Plastic Surgeon Breaks Down the Myths of Botox

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
As a plastic surgeon. You know, there's so much stuff
out there. What works, what doesn't, what's real, what's fake?

Speaker 2 (00:06):
A cebo effect? Do you think women are more prone
to bind into that, hopefully see bow effect? Because I
think I might be one of those people. There's some
of the biggest questions you'll get, and you know what,
I'm just gonna full disclosure here. Why don't you just
show where you put a little bit of filler in
my face.

Speaker 1 (00:23):
And that makes her look happier? Because this is not
a happy pa.

Speaker 2 (00:27):
It's not a happy face. Let's talk about the Michael Myers. Okay, nah,
because I love this thing so much because it's creepy,
but I wanted to know if it works, it looks,
it looks good. Hi, I'm Leslie low Welcome to Leslie's
Low Down on Life. All right, everybody, welcome today. I'm

(01:02):
always excited about my guest, but I'm super excited about this.
This is my good friend, doctor Chad Wheeler. He's one
of the owners of Plastic Surgery Northwest. I'm going to
just go ahead and forewarn you it's probably going to
be a long conversation. Were actually want to invite you
into to ask questions because when we do our next podcast,
we want to be able to answer some of those questions.
So we're hoping this is kind of a reoccurring thing

(01:23):
that we set up and do hopefully.

Speaker 1 (01:25):
And thank you so much for letting me come on
and just help to dispel some of the myths and
talk about things that a lot of people ask you
about and ask me about. Obviously as a plastic surgeon,
you know, there's so much stuff out there. What works,
what doesn't work, what's real, what's fake, what's a waste
of money? Yes, you know, and just this, I'm sick
of misinformation, especially in social media where people who don't

(01:50):
know anything, they're an influencer, which just means they have
a lot of followers and they they'll be on there,
like Kim Kardashian was on there talking about how she
loves her Morpheus eight laser. Like that's not even a laser,
Like what are you talking about? Right? You know if
that's RF micro needling, which is something totally different. And
but this expert now everyone wants this Morpheus eight laser

(02:11):
and they ask me, where's your Morphias eight laser? I'm like,
we don't have a morphia S eight laser. There's no
such thing, you know. So, like I'm just tired of
all of the misinformation.

Speaker 2 (02:19):
That's you're going to help us debunk everything to.

Speaker 1 (02:22):
A degree, right, yeah, yeah, at least you'll have an
expert talking about things in a nobs kind of way,
where like I want people to have the best bang
for their buck. I want them to actually see the
results that they paid thousands of dollars for or save
their money, you know.

Speaker 2 (02:39):
And that's what I love. Yeah, I love that because
as a woman who's going to turn sixty in a
few months, sh don't tell anybody that she looks for
Thank you, thank you, I'll pay you later. It's one
of those things like aging, it's a blessing and right,

(03:00):
we want to get older because that means we get
to get older and some people don't. But then we
get older, and then we're are we supposed to be
ashamed of getting older? Should we feel bad about getting
older as females? I think I'm sure males to a
certain extent too, But I think there's a lot of
that spotlight on females and the whole Hollywood thing. And

(03:20):
you're done at twenty nine and you're no good anymore.
And so we like, for me and then a lot
of my girlfriends, we're scrolling. We're looking for the next
best thing. What can we do? How can I do this?
You know, there's the botox and the fillers, which I've
been very open about. Yes, I've done both.

Speaker 1 (03:38):
So I've done filler yet we can talk about male
versus female agent.

Speaker 2 (03:44):
Right.

Speaker 1 (03:44):
I definitely do botox. So if I try to scowl
at you, I can't really do it because the muscles
between my eyebrows have been paralyzed. But a lot of
people think that if you get botox, you're going to
look like you can't move anything, and that's just not true.
I can raise my eyebrows, you know, I can smile,
I can do whatever. But you know where I botox,
I get rid of the angry lines so I won't
be a grumpy old man when I'm older. And I

(04:07):
also help with my crow's feet, and I'm doing that
mostly to try and get my eyebrow to elevate because
I have extra skin on my upper eyelid from my
eyebrows coming down. And if I tried to do surgery
on myself that'd be hard. But if I had somebody
do surgery on me to do a brow lift, and
a man, that's hard because you don't have anywhere to
hide the scars. So I basically I could have a rowllift,

(04:31):
but I would have a pretty noticeable scar where a
female you can hide it in the hair. So the
only thing I can do is try to prevent the
lines in my forehead from getting a lot deeper by
trying to get my eye to open up by taking
away what's pulling it down mediately and laterally along my op.

Speaker 2 (04:44):
Okay, so let's talk about that. Let's talk about the
bowtox from the fillers, and the difference between men aging
and women aging, and when people should start getting botox
and fell I'm really paying attention to our skin and
our skin care.

Speaker 1 (04:58):
I would say the number one thing to do, especially
for youngers, to start with the good skincare regiment. The
skincare regiment should include some version of retine retinol that
thickens your skin so your skin cells turnover in about
one hundred and twenty days, and those products take your
skin cells from a one hundred and twenty day turnover
to a ninety day and so having that shorter life

(05:19):
span of your skin cell makes your thick healthy layer
of your skin have to be about twenty five to
thirty percent thicker to keep up with that higher skin
cell turnover. And so when you look at people who
have like naturally very glowy skin, they're probably using a
product like that which helps that. Now a lot of
people can't tolerate it because it makes their flace irritated initially,

(05:40):
so and they don't know that, so they start using
this product. Three weeks into it, they're like, oh my god,
this stuff is crap and my face has never looked worse. Well,
it's because you're having ninety days worth of breakouts and
peeling and flaking and all that sort of stuff until
your skin is then reset and the skin cell life
server's turned over more quickly. Then you're gonna have less
of all of that for the.

Speaker 2 (05:58):
Rest of your life, which is past.

Speaker 1 (06:00):
So that's one of the key things for really young
people for botox. I say to start that when you
are noticing lines of animation that you don't like when
you're not animating. So what I mean by that is
like you're trying to make an angry face and the
lines are appearing between your eyebrow, and then you don't
make the inervac and you can still see who those
lines are. You don't want those lines to be there
all the time when you're older, they're going to be

(06:21):
there all the time if you don't botox. So when
you're young, you can do it where you don't get
those lines, and you'll never get those lines, So botox
start twenties thirties, or whenever you're seeing the lines of
animation that you don't like. Filler is usually late twenties
early thirties. A lot of young women are doing filler
for their lips because they want their lips to look fuller.
And the reason they want that is because they're using

(06:42):
filters like on Snapchat or Instagram or whatever that makes
their lips look bigger. And then when they look in
the mirror they see a picture of themselves that doesn't
have the filter on it, they don't have those full lips,
and they're like, oh, so then they feel like their
lips are small. So younger women are getting fuller in
their lips to have the look of their filters. Older
women should get filler in their lips in order to

(07:03):
help prevent some of the oral peri oral aging, where
the vertical lines of the smoker lines around their mouth.
If your lips are always pretty full, not overly filled,
but just nice and plump and hydrated looking, you'll get
less of those lines as you get older.

Speaker 2 (07:15):
I'm glad you brought up the filter thing, the camera filters,
because I think everybody's got one on their phone these days,
and you and I had talked about this. I started
getting a complex and feeling really bad about myself because
I would see this picture that had gone through the filter,
and I didn't think the before me looked bad until

(07:35):
I saw the after me filtered picture where it was
like the full lips and the eyelashes and the whole
and then I thought, wow, I really look like crap,
and I started to feel bad about myself.

Speaker 1 (07:49):
Yeah, and it's amazing, right, because you take somebody who
is seeing on TV and has been a personality on
TV for a long time that I guarantee you most
people who watch you or see you think that you
are a very beautiful attractive woman. So here is a
beautiful attractive woman feeling bad about herself all because of
these stupid filters, you know, And that's it's ridiculous. It's

(08:12):
it's hurting our society. So like, I started a thing
on my Instagram months I posted the unselfie. So I
took the most unflattering picture of myself and posted it
and wanted to start like a thing like dag and
share shockingly and not a lot of people posted it unflatteringly.

Speaker 2 (08:25):
Didn't want to do it.

Speaker 1 (08:27):
But I'm just trying to bring back, bring us back
to earth, bring us back to reality. Yeah, the real
If you if you can tell that somebody's had something done,
whether it's plastic surgery or fillers or whatever, if they
look like they've had something done, then it's done incorrectly.

Speaker 2 (08:40):
So that's what I really appreciate that about you, because
you're when you're looking at somebody's face, or when you're
doing filler or botox or plastic surgery, which we'll get into,
I think you're looking at the overall picture and you
don't want to change that look. You will actually tell somebody, no,
I won't do.

Speaker 1 (08:59):
That, oh hundred percent. I probably tell ten to fifteen
percent of the patients who come in to see me no,
whether it's them wanting their lips to be bigger, when
they're already too big, or they come in they just
moved here from LA and they're like, doctor Wheeler, I
just need you to make me a little bit tighter.
And I'm like, tighter, tighter, Are you kidding me? You
need to be looser, you know, So like I just say,
I'm sorry, I'm not the person you're looking for if

(09:21):
you think that that. You know, if you think Madonna
looks good or any of the really overdone celebrities where
it's obviously they've had something done and it doesn't look
normal or good, that's not the look like give me,
you know, Lindsay Lohan with their recent glow up, or
Kim Chris Kardashian, or you know all of the people
who like Anne Hathaway, she clearly had a brow lift.

