The Psychology of your 20s - 361. The psychology of plastic surgery ft. Dr Rady Rahban

Episode Date: December 4, 2025

Plastic surgery rates are on the rise, especially amongst people in their 20s, so what drives people to get plastic surgery? How does it intersect with psychology, insecurity, confidence, class, social media? In today's episode we are joined by Dr Rady Rahban, a board certified plastic surgeon operating out of Beverley Hills to discuss:  What drives people to get plastic surgery? Why are we seeing more and more extreme surgeries? The role of social media, filters and AI When is plastic surgery not just about insecurity? Can you be truly body positive and still get plastic surgery? How common is surgery addiction? What you REALLY need to know before you get plastic surgery! Plus so much more! Listen now!  Dr Rahban's podcast HERE  Follow Dr Rahban HERE    ORDER MY BOOK Follow Jemma on Instagram: @jemmasbeg Follow the podcast on Instagram: @thatpsychologypodcast For business: [e-mail]  *Please note the views of guests are not necessarily shared by our host. We invite open discussion and differing viewpoints, experiences and information. The Psychology of your 20s is not a substitute for professional mental health help. If you are struggling, distressed or require personalised advice, please reach out to your doctor or a licensed psychologist.See omnystudio.com/listener for privacy information.

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I'm Gemma Spike and welcome back to the psychology of your 20s, the podcast where we talk through the biggest changes, moments and transitions of our 20s and what they mean for. our psychology. Hello everybody. Welcome back to the show. Welcome back to the podcast, new listeners, old listeners, wherever you are in the world. It is so great to have you here back for another episode as we of course break down the psychology of our 20s. Today, I hope you are ready for a big episode, a very long episode, an incredibly interesting episode. We are talking about the psychology of plastic surgery. We know that there is this huge intersection between plastic surgery and psychology, between plastic surgery and insecurity, social conditioning, social media, self-confidence.

And sometimes it stirs up a lot of debate online and in our own conversations. I've always wanted to do an episode on this, but I am not an expert. So I thought I would bring on somebody who most certainly is somebody who has decades of experience, navigating this industry, navigating the emotions to do with plastic surgery, navigating every single little bit and part of, yeah, of this experience and of this process. So I'm so excited to have him on board for a super interesting conversation. Whatever you believe, I just feel like you can learn so much from how he approaches this, what we talk about, the nooks and crannies that we get into. So without further ado, let's talk about the complex, interesting, incredibly fascinating

psychology of plastic surgery. Dr. Rati Raban, welcome to the show. Can you introduce yourself to the audience and just tell them a bit about who you are and what you do? Sure. My name's Rodi Raban. I'm a board certified plastic surgeon out of Beverly Hills in California in the United States. I've been a board certified plastic surgeon practicing predominantly, I would say aesthetic surgery for over 20 years in this sort of epicenter of Beverly Hills. And I've done, I kind of uniquely find myself doing all aspects of plastic surgery. Usually the minute you tell someone you do plastic surgery, their next question is, oh, really? Okay, great. What do you specialize in? And I kind of find myself a little bit of a unicorn in that I literally do face, nose, eyelid,

breast, bellies, et cetera, et cetera. So I do the gamut of plastic surgery. This is the question I've always wanted to ask a plastic surgeon, which is, how did you find yourself in this industry slash in this space? Like when you went and did your MD or I don't know what the process is in the US, did you know you wanted to do plastic surgery or did you just kind of like trip and fall into it? That's a great question. The answer is that people go about it in both ways. Some people know early on, I would say most sort of find themselves, uh, trip and fall into it. I always, always wanted to do something in design, fusion with science. You know, I actually wanted to be a mechanical engineer for a period of time and then I wanted

to be an architect. So plastic surgery was a, the minute I decided, I went to college at UCLA, which is down the street from my home. And I went in as a biochemistry major just simply because I liked science and science came pretty naturally to me. But I always knew that I need to do something in the design, aesthetic, creative realm. But I had a very strong liking towards the sciences, mechanical and civil engineering. So when you actually really, really think about it, plastic surgery is that beautiful fusion. And then I always loved entrepreneurship.

I love business. I love, you know, VCs, I love Shark Tank. And then when you think about plastic surgery, it is actually the perfect tricycle. It's, you know, business, medicine, and design, all merged into one. And for you to be arguably successful, you need to sort of excel in all three categories. If you imagine one of those wheels being smaller than the others, you're not going to get very far. So it was actually the minute I got to undergrad, I knew pretty quickly that I wanted to do something in the medical space. And the only thing in medicine that allows you this degree of latitude into creative element really is plastic surgery, not orthopedics, not OBGYN, not pediatrics. So it was plastic surgery or bust. That's so interesting that you say it's like almost a creative part of

medicine. And I feel like when I first hear that, I'm like, wow, that sounds, that's like actually, that sounds strange and then I'm like, well, yeah, you are. You're like sculpting the body and changing it to match someone's vision for how they want to look, which is the fact that they're putting their care in your hands to execute their vision is also pretty amazing. Like, there must be a great deal of trust in that as well for you to have these people come to. Yeah, I mean, I actually take it with great reverence and a certain degree of stress associated with it. you know, I think the sign of a great surgeon is one who has a certain degree of humility and fear. And that fear is, you know, you say people are God-fearing and that, you know, they have

respect for something outside of themselves. And so when people come to you and they say, you know, whether it's a young girl or a young gentleman or an older person or what have you, and there's something about themselves that doesn't, isn't congruent with the way they see themselves and they ask you to help them get there, it's a very, um, sizable responsibility. And so I take it as such. So I have always been in awe with what I get to do on a daily basis. I never take it lightly. One more icebreaker question for you. And I don't know if this is, if this is a weird question. And you can not answer it if you don't want to. What was the first surgery that you performed as a plastic surgeon? Do you remember? Of course I do. I remember it vividly.

