Dumb Blonde - Dr. Ricky Brown: Plastic Surgery Q&A

Episode Date: May 1, 2024

Bunnie welcomes world-renowned plastic surgeon and author Dr. Ricky Brown, aka "The Real TikTok Doc", to the show this week. Dr. Brown gets real about his journey from not knowing what path to take after college to becoming a double board-certified surgeon with millions of social media fans and followers. He answers listener questions about the complex reconstructive procedures he's performed and gets candid about navigating controversies in plastic surgery, including his take on breast implant illness. Dr. Ricky shares more about his approach to consultations, the differences between saline and silicone implants, and Bunnie talks about her own experience with implants and removal. Watch Full Episodes & More:www.dumbblondeunrated.comDr. Ricky Brown: TikTok | YouTube | The Real Beauty Bible See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hey guys, I need to ask you a question. I want to know why in the hell are you not on Patreon? I don't think you guys even realize how much content we have on Patreon. Let me break it down for you. We have the BunnyXO show. We have Meet the D-Fords. We have propaganda. We have a cooking show that's coming.

We have more shows that we're adding. And not to mention, we have the visuals of the podcast. Not only that, we have four tiers that caters to everybody's budget and everybody gets the podcast. There's no more excuses. Stop listening right now and head over to www.patreon.com backslash dumb blonde podcast and sign up. Stop missing out. We have built a huge community over there, guys. I'm talking about hundreds of thousands of people over there. We even have live chats, live chats that I actually am talking in every single night. I'm in there just confessing all of my sins to you guys.

I mean, it gets a little ridiculous. Last but not least, we give away gifts every freaking month. I'm talking like signed stuff from Jay and I, lives. You just never know what kind of surprise you're going to get. It's like a Cracker Jack box. I love the community that we've built over there at Patreon. If you are already a Patreon member, I freaking love you, dude. Thank you so much. From my sideshow tier to the carnival tier to the ringleader tier to the main attraction, you guys are my babies for life my writers if i could i would

literally make out with each and every one of you i love you guys so much and that's a lot of kisses actually gotta go bye is this thing on bonnie who used to be a former sex worker and now hosts the podcast dumb blonde most little girls grow up wanting to be doctors and lawyers and shit and i was like i want to be super hot make a lot of fucking money and be a rock star's wife that was my goal as a child and here we are what's What's up, you sexy motherfuckers? Welcome to another episode of Don't Blonde. Today, these are always my favorite podcasts because I get to learn so much stuff. We have world renowned plastic surgeon and author, Dr. Ricky Brown. How are you doing, baby? I'm good. What's happening?

Man, I'm so sorry I made you wait outside. Oh my God. It's so beautiful outside. I'm like of a dad with kids. I'm like, it's peaceful and nice out here. And I grew up in Georgia, so I miss this weather. Oh, well, I appreciate it. Me and Mimi were running late today. Poor Mimi's car broke down. And I'm just like, of course, the one day that we have podcasts that were running late. So I just wanted to apologize to you. But this has been a long time coming, dude. I feel like we've been talking about this for like, what, a year? Yeah, it's been a year.

Yeah. Crazy. Like, I think I was telling all my stories this morning how I made that video about your explant. And I didn't even know who you were. Yeah. Like, I don't even remember if someone sent that to me on TikTok or I saw it randomly. And then when you reached out, I was like, oh, my gosh.

And yeah, you asked me like a year ago, it's taking that long to get here. Yeah. So I had my explant in 2019 and I came across those, my implants. Cause I still have them. I don't know where they are right now, but, um, I came across them like in, I think it was like 2021 Mimi that I posted that and they had like stuff floating around in them. So I did this thing of like, this is what happens with saline, um, implants and it got, ended up getting like 5 million views. And I was like, why are people so fascinated with this stuff? It's crazy. I know. Well, the BII thing, and we could talk about it. Is that why you took yours out? Do you think they were making you sick? So I never want to claim breast implant illness. I had every

symptom that you could possibly think of, but I never was officially, I had a doctor say, yes, this is breast implant illness, but I don't know. I just never wanted to claim that because I feel like there's so many other people who have way worse shit going on than I did, you know? Um, but what had happened was my, one of my implants folded in half and I didn't know that until they went in. But my left tit was like huge compared to my other one and so sore dude. And I was like, this is it. I got cancer. Like I didn't know what was going on. You know, instant hypochondriac was just like, bro, I don't know what's going on. And then I just was feeling terrible. And plus all those other symptoms that I had. So I think the older you get, you also kind of want to go back to your natural form. Yeah.

Whereas in my young twenties, I was like Pamela Anderson, give me the big hooters. Like I want to, you know, topple over when I walk. And then, you know, getting into your forties, you're just kind of like, do I really need all that? And I felt like they made me look really matronly. Yep. So there was just a slew of reasons. Well, so that's why those videos at that time, back in 21, when Tik TOK was like,

it was anything goes, you could put anything up. Kids were so fascinated by that stuff. And I think the mold thing is what got me on that. Cause people are like, Oh, there's mold and implants. And then the,

in the 15 years I've been doing this, I have not once ever seen mold in a saline implant. And I think what happens is there's little valves on those, on the saline ones. And if they sit in a drawer, I presume in the human body, if the valves can become defective and if something traverses the valve and goes inside, cause they're supposed to be one way, then yeah. I mean, it's saltwater. I am presuming that something could grow in there, but I've just never seen it. But that I was like, damn, when I saw that, I was like, I got to make a

video on this. Yeah. So when they gave them back to me, there was little, not as many, there was little floaties in there, but I just was just like, they just came out of my body. I thought it was normal. And then it multiplied over time of just having them. It is wild. And I mean, there's really no explanation that maybe bacteria gets in there. It could be crystals from the salt water in there. I mean, I don't know. But I've just like I've taken out so many saline implants and they've all been crystal clear. Can read the newspaper through.

But that's not to say that it clearly it happens. But that's those videos were pretty crazy back then. Do you prefer saline for females or silicone implants? You know, it's a loaded question. I don't prefer either one for them, but there's pros and cons. Silicone tends to be a softer, more natural feeling implant. And so women who have maybe breastfed have really thin skin, not great tissue quality. Saline can feel more like a water balloon. That's what I tell them. And silicone just feels a little softer, more natural. You can get a beautiful result with either one, but there's pros and cons to each. And I don't know, did you ever

have rippling with your implant when you would lean over? Could you see the little ripples in the side of the implant? I have really dense breast tissue. So you had good coverage. Yeah. So women like you, I would tell them you can get a good result with either one, but the moms who come in, who've had four kids, super thin skin, not great quality breast tissue, silicone offers a little bit smoother, more natural feeling. Gotcha. But either one is fine. Awesome. Yeah.

Well, before we get into all these questions, because I know my girlies on Patreon have so many questions for you. You have a really cool story, dude. Yeah. You have a really cool story, dude. And I got into it last night and went down the wormhole. And I was just fascinated, really, because you're not technically supposed to be here, but you are. And I just was like, wow, this is really inspiring. So let's take it all the way back. Where did you grow up?

So I grew up in Macon, Georgia. Yeah, right outside of here. Yeah, exactly. That's Jason Aldean territory. Yeah, right outside of Europe. Yeah, exactly. That's Jason Aldean territory. Yeah, the Allman Brothers, home of the Allman Brothers. So I grew up in Macon, Georgia. We moved to Atlanta when I was like 12. And my parents owned a computer company and they actually sold computers to medical practices,

which was way ahead of their time at that time. How did they know to get into that? Because that's actually awesome. Yeah, so my dad worked for IBM for a while. And then he ended up meeting a guy who was kind of doing this in Washington who had this own software system they had developed. And they were using the hardware, the computer systems from Alpha Micro. And they had the program. And they were like, hey, we're selling these computers to doctors. And it was more, it wasn't like today. Today is electronic medical records where we actually chart and write notes. Back then it was, let's do your scheduling, like getting, getting patients scheduled. Let's do

all of your financial statements. Like that's what the computer systems did. So my parents did that and they were really fashioned for it in that way. And, uh, and I just never knew what I wanted to do. Like I was just an energetic little boy. I was not a great student. I really didn't want to study. I just wanted to be outside having fun. And so I struggled in school. I really struggled. I was like a BC student. Um, and, and, and actually in sixth grade, we were going to move from Macon to Atlanta. I pretty much flunked out of sixth grade. And so when we moved to Atlanta, my mom was like, we were thinking about, you know, holding you back. Like, do you have a problem with that? I was like, I don't care. Like to me,

school is whatever. I was like, sure. Sounds great. You know? So, and I, and I ended up doing okay. But as, as time moved on, I never really had an inkling and desire to do anything. I didn't know what I wanted to do. They also had you in special education classes, correct? Yeah. I was labeled with a reading comprehension learning disability. So, and I know where this came from now when I think back, there was a kid that lived up the street from me in Macon and we used to see who could read a page in a book the fastest. And so I could read really fluent and really fast, but I wasn't grasping anything I was reading. And I think that carried forward into my schooling where I would read really fast and I would

never just slow down to absorb the content. And so I was sort of lumped into this reading comprehension learning disability. And it was more when I looked down, look back, it was more of, I was just lazy and just didn't care. I just didn't care. I also feel like, cause I was the same way. I did the same thing, but they just didn't put me in special, um, education classes. I feel like when you are at a certain intelligence that young to school is boring and it's hard

for you to focus, you know, because you have so much other shit going on. I was the same way. Like I could, but give me a test. I would flunk it because it would be so much pressure, but anything else I would ace, you know, like it was just crazy for sure. And I was not a great test taker and I, and that led me through med school. I mean, I obviously at some point cleaned it up and we could talk about that. But when I take a test, if it's a, B, C, and D, I make a fricking good argument for why any of those could be correct in my own mind. And so I'm like, it could be C, but wait a minute, it could be D. Too many options.

Yeah, there's too many options. And that's what would happen to me on tests is I would get stuck in that mode. But yeah, so I really didn't know what I wanted to do. And fast forward to high school, I was like a BC student. I did fine. I studied. I was a baseball player, loved sports, was into all that. And, uh, and then ended up going to college and still just did not know what I wanted to do. I had no idea. So I had a pushback moment where I decided I was going to go work for my dad. Like I was going to take over the company. That was what I was going to do, but something just never felt right about it. And when I grew up in Macon, I grew up across the street from an OBGYN. So I'd always been interested in medicine and thought it was cool. And I was always a science minded guy.

