January 2, 2024 • 36 mins
Thinking of enhancing your body this new year? Join us as we dive into the world of plastic surgery with NYC's sought-after surgeon, Dr. Ryan Neinstein. In this episode, we explore:
- Liposuction vs. Tummy Tuck: Unpacking the differences and identifying the ideal candidate for each procedure.
- Surgical Journey: A comprehensive walkthrough from pre-op preparations to post-op realities—what to expect every step of the way.
- Scars Unveiled: Understanding the various types of scars post-surgery and the honest truth about their appearance.
- Reverse Tummy Tuck: Debunking myths and uncovering whether this procedure delivers desired outcomes.
- Finding Your Surgeon: Expert tips on how to identify the perfect surgeon tailored to your needs and aspirations.
Get ready to discover the ins and outs of body transformations as Dr. Neinstein shares invaluable insights and guidance on achieving the body you desire.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
This is the Art Beauty podcast where weare always reaching for truth in beauty.
Remember, the people and the brands onthe show are not paying to be here,
so we get to ask themthose tough questions
you want answeredbecause you deserve to be informed
so you can make the best choicesfor yourself.
With that said, I'm Amber, and todaymy fabulous co-host is Dr.
Ryan Neinstein.
He is a board certified plastic surgeonhere in New York City.
(00:25):
All he does is bodies.
And all I do is juggle his Instagrambecause it is insane.
Before we get into all things today,we're going to be talking a little bit
about tummy tucks,the mommy makeover, reverse tummy talks.
But before we get into that.
Welcome to the show, Doctor Neinstein.Thanks for being here.
Amber Thank you so much for having me.
(00:46):
I'm so excited to be here and I can'twait to jump right into it. Yes.
And you know what? Got to keep this up.
Happy New Year, everybody. Right.
I mean, here we are, 2024.
Whoever thought we would make it.
(sigh) Do you have any resolutionsfor the New Year, Doctor Neinstein?
No, I don't make New Year's resolutionsbecause,
you know, always advancing,always growing, always learning.
(01:08):
You know, I don't have to,you know, set the clock at a certain date.
It's just a thing I do each and every day.
I love that.
I feel like it's somethingI clock at my birthday.
So not necessarily like New Year's.
But here's a crazy thing.
My husband's birthday is New Year's Eve,so for him,
it's like it's kind of a no brainer. But.
But I don't change my goals.
But yeah, usually.
But I do kind of a personal evaluationyearly
(01:31):
and then a personal evaluationdecade wise, because most people
you know, I think it was Bill Gateswho said most people overestimate you
overestimate what they can do in a year,but they underestimate
what they can do in a decade.
So you need to have a different lensby which you evaluate yourself yearly.
You're probably going to feel let down
(01:52):
because you couldn't in a yeardo as much as you could say over a decade.
So I like to look at things in the shortand a long to give a better perspective.
But the move forward goals, initiatives,imperatives stay the same day in day up.
Well, I have to say,I've been following your career,
not quite for a decade,but for many, many years.
And I have to sayI feel like of all of the body plastic
(02:16):
surgery before and afters, I think I'mthe most blown away by yours, you know.
So so we have I want to talk todaykind of on the tummy tuck.
I feel like there'sso many different names for that.
Some of it is the mommy makeover,which I know is more than a tummy tuck.
You know,people think of plastic liposuction.
You know, I'd like you to kind ofgo through what this is.
(02:39):
And let's just start with this.
How what is a tummy tuck?
Well, I'm definitely to get into that.
But what I want to specifically talkabout what you said before,
about how you thinkin your watching over the years
something has gotten so good, outstanding.
You know, quite an outlier.
You know, the ocean between good and greatis vast, and that's all in the details.
(03:02):
So if you pick one
operation or few whatever you in life,
you pick a few things to focus on,but then you really focus on it.
And I'm talkinglike all in 24 seven or a decade.
So for me,you know, tummy tucks and then, you know,
the accouterments,the mommy makeover to go with it has been,
(03:26):
you know, at the center of my essentiallypersonal and professional life.
And like all compound interest,
you know, if we think about basicinvesting philosophy, it's small.
Like big things happen and small changeslike it's it's small.
So like every literally every month we are
(03:49):
making tiny adjustments to our tummy tuck.
And then when you do this over a decade,like the difference
between a seven out of tenand a 9.5 out of ten
is a decade of literally ruining your lifetrying to get into the details.
And I'm happy to do it.
I'm glad I didit, and we'll never stop doing it.
But it is literally it'sno one comes up with something overnight
(04:11):
that makes an operation better.
You have to slowly move it up
1% at a time, year over year,and it has to be an obsession.
And the best part about it is the patientsjust get all the benefit.
And that reciprocal reciprocity is,you know, they pay back to you
in the sense that they just make you feelgreat for all the work you put in.
well, you know, on that, though,it's very interesting because do you find,
(04:35):
you know, as a plastic surgeon,
you know, obviously as a consumerthese days?
You know,I look at plastic surgery and it's
you know, whileyou can be a general plastic surgeon,
I really lookfor those specialties. Right.
So you want to go to a guy who only doesrhinoplasty
as if you're getting your nose done,right.
You want a guy to go to a guywho only does facelifts.
I that's why I wanted to bring you on forour kick ask first episode of the year,
(04:58):
because I feel like you'rethe guy you go to
if you want something done from,you know, tits.
I mean, like your neck down.
And I'm friendswith all the faces of guys in town.
Yeah, surgeons.
And they refer me all their body workbecause, yeah,
that's an appreciationfor the hyper specialization,
you know, because we
see the world through the same lens,and it's a narrow focus lens.
(05:18):
Yeah. Yeah.
And you want to go to the personwho's doing
and you do hundreds of them, right.
Hundreds of, of, of liposuction about.
A year, a. Body, a year of.
Pure love and joy.
You know, one of the nicest thingspatients always say to me
when they come in for a consultor they leave,
their feedback is always,this guy loves what he does.
(05:39):
Yeah, he's so interested in me
and my operation, like,
and that's because I truly, like,I actually love it.
I wake up like, jump out of bedat four in the morning.
I'm like, Get me into an operating roomand like, Let's go.
Let's go, because.
I have this amazing skill and I want toshare it with this woman and the world.
(06:00):
You know, on that, you know,
can you quickly go throughwhat is the difference
between liposuction,a tummy tuck and a mommy makeover?
Okay. So pregnancy
causes changes to the body like newsflash.
Okay.
And that this is the biggest paradigmshift I'm seeing.
We are understanding that thin, fat women
(06:22):
or get the most
changes from pregnancy,there's the most amount of stretching.
So it's paradoxicalbecause you're probably thinking
like if you're thin and fail,just bounce right back.
It's like not truebecause you get stretched more.
Yeah, and the laws of physicsare the laws of physics.
So when you have big babies,multiple babies, multiple big babies,
(06:43):
twins, triplets, your body isphysically stretched and torn.
So the three main things that happenis the muscle separation, which is,
number one, the distances that gives youthe pooch. Okay?
That drives women nutswhen they are literally pregnant
and they haven't had a kidin two or three years.
And those muscles are emailing each other.
They're not texting or not talking.
(07:04):
They're so far apart.
There is nothing in the worldthat you could do.
You could do a plank for a year.Nothing's going to happen.
And then we come to this stressed skin.
Now, loose skin on the surfacedoesn't seem like that's a problem, right?
Maybe even seem frivolous, looseskin, bunch of skin you can grab.
But, you know, it's not frivolous,not being able to wear a bathing suit,
(07:26):
not wanting to go on vacation,not going on a date with your husband, not
you know,
you don't want to go to your child'sbar mitzvah, bar mitzvah or wedding
because you can't put on clotheswithout wearing 65 contraptions.
And the clothes you're wearinglook ridiculous or frumpy, as they say.
So it's not frivolous because it'sa physical constraint, loose skin,
(07:46):
stretched muscles you can never eat againand plank for a year.
Nothing's going to changeand fat gets deposited in stock.
So when we're doing a tummy tuckor sculpting that's lipo,
we're doing a muscle repairand we're removing skin.
And I can talk and we will like
we can get granularon how the tummy talks have evolved
(08:07):
because it evolves
with the desires of the patients, right?
Like markets move where the demand is.
So you have to change the procedure tothe demand of the patient and the patients
we see in New York who come to my officeand they come from all over the world,
it doesn't matter where they come from.
They want the same thing.
They want long, lean and elegant.
(08:29):
They want when they're at a poolor whatever resort,
they're out in the worldor they're at their gym.
They want people to look at them and say,She looks great.
