Are fat grafts leaving you lumpy? Wondering if PRP can really refresh tired under eyes? Or concerned about the safety of your breast implants?
If these questions sound familiar, you’re not alone — and this episode of Plastic Surgery Uncensored is for YOU. Join Dr. Rady Rahban and former producer Maria as they dive into real concerns from women just like you. From the hidden risks of fat grafting (think: bumps, irregular texture, and why technique matters) to the truth about under-eye rejuvenation with PRP — Dr. Rahban pulls back the curtain on what’s hype and what’s helpful. Plus, they unpack the latest on Breast Implant Illness and what every woman should know about textured implants. This is a must-listen if you're considering a procedure, recovering from one, or simply trying to stay informed in a sea of misinformation.
🎧 Your body, your questions — honest answers from a board-certified plastic surgeon.
Follow us on social for more expert insights:
Instagram: @drradyrahban
TikTok: @radyrahbanmd
Facebook: Dr. Rady Rahban
Website: www.radyrahban.com
✨ If you enjoyed this episode of Plastic Surgery Uncensored:
✔️ Subscribe on Apple Podcasts, Spotify, or wherever you listen.
✔️ Rate & Review—your feedback helps more people find us.
✔️ Follow Dr. Rady Rahban across all platforms for daily insights, behind-the-scenes, and patient education:
If these questions sound familiar, you’re not alone — and this episode of Plastic Surgery Uncensored is for YOU. Join Dr. Rady Rahban and former producer Maria as they dive into real concerns from women just like you. From the hidden risks of fat grafting (think: bumps, irregular texture, and why technique matters) to the truth about under-eye rejuvenation with PRP — Dr. Rahban pulls back the curtain on what’s hype and what’s helpful. Plus, they unpack the latest on Breast Implant Illness and what every woman should know about textured implants. This is a must-listen if you're considering a procedure, recovering from one, or simply trying to stay informed in a sea of misinformation.
🎧 Your body, your questions — honest answers from a board-certified plastic surgeon.
Follow us on social for more expert insights:
Instagram: @drradyrahban
TikTok: @radyrahbanmd
Facebook: Dr. Rady Rahban
Website: www.radyrahban.com
✨ If you enjoyed this episode of Plastic Surgery Uncensored:
✔️ Subscribe on Apple Podcasts, Spotify, or wherever you listen.
✔️ Rate & Review—your feedback helps more people find us.
✔️ Follow Dr. Rady Rahban across all platforms for daily insights, behind-the-scenes, and patient education:
- Instagram: @drradyrahban
- TikTok: @radyrahbanMD
- YouTube: @Rady Rahban
- Facebook: @Rady Rahban
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
All right, welcome to another episode of Plastic Surgery on Censored.
I'm your host, doctor Roddy Raban, and we have our
monthly Q and A question and answer episode. Of course,
as always, my right hand woman, Maria, the producer, is
going to be asking your questions. I have to say
that you guys are doing great. Historically, in the past,
(00:27):
I would say that when you guys would send questions,
and by past I meant maybe we started in twenty nineteen,
five years ago. I don't think the questions you'd send
in let's say one hundred questions and I'd pick twenty
of them, so it was like twenty percent.
Speaker 2 (00:39):
Of them were useful.
Speaker 1 (00:40):
Now I think we just went through all of them
and we're going to use all of them, which says
a lot of things. Number one, it says that people
are really beginning to understand a deeper understanding.
Speaker 2 (00:50):
Of plastic surgery, which is awesome.
Speaker 1 (00:52):
They're more educated, they're educated, and your questions are very
app appropriate. So all right, Maria, let us get started
from Miami, by the way, and I'm glad that your
mom is doing better.
Speaker 3 (01:03):
Thank you very much.
Speaker 2 (01:04):
All right, fire away.
Speaker 3 (01:05):
Okay, so we have this from Rochelle.
Speaker 1 (01:08):
Redimon, Rochelle Redimen, this is your question.
Speaker 3 (01:12):
Fat grafting to face lumps, hardening, etc.
Speaker 2 (01:15):
Please Okay.
Speaker 1 (01:17):
So fat grafting is a massive concept of its own
and it's been around for many, many years, but like
a lot of things, it's just more popular now. So
first of all, it's not new, okay. Second of all,
we have what I would say large volume and small
volume fat transfer.
Speaker 2 (01:37):
What do I mean by that?
Speaker 1 (01:38):
Fat transfer to the breast and the butt is large volume,
fat transfer to the face is small volume. That makes
a huge difference because the way we prep and prepare
the fat matters.
Speaker 2 (01:51):
In general.
Speaker 1 (01:52):
The basics of fat transfer is I go somewhere that's
the donor site.
Speaker 2 (01:57):
I take that fat, how do I take it through life?
Per suction?
Speaker 1 (02:01):
I prepare that fat in some manner, and there's one
hundred ways to prepare it, and then I reinject it
in areas that I want to add volume.
Speaker 2 (02:09):
That's the basic principle. Okay.
Speaker 1 (02:11):
So when you want to inject to the face, the
purpose is as we're aging, we become forty, then we
become fifty, then we become sixty, we start to hollow out.
In addition to sagging loose skin. We also lose volume,
we get hollow in certain areas. So we realize in
that probably in the last fifteen twenty years that in
addition to just pulling which we used to do, we
(02:33):
now pull and fill in order to look more natural
and more rejuvenated. So the issues that you run into
with fat transfer to the face.
Speaker 2 (02:43):
Now going to the question was.
Speaker 1 (02:45):
Lumps, irregularities, and things of that nature. In the past,
people people being doctors, weren't as good at preparing and
injecting the fat. So I take the fat out and
depending on how large the goblets or clumps of fat are,
will determine how large they are when I inject them.
(03:08):
So when you inject in the breast and or the butt,
you can get away with larger clumps of fat it's
a huge area, but when you want to put it
in the face, you can't get away with larger clumps
of fat. So first thing is when your surgeon prepares
that fat. We have a method of downsizing the fat,
meaning we take it out from let's say the abdomen,
(03:28):
and then we start to pass the fat and prep
it by going back and forth through syringes and making
the size of the fat cells smaller, so you're it
should be injecting more of a puree than clumps. So
surgeons who don't prep or don't know how to do it,
they're going to inject more large clumps of fat. So
(03:49):
that's the first reason you get irregularities because you go
in air and eject and you just drop a big
clump of fat somewhere imagine underneath your eyelid or shit,
that's going to show in two seconds. The second one
thing is the nature in which you inject it, right,
So you can't just go in there and go PLoP, PLoP, PLoP.
You don't just drop little let's say, little cobblestones. You
(04:10):
need to put it in with a canula, and.
Speaker 2 (04:12):
You need to be moving constantly.
Speaker 1 (04:15):
When you inject, so more like asphalt, and you need
to go high low, side to side, So the two
areas and spreading, and you're putting very small amounts often
as opposed to large amounts infrequently, right, and so it
all last thing is where you're injecting it. There's a
lot more forgiveness. There's a lot more forgiveness in the
(04:37):
cheek than there is under the eye. So one of
the areas that people got into and get into trouble
is under the eye and the tear trough. So in general, today,
with the advances of fat transfit, like we now know
a lot more and whatnot, it really should be incredibly
infrequent and uncommon, But it still happens because people don't
(04:58):
know what they're doing.
Speaker 3 (04:58):
But how do Okay, so how I go to a doctor?
Now I go, I want to do this. What should
I ask the doctor to make sure that you.
Speaker 2 (05:06):
Know in the right problem.
Speaker 1 (05:08):
The problem is you can ask them, but they're not
going to be forth right. Hey do you make clumps? No?
Speaker 2 (05:12):
Of course not. Hey when you do it, do you
prep well? Of course?
Speaker 1 (05:17):
So what's your rate of irregularities? Oh?
Speaker 2 (05:19):
I don't get any.
Speaker 1 (05:20):
So this is not one of those things that you
can ask, whereas with other things, like you be like
who closes? I mean technically they can lie, but that's
a very straightforward question. But with fat transfer it's you
just just.
Speaker 2 (05:30):
Want to go to reputable people like.
Speaker 3 (05:32):
You just see their results.
Speaker 1 (05:34):
You want to look at their results, of course, but
fat transfer results are not very helpful either, because you
can't see a clump in a photo on an internet
You can only see a clump when I'm looking at
you in overhead light. I'm like, Maria, what's that thing
under your eye? So it's a very tricky thing to
be able to decipher. So you can't really prep for it.
