Beauty, Aging, and the Truth Nobody Wants to Hear- with Dr. Ben Talei

Episode Transcript
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Speaker (00:01):
Alright, welcome back to the Daria Hamrah Podcast.
We have today a returningguest, the one and only Dr.
Ben Talei out of Beverly Hills,facial plastic surgeon, car
lover, speaker, author,educator, legend, whatever you
want to call him.
Thanks for coming back,brother.
I really appreciate you comingback.

(00:22):
It means a lot to me,especially since you're all over
the world, all over the place.
And every time I call or text,you answer.
And this is the second time Iinvited you on this podcast, and
you didn't hesitate and yousaid yes.
Means a lot to me, brother.
I just want you to know that.
I must.
You're Daya Hamlet.
Nobody, nobody must.
Oh, come on, man.

(00:43):
Come on.
By the way, how do you do this?
Like every time I lovefollowing your Instagram, by the
way.
If you are not following Ben,you're missing out because it's
not just about plastic surgery,it's about everything.
And I can't remember yourhandle on top of my head is what
Dr.
Ben Tele.
D-R-B-E-N-T-A-L-E-I.

(01:06):
Okay.
Yes.
And also you have another page,Mui Benno, right?
Yeah, Mui Beno.
Mui Beno.
Not Bueno, but Benno for Ben,right?
Is that correct?
Yeah, exactly.
I just stumbled on it and Idon't know why I stumbled on it
so late, but I'm obsessed withit because I'm obsessed with
cars.

(01:27):
So I'm so jealous, first ofall, for the cars you have.
And I always wanted to ask youwhich one, I know what my
favorite is, I'll tell you, butwhich one is your favorite?

Speaker 1 (01:38):
The well, if I had to pick one.
Only have one before so lastyear that question would have
been impossible to answer.
This year, I can tell youwithout a doubt, it's the uh
Mercedes McLaren SLR HDKroadster.
I said that one.
There's nothing more beautifulthan that.
It's like perfect sound, it'sfast, it handles, it's like it's

(02:03):
because it's it's about almostfour inches wider than a
standard SLR.
It's pretty crazy.
It's a it's a wild-looking car.
So how do you decide which caryou drive?
I rotate whatever's on thebottom.
I have four cars that are onbottom, three on top, and then
I'll have ones in other storageplaces, like my office or the

(02:24):
house next door to my brother'shouse.
And then whatever's on bottom,I rotate that week.
And then usually at the end ofthe week, if I can flip them or
switch them, I rotate.

Speaker (02:32):
Now you have you have sold some in the past, right?

unknown (02:36):
Yeah.

Speaker (02:37):
How's that feeling?
You know, the compared to theexcitement when you first get
it, right?
It's like you got your new toy,something you were like looking
for, that you got the perfectspec and everything.
You were chasing it, huntingit, and then you got it.
And then a year later, a coupleof years later, you have to say
goodbye.
How to tell talk to me a littlebit about the goodbye, how that

(02:58):
feels.

Speaker 1 (02:58):
Well, there is certain cars that you get, and
they, you know, once you have acertain number of cars, they
kind of rather than beingindependent, kind of experience
by itself, you're comparing itto all the other ones.
So there's a few, like the 550Marinello that I always wanted,
but then when you drive itcompared to my 512M, there's no
day that I would rather take the550 over the 512.

(03:21):
And you only have so many daysto drive them.
If you just have a collection,then it doesn't matter.
But I drive them, so I have tofigure out which ones, and then
I'm a dealer now, so it's likeI've I'm gonna be buying and
selling and moving things along.
And so sometimes I buy a 550,keep it for a while, and then
sell it.

Speaker (03:39):
Well, if you ever want to sell any of them, can you
please shoot me a text?
Yeah.
Before you put it before youput it on cars and bids, okay.
Now you got it.
Thank you.
Well, I could tell you what myfavorite is.
Uh it it's it's based on whereI was born, where I grew up,
spent most of my life, which iswhich is Germany.
So you have a wild guess?
The career GT.

(04:01):
Yes, sir.
Yeah, that was I mean that Iwould sell my house to get that.
If I didn't have kids, if Ididn't have wife and kids,
that's what would have happened.
Yeah, yeah.

Speaker 1 (04:18):
Exactly.
Yesterday I drove the uh the964 Turbo 3.6.
That one is another one.
Yeah, it's phenomenal that'sanother one.

Speaker (04:29):
I have a regular 993 and I love driving it.
It's just the more the rawestfeeling of driving.
We just took it down.
I'm I'm a part of a group ofPorsche guys.
We pick a week and a year, andthen we drive to amazing areas.
So we went to Asheville thisyear, and from there we went to
Trail of the Dragon, Tale of theDragon, um, which is the famous

(04:53):
11-mile with 300-somethingcurves, and we were like 10 or
11 Porsches of all generation,all specs.
It was amazing.
We had all the way Porschesfrom the 80s to the latest Turbo
S.
And we were driving like MadMen behind each other, and we
had like walkie-talkies andeverything.
We drove them out for a wholeweek, and then after that, we

(05:15):
went to the Porsche experiencein Atlanta, which was where you
do the yeah, and it was, I mean,for a week we were like little
kids, we were like boys back inthe playground, and so that's I
think I I feel like as men we'revery simple.
We we love the simple things inlife, and and so for me, I

(05:36):
share the same passion with carsas you do, so I totally relate
to that.
So I'm a big fan.
You too.
I'm a psycho.
Yeah, so tell me now, the otherthing that you do, you love
educating, and uh you youbasically all over the world,
not just all over the country,all over the world.
How do you reconcile that withyour responsibilities?

(05:58):
You're also running afellowship, so you're training
fellows, you have a busy,successful practice, you have
another business called CupidLips that you're expanding.
I saw you're building out uhspaces.
How does that work?
I mean, how how how do you thatI mean my day has only, let me
check, 24 hours.

(06:20):
Yeah, just uh multitasking.
So do you have P do you howmuch do you delegate?
Are you are you a micromanageror are you one that has figured
out how to delegate and workefficiently?
How do you do that?

Speaker 1 (06:33):
I have to do most of it myself, unfortunately.
I for most of the things I do,nobody's able to help me.
My my assistant is like out tolunch and probably doing, I
don't know, God knows what inthe day.
So I kind of have to doeverything myself and the
education stuff I'm trying toslow down.
I was doing a few years ago 52lectures, then like two years

(06:56):
ago I did 42, then last year Idid 25.
This year is already at like15, and I'm trying not to do
any.
So next year I've been sayingno to everything, and hopefully
it's just like six remaining.
I like teaching because ithelps me in my thought process
kind of figure things out, butit also is hard for me to say no

(07:16):
to people when they ask me andthey want me somewhere.
But now it's gotten to thepoint where I think they're kind
of taking advantage and justtrying to promote themselves and
using my name to do it, andit's getting it kind of annoying
because the crowd that theydraw in some of these places is
like not the most advanced orintellectual people, and I'm not
there to babysit them throughgrade one of face.

(07:40):
I'm like very advanced in whatI'm doing relative to other
people, so it's uh painful.
You know, I go and I try toteach and I talk about things
that it's just like right overtheir head, and that even the
most I even that some of the topguys in the world, they just
don't get very basic logicalanatomic descriptions, and they
just like believe in it'smake-believe a lot of this

(08:01):
stuff.
Or I start talking about smiledynamic, and they think it's
hocus pocus, they think it'sfake, but it's very real.
It's just they can't wrap theirminds around it because they're
so stuck struggling, trying tounderstand lifting, how to get
that to happen.
Whereas lifting is like I canexplain it, I can teach it, and
I do it so reproducibly.
All I care to talk about is thethings that I'm you know

(08:22):
discovering myself, which now islike smile modulation and you
know that kind of stuff.
So I'm I'm really trying to cutback on that and then focus
more on my like primarypractice.
And Cupid, we're building, wewe've had West Hollywood for two
and a half years now, and thenwe're building Newport Beach.
And I wanted to jump intoDallas, Miami, but I may do

(08:44):
something more locally here forthe for the next one.
And then we have the hairgroup, but the hair group I
don't really spend a lot of timeon.

Speaker (08:50):
It's kind of runs itself away from and that's run
by one of your former fellows,right?

Speaker 1 (08:56):
Yeah, Hetty is there, she works with Fabian, who's
our manager over there, and theydo uh hair transplant, but
mainly non-invasive hair stuffwith injectables and other ways
to like stimulate hair growth.

Speaker (09:08):
Wonderful.
Yeah, I mean, uh you you'reonto something when you said
everything you said aboutcommunicating or trying to teach
people that are too stuck ontheir ways, it's almost like I
call it cognitive dissonance isyou're you're trying to teach
someone a new concept and nomatter how much proof and

(09:31):
evidence you bring, becausethey're so stuck in their
beliefs, it's almost likethey're trying to intentionally
reject the new concept becauseit causes pain when when you
realize that all these years youmight have been wrong and
someone tells you otherwise.
And so cognitive dissonance isis real in in in anything in
life.

(09:51):
It's in politics, in religion,and in even in in science itself
and basic science.
But the one thing that to me isstill in 2026 somewhat not
strange, it's almost disturbingwhen you just said there's a lot
of prominent surgeons out therestill stuck in old ways and

(10:13):
trying to defend old ways.
And I don't want to beat a deadhorse and go back into the
conversation of Smash versusD-Plane.
I think that topic hasexhausted itself on social media
already, so I don't want tobore the audience.
But my question is contextuallyrelated to that.

(10:34):
We don't have to go into thenuances of it, that's not the
purpose of this podcast.
Is why is it that, and like yousaid yourself, these I call
them old guards, so-calledprominent, whatever that means
in today's world?
I think that's changed becauseof social media.
But they still they publisheven an article I saw 2026 an

(10:58):
article got published,apparently a meta-analysis
comparison between SMAS and DPlane stating that there's no
freaking difference.
Like so, so does it mean likewhat we see doesn't exist?
Like, how could you ignorethat?

Speaker 1 (11:14):
And how could Yeah, so the the the conversation
between the two is is a prettystupid one overall.
It's and I'll I'll tell youabout that article, but the the
conversation between the two,let's just say your approach or
your vision of what you'retrying to do, or your
understanding of aging, whensomeone's droopy as they get

(11:36):
older, do you care at all abouthow that happened?
Do you care at all?
Yes or no?
And if the answer is yes, thenyour goal would be to figure out
how that drooping actuallyhappened, in what plane did this
happen, in what layer did thishappen?
Is it drooping that happenedfrom tilting of volume loss?

(11:57):
Is it a shearing movement thathappened?
What kind of movement causedthis?
What kind of three-dimensionalchange?
What kind of segmentalattachments are there in each
area that cause it to lookdifferent from one area to the
other?
You know, so that's the yes, Ido care.
And then there's the no, Idon't give a shit.
I just want to lift them.
I don't care how it got there.
I'm not trying to reverse it.
I'm just trying to lift them.

(12:17):
They'll look better if they'relifted.
That's in general your if youwere to give a logic behind deep
plane versus smash playcationas a general kind of term or
view, you would say smashplacation is I don't give a shit
where they came from.
I'm just lifting them.
And deep plane is I'm actuallytrying to reverse it in one of

(12:38):
the ways that it aged.
Not all of them, one of them.
But that's not, you know, whenI say it's a generalization,
it's because you can look at 80facelift surgeons and 80, 40 of
them are doing smash placationtypes, 40 of them are doing deep
plane types, and they getgenerally the same durability
and result, which is what thatpaper is, you know, saying when

(13:00):
they come back to get a uhrevision.
Qualitatively, when you'relooking at the appearance of the
face, does it just look like acleaner jawline, or does the
cheek look cleaned up?
Do the eyes look younger?
These are things that you can'teven measure in those studies.
They are not measurable.
And you have to look at like,if I, as a surgeon, who I have

(13:20):
the you know, a lot ofcapability, did everything I
could possibly do in a deepplane versus everything with a
placation technique, and I'm thebest in the world, let's say,
meaning in terms of capabilityand I'm some kind of whiz,
definitively in the deep planeportion of where I went under
and released and came over, I'mgonna be getting better results.
Definitively.

