The Viall Files - E256 Plastic Surgery with Dr. Taban

Episode Date: April 7, 2021

On today's episode of The Viall Files we're talking about Plastic Surgery. Dr. Mehryar Taban, who is an eyelid, orbit, and facial plastic cosmetic and reconstructive surgeon, joins us to talk realistically about the do’s and don’ts when it comes to elective surgery. Nick and Dr. Taban cover what you should be looking for when finding the right doctor, stigmas around plastic surgery, what can have an impact on your body in the long-term, fads, and even the "Kardashian effect."  If you have ever thought about getting plastic surgery there may be some information in this episode you don’t want to miss.  “Feel better about yourself without looking done.” Please make sure to subscribe so you don’t miss an episode and as always send in your relationship questions to [e-mail] to be a part of our Monday episodes.  THANK YOU TO OUR SPONSORS: Figs: http://www.wearfigs.com use promo code VIALL15 for 15% off your first order.  Article: http://www.article.com/VIALL to get $50 off your first purchase of $100 or more.  Blenders: http://www.blenderseyewear.com and enter code VIALLVIP for 15% off  Vizzy: http://www.vizzyhardseltzer.com/VIALL to find out where you can purchase Vizzy.  Episode Socials:  @viallfiles @nickviall @tabanmd  See omnystudio.com/listener for privacy information.

What's going on everybody happy Wednesday to you all I'm your host Nick joined by my producer Chrissy Alley and Amanda are with us as well. We have a fantastic episode for you. Chrissy, how are you? I'm good. It's snowing. Oh, I was about to ask you if like, is the weather changing? It's like, cause it's, you know, fucking April. Yeah, it was warm like yesterday, but today there's like a little spring snow and it's so pretty and I love it and it makes me super happy and I can't wait to go for a walk that's exciting I guess is that weird it's a little weird uh it's been really beautiful here and it's like 80 degrees well it's LA my tan I've been watching you in your pool all weekend seeing you on that Instagram crushing

life we have uh like I said a great episode uh let's see here other things we're doing on the vile files go back and check out and what i i a kick-ass episode of s nick on on last monday uh another one coming out next week and uh we also have jenny garth and tori spelling with us next wednesday that should be fun let's tap into my childhood crushes i know my childhood is so good. I'm so excited. Wow. Yeah. I want to be like, hey, I wasn't allowed to watch you as a kid.

And that's a good. I'll be like, hey, I'm obsessed with you. For good reason. Oh, gosh. We are talking plastic surgery today with the very, what do you call him? Is he probably world renowned? He's one of the leading plastic surgeons in the world. He specializes in eyelid surgery, facial reconstruction. I know him because my loving girlfriend, Natalie, has worked for him. She is a surgical technician

who specializes in the plastic surgery space. You know, there's so much talk around plastic surgery nowadays. You have, you know, with social media and the desire to you know fix our looks it's funny because people will often talk about my glow up from the time i was on andy season i've been accused of having like facial reconstruction surgery really it's like it's called a beard people you just got a haircut um and but but my point of saying that is like you you, we, you know, I'll get defensive and be like, what the fuck? But also like plastic surgeries, is it good? Is it bad?

Uh, like, where do we draw the line? Is it dangerous? Is it safe? Uh, I think there's a lot of questions and I was kind of curious. I learned a lot from Natalie in terms of like, you know, when I started asking about her work, I heard so much about like, just like the surgery she was doing and the people she was helping, you know, a lot of people obviously. Elective versus necessity. Yeah. Elective versus necessity. And what defines elective? I feel like if you're born with some

sort of defect in your face or like something that you're insecure about and you have an opportunity to fix that, like, you know, or, you know, women who suffer from breast cancer, right. And, and? And lose their breasts and breast reconstruction and what that can do. And it really kind of opened me up and enlightened me to, you know, the benefits of plastic surgery, because there's so much kind of judgment around it. And so I invited Dr. Taban to come on, and he's one of the top plastic surgeons in his field, and just a really great guy. We just had a fun conversation about plastic surgery and hopefully the people listening find it to be insightful and informative.

So if it's something you're considering questions, you should be asking things to consider what's good, what's bad. And hopefully you guys will all enjoy this episode. I thought it was a lot of fun. I learned a lot. Hopefully you will too. I'll stop rambling.

We also have some merch. Go to vilefiles.com. Also we appreciate you guys supporting the show. I know we had a big announcement about creating more shows under the Vile Files brand. Nothing's happening with the Vile Files. That's not going anywhere. Fear not. More to come there but just so you know

your favorite podcast in the world isn't going anywhere. Nothing's changing with that. Should we just get to the show? Just get to the show. Dr. Tavon, everybody. Dr. Tavon, thanks so much for coming. Pleasure to be here.

We thought it would be fun to have an episode talking about plastic surgery and um i got this idea uh talking to my girlfriend natalie who works for you and uh and i got a lot of questions from audience members about plastic surgery since living in la it's something i've became a lot more aware of i'm from wisconsin we don't talk about plastic surgery as much over there and in fact in a lot of i think in a lot of places in this country there's still like a negative stigma around plastic surgery what it meant i was joking with natalie the other day we were talking about having this conversation it wasn't too long ago like i just always thought like plastic surgery literally meant plastic even if it like an all plastic surgeries, you know, it's just like as a kid, you didn't really understand what it meant.

I just think there's a plastic was actually being inserted into people. I don't know. I was just like plastic surgery. Okay. Yeah. I mean, yeah, I understand with implants. It can. But like I thought that's what it meant.