You just got to go to good people.
Speaker 3 (05:53):
And with time it does it get better?
Speaker 2 (05:55):
No? No, no, once it's clumped, you clumps. Yeah, yeah,
don't clump.
Speaker 3 (05:59):
Don't clump. Yeah, that's not a good thing. Okay, this
one is does PRP work for underrise? Does it work
for hair growth?
Speaker 2 (06:07):
PRP for what.
Speaker 1 (06:09):
Was the two places that they ask for?
Speaker 3 (06:10):
Underwrise and hair growth?
Speaker 1 (06:12):
Okay, so let's just talk about PRP for a second.
Plasma rich protein, I think is what it stands for. Essentially,
what it is.
Speaker 2 (06:19):
You pull out people's blood, You draw their blood, you.
Speaker 1 (06:22):
Prep it, and you separate out this area of the
blood PRP.
Speaker 2 (06:27):
It's considered to.
Speaker 1 (06:28):
Be a very rich like it's the enriched area of
the blood. You're getting out the blood cells and you
got this PRP pure stuff. And the truth is, no
one really even knows what this stuff is. The gold
and basically what we've been doing for the last ten
years is starting to inject it in different places. Now,
don't get me wrong, there's science behind it, but it's
not that specific. So doctors and specialties like orthopedics and
(06:55):
are now starting to inject PRP all over the place,
hopes that within the PRP is this magic stuff that
will make things heal, rejuvenate, whatnot. Now, there is some
science to it, but it is very general, so know
that you can't no one can tell you this is
(07:17):
going to work.
Speaker 2 (07:18):
It's sort of like still very early stages. Now.
Speaker 1 (07:21):
Some of the areas that doctors use them is a
under the eyes. What are you using it for? If
you're using it to get rid of dark circles, never
gonna work. We've had many episodes about dark circles.
Speaker 2 (07:33):
It ain't gonna work.
Speaker 1 (07:34):
Dark circles is super complex, it's pigmented shadowing. It's a
PRP is a surface imagine, it is like a polish.
Speaker 2 (07:42):
It's not gonna do nothing under the eyes.
Speaker 1 (07:45):
So you shouldn't be using it under the eyes if
your goal is to get rid of dark circles. If
your goal is to resurface, resurface your skin, like with microneedling,
there's been some data that says it helps make the
skin a little shiny or better, but definitely it's not
gonna do anything more profound. In regards to hair loss,
there is mixed science. If your hair loss is due
(08:08):
to male pattern hair loss, like ninety percent of men
who lose their hair, very little science it helps.
Speaker 2 (08:16):
But if your hair loss is.
Speaker 1 (08:17):
A woman who is going through hormonal things, or you
had anesthesia and you lost a little bit of hair
and it's gonna come back, but you want to super
boost it, then there is some science that you inject
the PRP into your scalp. I've done it, very painful,
and that it will supercharge your hair coming back. So
(08:37):
all you need to know about PRP is it's kind
of experimental, not in a dangerous way, but like don't
hold your breath, and definitely don't spend thousands and thousands
of dollars.
Speaker 3 (08:48):
Yeah, the results are still not very well.
Speaker 1 (08:51):
They just don't know where it does and doesn't work.
Speaker 3 (08:53):
Okay. The next one is from Robideau Jacqueline Wait.
Speaker 1 (08:57):
Wait wait, Robudeau, Robidoux, Acacklin, Jacklin.
Speaker 3 (09:01):
I don't want to look like I had a facelift.
What is a secret to a natural look?
Speaker 1 (09:05):
So that is a very common question. So anyone who
gets plastic surgery. I'm here for my nose, I'm here
for my eyelids, I'm here for my breastog I'm here
for my tummy tuck. Everyone says the following initial phrase,
I'm here for my fill in the blank, and I
want it to look natural. I've never had a patient
(09:25):
come in here and be like, I want to get
a no job and I wanted to look fake. So
facelifts are no different.
Speaker 2 (09:31):
Now.
Speaker 1 (09:32):
We think of facelifts more as looking fake because we
have so many celebrity examples, right like God rest her Soul,
Joan Rivers or all.
Speaker 2 (09:40):
These other people.
Speaker 1 (09:41):
And the key with looking natural in all genres is
to find that line and stay behind it. So what
do I mean by that? So let's take a facelift.
If you don't do it, you look the way you do.
If you pull, you're starting to look good. And you
(10:03):
pull a little more. Wow, that looks really good. And
you pull a little bit more. Huh, that's looking a
little weird. You pull a little more. That looks really weird.
You look pull more, catwoman. So it's a dial, right,
it's slightly slightly more, slightly more bam, that's the best
you look.
Speaker 2 (10:16):
Keep going. Now I'm looking weird.
Speaker 1 (10:18):
So your surgeon needs to have a good understanding and
sense of taste and realize that if the line is
somewhere here, you will never get there. Right if you
try to get to the line, you've gone over. So
as a good surgeon you always stop shy of the line.
Speaker 3 (10:38):
But then they can go somewhere else and then do
it somewhere else.
Speaker 1 (10:41):
So the thing that prevents you from looking fake is
for you to be over pulled. And then in addition,
when you pull, when you remove the excess, the direction
in which you move makes a big difference. So for example,
if you look at my face and I start to
pull my little bit of excess skin straight back, what
do I look? It looks weird like my mouth is
(11:03):
getting pulled. But if I move it's somewhat upwards and
at at an angle of forty five degrees, that looks
more normal. Why because that's how I aged. I didn't
age forward and backward. I aged down at forty five degrees.
So when you rejuvenate, you want to do so in
the direction that you aged. So one of the reasons
why people look weird is they have this what's called
a swept looked, a swept look, which means something looks
(11:26):
fully pulled. And the last reason, you've had too many, right,
Like you've had like four nose jobs like.
Speaker 3 (11:32):
The wind tunnel look.
Speaker 1 (11:33):
Yeah, you've had four nose jobs. There ain't nobody making
you look natural. You've had three facelifts. Now I'm not
talking about one at fifty one, at seventy one, at ninety.
I'm talking about one at fifty one, at fifty three,
and one at fifty four.
Speaker 2 (11:47):
You understand what I mean.
Speaker 3 (11:48):
Yeah, all right, So that pacing it out probably will
make it more natural.
Speaker 1 (11:52):
Well, if your facelift at forty seven fifty two was done, well,
chances are within fifteen you're still aging and you'll need
someone to just ratchet a little bit. Then you'll look
really good. And chances are, if you're a vivacious eighty
year old, as it is my mom, you'll want.
Speaker 2 (12:12):
It ratchet a little bit.
Speaker 1 (12:14):
That's normal. But so many times people get it done.
It does, then they go do it again and then
you're just then you're screwed.
Speaker 3 (12:22):
They fall in the little trap. Yeah, okay, this one
is from DD seventy four. Can you do a tummy
tuck revision if the first time around it didn't come
out well, specifically the belly button.
Speaker 2 (12:33):
So revision surgery as a whole is very difficult.
Speaker 1 (12:41):
It's not just difficult because you're doing something. It's difficult
because the anatomy that the actual thing that you're operating
on is no longer the way it was before. Certain
areas are more amicable to being revised. Obviously it all
depends on how jacked up it is the first time.
(13:02):
But like breast, for example, have a little bit, they're
a little bit more forgiving, abdomens not as much. And
while you always want to get it right the first time,
things like noses and bellies you want to get more
right than say, your breast, if I had to say something, so,
(13:23):
I've done many revision of donoplasticis, unfortunately, and the one
area that's very tricky to fix is the belly button
because someone cut open a hole and pulled your belly
button out and set that for life. And if that
belly button nine out of ten times when people come
in and like, I hate my tummy tuck, it's two
(13:44):
main things.
Speaker 2 (13:45):
It's my bell.
Speaker 1 (13:46):
Button looks super weird and my scar is jacked up,
it's too high, it's irregular, there's like a fullness down there.
Something to do with those two main things, amongst others. Well,
once the person cut the hole and brought your belly
button out, they set the size right. In all these
twenty years that I've been in practice, I've tried one
hundred different ways to somehow make that belly bun smaller,
(14:08):
and it's never turned out to be anything that I'm like, Wow,
that was a great solution. So unfortunately, refixing a belly button,
fixing scars no problem. Fixing bellybun's very difficult to do.
Speaker 3 (14:21):
Okay. So the next one comes from Regina dot Fitch.
Do texture implants need to be removed? I found out
mine was recalled so Regina Regina Fitch, Regina Fitch.