So in school, I loved science. So I ended up going to college and was going to go to business school and had a pushback moment where I was like studying supply and demand curves. And I was like, this shit sucks. This is so boring. It doesn't stimulate you in any way. I was like, I don't want to sit behind a desk. Like that's not who I am. So I started thinking like, Oh, maybe healthcare,

maybe medicine. So I volunteered at the hospital and I started to interact with patients. I was a patient transporter and I used to just take them from ultrasound to surgery, surgery back to their room. And I was talking to them and I started to like that. And then behind my parents back, I like signed up for general chemistry and I got an A and I barely worked hard. It just jived with my brain. Did they want you to be in the family business? Was that like their hopes and dreams for you? It was like taking it over. Yeah. I think deep down my father wanted that. Cause the idea of that was cool. My mom was always like, whatever you want to do. So when I took a couple of science classes and did really well, I was like, dang, if I'm going to do this, I'm going to med school. I thought about PA, not that there's anything wrong with that, but I just

started to think like, what would I want to do? So I was like, if I do this, I'm going to do it. So I mapped it all out, drove. I was at the university of Georgia at this time, drove home, like told my mom, I'm a senior in college at this point. So how old you're like 26, right? 26, 25, 25. Cause I was about to graduate. Yeah. Which is crazy to be saying, Oh, I'm going to start all over and go to med school all over. And I remember people like, you know, my friends, they were being very supportive because I thought I was going to get a lot of crap for it. They were like, that's really cool. So I like mapped it out. I people like, you know, my friends there being very supportive because I thought I was going to get a lot of crap for it. They were like, that's really cool. So I like mapped it out.

I was like, I could go a full year, full summer, full year, take my pre-meds, take the MCAT, do the whole thing. Right. So I made this decision to do it and I ended up with like a 3.8 science GPA. So I did really well because I finally had this thing that I was chasing, this thing that I grasped onto. I was like, yeah, that passion grasped onto. You had a passion for it. Yeah, that passion for it.

And it's really weird. I wasn't going to accept no for an answer. I think ignorantly not knowing how difficult it was to get into medical school at that time, I was just like, no, I'm totally doing this. What do you mean I'm not getting in? Not realizing that barely anybody can fucking get into it. Yeah, exactly.

And when I look back, I'm like, holy fuck. Like how, how, how did I get in? How did I get in? How did you get in though? You kind of had to fight to get in. So that's a whole story in and of itself. It's kind of interesting. So I take the pre-meds, I do the MCAT.

All the requirements are done. And I had a year off because usually you'll do that your junior year, then apply to med school and interview your senior year, and then you'd get into med school or not get in. So I'm a year off because usually you'll do that your junior year, then apply to med school and interview your senior year, and then you'd get into med school or not get in. So I'm a senior, I graduate and I'm done. So I go work in surgery for a year, which was crazy. I was an orderly cleaning ORs, mopping floors. That was like my thing. I also heard that, heard you say that you used to like sneak in just to watch the surgeries. Oh, totally. That's where I fell in love with surgery. So doing in that job, where I fell in love with surgery.

So doing in that job, I remember going in cause we had a family friend who was a plastic surgeon and that's not where my plastics came from. But so I would duck into rooms and watch. I'm like, I'd go back to the open heart room and they're like playing like fucking Metallica dude. So loud that you can't hear, but it was poetry emotion. It's like you see on shows sometimes where the smoke from the cautery is floating through the room. No one's talking. Instruments are just passing and they're doing open heart surgery. It's literally like symphonic. It was crazy. I was like, this is crazy, crazy. So I started ducking into rooms and they were like, yeah, anytime you want to come in

and watch surgery, come, come in and watch surgery. So that's how I got interested in surgery. But, Bunny, I was getting rejected from every school. I applied to like 50 schools. And I kept getting rejections. And I thought for sure with my GPA and kind of my line up, like I figured it out. This is where I want to go. I figured I would get accepted somewhere. But so one day I went home and I was like, okay, I've got like 10 schools that I

haven't heard from. Like, I'm just going to start calling. So I started calling, I called schools and I, one girl at the Chicago medical school was like, Hey, your story's amazing. I think that I can get you a phone interview with the director of admissions. And then if they like you, you know, maybe they'll invite you for an interview. I was like, cool. Anything would be great. At this point, you didn't care where you went. No, I mean, get me in fucking med school. Med school is med school. I mean, honestly, wherever you go, anatomy is anatomy, right? Like it doesn't change. So I ended up, I ended up doing this phone interview and a week later I get an in-person interview and it was the only school I got into. Isn't that amazing though, that all it takes is

that one person to just believe in you and to just I don't think I realized at the young age of my twenties, how much I was believing in myself then, because I don't know where that came from. When I look back on it and I, cause I was on a pre-med podcast once and he was like, dude, do you realize how often that does not happen? Like it is so difficult to do what you did. But to me, it was like, this was all, this was my last ditch effort to get in. I was like, if I don't, if I don't pull for myself, no one's going to pull for me. You have to be your biggest advocate. I tell everybody on this podcast all the time. It doesn't matter what you do, how you want to do it. You have to believe in yourself and root for yourself. Yeah. You have to be your biggest advocate because if

you don't believe in yourself, nobody else's totally a hundred percent. And I have some crazy stories. I'll tell you about that. Like I had, I had one girl DM me on Instagram a couple of years ago. She's like my husband, similar story. He's older. This is what he's always wanted to do. He doesn't do social media, but I play everything you put up so he can see it. I used to do a lot of motivational stuff. And, um, so I messaged her back one day. I was like, do me a favor, tell your husband because no one will do this. Go to the local medical school in town where you live in Illinois, the closest one, tell him to walk into the admissions office and just introduce himself to someone and try, try to talk to someone in the admissions committee. So six months or a year goes by and I

get this whole long DM from her and I'm reading this DM and I'm like starting to cry in the car reading this because it's just so killer, right? This guy, she's like, I showed this stuff to my husband. He went to the med school. He talked to someone in the admissions committee and he got in and he was like, and he was like in his late, late twenties, kind of older, like me doing it a little older than me. And I'm like, see, you just got to put yourself out there. It was pretty cool. But that's so cool that you can motivate people to want to do that. And that's another thing that I love about your platform is it's always so positive. Like you're always just preaching, like just happiness and goodness and

like, you know, getting, I don't know. You just always have such a great energy and great spirit about everything. It's important, man. I mean, I've met a lot of doctors in my lifetime because of my past profession and not a lot of them are very positive people. I can't wait to get into that. No, I'm sure. But no, it's so true. Like, I don't know. I mean, like there's just a lot of really bitter docs out there, people who aren't happy. It's really sad, but I grew up a happy kid. Like I've always been happy. It's just my personality. I had a, I had a client one time and he was an OR, an emergency room doctor. And, um, we were doing like eight balls of cocaine one night and just,

I mean, it was like a party and I looked at him and I remember looking at him and I was just like, this guy's energy is so weird. And I was like, why did you become a doctor? You know, like I was really curious because his energy was just so weird. And, um, he's like, you want to know why? And I was like, yeah, he said, because I love playing God. And I was like, I'm never going to the hospital again. I can't even wrap my head around that mentality. Like it doesn't make any sense to me that like, like, and there's so many out there that are like that. I mean, look, we're all people, you know, I am no better than anyone else. And, and I don't know if he meant that he likes being able to control people's lives, whether they live or die like that.

Scary. That's pretty scary. That's pretty scary. So have you seen some of those shows? What is it? Dr. Death? No. Oh my God. You got to watch Dr. Death. Where's this? What channel? What is it about? Is it like Dr. G? Like she does autops. You got to watch Dr. Death. Where's this? What channel? What is it about? Is it like Dr. G? Like she does autopsies? He's a neurosurgeon and he was like intentionally killing people. Oh, come on. I see. I just, I could never like that. I have too much of a conscience to ever like have somebody else's blood on my hands like that. Yeah. You'll have to find it and watch it. It's there series. It's on Netflix or something like that. I'll have to look it up.

It's insane, dude. He's a neurosurgeon, and he was paralyzing people and causing all these problems intentionally. Oh, my God. It was like bouncing hospital to hospital. One hospital didn't want to say anything because they didn't want to kind of, oh, crap, people died on our watch and didn't want to say anything. It was bad. Mimi, write that down so we watch that. I'm already scared of doctors as it is so that's going down this friggin you

know what though that some of the coolest people I've met though are plastic surgeons like my surgeon in Vegas who did my body doctor I guess love him oh he's the best dr. Christopher Korsandi Korsandi he's the best I know Chris very well he's's my baby. I love him. He comes out to J shows out here and like, he's just a sweetie pie. And, um, everybody that I've ever met that's a plastic surgeon always has like the best energy. Most do for sure. And aren't you guys like the highest paid? I don't know. I think, I think neurosurgeons and probably orthopedic, some orthopedic surgeons do pretty well, but neurosurgery is probably up there pretty high and plastics is all relative, right?

Like, I mean, when the economy's down and you're all cosmetic, it's tough times, you know, it can be tough, but I'm not playing the bio wind. I mean, we do well, but, but there are times when things are not so, so awesome. I bet whenever like COVID and stuff happened. Yeah. I mean, COVID actually, interestingly coming right out of COVID and 21, I was as busy as I've ever been. Oh, because everybody had fucking gained weight and had to stare at themselves for a whole year. There was so much time and people were like, not working, got money, not spending it. Let's do it.