So I've been in practice now 20 plus years. And, you know, every pilot, every police officer, every person does, has a first of something, right? The first time of fly plane. And you think to yourself like, okay, but like those other jobs, like, who cares if you mess it up? Who cares if you fuck it up? But with surgery, the first person is, you know, it's going to have to, is the one who is your icebreaker. So the first surgery I did actually was a breast augmentation. A very dear friend of mine who I adore and was at my wedding and is still a very close friend of mine,

always had great faith in me. And she sent me one of her friends who had had a few kids. And I ended up doing a breast augmentation on her. And I remember her very, very well because she was so sweet and so bubbly. She had had four children. And yeah, I did my first case was a first breast dog. And it actually went quite well. Yeah.

She's still sending me patience. So I think it was a success. Well, that's good. Moving on to like the actual questions around the nitty-gritty of plastic surgery, one thing I feel like we need to get out of the way slash discuss is the difference between plastic surgery and cosmetic procedures or cosmetic surgery. I feel like I think they're kind of different. Am I wrong in that or are they quite similar?

So I think you ask a very good question. If the goal of today's episode is to educate and elevate people's understanding, then you've got to understand the alphabet soup. You've got to understand the vocabulary. You've got to understand the glossary of plastic surgery. And so unlike all other fields, plastic surgery is very confusing. And that's not by accident. Because ultimately, a lot of it is driven by marketing. Marketing. You don't get confused when you have an arrhythmia and your heart is not functioning correct, you go to a cardiologist. There's no confusion on that.

When you have a ovarian cyst, you go to your OBGYN, your gyne, your gynecologist, you're obstetrician. There's no confusion in that. But in the area of cosmetics, my God, there are thousands of different providers with all kinds of names and things like that. So the way it works is as follows. When you go, at least in the United States, when you go to medical, school, you are all equal. And then you have to select a specialty. You say, okay, when I'm done with my four years of med school, I'm going to be a, again, orthopedist, neurologist, psychiatrists, blah, blah, blah, blah, blah, and one of those is a plastic surgeon. There is no cosmetic surgery residency. There is no, it's just

plastic surgery. There are dermatologists and there are ear, nose and throat. doctors, but cosmetic surgery is not a residency. You then go into being a plastic surgeon, and in your training, which is quite diverse, one of the things that you learn is aesthetics, beauty, cosmetics. So you'll learn burn surgery. You'll learn reconstructive surgery with microsurgery. You'll learn hand surgery, blah, blah, blah, blah, blah. And one of them is beauty or aesthetics or cosmetic surgery. Then if when you graduate, you decide, you know what, I really like cosmetic. surgery. I really want to specialize in this in my career. Then you will take additional training, but you will be a board certified plastic surgeon who specializes in aesthetic surgery,

which is what I do. Then comes, you know, years go by. And then the field of medicine, naturally, like all other businesses, is driven by money. Non-cosmetic things like my gallbladder, my hernia, becomes poorer and poorer. So what that does is it drives people who are not trained, in aesthetic surgery to then change directions mid mid game and say you know what i can do this how hard could this be and then they then start to take any any any variety of lessons whether that be watching a friend going to courses whatever they want and then overnight they can deem themselves as cosmetic surgeons i know that's hard to imagine i know it's really Like, no, come on.

And so if you go look at cosmetic surgeons and you start to say, okay, well, where, what is your actual training in? You will find out that they were general surgeons. They were OBGYNs. They were radiologists. They were ER physicians. And at some point in their career, they decided, I don't want to do a shit anymore. And then they get whatever degree of training, which is not very regulated. And then they call themselves cosmetic surgeons.

So the answer is your listeners need to. to sadly do their home. Yeah. And I agree with that entirely. And it's so interesting to hear behind the scenes of like the labels and like you said, the alphabet soup. I also just think like if you're going to permanently change the way you look and undergo surgery, it's not something necessarily to skimp on or to cut corners with. So you like bring up a very interesting point, which is like think this through and there's multiple sides to think through. Before I go, further in that kind of direction. You know, we're talking about plastic surgery,

specifically in our 20s, really. I just have to ask, how many people are getting plastic surgery in their 20s? What is the most popular age group that you see that gets worked on? So that's very interesting. So it turns out that every decade has its more common procedures. I will say more than ever before

younger and younger patients are coming in to get surgery. Why is that? Social media. The end. We've always had young people having surgery. My sister, who's almost 60, had her nose done 30-some-odd years ago. My mom, who's 85, had her nose done 60 years ago. So it wasn't crazy to go to nose job.

But this idea of Bella Hadid cat eyes, mini facelifts, lip-lifts. I mean, there's BBL's lipop, fat transfer, rib remodeling. There's some crazy things that are getting done and they're getting done younger and younger. The only reason that is occurring is social media. That being said, you know, there's things that have happened at different ages in our life. So let's start with 20s. What are the things that people come in commonly for their 20s that are within reason? And what are some of the bad things that I think are a little overboard?

If you're 20-year-old young lady and your breasts never really fully developed and you find that while you love your body and you think everything about yourself is amazing, you work out and everything, but you just simply never develop much breast tissue, then getting a breast augmentation is not an unreasonable concept. And that happens often in your 20s. If you were born and you were unlucky and your nose just was crazy out of balance with your face and you and you and. inherited his big nose and otherwise we're a beautiful young lady. It doesn't seem crazy to alter your nose and get a rhinoclasty. That happens in your 20s. If you were born with a very weak chin, just because genetically, orthognatically, you've never developed and you have a massive underbite, it's not crazy to get a small chin implant or an enhancement

of your chin to create harmony imbalance. That happens in your 20s. Conversely, now we're getting people calling about brow lifts. but you're 20 lip lips face lips neck lips rib remodeling those are some really extreme surgeries that are not were never really designed or really indicated for young adults so i think the question you're going to lead to eventually is where is the line right and the answer is who knows and that line is drawn by both surgeon and patient but i i don't know if that answers your question but those are often the surgeries that are getting done.

