat we've seen recently, myself
personally, I've had three orfour young ladies, is that
there's complications of thesesurgeries, right?
And so, uh, infections can cropup and there's no real follow
up, um, uh, after that.

(22:49):
They're, they're literallytalking to the surgeon on, on,
on GroupMe, right?
And so, I, I, I wanted to, tokind of get your perspective.
I mean, of course, that isegregious and we know, we know
what your perspective would beon that.
But more so on, on this, this,this fad, I would say more so,
or, um, uh, the travel medicine,uh, uh, culture that's, that's
going on right now for theseprocedures.

Aisha (23:11):
Okay.
So, you know, for me, I have, Ihave several opinions about
that.

Chris (23:16):
Which I appreciate

Aisha (23:18):
so I mean, okay.
First, let, let's, let's back itup and, and start with like
finding a doctor.
Okay.
So I think that, um, a lot of,uh, patients, whether they're
having something like aninjectable done or surgery done.
Do not know the credentials ofthe person doing that.
And, you know, for those of uswho have gone to medical school,
gotten board certified by ourrespective boards, you know,

(23:41):
that is a marker of quality andsafety.
You know, and I think thatthat's often something that
patients don't understand.
Um, so first of all, I thinkit's really important for people
to know who they're seeing, youknow, and the training that that
person has.
Now, I will say in the aestheticsurgery world, it gets tricky on

(24:03):
multiple levels.
Number one, the terminology.
So most board certified plasticsurgeons who you encounter, even
someone like me who only doescosmetic surgery, we will not
refer to ourselves as cosmeticsurgeons, even if all we do is
cosmetic surgery.
That's actually Not a real term.
I mean, it's real in the termsof that it's English language.

Chris (24:26):
Right.

Aisha (24:26):
But it doesn't mean anything.
If someone like, and it's alwaysto me a red flag if someone
says, Oh, I went to so and soand their, their website says
they're a cosmetic surgeon,because that is not, um, you
know, a term that's regulated.
And so, I can't say that I'm ananesthesiologist or a
neurosurgeon.
That is false advertising.
That's representing myself assomething that I'm not.

(24:48):
But again, that cosmetic surgeryterm isn't something that's
regulated.
And so when you have somebodywho uses the term cosmetic
surgeon, they could be someonewho's taken a weekend course and
they could be Uh, not to pick onany specific specialist, it
could be a podiatrist or apediatrician or a psychiatrist,
you know, And I think most inmost states when you have a

(25:10):
medical license This is alsosomething that patients don't
understand and this is notillegal Most of the time, the
medical license will say, youknow, state of whatever,
physician and surgeon, even ifyou're not a surgeon.
And so when you want to do aprocedure, and you know, these
are the things that weunderstand, but patients
absolutely don't understand.
So if I wanted to do acraniotomy, a brain surgery, and

(25:34):
I went and scheduled this, putthis on the schedule at the
hospital, the OR would call meand say, Oh, Dr.
White, we're so, so sorry.
We don't have privileges for youfor craniotomies and
neurosurgery procedures.
And then they would say, Oh, youknow, did you, did you do a
neurosurgery fellowship thatwe're unaware of?
If you did, they sent us thatinformation and we will

(25:54):
credential you for that.
Um, now of course, then I can'tdo it.
So, but if I had my own surgerycenter that I owned.
I get to determine what I'mcredentialed for.
And if I wanted to do acraniotomy there, I could.
So now that it also gets intothe nuance of, um, does your
malpractice insurance companyknow that you're doing these

(26:14):
procedures?
They may say, no, absolutelynot.
We're not gonna, um, We're notgoing to cover you for that.
Or they may say, Oh, we'll coveryou for it.
If you claim you've taken somecourses, but we're going to
cover you at a higher rate thanwhat we would a neurosurgeon.
But, you know, in allsituations, it is not illegal
for me.
If I find a way to do thiscraniotomy, it's not illegal for

(26:35):
me to do it.
You know, other people,hospitals, you know, well
established surgery centers thataren't individually owned
insurance companies, they'retrying to do what they can to
protect patients and make surethat doctors aren't doing
procedures that they shouldn'tbe.
But, you know, again, if youhave your own facility, it's
sort of like the wild, wildwest.
And again, you are not breakingthe law.

(26:56):
And so I think, you know, a lotof these patients are choosing
people.
that, you know, don't haveappropriate training and
credentialing.
Also, I just want to say, youknow, um, that, you know, yes,
the standards in the U S aredifferent for how we train.
And I think, you know, in somecircumstances we are definitely

(27:17):
generally speaking bettertrained than in some other
countries, but that's notuniversally true.
You know, I mean, there are gooddoctors and bad doctors
everywhere.
And I think often when patientsare seeking doctors in other
countries.
They're not necessarily seekingthe best doctor in that country.
They're going there forfinancial reasons.
And so they are seeking outanother bargain basement surgeon

(27:41):
that's even cheaper than the U.
S.
bargain basement surgeon.
And like the old adage, you,you, you get what you pay for,
you know?
And, you know, I think that, youknow, but in this time you're
gambling with your life.
I think the other piece.
of this whole medical tourismthing other than picking a
doctor with the appropriatecredentials.
Let's say you saw the bestdoctor anywhere, in another

(28:04):
state, in the U.
S., you know, in anothercountry.
I think people have thisperception that surgery is a one
time thing.
Time invent, you know, it's anencounter.
I think they're like my surgeryday.
You know, I say to patients allthe time, like surgery is like
marriage.
And if I get some big red flags,um, ahead of surgery, I don't
want to operate on somebodybecause we are going to be
together for a while.