(09:42):
I don't know for sure, but that's my guess. You know,
they look just refreshed and they click themselves and they're like, wow,
you know that's not olive oil, j Lo. You know,
it's not any of that stuff. It's it's real life
things that do stuff. And I know we're going to
talk about a bunch of the different things that are
out there. Yeah today and hopefully you guys will ask
a bunch of questions so that next time we can

(10:04):
answer whatever the questions are. I do a thing on
my Instagram oftentimes where I say, ask me anything about
plastive surgery, and I usually gettingwhere from twenty to forty
questions that I try to answer, you know, in that
twenty four hour period. But I don't know what this
audience woul probably be.

Speaker 2 (10:17):
I feel like they have the same questions I do.
I really do, and so I really I do want
you to ask the questions because I have so many
of them. It is humbling getting older. I am one
of those people. I am on camera every day, and
again that can be humbling in itself because people always
have something to say, whether it's good, bad, or indifferent,

(10:38):
and whenever you hear the bad, you take it to
heart and it hurts and you tend to linger on
that a little bit longer. But I'm also I just
think in my own personality trait, I want to do
everything I can to take care of myself and take
care of my body and work out and eat well
and then take care of my skin and my face.
And so I'm always interested in what south there the

(11:00):
facials Okay, what's the best facial to get or red
light therapy, which we're going to talk about the Michael
Myers mask which I love so much, or these things
that you can get on you know when you're scrolling
through Instagram and they get there, they're like, you can
tape your neck back so they don't have the what
do we call this the wobble? The wobble. We're going

(11:23):
to try this too. So I'm always looking for like
what is the next thing? And then my girlfriends and
Arrow he's talking about, Okay, what what do you do?
What do you do? What? What have you seen?

Speaker 1 (11:33):
Yeah? So there everybody wants the minim minimal costs, minimal downtime,
maximal results, right exactly. If it sounds too good to
be true, it probably is. So there's a lot of
stuff that's out there that does stuff. Is it worth
the cost that you're going to pay for that or
the recovery? You just have to put it all together.
So like our practice, we don't offer a lot of

(11:55):
the brand new, latest and greatest things out there because
usually what we find is that the hype is not
worth the expense, and so you know, we don't offer
a lot of the things that are very, very very
popular on social media because I want to be able
to stand behind the thing I want. If I can't
see a result, I'm not going to convince you have one.

Speaker 2 (12:14):
Well that's the thing is like, maybe you'll see a
result for a second, but then do you need to
or not or you know these very expensive things that
you can do, facials or whatnot, but then you need
a series of two or three or four before and
then that's thousands of dollars later.

Speaker 1 (12:33):
Can be Yeah, So things that are really good that
you can do are facials. So facials are mostly just
removing the dead skin. It's usually a derma plaine facial
is what we call it, removing the dead skin, giving
the healthy glow and hydrating it. There's something called a
hydrofacial that we also offer, so that's doing that same
thing but then also infusing growth factors and stuff into
your skin. On the very superficial level, it is something

(12:56):
that you should do, you know, pretty frequently. Doesn't cost
thousands of dollars though theyre about one hundred and fifty
bucks or something like that, so it's not super expensive.
One hundred fifty dollars is a lot of money to
some people. But you know something that's really good skin
health and skin care, you know there then there's micro needling.
So micro needling is they take a pen that has
little tea tiny needles, you can barely even see them,

(13:17):
and they poke one bajillion dots into your face that
are just barely through the skin. And what that does
is it stimulates the skin to grow more collagen or
to get thicker, because we're literally damage the skin slightly
and our bodies respond to damage by putting in a
little bit of extra stuff in there. And so micro
needleing is great. It usually is a treatment, usually getting
it every you know, three months or so. It's usually

(13:38):
about three hundred dollars for just regular microneedling. And then
if you want to amp it up, then you could
do something called rf micro needling, which is what Morpheus
eight is, which is what the Kardashians we're talking about.
R IF microndleing is the same thing, except there's a
current in the needle that damages your skin a little
bit more to make it a more intense result and
a more intense thickening of your skin in it probably

(14:01):
adds fifteen to twenty percent to the result, but it
costs usually three times as much, so I would rather
you get three sessions of regular micro needling. If all
you can afford is one session, then one session of
UR of micro needleing. I think that those would be
your three sessions of just macroteiling would be better than
one of r F macanleaning. But if you did three
of our F marcantilean, then you'd have the best result

(14:22):
of all.

Speaker 2 (14:23):
Right, right, the three micro needling is kind of more
bang for your buck as opposed to the one.

Speaker 1 (14:29):
But if bucks are okay, yeah, if you've got bucks,
if you've got bucks, you know, you know an RF micronelen. Oh,
don't ask me about prices. Very well, I think it's
around nine hundred dollars, but that might be too right,
but you know it's usually about double or triple the cost. Yeah, right.
So the other thing that we were talking about the
other day was a vampire facial Right, So this is

(14:50):
you take the person's own blood, you put it into
a centrifuge, you spin it down and the blood becomes
three sections. Three sections, so the red blood cells, the serum,
and then this layer in the middle and that's called
the buffy coat. That's where all of the white blood
cells are, all of the growth factors are, all of
the stimulating, all the good stuff is in that little
thin section of the buffy coat. And we also call

(15:11):
it platelet rich plasma or PRP. You'll probably have heard
of PRP. Yeah, PRP is great. It's your own body's
own like band aid, let's call it right. So like
people will put PRP in the scalp for hair loss,
the will inject PRPR into joints for arthritis, into the
underreyes to help with under eyepuffinus. So when you do

(15:32):
a vampire facial, you take that same product, that platelet
platement rich plasma, and you after you have all the
needles pokes in the skin, you rub that into their
skin so that it has a way to get in. Again,
it adds to the result of the facial or the
micro needling. But again it's two or three times the costs.

(15:52):
You know, if money's no object, do our micantling with
a buffy coat.

Speaker 2 (15:55):
Right, you know, And that is always the I think
the big thing is like the cost of everything, because
we budget for things and plant ahead for things, and
it all depends on what we can afford, what we
want to do, and how far we want to take it.

Speaker 1 (16:06):
But I would say those types of things are really
great interventions for people in their sewing, shines of skin aging,
in the texture of their skin. Right, So not nasal
abial fold, heavy wrinkles, not you know, their face is
falling off, that's all surgery, but like just the skin
texture is starting to look a little bit older. That's

(16:27):
where that's going to fall into place. So if somebody
has a lot of skin damage, it's going to get
a younger age. If they've protected themselves from the sun
a lot, then it's going to be at an older age.
But it's not going to be this dramatic big thing.
It's just your sin's going to look better.

Speaker 2 (16:40):
Okay, what about soft wave, So there's.

Speaker 1 (16:43):
A lot of energy delivering devices that are out there.
Our practice, we don't have any of them. Soft wave
or face tight or therapy or thermage. They use some
sort of energy delivery system, whether that is a laser
or ultrasonic frequency or radio frequency to basically damage the

(17:05):
layer in the skin and underneath the skin in order
to cause it to tighten. My biggest problem with all
of them is they all work, they all do something,
but it's really hard to see that result, and they
all charge thousands of dollars to do it. Yeah, so
if I'm going to pay thousands of dollars to have something,
I want to be able to see a result. And
when I look at the results from the companies where
they have their own before and afters, I can't tell

(17:26):
which is which half the time, and a lot of
times they're using tricks in photography, whether they know it
or not, to make the result looks better. So in
the before they have makeup on, the lighting is different,
the head position is different, and then in the after,
in the before they have no makeup on, the lighting
is harsher and their head position is different. And then
the after they have makeup on, the lighting is better

(17:47):
and their head position is better. And so like, those
are uncomparable results.

Speaker 2 (17:50):
Right.

Speaker 1 (17:50):
So if I look down, I have all this crazy
skin underneath my chin, right as we all do when
we look down. But if I just have my head
slightly more elevated, I don't have that as much. And
that's the before and after, the trying to show you, like,
look what it did to this guy's neck, you're like, Allly,
did is raise his.

Speaker 2 (18:03):
Chin up a little bit and just walk around like that?

Speaker 1 (18:05):
So I don't. All of the energy delivery devices are
fairly expensive pieces of equipment for a place to buy,
and so then you start using it, so then now
you have to make your money back, right, So then
they're selling it to people, and they they usually if
they say something like, oh, the results take six weeks
to two months to see the result, probably by then

(18:26):
you're not going to even notice a change. That already
sell sounds like something that's probably not going to work
very well. So in general, we don't offer a lot
of those things because I just can't stand behind them.
In the experience that I've seen. There's a guy I
follow on Instagram who's constantly challenging all of the machines
out there to, hey, bring me your patient. I will
treat them with standardized before and afters. I will pay

(18:49):
for the entire treatment if you will let me do that.
And no company has taken them up on it. And yeah, no,
because in a standardized photo fashion, you're gonna have a
really hard time seeing a result of it. Yeah, that's
not what I want to sell people. That's not what
I want to help people with. If you spend thousands
of dollars, you want to see a result, not be
convinced that there is one. Yeah, so that's just that's

(19:09):
my philosophy. You know, I'd rather have it heard you
where there is a downtime, or do a intervention that
does do something. You know, like filler. We were talking
about philler earlier. You know, Filler's great. Filler's overused in
the sense that it doesn't treat everything. It adds a
volume back to your face. Part of facial aging is
volume loss, especially as you get older. So adding a
little bit of volume in just the right places looks amazing.