I didn't know. You know, like we don't talk about that stuff in Wisconsin. In fact, I remember kind of like the... We didn't talk about it. And again, there was a stigma about, oh, if you get plastic surgery, it's a negative thing. What does it mean? You're not satisfied with how you look or you were made, et cetera, et cetera.

So I thought it'd be interesting to just have a discussion about the industry, what it's like, and then just inform the listeners how to go about it if they're interested, how to be safe, how to be smart, what to avoid, et cetera, et cetera. So thank you again for taking the time. I guess to kick things off, why don't you just talk a little bit about what you do? I know we talked about it a little bit in our intro, but you're an expert with eyes. And I guess why don't you just give a little bit of background on that and we'll go from there. So I'm an oculoplastic surgeon, which means

I specialize in eye plastic surgery, both reconstructive and aesthetic. The path I took to become an oculoplastic surgeon was medical school, then ophthalmology residency, and then fellowship in arqueoplastics, which I did at UCLA. So that's how you become an arqueoplastic surgeon. And you specialize around the eyes and the eyes. And that includes the eyelids and surrounding structures, the eye sockets, you know, the eyebrows and cheeks. And you can sometimes expand on that, but that's the main focus. What made you want to get into that like as opposed to I guess that's a question you ask all doctors is what why did you become a ocular plastic surgeon or a heart surgeon or a brain

surgeon or a you know a foot doctor? A lot of times it's just life experiences so I had some exposure to ophthalmology as a when I was in college okay um always knew i want to become a surgeon so that part i knew but once you start med school uh i already had that in the back of my head about ophthalmology but then i also explored other fields but i was always drawn into eyes i was just thought eyes are so fascinating i didn't know about oculoplastics part per se, but just eyes in general. So after I got into residency for ophthalmology at Cleveland Clinic, then you get exposed to different subspecialties within ophthalmology. And I was fascinated by oculoplastic. There's so many different procedures that you do, and a lot of them have immediate effect.

So I really was fascinated by that. So that's what I wanted to do. And a lot of them have immediate effect. So I really was fascinated by that. So that's what I wanted to do. You said there's so many different types of procedures. What are the most common ones that you are doing? And you're one of the leading doctors in this industry. And I think what Natalie told me is other doctors are now using a procedure you invented because it's doing less scarring on the eyes. I've definitely modified procedures that I've learned during fellowship. So there are definitely new techniques that I've published and there's one recently that I published in the last month. Yeah, I take pride in what I do. I do try to push the envelope. So I've done that throughout my career for, it's been since 2009

when I finished my fellowship. So I do get patients that come to me from all over the world for my expertise. LA is sort of the Mecca, you know, Beverly Hills. But you know, people find me in different ways and we'll get to that. So as far as some of the procedures that I do most commonly are, you know, you could call them eye jobs, but upper blepharoplasty or eyelid lift, lower blepharoplasty for patients who have under eye bags or circles that look tired or droopy upper lids, we call that ptosis. So those are probably the three most common things that I do. So those are the three most common procedures that I do. Believe it or not, it's very common for people to have these issues at some point in their lifetime.

Bags could be as young as a 20-year-old who has under-eye bags genetically, and it just constantly makes her look tired. Or they could have droopy eyelids that it's congenital, or it could be age-related droopy upper lids. So it's pretty common throughout society to some extent to various degrees. Interesting. So in like in layman's terms, what like I say, if you if you look tired or have droopy eyelids, what does that procedure look like in a sense, like what's going on that makes them less tired or improves the look that gets them the look that they are desiring or wanting the two most common causes are under eye bags and dark circles that just makes them so they haven't they look they look

like they haven't slept uh even though they could be as rested as they can be what causes that it's fat pockets under the eyes um and hollowness around that area so the bags and the surrounding hollowness give that appearance now some people who actually don't sleep that can get worse because of fluid buildup but most of the time this is just the eye fat that they have and it's against genetics and age related so that's a very common cause of looking tired. And the other common cause of the droopy eyelid is droopy upper lids or the upper lid is not as high as it should be. So they have this sleepy look. The eyelids are droopy, makes the eyes look tired and smaller. So what we do for that is it's a muscle thing. You tighten the muscle in the upper lid that controls the upper lid and that

elevates the upper lid. So that's ptosis surgery, which is different than upper blepharoplasty, which is another common thing we do that has to do with more excess skin, loose skin in the upper eyelids. So those all things can be done individually or together depending on the patient's anatomy and desires. And like you said, this could happen to someone like you said it could be 20 is this something that does for most people get worse as they get older because i feel like obviously in a lot of plastic surgery or a lot of people i'm assuming who get plastic surgery they're trying to define mother beat mother nature or you know roll back the clock or keep that youthful appearance or is this more just a genetic thing that this will always be an issue

or it may never be an issue, like to say like men with hair loss? Some guys might be 80 and just Brad Pitt's just flowing his hair. How does that work with eyes? So it's really a combination. Again, genetics has a lot to do with with it but definitely aging makes it worse and everybody ages differently some people they look good until their eyes look good until they're 50 some people age slower some people age faster aging definitely makes things worse so the eyelids will get droopier with age the eyes bags will get worse with age. But if you do surgery earlier on, that usually

treats the issue and you don't have to repeat it. Although there's always exceptions where, and again, you can't stop the aging process, so aging will continue, but it usually doesn't get bad enough for the person to repeat those procedures, but it's possible. Interesting. So that's funny, interesting that you said that, because I was wondering, like, sometimes most plastic surgeries, is there, or is it just specific with eyes? Is there like a, there's, it sounds like, I was wondering, is there like a, once you open Pandora's box, you will always have to like keep fixing it, so to speak. But that's not necessarily the case with procedures.

