Mind Pump: Raw Fitness Truth - 2242: The Non-Surgical Way to Look Younger With Dr. Anthony Youn

Episode Date: January 4, 2024

The difference between a holistic and traditional plastic surgeon. (1:55) How there are ‘turf wars’ in ALL of medicine. (5:47) Why did he almost leave medicine? (7:15) An example of when n...ot to do surgery. (9:55) Why it is much harder to say NO to a patient than YES? (11:27) The importance of a health coach. (14:05) The supplements you want to avoid before surgery. (18:53) The do’s and don'ts for women post breast augmentation surgery. (20:18) The truth surrounding breast implant illness. (30:49) Why he is NOT a fan of butt implants. (39:42) How does he reconcile when surgery is NOT right for someone? (48:59) The most common surgeries men are getting. (52:42) When to get liposuction. (55:25) His take on peptides. (59:03) What can you do about thinning hair? (1:00:40) What procedures/treatments will he consider as he ages? (1:06:41) The evolution of his social media rise. (1:09:57) Medicine is NOT what it used to be. (1:15:11) His most rewarding patient. (1:22:04) Related Links/Products Mentioned Visit Legion Athletics for the exclusive offer for Mind Pump listeners! **Code MINDPUMP at checkout for 20% off** January Promotion: New Year's Resolutions Special Offers!! New to Weightlifting Bundle | Body Transformation Bundle | New Year Extreme Intensity Bundle Body | Transformation Bundle 2.0  Younger for Life: Feel Great and Look Your Best with the New Science of Autojuvenation – Book by Dr. Anthony Youn Plastic Surgery Societies Issue Urgent Warning About the Risks Associated with Brazilian Butt Lifts Plastic Surgeons Use Abdominal Etching to Create Six Pack TRANSCEND your goals! Telehealth Provider • Physician Directed GET YOUR PERSONALIZED TREATMENT PLAN!  Hormone Replacement Therapy, Cognitive Function, Sleep & Fatigue, Athletic Performance and MORE. Their online process and medical experts make it simple to find out what’s right for you. Telogen Effluvium: Symptoms, Causes, Treatment & Regrowth Hair Wellness from Within | Nutrafol Visit Joovv for an exclusive offer for Mind Pump listeners! Morpheus8 Benefits, Side Effects, Pain, How Long It Lasts | RealSelf The Swan (TV series) - Wikipedia Mind Pump Podcast – YouTube Mind Pump Free Resources Featured Guest Anthony Youn, MD, FACS (@tonyyounmd) Instagram Doctor Youn (@doctoryoun) Official TikTok Website Doctor Youn - YouTube

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Starting point is 00:00:30 there's only one place to go. Mind, pop, mind, pop with your hosts. Salda Stefano, Adam Schaefer, and Justin Andrews. You just found the most downloaded fitness health entertainment podcast. This is Mind Pup Raint today's episode. We talk about youthfulness, anti-aging, rejuvenation, how you can live a long life and look and feel younger.
Starting point is 00:00:55 And we brought Dr. Anthony Yoon on the podcast. He's a plastic surgeon, but he's a holistic plastic surgeon. In fact, he wrote a book called Younger for Life, which talks about all of the non-surgical ways to make yourself look younger. He's one of the most honest doctors and surgeons I've ever met in my entire life. And we asked them all kinds of questions. He was opening, he was opening, answering all of them
Starting point is 00:01:18 in a very honest and authentic way. We became fast friends. We know you're gonna love this episode and you have to check out his book Younger for Life. Now, this episode is brought to you by one of our sponsors. Legion. Legion makes supplements for high performance athletes. People interested in fat loss and muscle gain. People who want the best. That's what Legion's all about. Anyway, go through a link and get yourself a discount. Go to buy legion.com. That's B-Y-L-E-G-I-O-N.com forward slash mine pump. Use the code mine pump, get 20% off your first order. If you're returning customer, the
Starting point is 00:01:50 hook you up with double rewards points. We also have a huge sale this month. It's beginning of the year. And this is what we do once a year in January. We put together four bundles, each one of them between 300 to 350 dollars off. Check it out. We have the new to weightlifting bundle, the body transformation bundle, the near extreme intensity bundle, and then another body transformation bundle, this one's 2.0.
Starting point is 00:02:14 All of them on sale, all of them only this month. If you're interested, just click on the link at the top of the description below. Dr. Yoon, welcome to the show. Hey, it's my pleasure. This is a privilege to meet with you guys. Thank you.
Starting point is 00:02:27 So, okay, so you've been referred to as a holistic plastic surgeon. Yes. What's the difference? What's the difference between a holistic plastic surgeon and just a traditional? So, yeah, so I went through my traditional training. I did four years of medical school.
Starting point is 00:02:38 I did three years of general surgery residency where I worked in ICU's and I worked in trauma bays. I did two years of plastic surgery. Then I worked in ICU's and I worked in trauma bays. I did two years of plastic surgery. Then I actually did a one-year fellowship in cosmetic plastic surgery on Beverly Hills with a top-name plastic surgeon. And for many years of my practice, I practiced like a traditional plastic surgeon. There are these sayings in surgery to cut is to cure, or the only way to heal is with cold steel.
Starting point is 00:03:02 And as a surgeon, I knew that my goal, we were always taught the goal is to operate, is to bring people to the operating room. So if you're, let's say, a general surgeon, the goal is to bring people to the operating room, and what surgery would you love to do? The big operation is the Whipple. The Whipple is a 10-hour massive cancer operation
Starting point is 00:03:22 that if you're so lucky that you can scrub into a Whipple, you know you have made it to the upper echelon. And that's when they remove, I had a client that performed this up here at the Good Samaritan here in Los Gatos. What are you removing with that? There's a lot of... Yes, you're going in here. Mainly it's for pancreatic cancer.
Starting point is 00:03:38 That's right. So, and pancreatic cancer spreads so quickly that this is an operation where you remove basically wherever it is. And it can be literally 10 hours long, and no, you don't stop and go to the bathroom in the middle of the operation, like you just plow through it. And so in plastic surgery, the pinnacle of success would probably be the facelift, you know, because people may trust almost anybody to do some lipo on them, but man, if you're going to have somebody do a facelift on you, you got to really make sure that that's
Starting point is 00:04:04 a good surgeon. So for many years, I actually gauge the success of my practice on how many facelifts I was doing. And I reached a point in my practice where I had a one-year waiting list. I had people flying in from all across the country to see me. And I was doing these facelifts, and I thought that I had reached the pinnacle of success. I was like the busiest guy in town, and everything. And then I had a patient of mine
Starting point is 00:04:25 who had a horrible, horrible complication after facelift. And it was one that I couldn't have predicted or prevented. It wasn't her fault, just sometimes as a surgeon, like bad stuff happens. And so it really sent me into a tailspin for months as I honestly thought about leaving medicine all together, I questioned Jesus, is this whole practice of cosmetic surgery? Because I do all cosmetic surgery.
Starting point is 00:04:51 Am I really doing the right thing as a doctor? It's that whole Hippocratic oath of do no harm. Am I now doing harm? So for many, many months, I really thought about it and I struggled with it. And I finally realized that everything that I had been taught about surgery was wrong. Like the goal of a surgeon should not be to bring people to the operating room. My goals should be the opposite of that. Like how do I keep people out of the operating room and still have them be happy with their
Starting point is 00:05:18 appearance? And so I started taking time to study things that I was never taught in medical school, nutrition, skin care. We didn't even spend any time as a plastic surgery resident. I didn't spend any time with dermatologists, believe it or not, because it's a big turf war. So, I studied works from dermatologists, from gut health doctors, from alternative medicine specialist.
Starting point is 00:05:41 And I came up with this concept of auto-juvenation, which is the basis of my new book, and this idea of holistic plastic surgery, which essentially is using actual plastic surgery as a last resort. And so that's something I have been for the last gosh eight or nine years, have been really kind of pushing, and have been pretty much at the forefront,
Starting point is 00:06:01 and it does, I do get some pushback, because sometimes you're telling people, hey, maybe you shouldn't get this done and there's a plastic surgeon who had already signed that person up for surgery, they're making money off them and now I just took money out of their pockets. Wow. So you said turf war between dermatologists and plasticists. What do you mean by that? Because they're both, they're both trying to get the person's skin better. Dermatologist is like, this is what we do. Surgeons like, this is what we do. So they're composing forces. There are turf wars in all of medicine. So with plastic surgeon dermatology, yes, you know, as a plastic surgeon, if somebody has acne issues, I'll
Starting point is 00:06:33 send them to the dermatologist. But if they want Botox, they can have it done with me or they can have it done with the dermatologist. If there are some dermatologists who are delving into actual surgery, I know some dermatologists doing eyelid lists, some of them even kind of getting into facelifts. As plastic surgeons, I have a complete skincare center at my office. We have lasers, we have, I have five injectors, I have two S-thetitions to do lasers in skincare. So there is that overlap. And dermatologists in plastic surgeons sometimes don't like that because they feel competitive. But you see this with other fields too.
Starting point is 00:07:06 General surgeons used to do all types of operations from thyroid surgery, to mastectomies, to collectomies, to appendectomies. Now they are limited because you've got colorectal surgeons who do the colon surgery. You've got endocrine surgeons who will do thyroid, you've got breast surgeons who will do mastectomies. So general surgeons are getting actually really down to doing the things that these other specialists don't want to do, appendectomies in the middle of the night,
Starting point is 00:07:33 you know, stuff like that, trauma surgery, where you have to spend the night in the hospitals, and so medicine in general is a big turf war. Well, going back to when you had that moment where there was a complication, and it sounded like it was very challenging for you, in general is a big turf war. Wow, but going back to when you had that moment where there was a complication and it sounded like it was very challenging for you, why were you thinking of maybe leaving?
Starting point is 00:07:52 Was it because you were just like, okay, this, I have my intentions are good, this doesn't seem to be like, what did that feel like? So, what happened is the exact story is I had a patient who was in her 60s, a woman in good health from what we could tell. She wanted a facelift. She had some loose skin over neck, some juggling, and she seemed to be a good candidate for it. So I had her cleared by internal medicine physician. Anybody over 40? I always get them cleared by their doctor. She had a clearance by a cardiologist, including a stress test.
Starting point is 00:08:21 On a Thursday morning, I performed a facelift on her, the surgery goes perfectly, like no bleeding. We kept her overnight in the hospital, which was at the time routine for me. And then next morning, Friday morning, I went and saw her and everything looked great and I sent her home. Fast forward, I come back to the office Monday morning and I have a message from her daughter. And the message was, why did my mom die? Oh my gosh. Oh, wow. And just like it's silent in this room, like I get this message from my office manager
Starting point is 00:08:54 and I mean, I was just floored. Like I had a sick feeling in my stomach. I started to sweat and feeling nauseous because what the heck happened. And, you know, I saw her and she was fine. So what happened is she had a massive heart attack over the weekend. Now I had her cleared by a cardiologist.