(28:25):
And the more complicated theprocedure, even if everything
goes perfectly, we are going tobe together for a while.
quite a while, you know, forsome of these bigger procedures,
at least a year, you know,because you have drains, there
can be little minorcomplications that aren't going
to have any big impact on yourultimate result.
But like you could get a littleredness of the skin, you could

(28:46):
have a little dog here, youcould have this, that and the
other.
And you're monitoring thosepatients through all the stages
of their recovery.
And if, you know, complicationsshould arise, you're addressing
those.
And so I think the expectationshould be when you decide to fly
out of town and have surgerythat number one you are going to
stay long enough for that sortof initial window of really

(29:11):
scary things that could happenbecause with any surgical
procedure, there are earlycomplications and late
complications.
The early complications areusually the scariest.
scary things that can be reallybad, like, you know, bleeding, a
very, very bad infection, youknow, a pulmonary embolism with
like, you know, shortness ofbreath, things, you know, early
complications can sometimes killyou.

(29:31):
Late complications tend to becosmetic things, rippling, a dog
ear, something that, you know,could be addressed almost at any
time.
So depending on the surgery, youknow, that window of being
observed for the early problems.
could be a week to severalweeks.
You know, again, a big mommymakeover.
If you still have drains inplace, you should still be very

(29:53):
near the person who operated onyou because it can be
challenging to find somebodyelse who's going to take care of
those complications when theydidn't do the original surgery.
And rightly so, because, youknow, they don't know what was
done.
They don't have all theinformation.
So I think, you know, when youdecide to fly away, you need to
stay Stay there for some periodof time, which also then at some

(30:14):
point will neutralize this costbenefit.
If you need to stay someplacefor a month and have a hotel
room or Airbnb or whatever, andthen you need to also still be
prepared to see someone forfollow up.
So like, again, for me, for abig surgery, someone might be
seeing me, you know, the dayafter surgery, then they're
seeing me weekly until theirdrains are out.
And then we start.

(30:35):
We start seeing one another onmonthly intervals, but like
those patients have severalvisits with me and always have
the ability to pop in Ifsomething is going on in between
scheduled visits

Chris (30:47):
And bravo, you know, those are all the things that
that we try to impress uponpatients And that's why i'm glad
that you're able to come on andtalk to us about this because I
think you hit a couple Keypoints in there.
So so first up This is a surgerySo a lot of people think, you
know, like you said, this is theone and done plastic surgery.
It's just something that we'redoing cosmetic.

(31:07):
This is a major surgery thatyou're, you're undergoing and
you have to treat it like youwould any other surgery.
If you had an appendectomy, youwould have a followup
appointment, right?
If even if you had your tonsilsremoved, you would have a
followup appointment.
Right.
And so, you know, to, to havethat in the back of your mind is
something that you want to makesure that you're planning for,
because it can cost you yourlife.

(31:27):
I've had several patients that Ihave had.
You know, to send to the ICU whohave had to have emergent,
emergent, uh, you know, uh,laparotomy is kind of opening up
the belly, et cetera, et cetera,because these pockets of
infection have been, you know,developing over time.
They didn't have their drainsremoved.
And that small short termcomplication becomes a long term
manifestation of sepsis, uh, orhaving, and then you're clinging

(31:49):
to life in those situations.
You know, a lot of patients are,are coming to the emergency
departments here in Milwaukee.
To have their drains removed, etcetera, et cetera.
And a lot of physicians arereluctant to do it.
And even the plastic surgeons intown, they're saying absolutely
not because for those reasons,like you said, that the way, you
know, I don't, I don't knowanything about the surgery.
I don't know like whatcomplications can ensue and what
was done in the OR.

(32:09):
So it's going to put yourself ina bad position, unfortunately.
Right.
Yeah.
So one of the things you said isthat you you do primarily
cosmetic surgery What what aresome of the you know types of
surgery some of the types ofprocedures that you do?
More so routinely and we willkind of tease out, you know
groups and demographics thatseek those procedures

Aisha (32:28):
Sure.
Um, you know, I do pretty muchprobably everything except for
rhinoplasty.
So I do facelifts, neck lifts,eyelid surgery all sorts of
breast surgery.
I definitely do a lot of breast.
I'd say breast is for sure morethan 50% of my practice, which
is probably true for most femaleplastic surgeons.
So breast reduction.
breast augmentation, breastlifts, breast augs with lifts,

(32:51):
fat grafting and thenliposuction, tummy tucks,
labiaplasty, thigh lifts,brachialplasty, like all those,
all those things.
I do think, you know, one of thecommon questions, and this is
probably what you're leading upto, you'll be like, what's the
most common thing you do?
You know, a lot of theprocedures vary by age and they
vary by gender.
So for example, in men Andyounger men, without a doubt,

(33:13):
the most common procedure I dois liposuction.
It's either liposuction of theabdomen or liposuction of the
chest or gynecomastia, which isextra tissue around the breast
in men.
But for older men, for sure,it's probably neck lift, face
lift, neck lift first withFacelift being a close second or
combination of both of them.
Same thing for women.
I do operate sometimes on veryyoung women, 16, 17, 18.