So I was super busy. Yeah, for sure. All right. Let's, we got, we got off track. Let's circle back. So you got into med school at the Chicago, the Chicago medical school at that time. Okay. And then, so take me on that journey. You did how many years and then, so four years of medical school in Chicago, and then I'm double boarded. So I'm double boarded in general surgery and plastic surgery. So double boarded means I took two sets of boards. So, um, so some plastic surgeons do what they call a combined program where they, they get in out of, out of medical school, they get into the residency program, but it's only three years of general surgery. They rotate through general surgery, orthopedic surgery, some of the other specialties. And then their last three years are more focused on plastic surgery. But when they graduate,

they're board certified plastic surgeons. I did a full five year general surgery residency in Chicago like Knife and Gun Club, crazy ass shit, could tell you the most fucked up stories ever. Oh, I bet in Chicago. Crazy. It was Knife and Gun Club. It was insane. So I did that for five years and I took my written and oral boards, became board certified and then did plastic surgery for another two years. So another residency took my oral and written board. So I carry two boards in each. I never practiced general surgery. But for what happened for me was I knew I wanted to be a

surgeon. So I cruised through med school and I'm like, peds, cool, but no. Go through all the specialties, neurology, everything. I'm like, no, no, no. Got to OB and I was like, okay, we're doing some surgery. This is pretty cool. So I knew surgery was it for me. I just didn't know what I wanted to do. So I ended up getting into general surgery in Chicago. And part of the way through some of the general, the plastics guys from Northwestern would come over to get their trauma experience. Cause we were just so heavy trauma. And they were like, dude, you should come in the lab with us over at Northwestern for your, do some scar research, like the chairman's lab. Like it'd be fun. Plastics is cool. Right? So I took a break after my third year and went over there and was like, damn, plastics is bad

ass. What do you do whenever you just, when they first put you in plastic surgery, like you start operating on like animals, like what do you do? Like, do you do a facelift on like a pig or something? It's so funny. So people always, there, there are labs, but what happens in residency, this is great. We should talk about this because people want to know. Right. So general surgery day one, you step in, right? Like they're not like, here's the knife, have at it, take out those appendix. You literally sit there and you hold retractors like a medical student and you watch. Oh, gosh.

You watch, you watch, you watch, right? So there's a reason that it's a five-year training program. Gotcha. I just took a year off to do research, but there's a reason. So as you move through the program and you get higher and higher, you're clearly getting smarter, better. Right. You understand.

And as you're moving up in the ranks- Stomach tougher. Yeah, exactly. It never bothered me. Really? Yeah. Like I never was nauseous. Nothing made me nauseous in the OR. I don't know why. It's just, I don't know. It's weird. That's amazing. It's weird.

I envy people like you. It's weird. So, you know, like your second year, it'd be like, hey, you want to learn how to sew? Come on, throw this stitch. Nope. Don't do it that way. Do it this way. And so you slowly graduate up. And by the time you're a chief resident, which is your final year of training, you're pretty much about to go out into practice. And if you don't know what you're doing, you're in trouble. And so in those cases, the attending surgeon might stand next to you and be like, okay, what's your plan? I'm going to do this. I'm going to make the incision here. I'm going to dissect down and find this landmark, that landmark. You talk through it and they go,

cool, do it. And you just, they just stand there next to you. So you're never doing it alone. There's always someone next to you helping like, Hey, nope, slow down. Don't make that cut before you do that. Do that. So that's how it goes. Right. And then facelifts and all that. Like you say that it's jokingly funny because we don't do a ton of cosmetics in our plastic surgery training. It's mostly reconstructive work. I mean, we do do a fair amount of it. Reconstructive is harder, right? Wouldn't that be harder?

Yeah, reconstructive, it's all tough. Yeah. Plastics is the most misunderstood specialty. Everyone thinks Hollywood TNA. No. And they have no idea of the reconstructive world out there that we partake in. Like car accidents. Crazy shit.

Yeah, you have to like sew people's bodies back together. Like you had half of your thigh chunked out for cancer and we got to take skin and bone, skin and tissue from one part of the body and bring it over here and under the microscope, sew the little blood vessels together so the tissue will live. It's called free flap, free tissue transfer. But there's a lot of crazy reconstructive stuff

that's just nuts. Yeah. It's just most people don't do that stuff. Yeah, that's crazy. It's fun though. That is, that's wild that you were just like, you know what, this is what I want to do with my life. Yeah. I mean, plastics, like I had an epiphany during general surgery. I was like, all right, I don't want to be doing gallbladders for the rest of my life and appendixes and hernias and be in the ER when I'm 70, like with a bowel obstruction. I just started to real, but I'll tell you what happened for me was in, in my trauma training, the plastic surgeons would come over and do a lot of the

reconstructive work for car accident victims, things like that. And that's where I was like, man, this stuff is so cool. So when I went into the lab to do research, I was like, yeah, I'm going to be a plastic surgeon. But I was like, I've already, I'm like two years from graduating general surgery. Why would I bail now? Right. So I just finished. I love that. You're pretty tenacious. It's meh. I don't know. Maybe you are. You're probably, I mean, I'm a tenacious human. You're very tenacious when your mind is set to something, you're going to do it. Oh, for sure. No question. Yeah, absolutely. So take me on. Okay. So you start doing plastic surgery. You graduate. What happens now? Do you immediately open a practice or do you go and work for somebody

else or how does that go? Yeah, it depends. There's two paths that people usually take. They either go academic, so they'll go to the hospital and they'll be in an academic doctor where the hospital hires them as a surgeon. So I'll use Northwestern as an example, because that's where I ended up transferring to Northwestern to finish my general surgery. But so they would hire you to do, you know, be a plastic surgeon in the department of plastic surgery. And you're just a professor and you just kind of do that. You teach, you work with residents, you could be cosmetic, you could do reconstructive,

a little bit of everything. Right. The second path is you're like, look, I want to work for myself. Like, I don't want anyone telling me what the hell to do. Right. And that was me. I was like, I cannot and I cannot be told how to take care of my patients or, you know, in social media, like you can't, those guys can't do it. I mean, the

hospitals just control the rules. Wow. I didn't know that. That's not why, but I'm just saying like, I can do whatever I want because it's my practice. And there's no, there's no one looking over my, there's no lawyer looking over my shoulder to represent the hospital isn't that scary just branching out and opening your own practice fresh out of school it is and that's a lot of weight on your shoulders it's a ton and i got out in 09 which is when the real estate market was crashing right the bubble burst i couldn't get a loan so i ended up finding a guy in Arizona who was like 67 or 68 who genuinely wanted someone to come take over his practice just so that I could take care of his patients. Like he wanted to know that they were going to be taken care of. So I ended up joining this guy, hung a shingle, paid him overhead.

He kind of helped me start to get busy doing reconstructive work. And literally a year later, he was like, I'm out. It's yours. And he was like, he believed in you. Yeah. He was like, whatever instrumentation you want to keep, it's yours, what you don't want. I'm going to sell off, but you're doing great. You're doing good work. Like it's yours. Just do your thing. And it's not like he handed me this Taj Mahal, but he did hand me this book of patients that I was able to take care of. And so, me this book of patients that I was able to take care of. And so, dude, I was humping it. Bunny, I was like driving 45 minutes to the West side of Arizona of Scottsdale to the West Valley to do reconstructive work and breast cancer work, driving home late at night, newborn twins,

just kind of humping it back and forth just to kind of make it happen. And just over time, it just slowly happened. You're a hustler. For sure. Yeah. You are a hustler for sure. What made you land in Scottsdale? Because they are like, they're like, I love Scottsdale and they're like really big with plastic surgery out there. Yeah. Um, so my wife went to NAU, she was a dental hygienist. She doesn't practice now. Shout out to my wife, Alexis Brown. She's the best. Um, she, uh, she loves you guys. We love, we love you guys. We're a huge country fan. So, but so she went to NAU for her dental hygiene training. She was like, Oh, let's go check out Arizona. I know I have a lot of friends out there. It's a pretty cool place. I lived there for a little while. So that's how we ended up going out there to visit. And then I just, I got

the American society of plastic surgery book that lists all the physicians around the country who are board certified state by state, city by city. And I sent a letter to every single surgeon in Scottsdale and Phoenix. I was like, Hey, are you looking for somebody? So that's what Ricky does. That's just what I do. So this guy, this was the guy that had messaged me and said, Hey, I'd love to meet with you. And it's interesting. Cause he told me, he was like, I was about to give up. Like every dude I'd met just wasn't the right fit. And, uh, he's like, so when we met you, we knew like, okay, if this works out, this, this, this guy seems legit.

I love that so much. And the rest is history. The rest is history. Now you still have that same practice or has it like grown? Same practice. I moved, I moved moved offices but i've been i've been in practice for 15 years now holy shit that's amazing it's pretty crazy to think back is it fulfilling very yeah it's very fulfilling and and then there are moments that are tough

right like there's there's moments in being a business owner that's tough um complications don't happen very often but i I've had one. I know, I know Dr. Yoon talked about a death that he had had. I've never had a death, but I've had one bad thing happen. And we, we sit with that stuff, that, that stuff, like you never, all the great people over 15 years that I've done wonderful things for that are super happy. It only takes one unhappy, bad thing to happen where you're just like, it's very depressing. It's, it's, one unhappy bad thing to happen where you're just like, it's very depressing. It's hard, right? Because we carry those losses with us and thank God they are few and far between.

What happened, if you don't mind me asking? Because I know everybody at home is like, well, what happened? Yeah. No, I mean, I'm in the middle of this right now. It's about to be done. And it's weird that it's happening in my 15th year in practice was I had a situation where someone had a really bad wound healing issue with the surgery, something that, that I didn't do wrong, could not have foreseen that this was going to happen. I think there were other things involved that, that may have caused it. I don't know, but nonetheless, whatever, whatever caused it, it happened. And there was a bunch of tissue skin loss in the procedure. And you know, just, it happened. Like you require blood work

before patients go in because sometimes, and I'm not putting fault on anybody here, but sometimes it's people's bodies, you know, like if they have the MTFHR gene mutation or diabetes or, you know, something like can help can hinder the healing process. Yeah. So it is, it is paramount that we take a good history, which I do. I take a thorough history of my patients and talk to them about all their health for every single patient I operate on. Now, this is not an American heart association guideline, but I do this. If they're 20, I get a set of labs in an EKG because God forbid they have some congenital heart thing. I might be the first doctor they've ever seen. Yeah.

I want to know if they have an easy heart thing. And then I get a set of labs just to make sure they're not anemic or anything like that. And in this case that happened, there was something that came up in her history after the fact that I didn't know about that may have contributed to it. I don't know. Oh my goodness. But, but it's just one of those things that happens. But yeah, I totally get labs on everybody.

But look, even in the best of situations. So I have a story for you. When I was in general surgery training, it was my chief year. And I was doing a bowel resection, taking out some intestines, laparoscopic procedure. My attending is kind of standing next to me. And he's letting me do the procedure with the junior resident and we're doing the procedure and I put in the stapling device, which you staple across the bowel to resect a piece of the bowel and you staple across the blood supply and we take that out and we put the intestines back together.