Definitely not necessarily the case. You know, a lot of it is surgeons, experts dependent, what exactly they're doing. You want to make sure what the surgeon is doing is not going to cause a different problem. For example, when you do the lower blepharoplasty for the under eye bags, you don't want to just remove the eye fat because now they're going to trade the puffy bags for hollow sunken eyes and then they look older in a different way by looking skeletonized so the surgeon's skills are very important how to manage that and give you the best most natural youthful results so. So that's absolutely critical. That's why you have to pick

expert for whatever you do. If you want to have a breast augmentation, tummy tuck, whatever you want to do, you want to go to the expert. And I can't stress that enough. How does one do that? Because to me, that would be scary, and any I mean I guess you know if you have a strep throat you're just like hey you know test test my throat and gave me the medication for most people who go to the doctor but especially for elective stuff or you know if someone has a heart attack or you know if God forbid someone has cancer you you want to find the best how do you go about doing that in a safe way and just have the confidence that

you're dealing with someone who knows what they're talking about? Research is very important. And you want to take your time researching whatever procedure you want to do. And don't be necessarily limited with geography. You want to go, to the expert. Sometimes in rural areas, you may not have an oculoplastic surgeon, or even if you do, it's not oculoplastic surgeons that does that specific procedure as well as can be done. You know, most of my patients find me by, you know, Google, their searcher specific procedure, procedure and you know they have to do their homework there's a lot of false advertising a lot of fake photos out there you want to make sure that the the surgeon has extensive before after gallery photos for whatever procedure you're

going to do not just one or two and you want to make sure the photos are not, are legit. You know, the before doesn't have, you want consistent lighting in the before after. There are other, there's gimmicks, you know, people can do to fake photos. So, you know, photo galleries are very important. They have to be legit. So, you know, that's how you're going to do part of research.

The person's training is very important where they've gone training what what kind of training they've had it's hard to know for the average consumer what schools are most important what programs they don't know that but at least they have to understand that an oculoplastic surgeon should have gone to medical school residency oculoplastics fellowship um not not skip things or doing things half-ass i woke up today and my uh lady friend natalie went off to work because she's in health care and she looked glorious just just strutting her stuff looking super hot wearing figs that's right because she's in health care

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Article is offering our listeners $50 off their first purchase of $100. Article is offering our listeners $50 off your first purchase of $100 or more. Go to article.com slash V-I-A-L-L, and the discount will be automatically applied at checkout. That's article.com slash V-I-A-L-L to get $50 off your first purchase of $100 or more. Yeah, yeah. Like, what are the regulations in that? Like, what does a doctor have to do or not have to do sometimes? Couldn't they get away with to say like,

well, I can do that, right? And where is the patient protected based off of like not knowing that they should have taken all these steps? Technically, any MD can do any procedure. But of course, in the US, there know, there is legal system involved. So most people don't just do that. However, there are people who did an emergency room, you know, they're emergency room doctors, and then they change and they go take a couple of courses.

And then now they're doing tummy tucks and other things. So to answer your question, board certification is very important in the field that you want to have. Here's the other thing that happens a lot. A general plastic surgeon is board certified by the American Society of Plastic Surgery. But that doesn't mean they know how to do a specific procedure just because they're board certified. So board certification is an important requirement, but it's definitely not the only thing you should look at plastic surgeon who does tummy thugs and boob jobs you know it's hard for that person to be good at everything for them to to be also good at rhinoplasty and facelift so again that's where i say expertise is very important you want to go to people who specialize, focus on a specific procedure or in at least an atomical area, not just they're all over the place.

It's just impossible for someone to be good at everything. So expertise, experience, board certification, those are all important. Before you have the galleries, those are all the things that are important. And the other thing is these days, online reviews. Those are all the things that are important. And the other thing is these days, online reviews. Now, online reviews can be faked, but it's important at least to look at online reviews as well.

Don't go to the Cheesecake Factory to get the best Italian food, even though they do serve pasta. Cheesecake Factory does everything. They have Mexican, they have Chinese food, they have Italian. It's all very below average, wildly overpriced. If you want good Italian,. They have Italian. It's all very below average, wildly overpriced. If you want good Italian, find a great Italian local restaurant. Yeah, but it's like that analogy is so like, of course, but then like people do do that all the time. And I guess a lot of variables go into it because obviously money is involved.

They want a procedure done. What I found most fascinating too, especially even just talking with Natalie, is that I think everyone just, they hear plastic surgery and they equate it with a vanity, right? And do you really need it? And then, you know, just talking with Natalie

about some of the patients that either with you or other surgeons, you know, a lot of people, like you said, are from genetics born a certain way, or they have an accident. I know you do a lot of work with people who experienced domestic violence and help reconstruct, you know, through, you know, their faces based off accidents they've happened. So there's a lot of, you know, people walk around with, you know, stuff that's happened to them or they're born with that, like they have confidence issues and there's a real kind of benefit from that. And I can

appreciate maybe in some cases, the desperation to get certain things fixed and that will get certain patients in trouble. To answer your question about um you know right before when you said you know what other things factor in finances convenience yeah sometimes convenience you want to get everything done at once and again that's not necessarily best thing you can do a facelift and a tummy tuck and eye job at the same time with the same person it just it's not you're not going to get the best of everything. But yeah, that factors into patient's decisions and finances also factor into patient's decisions. Now you don't want to get ripped off in doing a procedure, but you also