Starting point is 00:09:12 I couldn't have done anything different. But when something like that happens, and this is the only person that this is the only patient I know of that's ever died after an operation for me, that sent me into a tailspin because I started thinking, first of all, is this my fault? Did somebody actually lose their life because of what I did? And I went through everything. I went through the old records. Is there a medication? I think because it took a while for us to find out why she died. I didn't know. So I poured
Starting point is 00:09:38 through the charting, I poured through all the hospital stuff. I could find nothing that I could have done differently, other than just not operating on her. And so after that, I contacted the family. I, it wasn't much to say, just I'm really sorry. I gave them all their money back from the operation. I just said, here, help me, because they said, look, we don't have much money to pay for the funeral. I'm like, well, here. And, and it literally, once again, at ex now, you know, story, that's why it sent me into a tailspin. And for months, I just thought, geez, should I just quit? Like, is something, this something this bad happened? Is it my fault? And I didn't know until really months later after the autopsy of exactly what happened to her.
Starting point is 00:10:22 So give me an example of like a patient that would come in, say today, that maybe in the past that you would have done surgery, where now you push them in a different direction. Like what's an example of like that? Oh, easily I would have gone on to the knife on that situation where now I would tell them to do this. So there are people who will come in. You know, so for example, right now,
Starting point is 00:10:43 the good thing is that there are so many things that we can do short of surgery to help people look better. Even when I start my practice back in O304, if you said, hey, I wanna get rid of some extra fat, I'd say, where do I always have this lipo? Now we have injections that can melt fat, we've got lasers, we can freeze fat,
Starting point is 00:10:59 there are a lot of other options available, but the one thing we cannot do without surgery is get rid of excess skin. So if you've got skin hanging from your neck, if you've got skin that's all over your eyelids that you can't see that well, you know, if you're a woman who's had four children and you've got skin hanging from your tummy with rashes and sores underneath it, there's no cream that's going to make it go away. There's no injection that will make it disappear. You just have to cut that out. So then there are those patients who come to see me and they've got a lot of extra skin
Starting point is 00:11:28 and jowling and hanging skin. Yeah, they're really their only option is a facelift. But there's that group of patients where there's extra skin there. There's some early jowling. It's kind of a gray area. In any of those situations, I really try to encourage them. Look, you got to consider all the risks. Are you sure you want to do this? Let's talk about other options for you.
Starting point is 00:11:50 And if we can get you happy and healthy without doing this, then that's obviously the ideal situation. Now, you've probably had to really work on how to communicate that because I remember as a trainer, one of the biggest struggles I had early on was people would come to me wanting to lose weight or whatever. They'd have an idea of what they wanted. They would tell me this is how I want this is how I want to feel This is my workouts. Here's my target and I knew as a trainer
Starting point is 00:12:12 That's unsustainable your goals unsustainable the workouts that you think you're gonna work for you are way too excessive They're not gonna work for you, but I was always like but they're not gonna hire me if I don't do what they ask and how do I communicate this? So you've have you had to work on how you can like communicate to them like, hey, I'm telling you right now we're not gonna do this, but I, there's still value in what I'm saying. And here's why, and this is why you should just go down the guy down the street who is gonna operate on you no matter what. So I say two things. The first thing is that I, I'm very fortunate and then I have a waiting list of over two
Starting point is 00:12:42 years for people to come to see me. Okay. So I'm lucky that I don't have the stress that other surgeons may have. Regis, they look at their operative schedule, it's empty and they need to operate to make money. Like, I have no worries with that, which has always been the case of my practice, which I've been very fortunate. But the second part of it is you are 100% true. It is much harder to say no to a patient than it is to say yes. Because
Starting point is 00:13:06 it's not like you say no and they go, okay, that's fine. Thanks anyway. You don't want them to leave your office upset. And for me, I get patients that say, hey, I waited two years to come see you. And you're saying no to me. And that, because they'll say, I waited two years. I could have gone to Dr. Sohn so and had this done a year and a freaking half ago. Now I'm waiting for you for two years, I pay all this consult money and you're saying no. And so it is, yeah, it is a bit of an art. How do you get somebody where they come in knowing what they want and to have them leave your office actually liking you and being happy with you? And that's something that, you know, I've been in practice almost 20 years and it's taken a long time to kind of figure out that dance that you do with the patients.
Starting point is 00:13:49 And it really is being honest with them, but also I think talking with them, I think very, it's honesty and it's also respectfully, sometimes you can agree to disagree. And a lot of times I'll just tell them, look, you know, what you want, I cannot give you. I physically can't give you. You know, do you want to go to the surgery
Starting point is 00:14:10 when we know we're going to fail? You know, and they, what are they going to say in that situation? Because sometimes our expectations are so odd aligned with what reality is that there's nothing you can do that's going to make them happy. And that's the worst situation as a surgeon is to operate on somebody, have them pay all this money, have all this recovery time,
Starting point is 00:14:27 and stuff like that. And then they don't get the result they want. People get upset. Of course. Now, you have other alternatives, like you've tried to kind of figure out other procedures and things that are quite as invasive. Do you also work with other practitioners that you've built in a network to kind of address more holistic needs for each one of these patients? I'm to an extent. So I have in my office, I've got a full team of skincare, a statistician. Basically, everything from literally just encouraging people
Starting point is 00:14:56 to get on the right skincare products to actual surgery. So I've got nurses, a statisticians myself. I don't have a dietician, I don't have a health coach, I have looked into that. I just have, you know, withitian, I don't have a health coach, I have looked into that. I just have, you know, as much, I guess, interventions and stuff that we do in my office, we just haven't had the, I haven't had the chance to bring in, I've just been so busy, honestly.
Starting point is 00:15:16 But that would be the next thing that we have taught about is bringing a health coach in to help people prepare even for surgery. Oh yeah, I could see a definite fit for that. That would make a huge difference. Cause I was like, I was talking off air, I worked see a definite fit for that. That would make a huge difference. Because I was telling off air, I worked with a lot of surgeons, and at one point, once they were with my clients,
Starting point is 00:15:30 they would send me their patients. And the success of their procedures and the recovery was so dramatically improved, just because they were fit going in and stronger. I understood correctional exercise. They're like, I never had to advertise at that point because the doctors would just send me patients. The challenge for you is gonna be finding someone who's good.
Starting point is 00:15:49 That'll be the challenge, right? That's always the challenge, right? It's gonna be good. And when you go through traditional training, they don't teach us anything about nutrition, about supplements or any of that stuff. And so, you know, for me, as early on in my practice,
Starting point is 00:16:01 I knew what I was taught. You know, I scored at the highest in all of our exams and all that type of stuff. I became certified. I scored it the highest in all of our exams and all that type of stuff. I became more certified. I was the top guy in town. And you know what, for probably the first eight or nine years of practice, if somebody would come to see me for surgery, they'd say, hey, I'm on all these supplements. What do I do? My answer to them was go off your supplements and you'll be fine. And then they'll ask me, what should I do for diet? And like, just eat a regular diet, avoid, you know,
Starting point is 00:16:25 garlic right before surgery and stuff like that. Because I didn't know. And the fact is, is a lot of traditional doctors don't know what they don't know. And so after this happened with that patient, it really got me thinking like, I've got to do this differently because I will not allow this to happen in my practice ever again.
Starting point is 00:16:44 And once again, it wasn't my fault. I've never been sued. I've been in practice 20 years as a surgeon. I've operated on tens of thousands of people. But I think really what I realized was I don't know what I don't know. And I started taking a lot of time, I mean, thousands and thousands of hours learning
Starting point is 00:17:01 what I didn't know. And interestingly, the first thing I did was I created a supplement system for my surgery patients. So I started looking at the research and combining the readings from alternative health physicians, alternative health experts, nutrition, and then I started actually comparing that to the literature in wound healing and surgical ICU. So I look at, hey, what are they doing for patients who have pressure sores in the ICU, who have diabetic ulcers?
Starting point is 00:17:30 How are they giving them nutrition? What helps them? And I combine the two into the supplement system, and I tested on my patients, and since then I've been using that, and interestingly, what I found over the last few years, as more and more doctors are being open to the fact that supplements actually help people people and that nutrition really does make a difference in
Starting point is 00:17:49 healing is that companies are creating their own products. I never actually put my products out there because I had a thought, okay, I've got this supplement system, I can sell it and patients will buy it because they want to heal from surgery and a lot of people believe that that will help them and I do too. But I was worried that some surgeons going to operate on somebody. They're going to get a complication and, oh, here's the easy scapegoat right here. Oh, you got that bleeding because Dr. You told you to take this, you know? And because I don't have studies to back up my specific products, because I don't have
Starting point is 00:18:18 time to run any of that stuff, I said, hey, I'm just going to keep it in. But now I'm finding there are these companies coming around who are creating supplement lines for pre and post operative patients, and they have almost the exact same things that I found. So, I'm like, hey, I actually had that. You wanna know what's funny, Dr. Unay? You wanna know what's funny, Dr. Unay? The sports supplement market will often look at the literature
Starting point is 00:18:40 that's done on post operation or burn victims, and they'll look at those and say, oh, glutamine, branching amino acids, essential matter, they help with burn victims heal faster than they'll apply it to the athlete and stuff like that, which is kind of interesting. By the way, do you use amino acids and stuff like that post surgery?
Starting point is 00:18:58 Or what are the things? So I have glutamine and amino acid supplement and then an Argentine supplement. Those are the two that we have patients on because that's where all the literature shows. Now it's the arginine for the vasodilation I'm assuming for the improved blood flow. Is that for before after or both?
Starting point is 00:19:13 It's both. So we have them start that two weeks before surgery and then they go about a month or so afterwards. Okay. And then you mentioned something about garlic beforehand. I'm assuming it's because of its anti-coagulant properties. What are, and this is very important for people to understand. There are very common over-the-counter supplements
Starting point is 00:19:34 that you can take that you do not wanna take a week or two before surgery because it could cause problems. What are some of those? I mean, the big one is gonna be fish oil. Yeah. So fish oil is the one now. Fish oil, interestingly though, I do give my patients fish oil as a supplement, but we have them all started two weeks after surgery because there is a risk of bleeding post-operatively
Starting point is 00:19:54 for the first two weeks, at least in the operations that I do. And so, that's that really is a big one. St. John's word, that may also increase the risk of bleeding. I mean, those are kind of the main ones that we look at. And then the problem is that there's some that we just don't know. You know, we just haven't. Have you looked into creating for its ability to heal the body? I've seen a lot of literature on it for organ health and stuff now, but I don't know how it would affect.