So I fire the stapler and something didn't feel right. Right. I was like, something just felt janky with the device when it fired. I'm like, Dr. T come check this out. Like, I don't, I don't see any bleeding. Everything looks okay, but this just doesn't look right. So he's looking and he's playing around. He's like, Ricky, the suture line looks great. I think everything's cool. It might've just been weird the way it felt. Long story short, we close, we're heading back to recovery and the guy's pressure starts tanking 120 80 like he's bleeding right he's bleeding so clearly the guy is bleeding and we turn him around and we're taking him back and of

course as a chief resident i'm like what the fuck like why did i do that i knew i'm like hemming and hawing about me and i knew something wasn't right and blah, blah, blah. So we get the guy back in the OR and we get him on the table and he reaches across the table and he grabs my hand. He goes, listen, as long as you're a surgeon, you will fucking have complications. Fix it. You do what you can to fix it. And that is the best that you can do. And I was like, okay. And we got to business and we fixed him. So as long as you're a surgeon, you're going to have complications. Yeah, shit's going to happen. And there's nothing you can do about it but to try to fix it.

And when you sign up for surgeries, that's you as the patient have to also know like, hey, we're rolling the dice here. Totally. Because I've had complications with my last surgery that I had with, this was in 2015 with Dr. Khorasandi. I came out of surgery and my fucking heart rate went through the roof. My blood pressure went through the roof. I, now I think it was a reaction to all the, um, the pain. What is the stuff that numbs you? Oh, the lidocaine, the lidocaine. Cause I'm allergic to it. Oh,

are you? Yeah. And we, I didn't find out I was allergic to it too. I wasn't, I didn't find out I was allergic to it until I had some dental work done years after that. And I ended up getting taken an ambulance. But anyways, yeah, my heart rate was through the roof. And I remember I looked at Dr. Korsani and I was like, am I going to die? Like, that's how bad I felt. Like it was so bad. So I mean, anything can happen. Yeah. So your story, this is what happened. Your story is not the lidocaine. It was the epinephrine. Yes. So I mean, anything can happen. Yeah. So your story, this is what happened. Your story is not the lidocaine. It was the epinephrine. Yes. So there are a lot of people when they go to do dental work, the mouth is very vascular and the epinephrine gets absorbed really fast and it can

spike your heart rate. And some people are, excuse me, some people are very sensitive to epinephrine and that's probably what it was. I'm sensitive to everything. Literally my entire life has just evolved around sensitivity. You're just a sensitive girl. I am. I'm telling you. Well, I know that some Patreons want to ask you some questions. Are you ready to ask some questions? And I know you brought some implants and then also we need to talk about this book, the Real Beauty Bible. When did you write this? I wrote that about four years ago. 2019. Yeah. And that book was, um was pre-COVID actually. That book came to be. Signed it for me.

I wrote you a whole thing. Thank you. I'll read it later. You want me to read it now? No. Okay. I wanted to, I'd always wanted to be an author. Didn't know what I wanted to do.

And I decided I was so sick of watching people get botched and not knowing how to find a surgeon. What's the process? Like, what do I need to know going into surgery? I have kids. How do I talk to my family who doesn't agree with me having surgery? So this, this book, this beauty Bible is really just three parts of here, all the things you need to know about before having surgery. The middle part is here, all the different procedures and which one might be right for you. And when is the timing, right? And then the third part is literally walking people through what it's going to be like and how you're going to feel from coming to the surgery center getting an iv to living in your new body and all the new changes so that's where that book came from

what a great idea for a book though i just and i don't promote it well enough i'm so bad at this you need to because a lot of the questions i had on Patreon too, where I had to deal with like leading up to surgery and stuff like that too. And I go through and I give one, a copy to every patient who comes in for a consult. We give them a copy. So yeah, that's the beauty Bible. That's amazing. I can't wait to read it. I'll read it. I know that I am like the worst when it comes to, and I know I have a surgery coming up. I will freak myself out. I'll back out of it like 10 times. Like I, they're so scary. And then you go and you get the surgery done and you're like, Oh, like right now I want

to get a facelift, but I'm so scared to get one because the doctor I want to go to doesn't, doesn't put you under. Oh. And I'm like, I'm freaked out about that. You know? So I don't want to be awake for a facelift. Me either. I don't. Yeah. Is that what you're looking to do? Yes. You don awake for a facelift. Me either. I don't. Yeah. Is that

what you're looking to do? Yes. You don't need a facelift. I'm listen, I got a bullfrog thing going on and I'm 44. So I mean, I'm 53. I know, but in the next five years, I'm going to definitely need to, you know, I mean, look, this is a great topic is when, when is, when is the right time? Yeah. I think that, um, for sure sure if you wait too long it becomes harder to enjoy your results for a long time right i i really try to get patients to to really like outdo all of your other options before you decide to do something like that because you can't go back right yeah but yeah i mean you look so good appreciate you. It's this that you don't like? It's like when I laugh, it like bullfrogs out.

You know what I'm talking about? And I hate it. It drives me crazy. But what would you think? Okay, besides getting a facelift, what would be the best treatment to get under here for anybody who has like that little bullfrog thing? Oh, lipo.

Just suction some of the fat out. I went and a surgeon told me that he said I don't need it. So here's the thing. There's muscles in the neck called the platysma muscle. It's like a corset around your neck. One fans out this way. One fans out this way. There's fat that can sit below the platysma muscles.

I don't do facial cosmetic surgery anymore. But I know all this stuff. So there's fat that sits below the platysma. And I don't do facial cosmetic surgery anymore, but I know all this stuff. So there's fat that sits below the platysma and there's fat that sits on top. So clearly you, yes, you can suction the stuff that's underneath the neck. No problem. If you happen to have some of that under the muscle fat that can only be taken out by surgery. But I don't know that I agree. If you've got some fatty tissue here and you don't like it, you know, people were doing Kybella forever. Kybella is over. It's shit. It doesn't really work. It causes a crazy inflammatory process. It really, it really we've it's we're past it. Okay. Like that is not the way to go. And I tell people one thing you can do awake in the office, which is not a big deal

is submental or chin lipo. It is not bad. They put the tumescent solution in your neck, so it numbs it. And you can absolutely do it in the office awake or just under a little sedation. It does not take that much to do. And just by getting some of the fat out fat for sure, submental light or underneath the chin liposuction, in my opinion, is the most definitive treatment for people who don't like the fat there. And then the skin just kind of contracts down and tightens up. I was thinking about doing the Morpheus eight. Yeah. Morpheus is good. I think you got to be careful. Um, you need to make sure you go to someone who knows what they're doing. Cause I think they were underreporting some of their complications, but, but my nurse does it and

she absolutely loves it and she knows what she's doing and she gets great results. I think in the right patient with good skin quality, like you have, it might be great. Yeah. You could try it, but I just, I'm not a huge believer in skin tightening devices as a solo therapy. I think it's solo therapy. They're not the best. So I've done Fractura and I had amazing results. It's the same thing as Morpheus, but it's a different version. So it's called Fractura and it was and I had amazing results. It's the same thing as Morpheus, but it's a different version. So it's called Fractura. And it was,

I had amazing results for it. My jawline was snatched. So I think, I think it does depend on patient to patient, but of course, you know more. So maybe I'll go find somebody who'll do some lipo under my chin then. I mean,

it's, it's really definitive and easy. Of course, Andy will do it. No. Yeah. We love Dr. Course Andy. All right. Are you ready to answer some of these questions? Yeah, let's do it. We definitive and easy. Of course, Andy will do it. No. Yeah. We love Dr. Course Andy.

All right. Are you ready to answer some of these questions? Yeah, let's do it. We got a lot. Did you get any questions for me? I saw your little story this morning. I thought that was first of all,

different Kayla. Who's my office manager said, I have no question. Just tell her I fucking love her. And she's awesome. I love you too. Kayla. Um,

don't mind my glasses guys. I lost my glasses. So I had to buy these from Walgreens. Those are interesting. I look like I'm like 85 over here. Don't mind me. Don't mind me. All right, listen, I'm blind. I got to pull my clears out, baby.

There you go. We are the shit show right now. Welcome back to the shit show literally i lost my glasses last night i had no opportunity to even try to find them or find a pair that didn't look like this so you guys do not mind what's going on this one girl surge tech 79 asked if you ever hung out with jenny mccarthy i feel like you two would be hilarious together oh I actually you know what Jenny McCarthy Carmen Electra Pamela Anderson those were all my like idols growing up so I love Jenny McCarthy I would love to sit down with her she is hilarious she seems hilarious no

she like embodies everything that I love in women like she's just down to earth she keeps it g and she just you know minds her business you never catch jenny mccarthy in some scandal or some drama like she's always just doing her thug puzzle and she married fucking donnie walbert oh yeah like how cool are you i know yeah that is awesome yeah yeah she seems so cool we used to watch all her stuff growing up when i love her yeah remember when they had that show singled out yeah i loved that and she was mtv for so long like that's where I like really loved her no she was the it girl there's one more so someone said um when you when you were in Wilmington North Carolina did you get a letter from a kid oh uh you know a lot of people will show up to my husband's shows and they give like people that work there

presents or like letters and i always feel so bad because i get these messages and they're like well did you get it and it's like no if you don't hand these off to our personal security or somebody who's on our team we're never gonna see them like so if you guys go to a concert please do not give them to anybody that works at the venue make sure it's somebody on our team and they'll make sure that Mimi and Haley are always running around. You guys can grab one of them or like one of our, the boys that are security. Um, you can always grab them. I saw that in the Hulu special.

Some of those like introductions he had with some of those kids. It's pretty amazing. No, the kids love Jay. They're so sweet. All right. I have a question about fixing tear troughs. I have genetically deep tear troughs and have tried filler and felt that made no difference. And I really, really hate them.