I think it, no, it totally does. And I feel like this is an even broader discussion of like, what is the point where you get something done because it is a genuine deep insecurity for you? And then what is the point you get something done where there is genuinely nothing wrong and genuinely nothing that a surgery could actually do? Like you're saying a brow lift for someone who is, you know,

22 or 23. And I feel like that's where the entrance of social media has probably greatly, greatly swayed people. How have you seen FaceTune or Instagram dysmorphia, dysphoria, change how people perceive normal beauty? Like you mentioned some of those really extreme procedures. Are you also seeing younger people coming in for perhaps more surgeries than they need? like repeat people coming in and changing back to a certain way or, you know,

redoing their nose or redoing their eyes or redoing their cheeks multiple times in the span of years. I'm curious to see how you've seen the impact of this even further. Okay. So we got to start with the psychology of beauty. Plain and simple. This is well before any social media. This goes back to Cleopatra. This goes back to the Amazon. You know, you go to the Amazon right now with a bunch, in a tribe where no one's seen any human beings outside of the Amazon. And you're going to know who the queen of the tribe is. She's the one with the most beautiful neck and the, you know, beauty is not a concept of modern times. Beauty is something that we know. There's tons of

studies that show that like monkeys will go to the more more attractive puppet than the other than the other puppet. So there is an inherent built in us to desire to, you know, it comes from mating, Right. Animals in the wild will go to the more attractive bird or the more attractive flower. So there is that. And then there is this turbocharged version, this version where you have this sort of innate being in our beings as people, this desire to look good or feel good or present our best. And then you pour gasoline on it. And I think that's essentially what social media has done. In modern society, we've had billboards. We have actors and actresses. We had magazines. We had celebrities. We had models. This has existed for over 200 years, right? And, you know, oh, I think Merlin-Roe is so beautiful.

Oh, my God, look at Grace Kelly. And it always sort of people admired and wanted to sort of emulate some of these people. But it was still manageable because those people were those people. Like, oh, I really want to go to this place I see in this postcard. It's a real place. Right? You can actually go there. And then we get into the modern world where manipulation,

alteration, fabrication, whether it's AI, FaceTune, filters, angles, and morph. And then reality changes. And because inherently we are vulnerable, right, we're all vulnerable, 16, 17, 18, even grown-ass adults are immature and have insecurities, then you, massively at a very high level, you start bombarding people with images, right? Social media. You'd see a billboard while driving.

Let's say you drive on Sunset Boulevard. You'd see 25 billboards over five miles. You now see 25 images within five seconds. Yeah. And these images are bombarding you. Secondly, they are not real. So you're looking at a destination. Like, oh, my God, look how.

beautiful, these trees and the water. There is no place. This island doesn't exist. It's not a real island. She doesn't look that way. No, look at Chris Jenner. Look at the excitement that Chris Jenner generated with her facelit, right? There must be one trillion views or comments.

Well, yes, she looks good. But the reason she looks so good is she's face-tuned every image that's come out over the last six months. And now that her images, she cannot stay up on it, people are noticing that she doesn't look as glossy and amazing as she did the first couple of months because she's face-tuned everything. So people are thinking that, wait, you have flawless skin. No, she doesn't have flawless skin. She's almost 70.

She has a good facelift. She looks amazing, but she doesn't have flawless skin. So what I'm getting at is there's this balance between what is reasonable and what is organic and what is part of humanity. And then there's this gasoline that you poured on this smoldering part of us. And then it's gotten out of control. And then what happens is 90% of us are subject to being impacted. And so when you are immature and you're vulnerable and you're 13 or 12 or 8 or 9 or 16 or 17

and almost every human being goes through a little awkward time, their voice is changing. They're growing hair in places they shouldn't be growing. Whatever. You look at these images and you get phomo and all this sort of sense of like, oh, wow, I'm so far from that. my God, how ugly am I? And you're so far from a place that doesn't exist.

And there's an amazing saying is, so it creates what? Sadness, depression, anxiety. And there's a very great saying. It says that your happiness is based on the delta between where you are and where you think you ought to be. I'm going to repeat that. Your happiness is based on where you are and where you think you ought to be.

So you are here. I make X, I look like this, I, this is my wife. And where you think you ought to be is the relativiveness of where you think you could be. And where you think you could be should be flawless skin with an amazing boyfriend, living on a boat, driving a Rose Royce, blah, blah, blah, skinny body, big butt, small waist, then you are far, far away from that, which then leads to feeling sad, depressed, anxious. And then what you do is you chase it. And that's where we are today.

And so I think that the amount of mental dissatisfaction and sadness amongst insecure people ranging from 8,9, all the way up to grown-ass adults is so massive. And I really, really think social media is to blame. It's not plastic surgery. It's not the chase to be beauty. It's the fact that you're creating these alternative universes that will never exist. It's like porn. It's not real. So anyways.

That's the problem. Yeah. No, I totally agree with you. And I agree with you as someone who has seen that happen to me in my own life, where I've been like, wow, this person is just so amazing. If I had that, wouldn't all these other things change? And we know, like, psychologically, and I'm sure you know this as well, obviously, like, with hedonic adaptation, you could have surgery.