(13:40):
It's like it's not a baby, sameexact person.
But you can't do that study, itdoesn't exist.
So you go back to the splitface study in you know 1990, and
they read the results, youknow, four or five years later
looking at durability, and theywere the same because it was
kind of older technique at thattime by those specific surgeons.

(14:02):
So the studies don't make anysense.
They do not represent actuallywhat's happening.
It doesn't help theconversation to say which one is
better.
Ultimately, if you're lookingat a hundred surgeons, most of
them suck anyways,realistically.
So, like the conversation is adumb one.
It doesn't make any sense.
These guys couldn't achievegreatness if you handed them the

(14:23):
recipe for greatness.
So you have to think aboutapplication, practicality.
What can we actually teachthese people that they can go
out and give people somebenefit?
Maybe not full reversal ormaximum or whatever, but they
give them some benefit.
So that's the real conversationis the practicality of it for
the majority of the population.
Now, if you say we're at thetop of our fields and we want to

(14:47):
push this as far as we can,different conversation.
But that's not the conversationpeople are having at all.
They're just saying whatever isbest in your hands, whatever
you can do in your hands.
That's a conversation.

Speaker (15:00):
Think of that.
I what if one if if I hear thatone more time, someone says
whatever works in your hands,you know, I'm not sure.

Speaker 1 (15:06):
But it's a realistic, you know, me too, but it's a
realistic application.

Speaker (15:10):
So you so you have to look at it as but it sounds like
an excuse, a justification.

Speaker 1 (15:14):
It's not real science, man.
I mean, that's reality, though,because these surgeons go out
and they can't do better.
So, you know, you do have tolook at it that way,
unfortunately, in two ways.
You got to separate it in yourmind of what's gonna benefit the
majority of surgeons who justdon't have it in them to
understand this stuff or growthis stuff, and it is in your
hands.
How can you get away with itwithout fucking somebody up?

(15:36):
That is, you know, I have tolook at it, and then versus
someone you know like me, whereI'm just like, I just want to
get the best possible out therein the world.
You know, that's that's adifferent game, though.
And you can't mix theconversations.

Speaker (15:49):
So, how confusing how confusing is it for young
surgeons that are trying tolearn?
Because they understand, youknow, I teach as well, just like
you.
I have fellows, I do cadavercourses, I see surgeons from all
generations from all over theworld, and I have fellows, they
come, they all come curious,they want to learn.

(16:09):
But then what I've noticed, andI'm sure you have too, they
some they're not risk takers, sothey they're very risk averse,
and they quote unquote don'twant to get in trouble.
And there's still this notionout there that there's a high
chance of nerve damage with oneversus the other, which has it

(16:31):
that that conversation is evenstupid.
Yeah, yeah, there's no so howdo you teach someone that is
biased towards one or the otherand then tries to justify that,
and then ultimately then thattrickles down to the consumer,
which is the patient that istrying to figure out what's the

(16:51):
best, who's my who's the surgeonI should go to, what's the best
techniques?
Because now social media has inone aspect it has educated the
public, but also then with thatcomes the confusion because this
is such I don't know, such acontroversial topic, and the
patients get confused.
So how like like where do yousee that even going?

(17:14):
Is it is it always gonna belike this?

Speaker 1 (17:16):
Yeah, it will.
So and it's because people getside railed pretty often by the
technique, and including I'mwatching Harvey Levin on TMZ
yesterday talking to JaniceDickinson, which is funny, and
he says, Well, I thought it wasjust, you know, all surgeons go
and they learn how to do it, andthat's it.
You get a facelift, you get afacelift.
I didn't know there were suchnuanced differences between

(17:38):
them.
Again, the focus is ontechnique.
Smash, deep, how much do youdo, how far do you do?
Realistically, that's not whatyou're looking for unless you're
going blindly into something.
When you don't go blindly intoit, you could actually just look
at what the surgeon understandsand sees.
It's about their vision andunderstanding of the face.

(17:59):
And when they can see thingsand understand things, not just
in your face, but in everyone'sfaces with aging, they will be
able to fix them to the greatestextent possible using their
knowledge of anatomy.
And based on their knowledge ofanatomy, they'll say, in this
area I'm placating, in this areaI'm releasing, in this area
lifting, whatever they need todo to maximize the reversal of

(18:21):
aging.
So I don't think anyone willever be able to focus on
something like that because theycan't understand it.
It's something that isdoctor-dependent to say, can
they see it?
Do they understand it?
And most people just basicallycan't.
And then so you look at it morefrom a consumer base or a
business base of let's say theseyounger guys, they're coming

(18:44):
out and they want to learn whatto do.
So there's a guy who owns apizza shop for like, you know,
20 years, and his pizza shop'sbeen running for 20 years, and
it's fantastic.
And he's got one pizza shop,maybe two, and he's successful
in life and does well.
And this guy comes out and he'slike, I want to do what this
guy did.
And he just follows his recipeand of opening a business and

(19:06):
running it.
And at the same course andtrajectory, he improves, which
is over about five to 10 years,a very average type of thing,
and he ends up in the averagerealm.
Or someone else comes and says,Well, I don't really want to
learn from the pizza guy.
My goals are a little higher.
I want to see how the CEO ofDell Computers did it.
I want to see how Bill Gatesdid it.

(19:26):
I want to see how whomever, youknow, the people that own the
chicken tender store did it.
Like I want to see how theyscaled it so rapidly and so well
with such a good product.
How did they do it?
So I'm gonna ignore the 99% ofthe businesses out there, and I
want to see how the one outlierreally did it, getting these
crazy, crazy type of results.

(19:47):
But not everybody looks towardsthat, right?
They look at what's in front ofthem and they come out and they
take advice from everyone, andeveryone in general is average,
right?
This is like, it's not likeevery surgeon is exceptional.
That's an impossibility thatthat breaks the rules of fucking
math.
It doesn't happen.
So there are averages, right?
So most surgeons are averageand they come out and they learn

(20:08):
from most surgeons.
And the thought leaders, justbecause they are considered
thought leaders because they'repopular, or because they were in
an academic institution, orbecause they've been promoting
themselves from egomania, doesnot make them the clairvoyant.
It doesn't make them the smart,you know, intelligent.
They're probably also average.
And you see these guys who arethe old guard, they are

(20:30):
extremely average.
That's why they're old guard.
Why else would they be oldguard?
They're old guard because theydon't have the ability to grow,
change, and understand.

Speaker (20:40):
Well, why do you think that is?
I mean, the the reason why theygot became the guard back in
the days where they were the newguard is because they were just
as curious, just as I guess,scientifically inclined or
approached this, I guess, andthey were they're educators to
themselves.
Did it stop at some point, ordo you think it has never been

(21:01):
that?
I mean, I I don't know what'sgoing on.
Like, are are we one day goingto be like that?

Speaker 1 (21:05):
No, so go back to your politics thinking about
that.
Think about how many people inthis world are so wrong about
what they do, yet how fuckingfervent and committed and
dedicated are they tounderstanding everything and
doing everything they possiblycan.
And they're spending all theirenergy in absolutely the wrong
direction.

Speaker (21:26):
So I I get that.
I I get that.
That's basic human.
But don't you, if you see aresult, and I'll tell you a
little bit my evolution, maybethe question becomes more clear.
So uh when I trained, this wasin 2007, eight, when I did my
fellowship, you know, prettymuch we're doing smash lifts.
You know, there was like ahundred different articles about

(21:49):
how to plicate the smash,imbricate, placate, I mean, you
name it.
And then this big question waslike how can we address the
neck?
How can we uh improve the lowerneck?
It was this.
Whole debate, and for me, I wasa fellow, I was just learning
everything, taking everythingin.
That's what I was doing.
Five years into practice, Ijust I liked my results.

(22:12):
I thought they were good basedon the standards that I was
taught and I had.
But then once I saw betterresults, I was like, what the
hell?
Like, how how can I how how canthis how can I do this?
So that's when I went down therabbit hole.
And then through social media,then I, you know, because before
social media, you either had togo to a meeting or a textbook

(22:35):
that was written like five orten years prior, or maybe uh
DVDs back then we had theseeducational DVDs that we learned
from, and or whoever yourmentor was.
So we didn't have this globalaccess to all surgeons around
the world that do an excellentjob, right?
So that's when I realized holyshit, there is more to this, and

(22:57):
that's when I became curiousbecause once I saw that, I
couldn't unsee it, and then Irealized how much my results
suck.
And the very results that Ithought are badass.
So my standard shifted, butthat uh evoked this curiosity to
learn that, and then it tookseveral years to mastering that.

(23:18):
So my question is, and thatcomes from genuine love for just
doing better, getting betterresults.
It's it's almost like I wascompeting with myself.
So my question is for for thequote I call them quote unquote
high profile people because youknow there is there, I feel like
there's two different worlds.

(23:39):
There's high profile in some acuh fictious academic world, and
then there is the real world,and they're they're so separate.
But how come those those onesthat they they're not that eager
to improve their results?
Like, is it because they don'tsee it?
They don't see the differencebetween their results and the
better results, or they see it,but then they don't feel like

(24:02):
evolving anymore.
It's almost like, you knowwhat, I'm just riding into the
sunset and resting on mylaurels.
Well, what is it?
Which one is it to you?
Because you know those you knowthose people probably better
than I do.

Speaker 1 (24:12):
Yeah.
Uh so most of the time it isthat they can't see or see or
understand what they're seeing.
And this is you know, a coupledifferent ways to like think
about why that happens.
But you imagine, like, uh, youknow, we we see sort of like in
the visible spectrum, and thenspiders can see infrared, right?
But there is all this otherstuff that's going on in the

(24:35):
infrared that you never see orunderstand, even though it's
affecting your life at alltimes.
In facelifting, let's just say,simplistically put, people look
at things in photos and theyonly analyze one part of the
photo.
So let's say they're reallylooking at like max 50% of the
picture, and they're looking atonly one dimension out of the

(24:56):
different points that you canlook around a face and think
three-dimensionally.
So they're really analyzing avery small part of the face
anytime you look at it, andthey're unable to completely
comprehend the differences thatyou would see between excellence
and average because they're notlooking for it.
They can't see it.
And when they look at yourresult when you're talking about

(25:16):
something, their eye goes toonly what they understand, which
is that very limited part, andthey don't see a visible
difference that's detectable tothem.
So they just say, okay, it'sthe same.
He didn't prove anything to me.
Why would I need to change anddo anything differently?
It's dangerous to add somethingadditional when I'm getting the

(25:37):
same result, anyways.
And but let me just put somescience behind it.
There's a paper that was donein 1990 where these two surgeons
had the same results, even whenthey thought they didn't.
So, see, I'm right.
So I don't need to go anywhere.
So they justify it like that.
And that's exactly what happenswith you know these top guys.
And really, what for them, likewhat's gonna define your

(26:01):
success, right?
Like my success is defined by,well, one, my patients not
complaining and going away andnever coming back again.
That's one.
But my success is defined by melooking at my photos and saying
I can't get any moreimprovements anywhere on any
millimeter of this photo, or canI?
And I keep going.
Most people, their success isbased on are they happy enough

(26:24):
with a photo?
Was the patient happy enoughwith the photo?
And is their businesssuccessful?
Let's say your business issuccessful and you're taking
academia and the patients arehappy.
Who gives a shit?
Like you think you're top, youknow?
Why?
You make 10 million a year,five million a year, there's
your gauge of success, right?
For me, my gauge is not that.
I have a different one.

(26:45):
I'm much more gauge.

Speaker (26:47):
Well, my what is what is your gauge?
What is your north?

Speaker 1 (26:49):
Why are you doing all of this?
Well, because there's stillthings that I haven't gotten
perfect yet.
So with like lip lifting, let'ssay I haven't figured out a way
to get any better.
I'm kind of plateaued.

Speaker (27:02):
So I lost my what are you not happy about?
Because the lip legs, theliplifts look amazing.

Speaker 1 (27:08):
So I'm curious to see what I just can't find any more
ways to improve it.
So I'm kind of stuck.
And because of that, I lose myinterest to kill myself.