(33:36):
Those are almost always breastreductions in young women who
are either young athletes andthe size of their breasts
interferes with their ability toperform in sports, or they're
just young girls who have very,very disproportionately large
breasts.
And then, you know, you get intothe 20s, it's still probably a
lot of breast surgery, but thenit's a mixture of augmentations

(33:57):
and reductions.
So it really does vary by ageand gender what kind of the top
procedure is.

Chris (34:03):
Yeah.
And more so just to tease thatout, you know, it seems like as
you alluded to before, you don'tlike to do like the large breast
implants.
You don't, you, you like to keepthings within the purview of,
you know, realisticexpectations.
How do you ensure that yourpatients have those realistic
expectations about the outcometo their surgeries when they
come and see you?
And how important is thatinitial consultation again with

(34:25):
a board certified plasticsurgeon in that respect?

Aisha (34:28):
Yeah, I mean, it's crucial.
Like, you know, I tell patientsall the time, you know, I'm not
here to sell you on the surgery,you know, I don't have to.
I mean, that's why you came intothe office.
I try to spend time, you know,again, giving them a realistic
expectation of the surgery whatto expect and the potential
complications, not in a way.
That's going to scare them, butin a way that allows them to

(34:49):
make a truly informed decision.
I think there's certain thingsthat I hit on for certain
procedures that again, aren'tnecessarily a good or bad, but I
want you to understand, like, sofor example, for breast
augmentation, you know, there'snot a single patient who I put
implants in.
Who is under the misperceptionthat these are lifetime devices?
So if you're signing up forbreast augmentation surgery you

(35:11):
are signing up for a lifetime ofmaintenance and multiple
surgeries unless Until youdecide that you're going to have
them taken out.
But it's not like you're goingto have a pair of implants
Placed when you're 20 and that'sgonna be the implants that you
have until you're 100.
If it's a breast reduction wemight talk about the pros and
cons particularly in a youngwoman who has not Had a

(35:32):
pregnancy and has no ideawhether or not she wants to ever
be pregnant or whether she willever be able to be Pregnant, but
we will have the discussionabout the impact of breast
reduction on breastfeeding andalso the changes that In the
breast that could occur after apregnancy or any significant
weight gain, which again, in ayoung woman, the most likely

(35:54):
significant weight gain is apregnancy and how that possibly
sets you up for needingadditional breast surgery.
So I think it's important, youknow.
Again, very rarely does someonehear all of this and say, no,
I'm not going to have surgery,particularly when I'm 20.
But every now and then someone'slike, wow, I didn't know that.
And I don't think this is theright surgery for me, or I don't

(36:17):
think I want to do that.
And I think that that's betterfor us to figure that out early
than for you to figure it outafterwards.

Chris (36:24):
Yeah.
And a lot of that kind of comesfrom our popular culture in our
society.
Right.
So there, there, there arebeauty standards in every
population and their perceptionsof culture that it changes from
each generation on it,particularly kind of the beauty
standards within AfricanAmerican community.
You know, how do thoseperceptions and how do those

(36:45):
cultural, you know, standards ofbeauty, how do those play into
the decision to pursue plasticsurgery or not in your, in your
experience?

Aisha (36:53):
Oh, 100 percent it does.
But I mean, you know, again, itdoes for every culture.
I think it does for women ingeneral.
I think, you know, sadly, womenhave much higher rates of body
dissatisfaction than men.
And those often start in thepreteen, you know, puberty
years.
And so I think that, you know,there's a, even if someone's not

(37:15):
thinking about surgery, peopleare definitely women in
particular.
often hyper focused on theirbodies and in particular what
they don't like.
I do think that there arecultural differences.
There are generationaldifferences in terms of what
people want.
There are also regionaldifferences.
I mean, plastic surgery looks acertain way in California in LA

(37:36):
and Miami, and it doesn't lookthe same way in New York and
Chicago.
You know so I think all of thosethings sort of play a role.
And, and like you alsomentioned, times change, you
know, it's like, you know, wideleg jeans are in now and skinny
jeans are out, you know, it'slike, you know, big breasts used
to be in and now sort of lookingmore natural is getting popular

(37:56):
again.
And then the pendulum will swingagain.
You know, I, I'm fine withpeople doing whatever, as long
as it's safe, you know, Again,it doesn't have to all be to my
aesthetic.
I'm not here to create a factoryof Barbie dolls that fit my
personal aesthetic.
You know, I'm here to let peopleknow, sort of, you know, the
pros and cons of the choicesthat they want to make.
And I'm willing to do whateverthey want as long as it's safe

(38:19):
and reasonable.
You know, and again, there are,there are trade offs to the
different choices that peoplemake.
I just want to make sure thatthey understand that.

Chris (38:26):
Yeah, and that's a tough job because I mean, a lot of
times too, you're not onlynavigating kind of that, that,
that perception of physicalbeauty, but also that, you know,
so that psychology that goesbehind that too, and navigating
how a person feels aboutthemselves, if this person is in
the right mindset to make thesedecisions about, you know, a
drastic change to themselves.

(38:47):
That must be a tough thing tonavigate as a surgeon and as a
doctor, you know, how do younavigate those, those
considerations when a patient'sdesired procedure may not be in
their best interest from whatyou know as a surgeon?