It might change your life. Normally, you are actually going to return to a baseline level of happiness. it's exactly what you were saying about, you know, Chris Jenna got this surgery and I'm sure for her she was thinking, this will be the one that eliminates all insecurity, and yet she's still face tunes, and yet there's probably still things she doesn't like. There's like an inner critic in all of us that social media

and the unrealisticness of beauty is really kind of promoting. This kind of brings me to, I think probably one of the more, controversial questions of this interview. We're going to take a short break and then when we return, I'm going to pose it to you. So stay with us. Two percent. That is the number of people who take the stairs when there is also an escalator available. I'm Michael Easter. And on my podcast, 2%. I break down the science of mental toughness, fitness, and building resilience in our strange modern world. I'll be speaking with writers, researchers, and other health and fitness experts, and more, to look past the impractical and way too complex pseudoscience that

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I vowed. I will be his last target. He's going to get what he deserves. Listen to the girlfriends. Trust me, babe. On the IHeart Radio app, Apple Podcasts, or wherever you get your podcast. This is the question I want to ask. Can someone be truly body positive and still want to change how they look?

Is there, I guess, something that surgery can never fix within somebody? So the answer is, let me get, let me make sure I understand the question. Can somebody truly love themselves, as we say today, be body positive, I think I'm amazing, and still find benefit from a surgery? Is that what the question is? I think still find benefit from a surgery or still find themselves thinking about a surgery. Does thinking about surgery, no, go ahead. So the answer is absolutely yes.

So that would equate the ideal. patient. The ideal patient is one who comes to you, who is otherwise very happy in their life. They have stability in their interpersonal relationships. They come in with a very finite issue, one that can easily be agreed upon. And as a result, the correction or the eradication of that one very specific issue can for sure, and I have now witnessed it for 20 plus years, dramatically change, enhance, and improve the quality of life of that person. So let me give you such examples. So you see a young lady and they come into your office. I refer to my four nieces and they are boss ladies. One's in law school. One's a venture capitalist. They played sports.

Their soccer. One was valedictorian. By all intents of purposes, kicking out. ass, boyfriends, everything, love their moms, just a great, like, great, great girls. Yet because of genetics, while they are beautiful and have great skin and nice teeth and everything, with all fairness, all four of my niece had bad noses. And so these four nieces of mine, on their own, really disliked their noses. Every other aspect of their lives were kick ass on 90th percent of whatever. So we sat down individually, and I mentioned them because there's so four different young ladies of all different ranges. And we identified the issues.

We had discussions. And we said, okay, if we alter your nose and create a better harmony, not perfection, not the nose on Angelina Jolie or let me see what Margot, a better looking nose on you, would this create a little bit of better appearance and hence make you happier? And the answer is all four of them, all four of their noses were done at different times in their lives, different ages. All four of their noses still have flaws, because I'm a critic and I know. And all four of them are over the moon about their noses. And then hence moved on and never looked back. So nothing about the way they love themselves has holistically changed.

But that one entity about themselves is significantly improved, which then adds to their overall confidence. Could they have lived life without it? Sure. Had they not had the means, would it have drastically changed their lives? No. But the fact that they were lucky enough to be able to afford it, have a surgeon who executed it, and it ended up being positive, has unarguably changed a trajectory of their life.

And I can tell of you that 95% of my patients, their lives have been massively improved by whatever surgery they did, where there was a mommy makeover after having multiple kids. And I can give you the stories behind these people. So if you've had three kids, you kick ass, you love. your husband your husband loves you your children are healthy you do yoga you go fix your body and now your insides match your outsides no amount of diet and exercise would have changed it right so these are such examples that connect with stories we are very good at isolating oh you should just love yourself your husband should love you this is all nonsense so the answer your question is when a patient is

a good patient a well qualified patient and has a stability around themselves and we're fixing a very finite issue, then yes, I do think they can be body positive and yet still have a dramatic improvement in their life. I find that interesting because I definitely see the point. But with your nieces, like what made them bad, what made them bad noses or like what made the body of the, of the woman who's given birth as a bad body? Like, you mentioned that they, these women were already in the 90th percentile and this woman already had everything. she wanted, what do you think it was about changing this bad part of them or this, I guess, you know, part of them they didn't like that that meant something to them?

Do you know what I mean? So the first question is, yeah. Yeah, yeah, I understand. The first question is defining bad. Bad is a relative term. Yeah, exactly. Like tall is a relative term. Good is a relative term.

I use the word in a very simple fashion, but it's, it's much more complicated in that. First of all, I'm not the one that tells them it's bad. So let's be very, very clear. These people come to me. I don't they don't come to me and say hey dr bond how you doing great so what do you think of me i go well you look pretty good but your nose is bad that's not how this goes this is a person who has been dwelling on this subject matter for years seeks out help comes to the office and I say how can I help you and they say well I'm not so happy about my nose what is it about your nose that

you dislike well I don't like this huge hump I don't like that it's droopy I don't like that my tip is massively bulbous, and that doesn't make it bad. That makes it bad to them. There is no such thing as bad. If that girl or that guy loved those features, then it would be good to them. So when I say bad or good, it's relative to the way they perceive themselves as to either what they would like and or what they used to be. So then people who like to,

people who like to sort of be naysayers like to be like, well, what, what's wrong with it? Who says that a hump is bad? And they like to sort of play that game. Then I ask you, why did you put on lipstick this morning? Are you wearing mascara? Have you done your nails? Do you cut your short, trim your split ends?

Do you wear perfume? Do you have jewelry? Well, why do you any of those things? What's wrong with you without perfume? Why are you shaving? under your arms. So if we want to play that game, everyone will fail because it's not about the actual absolute, meaning this is okay and that's not, because all that is is a line in the sand. Who are you to tell me that I'm allowed to put on mascara, but when I get a tattoo, I've gone too far? Who are you to

tell me that I'm allowed to put Botox, but if I get a nose job, it's too far. No one can say that. It's about relativism. And relativism is a dangerous area. So because no one can make that definition, it's a slippery slope because the person who has had 47 surgeries can now reverse the argument and be like, so what? Who said 47 is bad? Why is it only two? But we're talking about mentally stable, healthy individuals who look at themselves and feel,

you know what? I don't really love my saggy breasts. And to them, it's bad. And then there's people to them, it's great. And what we have to do as a society is make sure that we don't get too far off the spectrum. And we were doing okay because, you know, at the end of the day, we had realistic images of what could be. But I think the dangerous area, the dangerous waters we're in now is that things are so accessible. You can go to Turkey.