Starting point is 00:20:18 Yeah, I haven't looked specifically at it. I know that that's become a pretty hot topic. I know you guys are big fans of it. You know, for me, I think it makes sense though, because what happens when you undergo and at general anesthesia is that your body will break down skeletal muscle afterwards. And it will, no matter what. And so part of it really is going to be,
Starting point is 00:20:37 hey, trying to get the body enough protein to help counteract that skeletal muscle breakdown. You know, creatine obviously, it can play a big part of that. Calp, present. One of the biggest questions we get from our audience comes from our female audience in regards to plastic surgeries in regards to breast augmentation. So, and I get I used to get this all time as a trainer. I don't want to work out my chest anymore because I have, you know, I got breast augmentation. Doctors said, can't don't do any chest exercises. Now as a trainer,
Starting point is 00:21:04 my expertise is not surgery, my expertise is not, but it's an exercise in health in regards to fitness, and not training a muscle group always felt so wrong to me. Yeah. Because of the imbalances that could be caused, I mean the pectoralis is important for lots of different functions,
Starting point is 00:21:18 including helping to stabilize the shoulder girdle. So okay, all of a sudden, we can't train your chest at all. So is there any truth to that? I know it changes the angle of pull with the peg. Maybe we could talk about that. So, the answer is it depends. So, implants can be put in two planes, either above the pectoralis muscle,
Starting point is 00:21:37 which we call subglandeter, or under the breast gland, or you can put it under the muscle. Now, under the muscle, technically, there's a complete sub-pactral, meaning it put it under the muscle. Now, under the muscle, technically, there's a complete sub-pactral meaning it's completely under the muscle. There's dual plane meaning it's partially under the muscle and partially not. Those are kind of the main things. So, whenever let's say I get patients who come to see me in their bodybuilders, and I do
Starting point is 00:21:59 a lot of breast-dominitation surgery, I will usually encourage them to go above the muscle because then you're not going to get that distortion. So the issue is if you have an implant that's under the muscle, the benefit of going under the muscle is that it lowers your risk of capsular contracture. Capsular contracture is when the scar tissue around the implant gets real thick and hard. Now, whenever you put an implant in the body, no matter what type of implant it is, no matter whether it's in your knee or in your chin, or in your breast, you will get a capsule around it.
Starting point is 00:22:28 Capsule is scar tissue. And that scar tissue can be real thin to the point where you can't even feel it, you can't tell it's there, or it can get real thick. And in some extreme cases, it can even become calcified like the shell of an egg. So in the most extreme cases, I can see a woman who may have had her breast and a silicone implants placed back in the most extreme cases, I can see a woman who may have had her breast and silicone implants placed back in the 80s And they are these rock hard balls on the chest you bring them to surgery and it literally is The like calcified to the point where it's white and chalky on the inside like literally white and chalky
Starting point is 00:22:58 And then the flip side of that you can have scar tissues. It's so thin that it's like wispy thing like a thinnest tissue paper Okay, and the ideal obviously is have is having thinner scar tissue that you can have scar tissues that's so thin that it's like wispy thing like a thinnest tissue paper. Okay. And the ideal obviously is having thinner scar tissue because then the breast is gonna feel more natural. So when you put the implant, so the number one most common complication from implants is calpcer contracture is the scar tissue
Starting point is 00:23:20 other than maybe breast implant illness, which we can talk about as well. Yes, sure. And so the best way to reduce the risk of that or one big way is to go under the muscle with it. And we believe that it may be the movement of the muscle over the implant can help prevent that scar tissue from really getting thick.
Starting point is 00:23:35 It could be the blood supply from the muscle, getting rid of any type of biofilm or bacteria that may be around there. We're not exactly sure what. That's what I've heard. I know one surgeon literally soaks the implants and like antibacterial stuff. We do it with all of them.
Starting point is 00:23:50 Oh, anyway, okay. Yeah, so yeah. So the goal is you don't want to get bacteria on the implant, but breast tissue sometimes has bacteria in the ducts and in the glands, and so you can get it anyway. So anyways, you can go below the muscle because you can lower the risk of complications, but the negative going below the muscle
Starting point is 00:24:07 is that when you flex those muscles, what happens, those muscles contract, they flatten on the chest and the implants move outward. Okay, and you may see videos on like TikTok and stuff where women are moving their chest all around, or you may see people when they're doing posing after with bodybuilding, and you can see this distortion of the chest
Starting point is 00:24:27 from their implants. So my patients who are bodybuilders, I'll say, hey, look, you have a choice. And occasionally, they'll choose to still go onto the muscle to say, hey, look, it's not that important to me. I really wanna make sure I lower my risk of complications. But a lot of them will go above the muscle
Starting point is 00:24:43 because then when you flex that muscle at the implants above the muscle, it's above the muscle. The muscle flattening is not going to really change it. So if you're above the muscle, whatever you want to do, go ahead because that muscle is not going to impact it. But if you're below the muscle, what can happen is kind of how like when they flex their chest muscles, the implants will move outward. What I have seen in some women
Starting point is 00:25:05 where those muscles are really, really well developed, is that it can gradually push the implants out to the side. It increases the pockets at the sitting position. It pushes them out and you get a wider gap between your breasts potentially. So when I do them below the muscle, which I do in probably 90% of my patients, I tell them, look, by
Starting point is 00:25:25 all means, stay fit, stay toned, just don't work out, don't try to build up your chest muscles. So, yes, you can do some pushups, you can do some benches, but you don't want to have chest day. Don't do chest day if you've got implants under the muscle. You're not going to cause like a big complication, you're not going to pop your implants or anything like that, but you may notice five years later, if you keep doing that, that those implants are gradually moving outwards. Now, okay, so is there like a candidate that you would like steer more towards like over
Starting point is 00:25:55 muscle or under muscle or how does that work? Yeah, so really the benefit of going under the muscle in addition to the fact that you have a lower risk of that capsule of contracture is that you can get some coverage of the implant by the muscles. So, you know, the one thing a lot of people don't, a lot of women don't like when they get implants is that you can sometimes see wrinkles of the implant, especially people who are really lean and they don't have much breast tissue. So, the muscle will cover the top half or so of that implant,
Starting point is 00:26:19 reducing the risk of wrinkles that may be visible through the skin. So, that's the first thing. The second thing is if women have a history of family history of breast cancer, going under the muscle is a bit easier to see on mammograms. And so that would potentially be beneficial. So yeah, so if you have a female who's thinking about implants and G's my mom and my grandma both had breast cancer, I mean, number one, you got to consider it is that the right thing for you, you know, look into potential genetic analysis to see if you're at high risk. And if you are,
Starting point is 00:26:48 do you really want to do implants because at will obscure your mammograms a little bit? And the second thing is if you do have a family history and you're at all concerned, then going under the muscle, probably make it easier to see any type of potential. Now, what about the implants that are textured underneath, they prevent them from moving, and I've read that there may be a potential increase for certain types of cancers coming from these types of implants, is that true? Yeah, you got it.
Starting point is 00:27:12 You're on top of this implant thing. Okay. So yeah, I'm telling you, I said, now he's a trained a lot of doctors. And let me tell you, he knows his implants. Now, this is implants. Here's why I love trained doctors.
Starting point is 00:27:22 So I used to ask some questions all the time while I trained them. So it's like, I was great. So yeah, breast implants come in a smooth surface or a textured surface. A textured surface implant feels like kind of like sandpaper on the top. And a lot of doctors will use that, have used that in breast reconstruction,
Starting point is 00:27:38 where let's say you've got a woman who underwent mastectomy, she does not have her native breast tissue. The textured implants are made to kind of stick in place. That sandpaper surface is made to kind of grow into the tissues around them so that they just don't move. Now, cosmatically, I never really like them because most people want breasts that are kind of soft and natural, not ones that are kind of bolted onto your chest. But in certain situations, those implants helped women, especially like I said, in reconstruction. But what we have found is that there is a rare type of cancer, a type of lymphoma,
Starting point is 00:28:11 an aplastic large cell lymphoma that is associated only with the textured implants. It's rare. There's, I think, upwards of 500 confirmed cases in the United States out of hundreds of thousands of millions of women with these types of implants. So it is definitely rare, but there have been a few people who've actually died from it. And so the FDA actually banned the use, or they recommended banning the use of one of those types of implants. It was actually taken off the market. And then there's still two that are still available.
Starting point is 00:28:43 And like I said, the benefit of that implant is stability and that it's supposed to stay in place. But we believe that what happens is if you get, and this is a hypothesis, we don't know how it causes cancer, but the belief is that if you get a biofilm of bacteria on it, which is just a little coating of bacteria on the surface of that implant, because the implant is textured,
Starting point is 00:29:02 it has these tiny little nooks and crevices, and you can get bacteria that kind of grow in there, and those bacteria will then cause your bite to a listen immune response. Oh, that's right. And if you have that immune response happen, you know, day after day, year after year after year, the average is about seven years where this cancer can develop. We believe it may have to do with that type of an interest. Is there, within the surgeon community,
Starting point is 00:29:28 is there a sense of pride around the job that you do and is like, is breast implants a really difficult surgery? And there is a real art form to how well it turns out or is there a lot more just genetics in what you choose as far as the profile of it? I think that I just a good question. I think that there is a lot of pride when you are doing fix-up jobs because breast implants can really go wrong. Okay. And one of the things I do a lot of are fix-up jobs for
Starting point is 00:29:56 breast implants. And it's frustrating because you get scar tissue problems. You can get issues where one implant moves outward to the side. The other one doesn't. You know, you could get... And is that the surgeon's fault who did it before or is it... Sometimes, but not always. And a lot of women, their anatomy is different. You know, they show up and one breast is real droopy, and the other one's real small, and not droopy, and it's trying to make them as even as possible can be definitely a challenge. Yeah, I've seen...
Starting point is 00:30:21 So, I mean, I don't have nearly as much experience as you have, but I've dated a handful of, I've actually had five different girlfriends that had breast implants while we were together. So I actually saw before and after his first hand, right? And one of the things that I realized was it, or at least in my experience of seeing this was like, it was less to do with the surgeon per se, and more so, just genetically what they had before going hand. So like, the best job was the girl who already naturally had really good symmetrical boobs
Starting point is 00:30:49 before and afterwards, it looks amazing. I basically tell them, you're going to look the same as you do now, just bigger. Yeah. Yeah, the implants aren't going to move one nipple higher than the other or anything like that. You're going to have what you have just bigger. Yeah. Unless something goes wrong then.
Starting point is 00:31:02 I did have a case with one of my girlfriends who had one that was significantly larger than the other and that balanced it out. So that made a massive life-changing difference for her. And that's very common. Most women have one breast bigger than the other. That's natural. Dr. you mentioned breast implant illness. Okay, so I've heard that this is a myth from doctors
Starting point is 00:31:22 and I've heard wellness people say, no, it's not. I've had people say, oh, I got mine out, and I feel so much better. And then other people saying, well, it probably wasn't that. It was something else. Is this a real thing? Seems like there's a big movement towards removing
Starting point is 00:31:34 because of this. So the history of breast implants, I'll just, and breast implants, I'll just kind of summarize it for you. Back in the 80s and early 90s, I was a big hubbub, a big uproar, because a lot of women believe that they're silicone breasts and plants were making them sick.
Starting point is 00:31:46 So there was a class action lawsuit, Dow Chemical went bankrupt and implants actually in 1992, the FDA imposed a moratorium on silicone breast implants saying that you can no longer use them unless they're in an FDA approved study. So they were taken off the market in 1992. So from between 1992 and November of 2006, we are only allowed to use saline-filled implants. So all the women, other than the smaller number of them in the study, all got saline implants for that period of time. Fast forward to November of 2006, the FDA lifts the ban on the implants. A silicone implants were allowed to use them again, and a lot of plastic surgeons took this as evidence that implants don't make people sick.