(19:30):
Adding a lot of volume and the problem with skin laxity.
Looks like Madonna.

Speaker 2 (19:35):
Yeah, it looks like plastic face.

Speaker 1 (19:37):
Yes, but if you looked at her from the Grammys
or whatever she was on, yeah, not that long ago.
You know, her picture went viral. I pushed it on
my Instagram because I'm just like wow, because her face
looks rounder than it's ever been, her lips are bigger
than they've ever been. It she doesn't look like Madonna anymore.

Speaker 2 (19:52):
Yeah, she doesn't look like herself, And you just want
to be a better version of yourself. You don't want
to look. Yeah, I just I called it plastic. Nobody
it's that look.

Speaker 1 (20:00):
Yeah, I mean some people do want that look, but
they're few and far between. It's usually people in the industry.
It's usually people who are in show bids somehow where
they've been torn down their entire life, you know, told
that they didn't get the part because they look too old,
or their skin can't play that part, or whatever the
thing is, and so they've literally developed almost like body
dysmorphic disorder.

Speaker 2 (20:21):
You know.

Speaker 1 (20:21):
If you look at Michael Jackson, he probably had five
rhino plastis between when he was born and ever. His
first two were pretty good. They accomplished what he wanted
to accomplish, but he was never happy with it, to
the point that he wore a mask, you know, and
his nose at the end looked absolutely gone awful and
it was still too big for him.

Speaker 2 (20:37):
Which is that makes me sad. That makes me incredibly sad,
because we talked about like the body dysmorphia when we
were talking the other day, and that's a tough place
to be.

Speaker 1 (20:48):
Yeah, I think if you are spending hours and hours
upon a day obsessing about some particular aspect of your
body that is unhealthy. Surgery will not help that. Even
if you fix it, you'll find something else to pick on.
And part of our job as plastic surgeons is to
identify those patients that are basically never going to be happy.

(21:09):
You're going to be miserable when they come in because
they're not happy with anything, and like you basically should
not operate on those people. So, like part of our
tests when we're talking to people is to understand whether
or not they're just too crazy to do it.

Speaker 2 (21:21):
Right right, there's too much of an expectation there, and
they're just never going to be happy because they're just
never going to be happy.

Speaker 1 (21:28):
They're going to be happy, Yeah, And that's ninety nine
percent of plastic surgery. Is not that it is not addictive.
It's you have something that you dislike. You don't think
about it constantly, but every time that photo's taken or
your pictures from the side, you hate something about your
nose or your neck or whatever the thing is. Then
that person where they're not really think about all the time,
but every now and then it comes up. You fix
that thing and they are over the moon happy. They're

(21:50):
usually like, I should have done this years ago. I'm
so much I feel so much better about myself. I
have so much more confidence. You know. That's what we
sell in plastic surgery. We sell confidence, which is what
I love that.

Speaker 2 (22:00):
And if you can afford to do that, and that's
something you want to do, I think that you should
do it.

Speaker 1 (22:06):
I agree with you. I think that if you've hated
this thing about you and you can't afford to do it,
why are we judging people for having that thing done?
If the person goes and buys a coach purse versus
a Louis and Tan purse, the cross difference between those
is thousands of dollars, but they're both just a bag
to carry your stuff in. If somebody wants that one,
great good for them. If the other person doesn't care
that much about it, great good for them. Like, why

(22:28):
are we not judging all of those people about everything?

Speaker 2 (22:30):
Yeah?

Speaker 1 (22:30):
The person driving to Mercedes versus Akia, you know, like
they just that it's important to them.

Speaker 2 (22:35):
Yeah, who cares? So I love that comparison so much.
It's like we're not judging people for the car they're
driving or the purse. But we'll judge them. If we
the judgment is there, I should say, if they've had
any kind of plastic surgery done I have.

Speaker 1 (22:50):
People would say, oh, I'd never do plastic surgery. I'm
just gonna grow old gracefully. Great, right, don't do it.
That doesn't bother you and you don't care about that. Great,
But like for you, like your image is something that
is extremely important to yourself personally, but also for your job.
Your image, and so you know, you get pressured on things.
You're damned if you do, You're damned if you don't.

Speaker 2 (23:08):
It's so true. It is so true every single day. Yeah,
it really is.

Speaker 1 (23:12):
Okay, so scoping cool sculpting Okay, yep, so cool sculpting
is a fast, fascinating is a fascinating thing. Yes it works, Yes,
there could be something so cool sculpting. Basically, how it
was discovered was there was this uh doctor scientist person
up in the Boston area Harvard area whose I don't

(23:33):
remember if it's his wife or his daughter or somebody,
would go horseback riding all the time in the morning,
and she started to complain about having atrophy of the
fat of her inner thighs and he was like, huh, yeah,
I don't know what would cause that. That's that's so weird.
And then he had a different person come in where
this son of one of his colleagues was getting dimples

(23:54):
and nobody in the family ever had dimples, and the
kid was sucking on a popstacle when he came in,
and he like, how often do you eat popsicles? And
he's like all the time. And so we kind of
put these two and two together and he found that
basically fat is exquisitely sensitive to freezing cold temperatures that
so much so that it can undergo reverse undergo apoptosis,

(24:14):
which is cellular program cellular death at a temperature that
is low but not so low that it can harm
everything else. So we spent you know, twenty years developing
this way of basically freezing your fat solid like a
brick of butter, and then about thirty percent of it
goes away over the next several months as your body
reabsorbs that tissue. So coold sculpting does work. It is
a legit thing. There is a tiny chance that you

(24:36):
could get the opposite effect, where your fat hypertro feeser
gets bigger, and that's what has been sensationalized in social
media because there's been a couple of celebrities that think
that that's happened to them, and so then now I
was like, oh, don't ever do it. It's terrible. Yeah,
it don't be the half a percenter, you know, the
other ninety nine point five percent of people. That's totally fine.
But yeah, basically, this machine sticks on wherever you have

(24:58):
extra fat and inste plain it.

Speaker 2 (25:00):
So you can do it like on your arms.

Speaker 1 (25:02):
You do it on your arms, you can do it
on your abdomen, you can do it on your neck.
You can do it anywhere where there's pinchable fat fat. Okay, thighs,
enter thi thighs. In general, you want it to be
kind of like a soft, buttery fat. If your fat
is pretty thick and firm and hard to grab or
has a lot of edma in it, those tend to
be the ones that might hypertrophy. More So, that might

(25:23):
not be a fantastic idea for everyone, but cool sculpting
is cool. It takes about thirty five minutes to do
a cycle. One cycle that there's different size heads, so
depending on how it fits your body, that determines that.
So like if you're doing someone's central abdomen, you usually
do it in a diamond pattern, said be four cycles,
about twenty to thirty percent of the pinchable fat and
your abdomen would go away over the next couple of

(25:45):
months or so.

Speaker 2 (25:45):
Okay, so your body just absorbs it. But then the
fat has to go somewhere else.

Speaker 1 (25:53):
So the fat. So let's say that in your abdomen
you have I'm just going to make up a number
a million fat cells, and you freeze those million fat cells.
So now a thirty percent of them go away. So
now you only have you know, seven hundred thousand you know,
fat cells in your abdomen. Your body has a set
point in your brain about what your weight is, and
so plastic surgery does not accomplish long term weight loss.

(26:14):
I could cut ten pounds off somebody, they can come
back three months later and they'd probably weigh the same amount.
Because your body is saying to itself, I need to
have a certain amount of storage for a rainy day.
And everyone's built differently in how that is, And so
when you take away some of the storage, it finds
a different place to put the storage back. So if
you freeze all the fat on your pinchable skin and
fat of your abdomen. You know, maybe your arms, your breasts,

(26:37):
or your thighs or whatever might get some of that
fat back, and you don't know where it's going to be.
So just keep in mind that plastic surgery is not
weight loss surgery.

Speaker 2 (26:46):
That's so fascinating to me, it really is. That's crazy.

Speaker 1 (26:50):
Yeah, So it's for people who have disproportionate fat. So like,
you should never have anything anywhere because you don't have
any disproportionate fat.

Speaker 2 (26:59):
I was like, oh, you're talking to me, well.

Speaker 1 (27:02):
Okay, so because you don't want to become disproportionate in
some suit, but I.

Speaker 2 (27:06):
Think I have some disproportionate fat.

Speaker 1 (27:08):
Well, I think as a woman, right, you probably hate
all the different areas everybody hates about their bodies as
a woman that society has taught you to hate, and
I hate that about that. But in reality, you're not
disproportionate anywhere. Right. You might not like your arm or
your butt, or your legs or your thighs or whatever
the thing is, but there's nothing that's like sticking out

(27:29):
as like, wow, that is a really full this thing
compared to everything else. Okay, if that makes sense, it's
not disproportionate.

Speaker 2 (27:36):
Yeah, Okay, that does make sense, because I was going
to ask you who are the best candidates for coal sculpting.

