Authenticity, Aesthetic Trends, and the Future of Plastic Surgery - with Dr. Charles Galanis - The Daria Hamrah Podcast

Episode Transcript
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Speaker 1 (00:01):
All right, everyone, welcome to another episode of
the Dario Hammer podcast.
Today I'm honored to introducea truly accomplished guest
plastic surgeon, dr CharlesGalanis.
He's a double board certifiedplastic and reconstructive
surgeon with a career path thatis as impressive as it's

(00:23):
inspiring, and we're going todive into that in this podcast
about his professional as wellas personal career.
Originally from Milwaukee, hestarted his medical journey by
going to medical school at theUniversity of Wisconsin, where
he excelled as a class presidentand earned a place in the

(00:43):
prestigious Alpha Omega AlphaHonor Society, and from there he
trained right around the cornerhere from where we are, at the
Johns Hopkins Hospital and, asyou all know, it's the number
one ranked hospital in thenation.
For many decades and during hisresidency as a general surgery
resident, he received a researchgrant from the NIH leading him

(01:05):
to spend two years conductinggroundbreaking research at the
prestigious Memorial SloanKettering Cancer Center, one of
the top-ranked cancer centers inthe nation.
So a lot of parallelism to mycareer.
Mine started also in cancerresearch and now in aesthetics.
I wonder if that's a commontrend.

(01:25):
Now, after completing hisgeneral surgery training, he
pursued his passion then forplastic and reconstructive
surgery, and I'm curious to seehow that came about at UCLA, one
of the most competitiveprograms in the country, and his
training spanned diversesettings from private practice
in Beverly Hills to high volumecounty hospitals and the

(01:46):
renowned UCLA Medical Center sohe's seen it all over there
during his training, that's forsure.
He then stayed at UCLA for anadditional year, almost like he
never loves or likes to stoplearning and specializing in
microsurgery and performingcomplex breast, head and neck
reconstructive surgeries as afellow and clinical instructor

(02:10):
later.
So he then traveled to Colombiafairly recent, in 2019, to
complete advanced training inhigh-def liposuction with the
one and only Dr Alfredo Hoyas,who is the world leader in that
field and with over 20 publishedarticles and book chapters.

(02:30):
He's not only a master of hiscraft, but also a true innovator
in aesthetic and reconstructivesurgery, and his work speaks
for itself.
So, for those of you who seehis work on social media and all
the platforms, you know whatI'm talking about.
So today we'll dive into hisincredible journey which I feel

(02:51):
it's just a beginning and hisphilosophy on patient care and
his thoughts on the evolvingworld of plastic surgery, as
well as health and wellness.
So, without further ado, let'swelcome Charlie.
Thanks for taking the time andcoming on my show on a Saturday
with a little girl.

(03:12):
So, being a father, a husbandand an international surgeon and
I just saw you open up anotherlocation in Nashville.
Dude, like two locationsweren't enough, you have to do a
third one.
What's up with that?

Speaker 2 (03:28):
Well, thank you for having me.
Yeah, I mean, I think kind ofgoing along the lines of all the
extra training maybe I'm just aglutton for self-punishment,
but yeah, there's a lot ofreasons, there's many reasons we
can get into for the differentlocations, but yeah, we just
sort of it's been a process fora while to get something set up
in Nashville, but we're excitedfor that and it's, you know, the
home base is still LA andthat's not changing.
But there's just, I don't know,maybe I need to slow down, but

(03:55):
there's just been these reasonsfor me to explore other options,
both personal and professional,to be honest with you.

Speaker 1 (03:58):
What are?

Speaker 2 (03:58):
those.
Well, you know, from aprofessional standpoint, I'll
tell you, and I'm sure this iswhat your experience has been
too certainly, with social mediabecoming more and more
prominent role in what we do,our patients come from further
and further away.
You know the borders of wherewe quote-unquote market are
extended and really we sort offace a borderless marketing

(04:20):
situation now where you havepatients coming from all over
the place.
About 50% of our patientstravel from out of town.
So, you know, I'm encounteringmore and more people who are
coming from further and furtheraway and getting more and more
interest in.
Hey, would you ever considercoming closer?
Or would you, you know, everconsider this community?
And so part of it was, you know, professional, based to to

(04:40):
capture a group of patients,make it easier for them.
Insofar as I could find asituation that worked for me too
.
I mean, as you know, it's noteasy to just set up a whole
system somewhere else.
It's not like we have a foodtruck and we just pull up into
town and start doing surgery.
So it had to be the rightsituation.
And, on a personal level, Ithink that you know my family
had an interest in Nashville, onexcited interest in Nashville

(05:03):
as like a as this possiblesource that you know, one day
maybe it could be more full-timethan here.
You know, not not necessarilytoday, not next year, whatever
but we saw a situation wherethere's a community and
something that you know where wecould raise kids that maybe a
little bit more potentially,could be more appealing than
what Los Angeles has to offer inthat arena and uh, so it was

(05:24):
sort of this two things inparallel that we're looking at
being like, oh well, this couldbe fun and who knows where this
goes, and if it becomes biggerand bigger, it's something we
could spend more time in.
And from a professionalstandpoint, you know another
place to capture patients and Ihave friends there too.
So you know there's anenjoyment part to this as well.
I grew up in the Midwest, so Isort of miss seasons, I miss

(05:46):
sort of a smaller town community, so it kind of it had a lot of
appeal to me and that's kind ofthat's the nuts and bolts, of
sort of how it feels it'sinteresting.

Speaker 1 (05:55):
I personally love Nashville so I always talk to my
wife.
You know we love going toNashville.
It's actually very close tohere in Virginia where I am.
Yeah, we love going toNashville, it's actually very
close to here in Virginia whereI am, and great community.
I love country.
I don't know if you're acountry boy, but great music
city.
And so from the outside, onewould look at a plastic surgeon

(06:20):
thinking, well, wait a second,you're in Beverly Hills, you're
in the hub and mecca of plasticsurgery.
Are you nuts Like, why wouldyou go to Nashville, even
considering one day settlingdown there?
But people don't understand.
It's so much more aboutlifestyle and happiness than it
is about business.
Business, of course, is part ofwhat we do.

(06:40):
I don't think any surgeon wouldtrade happiness for um some
other type of, um materialisticor financial gain, um, because
no money on earth can make youhappy if you're miserable where
you live.
And not saying you're miserablewhere you live, but uh, just um
.
You know, responding to some ofthe people, because I've been

(07:03):
been asked many times like whydon't I go to Beverly Hills, why
don't I go to?
And I did my training in Miami.
They asked me why didn't I stayin Miami?
And it's just like I didn'twant to live in those areas.
Business was a second thing.
And but back to doing multiplelocations.
You know myself, like you have,I've been approached many times

(07:24):
by many clinics, also in theMiddle East, as well as a lot of
patients on social media askingwhether I have a location here,
there and I could do that.
But, like you said, half of ourpatients they already are
traveling out of state and outof country to us.
So, personally, when I uhdebated that with myself, I'm

(07:46):
like, well, if, if people aretraveling, it's getting so much
easier for them to travel.
It's almost become a normalcyfor people to travel for surgery
.
I remember when I started 15,20 years ago um, hearing about
people like about surgicaltourism was so bizarre, like we
would frown upon it or roll oureyes, and now it's more of a

(08:08):
normalcy.
So, given the fact that peopleare willing to travel, how did
you see the incentive other thanpotentially being able to
relocate?
Specifically talking aboutDubai, because that's something.
I'm still being.

Speaker 2 (08:24):
I'm still being messaged, yeah no, I think it's
a good question.

Speaker 1 (08:28):
It's a good question I'm trying to figure out for
myself, because I was this close.
I even sent my application andeverything and then last minute
I was like do I really want todo that?
I mean, I don't know how oftenyou go there, but I was offered
to go there every um, I think itwas every three weeks or four
weeks, and stay, or yeah, everyevery four weeks and then

(08:52):
practice her for one week andthen come back.
So I ran the math and I travela lot and I hate sitting in a
plane for longer than, like, mylimit is five hours okay, beyond
five hours.
I'm like where's the parachute?
I'm out yeah, yeah so so I wantto hear your perspective on
that how you made it work,because so originally.

Speaker 2 (09:15):
So I was approached um by a group in dubai.
It was maybe it was beforecovid.
It was years, years ago andthis was at a point in my
practice where we're starting togrow and I was getting more
traction.
And I tell people my Dubaiexperience has gone in phases
and the first phase was I wasapproached by them.
I was single at the time.
It was sort of like thisexciting opportunity to build my

(09:38):
brand, get some more exposure.
Maybe there's some ego involved, like yeah, now I have an
office in Dubai and BeverlyHills, I'm you know this big
deal, whatever.
And that was kind of this firstphase of it.
The second phase is it wasexhausting and I'm like why am I
still doing this?
You know, it was kind of likethings were growing.
I'm like God, do I really wantto keep doing this?
The third phase is I do lovethe city and it became more

(09:58):
about my seeing my friends whowere there.
I developed a kind of acommunity of friends there.
I enjoyed going there.
It was wasn't really about themoney anymore.
My practice had grown herewhere I was probably doing
better staying or at least thesame.
So it wasn't like I had thisbig financial incentive and it
wasn't only the people that Iwould my friends but also the
patient population was adifferent patient population I

(10:18):
kind of enjoyed.
I mean, my Middle East patientsare some of my favorite
patients.
I really did enjoy seeing themand having an experience.
Now I have a one-year-olddaughter Now.
I've taken her out there withme one of the times when she was
still young enough, where shecouldn't move anywhere, so it
was easy to get her on a longflight.

Speaker 1 (10:36):
Yeah, it gets harder.
Let me tell you, I have afour-year-old.

Speaker 2 (10:39):
We just tried her a flight to Florida a few weeks
ago.
She's about 13 months and thatwas a.
That was no picnic but anywayso so now it's kind of been
another crossroads, honestly.
You know, I've been doing itfor about five, six years.
I've enjoyed it.
I don't regret it.
It did help me in terms ofbrand building.
I think where I'm at now, kindof where you're at now, candidly

(10:59):
I don't know that it reallymakes a whole lot of sense for
someone in your position.
I mean, when I started I wasstill trying to get my name out
and grow and sort of cash in onthat sort of, you know, the
growth of my, my name and mypractice.
I think as a, once you're kindof established, it can be a fun
thing.
I don't you know if you coulddo a one-off and be like, hey,

(11:30):
you know what, I'll come outthere and do you know it could
be a heck of an experience orfun that way.
I just don't know.
I don't know if that's we canhear that.

Speaker 1 (11:32):
I don't know if that, I don't know how much weight
that would carry for someone inyour position now.
Well, I was approached again,like many years ago it was
before the pandemic and um mypractice.
It was during a time mypractice was growing
exponentially and I didn't seethe need.
But I remember I discussed itwith colleagues.
I said, you know what I wishthey had like, approached me 10
years ago.
10 years ago I would have,because back then we didn't have

(11:54):
social media and growing umcosmetic surgery practice and
aesthetic practice.
You know our, our mentors andpredecessors.
They were telling us um, itwould take about 10, it takes
about 10 years to reallyestablish yourself.
Now, with social media, if youknow, if you're good, if you can
show good results and you'reable to communicate that

(12:17):
effectively meaning you have agood team your practice can grow
within a year.
You can become famous within ayear because you know you have
the ability, you have the talent, you have the training.
Now it's how do people get toknow you or how do they know
that you exist?
So with social media, I thinkthat the playing field has
changed.
So a lot of our old, the oldguard that was just relying on

(12:39):
their titles and on their.
You know, being a professor atthe university and being the
expert in the field, it was mucheasier for them than someone in
private practice to becomeknown, become well-known.
I mean, you wrote a book, youpublished, you were teaching
Back then.
That's how you got known.
Today, it's not that it's justresults, it's purely results.