You can go to downtown. You can go to Miami. Things have become relatively affordable, even though everybody bitches is. expensive. I mean, you could literally go and get a boob job for nothing. And images are endless. So this is a cocktail or a recipe for a very bad outcome. Does that answer your question as to what defines the person as a bad nose or what my nieces felt was a bad nose? Yeah, it does. And I think it's like a very, like you said, it's incredibly complicated. And I think I think the line some people would draw is that there's a difference between mascara and permanently,

altering how you look, like you can take the mascara off. You can't take the nose drop off. What do you tell people with tattoos? No, I know. I would have seen the same thing where it's like I mean tattoo, 85% of young adults. Not really. No, that's a lie. Those are what people tell themselves. But tattoos are essentially permanent. Even if you remove it, you have the scar of it. And the reality is that, again, I agree with you. It's all a sense of relativism. And I think it's great to play devil's advocate because we need to make sure that we find center ground. Center ground is that we're not far left, we're not far right, whether that's in politics, whether that's in religion and whether that's in plastic surgical philosophy.

So I do agree that each person will find that center area and draw that line. And yes, for someone, mascara is reversible, yet a tattoo is not. For some people, that too is not really reversible because I can cover it. So there's all these versions of the way we sell it to ourselves. I think the key is, and it has been for me, because ultimately I'm the gatekeeper, right? I'm the one that is the church. I'm the one that will facilitate this alteration in you. So I take that responsibility quite heavily.

And there are many patients over the course of 20 years that I have redirected, re-advised, recentered, and refused. Let's talk about those patients because I think regardless of, You know, if you're listening to this, regardless of whether you think plastic surgery is a good idea, you've had it done yourself, or you're one of those people who's like, I would never do that. I want to go through the psychological process of loving my body as it is. I think we can all kind of identify that there is a level where someone seeking out plastic surgery might be a little bit problematic. Can you tell me when you know, or instances where you've been like this person is probably not a good candidate for plastic surgery? Great question. So first and foremost, my overall philosophy is not that plastic surgery is good for everyone. As a matter of fact, absolutely, it's not good for everyone. My simple philosophy is that if you are the right candidate, and we've been sort of touching on what that is, and you do a good surgery and you find a good surgeon who collaborates with you, my experience for 20 plus years is that the

overwhelming majority of those patients do well. That doesn't mean everyone should be doing it. Conversely, there are absolutely people that shouldn't be doing it that are seeking it. And who are those people? And I tend to be a bit more transparent. If you follow me on social media, you listen to my podcast, everything and anything that comes out of my mouth is cautionary. I live and die. I'm sort of the Howard Stern meets Geraldo and the, you know,

report of investigator of plastic surgeons. I'm the guy that everyone keeps sending DMs to like, hey, should I do this procedure? This sounds fishy. No. So these are the things that would be a concern to me. Number one is when a patient comes into you and says how much they dislike something, they describe it to you in great detail of much how terrible it is. And when you look at them, you simply just don't see it.

Like I genuinely don't know what you're talking about. A perfect example is a girl that came in just today who wanted a nose job, a revision nose job. And at the end, I said, listen, I have to tell you, I think your nose looks great. It has a little bump on it and a little this. But those things are like minor. By and large, you look good. I wouldn't touch it. So red flag number one is what they see, you don't see. Right. If my son comes to me, who's four years old and says, Papa, Papa, do you see the monster? And I'm like, I don't know what you're talking about, blah, blah. You know, I don't see what you see. Second thing that's a red flag is when they make it seem as though this issue is really the end-all be-all.

It's going to change their lives. They apply too much emphasis on something. You can tell that psychologically they've attached too much value to this item, right? And while I think changing the way you look creates a sense of confidence, which then bleeds into your personal relationship. I cannot tell you the countless number of people who have had surgeries and as a result have massively kindled their interpersonal relationships with their loved ones, their boyfriends, their girlfriends, their husbands, their wives. But when you're making it sound like this is going to change your life, like you just got,

you know, I don't know, brain transplant. That's a concern. When patients don't track the risks when you talk to them, I say, you know, I'm very underpromise over-deliver kind. I'm very like, and then this can happen, and then this can happen. And then you could be paralyzed and then you could die. Like, I'm very much doomsday because I like to push the dooms because if you go through the doomsday conversation, you're still on board.

It means that, you know, you understand the real risks. But when they actually act like nothing, like they don't register it, it's a concern to me that they're not going to follow through. When they have any type of psychological condition, whether they have borderline disorder, they're very jittery, dismissive. They're very labile in their emotions. They're crying and then they're excited. They're angry and then they're depressed.

Any type of mood swings, I won't do. And when they're asking for things that are extreme, that I just like, like if you're 5 foot two and you weigh 125 pounds and you're an A cup and you bring me a photo of some huge bar and you're like, I want these massive boobs. It's like, and there's no way that's going to happen. So remember, I don't want to be. entangled in a marriage with someone with a bad outcome.

So as much as it is my responsibility to prevent them from doing it, I don't want to get involved in this with you because you're ultimately going to be a patient who is going to be dissatisfied or unhappy or not have a good outcome. So I spend a lot of time trying to make sure that I marry the right people because once I operate on you, you're my forever responsibility, right? It's not like I sold you a bag, a handbag at the mall. Yeah.