Speaker (27:19):
Where where is where do you feel in your technique is
room for improvement?
If you were if you werecritical at yourself.

Speaker 1 (27:26):
Uh well, can you ever get the nasal base to heal
perfectly on every single personversus it keeps scarring on
like, you know, 5%, 2%, 10%,whatever it is, and you have to
treat it.
So that I don't know how tocompletely get rid of that or
track marks or little tinythings like that.
But I kind of leave it at thatbecause I'm not able to pass

(27:49):
where I am.
And uh, but I I lose myexcitement for it.
So I don't go kill myself anddo I used to do 10 to 12 a week,
and I just wanted to keep goingand going and going.
Now I'm like, well, I'm good.
I'm like, I don't need to killmyself for it.
Facelifting, though, I'm alwaysgonna see something where the
patient comes in and thenthey're like, what about this?
What about this?
What about this?

(28:09):
And they point to the tiniestlittle thing.
And how do you deal with that?
Well, I mean, sometimes I thinkit is a physiologic limitation
where I can't do anything aboutit, but other times I'm curious
and I'm like, okay, well, theydidn't have it when they were
younger, so it came fromsomewhere.
Am I able to reverse it back tothat point, or am I just
structurally limited because ofso many factors that have

(28:32):
changed?
I can't correct all of them.
So is it can I not see all ofthem or can I not correct all of
them because it's just notpractical because their skull is
a different size now, right?
Like I I always kind of go backand forth between the two.
I'm is it me or is it you?
Like, I don't, you know, Idon't know.
But facelifting for me is notjust a facelift, it's all facial

(28:55):
rejuvenation.
Everyone keeps limitingthemselves to a facelift, and
the talk is all about deepplaying this, that dude.
Like, I'm so far beyond justlifting.
I'm trying to do so many otherthings.
Yeah, and people think myresults, they're not real.
Like they look at it, they'relike, No, you can't get skin
quality better with a lift.
I'm like, Well, you don'tunderstand then why the skin
looks aged, because that's whyyou're saying that.

(29:17):
Oh, you can't get pores better.
I had this fucking dumbass inMiami saying my photos are
filtered because a faceliftcan't make pores better, because
he's so dumb, he doesn't knowthat you can actually change the
appearance of skin quality.
Well, just with your hand, youcan.

Speaker (29:33):
I could improve my pores just lifting this mess up.
I mean, that is common sense.

Speaker 1 (29:37):
However, is this achievable with a facelift?
So I'm so far again beyondwhere I'm trying to improve
reflection of light, I'm tryingto improve softness of contours
on the forehead.
Like, you know, I'm trying toimprove array of brow hairs, I'm
trying to improve corrugationof the brows, I'm trying to
decrease DAO contracture.

(29:58):
So I'm trying to reverseeverything, and that's where I
am.
And everyone else is stuck onthis conversation of deep plane
versus not.
And if they're in thatconversation of deep plane
versus not, they are not thegreat surgeons.
Yeah, the great surgeons arenot in that conversation.
They're like, why are you guysso fixated on this?
It makes no sense.

(30:20):
Like, who do you think?

Speaker (30:21):
To me, it's a complete concept flaw.
That it's it's a completeconcept flaw.
To me, like there shouldn't bea conversation if one
understands, like you said, theconcept and the causes of aging.
And you have to understand theroot cause before you have can
even are qualified to enter adebate.
And then you realize thereain't no debate.

(30:44):
Yeah, there's nothing.
There is no debate.
Yeah, the debate again is doyou care about how the face aged
or do you not?
Exactly.
That's it.
And that's that's perfectlyput.
I could, you know, and andthat's really where the
conversation begins but alsoends.
And I I that's one of thereasons, you know.
I don't particularly enjoy likeI'm when I go talk on a panel,

(31:08):
I swear to God, it's me and thenanother D-Plane face of guy,
like we're on the same page,we're all talking the same
stuff, and then there's threeothers showing their smash
lifts, and then blatantly andaudaciously claiming that they
can get just as good of results,and then even posting their
pictures in front of a thousandpeople, and you're like, I would

(31:30):
be embarrassed to put thatstuff up.

Speaker 1 (31:32):
Yeah, but that's the lack of the vision.
Yeah, that's the lack of thevision.

Speaker (31:36):
But but I I just can't understand because typical stuff
uh that SMAS stuff can'taddress, which is the mid phase.
I mean, the SMAS ends at thezygomatica, so you then they end
up injecting the shit out of itwith fat or fillers afterwards
just to you know improve the midphase, just because it's so
there's so many things thatthat's patients.

(31:58):
I feel patients see more thansome of these people because
patients come and say, Hey,what's what's going on with
here?
Why is it so flat?
Why is it drooping?
And then they get a phase diff,and then this doesn't change at
all.
And then they get these curtainuh like and then it's like how
is that then better?
So anyway, so for me it's veryfrustrating.

(32:20):
So I don't blame you if you'resick and tired of doing these
courses and giving thesespeeches, as you said, it's like
it's you you're at this pointyou're speaking a different
language than 90% of theaudience can understand.
So, where do you do you seeever in our lifetime, our
careers, let's say before weretire, things changing, the

(32:42):
pendulum swinging, going from9010 to 1090?

Speaker 1 (32:46):
Well, the the pendulum has swung for sure, it
already has.
You know, there's peoplefighting it for whatever reason
and you know, celebrating whenthey get little tiny things that
go in their direction becausethey think it's some kind of
like team versus team.
The pendulum is swingingtowards better results, and to
get better results, you have torealistically address the

(33:10):
anatomy better.
And so that that's happeningmore, anyways, and it's gonna
keep going slowly in thatdirection.
And ultimately, again, youknow, well, who cares?
Like, if they don't want to, Idon't care.
Like, let them have shitresults, you know.
Mine stand out a lot more, andthat benefits me.
So I I don't care anymore.

Speaker (33:30):
Well, the the consumer cares, and I think we never had
in in the past this thisdichotomy between these or
differences between what peopleare willing to pay for a
facelift today compared to 10years ago.
And uh I see this outrage outthere on social media.

(33:51):
How could you charge this much?
I mean, I have patients likethe ones that obviously don't
come to me is like, oh, yourprices, why are your prices so
much higher than uh Dr.
Such and Such?
I'm like, because you'recomparing apples and oranges.
I mean, I'm not doing thatsurgery.
It's called facelift, but it'snot the same surgery.
But the patient, I I can't, Idon't expect the patient to

(34:12):
understand that because even ifa surgeon, like an old guard,
doesn't understand it, like howcould we expect a patient to
understand that, right?
So that's my first thing.
But the other thing is thereare a large amount of patients
who are willing to pay that topdollar price because they can
see the difference between theresults, and their face is the

(34:34):
most important thing to them,and they're willing to pay for
it, and that's okay for someoneelse to be outraged by it and
out of shape about it.
Forget about it being silly.
It's like, what is it to you?
I mean, uh, people obviouslyhave different standards, you
know.
Just like someone goes buys apair of pants at Walmart and

(34:54):
someone else goes to Gucci andbuys and pays 10x that and
argues that this came from thesame factory or was made in the
same country.
What's I mean, there's so muchmore that goes into these
things.
So, how do you see that?
What's your sentiment and howdo you respond to these people?

Speaker 1 (35:13):
Yeah, well, the the there's no more value for
clothing yourself in Gucci thanWalmart, right?
So you can have either one andbe fantastically happy with it.
You know, you pick who you wantto go to and you go to them and
you pay what they want to payor where they want to charge,
and that's that's about it.
It's we're we're not realdoctors, you know.

(35:36):
I don't think people understandthat.
We're we're we're cosmeticsurgeons.
Like this is a purely elective,luxurious field.
If it were something that werelife-saving, and we were the
ones who are the gatekeepers,and people would die if we
didn't treat them, I hundredpercent agree.
It is completely wrongethically to do that, because

(35:59):
then we're real doctors andthere's no one else that has
they have access to.
And realistically, there's somuch access now that even the
real doctors don't takeinsurance and they charge a lot
if they want to, and that's howthey want to live their lives.
And nobody complains.
So the, you know, for peopleout there who complain about it,
it's ridiculous.
It's like just don't go to thatperson.
It's like I don't have to,nobody's forcing me to go buy a

(36:21):
Ferrari.
And if I don't buy a Ferrari,I'm not gonna die.
I'm gonna be totally fine if Idon't buy a Ferrari.
I can still get to work, I canstill do whatever I want to do,
or I can just walk.
Like so, there's there's otherthings you can do.
So it's a ridiculousconversation.
And for surgeons, there aresurgeons who comment on it.
Obviously, it's the surgeonswho can't charge more or can't

(36:43):
do more.
There are a few out there whojust don't care to, and great, I
love them for it.
That's fantastic.
The ones you know who do chargemore, they have their everyone
has their own reason why.
I have my reasons why.
It's because people have mademy life miserable, and I want
less of them in there, and Iwant to just focus on fewer
patients and give them moretime, and that makes me happier.

(37:04):
And I don't know how to limitmyself because I say yes to
everything.
So I just do the dumbest thingyou possibly can do, which is I
mean, dumb, like you don't haveto think much.
You just take your price up.
You're like, okay, it'll slowpeople down.
That's it.
And that's why I do it, andthat's why I want to do it.
And if I want to do it forsomeone for free, I'll do it for
free.
Not for the asshole who'scomplaining about charge about
the charges.
You know, I'll just it's it'sit's I'll do whatever I want.

(37:29):
This is I'm a I'm a luxuryitem.
Nobody in this world needs me.
They're not gonna die withoutme.
I don't owe anybody anything,I'm here for fun.
And this is what it'll cost tohave fun with me.
That's it.

Speaker (37:42):
What what do you yeah, I totally agree with you, and
and uh it's choices we make, sowe can't you know blame someone
for making choices based on whatis important to them.
How do you how do you see whatwe do in terms of enabling human

(38:02):
behavior?
Uh you know, you see on socialmedia people commenting that
hey, uh I don't appreciate whatyou do, you're taking advantage
of people's insecurities andyou're making money off of
people.
Have you read those comments?
Yeah, yeah.
So there's what what do youwhat do you what do you have to

(38:25):
say to someone that that accusesyou of something like that?
Taking advantage of someone'sinsecurities, shame on you.

Speaker 1 (38:35):
Yeah, yeah.
I mean, good for them, let thembelieve that it doesn't matter.
Like they were not in a on atrial that we have to prove
something, but let's say youwanted to give them an answer,
you never will because to havethat thought is is very, very
narrow-minded, and it's it'sridiculous because the reason we

(38:56):
exist in the first place isbecause people want to make
changes.
So, you know, Ferrari doesn'tcreate the desire again, like
the you have it's it's notnicotine, you know.
So nicotine, I get it.
Yes.
That's a good, that's a good umlike nicotine, you're trapping
people and you're takingadvantage and you're creating a
desire and you're doing all thisand that.

(39:17):
For us, the desire exists,which is why we exist.
So the in essence, when youlook at the evolution of it, the
patient created us.
It's not the other way aroundwhere we created a need.
People want to do something.
Now, if someone came to uswho's beautiful and fantastic,
and our intervention can't helpthem, or our intervention is not

(39:39):
going to help how they feelabout something basic, or their
problems are more deeply rootedthan something aesthetic, then
yes, there would be a problemthere.
So there might be a situationwhere somebody could take
advantage and take advantage ofsomeone's insecurities.
That can happen for themajority of it.

Speaker (39:58):
It does happen.

Speaker 1 (39:59):
I mean, we the majority of time the people that
we're treating are seeking us.
They want to feel better aboutsomething very you know simple
that's been bothering them, andit'll allow them to get it out
of their minds.
Whether it's for vanity and forbeauty, whether it's for an
advantage in the workforce,whether it's for getting over a
divorce and feeling betterlooking when your husband or

(40:21):
wife is going out and bangingyounger people, there's a
million materialistic reasonsyou might want to do something
like this.
Then we're here for it.
And that's our job to judge whowe can do it on, who we can't
do it on, who needs it, whodoesn't need it.
And ultimately, if there'ssomebody who is completely
unhappy with life in general,teaching them that an aesthetic

(40:43):
surgery is not gonna make themhappy.
So I I I I don't think, firstof all, responding to those
people is very wise because theydon't get it, but that would be
the response that they willnever understand.
Yeah.