Speaker 2 (13:03):
I think social media has made it harder and easier.
In some ways it's made itharder because I think it is.
Now we just have a saturatedmarket.
You open your phone and youcould find 20 providers in a
second who hear you.
That wasn't the case before.
A friend had it or you justknew the guy who was down the
street from you.
Now you can just grab yourphone in your hand and you can

(13:26):
find 50 surgeons within 200miles.
So I think the market has beenmore saturated, so there's more
competition.
But to your point, yeah, I thinkyou can create the.
Maybe it's the illusion thatyou're an expert in your field.
You can create this persona,even apart from results, by the
way.
I mean, I agree, results.
You have to have results togrow, but the reality is I see a

(13:48):
lot of people growing who donot have a lot of results, maybe
don't have great results, butthey're very good at marketing
the plastic surgery.
You know, what people maybedon't want to acknowledge is our
world right now is two pieces.
It's it's our role as aphysician and as a as a surgeon,
and it's our role as aphysician and as a surgeon and
it's our role as a marketer, andsome people are okay at one and

(14:08):
really good at the other.
They might be terrible marketersand great surgeons, or they may
be amazing marketers andaverage or below average
surgeons, and the reality is themarketers are probably winning
that battle.
They're getting enough peoplein.

Speaker 1 (14:26):
I think the ones that , and that's what intrigued me
about you and I'm gonnacompliment you because you
deserve it and that's why Istarted following you, because I
feel, um, I can see, you gotboth aspects down.
Um, not only you're a greatsurgeon, because obviously your
result speaks for themselves andanyone can look at them, but
also you're a great surgeonbecause obviously your result
speaks for themselves and anyonecan look at them, but also

(14:47):
you're a great communicator.
I think the best marketersmarketing.
I separate marketing andbranding.
I think we're actually talkingabout branding, not so much
marketing, because marketing isthe asking for sale thing, but
branding is what most people cando, but then, at some point to

(15:08):
really become successful, youhave to back it up with results,
otherwise people will seethrough you, you know, and one
of the things that intrigued meabout you and I what's why I
love to have you on this podcast, is because you, you got both
aspects down and I think, um Idon't know who said it I said
the primary um skill that youneed to have as a doctor to be

(15:33):
successful is you have to be agreat communicator, and there's
different communicators.
There are some communicatorsthat are, you know, very, um, I
don't want to say abrasive, butthere's just too much, and there
is some that are, you know so,more more timid, more hump,

(15:56):
almost too humble that no onetakes them serious.
And then there's the ones inbetween and I feel like you
really, um, got the the middledown, uh, almost like better
than anyone that that I haveever seen, and that's what was
intriguing.
It's.
It's very pleasant when I go onyour channel and you, you start

(16:17):
talking and teaching, um, youknow, sometimes, uh, when you
hear someone talk, after threeseconds, if you, if they don't
engage you, you get bored, youstart swiping.
But there's something about thecommunication skill that is
engaging, that it's a talentthat you must have.
And you know, I was just hostinga webinar a couple of days ago

(16:37):
for new fellows that areinterested in fellowship
training program, interested infellowship training program, and
they asked me.
The panel asked me whatqualities I believe, uh, fellows
interested in aesthetic andcosmetic surgery need to have,
and I said you need to havegreat communication skills, you
need to have a good bedsidemanners and you need to be a

(16:57):
great educator and teacher,because every day we're
educating and teaching ourpatients, and I feel like you
got it down and I don't know ifsomething that was innate to you
, like natural to you, orsomething that you learned to
tell me.
Are you first of all aware ofthat and if so, how did you
acquire that?

Speaker 2 (17:15):
You're more than generous with the compliments.
I'd probably rein it back alittle bit.
I think I look.
We're all evolving, you know.
If you know, I can look back atmy use of social media seven,
eight years ago and probablycringe and want to throw my
phone out the window.
So I think there is an evolutionof you know how we use social

(17:37):
media and how we communicatewith patients.
You know, I've always toldpeople we have a very, very
strange job.
You know I do obviously largelybody work and it is I think we
were talking about this.
The other job, you know I doobviously largely body work and
it is.
I think we were talking aboutthis the other day.
I said it's an.
It's an extremely unnaturalthing for a stranger to come in
front of you, take off theirclothes and say this is what I
don't like about myself.
That isn't a completelyridiculous concept at its face.

(17:57):
So I've always looked at socialmedia, for example, as a
tremendous vehicle.
We have to at least start theprocess of getting people more
comfortable.
And to your point aboutcommunication, I think the
tenets that I hold dear are beconfident but humble.
You have the obligation and theresponsibility to inform and

(18:17):
educate your patients on thefield in general and on what you
do specifically.
And then, lastly, going back tothe first point, is it's really
important that you make themfeel comfortable, and for me,
overcomes from connection.
So so I with each of my patients, and this is kind of you know,
it's not a stretch for me,because it's part of the reason
I got into this, this line ofwork, is I do love interacting

(18:39):
with people, I loverelationships.
I that's, you know, my joycomes from those interactions
with patients and watching theirsort of experience in real time
.
And so with every personthere's something we can just
about every human we interactwith there's something we can
connect over Just about everyone.
It's very rare that you'll meetsomeone you know certainly if

(19:01):
they're coming to you in youroffice, where there isn't
something that you can kind ofget to in two minutes to talk
about, not fakely but likeactually genuinely be interested
in engaging their lives.
And for me that was just sortof a, a simple sort of thing
that I enjoyed personally, but Ialso there's value in it
because you know, without that,without that level of comfort,

(19:22):
you're already behind the eightball and the relationship will
be strained.

Speaker 1 (19:26):
Well, it's all about authenticity.
I think one of the things I seea lot on social media people
are trying to fake to be someoneelse, whether it is they're
trying to hide their owninsecurities, or someone told
them this is how you have tobehave and act and it was
completely different than whothey actually are.

(19:46):
So you see them struggling.
I think what you're talkingabout truly is and you're very
humble about it is authenticityand, surprisingly, not many are
comfortable in their own skinand therefore they can't be
authentic.
And that's when you're notauthentic.
You can't connect with someone,because human connection has to

(20:08):
do with authenticity, and whatyou're alluding to perfectly is
that you you're absolutely right.

Speaker 2 (20:14):
You can start a conversation with anyone, no
matter how long you've knownthem, or whether you disagree or
agree, as long as you'reauthentic yeah, and I I've never
, and I agree you, there'sdefinitely certainly a fair bit
of inauthentic folks out onsocial media, and some of them
are my friends.
I mean some of them.
I'll see them in person and belike what the hell is this stuff
?
I was watching on your mediathe other day and, for me, the

(20:36):
thing I don't understand aboutit, the thing I cannot get, is
that here we have this mediumwhich is giving us an
opportunity to show ourselves ina real way, so that when
patients come to the office,they already know us a little
bit what a what a great gift wehave, that we were just handed
for free.
And instead of using that andharnessing it and, by the way,
it doesn't mean you have to besuper personal and gregarious

(20:57):
and all these things you can bevery analytical, you can be very
yourself and you know whatyou're going to attract people
who like that, because there arepeople that like all of these
different things.
And instead of doing that andattracting what's like you, or
attracting those who are, whovibe with your vibe, or whatever
you want to call it, you you'redoing dances or you're doing
something that I know is not whoyou are.
What happens when they walk inthe door and they meet you Like

(21:20):
I don't understand that part.
Because if it was me and I was apatient and I had a certain
perception of someone and then Igo and meet them and they're
different, that would throw meoff because I would just be like
, wait, what else is different,what else is not?
Kind of what I thought it wasthat I saw on social media.
So I just never got that.
I mean, it's to each their own.
People can use it all they want.
Some people are successful withthat.

(21:40):
I just have to be able to lookat what I put on and be like,
yeah, I'm good with this, thisis me, yeah you just have to be
comfortable in your skin.

Speaker 1 (21:48):
I try to teach my fellows a lot because I want
them to be successful when theygraduate.
I want them to really go outthere and really kick ass.
And I'm surprised to see howmany are not comfortable just in
front of a camera or are notcomfortable and I tell them look

(22:10):
, just talk about what you know.
Don't try to talk about stuffyou don't know.
Just talk about what you know.
Just talk about it like you'retalking to a patient, which you
do every single day, exceptthere is a camera in front of
you and so it takes time, justlike me.
And you were kind of dorky inour first years on social media
and I show them some of my oldstuff.
I'm like, look, this was meTotally embarrassing, so don't

(22:32):
look at me now.
I mean, I have like seven yearspractice now in front of the
camera and all that stuff.
But I feel like there isespecially this younger
generation.
They're so afraid of judgment,they value people's opinions so
much that they don't even givethemselves a chance and I think

(22:53):
you have to overcome that orelse you're never going to make
it.
And I feel, because of socialmedia, like you said, there is
terrible doctors, but there aregreat marketers and they've
branded themselves.
They're just going to win themarket.
So, no matter how good you are,if you're not able to
communicate, if you're not ableto overcome that hurdle of being

(23:15):
comfortable in front of thecamera, I don't know how you're
going to make it in this world.
I mean, do you see a wave wheresomeone is not on social media
or on the internet and they're aphenomenal surgeon just through
word of mouth, like in old days, that they're gonna break
through the market somehow?
Do you know someone?

Speaker 2 (23:34):
I think?
No, I think it does happen.
It just happens slower.
Um, I think it does happen.
It's just a function of.
It's a time game and you'regonna make the.
It's gonna take a lot longerand it's gonna also absolutely
require that you do great work.
You know game and you're goingto make the.
It's going to take a lot longerand it's going to also
absolutely require that you dogreat work.
You know versus.
If you're a great marketer, youmay be able to get get away with
more misses and I you know oneof the points you made earlier
about you know speak about whatyou know about.

(23:54):
I also think that if you're notpassionate about this stuff,
you can tell.
You can, absolutely, absolutelyand, by the way, patients can
too.
Patients can tell thedifference when you have a
personal interest in what you'retalking about or what you're
doing, versus if you're gettingup there and reciting a line
like.
They know the difference and Ican tell you that because
they'll tell them, they'll pointit out to me on certain things

(24:15):
that I'm talking about that Iclearly have a strong feeling
about.
So if you, if you don't knowwhat you're talking about,
that's not good.
If you don't care about whatyou're talking about, it's even
worse.
So I think you know one thing I, when I'm talking to people, I
say listen to your point, beauthentic, focus on your work,
talk on what you know and findwithin what you've chosen,

(24:36):
hopefully this is a passion ofyours.
It doesn't have to be thepassion of yours, but hopefully
it's a passion of yours or,within what you're doing, find
what you're passionate about andtalk about that, because people
identify with that and peoplewant to be with someone who's
passionate about what they'reinterested in having addressed.
And yeah, I don't know, I thinkthere are some people where
it's tough.
I mean, let's, let's be honest,most of most plastic surgeons

(24:57):
probably don't have the greatestpersonalities in the world.
Most surgeons in the worlddon't have doctors.
Yeah, we were just as acollective.
We're not an impressivepersonality trait bunch.
There's a lot of sort ofeccentricities and issues and
whatnot, and I think there's alot of god complexes.
There's a lot of people thatwere.
You know, I always joke.
I say there's a lot of people.
We were dorks coming up, weweren't social animals, we

(25:18):
weren't the popular people.
We were really good at schoolor we really excelled there, and
then all of a sudden, sudden,one day we're successful, we
have money, people are lookingat us and some people, I think,
don't know how to do that.
They're acting out what theythink that person is supposed to
look like, rather than just no,no, just be who you are.
You know, carry on.