Not she had great plastic surgery.
Right? Yes. That is so important.
You know, soso really kind of just clearing this up
because I think that sometimespeople listening
might not know the differenceand they go to their doctor
(08:50):
and they're like,I want liposuction when really
what they need is a little bit like yousaid.
So liposuctionis the simple removal of fat.
The two most dangerous words. Yeah.
I most dangerous words in plastic surgery.
And I joke about this on social mediaall the time.
And the numberone revision procedure, I do
spit thin women.
Doesn't matter if they're 35 or 65.
(09:11):
Go to their local plastic surgeon.
They've had a couple of kids
and they just say,I want a little bit of a little lipo
plastic surgeon to ask them to deathbecause they want the case.
Absolutely destroy their body, period.
Full stop.
If like
I don't know, said 6 to 700 cases
a year, literallythe amount of women who had even one
(09:35):
kid that I do pure lipo on out of 600is maybe two.
Right?
If you've been stretched,you have stretched tissues.
Those tissues need to be removed,not cooked.
And I got to make sure we're not justfocusing on pregnant women here.
Right.
Because I feel like now I mean, there'smen who go in for tummy talks, right?
(09:56):
I mean. There's it's so. Funny.
I've had no baby, but I can't wait to comeand see you to get this midsection done,
because I'm going call it I'mnot a mommy makeover.
Look, you we age,the skin gets loose and there's just a
you can do about that, right?
Well, it's so funny you said thatbecause I'm just doing an interview.
I'm not going to say which magazine.
And I think they're calling ityou know, they always call my procedure
(10:18):
the broken body and they're calling itBirkin body without the baggage.
Meaning we're doing a lot of mommymakeover procedures
for women who have never had children.
And it'sbecause they have the same diagnosis.
We're seeing a lot of skinlaxity and looseness
from womenfocusing on, you know, exercise.
Also in I throw in all the GOP oneagonist, the cosmetics in the this
(10:41):
you're getting people who used to lose £10but now women in their mid thirties
mid-forties mid-fifties,even if they don't have children,
you're addinga little bit of perimenopause.
You throw in a month or two of ozempicyou've lost £20.
You have now completely switched from aliposuction to a skin removal patient.
So you can call it whatever you want,but we do breast lifts
(11:01):
and tummy talks on patients.
Probably a third of our patientsdon't have any children.
Right? Right. It's the Burkin body.
That's the baggage.Not that the kids are baggage.
The best thing I've ever done,but it's a quirky name.
But yeah, the practice is the sameprocedure with or without the babies.
Do you think it's important then, youknow, for people who might be considering
(11:23):
really at the end of the day,
if you are looking in the mirrorand you're saying, you know,
my midsection bothers me,is it more important
I guess your what you're saying
is it's important to go to your doctorand then have that consultation
and not necessarily go in and say,I need lipo or I need a tummy tuck.
But we actually don'tWe screened people on the phone
saying, you know, before you can meet me,are you willing to do the
(11:46):
procedure, Doctor?
The doctor suggests to get the resultsyou desire.
Yeah.And if they say no, we say no problem.
Like go somewhere else.
Yeah,
because if you come in with looseskin and say, I want lipo,
you know, it's uncomfortable becauseyou're like, Well, it makes no sense.
Okay, square peg, roundhole, complete waste of time.
It would be immoraland unethical to do it.
(12:07):
So but our patients know, and that'swhy we spread
through social in our website and patientsshare it themselves, which is amazing.
New World where our full paying patientsare happy to share their own experiences
on social media tagWe use their face name, use their voice.
Nobody cares about the scar.
Nobody cares about the downtime
(12:28):
because when you get the body,you want to live the life you deserve.
Nobody cares.
Zero 600 a year 6000 talks zero.
Literally, when they get the body,
the resultsthey want zero complaints about scar zero.
You know so I do I let's talk a little bitabout what that procedure is, you know
(12:49):
so let's not focus on I want to focusspecifically for the rest of this episode
on tummy tucks. Right.
Let'sget into the details of an operation.
And this is what a patient
say. Someone's listening to thisand they're looking
what you should be looking for.
Okay, this is how you want your tummytuck to go.
This should be like a fouror five hour procedure.
This is not a 90 minute procedure.
(13:10):
You can't do this work in 90 minutes.
This operation is 4 to 5 hours.
This operation should be donein an accredited facility.
I like the privatemeaning someone's office
because you have your selected team.
So we have better instruments,
we have better people,and we're like a well-oiled machine.
The other real specific detailabout the safety of doing a tummy tuck,
make sure there's two anesthesiologistsin the office.
(13:33):
Okay.
I don't I wouldn'tgo on a plane that had one pilot.
The pointwe always have two anesthesiologists.
Listen, we have the benefit of havingtwo operating rooms in my office, but
have two around.
God forbid there's is a problem.
Have another set of hands.
We don't have any issues.
I will always say
(13:54):
you need blood thinners at your surgeryand for the week after,
because I can deal with bleeding,but I'm not dealing with a blood clot.
Okay?Everyone walks in, everyone walks out.
The details of the operation.
The operation starts with the lipo.
360. Okay.
You should get complete sculpting
of the waist back, armpits,
(14:16):
lateral chest, all of that stubborn fat.
It's got to go.
It's got to go to get those longlean lines.
The sculpting has to be done.We like Baiser.
We do a lot of fat harvesting for breastand but, you know, injections.
But it is complete sculpting.
And that part of the operationshould probably take 2 hours.
Okay. Yeah.
So someone's doing 90 minute total.
(14:39):
You're not doing the sculpting.
You have to really turn the patientlike rotisserie to get all the way around.
Okay.
And you want to use all the accoutermentswe're using.
These are using Jay plasma.Anything you can do it.
Move the procedure a little further.
But really, it's the complete sculptingtaking that time.
That's step one.
That's the numbertwo reason I see revisions is the patient
didn't get the right lipoor they just got a little bit like,
(15:02):
I don't know, I play to win. Okay. Right.
They're going to do it. Go and do it.Yeah.
Like we're going to do this.We're going to do this.
Okay.
So after the lipo,we go to the muscle repair.
You make your incision,you're doing the muscle repair.
The muscle repair is key.
There's a million ways to do it.
But basically you want to repairall the muscles that are separated.
So, you know, most people just do it downthe middle.
The rectus muscles.
(15:22):
But really, you can have multiple vectors.
So you I'm in there,especially these thin fat women,
petite from all over the worldthat have three or four or five kids.
Their muscles not just in the middle buton the side, are separated, repair more,
repair them all.
So you've got to
have a you know, the musclerepair is not like everyone gets the same.
You want to have the lipo completeyour body,
(15:45):
want the muscle repairfor your body, skin removal.
Okay, Here's the detail.
The incision needs to be wherethe pubic area transitions to the skin.
It should be under your C sectionand you make it as far as you have to
to get the result.
The number one reasonpatients come to my office
(16:05):
from all over the world for a visiontummy tuck incision was not long enough,
which means you didn'tget enough of the stretched skin out,
whichI mean, you just did that whole journey
and you got like 70% of the resultsbecause you told the surgeon
you didn't want the incision.
You know,
I don't there's no negotiating with melike I'm making the incision
(16:27):
as long as I need toto get the result that you want.
It's it's normally hip to hip, right?
I go way past the hip. We're way past him.
That's hip to hip.
Like you're missing 30%.
That's a seven out of ten.
If you're not 3 to 4 inches, passthat on both sides.
You're not at 9.5 to 9.8 out of ten.
(16:47):
So what is that like?
What does that look like? And I mean,
my patients were string bikinis,so don't tell me the scar matters.
Got it. Okay.
Now, my next question for youis, you know.
So how why am I confidentmaking a long shot?
Right? Yeah.
Well, while awesome and maybe maybeif you want to talk about that first,
(17:08):
but you also do the reverse tummy tuckwhere they pull it up into it.
A lot of people are scared of scars.
We show pictures all day long, all daylong of scars on every skin type.
So so why am I not scared of scars?
So when the skin
is pulled down a tummy tuck,they used to just pull it down so it up.
But then all the force or strength
(17:29):
or tension is on the,you know, the stitches at the bottom.
So now we do this very thoroughthing called progressive tension
where when you pull the skin down, you'reshowing the skin down to the muscles
so that when it gets to the bottom,there's no tension.
Then we're closing in three layersmeticulously by the surgeon side.
The surgeon walks out of the roomand someone else does it.
The surgeons do itbecause you should care.
(17:50):
Because if it's worth doing, it'sworth doing well, too.