Is there actually a surgery to fix them as I only ever see people fixing the puffy under eyes? So tear troughs are really difficult. So for people who don't know what that is, between the lower eyelid and the cheekbone here we all see that little indentation it starts to starts to get deep with age it's the thinnest skin in the body so it's really difficult filler is typically not great there because filler can really take on fluid if you use a specific filler and it can get really puffy there there is is no great answer for tear troughs. So if you need a lower blepharoplasty, so if they have the fat pads protruding or they have extra skin, for sure, lower blepharoplasty surgery is great for that. You still might have a little bit of

an indentation there. Sometimes at the time of a blepharoplasty, or you can even do this without a blepharoplasty, fat like micro fat, they'll spin fat down, they'll harvest some fat from your body. It's called nanofat. They'll spin it down so it's a really tiny particle and they'll layer in a little bit of fat to try to fill out the troughs. But you have to have,

this is just what I would tell people who are listening to this, like I don't do facial cosmetic surgery anymore. You need to go to someone who does it a lot because those surgeons have it so dialed in. And obviously certain candidates are better than others. It's like their specialty. Yeah. They have it so dialed in that they will know what to do. Some might suggest, Hey, let's do exosomes, you know, with your stem cells first with some microneedling to try to tighten up some of that skin and help. But look, it's an ethnic thing too,

right? Like we see darker skin patients get really dark tear drops. It's just their skin. Like there's not a lot you can do for it. So there's not a great fix for it. Um, but there are some little things that can be done to hopefully improve it. Yeah. Awesome. Awesome answer. Always go to somebody who specializes in what you're looking for sure for whenever i had my explant that's what i did is i yeah searched so i what is it seeked out somebody who like i was going to make sure didn't scar me you know like really bad because i got a lift also i'm gonna ask you if you had a lift i do a ton of explants yeah are you seeing a rise in them now because of big time yeah yeah i mean i do a lot of explants because i don't know a lot of surgeons just don't do it um this is separate from bii like i have a lot

of women who just want their implants out they want their capsules out i think because of my breast cancer reconstructive days i have a really good command on the breast and i feel comfortable doing that operation and a lot of surgeons just don't feel comfortable taking out the capsules i guess but honestly taking out the capsules to a plastic surgeon is like a hernia to a general surgeon. It's just something we do, but a lot of people just don't have the patience because it's a tedious procedure and you have to be really careful when you're on the chest wall. But yeah, I've seen a lot. I've seen a lot of explants. In fact, last week, I think I saw six consults for it. Wow. That's amazing. But I still have a ton of women coming in who want implants. In fact, last week I think I saw six consults for it. Wow. That's amazing. But I still

have a ton of women coming in who want implants. Right. Yeah. Oh yeah. No, that's always going to be a revolving door. Yeah, for sure. Do you think that, um, and I think this was actually a question in Patreon and I thought it was a great question was, do you think that most women who get implants will end up getting BII? No, I don't actually. I think quite the opposite. So my BII spiel is the following, breast implant illness. The things that I hear patients come in and say are brain fog, joint pain, swelling, rashes they never had before.

Some have gut issues. All these symptoms which we could attribute to lots of other things, right? So I truly believe that there's a small part of the population who's rejecting this piece of plastic that we put in their body. Like it makes sense to me as a surgeon to be able to say, is it possible? Of course it's possible. We don't know everything about the human body, but I think it's, it's, it's not, I don't want to miniscule it and say it's a small group. It's a much smaller group than the women who have implants that are doing fine with implants. So I think what's important is as surgeons, we need to be educating patients and saying,

and I do this with every single patient of mine who comes through the door for implants. The last thing we talk about is breast implant illness. And I tell them, while we don't have any scientific data to corroborate the two, we have real people who have symptoms. I don't have a test that I can test you to tell you whether it's going to happen to you or not. We don't have that kind of data. But what you do need to know is you probably have a better chance of not having a problem than you are going to have a problem. I can't tell you whether this is right for you or not right for you because we don't have any tests or study. I know the MTFHR gene you talked about, supposedly some of those patients have a higher, higher issue with it. And I just tell them, listen, if you have it, all we do is

take out your implants, but more women are doing fine than aren't, but I don't want to belittle the women who aren't doing okay. And so what I have a hard time with some of my colleagues is that they just emphatically deny and say, there's no way they're not sick. This cannot be happening. And I'm like, look, man, I'm not saying it is happening, but I'm saying it's for sure possible that it's happening. it into someone's body, it doesn't make sense to shame them or tell them to go away. And I'm not trying to invite people to say that they're sick because I'm talking about this. The party is already here. Like one of my friends was like, don't invite people to the party. I'm like, I'm not inviting anyone to the party. Like the party is here. It's being talked about already. Right. So, and I would rather surgeons just say, listen, I don't believe in this. I am just not, I don't believe in it, but I know Dr.

Smith down the street does. And I'm just going to refer you to Dr. Smith to take care of you rather than being like, you're crazy. Get out of my office. Like your implants aren't making you sick. Like that's the kind of thing that some people are doing to these women and they're getting obviously rightfully frustrated and angry. Yeah. So I mean, not feeling heard. Yeah. But I, I have a lot of women who are just wanting to explant cause they're kind of naturalizing and just want to go back. Absolutely. And that's another reason why I don't claim the BII thing is because like I said, there's so many other women that have way worse symptoms than I did, but I do know after, you know, but I had also got freshly sober. I had, you know, went through a miscarriage. So there was so many things that could have played into how I was feeling.

But I do know now in 2024, I feel better than ever. So could it have been the implants? A lot of people say that. I don't know. Bunny, a lot of people say that. They really do. And the mind is a powerful thing. Absolutely.

So I think this plays into BII a little bit, that maybe you're getting symptoms. And then all of a sudden, when you think you're sick, you know how sick you can make yourself. You can escalate what's already happening. Absolutely. And in the reverse mode, I think once they come out, whether they were or were not making you sick, people miraculously are just feeling so awesome. And if that's their mind, great. Whatever it is, like happy, you're feeling better, you know?

So I think we have to, I think more surgeons need to be more accepting of the possibility. Absolutely. You know, um, we've talked a lot about BII, so I want, I don't want to hinder anybody who's listening and actually wants to get breast implants because I love breast implants. I think they're beautiful. I love the way they look. I love the way they sit. You brought some implants with you. He's so excited. Yeah. Can we play with that? Yeah. Yeah. Yeah. I brought you a jelly. I love the way they sit. You brought some implants with you. He's so excited. Yeah. Can we play with them? Yeah. Yeah. Yeah. I brought you a jelly. I have more questions. Oh, I love that. I have more questions for you, but I want to, I don't want you guys to listen to this and think

like, damn, she's against breast implants. Cause no, I want you to do whatever you want to do for your body. Let her play with them. Let me play. I love, okay. So what are these? I can take one if you want. Um, so those are thrown across the way take one if you want. Okay, yeah, yeah. You want me to throw it across the way? Yeah. This is what my boys do. Let me toss you a boob. Look who woke up. He's like, I too love a boob. Look who woke up. He's like, I too love boobs. He's a man. What do you expect? Ready? I know, I love it. Yay. Okay. All right, so is this, this is silicone, correct? Okay, in your hand you hold an ultra high profile silicone implant. And if you look at the back, I don't, we probably can't say the company's name, but if you look

on the back, it'll say the CCs, 445 CCs. I had 490 in mine. Did you really? And if you have a lot of breast tissue, you were probably big. Oh, I was huge. The style number on this one is X, which means extra high profile. That means I love that. That means like up here Hooters. Yeah. It means it sits tall. Yeah. So here's how I love to explain implants to women and women's terms. Yeah. Implants come in flats, wedges, and high heels, just like your

shoes. So implants come kind of flat. Yeah. That's a moderate profile, a little bit taller, which would be a high profile. And your stilettos would be your ultra high profile. I love the one, put them in my neck. If I ever get, I think I might be 60 and get like the hope high profile just to go out with a bang. Heck yeah. Why not? Jay deserves a nice big fake rack, you know, before he croaks. Oh man. So these are, these are, these are high profile silicone implants. He would love that. I'm sure. Yeah. I'm sure he loves natural boobs. Cause I, he was with me when I had my implants. So these are, these are, these are high profile silicone implants. He would love that. I'm sure. Yeah. I'm sure he actually loves natural boobs because I, he was with me when I had my implants. So, and he, he didn't know what to do with them. He was like, what do I do with all

this? I know. Yeah. So yeah, these are silicone implants, so you can feel how they're softer. These are like the highly cohesive gel. So these are fifth generation implants. Yeah. Whereas back in the day when these first came out, the first, second gens were like liquefied silicone. Yeah. So when these would rupture, it would ooze everywhere. So he loves them. I love that. He's like, I want to lick that. Yeah, he does. Stop. Such a dude. These are the gummy bears, the highly cohesive gummy bears. So if you cut this in half, it would stay very solid. It wouldn't just ooze out, which are the gummy bears. So if you cut this in half, it would stay very solid. It wouldn't just ooze out, which is nice, right? So if you have a rupture, it doesn't just ooze everywhere.

Yeah, you don't want that to go into your body. It stays like in a nice ball of silicone. Has anybody ever had problems with these leaking or anything and making them sick? Yeah, they bust. They all rupture. The rupture rates are about 1% per year. That's what we tell people. So I want to dispel a myth right now.

The most common question I get is, do I have to have them changed out every 10 years? And you do not. So that is an old wives tale. That might have held true for the earlier ones that ruptured a lot easier. But the FDA even changed their guidelines for monitoring silicone now. It used to be every three years they wanted an MRI. Now it's at five years. But I tell people if it ain't broke, don't fix it. If you're not having any problems at 10 years and you feel great and they're doing great, you do not need to have surgery. I would never marry someone to an operation every 10 years. Yeah. That's horrific. I had mine in for 13 years. Did you? Yeah. And like I said, the only reason I had them taken out too was because of the pain. Were yours silicone? No,

they were saline. You had saline. Yeah. I had saline. I was scared to do silicone because back in the day they were not, I have always been kind of, uh, health conscious and I did my studies and I had learned of women, you know, getting like lupus and stuff like that from the older, older silicone implants. I think that is what the BII talk is. I think if we look in hindsight, it's women were having joint pain. They were having joint pain. And so I don't think it's a matter of, this is what I tell my patients in consults. It's not an issue of silicone versus saline as far as I'm concerned. It's the presence of a foreign body versus not because I have patients who have saline who have symptoms and I have patients who have silicone who have the same symptoms. So in my opinion, I think it's just this piece of plastic that's not supposed to be there.