Speaker 1 (25:37):
Yeah, I think it's easier said than done, but
you're absolutely right,absolutely right.
We were almost given that badgeof authority that some just
don't know how to handleproperly.
To me, there's two groups ofpeople.
There's a group of people that,whatever they do, they do it in

(25:59):
service of others, meaning whatcan I do or what is it that I
will or can do to improve theother person's life.
And that's coming from a pointof service and that's, I think,
primarily what we should bedoing monetize what I'm doing on

(26:22):
daily basis, meaning what's init for me, and not caring as
much about the consumer or thepatient that is coming to us.
And you see that in ourprofession there's two groups of
people, and I'm not surewhether patients can easily see

(26:42):
through that, because,especially when your work is
great and when you come highlyrecommended, it's almost like
they get starstruck and blindedand they might not see it until
they realize halfway into itthat you know they were just
taken for a ride, versus theother group where they genuinely

(27:04):
do what's in the best interestof the patient.
And that's where I thinklong-term is probably the more
successful strategy, and I thinka lot of it has to do with what
motivates you, or has motivatedyou, to become a plastic or
cosmetic surgeon.
So what motivated you, inparticular, having been

(27:27):
passionate about cancer, curingcancer and I come from the same,
I'm made from the same clothand what motivated you to become
a plastic and cosmetic?

Speaker 2 (27:37):
surgeon.
So I, as you know, I started ingeneral surgery.
I thought I wanted to be asurgical oncologist.
I did oncology research.
I found there's a few thingsthat kind of started to change
the landscape for me.
One is I liked the idea ofputting things together more
than I liked taking them out.
It was I found the process ofputting things together far more
interesting to me than cuttingstuff out.
It's sort of started there juston a conceptual level.

(28:01):
Um, the other thing is one ofthe things that attracted me to
general surgery was the breadthof work that you would do in
theory.
You know, general surgeons do alot of different things.
General surgery trainingincorporates vascular and
cardiothoracic and trauma andall these different areas.
But what I was finding ingeneral surgery is, if you
really wanted to excel, youbecame kind of.
You were a liver surgeon, youwere a pancreas surgeon and you

(28:21):
did the same operation over andover again.
I mean, and that was the biasof being at somewhere like Johns
Hopkins where you had thesesuper specialists.
But and then I looked atplastics and yes, you can focus
on an area, like I focus on anarea, but I'll do.
I do several differentoperations all the time and each
one can be done differently.
They're not done the same thing.
So the same way you know you doa right hemicolectomy, you do

(28:41):
it the same way pretty muchevery time.
You know you don't do a tummytuck.
The same way every time.
There's nuances based on wherethe patient's starting.

Speaker 1 (28:48):
It's more of the creativity aspect.

Speaker 2 (28:51):
Yeah, I just like the idea of, oh, there's going to
be a different way to do thisand different avenues.
And, candidly, I like thatthere was a reconstructive
avenue and there was anaesthetic.
And I think in the back of mymind I saw where hospital
systems were going.
I saw how our insurancecompanies were going and I'm
like, wouldn't it be great if Iwas in a, if I was in a

(29:11):
discipline within medicine,where I could leave those behind
and be a business owner andcreate my own work culture, the
what I wanted out of a practiceto be, rather than to be married
to whatever the hospital systemI was saying, had to be the
work culture or the payment asthe insurance company, you know,
so on and so forth.
I think that was in the back ofmy mind and I think when I got
into private practice and I wasfirst with a group where we did

(29:31):
mostly reconstructive, itsolidified it.
Once I saw how we were handledby insurance companies, I'm like
, why am I?
Why am I dealing with this?
Um, so, yeah, so it was kind ofall these things came together
and then the last thing for metruly is the jump from
reconstructive surgery tocosmetic was sort of a leap of
faith, because I always had thisfear.
I think there's a huge populaceof misunderstanding about

(29:53):
cosmetic surgery.
Is this vanity exercise?
You're going to be dealing withcrazy people and it's not
fulfilling and all these thingsversus.
I was coming fromreconstructive, which did have a
fulfilling aspect.

Speaker 1 (30:03):
Well, those are typically people saying that
that are not cosmetic or plasticsurgeons.
Right, but even I, even I as areconstructive.
Why would you listen to them?

Speaker 2 (30:10):
I know.
But even I, as a reconstructiveplastic surgeon, I didn't know.
You know, you don't know untilyou're in it.
In it and I think there was alittle bit of that is like, oh,
am I going to be dealing withthat?
And I, as you know, I was sorelieved when I found that no,
most of my patients are normalfolks and they had just as

(30:31):
fulfilling an experience and itchanged their lives just as much
.
That was a relief because Idon't think for me it wasn't
about chasing money like, oh,that career is more lucrative.
I separated myself from themoney years ago.
I don't really look at it thatway.
I know it sounds naive andidealistic, but I legitimately
went several years.
I tell people sounds naive andidealistic, but I legitimately
went several years.
I tell people this and itsounds horribly irresponsible.
I went several years withouteven knowing what I was making.
I didn't.

(30:51):
I had to go to my manager tocheck things.
I didn't.
I couldn't if someone said, gointo your bank account, I had to
call them to be like what's mypassword?
I literally stayed away from itand because it was that was
that was robbing me of the joyof what I was trying to focus on
and do, and that's anotherthing I tell people is I say
listen, I promise you, certainlyin our field, if you focus on
the work, the money will alwaysfollow you, amen, amen.

(31:15):
But if you focus on the money,the joy will not follow you.
And so I've just seen it happentime and time again where
people do it the right way orthe wrong way, and it's almost
100%, with 100% accuracy.

Speaker 1 (31:28):
You know I thought you just threw a golden nugget.
I thought about that a lot andI give that advice.
You know, there's not a podcastwhere I don't say exactly,
almost verbatim, what you justsaid.
And when I talk to my youngerself and younger surgeons and or
residents and fellows that Imentor, when I say them exactly

(31:51):
what you said, the look in theireyes is almost like I don't
think they get it and I and, andI think when someone told us
the same thing when we wereyounger, um, I don't know
whether we would have understoodit the way we understand it now
.
And I think the way we come tothis understanding is a natural
evolution.
You have to have lived it tounderstand it, which is okay.

(32:15):
That's how we grow as people,but nevertheless it doesn't
devalue the fact or diminish theimportance of mentioning it to
younger people, because I thinkit's like planting the seed, and
then there is going to be aninstant in their life where
they're at a fork, where theyhave to make a decision are they

(32:38):
going to take the right or leftturn?
And then that seed that wasplanted in their head is going
to help them to take the rightturn.
But one of the things you knowI really resonate resonates with
me when, where I made thetransition from reconstructive
surgeon, I was doing head andneck cancer.

(32:59):
I did two years full timeresearch at Harvard in head and
neck cancer and my residency.
I picked my residency at theUniversity of Miami Medical
School because it had it was thenumber one head and neck cancer
.
It had the number one head andneck cancer fellowship in our
specialty with the mostworld-renowned cancer surgeon

(33:21):
and so I was destined to becomea head and neck cancer surgeon.
And that one day where I was inthe Wednesday clinic where we
did all the follow-ups andpost-ops and people from all
over the country would come,there was this one patient that
after we cured his cancer, wehad resected the cancer with it,

(33:45):
the whole flap and he ended uphaving a neck scar right, it
wasn't actually bad, it was fromthe neck dissection and
everybody left.
I was still in the room justanswering the last questions.
I was the chief resident and hesaid what can you do about the
scar?
And I looked at the scar.
It didn't look bad, but youcould see it and I said you know

(34:08):
, um, I could find out, maybe wecould laser it, or here in my
head I'm trying to go down thealgorithm as a resident.
I'm like maybe we could do a zplasty.
All those things go through myhead and I'm like, well, let me
go ask my attending.
So I leave the room, I askattending and when I ask him
that question he was readingsomething and lifts up his head

(34:30):
and he goes like he's not happythat we occurred as cancer, like
he's complaining about.
I'm like, no, no, he's notcomplaining, he was just asking
whether we can do something toimprove it.
And it was just, I don't know,just refer him to dermatology or
plastics, we don't deal with ithere.
And so I went back and told himthat it was almost the news of

(34:53):
me telling that was worse thanthe news we told him when we
told him he had cancer.
And so what I realized that day,and I always remember that, is
that what we do is essentiallywhat everybody wants is about
self-esteem and self-confidence.
And that day I made theconnection that it's not about
vanity.
Aesthetic surgery is not aboutvanity, it's about self-worth,

(35:19):
it's about self-esteem, it'sabout self-confidence.
And same thing, our cleft lipand palate patients.
You know, children, orasty orsomeone would love to wear a

(35:49):
bikini again, or someone wantsto look better for their spouse.
I mean all of those things.
It's all about self-confidenceand self-esteem.
And I think our specialty hasdone such a disservice, not just
to the rising doctors andresidents, but even to the
community, in labeling it asvanity and almost putting the

(36:13):
stigma on what we do, for evenother colleagues of ours, the
specialties like even the cancerreconstructive surgeons rolling
their eyes or devaluing what wedo and not realizing we were
there, you know, we've beenthere too, so we might just know
something that they haven'tunderstood yet, because they

(36:35):
haven't really discussed theseconcerns with the patients.
And so that's, for me, whatgets me to work every Monday, to
, yeah, we're not saving livesanymore, you know, but we, I
mean.
I think changing someone's lifeis just as valuable, if not
more valuable, because whenyou're dead, you don't care
anymore.

(36:55):
Yeah, your loved ones are goingto suffer, but when you live
your life with lack ofself-esteem and self-confidence
to the point you don't go outthere and socialize.
And we're going to get to talkabout longevity a little bit too
and, as you know, humanconnection is one of the biggest
predictors of all causemortality and lifespan, and

(37:18):
that's why there's so much, youknow.
Look at the rates of depressionand anxiety that are out there,
and I think we have a big partin improving the quality of
lives of those people.

Speaker 2 (37:28):
Well, I think you just that last part right there.
So quality of life.
I think there's a hugemisconception of what we do.
Plastic surgery is a very easytarget, and I get it, of course.
If you look at any TV show thatdepicts a plastic surgeon, I
challenge you to find one thatdepicts it in a sympathetic or
positive light.
Never, it's always a sourcething to mock, and what have you
so?

Speaker 1 (37:48):
yeah, you're almost not the real doctor yeah, and so
it's.

Speaker 2 (37:51):
It's.
It's a thing we deal with allthe time.
There's a story I share withpeople, you know, and I I
remember you sharing that onetoo and I I remember you, I
think, mentioning it on socialmedia that that really drove
this home for me and that thereis a functional, there's a life
function component to what we do.
It is not just about what yousee in the mirror, it is about
feeling, it is about quality oflife.

(38:12):
And the story I remember is awoman who and I tell this over
and over again because it thisis one of the only times I
almost not like I'm an I don'twant to say I'm an unemotional
guy, but this one kind of caughtme.
If gardener was in the clinicand I was like, okay, collect
myself, there was this woman.
She was, I think she was, Idon't know something like eight
months post-op or maybe a yearpost-op when I saw her and she
was from hawaii and she waspolynesian.

(38:33):
So her family always had eventsin the water.
You know her kids, they woulddo things in the water.
And when she was like sixmonths post-op from her mommy
makeover, her daughter ran up toher and grabbed her leg and
said mommy, you come to all myevents now.
And the mother in that momentrealized how much her just being
unhappy in her skin had kepther from living her life and

(38:56):
being present for her, for herfamily, for her kids and she
loved her kids.
It was just.
It was hindering her ability tobe present, to be engaging in
her life.
So I would challenge anyone whosays this is a selfish vanity
exercise to look at thatexperience and say what part of
that was selfish versus whatpart of that actually helped her

(39:17):
relationship with her children,helped her happiness and
fulfillment in her life.
And that is the functionalcomponent to this that is
completely lost in what we doand what I tell people all the
time is.
I hate before and after photosin the office and I love before
and after photos that patientssend me, because the difference
is before and after in theoffice is just focusing on form.

