October 1, 2025 • 32 mins
In this powerful episode of Plastic Surgery Uncensored, Dr. Rady Rahban sits down with Lucy, a remarkable patient who faced one of the most difficult reconstructive journeys imaginable. At just nine years old, Lucy was diagnosed with autoimmune hepatitis and later primary sclerosing cholangitis (PSC), conditions that ultimately led her to undergo a life-saving liver transplant at the age of 26. Her brother became her living donor, giving her not only a second chance at life, but also a new battle: living with the aftermath of a massive Mercedes incision scar, abdominal wall weakness, and multiple failed hernia repairs.
Dr. Rahban walks listeners through Lucy’s story of resilience, exploring the intersection between reconstructive surgery and cosmetic outcomes. He explains why scar tissue, abdominal wall hernias, and post-transplant deformities are not just functional issues but deeply impact body image and confidence. Lucy’s journey highlights how revision surgery is about more than “fixing” a scar — it’s about restoring strength, balance, and aesthetic harmony to the abdomen.
From failed liposuction recommendations to the dangers of blind fat transfers over hernias, Dr. Rahban exposes the pitfalls of one-size-fits-all surgical solutions. Instead, he reveals the meticulous, individualized approach required in cases like Lucy’s — blending the principles of a tummy tuck (abdominoplasty), abdominal wall reconstruction, and functional hernia repair into a procedure that is both life-changing and aesthetically transformative.
Seven months post-surgery, Lucy shares how she’s back to horseback riding, jumping, and training multiple horses daily — a true testament to the power of plastic surgery done right. Together, Dr. Rahban and Lucy shed light on key lessons for anyone considering revision surgery, scar revision, or reconstructive procedures after major abdominal operations:
This episode is not just about one patient’s story — it’s about a universal message: whether it’s breast reconstruction, hernia repair, or abdominal scar revision, every patient deserves results that look as good as they feel.
👉 Tune in for an honest, eye-opening discussion about the overlap between cosmetic plastic surgery and reconstructive surgery, and why patient advocacy and surgical expertise matter more than ever.
✨ 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:
Dr. Rahban walks listeners through Lucy’s story of resilience, exploring the intersection between reconstructive surgery and cosmetic outcomes. He explains why scar tissue, abdominal wall hernias, and post-transplant deformities are not just functional issues but deeply impact body image and confidence. Lucy’s journey highlights how revision surgery is about more than “fixing” a scar — it’s about restoring strength, balance, and aesthetic harmony to the abdomen.
From failed liposuction recommendations to the dangers of blind fat transfers over hernias, Dr. Rahban exposes the pitfalls of one-size-fits-all surgical solutions. Instead, he reveals the meticulous, individualized approach required in cases like Lucy’s — blending the principles of a tummy tuck (abdominoplasty), abdominal wall reconstruction, and functional hernia repair into a procedure that is both life-changing and aesthetically transformative.
Seven months post-surgery, Lucy shares how she’s back to horseback riding, jumping, and training multiple horses daily — a true testament to the power of plastic surgery done right. Together, Dr. Rahban and Lucy shed light on key lessons for anyone considering revision surgery, scar revision, or reconstructive procedures after major abdominal operations:
- Why transparency and patient education are non-negotiable.
- The red flags of overconfident surgeons.
- How to evaluate surgical recommendations that actually make sense.
- The importance of marrying form and function in every operation.
This episode is not just about one patient’s story — it’s about a universal message: whether it’s breast reconstruction, hernia repair, or abdominal scar revision, every patient deserves results that look as good as they feel.
👉 Tune in for an honest, eye-opening discussion about the overlap between cosmetic plastic surgery and reconstructive surgery, and why patient advocacy and surgical expertise matter more than ever.
✨ 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
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Welcome to another episode of Plastic Surgery and Censored. I'm
your host, as always, doctor Ruddy Rabon, and we have
a very interesting and slightly different episode for you today
in that often when we have conversations, most of them
revolve around pure cosmetics or esthetics. For that is that
being said, today's episode is actually more of a reconstructive episode.
(00:30):
But I'm a firm believer that all reconstructive surgery should
be cosmetically inclined. In other words, there's this sort of
idea that it's either cosmetic and we should care about
how it looks, or it's reconstructive and it's really about
the function, when in reality, every person who has anything
reconstructive done still cares about the way it looks. I
have never met anyone who's like, oh, I don't care
(00:51):
how my mask step to me reconstruction looks in my breast,
or I don't care how my hernia repair is. That's
just nonsense. And unfortunately, a lot of the work that
I do in the revisional space is around people who
had maybe something functional done and it looks terrible. So
today's episode is very lucky. We have Lucy, who's a
(01:14):
very sweet and fantastic patient of mine. Thank you for coming.
We can't do the shows. We can do the shows
without the Lucy's of the world, but the show is
nowhere near as educational, effective, interesting without patients. So thank
you for coming, sharing your story, being vulnerable and all
those good things. So let's dive right in, Lucy. How
(01:37):
old are you?
Speaker 2 (01:38):
Thirty one?
Speaker 1 (01:39):
Thirty one? And Lucy, let's talk a little about your story,
because your story is one of a very difficult condition
that you I think is probably genetic. They don't really know.
But at the age of nine, right, you just didn't
feel well and you know't sure what was wrong with you.
(02:01):
So they started doing some investigation and it turned out
that you.
Speaker 2 (02:04):
Had one autoimmune hepatitis.
Speaker 1 (02:07):
So autoimmune hepatitis essentially is your body starts attacking your liver, right,
and like most autoimmune things, it's usually just internal genetic
we don't know why. And as a result of that
autoimmune hepatitis, aka your own immune cells attacking your liver,
you developed yet another condition. And what was that PSC? PSC?
(02:30):
So what does PSC mean?
Speaker 2 (02:32):
Primary sclosing cholingitis?
Speaker 1 (02:34):
Right, So basically, and we were talking about that before
we had the episode. It's not uncommon that these things
are linked, which means now, in addition to your liver
being attacked, your bile ducks, that is, the ducks that
connect your pancreas, your gallbladder, and your liver, all of
those communicate and empty everything out into your intestines through ducks.
(02:57):
And those bile ducks are critical and they're tiny, and
in your instance, they started to get inflamed and scar
down to the extent that at some point they no
longer communicated any of the critical things that they needed
to to the intestines. Right, they basically completely shut down.
Speaker 2 (03:17):
Yeah, you end up with crosis, You get cirrhosis.
Speaker 1 (03:20):
So then at the age of twenty six, right, so
from nine to twenty six, you're managing this, right, Yeah,
living your life, doing holistic things, Western Eastern medicine, everything,
to the point that at twenty six it turns out
that you can't live like this anymore and you end
up having a liver transplant.
Speaker 3 (03:39):
Yeah, it's the only cure for this disease as it
is right now.
Speaker 1 (03:42):
So liver transplant, holy shit, very big surgery. I think
it's up there in the top five biggest surgeries we
do on people, right, next to face transplant, you know,
heart transplant, craniotomy. There's a handful of things that are
like in the holy shit, yeah, holy shit category. And
it turns out your brother was your donor. Yeah, yeah, I.
Speaker 3 (04:05):
My disease is such that my MELD score was never
really going to get high enough, because that's how it's measured,
how you receive an organ. But the thing about the
liver is it grows back. So the best thing to
do was to use a living donor, right, And we
went through everyone, a lot of people, about thirty people.
I'm the universal recipient, but my brother, one of my brothers,
(04:26):
was the most fit and apt for it and ready
to do it.