Speaker (40:56):
But I see it, I see it the same way as you could argue
that the makeup industry is alsotaking advantage of people's
you know, insecurities, youknow.
That that's so why why sellmakeup and you're basically
taking advantage?
It's the same thing.
Yeah, you know, exactly.

(41:16):
And I like I like StephenDayen's perspective on that.
And I did a podcast with himseveral years ago, and he said,
you know, we're we're heconsiders himself a
self-confidence doctor.
He said, Well, we'reself-confidence doctors, because
we treat, we help people withtheir self-confidence and
self-esteem by making them uhfeel uh look the way they want

(41:38):
to feel, by enhancing theirbeauty, their aesthetics so that
they can feel more confident.
So it's to me, it's the otherway around.
I think in in a way we aretherapists more than anything.

Speaker 1 (41:52):
Yeah.
Yeah, and you see it's uh somepeople you can help, some people
you can't.

Speaker (41:56):
So so how do you feel that social media and AI has, do
you think it's it's helped usor hurt us?
Do you think I mean obviouslyit has altered uh the way people
see themselves, but do youthink it's a how how much of it
do you think is good and howmuch of it do you think is bad?

Speaker 1 (42:16):
Well, um people are more aware of how they look,
which is the first issue, youknow, let's say like 40 years
ago, not an issue, becauseunless you're taking tons of
photos of yourself as an actoror something like that, you're
really not staring at yourselfin the worst lighting versus,
you know, like in the morningyou go in the mirror and there's

(42:37):
light flashing on it,reflecting you get you're not in
the worst lighting.
When you start taking more andmore photos, and you see
yourself on social media more,you see yourself in Zoom, on
Zoom more, in weddings, youknow, wherever you are, you may
see you're the worst version ofyourself because you'll catch
those bad angles with badlighting and in a bad strained

(42:59):
smile position or whatever itis.
So certainly, you know,patients have come out more and
more over the past 10 years,especially saying, Hey, I've
noticed these things I wouldn'thave noticed before.
Can you help treat them?
So, in one way, it kind ofsucks for patients because they
see those photos and they wantyou to take their worst photo
ever and then make it look liketheir best photo ever, right?

(43:21):
Whether it's filtered or not,they just want to make it you
know look like the best photoever.
So, in a way, it kind of hasincreased self-awareness and you
know, judgment.
So not so great for people.
In other ways, it's helped outa ton because they're able to go
find help for it when they neednow, because it's all over the

(43:41):
place.
It's like, you know, theplastic surgery on the internet
is much more now than all thefamous chef TV shows and stuff
that came out that we all usedto watch and reality housewives
and all that.
Then you have the whole like AIin the industry itself.
You know, AI and And morphingand all that has created

(44:02):
unrealistic expectations forpeople because they think that
they can achieve what you see ona filtered photo realistically.
And the photos become sorealistic, also, that you can't
really tell the difference.
So people say, oh my God, soand so had a necklift, so-and-so
had a facelift, so had a nosejob, they had a radio frequency,
whatever.

(44:23):
And look at them in this photo,they look like they're like,
you know, little baby eyefive-year-old adorable face.
Oh my God.
But it's all, you know, AI.
So it does set some unrealisticexpectations.
But at the same time, now we'reusing AI to help us out in our
own surgeries and help withother stuff.
So for now, the AI ismisleading for most of it, where

(44:45):
you say, okay, let me like, Ican make an AI version photo of
you of your face, but it's notreal.
You know, to say like to sellyou something, which is very
misleading.
But on the other hand, I knowthere's going to be a benefit
because I've already created onefor like the Cupid lift with
the lip, where I have now, aspart of our video library, you

(45:06):
get access to the app.
And the app is almost publishedwhere you can use the
calculator.
You take a picture of yourselfas a patient or as a doctor
doing it for their patient or adentist, and you say, Show me a
five millimeter lip lift, fourmillimeter, five, six, whatever,
using the Cupid algorithm.
And it'll actually show therealistic change you can get
using the Cupid lift, anincisive display, and all this

(45:28):
and that.
So AI has helped mespecifically with that.
But if I try to apply this tothe whole face, there's no way
you can get an accuraterepresentation of course.
So it's it's good and bad.
In general, AI for the world isgonna cause more problems than
good.
That's for sure.
Like, sure, it'll cure cancerpretty soon.

(45:50):
It'll find a way better than wecan at an accelerated rate.
But as you cure cancer, youalso at the same time destroyed
everything else in the world andled to like five world wars and
made people, you know, uh hateeach other and you know they
can't even talk to each otheranymore.
So it's got its good and bad.
I think AI ultimately the badis gonna outweigh the good

(46:11):
stuff.
The good stuff is gonna be inpeople's faces, which is like I
can push a button on my phoneand my whole house gets cleaned,
you know.
Like there's gonna be coolstuff for sure, and then cancer
goes away for a large part, anduh, they even get a treatment
for like herpes, you know.
There's gonna be some goodstuff that people visualize and
see, but there's gonna be abunch of other fucking chaos
that's happened that's gonna benegative.

(46:32):
Same application towardsfacelifting.

Speaker (46:36):
And I think at the end of all of it is us humans, uh,
we're the ones ultimately incontrol and deciding where it's
gonna go.
And to me, AI and social.
Not for one more year, yeah.
Yeah, it's AI will take over.
Yeah, I I don't believe that,you know, because as long as we
are still in trouble, we canturn it off anytime we want,

(46:57):
unless it knows how to turnitself back on, then we're in
trouble.

Speaker 1 (47:01):
Yeah, why wouldn't it?
Why wouldn't it know how?

Speaker (47:04):
If we know how and we've taught it, I know we
figured it's uh it's it's kindof scary.
I that's one of the reasons Idon't want to go down that
rabbit hole because I don't wantto scare the shit out of
myself.
I I I always like to believe inthe good in people and good in
things.
That's just my nature.
And I I just don't I just don'tbelieve in doomsday.
I I I don't understand howhumanity could have come this

(47:26):
far to then destroy itself andyou know, but that's a different
conversation.
You know, what I want to know,where do you see now you're
still I would say you're at theheight of your career, and you
you're not probably not gonnahang up your cleats anytime
soon?
Where do you still see theimprovements that I guess are

(47:47):
possible when it comes to facialrejuvenation, but also facial
aging?
Is there is there how much roomfor improvement does Ben in
2026 exist for the next, I don'tknow, 10 years, 20 years?

Speaker 1 (48:04):
Well, for facial rejuvenation, the stuff I'm
doing now eclipses by far likethe stuff I did like two years
ago or a year ago.
For me, it's like so much morefinely tuned, and there's so
many things that I don't missanymore that nobody understands,
that nobody understood, nobodycould have explained to me.

(48:26):
There's areas out here wherepeople call it a zygomatico
cutaneous ligament, and I havenow realized exactly what that
is, exactly what the depressionunder it is in some people and
not the others, which is noteven what other they're not even
it's not even referred to.
Would you mind sharing?
I'm curious personally.
Well, so that specifically isthere well, so there's no such

(48:50):
thing as a bony category.

Speaker (48:51):
I know this might be boring for the audience right
now, but this is me right nowgeeking out from nerd to nerd.

Speaker 1 (48:57):
So so so first there there's definitively in this
world, there's no such thing asa bone bone skin ligament.
It doesn't exist.
Agree with you.
You can't go from ectoderm toendoderm.
It doesn't embryologicallyexist, it doesn't exist in a
human, you can't show it on acadaver or a person when you
flip the skin over.
There's no attachments there.
There's none on the boneeither.
So like you can peel off thebone on any skull and see

(49:20):
there's none.
So what are people seeing isthe question over there.
And it's actually two things.
One is what they're focused on,which is right under the
zygomaticus, and then there'sactually another area just
inferior to that as well, whichis similar but different that
they completely ignore.
So this area over here, thereis a difference in tissue

(49:41):
density from above it and belowit because the structures are
different above and below it,not because there's a ligament
there.
This area over here has amuscle, this area over here has
a muscle, this area over herehas buccal fascia with a deep
muscle, and then parotid.
This area has a bone, this areahas no bone.
It's hanging open in front ofthe mandible to the cheek.

(50:02):
This area has underlyingadhesions towards the bone where
layer five of zygomaticus is.
This area has attachmentstowards parotid or floats away
from parotid.
So, with all this, you end upwith a gliding plane here, a
gliding plane here, fixationhere, gliding plane here.
So if you're going through thisgliding portion, you can

(50:23):
elevate.
If you're going submuscular orsupromuscular, you can elevate.
And then through here, itbecomes variable based on the
person if they have densetissues in layers three, four,
five, or if they don't havedense tissues there, depending
if they're white, black, thinwhite, thick white, whatever it
is.
Nothing that would have to dowith the ligament, however,
different density and tissues.
And there's no glide planebecause there's no muscle there.

(50:45):
So that's what they're seeingas a ligament, is because they
create a glide tunnel above it,a glide tunnel below it, they
retract upwards and they seevertical striations because
they're retracting tissues thathaven't been released.
And then magically, when theyrelease the one portion that
didn't get released, it moves.
Wow.

unknown (51:05):
Wow.

Speaker (51:05):
It must be a ligament.

Speaker 1 (51:07):
Oh my god.
I released here, I releasedhere, I didn't release here, and
then when I release here, now Iget my movement.
Oh my god, how did that happen?
It's so crazy.
It must be a ligament.
Versus, I'm like, okay, well,what if you just release that
and not above and not below?
Well, nothing happens.
Then what are you talkingabout?
What you're saying essentiallyis that everything needs to be

(51:29):
released up to where it doesn'tto move your tissue plane,
correct?
And they're like, no, there's aligament, whatever.
So either way, that's oneportion.
The second portion they'remissing is, as I said, directly
inferior.
As you see, people get a largerdepression that goes inferior
to McGregor's patch.
What is that?
That is your layer three bucklefascia that when you're younger

(51:50):
is approximating your anteriorborder of your parotid gland,
migrating away from it, and youactually create a gap in layer
three.
So if someone says this mass isnot contiguous in layer three,
they are correct.
There are places, first of all,it overlaps, orbicularis
overlaps, zygomaticus,zygomaticus overlaps TP fascia,
orbicularis overlaps Tp fascia.

(52:11):
It's not a direct plane, it'slike this.

Speaker (52:13):
Yep.

Speaker 1 (52:14):
Yeah, we get that.
But there's also gaps there asit migrates away.
And you end up here with abuccal fascial gap from the
parotid.
And you have to reapproximatethis in surgery, not only to
fill that gap, but to move yourmodeolus back, to move your soft
tissue back and to recreatefullness in this area because
you've hollowed.
And it's partially because ofthe migration away.

(52:37):
And it's this is reproducible,and I can show it over and over
again.
But those are the things I'mseeing.
You know, those are the thingsI'm seeing, and I'm fixing that.
So, but other surgeons arelike, no, there's a ligament
there.
I'm like, show me one fuckingembryo.
Show me, show me where thiscomes from.

Speaker (52:54):
Well, I I don't I don't blame them because they get
their information fromtextbooks, from articles, and
then that's when cognitivedissonance kicks in, right?
They it now it's a fact becauseit's written everywhere,
everybody talks about it, andthen you come and say this.
It's almost like Galileo comingsaying, Hey guys, I think the
earth is round.
I just looked under uh througha telescope and it's not flat,

(53:15):
and then you get uh you know putin jail.

Speaker 1 (53:18):
Yeah, but the so sadly, this whole so I don't
even do technically a full deepplane.
I'm kind of like manipulatingthat plane, which is layer four,
as much as I possibly can.
I'm deep plane focused, I'm nota full deep plane surgeon,
right?
Hamra was the only, your hammerwas the only uh I know, but he
was the only real deep planesurgeon.