You know, the meticulous three layerclosure, progressive tension seizure to
take the tension off.
And now we had a prevent incisionmanagement system which increases
blood flow.
It's like being in a hyperbaric oxygentank for a week.
Yeah.
And we have the patient post-op monitored
by our African nurses and flexedand they're bent over for two weeks.
(18:11):
I mean, surgery with us is huge downtime,but we get the results.
So let's let's talk about that.
But but before we do that,so so we're talking about the tummy tuck,
which involves, like you said, 360 lipo,that repair of the muscles.
And you know what?
And then the skin removal. Yeah.
Now what about people?
(18:32):
So in general with the tummy tuck,
you're youknow, you're getting that total repair.
How does little.
Torso, total torso.
Differ from a reverse tummy tuck.
So I probably do two or three a year againversus 600.
So obviously we're in this.
Usually the reverse is someonewho had a mini tummy tuck done elsewhere.
(18:55):
So the so from the bellybutton down there.
Good.
And it's just loose skin above the bellybutton.
Got it. Okay.
And then that kind of pulls upinto the breast.
Correct.
But I getthat is the exception, not the rule.
And like it's a funoperation pulling up, but
it doesn't allow youto repair the muscles.
Right.
So it's a pure skinre draping above the belly button.
(19:18):
Gotcha.
Okay, so let's talk recovery becauseyou just said two weeks of downtime.
They're bent over.Way, way, way, way more than you.
Know. Yeah.
So if anyone if you walkinto a consultation, first of all,
if you're like if you're not feelingthe vibe with your doctor,
like you should like them,like I like to work with people.
I like that like the same things as me.
Like because this is,
(19:40):
you know, this is a relationshipthat's as intense
as any other relationshipyou're going to be in.
So you better literallyputting your life in your surgeon's hands.
So I don't care because you're.
The operation doesn'tstop at the when the knife goes down.
The operation is basicallygoing on forever.
And like the first month,like I joke, it's dating.
It's like, you know, we basically see,you know, see naked every day.
(20:01):
And then, you know, afterlike a lot of the kind of trails off like.
This, like dating and marriage.
Okay.
Henceso you got to really vibe with the surgeon
and the surgeonsgot a vibe with the patient
and the patient has to like the officeand the office has to like the patient.
This has to be a big deal.
If it's not a big deal, like it'snot going to be a big deal for you, Right?
(20:26):
So what is so what is that downtime?
Have your. Yeah,you have your operation in my office.
You go in a recovery room
and then you're gettinga private care nurse because I don't care
who your spouse, partner or whoever is,they can't take care of you.
They don't want to take care of you.
We're going diapers, we're goingleaking fluid that looks like a faucet.
You have tubes coming out of everything.
You can't go to the bathroom.
(20:47):
You can't get up, you can't eat.
You can't I mean, you need full time care.
This is not send you home with a pieceof paper from 1986 with instructions.
This is an immersive experience.
The way we do it is we want to say,Hey, let's do this big operation,
and then let's bring some hospitalityand some razzle dazzle into it.
So let's put you up in the plazaoverlooking Central Park with your nurses,
(21:10):
because you know what?
There's no reasonwhy your surgery can't be special.
Obviously, not everyone needs to do that.
But I do think the aftercare isspecialized.
Nursing makes a big difference.
The first week you are essentiallycompletely useless to the world.
Okay, You can't move.
You are resting, you are flexed.
Your job is to hydrate, take protein
so you heal and start lymphatic massagesand literally do nothing.
(21:33):
You are not a caregiver.You are not the CEO.
You are not this. You are not that.
I have a ton of surgeons and lawyers.
I'm like, You are not a surgeon this week.
You are not a lawyer this week.
The second weekyou can start moving around,
but you're moving over aroundlike a grandmother.
You're bent over,we're getting your drains out,
we're getting your incisionmanagement system off.
But you're pretty useless to the world
(21:55):
from week to
week six, you start regainingsociety. Okay?
And when I say regain society,I mean you are going for lunch,
going for dinner, you are driving andgoing to activities back in the office.
But you are moving slow.
You are moving slow.
It takes about three monthsto really start seeing results.
(22:15):
That's when we're goingto let you back into the gym.
I mean, you're going to see resultsin six weeks, but at three months
you're going to start getting thatwow factor
and then that's going to keep improving.
And guess what?
One thing people don't talk about,year two is better than year one.
Year three is better than year two. Why?
Because we take,you know, people like you, Amber,
people are dedicatedto taking care of themselves.
They enjoy eating clean,they enjoy exercising.
(22:38):
Obviously, they like to drink and stuff,but they enjoy taking care of themselves.
But when we take awayall the constraints on your body, like
it's again, compound growth, like,yeah, imagine you know,
you don't have your muscles arewhere they're supposed to be.
You don't have any extra skin,you don't have any extra fat
do plots four times a week for three yearsand you'll look like you're 22
when you're 65. Yeah.
(23:01):
So on that,
I think that we should address this now
because I saw a woman in her late sixtiesthat you put on your social recently.
So let's talk about age ranges.
Now, of course,we know that everybody is different.
Everybody's health.
Yeah, but where do you find you know, thatthat age range to size a good candidate.
(23:21):
I got
just awesome people are good candidatebut like you know
I just like working with good peopleI got to silos
It's like that 35 to 45.
These are younger women.
They just had a bunch of kidskind of quickly.
Usually, you know, they had two or threefor this kind of like the most common say.
Actually, no, they're about 50, 50.
(23:43):
And they've literally in like a few yearswent from like this being in college
body to like, they can't even lookin the mirror anymore.
And they're like, I'm not waiting.
Let's go. Okay.
And then there is So that's 35 to 45 yearold, a few kids,
and they just don't
want to live the rest of their lifewithout like they want to enjoy their life
and they don't want to likethere's nothing they can do.
(24:05):
They've maxed out.
They all do cloudy, seven daysa week, never eat, you know.
So yeah, that's the first agegroup, second is like my 50
plus my and we that's againhalf of my patients.
A lot of those are moms who are super busy
and they look pretty good after their kidsand they were like, happy.
And then usually it's the menopausethat really just added that extra stretch.
(24:29):
The breast just deflated,the exercise is doing much less
and the skin just loosened upand they're in their 55, 60, 65.
They feel goodbecause they take good care of themselves
and they look in the mirrorand they're just like, who is this old?
Like, Who is this woman?
Because I don't look the way I feel.
So we have that 35 and 45and that kind of 55 to 70.
(24:52):
I mean, I do I know this sounds odd.
I do a lot of 65 to 7 year old womenbecause there's a lot of
pretty awesome 65 to 7 year old womenwalking around who don't feel like
life is over, who have this incrediblecloset of clothing that they can't wear.
And, you know,they have the resources and they're like,
(25:12):
you know, and they're healthy.So like, let's do it.
My oldest is an 87.
She was going on to Boca West, right?
I mean, I'm in my family's in Boca and
the people there are like, yeah,I mean, the women,
they're in their seventies and eighties,put me to shame and I love it.
I probably most of them
was like I say, all they always saythe older patients is why do I wait?
(25:35):
I should have done this when I was 35because they're like, You're telling me
I could have had like from 35 to 65,I would have had this body.
Yeah.
Okay. Those are the two groups.
It's like right after kidsand kind of right after menopause.
You know, going into that recovery.
And I want to dive into thisa little bit more because,
you know, you talk about that first weekand when you say
(25:58):
you're not going to be,do I mean anything like you are?
You are basically you're. You're a child.
You need a baby nurse.
Like you're you'resomeone has to, like, care for you.
So do most people,you know, have to get private nursing?
I know.
I know that you offer that with yours.
But again, we have a worldwide audience,so I'm trying to make this educational
for people who might not be herein New York with you.
I mean, it's easier to have someone elsetake care of you.
(26:22):
Can someone take care? Yeah.
I also, like my operations are veryI don't want to say aggressive,
but it's comprehensive.I mean, we push things, right?
We're a very we doing the like we're goingdefinitely farther
than most comfortablebecause I do it every day.
I mean, I really need a nurse managingand following blood pressure.
(26:43):
Heart rate fluids I like
would just not feel comfortableat the extent of operating.
I do setting people off into the wild.
And that's why,
you know, there is, you know, tummy tucklight versions out there where they're
in the operating room for 90 minutesand have a little bit of lipo
and they have a little bit of skin removaland they have a straightforward
muscle repairand they're not flexed and bent over.
(27:05):
And it's probably a lot safer to go home
with, you know, just a wraparound their stomach and call it a day.
That that's not your.
