Well with Arielle Lorre - 182: Plastic Surgery & Singleness of Purpose with Dr. Ryan Neinstein

Episode Date: July 6, 2022

In this episode, I talk with Dr. Ryan Neinstein, a board-certified plastic surgeon who specializes in body contouring & lipo. We talk about more personal stuff like optimizing yourself for your purpose, surgery trolls, body empowerment, and "balance". He also gets into the details of body contouring; what a mommy makeover entails, how he sculpts the perfect arms, and the different types of breast augment surgeries (including his thoughts on breast implant illness).   www.allarahealth.com/arielle  code ARIELLE for 25% off your first month or diagnostic test    ritual.com/BLONDE for 10% off your first three months   Get 20% off with code “BLONDE” at KEANHEALTH.COM   granolabutter.com code BLONDE for 20% off your order   Drinkkarma.com for more information   Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Sonderger Go to your Reisadviseur Orsoniccars. The following podcast is A Dear Media Production Hey, welcome to the Blonde

files podcast. I'm your host Ariel Lori and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits and I'm bringing it to you real and unfiltered. I know there is so much information out there, so I'm here to help you navigate it all. Thanks for listening. Let's get into it. Hi, everybody. Welcome to the show. I am excited about today's episode and today's today's guest. We had a really interesting conversation. It kind of went in a bunch of different directions and full disclosure when we recorded this. I was sick with COVID, terrible COVID brain, which I still have brain fog. And my guest, Dr. Ninstein, did enough work for the two of us.

He is super passionate about what he does. And his energy, his enthusiasm is definitely palpable. So he's a board certified plastic surgeon in New York City. He's the owner of 19 plastic surgery. He's often referred to as the surgeon's surgeon, as many surgeons choose him as their own trusted doctor. He's the author of safety guidelines and he's a master class instructor. He stresses the importance of hyper-specialization, which you'll hear in this episode and patient care above all else. He's also an entrepreneur and frequent speaker on how to harness personal and team potential in a modern world. And his most proudest achievements are the loving family he has with Celebrity Fitness Instructor, his wife, Lauren Weinstein.

And in this episode, we get into so many different topics. We, of course, talk about body contouring and lipo and the procedures that he does. But we also talk about more personal things like optimizing yourself for your purpose. We talk about like surgery trolls. We talk about body empowerment. We talk about balance. And then, of course, he gets into the details, the nitty gritty of body contouring, mommy makeovers, how he sculpts the perfect arms. I talked in my episode with Harley about arms.

And Dr. Ninstein, I think, echoes the sentiment that this is like a lot of women's problem area. So we talk about sculpting arms. And we talk about different types of breast augmentation surgeries, including his thoughts on breast implant illness and so much more. So I hope you guys enjoy the episode with Dr. Dr. Ryan Ninstein. Welcome. So excited to talk to you. Thanks for having me.

I'm very excited to be on the podcast today. I've been looking forward to this for so long. Aw. I've been looking forward to it also. And then COVID threw a wrench in our plans. Yeah. Unfortunately. Sure does.

I was telling Dr. Ninstein off Mike that he's going to be kind of leading this conversation today because I've had COVID for the last 10 days. and I have been struggling to even string together a sentence. So this is going to be really interesting. But you're the perfect guest to have on for this situation because you're so charismatic and energetic. Like you can just do the podcast for the both of us.

I am happy to lead the way. And whether or not is a fault or one of my advantages, I have plenty to say. And I will just tell me when you don't want me to say no more. But thanks again for having me. We're really excited. And, you know, I think that there's a lot of commonalities that we can share today. For sure. So to start off, why don't you just tell everybody about who you are and what you do and how you came to do it.

Gotcha. Okay. So we're going to jump right into it. So Dr. Ryan 19th, I grew up in Canada, you know, America's hat, that place up north, a grandchild of Holocaust survivors. And, you know, being a grandchild of Holocaust survivors really imprinted something that's super important to me and stays with me to this day. And I look forward to passing it on to my own children. And that is, you know, you can't float in life. You must find

something, whatever it is that has significant purpose. And it should make a positive impact on others. So that was kind of my upbringing. Kind of had a sense of looking for purpose. The things that I was into when I was young, like every, you know, like most young people, the things that I liked were sports and science. I liked the camaraderie and the competitiveness of sports. And I like the certainty of science. And then that sort of diffidously led me to go into medicine. And I wanted to, you know, bring those things together, working as a team to help others

and with things that were finite. It wasn't so abstract. And surgery became something very clear to me that I wanted to do. And I did my surgical training in Canada. And then I came to New York to do subspecialty training. And then I met a girl. And then I subsequently married another girl as the story goes. But I fell in love with the American way.