don't want to go to, you know, you kind of get what you pay for in life, but at the same time, yeah, there are people who, you know, are are religiously charged so you got to factor that in the stigma around uh plastic surgery where everyone i think most people assume there's just it's all all about vanity you know taking someone who's already good looking but they want to be better looking and they don't really need it and i'm sure that happens a lot but i guess I didn't appreciate just how much, like in terms of like plastic surgery, I know like breast augmentation, a lot of the breast augmentation that's done

are say women who've had breast cancer, lost their breasts. And there's a lot of those procedures because it gives the women their confidence back. And I guess it makes so much sense when you hear about it, but a lot of people don't think about, you know, the good, you know, that like say plastic surgeons do or like women who, again, who have domestic violence or physical abuse, they've had some permanent damage to their faces. And a lot of those things do happen. And it's kind of crazy. I think most people don't think about it and realize it. They always just assume it's all's kind of crazy i think most people don't think about it and realize it they

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to find out where you can purchase busy go to fizzy hard seltzer.com slash V-I-A-L-L. That is Vizzy, V-I-Z-Z-Y, HardSeltzer.com. Must be 21 or older. Plastic surgery doesn't mean cosmetic only. There's reconstructive aspect of it as well. So plastic surgery encompasses reconstructive and cosmetic surgery. People have to understand what plastic means. I definitely help a lot of patients who've had either trauma-related eye deformities or congenital, but it could be, again, age-related. There's so many different factors. It could be

neurologic. It could be other reasons that cause a specific problem. It could be neurologic it could be other reasons that cause a specific problem it could be major or it could be minor but minor can seem big to a specific person you know people have different insecurities and they want to feel and look better they want to feel better about themselves when they look in the mirror so it's you can't judge those people for what they want to do. Again, a lot of what I do ranges from a baby to a 90 plus year old when I've done surgeries. So there are different reasons throughout that spectrum. Some of them don't absolutely need things. Some of them do need it. Some of them want it. It just depends depends on each person um yes there has been a stigma throughout history but you know it has come a long way for the better and still changing to me the important things are you know again having a natural result um with with the procedure

you're gonna have so patient feels better about themselves without looking done. So they don't have this insecurity, look in the mirror, and they don't have this insecurity after surgery, thinking somebody else knows they've done something as well. So it's important what kind of result they get that will make him feel better. Yeah. You mentioned that you like to push the limits, so to speak. How does one do that after med school? Like, if you have an idea, it's like, oh, I think this could work. I think I could make an adjustment in this procedure and therefore have less scarring. Do you just try that out? Or where do you test that stuff? I find that to be fascinating knowing you're operating on people

and then how do you go about publishing papers and make those advancements? I did a lot of publishing throughout my training. So I've had some experience publishing. In fact, a lot of experience publishing. But as far as ideas, you have to kind of have the guts to try things uh in a safe way maybe a little at a time you have to have the right patient for it sometimes patients themselves give you ideas and say why don't you do this? Or can you do this? Or can we do this and this? And if the

patient is willing to try it and the surgeon has the confidence and the skills to do it, then everything comes together. So that's based on my experience. Of course, there's also cadaver courses that I'm part of instructor and also I try things at UCLA so if I want to also try something I can also try in cadavers but a lot of it has to do really with the surgeons you know experience confidence skills and just trying to always think what can I do to make things better, easier, quicker recovery, better results. So, you know, the surgeon, a good doctor, anything, any profession, you always got to be thinking about those things. Yeah.

So is that conversation or a patient might come in and say, hey, doc, I don't like this aspect of my eyes, or can you do this? And you might say, well, I don't typically do that. And then you kind of almost assess the risk or if it's done. And then I'm assuming you might tell the patient, have you ever told a patient, I haven't done that a lot, but I want to try something new with you, but here's the risk. Have you ever had that conversation? Not necessarily in those terms per se, some variation, yes. So it's not usually something totally new. It's usually a modification of a procedure or combining this procedure with that procedure that hasn't been done.

So those are some of the things that I've done very successfully. But yeah, I mean, you have to be honest with the patient. Again, that's why, as I said, patients need to also question. When you go for a consultation, question the doctor about what they're going to do. Again, see before, after gallery. See other examples the doctor has done. Again, you can push the envelope to do things. For example, one of the things I've done is bulging eye surgery for not just thyroid patients who get bulging eyes, but I had a patient that wanted it. He had very

insecurity about his big eyes congenitally. So I did it for cosmetic reasons or non-thyroid related case for that patient. And that's how that started where I published on this in a static surgery journal about my experience of doing bulging eye surgery for aesthetic reasons in non-thyroid patients. So prior to that, it was only done for people who had a thyroid problem. Yes, yes.

Interesting. And what was the, why wasn't that done before? I mean, I can't assume that your patient was the first one who didn't like his bulging eyes. Right. It's not, first of all, nobody would talk to him about this. There's nothing in the literature or, you know, anybody doing this. Still, that's the case.