(39:38):
It's just saying this is whatthis looked like before, this is
what this looked like now.
When a patient sends me apicture, it's really showing
what this is about, which I amconfident.
Now I feel great.
Now.
That's a before and after.
That's showing the this is whatI felt like before.
This is what I feel like now.
That's a more effective andmore a true reflection of what
it is that we're trying toaccomplish, what we do, and

(40:00):
until the day I last practice, Iwill relay this to patients and
tell them no, no, listen, thisvanity is what you do for other
people, you're doing this foryourself.
That's a different animalaltogether.

Speaker 1 (40:11):
A hundred percent and you know talking about the flip
side.
You know there are, you know,patients that are suffering
because of other mental issues,like body dysmorphia, and which
leads them down this rabbit holeof following certain trends and
then ending up in hands of.

(40:32):
You know, I call them more ofthe predatory, not to try to
bash anyone, but there's goodand bad.
There's 7 billion people inthis world and there's good
people and there's bad people.
There's going to be opportunity.
So there's opportunity world andthere's good people and there's
bad people.
Yeah, there's gonna beopportunity.
So there's opportunity.
There's a lot of low-hangingfruit and, uh, social media, I
feel, augments that opportunity.

(40:54):
Um, where do you see, I want totalk to you a little bit about
trends, um, so that you can kindof give the audience, um kind a
good guide.
Also talk about differences andtrends between the US, even
though within the US it's sodifferent, like I'm pretty sure
Nashville is going to bedifferent than Beverly Hills but

(41:17):
mainly about the US and Dubai.
You know, I want you to talk alittle bit about that and kind
of help guide the audience inhow they can safely navigate
through these muddy waters.

Speaker 2 (41:30):
I think the overwhelming trend I'm seeing
across all platforms is reallytwo things, and this is not
rocket science.
You see this a lot.
There's a trend towards tryingto push non-surgical
methodologies to get surgicalresults, which in most cases is
fool's gold.
But I think there is this sortof growing industry trying to

(41:50):
show people, hey, if you just dothis, it's just as good or
close enough to surgery andyou'll get this great result.
The second thing, which is whatI'm happy about, is I see a
trend more towards a naturalaesthetic, and what I mean by
natural aesthetic is the kind ofresult where someone isn't sure
, looking at you, that you hadsurgery.
I mean by natural aesthetic isthe kind of result where someone
doesn't isn't sure, looking atyou, that you had surgery, which

(42:10):
you know is the ideal.
If you know it's not to, it'snot to condescend on someone who
wants something that maybedoesn't look quite natural to
each their own, but in terms ofthe longevity of a result or
result that will endure trendsin time, the natural aesthetic
is always going to be that, andso we're.
I think we're at a point rightnow where we're seeing more of
that, and now, as it as it kindof pertains to different regions

(42:32):
of the world.
I think one of the things Inoticed different between
different regions of the worldis the I guess the even within
this country, people who areokay with you know it being
public or people sort of beingit's not a big deal versus
people being we'll hold thatsecret to their grave.
And so there is a there iswhich, to me, steps um speaks to

(42:53):
stigmas being different indifferent parts of the country.
I remember when I, you know,when I was in practice in
Chicago for a few years before Imoved back out to California,
and the difference I wouldalways bring up to people that
this is at the time, this is atthe time.
It could be different now.
This is, you know, 15 years ago.
But the difference in chicagoand la is in chicago you'd have
a 50 year old woman coming insaying I'm thinking about
getting botox.
In la you'd have an 18 year oldcoming in saying I want botox.

(43:15):
So there's this differentmentality about what is normal
and acceptable.
Part of sort of plasticsurgery's not a big deal versus
other places of the world it isis Internationally.
When I'm in the Middle East andI'm seeing European patients,
by far the natural aesthetic isdominant.
It is very, very rare there,way more so here than you see

(43:36):
people who show me a result thatlooks, you know whether it's
breast augmentation, where it'slike the kind of breast
augmentation where it's notgoing to leave a lot of people
guessing.
That's very rare over there inmy European and Middle Eastern
patients here, you know, youstill get those people who are
like no, this is what I want.

Speaker 1 (43:53):
So would you say the Europeans and Middle Eastern are
very similar, since you'reseeing both.
I mean, I'm from Germany, Igrew up there, and I know
they're very conservative there,to the point that actually
they're almost demonizinganything that you do.
They're really calling itvanity.
I feel like they're way behindas far as that social evolution

(44:18):
than here in the US and theydon't have a good relationship,
let's just say, with plasticsurgery.
They secretly want it, but it'salmost like they want.
They don't want to admit it andI'm very familiar with their
psychology, just because youknow again, I grew up there and
and I could see that and it'svery important to them, um, that

(44:40):
they look natural because offear of judgment.
They don't, because they judgea lot, they don't want to be
judged and therefore they don'twant to have any changes made
where one could tell um, how doyou?
So you, how are the middleeasterners?
Uh, in dubai?
There I know in dubai youprobably see a lot of uh,

(45:01):
persians, a lot of um, peoplefrom all over the middle East,
and hereditary I'm Persian, soI'm also familiar with that
psychology.
Do you see a difference there?
I mean, I can't imagine thatit's not different between
Europeans.

Speaker 2 (45:19):
Whether or not there's a stigma that exists.
The patients that I meet do notseem to mention that or combat
that, insofar as they just wanta natural result.
They're not looking foranything crazy, but I don't get
a sense of shame that they'redoing it.
Um, and I'll see patients and,and also it's a growing market.
There are certainly Dubai isSaudi is trying to get involved
with this, kuwait.
There's more clinics that arepopping up, so you have a lot of

(45:40):
this becoming becoming.
They're trying to create theseregional centers.
Um, one interesting thing abouteurope and I'm curious if you
think this, you know, when Ithink about europe
geographically, I look ateastern europe.
When you get to the former sortof soviet blocks russia, very
high into plastic surgery,bulgaria, romania, huge, huge.
You go into western europe,places like spain, pretty big
into plastic surgery.

(46:00):
They have a huge, boomingmedical tourism business in
spain.
The uk, a good amount ofplastic surgery.
Central Europe is a differentanimal.
When you go sort of Germany,you know, scandinavia, down
through Germany into Austria,yeah, that's not a market, it's
not a place you think about asmuch and I don't know.
I have no data to back this up,I'm just thinking sort of

(46:21):
anecdotally that, yeah, thatthere is kind of this place in
the middle of Europe where it'slike it's almost almost like
plastic surgery slowly doingthis in Europe.
Because I do agree they're.
They're behind in many ways and, by the way, the US is behind
in many ways when it comes tobody surgery.
South America is sort of groundzero for a lot of what we do,
and then we're sort of kind ofcatching up to them and other

(46:42):
places.

Speaker 1 (46:42):
So yeah, I think it's it's.
It's interesting that you madethat observation.
You're actually 100% right.
Like Austria, Switzerland,Germany.
It's interesting that you madethat observation.
You're actually 100% right.
Like Austria, Switzerland,Germany.
It's almost like theGerman-speaking countries.
They're one of the countries.
Yeah, and it has to do with theculture.
Actually, for me, moving to theStates 25 years ago, it was a

(47:04):
little bit of a culture shockand I'll give you a couple of
examples.
Maybe that helps explain, toextrapolate that to what you
just said, because it's actuallytrue what you said.
So Germans are very pragmatic,you know.
They're very disciplined andthey're very opinionated.
They're great people.
They're probably some of themost loyal people, like a loyal

(47:32):
German friend is a better friendthat you can dream of.
But because of their pragmatism, because of their it's almost
like ultra-conservatism andtheir discipline, they don't
like change.
They have problems with change,and I'm not a historian or

(47:54):
social psychologist so I don'tknow where it's rooted.
It's just an observation,having grown up there To the
point.
I'll give an example.
So in my last year, when I wasthere, when I came to the US, so
my professors were asking melike so what are you doing?
And what are you doing nextyear?
And so I said I'm moving toAmerica and I'm going to

(48:17):
continue my studies there.
And all of a sudden there was asilence like why would you do
that?
And I thought they're going tobe happy, they're going to say,
oh, that's amazing.
Great, and it was like this.
Why would you do that?
I'm like, what do you mean Like?
Why wouldn't I do that?

Speaker 2 (48:33):
Sounds like a lot of Hopkins attendings.
To be honest with you, yeah,and then they're like what's
wrong with Germany?

Speaker 1 (48:39):
I'm like nothing is wrong with Germany.
I'm very grateful.
I lived all my life here.
I just want to exploresomething new and I see more
opportunity for what I want todo there.
And all of a sudden they turnedon me, they turned around and
left and I said what justhappened?
Did I say something wrong?
So they're opposed to change andthey're very judgmental.

(49:01):
And I think if you extrapolatethat to changing your face or
your appearance, they think likeit's you're, you're being
shallow, and they have thisobsession of being deep and not
shallow, to the point that theywere even saying, well, why you
go to america.
You know they're just shallow,superficial people.
They're just so loud and likehave you ever been there?

(49:23):
I mean, how many americans doyou know?
And, by the way, america is abig country.
I mean it's people from allkinds all over the entire world
living there and it's, you know,like why would you even say?
Of course I didn't argue withthem, but I was thinking it's
like how could you say somethingabout a country with over 300
million people and having such astrong opinion and then trying

(49:47):
to influence me and almostpooping on my party, but that
has to do with the fact thatthey don't like change.
They see themselves as asuperior nation, as a complete
nation, and that no one shouldhave a reason to leave, and they
see that as an insult.
So that's their mentality, and,of course, not all Germans are

(50:08):
like that.
It's mostly that I think Germanyhas changed because it's become
now a melting pot.
You know, you go to Germany nowyou see people from all over
the world, and back then, when Ilived there, I was the only one
standing out with dark hair.
I would walk into a bar.
Literally the music would turnoff and everybody would turn
around.
It actually happened to me whenI got lost and I walked

(50:31):
somewhere to ask for address.
But now that has changed, eventhough in certain parts it's
like that.
So that's just their mentalityand they will catch up.
Now that more foreigners areliving there and assimilating
there, I think it's changed.
There's a huge Greek communitythere, a huge Turkish community
there, and so that helps them.

(50:53):
But again, they're very opposedto change and they just don't
have a good relationship withthese types of things.
Even with makeup, however,they're very stylish, so I can't
make sense of it, like inGermany when I used to go to,
wanted to go to a grocery storeor a drugstore, you could not go

(51:16):
with sweatpants and hoodie,like my mom would not let me
leave the house.
She's like you're going likethat out of the house.
I'm like what's wrong with it.
She's like, you know, you'redressed like a homeless person.
I'm like these are mysweatpants.
You know, it's just, I justcame from practice Like it's
okay.
She's like no, no, no.
So they would judge you andthey kind of I don't know how it
is now, but you know, and yousee, men, they're very stylish,

(51:39):
to the point that, you know,here in America, european men
are kind of judged because oftheir stylishness, because, oh
yeah, dress.

Speaker 2 (51:48):
So it's different, it's just a different culture,
you know, um, so it's kind ofinteresting to see that yeah, I
think, uh, you know, it's funny,you're, the older I get, the
more I sort of, in part yes, Iwant to educate people, inform
people, give my opinions on whatplastic surgery is.
But there's a part, anotherpart, of it's like think
whatever you want, it's okay.