Speaker 1 (27:42):
Yeah, I would say somebody has a disproportionate whatever. So like,
if you pinch on on my arm, it's pretty thin,
my thigh's pretty thin, but if I pinch on my side,
it is much thicker in my flank. I'm a typical
guy carrying my fat in my mid section. So if
I got rid of some of my fink lpe fat,
which I have done cool sculpting before, then it might
come back on my arms and my thighs and whatever.

(28:03):
And it's fine because I'm trying to get rid of
it in the disproportionate area, right, So I say disproportion
of people.

Speaker 2 (28:08):
Okay you're saying here, But like for me, I like
always feel like I work on my arms, but then
I'm like, there's that like as a female, and like
we know what we so I don't want.

Speaker 1 (28:19):
Those and usually so uh inner a thigh skin and
arm skin is really really really thin. So when you
have even a fairly small amount of weight loss, oftentimes
that skin doesn't bounce back because the skin is so
thin that it just kind of hangs, and especially as
we get older. So really the only way to make
an arm or a thigh a lot tighter is usually

(28:39):
some sort of skin tightening procedure, but those procedures are
kind of bad procedures because your scar gets to be
pretty ugly usually. Yeah, and so if the trade offs
just generally isn't worth it unless you have like massive
weight loss and you have like rolls of skin that
like are kafeen and all the things.

Speaker 2 (28:56):
Yeah, and that's that'll be one of the things that
when I talk to you about too. But I want
to talk about in one of the big conversations that
all have with people, and honestly I'm always looking at
it too, is the different supplements that we can take
get there so many of them out there. There's the
collagens and anti aging things, and I'm like, do they

(29:16):
actually work?

Speaker 1 (29:17):
Nobody knows? Okay, Okay, So in order to have a
quick answer, well, because all of the supplements basically they
claim to have science behind them, but they don't have
real science behind them. They might have oh, well, this
person had a wound and it wasn't healing for three months,
and we gave them our supplement, and now look and
now it's healed well. Wounds heal over time, so of

(29:40):
course three months later it's going to be more healed
than it was before. Did your supplement really do it
or was it something else. In order to have true
science behind a supplement, you'd have to have a randomized,
double blind control trial, which means you're giving somebody a
sugar pill and you're giving somebody else to the thing,
and then you're measuring whatever the thing is, and you
have to show a statistically significant difference between the two groups.

(30:00):
Now here's the tricky part. If you give somebody a
sugar pill and you tell them it's going to you
pick your thing, it's going to make your hair thicker,
whatever the thing is, and they believe that it is
actually going to make their hair thicker, about twenty five
to thirty percent of people will get thicker hair, or
their blood pressure will be lower, or whatever the thing
is you're trying to tell them. So that's called the
placebo effect, and it's a real effect that has real

(30:21):
things that can change your numbers, it can change your
blood pressure, it can change all sorts of different things.
If you truly believe that's the case. And so because
that's so hard to show anything statistically significant, especially in
something that's like collagen.

Speaker 2 (30:37):
Yeah, collagen is the big one because everywhere you go,
you go through Costco and there's the big container of colard.

Speaker 1 (30:44):
Yes, and it's not going to hurt you. But basically
collagen is and forty four amino acids. So our bodies
absorb amino acids in packets of one, two, or three.
So you could take this one hundred and four for
amino acid supplement, but your boy's gonna break it down
to the basic parts anyways, and what your body puts

(31:05):
it back together, and once it gets through your gut
is up to your body. So just because you're eating
collagen doesn't mean your body's getting more collagen. It has
to make the collagen because the collagen can't get through
the gut to get there to begin with. So I
would say, save your money, you know, just eat a
nice well rounded diet or you have the extra money.
Is Tommy not going to hurt you. It's just amino acids.

Speaker 2 (31:24):
Yeah, I mean that's I mean, that is the one
side to it. It's not going to hurt you or
you'll hope it.

Speaker 1 (31:29):
Supplements absolutely can hurt you, and it's one of the
reasons why we take everybody off of their their natural
supplements and all of that before surgery, because things like
vitamin E and vitamin D at very high levels can
become become toxic poisonous to your blood. So they're not
and because they're naturally occurring substances, you can take as

(31:52):
much as you want, but it does not necessarily good
for you, So we take everybody off of it because
we don't know what a lot of these things do
not say that they don't do anything. We just don't know.

Speaker 2 (32:01):
Yeah, and there's just so many of them out there.
It gets overwhelming for me personally. I'm like, should I
be taking this? And should I be taking this? And
you know, because I'm getting older, should I take this?
And does it actually work?

Speaker 1 (32:14):
Yeah? And unfortunately, because the placebo effect is so strong,
we just don't know. I don't know. I don't know
if taking collagen is the right thing for somebody or skin,
hair and nails or whatever the supplement is that we're taking.
There are definitely ones that are good for you to take.
Living here. Vitamin D right most people are they're low
on vitamin D because we don't get enough sunshine, and
so I'm low on vitamin D. So taking vitamin D

(32:35):
supplement is probably a pretty decent idea. But having your
level checked every now and they make sure you're not
getting too much probably a good idea as well.

Speaker 2 (32:41):
Okay, so this is just like off the little off
the rail there, but placebo effect. Do you think women
are more prone to bind into that whole placebo effect?
Because I think I might be one of those people.

Speaker 1 (32:56):
Yeah, I don't know if it's a male or female thing,
but I think people who I I don't know, I
would say yes, But now people are gonna hate.

Speaker 2 (33:12):
Me because I just said that I'm one. I'm one
of those PI.

Speaker 1 (33:17):
Right. I think everyone wants something for nothing, Yes, right, yes,
So if if all I have to do is take
this thing that has no side effects and it makes
me better than great, So whether it actually does it
or not, if you believe that it does, then it
probably will. There's a lot of things out there that

(33:38):
get blamed for something that we don't have any science
that it's actually that thing that's doing it right. Right,
And we'll probably talk about this at some other point,
but like like breaston plant and breasist and plant illness, yes,
and how that is and what that is and how
we've never been able to prove it. But a lot

(33:58):
of women get their implants out and they feel better.
Yeah you know, is that a placebo effect? I don't know.

Speaker 2 (34:03):
Yes, yeah, I know that. That was an earlier conversation
that we had here on the podcast. I think that, Yeah,
we have a lot of things that we're gonna be
able to cover over time, so many different things. And
I know for like, Okay, we're gonna try this, and honestly,
I'm gonna have you put this on me. This is
supposed to go on the back of your neck. Okay.

(34:28):
Have you ever seen My Big Fat Greek Wedding. I
think that's the movie where they like hold the back,
should there's neck in the picture? So in the picture
so that they're like.

Speaker 1 (34:40):
It would do it? Oh God, I've never tried to
put one of these things on.

Speaker 2 (34:46):
And I because I thought it's because it made me
laugh And I was like, well, doctor Wheeler, should I
get my neck fixture? Should I just buy a bunch
of plastic things? We're trying so that you don't have to.
Maybe you'll want to. Okay, okay, that's hilarious.

Speaker 1 (35:10):
I don't know. Look look look towards me.

Speaker 2 (35:14):
Ye did it work?

Speaker 1 (35:16):
Yeah, it totally didn't. Yeah, let me you can you.

Speaker 2 (35:22):
Can't really can you see the sides? I'm like, I
feel like if I have my that's it.

Speaker 1 (35:27):
Yeah, turn that way, I'll take your pictures.

Speaker 2 (35:29):
Take my pictures. You're getting there. You go, oh hey,
it looks pretty good. Like, but again, I think you
can see stuff and it's not. This is not comfortable.
This is so uncomfortable, and I'm gonna take it off.
It's hilarious. First of all, pulls your hair, Yeah.

Speaker 1 (35:47):
I'll let you pull it off. I pull your hair out,
pull your own hair out.

Speaker 2 (35:54):
Yeah.

Speaker 1 (35:55):
Like, I'm sure people have seen stuff like that either
either there or in their in their like lower face section. Yeah,
I mean it is simulating what we're trying to do
in surgery. Sometimes it's just kind of uncomfortable. A lot
of people have adhesive allergies where they feel like they'll

(36:16):
start to get a rash associated with that, so that's.

Speaker 2 (36:19):
And it's uncomfortable, Like it's not like you want to
walk around with that on all day long, and I
suppose like, yeah, no, I mean, if you want to
get it fixed, just go get it. Go get it fixed.

Speaker 1 (36:31):
And usually the thing that prevents people from getting it
fixed is things like they think the recovery is going
to be a giant recovery, right, which is it's really
not that big of a recovery.

Speaker 2 (36:39):
Okay, you were showing me some pictures because you do
post your before and efforts on your Instagram page, which
is fascinating to go through and look at. But you
were showing me a plastic surgery that was just like
the day before. Yeah, yeah, so amazing.

Speaker 1 (36:54):
Just just to help dispel some of the places, do
what you're going to look like, you know, me after
everyone thinks you're gonna look like you've been caught in
a war zone, right, you know, for months on end,
and generally speaking, that's not the case. It can happen
where you're bruising this pretty significant, but usually it's not.
Usually it's it looks pretty normal, and most people look
pretty normal, even after a full deep plane facelift, you know,

(37:16):
two weeks later, they look pretty normal.