It's just not me.
And by the way, that's probably fineand great for a lot of people in.
They're thrilled.
I live my life a certain wayand like I'm going at a certain speed
in a certain directionand people who vibe with me
(27:26):
and are moving at my speedand want the same things,
they're they're signing uplike I don't offer the lite version.
Like.
So, you know, keeping in mindthis general, you know, we're talking
just to the general public here, right?
Not your specific, but you know,we have to focus on like what are
what are some complicationsLike who's not a good candidate for this?
(27:47):
You know,what are some of the negative things
that that people really need to be awareof when doing a surgery like I'm.
Not a good candidate.
So it's usually a medical reason, right?
Obviously, you can have some peoplethat you're just like,
I don't really know if I want to operate,be partners with this person on a project
for the next few years because justpersonality issues is usually medical.
The most common is BMI, meaningthey're they need to lose weight
(28:09):
because a lot of the the mass that they'recarrying is inside their stomach.
So if you went to the operating room,I mean, when I say inside the stomach,
visceral, under the muscle,if you went to the operating room,
you might be able to pull some skin off,
but you won't be able to tighten
the barrel or tighten the muscles becausethe inside of the barrel is full of fat.
So you're not going to get a good result.
So what does that target BMI for?
(28:30):
For for tummy tuck,Because I know that's changed a lot
from like the days of old with liposuctionwhere they would just listen.
People are differentin their kind of the way they do things.
I would say under 30 is ideal.
32 is okay, 35 is too much.
Got it. Okay. And that's BMI.
Yeah, got it. Okay.
And you remember,you got to take BMI with a grain of salt
because if you have a power lifterand they're super dense,
(28:51):
they probably have a BMI 50,but they have a body fat of zero.
So, okay, okay.
Everything's got to be taken into context.
That's again, why
you want to go to someonewho does it all day, every day,
because they're going
to see around the corners, you know,they're going to have the nuances down,
Right.
And then
any time you have surgery, there's alwaysa risk of an anesthetic complication.
(29:11):
So that's why I like to have to askphysiologists around.
Do you somehow have some unpredictable,complicated airway,
get a second hand in there bleeding?
You know,that's usually a technical thing,
but we do use blood thinners.
Infections should be very low.
It's definitely not going to be zeroand infections can be devastating.
(29:32):
Cut from a little bit of skin rednessneeding an oral antibiotic, too, like,
you know, rare infections in the skinthat cause tissue loss.
You know, nothing great or amazingdoesn't have risk.
So and blood clots.
We give blood thinners after for a week.
Some people do.
Some people don't.
It's, you know, seems to preventblood clots in her patients.
(29:55):
But when you're going into this knowyou're going to have nuisance
you know I think of complicationswhich are significant
problems are going to interferewith your life infection bleeding
blood clotthat's admission to the hospital time.
Really scary stuff.
And then there are the nuisanceslike you're going to bruise,
you're going to ooze, you're going to bepainful and you're going to be swollen.
That's not a complication.
That's just is that's partyou know, that's along for the ride.
(30:17):
Yeah. And you're going to be emotional.
Listen, I've had surgery before, so I cantell you one I think that you never can
that most people underestimatewhat that downtime is.
It's why I'm asking you to really gointo it, because downtime to me was like,
I want people to go to the gym.
It was like, No, I can't even get myI couldn't even sit up for a week.
You can even for a week.
You can't even go to the bathroomby yourself.
(30:40):
Yeah.
Like that's how knocked out you are.
And you don't feel normal.
Now in terms of the mental, it's funnyyou bring that up.
I've written a blog recently
if anyone want to check it out on my site,but I tell people the first three
weeks are going to hate me.
And then after you'll hate meand then you'll love me
for the rest of your lifefor the first three weeks.
It's like a psychological battle.
Yeah. And like.
Yeah, you just paid this guyall this money.
(31:02):
You were cut in half,you bruise, you're swollen.
Every part of you just looks great.
Yeah.
Then you're like, What did I do?
And you always start getting the.
Did I really need to do this?
I wasn't so bad.
Well, yeah, I am.
And so my husband,you know, all that goes away.
(31:23):
So it goes. Away. But it's so important.
I remind people.
Just don't forget, you're going to feelvery sorry for yourself.
And that is a natural part of having.
But if even if you had dental surgerywhen you're in pain,
you feel sorry for yourself.
So doingsomething like this, just mentally prepare
that,that's how you're going to be feeling.
So if you're at a point in your life
where you're not feelingwell, you're mentally not ready for this.
(31:45):
Now. To make sure you know,before you do something, you know,
big on your body.
Okay.
So I want to be mindful of your timebecause I know you are a busy, busy man.
And we know that costs varyfrom where you are
in the worldto, you know, specific surgeons.
But can you give us ballparksfor these types of things?
(32:08):
Yeah. Listen, cost structures vary.
Margins don't vary that much,which is an interesting concept,
meaning like, say, for instance,something in my office is 80,000
and it's 20,000 down the street.
You're not charging four timesfor the same everything.
I think you're probably getting
400 times worth of,
(32:31):
you know, when you get into the details
pricing,a lot of it is obviously you're going to
be in Manhattan,the Upper East Side, just like commercial
leases are going to be more expensivethan Wichita, Kansas.
Staffing. You want the best of the best.
I mean, we recruit our nursesfrom around the country like Walmart,
like if you're in, you know, Oklahoma,but you're amazing.
You're moving here.
You know, we we want the bestand we pay them the best.
(32:51):
We have an all star teambecause I don't think you can do the work.
You're going to be spending a lot more.
You have a lot more resources.
I have 15 full time nurseswho are dedicated.
You know, you have your cell phonenumbers, 24 seven for that.
So what are like what are it like?
Can you kind of give ballpark?
I know it's hard, but no ranges.
(33:13):
My guessis, you know, the average for a tummy tuck
nationwide sideis probably like 15 to 20000,
kind of all in soup to nuts,as they say in New York, which is like
your anesthesia,your facility and your surgeon and,
you know, I'm going to be five,
six times that right now.
(33:34):
But I think you're getting 100 timesthe value.
So I think it's a bargain. Yeah.
Well, I want to thank you so much.
You know, doctor names,I feel like there's probably
so many questionsthat are going to come in.
I want to remind everybody at home,if you have questions
you want me to pass on to him or his team,I'm always happy to do that.
You can email mehello at our BD podcast dot com.
If people want to come to see you,what's the best way to find you?
(33:57):
The best way is to go on our website andfill out a form : NeinsteinPlasticSurgery.
com and follow meand my associate surgeons, Dr.
Chris Funderburk.
Dr. Anna Steve on social media,you will find us on the web.
my gosh.
And trust me,you want to check out his social media
because it's like the thing that I spendtime Googling.
(34:17):
I feel like you're my friend in my head.I know you.
I know your kids.
I mean, like, I'mlike and I certainly know York.
So I know we're going to take offa lot of the times patients come in
and we're like you and they say, like,hey, like, I know, I feel like I know you
because, you know,because I do show my life
and I know a lot of peopledon't want to do that.
But what that really does,it really filters.
(34:39):
You know, we're all trying to searchthrough this world to find
find our people.
And I show you who I am.
And you know,you're going to line up with that. Yeah.
You don't like who I amand what I do, which is fine.
Then. Like, you don't have to wasteyour time coming to see me.
Well, I was so pumped to have you on,
because I'm telling you, like I said, gocheck out that.
(35:00):
I mean, it's like what I do.
It's like my my husband to be like,Are you looking Neinstein again?
And I'm like, my God, look at that.
Look at this.
You know, the way I do it alland nobody helps me.
And we just showwhat we do is like nothing else to it.
I don't know if there's any.
Just show what you do.I won't be yourself.
I want to thank you so muchfor spending time with us here.
(35:20):
Do you feel like we covered anythingbefore I let you go to be
you know, we kind of hitlook what it is, who it is, who it's good
for, hit the risks, hit the costs,
you know, and certainly have highlighteda lot of the benefits.
Anything else that you find thatyour patients really need to know before?
Like I think all people should knowthat plastic surgery is a big deal.
And if it doesn't seem likethe office is making it a big deal,
(35:42):
then it won't be a big deal to you.
Look for an office in a surgeon
that show like is obsessed
that and the staff should all be smiling.
Everyone should want to be there.
It should smell nice,it should be inspiring.
It should look great.
If it looks, you know, your dental officefrom when you were a kid.
(36:07):
That's the results.
You're going to get the point.
I really like that.
Yeah, you want to make sureto take a look around, Use those eyes.
Everything you see reflects the result.