Speaker 1 (04:28):
Amazing. So that's yet another reason to have siblings and
not to be an only child. So your brother donate
a lobe and you get a liver transplant, and that
was now five years ago. Yeah, so here you are.
Not only are you like survived, you're thriving. You look amazing.
We'll get into the rest of your story, and everything
(04:50):
for the most part goes pretty good. Right, you get
your liver transplant. Of course, all transplants have their ups
and downs and what have you. So settles and here.
You are a very pretty, very pretty young female. For
those of you that don't know, a traditional liver transplant
scar is shumongous. Yeah, and it's a Mercedes type scar.
(05:14):
What does that mean? It's entire It runs from the
entire across your entire abdmen under your right rib to
the middle of your abmin up a bit and then
down again under your left rib halfway or two thirds
of the way. So essentially it's like looks like a
Mercedes emblem, and it's quite large, and it is what
(05:37):
it is. And you are a very reasonable person and
you're like, it is what it is. I'm going to
live with it. I have a new leaf on life. However,
you then started to develop issues with that scar, which
is not uncommon. And why don't you tell me what
issues you were starting to have after the transplant with your.
Speaker 3 (05:55):
Abdomen immediately after, while still in the hospital. Was there
too many bio ducts didn't get connected, and so there
is fluid in my abdomen and lungs. And so they
opened the right section of the scar bedside, excised it
there and then just left it to heal and close
(06:15):
back up on its own, which left a hernia originally, right.
Speaker 1 (06:20):
Okay, so you had hernia there, and as time went on,
you started to notice a couple of other things, right,
One that you now have this weird fold. Right, so
you have this scar. The scar generally leads to a dent,
and then above and below that scar you have these rolls.
So here you're how tall are you? Five five feet tall?
(06:43):
How much do you weigh one? And you're like ninety
eight percent muscle mass? Because I know you're super lean,
super fit. Did you ride horses back then?
Speaker 2 (06:56):
A little bit?
Speaker 3 (06:57):
Yeah?
Speaker 2 (06:57):
I mean growing up I didn't.
Speaker 1 (06:58):
But you were active individual, so you really had no
fat weightlifting whole shabang. But your abdominal wall had this
weird totally like dent divot kind of look to it. Furthermore,
you ended up having some pressure and fullness in the air.
They did it long story short after about how long
was it after that you went in to get your
(07:19):
first revision.
Speaker 2 (07:20):
Two about two years after.
Speaker 1 (07:22):
So two years later you go and say, listen, I'm
okay with the scar. It is what it is, but
I'm having functional issues. So you seek out a doctor,
and this is very important of course. Naturally you go
to a medical center. You go to a major medical center,
which is totally fine, which makes sense, and this doctor
and you plan on revising the abdomin, the transplant scar,
(07:45):
fixing whatever it needs to do. Now, you said you'd
seen multiple surgeons for that, right, and they had told
you to do.
Speaker 3 (07:52):
What either just light bosection and maybe like a fat transfer.
There was someone else who just said they would just
kind of try and pull the skin up. He was
the first one out of those consultations where it felt
like I was like, Okay, what he's saying makes sense.
Speaker 1 (08:09):
Right, So the gist of it was we can mickey
mouse something and make it look a little bit better,
but nobody sounded very excited to do anything. Yeah, So
fast forward, you find this guy major medical center, says
he's going to do it, goes in there, opens things up,
and according to him, there was a huge hernia where
things were coming out. Thank god they didn't liposuction you,
because they would have punctured through that hernia, which is catastrophic,
(08:32):
which is one more reason I'm not a huge fan
of liposuction. Yeah, which is your liposuctioning blindly an area
you have no idea what's under there, and lo and
behold he does something da Dad, and you heal and
now you're worse. Yeah, so you're worst. Esthetically, the ripples
and rolls and dents and all that is worse than
(08:55):
it was. And functionally somehow with the mesh, and there's
just some discomfort or tight knit what was the issue functionally?
Speaker 3 (09:04):
Yeah, discomfort, especially like using my abs.
Speaker 2 (09:08):
I still not I don't know like I'll ever be
able to do a full sit up.
Speaker 3 (09:11):
But like just discomfort in working out, doing a plank,
like using that part of my lower abdominal area.
Speaker 1 (09:18):
Okay, So the abdomen is one of those areas of
our body. I happen to sub specialize in abdominal work.
That is very much. Fifty to fifty fifty percent of
your abdomen is beauty. It's an attractive part of our bodies.
We work out, we work hard to stay healthy, stay lean,
get muscles, so we have a beautiful torso. And especially
(09:41):
in our late twenties early thirties, I mean, those are
the years where you want to get cash in. Right,
you get become seventy sixty fifty, you're like, ah, whatever,
I'm an older person. It's all good. But when we're
twenty or thirty. Shit, it's the holy grail is to
have a nice abdomen. Fifty percent of it is function.
I want to run, I want to buy. You do
a lot of horseback riding. Horseback riding, for any of
(10:04):
you who don't know, is like ninety percent core. Yeah,
maybe like fifty fifty percent quads and glutes. But one
thing is for sure, it's a shit ton of core.
So you can imagine trying to ride a horse with
a shitty abdominal core, and here you are unable to
not only strengthen it or use it. So time goes
(10:25):
on and I think it's several years go by, right,
and you just sort of deal with it. What is
the tipping point in which you're like, ugh, I have
no choice. I have to try to fix this. It's
you know, it's in close. I look crazy, right, anything
fitted right? You look like you have this weird yeah
(10:45):
pocket like roll across your abdomen. And then functionally you're
not able to really do any of the high level
things that you want to or a customed to doing.
So tell me what goes through your mind and what
that process is like for you. What is it that
your experience that forces you to do something, and what
do you do about it?
Speaker 3 (11:03):
I think i'd just again, I had gotten tired of
it over time. It was tired of the way it looked.
It bothered me continually, and then again, yeah, the function.
Speaker 2 (11:12):
Part of it too.
Speaker 3 (11:13):
I just felt like, this is this can't be how
it needs to be for the rest of my life.
Speaker 2 (11:19):
There has to be a better solution to.
Speaker 1 (11:21):
The Okay, So then you do what what.
Speaker 3 (11:23):
I did was I reached out to my costierage doctor,
Jeremy Fine, who referred me to you, okay, and like
we had a consultation and like, I think I mentioned this,
but you were the first person who said something that
I was like, Okay.
Speaker 2 (11:35):
That actually this is realistic, this makes sense. This isn't
some some workarounds.
Speaker 1 (11:41):
Mickey mouse band aid thing. So I want you guys
to listen very carefully. There's this notion and it's not
uncommon that doctors know something that patients don't know. In
other words, you go to a doctor, the doctor says
you have blobbery blah blah blah condition as such, blobberity blah,
we need to do this that the other and you
walk at You're like, oh, I don't really know what
(12:02):
the hell he was talking or she was talking about.
You go see a friend and your friend says, oh,
what did the doctor say? And you are unable to
repeat it. You are ill informed. There is nothing and
I'm gonna repeat nothing in medicine that a patient should
not understand and be unable to repeat to a friend.
(12:22):
It means that in that consult the information was not
adequately relayed to you or simplified for you in such
a way that you go, oh, that makes sense. The
second is if someone explained something to you and it
doesn't seem like wait, so wait, how is that gonna work?
Then it's not gonna work. Yeah. So what you said
(12:46):
was it was the first time in this whole journey
since your transplant that what was being suggested made sense
to you. Like, oh right, so if you put a
beam here and then you attach this to this beam, ah,
then you can hang the show. Oh I get it. Yeah.