Speaker 1 (14:36):
Okay, so textured implants. Let's have the skinny on textured implants.
So what makes up what are the various types of implants?
So first thing you need to know is what's in
the implant. So you have silicone, you have saline, Okay.
Then you need to know what is the shape of
the implant. We have round, and then we have shaped,
(15:00):
and then lastly you need to know what's the texture
or the surface of the implant.
Speaker 2 (15:05):
We have smooth, and we have texture.
Speaker 1 (15:07):
That's the We have a few other elements like profile, whatever,
but for the most part, those are things you need
to know back in the day. Back in the day,
we had smooth outside of smooth, and we had texturing.
Speaker 2 (15:19):
And the thoughts were.
Speaker 1 (15:21):
One of the main reasons why we had texturing was
the idea with that the texturing perhaps would lower the
rate of capsular contractor the thing gets hard. My breast
is rock hard. My left breast doesn't hurt, it's up it.
We thought that making the surface of it kind of
like sandpaper would reduce that risk. We now have learned
that it doesn't really make a difference. The second reason
(15:43):
why texturing was useful is that when you picked a
shaped or anatomical or tear dropped breast implant, you needed
that breast implant to stay where you put it, because
that implant has a north of south and east and
the west like, it has a shape. You can't just
spin around right. The top is the top, It can't
be on the bottom. Well, how the hell do you
(16:03):
make it not move? How do you make that implant
not go around in search. So you can't.
Speaker 2 (16:10):
Suture it, you'll rupture it.
Speaker 1 (16:12):
So the texturing allowed that implant to stick kind of
like velcrow and stick in place.
Speaker 2 (16:20):
Okay, as of probably I.
Speaker 1 (16:23):
Can't remember now, four years or something, there has been
identified a super rare type of cancer. Now it's not
breast cancer, meaning cancer of the breast tissue. It's cancer
of the capsule. And the capsule is the scar tissue
that your body forms around any foreign device. That capsule
is just it's just it's just an envelope. And there
(16:46):
is a type. There are actually two, but the most
more common of the very uncommon cancers is AlCl anaplastic
large cell lymphoma. It's a type of lymphoma. It occurs
within this capsule. The treatment is to remove the capsule
and for all intentsive purposes, in most cases.
Speaker 2 (17:04):
It's cured it. When they did the studies, they realized
that the.
Speaker 1 (17:10):
Cancer was pretty much directly linked to patients who had
textured implants. In other words, yes, in other words, of
the in the world over seventy years. Let's say I'm
making up numbers. Let's say there's one hundred million women
that have breast implants. I think there's like fifteen hundred
or two thousand or three thousand cases of this AlCl
(17:31):
globally over all these years, so it's not nothing, but
it's relatively rare. Of those cases, the overwhelming preponderance was
due to women who had a texture it.
Speaker 2 (17:43):
Now, mind you, there.
Speaker 1 (17:45):
Are hundreds of thousands, if not millions, of women with
textured implants that have no problem. So as a result,
texturing was removed off the market until they could figure
out what the hell is going on. So today, if
you came into an office in America, you can't get
a textured implant.
Speaker 2 (18:02):
None of the manufacturers make it.
Speaker 1 (18:04):
So also with that went the shaped implants, right, because
you can't have a smooth shaped implant. That being said,
it was not advised, nor is it advised for women
with textured Now I'm going to get to your question
with her, Oh my god, I have textured implants. Holy shit,
I gotta run out and go remove them.
Speaker 2 (18:22):
You don't remove your.
Speaker 1 (18:23):
Implant, let's say, thousands of women when there's nothing wrong.
How the hell do I know if I have ALCO
So it is almost always associated with swelling, redness, and
other types of symptoms. So the recommendation was pay attention,
pay attention to your breast, be more vigil and if
(18:44):
you've had your implants in for a very long time,
you should probably go in have the exchange and take
the capsule out and remove the capsule and reset everything
with a smooth implant. Now, to answer your question, she said,
my implants were recalled, So these implants were not recalled,
they were no longer manufactured. There was an implant that
was recalled, and that implant was a pip implant.
Speaker 2 (19:07):
I just took one out a month ago.
Speaker 1 (19:08):
That was a French implant that was noted to rupture
all the time, and the silicone was like like Industrials
A grade.
Speaker 2 (19:16):
It was a huge disaster. Those implants. If you have it,
you open, I'm like, holy shit, I have a p
ip implant. You should take that out.
Speaker 1 (19:22):
So texturing and recall and it's just a mishmash of works.
But if you have a standard garden variety textured implant
and your breasts are awesome and you have no problems,
I don't think you need to run out and just
remove them for the hell of it.
Speaker 3 (19:35):
Okay, we're gonna come back. I have I have a
couple more questions on rhinoplasty and fillers for labyo plasty.
Speaker 1 (19:42):
Fillers for labor No, I'm just kidding it. Fillers for
labio plastic.
Speaker 2 (19:45):
That's right.
Speaker 1 (19:45):
You better want to You're like, oh, yes, fillers for
laby plastic.
Speaker 2 (19:50):
You're gonna want to check out.
Speaker 1 (19:51):
The second half of this amazing episode will be right
back with Plastic Surgery and Sensored.
Speaker 2 (20:03):
All right, welcome to.
Speaker 1 (20:04):
The second half of Plastic Surgery Uncensored Q and a
session with Maria, my producer. You guys have been doing great.
These questions are fantastic. Uh so, Maria, don't go straight
to the labia once. Save that for the hands. So
people have to listen to the end. Okay, what's what's
the question?
Speaker 2 (20:19):
What do you got?
Speaker 3 (20:19):
What's the different This is from Eli.
Speaker 2 (20:22):
Design, Ellie Design. Here's your question.
Speaker 3 (20:24):
What's the difference between tip plasty versus rhinoplasty? Is tip
plasty meant for bulbus nose?
Speaker 1 (20:30):
So the question was what's the distinction between tip plasty
and rhinoplasty?
Speaker 2 (20:37):
And was is a tip plasty design for a bulbus nose?
Speaker 1 (20:40):
So tip plasty is just a part.
Speaker 2 (20:44):
Of a rhinoplasty. So people.
Speaker 1 (20:48):
Let me back up a lot of the things that
a lot of the terms that we use in plastic
surgery are used not amongst other doctors, but are used
for marketing.
Speaker 2 (20:57):
Right.
Speaker 1 (20:57):
We create up these terms so that you, the lay
person can google it and read it. But the reality
is that's not what we would be talking about. And
the reason why I say that is a rhino PLASTI
means rearranging the nose so it looks good. And within
a rhinoplasty, let's say on average, there's probably thirty different maneuvers.
You can bring the bridge down, you can narrow the bones,
(21:18):
you could take the nostrils, and you can make the
tip lower, higher and make the tip smaller, make the
bridge taller.
Speaker 2 (21:26):
There's all these maneuvers.
Speaker 1 (21:27):
Right, of those, say thirty maneuvers, a handful of those
are are designed or they're directed towards working on the tip.
Speaker 2 (21:40):
So in the super rare instance.
Speaker 1 (21:43):
That someone walks into my office their nose is perfect
bridge with this, but their only issue is their tip,
then my rhinoplasty will only be dealing.
Speaker 2 (21:57):
With the tip.
Speaker 1 (21:58):
And if I wanted to mark kid that, I could say, hey,
you're getting a tip plasty. The reason the tip plasty
is of words that we use, is because makes patients
feel like their nose job is lesser. I didn't get
a nose job.
Speaker 2 (22:10):
Everybody, well, what the hell did you do?
Speaker 1 (22:12):
I got a tip tip plasty, You got a tip price?
What the what the hell's a tip plus.
Speaker 2 (22:17):
It's well, it's not a whole nose job. So it's
just nonsense.
Speaker 1 (22:21):
And the reason I say that is in the hundreds
and thousands that I've done, I don't remember the last
time that someone walked in with the most spectacular nose
minus their tip. The second thing is that patient think
that all they need is a tip plasty. And the
thing is, how can I help you? Oh, I love
my nose except for my tip. I don't want to
(22:43):
touch anything else, just my tip. That's not how this works,
because your nose, your tip is connected to your bridge,
which is connected to your nostrils, which there is no
way to move this lever without changing those other levers.
So it's a it's a it's a it's a all
an interwining of your watch. You cannot affect one part
(23:04):
without affecting the other. So ninety nine percent of the
patients who are asking for tip. Plassies need other stuff done.