Speaker 2 (37:18):
And okay, so you said, here do you want to
see this picture? And I was expecting the full bandage
head and that you could hardly even tell like there
were Yeah.

Speaker 1 (37:27):
Especially the way that you wear your if you were
to get a facelift. Ever, not to say that she
ever needs one, but she would have incisions, so usually
around the ears and bound into the hairline, and another
one underneath the chin. But when you're looking at somebody
straight on, especially with the way that you wear your
hair over your ears, right, you wouldn't really see. Even
if you had the sutures in right now, you wouldn't
see the incisions.

Speaker 2 (37:46):
Which is amazing. Okay, let's talk about the Michael Myers
mass because I love this thing so much because it's creepy,
but I wanted to know if it works because a
lot of it. I mean, these are all over the place.
My girlfriends and I talk about these all of the time.
I'm here. Yeah, go for it.

Speaker 1 (38:02):
Yeah. So this is red light therapy. Red light therapy
does work. It looks amazing. Yep. You want to use
it for basically fifteen to twenty minutes a day at
least three or four times a week. And what they
do is it helps with skin lossicity, it helps with inflammation,

(38:24):
so like orgization, it helps with healing, so pimples cuts
that sort of thing. It basically is the near infrared
light is penetrating your skin and increasing the blood flow
to your skin, which their blood flow brings nutrients and
nutrients make your skin healthier and thicker. Right, So a

(38:45):
lot of the things that people are using on their
skin is all about the increase of blood flow to
the area and increase of nutrients to the area. Whether
it's topical growth factors or whatever the product that's out there,
that's usually what we're trying to do. So this is
just another way of doing it. It's non invasive, it
doesn't hurt, it doesn't get hot, it's not super expensive.

(39:06):
I think we sell these hurt around three or four
hundred bucks, okay, and it's they'll last for a super
long time. They help with they make ones for like
hair loss, so they and that works. That definitely works.

Speaker 2 (39:17):
Wow.

Speaker 1 (39:17):
Yeah. So just simple things that you can do that
will help you look healthier and it's a good bang
for your buck. Right if you're talking three four hundred
dollars something that you're gonna use for years, you know,
that's that's something you can do that's not going to
hurt you, that's definitely going to help you. And even
if it's a pretty minor effect, hey it's something. Yeah,
that's better than nothing.

Speaker 2 (39:38):
And I think that's what we want to do here,
is we want to give people the options because there
are just so many options that are out there, and
for the people that don't know what they are, they
it gets overwhelming looking through everything trying to figure it out.

Speaker 1 (39:50):
Yeah, in general, I would say there's nothing that's going
to have a very significant impact on your face very
quickly with no down time, right, So anything that sounds
like it is doing going to do that probably isn't
going to do that. Minor changes with consistent use over time,
lots of things out there to do that right versus

(40:12):
a surgery would definitely will be a big change all
at once and you'll see a long lasting effect and
the recovery is not as bad as everybody tries to
make it out to be.

Speaker 2 (40:20):
What are some of the biggest questions you'll get.

Speaker 1 (40:24):
There's a lot of questions oftentimes around traveling to other
countries to get plastic surgery.

Speaker 2 (40:30):
Yes, we so.

Speaker 1 (40:32):
My group's the largest group in town for plastic surgery,
and we're on call all the hospitals, and I would
say probably two times a month will have to go
into the er to see somebody who's traveled to a
different country with some sort of complication that now they
can't get back to that surgeon, and what they had
done is oftentimes not done the right way or strangely.
So I'm not a big fan of medical tourism to

(40:53):
other countries because you don't it's cheaper, for.

Speaker 2 (40:56):
Sure, that was what I was going to ask. It's
just cheaper.

Speaker 1 (40:59):
But the reason why it's cheaper is because they don't
have to jump through all the hoops that we have
to jump through to make sure things are sterile and
safe and get inspected and all the other things right.
So maybe the implants have been expired on the shelf
for three years that they just put into your body.
Maybe they forgot the end of biotic because no one's
checking that they're doing that. You know. Maybe they used
to work in America and they lost their license because
they were unethical, and they moved to Mexico. They have

(41:22):
to do it down there. I I you you've lost
all of the safety of having something in the United States,
and even the United States, you can find providers that
are total quacks. So I would just say, you know,
you're there's certain things in life you probably don't want
to skimp on.

Speaker 2 (41:38):
Yeah, and I don't. Yeah, I was gonna say, if
you're doing a surgery, I wouldn't think that that would
be one of them. And you're in a different country,
which to me is scary, and then you have to travel.

Speaker 1 (41:50):
There's a guy in uh, the Dominican Republic who does bbls.
So that's fat drafting to the buttock, and he does
it in a way that you're not supposed to do it.
Back up that graphic, that grafting to the butt Okay.
So it's usually in a more ethnic population where you know,
a large.

Speaker 2 (42:08):
Oh so okay, that's what I was going to say. Okay,
so making the Kardashian booty, all right, Okay.

Speaker 1 (42:14):
So it's very popular. And basically there's a way that
we were taught to do it, you know, fifteen twenty
years ago, and then about five years about ten years ago,
we found out no, no, no, we can't do it that way.
There's a high risk of death if you do it
that way. Well, there's this guy in the Dominican Republic
who's killed like twenty two people doing BBLS and he's
still out there doing it and.

Speaker 2 (42:35):
He's still practicing, still practice. Yeah, that's scary. You've really
got to do your due diligence. You should look into it.

Speaker 1 (42:40):
Yeah, but it's really hard because like there's there's people
on social media who specialize in medical tourism and where
they'll help you find you your hotel and your doctor,
and there's all these other people. Like I just had
a lady who came back from Mexico and she had
had a breast augmentation and a breast lift all at
the same time, and she was having major wounds on
the bottom of her of her chest on both sides,

(43:03):
and she's basically on a loser implants. And she went
down there with her girlfriend and they both had major
wound problems, and we're dealing with both of them trying
to fix these problems.

Speaker 2 (43:11):
Trying to fix those problems, you know, And I should
say this too, and I should have said this earlier.
You cover such a multitude of things because how we
met initially was through a breast cancer walk. So yeah,
you take care of patients who have gone through breast
cancer and reate and then you go through the reconstructive

(43:32):
process with them to just a breast augmentation, to facelift.

Speaker 1 (43:38):
To to limb of salvage. Right, So two of my
partners were up all night the other night trying to
this guy had a wound on his skull from cancer.
They had to take out a portion of his skull,
so he has his brain is exposed. Well, we can't
walk around like that, so they took a piece of
his leg and they disconnected it from his leg and
they reconnected it to an area in his neck so

(44:01):
that the skin could live and cover over top of
the hole in his head. And the flap had a problem.
So they were there literally the entire night, you know,
saving this flap. You know, and that has nothing to
do with cosmetic surgery or making people look pretty.

Speaker 2 (44:15):
No, yeah, it's just kind of, you know, making them
so that they can live and walk around every single day. Right.

Speaker 1 (44:21):
So, plastic surgeons, we joke around the plastic surgeons are
a surgeon's surgeon because when whatever other type of surgeon
is having a problem, oftentimes were the ones they call
to help them get out of that. Whether it's a
sternum that's fallen apart after cardiac surgery, or a knee
that's gotten infected from an orthopedic surgery. Oftentimes there's then
a wound and we need to go in and help
them clean it up and cover the wound because the

(44:43):
things that are deep inside you shouldn't be.

Speaker 2 (44:45):
Exposed, right right. Oh my gosh. Oh some of the
other questions, what other questions do you gut? Because I
know that you get times of done it like yeah.

Speaker 1 (44:53):
Yeah, So I would say medical tourism was definitely one
of them. I get a lot of questions, very specific questions.
A lot of people were like, can you fix my
neck or whatever the thing is, and so I'll send
me a picture. I try to have them standardized and
then you know, I'll be like, come have a console.
But I'll just talk in general about you know. One
of the things that comes up frequently is something called
facial beauty as opposed to facial aging. So there's a mask.

(45:17):
It's based on the Golden rule that you can put
on any person's face, male or female. There's a male
one and a female one of any ethnicity, and the
closer they fit that mask, the more beautiful society considers them.

Speaker 2 (45:30):
Wow, okay, I heard of that.

Speaker 1 (45:32):
Yeah, so I have it on my page. But basically
I take it and I put it on Kim Kardashian.
I put it on Angelina Julie. I put it on
the actress from Game of Thrones, Denary Stargarian. I forget,
I'm blanket on her name.

Speaker 2 (45:45):
I can't. Anyways, a beautiful.

Speaker 1 (45:48):
The more you fit the mask, the more beautiful you're considered.
So some people are delta raw deal in life, where
maybe they have a really recessive jaw and so they
don't fit that very well. Well, there are things you
can do. It's not facial aging, but it's to change
them so that they're just more in line with the
averages or trying to improve what they are. And so
a lot of people, a lot of my questions come

(46:10):
through with young people who basically have been dealt a
raw deal a really big nose too big for their face,
or really tiny lips or whatever the thing is, and
it's like, yeah, there is something you can do about that.
And then once you do that for them, they're like,
oh my god, I feel like I have so much
more confidence. It's really amazing to do that, and they're
just so happy. I mean, some of my most stout

(46:31):
online followers are patients of mine who was facial aging
I'm not sorry, facial beautification, and they just are over
the moon with their results.