I love that.
I want to thank you again for being here.
Thank you, everybody, for listening.
I think we're going to have a great yeartogether.
Like I said, remember, you can email mequestions at hello@artbeautypodcast.com.
(36:29):
You can find us on Facebook, Instagram
and right here on YouTube: @artbeautypodcast. (36:30):
undefined
Happy New Year, everybody.
Happy New Year to you and yours.
And we will see you next Tuesday. By
All right.
This is the Art Beauty podcast where weare always reaching for truth in beauty.
Remember, the people and the brands onthe show are not paying to be here,
so we get to ask themthose tough questions
you want answeredbecause you deserve to be informed
so you can make the best choicesfor yourself.
With that said, I'm Amber, and todaymy fabulous co-host is Dr.
Ryan Neinstein.
He is a board certified plastic surgeonhere in New York City.
(00:25):
All he does is bodies.
And all I do is juggle his Instagrambecause it is insane.
Before we get into all things today,we're going to be talking a little bit
about tummy tucks,the mommy makeover, reverse tummy talks.
But before we get into that.
Welcome to the show, Doctor Neinstein.Thanks for being here.
Amber Thank you so much for having me.
(00:46):
I'm so excited to be here and I can'twait to jump right into it. Yes.
And you know what? Got to keep this up.
Happy New Year, everybody. Right.
I mean, here we are, 2024.
Whoever thought we would make it.
(sigh) Do you have any resolutionsfor the New Year, Doctor Neinstein?
No, I don't make New Year's resolutionsbecause,
you know, always advancing,always growing, always learning.
(01:08):
You know, I don't have to,you know, set the clock at a certain date.
It's just a thing I do each and every day.
I love that.
I feel like it's somethingI clock at my birthday.
So not necessarily like New Year's.
But here's a crazy thing.
My husband's birthday is New Year's Eve,so for him,
it's like it's kind of a no brainer. But.
But I don't change my goals.
But yeah, usually.
But I do kind of a personal evaluationyearly
(01:31):
and then a personal evaluationdecade wise, because most people
you know, I think it was Bill Gateswho said most people overestimate you
overestimate what they can do in a year,but they underestimate
what they can do in a decade.
So you need to have a different lensby which you evaluate yourself yearly.
You're probably going to feel let down
(01:52):
because you couldn't in a yeardo as much as you could say over a decade.
So I like to look at things in the shortand a long to give a better perspective.
But the move forward goals, initiatives,imperatives stay the same day in day up.
Well, I have to say,I've been following your career,
not quite for a decade,but for many, many years.
And I have to sayI feel like of all of the body plastic
(02:16):
surgery before and afters, I think I'mthe most blown away by yours, you know.
So so we have I want to talk todaykind of on the tummy tuck.
I feel like there'sso many different names for that.
Some of it is the mommy makeover,which I know is more than a tummy tuck.
You know,people think of plastic liposuction.
You know, I'd like you to kind ofgo through what this is.
(02:39):
And let's just start with this.
How what is a tummy tuck?
Well, I'm definitely to get into that.
But what I want to specifically talkabout what you said before,
about how you thinkin your watching over the years
something has gotten so good, outstanding.
You know, quite an outlier.
You know, the ocean between good and greatis vast, and that's all in the details.
(03:02):
So if you pick one
operation or few whatever you in life,
you pick a few things to focus on,but then you really focus on it.
And I'm talkinglike all in 24 seven or a decade.
So for me,you know, tummy tucks and then, you know,
the accouterments,the mommy makeover to go with it has been,
(03:26):
you know, at the center of my essentiallypersonal and professional life.
And like all compound interest,
you know, if we think about basicinvesting philosophy, it's small.
Like big things happen and small changeslike it's it's small.
So like every literally every month we are
(03:49):
making tiny adjustments to our tummy tuck.
And then when you do this over a decade,like the difference
between a seven out of tenand a 9.5 out of ten
is a decade of literally ruining your lifetrying to get into the details.
And I'm happy to do it.
I'm glad I didit, and we'll never stop doing it.
But it is literally it'sno one comes up with something overnight
(04:11):
that makes an operation better.
You have to slowly move it up
1% at a time, year over year,and it has to be an obsession.
And the best part about it is the patientsjust get all the benefit.
And that reciprocal reciprocity is,you know, they pay back to you
in the sense that they just make you feelgreat for all the work you put in.
well, you know, on that, though,it's very interesting because do you find,
(04:35):
you know, as a plastic surgeon,
you know, obviously as a consumerthese days?
You know,I look at plastic surgery and it's
you know, whileyou can be a general plastic surgeon,
I really lookfor those specialties. Right.
So you want to go to a guy who only doesrhinoplasty
as if you're getting your nose done,right.
You want a guy to go to a guywho only does facelifts.
I that's why I wanted to bring you on forour kick ask first episode of the year,
(04:58):
because I feel like you'rethe guy you go to
if you want something done from,you know, tits.
I mean, like your neck down.
And I'm friendswith all the faces of guys in town.
Yeah, surgeons.
And they refer me all their body workbecause, yeah,
that's an appreciationfor the hyper specialization,
you know, because we
see the world through the same lens,and it's a narrow focus lens.
(05:18):
Yeah. Yeah.
And you want to go to the personwho's doing
and you do hundreds of them, right.
Hundreds of, of, of liposuction about.
A year, a. Body, a year of.
Pure love and joy.
You know, one of the nicest thingspatients always say to me
when they come in for a consultor they leave,
their feedback is always,this guy loves what he does.
(05:39):
Yeah, he's so interested in me
and my operation, like,
and that's because I truly, like,I actually love it.
I wake up like, jump out of bedat four in the morning.
I'm like, Get me into an operating roomand like, Let's go.
Let's go, because.
I have this amazing skill and I want toshare it with this woman and the world.
(06:00):
You know, on that, you know,
can you quickly go throughwhat is the difference
between liposuction,a tummy tuck and a mommy makeover?
Okay. So pregnancy
causes changes to the body like newsflash.
Okay.
And that this is the biggest paradigmshift I'm seeing.
We are understanding that thin, fat women
(06:22):
or get the most
changes from pregnancy,there's the most amount of stretching.
So it's paradoxicalbecause you're probably thinking
like if you're thin and fail,just bounce right back.
It's like not truebecause you get stretched more.
Yeah, and the laws of physicsare the laws of physics.
So when you have big babies,multiple babies, multiple big babies,
(06:43):
twins, triplets, your body isphysically stretched and torn.
So the three main things that happenis the muscle separation, which is,
number one, the distances that gives youthe pooch. Okay?
That drives women nutswhen they are literally pregnant
and they haven't had a kidin two or three years.
And those muscles are emailing each other.
They're not texting or not talking.
(07:04):
They're so far apart.
There is nothing in the worldthat you could do.
You could do a plank for a year.Nothing's going to happen.
And then we come to this stressed skin.
Now, loose skin on the surfacedoesn't seem like that's a problem, right?
Maybe even seem frivolous, looseskin, bunch of skin you can grab.
But, you know, it's not frivolous,not being able to wear a bathing suit,
(07:26):
not wanting to go on vacation,not going on a date with your husband, not
you know,
you don't want to go to your child'sbar mitzvah, bar mitzvah or wedding
because you can't put on clotheswithout wearing 65 contraptions.
And the clothes you're wearinglook ridiculous or frumpy, as they say.
So it's not frivolous because it'sa physical constraint, loose skin,
(07:46):
stretched muscles you can never eat againand plank for a year.
Nothing's going to changeand fat gets deposited in stock.
So when we're doing a tummy tuckor sculpting that's lipo,
we're doing a muscle repairand we're removing skin.
And I can talk and we will like
we can get granularon how the tummy talks have evolved
(08:07):
because it evolves
with the desires of the patients, right?
Like markets move where the demand is.
So you have to change the procedure tothe demand of the patient and the patients
we see in New York who come to my officeand they come from all over the world,
it doesn't matter where they come from.
They want the same thing.
They want long, lean and elegant.
(08:29):
They want when they're at a poolor whatever resort,
they're out in the worldor they're at their gym.
They want people to look at them and say,She looks great.
Not she had great plastic surgery.
Right? Yes. That is so important.
You know, soso really kind of just clearing this up
because I think that sometimespeople listening
might not know the differenceand they go to their doctor
(08:50):
and they're like,I want liposuction when really
what they need is a little bit like yousaid.
So liposuctionis the simple removal of fat.
The two most dangerous words. Yeah.
I most dangerous words in plastic surgery.
And I joke about this on social mediaall the time.