There's only a few surgeons who do it for that reason. And the reason it hasn't been done before, because it's a complex surgery, there are some risks involved. So the surgeon has to be really confident with very low complication risk to want to do something like that. So it's not, so that's, those's those are the reasons yeah that's interesting uh we were talking a little bit before we started in terms of how social media selfies and even recently with the pandemic the increase in zoom calls how that's affected even specifically your industry in doing eye surgery because i feel like back in the day you know plastic surgery nose jobs boob jobs that was like the two most common ones um and yet now

it makes a lot of sense people are taking selfies and they're seeing their face and there's always these filters to under eye filter kind of stuff like that and in yours i'm it sounds like you're seeing an uptick in the requests and cosmetic surgeries based off of their need to have better selfies. Yes. So yeah, so selfies from several years ago, I think for all plastic surgeons, there was an uptake and a number of patients that would see and procedures they would do, especially, I think, faces with selfies uh but other other procedures as well but then during the pandemic with so many video zoom calls people would then see themselves on

zoom and now they would they look tired you know again that's probably the number one thing they look tired or or they have asymmetry with the eyes or something along those lines. That's where my profession goes. But again, it could be something else on their face for another plastic surgeon. So they will see those things and then it will bother them. And they want to, again, feel better about themselves, look better. So that's one of the reasons there was definitely an uptake. there was definitely uptake uh the other reason specifically is they had more downtime uh during the pandemic to to do you know any kind of surgery because they had the downtime to be home and

recover um and what other one other funny thing is uh with the mask factor um you know masks would cover their face their nose and mouth but the eyes would be visible to everyone else. So then they would more focus if, you know, they didn't like their eyes. And that was the only feature that was they would show to people because everything else was covered with a mask. So that was another reason for uptake in patients wanting to do eye plastic surgery. That's fascinating. How many patients do you turn away, if any? And what would make you turn away a patient

who came in and say, hey, doc, I want to do X, Y, and Z. They recognize it's a fully cosmetic request. Is there, you know, what would make you, or is it just like, hey, I don't think you need it, but if you really want it, it's still safe. So it's up to you if you want to i'm going to just be honest with you about like the degree of enhancement that you can expect but other than that it's up to you i think it's kind

of a little bit of everything um there are certain patients who are something i just mean not just me but i just can't do and i have to tell them sometimes they don't take it the right way. And I've had negative reviews online because of patients who didn't like the way, tell them, I'm sorry, I can't help you with that procedure. Or, you know, really, it's about unrealistic expectations. So if I don't feel like there is realistic expectations there, expectations so if i don't feel like there is realistic expectations there uh and i can't make the patient happy uh then i have to turn them away um or at least modify things i said you know this is not exactly possible but we can do this or we can do that to make your eyes better or variation of what they're talking about or maybe so there is sometimes a negotiation involved you know this is not realistic but this is realistic

these are the risks what what is one myth about the industry about plastic surgery that you think is unfair or that you think should be debunked out there because it's just simply not true if anything I mean a lot of myths have some truths to them we we already talked about this this stigma of plastic surgery and plastic surgery is not just cosmetic surgery there's a lot of reconstructive aspects as well again it's it's a could be a myth but some truth you know there's some arrogance involved with plastic surgeons and um i i certainly don't like that aspect of it you know there's a lot of plastic surgeons who like to flash nice cars and nice watches and and this and that and so there is some truth to that i mean you see it on instagram um

it's so but i don't know if that's a myth let me get there's some truth to that i mean you see it on instagram um it's so but i don't know if that's a myth let me get there's some truth to that stigma yeah or or maybe the myth is like not all plastic surgeons or even surgeons are like that where right yeah there's there's some exactly yeah that's that's what i was trying to exactly you know and then maybe that might like you said speak to like when you're looking for uh like is their end goal, you know, the plastic surgeon. I mean, medicine is obviously always changing, always advancing. It's been, I'm assuming, crazy. Where do you think the industry is going, even specifically with ocular surgeries?

Yeah, where is it going and what are some of the is there some crazy advances we can expect in the next few years i can tell you in the past five seven years there was there was a push towards doing a lot of injectables uh less surgery more injectables for example specifically for on the right area trying to do a lot of filler injections under the eyes, either for the hollowness or to camouflage the bags they have. But more and more have we learned that the more fillers you do specifically under the eyes, it's not necessarily a good thing. That was one of my publications, for example, that came about that I I saw so many problems with under-eye fillers. I've heard that with female friends in the area where they've done it, and then I have other friends who look to do that,

and they've heard from doctors. Maybe it was even you. It was like, you could really damage your eyes. There is definitely, I mean, there's probably thousands of them every day, and most patients by far do well but over time i do think fillers under the eyes cause problems and how so the fillers are semi-liquid and after a while they kind of stretch the soft tissue and then now you you see the filler and it has a we call call it Tyndall effect,

has a bluish color to it or it's puffy. So it's important when you do fillers, it has to be underdone. And again, there is a limit to me how many times it should be done. Again, every case is different. Depends on the anatomy. It depends on the thickness of the skin they have. But that was definitely a big trend over the past seven years, doing a lot of injections.

But we see more and more that that's still being done, but at least the experts in my field realize some of the ramifications of it and they don't push it as much and they have to deal with the ramifications with the fillers under the eyes uh again this is specifically under the eyes um not another other parts of the face they and that's interesting you say that because i had heard that from friends and i and like you said like i'm not i don't but living in l.a you you hear friends are talking about procedures or have an interest.