(13:07):
So if it doesn't click for you, then you need
to keep asking because there's nothing that we're doing. Like, listen,
you may not understand AI. Right. If I hire an engineer,
I'm like, hey, make me an ai app. I don't
necessarily know that he or she could dumb it down
enough that I understand that, or quantum physics. This is
(13:29):
not quantum physics. We're not doing anything that you should
be like, listen, you just can't have trust me you understand.
So I think that's really important. And why I say
that is I think for a lot of patients, either
moving forward and or doing revisions. Moving forward is you
want to feel like whatever is being explained to you
(13:50):
makes sense to you, Like I can see that working,
and in revision you could probably think back and be
like this doctor told me x Y and Z. I
didn't think it was gonna work, but I was like,
he or she's the expert, what do I know? And
sure enough it didn't work. So that's really important. So
you and I met and I made some suggestions to you,
(14:11):
and those suggestions included both esthetic, yeah and function. Right.
Wasn't like I don't really know what's going on with
your abdominal wall, like I can't help you with that,
but I can make this look better, or hey, I
don't really know how to make this look better. It's
probably going to look like shit, but maybe I can
make it a little bit better for you. Maybe you'll
be able to ride a horse here and there right.
Speaker 3 (14:33):
Well, and transparency too, and saying that you know, I
know that I've gone through so many surgeries in my life.
This is not new to me, and it's there's something
nice about hearing like, I'm gonna do the best that
I can do.
Speaker 2 (14:46):
I can't you know, you can't make a promise on
that sure.
Speaker 1 (14:48):
And I think one of the things that also matters is,
in your instance, you're not a garden variety routine tummy tuck.
So if you come into me and you're like, hey,
I've had three kids, i have blue skin, I have
a hern yet, blah blah, you are routine in that
your outcome is predictable in that if everything goes according
to plan, you should fall within this range of outcomes.
(15:12):
But in people who are revisional and or have unusual presentations,
your scar is at the top of your abdoen across
the midline. You have had no children, you have had
two surgeries, one of which was a liver transplant. Yeah,
so wait, what about that is customary? How many of
those patients do you think a surgeon will have seen one? Right?
(15:36):
So what I said to you is Here is what
I see is wrong with your abdomen ab CD. You said, yes,
I see those things. Here is my plan or what
I think needs to happen, ab CD. Those things make sense,
And I'm not sure what's going to happen until I
get into surgery, because I don't have three hundred and
forty seven of these to tell me that this is
(15:58):
what's going to happen. Yeah. The transparency is the second
thing that you need to pay attention. When you have
an unusual situation and your doctor comes in, it's like, oh, yeah,
no problem, we're gonna go ahead and do that. The
other if it sounds too good to be true and
they have no sense of uncertainty, that's a bad sign. Actually,
they're way too confident about something that really there's no
(16:21):
way of actually knowing. Again, straightforward breast dog. Yeah, we
need to make a decision. But okay, I'm talking. I'm
having a revisional rhinoplasty. Oh this is my third breast
dog where I had a capsule and now it's data.
So a surgeon should be acting a little bit like hmm,
I'm not sure. Yeah, let me think about this first second.
(16:45):
It's a complex problem. Complex problems require thinking and thorough
analysis and the possibility that I'm not exactly sure. And
I never hesitate to a patient, especially a revision. And
the last thing I want to do is trick you.
I don't want to do your surgery. If you say
(17:06):
to me, but doctor Vaughan, if this doesn't work out,
I'm going to kill myself. Well, you know what, I'm
not your guy because I don't want to take you through.
My wife's had six spine surgery, six spine surgeries, she's
still in pain. I was somebody would have not been
so goddamn confident and said, hmm, I don't know. Instead
(17:29):
everyone's like, yeah, yeah, the problem is X, Y and Z.
Obviously it wasn't. So what I planned on doing for
you was really it's kind of like what's called a
mid abdominal abdominoplasty, which means we do an abdominoplasty whereby
which we removed tissue, but we do it right in
the middle of your abdomen, and we removed some redundancy
(17:49):
which was causing the fold. And then I went and
did repair of your midline that had been opened, not
because you had had three kids, but because you've had
someone go in there and cut it open and it
never healed correctly. So we use the principles of a
Mommy makeover tummy tuck in a reconstructive abdominal wall so
(18:13):
that we can improve your esthetic and function. That was
the goal, right, And we did a bunch of breastwork
as well, because unfortunately, usually when a patient gets bad
X work, they get bad why work, right, It's uncommon
for you to go to someone's house and their living
room is disheveled, and then you go into the guest
bathroom and it's spotless.
Speaker 2 (18:33):
Yeah.
Speaker 1 (18:34):
Right, it's the same goddamn house, same owner. So you
had a bunch of things that had gone wrong with
previous surgeries that, to be honest with you, were equally
bad in my opinion, in terms of decision making and
things of that nature. So how far out are you
now from our reconstructive abdominal surgery.
Speaker 3 (18:53):
Let's see, sumbers were probably about six months, seven months.
Speaker 1 (18:57):
Seven months, okay, so ample amount of time, not seven days,
not seven weeks, seven months, ample enough time for you
to see the directionality of where you're headed. Right, you
can see if the contour is the same, better or worse.
How's the contour of your abne. In other words, I'm
gonna wear a two piece or I'm gonna wear super
(19:18):
tight dress and I'm going to rocket or how's that
going much more the former? Right?
Speaker 2 (19:24):
Yeah?
Speaker 1 (19:24):
So how do you feel in your How do you
feel in your.
Speaker 2 (19:26):
Skin so much better?
Speaker 3 (19:29):
Like it's not as it's just I didn't even know
that it could be as flat as it is because
it never was post transplant, right, And that was maybe
something that I thought I just had to accept and
live with.
Speaker 1 (19:42):
Yeah, I have to say you have a very good
frame of mind in terms of your it is what
it is mentality. I don't know that I would, meaning
if I were you, I'd probably be still very frustrated, angry, distraught.
You had as certain a very good acceptance you were
that it is what it is, but still wanting it
(20:02):
to be better. And I think that's a really good model.
I don't think you need to accept shitty work at
the same time. You you have to have a sort
of like, you know what am I going to do?
It is what it is, so and I think you
balance that very well. So I think from a contra standpoint,
minus the scar, which oddly you're like it's kind of cool,
like that's kind of person you are, Like, well, it's
(20:24):
kind of it's kind of a war wound, you know
what I mean.
Speaker 2 (20:28):
You can't worry too much about that.
Speaker 1 (20:30):
I think your abdominal contour looks great. Yeah, like I don't.
I think it's a kin to having had not had
the transplant in terms of contour, like how smooth it
is and how normal it looks. Would you agree? Yes? Yeah?
And then functionality obviously you're never going to be the
woman you were in terms of like I'm gonna climb
(20:53):
you know, half dome with my fingertips and my core.
Having having said that, what is your What tell me
what activities you can do?
Speaker 3 (21:03):
Now?
Speaker 2 (21:04):
It's just much more comfortable.
Speaker 1 (21:07):
What do you do? You ride horses?
Speaker 2 (21:09):
Yes, I jump horses, jump horses.
Speaker 1 (21:11):
So there is there is I watch horses, which is
what I do. Then there's I ride horses, and then
there's I jump horses. Okay, so jumping horses is like
getting punched in the abdomen a thousand times in terms
of having to brace correct. Why don't you explain to
people what it requires to jump horses.
Speaker 2 (21:32):
It's called a two point position.
Speaker 3 (21:33):
So there's only two points of contact, and in doing that,
you are up allowing the horse like a basketball, to
come up to your body when it's going over a
jump and.
Speaker 2 (21:43):
Going with them.
Speaker 3 (21:43):
So that's engaging just your lower core and using that
to balance your entire body.