It doesn't need to be dramatic. You don't need to
be unrecognizable. But you can't just just like isolate the
tip and not touch anything else and then think it's
gonna look harmonious.
Speaker 2 (23:20):
It just doesn't work that way.
Speaker 3 (23:21):
Yeah, okay, So this next question comes from uh Senaya
A ninety.
Speaker 1 (23:27):
Two Shanaa and a ninety two.
Speaker 3 (23:29):
Can a liplift be done at the same time as
a nose job or better to do them separately.
Speaker 2 (23:34):
It's a great question.
Speaker 1 (23:35):
So that's a little controversial. So let's start with what
it is. A liplift is a facelift of your upper lift.
What that means is that, by the way, this whole
lip lift phenomenon again all due to social media, liplifts
have been around for seventy years. A liplft was designed
(23:56):
Woo probably in the sixties and seventies. All it is
going on the under surface of your nose, on your
upper lip, taking out a wedge hiding that incision in
the sill of the nostrils, and when you remove that wedge,
it lifts the upper lip, therefore giving your upper lip
(24:19):
a face lift. Why would you do that, because as
we age, just like our neck and our breasts and
our ear lobes, your upper lip lengthens and your upper
lip slowly disappears. Where the hell did it go? When
I look at my twenty year old pictures, I had
such full lips. Now I look like I have two
little pencils on my lips.
Speaker 2 (24:38):
What happened?
Speaker 1 (24:39):
You lost volume and you have extra upper lip skin,
and your upper lip rolled inside your mouth. Rather than
your upper lip looking like a ski slope meaning nice
and full, your upper lip is now a parabolic convexity
and it rolls inwards and down. It's a very powerful,
(24:59):
very effective surgery.
Speaker 2 (25:01):
In exchange, you have.
Speaker 1 (25:02):
A little scar underneath your nose. And if it's done well,
maybe it's a good trade off. Now, the reason why
I say it's controversial, the reason why I say it's
popular is because now twenty year olds are getting it.
It was designed for an older woman or an older gentleman.
Now it's like I'm on Instagram Angelina. Yeah. And the
other thing is I'm tired of getting filler, and so
I want to do a lip lift. Well, now you
(25:22):
look like you have a cleft flip, Like your lip
looks almost like it's a sewn tiered lower nose.
Speaker 2 (25:27):
Anyways, we digress.
Speaker 1 (25:30):
So the concern is that when you do a rhinoplasty
and you do a lip lift, they are intimately same borders.
You're at the border of Russia and Iran. In other words,
your nose were cutting here often and your lip were
cutting here. So there is some concern that the blood
supply to the stuff in between will be a little compromised. Therefore,
(25:57):
some surgeons recommend separating them. That tends to be my
general philosophy, and some do them simultaneously. That's a per
surgeon preference, and so you're gonna have to talk to
the surgeon about it.
Speaker 2 (26:10):
But it is.
Speaker 1 (26:11):
It definitely is an area that people are a little
you know, I don't know, I should maybe take my time,
maybe separate them. I tend to separate them myself.
Speaker 3 (26:20):
I probably would not want to devote together. Okay. P
Money sixty one wants to know is it possible to
get filler in Labia area for a little more fullness?
If so, what type of filler is safe down there?
Speaker 1 (26:33):
All right?
Speaker 2 (26:34):
So who is the person? P money?
Speaker 1 (26:35):
P money sixty one, P Money sixty one.
Speaker 3 (26:38):
Okay, So she's probably two years older than being sixty one.
Speaker 2 (26:42):
How do you know?
Speaker 1 (26:43):
She?
Speaker 3 (26:44):
Well?
Speaker 1 (26:44):
But who it has to be a war. Maybe it's
a guy asking for his girlfriend.
Speaker 3 (26:48):
Oh okay, okay, that's true.
Speaker 2 (26:49):
P money, all right.
Speaker 1 (26:51):
So the first thing you're you're I think a decent
number of people are like, what the what? Late?
Speaker 2 (26:56):
Why? Exactly?
Speaker 3 (26:57):
So that's what I thought to you.
Speaker 1 (26:59):
I know, well, and then you said, well, I guess
I haven't looked down there. No, So what based on
our whole dialogue today, what happens to your labia when
you get older, same thing that happens with your ear
lobes and your breast, and your upper lip and your neck.
Speaker 2 (27:15):
As you get older, you lose volume and you get
extra skin.
Speaker 1 (27:20):
That's what happens to every part of your body, your
upper eyelids. You're da da da da da da everywhere.
Some areas it's more volume loss than it is skin.
Some areas it's reversed, and most areas is a combination
of things. So you're inner labia, the labia minore, the
(27:41):
labia parts that are thin and more floppy. Those labias
tend to get longer, and they tend to be asymmetric
and that's treatment for that is a labioplasty. We remove
the redundancy, hence creating a cleaner outer surface.
Speaker 2 (28:01):
Okay, that's not what this person's referring to. They're referring to.
Speaker 1 (28:05):
The labia majory, which is the outer labia. Because as
we age and we change our hormones, the outer labia
lose fullness and become flat and deflated. And so a
youthful labia has a short inner labia and a full
(28:27):
outer labia. Okay, And so naturally the question is if
I lose volume in my outer labia and I don't
like the way that looks, what can I do? And
you could replenish the volume. There are two ways to
replenish the volume in your labia. A fillers b fat
and they're identical to your lips. Ironically, they're both called
(28:51):
labia lips. So what you would do is you would
fill it with some source of volume. Now, fat transfer
tends to be surgical. You have to you know, it's
you know, it's something that you would often do onder
anesthesia or local whatever.
Speaker 2 (29:09):
Filler.
Speaker 1 (29:09):
As you walk in you open up a syringeine to
do it. So the filler I always and only recommend
in general just ubiquitously is highly uronic acid based fillers
h A. Why because highly uronic acid based fillers are a.
Speaker 2 (29:28):
Reversible, be absorbable, see.
Speaker 1 (29:32):
No reaction, because we have it, and therefore you don't
need to get tested. I don't see any reason for
you to start using other items that have a longevity
in this when you don't know if that product will
go away.
Speaker 2 (29:48):
What if you occlude a vessel.
Speaker 1 (29:50):
What if you acclude a vessel and it's an emergency,
you can't reverse it till it goes away and maybe
takes five.
Speaker 2 (29:55):
Years or never.
Speaker 1 (29:56):
So to answer her question, if you're going to use filler,
you should use h A, and within h A, we
have various thicknesses a filler. So imagine thin paint, moderate paint,
and thick paint. And you want to use thin paint
(30:17):
in areas that are delicate under your eyelids, in your nose,
you want to use medium and thicker in places that
have a lot of space your cheeks, your jawline. And
I think the medium ones are appropriate for the labia
because it's really a sizeable area and you need some cushion.
So that's that's that's why people do fill you're gonna
(30:43):
go grab a mirror. I know.
Speaker 2 (30:47):
Your husband will grab a mirror.
Speaker 3 (30:48):
I just ask him, am I okay?
Speaker 1 (30:49):
There? Your husband will tell you you're okay, period.
Speaker 3 (30:54):
Sometimes he does okay. I want to mention some reviews
that we've gotten that.
Speaker 2 (30:58):
I don't want to hear any bad No, no, you're
not going to get any bad reviews.
Speaker 3 (31:03):
But I have here refreshingly honest, I've been listening to
doctor r. Bron's podcast for a while now, and I've
been meaning to write a review. Doctor Rabon has a
downtoward conversational style that is easy to understand and entertaining
to follow. I truly enjoy his insights and eye opening information.
Speaker 2 (31:18):
Is that from my mom?
Speaker 3 (31:20):
No, no, it's a long one. And let me see
this other one is from top notch, very informative and unbiased.
Some of these should be required listening before major elective
cosmetic surgery. Let me tell you every time that I
have a friend who knows that I do the podcast,
ask me and I go listen to the podcast. If
you want to know, you'll hear from him the horse's mouth.
(31:44):
So yeah, thank you for telling us on the patient side,
the realistic outcomes versus the blurred perfect images we see.
Speaker 1 (31:51):
I appreciate that at the end of the day, the
purpose it's Sunday, Maria Fluin from Miami, Me and my
whole team are here on a Sunday, and the only
reason we do this is because we want to share
this information with the listener in hopes that the listener
will take this information, convert it into knowledge, and from
that knowledge make the right choice for them without being
(32:11):
misled or confused or manipulated. So when I read these reviews,
it's very heartwarming, and more importantly, it's reaffirming that you
know what getting here, coming here, leaving my kids, you,
leaving your home is well worth it.