And that is, I thought even for me, I heard and noticed that the disconnect between what a lot of people were doing and then hearing that that might not be a good thing. And knowing that it seems to be so prevalent out there. I mean, I get it. The patients want less downtime. You know, save money, quick, something quick and easy. So, fillers have been done a lot and are still being done. And again, there is a role for a lot of patients in a, in my opinion, in a temporary fashion, not something long-term for on the thighs. Again, not talking about the rest of the face. In fact in fact the upper lids i'm a big fan of filler injections upper eyelids but i'm specifically i'm talking about the under the eyes to me it's not a good long-term treatment

now now going forward as far as other things happening um you know i always try to as i said push the, think of new things. As I said, a couple of months ago, I published a new manuscript that talked about combined upper blood folplasty and upper lip filler injections. Again, that was one of those things that, you know, I do this, I do that. Why don't I do it together? And I did it for patients who would come from out of town because I have a lot of patients who come from other states and it was inconvenient to do things separate times. So I said, why don't I combine these two?

And it worked great. And I do it every day many times and I published it. So I can't speak of other aspects of plastic surgery what's what's what's going to come down the pipeline but um i'm always looking to improve things that at least i do um and in a less invasive fashion uh more convenient for the patient what's the recovery time for the doing a procedure on your eyes i mean and and And are there people able to see? Yeah, good questions, yeah. So people can see.

It depends on the procedures. If you're doing an upper-lower blepharoplasty, the first day you have some blurry vision, the next day you should be seeing fine. But again, a lot of it is surgeon's dependent. This is, in my hands, what the techniques that I use. You could, I've seen, so again, I lot of it is surgeons dependent. This is in my hands what the techniques that I use. You could, I've seen, you know, so again, I speak for me. The main recovery phase that people care about usually, it's about 10 days.

That it looks like they had surgery because of obvious bruising, swelling, and also they have limitations and things they can't do, they can't do. You know, they can't exercise, they have to sleep on their back. So it's mainly 10 days, maybe two weeks. That's the main healing phase. Most patients after that 10 days, really, they should look presentable. They can go public with makeup on at least. People should know they had surgery.

This healing takes longer than 10 days it takes several months for full healing and everybody heals differently but main part that people care about as far as downtime they take they have to take time off from work is usually 10 days yeah like the how long will people be able to tell i had surgery right it's getting in my hands with technique that i use it's about 10 days interesting we talked more about injections and I know not necessarily your specialty, but like we talked about fillers and then there's Botox. Are there health? I'm always curious because that seems to be the most common one, Botox, wrinkles.

Is there a certain age where you recommend people to start doing that stuff? Is there a downside to Botox? You hear people talking about it could even help with migraines. Is that real? Is that an excuse? Where do people draw the line? And is it really just a cosmetic preference rather than a health concern or benefit? Botox is one of the safest things out there.

And it has both functional uses. It definitely works for some cases of migraine that have to do with tension, headache. There's so many different kinds of migraines, but definitely it works for some migraines. And it works for some other functional issues, spasms in other parts of the body. Even eyelid spasms. other parts of the body um so even eyelid spasms so this is a functional benefit but definitely has a cosmetic benefit as well to reduce

what we call dynamic wrinkles that have to do with movement so frown lines forehead lines cross feet it helps with those both immediately but also it helps in a preventative fashion because if you keep imagine if you keep frowning then that's the skin is going to crack in those in the we call the 11 lines or the forehead lines so if you reduce the movement then there is a preventative effect as well for botox interesting um you do i'm assuming most of your is do, I'm assuming, most of your, is it, well, I should just ask, most of your procedures, is it mostly on women versus men?

Is it, are there a surprising amount of men doing more of these procedures? Or do you find it to be more dominated for women getting this elective surgery? It's definitely dominated by women, but more and more men are doing it. In my practice, it's actually probably 80 to 20 ratio, four to one ratio. So four women, one man. This is just different procedures. And when it comes to men, it's even more important how procedures are done, specifically eyelid

surgery to make him, again, natural. Usually, for example, you don't want to do a brow lift in a man. There are always exceptions. What's a brow lift again? Brow lift, eyebrow lift, forehead lift. So you just kind of raise it up? Yeah. So it looks feminizing in a man.

And also, if you do an aggressive upper ble up? Yeah. So it looks feminizing in a man. And also if you do an aggressive upper blepharoplasty, it looks feminizing. So you have to understand the differences in sexes and also ethnicities factor in as well. Different ethnicities, you have to factor in as well. Well, that's really interesting. I never even thought about that. What, how do you learn about that? Is that just trying it out or a study, like how just different ethnicities, their genetics and how they're made and then how procedures affect it?

It's part of the, hopefully, your fellowship training or residency fellowship training. But like anything else, you've got to master it yourself. So, again, that's where the surgeon's experience comes into play. Again, I've been doing this for 12 years now. A lot of cases. So the main ethnic differences are when it comes to upper lids, it's the Asian eyelid versus a non-Asian eyelid.

So there's definitely a difference there that's very, very critical. So that's important for the audience to know interesting um and do you like do you think that more men will have more elective surgery uh as you know society i think there puts a pressure on women as they get older that's there's a double standard for you know men are told they age more gracefully. But like as we continue to have a more progressive society, you know, gender roles are kind of overlapping. Do you think more men, whether it's because they care more about their looks

or they feel that pressure or maybe women feel less pressure because they're just like, fuck it, I i don't care where do you see that going or do you think it will continue to be pretty much the same or have you noticed i know you've mentioned men a little bit more but do you see that spike continuing or that increase i think so it's it's all about i think again men educating themselves and you know learning you know my dad i operated my dad years ago when he had under eye bags uh he was one of one of those people who would never think about any cosmetic surgery but you know after a while he sees that you know these are making me look really older and tired i'm tired of looking at these bags so because he knows my

work and he's seen before after photos he knows that he's not going to look done he's not going to have problems so he does it so i think if men more and more realize what's possible then they will do more but of course society has a lot to do with it too. We talked about the selfies and Zooms and everything. I mean, definitely when I say the Zoom factor, it includes men as well. Yeah, for sure. I mean, I take selfies. It's embarrassing, but I do.