Speaker 1 (21:49):
And your tiptoes are in the your toes are in
the stirrups, stirrups. You stand up, you bed forward a little,
you fire your quads, your glutes, and your abdomen, and
you just gonna hover there while the horse.
Speaker 3 (22:01):
Is moving and keeping your body in that position over
down and then coming back to the saddle.
Speaker 1 (22:08):
Right, So I can't even do that in neutral. That's
like doing the Roman chair.
Speaker 3 (22:13):
Yes, right, a little bit right.
Speaker 1 (22:15):
So it's safe to say, if you're able to do that,
are you doing that now? Right? Holy shit? Seven months
out from a transplant liver transplant and two previous surgery,
which is a transplant and a revision, you are able
now to engage your core at not an okay or
average level, at a super high level. Granted, sure, if
(22:36):
you never had the transplant surgery, maybe you'd be Olympic bound,
But I mean, you're still doing things that no one
would dream of doing. I could I have a normal core.
I've never had surgery. I can't do that.
Speaker 3 (22:47):
Yeah, it's the I've been able to continue to do
it now.
Speaker 2 (22:50):
I'm riding sometimes three.
Speaker 3 (22:52):
Four horses a day, six days a week, and my
card's strong and balanced.
Speaker 1 (22:58):
Yeah. And so the reason why I brought you on
today was even though you don't have a conventional abdominoplasty
or your journey, may never be mimicked again. In other words,
people listening may there may never be another Lucy in
our practice, in terms of the specificity of liver transplant flail.
Whatever I have done now in my career, hundreds of
(23:21):
people who have had. I did a guy, super CFO
of a major company. He was in a car accident.
They had to they helicoptered him to a hospital. He
was near dead. They did a midline split of his abdomen,
opened it up, did a splenectomy like you know, one
of the trauma things, and after that he's had nothing
but heartache. Hernia's midline issues can't work out bulges right,
(23:46):
sound familiar, and he's about now four months out. I
had other patients. So the theme here is there are
lots of people who have had abdominal surgery through the
middle of their ab and they're ab them in blows
and it doesn't work. And those patients both have cosmetic issues.
I got this weird lump here, it's got a dend here.
(24:08):
What is this weird divid here? I look like I
have a butt in my middle of my belly because
things vaginate and then functionally it doesn't work. So you
represent a very large patient population. Maybe not your specific surgery,
maybe they're not willing to ride horses, but there are thousands,
hundreds of thousands of people with previous abdominal surgery that
(24:30):
have your issue. And so I think it's really really
your journey highlighted so many things because I think it was.
It highlighted your overall mentality, I think is very very powerful.
Number two, It highlighted the fact that not just because
you go to a medical center, it doesn't necessarily mean
even though it is a right you did the right thing.
You went to a well trained like you didn't do
(24:51):
anything wrong. But it just shows you that doesn't always
turn out right. It shows you that things need to
make sense to you. If they don't make sense to you,
then they don't make sense. That they're not talking to
you about, you know, as I said, quantum physics or
calculus or something like it should make sense to you.
And I think that the fact that you never really
(25:12):
ever accepted that, like, you know what this is. It
is what it is. I just have to It just sucks,
but I'm going to be okay with it. I think
those all highlight lots of key elements of people with
abdominal issues. What did you say?
Speaker 2 (25:26):
Yeah, definitely, I mean.
Speaker 3 (25:28):
And also the last thing that I found really important too,
that just to add is I've had hundreds of surgeries
in my life, not all of them have been elective,
but there is something so reassuring about feeling confident and
like you communicate with your surgeon that you are a
person and not just a patient, and that extra care
(25:49):
has taken time.
Speaker 1 (25:51):
Yeah, you and I. And that's really the secret sauce
of medicine, right is you know, how long did our
consult takes two hours? Why the hell would it take
two hours? You're very complicated. We have to analyze this,
we have to think this through. We can't just be like, yep, okay,
so you got the scar there and there's a bullet there.
(26:12):
I can LiPo that? Yeah, well, what about the mesh underneath?
What about the hernia that I had? What about this?
What about that? Do I need to get? And then
we had We didn't just run in into your surgery.
We got clearances, We double checked you're on medications. We
need to make sure those right. So it's it can
be done. It can be done well, but it does
require a really a high level of care when you
(26:36):
are sort of unique in that regard. And I think
and lastly, and I think it highlights, is that when
you are a person who is unfortunate like my wife,
like you, that's had multiple surgeries and have failed or
is not where they need to be, then you need
to be incredibly cautionary. When you see people and they
(26:57):
sell you the moon. Yeah, and if they're not themselves
a little reticent, then there's a problem. And I think
that you know, we had a very earnest conversation about
what could or couldn't be done. And you know, obviously
we always want under promise and over deliver, right, that's
(27:19):
the goal. And I think in your instance we were
able to do that. So for people that are out
there that are struggling with you know, revisional surgery, functional
issues that have a cosmetic element. What are your overall
just general suggestions to do.
Speaker 3 (27:35):
Your research, take your time, and you know, finding what
feels the best for you.
Speaker 2 (27:41):
I think again it's the you should feel comfortable.
Speaker 3 (27:44):
A lot of surgeons are cocky and not as opposed
to confidence. I'm sure it's a very fine line to
tell correct And I understand why you guys are kind of,
you know, playing god in there, like you're doing something
that nobody else is doing. But you should find someone
who you feel like is not just going to fix
(28:05):
the issue because that's what they know how to do,
but they're always going to take care of you.
Speaker 1 (28:08):
Yeah, And you know it's a hard thing to do
because if you think about it, you thought you were
doing that with the first person. Yeah. Right, So now
that you have those two juxtapositions, both myself and this individual,
very well trained, both positive reviews, both all those things,
what do you think is the essence now now that
(28:30):
you've kind of had those two jucks deposed? Because I'm
always trying to distill it down to figure out what
it is. Because when we tell patients like how do
you avoid becoming that person's like, well, do homework. It's like, well,
I did homework. My wife and I did homework. But
I know what the difference was for us. What do
you think the difference is now that you've done the
(28:50):
homework and on the surface they seem the same. I mean,
Jesus Christ, you went to a major medical center. I
mean it's probably one of the top in the country.
The guy's well trained. I'm not again, nothing take away
from the individual. That's not really relevant, but it obviously
didn't turn out the way, and in hindsight, you're like, wow,
these were two different experiences. So if you I'm not
sure you can, but can you can you reduce it
(29:12):
down to some of the nuances that you like, now
that you experienced that and you experienced this, what that feel.
Speaker 3 (29:18):
Was, Yeah, I mean a big part of it was
that you came by referral of a doctor that I
also very much trust, sure, and he has only led
me to the right people.
Speaker 2 (29:28):
So I think that's part of it. If you didn't find.
Speaker 1 (29:30):
A good referral source that you really trust that they
themselves are outstanding, then they're likely to send outstanding I
think that's very important.
Speaker 3 (29:37):
I think having good reviews but that's something. Honestly, I
think the original consultation is where you figure that out.
It's worth paying the whatever each doctor charges to go
talk to them because it's in that conversation. Was when
I felt like you were offering more than anybody had
offered me before, but it not in a way that
(29:58):
was unrealistic.
Speaker 1 (29:59):
Yeah, and I think reviews are great, but are not
I mean, listen, I know people who get their whole
entire family write them reviews. I know people who pay
to have reviews written. I know people who have paid
to get reviews removed. So it's helpful if you are
astute and you can read through. Okay, this one's fake,
this is AI. Wow, this is a real patient. But
(30:19):
I do think that there is no substitute for authenticity
and time. And I think if you have a complicated
issue and you go to see a doctor and it's
done in your consults about twenty minutes and your entire
journey is summed up in twenty minutes, I think there's
a problem there.