And the numberone revision procedure, I do
spit thin women.
Doesn't matter if they're 35 or 65.
(09:11):
Go to their local plastic surgeon.
They've had a couple of kids
and they just say,I want a little bit of a little lipo
plastic surgeon to ask them to deathbecause they want the case.
Absolutely destroy their body, period.
Full stop.
If like
I don't know, said 6 to 700 cases
a year, literallythe amount of women who had even one
(09:35):
kid that I do pure lipo on out of 600is maybe two.
Right?
If you've been stretched,you have stretched tissues.
Those tissues need to be removed,not cooked.
And I got to make sure we're not justfocusing on pregnant women here.
Right.
Because I feel like now I mean, there'smen who go in for tummy talks, right?
(09:56):
I mean. There's it's so. Funny.
I've had no baby, but I can't wait to comeand see you to get this midsection done,
because I'm going call it I'mnot a mommy makeover.
Look, you we age,the skin gets loose and there's just a
you can do about that, right?
Well, it's so funny you said thatbecause I'm just doing an interview.
I'm not going to say which magazine.
And I think they're calling ityou know, they always call my procedure
(10:18):
the broken body and they're calling itBirkin body without the baggage.
Meaning we're doing a lot of mommymakeover procedures
for women who have never had children.
And it'sbecause they have the same diagnosis.
We're seeing a lot of skinlaxity and looseness
from womenfocusing on, you know, exercise.
Also in I throw in all the GOP oneagonist, the cosmetics in the this
(10:41):
you're getting people who used to lose £10but now women in their mid thirties
mid-forties mid-fifties,even if they don't have children,
you're addinga little bit of perimenopause.
You throw in a month or two of ozempicyou've lost £20.
You have now completely switched from aliposuction to a skin removal patient.
So you can call it whatever you want,but we do breast lifts
(11:01):
and tummy talks on patients.
Probably a third of our patientsdon't have any children.
Right? Right. It's the Burkin body.
That's the baggage.Not that the kids are baggage.
The best thing I've ever done,but it's a quirky name.
But yeah, the practice is the sameprocedure with or without the babies.
Do you think it's important then, youknow, for people who might be considering
(11:23):
really at the end of the day,
if you are looking in the mirrorand you're saying, you know,
my midsection bothers me,is it more important
I guess your what you're saying
is it's important to go to your doctorand then have that consultation
and not necessarily go in and say,I need lipo or I need a tummy tuck.
But we actually don'tWe screened people on the phone
saying, you know, before you can meet me,are you willing to do the
(11:46):
procedure, Doctor?
The doctor suggests to get the resultsyou desire.
Yeah.And if they say no, we say no problem.
Like go somewhere else.
Yeah,
because if you come in with looseskin and say, I want lipo,
you know, it's uncomfortable becauseyou're like, Well, it makes no sense.
Okay, square peg, roundhole, complete waste of time.
It would be immoraland unethical to do it.
(12:07):
So but our patients know, and that'swhy we spread
through social in our website and patientsshare it themselves, which is amazing.
New World where our full paying patientsare happy to share their own experiences
on social media tagWe use their face name, use their voice.
Nobody cares about the scar.
Nobody cares about the downtime
(12:28):
because when you get the body,you want to live the life you deserve.
Nobody cares.
Zero 600 a year 6000 talks zero.
Literally, when they get the body,
the resultsthey want zero complaints about scar zero.
You know so I do I let's talk a little bitabout what that procedure is, you know
(12:49):
so let's not focus on I want to focusspecifically for the rest of this episode
on tummy tucks. Right.
Let'sget into the details of an operation.
And this is what a patient
say. Someone's listening to thisand they're looking
what you should be looking for.
Okay, this is how you want your tummytuck to go.
This should be like a fouror five hour procedure.
This is not a 90 minute procedure.
(13:10):
You can't do this work in 90 minutes.
This operation is 4 to 5 hours.
This operation should be donein an accredited facility.
I like the privatemeaning someone's office
because you have your selected team.
So we have better instruments,
we have better people,and we're like a well-oiled machine.
The other real specific detailabout the safety of doing a tummy tuck,
make sure there's two anesthesiologistsin the office.
(13:33):
Okay.
I don't I wouldn'tgo on a plane that had one pilot.
The pointwe always have two anesthesiologists.
Listen, we have the benefit of havingtwo operating rooms in my office, but
have two around.
God forbid there's is a problem.
Have another set of hands.
We don't have any issues.
I will always say
(13:54):
you need blood thinners at your surgeryand for the week after,
because I can deal with bleeding,but I'm not dealing with a blood clot.
Okay?Everyone walks in, everyone walks out.
The details of the operation.
The operation starts with the lipo.
360. Okay.
You should get complete sculpting
of the waist back, armpits,
(14:16):
lateral chest, all of that stubborn fat.
It's got to go.
It's got to go to get those longlean lines.
The sculpting has to be done.We like Baiser.
We do a lot of fat harvesting for breastand but, you know, injections.
But it is complete sculpting.
And that part of the operationshould probably take 2 hours.
Okay. Yeah.
So someone's doing 90 minute total.
(14:39):
You're not doing the sculpting.
You have to really turn the patientlike rotisserie to get all the way around.
Okay.
And you want to use all the accoutermentswe're using.
These are using Jay plasma.Anything you can do it.
Move the procedure a little further.
But really, it's the complete sculptingtaking that time.
That's step one.
That's the numbertwo reason I see revisions is the patient
didn't get the right lipoor they just got a little bit like,
(15:02):
I don't know, I play to win. Okay. Right.
They're going to do it. Go and do it.Yeah.
Like we're going to do this.We're going to do this.
Okay.
So after the lipo,we go to the muscle repair.
You make your incision,you're doing the muscle repair.
The muscle repair is key.
There's a million ways to do it.
But basically you want to repairall the muscles that are separated.
So, you know, most people just do it downthe middle.
The rectus muscles.
(15:22):
But really, you can have multiple vectors.
So you I'm in there,especially these thin fat women,
petite from all over the worldthat have three or four or five kids.
Their muscles not just in the middle buton the side, are separated, repair more,
repair them all.
So you've got to
have a you know, the musclerepair is not like everyone gets the same.
You want to have the lipo completeyour body,
(15:45):
want the muscle repairfor your body, skin removal.
Okay, Here's the detail.
The incision needs to be wherethe pubic area transitions to the skin.
It should be under your C sectionand you make it as far as you have to
to get the result.
The number one reasonpatients come to my office
(16:05):
from all over the world for a visiontummy tuck incision was not long enough,
which means you didn'tget enough of the stretched skin out,
whichI mean, you just did that whole journey
and you got like 70% of the resultsbecause you told the surgeon
you didn't want the incision.
You know,
I don't there's no negotiating with melike I'm making the incision
(16:27):
as long as I need toto get the result that you want.
It's it's normally hip to hip, right?
I go way past the hip. We're way past him.
That's hip to hip.
Like you're missing 30%.
That's a seven out of ten.
If you're not 3 to 4 inches, passthat on both sides.
You're not at 9.5 to 9.8 out of ten.
(16:47):
So what is that like?
What does that look like? And I mean,
my patients were string bikinis,so don't tell me the scar matters.
Got it. Okay.
Now, my next question for youis, you know.
So how why am I confidentmaking a long shot?
Right? Yeah.
Well, while awesome and maybe maybeif you want to talk about that first,
(17:08):
but you also do the reverse tummy tuckwhere they pull it up into it.
A lot of people are scared of scars.
We show pictures all day long, all daylong of scars on every skin type.
So so why am I not scared of scars?
So when the skin
is pulled down a tummy tuck,they used to just pull it down so it up.
But then all the force or strength
(17:29):
or tension is on the,you know, the stitches at the bottom.
So now we do this very thoroughthing called progressive tension
where when you pull the skin down, you'reshowing the skin down to the muscles
so that when it gets to the bottom,there's no tension.
Then we're closing in three layersmeticulously by the surgeon side.
The surgeon walks out of the roomand someone else does it.
The surgeons do itbecause you should care.
(17:50):
Because if it's worth doing, it'sworth doing well, too.
You know, the meticulous three layerclosure, progressive tension seizure to
take the tension off.
And now we had a prevent incisionmanagement system which increases
blood flow.
It's like being in a hyperbaric oxygentank for a week.
Yeah.
And we have the patient post-op monitored
by our African nurses and flexedand they're bent over for two weeks.
(18:11):
I mean, surgery with us is huge downtime,but we get the results.
So let's let's talk about that.