The Kardashian effect with plastic surgery is something that's been discussed whether it's fair or not fair but i you notice it right and you see uh more people more women trying to look like a certain type of person and recently it seems to be the more of a kardashian look do you notice that or is that accurate? When it comes to specifically eyes, Kendall Jenner eyes, I get that request. How can I get that kind of a look? So Bella Hadid, there are other beautiful ladies out there that people want to look like. And beautiful ladies out there that uh people want to look like and again that's definitely a subset of my patients who i just have to say no to to you know there's just this is not realistic

but we can do some you know we can get it maybe to this much or there are things you're almost like these are just aren't your eyes yeah yeah it's how she was made yeah you know sorry she got the genetic lottery and and they always question me what does she do what does she do i mean i think most of it is genetics on them for sure uh so anyway that that topic always comes up going off of that when you're like out in public or at a restaurant or talking to someone new are you able to automatically know if they've had things done what they've had done like are there little signs that you as the surgeon can see that typical

people wouldn't yeah i mean i would uh some of it has to do with if it was done in a natural way unnatural way but also i mean that's the main thing if it's done something natural i shouldn't be able to tell except if i know the guy is 80 years old and his eyes look 50 years old he probably did something same thing goes for a facelift you know if they're you know if they're that old and they have tight neck i mean you know they did something with the neck. They did a neck lift, face lift. So it's still important to look natural. And, you know, that stigma is going to keep getting going away in a way. It just, I think, to me, it's important to have natural results. I think the stigma, a lot of it is when people change things for the worse and now they look

done. They look unnatural. I mean, that's, I think a lot of why stigma is out there because of plastic surgery. Just it's the unnatural look. So I can't stress that enough. You know, whatever you do, you want to have natural results. You want to look more youthful for yourself. You want to look more rested.

You don't want to look done. You don't want to look more youthful for yourself. You want to look more rested. You don't want to look done. You don't want to look pulled. Yeah, pulled. Because there is a – if you go hang out in Beverly Hills, let's say on a Saturday afternoon and go shopping, and you – there's like a group of women who, let's say, over the age of 40, and some of them all kind of look the same and they all look like it's a very specific plastic surgery look is that do you think that will keep happening

or what you're saying something chrissy i was just gonna ask is there a responsibility of the doctor at some point to be like look like you're not you're gonna look crazy but there's so much yeah but this is what this is where you need to stop like is that like is the doctor have any responsibility to be like this is where you need to stop putting stuff in your face or is it like no that's what they want so we do it no there should definitely be a responsibility but that doesn't mean they're going there is yeah i mean there's when people shop around they're gonna find unfortunately somebody who's gonna say yes to to more filler to more lip filler to you know it just you know i you know especially to fillers and things i you gotta i push away patients a lot they said you've had if you do more it's gonna

look fake you know no more this no more. But a lot of doctors who don't. It's like people asking for dating advice. Those go around asking someone until they get the answer they want. Yeah. Oh, wait, you think I should break up with them? Fuck you. All right. Hey.

I was just watching Housewives of New Jersey, and the whole first episode of the whole season is all about the breast lifts, the face fillers, the whole season is all about the breast lifts the face the face fillers the butt implants they all got and like it was but like one girl's mouth is like this and she talks like that and it was just like crazy yeah that's what I'm saying

it was okay to stop in Beverly Hills there's a there's a certain look of older woman that that they clearly have done I don't know what they've done but they yeah they look different but also the exact same like clones you can also say like it's now becoming a thing in like art like in the 20 year olds like the lip filler the microblading of the eyebrows like there's now a look of like the beauty influencers too that is just as bad and it's extreme well yeah

that's that brings up an interesting point. It's just like, yeah, you're getting, it's more and more common with younger women. Where do you draw the line between, and we kind of touched on it a little bit earlier, but does it affect how they age, right? If you have all this plastic surgery in your early to mid 20s, will you end up looking older later

or have to keep getting more surgery as a result of a bunch of fillers, a bunch of Botox, some ocular surgery, lip injections, et cetera, et cetera? So I can't speak of other plastic surgery, but when it comes to eye plastic surgery injectables, I mean, Botox goes away you know that wears off so that has no long lasting effect per se again it

has a preventive effect for wrinkles. It like disintegrates? Yeah it just effect goes away. My sister uses that in her neck because she got whiplash and that's how that happens. Right so it has a lot of functional benefits as I said. Fillers like I did mention that for example the under eye filler yeah i do think over time it's going to cause problems so whoever is doing it has to understand that there has to be a limit to it um when it comes to surgery we also talked about one of the key things about eye plastic surgery is you don't want to remove fat you don't want to remove fat from under the eyes.