Speaker 2 (46:42):
And they just feel better about themselves.

Speaker 1 (46:43):
And then they're not getting nine million things done they
did like the one or two things that they were
off on. Yeah, and then like they have this new
confidence and that's it, and they don't they don't want
anything anymore, they don't need anything anymore. They're not addicted
to plastic surgery or any of the myths that are
out there.

Speaker 2 (46:57):
And that's why it's so great, because it gives people
back their self confident and I love that we should
all have that opportunity. I'm going to bring up one
thing because when you had looked at my face a
few years ago, when we had talked firm deny, you can't.

Speaker 1 (47:15):
I can't get you're here saying it, so I'm not
the one, Shay, that's true.

Speaker 2 (47:18):
But you looked at me and you said change the
part in your hair, and I was like why, Like
I'd never heard that before, which was so interesting. Explain that.

Speaker 1 (47:29):
Yeah, so everyone's face is asymmetric. The more symmetric you are,
the more attractive you are, the more you fit the mask.
But everyone's basically asymmetric. And so everybody generally speaking, has
a long, skinny side and a short fat side. So
if you look at my face, this is where my
jaw ends on my left side, and this is where
my jaw ends on my right side. So this is

(47:50):
my long skinny side, and this is my short fat side.
And so my right eye is slightly bigger than my
left eye, and all of that is telling me that
this is my photo morphetographic side. And so Leslie's the same.
She has a very symmetric pace. No would ever see
that except for somebody like me who does this for
a living. And so most people figure out how to
part their hair without knowing that. That's why they do it. Yeah, right,

(48:12):
And so she was parting her hair the opposite and
I was like, you should really put your hair on
the other side, because this is your more attractive side,
even though both sides are attractive, you know, And she
was like huh, and then it kind of made sense.
But her left eyes a little bit more open than
her right eye, her jawlings a little bit longer on
her left side, and so if you're going to part
your hair, well part on the other side.

Speaker 2 (48:32):
Which I did. I switched to the part, and then
I did get people asking about it or what was
I doing different, or which I thought was so fascinating
in itself.

Speaker 1 (48:42):
Yeah, and I mean, I mean there's a really simple thing.

Speaker 2 (48:45):
Yes, such as simple it was. It was it was free.
I mean, yeah, I mean, I just changed, you know,
the direction of the part my hair and showed off
the better side of my face. And it's so funny
because I never I'd never been told that before, and
I guess I've looked at my face, but you look
at your face so often you're like, I can find

(49:06):
everything wrong and tell you all about it.

Speaker 1 (49:08):
The best way to assess any part of your face
or your body or whatever, to look for asymmetries is actually
in a picture, rather than in a mirror. A mirrors.
We're so used to seeing our mirror that the more
facially asymmetric somebody is, the more you will see it
in a picture, the more you will feel like when
you look at a picture of yourself from straight on
versus a mirror, the more you really don't like the picture,

(49:30):
probably the more asymmetries you have. Interesting, It's one of
those things like when we're doing breast reconstruction, most women
have sisters, not twins, and pretty much nobody has twins, right,
some people have cousins. So when I'm doing breast reconstruction.

Speaker 2 (49:46):
Wa wait to hang on, sisters.

Speaker 1 (49:48):
Most people are sisters.

Speaker 2 (49:49):
Sisters, right, twins and cousins.

Speaker 1 (49:52):
Right, So no one has twins. Okay, everyone has sisters.
Some people have cousins. Okay, so about thirty five percent
of people have cousins.

Speaker 2 (49:58):
What is cousins?

Speaker 1 (49:59):
Where they when you look at them, and they're obviously different,
very different, Okay, where like anybody looking at that picture,
they're different. Yeah, versus looking when you're looking at somebody,
you're like, yeah, you know that's normal, right, But then
when you really look at it and you're like, okay, okay,
this one's a little bit higher, that one's a little
bit lower, this one's a little more left, a little
more right, a little bit bigger, a little bit smaller. Yeah, sisters. Interesting,

(50:21):
So when I'm reconstructing people, everybody remembers their breast as twins. Right,
And during our conversation for a breast reconstruction, I'm like, look,
I'm going to give you sisters, not twins. I know
you want twins, and I want you to have twins,
but if God couldn't get it right to begin with,
I'm not going to eat it.

Speaker 2 (50:34):
Right.

Speaker 1 (50:35):
If you have cousins, we'll do something about it.

Speaker 2 (50:37):
Yeah, it was gonna say, that's a good way to
put it. And I love that you have had women
who have gone through breast cancer and then had to
go through the whole reconstructive process, but they come out
on the other side after all of this. It's a
lot of trauma, yes, feeling better about themselves.

Speaker 1 (50:57):
Yeah. You know what we generally say to patients is
since most women have sisters, and most women don't have
the perfect breast that they've always wanted, whether that's because
they're smaller than they ever wanted to be or larger
than they wanted to be, or child bearing or age
or whatever. Most people have something about their chest that
they're not in love with, and this is their opportunity

(51:20):
for us to make it something different.

Speaker 2 (51:22):
Yeah.

Speaker 1 (51:22):
Right, So if they've always been an A cup and
they've always wanted to be a C cup and we
have to do a masstectomy, oftentimes I can reconstructive breast
when now maybe an implanter of their own tissue, where
it's the fullness that they wanted to have before, and
they feel oftentimes better about it. I would say about
eighty eighty five percent of our patients feel better about
their body self image once we're done with the reconstructive process,
even after a mastectomy. And that's a huge difference from

(51:43):
me twenty years ago.

Speaker 2 (51:45):
Yeah, because how far we've come right and what we
can do.

Speaker 1 (51:48):
Yeah, there's a lot of technologies that have come out
and processes that have come out that have allowed us
to not make somebody look mutilated anymore. Yeah, sometimes we
have to because the cancer is like eaten away all
the skin or whatever the thing is, but that's not
usually the case. One of the reasons why you'd want
to get detected early because if we could detect your
breast cancer early, then we can make it all about

(52:08):
looking as good as we can afterwards, versus if we
detect it late, it has to be all about trying
to save.

Speaker 2 (52:13):
Your life, which is why we always say get your exam,
get mammogram, Yeah.

Speaker 1 (52:18):
Get your ultrasound, get your get your whatever, do yourself examined.

Speaker 2 (52:21):
That's part of that whole health thing. Right.

Speaker 1 (52:23):
I just had a lady recently who I did a
brest doragmentation on. While I was in there, I found
breast cancer.

Speaker 2 (52:30):
Wow.

Speaker 1 (52:30):
Yeah, so I had to like send it off and now,
thank god you got a breast augmentation. Yeah. She had
just had a mammogram and they didn't see anything.

Speaker 2 (52:39):
So that's and yeah, thank god she had the augmentation. Yeah. Yeah,
and now you'll take care of her from here, which
is what's fantastic. Yeah, I forget the sounds. Oh that's okay,
you're an important person.

Speaker 1 (52:53):
My phone is never silent.

Speaker 2 (52:55):
Mine is always silent because I always get it. I've
had to go when I've been on air before, which
is that. Sorry about that? Sorry about that. Okay. So
let's talk about hydration for skin as it gets a
little bit older, because so.

Speaker 1 (53:15):
Skin hydration is really important. There's a lot of things
that affect hydration. So think of it as you have
a bathtub full of water. So one way to keep
that bath up full of water is to prevent it
from leaking. One way is to add more water to it. Okay, right,
So there are things out there that help prevent it
from lenking like seramides or huronidase, all of that helps

(53:42):
to hydrate your skin and then just moisturizers like emullions
and stuff. So like, this is a locally made product
that we carry that people tend to love, that is
really good. So Leslie had asked me about hydration.

Speaker 2 (53:55):
I did because yeah, that creepy skin or.

Speaker 1 (53:58):
That this is a VI this is in FISA, and
I'm not trying to do a promo or anything. It's
just I love the fact that it's made locally.

Speaker 2 (54:05):
Yeah, locally, I didn't know, so I won't be able
to help you.

Speaker 1 (54:12):
I would just put a little bit on your hand.
I put it on the back of your hand just because, okay,
and it a little goes a long way.

Speaker 2 (54:18):
Yes, it's you weren't kidding there.

Speaker 1 (54:21):
So this is a really heavy actually and smell is
pretty good.

Speaker 2 (54:27):
I'm a small person, so like, yeah, but it's so.

Speaker 1 (54:31):
I would recommend like take that and try using that
at night before you go to bed, and okay, because
it's pretty greasy, right, So.

Speaker 2 (54:40):
Yeah, but I like it, like it feels good, and
so you're just replacing then that hydration.

Speaker 1 (54:46):
Yeah. Well, plus this has you know, oils and stuff
in it, So it's also helping to keep your hydration
in there. You're replacing it while at the same time
preventing like evaporation, right, because you have the stuff.

Speaker 2 (54:57):
On it, And is it the evaporation that gives you
the creepy look games, kidd Some.

Speaker 1 (55:01):
Of that, some of it is of operation, some of
it is having dead skin on it, so like that's
where your dermo plane facial will come in. Some of
it is using the retine or retinyl product that makes
your skin thicker. All of that is what's contributing to
the texture qualities of yourself. Okay, so red light therapy,
good quality, medical grade skincare. We're going to talk about
medical grade skincare versus encounter.