Aisha (38:58):
No, I'm so glad you asked me this question because you
know, it's, it's funny.
I gave a grand rounds about ayear and a half ago in a child
psychiatry department on theimpact of social media.
On body image in adolescence andtheir desire to pursue plastic
surgery and the summer actuallypublished a pop sugar article on

(39:19):
like how mom should talk totheir, you know, young adult
daughters about about plasticsurgery and the article wasn't
to encourage plastic surgery,but, you know, how to think
about this.
I mean, it's natural that peopleare going to want to make
changes In their body, you know,and sometimes, you know, again,
plastic surgery is so nuanced,Chris, like I'm not trying to

(39:39):
say by any means that, you know,everybody should have plastic
surgery.
I'm not trying to encourageeverybody at plastic surgery,
but in that same way, you know,I think.
Plastic surgery can be highlypoliticized and I think people
have very strong opinions aboutit.
I mean, there are the people whoare like, You should be so
grateful with what God gave you.
You shouldn't change anything.
There are people who have bodydysmorphia and are doing way too

(40:03):
much.
And you're right, like on adaily basis.
I need to try to figure out likewho's in front of me and what am
I dealing with?
And I think that's why, youknow, you want to take the time
with consultations.
You're seeing patients not onlyin consultation, but again at
pre op visits.
And the more you talk to them,the more you're able to sort of
tease some of those things out.
And if I do feel like there'ssome red flags, particularly

(40:23):
like some, you know, mentalhealth red flags, you know, you
know, I will suggest that maybethat patient be.
You know referred to apsychiatrist and that could be
for a variety of things bodydysmorphia It could be maybe
somebody with a history ofeating disorders, which again
isn't a contraindication tohaving plastic surgery But if it
seems like that eating disorderisn't controlled then this isn't

(40:44):
going to be the right time Tohave surgery or if you are
seeking plastic surgery becauseyou think it's gonna I don't
know save your relationship oryou know Things like that like,
you know again for the wrong

Chris (40:57):
reasons.
Yeah for the wrong reasonsReally

Aisha (41:00):
clear or, or, you know, or even unrealistic expectations
when people like, am I going tolook 20 again?
It's like, you will not, youknow, if you are 80, but we can
have you look better.
So I think, you know, yeah, Ithink I spend a lot of time
trying to, you know, setrealistic expectations for
people and look out for redflags because as, you know,

(41:22):
people who.
have other issues that need tobe dealt with, you know, they're
not served by having thoseprocedures.
And as an aside, I mean, it'snot completely connected to the
question you asked, but that'salso true for like health
things, not just, you know, likephysical health things, not
mental health.
So, you know, if we have, wehave BMI restrictions, you know,

(41:43):
obviously if people haveunderlying medical conditions
that aren't well controlled, I'mnot going to operate on them,
you know, because again, I careabout your safety and your
overall health.
Okay.
You know, more than getting yourmoney.
But again, that's notnecessarily the case for all
providers.

Chris (42:00):
And that's a good question too, because a lot of
times we see folks who arecoming to the hospital to get,
you know, their screening testsfor whatever surgical procedure,
you know, gallbladder removed,they're getting a cardiac stress
test for whatever procedure ingeneral.
In your practice and, and inyour opinion, you know, has

(42:20):
there been a large number ofpatients that you've turned away
if they don't have kind of thatprimary care doctor, if their
vital signs look to be abnormal,if they have any uncontrolled
medical conditions, how do youapproach that in your practice?

Aisha (42:30):
Yeah, no, I mean, if let's say if somebody doesn't
have a primary care physician,you know, there are, as you
know, as a physician, people whothink they have no medical
problems, it's just thosemedical problems haven't been
diagnosed.
So, you know, for sure peopleget sent to the doctor for
medical clearance every now andthen you have people who push
back.
Like I don't often get a lot ofpushback on the medical

(42:50):
clearance, but sometimes I'llget pushed back, for example, on
the mammograms, you know,because there are women who
don't believe in mammograms who.
want thermography and thingslike that, then I'm like, no,
the standard for diagnosing abreast cancer is still a
mammogram.
And that is something thatshould start at age 40, unless
you have a family history ofpeople having breast cancers

(43:10):
much earlier, then therecommendation may be 10 years
prior to that age of diagnosis.
I will not operate on breast ofwomen over 40 without a
mammogram and it is nonnegotiable for me.
And I do a lot of breast surgeryand, you know, I'm, I do a
really good job at a lot ofbreast surgery and there have
been patients who've sought meout and they'll say, Oh, well, I

(43:32):
really want to have surgery, butI don't feel comfortable with
that.
And like, will you just take anultrasound?
And I'm like, no, I won't takean ultrasound.
And let me explain to you why,you know, like an ultrasound
diagnosis, different things thana mammogram, which also
diagnoses different things thanan MRI.
Again, the gold standard for,you know, diagnosing, diagnosing
breast cancers and screening isa mammogram and if, and I, and

(43:55):
I'll say to patients, I'll say,you know, by all means, I
support your, you know, yourright to choose what you want
for your body, but I'm not goingto then be able to do your
surgery.
So if you're not comfortablehaving a mammogram, you don't
have to have that mammogram, butI can't be the plastic surgeon
for you.

Chris (44:14):
And that kind of harkens back to Dr.
Weiss point of the, this is asurgery, right?
And there are consequencesrelated to this.
If you go into the surgery, ifyou're doing a surgical
procedure and you don't knowwhat the risk associated with
it.
And so by operating on someonewith a potential breast cancer,
you have, you, you increase therisk that that can metastasize.
You can go into a lymphaticsystem, et cetera, et cetera.