Yeah. Your body's going to love it or hate it. Some women can rock it and some women can't, um, take me on. Okay. So a lot of women have questions on Patreon also like take me through the process of getting breast implants. So I come to see you and I'm like, Hey, I want to get some hooters put in, you know, where do we go from there? Okay. So the come to see you and I'm like, Hey, I want to get some hooters put in, you know, where do we go from there? Okay. So the first thing that I always do with patients and I, I try to ask them, why do you want them? So I, you need to know your why, right? Like you got to be doing it for you and not for anyone else. Cause you wouldn't believe how many women come in that are trying to save a marriage or something else or relationship. That's why I got my boobs done. I caught my ex watching porn with the girls who had like really big tits. And I was like, well, I can do that too.

That's crazy, right? Isn't it crazy how the mind works? So that's my first is what's their why. But then once we- Never do it for a man. Never do it for a man. That's a man telling you. Yeah, there you go.

For whoever, do it for yourself. Yes. So I usually go through certain things in my consult. The first is how do we size a breast? And I always try to tell women, don't focus on a cup size. If you focus on a cup size, you're going to be miserable because no one can promise you an ABC or D cup. Absolutely. I have people go look for vision board photos. I send them to a website where they go look at before and afters of women who are topless. It's a medical website. And I go, hey, listen, find a woman that kind of looks like you in the before, find some afters four or five

that you really like the shape and size. Let's review those together. And we'll hone in on one that we think is a reasonable expectation for you that fits your body. Something I feel I can get to pretty close to creating. And then when I go to surgery, let me decide flats, wedges, or high heels. Let me decide which size you need based on your photo because it might take a different sized implants for you than your girlfriend had. Right. So people get the whole, my girlfriend has a three 30 and she looks perfect. I'm like, well, a three 30 might not even get close on you to what you want. Yeah. Like it depends on how broad your shoulders are. It depends on how you carry your everyone's already. Yeah. So that's

what I do for sizing. Then the second thing we go through is we talk about the operation itself making a small incision in the crease to put it underneath the muscle i talk about silicone versus saline the position of the implant what's the best place to put it we go through what's healing going to be like what are potential complications from the operation what can you and can you not do so no heavy lifting or strenuous exercise for six weeks which is what most people can't stand Um at a month I let people do cardio, but they're a legit bleeding risk for the first month, right? We're creating this pocket and it can bleed So if your heart rate goes up and your your heart rate goes up and your blood pressure goes up exercising

You could pop a clot off a vessel and start bleeding in the pocket Right around a month. They become mature scars on the end of a blood vessel. So it's not as high of a risk. Um, so after I go through that, the last thing I talk about is BII. So I have a specific, like I go through protocol. How do we size you? What's the difference between silicone and saline? Let's talk about where we place the implant. Let's talk about complications and recovery and BII. When you say where you place the implant, does that mean like above the muscle or under the muscle? Because those are options also, correct? So if this is the pectoralis muscle and this is your chest wall, the muscle is sitting on, it can go underneath the muscle where we elevate the muscle and go under or on top. Most of us go under the muscle. I like the protection

of the muscle on top of the implant, especially in women who have thin skin and not great quality breast tissue. If we go above the muscle, the implants are tissue expanders. They are going to stretch your tissue over the years and years that you have them. So if you already have thin skin, that rippling I asked you about the increased risk of rippling is more so above the muscle versus below the muscle. I went above the muscle. And as i got older and like my weight fluctuated and stuff like that my boobs like you know it was like a we were just playing a game over yeah i mean they're stretchers towards the end it was just like they were just flopped over i mean they still looked fucking glorious i look back now and i'm like god i can't even believe i thought these were horrific but i looked amazing but, they did they looked so good

But it was just like they still were away like from the side. Oh, yeah way saggy than it should have been Yeah, if I ever did it again, I would go under the muscle I think an important point for people to realize going into a console if they're thinking about having implants is It's probably the most important thing I tell patients. This will not be your only operation, right? So you need to realize that you are marrying yourself to at least a minimum of two surgeries, if not three or four. Because if you have them and live with them for a long enough time, you will start to have what you had.

These are tissue expanders. They will stretch your skin and they will stretch the collagen sac, the capsule that forms around the implant. They'll stretch over time. And so where they used to be at attention and you lay down and they start going off to the side, that's going to happen. And you might need a pocket revision and a lift and all that stuff. So that's like my younger patients in their twenties that come in who clearly have made up their mind, like fucking for real. I have these conversations with 20 year olds and I'm going through all the shit,

the complications, the bad things that happen. They're like, sweet. So what size am I going to get? Like they've already decided that they're doing this and there's nothing I can do to sway them. Um, having kids, having kids after you have your boobs done, that changes your boobs too. Can we talk about that? Yeah, for sure. Some women don't really have much effect at all and they're fine and they go back to normal, but for sure. So just like implants or tissue expanders, so is the But for sure. So just like implants or tissue expanders, so is the milk coming in. So when the milk comes in and swells, it stretches your skin additionally. So if you already have an implant, then your milk comes in and it stretches and then

it goes back down. Then you have another kid and the milk comes in and stretches you even more and it goes down a little, but now your elasticity is not so great. And the breast is starting to sag a little. Then you have a third kid and it happens again. And so there are women who... Can you breastfeed with implants? Absolutely. So it's better under the muscle versus above. Underneath the muscle, we don't interrupt the milk ducts because the milk ducts go right behind the breast in the breast tissue up to the nipple. If you interrupt above the muscle and we elevate the breast off of the muscle, you could potentially disrupt some of that flow and that pattern of milk production. But, um, so yeah, I mean, when that happens, right, all of a sudden now, you know, the implants here and the breast is starting to sag and that's when they need to

lift and they probably need a new implant. So I think it's fine to have implants if you're not having kids for three, four or five years down the road, right? Tomorrow's not guaranteed, like do your thing. But if you're having kids next year, I'm like, maybe you should wait. Please look at the surgeons before and after pictures of girls and go on the, don't look at what the, just the surgeon posts, go look at those patients, actual pages and see what they look like in their everyday life. You know, cause you, some of these girls are out here just getting stuff done just to say they have it done.

Not realizing that it's scary. Yeah. Vaser is the best by the way. I do that. I do vaser. Yeah. I joke around about surgery though. I'm actually a huge advocate of natural bodies because once you start cutting on yourself,

you're, you're, and getting lipo and stuff like that, your weight distribution is completely different in your body. So like now I collect, I get like saddlebags if I don't work out right. Or like. People ask that a lot. And it's. About lipo. Yeah.

Can we talk about it? Yeah. Yeah. Let's talk about it. Like one of the most common questions is I heard if I have lipo that I'm going to like gain weight somewhere else. So this is what happens. We're all born with a finite amount of fat cells, which means we're, they're determined,

right? So if we suction a bunch of fat off of your tummy, theoretically that fat is never coming back. But the way that you can regain weight in your stomach is if you gain more weight, the fat cells that are left behind can swell back into the space and you can gain weight. But the question that people are asking- And it's harder to lose. It's harder. It can be harder to lose. The question that women are asking is, if I get my tummy lipopo, am I all of a sudden going to gain weight in my hips? It's not that you all of a sudden gain weight in your hips. It's just that you have more fat cells there and they're going to take on volume maybe

before your tummy starts to show. So you may eventually show in your stomach as well, but it might show first in another area and everyone's kind of different with where they carry their fat. So that's, that's the phenomenon that's happening. It's like, because you have lipo, it doesn't cause fat to go somewhere else. It's just that you have more fat cells in an area where you didn't have lipo. And if you're prone to gaining weight there, you might show their first and faster than you would in the place where you already had lipo. Absolutely. But also eat after you have body surgery done you have to eat correctly you cannot just get out of surgery and start eating fucking hot cheetos and in and out and all that stuff

because one you're gonna lose all the results you just went and spent money on getting and two i am here to tell you because i've had to do it myself maintaining uh having work done is not an easy feat. And I'm very vocal about that. The fact that I had the surgery in 2015 and still have maintained these results is because I have the strictest diet ever, you know? And it's like, you ha you have to know that it's not a, it's, it's a quick fix for in the moment, but it's not forever. And you, that's why women get multiple surgeries and have multiple batches of lipo because they didn't, you know, adhere to diets or eating healthy. And they just figured that they could just eat whatever they want. And you can't like, you really have to work at keeping weight off no matter what.

1000%. So this is the BMI question, right? And I am, first of all, I, I preach big, surgery should be your last resort. You should be maximizing your meal plan and your exercise routine before you think about surgery. So we get the BMI question all the time, like, do you have a BMI limit? Yeah. Body mass index or BMI is not- I feel like it's so outdated too.

It is outdated. So BMI is a good sort of a screening tool. It looks at your weight and your height, and it gives you a number that puts you into overweight, underweight, whatever weight, right? The reason that's not so great is because it takes muscle mass into account. So a bodybuilder could have a high BMI that would put him in the obese category, yet they're perfectly

healthy because they're six feet tall and a block of muscle. The fact of the matter is most of the people in America that are walking around with a high BMI are not muscular. That said, the first thing I ask a patient when they walk through the door, how are you on your health and wellness journey? Where are you? Are you happy in your body? Are you trying to lose weight? Are you struggling to lose weight? I try to get my finger on the pulse of where they are because if they're struggling to lose weight, I have a nutritionist in my, in my practice that I match them up with to help them maximize their nutrition plan to get that, that lifestyle part that you talked about in order before surgery. Because if they don't get

their lifestyle right and they're eating well and have a good exercise routine, it doesn't matter what I do. You won't maintain it. If you go back to eating Twinkies and Ho-Hos, you're going to gain weight again. And the surgery was a waste. So that's number one. So it's really important that people realize that BMI, while it is a little imperfect, most people with a high BMI are overweight. And so why is that important with body surgery? When a patient comes in to see me for a tummy tuck, the first thing that I look at, because what they want is to be as flat as possible. I want the skin gone, doc, and I want to be flat. That's what I'm looking for. Awesome. Let me tell you how having a little bit higher

BMI can sabotage your tummy tuck results. There's the fat on the outside that we store, right? And then there's internal fat around our organs called visceral fat. That's the dangerous fat. When we maximize our external fat stores, everything starts to spill out of the bathtub and enters and starts forming around the guts. Those are the things that increase heart disease, diabetes, all of the problems that we see with health. But also let's say surgically, if these are their six pack muscles and they've got the skin on the outside, I can lift that up, pull it tight, cut it all off. Awesome. Behind that are all of your organs. And if you're harboring a lot of visceral fat, it's pushing out on the six pack muscles. It doesn't matter what I do out here.