And you're unhappy. Whatever. And you return it. You're like, this bag sucks. You're like, okay, here, buddy, here's your money back. Just be well. This is kind of like we're forever tied. So I am very cautionary about making sure that the patients have realistic and doable expectations.

And they're emotionally stable and seem to be present in that moment. I want to hone in on the second point you said here, because I think this is interesting, and I feel like the listeners will want me to talk about this a bit. The patient who is like, this is going to be the thing that changes my life. Why for them would you not operate on that kind of person? Do you think it's because there's a deeper psychological insecurity going on

or a deeper relationship with their body that like surgery can't fix, what about that kind of patient would maybe scare you as a, as a surgeon? So listen, every single person has insecurities, period. So this notion that, you know, the person who has insecurities is unstable and you should love your body is nonsense again. I'm not going to allow these terminologies to float around, or at least in my presence, because it just then makes people who actually had surgery and have an amazing outcome feel

that about themselves. Every single person, myself included, my wife, the supermarkets, the supermarkets, the superman. The girl walking down the runway at Victoria Secrets has insecurities. That's part of being human. It's about being in the center. It's about that insecurity being within reason where it doesn't consume you. It's about that insecurity making sense in reality. This dimple in my butt makes me a little insecure.

It doesn't mean that I can never be naked in front of anyone again. Do you see how there's a difference between the two of those? So everyone that comes to me is fixing an insecurity. Every single human being that I've operated on doesn't like the thing. thing that they're operating on, whether it's the mole, whether it's the breast, whether it's the nose, it's the island. That's an insecurity. Where it becomes a concern is where that insecurity is so grand and it is so, you describe it as like, as it's altered your entire life. You having an ugly nose or a big nose or nose that doesn't fit your face is not altering your very existence. It's not preventing you

from getting a job. It's not preventing you from finding a good boyfriend. It's not preventing you from having a loving relationship. It might make you feel happier and you'll be a little more confident and you'll take a few more pictures and you'll be a little bit more aggressive in life. So it's about appropriateness of that emotion. So it's kind of like the difference

between being scared of dogs and being a little careful around dogs and then being so scared of dogs that you see a dog across the street and you cross the street to the other side. So it's the difference between being reasonable and it's making sense and being irrational. There are irrational fears and there's irrational emotions.

And when the emotion is not congruent with the condition, it's a red flag, right? It's a red flag. And it's kind of like love bombing someone. It's like, how could you love me? You've only met me for two hours. No, I do you mean. So when the love doesn't balance out

with the reality of our relationship. And it's the same thing when the condition, now, God forbid, God forbid you've been burned and your face has been mutilated and you're telling me it's destroyed your life. Well, that's a goddamn appropriate discussion. But the mole. Yeah, no, I see what you mean.

Yeah, because the condition warrants the emotion. But when you come to my office and you're just flabbergasted and just for clamped and you're just beside yourself and I ask, okay, well, what's going on? You're like, this mole, it's just, which mole this one right here oh okay what about it well it just ruined my life and i just can't and my boy and you're like okay this is just this is a problem and i you know i obviously use that as a silly example but it can be your nose it can be your breast it can be anything but you

have to be reasonable about it and that's what i mean about emotional stability and the truth is most consults that surgeons do is about 15 minutes that's the average my consults are one hour What do you think I'm doing for the additional 45 minutes? I would just say probably interrogating those four things, right, making sure that this person is emotionally ready. A hundred percent what I'm doing is digging. I'm digging. I'm having conversation with you.

I'm asking about your profession. What do you do? I can examine you in five minutes and tell you what surgery you need. I've been doing this for 20 years. I don't even need to have a conversation with you. Just send me your pictures. But the consult is actually an interview. It's for you to interview me.

And I like this guy. He seems cool. I don't like this guy. He seems arrogant. It's that. And then for me to interview you, you don't sound like you're going to be a good patient for me to take care of. I'm not so sure I can make you happy.

Right? I'm not sure if I can make you happy. And the problem with what I do, that's totally different than every other specialty is what I produce is subjective. Yeah. When you go get your gallbladder removed, how many patients are unhappy about their gallbladder being removed? It's out the end.

Unless there's like a side effect. Yeah, genuinely. Right, of course, if you have a complication. But I'm saying is there's no variation of out. It's out or it's not out. Right? No, exactly. But when you do your nose, I have four million permutations.

And while you and I may have a lot of conversation, who on earth can predict what your nose is going to look like? You go to sleep, you wake up, and you are a different. person. Do you understand how scary that experience is for both of us? What if you hate it? And I think it looks amazing. It's subjective. You say, what is this ugly thing? And I say, what do you mean? This is a work of art. It's disgusting. I hate it. So you better bet I'm going to spend hours, 45 extra minutes digging to make sure that you and I are going to be a good match. And in all the years I've been in practice, I've done a pretty good job. Of course, a few people slipped through the cracks.

Yeah, of course. But by and large, I think it's worked well for me. Follow up question here. This is so fascinating. I feel like I'm learning a lot. When you have one of those patients who fits all four criteria, well, let's say three of the, I guess, I think you gave four or five, let's say three of the four or five.

What do you say to them? Do you say, here's a therapist, I think you should go see? Do you say, here's a friend of mine? Do you say, give it six months? Like, what's your protocol for those patients who you're like, this isn't going to be a good idea for you? A great question. And actually, that is probably the most challenging consult,

is to go into a room. Someone's come to see you. They paid you a fee. You internally realize this is not going to work. And you have to walk them off the ledge and tiptoe out of the room. So it depends. If they are logical, I will spend time and I will spend the energy because I have them and I have captivated their attention. And frankly, they only will respect the voice or the reason of a plastic surgeon, not their mom.

My mom said the same thing or my friends. Those people don't count. I'm a professional who stands to make money from this. Remember, my incentive is to make a living. So if I'm telling you that this is a bad idea, I am foregoing thousands of dollars of benefit. I don't get an Academy Award. I don't get any trophies.