(44:37):
And that can end very quickly.
Poorly for the patient and, andhaving a surgeon do that due
diligence is actually what youwant, you know, in, in the
moment, if you really want thatprocedure, it feels terrible
enough, but that, that issomething that could be
potentially life saving for you.
And that may not be something ifyou're, if you're going to like,
like Dr.
White was talking speaking tosome of these institutions
overseas or wherever that youmay not have that board

(44:59):
certified plastic surgeon ableto do that procedure for you.
You may be putting yourself atthat unwanted risk.

Aisha (45:06):
No, absolutely.
Absolutely.
You know, and I, I mean, I loveplastic surgery and I love what
I do.
And like I said, even, I thinkpeople think, Oh, this is so
superficial, but you know, theimpact on people's lives can be
really great.
Like Chris, I will say to, topeople who are, you know, just,
completely anti plastic surgeryand not just anti for them
because I'm fine if you're antiplastic surgery for yourself,

(45:28):
but people who have this sort ofsweeping generalization of what
they think it is.
And, you know, I'll say, youknow, look, it's like people who
have dental work, like imagineif you had like, you know,
really not great teeth and theywere crooked or you were missing
some, and then like you werereally self conscious about
smiling.
And so it impacted how much.
You talk to people or you alwayscovering your mouth and then all

(45:49):
of a sudden you have dental workdone and like you smile all the
time and how you engage withpeople is different like that
can be the impact of peopleaddressing something that's
always bothered them, alwaysmade them feel self conscious
and you know, people go out intothe world more confidently.
They have more.
Confident and intimateinteractions with their partners
because they feel better aboutthemselves and their bodies.

(46:12):
I mean, it can be good.
But again, I'm not naive.
It can also be bad.
But you know, again, you want tomake sure that like, if like for
me, you know, if I'm doing this,because these procedures that
I'm doing now, are notprocedures that people need.
They're, they're not things thatare going to save your life.
They are not only elective,meaning they don't have to be

(46:33):
done emergently, but they arecosmetic, meaning they don't
need to be done at all, youknow?
And so I, for me, the safety baris even higher, you know, if it
could be than when I was doing,you know, reconstructive or
general surgery procedures.
I mean, again, I've always caredabout safety, but, you know,
sometimes you're like, okay.

(46:53):
You know, if someone comes intothe ER, for example, with, you
know they're super sick andtheir appendix needs to come
out, but their blood glucoselevels aren't well controlled.
Well, you don't have time towait for the glucose to be
controlled.
We gotta go.
You have to go.
But like, I'm not taking you foran elective procedure unless
you're as perfect as you couldpossibly be.

(47:15):
Because, you know, the otheroption is just to not have the
procedure.

Chris (47:20):
And we've seen, unfortunately, again, in popular
culture, some folks thatunfortunately have had adverse
outcomes and have passed, youknow, down to West was like kind
of the biggest one in popculture that we saw as well.
And so it really harkens to thefact that you, you have to do
your due diligence and you haveto make sure that you're in the
safest environment, puttingyourself in the safest situation
as possible.
Yeah.

(47:40):
In plastic surgery, there's aton of misconceptions, right?
That social media is rampant,you know we, we, we get reality
television, we get all thesethings, fillers, et cetera, et
cetera.
People are having these Botoxparties, you know, wrestling,
all these things, right?
What are some of the biggestmisconceptions about plastic
surgery that you see in yourpractice and how can we help
address them?

Aisha (48:02):
This is, I think this is the biggest kind of general one.
Like if I had to put like anumbrella over everything, I
think people judge plasticsurgery by what they see and
know.
And again, Chris, this is not acommercial for people at plastic
surgery, but I think you'llappreciate this analogy that I
use for people.
Like I've lived in New York andI've lived in Chicago.

(48:23):
Both places have amazing pizza.
I like them both depending onwhat I'm in the mood for.
And I will say to people, like,imagine if you've never had
pizza, but the only pizza you'vehad was like some grocery store
frozen pizza, and then youdecide, Oh, I don't like pizza.
And I'm like,

Chris (48:40):
what?

Aisha (48:41):
It's like, dude, you don't know.

Chris (48:44):
Tombstone ain't Geno's East, man.
Tombstone ain't Luminosa.
Oh

Aisha (48:47):
my God.
Oh my God.
Like the cornmeal crust.
I mean, shout out to Geno's Eastin the South.
Spinach, the spinach for me, butyeah, like seriously.
And so I think, you know, youlook at like, I'm sure this
question is coming.
So I'm going to just put it outthere.
Like, like the BBLs.
Okay.
I think that's the big thingnow.
I think you know, people, sothere are people with BBLs.

(49:11):
Like BBLs and lip filler, Ithink are the two biggest things
where people like, Oh, likethere's some people who are
like, I kind of want that, or Ican do that, but I've seen that.
And I'm like, well, yeah, youknow, you only notice bad
plastic surgery.
The good plastic surgery, youdon't notice because you think
it's somebody who's good genes,you know?
And not.
every BBL is exaggerated.