Speaker 2 (32:24):
So thank you for the reviews.
Speaker 1 (32:26):
So that wraps up yet another episode of plastic Surgery
and Censored. I always end every episode with two requests.
One is, if you find this information, as these reviews
have written, informative and helpful and educational, share it with
your friends and family. You have no idea who is
considering or contemplating surgery until it's too late.
Speaker 2 (32:44):
They'll show up one day and they'll have had a complication.
Speaker 1 (32:46):
You'll be like, what the why didn't you tell me, so,
just share it, just say hey, check out this podcast.
Speaker 2 (32:50):
It's super cool.
Speaker 1 (32:51):
Secondly, if you do enjoy the podcast, we love to
hear back from you. Write something nice. Go take right now,
get off the podcast. Go write something takes two seconds.
And what it does is it a helps us know
that this is helpful, and two it helps the podcast
elevate in its ranking. And the goal is for this
(33:12):
information to get to more people.
Speaker 2 (33:13):
So we love you and we appreciate it.
Speaker 1 (33:15):
And that's a wrap for this week's episode of Plastic
Surgery Uncensored until next week.
Speaker 2 (33:21):
I'm your host, doctor Roddy Raban.
All right, welcome to another episode of Plastic Surgery on Censored.
I'm your host, doctor Roddy Raban, and we have our
monthly Q and A question and answer episode. Of course,
as always, my right hand woman, Maria, the producer, is
going to be asking your questions. I have to say
that you guys are doing great. Historically, in the past,
(00:27):
I would say that when you guys would send questions,
and by past I meant maybe we started in twenty nineteen,
five years ago. I don't think the questions you'd send
in let's say one hundred questions and I'd pick twenty
of them, so it was like twenty percent.
Speaker 2 (00:39):
Of them were useful.
Speaker 1 (00:40):
Now I think we just went through all of them
and we're going to use all of them, which says
a lot of things. Number one, it says that people
are really beginning to understand a deeper understanding.
Speaker 2 (00:50):
Of plastic surgery, which is awesome.
Speaker 1 (00:52):
They're more educated, they're educated, and your questions are very
app appropriate. So all right, Maria, let us get started
from Miami, by the way, and I'm glad that your
mom is doing better.
Speaker 3 (01:03):
Thank you very much.
Speaker 2 (01:04):
All right, fire away.
Speaker 3 (01:05):
Okay, so we have this from Rochelle.
Speaker 1 (01:08):
Redimon, Rochelle Redimen, this is your question.
Speaker 3 (01:12):
Fat grafting to face lumps, hardening, etc.
Speaker 2 (01:15):
Please Okay.
Speaker 1 (01:17):
So fat grafting is a massive concept of its own
and it's been around for many, many years, but like
a lot of things, it's just more popular now. So
first of all, it's not new, okay. Second of all,
we have what I would say large volume and small
volume fat transfer.
Speaker 2 (01:37):
What do I mean by that?
Speaker 1 (01:38):
Fat transfer to the breast and the butt is large volume,
fat transfer to the face is small volume. That makes
a huge difference because the way we prep and prepare
the fat matters.
Speaker 2 (01:51):
In general.
Speaker 1 (01:52):
The basics of fat transfer is I go somewhere that's
the donor site.
Speaker 2 (01:57):
I take that fat, how do I take it through life?
Per suction?
Speaker 1 (02:01):
I prepare that fat in some manner, and there's one
hundred ways to prepare it, and then I reinject it
in areas that I want to add volume.
Speaker 2 (02:09):
That's the basic principle. Okay.
Speaker 1 (02:11):
So when you want to inject to the face, the
purpose is as we're aging, we become forty, then we
become fifty, then we become sixty, we start to hollow out.
In addition to sagging loose skin. We also lose volume,
we get hollow in certain areas. So we realize in
that probably in the last fifteen twenty years that in
addition to just pulling which we used to do, we
(02:33):
now pull and fill in order to look more natural
and more rejuvenated. So the issues that you run into
with fat transfer to the face.
Speaker 2 (02:43):
Now going to the question was.
Speaker 1 (02:45):
Lumps, irregularities, and things of that nature. In the past,
people people being doctors, weren't as good at preparing and
injecting the fat. So I take the fat out and
depending on how large the goblets or clumps of fat are,
will determine how large they are when I inject them.
(03:08):
So when you inject in the breast and or the butt,
you can get away with larger clumps of fat it's
a huge area, but when you want to put it
in the face, you can't get away with larger clumps
of fat. So first thing is when your surgeon prepares
that fat. We have a method of downsizing the fat,
meaning we take it out from let's say the abdomen,
(03:28):
and then we start to pass the fat and prep
it by going back and forth through syringes and making
the size of the fat cells smaller, so you're it
should be injecting more of a puree than clumps. So
surgeons who don't prep or don't know how to do it,
they're going to inject more large clumps of fat. So
(03:49):
that's the first reason you get irregularities because you go
in air and eject and you just drop a big
clump of fat somewhere imagine underneath your eyelid or shit,
that's going to show in two seconds. The second one
thing is the nature in which you inject it, right,
So you can't just go in there and go PLoP, PLoP, PLoP.
You don't just drop little let's say, little cobblestones. You
(04:10):
need to put it in with a canula, and.
Speaker 2 (04:12):
You need to be moving constantly.
Speaker 1 (04:15):
When you inject, so more like asphalt, and you need
to go high low, side to side, So the two
areas and spreading, and you're putting very small amounts often
as opposed to large amounts infrequently, right, and so it
all last thing is where you're injecting it. There's a
lot more forgiveness. There's a lot more forgiveness in the
(04:37):
cheek than there is under the eye. So one of
the areas that people got into and get into trouble
is under the eye and the tear trough. So in general, today,
with the advances of fat transfit, like we now know
a lot more and whatnot, it really should be incredibly
infrequent and uncommon, But it still happens because people don't
(04:58):
know what they're doing.
Speaker 3 (04:58):
But how do Okay, so how I go to a doctor?
Now I go, I want to do this. What should
I ask the doctor to make sure that you.
Speaker 2 (05:06):
Know in the right problem.
Speaker 1 (05:08):
The problem is you can ask them, but they're not
going to be forth right. Hey do you make clumps? No?
Speaker 2 (05:12):
Of course not. Hey when you do it, do you
prep well? Of course?
Speaker 1 (05:17):
So what's your rate of irregularities? Oh?
Speaker 2 (05:19):
I don't get any.
Speaker 1 (05:20):
So this is not one of those things that you
can ask, whereas with other things, like you be like
who closes? I mean technically they can lie, but that's
a very straightforward question. But with fat transfer it's you
just just.
Speaker 2 (05:30):
Want to go to reputable people like.
Speaker 3 (05:32):
You just see their results.
Speaker 1 (05:34):
You want to look at their results, of course, but
fat transfer results are not very helpful either, because you
can't see a clump in a photo on an internet
You can only see a clump when I'm looking at
you in overhead light. I'm like, Maria, what's that thing
under your eye? So it's a very tricky thing to
be able to decipher. So you can't really prep for it.
You just got to go to good people.
Speaker 3 (05:53):
And with time it does it get better?
Speaker 2 (05:55):
No? No, no, once it's clumped, you clumps. Yeah, yeah,
don't clump.
Speaker 3 (05:59):
Don't clump. Yeah, that's not a good thing. Okay, this
one is does PRP work for underrise? Does it work
for hair growth?
Speaker 2 (06:07):
PRP for what.
Speaker 1 (06:09):
Was the two places that they ask for?
Speaker 3 (06:10):
Underwrise and hair growth?
Speaker 1 (06:12):
Okay, so let's just talk about PRP for a second.
Plasma rich protein, I think is what it stands for. Essentially,
what it is.
Speaker 2 (06:19):
You pull out people's blood, You draw their blood, you.
Speaker 1 (06:22):
Prep it, and you separate out this area of the
blood PRP.
Speaker 2 (06:27):
It's considered to.
Speaker 1 (06:28):
Be a very rich like it's the enriched area of
the blood. You're getting out the blood cells and you
got this PRP pure stuff. And the truth is, no
one really even knows what this stuff is. The gold
and basically what we've been doing for the last ten
years is starting to inject it in different places. Now,
don't get me wrong, there's science behind it, but it's
not that specific. So doctors and specialties like orthopedics and
(06:55):
are now starting to inject PRP all over the place,
hopes that within the PRP is this magic stuff that
will make things heal, rejuvenate, whatnot. Now, there is some
science to it, but it is very general, so know
that you can't no one can tell you this is
(07:17):
going to work.