(53:40):
I don't even do full deepplane, I do manipulation of it
as much as possible segmentallydifferently to be safe and take
advantage of different parts.
I segmentally treat these guysthink that deep plane surgery is
based upon the idea of ligamentrelease.
That's what they think it'sabout, which is purely

(54:02):
ridiculous.
It's about planar release andredistribution or you know,
replacement or repositioning oflayers composite as much as
possible.
That's what it's about.
But they were taught that it'sabout ligament release, and
ligament release has now becomesynonymous with deep plane
surgery, even though there is itwould make in what world, so

(54:24):
like a ligament is a stabilizingstructure.
So why would you want to do thething?
Yeah, exactly.
Why would you want to releaseit?
Yeah, a ligament would not bedrooping, nor would it be
drooping more than the tissuesaround it.
So why is that the importantthing to release?
It doesn't make any sense, butthey do exist in the face,
they're just looking at thewrong place.

(54:44):
And when you look at facialaging, you see where they exist,
they exist here and they existhere.
That's it.
And when you smile as you getolder, everything bunches
towards here, everything bunchestowards here.
That's where your deepattachments are, and the
separation in planes where yousee that.
That's where your deepattachments are.
So they do exist, it's justthey're important, and you need
to maintain them and you need tolift everything that drooped

(55:07):
onto them off of them andtension them back up.
So when you you see where myfocus is going in my evolution,
is now optimizing the positionof the SMAS, all of the SMAS.
So when people talk about SMAS,they're only talking about
surgical SMAS.
Surgical SMAS is layer three.
The SMAS is not one layer, it'smulti-layer.
It's three and it dives downtowards five.

(55:29):
Okay, so that's your actualSMAS.
You have diving down and youhave deep five, which is
Rhizorius and Zygomaticus majordeep belly.
So it's a multi-layer system.
The aging portion is layerthree.
So when people say SMAS, theymean surgical SMAS, meaning the
part we're operating, not all ofthe rest.
So I am optimizing the tensionon my surgical SMAS, my volume

(55:53):
under, my volume cushioning.
And when you look at my smiles,they do they dynamically have
changed dramatically, all ofthem.
They don't bunch towards themouth, they don't bunch towards
the eyes anymore.
Now they're neutral and themouth lifts towards the side.
Everything lifts towards theside.
And I'm able to do that becauseI go segmentally and make sure
I get rid of laxity in everyportion of the face.

Speaker (56:15):
And I've noticed that on your before and afters.
And actually now, because I'vebeen listening to you and and
you help me really dramatically,I'm a big fan, and always like
hearing you explain these thingsbecause it makes total sense
and it requires a reallyin-depth knowledge of anatomy,

(56:36):
though, to even be able tofollow the things that you're
saying.
And I think also certainnarratives like ligament release
and all of that are in the wayof people understanding the very
things you're trying toexplain.
You know, I feel the narrativesare in a way for us to
understand a more simpleexplanation.

(56:56):
And everything you're sayingmakes sense.
It's very simple, it's verylogical, but only if you
understand anatomy.
So it's like I can't talk aboutsomeone how the car feels when
you drive it at certain speedsor certain RPM if they have
never driven a car or or or ifthey don't even have a driver's
license.
And and I think again, thesenarratives around these old uh

(57:20):
schools of thoughts and oldteachings are in the way of
people breaking outside of ourshell uh their shelves and uh
giving themselves at least achance of understanding the very
things that you're explaining.
And I can now see howfrustrating it must be for you
talking in front of a thousandpeople where you already know
before you even started yourtalk that probably 98% are not

(57:44):
understanding anything of whatyou're saying.

Speaker 1 (57:47):
And it does yeah, it does get in the way.
Like you have cervicalretaining ligament, if you
believe in that it exists,number one, if you believe that
it is the platisma on theanterior border of the SCM,
number two, which is untrue,you're never gonna actually get
to a reproducible endpoint ofwhat it takes to recreate the

(58:10):
contours and the lift in thatarea, because you're focused on
something that doesn't exist andyou don't actually see the
anatomy that's there.
The true anatomy that's thereis the platismal, the platisma,
the parotid fascia, and theparotid.
And if you understand that,then you can now manipulate that
anatomy.
You can say, Well, the parotidis an anchoring structure, layer

(58:31):
five.
I have to take layer three andfour off of it until it's
released from it, roll over it,and push it back down.
That's how I get my lift.
So if you know that, then nowyou have reproducible results
versus you're like, okay, thisfake thing exists, you don't
know how much to lift it, whereto stop, what's your endpoint,

(58:52):
what guarantees the lift, right?
They don't care what guaranteesthe lift.
They say if you release it, youlift it.
No, there is an endpoint thatwill allow you to actually lift.
What is that?
Some people say it's palpablemovement, it's not just that.
You have to actually releasethe prod or else it rolls with
you.
Or else what happens is everyonce in a while you're like,
fuck, why is it still full underthere?
Man, I don't know why thathappened.

(59:12):
I don't know why that happened.
And it's and they just stop atthat.
They don't say my understandingof it's wrong.
They say it doesn't work.
It just happened.
Something just happened.
Oh, you can't control it, itmust be scarred tissue.
Not that my understanding ofthe anatomy was wrong, so I
manipulated it incorrectly.
That's like, but whatever.

Speaker (59:32):
And I think I think uh one of the on that topic of the
product, one of the I feel forme, how it changed my results
personally in the past, I wouldsay, two years, your crevasse
technique that I initiallythought it would improve just my
gonial angle, which for theaudience it's the angle of your

(59:53):
jaw right underneath yourearlobe, is that little corner
there.
And to me, the genius of thecrevasse, which I use almost, I
would say in 80% of the cases,you know, unless someone freely
already has their gonial angle,is already sticking out pre-op,
has significantly improved mylower neck.

(01:00:16):
Because now I'm able totransfer all that distance
further from vertical tohorizontal, all the way, tuck it
back, and it's really improvedthe lower neck, the sternal
notch area.
And that's something that Inoticed after the fact trying to
get a nice gonial angle, butfrom a volumetric perspective,

(01:00:41):
and your article really shows itbeautifully with those lines,
it makes total sense.
And so to me, that was probablyone of the biggest, even though
it's a small technique, veryeasy to do for anyone that does
a facelift.
And it's uh it's just it's notthe the genius, is in its
simplicity and its conceptual uhlogic, and it it just helps not

(01:01:08):
only the jawline but also theneck all the way to the sternal
notch and the clavicle.
So that I I have to give yougive you huge credit.
And for any facelift surgeonthat is listening and either
doesn't know what we're talkingabout or hasn't read it the
article or watched your video,uh it will be a game changer,

(01:01:28):
but of course, only for the oneswho see the problem.
If you don't see the problem,you can't understand the
solution.

unknown (01:01:36):
Yeah.

Speaker (01:01:37):
So how did you how did you come up with that?
I just want to be in a put putme in a time machine back in the
operating room where you gowhen you went.
Let me try this.

Speaker 1 (01:01:48):
It was on revision cases where there had been
placation in this area that andyou couldn't see a ramus
anymore, and you couldn't see agonial angle anymore.
It was just a bunched up tissueover here, and I was scared to
keep trimming it because thegreater Rick is in there.
So you could just trace it up,but it was hard to find on most
of these people because they'vebeen so placated.

(01:02:09):
So instead of doing that, Itrimmed it a little bit and I
said, okay, let me inset it alittle and push it down.
So I would try to cut throughthe tissue on the mastoid where
I knew it was safe, and then I'dkind of keep compressing it.
After a while, I started, and Iwas still doing myotomies at
the time.
After a while, I started to seeposterior myotomies or medium.

(01:02:30):
Yeah, right over there,posterior myotomies.
And then I started to see thechanges, the problems, and I
started to focus on the parotidand understand the gland and
understand its protrusion overtime and how everything moves
away from it.
And so then I started to findways to recompartmentalize it.
Then I started to look at theactual line of the mandible
relative to the hyoid mastoidline.
Then I started to look at theposition of the ear canal

(01:02:53):
relative to the mandible, and Istarted to understand all these
things and why on some peopleyou can get the improvement and
why on others you can't.
So I just started seeing itslowly with all that, and
saying, okay, how come on thispatient my hyoid goes up behind
the mandible and the entiresubmentum disappears, whereas in

(01:03:13):
that person it's still obtuseand below the level of the
mandible.
And it's because of my vectorof movement, my suspension point
of the platisma.
So ultimately, I found thatuniversally, if you want to
improve the plateau under themandible, recompartmentalize the
post-mandibular volume, whichis where the parotid is, to show

(01:03:36):
your ramus, because the ramusdisappears in everybody.
Yeah.
I want to show the ramus, showthe gonial angle, lift the hyoid
all the way up, horizontalizethis entire area behind it and
create a plateau, create aparallel between the mandible
and the hyoid mastoid line, andultimately lift the entire
platisma back to where it was.
It was going pretty much takingthe platisma and parotid

(01:03:59):
fascia, where you release it offthe parotid in the tail of the
parotid and suspending it ashigh up and deep and far back
posteriorly as you can.
And it's super easy to do.
It's a centimeter cubicmovement.
And this fell into theunderstanding that I was getting
with the rest of the aging faceis that if you treat a

(01:04:19):
three-dimensional problem, sowhat we see in the face with all
we see massive amounts of skinexcess on some people, it's not
it's not skin excess, it'sthree-dimensional changes that
compound on each other.
And so you see these biggerchanges visually.
But what I was seeing with therest of the face and here is I
make smaller movements in threedimensions rather than big

(01:04:43):
movements in two.
And I was getting biggerchanges with less movement.
And for me, that was logicallymore of a reversal of aging.
Whether or not it's true, Ididn't know yet until I started
looking at the face everywhere.
Afterwards, I'm like, oh myGod, it is.
Everything is just compoundthree dimensions.
And when you look at my photosof these like old ass ladies

(01:05:05):
with crazy amounts of like neckand skin excess and wrinkles,
and then you look at a younglady I did, I'm removing the
same amount of skin.
Like, how do you explain that?
Right.
Other than it'sthree-dimensional things,
volumetric things, size things,expand, you know, it's not
planar issues that are causingall these all these changes.

Speaker (01:05:27):
Now, on that um, on that topic of aging, have you
this is a bug that I got severalyears ago that took me down the
rabbit hole.
Uh, but I want to ask you haveyou ever thought of the causes
of aging?
I know we do age, but we alsoknow that people age at a

(01:05:49):
different pace and differently.
And we as facial surgeons, wesee it in the face all the time.
We see a 45 year old that hasaged like A 60-year-old and a
six-year-old at his age, like a45-year-old.
Have you ever thought aboutother than what we used to be
told, like, well, it's genetics,that's it.

(01:06:10):
It's genetics.
And the second follow-up linewas people are different.
Okay.
Have you ever thought of whatthat means?
Has it ever bothered you tofind out the root cause of that
and address it in a way to maybein a way to be able to predict
your results long-term, the thelong-term, your long-term

(01:06:32):
results, but also help patientspost-operatively to better
maintain their results almostinto perpetuity?
Yeah.

Speaker 1 (01:06:42):
Well, do you know what I mean?
No, I I I do.
So I have a betterunderstanding of aging and why
it happens more indifferently onsome people than others for
sure.
Skipping to the last part, canyou use that to get a better
result?
Yes.
Can you use that to make surethat somebody who's hyperelastic
or something else doesn't needa facelift sooner than somebody?