(52:08):
Like I, I'm not, of course you.
You think whatever you want.
If that's what you think,that's fine.
And this stretches, as you andI have discussed, way beyond
just medicine and I'll just saylisten, you think what you want,
it's okay.
Like, I'm not gonna, I'm notgonna try to impose my belief
system on you.
That you know.
Yes, maybe it may be secretly.
My hope is like I hope you, Ihope you see my perspective.
If you don't, that's okay, I'mgoing to do it 100%.

Speaker 1 (52:29):
And that has to do with self-confidence and that
has a lot to do with that.
If someone judges you Most ofthe time judgmental people they
lack some sort ofself-confidence and they're
trying to impose that to.
You know that gives themconfidence.
But you know I want to talkabout now.
So that was a very interestinginsight about I did not know

(52:52):
that about the Middle East.
I never thought of a hugeEuropean population, but I'd
heard that before, so that'skind of interesting, I believe.
So my guess is that people,european people that live in
that area, are different justbecause they're more open to
other cultures and more open toother possibilities than the
ones that have never left europeor other and admittedly, dubai

(53:16):
is a different animal.

Speaker 2 (53:17):
I mean, dubai is different than riyadh, and
you're not in iran.
I mean it's very different.
So I mean dubai is very muchhas made it a very expatriate
friendly city.
It's much more progressive thaneven abu dhabi, which is an
hour and a half down the street.
You know, and so it it.
It makes it.
It's less of a, an adjustmentfor a European or a Russian to
come to the middle East.
Um, you know what I'm saying.

(53:39):
So it's, it is for for that.
You know that, anothersituation.
So I think Dubai is a littlebit of a.
You got to put an asterisk byMiddle East when you mentioned
Dubai, middle Eastern city, forsure.

Speaker 1 (53:53):
It's like.
It's like New York Miami.

Speaker 2 (53:55):
LA in one like literally put on the map in the
Middle East.
Exactly.

Speaker 1 (54:00):
Yeah, so are you familiar with the healthcare
system over there?

Speaker 2 (54:05):
Um, I I not as much as I should be, but what's
interesting, I will tell you.
With cosmetic surgery and thisis not just true in the Middle
East, but it's also like in theUK there's no surgery centers.
There you do everything in ahospital and a lot of that has
to do with the fact that theydon't have opioids like we do to
send people home with.
So a lot of it's a pain controlthing, which is probably a good
thing that they don't have that.

(54:26):
Um, so so you, even though I'mnot as knowledgeable as I should
be in the health care system,I'm a part of it, you know,
because you have to be sort ofwithin a hospital system.
And you, when I'm around, I'mrounding on patients in patients
, like it's the weirdest thingyou know.
I go to the nurses.
It's just like when I was aresident.
I'm going to the nurses gettingthe nurse.
Let's go to the chart, go to theroom.
I mean it's like I have likeptsd, but oh my god yeah, so it

(54:50):
is.
The dubai is a growing.
They have huge health carecorporations.
I mean, there's a big one inabu dhabi, big ones in dubai
where, um, and I know that theemiratis get free health care.
In fact, the emiratis, to myknowledge, they get like a
credit card and they can justwith like, just swipe whatever
you need for healthcare.

Speaker 1 (55:07):
Amazing.
We should have that here.

Speaker 2 (55:10):
Yeah, but that's only Emiratis, I know, you know it's
not people who get citizenship.
They have to be sort of nativeEmiratis.
They just get.
They get whatever they want, doyou?

Speaker 1 (55:19):
see.
Do you see differences inchronic diseases?
Slash health in your patientpopulation there of the same age
group.
Let slash health in yourpatient population there of the
same age group, let's say themiddle-aged, than here in the
States.
Say that again.
Do I see a difference?
Differences in patients' healthand chronic diseases?
Like here there's not a patientover 50 that is not either on

(55:48):
statins, blood pressuremedication or has some sort of
immune disease like thyroiddysfunction or some other
autoimmune disease.
I mean, it's just so prevalentthat I'm always surprised if a
patient says I don't have anymedical problems and they're
like 55.
I'm like usually my question iswhen was the last time you saw a
doctor?
Because I'm very suspicious.

Speaker 2 (56:09):
Or they tell me they don't have a medical problem and
I say, okay, what medicationsdo you take?

Speaker 1 (56:13):
And they say, oh, I have no medication.

Speaker 2 (56:15):
And I'm like, okay, those are those kinds of medical
problems.
I think my thing is a littlebit biased, because I'm seeing
patients who are on the youngerside because of what I do, so
they're generally a healthierpopulation.
What do generally a healthierpopulation?
Um, I would be younger, likewhen you do like.
So, like most of my patients,I'd say, are 30s to, let's say,
the majority are 30s to early50s and probably 30s to 40s okay

(56:36):
, so so early 50s, that's,that's premenopause.
Yes, you know yeah, yeah, so I Idon't, but I would.
My guess, without havinganything to back it up, is
there's probably a little bitmore things here where what I
would see more here for sure isthe number of people on an
anxiolytic and antidepressant,something like that.
That is very common.
You don't see that as muchthere.

(56:58):
You know they're not.
They're not taking those kindsof medications as often so, at a
minimum I'd say, mental healthmedications.
I see more here.

Speaker 1 (57:06):
Well, they don't even you said they don't prescribe
opioids there.
I mean, I think the USpopulation is what?
2% or 3% of the world'spopulation and 80% of opioids in
the world are prescribed herein the US.
I mean, you know that's?
I mean this is not surprisingand I don't prescribe any
opioids.
I don't think they're necessary.
You know, I know it's differentwhen you do a tummy tuck.

(57:51):
It's probably a more painfulprocedure, but it's definitely
overprescribed here andhopefully our new healthcare
will crack down on it, as it hasbeen already made us aware of
that.
There is such a problem wherefor many decades we were told
opioids don't cause, um, youknow, dependence and which which
brings me to the next topic umof the state of health care, uh,
the way medicine is currentlypracticed and how should I say

(58:13):
it?
Politically correct?
You shouldn't, Okay, so I won't.
So healthcare in the US isfucked up.
It's fucked up because it'salmost a financially derived
institution.
I mean, you look at hospitalsand you look at doctors treating

(58:36):
disease as opposed to helpingprevent disease or getting to
the root cause.
You see at how hospitals areincentivized.
You see how research isincentivized.
You see how our government isinvolved with pharmaceutical

(59:01):
industry.
So you look at all of thesethings and you realize how many
of our colleagues, first of all,aren't aware or, if they are
aware, they just turn a blindside just because they would be
shooting themselves in their ownfoot, because they're in that
system and they have almost nochoice because they're in the

(59:26):
system.
The payroll is dependent on thesystem.
They're not going to raiseawareness, so there's a huge
conflict of interest.
So, in other words, when I sayit's fucked up because there's
so many levels, we have an issuethat unless we crack on things

(59:48):
down at the government level, Idon't see that changing.
And now with the newadministration, love them or
hate them.
You know Robert F Kennedy.
Now I think he's been nominatedas Minister of Health.
How do you feel that mightimpact our healthcare?
Is there even a chance?

(01:00:09):
Or is it just?
Are the people residing overthe power just too powerful?
And do you think in any way isit going to affect aesthetic
medicine?
Or is aesthetic medicine acompletely different animal?
Are we completely immune?
Because it's pretty much directto consumer, has nothing to do
with insurance so I think,fundamentally, the great

(01:00:32):
corrupter of the medical systemis money.

Speaker 2 (01:00:35):
As with a lot of the things that are the things that
infiltrate and make, maybecorrupt, a system that is
otherwise intended to beincorruptible, healthcare should
be corruptible.
You know, when you're talkingabout people's health, that's
not something where you shouldwe should be looking at dollars
and cents, right.
Ideally, there is a good and abad part to having money being

(01:00:58):
part of medicine.
I mean, the uncomfortablereality is money will attract
great minds, money will attractinnovation and research.
Those things are true.
That doesn't happen withoutmoney.
That's the good side of it.
Unfortunately, I think thatwe've gotten to a point where
the bad side is greater.
And you know, I think,fundamentally, when the large
proportion of the money inhealthcare is not going to

(01:01:20):
providers, and obviously we'rebiased.
But if I'm a patient and I'mgetting life-saving care by a
doctor, who do I want to makemore money?
An insurance executive, ahospital executive of a
pharmaceutical company or mydoctor?
I can't imagine anyone is goingto pick someone other than the
doctor.
But that's what's happening.
The doctor gets pennies on thedollar of what those other

(01:01:41):
people get.
So do I think this can change?
Well, the only way this changesis if you break up the marriage
between money and medicine, andthat happens at the level of
the hospital system, theinsurance companies and the
pharmaceutical companies, andthat is something that can
happen at the government level.
There are things that can bedone or implemented to influence
how much, or that can affecthow much influence a

(01:02:04):
pharmaceutical company can have,even if it's like hey, you
can't do commercials.
Hey, you can't visit doctor'soffice.
Hey, you can't do these things.
Hey, your research needs to befunded independently.
You know things like.
There are things that could beimplemented to at least start to
create this chasm between themoney and the service of
delivering healthcare.
Now, do I think that's going tohappen?

(01:02:26):
The cynic in me says no,probably not.
Do I think we can make itbetter?
Yes, but I don't think it'sgoing to be through the
government that we make itbetter.
I'm not someone who trusts thegovernment to do the right thing
.
It's too big, it's too big.
I think what is happening is, Ido think there's more of a
grassroots movement towardshealth and wellness and that
people have to take custody overtheir own health.
They can't rely on their doctoror their hospital or whatever

(01:02:48):
to say, hey, this is what youneed to do to be healthy,
because they're not going to dothat.
Unfortunately, western medicineis largely reactive medicine.
It's not proactive medicine.
You know, we treat disease, wedon't treat health.
So, or we don't foster health.
I think what's gonna, what Ithink we're already seeing, is
there's this move towards givingpeople, arming people,
hopefully, with good informationas best we can to say, hey, do

(01:03:10):
do these things so that youdon't have to see your doctor or
not to see them as often.
You know, food isn't medicine,but food can help prevent you,
help limit your need to havemedicine.
You know things like that, I.
So I think it's amultifactorial problem, but I
think one of the big things isgetting money out of it.
I think we're seeing a lot ofexposure of what big pharma is

(01:03:31):
responsible for, particularlyaround the time of the COVID
vaccine and some things that arecoming out in lawsuits now are
pretty damning.
But I think that's one part ofit getting money sort of
divorced from healthcare.
But I think that's one part ofit getting money sort of
divorced from health care.
But I think what we can do justevery one of us is try to
educate our patients, educatepeople to say listen and it's
not to say I'm going to pretendto be an expert in things would

(01:03:52):
be like hey, look into this,maybe this would work for you.
Consider this, because thereare things that people weren't
doing before.
That's where, I think, maybethe hope lies, more so than the
government helping us.
Well, I think.

Speaker 1 (01:04:05):
I think that one argument of um people poo-pooing
functional medicine or rootcause medicine I call it root
cause medicine like it waspracticed before the 1920s and I
think is, um, because we don'thave enough research, yeah, on

(01:04:29):
like the long term value ofthese things.
And and the reason why we don'thave research is because it's
not being funded, because itcan't be monetized.
You know, you can only monetizea pill.
If there's no pill, there is noresearch.

Speaker 2 (01:04:42):
So I think if they find out eating the apple day
works every day, then they'renot going to.
They don't want you to knowthat.
They're not going to want youto eat the apple every day.

Speaker 1 (01:04:48):
So exactly, and the perfect example is the flu
vaccine.
You know we actually, you knowthey have actually done research
on a global flu vaccine, aone-time shot that you don't
have to get every year.
It's a universal flu vaccine,one-time thing, where they're

(01:05:10):
working on the N part of thevaccine as opposed to the H part
of the virus that they've beenresearching for decades on.
And, interestingly, thatresearch was shut down even
though it showed to be effective, for obvious reasons.
I mean, if I was Pfizer, Iwould go to NIH saying, like
what are you doing?
Like why would you publish that?