Speaker 2 (07:18):
It's sort of like still very early stages. Now.
Speaker 1 (07:21):
Some of the areas that doctors use them is a
under the eyes. What are you using it for? If
you're using it to get rid of dark circles, never
gonna work. We've had many episodes about dark circles.
Speaker 2 (07:33):
It ain't gonna work.
Speaker 1 (07:34):
Dark circles is super complex, it's pigmented shadowing. It's a
PRP is a surface imagine, it is like a polish.
Speaker 2 (07:42):
It's not gonna do nothing under the eyes.
Speaker 1 (07:45):
So you shouldn't be using it under the eyes if
your goal is to get rid of dark circles. If
your goal is to resurface, resurface your skin, like with microneedling,
there's been some data that says it helps make the
skin a little shiny or better, but definitely it's not
gonna do anything more profound. In regards to hair loss,
there is mixed science. If your hair loss is due
(08:08):
to male pattern hair loss, like ninety percent of men
who lose their hair, very little science it helps.
Speaker 2 (08:16):
But if your hair loss is.
Speaker 1 (08:17):
A woman who is going through hormonal things, or you
had anesthesia and you lost a little bit of hair
and it's gonna come back, but you want to super
boost it, then there is some science that you inject
the PRP into your scalp. I've done it, very painful,
and that it will supercharge your hair coming back. So
(08:37):
all you need to know about PRP is it's kind
of experimental, not in a dangerous way, but like don't
hold your breath, and definitely don't spend thousands and thousands
of dollars.
Speaker 3 (08:48):
Yeah, the results are still not very well.
Speaker 1 (08:51):
They just don't know where it does and doesn't work.
Speaker 3 (08:53):
Okay. The next one is from Robideau Jacqueline Wait.
Speaker 1 (08:57):
Wait wait, Robudeau, Robidoux, Acacklin, Jacklin.
Speaker 3 (09:01):
I don't want to look like I had a facelift.
What is a secret to a natural look?
Speaker 1 (09:05):
So that is a very common question. So anyone who
gets plastic surgery. I'm here for my nose, I'm here
for my eyelids, I'm here for my breastog I'm here
for my tummy tuck. Everyone says the following initial phrase,
I'm here for my fill in the blank, and I
want it to look natural. I've never had a patient
(09:25):
come in here and be like, I want to get
a no job and I wanted to look fake. So
facelifts are no different.
Speaker 2 (09:31):
Now.
Speaker 1 (09:32):
We think of facelifts more as looking fake because we
have so many celebrity examples, right like God rest her Soul,
Joan Rivers or all.
Speaker 2 (09:40):
These other people.
Speaker 1 (09:41):
And the key with looking natural in all genres is
to find that line and stay behind it. So what
do I mean by that? So let's take a facelift.
If you don't do it, you look the way you do.
If you pull, you're starting to look good. And you
(10:03):
pull a little more. Wow, that looks really good. And
you pull a little bit more. Huh, that's looking a
little weird. You pull a little more. That looks really weird.
You look pull more, catwoman. So it's a dial, right,
it's slightly slightly more, slightly more bam, that's the best
you look.
Speaker 2 (10:16):
Keep going. Now I'm looking weird.
Speaker 1 (10:18):
So your surgeon needs to have a good understanding and
sense of taste and realize that if the line is
somewhere here, you will never get there. Right if you
try to get to the line, you've gone over. So
as a good surgeon you always stop shy of the line.
Speaker 3 (10:38):
But then they can go somewhere else and then do
it somewhere else.
Speaker 1 (10:41):
So the thing that prevents you from looking fake is
for you to be over pulled. And then in addition,
when you pull, when you remove the excess, the direction
in which you move makes a big difference. So for example,
if you look at my face and I start to
pull my little bit of excess skin straight back, what
do I look? It looks weird like my mouth is
(11:03):
getting pulled. But if I move it's somewhat upwards and
at at an angle of forty five degrees, that looks
more normal. Why because that's how I aged. I didn't
age forward and backward. I aged down at forty five degrees.
So when you rejuvenate, you want to do so in
the direction that you aged. So one of the reasons
why people look weird is they have this what's called
a swept looked, a swept look, which means something looks
(11:26):
fully pulled. And the last reason, you've had too many, right,
Like you've had like four nose jobs like.
Speaker 3 (11:32):
The wind tunnel look.
Speaker 1 (11:33):
Yeah, you've had four nose jobs. There ain't nobody making
you look natural. You've had three facelifts. Now I'm not
talking about one at fifty one, at seventy one, at ninety.
I'm talking about one at fifty one, at fifty three,
and one at fifty four.
Speaker 2 (11:47):
You understand what I mean.
Speaker 3 (11:48):
Yeah, all right, So that pacing it out probably will
make it more natural.
Speaker 1 (11:52):
Well, if your facelift at forty seven fifty two was done, well,
chances are within fifteen you're still aging and you'll need
someone to just ratchet a little bit. Then you'll look
really good. And chances are, if you're a vivacious eighty
year old, as it is my mom, you'll want.
Speaker 2 (12:12):
It ratchet a little bit.
Speaker 1 (12:14):
That's normal. But so many times people get it done.
It does, then they go do it again and then
you're just then you're screwed.
Speaker 3 (12:22):
They fall in the little trap. Yeah, okay, this one
is from DD seventy four. Can you do a tummy
tuck revision if the first time around it didn't come
out well, specifically the belly button.
Speaker 2 (12:33):
So revision surgery as a whole is very difficult.
Speaker 1 (12:41):
It's not just difficult because you're doing something. It's difficult
because the anatomy that the actual thing that you're operating
on is no longer the way it was before. Certain
areas are more amicable to being revised. Obviously it all
depends on how jacked up it is the first time.
(13:02):
But like breast, for example, have a little bit, they're
a little bit more forgiving, abdomens not as much. And
while you always want to get it right the first time,
things like noses and bellies you want to get more
right than say, your breast, if I had to say something, so,
(13:23):
I've done many revision of donoplasticis, unfortunately, and the one
area that's very tricky to fix is the belly button
because someone cut open a hole and pulled your belly
button out and set that for life. And if that
belly button nine out of ten times when people come
in and like, I hate my tummy tuck, it's two
(13:44):
main things.
Speaker 2 (13:45):
It's my bell.
Speaker 1 (13:46):
Button looks super weird and my scar is jacked up,
it's too high, it's irregular, there's like a fullness down there.
Something to do with those two main things, amongst others. Well,
once the person cut the hole and brought your belly
button out, they set the size right. In all these
twenty years that I've been in practice, I've tried one
hundred different ways to somehow make that belly bun smaller,
(14:08):
and it's never turned out to be anything that I'm like, Wow,
that was a great solution. So unfortunately, refixing a belly button,
fixing scars no problem. Fixing bellybun's very difficult to do.
Speaker 3 (14:21):
Okay. So the next one comes from Regina dot Fitch.
Do texture implants need to be removed? I found out
mine was recalled so Regina Regina Fitch, Regina Fitch.
Speaker 1 (14:36):
Okay, so textured implants. Let's have the skinny on textured implants.
So what makes up what are the various types of implants?
So first thing you need to know is what's in
the implant. So you have silicone, you have saline, Okay.
Then you need to know what is the shape of
the implant. We have round, and then we have shaped,
(15:00):
and then lastly you need to know what's the texture
or the surface of the implant.
Speaker 2 (15:05):
We have smooth, and we have texture.
Speaker 1 (15:07):
That's the We have a few other elements like profile, whatever,
but for the most part, those are things you need
to know back in the day. Back in the day,
we had smooth outside of smooth, and we had texturing.
Speaker 2 (15:19):
And the thoughts were.
Speaker 1 (15:21):
One of the main reasons why we had texturing was
the idea with that the texturing perhaps would lower the
rate of capsular contractor the thing gets hard. My breast
is rock hard. My left breast doesn't hurt, it's up it.
We thought that making the surface of it kind of
like sandpaper would reduce that risk. We now have learned
that it doesn't really make a difference. The second reason
(15:43):
why texturing was useful is that when you picked a
shaped or anatomical or tear dropped breast implant, you needed
that breast implant to stay where you put it, because
that implant has a north of south and east and
the west like, it has a shape. You can't just
spin around right. The top is the top, It can't
be on the bottom. Well, how the hell do you
(16:03):
make it not move? How do you make that implant
not go around in search. So you can't.