Starting point is 00:32:30 The dogma in plastic surgery has always been breast implants don't make people sick. If you have an illness, or you think you're getting sick from implants, it's not to the implants as due to something else, whether it's in your head, whether it's autoimmune disease, or whatever. And honestly, and this was what I was always taught throughout all my training, and I believed
Starting point is 00:32:48 it because my professors, the surgeons would tell me, oh, the studies show that they don't create these problems. But the big question is, did I read the studies? Not really. I skimmed over the studies, and that's what they told me, so I assume what they told me was true. So, you know, I ended up believing this for a long time and after the tragedy that happened my practice, I started really rethinking everything and questioning everything.
Starting point is 00:33:16 And I started seeing these, you know, websites start showing up. And this was at the early 2000s, websites started showing up where people would congregate, women would congregate, telling would congregate telling their stories about their breast implants and how, when they had them removed, they would get better afterwards. And then fast forward to the 2010s, there are now Facebook groups of tens of thousands
Starting point is 00:33:35 of women coming forward saying, I think my implants are making me sick, I've had them taken out and I've gotten better. And so I was actually one of the first plastic surgeons to go public after reading their stories. And what I ended up doing is actually looked at the research that they put out on their websites. Not the ones that we put out, but the ones that they put out.
Starting point is 00:33:54 And I'm like, I haven't heard of any of these studies. It's because they are in the literature for rheumatologists, for internal medicine doctors, not plastic surgeons. Our studies are funded by the implant companies for the most part. Of course. And are performed by plastic surgeons. Our studies are funded by the implant companies for the most part. Of course. And are performed by plastic surgeons, a lot of them being paid,
Starting point is 00:34:09 some of them over six digits, six figures by these implant companies. And when I actually looked at the studies from the implant companies, they were still, you know, we're surgeons, like, and we're plastic surgeons. We're all about the surface, you know, and were they asking about hair loss, you know,
Starting point is 00:34:26 Rashes like all of the 40 plus symptoms that patients may be having from plants. Not really. They were asking more Hey, hematoma capster contracture the things that we are aware of, you know And so I was one of the first ones to go public basically saying that I believe that this is real and that some women get sick from their implants and the backlash was pretty swift public basically saying that I believe that this is real and that some women get sick from their implants. And the backlash was pretty swift. My colleagues were not happy with me, but that's okay because I want to put out information that is true and that's true, that I believe is true. So really what is a truth then?
Starting point is 00:35:00 When you look at studies now, and there's very little science, unfortunately, out there on breast and blood and illness period. But what we do know is that anywhere from 55 to 85% of women who do have these types of symptoms, fatigue, rashes, hair loss, joint pain, brain fog, about 55 to 85% of them, their symptoms will significantly improve when they their implants are removed. Wow. But it's not 100%. And if it's a patient who comes in and they already have, let's say, a diagnosis of rheumatoid arthritis, or they have a diagnosis of scleroderma or something like that, and
Starting point is 00:35:36 they have implants and they have all these symptoms, taking their implants out usually does not make them better. Got it. Okay. So, there's a lot more to it than I think we understand. There are studies being performed now and I do credit the societies now in that every big national cosmic surgery meeting now, breast and plan illnesses on the docket to discuss. Wow. Wow. Which I think is a huge
Starting point is 00:35:57 jump. And it's still pretty rare, right? People who experience these symptoms out of all the people that get implants are still pretty rare. My belief is that the vast majority of women do tolerate implants just fine, but we do not have a statistic. I would love to be able to tell my patients, hey, if you're thinking about implants, you have a 7% chance that you'll get BII or a 10%, or a 3%, but we do not have even that number. My clear always that chance with any prosthetic that you're putting in the body of the body rejecting it, isn't that? I mean, but there's a difference, I think,
Starting point is 00:36:27 between rejection, because you can get rejection where literally if you have something put in your body, like if you get, let's say you get in a car accident, or let's say you're on a motorcycle and you slide along the road, you fall off and you get pebbles and gravel, you get stuck under your skin, your body will actually expel a lot. Push it out. It will actually push it out.
Starting point is 00:36:44 And that's what we would consider like more rejecting something. I see. implants aren't necessarily, I mean, they can be rejected if they're actually infected. What will happen is the incision can actually open up and the implant can literally put fruit out. But this is different because we don't really understand
Starting point is 00:37:00 what's going on. And patients, I have patients who have BII, or we believe have BII, who have just absolutely absolutely amazing results and it's tough because they're so happy with their cosmetic result, but they feel crummy. And it's like, what are you going to trade that? I have a theory around this that the immune response that happens inevitably when you do any type of procedure, but with these women, with these implants, that that immune response is kind of this, it's just like ongoing systemic low level immune response, and that can cause all kinds of different things.
Starting point is 00:37:33 It can cause joint pain and hair loss and rashes and all those other things. That would be my theory is that the body's doing that. Then the other side is, how hard is it for you? Because I can only imagine how hard this is for doctors to separate the physiological from the psychological because if someone experiences something, they experience something.
Starting point is 00:37:51 So how do you do that? Well, the hard thing, I mean, the number one thing and what doctors have not been good at is actually listening to a patient and believing them. You know, I had a patient of mine. I did breast augmentation on her. I think like 18 or 19 years ago, like one of my early ones. She accompanied her husband to a consultation with another plastic surgeon in my area.
Starting point is 00:38:09 And while she was just as an aside, she's like, hey, you know, I had implants put in by a different doctor and I think I may have breast implant illness symptoms. And he goes, oh, we just call a psychiatrist. It's not, it's not, it's not what it is. Like he just dismissed her. Yeah, and this is an old school older doctor. But, you know, I mean, really, you know, here we are, four guys sitting around talking about this, but the fact is, is that medicine has neglected women's issues for a very, very long time, you know, and has not listened to them. And I think that's the first thing, is that we actually have to believe that they have these symptoms and that they know their body.
Starting point is 00:38:42 And that I do, I do believe in bio individuality. I think that what may work well for one person just won't necessarily work well for another one. And sometimes it just depends on what type of, what stage your life is in. Women after menopause, their body acts very differently than it does before menopause. You guys know that.
Starting point is 00:39:01 I mean, you train them. And so you can't assume that the bi is gonna react the same way all the time. Yeah, I mean, even train them. And so you can't assume that the bi is going to react the same way all the time. Yeah, I mean, even if you look at the data on autoimmune disorders and depression, it's very interesting. It's definitely a strong potential connection. Because, and then you look, you know, we might be veering off here a little bit, but what you believe,
Starting point is 00:39:22 it makes perfect sense that your, our bodies would evolve to believe what you believe. So if I believe my body's an enemy, I don't like myself, I hate myself, would my immune system react to that? And potentially believe I'm an enemy and something like my joints or my thyroid, sounds plausible to me. Yeah, and there are studies being done
Starting point is 00:39:42 where you are seeing those numbers actually match up. So people who have anxiety about breast implants are gonna have a higher chance of getting those types of symptoms Oh, and so it does really follow that interesting. There are studies being performed now It's still once again. We still just don't have the real numbers that we need But we're gonna get them and I think in the end what we'll probably find is that there is a subset of patients that for some reason are hypersensitive to implants and they get these symptoms and they can get better afterwards. Now, as a trainer, I'm going to be quite honest with you, there's one type of procedure that just annoys me and it's not because, you know, I don't think people should make their own decisions, it's not because I think anything other than I'm a trainer and I can
Starting point is 00:40:22 do this for you as well, which is but implant. You're going to have to turn four here. Yeah, because it's a muscle like boobs body fat. Get it. Can't build your boobs. Can build your packs for the same thing. You can't build a butt. But you got a butt.
Starting point is 00:40:33 You can build it. But let's talk about butt implants. What are they? Is it like a breast implant? You got to sit on them. The glutes are strong. Big muscles come. So it's different.
Starting point is 00:40:43 Tell me how much more common is it now? I feel like it's exploded in the last decade. It's still, I mean, it has exploded, but it's still relatively small numbers. So when somebody wants to get a bigger butt and they are not happy just doing, working with you guys doing the squats and the exercises, there are three ways
Starting point is 00:41:00 that you can get a bigger butt without having to do it yourself. The first way is buttticum plants. These are solid silicone implants. These are not the same as breast implants because these are actually solid. There's same type of implants that we put like in a chin where it feels hard. Got it.
Starting point is 00:41:15 And they're big. The main problem, two main problems with butticum plants. Number one is that that area is not the cleanest part of the body. So you're gonna have a much higher risk of getting an infection of an implant in that area than you would somewhere else. Okay, so that's number one thing.
Starting point is 00:41:31 And number two thing is implant displacement. You know, you can put the implant there, but you're sitting on that area how many times a day, how many hours a day, there's a high chance that that implant can move or it can flip and go out and place. This. Because that area of the body is, you have so much pressure on it and up and down and all that type of stuff.
Starting point is 00:41:51 So I'm not a big fan of buddhikin plants. I don't do them. There's really not a lot of surgeons across the country that do them. There are people that do, but it's not like breast implants where almost every plastic surgeon will perform that operation.
Starting point is 00:42:05 Second way to make the butt bigger. So that's always, butterkin plants has always been considered like kind of a niche procedure, most doctors, most plastic surgeons, the dogma is like not the best operation. Okay, so amongst yourselves, when your buddy says, yeah, I do, the rest of the plastic is like, oh, he needs to do that.
Starting point is 00:42:22 He's really like, he's like, hey, you know what, it's money. You can have that go, hey, you know, it's money. You can have that. Go ahead. But you know, if you're real thin and you want a big but donka-dunk, that's your only option. Okay, the other option is BBL, Brazilian butt left.
Starting point is 00:42:35 And that's liposuctioning fat from one area and then injecting it into the butt. And for many, many years, that was considered the gold standard of making the butt bigger because, oh, you know, it's the fast, the unlife, you get infected, it's your own tissue, and all that type of stuff. But the problem was, was there are a lot of women, women who are typically Florida, is the problem place, where there are these chop shop places where women go to Florida and they
Starting point is 00:43:01 get their BBLs, and they die. Oh, my God. And there was actually a survey done of plastic surgeons that found a one in 3,000 death rate from BBL surgery. One in 3,000, which is the average death rate and all of cosmic surgery is about one in 50,000. And this is one in 3,000.
Starting point is 00:43:18 Oh my God, that's your first time riskier. Yeah, I mean, it's so, and what they found was that, so that really this happened, there was a huge uproar of like, and these are young women who are dying, it's not like you've got like grandma having this and you know, isn't bad health in dies. Like this is like a 22 year old,
Starting point is 00:43:34 healthy woman who freaking dies. So what we found out is what happens is that, when you inject fat, for that fat to actually stay in the place and to live there, you need to have blood supply to it. Okay, because if you don't have blood supply to a body part, it dies. It goes necrotic, or just...
Starting point is 00:43:50 Yes, exactly, it gets necrotic. And so what part of our body has the most blood supply, are muscles, okay? And where are the biggest muscles of the body? Negludious muscles. So it would make sense then, if you, the doctor would say, okay, we wanna put a bunch of fat into the butt.
Starting point is 00:44:06 The fat's only gonna stay if we have blood supply to it. So let's inject the fat into the muscles. So that's what doctors did. But the problem is, it was with big muscles, come big blood vessels. Oh no. And the fat would be injected into this muscle.
Starting point is 00:44:19 The blood vessels would tear, the fat would go through those tears into the bloodstream. Wow. And the way to describe it, it's like your, it tears into the bloodstream, and the way to scribe it. It's like the death star, and you've got Luke Skywalker shooting those two missiles just to the right place. The death of the phantom. The phantom of the phantom.