(01:05:32):
Then you know you still want toget paid or not, and if you
want to get paid, you bettershut down this research or else
we're not going to be able tosell a new vaccine every year.
I get it.
So I think the and then if youlook at I just put it on my site
the former FDA commissionersthat are now on board of

(01:05:54):
directors of Pfizer and ModernaI mean that is a joke, like that
.
Stuff actually is illegal inGermany.
You can't do that in europe,and here in the states it's
possible.
I think and that's how I gotour government can, um, prevent,
uh, these things fromescalating and happening behind
the behind closed doors.
And then you're absolutelyright.

(01:06:16):
I like your comment saying,like we can educate, we can do
something about it.
I mean each individual, becausewith the internet the cat's
kind of like out of the bag, soif anyone cares enough, they can
find information.
I mean, today, anyone can be anexpert if they spend enough
time in educating themselves onthese things.

(01:06:37):
That's what we did in school.
That's what we did in residency, in our fellowship.

Speaker 2 (01:06:42):
All we did is we studied a particular field, we
spent intense time in studying aparticular field and we had a
professor that was an expert inthat and who guided us and now,
a lot of it was dogma orindoctrination but at the end of
the day, science is for anyoneto grab if they care to I think

(01:07:04):
that the only danger is we canboth agree with this is that
there's so much information outthere that, unfortunately, a lot
of it is misinformation.
Yeah, so you know, that's thepart where, when you put the
onus on the person to find itout that you're, that you're
also into the wolves a littlebit, and I, and I don't know the
, I don't know the answer tothat.

Speaker 1 (01:07:24):
What I meant is there's enough information for
the public to become aware thatthere is a possibility and then
go find a doctor that isknowledgeable about that topic,
Not to self-medicate or treatyourself.
You have already pancreaticcancer and then try to eat apple
juice every day.
That's not what I'm saying.

(01:07:44):
So you know, doctors definitelyhave their value.
I mean it's definitelyimportant.
You know me and you were bothin there.
They do life-saving surgeries,life-saving treatments, but it's
about the preventative part andI think where there are more
doctors that care enough aboutit to have educated themselves,
and those should be at theforefront and people just have

(01:08:08):
to find them.

Speaker 2 (01:08:09):
And I also think that you know, I've become more open
to for lack of a better way ofputting it more holistic
medicine in the sense of doctors, I think traditionally we were
told to askew and be like, oh,these quacks, whatever.
And I think now, as time hasgone, I'm like well, you know,
we don't have all the answersclearly, because we're still we
still have a lot of sick people,so I'm getting it all right.
So I think I, and so I thinkthere's a growing audience for

(01:08:31):
people that are talking aboutthings that are from a more
holistic approach.
And yes, it still is.
You still have to sort offigure out who's a quack and
who's not, but I think at leasthaving the discussion and
bringing it up and being likeokay, and diving deeper you know
, there are things that are justout there for you to take even
little morsels here and there,every little bit's going to help

(01:08:51):
.
Um, I think that's, that's thethe good power of social media I
mean that's a good aspect of itis it does raise awareness, if
not knowledge, at least raises.

Speaker 1 (01:09:01):
I mean the whole quack thing started with.
I don't know if you know thestory about Rockefeller, how he
changed medicine from the way itwas practiced to uh so quote
unquote, like the medicaleducation system basically,
wasn't it?
Well, yeah, he, he created it.
It was the um, it was um, itwas Abraham Flexner.

(01:09:23):
It was basically his attorneywho drafted the current way
magical education is taught bysaying that it should only be
evidence-based.
And then they funded all theseuniversities that do the
research so they can control thenarrative, and that's how
Medicine 2.0 started.

(01:09:45):
Um, and I mean it's amazing howfew of our colleagues are aware
of that and you immediatelylabeled as a conspiracy theorist
.
If you just bring it up becauseyou're threatening um, you
believe it's like this.
Uh, mark mccary talks aboutthis, about cognitive dissonance

(01:10:06):
.
Yeah, um, which is?
Which theory was um describedby um?
What's his name?
Leon fessinger.
Um, in in the 50s, where yourbrain tries to compute a new
piece of information that iscompletely against what you
believed in, and this causesstress.

(01:10:27):
And then the way your brainhandles that stress typically is
by trying just to deny it.
And he says it beautifully.
He says first, when someonedisagrees with you, they turn
around and leave.
When you bring them charts andgraphs to prove them your view,

(01:10:48):
they question the source.
When you appeal to their logic,they don't get the point, and
so that describes best what'sgoing on with cognitive
dissonance when someone goingthrough the whole medical system
and education, making or theywere made to believe that this

(01:11:09):
is the right thing, thateverything else is snake oil,
everything else is bs,everything though you know,
making fun of holistic medicine,so you grew up in that
community.
Now someone comes and saysactually you know, good diet,
exercise, sleep and mindfulnesscan prevent depression can
prevent cancer.

Speaker 2 (01:11:29):
There's all these diseases.
Yeah, you just look at diet byitself.
We had one month, yeah, onemonth.
I remember this.
And even then in medical schoolI'm like this seems kind of
crazy.

Speaker 1 (01:11:39):
We're gonna become doctors and you're gonna give us
one month to talk aboutnutrition like well, because we
got nutrition consult as soon asit and it was all about
calories in and calories out.
And look what they serving inhospitals like you get like
applesauce, you get pudding.
Like what kind of nutrition isthat?
Like crazy.
Like where the fuck is theprotein?
Man, I mean post-surgicalpatients, the one thing you need

(01:12:01):
is protein and you give themapplesauce and like jello yeah,
like are you kidding me?
And that's.
And then nutrition I wasreading the nutrition consult
results.
It was all about calories, itwas not.
And then, and then the thedietary values.
They were way below what now weknow that recommended.
Like it was way, especiallywhen it came to protein.

(01:12:24):
So you have to question thesystem.
You have to ask yourself, like,what the hell is going on.
You know who is actuallycreating these protocols?
And to me, the societies andacademies are where the biggest
corruption lies.
Um, where, because they'regetting paid like.
Um, my, my latest child wasborn four years ago, right

(01:12:45):
during covet, and um, theformula, my, my wife had trouble
breastfeeding initially becausehe, he didn't latch and stuff
like that.
So we had to kind of supplementa little bit with formula until
he, he learned it andeverything worked fine.
And I was reading the back ofthe formula, there's like soy

(01:13:08):
seed oil and all that stuff inthere and I'm like how is that
good for a newborn?
And then I think it was Similacor one of these things.
And then there was a label onit recommended by the American
Academy of Pediatrics.
Well, guess what I found out?
They're paying millions ofdollars, if not billions, to the

(01:13:29):
American Academy of Pediatricsso they can recommend them.

Speaker 2 (01:13:32):
Well, that's what I'm saying so who are those people?
That's my question, Like whywould you either?

Speaker 1 (01:13:37):
they don't know or they are recommending it for
other reasons, I don't know.

Speaker 2 (01:13:44):
Well, this is the part where I go to, where the
money trail is the problem, andthe fact is that money does
influence all these decisionsand all of these policies, and
until that money trail issomehow stymied or limited, it's
going to continue.

Speaker 1 (01:13:58):
Yeah, and not to speak of the fact that literally
the next day, a nurse comes inand is about to give him shots

(01:14:27):
and I asked what kind of shot isthis?
And it was a hep B vaccine.
I'm like he was just bornyesterday.
Why are you shooting him up?
And I'm not an anti-vaxxer, sohe's got all the vaccines, but I
had a problem with the timing.
I'm like he's a one day oldnewborn.
Why does he need a hep bvaccine?
You know, the only way you canget hep b is if you're sharing
needles or, um, sex, sexualencounter.
That's the only way you can gethep b.
Why is it and and andimmediately, uh, the nurses
added to turn is like, well,that's our hospital policy.
I'm like, show me the policy,because my other sons they were

(01:14:48):
now 17 and 14, they didn't getthat happy vaccine the next day.
I remember it.
No one walked in.
So I have a problem with thatand in general is just, I guess,
group thinking, this shaming,gaslighting that's going on,

(01:15:08):
that starts at the medicalsocieties 100%, and so that has
to change.
You can't penalize a parent.
You have to give people thechoice.
I hope that this administration, with RFK, they can at least
bring it back to normalcy, asopposed to shaming and
gaslighting.

Speaker 2 (01:15:28):
I agree, and even dropping, and even dropping,
they drop patients.
Yeah, I agree.
I do think that there's aespecially having a child.
Now I think this dichotomousapproach where it's like the
family choosing versus someinstitution choosing, is a
problem.
I think you can't rob robparents of some sort of input in

(01:15:48):
this process how do you, how doyou handle that with your
daughter now?

Speaker 1 (01:15:52):
because I'm sure every other time you go to a
pediatrician she they're readyto shoot her up with something.
Uh, Because I remember one daythey were going to give him, I
think, six shots and I askedthem if they could just split it
like three now and I'll comeback in a month the other three
and big time attitude, Like Iwas immediately labeled as an

(01:16:15):
anti-vaxxer, but all I did Isaid I don't want to not give
him the vaccine, I just don'twant to give him six vaccines.
He's like six months old, Likewhy would you give him six shots
?
That's a little bit too much.
So I don't know what yourexperience has been.

Speaker 2 (01:16:30):
Well, I haven't gotten as far along this process
as you have.
I mean, candidly, I did.
I think they offered the COVIDvaccine, which I declined for
her.
But I think my mentality on isgoing to be unfortunately, you
have to sort of be diplomaticbecause I can see what the
reaction would be in the senseof, you know, I almost have to
preface it saying, hey, listen,I I'm not, as you said, I'm not

(01:16:52):
anti-vaccinations.
I know that you have to makesure you say that, because once
you get that label, you're donewhen you're thinking I'm trying
to, you know, start a measlesoutbreak in my kid's school, but
I just just for their wellbeing, I'm wondering if we can just
you know, kind of like what youdid.
I suspect that's going to be myapproach.
It's it's, you know, certainlya controversial topic and I
think we're going to, we'regoing to I don't know that this

(01:17:14):
RFK thing is going to beinteresting, especially in the
world of Vax.
I think people misunderstand.
From my, from my knowledge ofhim, he's not truly anti-vax.
In fact, I think he has hadsome vaccinations.
I think some of his family.

Speaker 1 (01:17:23):
Yeah, he actually has all vaccinations yeah, so I
think there's.

Speaker 2 (01:17:26):
They've created this hysteria that he's anti-vax.
I don't think it's that yeah,that's gaslighting.

Speaker 1 (01:17:30):
All he says is that we don't have long-term research
and that law that um presidentreagan brought in the 80s to
immunize the pharmaceuticalsagainst adverse effects of
vaccine and not requiring themto do research and show signs
and evidence-based signs thatthey're safe, just the safety

(01:17:52):
issues.
He just wants to get rid ofthat so that they're held to the
same standards as other drugsas far as safety.
And there is actually a largestudy I think they did it at
Johns Hopkins where they wantedto see if the booster is
effective on young adults,because the whole point is

(01:18:17):
reducing cost of healthcare.
Meaning if you get COVID andthen end up in a hospital, that
is going to cost healthcare Xamount of money, right.
So they noticed in theirresearch they showed that if you
don't get the booster, thechance of you getting COVID is
one in 44,000, I believe, andthat study was done at Johns

(01:18:38):
Hopkins.
And then if the adverse effectof myocarditis and pericarditis
in young adults is one in 18 000and that and that one and then
death, right.
So you're trying to burn downthe village to save cost or save

(01:18:59):
one person makes no sense.
So we have data that thebooster does not make sense for
young adults or healthy adults,but yet they're pushing it.
You go to your doctor's office.
They're going to say, okay,you're ready for your booster,
you're ready for your fluvaccine and all of that stuff.
And that's where I draw theline, because when you ask those

(01:19:22):
doctors about these studies,they don't even know about them.
They're just following, likesheep's, whatever recommendation
they've been forced on.
And I think they should carrymore responsibility than that
than blindly following.
More responsibility than thatthan blindly following.