Speaker 3 (30:37):
Yeah, you should feel comfortable with the person you're doing
it with, which could differ for everyone too. Doesn't mean
that you know the next door is the right fit
for someone who comes over here.
Speaker 2 (30:49):
It's all personal, very personal.
Speaker 1 (30:52):
Well, all I care about is that number one, you
feel fantastic. Of course, i'd be lying. I also care
very very much that you look fantastic, and I really
believe there is no reason why you can't feel and
look fantastic with modern day plastic surgery. So hold every
one of your surgeons accountable for those function and aesthetic.
(31:16):
Yeah all right, well, thank you so much for coming.
Hopefully that wasn't too painful for you. As always, I
always tell you guys the same two things at the
end of every two every episode. Number One, if you
enjoy the show, go write something lovely. I know you
guys are busy. Everyone's like probably on a treadmill, maybe
in the car driving. But if you happen to have
(31:38):
a second right now, go write us a wonderful review.
It makes the podcast crew happy, it gives us fuel
to keep doing it, and it also helps our ranking
so our show can get out to more people. The
second thing is forward our show to friends and family.
You think you know who's going to have plastic surgery,
and the until they come to you and like, oh wow,
(32:00):
I just had a botch blah blah blah, and you're like,
oh my god, I didn't even know you were gonna
do it. You're like, yeah, I know, I didn't tell anybody.
Well god if I only knew, and I would have
told you X, Y, and Z. So just send a
goddamn show to everybody you know, because I promise you
everyone is contemplating something. All right, guys, that's a wrap.
As always, I'm your host, Doctor Rider Raban, and we
will see you next week on yet another fantastic episode
(32:23):
of Plastic Surgery Uncensored
Welcome to another episode of Plastic Surgery and Censored. I'm
your host, as always, doctor Ruddy Rabon, and we have
a very interesting and slightly different episode for you today
in that often when we have conversations, most of them
revolve around pure cosmetics or esthetics. For that is that
being said, today's episode is actually more of a reconstructive episode.
(00:30):
But I'm a firm believer that all reconstructive surgery should
be cosmetically inclined. In other words, there's this sort of
idea that it's either cosmetic and we should care about
how it looks, or it's reconstructive and it's really about
the function, when in reality, every person who has anything
reconstructive done still cares about the way it looks. I
have never met anyone who's like, oh, I don't care
(00:51):
how my mask step to me reconstruction looks in my breast,
or I don't care how my hernia repair is. That's
just nonsense. And unfortunately, a lot of the work that
I do in the revisional space is around people who
had maybe something functional done and it looks terrible. So
today's episode is very lucky. We have Lucy, who's a
(01:14):
very sweet and fantastic patient of mine. Thank you for coming.
We can't do the shows. We can do the shows
without the Lucy's of the world, but the show is
nowhere near as educational, effective, interesting without patients. So thank
you for coming, sharing your story, being vulnerable and all
those good things. So let's dive right in, Lucy. How
(01:37):
old are you?
Speaker 2 (01:38):
Thirty one?
Speaker 1 (01:39):
Thirty one? And Lucy, let's talk a little about your story,
because your story is one of a very difficult condition
that you I think is probably genetic. They don't really know.
But at the age of nine, right, you just didn't
feel well and you know't sure what was wrong with you.
(02:01):
So they started doing some investigation and it turned out
that you.
Speaker 2 (02:04):
Had one autoimmune hepatitis.
Speaker 1 (02:07):
So autoimmune hepatitis essentially is your body starts attacking your liver, right,
and like most autoimmune things, it's usually just internal genetic
we don't know why. And as a result of that
autoimmune hepatitis, aka your own immune cells attacking your liver,
you developed yet another condition. And what was that PSC? PSC?
(02:30):
So what does PSC mean?
Speaker 2 (02:32):
Primary sclosing cholingitis?
Speaker 1 (02:34):
Right, So basically, and we were talking about that before
we had the episode. It's not uncommon that these things
are linked, which means now, in addition to your liver
being attacked, your bile ducks, that is, the ducks that
connect your pancreas, your gallbladder, and your liver, all of
those communicate and empty everything out into your intestines through ducks.
(02:57):
And those bile ducks are critical and they're tiny, and
in your instance, they started to get inflamed and scar
down to the extent that at some point they no
longer communicated any of the critical things that they needed
to to the intestines. Right, they basically completely shut down.
Speaker 2 (03:17):
Yeah, you end up with crosis, You get cirrhosis.
Speaker 1 (03:20):
So then at the age of twenty six, right, so
from nine to twenty six, you're managing this, right, Yeah,
living your life, doing holistic things, Western Eastern medicine, everything,
to the point that at twenty six it turns out
that you can't live like this anymore and you end
up having a liver transplant.
Speaker 3 (03:39):
Yeah, it's the only cure for this disease as it
is right now.
Speaker 1 (03:42):
So liver transplant, holy shit, very big surgery. I think
it's up there in the top five biggest surgeries we
do on people, right, next to face transplant, you know,
heart transplant, craniotomy. There's a handful of things that are
like in the holy shit, yeah, holy shit category. And
it turns out your brother was your donor. Yeah, yeah, I.
Speaker 3 (04:05):
My disease is such that my MELD score was never
really going to get high enough, because that's how it's measured,
how you receive an organ. But the thing about the
liver is it grows back. So the best thing to
do was to use a living donor, right, And we
went through everyone, a lot of people, about thirty people.
I'm the universal recipient, but my brother, one of my brothers,
(04:26):
was the most fit and apt for it and ready
to do it.
Speaker 1 (04:28):
Amazing. So that's yet another reason to have siblings and
not to be an only child. So your brother donate
a lobe and you get a liver transplant, and that
was now five years ago. Yeah, so here you are.
Not only are you like survived, you're thriving. You look amazing.
We'll get into the rest of your story, and everything
(04:50):
for the most part goes pretty good. Right, you get
your liver transplant. Of course, all transplants have their ups
and downs and what have you. So settles and here.
You are a very pretty, very pretty young female. For
those of you that don't know, a traditional liver transplant
scar is shumongous. Yeah, and it's a Mercedes type scar.
(05:14):
What does that mean? It's entire It runs from the
entire across your entire abdmen under your right rib to
the middle of your abmin up a bit and then
down again under your left rib halfway or two thirds
of the way. So essentially it's like looks like a
Mercedes emblem, and it's quite large, and it is what
(05:37):
it is. And you are a very reasonable person and
you're like, it is what it is. I'm going to
live with it. I have a new leaf on life. However,
you then started to develop issues with that scar, which
is not uncommon. And why don't you tell me what
issues you were starting to have after the transplant with your.
Speaker 3 (05:55):
Abdomen immediately after, while still in the hospital. Was there
too many bio ducts didn't get connected, and so there
is fluid in my abdomen and lungs. And so they
opened the right section of the scar bedside, excised it
there and then just left it to heal and close
(06:15):
back up on its own, which left a hernia originally, right.
Speaker 1 (06:20):
Okay, so you had hernia there, and as time went on,
you started to notice a couple of other things, right,
One that you now have this weird fold. Right, so
you have this scar. The scar generally leads to a dent,
and then above and below that scar you have these rolls.
So here you're how tall are you? Five five feet tall?
(06:43):
How much do you weigh one? And you're like ninety
eight percent muscle mass? Because I know you're super lean,
super fit. Did you ride horses back then?
Speaker 2 (06:56):
A little bit?
Speaker 3 (06:57):
Yeah?