Speaker 2 (16:10):
Suture it, you'll rupture it.
Speaker 1 (16:12):
So the texturing allowed that implant to stick kind of
like velcrow and stick in place.
Speaker 2 (16:20):
Okay, as of probably I.
Speaker 1 (16:23):
Can't remember now, four years or something, there has been
identified a super rare type of cancer. Now it's not
breast cancer, meaning cancer of the breast tissue. It's cancer
of the capsule. And the capsule is the scar tissue
that your body forms around any foreign device. That capsule
is just it's just it's just an envelope. And there
(16:46):
is a type. There are actually two, but the most
more common of the very uncommon cancers is AlCl anaplastic
large cell lymphoma. It's a type of lymphoma. It occurs
within this capsule. The treatment is to remove the capsule
and for all intentsive purposes, in most cases.
Speaker 2 (17:04):
It's cured it. When they did the studies, they realized
that the.
Speaker 1 (17:10):
Cancer was pretty much directly linked to patients who had
textured implants. In other words, yes, in other words, of
the in the world over seventy years. Let's say I'm
making up numbers. Let's say there's one hundred million women
that have breast implants. I think there's like fifteen hundred
or two thousand or three thousand cases of this AlCl
(17:31):
globally over all these years, so it's not nothing, but
it's relatively rare. Of those cases, the overwhelming preponderance was
due to women who had a texture it.
Speaker 2 (17:43):
Now, mind you, there.
Speaker 1 (17:45):
Are hundreds of thousands, if not millions, of women with
textured implants that have no problem. So as a result,
texturing was removed off the market until they could figure
out what the hell is going on. So today, if
you came into an office in America, you can't get
a textured implant.
Speaker 2 (18:02):
None of the manufacturers make it.
Speaker 1 (18:04):
So also with that went the shaped implants, right, because
you can't have a smooth shaped implant. That being said,
it was not advised, nor is it advised for women
with textured Now I'm going to get to your question
with her, Oh my god, I have textured implants. Holy shit,
I gotta run out and go remove them.
Speaker 2 (18:22):
You don't remove your.
Speaker 1 (18:23):
Implant, let's say, thousands of women when there's nothing wrong.
How the hell do I know if I have ALCO
So it is almost always associated with swelling, redness, and
other types of symptoms. So the recommendation was pay attention,
pay attention to your breast, be more vigil and if
(18:44):
you've had your implants in for a very long time,
you should probably go in have the exchange and take
the capsule out and remove the capsule and reset everything
with a smooth implant. Now, to answer your question, she said,
my implants were recalled, So these implants were not recalled,
they were no longer manufactured. There was an implant that
was recalled, and that implant was a pip implant.
Speaker 2 (19:07):
I just took one out a month ago.
Speaker 1 (19:08):
That was a French implant that was noted to rupture
all the time, and the silicone was like like Industrials
A grade.
Speaker 2 (19:16):
It was a huge disaster. Those implants. If you have it,
you open, I'm like, holy shit, I have a p
ip implant. You should take that out.
Speaker 1 (19:22):
So texturing and recall and it's just a mishmash of works.
But if you have a standard garden variety textured implant
and your breasts are awesome and you have no problems,
I don't think you need to run out and just
remove them for the hell of it.
Speaker 3 (19:35):
Okay, we're gonna come back. I have I have a
couple more questions on rhinoplasty and fillers for labyo plasty.
Speaker 1 (19:42):
Fillers for labor No, I'm just kidding it. Fillers for
labio plastic.
Speaker 2 (19:45):
That's right.
Speaker 1 (19:45):
You better want to You're like, oh, yes, fillers for
laby plastic.
Speaker 2 (19:50):
You're gonna want to check out.
Speaker 1 (19:51):
The second half of this amazing episode will be right
back with Plastic Surgery and Sensored.
Speaker 2 (20:03):
All right, welcome to.
Speaker 1 (20:04):
The second half of Plastic Surgery Uncensored Q and a
session with Maria, my producer. You guys have been doing great.
These questions are fantastic. Uh so, Maria, don't go straight
to the labia once. Save that for the hands. So
people have to listen to the end. Okay, what's what's
the question?
Speaker 2 (20:19):
What do you got?
Speaker 3 (20:19):
What's the different This is from Eli.
Speaker 2 (20:22):
Design, Ellie Design. Here's your question.
Speaker 3 (20:24):
What's the difference between tip plasty versus rhinoplasty? Is tip
plasty meant for bulbus nose?
Speaker 1 (20:30):
So the question was what's the distinction between tip plasty
and rhinoplasty?
Speaker 2 (20:37):
And was is a tip plasty design for a bulbus nose?
Speaker 1 (20:40):
So tip plasty is just a part.
Speaker 2 (20:44):
Of a rhinoplasty. So people.
Speaker 1 (20:48):
Let me back up a lot of the things that
a lot of the terms that we use in plastic
surgery are used not amongst other doctors, but are used
for marketing.
Speaker 2 (20:57):
Right.
Speaker 1 (20:57):
We create up these terms so that you, the lay
person can google it and read it. But the reality
is that's not what we would be talking about. And
the reason why I say that is a rhino PLASTI
means rearranging the nose so it looks good. And within
a rhinoplasty, let's say on average, there's probably thirty different maneuvers.
You can bring the bridge down, you can narrow the bones,
(21:18):
you could take the nostrils, and you can make the
tip lower, higher and make the tip smaller, make the
bridge taller.
Speaker 2 (21:26):
There's all these maneuvers.
Speaker 1 (21:27):
Right, of those, say thirty maneuvers, a handful of those
are are designed or they're directed towards working on the tip.
Speaker 2 (21:40):
So in the super rare instance.
Speaker 1 (21:43):
That someone walks into my office their nose is perfect
bridge with this, but their only issue is their tip,
then my rhinoplasty will only be dealing.
Speaker 2 (21:57):
With the tip.
Speaker 1 (21:58):
And if I wanted to mark kid that, I could say, hey,
you're getting a tip plasty. The reason the tip plasty
is of words that we use, is because makes patients
feel like their nose job is lesser. I didn't get
a nose job.
Speaker 2 (22:10):
Everybody, well, what the hell did you do?
Speaker 1 (22:12):
I got a tip tip plasty, You got a tip price?
What the what the hell's a tip plus.
Speaker 2 (22:17):
It's well, it's not a whole nose job. So it's
just nonsense.
Speaker 1 (22:21):
And the reason I say that is in the hundreds
and thousands that I've done, I don't remember the last
time that someone walked in with the most spectacular nose
minus their tip. The second thing is that patient think
that all they need is a tip plasty. And the
thing is, how can I help you? Oh, I love
my nose except for my tip. I don't want to
(22:43):
touch anything else, just my tip. That's not how this works,
because your nose, your tip is connected to your bridge,
which is connected to your nostrils, which there is no
way to move this lever without changing those other levers.
So it's a it's a it's a it's a all
an interwining of your watch. You cannot affect one part
(23:04):
without affecting the other. So ninety nine percent of the
patients who are asking for tip. Plassies need other stuff done.
It doesn't need to be dramatic. You don't need to
be unrecognizable. But you can't just just like isolate the
tip and not touch anything else and then think it's
gonna look harmonious.
Speaker 2 (23:20):
It just doesn't work that way.
Speaker 3 (23:21):
Yeah, okay, So this next question comes from uh Senaya
A ninety.
Speaker 1 (23:27):
Two Shanaa and a ninety two.
Speaker 3 (23:29):
Can a liplift be done at the same time as
a nose job or better to do them separately.
Speaker 2 (23:34):
It's a great question.
Speaker 1 (23:35):
So that's a little controversial. So let's start with what
it is. A liplift is a facelift of your upper lift.
What that means is that, by the way, this whole
lip lift phenomenon again all due to social media, liplifts
have been around for seventy years. A liplft was designed
(23:56):
Woo probably in the sixties and seventies. All it is
going on the under surface of your nose, on your
upper lip, taking out a wedge hiding that incision in
the sill of the nostrils, and when you remove that wedge,
it lifts the upper lip, therefore giving your upper lip
(24:19):
a face lift. Why would you do that, because as
we age, just like our neck and our breasts and
our ear lobes, your upper lip lengthens and your upper
lip slowly disappears. Where the hell did it go? When
I look at my twenty year old pictures, I had
such full lips. Now I look like I have two
little pencils on my lips.