Starting point is 00:44:33 The phantom of the phantom can go to your heart and lungs, and you can die like that. Just like the death star blows up, you can die within minutes. Wow. And this is what would happen to these poor women because these doctors were in these chop shops or just moving and speed as of the essence could solve about money and these people die. So then what happened is the society's got wind of this and there are people who are even
Starting point is 00:44:54 talking about banning the operation altogether. And what now the idea is that you can do it safely, but you have to inject it into the subcutaneous fat, meaning the fat below the skin above the muscle. And now even the state of Florida requires you to have ultrasound guidance so you know exactly where your cannula is going, so when you inject it, you're not in that muscle.
Starting point is 00:45:12 Wow. And the fat stays there and it just becomes a part of that part of your body. Yeah, so if you get blood supply too, so some of the fat will disappear, about half the fat that you inject, whether it's in the face, the reabsorbed, or even in the breast, it will reabsorb.
Starting point is 00:45:26 And the rest of it will stay, as long as you have that blood supply too. Now, do some of these thin women who wanna do that, are they told to gain body fat to get more fat to get more people who will do that? But the problem is, is if you lose the weight afterwards, then you lose the fat too, because that fat will go up and down.
Starting point is 00:45:42 Hold on a second, this is amazing. This is amazing. Girl walks in, she's skinny, I want a BBL. We need to gain 15 pounds of body fat so I can have some place to take body fat from and inject it. And then they do it and they say, cool, I can get lean again. She can lose the fat from her butt like she, yes. Exactly. That's terrible.
Starting point is 00:45:59 But that doesn't stop some plastic surgeon's retirement patients distilled to do that. Wow, that's, of course that makes perfect sense. Wow, that's very interesting course that makes perfect sense. Wow, that's very interesting. What is the most, what are the fastest growing procedure right now that you're seeing? Because all these plastic surgeon procedures seem to go through trends, right?
Starting point is 00:46:16 Like at one point it's for the face and the ears and eyes whatever, what seems to be on the rise right now? What do we see? For that, so with the fat injections, like, does seems to be on the rise right now? What do we see? So with the fat injections, like, does that get pocketed over time? Like, what is the aesthetic of that over time? That's what we don't know, and that's what that's a concern that I have.
Starting point is 00:46:34 You know, there are women who are getting one to two liters of fat injected into each butt cheek. Wow. And what happens is our skin as we get older, you know, and this, they may be 22, 25, they've got tight skin. What happens 20 years later? Where's that fat gonna be?
Starting point is 00:46:49 And these are discussions being, they're happening in our meetings now, and the people who do a lot of this, they kinda shrug their heads. Should have some weird butts in the front of you. It's a weird landscape out there. I mean, what's gonna happen to some of these famous influencers and reality show stars with big butts, you know?
Starting point is 00:47:04 I mean, that skin is not going to stay tight like that forever. All right, so popularity, what's growing right now? What is the trend? Well, one thing I should mention because I mentioned there are three ways to make the butt bigger. And this is one thing that's growing in popularity is, I don't know if you guys know, but there are devices that will stimulate your muscles to contract 20,000 times in a half
Starting point is 00:47:21 hour session. So is this just the electric muscle simulation? This is yeah. And these are ones that, like I have one in my office, they market these to plastic surgeons and stuff like that's a safe way to the lazy safe way to make your butt a little bigger. And those studies show that if you do four sessions over a span of about two weeks, you can gain about 20% of thickness of the muscle. And so this is technically a safe way to enhance the muscle.
Starting point is 00:47:43 Why that's a proctomy. No, well, 20% of the thickness of that muscle are one of the muscle. And so this is technically a safe way to enhance the the proximity of the rock. No, 20% of the thickness of that muscle I want to stay away from. From East. Here's where I believe it. Here's where I believe it. It's never said East M versus I mean, there are those devices that you can
Starting point is 00:47:57 buy on Amazon. This is different. This is like I bought one and part of me, I don't know, part of me I wonder if I should have bought it, but it cost me over 200 grand. Oh, you know, these are powerful devices. And when you put them on, like, it's powerful. Okay.
Starting point is 00:48:12 So part, here's why I believe, yeah, you need to close me on this. No, here's why, here's why I believe it. That's a 20% is a big difference. Oh, yes, it is. Here's why I believe it. One, what you said, I don't think it's the same machines that they sell, you know, like, do thousand crunches, why you work on on a computer for 19 or even these are a decade. Okay, I think this actually is like, you probably like, it was uncomfortable.
Starting point is 00:48:30 Oh, yeah. But number two, the group that they're using is probably sedentary, like they don't do anything. So you're gonna contract the muscle relax. You're gonna get, you're gonna see double gains. Yeah, 20%. Just like if they did like three squats, you would see a little bit of growth. I don't think it would continue. No, I don't think any of us could use it and see any changes at all because of, you know, how much multiple of that's interesting. Yeah, that's super fascinating. Yeah, yeah, yeah. But this machine mustn't feel very good. If it's, if it's causing contractions, that hard. Yeah, so I had it on my, I had on my abs and I tell you the way, what it feels like, is you know, when you've got like, you've got
Starting point is 00:49:05 like a stomach flu and you're, you can feel things just moving around in there and you're, you know, you got to rush the bathroom. That's how it feels when that stuff's going on. But you're not half to go to the bathroom, but it's, it's that, it's that like crampy feeling of they're like, oh no. Just work out. And yeah, crazy shit. We go through half hour work out. For half a hour. For half a hour. For half a hour. I have a difficult question for you
Starting point is 00:49:28 because you have to have thought about this. How do you reconcile that, and I have no idea the numbers, you obviously have a better idea of the amount of people coming in to see you that probably shouldn't do whatever it is that they're asking for, right? Like, for example, in our space, more often than not, the client that comes in that wants a certain way of training, that's like the worst thing they should do. It's like, I know that because they have all these issues and they're using this form
Starting point is 00:49:58 of exercise as an outlet or they have some sort of dysmorphia going on, right? And I would imagine people that are getting cosmetic stuff done have, and I'm sure it was a spectrum of body dysmorphia going on here. How do you handle that? How do you reconcile that when you're talking to someone and you're like, they don't need to do that. But they're probably gonna go off and go get it from somebody else.
Starting point is 00:50:20 I'd rather do it, I'd rather do it because I'm better and say for what? There are doctors who will say that. They're like, well, I'm gonna do it, but it's only because I'm better and safer. There are doctors who will say that. They're like, well, I'm gonna do it, but it's only because I'm the best doctor in town. And if I don't do it, somebody else will, and they'll screw it up. And for me, I just say no.
Starting point is 00:50:33 And I have a woman really good patient mind. And every time she comes in, she wants her lips bigger. And her lips are like, Angelina Jolie lips already. And so every time she comes in, I tell her no. And every time she leaves unhappy, then she comes back six months later, I want my lips done like no.
Starting point is 00:50:48 And you know what, it is what it is. I mean, for me, I think what I try to do is, is try to massage the message as much as I can so that they're not sad. I don't want to hurt their feelings or anything like that. But at the same time, I turned down about one out of every five people who come to see me, at least for surgery, just because I don't feel that that's going to be right for them. And sometimes I'll give them their money back for a
Starting point is 00:51:10 consultation, like if it's like, oh yeah, it's obviously I'm not going to offer you, then I'll just give it, because it's not a money issue, it's just like, hey, I don't want to do something and put somebody under a risky procedure for what, you know, not for a lateral move. It's always trying to move forward. If we're going to operate, we want to move you forward. We don know, not for a lateral move. It's always trying to move forward, if we're gonna operate, we wanna move you forward. We don't want to do a lateral move.
Starting point is 00:51:28 It's like, you know, you've always heard people say things like, you know, who was it responsible for all of Michael Jackson's surgeries? Like, how do you let that guy come in every single and allow himself to keep doing that? So, interestingly with him, and, so I trained out in Beverly Hills, and one of our receptionists
Starting point is 00:51:45 actually used to work at the office where he allegedly had a lot of plastic surgery. And she said that they were really allegedly stole. I mean, I'm not a stock here anymore. I said still allegedly. You can barely tell. But she said that they would come in sometimes and they had their own in office OR and he'd be kind of cordoned off in the corner and then every so often they get a check from MJP Michael Jackson productions basically pay for it.
Starting point is 00:52:09 The interesting thing is his plastic surgeon actually went off reportedly went off the deep end and was I think ran for president against Obama at one point. What? And was yeah, like way off the deep end. And yeah, so I don't want to play as a surgeon that also wants to be the president. Yeah. There's too much craz defense. Yeah, so I don't want to play a surgeon that also wants to be the president. There's too much craziness. Yeah, so Adam's going to be really mad if I didn't ask you this. Uh, Catherine plants.
Starting point is 00:52:32 How? Are they calm in? What are they? Can I stick your electric machine on my cat? Yeah. That's what he's saying. Actually, you can. Oh, wow.
Starting point is 00:52:43 There, you can put it on your biceps and you can put it on. There, you can put it on your biceps, and you can put it on your calves, and you can put it on your triceps. Okay. So, technically, you can. Now, calf implants are even less common than bud and plants. Yeah. I've actually never seen one put in. I have one in my office,
Starting point is 00:52:55 just because I wanted to use it as a prop occasionally when we talk about stuff. But that also is solid silicone. Got it. It's kind of long like this. Yeah. Yeah, you put it, but I've never actually seen one put in.
Starting point is 00:53:08 Wow, it's really... Are we seeing more men get things like picking plants and stuff like that? Or is that still super rare? No, we're seeing a lot of that. And especially what we're seeing a lot of our patients who are men who are undergoing abdominal etching. And there's a lot of different ways to describe it.
Starting point is 00:53:21 Essentially, it's liposuctioning the fat of your abdomen to look like muscle. Oh my God. And they've seen liposuctioning the fat of your abdomen to look like muscle. Oh my God. And there's seen this. I saw the guy who tattooed it the other day. I thought he was saying. That was a pain. It all looks good until she asked the feel.
Starting point is 00:53:33 I'm going to be feeling your heart out. No, stay back there. They're real quick. So that's actually really calming. People now they call high definition liposculpture or moderate definition liposculpture. And the idea really is that you liposculpture, or moderate definition, liposculpture, and the idea really is that you liposuction along your, what do you call them?
Starting point is 00:53:49 Your natural inscriptions. And along your ten-nose inscriptions, as a way to kind of create those contours. And sometimes, if you're not overdone, it can actually look pretty nice on some people. But the problem is there's some doctors who aren't choosy about their patients. And I've seen guys who have potbellys with this six pack on a potbelly.
Starting point is 00:54:09 And so you know that this is just... So I'm here. Yeah, there's got to be... I imagine it would probably look best in somebody who's not that overweight. That's already... They have kind of stubborn fats maybe there, but... It's going to be somebody who's just a little soft, but they've got a good muscle structure underneath that if you just kind of...