(01:19:44):
And, um, I don't know, one ofyour former professors actually
mark mccary.
He just wrote the published abook blind spots.
I don't know if you've read it,I haven't read it marty's a
great.

Speaker 2 (01:19:51):
He's actually a fellow when I was there.
He's a great guy.

Speaker 1 (01:19:54):
So his book is uh, really is.
Um alludes to this issue thatwe have about the blind spots in
medicine and how we blindlyjust follow dogma and
indoctrinations and don't askquestions.
And I think every doctor bearsmore responsibility, even if
it's for your old child.

(01:20:15):
Let's say you're a pediatrician, aren't you worried about?

Speaker 2 (01:20:17):
your own children, or are you?

Speaker 1 (01:20:19):
treating your children differently.
I don't know that.

Speaker 2 (01:20:22):
Yeah, I think.
I mean, we all want to beadvocates, certainly for our
families, and I do think there'san opportunity now that hasn't
existed before in terms ofaccess to information and
questions.
We're in a whole new age whenit comes to that things off um?

Speaker 1 (01:20:46):
how do you handle the whole pressure, whether it's
your own expectations, whetherit is um just life in general,
traveling, juggling um familyand business?
How do you handle what's youroutlet?
How do you ground yourself?
How do you um motivate yourself?
What is your drive?

Speaker 2 (01:21:06):
so I think there's there's a lot of different
things to unpack there.
I think, first of all, handlingstress.
You talk about so, and there'scertainly no shortage of it in
our lives.
I think one thing I do, onething that is a fixture of what
I do is differentiating thethings I can control and the
things that I can't.
And when you really do that andyou practice it consistent,

(01:21:27):
consistently, you realize thatthe vast, vast majority of the
things that cause us stress,anxiety, are things that we do
not actually control, and soit's wasted energy.
So, whether that's otherpeople's opinions, whether
that's whether an outcome isgoing to be the way we want,
whether we're going to meet acertain amount of money, or

(01:21:47):
whether whatever, it is the vastmajority of those things we
don't control.
So it's very freeing for it hasbeen very freeing for me to let
go of those things.
It doesn't mean they can'taffect me.
It doesn't mean I can't have anemotional response.
But what I do with thatemotional response is I let go
because I can't control that andI put all of my energy into
things I can't control.
I can control how, what I dofor my patients.
I can control how I take careof myself.
I can control how I am therefor onyx or our daughter.

(01:22:11):
I can control those things, youknow.
Um, that has been very freeingfor me.
You know, I started this iskind of a benchmark of stoic
philosophy, which is something Istarted following years ago,
and I just found it to be veryhelpful and applicable to my
life.
And I tell everyone look, youknow, everyone's got to find
their own tools or philosophiesor whatever to help help them,
and that was helpful for me.
But people have differentthings, so so that's the stress

(01:22:33):
part of it.
As far as the motivation, that'sa good question.
I think if you rely onmotivation, you're in trouble.
You have to be disciplinedbecause, as you both, as you and
I both know, there's days I'mdefinitely not motivated.
I don't want to do shit, that'sjust what it is.
I want to retire and be donewith it.
I don't want to work out, Idon't want to do anything.
So I can't rely on motivation.
Motivation is great when ithappens and I want to capitalize

(01:22:54):
on it.
If I'm motivated, I'm inspired.
But it really comes down todedication and for a dedication,
and for me that's about routine.
So I am a creature of routine.
Absolutely.
It kind of is built indiscipline for me, and I can
sense when I'm off of it and andI can see how that dominoes
into other areas of my life.
If I'm not eating right orsleeping right or working out,

(01:23:14):
it starts to impact everything.
Yeah, um, and so you know, fortrying to create a routine and
therefore maintain discipline ishow I do that.
I think one thing I've beenlooking at recently is trying to
almost come up with a personalstatement, a mission statement,
if you will, for myself, and Ithink it's a fun thing to go

(01:23:37):
over from time to time, becauseit forces you to create your
values or really to define whatthe things are that you value.
It's what's important in lifeand how you want to live your
life, and and that changes, andso from time to time I try to
revisit that and say, okay, whatvalues?
And I very different from whatit was 10 years ago and

(01:23:58):
hopefully 10 years from nowit'll be very different.
But that's something that I'mactually currently doing just to
kind of reset a little bit, um,because there's been so much
change in the last few years, um, so they're very generic
answers I'm giving you, butthey're, they're, they.
They apply sort of universallyto everything.

Speaker 1 (01:24:15):
For me, well, I think it's.
You're talking aboutperspective and I, you know, I I
truly believe in stoicism.
I apply a lot of the stoicbeliefs and it's very helpful in
how you put things intoperspective and try to
understand that, like you said,you can't control everything.

(01:24:36):
It's just how you interpretevents and what you learn of it
and how you grow from that andas opposed to letting that crush
you.
And I think, um, perspectivereally significantly changes our
mindset in how we interpretthings that happen to us and

(01:24:58):
whether it is a terrible eventor whether it's a patient that
just, let's say, you have a verytoxic patient and they just
suck your energy out and theyjust come there and just always
complain and there's reallynothing wrong with them.
But there is more wrong withthem.
What's going on behind thescenes Very difficult to handle.

(01:25:18):
One of the things that actuallyI have changed in my approach,
just so it doesn't suck out myenergy.
I approach it with a lot ofempathy and with a lot of
compassion because I knowthey're hurting somewhere and I
try to have conversations withthem about that, and sometimes
these conversations take a wholehour, but that hour is so well

(01:25:41):
spent, not just for thepatient's mental health, but
also for my own mental health,because I feel like I did what I
was supposed to do, not as adoctor, but as a human being,
someone coming with a lot ofhurt, with a lot of pain.
And I know they're just lettingit out on me because, uh, I
happen to be involved in theircare one or the other way.

(01:26:03):
But the true reason why they'renot upset is not me, it's not
necessarily the result, it'ssomething else.
And suddenly you see thatpatient has become so grateful
for you, opening their eyes towhat actually is going on, which
makes almost those days to bethe most rewarding only if
you're able to get the patientshere, because sometimes they

(01:26:24):
don't want to hear it or someone, they take it the wrong way and
they get actually even moreupset.
So to me, the biggest stress inmy job and profession is really
that is is knowing that thepatient is unhappy because all I
my intentions were to help themand now they're still hurting
and worse, even they becomebecome very aggressive.

(01:26:44):
And you, you go home on thosedays, like you said, you just
want to quit, you just don'twant to do it again, and you
remember those words of otherssaying yeah, that's why you
shouldn't go into thisprofession.
Everybody's crazy and it'salmost like this devil and the
angel every day trying toconvince you.
So how do you deal with thosesituations?

Speaker 2 (01:27:07):
It's a great question and it's a great topic Because,
I mean, one of the main thingsfor me is that the discussion
has to start long before thatone happens.
So I do have very honestdiscussions with patients about
expectations and I tell everyone of them that there are
complications.
I'm not God, I don't pretend tobe.
Anyone that says they don'thave complications is either
lying or they don't operateenough.
It's one of the two things andyou don't want to work with

(01:27:28):
either one of those people.
So I say they're going tohappen.
I'm going to do everything Ican to minimize them and what I
tell people I say theuncomfortable reality of what I
do is you're not paying for afrom the probability of a result
.
You could go to Tijuana and youcould maybe get a good result
50% of the time with what youpay 50%.
Okay, if that's good enough foryou, go.
Or you could go to the bestsurgeon in the world and maybe

(01:27:48):
your probability is 98%.
It's never 100.

Speaker 1 (01:27:52):
I like that perspective.

Speaker 2 (01:27:53):
Isn't buying a TV where you know what you're going
to get.
You're buying the probabilityof getting a result.
You do everything you can tostack that in your favor, and I
do everything as a surgeon tostack it in my favor.
I'm picking a patient who Ithink is the right patient, I'm
doing a technique that I'mfamiliar with, et cetera, but
it's never 100.
And so I really hammer thathome with them.
I really say listen, thingswill go sideways, but I'll say
listen, I'm committed to doingeverything I can, and in the

(01:28:15):
vast majority of cases, ifsomething goes sideways, there's
to help to move the needle backin a direction you're happy
with.
There is an element of riskyou're taking on by doing this,
and you have to know that thegood news is the vast majority
of people are going to getthrough very happy.
I don't want to be that one ina hundred or one in a thousand.

Speaker 1 (01:28:32):
That's a very good perspective.
I like the way you put it, thatyou're paying for potential
outlook, probability of theresult, not the actual result.

Speaker 2 (01:28:44):
Yeah, because that's what differentiates cost.
Yeah, it's not you're.
You're paying for probabilities, because experience, etc well.

Speaker 1 (01:28:50):
Another thing that I've become more aware, um, in
recent years is the differencesin how patients heal
post-operatively.
And by healing I don't meanlike wound necrosis necessarily,
which is the extreme, but I'mtalking about prolonged swelling
, prolonged inflammation.
Especially for me in the face,it could be problematic.

(01:29:15):
Someone wants to go just backto normalcy.
They don't want to have likepuffiness under the eyes or on
their cheek for more thanseveral months and they start
asking questions and, of course,first one to blame is is the
surgeon, and we didn't doanything different.
It's just the biology of thatparticular organism.
Slash patient right, um, and Ifelt like for and still today

(01:29:39):
that it's out of our hands andand, yeah, you can't control the
uncontrollable.
That's a biology.
And a lot of times I tell mypatients like, look, I use the
80-20 rule.
I tell them, look, I don't knowhow it's going to heal because
your biology is specific to you.
We're going to find out and youcan't always extrapolate from
previous surgeries.
Some of them didn't haveprevious surgeries, so, and
that's usually speculationanyways.

(01:30:00):
So the one thing and I want tohear your perspective if you're
integrating that or if you'vethought of integrating that in
your practice with your patients, which is preoperatively.
Like you said, you're assessingthem psychologically, assessing
their expectations, but whatI've started doing now is I

(01:30:21):
start assessing their metabolism, whatever metabolic
dysfunctions they may or may nothave, their lifestyle, all of
which, their diet, sleep, all ofwhich can affect their recovery
process.
I believe that's one topic thatour specialty hasn't tapped

(01:30:42):
into and I'm curious.
I'm actually researching itright now myself to see how that
can affect not just the finaloutcome but, more so, the
recovery process to it outcomeafter six months or a year, how
is that journey throughout thatperiod?

(01:31:03):
If someone has somewhat of ametabolic dysfunction, whether
it is they have elevatedcortisol levels or elevated
HSCRP, which is an indicator forgeneral inflammation, whether
they have low vitamin D levels,whether they have high fasting
sugar levels or high insulinlevels, whether they have a high
fasting sugar levels or highinsulin levels, whether they get

(01:31:27):
enough sleep, whether they haveanxiety, whether they take, you
know all of those things I tryto integrate that in my
preoperative assessment, mypreoperative assessment and then
, because I'm pretty confidentthat that will affect their
recovery process and journey.

(01:31:49):
So what I've started now is totry to optimize, using their
biomarkers and giving them,providing a food diary, sharing
their health app with me, sothat at least two months pre-op
so at least I have the chance tomake an assessment and then try
to optimize preoperativelyuntil the day of surgery, create

(01:32:13):
a certain habit and then,wherever they're deficient,
adding supplementation, makingdietary recommendation, teaching
them mindfulness.
I invest a lot in that right nowand I believe what we do with
anti-aging procedures is not anydifferent than longevity
through turning back the clock.