Speaker 2 (24:38):
What happened?
Speaker 1 (24:39):
You lost volume and you have extra upper lip skin,
and your upper lip rolled inside your mouth. Rather than
your upper lip looking like a ski slope meaning nice
and full, your upper lip is now a parabolic convexity
and it rolls inwards and down. It's a very powerful,
(24:59):
very effective surgery.
Speaker 2 (25:01):
In exchange, you have.
Speaker 1 (25:02):
A little scar underneath your nose. And if it's done well,
maybe it's a good trade off. Now, the reason why
I say it's controversial, the reason why I say it's
popular is because now twenty year olds are getting it.
It was designed for an older woman or an older gentleman.
Now it's like I'm on Instagram Angelina. Yeah. And the
other thing is I'm tired of getting filler, and so
I want to do a lip lift. Well, now you
(25:22):
look like you have a cleft flip, Like your lip
looks almost like it's a sewn tiered lower nose.
Speaker 2 (25:27):
Anyways, we digress.
Speaker 1 (25:30):
So the concern is that when you do a rhinoplasty
and you do a lip lift, they are intimately same borders.
You're at the border of Russia and Iran. In other words,
your nose were cutting here often and your lip were
cutting here. So there is some concern that the blood
supply to the stuff in between will be a little compromised. Therefore,
(25:57):
some surgeons recommend separating them. That tends to be my
general philosophy, and some do them simultaneously. That's a per
surgeon preference, and so you're gonna have to talk to
the surgeon about it.
Speaker 2 (26:10):
But it is.
Speaker 1 (26:11):
It definitely is an area that people are a little
you know, I don't know, I should maybe take my time,
maybe separate them. I tend to separate them myself.
Speaker 3 (26:20):
I probably would not want to devote together. Okay. P
Money sixty one wants to know is it possible to
get filler in Labia area for a little more fullness?
If so, what type of filler is safe down there?
Speaker 1 (26:33):
All right?
Speaker 2 (26:34):
So who is the person? P money?
Speaker 1 (26:35):
P money sixty one, P Money sixty one.
Speaker 3 (26:38):
Okay, So she's probably two years older than being sixty one.
Speaker 2 (26:42):
How do you know?
Speaker 1 (26:43):
She?
Speaker 3 (26:44):
Well?
Speaker 1 (26:44):
But who it has to be a war. Maybe it's
a guy asking for his girlfriend.
Speaker 3 (26:48):
Oh okay, okay, that's true.
Speaker 2 (26:49):
P money, all right.
Speaker 1 (26:51):
So the first thing you're you're I think a decent
number of people are like, what the what? Late?
Speaker 2 (26:56):
Why? Exactly?
Speaker 3 (26:57):
So that's what I thought to you.
Speaker 1 (26:59):
I know, well, and then you said, well, I guess
I haven't looked down there. No, So what based on
our whole dialogue today, what happens to your labia when
you get older, same thing that happens with your ear
lobes and your breast, and your upper lip and your neck.
Speaker 2 (27:15):
As you get older, you lose volume and you get
extra skin.
Speaker 1 (27:20):
That's what happens to every part of your body, your
upper eyelids. You're da da da da da da everywhere.
Some areas it's more volume loss than it is skin.
Some areas it's reversed, and most areas is a combination
of things. So you're inner labia, the labia minore, the
(27:41):
labia parts that are thin and more floppy. Those labias
tend to get longer, and they tend to be asymmetric
and that's treatment for that is a labioplasty. We remove
the redundancy, hence creating a cleaner outer surface.
Speaker 2 (28:01):
Okay, that's not what this person's referring to. They're referring to.
Speaker 1 (28:05):
The labia majory, which is the outer labia. Because as
we age and we change our hormones, the outer labia
lose fullness and become flat and deflated. And so a
youthful labia has a short inner labia and a full
(28:27):
outer labia. Okay, And so naturally the question is if
I lose volume in my outer labia and I don't
like the way that looks, what can I do? And
you could replenish the volume. There are two ways to
replenish the volume in your labia. A fillers b fat
and they're identical to your lips. Ironically, they're both called
(28:51):
labia lips. So what you would do is you would
fill it with some source of volume. Now, fat transfer
tends to be surgical. You have to you know, it's
you know, it's something that you would often do onder
anesthesia or local whatever.
Speaker 2 (29:09):
Filler.
Speaker 1 (29:09):
As you walk in you open up a syringeine to
do it. So the filler I always and only recommend
in general just ubiquitously is highly uronic acid based fillers
h A. Why because highly uronic acid based fillers are a.
Speaker 2 (29:28):
Reversible, be absorbable, see.
Speaker 1 (29:32):
No reaction, because we have it, and therefore you don't
need to get tested. I don't see any reason for
you to start using other items that have a longevity
in this when you don't know if that product will
go away.
Speaker 2 (29:48):
What if you occlude a vessel.
Speaker 1 (29:50):
What if you acclude a vessel and it's an emergency,
you can't reverse it till it goes away and maybe
takes five.
Speaker 2 (29:55):
Years or never.
Speaker 1 (29:56):
So to answer her question, if you're going to use filler,
you should use h A, and within h A, we
have various thicknesses a filler. So imagine thin paint, moderate paint,
and thick paint. And you want to use thin paint
(30:17):
in areas that are delicate under your eyelids, in your nose,
you want to use medium and thicker in places that
have a lot of space your cheeks, your jawline. And
I think the medium ones are appropriate for the labia
because it's really a sizeable area and you need some cushion.
So that's that's that's why people do fill you're gonna
(30:43):
go grab a mirror. I know.
Speaker 2 (30:47):
Your husband will grab a mirror.
Speaker 3 (30:48):
I just ask him, am I okay?
Speaker 1 (30:49):
There? Your husband will tell you you're okay, period.
Speaker 3 (30:54):
Sometimes he does okay. I want to mention some reviews
that we've gotten that.
Speaker 2 (30:58):
I don't want to hear any bad No, no, you're
not going to get any bad reviews.
Speaker 3 (31:03):
But I have here refreshingly honest, I've been listening to
doctor r. Bron's podcast for a while now, and I've
been meaning to write a review. Doctor Rabon has a
downtoward conversational style that is easy to understand and entertaining
to follow. I truly enjoy his insights and eye opening information.
Speaker 2 (31:18):
Is that from my mom?
Speaker 3 (31:20):
No, no, it's a long one. And let me see
this other one is from top notch, very informative and unbiased.
Some of these should be required listening before major elective
cosmetic surgery. Let me tell you every time that I
have a friend who knows that I do the podcast,
ask me and I go listen to the podcast. If
you want to know, you'll hear from him the horse's mouth.
(31:44):
So yeah, thank you for telling us on the patient side,
the realistic outcomes versus the blurred perfect images we see.
Speaker 1 (31:51):
I appreciate that at the end of the day, the
purpose it's Sunday, Maria Fluin from Miami, Me and my
whole team are here on a Sunday, and the only
reason we do this is because we want to share
this information with the listener in hopes that the listener
will take this information, convert it into knowledge, and from
that knowledge make the right choice for them without being
(32:11):
misled or confused or manipulated. So when I read these reviews,
it's very heartwarming, and more importantly, it's reaffirming that you
know what getting here, coming here, leaving my kids, you,
leaving your home is well worth it.
Speaker 2 (32:24):
So thank you for the reviews.
Speaker 1 (32:26):
So that wraps up yet another episode of plastic Surgery
and Censored. I always end every episode with two requests.
One is, if you find this information, as these reviews
have written, informative and helpful and educational, share it with
your friends and family. You have no idea who is
considering or contemplating surgery until it's too late.
Speaker 2 (32:44):
They'll show up one day and they'll have had a complication.
Speaker 1 (32:46):
You'll be like, what the why didn't you tell me, so,
just share it, just say hey, check out this podcast.
Speaker 2 (32:50):
It's super cool.
Speaker 1 (32:51):
Secondly, if you do enjoy the podcast, we love to
hear back from you. Write something nice. Go take right now,
get off the podcast. Go write something takes two seconds.
And what it does is it a helps us know
that this is helpful, and two it helps the podcast
elevate in its ranking. And the goal is for this
(33:12):
information to get to more people.
Speaker 2 (33:13):
So we love you and we appreciate it.
Speaker 1 (33:15):
And that's a wrap for this week's episode of Plastic
Surgery Uncensored until next week.
Speaker 2 (33:21):
I'm your host, doctor Roddy Raban.
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