You will never be flat. When we go to tighten up those muscles, the diastasis repair, I can only make you so flat. So when I tell patients that they probably should lose more weight before surgery, it's not a skinny versus fat issue. I want you to have the best result possible. In order to do that. You need to lose some of that visceral fat, which you can't target specifically. It's just as you lose weight, that will go away. And once that goes away and they just have loose muscles, then you're a great

candidate for surgery. Absolutely. That's what the surgeon should be really explaining to patients. Absolutely. And that's why like, you'll see some of these girls who have like washboard abs, but their abs are like pushed forward. It's because those were made in the surgery room and they have that visceral fat behind their wash. Yeah. I've seen a lot of girls who have had their bodies done have that. Dude, how weird is that carving fat cubes out of fat to make abs?

It looks wild. Weird. Yeah. My, so my doctor did a little, um sketching but he did it so like i'm telling you dr corsani i i say i call him he's just a god like he literally did it so good because it's not overdone but i have a couple girlfriends who have had it done and they look like fucking he man like is it hard for you to look at girls and find them attractive after all the shit you've had to do like no i, I love the

human body. Someone asked me that they're like, do you like walk around and pick everyone apart? I would. I'm like, I don't. I mean, I don't originally when I wanted to be a rhinoplasty surgeon, like I really liked doing noses. Yeah. I would look at every nose. Like I was definitely picking noses apart, but no, I still, the body is still beautiful. Right. And everyone's differently beautiful in their own way. And, you know, the female form is, in my opinion, way more beautiful than the male form. But, but, you know. Do you prefer natural females or females with work done?

Because I know a lot of plastic surgeons who prefer natural women. It's not that I prefer natural versus unnatural because, for instance, I'm in pretty good shape. Like I've been doing crossfit for 10 years and i'm pretty fit i had lipo two summers ago because i collected out here in my my flanks and i hated some people just and i no matter how lean i got i just kind of had it my buddy at the time was like let me do your belly man like i'm like i already kind of have a six pack he's like yeah but whatever's there we take it out. We'll unveil whatever's underneath. And I was like, cool. Like I'm going to be there. Like, go for it. Let's see it. No.

You want me to strip down right now? I mean, just lift it up. I mean, I want to see these abs. I got abs. Yeah. Look at that. I mean, it's not a six pack, but I got, I got little cubes. Look at Doc over there. He's flexing. But the funny thing is, is I told him, I was like, bro, listen, like I would love to have abs and I know they're under there. Like I can feel them. And he was like, yeah, but if I lean you out, like the skin will just kind of drape around him. Dude, he is absolutely right.

It took about eight months, eight or nine months down the road. I was like, did he even fucking do anything? I was like, did he take anything out? And like one day I was in the gym at CrossFit, like we all take our shirts off. That's just what we do when we're working out. Like some guy walked up to me, he's like, bro, you're fucking jacked. I was like, am I? I'm like, I can't see it. Like when I look down, that's not what I see. He's like, no, dude, like you're fucking ripped. I'm like, cool. I'm like, all right, that feels good. But so do I prefer natural versus not? So I'm an example of,

I think I looked great before and I kind of had abs before, but then afterwards it's a very natural look. Like I'm still a 52 year, 53 year old guy and I have some loose skin, but like, I don't mind if someone has a little work done and it looks more natural. I don't like fake. I don't, you know, like I think I am more of a small breast lover, meaning I don't want huge, crazy overdone boobs. I think like a nice athletic looking breast looks really nice. Me too. That's how I feel too. Um, but that is a perfect example on yourself. And for me also is that we are already athletic people. So the work that we had done looks natural. Whereas if you go in and you're not working out and you're not taking care of your body, you're going to get unnatural results

because you're trying to achieve something that isn't part of your form right now. Yeah, exactly. Yeah. I think that was a great, you know, example to use was your own body. That's why I had you lift your shirt up. Babe, I'm sorry. I totally just lifted up my shirt on a podcast. It's all right. We got to get her here here next time I'll show my body to my wife my wife Alexis oh dude her and it's natural

she has the most banging abs on the planet that woman I'm gonna have to go find her I don't know if I've seen her on her page her page is OMG overnight oats she has an overnight oats company and her videos as of lately she just had a big photo shoot, are so cute. You got to go check her out.

I will. She is the shit. We love a hubby that plugs the wife. She's fucking amazing. I love her. How long have you guys been together? I married up, girl. Aw.

Hold on. Let me go look her up right now. OMG Overnight Oats. Hold on. OMG Overnight Oats. 17 years we're coming up on. We've known each other 20. We met in 04

got married in 06 overnight oats she's the best she is such a she's an incredible mom she's an amazing woman she's the bomb I love that yeah OMG overnight oats it's a yellow is this her right here

I think she just recently yeah she's so cute her abs are jacked her face is so pretty i love her cheekbones she's a pretty girl she's gorgeous she is look at you alexis inside and out she's hot i'm gonna have to try some of those overnight oats all right you're ready for some questions some more questions yeah with the kardashians all getting so thin right now are bbls less popular and getting reversed? Yeah, I haven't seen that. Like in my practice,

I haven't had women coming in for reversals. I'm sure that people are. The Kardashians are such a hard barometer to go by. Yeah, I don't really even know if they're having BBL reversals. When you lose a significant amount of weight, won't you lose the fat? Yeah, of course, you'll lose the fat. And some women do suction their butts back down. You can sculpt them back down and lipo them a little bit, but I feel like it won't ever sit naturally. If you do that though, it depends on the quality of their skin and how much you take. So you can't,

they have pretty decent quality skin and you just take enough to kind of devolume it a little bit. Do you volumize it? it can't look really good. But who knows, right? With the Ozempic craze right now, who knows who's doing what? I can't believe Ozempic is on the rise like this. And I actually want to make a TikTok about it because what are your thoughts on Ozempic?

So I think for the casual weight loss person who's trying to lose five to 10 pounds, it's ridiculous. I really do. I don't have a problem pounds, it's ridiculous. I really do. I don't have a problem with it's for obesity. There is an indication for obesity. And I think that it is an incredible tool shy of going to get a gastric bypass. I had a patient who I consulted with who wanted lipo was a guy and he's like, doc, I've tried to do everything. I'm trying to lose weight, all this stuff. Right. He's like, should I just go get a gastric bypass? I'm like, no, I'm like, I would

rather you, if you're truly obese, go try Ozempic first. See if that can help you lose the weight you need to do before you get a tummy tuck or before you get a gastric bypass. And then if you can wean off of it and maintain your weight loss, then you're good, man. Like you're good to go. Because look, even someone who has a gastric bypass, if they don't change their lifestyle, the gastric pouch that's left behind, that's this big will stretch to this big and they go right back to where they were. The lifestyle has to accompany it. Right. So the same thing with those Zympic. So I'm okay with those Zympic for morbid obesity for pay. Cause it really, really can't help. It's better than fen-fen, right? That crap they used to use. So I'm okay with it for that as a lifelong drug. I don't know. I mean, a lot of

docs I follow on Instagram that I'm friends with will talk about it like it's hypertension. They'll be like, look, obesity is a disease and women who, not women, people who have hypertension take a medication for their blood pressure their whole life and they're on it forever. So if someone who has the disease of obesity, maybe they should be on it their whole life because of insulin resistance and it helps to balance that out. A lot of that stuff. But, um, you know, so I just don't like it for the casual weight loss. Right. Absolutely. And I believe that too. And that was actually my next question was about the bariatric surgery. So I'm, I, I like to see where your stance is on that too. Um, my thing is, is I was around for the diet pill craze and I was getting diet shots and

I don't even know what the fuck I was getting shot into me fucking a decade ago for me actually probably 15 years ago. And I had it and I did it for probably six to seven years. I was taking Bontrol, 105 milligram diet pills, Phenermine, getting diet shots every week. And I just know that my health in my 40s, my heart is a normal heart rate for me is 110, 100, 110 when I'm walking. You know, like I last year I had to deal with a bunch of health problems because, you know, my blood pressure was crazy and stuff like that.

And I just feel like this craze is is just like that you know it's not the long you're already hearing people having um you know uh side effects from the olympic and sharon osborne looks like you know heaven forbid amazing woman i love everything sharon stands for but this poor woman what did she do to herself i know look at her face like she there's calling it Ozempic face. And it's like, she didn't need that. She was a beautiful woman. And it's just like you said, she was trying to lose five to 10 pounds. And now look, it becomes an addiction. They, they love that. There's a little central nervous system thing that suppresses your appetite. And then there's obviously it decreases the emptying of the stomach. So, so you hold on to it. You feel full sooner. Um, and it just like, they get addicted to it.

And it's just like anything else where it's like, Oh, I did it to lose five or 10 pounds, but man, I'm just going to keep going. Cause I don't, I, I don't want to eat all that stuff over there. And I don't really desire it when I'm on this medication instead of just kind of developing a little bit of that control, which is hard for people with the disease of obesity. My husband, I live with that every day. Is he still training for the 5k by the way? He is. He's doing so good.

And I'm proud of him. He kind of had a little bit of a setback, but I'm sure he'll talk to everybody about it when he's ready. But it happens, you know, you, and the reason why I'm speaking from the heart from this whole situation is because of my husband, because he's contemplated taking Ozempic and you know, I'm of course against it. Is he a candidate for it?

Absolutely. But at the same time, my husband also has, um, AFib, you know, and it's just like, I don't, we don't know enough about the drug yet to just be pumping it in our bodies, you know, and I don't want him to be a Guinea pig. I mean, I don't, I don't know how it would affect a fib, you know, talk to someone, talk to a specialist. I mean, it is, it is a good tool to help jumpstart people, but I do think the mentality has to be at some point, maybe I'm weaning off of it so that I can, I can get there and stay there, but yeah, he can do it. You've got to be your biggest advocate though. You it's it's, you have

to have dietary changes and stuff like that too, even when you're on it. Lifestyle is everything. I think, didn't he talk about that in the Hulu episode where he said, I traded stopping the drugs and all that stuff and like food was my thing. And so maybe the next step is like controlling that. Yeah. Well, I'm proud of my husband. March is dedicated to my husband doing a whole 30 day program with onsite where he's going to just kind of retrain his brain and his eating habits and stuff because that's my husband's demon and he doesn't eat bad. Like you would think like people who are, who are, you know, considered morbidly obese are eating like fried foods and sugar and all. He doesn't, he eats

healthier than I do sometimes, but he does go off on little binges and that's what really affects him. Yeah. I mean, calorie deficit is major. You have to have a calorie deficit. And also when you get into that loop of insulin resistance, it makes it really hard to get out of it. And sometimes that's why something like Ozempic can help control their insulin to help them start to lose. And if this is in or not, um, kickstarting it, I will tell you my advice to him is dude, it is always this. It is never a straight line. And like a lot of my patients that I deal with, with obesity, who, who just are unhappy and can't get there whenever they have a little trip or a fall, the world falls apart. Yes. I'm like, you have to remember, you are not perfect.