(01:32:34):
But also I think we owe themthe responsibility of doing that
at the cellular level, which wehave signs on it.
And then, postoperatively, Icontinue to monitor them.
I continue to take, monitortheir biomarkers and then
optimize and level themaccordingly, based on how well

(01:32:56):
they follow those instructions,how disciplined they are and
some of them they're relying onhelp of their spouse, sister,
mother, father, whoever it isthat is involved in their
post-op care and then educatingthem because they're the
integral part.
So I have adopted this holisticapproach to my patients that
starts in the preoperativejourney all the way into the

(01:33:18):
late post-operative journey,because I'm very confident that
that has a significant impactnot just on the final result but
also their rollercoaster ridethroughout the journey.

Speaker 2 (01:33:30):
Yeah, so I it's interesting you bring this up so
I had had this thing about ayear ago where I started to
create this template that wouldbe more holistic in the sense of
from a nutrition and fitnessstandpoint at a minimum, and
that I had linked up with a fewof my nutrition three things
actually nutrition, fitness andbasically bioidentical hormone

(01:33:50):
therapy essentially peptidebioidentical hormone therapy and
so I'd kind of enlistedcolleagues of mine who do those
things and it kind of made atemplate for doing it.
We only got so far with it andit's still kind of something
that we're trying to develop,because right now, as it stands,
my recommendations I do givethem sort of very specific micro
and macro recommendations basedon their weight and the
procedures that they have.
So I try to give them somenutritional guidelines, at least

(01:34:12):
postoperatively.
The preoperative things are notnearly as kind of advanced as
what you're doing and I thinkyou know you were complimenting
me earlier on my social mediaand one of the things I've been
enjoying about yours is sort ofbecause you know I think you and
I are both the same in terms ofoverall health and wellness and
how you're integrating that notonly in what you're educating.
You know your, your following,but also how you're integrating

(01:34:34):
that in your practice, causethat's really an ambition of
mine as well, and so, basically,you're my guinea pig, so I want
you to keep at it and let meknow how this is working out for
you.
I will, because I want to sortof do something similar, and
that still is a goal.
I had initially wanted tocreate a brick-and-mortar space
that had all these under oneroof, but it was really very

(01:34:54):
difficult to do in Beverly Hills.
How?

Speaker 1 (01:34:57):
so.

Speaker 2 (01:34:59):
I mean from just a dollar-per-square-foot area,
creating a space that I couldintegrate all of these different
disciplines.

Speaker 1 (01:35:06):
Why not in your own practice?
That's something I've beencontemplating of bringing
functional health.

Speaker 2 (01:35:13):
That's what I wanted to do.
I wanted to have themphysically in my practice, but
that would require a spacerequirement when I kind of drew
up the plan in my mind andhaving a space for nutrition,
having a space for massage thefunny thing is for me, the
challenge is finding the skilledand properly trained person I
know I have.
It's like finding a needle in ahaystack I know I have the

(01:35:34):
opposite problem because we dohave we're fortunate here and
that we have a lot of amazingpeople the frontiers of what
they do, you know.
You know one of the greatthings about ending up here in
Beverly Hills.
I will say and it's not to sayI mean, obviously there's great
doctors elsewhere, it's, it'sludicrous and there's shitty
doctors in Beverly Hills.
By the way, it's not to saythat you need that, but there is
this part of you that pushesyou to be really good at what

(01:35:56):
you do and you are surrounded bysome, you know, frontierushing
leaders in field.
You really benefit from thatand you have access to that.
And I tell my patients I say,listen, you have a luxury living
in this part of the worldbecause I'm one of many great
doctors here.
I'm not the best.
Anyone that says that's full ofshit.
I'm like, I'm confident in whatI do.
I think I do go right, but youhave a luxury of having a lot of

(01:36:17):
good people that you connectwith and you know when, as it
relates to these otherdisciplines and anti-aging and
all these things, we have a lotof great people here who who can
help patients on that.
So I send.
So what I do now is I do sendpatients to.
There's an anti-aging doctorwho I have them see, who does a
full battery and but they haveto want to do it.
I can't make them do it becauseit's pricey, because he does.

(01:36:38):
He will assess.
He does an initial lab drawwhere he assesses everything.
You know, everything from.

Speaker 1 (01:36:44):
You know their metabolic function, their other
hormone function, inflammatorymarkers you know that that's
what I'm doing now on my bymyself, and then you know um,
and then, if there is issuesthat I can't handle, I then try
to refer them out for someoneeither in their area or my area
to handle.
So right now.

Speaker 2 (01:37:02):
now I'm outsourcing it.
Yeah, if you need some helpwith that, I have someone who
does largely telemedicinebecause, quite frankly, most of
it's telemedicine.

Speaker 1 (01:37:10):
honestly, yes, true.

Speaker 2 (01:37:12):
A lot of it is adjusting the numbers.
So the guy that I work with hasclients or patients all over
the place, and so he's donewonders for my patients.
And it depends on what yourgoal is is your goal to build
muscles, your goal to loseweight?
Yeah, shoot me that information, I will.
I will.
I'll connect you with him andhe take and it's funny because
he's very eccentric guy but hetakes care of, like, the a-list

(01:37:33):
of a-list well, you need to beeccentric to do.
Have a practice like that, and Imean that in an endearing way.

Speaker 1 (01:37:38):
I don't if he sees this, I don't want to.

Speaker 2 (01:37:41):
He's very good at what he does and I trust him
implicitly.
I took it in a positive wayyeah, but um, but no.

Speaker 1 (01:37:46):
I think what you're doing is, is should be, what all
of us are doing, and you shouldbe commended for being at the
front of that and doing that andand showing people that it can
be done and being an example ofthat, because that is where the
future lies well, look, honestly, the reason why I'm so
passionate and compelled isbecause the way I became aware
of this is through my personalexperience, and I was going

(01:38:10):
downhill and I've shared that inmany podcasts and outlets where
my doctor didn't have an answerand I just wasn't happy with
the answer I got, which was none, and it sent me down that
rabbit hole through a friend ofmine who's an orthopedic surgeon
he was actually on my podcastbefore you and that's when I

(01:38:32):
became aware of it and throughlifestyle modifications, simple
changes that I made, it got ridof all my symptoms.
I became so compelled and Ibecame so convinced that there
is more to what we were taught.
That um, now, um, that's how Ievolved as as a clinician and as
a person, and so that's for me.

(01:38:55):
I think with everyone, itstarts with a personal story, um
, until you become aware ofsomething, and then you know
once, know, once.
You become.
I would call myself.
I'm pretty obsessed now, to thepoint that I'm even writing a
book and I'm I'm sharing myprotocol and I keep changing it
every day as I'm learning newstuff, but I re I realized that

(01:39:19):
at least I can share it with ourcolleagues out there, just to
raise awareness, to make themaware of a paradigm shift that I
believe should happen in ourfield.
If we truly perform anti-agingmedicine, that we should tackle
it at a cellular level, and Icall it the anti-aging paradox.

(01:39:40):
And so that's how it startedfor me and honestly, I don't
know where this road will lead,but I'm really excited.
So for me, that's what gets meexcited on Mondays.
It's almost like it broughtthis breeze of fresh air into my
practice.
This opened up this whole newworld that changed my life, and
I'm so excited to help mypatients.

(01:40:01):
And some are more receptivethan others, which is okay to
each their own, like you said,but it's to the point that you
know, once you know aboutsomething, you feel like you
have to share it.
Otherwise you would be kind oflike it would be like very
similar to lying.
That's how I look at it.

Speaker 2 (01:40:20):
So in that regards, I'm very passionate about it
right and I think, look, all wecan do is offer a service.
True end of the day, all we cando is say listen, I believe in
this, I think this works, but Ican't take custody of the
decision for you.
But, um, that's all we can do,and I think having the having
that to offer is you've doneyour part.
You've done your part, perfect.

(01:40:41):
Okay, so to your part, perfect.

Speaker 1 (01:40:42):
Okay.
So to close it up, I have alast question for you, yes,
which is mostly for aspiringsurgeons and entrepreneurs.
Is that what advice would yougive your 20 year old self,
knowing what you've known now,what you've learned till today,
to become successful?
What would you tell your 20year old self.

Speaker 2 (01:41:08):
I don't know this applies to being successful, but
this may be just personal forme and I and I tell this all the
time- I think success,whichever way you measure it
right yeah, I think I in myearlier years I put too much
stock in other people's opinionsor validations and I think that
I think it was imperative.

(01:41:29):
And what I would hope to instillin my kids is establishing
their own intrinsic sense ofself-worth, so that you are
immune to others.
It doesn't mean you're immuneto critique, you can't take it
constructively, but that you'renot making decisions for the
purpose of pleasing other people, but you're following your own
truth, you know what it is thatyou want to do and you can
follow your passion with vigor.

(01:41:52):
Because I think the youngerversion of myself and I think I
see this symptom growing intoday's culture is this
fascination with other people'sapproval, this fascination with
what other people think youshould be doing or should be
wearing, or should be looking orwhatever.
And I think when you start toplay that game and you lose, as
you said, your authenticity oryour truth to yourself, you're

(01:42:13):
already behind the eight ball alittle bit.
So if I could tell anyonecoming up now, it would be that
being true to yourself.
And I think we're lucky if wecan find our passion, we're
fortunate if we can't.
I don't think everybody can butfind something that at least on
some level inspires you.
You don't have to ascribe somemythical.

(01:42:34):
This is my passion in life.
Don't put that kind of pressureon yourself.
Find something that you knowthis inspires me a little bit.
I like this there.
Find something that you knowthis inspires me a little bit.
I like this.
There's something about thisthat intrigues me, and then
everything else will follow fromthat, and we talked about that
earlier.
If you're chasing dollars, Ifeel sorry for you a little bit.
I wish you the best, but Idon't think that's where

(01:42:55):
happiness lies.
So, being true to yourself andfinding something that inspires
you Truly, I think those are thethings I would tell my younger
self and would tell someonecoming up now.

Speaker 1 (01:43:04):
Beautifully said.
Thank you so much, everybody.
Dr Charlie Galanis, I hope youenjoyed my conversation, which
both scientific as well asspiritual, and that's why I
honestly wanted to have you onhere, because I feel like we
share so much of similar values.
I've learned so much and I'mreally looking forward to

(01:43:27):
hopefully we get to meet eachother in person.

Speaker 2 (01:43:29):
Definitely.

Speaker 1 (01:43:30):
And keep each other posted about on our developments
and because I really feel likewe're very like minded and I'm
really grateful for you takingthe time and if you all loved
our conversation.
Um, please don't forget toleave me a review on apple,

(01:43:52):
itunes or even on spotify, andyou can ask me or dr galanis any
questions you want on spotifyon the comment section and we'll
be glad to answer it.
And, charlie, what's the bestway for people to get in touch
with you?

Speaker 2 (01:44:08):
I think.
Well, we have an office number,of course, which is and they
can call or text that, but it'sjust 310-858-8930.
But they can just call or textthat number directly.
We try to stay on top of ourInstagram.
The main Instagram is justCharles Galanis MD.
We try to stay on top of ourInstagram.
The main Instagram is justCharlesGolanisMD.
We try to stay on top of theDMs there, but people can always
try to slide in there andmyself or my digital media guy
will see them usually.

Speaker 1 (01:44:28):
Thank you so much, and Charles, thank you for
coming on and bye until nexttime.

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Authenticity, Aesthetic Trends, and the Future of Plastic Surgery - with Dr. Charles Galanis

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Authenticity, Aesthetic Trends, and the Future of Plastic Surgery - with Dr. Charles Galanis