But but before we do that,so so we're talking about the tummy tuck,
which involves, like you said, 360 lipo,that repair of the muscles.
And you know what?
And then the skin removal. Yeah.
Now what about people?
(18:32):
So in general with the tummy tuck,
you're youknow, you're getting that total repair.
How does little.
Torso, total torso.
Differ from a reverse tummy tuck.
So I probably do two or three a year againversus 600.
So obviously we're in this.
Usually the reverse is someonewho had a mini tummy tuck done elsewhere.
(18:55):
So the so from the bellybutton down there.
Good.
And it's just loose skin above the bellybutton.
Got it. Okay.
And then that kind of pulls upinto the breast.
Correct.
But I getthat is the exception, not the rule.
And like it's a funoperation pulling up, but
it doesn't allow youto repair the muscles.
Right.
So it's a pure skinre draping above the belly button.
(19:18):
Gotcha.
Okay, so let's talk recovery becauseyou just said two weeks of downtime.
They're bent over.Way, way, way, way more than you.
Know. Yeah.
So if anyone if you walkinto a consultation, first of all,
if you're like if you're not feelingthe vibe with your doctor,
like you should like them,like I like to work with people.
I like that like the same things as me.
Like because this is,
(19:40):
you know, this is a relationshipthat's as intense
as any other relationshipyou're going to be in.
So you better literallyputting your life in your surgeon's hands.
So I don't care because you're.
The operation doesn'tstop at the when the knife goes down.
The operation is basicallygoing on forever.
And like the first month,like I joke, it's dating.
It's like, you know, we basically see,you know, see naked every day.
(20:01):
And then, you know, afterlike a lot of the kind of trails off like.
This, like dating and marriage.
Okay.
Henceso you got to really vibe with the surgeon
and the surgeonsgot a vibe with the patient
and the patient has to like the officeand the office has to like the patient.
This has to be a big deal.
If it's not a big deal, like it'snot going to be a big deal for you, Right?
(20:26):
So what is so what is that downtime?
Have your. Yeah,you have your operation in my office.
You go in a recovery room
and then you're gettinga private care nurse because I don't care
who your spouse, partner or whoever is,they can't take care of you.
They don't want to take care of you.
We're going diapers, we're goingleaking fluid that looks like a faucet.
You have tubes coming out of everything.
You can't go to the bathroom.
(20:47):
You can't get up, you can't eat.
You can't I mean, you need full time care.
This is not send you home with a pieceof paper from 1986 with instructions.
This is an immersive experience.
The way we do it is we want to say,Hey, let's do this big operation,
and then let's bring some hospitalityand some razzle dazzle into it.
So let's put you up in the plazaoverlooking Central Park with your nurses,
(21:10):
because you know what?
There's no reasonwhy your surgery can't be special.
Obviously, not everyone needs to do that.
But I do think the aftercare isspecialized.
Nursing makes a big difference.
The first week you are essentiallycompletely useless to the world.
Okay, You can't move.
You are resting, you are flexed.
Your job is to hydrate, take protein
so you heal and start lymphatic massagesand literally do nothing.
(21:33):
You are not a caregiver.You are not the CEO.
You are not this. You are not that.
I have a ton of surgeons and lawyers.
I'm like, You are not a surgeon this week.
You are not a lawyer this week.
The second weekyou can start moving around,
but you're moving over aroundlike a grandmother.
You're bent over,we're getting your drains out,
we're getting your incisionmanagement system off.
But you're pretty useless to the world
(21:55):
from week to
week six, you start regainingsociety. Okay?
And when I say regain society,I mean you are going for lunch,
going for dinner, you are driving andgoing to activities back in the office.
But you are moving slow.
You are moving slow.
It takes about three monthsto really start seeing results.
(22:15):
That's when we're goingto let you back into the gym.
I mean, you're going to see resultsin six weeks, but at three months
you're going to start getting thatwow factor
and then that's going to keep improving.
And guess what?
One thing people don't talk about,year two is better than year one.
Year three is better than year two. Why?
Because we take,you know, people like you, Amber,
people are dedicatedto taking care of themselves.
They enjoy eating clean,they enjoy exercising.
(22:38):
Obviously, they like to drink and stuff,but they enjoy taking care of themselves.
But when we take awayall the constraints on your body, like
it's again, compound growth, like,yeah, imagine you know,
you don't have your muscles arewhere they're supposed to be.
You don't have any extra skin,you don't have any extra fat
do plots four times a week for three yearsand you'll look like you're 22
when you're 65. Yeah.
(23:01):
So on that,
I think that we should address this now
because I saw a woman in her late sixtiesthat you put on your social recently.
So let's talk about age ranges.
Now, of course,we know that everybody is different.
Everybody's health.
Yeah, but where do you find you know, thatthat age range to size a good candidate.
(23:21):
I got
just awesome people are good candidatebut like you know
I just like working with good peopleI got to silos
It's like that 35 to 45.
These are younger women.
They just had a bunch of kidskind of quickly.
Usually, you know, they had two or threefor this kind of like the most common say.
Actually, no, they're about 50, 50.
(23:43):
And they've literally in like a few yearswent from like this being in college
body to like, they can't even lookin the mirror anymore.
And they're like, I'm not waiting.
Let's go. Okay.
And then there is So that's 35 to 45 yearold, a few kids,
and they just don't
want to live the rest of their lifewithout like they want to enjoy their life
and they don't want to likethere's nothing they can do.
(24:05):
They've maxed out.
They all do cloudy, seven daysa week, never eat, you know.
So yeah, that's the first agegroup, second is like my 50
plus my and we that's againhalf of my patients.
A lot of those are moms who are super busy
and they look pretty good after their kidsand they were like, happy.
And then usually it's the menopausethat really just added that extra stretch.
(24:29):
The breast just deflated,the exercise is doing much less
and the skin just loosened upand they're in their 55, 60, 65.
They feel goodbecause they take good care of themselves
and they look in the mirrorand they're just like, who is this old?
Like, Who is this woman?
Because I don't look the way I feel.
So we have that 35 and 45and that kind of 55 to 70.
(24:52):
I mean, I do I know this sounds odd.
I do a lot of 65 to 7 year old womenbecause there's a lot of
pretty awesome 65 to 7 year old womenwalking around who don't feel like
life is over, who have this incrediblecloset of clothing that they can't wear.
And, you know,they have the resources and they're like,
(25:12):
you know, and they're healthy.So like, let's do it.
My oldest is an 87.
She was going on to Boca West, right?
I mean, I'm in my family's in Boca and
the people there are like, yeah,I mean, the women,
they're in their seventies and eighties,put me to shame and I love it.
I probably most of them
was like I say, all they always saythe older patients is why do I wait?
(25:35):
I should have done this when I was 35because they're like, You're telling me
I could have had like from 35 to 65,I would have had this body.
Yeah.
Okay. Those are the two groups.
It's like right after kidsand kind of right after menopause.
You know, going into that recovery.
And I want to dive into thisa little bit more because,
you know, you talk about that first weekand when you say
(25:58):
you're not going to be,do I mean anything like you are?
You are basically you're. You're a child.
You need a baby nurse.
Like you're you'resomeone has to, like, care for you.
So do most people,you know, have to get private nursing?
I know.
I know that you offer that with yours.
But again, we have a worldwide audience,so I'm trying to make this educational
for people who might not be herein New York with you.
I mean, it's easier to have someone elsetake care of you.
(26:22):
Can someone take care? Yeah.
I also, like my operations are veryI don't want to say aggressive,
but it's comprehensive.I mean, we push things, right?
We're a very we doing the like we're goingdefinitely farther
than most comfortablebecause I do it every day.
I mean, I really need a nurse managingand following blood pressure.
(26:43):
Heart rate fluids I like
would just not feel comfortableat the extent of operating.
I do setting people off into the wild.
And that's why,
you know, there is, you know, tummy tucklight versions out there where they're
in the operating room for 90 minutesand have a little bit of lipo
and they have a little bit of skin removaland they have a straightforward
muscle repairand they're not flexed and bent over.
(27:05):
And it's probably a lot safer to go home
with, you know, just a wraparound their stomach and call it a day.
That that's not your.
It's just not me.
And by the way, that's probably fineand great for a lot of people in.
They're thrilled.
I live my life a certain wayand like I'm going at a certain speed
in a certain directionand people who vibe with me
(27:26):
and are moving at my speedand want the same things,
they're they're signing uplike I don't offer the lite version.
Like.
So, you know, keeping in mindthis general, you know, we're talking
just to the general public here, right?
Not your specific, but you know,we have to focus on like what are
what are some complicationsLike who's not a good candidate for this?