Speaker 2 (06:57):
I mean growing up I didn't.
Speaker 1 (06:58):
But you were active individual, so you really had no
fat weightlifting whole shabang. But your abdominal wall had this
weird totally like dent divot kind of look to it. Furthermore,
you ended up having some pressure and fullness in the air.
They did it long story short after about how long
was it after that you went in to get your
(07:19):
first revision.
Speaker 2 (07:20):
Two about two years after.
Speaker 1 (07:22):
So two years later you go and say, listen, I'm
okay with the scar. It is what it is, but
I'm having functional issues. So you seek out a doctor,
and this is very important of course. Naturally you go
to a medical center. You go to a major medical center,
which is totally fine, which makes sense, and this doctor
and you plan on revising the abdomin, the transplant scar,
(07:45):
fixing whatever it needs to do. Now, you said you'd
seen multiple surgeons for that, right, and they had told
you to do.
Speaker 3 (07:52):
What either just light bosection and maybe like a fat transfer.
There was someone else who just said they would just
kind of try and pull the skin up. He was
the first one out of those consultations where it felt
like I was like, Okay, what he's saying makes sense.
Speaker 1 (08:09):
Right, So the gist of it was we can mickey
mouse something and make it look a little bit better,
but nobody sounded very excited to do anything. Yeah, So
fast forward, you find this guy major medical center, says
he's going to do it, goes in there, opens things up,
and according to him, there was a huge hernia where
things were coming out. Thank god they didn't liposuction you,
because they would have punctured through that hernia, which is catastrophic,
(08:32):
which is one more reason I'm not a huge fan
of liposuction. Yeah, which is your liposuctioning blindly an area
you have no idea what's under there, and lo and
behold he does something da Dad, and you heal and
now you're worse. Yeah, so you're worst. Esthetically, the ripples
and rolls and dents and all that is worse than
(08:55):
it was. And functionally somehow with the mesh, and there's
just some discomfort or tight knit what was the issue functionally?
Speaker 3 (09:04):
Yeah, discomfort, especially like using my abs.
Speaker 2 (09:08):
I still not I don't know like I'll ever be
able to do a full sit up.
Speaker 3 (09:11):
But like just discomfort in working out, doing a plank,
like using that part of my lower abdominal area.
Speaker 1 (09:18):
Okay, So the abdomen is one of those areas of
our body. I happen to sub specialize in abdominal work.
That is very much. Fifty to fifty fifty percent of
your abdomen is beauty. It's an attractive part of our bodies.
We work out, we work hard to stay healthy, stay lean,
get muscles, so we have a beautiful torso. And especially
(09:41):
in our late twenties early thirties, I mean, those are
the years where you want to get cash in. Right,
you get become seventy sixty fifty, you're like, ah, whatever,
I'm an older person. It's all good. But when we're
twenty or thirty. Shit, it's the holy grail is to
have a nice abdomen. Fifty percent of it is function.
I want to run, I want to buy. You do
a lot of horseback riding. Horseback riding, for any of
(10:04):
you who don't know, is like ninety percent core. Yeah,
maybe like fifty fifty percent quads and glutes. But one
thing is for sure, it's a shit ton of core.
So you can imagine trying to ride a horse with
a shitty abdominal core, and here you are unable to
not only strengthen it or use it. So time goes
(10:25):
on and I think it's several years go by, right,
and you just sort of deal with it. What is
the tipping point in which you're like, ugh, I have
no choice. I have to try to fix this. It's
you know, it's in close. I look crazy, right, anything
fitted right? You look like you have this weird yeah
(10:45):
pocket like roll across your abdomen. And then functionally you're
not able to really do any of the high level
things that you want to or a customed to doing.
So tell me what goes through your mind and what
that process is like for you. What is it that
your experience that forces you to do something, and what
do you do about it?
Speaker 3 (11:03):
I think i'd just again, I had gotten tired of
it over time. It was tired of the way it looked.
It bothered me continually, and then again, yeah, the function.
Speaker 2 (11:12):
Part of it too.
Speaker 3 (11:13):
I just felt like, this is this can't be how
it needs to be for the rest of my life.
Speaker 2 (11:19):
There has to be a better solution to.
Speaker 1 (11:21):
The Okay, So then you do what what.
Speaker 3 (11:23):
I did was I reached out to my costierage doctor,
Jeremy Fine, who referred me to you, okay, and like
we had a consultation and like, I think I mentioned this,
but you were the first person who said something that
I was like, Okay.
Speaker 2 (11:35):
That actually this is realistic, this makes sense. This isn't
some some workarounds.
Speaker 1 (11:41):
Mickey mouse band aid thing. So I want you guys
to listen very carefully. There's this notion and it's not
uncommon that doctors know something that patients don't know. In
other words, you go to a doctor, the doctor says
you have blobbery blah blah blah condition as such, blobberity blah,
we need to do this that the other and you
walk at You're like, oh, I don't really know what
(12:02):
the hell he was talking or she was talking about.
You go see a friend and your friend says, oh,
what did the doctor say? And you are unable to
repeat it. You are ill informed. There is nothing and
I'm gonna repeat nothing in medicine that a patient should
not understand and be unable to repeat to a friend.
(12:22):
It means that in that consult the information was not
adequately relayed to you or simplified for you in such
a way that you go, oh, that makes sense. The
second is if someone explained something to you and it
doesn't seem like wait, so wait, how is that gonna work?
Then it's not gonna work. Yeah. So what you said
(12:46):
was it was the first time in this whole journey
since your transplant that what was being suggested made sense
to you. Like, oh right, so if you put a
beam here and then you attach this to this beam, ah,
then you can hang the show. Oh I get it. Yeah.
(13:07):
So if it doesn't click for you, then you need
to keep asking because there's nothing that we're doing. Like, listen,
you may not understand AI. Right. If I hire an engineer,
I'm like, hey, make me an ai app. I don't
necessarily know that he or she could dumb it down
enough that I understand that, or quantum physics. This is
(13:29):
not quantum physics. We're not doing anything that you should
be like, listen, you just can't have trust me you understand.
So I think that's really important. And why I say
that is I think for a lot of patients, either
moving forward and or doing revisions. Moving forward is you
want to feel like whatever is being explained to you
(13:50):
makes sense to you, Like I can see that working,
and in revision you could probably think back and be
like this doctor told me x Y and Z. I
didn't think it was gonna work, but I was like,
he or she's the expert, what do I know? And
sure enough it didn't work. So that's really important. So
you and I met and I made some suggestions to you,
(14:11):
and those suggestions included both esthetic, yeah and function. Right.
Wasn't like I don't really know what's going on with
your abdominal wall, like I can't help you with that,
but I can make this look better, or hey, I
don't really know how to make this look better. It's
probably going to look like shit, but maybe I can
make it a little bit better for you. Maybe you'll
be able to ride a horse here and there right.
Speaker 3 (14:33):
Well, and transparency too, and saying that you know, I
know that I've gone through so many surgeries in my life.
This is not new to me, and it's there's something
nice about hearing like, I'm gonna do the best that
I can do.
Speaker 2 (14:46):
I can't you know, you can't make a promise on
that sure.
Speaker 1 (14:48):
And I think one of the things that also matters is,
in your instance, you're not a garden variety routine tummy tuck.
So if you come into me and you're like, hey,
I've had three kids, i have blue skin, I have
a hern yet, blah blah, you are routine in that
your outcome is predictable in that if everything goes according
to plan, you should fall within this range of outcomes.