Starting point is 00:54:25 Just do some tweaks to the, where the, where the, your fat is essentially on your abdomen, you could try, the idea is to, is to try to accentuate it. Yeah. I have a friend of mine who's a plastic surgeon who does a lot of male plastic surgery and some of the stuff he was doing was,
Starting point is 00:54:38 really, was really fascinating because he was injecting fat into biceps and when you think about it makes sense because he was, I say, well, okay, you inject fat into biceps. And when you think about it, it makes sense. Because I say, well, okay, you inject fat into biceps. And he goes, well, the thing is, is I would tell my patients that if you gain weight, your muscle actually gonna get bigger. And I'm like, wow, that makes sense. You marbleize that meat, essentially.
Starting point is 00:54:57 You add fat there, they gain weight. The muscle actually gets bigger because it's got the fat inside of it. And so he would do that in the abs, too. Like each individual abdominal rectus abdominis muscle, he would inject into the fat into it. And then once again, somebody gains a little bit of weight and the muscle actually sticks out more. And then he would have etch around it.
Starting point is 00:55:15 So what you're doing when you're doing the etching, or when they're doing the etching, is you do have to follow their natural lines. Because that would suck if they got lean and the lines were off. But sometimes, but not everybody's lines, as you know, are like perfectly symmetrical. No, some people have three on one and two on the other. And so when you do see that somebody has got perfectly
Starting point is 00:55:32 symmetric like crazy defined abs, you got a wonder. Yeah. So I remember years ago, I was a young trainer. I had a woman come see me and I did her body fat test. Now, it was a body fat test with skin calipers and you did the bicep, the tricep. You went by this capula and then you did right above the super iliac crest, right?
Starting point is 00:55:53 So I remember I did, and at this point I had done, I don't know, 60, 70 body fat tests. I was a new trainer but I'd done a few of them. And I remember I did her tricep measurement and I had never seen a leaner tricep measurement than bicep. That almost never happens. People store more body fat in the back of the arm.
Starting point is 00:56:08 They do the front arm especially women. So as I did this and I kept doing the measurement like this is weird. This is way leaner in the back of the arm than in the front of the arm. And I remember asking her, I said, have you ever had liposuction on the back of your arms? She's like, yeah, how did you know? And I was like, oh, because the measurements. So in other words, when people get liposuction, that you're not eliminating or removing
Starting point is 00:56:31 their body's ability to gain body fat, you're just removing body fat from one area. If they ever gain a lot of weight, then you start to notice this strange, potentially strange body fat story, distribution, right? Yeah, so the way I explain to patients is some of us, we have asymmetric
Starting point is 00:56:49 or these kind of stubborn areas of fat that we just develop and we can't get rid of. Like that's really the best thing for lipos. So if you've got like love handles no matter how lean you get, those are still there. Or sometimes you may inherit a double chin. And no matter how lean you are, you got that double chin or something like that. Yeah, and that's where liposuction can really help and no matter how lean you are, you got that double chin or something like that. That cheeks.
Starting point is 00:57:05 Yeah, and that's where liposuction can really help like saddlebags. You know, someone may get these saddlebags and it's just these pockets of fat. And so the way I describe when I lipo, basically, is that let's get you proportional, and then if you do gain weight, the hope is that you gain weight
Starting point is 00:57:18 in a proportional manner after that. Because you're still gonna have fat cells in that area that you remove it, you're just gonna have less of them. And so the hope, and I don't know that it's ever been fat cells in that area that you remove it, you're just going to have less of them. And so the hope, and I don't know that it's ever been proven, is that if you do gain weight, that you don't gain weight at that problem area worse than everywhere else, but because there's a lot less fat cells there, hopefully it just looks like you gain weight naturally. So much to consider with what you do, because you can't just, you have to consider not just,
Starting point is 00:57:44 of course, all the obvious stuff, are the candidate, is this going to be safe, because you can't just, you have to consider not just, of course, all the obvious stuff, are they a candidate? Is this gonna be safe, et cetera, et cetera? But also, how is this gonna stand the test of time? How is this gonna look if this person gains or loses weight in all these different things? There's way more than goes into what you do than just the procedure.
Starting point is 00:58:01 And I would imagine that's a large part of what makes someone good versus someone who's just whatever. Yeah, and I think that that's something that as plastic surgeons were not the best at. And honestly, there's one, injecting fat into the breast is something that's become real popular. And a lot of people are asking me about that now because they're people posting on social media.
Starting point is 00:58:18 Like, go ahead and get implants. I just had fat injected in my breasts. And there are a lot of plastic surgeons who go to meetings, go, oh, these are this my technique of doing it. And look, I have a really low complication rate. But one thing that I tell patients that they don't realize and nobody is talking about for a procedure like that is when you have an organ of the breast,
Starting point is 00:58:35 where you have one in nine women get breast cancer in their lifetime, we know that our fat is chock full of stem cells. What happens when you take a cancer prone organ and you inject it filled with stem cells? What if this woman has got a cluster of dysplastic abnormal cells that are growing that we don't know about because it's not a lump or anything? And maybe it wouldn't turn into a cancer until she turned 120 years old.
Starting point is 00:58:57 And you introduce a bunch of stem cells. Now you got a ton of stem cells that you just injected all around it. What are stem cells? There are cells that are so young that they turn into whatever organ that they are in. Are they going to then potentially, now is she going to potentially develop a breast cancer at the age of 55? Because we patentiated that. And that question has never been answered.
Starting point is 00:59:17 Now, it's a safe operation from a surgical standpoint of risks of hematoma and other types of infection and stuff like that. But long term, are we doing this patient a favor? Are we doing them a service? Or are we actually doing them a major disservice? Dr. Ian, do you work with peptides at all? We recently got into the space where we partnered with a company that offers peptide therapy, things like BPC157 and thymus and beta and all these other...
Starting point is 00:59:43 Do you work with those at all to help accelerate the healing process or prevent complications, or is this still a little bit like? Yeah, not yet. So I do a little bit of peptides with skin care, but I don't do it with the healing. We don't do it peptides for internal use, that type of thing.
Starting point is 01:00:00 No, I have to. What about for the skin? What are good peptides for the skin? So I'm imagining topical. That's what you're referring to. Yeah, yeah. yeah, so I mean really there's a lot of them. I mean copper is a good one G-H-G-A-L There's dermaxle which is another good one There's a bunch of them and really what are peptides are basically to cellular signals right?
Starting point is 01:00:18 Cellular signal signals to produce more collagen And so but what I focus on, peptizer, honestly, in skincare, they're kind of like the less expensive, not quite as effective option right now. So it's not my top option for anti-aging for skincare. You know, if I were to put, when you're talking about anti-aging skincare in a list, I would put number one would be the retinoids,
Starting point is 01:00:43 so that's an all. Number two, you'd probably look at Bakuchiao, which is a plant-based alternative to retino. Number three would be growth factors, and then peptides are probably number four. Interesting. So we don't focus a lot on them yet. I think there's a lot of focus on peptides for other things, like what you're talking about. Obviously, semagglutide, that's a peptide, technically. Yeah.
Starting point is 01:01:04 So I think that there's a lot more outside of actual plastic surgery that we're seeing. Do you do anything for hair, for men who are losing hair or thinning hair? Do you, because I know that's a whole another, I had a friend who did it who went to Mexico, which we could talk about as well, people going overseas to get procedures.
Starting point is 01:01:19 But man, I saw him the day after, and everything turned out great, which was good, but I saw him the day after. I mean, I was like, yeah, I'll never do that. It just looks scary. His head looked like a big mushroom after, so. What, are there any, what can you do for people who have thinning hair?
Starting point is 01:01:34 So, thinning hair needs to be separated from bald areas. Okay, so if you've got areas that are just bald and or if you've got a hairline that has receded, then the only real way to treat that is with hair transplant. Now, hair transplants are a lapper and they used to be. You know, it used to be that you would take literally a strip of scalp out of the back of a person's head, and then you would chop it up into what essentially are like dolls
Starting point is 01:01:56 hair, like five to six hairs, follicles at a time, and put in actual plugs, and then look like dolls hair back in the day. That proceeded to then cutting them up into individual follicles, maybe every two to three follicles, and then you make tiny little incisions, and then literally it's like planting little blades of grass, essentially. I've done that a bunch of times, and I hate doing that operation. It's just so tedious. Yeah, it's time consuming.
Starting point is 01:02:23 What are you using to do that? You're like a pair of tweezers. And you got like, like, big old, like, zoom glasses on. And you're just, and you put one hair in and then it pops out, the whole right next to it. And then you're like, ah, then you take that one. You do the gamer hair, hair, hair form. I was, but it's still.
Starting point is 01:02:37 So we know what doctors do. But like, you gotta be, you know. Is they hire people to do this for them. And so if I, I was at, when I was out in Beverly Hills, my doc, he did a bunch of them, but he didn't do them. He basically cut the strip out, and then he set it aside, and they hired these teams of nurses and technicians that will cut the little hairs up.
Starting point is 01:02:53 You make the little poaks in the scalp because you have to do that part of the procedure, and then the other people will put actually the hairs in for you. Wow. But that's all, now the way to do it, actually, is you don't even have to remove the strip of scalp because the problem with the strip of scalp
Starting point is 01:03:05 is you got this big scar in the back of your head and there are certain celebrities that you supposedly can even see some of that. Now you can actually, you can harvest them one follicle at a time using robotic devices and there's actually a robot where you can lie down and the robot basically goes in and pulls each individual follicle out and then can put the follicle goes in and pulls each individual follicle out and then can put the follicle back in for you into the place you want. It's like it's really getting a lot of technological stuff. I don't do that, like I said, I still feel like it's
Starting point is 01:03:33 so tedious, I'm not a big fan, but that's only if you absolutely need the hair transplant. But there's a lot of things you can do for thinning hair that are natural. So I'm most curious. Somebody that has your skill sets, you have all this at your fingertips. What do you currently do for yourself and what do you plan to do as you age? Like I'm sure you have thought of actually right now, one of my big focuses is my hair.
Starting point is 01:04:03 Yeah, about a year or two ago ago I was on vacation, the Caribbean. And you know, years ago when I, my wife and I've been married since 2000. And she fell out this survey at one point. It was like, what do you, what attracts you most about your partner? And she's like, when you're in a car, oh man, that's just a great hair. So we're on vacation and we're jumping, we're doing this cliff diving. And she's, I'm on this, I'm on this ledge below her. It's just like, oh my gosh, you're losing the hair at the top of your head.
Starting point is 01:04:27 I almost fell off the cliff and hurt myself. So then I'm like, oh man, what am I going to do? And I'm taking mirrors. I'm like, oh my gosh, it's thinning up there. So really this is what I recommend. Okay, if you've got thinning hair, but you're not bald and you want to try to fight it off, but you don't want to take medications. Because yeah, you can take propitia.
Starting point is 01:04:43 You can use Roganerm and Oxidil. But the first thing you wanna think about number one is a condition called tealogen effluvium. Are you really stressed? Okay, because just being under a lot of stress can cause your hair to thin. And so the first thing I started doing is I started getting into meditation,
Starting point is 01:04:59 started doing some yoga, and really focusing on stress. But as a surgeon, I'm always stressed because I'm always stressed about my patients. So there's only so much you can do. Second thing is I take a nutritional supplement. I take one called neutrophil. Now you can see a functional medicine doctor,
Starting point is 01:05:13 maybe some dermatologist will also test you for all your various nutrient deficiencies. There's a lot of nutrient deficiencies that can result in thinning hair, iron deficiency, vitamins D, zinc, all these can potentially result. So there are these all-in-one supplements that you can buy and I myself take neutrophil every day. It's basically an all-in-one that way. I don't have to draw the labs and follow it. I just take this. Third thing that I would do would be a low-light laser therapy helmet.