Speaker 2 (55:23):
So thank you for bringing that up because I would
have left that one slip. But that one is so
important and that is one thing that I've been like
a cheerleader about from years ago.

Speaker 1 (55:35):
So, like things that are like over the counter from
Nord Drum or Costco or Macy's or wherever getting your
stuff from, they all have the same active ingredients as
a lot of the medical grade stuff, but the difference
is they can't have a very high concentration of it,
because once you start having a higher concentration, you might
have some side effects associated with it, And who are
you going to call from nutrigma if you're having a
side effect from this product. So the FDA limits how

(55:58):
much they can put in of the really act ingredient
that's in there, and they don't want to have something
where it's causing all these side effects. So the difference
being medical grade skincare, we can increase the doses of
the things that are really working because then you can
just call us and we'll be like, Okay, this is
that or the other adjust it like this, or do
it like use it every other day and that sort
of thing. And so that's why you know, for pretty

(56:18):
much the same cost, you can get medical grade skincare
at the same cause as something that you're getting over
the counter with way more effectiveness in it.

Speaker 2 (56:25):
Well, I feel like you have to use well obviously
because they don't have as much of the product or
you know, the ingredients in the over the counter of products,
so you're having to use more, so you're actually spending more.
I feel like.

Speaker 1 (56:39):
I think that whether it's the volume of the product
that you're using or it's at a certain point you
can't get It doesn't matter if you put a gallon
on your skin, if it's not concentrated enough. The only
thing your skin can absorb, maybe because your skin's job
is to keep things out, is the stuff that's directly
on the first layer. Anything built up above that can't

(57:00):
get in because it's not in contact with your skin,
if that makes sense.

Speaker 2 (57:03):
No, that does make sense. So is that where like
the facials and the derma plane, which I love because
it does get off all the dead skin.

Speaker 1 (57:10):
So that in the hydrofacial, that's where south that's when
it comes where you're taking that dead layer off so
that you can get to the healthy layer more easily
with your products and with your stuff. And you know,
everybody you know washes their face, so that's like dirt
and stuff like that. But I mean you've had you've
had a derma planing fasion or have you ever had
a hydropasion?

Speaker 2 (57:28):
Yeah, and I love both.

Speaker 1 (57:29):
Yeah, it's just your skin feels like ridiculously squeaky clean
for like days on end afterwards. Right, so great, So
it's so different than what just washing your face is.

Speaker 2 (57:38):
Yeah, it feels like it sucks. All the it doesn't yeah, rights,
all the bad stuff.

Speaker 1 (57:44):
If you ever go and look at the canister after
you've had one of those, oh it's gross.

Speaker 2 (57:49):
Oh I'm doing that I've never done.

Speaker 1 (57:52):
Somewhere in my phone, I have a picture of when
I had one done and I was like, and it
just okay, yeah, okay, it'll make you go, I should
do this little more for you.

Speaker 2 (58:00):
Yeah, I probably should. I thought that wash cloth it
was doing a better job, right, And especially.

Speaker 1 (58:05):
For women, you guys generally speaking, put on sunscreen, makeup
all the different things, so there's just layer after layer
of the layer that you've put on your skin that
then makes it to the next layer you put on
has a harder time getting in. So if you really
want to have effective use of your skincare products, you know,
making sure that you're putting it on a really clean
face is important. The other thing with hydrating things like this.

Speaker 2 (58:25):
This feels amazing, by the way, like I can't still.

Speaker 1 (58:28):
You'll want to use that immediately after your shower, Okay,
don't wait until your skin is dry. Okay, even when
it's still moist So all of the things that you're
trying to do for moisture you want to apply when
your skin is moist because it can get into your
skin more easily formed up and so you'll get more
of the product in.

Speaker 2 (58:44):
Okay, that makes sense. Now I want to see the
canister after a I intro facial. I feel like there
are going to be so many questions on this.

Speaker 1 (58:54):
Yeah, I hope so. So the other thing that we
never got to because this is what happens when we talk,
We get you know, we get side backed.

Speaker 2 (59:01):
Yes, there are so many things.

Speaker 1 (59:03):
We talked about a lot about filler.

Speaker 2 (59:05):
Yeah, let's talk about that.

Speaker 1 (59:06):
So there's a lot of different types of fillers that
are out there, and what you'll find is that most
of the fillers, all the fillers that I use, are
some version of a hyaluronic acid. And the reason why
I use that is because it's reversible. If we've put
it in and you hate how big your lips are,
you hate your chin or your cheek or whatever, there's
a different enzyme I can use to solve that filler.

(59:28):
And if God forbid, it gets into one of your
blood vessels and you have what's called a vascular inclusion,
we can flood the area with the medication that makes
it go away so that we can get the blood
flowing again. But there are definitely fillers that are out
there that are either permanent fillers or semi permanent fillers
that there's nothing you can do if you get it
in the wrong area.

Speaker 2 (59:46):
And that seems like a scary thing today.

Speaker 1 (59:47):
Well, I mean, it's why I don't use them. There
are definitely people in our community and people across the
world that use all sorts of different things for different reasons.
But it's one of the reasons I avoid using those
is because I don't want to be able to undo it.

Speaker 2 (01:00:00):
Yeah.

Speaker 1 (01:00:00):
So, and being a plastic surgeon that does facelifts, I
oftentime in doing a facelift and I get in there
and there's all this crap everywhere from these products that
people have used that I just it's created scar tissue,
it's created really weird adhesions, there's lumps of Well, so,
when you put something into your body and it recognizes
it's not self, it forms something called a granuloma around her.

(01:00:22):
It's your body's way of trying to eat and get
rid of the thing, and if it can't get rid
of it, it just kind of walls it off. And so
you can get absesses, you can get all sorts of
crazy weird stuff with these some of these permanent things.
So that's why I don't use them, and I don't
recommend them, not because I'm just trying to make sure
you have to come in every couple of years to get.

Speaker 2 (01:00:39):
Your filler right right, and I would think you would, yeah, yeah.

Speaker 1 (01:00:43):
So the ones I generally use are it's called Rha
or the Jupiter and products. Those are all that, and
I don't really use wrestle in but it's another hyaluronic acid.
All three of those are the I would say the
safest ones, the ones that we can reverse, the ones
that you know have been around for a long time

(01:01:04):
and generally speaking, people don't really react to. So I'll
just say some some names because everybody they all sound
the same. So uh, Jupiter, Voluma, r h A one
two three for urge density and restall in. The ones
I avoid are the ones that are either biostimulants. I'm

(01:01:24):
using that as a term because that means scar tissue,
so that would be like radius sculpture. And then the
permanent filler is bella film. So those are the three
I don't use, and I don't recommend.

Speaker 2 (01:01:34):
Okay, who's a candidate though? For a filler? And you
know what, I'm just gonna full disclosure here. Why don't
you just show where you put a little bit of
filler in my face? I mean, I do it. Yeah.

Speaker 1 (01:01:45):
So Leslie came to me not too long ago, and
she was like feeling you know, when you're on camera
all the time. Cameras are harsh and harsh, the very
harsh every day. And I guess her old set was
worse than her new set.

Speaker 2 (01:02:00):
It's true. The lighting in this new set is fantastic.

Speaker 1 (01:02:05):
So as we age, we lose bone and fat in
our face, and so one of the areas that we
tend to lose bone is right through our cheek that
bone and fat. And so what happens is a lot
of people want me to fill their nasal abial fold
this fold right through here. But the problem that's happening
is that as you're losing that bone in fat, the
nasal abial fold is getting deeper and deeper because your
cheek is dropping. And so to some degree, adding a

(01:02:28):
small amount of filler right through the highlight of her
cheek right through here just kind of makes the cheek
pad of the cheekbone become one again and makes it
where you a nice little subtle pop the cheek, And
as you do that, it can help to lift the
cheek a little bit and lift the jaw a little bit,
not to a degree that a facelift would big it.

(01:02:49):
But a facelift doesn't only add volume unless you're doing
fat grafting with it. So faselift pulls titans skin redistributes
the soft tissue to the right spot where it doesn't
necessarily add volume unless you're also adding volume. So for
people as they're aging who are not quite ready for
a facelift, 're not sure they want that. Adding a
little bit of subtle volume in certain areas where we

(01:03:11):
lose bone and fat, chin pregow sulkis cheeks are definitely
very helpful in the aging process and so making somebody
not look as aged as they were before without looking overdone.
When you put in too much filler, when somebody needs
a facelift, needs they hate something about their face that
they want to get better. They've had filler for years
and now they're like, Okay, I need more filler, and

(01:03:32):
I'll get to the point I'll be like I'm sorry.
It's not a filler problem anymore. If I put more
filler in your cheeks, you're gonna look like you like Madonna.
You're gonna look like a chipmunk. You look like you
have too much filler in your cheeks. You're at the
point now where we need to do something different because
it is to address a different problem. And that's where
a lot of my patients that come in to see me,
they're surprised when we're talking about things because they think

(01:03:53):
they're there just for a little botox or a little
touchup or a little little filler, because that's what we've
done for years. And I get to a point where
I'm finally like I've done everything I can in that department. Yeah,
I know you don't want the surgery. Don't get it
if you don't want it, But if I do more
of this in that location, you're going to start to
look strange.