(15:12):
But in people who are revisional and or have unusual presentations,
your scar is at the top of your abdoen across
the midline. You have had no children, you have had
two surgeries, one of which was a liver transplant. Yeah,
so wait, what about that is customary? How many of
those patients do you think a surgeon will have seen one? Right?
(15:36):
So what I said to you is Here is what
I see is wrong with your abdomen ab CD. You said, yes,
I see those things. Here is my plan or what
I think needs to happen, ab CD. Those things make sense,
And I'm not sure what's going to happen until I
get into surgery, because I don't have three hundred and
forty seven of these to tell me that this is
(15:58):
what's going to happen. Yeah. The transparency is the second
thing that you need to pay attention. When you have
an unusual situation and your doctor comes in, it's like, oh, yeah,
no problem, we're gonna go ahead and do that. The
other if it sounds too good to be true and
they have no sense of uncertainty, that's a bad sign. Actually,
they're way too confident about something that really there's no
(16:21):
way of actually knowing. Again, straightforward breast dog. Yeah, we
need to make a decision. But okay, I'm talking. I'm
having a revisional rhinoplasty. Oh this is my third breast
dog where I had a capsule and now it's data.
So a surgeon should be acting a little bit like hmm,
I'm not sure. Yeah, let me think about this first second.
(16:45):
It's a complex problem. Complex problems require thinking and thorough
analysis and the possibility that I'm not exactly sure. And
I never hesitate to a patient, especially a revision. And
the last thing I want to do is trick you.
I don't want to do your surgery. If you say
(17:06):
to me, but doctor Vaughan, if this doesn't work out,
I'm going to kill myself. Well, you know what, I'm
not your guy because I don't want to take you through.
My wife's had six spine surgery, six spine surgeries, she's
still in pain. I was somebody would have not been
so goddamn confident and said, hmm, I don't know. Instead
(17:29):
everyone's like, yeah, yeah, the problem is X, Y and Z.
Obviously it wasn't. So what I planned on doing for
you was really it's kind of like what's called a
mid abdominal abdominoplasty, which means we do an abdominoplasty whereby
which we removed tissue, but we do it right in
the middle of your abdomen, and we removed some redundancy
(17:49):
which was causing the fold. And then I went and
did repair of your midline that had been opened, not
because you had had three kids, but because you've had
someone go in there and cut it open and it
never healed correctly. So we use the principles of a
Mommy makeover tummy tuck in a reconstructive abdominal wall so
(18:13):
that we can improve your esthetic and function. That was
the goal, right, And we did a bunch of breastwork
as well, because unfortunately, usually when a patient gets bad
X work, they get bad why work, right, It's uncommon
for you to go to someone's house and their living
room is disheveled, and then you go into the guest
bathroom and it's spotless.
Speaker 2 (18:33):
Yeah.
Speaker 1 (18:34):
Right, it's the same goddamn house, same owner. So you
had a bunch of things that had gone wrong with
previous surgeries that, to be honest with you, were equally
bad in my opinion, in terms of decision making and
things of that nature. So how far out are you
now from our reconstructive abdominal surgery.
Speaker 3 (18:53):
Let's see, sumbers were probably about six months, seven months.
Speaker 1 (18:57):
Seven months, okay, so ample amount of time, not seven days,
not seven weeks, seven months, ample enough time for you
to see the directionality of where you're headed. Right, you
can see if the contour is the same, better or worse.
How's the contour of your abne. In other words, I'm
gonna wear a two piece or I'm gonna wear super
(19:18):
tight dress and I'm going to rocket or how's that
going much more the former? Right?
Speaker 2 (19:24):
Yeah?
Speaker 1 (19:24):
So how do you feel in your How do you
feel in your.
Speaker 2 (19:26):
Skin so much better?
Speaker 3 (19:29):
Like it's not as it's just I didn't even know
that it could be as flat as it is because
it never was post transplant, right, And that was maybe
something that I thought I just had to accept and
live with.
Speaker 1 (19:42):
Yeah, I have to say you have a very good
frame of mind in terms of your it is what
it is mentality. I don't know that I would, meaning
if I were you, I'd probably be still very frustrated, angry, distraught.
You had as certain a very good acceptance you were
that it is what it is, but still wanting it
(20:02):
to be better. And I think that's a really good model.
I don't think you need to accept shitty work at
the same time. You you have to have a sort
of like, you know what am I going to do?
It is what it is, so and I think you
balance that very well. So I think from a contra standpoint,
minus the scar, which oddly you're like it's kind of cool,
like that's kind of person you are, Like, well, it's
(20:24):
kind of it's kind of a war wound, you know
what I mean.
Speaker 2 (20:28):
You can't worry too much about that.
Speaker 1 (20:30):
I think your abdominal contour looks great. Yeah, like I don't.
I think it's a kin to having had not had
the transplant in terms of contour, like how smooth it
is and how normal it looks. Would you agree? Yes? Yeah?
And then functionality obviously you're never going to be the
woman you were in terms of like I'm gonna climb
(20:53):
you know, half dome with my fingertips and my core.
Having having said that, what is your What tell me
what activities you can do?
Speaker 3 (21:03):
Now?
Speaker 2 (21:04):
It's just much more comfortable.
Speaker 1 (21:07):
What do you do? You ride horses?
Speaker 2 (21:09):
Yes, I jump horses, jump horses.
Speaker 1 (21:11):
So there is there is I watch horses, which is
what I do. Then there's I ride horses, and then
there's I jump horses. Okay, so jumping horses is like
getting punched in the abdomen a thousand times in terms
of having to brace correct. Why don't you explain to
people what it requires to jump horses.
Speaker 2 (21:32):
It's called a two point position.
Speaker 3 (21:33):
So there's only two points of contact, and in doing that,
you are up allowing the horse like a basketball, to
come up to your body when it's going over a
jump and.
Speaker 2 (21:43):
Going with them.
Speaker 3 (21:43):
So that's engaging just your lower core and using that
to balance your entire body.
Speaker 1 (21:49):
And your tiptoes are in the your toes are in
the stirrups, stirrups. You stand up, you bed forward a little,
you fire your quads, your glutes, and your abdomen, and
you just gonna hover there while the horse.
Speaker 3 (22:01):
Is moving and keeping your body in that position over
down and then coming back to the saddle.
Speaker 1 (22:08):
Right, So I can't even do that in neutral. That's
like doing the Roman chair.
Speaker 3 (22:13):
Yes, right, a little bit right.
Speaker 1 (22:15):
So it's safe to say, if you're able to do that,
are you doing that now? Right? Holy shit? Seven months
out from a transplant liver transplant and two previous surgery,
which is a transplant and a revision, you are able
now to engage your core at not an okay or
average level, at a super high level. Granted, sure, if
(22:36):
you never had the transplant surgery, maybe you'd be Olympic bound,
But I mean, you're still doing things that no one
would dream of doing. I could I have a normal core.
I've never had surgery. I can't do that.
Speaker 3 (22:47):
Yeah, it's the I've been able to continue to do
it now.
Speaker 2 (22:50):
I'm riding sometimes three.
Speaker 3 (22:52):
Four horses a day, six days a week, and my
card's strong and balanced.
Speaker 1 (22:58):
Yeah. And so the reason why I brought you on
today was even though you don't have a conventional abdominoplasty
or your journey, may never be mimicked again. In other words,
people listening may there may never be another Lucy in
our practice, in terms of the specificity of liver transplant flail.
Whatever I have done now in my career, hundreds of
(23:21):
people who have had. I did a guy, super CFO
of a major company. He was in a car accident.