I just lose money. So if they're rational in that they're logical, I can sense that I could educate them, then I will take the time to be like, listen, let me show you a photo. Let me draw this. Let me do this. Let me show you that.

This is why that. This is that. And occasionally I can walk them back to where they can see that this is a bad idea. If I find that there's just no getting around it, I'll never disrespect the patient or ever make them feel bad about what they're saying. I'll never say, you know what, you're crazy. I don't even know what you're talking about.

That's just never going to go over well. So often, if I don't feel that I can really connect with them and educate them as to why, I'll often tell them that, you know, you have a very complicated situation. And to be honest, I don't think I'm skilled enough. Like, I don't think I'm good enough to fix this problem. In other words, I'm the issue here in terms of skill than you. Because at the end of the day, they're going to go and get it done. I cannot tell you, actually, I can't tell you.

One third of my practice is revisional. One third of my practice is someone that went somewhere, got it done, and it's a bad outcome. So I know, unfortunately, and I've happened to me a thousand times where I've seen patients, I've walked them off the ledge, I told them it's a bad idea, yet they go out one door and into another door. And the next guy says, no, no, no, that guy doesn't know what you're talking about. They do the surgery and then they come back here and ask me how to fix it. I'm like, because I have their notes, right?

I'm like, I saw you four years ago. Didn't I tell you not to do your nose? Didn't I tell you to leave your breasts alone? And so I know a lot of people are, they want to hear what they want to hear. And I can only do so much to guide them. So I would say 50% of the patients that are in that category, I can educate them. And I can gradually and slowly reel them back. And then the other half, you're going to go elsewhere no matter what I tell them.

They're just have a beeline to get this done. And you look at social media every day. Look at how many people have gotten so far bizarre in terms of they look, the way they look. Chances are they met someone along the way that said no. And they just said, fuck it, I'm going to go somewhere else. I don't care. My job is to not harm them. That's my first duty.

My first duty is you've come to me and I'm not going to participate. I'm not going to drive you to a bank robbery. I'm not your Uber driver. I'm not going to take you to your weird-ass destination. That's a good analogy. That's a very good analogy. I like that. We're going to take one more short break,

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I feel like we've been circling the drain on this one. I think it's come up like in a couple of times, which is surgery addiction. You said a third of your patients are there for revisions. Correct. People give you a laundry list of things that they want. We've all seen people who have been, I would genuinely say disfigured by plastic surgery. What's been your experience with that?

And how do you, two questions. What's been your experience and this being a psychology podcast? What do you think the psychology behind that is? Okay. So they represent 0.000. 0.000% of patients. Let me reiterate. Body dysmorphia, which is the term for what you're describing, represents 0.000% of the patients out there. The overwhelming majority of patients are normal, regular folks like you and me, have an issue or two that they don't like, that they identify a surgeon,

and go get done. The fact that they have a bad outcome is not because they are crazy and they have body dysmorphia, it's because they pick the shitty surgeon. And the reason they picked the city shitty surgeon is because there are, for every one good surgeon, there's 14 charlatans running around acting like their experts. Now, to address your true quent question is, this body dysmorphia people, these people that look like the cat lady that look literally unrecognizable. Well, they're fascinating. That's why they occupy so much of the discussion when it comes to plastic surgery. I've done 100 podcasts. And every podcast are absolutely. to me about body dysmorphia because it's fascinating. Like it's a train wreck. We're all watching.

Like what the hell? Why does she look like that? And moreover, who did that to her? Yeah. So the issue is twofold. The issue is what's wrong with the person? And the second issue is who would have done that to that person? So body dysmorphia is a psychological condition. And it's a condition in which you see yourself as different than you really. are much like people who have anorexia and they are not well and they have some degree of paranoia and they have an underlying true psychological condition. So they need to be on medication, just like a schizophrenic needs to be on a medication, just like someone who hear voices need to be on a medication and seek psychological help. However, because often they're estranged, because often they're

isolated. Often they're just by themselves. Often they're at the end of their lifespan in terms of the money they've spent on themselves. They're usually not at a job with their husband and kids, not those people. I'm talking about body smorphia. People who walk around, you're like, whoa, there's no one who can intervene in those people. So that's not the issue. The issue is who the hell operated on this lady 17 times. Yeah. That's the sick part. The sick part isn't that they are. She had. Yeah, that she was sick.

Somebody showed up. She went to somebody's office, having had three facelifts, looking literally like a stretched tambourine. And someone said, sure, I'll take your 20, 30, 40, 50 grand and do another facelift. That's the sick part because that's literally like child abuse as far as I'm concerned. It's like elderly abuse. This person is not well. So it happens.

I'm lucky in that it doesn't happen in my office. occasionally they'll get through the window. If you call my office and you say, I've had four facelifts and I'm thinking something's not right and I want a fifth, we just don't see you. I'm so sorry, you know, there's nothing we can do to help you. We're not going to engage the dialogue. There is no scenario in which, zero, where you need five facelifts before 50. That's one, like that's literally like one every five years.

And it happens. There was a girl. There was a girl. What is the name? of that. And I don't know. She was like literally her six facelift. And she was like 50. So Faddi is more to thank the Lord. It's a very small minority. I think it's an addiction, right, as well, right? You have to treat this as something deeply psychological. A hundred, a hundred percent. It is the same exact area in the brain that leads to cocaine addiction, alcoholism, gambling,

pornography. It is a impulse. I got two final questions for you. The first one is, here is your space to just address the biggest myth about plastic surgery that you want to address. And the second one is more specific to our audience. But I'll let you do that one first. What's the biggest myth that you want to address here about plastic surgery? So I think I have been blessed over 20 plus years to have been graced with so many amazing interpersonal experiences, thousands of letters and thank you notes and gifts and chocolates and and pictures and reviews from people whose lives I've improved.