(49:32):
Not every lip filler looks likeduck lips, but those are the
ones that, you know, youruntrained eye, you know,
notices.
But for every single procedure,whether it's a facelift, a
breast augmentation, there's anatural version and there's an
over exaggerated extremeversion.
And so, you know, I'm, again,not trying to convince people

(49:52):
about plastic surgery, but I dowant you to make good decisions
and informed decisions.
And if you are making yourdecisions about plastic surgery
based only on bad plasticsurgery results, then that's
unfortunate, you know, becausethat's not truly making an
informed decision.
I, I, I think one of the otherthings that's a big problem is

(50:15):
like, you know, especially withthe celebrities, they have
things done and with big things,you know, they have something
done and they go away and thenyou see them once they're like
fully recovered and healedbecause you didn't know they had
something done.
Or even when you're looking onour websites or social media,
we're posting results oncepeople have fully healed.
So there are three months, sixmonths, a year down the line,

(50:36):
depending on what the procedureis.
And I think patients think thatthey're going to have something
in.
The next day, it's going to looklike this.
There's not going to be anydowntime that there aren't any
Potential complications.
I think Yeah, and I think thelast thing I'll say about
misperceptions is which sort ofties into this like people not

(50:56):
understanding the process IThink that for a lot of plastic
surgery people's perceptions isit's gonna it's almost like
Going to the mall and gettingyour makeup done and then you
come out and now your makeup isdone or going to the hairdresser
and having your hair done.
Like, no, no, no, it is not thatimmediate and there's a process
and also it is a serious medicalprocedure.

(51:21):
Even if we're talking aboutsomething like lip filler, you
know, you can occlude a vesseland someone could necrosis.
off part of their lip.
You know, this is not like goingto have your makeup done.
And you know, it's why, youknow, I emphasize, it's really
important to know thecredentials of the person who's
treating you.

Chris (51:38):
Yeah.
And that's a good point too,especially, you know, the, the
private equity, you know,situations are cropping up
everywhere.
You go to a Medi spa and theyget all these things that are
available for you and not toknock them because you know,
some of those places do havemedical directors and they are
certified and they do, you know,rigorous training, et cetera, et
cetera.
But I, as Dr.

(51:59):
White said, I would always be abit apprehensive to, if you
don't have that available to,you know, at your fingertips in
terms of how that person iscredentialed, how they're
certified, what hours oftraining they had, et cetera, et
cetera, et cetera, because theseare major procedures, even if
you're doing injectables, as Dr.
White said, you know, some ofthese areas that you're
injecting it, are not very, youknow well perfused areas.

(52:21):
So you can get that necrosis,you can get, you know, some,
some ill effects that'll bedevastating.
And then you may down the linehave to do more invasive
procedures in order to kind ofcorrect those things.

Aisha (52:31):
Yeah.
And you know, and I mean, Chris,the reconstructive techniques
have definitely advanced and Ithink we can do some really
amazing things withreconstructive surgery.
But, you know, when you're doingreconstruction, It is not like
doing an aesthetic procedure andthere are results that we're
proud of.
And we're like, these resultsare great.

(52:53):
But, you know, reconstructingsomebody's lip is no matter how
good it looks, it's not going tolook like you were born with,
you know, and, you know, I'veseen this, like, you know, I, I
remember when I first moved toTexas, I saw a young woman who
had had something probably likenon medical grade silicone.

(53:14):
injected in her buttocks.
And when I saw, when I saw her,this was probably a year or two
after that encounter.
So she had been treated at atrauma hospital in Houston,
where they had, where I guessshe ended up having like
infections, pockets of thatsilicone and tissue loss.
And so they debrided it and theyessentially removed Probably all

(53:39):
the buttocks that she had andthen the muscle, the gluteus
maximus muscles were skingrafted because they were
exposed.
And, you know, she was coming tome to see like what could be
done.
And I mean, unfortunately Ididn't have anything that I
could offer her.
I mean, you know, she hadalready been reconstructed to
manage the wounds.

(53:59):
So, you know, from a medicalstandpoint, she's stable, but
from a cosmetic standpoint,she'll never be able to have
something.
That looks normal, you know, ifyou put a butt implant in under
that muscle You still have theskin graft on top of the muscle.
There's not enough tissue thereto fat graft and you know It's

(54:19):
so unfortunate because i'm sureno matter how much she didn't
like her buttocks before sheprobably would give anything to
have those original buttocksback instead of what she has now
because what she has now looksquite, you know, abnormal and
deformed because it isessentially a reconstruction
after a traumatic thing.

(54:40):
You know, it is not like havingyou know, a fat, fat grafting
BBL or, you know, a buttimplant.
Like it is not, It's not thesame procedure.
It's not

Chris (54:50):
the same.
And that kind of talks about, itmorphs into our next question
too, you know, obviously there,especially with the aesthetic
procedures with the electiveprocedures, there is a price tag
that is associated with it.
And a lot of folks, you know,kind of.
Grapple with that and that is alook the allure of some case in
some cases to do this travelmedicine to do You know kind of

(55:12):
the spa medicine, etc, etc Butas you spoke to that the way,
you know, if you are are cuttingcorners in that respect You may
pay for it down the lineAbsolutely.
So, you know, what, what, whathas been, you know, what is your
advice to folks who say that,you know, maybe I won't be able
to afford this now, is it forsomeone who should wait or
maybe, maybe find other ways tofinance that versus kind of

(55:35):
undergoing a drastic travel oryou know, a questionable
procedure.