They had to they helicoptered him to a hospital. He
was near dead. They did a midline split of his abdomen,
opened it up, did a splenectomy like you know, one
of the trauma things, and after that he's had nothing
but heartache. Hernia's midline issues can't work out bulges right,
(23:46):
sound familiar, and he's about now four months out. I
had other patients. So the theme here is there are
lots of people who have had abdominal surgery through the
middle of their ab and they're ab them in blows
and it doesn't work. And those patients both have cosmetic issues.
I got this weird lump here, it's got a dend here.
(24:08):
What is this weird divid here? I look like I
have a butt in my middle of my belly because
things vaginate and then functionally it doesn't work. So you
represent a very large patient population. Maybe not your specific surgery,
maybe they're not willing to ride horses, but there are thousands,
hundreds of thousands of people with previous abdominal surgery that
(24:30):
have your issue. And so I think it's really really
your journey highlighted so many things because I think it was.
It highlighted your overall mentality, I think is very very powerful.
Number two, It highlighted the fact that not just because
you go to a medical center, it doesn't necessarily mean
even though it is a right you did the right thing.
You went to a well trained like you didn't do
(24:51):
anything wrong. But it just shows you that doesn't always
turn out right. It shows you that things need to
make sense to you. If they don't make sense to you,
then they don't make sense. That they're not talking to
you about, you know, as I said, quantum physics or
calculus or something like it should make sense to you.
And I think that the fact that you never really
(25:12):
ever accepted that, like, you know what this is. It
is what it is. I just have to It just sucks,
but I'm going to be okay with it. I think
those all highlight lots of key elements of people with
abdominal issues. What did you say?
Speaker 2 (25:26):
Yeah, definitely, I mean.
Speaker 3 (25:28):
And also the last thing that I found really important too,
that just to add is I've had hundreds of surgeries
in my life, not all of them have been elective,
but there is something so reassuring about feeling confident and
like you communicate with your surgeon that you are a
person and not just a patient, and that extra care
(25:49):
has taken time.
Speaker 1 (25:51):
Yeah, you and I. And that's really the secret sauce
of medicine, right is you know, how long did our
consult takes two hours? Why the hell would it take
two hours? You're very complicated. We have to analyze this,
we have to think this through. We can't just be like, yep, okay,
so you got the scar there and there's a bullet there.
(26:12):
I can LiPo that? Yeah, well, what about the mesh underneath?
What about the hernia that I had? What about this?
What about that? Do I need to get? And then
we had We didn't just run in into your surgery.
We got clearances, We double checked you're on medications. We
need to make sure those right. So it's it can
be done. It can be done well, but it does
require a really a high level of care when you
(26:36):
are sort of unique in that regard. And I think
and lastly, and I think it highlights, is that when
you are a person who is unfortunate like my wife,
like you, that's had multiple surgeries and have failed or
is not where they need to be, then you need
to be incredibly cautionary. When you see people and they
(26:57):
sell you the moon. Yeah, and if they're not themselves
a little reticent, then there's a problem. And I think
that you know, we had a very earnest conversation about
what could or couldn't be done. And you know, obviously
we always want under promise and over deliver, right, that's
(27:19):
the goal. And I think in your instance we were
able to do that. So for people that are out
there that are struggling with you know, revisional surgery, functional
issues that have a cosmetic element. What are your overall
just general suggestions to do.
Speaker 3 (27:35):
Your research, take your time, and you know, finding what
feels the best for you.
Speaker 2 (27:41):
I think again it's the you should feel comfortable.
Speaker 3 (27:44):
A lot of surgeons are cocky and not as opposed
to confidence. I'm sure it's a very fine line to
tell correct And I understand why you guys are kind of,
you know, playing god in there, like you're doing something
that nobody else is doing. But you should find someone
who you feel like is not just going to fix
(28:05):
the issue because that's what they know how to do,
but they're always going to take care of you.
Speaker 1 (28:08):
Yeah, And you know it's a hard thing to do
because if you think about it, you thought you were
doing that with the first person. Yeah. Right, So now
that you have those two juxtapositions, both myself and this individual,
very well trained, both positive reviews, both all those things,
what do you think is the essence now now that
(28:30):
you've kind of had those two jucks deposed? Because I'm
always trying to distill it down to figure out what
it is. Because when we tell patients like how do
you avoid becoming that person's like, well, do homework. It's like, well,
I did homework. My wife and I did homework. But
I know what the difference was for us. What do
you think the difference is now that you've done the
(28:50):
homework and on the surface they seem the same. I mean,
Jesus Christ, you went to a major medical center. I
mean it's probably one of the top in the country.
The guy's well trained. I'm not again, nothing take away
from the individual. That's not really relevant, but it obviously
didn't turn out the way, and in hindsight, you're like, wow,
these were two different experiences. So if you I'm not
sure you can, but can you can you reduce it
(29:12):
down to some of the nuances that you like, now
that you experienced that and you experienced this, what that feel.
Speaker 3 (29:18):
Was, Yeah, I mean a big part of it was
that you came by referral of a doctor that I
also very much trust, sure, and he has only led
me to the right people.
Speaker 2 (29:28):
So I think that's part of it. If you didn't find.
Speaker 1 (29:30):
A good referral source that you really trust that they
themselves are outstanding, then they're likely to send outstanding I
think that's very important.
Speaker 3 (29:37):
I think having good reviews but that's something. Honestly, I
think the original consultation is where you figure that out.
It's worth paying the whatever each doctor charges to go
talk to them because it's in that conversation. Was when
I felt like you were offering more than anybody had
offered me before, but it not in a way that
(29:58):
was unrealistic.
Speaker 1 (29:59):
Yeah, and I think reviews are great, but are not
I mean, listen, I know people who get their whole
entire family write them reviews. I know people who pay
to have reviews written. I know people who have paid
to get reviews removed. So it's helpful if you are
astute and you can read through. Okay, this one's fake,
this is AI. Wow, this is a real patient. But
(30:19):
I do think that there is no substitute for authenticity
and time. And I think if you have a complicated
issue and you go to see a doctor and it's
done in your consults about twenty minutes and your entire
journey is summed up in twenty minutes, I think there's
a problem there.
Speaker 3 (30:37):
Yeah, you should feel comfortable with the person you're doing
it with, which could differ for everyone too. Doesn't mean
that you know the next door is the right fit
for someone who comes over here.
Speaker 2 (30:49):
It's all personal, very personal.
Speaker 1 (30:52):
Well, all I care about is that number one, you
feel fantastic. Of course, i'd be lying. I also care
very very much that you look fantastic, and I really
believe there is no reason why you can't feel and
look fantastic with modern day plastic surgery. So hold every
one of your surgeons accountable for those function and aesthetic.
(31:16):
Yeah all right, well, thank you so much for coming.
Hopefully that wasn't too painful for you. As always, I
always tell you guys the same two things at the
end of every two every episode. Number One, if you
enjoy the show, go write something lovely. I know you
guys are busy. Everyone's like probably on a treadmill, maybe
in the car driving. But if you happen to have
(31:38):
a second right now, go write us a wonderful review.
It makes the podcast crew happy, it gives us fuel
to keep doing it, and it also helps our ranking
so our show can get out to more people. The
second thing is forward our show to friends and family.
You think you know who's going to have plastic surgery,
and the until they come to you and like, oh wow,
(32:00):
I just had a botch blah blah blah, and you're like,
oh my god, I didn't even know you were gonna
do it. You're like, yeah, I know, I didn't tell anybody.
Well god if I only knew, and I would have
told you X, Y, and Z. So just send a
goddamn show to everybody you know, because I promise you
everyone is contemplating something. All right, guys, that's a wrap.
As always, I'm your host, Doctor Rider Raban, and we
will see you next week on yet another fantastic episode
(32:23):
of Plastic Surgery Uncensored
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