So I don't like when plastic surgery gets a bad rap because inherently it's an incredible tool. That being said, my biggest quam and my biggest message is that tool is a very, very sharp knife. and if that knife is incorrectly, incorrectly handled, used on the wrong patient, done in the wrong way can create everlasting damage. And because of the things we discussed, more damage is being done than ever before, thereby tainting and ruining the beautiful possibilities that a good plastic surgical experience can bring. So what I say is people are now treating plastic surgery operating, going under anesthesia,

like it's literally going and getting extensions. They have lost their reverence for it. They have lost their fear of it. They have lost their, you know, if you were going to do something super significant in your life, you would do a tremendous amount of analysis before. Plastic surgery is no longer in that category. It's like a whimsical decision. And that is my biggest concern for young adults.

It's something you feel like you want. And the biggest issue is at 20, you can't afford it. So what I see more than ever is that when you're $25,000 is a lot of money at 20. And as a result, when someone good is 10 grand and someone mediocre is $5,000, is five grand, you have to have it. I have to have this now. And you forego what you would normally have done in any other scenario. And you say, how bad could it be? Because it's getting extensions. And so a lot of the revisions I do are in people who had surgery as young adults. And at that time, aside from the fact that their wisdom hadn't settled in, there's a reason why 20 year old people do

stupid shit and 60-year-old people are like, God, when I was 20, what the thing. Because that's when you are in the military. That's when you get into fights. That's when you go to war. That's when you protest. That's when you are at a certain place in your life that you're conquering things. You don't make always the best judgment. And the problem is that you don't have the finances to do what's better.

So my biggest advice is save your money. So if you can't afford the person that you did homework on, that's 10 grand, Don't kid yourself that the four grand, three grand guy is just as good or I'll go to, I don't know, the Bahamas or Turkey or Greece. I'm saying be wise, put your mature thinking cap on and just treat it with the reverence that it deserves. And if you do that, then I hope for you that you will be a part of what I experience in my practice, which is amazing, transformative experiences. And that's what it should be. 99% of plastic surgery should be amazing. Like, wow, this was fucking great.

I'm so happy I did this. And there's just a lot of bad decisions being made. Yeah, that's great advice. Now that we have you in the advice-giving mood, this is the question that we ask everybody, which is a piece of advice you would have for yourself in your 20s or people in their 20s now that has nothing to do with what we talked about today. So I think for me personally, one of the things that I probably over did that I wish I didn't

is I spent too much of my young adult worrying about getting where I needed to go in life. So there are two major paths in life, those that really plan and those that don't plan enough. And generally the conversation is, hey, you got to have a plan, kid. Like you can't just let the universe take you where it goes. You're never going to get there. And that's actually quite true. But because of my personality, I think I over planned and over worried and over stressed about my destination. And so I got to where I got in life, which I'm so grateful I got married and I had kids a little bit late and I have a wonderful practice.

Everything about my life is where I always imagined it to be. But I think I worried too much about getting here. And it took a little bit of the fun out. out of it. I was all too worried about making it to my end destination and not enough time, not smelling the rosars or watching the view, but relaxing a bit. And so for the type A people who are out there, you can probably release the reins a bit. And as long as you're headed in the right direction, you'll probably get to your end destination without having to knuckle grip it all the way there. I love that advice. And you know what?

It's very pertinent because that is the question I get. The theme of questions I get all the time, which is like, how do I know that I'm on the right path? Like, how do I know where I'm going? So I like what you said. Like the destination will be there. You can take a bit of time. Yeah. I mean, you've got to have, first of all, if you don't, if you're not on a path, you will make it anywhere.

So you don't know that you're on the right path, but you need to be on a path. That's first of all. You have to, you have to be in the best thing. You have to be in the game, and that path has to be one that's worthy of traveling, even if it ends up not being the one. So, A, you can't not be on a path and B, pick a path that's worthy of traveling, and don't worry about it if it's the path. If you are on a path and it's a path worthy traveling, the path will present itself. I want to say thank you so much for coming on the podcast. Yes. Can I have a moment to plug my podcast?

Yeah, absolutely. I think that if people enjoy this dialogue, which I hope they did, meaning if you have any interest in cosmetic surgery, which most people find kind of curious or fascinating or whatever, I have an amazing podcast called Plastic Surgery Unsex, which as from this podcast, you can get a gauge of how I communicate information. And it really covers everything in plastic surgery, from minor things to major things, to trends, to disasters, catastrophes, to patients, to pastrophies, to patients, to patients. their journeys to experts to et cetera. It's called plastic surgery uncensored. You find it all over to play Spotify, Apple, whatever, whatever. It will be in the description as well. Yeah. And I think that for anybody who wants more of this kind of stuff,

you can kind of dig in and do a little deep dive there. And then if they want to follow me or anything, it can always come on to our Instagram and peruse at Dr. Roddy Raban, which is DR, R-A-D-Y-H-B-A-N. So we'd love to have some of your 20s. My dream is to get a hold of all the 20s, 20 year old before they do shitty mistakes. That's my goal is to get ahead of it, not to fix it afterwards. So good on you for having a podcast that is specifically targeting young adults because often the choices we make in young adulthood are the ones that forever change our lives.

And if we can alter them early enough, maybe the trajectory will be better. I appreciate it. Well, it was such a pleasure to have you on board. If you enjoyed this episode, give us a five-star review. Share it with a friend and follow us on Instagram at That Psychology Podcast. If you want to, you know, give any feedback, if you have any further questions or thoughts about this episode or any other episodes, if you want us to expand on anything we talked about, or if you just want to see behind the scenes, we'd love to have you over there. But until next time, stay safe, be kind, be gentle to yourself. We will talk very, very soon.

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