Aisha (55:40):
Right.
I mean, most practices, mypractice does most practices
offer financing.
So that's always an option.
But yeah, if you really can'tafford it, you should wait.

Chris (55:48):
You should wait,

Aisha (55:49):
you know, because, you know, you don't want to risk
your life, you know, forsomething that's super cheap,
you know, you it's just, it'sjust not worth it.
Chris,

Chris (56:00):
you know, that that's, that's one of the biggest
reasons why I wanted to do thisepisode too, because I see
predominantly, especially in ourMilwaukee population.
I see over and over again theseadverse outcomes and you know
These are cases that they almostseem predatory in some in some
respects, right?
And I misspoke before I saidpuerto rico is actually the
surgeon the quote unquotesurgeon has a license based out

(56:22):
of florida, but actuallypractices in the dominican
republic So for anyone out therethat's listening, you know Just
just know that you're you may beputting yourself in a bad
situation And it's a situationthat as you said before there
there there is that riskassociated with it You may end
up in a reconstructive situationwhere now you're dealing with
something that you're dealingwith less to kind of do the
repairs or you may also loseyour life too.

(56:43):
So we want to make sure that weget that message out there.

Aisha (56:46):
Absolutely.

Chris (56:47):
Yeah.
You know, what, what advicewould you give anyone who is
considering plastic surgery atthis time?
And, and, you know, what are,what are some of the stories
that you may have for folksthat, you know, some of the, the
memorable experiences, some ofthe positives that you can see
to highlight the importance ofplastic surgery.

Aisha (57:05):
Yeah, I think, you know, again, if you, if you're
considering plastic surgery, Iwould say, you know, first do
your research.
I mean, I feel like Dr.
Google is, you know, I have alovely relationship with Dr.
Google, but I mean, I thinkthere is some good information
out there.
That's at least a place tostart.
And you could gather informationabout the procedure.
You could gather informationabout costs.

(57:27):
There are again a lot of groupson social media, Facebook and
other places where you caninteract with other people
who've had procedures.
I also think that like whileyou're doing that whole process
of discovery on the procedures,I think it's It's also a good
time to be doing some selfreflection and figuring out what

(57:48):
you want, what your goals are.
Because I think ultimately onlyyou will be able to answer those
questions, you know, and I thinkyou, if you're prepared with
that, you're less likely to bebullied by a provider who's
maybe pushing his or her ownagenda in terms of, you know,
aesthetic things like, like I'llgive you an example that happens
all the time.

(58:09):
Like, I had a a woman who saw mehere.
Probably about six months ago,and she was coming to see me for
a breast lift, and when someonecomes in and tells me, like,
whenever someone comes in andasks about a procedure, which is
normal for patients to do this,they're like, I want this
procedure.
I always like to back it up andsay, okay, well, Tell me what's

(58:31):
bothering you because sometimesthe procedure that you're coming
in and asking for isn't actuallythe thing that will get you what
you want or what you need.
And so this particular womansaid she wanted a breast lift.
And so I'll always say, okay,just so that we're on the same
page.
You're happy with the size ofyour breasts.
You just want them lifted to amore youthful position.
She said, yes.

(58:51):
So we go through the wholeconsultation and.
Talked about everything and atthe end, I'm like, Oh, so you
have any other questions for me?
And she says you didn't youdidn't talk to me about an
implant and I said well Youdidn't say you wanted your
breast.
Remember in the beginning Wewent through this and you said
you just wanted a lift and Shewas like, well, I saw another

(59:13):
plastic surgeon and he said thatit's not possible to do a lift
without an implant.
I was like, well, it's possibleto do a lift without an implant.
I was like, if you don't want tobe bigger, then you don't need
the implant.
I was like, but if you do wantto be bigger, then by all means,
we can talk about the implant.
And then she goes, well, Youknow, that makes sense because
when I saw him and when I openedup my robe for him to examine me

(59:35):
after examining my breasts, helike took my belly like this and
jiggled it from side to side andsaid, we can fix that too.
And,

Chris (59:42):
you

Aisha (59:42):
know, again, I think it, you know, again, depending on
the providers who you'reinteracting with, people are
trying to upsell people, people,you know, like I'm not, you
know, you talked about.
Earlier, we talked a little bitabout like, you know, cultural
body standards.
Like I'm not here to body shamesomebody, you know, like, and
again, I want to give you whatyou want.
There's some women who will cometo see me for liposuction and in

(01:00:04):
my head, I'm thinking, Oh myGod, they have the cutest little
curvy shape.
And they're like, I want thesehips liposuctioned.
I want to have like an athletickind of like straight shape.
Other people will come in andsay, Oh, I want some liposuction
to my abdomen.
But don't touch my hips.
Don't touch my butt.
I like that.
Or I want my thighs thick.
You know, again, you should beable to have whatever you want
with your body.
And so I think if you know whatyou want for yourself, you're

(01:00:28):
able to better articulate thatto the person who's going to
provide you care, but you'realso in a better position to
avoid the person who's pushingtheir own agenda.
Because then when they're like,Oh, well, you need an implant,
you know, then you can be like,well, and I don't want to be
bigger.
And also I've done some researchand it seems like it is.
actually possible to get a liftand not have an implant placed,

(01:00:50):
you know?
So I also think that, I mean,you know, nothing is about
choosing one or the other, butlike, I care most about
credentials and safety, but avery, very close second is also
personality fit,

Chris (01:01:02):
you know?