Speaker 2 (01:04:11):
So here, and I'm going to bring this up because
and I'm going to say this, Listen, if you want
to do something and it's available. And I love that
there are so many different small things that we can do.
They can make a big difference in how we look
and feel. About ourselves, and the big thing there is
how we feel about ourselves, and that's a big one
for me. I know, just putting a little bit in

(01:04:32):
my gym made me feel so much better with such
a small thing that we did.

Speaker 1 (01:04:36):
Yeah, it was a single syringe of voluma that we used.
I split it between your cheeks. I put a little
bit more on one side there is to the other,
because we're all officially asymmetric, right, But that just taking
that little dent that's kind of always there out by
adding that volume behind it. You know. She literally texted
me a picture of herself the next day. It was like,
you know, I didn't know that that's what it was,

(01:04:56):
but there we go, such.

Speaker 2 (01:04:58):
An easy quick figs that that was just and that's available,
and I think that so many of us walk around
for so long not realizing that that's available, and so
that is available.

Speaker 1 (01:05:11):
Well, so like one of the things that one of
the reasons I wanted us to talk about this and
thank you so much for being so open about what
you had done.

Speaker 2 (01:05:18):
Yeah, I don't mind. I want other people to feel
good about what they want to do or don't want
to do.

Speaker 1 (01:05:23):
You know, clearly, Leslie is a beautiful woman that has
been you know, in the social media, in media for
a long time, and most people probably guess that you've
never had anything done and you're just naturally blessed, and
for the most part she is. I know. So, but
you can get plastic surgery or do even small things
where you still look exactly like you. You just have that

(01:05:45):
inner confidence where you feel better. And if you look
at the before and after pictures, you actually can see
a difference where you're like, oh, yes, her cheek is
a little less deflated right there in that particular location,
and that makes her look happier, because this is not
a happy fig It's.

Speaker 2 (01:06:00):
Not a happy face is a happy face.

Speaker 1 (01:06:03):
So as we age, we lose bone fat in our
face and their skin gets looser, and so a youthful
face is a chalice, right, So the volume is high
and tight. Leslie has very strong cheekbones, and so she
is blessed with those strong cheekbones. People with strong cheekbones
look younger than their true age. But as we age,
we lose bone and fat in our face, and this

(01:06:25):
is coming down, and so adding that volume back is
helpful stopping the muscles that are pulling it. Down is helpful.
Redraping them to the right place is helpful, just depending
on your age and depending on your budget, and depending
on what you're trying to have done. But good plastic
surgery is undetectable. You look exactly like the same person.
Even if I did a face withthon her, which of
course she doesn't need that. But if I did that

(01:06:46):
on her, you would never even notice that I did it.
She would just feel better. But if I showed you
her before and after pictures, you would go, wow, what
a huge change. But all of her friends would be like,
you didn't have a face. You look the same, which
is exactly which is exactly what everybody wants.

Speaker 2 (01:07:04):
Yeah, that's exactly except for the ones that want to
look like a yeah cat everything. Yes, I don't do that.
Don't call you for that one.

Speaker 1 (01:07:15):
You want to have a forked.

Speaker 2 (01:07:16):
Tongue, No, no, guy, do it. Not going to do it.

Speaker 1 (01:07:19):
You can do whatever you want. I'm just saying I'm
not going to do it.

Speaker 2 (01:07:22):
Right, Okay, So I'm going to leave it there, and
I do want to open it up for like questions,
please like, ask the questions and I'll answer whatever because
I'm not I don't feel bad again. I want to
empower women.

Speaker 1 (01:07:35):
What we should do is un empowered. When they ask questions,
we should have you answer it first. Okay, right in
the sense of here is a you know, non medical
person with all of the knowledge. Right, you're clearly into healthcare,
you're clearly into beauty, you're clearly into fashion. Right. So
a lay person's answer or what you think the answer
is to those things would be very interesting. And I'm

(01:07:58):
not saying that mine is the right answer, but if
I have more education on that, I can be like,
but you do well depending on what it is, right,
I Mean, they can ask us a lot of things,
but when it comes to something like you know, if
they're like, oh, what's morphius eight, and you're like, oh,
it's a laser, I'm like, well, actually it's not.

Speaker 2 (01:08:14):
A laser laser. Yeah, I didn't learn that.

Speaker 1 (01:08:16):
Right, But I'm just whatever the the lay person's perception
of that, right, there might be an interesting spin on things,
because whatever you think it is, probably other people do too.

Speaker 2 (01:08:27):
That's true. That's so true.

Speaker 1 (01:08:28):
So like one other thing that we should talk about sunscreen.
Oh so sunscreen like Banana Boat or you know, name
whatever brand is at the normal store.

Speaker 2 (01:08:40):
Right.

Speaker 1 (01:08:40):
The thing you want to look for in the sunscreen
is you want to have a physical barrier to UVA
and UVB and that's usually zinc oxide. So if it
doesn't have zinc oxide in the ingredient, then it's not
as good of a sunscreen as one of the other ones.
So just something to look for. That's the active ingredient,
zinc oxide. The more zinc oxide, the better it is. Okay,

(01:09:00):
really really really really good zinc oxide from like like
from our facility or from a medical provider. You can't
even tell that you have sunscreen on it like just disappears.
Where if you go and get zinc oxide from like
Target or whatever, yeah, it's like that whit.

Speaker 2 (01:09:16):
White yeah, and you're just like Jesus, yeah, it's gone on.

Speaker 1 (01:09:21):
So that's why a lot of people avoid zincoxade because
they don't want to look like, you know, the old
fashioned lifeguard with the white thing on their nose. But
that is the best sunscreen and really good quality zinc oxide.
Sunscreens are undetectable, So just don't throw out the baby
with the bathwater.

Speaker 2 (01:09:35):
Yeah, and sunscreens incredibly important.

Speaker 1 (01:09:40):
Day good, but do it with a spray tan.

Speaker 2 (01:09:42):
Yeah, yeah, or spray tan is the friend. I love
myself some fake tan, as you all know I do.
I get people asking all the time, what do you use?
And I'm like, well, I don't get to see the
sun very often for many reasons.

Speaker 1 (01:09:56):
Terrible for us.

Speaker 2 (01:09:57):
And it's not good for us because I spent many
years in the sun because I grew up in that
whole generation baby oil and you know, the what's that,
the aluminum everything.

Speaker 1 (01:10:08):
I remember my sister would lay out baby oil and
her mirror and bacon herself in the sun.

Speaker 2 (01:10:15):
Baked myself many times and then I just stop baking.

Speaker 1 (01:10:18):
Honestly, when when somebody has done that in the past
and they come in, it's really hard to reverse that
because that skin texture, that skiality is us changed forever.
And not to mention skin cancer.

Speaker 2 (01:10:31):
Yeah for sure. Okay, well we just opened we opened
pan doors.

Speaker 1 (01:10:35):
I hope, So I hope. There's a lot of questions.

Speaker 2 (01:10:38):
I do too.

Speaker 1 (01:10:38):
There's a lot of things that we can talk about
that would be probably something questions about.

Speaker 2 (01:10:44):
Yeah, and I'm going to say again because I do
just want I want to power women and men really
and just say if you want to do something, you
should do it and feel good about yourself.

Speaker 1 (01:10:56):
Right, Yeah, I mean the barrier should mostly be finances.

Speaker 2 (01:11:01):
Yes, it always is. Right.

Speaker 1 (01:11:02):
If you can't afford it, then obviously you can want
it all you want. But you know, I wouldn't use
your perception of plastic surgery because you don't know good.
You don't know if somebody's had something done. You don't
know if good plastic surgery. They look normal, they look good,
they look the same. Everyone in Holly Hollywood pretty much

(01:11:23):
has had something done. So and every picture you ever
see of them is airbrushed and filtered. Oh so stop
comparing yourself to those people A meant at that, you know,
find them on their bad day and compare yourself to that.
If you're going to compare yourself.

Speaker 2 (01:11:36):
Yeah, and again, if you don't want to do anything
and don't do it, then don't do it. Yeah. If
you are totally empowered to do whatever you're most comfortable
with and most happy.

Speaker 1 (01:11:48):
With, yeah, I would say, you know, the patients who
get plastic surgery done cosmetic surgery should say a ninety
nine percent of the time they wish they had done
it sooner. But yeah, that's usually what it as they
wish they'd done it sooner.

Speaker 2 (01:12:01):
Yeah. Yeah, I could see that, I really could.

Speaker 1 (01:12:04):
Very few people are always like, oh I should never
should have done this.

Speaker 2 (01:12:06):
All right, Well, you're going to be back. We have
a lot of questions that hopefully we're going to answer. Yeah,
and so we appreciate it and thank you so much
because you're so candid, and I always just love you're
very animated. I love that you're so direct. I do
love that. No, it's actually it's a great thing.

Speaker 1 (01:12:23):
If you're a sensitive Sally, you might not want to
go just.

Speaker 2 (01:12:26):
Back away slowly, but you give the honest like.

Speaker 1 (01:12:33):
Yeah, I definitely, I definitely will say it as it
is in my opinion, you know.

Speaker 2 (01:12:37):
Yeah. Okay, well good, we'll see you next time. Right,
Ask the questions. Ask the questions. Ask the questions. We
want to answer them for you. Go make the rest
of your days the best of your days.

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