When you're doing lower blepharoplasty, you want to remove fat from upper eyelids. There are exceptions, but usually you don't want to do that. When you do, either immediately you're going to look more hollow, sunken, older, or as you age, when you lose more of your fat, then it becomes more pronounced. So again, a lot has to do with how the surgery is done. The other thing people should think about is, some of these things are fat. So the butt implants and that sort of thing,

you don't want to do things because they're in right now and five, 10 years from things because they're in right now and five ten years from now they're not and then you stuck with something you've done that is permanent that's an interesting point like a fat you know like a big big butts are in versus small butts like skinny jeans versus baggy jeans right like it's almost a fat that's you know bigger boobs always almost always in but now it's getting smaller so you know again i'm not into that almost always yeah you're never almost always in almost i'm not in that field but i see that other surgeons now they're promoting you know very natural size implants which i'm in favor of any of i don't do that but again you want to be careful what you do

with your body in thinking long term as well not just because the influencer is doing it and it looks good and it's in to do it for the next few years how many surgeries if any are reversible you've seen women like take implants out, their breast implants. Does that work the same way with butt implants? And if they do do that, I'm assuming you never really can go back to the way you started. Or is that not true? I don't do those procedures, but I'm sure when you do implants like that, there is some stretching effect. So if you remove implants now you have

saggy tissue that needs to be tucked and again i do think there is it can be done i mean people women do it all the time where you know they downsize or they even have naturally large breasts and they they they want to get the reduction so there is lifting and tucking that can be done um but again you won't you don't want to do it unless, you don't want to get to that position if you just think ahead. Interesting. Any more questions ladies before we let Dr. Tabani-

One last thing I think is worth talking is anesthesia types. Yeah. You want me to start? Yeah, please. The other key point about any surgery, but I'll talk about eye plastic surgery, is anesthesia options. There are three types of anesthesia, general anesthesia, twilight anesthesia, and just local anesthesia. So general is when you completely put out tube down your throat breathing for you. So general is when you completely put out tube down your throat breathing for you.

For some surgeries, you know, heart surgery, brain surgery, a lot of surgeries, you're forced to do that. But when it comes to eye plastic surgery, especially upper blood flow opacity, lower blood flow opacity, these common things, it's really, in my opinion, overkill. But it's been done. Most surgeons out there do general anesthesia. And to me, it's not necessary. I think it's really overkill but it's it's been done most surgeons out there do general anesthesia and to me it's not necessary i think it's really overkill um if the patient wants to be out of it they can do it on their iv sedation um similar to when they have a colonoscopy so they're it's it's this dominant anesthesiologist they're out of it but a lot of patients in my practice, and that's one of the things that I do a lot and people come to me for, is I do these procedures under local anesthesia,

where, you know, first I give them a Xanax to relax them, and then I numb the eyelids. That's a lot to do with the technique of the numbing injection and the confidence and the skills of the surgeon to do eyelid surgery on the local anesthesia. So the advantages of local anesthesia are it's quicker healing, no general anesthesia issues, no nausea, vomiting, no foggy brain issues for a week, and definitely no long-term issues that general anesthesia can cause over time. You want to limit the number of general anesthesia you do in your lifetime. So when it comes to eyelid surgery, I think it's really important to avoid general anesthesia. So go with the local anesthesia or

IV sedation if you have to. I've never heard of that, that there's risks involved in that. Why is there a limit to how much a patient should do? There's studies out there that the number of general anesthesia, there's no specific number, but the more you do, and some people are more prone to it, the more you do and the longer cases can affect the brain and other things. So in general, you want to minimize general anesthesia use unless you have to do such a thing. Wow. Does that also mean that you can do those procedures like in office and they don't

require an operation room? Exactly. Now, everything I do specifically is an operating room. However, there's no anesthesiologist when I do a local case. It's just me and my assistant, for example, Natalie, and the patient. Just like you would go to a dental office where it's just the dentist, the assistant, and the patient, and numbing injections, except we do give an oral Xanax to relax the patient. But again, it's not for everybody. Some people are really freaked out and then they can easily choose the IV sedation option. And that's a very safe option. To me, just general anesthesia is really overkill.

Do you think that could be a way for a patient to help qualify certain surgeons? And what I mean by that is, you know, and you're speaking specific to your industry and you're giving your expert opinion about that, but knowing that about general anesthesia, if there are a certain procedures out there that some doctors are doing more local than general, is that suggesting that maybe the doctor is doing general, they don't know as much or kind of lazy or, you know know there's a reason why they're yeah i think the reason is that's what they're used to okay uh that's the main reason uh perhaps they don't have the confidence and the skills of doing also the case when the patient is

awake uh they're afraid of something um but a lot of it is what they're used to, what they're experienced. So if they're always done out on their general, unfortunately, they keep doing general. Where again, to me, it's really unnecessary for most either procedures. Gotcha. But yeah, that would almost speak to like these, maybe that means they're just always used

to doing a certain way. That might suggest that they're not necessarily as innovative or as confident in their skills but they certainly can do it but definitely you can say that in the basics yeah you can definitely say that interesting yeah that's something i would never have thought of um any other questions ladies before we let the good doctor go the conductor it's just fun to say uh This has been really fun, Dr. Dabat. I really appreciate you taking the time. Thank you so much for having me here. Really, really interesting stuff. And I hope that the people listening feel more informed about plastic surgeries. I mean,

it's definitely one of those things. There's a lot of thoughts and opinions and a lot of false and bad information floating out there. So it's always nice to become more informed about these things so people can make better decisions. Thanks so much for listening, guys. We always appreciate it. Don't forget to send in your questions at AskNikaCastMe.com. Dr. Dabam, before we do let you go, if people are interested in learning more about what you can do for them, if want to reach out to you get a consultation where can they find you so we do either a virtual or in-person consultations um you can um call 310-278-1836 or go on the website at tabonmd.com um you can also email office at tabonmd.com or also follow me on Instagram, tabonmd. And we'll put all his information on our episode bio

if you guys are interested in learning more. Thanks so much, guys. We appreciate it. We'll be back on Monday. Bye.