(01:07:03):
Like a longer lasting result.
Maybe not, you know, but thebetter results you get, the
better they're going to last,anyways.
Now, the techniques that I havenow sort of treat universally
everybody, whatever theirproblem is.
Now, for somebody who's droopyin the neck at a young age, this

(01:07:25):
happens for a few true likereal visible anatomic reasons.
It happens, well, sometimesbecause they're just massively
fat, that can happen.
Sometimes because they haveprominent teeth.
If you have very prominentteeth or low-hanging, clockwise
rotated maxilla, your mouthcan't close properly and you're
constantly contracting, you'rebringing your chin to a higher

(01:07:45):
point, you're depressing it,you're compressing this area,
getting fat loss, and you'regetting strain in the neck, so
it makes it obtuse.
That's a realistic thing yousee.
You see patients who havestructurally from a young age a
horizontal platisma on the sideof the face, even though they,
sorry, vertical platisma on theside of the face, even though
they're horizontal down overhere.
And because of that structure,and it's structured like that

(01:08:08):
because of the position of themastoid relative to the mandible
and neck, it's just all kind ofone plane, then they start to
evulse at a much younger agethan somebody else who is
horizontally suspended foreverand their muscles contract
against their mandible insteadof against it, instead of away
from it, pulling it down.
So you see these things thathappen.
And then you havehyperelasticity, of course,

(01:08:30):
which it's varying degrees, andit's not a dermal issue.
Hyperelasticity is translatedthrough all planes.
So it is hyperelastic softtissues.
They they have differentconnections, different amounts
of elastin, you know, differentamounts of collagen, different
contents.
So it's more stretchy tissuesoverall.
And those tend to exaggerateany rate of aging that we see,

(01:08:55):
because part of what we'reseeing with aging is
gravitational effects on theface and gravity effects on the
face, two types of drooping.
One type of drooping is planarshearing, which is within layer
four.
Fixation is also within layerfour.
So planar shearing is not aglide plane that's open.
It's if you find neutral, let'ssay you go all the way up, all

(01:09:15):
the way down, find the middlepoint.
Okay.
Your areolar fascia is going tobe able to let you move a
centimeter up, a centimeterdown, a centimeter forward, a
centimeter back in a circle.
Okay, that's your plan armmovement that you can get within
layer four.
And layer four is an infiniteseries of fascial connections.

(01:09:36):
It's not an open glide planethat it glides over itself.
It's an infinite series offascial connections, and every
single one of these connectionshas one degree of movement.
Yeah, it's like a croissant.

Speaker (01:09:45):
Imagine for the audience, like a croissant, the
layers inside the croissant thatthese diff has multiple layers
that interconnect.
By the way, just for theaudience, real quick, we talked
a lot about layers.
I just want for the audience,maybe they don't know what the
layers are.
Quickly go from layer one tofive and explain just briefly
what those are.

Speaker 1 (01:10:04):
So for most of the face areas that you want to just
generally understand the skinorganization, it's the three
consistent layers are layersone, two, and three, which is
your dermis epidermis, which istwo layers, but it's considered
one.
It's your skin.
So layer two is your subdermalfat fascia, which is fascia in

(01:10:25):
some places, like here, areolar,and here it's fatty.
And some places where all theblood vessels are, where glands
are, etc.
The the sweat glands fall intothe floor.
Sweat glands, not the realones, yeah.
And the then layer three isgonna be the superficial layer
of the superficial muscularponyuritic system.
So it's the super smash,basically.

(01:10:46):
And that's where the musclesthat move your skin are located
versus the deeper muscles thatcause flexion are attached down
to periosteum, and they'reusually in layer five or layer
four and five.

unknown (01:10:59):
Yeah.

Speaker (01:10:59):
Layer five, the definition for people.

Speaker 1 (01:11:02):
So layers one, two, and three is what you would
perceive as your skin and yourmovement.
Layer four is the layer that itmoves over or locks into.
So it's the glides over, andthen layer five is your deep
structures.
The deep structures can be yourparotid gland, your periosteum,
your masseter, your temporalis,muscle, including both layers

(01:11:22):
of fascia, your temporal fatpad, include so you can get
multi-layered here if you godown, you have one, two, three,
four, five, six, seven, eight,nine, ten.
So like yeah, multi-layered ifyou go into a place which
crosses zones.
So that's layers one, two,three, four, and five.
But anyway, that layer four isit's like a yeah, potato
agratin.
So like exactly.
Yeah, if you slide, yeah, andeach one locks here, locks

(01:11:43):
there, locks there, locks there,and you get ultimately this
pendular movement.
And it's important to know thatbecause layer three has much
more movement than the bottom oflayer four.
The bottom of layer four locksto periosteum, has very little
to no movement.
The top of layer four has a lotof movement.
Yeah.
So that's layer four, that'syour shearing planar movement.

(01:12:05):
That's one kind of kind oftosis that you see with gravity
when you go back and sit up.
And the other is tilting tosisfrom volumetric distension,
which means let's just saysimply, you have multiple
layers, but just make it layerfive and layer, let's say bone
and skin.
If they're expandedvolumetrically, then the amount
of tilting you would get withinthis when you lay down and sit

(01:12:28):
up is very little.
If it gets deflated, now you'rehere when you sit up and it
goes back when you lay down.
So you have a tilting movement.
Then you have fixation points,fixation zones, and more mobile
zones.
Again, it's gradients.
So when you look at thesestuff, it helps explain why you
get this plane arm movement thatcomes forward, you get a
tilting movement that comesdown, and then you see these

(01:12:50):
pyramids on the face.
Pyramid is a three-dimension.
You can see thatthree-dimensional kind of stuff,
accumulation of pores and allthat.
So most of the drooping isexplained by that.
And when you look at someonewho's hyperelastic, they have
all of that to a greater degreethan somebody who's not
hyperelastic.
And there's nothing you can dofor that tissue quality.

(01:13:11):
There's not much.
What are you gonna do?
You can try to tighten.
Yeah.
The only way to reverse it,there's no way to reverse it.
It is that's the way that'sthose are their ratios.
So those are your ratios.
Like when you look at them,they have a greater extent of

(01:13:32):
you know, less collagen, lesselastin, whatever it is, they
have different ratios than wehave.
You can't change those ratios.
That's what they're born with,that's their genetic makeup.
So it is their that's sort of agenetic thing, whether it's
it's not caused by necessarily agenetic marker specifically,
but that's their genetic makeup.

Speaker (01:13:49):
You know, you know, whenever someone tells me things
like it's not possible, I Ibecome more curious.
Like, yeah, is it can can wereally not do anything about it?
So I went down that rabbit holeuh several years ago and tried
to understand, you know, I comefrom a cellular biology
background, so that's why I waswondering if, from a cellular

(01:14:13):
biology standpoint, from anepigenetic standpoint, are there
things, what are the thingsthat are occurring as part of
the aging process from acellular standpoint, which is
our epigenetics, which reallycontrols 90% of our phenotypes.
10% obviously is going to beour genotype, what happens to

(01:14:34):
us, but 90% of what happens tous over the periods of our
lives, and we have that on twinstudies showing the epigenetics
of twins, how dramatically anddrastically it changes based on
lifestyle, etc.
Sleep, diet, nutrition, sunexposure, smoking, stress, all
of those things.
So from a cellular perspective,different things can happen

(01:14:59):
even to twins throughout theaging process of their lifetime.
And part of it is skin quality,connective tissue quality, all
of those things.
So if that is true, that meansthere should be ways to either
slow that process down, and nowwe have the science from the

(01:15:23):
anti-aging science, which is notthe word anti-aging that we
hijacked in the aesthetic world,which is you know exosomes and
fillers and that.
That's not true anti-aging.
I'm talking about anti-agingfrom a cellular perspective.
That's in its own specialtythat evolved in the 90s in a lab
in MIT, where they describedthe hallmarks of aging from a

(01:15:47):
cellular perspective.
So now we have science from acellular perspective that we can
reverse aging, we can reversethe epigenetic clock.
And so if that is true,couldn't we use that science and
implement it on what we aredoing, whether it is

(01:16:08):
preoperatively to improvesurgical outcomes, improve
tissue composition, and therebymake our surgeries more
effective, but alsopostoperatively improve the
longevity of our results andneed for revisions earlier
rather than later.
So these are questions thattoday I'm asking myself.

(01:16:29):
I spend a lot of my time divinginto, and I've really stumbled
on really fascinating data andtrying to connect these two
worlds together in justimproving not only our results,
but also their longevity.
So I believe that this ispossible based on science that
already exists since the 90s.

(01:16:50):
Yeah.
So none of well, so let's verysimply put, very simply put,
you're the collagen compositionof our skin.

Speaker 1 (01:17:01):
No, no, no, it's not like that.
You can't do that, though.
It's not simply put.
So like the the only way to endworld hunger is ultimately to
like destroy the world.
Like there's not gonna be anyother good way to do it, but
that's the definitive way to doit.
When you look at cellularaging, there has been no it's so

(01:17:21):
complicated.
And you being you being thegenius you are, and the other
guy being the genius he is, puteverything you know together for
the past hundred years, andit's still not one one millionth
of what's happening with aging,not one one millionth of what's
happening.
Yet we look at a study fromIsrael and say, hey, the
telomeres are longer, and thenthey get shorter slightly when

(01:17:43):
we do hyperbaric oxygen.
That's one of a million thingsthat are happening, yet we saw
it change and we saw it getlonger with aging.
Does that mean at all in anyway that reversing that and
shortening it reverses aging?
We don't know that.
We don't know that.
But I'm saying, so the onlyway, let's say, to do this

(01:18:04):
reprogramming of global cellulardata global, it's not one.

Speaker (01:18:10):
Absolutely, it's every cell in your body.
What's good for your skin isgood for your heart, brain,
lungs, everything.

Speaker 1 (01:18:15):
Yeah.
So to achieve that, you'd haveto pretty much destroy the
world, or you would have to goback so far in the past at this
point with what we know, you'dhave to go so far back to pretty
much when they're a fuckingneonate or you know they're an
embryo and reprogram them atthat point.
Are you willing to go reprograma cell of a baby in case

(01:18:36):
they're possibly gonna get olderfaster cosmetically and look a
little older?
No.
Is there anything in betweenthat can reprogram cells at a
local level on the face?
How would you ever achieve thatunless there was something
causing the changes other thanthis lifelong genetics?

(01:19:00):
So, how would you go andachieve that?
To say, I'm gonna reprogramyour cells to do something
different, your fibroblasts arevery specifically gonna go back
and change the ratio of elastin,collagen, and the crosslinking
that they're putting in.
So, not that little things arenot impossible to improve.

Speaker (01:19:20):
Well, to that to your point, have you heard of the
Yamamoto factors?
You know, Yamamoto is a thisJapanese scientist, he got Nobel
Prize, I think, in 2017 or 18.
No, so it's basically, I thinkhe discovered uh four genes,
like a four-gene cocktail thathe used directly uh used to

(01:19:43):
directly program adult cells inbone forming cells, and he
basically was able to reverseand uh cellular aging through
reprogramming the cells throughthese four genes that are called
oh sorry, Yamanaka, Yamanakafactors, and so and and so

(01:20:06):
there's a lot of it.
This is sounds like sciencefiction that is actually
happening.

Speaker 1 (01:20:11):
So I don't know where all of that ends, but I think
you can do directed stuff,directed, directed things to
reprogram an area.
Even definage technically doesthat.
Definage, you know, goes andsort of redirects the base of
the follicle to make every setof hair skin.

(01:20:31):
So yeah, the little directthings, yeah.

Speaker (01:20:34):
So so so my quite that but but my point is this.
But my point is this we don'tnecessarily have to destroy the
world.
My point is there is somescience that right now sounds
like sounds fiction, but it ishappening.
So I think there's so much moreto be explored, and I'm just uh
trying to understand and learnmore.
And to the very least, I thinkwe can improve patients that are

(01:20:57):
not let's just say quoteunquote healthy because without
diving deep into what nothealthy really means.
I mean, this could be anywherefrom bad nutrition, bad sleep,
stress, uh low vitamin D levels,anything, what whatever that is
that actually hurts tissue,where we know from studies, and
a lot of the studies are in theburn literature, they're in the

(01:21:19):
orthopedic literature, and howthose things affect healing,
tissue quality, tissuecomposition, etc.
I'm just uh right now inresearch mode trying to identify
what do we know currently inbasic science that we haven't
really considered applying.
And I understand it's hard inour field to conduct this type

(01:21:41):
of research because it would beunethical.
And you can't even do a splitstudy, split face study, because
it's a whole organism.
And using different populationis also there's so many
variables, like you said, thatare involved.
But yeah, I just wanted to pickyour brain, see if if if you
ever considered or even wentdown the rabbit hole, even for

(01:22:03):
yourself, because that's how itstarted for me.
I just wanted to see what I cando more for my health without
without listening to this uhnoises from the wild west with
all these uh peptides and theseall these gimmicks that they try
selling uh and promising peopleanti-aging and reverse aging

(01:22:24):
and that stuff.