Starting point is 01:05:41 So there are helmets that have hundreds of lasers on the inside, and essentially the way that you describe it is that the energy from the laser will cause your hair to grow into a growth phase. And these are scientifically proven. There are tons of studies in literature. Should I like red light therapy? Yeah, we work with a company that has uses red light sci-fi.
Starting point is 01:05:59 Yes, so red light is also used a lot for the face and for skin, but it's really good for the scalp and for growing hair And that's where there's a ton of studies for yeah And then the the next thing I recommend would be like dermal stamping or derma rolling There are people who are rolling for beards. They're like little tiny needles on the face Yep, that seems to help Especially if you follow that up with an application of some sort now you can follow up with like Rogaine or an oxydil
Starting point is 01:06:23 There was a small study that compared topical Rogaine slash Menoxidil to rosemary oil and found very similar results for thinning hair and for thicker hair with topical rosemary oil. So that really is a favorite in the holistic community. So you can take like rosemary essential oil, you want to mix it with a carrier oil and then use that on your scalp or there are some commercially available versions as well. But what the study found is very similar results between rosemary oil and monoxidil, but the difference was, is much less scalp irritation with rosemary oil. Yeah, interesting. I used, I tried monoxidil for a bit, but I felt terrible.
Starting point is 01:06:58 I think it was absorbing too much of it. And then monoxidil was originally researched as a blood pressure medication. Yes, I'm like that. So I don't know if that's what it was, but it made me feel really weird. So what else, okay, we're working on your hair. What do you foresee, what is there any sort of facial surgeries
Starting point is 01:07:14 or lipo or any, what would you do as you age? So one thing that I'm doing, when I'm worried about right now, so I'm 51, and I know that once you hit your 50, is that's when the skin starts to sag. And that's my biggest fear is like, I don't want to have too much losing skin. Yeah, really good skin, though.
Starting point is 01:07:31 So I work on it. So the one thing that I do, I mean, I have a skincare regimen that I do, and I brought you guys some products, you know, but. Thank you. So skincare is one thing, but the second thing is I do a treatment called Morpheus 8. It's radiofrequency micro-needling.
Starting point is 01:07:44 And essentially the way it works, you know, it's kind of like what you guys do. It's hormesis for the skin, essentially. Oh, interesting. So all of the treatments that we do for the skin, whether it's laser treatments, chemical peels, or this one's radio frequency micro-needling, or just micro-needling on its own, work by creating a controlled trauma to the collagen or to the skin, specifically the collagen the skin. And when you traumatize the skin to a certain extent, the collagen, which I liken to the
Starting point is 01:08:08 logs of a log cabin, the collagen makes about 70 to 80% of your skin. And that's what causes your skin to be tight and youthful. And as we get older, we lose about 1% of the thickness of our collagen every year. And women after menopause, that goes up to 2% a year. And that's why you say women who are in their 60s and 70s, and 80s with like tissue paper thin skin that can even tear. So what happens in the collagen, it gets thinner,
Starting point is 01:08:32 and the treatments that we do then to tighten the skin basically will damage that collagen. And when the collagen is damaged, it becomes tighter. As it heals, it becomes tighter fibers. And it's kind of like hormis, it's like when you break the muscle down from working out and it comes back stronger, the same thing happens with our skin.
Starting point is 01:08:49 Now lasers do that using light energy, heat, chemical peels do that using enzymes and acids. And the easiest thing in the most cost effective way to do it is with using needles, micro-needling. So micro-needling can be done with the dermal rollers, which most doctors aren't big fans of because they can create some kind of tearing of the skin. But we can do that in our office using an automated device.
Starting point is 01:09:11 It's not very expensive, so the treatments can cost as low as $100 to $150. And what you're doing is you're making tiny little pokes in the skin. By creating those tiny little pokes, you create that acute trauma and the skin heals tighter afterwards. You take that to the next level and you add PRP.
Starting point is 01:09:26 So you take blood, you remove the platelets, it's chock full of growth factors, you make those tiny holes in the skin and then you apply the PRP the surface and that will seep into those holes causing the skin to essentially rejuvenate from the inside out due to those growth factors. Morpheus 8, which is what I'm doing, takes that even to the next level, where the needle that goes into your skin is actually insulated all the way up to the tip, and that tip emits radio frequency energy or heat, and that heat when it's applied to the collagen will cause that collagen become damaged, and it tightens up even more.
Starting point is 01:09:58 And so that's what I'm doing to try to tighten up the skin under my neck. And really right now, that's the gold standard for non-invasive skin tightening. Anybody who's in their 30s, 40s, 50s, and they don't need a facelift, but they're finding things are getting a little bit looser. That's really what a lot of it. And how often would you do something like that? So, usually, I recommend a series about three to four treatments. You space about a month or two apart, and then maybe once every six months or a year. Oh, that's not bad at all.
Starting point is 01:10:23 Yeah, honestly. All right, let's talk about how you've gone so big on social media. So you obviously, like your doctor very successful, long wait list. What made you go to social media? What's that been like? Has that brought you more patients? Has it been good, bad, both?
Starting point is 01:10:40 Yeah, I think, I mean, it's been great. I mean, so I did a lot of TV for a long time. I was on Rachel Racial's like 25 times. She had a talk show. I was on Dr. Oz and the Dr. Oz on stuff. And kind of like an actor that's getting older. I started seeing that they start bringing younger, better-looking surgeons than me.
Starting point is 01:10:54 I'm like, what's going on, man? So I'd send them like, oh, I got this pitch for this segment. And then I see somebody like 10 years younger and better looking to me do it. And I'm like, okay, I could see the writing on the wall. So I pivoted to social media many years ago and then what happened is, and I did fine and I was the plastic surgeon on social media and I had decent amount of followers.
Starting point is 01:11:15 And then the pandemic hit. So March of 2020, pandemic hits and my office shuts down. We had to shut down the government or the governor ordered it. And I found myself in an empty office with 11 employees that I told them, I will pay you for as long as this goes, I will take care of you. But I had just paid off all my taxes. I did not have much money in the bank. So I started thinking, how am I going to make money to pay for my employees?
Starting point is 01:11:41 Because they're all sitting at home. And I have no patience now. And the only thing I was making money off at that time was from social media. It was like Google, from YouTube, and from Instagram and TikTok and all that. So I started thinking, okay, well, why don't I create more content? And I had this feeling that I wanted to help in some way. I mean, I'm a plastic surgeon. I actually did volunteer at my local hospital.
Starting point is 01:12:05 And so look, if you need me, call me. I'll come in and I'll help out. But God forbid, if you've got COVID and you're in the ICU, you don't want me taking care of you. Like, you know, it's like, arm again and then, like if I'm there taking care of you. And so they never called on me. Thank God, they didn't need me.
Starting point is 01:12:20 But I wanted to do something to help in some way. And, you know, as plastic surgeons, if you look at plastic surgeons social media, it's like, oh, here am I before and after photos. Let me talk to you about breast implant surgeries, stuff like that. And I did a lot of that type of content for a long time.
Starting point is 01:12:33 And I started not worrying. I'm just going to put stuff out there to maybe entertain people for a few minutes. Or even if I could take people 30 seconds out of the horrible, crazy, scary, lonely time that it was, then that would be a privilege to do that. And so when I stopped worrying about acting like this doctor who wants to talk about my practice and stuff
Starting point is 01:12:51 and just started creating stuff that I thought was interesting and fun and entertaining and educational, everything just freaking exploded. Did you have a single one that really took off? What was like the first video that took off? So I had one where I was showing how strong a saline implant was, and I was trying to pop it, and the thing actually popped and like exploded in my hand.
Starting point is 01:13:12 So that was probably my first one that went viral. And then the second thing that it was weaker, you're real strong. I was following you guys' recommendations. And then the second one was when the show's quigain came out, I supposedly looked just like the main actor of it. Oh my God. I thought you'd say that.
Starting point is 01:13:29 Oh my God, I just watched the game show version of it. Well, I almost went on that show. Did you? They basically offered me a spot on it because I went viral with this, there's this plastic surgeon on Tiktok. And I would, people would say like, oh, are you on squid game? I'm like, yeah, sure, I was on Squid Game. Like really? And you're a surgeon and like, and I literally gain on TikTok like a million and a half followers in the span of two weeks just off of people thinking I was on Squid Game.
Starting point is 01:13:56 Like it was insane. And so that was it. And what was I going to say? But that really... Well, the we're time with the viral video. So the press and planning exploding, the Squid Game. And that really exploded it. And it's been fun. I mean, it's just a great tool to help educate people now. I mean, there's so much hate there too. I mean, I get so many people that attack me.
Starting point is 01:14:18 What are the biggest attacks against you? People say that they think I had a ton of work done. Like, I've had people like, oh, you look like a 65 year old Thai woman who's had too much work. Like what? Wow, they really, it's pretty funny. That's brutal. That was one of them. That's pretty good though.
Starting point is 01:14:37 That's what I like. You got a lot of fun. I love it when it's like, it was something that's clever like it. Yeah, somebody insults me while I like it. Oh yeah, no, I find hilarious. I mean, people are like, oh, you know, how do you live with a forehead that long? Yeah, like, yeah.
Starting point is 01:14:51 You gotta have thick skin to be on. Well, what I do now is I've got teenagers who are, you know, they're in high school and they're on social media, but they're not on any of my stuff because I know, I mean, I could imagine being like a 15 year old girl and somebody writes a comment like you're ugly how horrible that What I do now is I compile all these insults and I show them to my kids And like look at look daddy gets this and I dad is to feels fine. Oh my god
Starting point is 01:15:16 Things are saying about dad It is not care, you know, because it doesn't mean I gotta do that. So we all have kids I think that's air out of it. That is really, really smart idea. So, like, some days, somebody's gonna say something. Of course, really mean to them, and they're gonna look back and be like, you know, my dad is good at all times. Yeah, and look at my dad, you know, I'm gonna.
Starting point is 01:15:32 It's actually really, so. I don't know why we've never thought, thought I was smart. I'm gonna 100% do that. Yeah, that's a really, that's a really smart idea. How many kids do you have? I have two. Yeah, so I have a senior in high school and a sophomore. Yeah, how is it being so busy
Starting point is 01:15:44 and working the way you do? Does your wife work too? Yeah, so she's a pediatrician. Oh god, wow, two doctors. Yeah. So are your kids just, oh, we gotta become doctors? No. It's not like, medicine's not like it used to be.