(27:47):
You know,what are some of the negative things
that that people really need to be awareof when doing a surgery like I'm.
Not a good candidate.
So it's usually a medical reason, right?
Obviously, you can have some peoplethat you're just like,
I don't really know if I want to operate,be partners with this person on a project
for the next few years because justpersonality issues is usually medical.
The most common is BMI, meaningthey're they need to lose weight
(28:09):
because a lot of the the mass that they'recarrying is inside their stomach.
So if you went to the operating room,I mean, when I say inside the stomach,
visceral, under the muscle,if you went to the operating room,
you might be able to pull some skin off,
but you won't be able to tighten
the barrel or tighten the muscles becausethe inside of the barrel is full of fat.
So you're not going to get a good result.
So what does that target BMI for?
(28:30):
For for tummy tuck,Because I know that's changed a lot
from like the days of old with liposuctionwhere they would just listen.
People are differentin their kind of the way they do things.
I would say under 30 is ideal.
32 is okay, 35 is too much.
Got it. Okay. And that's BMI.
Yeah, got it. Okay.
And you remember,you got to take BMI with a grain of salt
because if you have a power lifterand they're super dense,
(28:51):
they probably have a BMI 50,but they have a body fat of zero.
So, okay, okay.
Everything's got to be taken into context.
That's again, why
you want to go to someonewho does it all day, every day,
because they're going
to see around the corners, you know,they're going to have the nuances down,
Right.
And then
any time you have surgery, there's alwaysa risk of an anesthetic complication.
(29:11):
So that's why I like to have to askphysiologists around.
Do you somehow have some unpredictable,complicated airway,
get a second hand in there bleeding?
You know,that's usually a technical thing,
but we do use blood thinners.
Infections should be very low.
It's definitely not going to be zeroand infections can be devastating.
(29:32):
Cut from a little bit of skin rednessneeding an oral antibiotic, too, like,
you know, rare infections in the skinthat cause tissue loss.
You know, nothing great or amazingdoesn't have risk.
So and blood clots.
We give blood thinners after for a week.
Some people do.
Some people don't.
It's, you know, seems to preventblood clots in her patients.
(29:55):
But when you're going into this knowyou're going to have nuisance
you know I think of complicationswhich are significant
problems are going to interferewith your life infection bleeding
blood clotthat's admission to the hospital time.
Really scary stuff.
And then there are the nuisanceslike you're going to bruise,
you're going to ooze, you're going to bepainful and you're going to be swollen.
That's not a complication.
That's just is that's partyou know, that's along for the ride.
(30:17):
Yeah. And you're going to be emotional.
Listen, I've had surgery before, so I cantell you one I think that you never can
that most people underestimatewhat that downtime is.
It's why I'm asking you to really gointo it, because downtime to me was like,
I want people to go to the gym.
It was like, No, I can't even get myI couldn't even sit up for a week.
You can even for a week.
You can't even go to the bathroomby yourself.
(30:40):
Yeah.
Like that's how knocked out you are.
And you don't feel normal.
Now in terms of the mental, it's funnyyou bring that up.
I've written a blog recently
if anyone want to check it out on my site,but I tell people the first three
weeks are going to hate me.
And then after you'll hate meand then you'll love me
for the rest of your lifefor the first three weeks.
It's like a psychological battle.
Yeah. And like.
Yeah, you just paid this guyall this money.
(31:02):
You were cut in half,you bruise, you're swollen.
Every part of you just looks great.
Yeah.
Then you're like, What did I do?
And you always start getting the.
Did I really need to do this?
I wasn't so bad.
Well, yeah, I am.
And so my husband,you know, all that goes away.
(31:23):
So it goes. Away. But it's so important.
I remind people.
Just don't forget, you're going to feelvery sorry for yourself.
And that is a natural part of having.
But if even if you had dental surgerywhen you're in pain,
you feel sorry for yourself.
So doingsomething like this, just mentally prepare
that,that's how you're going to be feeling.
So if you're at a point in your life
where you're not feelingwell, you're mentally not ready for this.
(31:45):
Now. To make sure you know,before you do something, you know,
big on your body.
Okay.
So I want to be mindful of your timebecause I know you are a busy, busy man.
And we know that costs varyfrom where you are
in the worldto, you know, specific surgeons.
But can you give us ballparksfor these types of things?
(32:08):
Yeah. Listen, cost structures vary.
Margins don't vary that much,which is an interesting concept,
meaning like, say, for instance,something in my office is 80,000
and it's 20,000 down the street.
You're not charging four timesfor the same everything.
I think you're probably getting
400 times worth of,
(32:31):
you know, when you get into the details
pricing,a lot of it is obviously you're going to
be in Manhattan,the Upper East Side, just like commercial
leases are going to be more expensivethan Wichita, Kansas.
Staffing. You want the best of the best.
I mean, we recruit our nursesfrom around the country like Walmart,
like if you're in, you know, Oklahoma,but you're amazing.
You're moving here.
You know, we we want the bestand we pay them the best.
(32:51):
We have an all star teambecause I don't think you can do the work.
You're going to be spending a lot more.
You have a lot more resources.
I have 15 full time nurseswho are dedicated.
You know, you have your cell phonenumbers, 24 seven for that.
So what are like what are it like?
Can you kind of give ballpark?
I know it's hard, but no ranges.
(33:13):
My guessis, you know, the average for a tummy tuck
nationwide sideis probably like 15 to 20000,
kind of all in soup to nuts,as they say in New York, which is like
your anesthesia,your facility and your surgeon and,
you know, I'm going to be five,
six times that right now.
(33:34):
But I think you're getting 100 timesthe value.
So I think it's a bargain. Yeah.
Well, I want to thank you so much.
You know, doctor names,I feel like there's probably
so many questionsthat are going to come in.
I want to remind everybody at home,if you have questions
you want me to pass on to him or his team,I'm always happy to do that.
You can email mehello at our BD podcast dot com.
If people want to come to see you,what's the best way to find you?
(33:57):
The best way is to go on our website andfill out a form : NeinsteinPlasticSurgery.
com and follow meand my associate surgeons, Dr.
Chris Funderburk.
Dr. Anna Steve on social media,you will find us on the web.
my gosh.
And trust me,you want to check out his social media
because it's like the thing that I spendtime Googling.
(34:17):
I feel like you're my friend in my head.I know you.
I know your kids.
I mean, like, I'mlike and I certainly know York.
So I know we're going to take offa lot of the times patients come in
and we're like you and they say, like,hey, like, I know, I feel like I know you
because, you know,because I do show my life
and I know a lot of peopledon't want to do that.
But what that really does,it really filters.
(34:39):
You know, we're all trying to searchthrough this world to find
find our people.
And I show you who I am.
And you know,you're going to line up with that. Yeah.
You don't like who I amand what I do, which is fine.
Then. Like, you don't have to wasteyour time coming to see me.
Well, I was so pumped to have you on,
because I'm telling you, like I said, gocheck out that.
(35:00):
I mean, it's like what I do.
It's like my my husband to be like,Are you looking Neinstein again?
And I'm like, my God, look at that.
Look at this.
You know, the way I do it alland nobody helps me.
And we just showwhat we do is like nothing else to it.
I don't know if there's any.
Just show what you do.I won't be yourself.
I want to thank you so muchfor spending time with us here.
(35:20):
Do you feel like we covered anythingbefore I let you go to be
you know, we kind of hitlook what it is, who it is, who it's good
for, hit the risks, hit the costs,
you know, and certainly have highlighteda lot of the benefits.
Anything else that you find thatyour patients really need to know before?
Like I think all people should knowthat plastic surgery is a big deal.
And if it doesn't seem likethe office is making it a big deal,
(35:42):
then it won't be a big deal to you.
Look for an office in a surgeon
that show like is obsessed
that and the staff should all be smiling.
Everyone should want to be there.
It should smell nice,it should be inspiring.
It should look great.
If it looks, you know, your dental officefrom when you were a kid.
(36:07):
That's the results.
You're going to get the point.
I really like that.
Yeah, you want to make sureto take a look around, Use those eyes.
Everything you see reflects the result.
I love that.
I want to thank you again for being here.
Thank you, everybody, for listening.
I think we're going to have a great yeartogether.
Like I said, remember, you can email mequestions at hello@artbeautypodcast.com.
(36:29):
You can find us on Facebook, Instagram
and right here on YouTube: @artbeautypodcast. (36:30):
undefined
Happy New Year, everybody.
Happy New Year to you and yours.
And we will see you next Tuesday. By
All right.
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