Speaker 1 (01:22:25):
Which is curious about I'm curious about all of
it.
It's just the body tends to notwant to be fucked with.

Speaker (01:22:33):
So that's you know, so I I I just I just finished
writing a book on this topic.
It's about 300 pages, and Ijust got a book deal, so it's
gonna be published next fall,unfortunately, not anytime soon.
But I'll give you an earlymanuscript because you're one of
the people that I trust youropinion dearly and just to you

(01:22:56):
know hear your opinion about it,because I need people to not
try to please me and tell mewhat I want to hear.
I want people to ask me toughquestions and be critical
because I think only that way wecan solve problems and rather
than tooting our own horn oreach other's horn.

Speaker 1 (01:23:15):
Yeah, I'd love to read it.
Yeah, so I'm always curiousabout it.
And I'm always curious, I'mcurious about these peptides,
and I'm curious about peopletaking growth hormone, and I'm
curious about hyperbarics, I'mcurious about ozone, I'm curious
about all this stuff, and Iread about it.
Ultimately, it's like so muchjust genetic.
Not that it's impossible to fixthings, but then you see like

(01:23:35):
like the body has a tendencyjust to correct itself when it
wants to.
Yes, it does.
Doesn't mean we don't find ayou know cure for cancer.
So there are gonna be thingswhen you know that does happen.
So 100% I'm curious about itand want to learn about it and
read about it, and I think it'sgonna have to spend cancer,
preventing cancer, is mucheasier than curing cancer.

Speaker (01:23:55):
I devoted two years of my career in cancer research and
I got frustrated, it didn'tmake sense to me.
I'm like, why don't we just tryto prevent it?
Because preventing is is mucheasier than trying to cure it.
But what's your take onhyperbaric oxygen post op, other
than for a patient that hasobvious vascular compromise,

(01:24:18):
meaning necrotic skin?
Like, let's say for a faceliftthat went really well, a
non-smoker, you don't anticipateany problems.
I I know people uh patients askme about it because people
advertise it on their socialmedia, on the internet, that
hey, we do hyperbaric auctionfor all our patients.

(01:24:39):
What's your take on this?
Well when you science.

Speaker 1 (01:24:43):
Well, science is different than what I think, but
I'll tell you both.
Or experience.
What's your experience?
Yeah, every facelift isischemic.

Speaker (01:24:52):
But does it require intervention?

Speaker 1 (01:24:55):
All of them do.
It's like they're all ischemicsurgeries, it's just as a
clinical ischemia or subclinicalischemia, they're all bad.

Speaker (01:25:02):
No, my question is because the body knows how to
adjust and adapt, yeah, do weneed to does it require an
additional intervention or extrahelp from us in form of
hyperbaric oxygen, for example?

Speaker 1 (01:25:15):
Yeah, need no, should you, probably.
The data or research is more onyou know 2.5, 3 atmospheres.
Yeah.
Uh and that's you know, for forfor and you do get vascular,
faster revascularization oftissues.
So that does happen.
What we're using is 1.82atmospheres.

(01:25:38):
And what I'm seeing is for mostpatients, not everyone, most
patients, do tend to heal fromwhat it looks like for the
patients that didn't, a littlebit faster on average.
And if they have any littlebits of congestion on the
lateral flaps, they tend to justresolve faster.
And it's, I don't really getit's not like a ton of
congestion, but there's littlechanges that you see or

(01:26:00):
exaggerated cap refill where yousee you know a little bit of
hyperemia and it's justshouldn't have even been there
in the first place if you hadgood inflow and outflow.
So I feel like that resolvesfaster.
So as a requirement, no, Idon't require anybody to do it
because I don't think it's makeor break.
I think they'll survive finewithout it.
But it it for healing purposesof speed and then that little

(01:26:24):
bit of congestion and whateverelse, and maybe decrease
remodeling in the future, maybe.
I like to do it for thatreason.
And when we do it, we usuallydo five sessions minimum, two
atmospheres, and then they cancontinue and do more than that.
How do you space the sessionsout?
They do it every day or everyother day, or you know, if it's
Saturday, Sunday and it'sclosed, they just go back on

(01:26:46):
Monday.

Speaker (01:26:46):
What do you think about photobiomodulation like LED
light therapy, whether it ispost-stop or at home for
patients that want to use anyanti-aging modality?

Speaker 1 (01:26:57):
So, yeah, I so most of LED light emitting diodes are
gonna be in the visible lightspectrum.
And as you get towards the redspectrum of longer wavelengths
and towards the 700s, let's say,you can get some photon energy
passed in through the skinbecause it's a taller
wavelength.
Realistically, if you wantedthe best, it would be infrared.

(01:27:20):
Infrared light, which is thewhat the original studies were
done using diodes.
So you they were using diodes,whether it was light emitting or
not, they would use diodes andplace them on like a rat who had
a stroke or a mouse that had astroke transcranially, and it
would show faster healing of thestroke or regeneration where

(01:27:42):
the other mice still haddeficits.
It increased cochlear bloodflow, it helps chronic back
pain.
So those are like the data forevidence for it.
Most of the panels are notinfrared, unfortunately, but
they're in the high red spectrumor red and orange, but they're
high red spectrum.
And I think what you You do seeis a little bit of a skin glow

(01:28:04):
that happens with it.
What that translates to, I haveno idea.
There's nothing wrong with it.
And at the very least, let'ssay you're doing full body
panel, it relaxes people.
And when you have more, and itdoes relax people, it's
interesting how it does that.
I don't know how, but itrelaxes people.
And when it does, you havesomebody who's more relaxed and
healing and feels a little morepeaceful.

(01:28:25):
And I think it's good for thatvery vague reason.
Blue light for acne and youknow, all this and that makes
really no sense, but it's notharmful at all.
So they can go ahead and useit.
It's not like ultraviolet, it'sjust blue.
So they can use it, it doesn'tmatter.
But if they're gonna really useinfrared, you have to have it
contact your body pretty much,because otherwise the light, the

(01:28:49):
amount of energy they put intoit's not gonna be strong enough
to really have to be very closeto contact to actually penetrate
through the dermis.
And that's why they're usinginfrared, is because it's taller
wavelengths.
I don't know if most peopleunderstand that.
It's not like the people whothought about the blue stuff for
acne, like I don't thinkthey're getting why infrared is
used.
It's not that every spectrum oflight has a benefit, or else
you just shine light on theface.

(01:29:11):
That you know, that's such acrazy thing.
We're like, well, blue is usedfor this, green's used for that,
red.
No, you could just shine awhole light if you want all of
them.
Broadband light doesn't helpyou.
It's infrared, which has ataller wavelength, which is able
to actually penetrate into theskin and deposit energy.
Now, well, it whether it'saffecting what they thought in

(01:29:31):
the past was like neuropeptide Yor certain other direct things
that it can like hit, who knows?
The data wasn't very strong forthose things.
The the mouse study was thebest one.

Speaker (01:29:41):
Yes, I I saw that one.
And again, a lot of thesestudies are on animals, so it's
only extrapolated to humans andalso on really compromised
organs and cells versus we useit a lot, not so compromised.
We're just trying to reverseaging.
So I think there's a lot ofresearch to be done there.
Well, a couple of we'll finishit off with a couple of rapid

(01:30:04):
fire questions.
So this is kind of like morefun.
So you ready?
Yeah.
All right.
One procedure you you performmore today than five years ago.
Oh, rapid fire.
Well, TOSIS repair for sure.
TOSIS repair.
One procedure you perform lesstoday than five years ago.

(01:30:25):
Lift.
Lift coming from that's for agood reason.

Speaker 1 (01:30:30):
Yeah, I know.

Speaker (01:30:30):
We talked about it.

Speaker 1 (01:30:32):
But it's not just because I don't like it, it's
because I have morecontraindications.

Speaker (01:30:35):
By the way, have you seen uh Teo's Scarless Liplift?
Yeah.
What is that?

Speaker 1 (01:30:40):
Is that he does it intra-orally, or how does he uh
he's keeping it top secretbecause he they tend to
plagiarize you a lot.
Even my friends plagiarize meall the time when I like teach
something and then they want tofeel very relevant, and so they
take it and go publish hisclasses.
Like, oh yeah, I have myfriends doing it right now,
you're like renaming stuff andlike oh my god, going buckwild
worldwide, trying to like talkabout it before I publish

(01:31:02):
because he just like is soexcited to be relevant.
Are you serious?
Yeah, it's fine.
So he doesn't talk about it,but what he does is makes an
intranasal incision from behindthe sill, releases the muscle
from the skin, hikes a stitchdown, and compresses the top
part of the muscle, lifting itup, which then widens the nasal

(01:31:23):
base, so yes, and narrow thenasal base somehow.
So that's essentially what he'sdoing.
And I don't know about mobilitysensation.
My assumption would be theydon't have too much of a
negative effect if he's justgrabbing the top five
millimeters if he's limited onwhat he's doing.
So it might be a cool thing ifit's not causing bunching

(01:31:45):
either.
So uh he just won't talk aboutit yet.
So we'll wait till he talksabout it.

Speaker (01:31:50):
Interesting.
Most underrated anti-agingintervention.
Nanofat.

Speaker 1 (01:31:57):
I agree with you.

Speaker (01:31:58):
Because I don't think people understand how to use it
either, and they don't know theit's it's bizarre even though
it's been out for years.
I mean, it's almost almost adecade.
Like I've been doing it for adecade, so that's that's the one
thing that's bizarre.
And everybody oh, anyways, mostoverrated anti-aging
intervention.
You knew that was not common.
Yeah, the like biostimulators.

(01:32:21):
Biostimulators for people,yeah.
I mean, I think gosh, that's awhole can of worms here.
If if should we go into it realquick?
Yeah, all right, let's forgetit, guys.
Don't worry about it.
Don't do whatever when peopletalk to you about
biostimulators, say thank you,no.
It's biostimulation, notregeneration.

(01:32:42):
But but that's another conceptflaw in itself.
There's so many concept flawsin it.
They treat them as the same,they're two different things.
Exactly.
One thing every surgeon shouldlearn outside of surgery.

Speaker 1 (01:32:58):
The well, I would say there's so many things I'm
learning right now, but it wouldbe like longevity for your
body.
So like stretching and tryingto do that kind of stuff.
Because I'm going downhillfast.
So I would say that.

Speaker (01:33:13):
Well, you yeah, I'm sure you're not sleeping much,
uh, all the stuff that you'redoing.
Yeah, um one thing everypatient should stop doing
tomorrow, please.
Public masturbation.
Okay, tell me tell me anotherthing other than public
masturbation.
Yeah, so uh now you gotta tellme two things.

Speaker 1 (01:33:34):
Yeah, stop doing tomorrow is I I I I would say
trying to fix every little tinything on their face with
fillers.
Like fillers are great, theyare not meant to fix everything,
and if you keep doing that,you're just fucking yourself up
permanently, permanently.
It can't be fixed.
Like, they gotta calm down.

(01:33:54):
Fillers are great, it's justcalm calm down, it's only for
little tiny stuff.
I agree with you, it's a gel.
Like I agree with you 100%.
It's a gel, like even doctorsdon't realize it's a gel, like
it's a gel.

Speaker (01:34:11):
You realize we're talking about gel.
Yeah, you realize you'retelling me.
So, what you're telling me, youcan lift the face.
In other words, you can dividegravity and tension with gel.
With gel, yeah, withwater-based gel.
You realize that what you justsaid, yes, yeah.
It's it's yeah, anyways, wecould I could talk to you for

(01:34:33):
this maybe on drink or a beer orsomething when I'm over in
California.
We can uh rant over it.
Last question Porsche orFerrari?
Uh Porsche.
Oh, thank you.

unknown (01:34:45):
Thank you.