Starting point is 01:15:55 Really? Yeah, my dad was a doc. He was a private practice doctor. I mean, I'm a plastic surgeon, but I'm more of an entrepreneur now than a, I mean, I still treat, I mean, I operate two days a week. I've got a full practice, but I've got other types of things I'm doing. And I tell my kids, I'm more of an entrepreneur now than a I mean, I still treat I mean, I operate two days a week I've got a full practice, but I've got other types of things I'm doing and I tell my kids I'm like, look, this is not the doctor life like this is an entrepreneur's life like I'm more of a businessman in some ways in a doctor
Starting point is 01:16:14 With the way that you see me live my life I mean, I have taken ER call for 20 years I just stopped where people get bitten the face by a dog they get in a car And they will call me and I go in the middle of the night to treat them But it's like I've done 20 years of it, and I'm finally like, okay, I think I'm done doing that now. I feel like I've given back enough. Yeah, yeah.
Starting point is 01:16:31 But it's different, the practice of medicine is very different now than it was. Is that because of the... Is that because of the... The cost, the regulate, because I noticed one thing, this one thing I've seen now is the smaller practices can't operate anymore.
Starting point is 01:16:45 Yeah, they're all becoming these huge megaliths now. Yeah, even the hospitals are all combining to become these masses. And that's because of the way these regulations are put forth that's like, makes it almost impossible for you, right? Yeah, a lot of it is, it's a combination of regulation
Starting point is 01:16:58 with a reduction in pay. And so it's harder and it's more and more paperwork to practice, but you get paid less and less. And what they'll do is they don't pay you more if you do the paperwork, they just don't penalize you. And it has to do with insurance. Now, as a cosmetic class surgeon, I'm so fortunate that I don't have to deal with that. You're all private. And I did insurance for a long time. And I still technically take insurance, but what happens is even to get paid, you have to have employees that do all the paperwork for you,
Starting point is 01:17:25 and then you submit paperwork to get paid, and then they reject it, and then you've got to fight them, and it just becomes this just... It's just what's crazy to me is that it's gotten so wild that, you know, my daughter might have an ear infection. All right, your first appointment in some four weeks. What? That was never the case before, and I think it's because of all these wild changes.
Starting point is 01:17:43 I think part of it, though, too, is there's disruption going on in healthcare which is necessary. Yeah. And so that's changing. As a physician it may make it harder because you have non-physicians who are delivering healthcare. You know, and so you used to be, oh you've got a sore throat, you go see your doctor. But now you can go to CVS or a drug store and see a nurse practitioner there and get your prescription and stuff. And I think with AI what's going to happen is you're going to go to let's say a drug store.
Starting point is 01:18:08 You have a sore throat, you put your symptoms into a machine, it spits out your diagnosis, it spits out your prescription, you walk it over, you get it filled, and then you don't even see anybody. Because so many people are now doing telemedicine, you know, I'm a friend of mine who's in LA, she does all telemedicine. She doesn't even, like, no hands on the patient, nothing. Yes, she's diagnosing them and treating them. And I just find it, I don't know how you do that. that's all telemedicine. She doesn't even, like, no hands on the patient, nothing, yet she's diagnosing them and treating them. And I just find it, I don't know how you do that. Like, I was in the training of where you put your hands
Starting point is 01:18:30 on the patient, you listen to them, you figure out what's going on, but. I mean, we watch training of all of us. Yeah, personal training, I would shit, now it almost seems like half the people we talk to are online for training. It seems crazy, because most of our job was so hands on. I think the way to go to, I have a lot of friends and they do well, they're successful.
Starting point is 01:18:51 So they can do this, but they do concierge because they're like, then I need something, it's right there, I could talk to my doctor. Otherwise, I had the best health insurance in the world and it was still terrible. Yeah, eventually it's gonna be AI, it's gonna be like, you go into this place, they'll take your temperature, they'll may look into your eye,
Starting point is 01:19:05 you know, you can turn, maybe they'll be able to see into your ears, see if there's renders in there and stuff. I mean, that's gonna be on the horizon. There's certain, and there's certain specialties like radiology. I mean, you got an X-ray and you've got a machine reading it versus a human reading it. You know, there's less human air even.
Starting point is 01:19:21 Yeah, well, the X-ray, the machines are gonna be able to look at every single pixel of data Whereas a human is your human eye, you know, and so if anything that's gonna be a especially. It's really gonna I think have a hard time so if somebody wants to go into medicine What are the best fields then in that case because some of these fields like I I remember at the time This was a long time ago too, so I'm assuming it's worse now. Right, if you're advising your kids, your teenagers right now, that if they were interested in that direction, what do you advise them? Yeah, because I remember being told,
Starting point is 01:19:48 oh, you want to be a primary care physician, we're going to graduate with a quarter million dollars of debt and you're only going to make this much when you come out and it doesn't make any sense that I do. And so for me, I mean, obviously I'm partial to my field because I have complete control over everything I do. I can set my prices. I can work whenever I want.
Starting point is 01:20:04 I made the decision to take ER call for 20 prices, I can work whenever I want. I made the decision to take ER call for 20 years, but I didn't have to. I could have worked out of a different hospital and not take any call at all and just do all cosmetic. So for me, I feel like it gives me the most control over my life, but at the same time, there are people in my field who take that control and they don't, I mean, it just comes down to money. There's a reason why I'm practicing in Detroit and not LA. When I was out in LA, I had an offer to stay there and work in Beverly Hills.
Starting point is 01:20:28 And it just, I was like, yeah, this is not me. Like, it's just all about the money and the competition. And it's just, I mean, people are, the doctors out there, it's just, it's a whole other world. Well, talk about that. I'm curious to consider that you have, you have the experience to LA, which I would think is like the epicenter
Starting point is 01:20:42 of plastic surgery, right? So what, how is it different there versus what I'm going to do? So I mean, some of the stuff, yeah, that I experienced, I mean, some of it was fascinating. It's a very nip talk, it was a tough talk. You would see a lot of like celebrities and stuff like that, which was really interesting and it was kind of fun and everything. But some of the stuff that you'd hear because it's so competitive, there are stories of surgeons sending patients to
Starting point is 01:21:05 other surgeons' practices as a way to sue them afterwards to try to hurt their business. Holy cow. I knew of one doctor who was calling the local TV stations lying and saying that their competitors had somebody die in their operating room. And like, oh, you didn't hear it from me. There was a show back then called The Swan where where there were 200 plastic surgeons doing that show, and I heard one plastic surgeon actually, I was around, and when I heard it, Dr. Collins,
Starting point is 01:21:29 they say, hey, I'm not telling a plastic surgeon, I'm not telling who I am, but I heard that so and so died, and that doctor's operant, because they were jealous that this other doctor got a TV show. So yeah, I mean, that's, it's nuts. Wow, that's crazy.
Starting point is 01:21:42 Well, it's really, I mean, look, I tell you what, I, you know, I have a lot of friends that are doctors and all the ones that I know personally every single one of them really generally does it because they care about people. I know there's a lot, you know, it's really popular right now to say, you know, Western medicine this that and the other and I have my I definitely have my issues with, you know, how it tries to treat certain things. But in my experience, the people I've worked with are amazing. And it's great to hear someone like you. I don't think you.
Starting point is 01:22:10 With obviously so much integrity. It's amazing, especially in plastic surgery. Because I bet if we ranked, if you took the average person, he said, rank doctors, in terms of who has the most integrity, I bet plastic surgery would be. Near the bottom of that barrel. I'm not gonna lie, I'm not gonna lie. I'm probably deserved it too.
Starting point is 01:22:24 Yeah, so. You don't see urologist dancing in the operating room on social media. So, is there a case or specific surgeries that you've done that are the most rewarding? Like what's the most rewarding patient to help or to work on? You know, I had a patient several years ago who came to see me.
Starting point is 01:22:45 She had lost a bunch of weight and she had a tummy tuck surgery by a different doctor and basically she was what we call a train wreck, basically a medical train wreck. So she came in and I looked at her chart. She had everything you could consider. Hypertension, she was diabetic. She had a history of heart attack.
Starting point is 01:23:04 She had a stent place. She was on blood thinners, she was massively overweight, and she came to see me, and she said, Dr. Union, you're my last hope, I've been to 12 other certain, as everybody has turned me down. And she goes, I'm in such chronic pain, and well, what's going on? And she said, I had a tummy tuck done by this other doctor, and everything fell apart afterwards. I was in the hospital for months, I was in the ICU, I had tissue that died, it was necrotic,
Starting point is 01:23:27 and I had basically this wound that took like four to six months to heal. And now it's a huge scarred mess and I'm in such chronic pain, I can't do anything. And she had tears in her eyes and she's like, Dr. Neon, I don't know who else to ask. She goes, all I ask for is I just want to play with my granddaughter again.
Starting point is 01:23:44 That's all I want to do. And so I look at her chart and I examine her tummy and it was a mess. I mean, like I said, she was really overweight, so she was not in good health at all. She was on blood thinners and everything. And every part of my body and my mind was telling me, like, don't operate on her. This is an elective operation. You don't have to do this. Just tell her, no, like, don't operate on her. Like, this is an elective operation. You don't have to do this.
Starting point is 01:24:05 Just tell her, no, like everybody else. But every once in a while, in the doctors experience, you have situations where you just know what the right thing to do is. And for me, I think it's from a higher power. I feel like I was being told at that time that you need to take care of this woman. And so I said, look, you know, I will consider doing this for you, but there's a chance you can die. There's a chance that everything will fall apart again.
Starting point is 01:24:29 Are you sure you really wanna do this? And she said, yes, my life is over anyway. She goes, if you don't do it for me, I don't have a life anyway. And so the night before her surgery, I prayed that everything would go well with her operation because I was really, really nervous. I didn't sleep well that night at all.
Starting point is 01:24:47 So the next day I performed the operation and the operation went super, super smoothly. Like everything went well. And she came back to see me a couple of weeks after surgery. When she first came in, she had a cane and was hobbling in. She came in with no cane walking in with a cake that she baked for me. And she said, Dr. Yoon, I know that my insurance rejected
Starting point is 01:25:08 the claim on the operation, which they did. They said it was cosmetic, which it wasn't. So she said, I know they're not gonna pay you for it, and I don't have any mind to pay you, but will you take this as payment? And I tell you, I have a rule that I don't eat food made by my patients that they bring in, because I don't know what their kitchen looks like.
Starting point is 01:25:24 It could be cats like pooping on their on their cab on their counters and stuff so I don't eat it, but I'm like, okay I'll I actually was one a few times actually ate it. It was really delicious But that was one of those where It really told me like sometimes you get these times and yeah, I get patients who are train wrecks and I'm just like I'm not gonna operate here. Like it's not worth it. But this was one of those few times where it was like,
Starting point is 01:25:49 all the cards are stacked against me. But I knew in my heart that it was gonna work out fine. And it did. And she said, you know what, Dr. Neon? I'm actually able to play with my granddaughter again. And she had tears in her eyes as she's telling me this. And I was like, wow, that's, I mean, you know, that's worth more than money.
Starting point is 01:26:05 Well, that's great. Dr. Smith, it's been absolute pleasure talking to you. I really appreciate you coming on the show and your book, I hope our listeners check your book out and look into some of the stuff that you do, but it's great talking to you. I really appreciate your conversation. Yeah, thanks for having me on.
Starting point is 01:26:18 I really appreciate it. Thank you. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance, check out our discounted RGB Superbundle at Mind Pump Media dot com. The RGB Superbundle includes MAPS and Ebola, MAPS Performance and MAPS aesthetic. Nine months of phased expert exercise programming designed by Sal Adam and Justin to systematically transform
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