No one is perfect. You are going to have failures. It's what you do after the failure that defines how you're going to go. Right? So it's okay to have a setback and then you just auto correct and get back to where you were. Yeah, absolutely. That's what I try to teach my husband.

Be okay failing. He gets so upset if he falls off and i'm like baby just today's a new day get back on that fucking tricycle and truck you know all right i'm gonna ask you a couple more questions you know about perimenopause and premenopause a little bit my wife's going through it i i know enough to tell you that i'm dealing with it on the other side tell her to get some wild yam cream wild yam wild yam cream it will regulate her hormones and it's like um it's a miracle i've been researching it because i'm really into health stuff sorry i cannot take myself serious with these things on i cannot take

myself serious with these um uh yeah cream what is wild yam cream? Um, I don't know exactly what it's made out of, but Barbara O'Neill, I love her. She is like this lady who is so knowledgeable on just holistic healing and stuff like that. I believe in a lot of, um, Eastern medicine, not Western. Yeah, me too. I'm all I'm down. Yeah. Tell her to just research wild yam cream. Tell her, go down the wormhole on Tik TOK. And And I guarantee you she's going to love it. I haven't started using it, but one of my best friends has. And she is loving it. And anybody that I know that's going through perimenopause or menopause that's been using the wild yam cream said that it's been a lifesaver.

It gets rid of hot flashes. It helps regulate moods, like just everything. Man, it's a good thing. She and I both like our house at like 65 degrees. Oh, yeah, me too. In the middle of the night, she's like, Oh my God, it's happening. Oh, poor baby. Gosh. Yeah. Tell her, get on that wild yam cream. I'll check it out. So what's the question surrounding that? I'll just see. Okay. I was going to skip over it, but we can, can we talk about perimenopause or premenopause? I feel like this is something that more women should be, should understand. It's even hard to get info out of my primary care provider. It feels like women are dismissed

when they express that they feel like they're hitting that stage. These, um, there are a lot of hormones that affect our moods, libido and energy, and this should be talked about more. What I would say to that question without being able to give you the details for the hormone stuff is that if you don't find the right practitioner who listens, go somewhere else. There are so many providers out there who are really good at what they do. And if you don't find the answers from the one that you don't like hearing what you're hearing, go to someone else. Yeah, absolutely. Second, third, fourth opinions. Yeah. I tell everybody to date your therapist, but you can also date your doctor too. You know, find somebody who listens to you because again,

you have to be your biggest advocate for your health. For sure. And you guys get the raw end of the deal, man. The hormone stuff, women. Oh dude, it's rough. Yeah. It's been wild. Yeah. I've had a last year. I fucking had to go through a ton of shit just to learn that I was allergic to rice. Oh, I heard you talking about that. It was, it was really fucking wild, but you just have to be your biggest advocate. Okay. Last question. If you don't agree with a procedure, but the patient or client is really wanting it, what ultimately makes the decision? Obviously you have to please the customer, but where do you draw the line? And was there a particular case that caused you to make that line? This is an easy answer. Yeah. I was always taught who not to operate on, not who to operate on.

If something doesn't align with my morals or that I think is right or wrong, I dismiss them and I send them somewhere else. It's as simple as that. It's, we don't have to operate on every patient that walks through the door. And so as much as I may not be for everyone, they may not be for me. So I'm interviewing the patient as much as they're interviewing me. And if we're having a conversation and I'm sort of getting in a consultation that either what they want is unreasonable or that no matter what I do, they're not going to be happy. I'm honest with them. And I just tell them, listen, I don't think we're a good match for each other. You're awesome. Thank you

for coming here. I just don't think you're the right patient for me. I don't think I'll tell them. I don't think I can make you happy or give you what you want, but I'm going to give you three or four other names if you would like of other doctors in town that I think are phenomenal that you might jive with better. That's amazing. Period the end. Because some doctors would just want to take the money. I can't do that. Bonnie, I probably could be a lot more wealthy than I am by just being unethical and just doing whatever to whoever. I can't. That's just not who I am. And I can't put my head on my pillow at nighttime. I have to feel good about what I do. And, and so everyone's not for me. And, and, and I don't want to, I don't want to hurt people. I'm not in the business of hurting people. We're trying to help people. So if I think that something's not going to go well,

I just divert them. I love that. That's amazing. Yeah. What's the weirdest surgery you've ever done? that's amazing yeah what's the weirdest surgery you've ever done weirdest craziest weirdest outlandish so we do some pretty crazy reconstructive stuff so here i have a good one for you when i was in residency we did a ton of jaw cancer reconstruction surgery so patients would have like a huge segment of their jaw cut out for a tumor. Some of it would be soft tissue. Some of it would be bone. So we used to do a free flap or a microvascular procedure where we would go down to the leg. We'd cut a piece of skin. We'd take a chunk of the fibula bone because you don't need the middle segment of your fibula bone. Yeah. Connected to an artery and a vein. We would take it out of the leg we would have 3d models made of their jaw so we knew the angle of their mandible the lower jaw yeah we would make

cuts in the bone to bend it just like a jaw we would put it into the jaw and plate it we would hook up the artery in the vein and then put the soft tissue in the skin where they were missing soft tissue and skin to completely reconstruct their jaw. It's crazy. That is wild. Oh, a free fibula flap. Dude, they are bad-ass operations. There are a lot of bad-ass operations,

but that's one. I remember doing those and I probably did 10 or 20 in residency. That was like, this is fucking crazy. How long does a surgery like that take? Man, when they go like so extensive, when they go well, those are 10 to 12 hours at least because the ENT surgeons will go in to do all the cancer part.

And they got to check lymph nodes and do all that stuff. While they're doing that, we'll go start working on the leg and harvesting. But we usually are faster and get to a point where we have to pause and stop. Leave it all attached to blood supply. Wrap it up and kind of leave. Let them finish their cancer resection. And once they get pathology to clear the margins, everything looks good. We'll come back and do it. So all together with both surgeons, those can be 10, 12 hour operations. Goodness, that is crazy.

Yeah, it's pretty crazy. We did one that was 18. Oh my gosh. The flaps started to go down. We took them to recovery. You could hear that the blood vessel supply after we hooked them up under the microscope, we, we wrap a little thing around it where we can hear the tone and the vessel and it disappeared and you got to take them back and explore it and see what's happening. Sometimes it's clotted. You have to redo it. So in that case we had to redo it twice. Oh my goodness. Like 17 hours. That's fascinating. It's crazy. That is really crazy. It's gotta be just so fulfilling

to just know that you're making people's lives really. When you see those people leave the hospital, it's pretty bad-ass. It's like a pretty incredible feeling. Breast cancer is that way. Breast cancer reconstruction is that way. But look, I derived the same pleasure from a cosmetic procedure. So something I think we didn't talk about that would be cool is I can't stand the comments that you get about people that comment, why can't you just love yourself? Like when we put up a cosmetic post, why can't you just love yourself the way you are,

the way that God made you? Look, people, just because you want to have a procedure to make something look better doesn't mean that you don't love yourself and it doesn't mean that you don't appreciate yourself. It is okay to do something that you can't do with other means like working out or exercising, like the saggy breast. You can work out all you want, but it is not going to lift and re-volumize itself without a procedure. to lift and re-volumize itself without a procedure. So I derive the same amount of pleasure from a reconstructive procedure when I have a woman come in feeling really down about their body and really negative. And I do a breast operation and they come back crying, happy, and everything's amazing,

you know? Um, so those, those are just, just as amazing victories as the other ones are. Yeah. Well, all in all, it's the same, uh, end game. It's you're literally making these people feel whole again or feel good about themselves. And that's like chicken soup for the soul. Totally. I mean, look, breast cancer reconstruction. I tell people, I see that as a cosmetic procedure. I'm cosmetically rebuilding your breast. And so no matter what I'm doing, it's always a cosmetic thing that I'm trying to make look better, whether it was for cancer or for personal, just wanted something better. It's all the same, same game. Well, we are so thankful for you. We're thankful for you guys. I'm thankful for you coming on the podcast too. Why don't you shout out your social so everybody can find you? Cause Dr. Ricky has a

pretty extensive tick talk. You you're really good at branding me. Yeah. Really? Oh yeah. I do all that shit on my own Really? Oh, yeah, yeah, yeah. Do you know I do all that shit on my own? That's wild that you don't have somebody helping you. I do all my shit on my own too. I need someone. Except for the podcast stuff. It's getting hard. But I mean, I'm everywhere. I'm Dr. Ricky on YouTube.

They can find me on TikTok, the real TikTok doc. And then my Instagram is drrichardjbrown. You know, when you're verified, you can't change your goddamn name. Yeah, I tried. What a fucking pain. And I, and like, it says, you know what I love? It says contact customer service to change your name because you're verified. I'm like, if you could tell me where customer service exists, then I will call them. If you could get an answer from customer service would be great. But yeah, I mean, you guys go to one of those pages and in my bio, you'll find me everywhere else. And I put all my content up on my own

and I get in these phases where I'm like this. I think we all do that. As content creators, it's, you know, some days you're like gung-ho and want to make five videos and some days you don't even want to post. Totally, 100%. Thank you so much for coming on. My pleasure.

Can't wait to see how much ass you keep kicking and faces you keep fixing and boobies you keep making. Like, I'm really excited. Same to you guys. You're going to have to come back and see me. I am definitely coming back, and I want to see you and Jay playing with these. Oh, yeah.

We will. I'm going to be like, hey, babe, I'm getting my boobs done again. He's going to be like, get the fuck out of here. He's like, maybe not. Thank you guys for tuning in to another episode of Dumb Blonde. I will see you guys next week. Bye.