Speaker 1 (01:34:46):
That's an easy one.
Yeah, for Ferrari classically,the beauty is nuts, but the
classic days of Ferrari are, asyou see, far gone at this point.
Oh my god, did you see thatelectric thing?

Speaker (01:34:57):
What the hell?

Speaker 1 (01:34:58):
It's beyond, but it's not just that, it's also the
past like eight cars they'vemade are just they've lost it.
The F8 Tributo and the maybethe super fast were the last
two, but really the the F8Tributo was the last one, and
then after that, just downhill.
Like do you think someone'sgonna get fired over this?
The whole company needs to getreplaced.

(01:35:20):
Like, what kind of morons wouldbe there allowing this to
happen in Ferrari, which was oneof the leaders in beauty of
cars, and they don't makebeautiful cars at all anymore.
They're just like fucking bulkyand ugh, they're weird, and
people like it because of thebadge and because they're gaudy
and big, but like that's notsexy, and same with like the new
Lambos, like it's not sexy tohave a giant blocky jet fighter

(01:35:43):
event out there.
Those days are over.
Like the little jet fighterchange they made on the Kuntash,
that was it.
You did it, it was cool at thetime.
Don't get stared away.

Speaker (01:35:52):
Yeah, don't get stared away.
But I feel Porsche is is goingdown the same route, then which
I don't like.
I don't like how big the 9-11shave gotten.
I think they're getting toobig, and I feel they're losing a
little bit of a character.
What do you think of the newones?

Speaker 1 (01:36:07):
Yeah, I mean they're they're they're cool.
I know you're classic, I knowyou're a classic guy, but yeah,
um, I think it's fine thatthey're getting bigger just
because we have the classics.
That's so you know, youappreciate the classics for
that.
Like I have my little 964 andmy 356.
I could park them into like oneparking spot.
They're so small, yeah.

(01:36:28):
So we have the classics, it'sfine.
You know, the the the new onesare getting this big fat ass on
them, so it's kind of you knownice that it's but the
price-wise, they have they kindof have to also get more of a
substantial look to the carbecause they are getting into
close to Ferrari territory now.
So it's like you do have tohave a substantial looking car
when you're doing that, and itcan't be a little dinky.

Speaker (01:36:47):
Yeah, true.
Did you know that 70% of allPorsches ever made they're still
alive?
Yeah, I wouldn't doubt that.
70% of every 9-11 ever made isstill on the road.

Speaker 1 (01:37:01):
Plus, because up to you know, up to 93, 94, I said,
Oh no, even 95, they're theywere all you know, from 70 till
then, they're kind of like notthat different and
interchangeable, and you canback up.
Until 98, they're allair-cooled, same engine concept.
And it was cheap to redo them.
Yeah, the 993 kind of took adifferent direction before, even

(01:37:23):
though it was air-cooled.
But the rest of them are allvery similar and also cheap,
they're super cheap.
Even a 993 is cheap to work on,it's not expensive.

Speaker (01:37:30):
I know, I have one.

Speaker 1 (01:37:31):
Yeah, yeah.

Speaker (01:37:32):
It's you can always fix it, you can drive it in
perpetuity as long as you fixit, you can rebuild the whole
engine.
So, are you gonna be when areyou gonna are you ever gonna
choose between plastic surgeryand cars?
Like if if the if the cardealer thing, trading thing ever
becomes more attractive.
Do you think it's ever gonnabecome more attractive as far as

(01:37:53):
lifestyle or just yeah?

Speaker 1 (01:37:56):
I mean, I'm I'm I'm kind of at the point where I'm
happy with the cars that I have,so I don't have a need to
develop like a bigger collectionor anything, and all my cars
are kind of the best drivableones, anyways.
Like, let's say I wanted aMaserati MC12, which is like my
top dream that I don't thinkI'll ever be able to get.
Why can I even the prices areastronomical, and like I'm I I

(01:38:19):
can't do that, so but would I bedriving it every day, you know,
all the time?
No, probably not.
But the dealer thing is funbecause a door ding on it.
Yeah.
Being a dealer is cool becausethen you can experience these
cars for a little bit.
Like you know, you can have it,stare at it, look at it, and
while you're you know, while I'mgetting the car dialed in, it's

(01:38:41):
me driving it.
It's like so you you drive it,see what's wrong with it, go fix
it up, drive it, see what'swrong until you get it dialed
in, and then you have that carsitting there for a while, and
then you sell it for more thanyou bought it, and then you go
on to the next one for the onesthat you don't have to keep, you
know, forever.
The ones you have to keepforever, then no, those aren't
gonna be dealer cars, those aregonna be like your regular cars
that you just have as part ofyour collection.

(01:39:01):
But yeah, I would love to.
I've always wanted to have likesome kind of exotic dealership
or something, just like stereocars.

Speaker (01:39:09):
Where did that come from?
You ever since you were a kid,or where did your passion for
cars came about?

Speaker 1 (01:39:13):
Car obsessed from childhood.

Speaker (01:39:15):
Me too.

Speaker 1 (01:39:16):
That's it's it's it's unhealthy.
It is unhealthy, but it's fun.
It's it's really my mom hasbeen my mom.
My mom says, Benny, Benny, goand said buy a house, buy a
house instead.
I'm like, mom, the value of mycar has gone up to a much
greater extent than your househas, and my car did it.

Speaker (01:39:34):
Ever will, ever will.

Speaker 1 (01:39:37):
Oh yeah, yeah.
But my did it in five years,hers has been 20 years, and mine
went up faster.
And I gotta drive it and stareat it.
I think COVID, how much do youthink COVID helped with those
car values?
Substantially, but also nowthere's a big move being made in
the watch world and the carworld, and I'm pretty sure it's
it's side parts of these bigbanks as part of diversification

(01:40:01):
strategy.
Yeah, so what they're doing isthey're buying up a ton of the
stuff in the watch market, andthey're they're pretty much
bidding up everything maximallyand taking it at the max bid.
And what that's doing issetting the standard higher so
that what they're doingessentially is seeing what the
market will tolerate.
They call it bringing things tomarket value.
So they would bring these cars.

(01:40:23):
Let's say someone, you know,you didn't know that someone
would pay an Enzo because outthere the market is set at three
mil.
You didn't know someone pay $10for it because you have to be a
psycho until you get to thatauction and you push and you
push and you push and you seewhere that breaking point is.
And the next auction you do it.
You do that for two auctions,three auctions tops, big ones
where everyone has their eyes onit.

(01:40:44):
You've set the new marketprice.
So these guys come in and theysee how far they can push it.
And in doing so, they've setthe new market price.
And then they'll it'll justkeep going up after that,
depending on how many cars arefloating.
You know, like you can'tnecessarily do that with an F40
because our 1400 people aregonna pay four or five million

(01:41:06):
for that car at this moment,probably not.

Speaker (01:41:08):
Yeah, you can do on one on one of ones or one of one of
two.
But who knows?

Speaker 1 (01:41:12):
But they're doing it with Enzos, F-50s, so they're
doing it with all the main maincars.
I'm hoping they do it with amirror.

Speaker (01:41:18):
So the banks, so the banks are doing it?
I didn't know that.

Speaker 1 (01:41:21):
That's that's what I've heard.
That's what I've heard is theit makes sense though.
I mean, it uh it private equityor the side funds of someone
was telling me which onesbecause definitively they were
doing it in watches, and thenthey said that's probably what
happened.
There was a big auction, ameekam auction last year, where
all these prices were like two,three X of what they should have

(01:41:43):
been.
And then the next auction wentkind of high too, and that sets
the new standard.
Now, why did that aberrationhappen?
Well, the nothing else changed,production didn't change, or
you know, the the amount inflotation didn't change,
circulation.
So, like, what else changed?
Nothing is the strategy ofthese guys to come in and bring
everything to market value,basically.
Meaning everything to thetolerable level of the market.

Speaker (01:42:06):
So that answers my question, which was is this
bubble gonna burst or gonnacrash?
Based on this theory, it willnot because this is what now the
true market value is.
Like the consumer decided thisis how much it's worth.

Speaker 1 (01:42:22):
Yes, but but it depends.
So if there's a thousand carsand only five consumers that
would pay that much, then you'regonna burst five of them.
So, well, after five of themthat were those were so they'll
watch who's bidding, right?
You'll see who's bidding onthat watch or who's bidding on
that car.
And if there's five peoplebidding, you know the market has
at least five people, five morepeople that are gonna pay that

(01:42:44):
exact amount for an enzo.
So now you know you can do fivemore sales and profit five
million dollars each sale basedon that one auction.

unknown (01:42:52):
Wow.

Speaker 1 (01:42:53):
And you know, that theoretically, that's what
you're thinking.
But there's only one personbidding against you, that's not
a great market.
But they can see that.
So hopefully it bursts becauseotherwise I can't buy anything.

Speaker (01:43:05):
Yeah, what I love about classic cars is that it's an
investment if you buy the rightcar and you get to use your
investment because you get todrive it too, so you get to have
fun with it, as opposed tobuying some real estate or
buying a bunch of stocks that'ssitting there and you can't do
anything with it.
So but personally, I mean, Imean, how I mean, what do you

(01:43:26):
live for?
I think you have to ask yourquestion, you know, what do you
live for?
Are you gonna put money intoyour grave or are you gonna
enjoy it while you can?
And so that's why, you know,and for those of you who want to
see Ben's cars, go to atmouybeno, m-y, double y B E N N
O, right?

(01:43:47):
Uh and I love the fact that yougive every car a name that has
the word Ben built into it.
That's hilarious.
How do you come up with that?
How can you come up with thenames?

Speaker 1 (01:43:58):
I have a list in my phone of Ben license, it has to
be seven letters.
Uh oh, it has to be seven.

Speaker (01:44:04):
Why seven?

Speaker 1 (01:44:05):
That's all.

Speaker (01:44:06):
Oh, because of the, yeah, yeah, yeah.
Got it.

Speaker 1 (01:44:08):
And so those were on my plates before I came a
dealer.
Now that I'm a dealer, I havedealer plates, but before that,
those were on there.
And so now I just have it onthe rim of the plate, on the
plate frame.
But yeah, there's yeah, muyveno, benissimo.
I love it.
It's hilarious.
Penetrate, pendejo, there'syeah, and it matches the
character of the car.

Speaker (01:44:27):
That the it matches the personality of the car.
So if you're a car enthusiast,you're gonna have a blast going
on this page.
Ben, thank you so much foreverything you do.
I really uh appreciate youcoming on and spending so much
time.
Your first podcast with me wasone of the top three most
listened to podcasts.

(01:44:48):
And and even though we'realways geeking out, many people
like to tune in.
And your charisma, yourcuriosity, your straightforward
shooter, and it's very inspiringto me.
I learned so much from you.
And I I'm I'm so fortunate to Ihope I can call you a friend

(01:45:08):
and uh and mentor, and so stillhave to come and visit you in
Beverly Hills.
And thank you so much, myfriend.
And yeah, and uh excited to seewhat you're gonna do next.
My pleasure.
Thanks.

Speaker 1 (01:45:20):
And yeah, the definitely come over here and
you'll see the the updates.
I put some of the updates onthe Cupid Compendium, the video
library.
So some of the updates arethere anyways, but like you
gotta come.

Speaker (01:45:32):
And I have to see the cars, I want to see every one of
them.
Right here.
I know.
I know, okay, buddy.
Thank you so much, my friend.
Have a good weekend, and um,yeah, everybody, thanks for
listening in.
Sorry we geeked out a littlebit on the facelift stuff, but
um that's what happens when youlisten to me and Ben.
And um uh hopefully you gotsome value out of this

(01:45:55):
conversation.
And if you have any questions,just put it in the comments on
Spotify.
And please don't forget toleave me a review on uh Apple uh
iTunes, Apple Podcasts, andalso you'll be able to uh view
the podcast on YouTube uh as wehave uh as Ben demonstrated a
lot of uh nuances in uh faceliftsurgery where we used a lot of

(01:46:18):
terms, but uh he was showing it,and so you will get more battle
watching the YouTube video.
Thank you everyone, and untilnext time, bye bye.

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