Aisha (01:01:02):
I mean, so there are, you know, I'm not going to be the
right doctor for everybody.
And again, my feelings aren'thurt by that.
And it's not a bad thing.
I mean, I think.
Certain people want certainthings, and so I think that, you
know, finding somebody who iswell trained, who listens to
you, and then, you know, again,sometimes there's just those,

(01:01:22):
you know, little things that youjust kind of know, like, I feel
comfortable with this person, Ithink this is the right person
for me.
I also strongly encourage peopleto, To get second opinions.
Like when somebody sees me, ifthey feel like they're not
getting the answer they want, oreven if they do feel like
they're getting the answer theywant, but they're a little
shocked.
I'm like, shop around, go meetsome other people.
You know, like, becausesometimes you don't know, you

(01:01:43):
know, until you see someone elseand you're like, Oh my God, you
know, like this is a completelydifferent experience.
This is a completely differentconsultation.
I didn't know it could be likethis.
The other ones weren't likethat.
So yeah, I think there's nothingwrong with that.
Yeah.

Chris (01:01:57):
Yeah.
Like you said, you know, the,the, the, it's like a marriage.
Right?
Like you're going to be involvedwith this person for more than a
one shot.
So it's better to.
Have that rapport with them andalso to be your own advocate.
That seems to be kind of therecurrent theme in a lot of
these specials and a lot ofthese episodes that we're doing,
you know, you have to be yourown advocate, you have to have
in the back of your mind, whatyou want and stick to your guns

(01:02:19):
and make sure that you do thatresearch and make sure that
you're trying to get the outcomethat you're trying to achieve
there.
Yeah, no, absolutely.
So dr.
White, you know, we're going toclose out here I know a lot of
our listeners are going to wantto Reach out to you.
Maybe look at look up more ofyour information.
Maybe even come down to texasand see you how do they get a

Aisha (01:02:42):
Don't come from Milwaukee for a day.
Don't

Chris (01:02:45):
come to me if you're looking for your stitches to be
taken out.
Am I going to tell you?

Aisha (01:02:47):
Yeah, yeah, yeah, no, exactly, exactly.
Come for a while if you'revisiting Texas.

Chris (01:02:53):
Exactly.
So, how can they get a hold ofyou and, and, and, and what
information would you give them?

Aisha (01:02:58):
Yeah, so my practice, I'm practicing at Synergy Plastic
Surgery in Austin.
We have multiple locations and Isee patients at several of those
offices.
Also you can find me on socialmedia on Instagram, I'm at DrDR.
AishaWhite, so my full name.
So yeah, and you know, feel freeto DM me, reach out there too

(01:03:18):
and I can answer questions orconnect you with the office
staff as needed.

Chris (01:03:23):
Awesome.
Bye.
So thank you so much.
I appreciate it and lookingforward to speaking more in the
future and yeah, I hope you'restaying warm down there and
we'll be good.

Aisha (01:03:34):
We're staying warm here.
We'll be staying warm all year.
Like, you know, I'll, I'll callyou and check on you and see if
you're staying warm in likeFebruary.

Chris (01:03:42):
You know, I went to undergrad South Carolina, all my
friends tell me like, boy,Chris, you know, you don't have
to live like that.
Like, I know, I know.
I just love it.
I love it up here.
I love

Aisha (01:03:49):
it.
I love it.
I love it.

Chris (01:03:51):
It's a deep love, right?
It's a marriage to Wisconsin.
No, it

Aisha (01:03:54):
has to be a deep love.
Because let me tell yousomething.
I have a deep, deep love forChicago.
I mean, for the longest, I'mfrom New Orleans originally, but
for the longest, like, Chicagohad been the place that I'd
spent the most time outside ofNew Orleans.
And, I mean, Chicago is, Magicalin the summer.
I mean, there's a reason why wesay summertime shy.

(01:04:14):
And it's just, I mean,everyone's like outside riding
bikes and they're on the lakeand it's so beautiful.
But those winters will breakyou.
They will break you.

Chris (01:04:24):
It changes things.
Yeah, absolutely.
Well, thank you again, Dr.
White.
I'll see you.

Aisha (01:04:29):
Yeah.
Thanks again.
I want to thank everyone forlistening today.
I want to thank Dr.
Aisha White for taking the timeand meeting with us in order to
share some of the salient advicethat she did, not only on
plastic surgery, but on ourconcept of beauty standards in
general.

(01:04:49):
I want to thank you all forlistening and I want to extend
to you the invitation to look onDr.
White's website.
She has a lot of goodinformation on there.
If you yourself are consideringplastic surgery and things to
look out for when you are and ifyou are considering plastic
surgery.

(01:05:10):
Now, with that being said,everyone's own standard of
beauty is their own.
And the point of Dr.
White's mission statement isthat she wants everyone to feel
comfortable in their own skinand feel beautiful in their own
skin as well.
So either if that is going theroute of plastic surgery or even

(01:05:33):
wellness in general, eatingbetter, doing all of the things
to take care of oneself, bothmentally and physically.
And even if that doesn't includesurgery, that is the goal.
Looking forward to seeing youguys next time.
We will be covering the subjectof wellness in our next episode.
So very excited to roll that oneout soon.

(01:05:55):
And with that being said, asalways take care of yourselves,
take care of each other.
And if you need me.
Come and see me.