I don't care what anyone says. It's the greatest country in the world. You can come here from anywhere in the world or from inside this country. And it's still true. Anything is possible. When I finished my training, I got my immigration organized. I started working for someone. And then I just didn't like,

what I saw in terms of, you know, the status quo for my industry and like many entrepreneurs, I was crazy enough to think I could do it differently. I could do it better. I could do it on my own. So eight years ago started my own practice, you know, with a hope and a dream in a dental chair in a dental office. So we've come a long way. And now we have biggest office in the city above Bergdorf-Goodman. We have a growing team of providers, all providing the same kind of highly focused body surgery, plastic surgery with that same energy and intensity and intellectual inertia that I bring with an amazing team. And I have an amazing loving wife who puts up with my chaos and two amazing children. That's my story. Do you have any advice for people

who are struggling to find a purpose and find a passion? Because I think that, you know, we hear that so often. Like, find, find what your purpose is and, you know, find something you love to do and you'll never work a day in your life, all of these things. But I get the feedback so often that, like, people just don't know what their purpose is and they just feel kind of lost and aimless and they try different things and they can't really figure it out. So do you have any advice for people? Yeah, purpose is everything. And Benjamin Franklin said there are three things in this world that are hard. Number one, diamonds. Number two, steel. Number three, and most importantly, getting to know yourself. Okay. Most people do not do a critical appraisal of themselves.

So you cannot find your purpose unless you are willing to sit down and get to know the only person you are actually stuck with for the rest of your life, yourself. What are your values? What are your goals? What do you want to be to live your best life? And once you have done that, and by the way, that's actually very hard because there are a lot of people who say things, but they don't actually know if they are the type of person who's willing to do that. So for me, what's my purpose? I want to make the biggest impact I can on other people by being the best version of myself as a surgeon. and I'm willing to go to the ends of the earth and farther past that to do that. Now, a lot of people may say, I also want to be, you know, a great surgeon or a great entrepreneur,

but are you really willing to make the sacrifices? And by the way, I'm not necessarily saying that's a good thing. Like, when I look at my purpose, I can tell you exactly what it is in one sentence. And I can tell you I know who I am. I know what I'm willing to sacrifice. I'm willing to sacrifice social life. I'm willing to sacrifice, you know, missing birthdays for my kids. I'm willing to sacrifice, you know, I don't drink.

I am like, I don't say I live like a monk. But everything I do, 24 hours a day, seven days a week, is how I optimize myself to accomplish my purpose. So there are a lot of people who, if your purpose is I want to have, you know, free time and be around for every part of my kids growing up, that doesn't translate into entrepreneurship. It doesn't translate into things like that. But you have to at least be honest. So you say to yourself, you know, the most important things for me to live my best life

is free time and being available or socializing or traveling. And you have to go and match that with an actual pathway. Because the most dangerous person in the world that I have ever met is an ambitious person who's lazy. Right. Those people are pure evil and will burn everything. everyone around them to the ground that they meet. Okay. You ask, I will tell you. It's actually really interesting that you say that is like the piece about self-appraisal because I just think about my own life and I was like totally aimless. And if you asked me what I wanted to do, I had a lot of

different interests and ambitions, but it wasn't until I got sober many years ago. And I had to do that like real self-reflective work. And I really had to do. And I really had to do. to like come to terms with who I was and my values and all of those things. And then my purpose kind of like, I didn't just then in that moment decide, oh, I want to like have a podcast, you know, but from that foundation, it just kind of like unfolded. And I was, I was able to, you know, see the path that I wanted to be on. I'm sure you've gone through this a number of time. I have like, you know, as everyone does, number of friends, patients, whoever that, you know, coming out of the sobriety world.

And the ones that I connect with have like a true enlightenment and real clarity about who they are. And it's overly impressive what these people have accomplished. And I don't know if it's you, but I don't think they would have gotten there without that arc in their life. If they didn't have the addiction to whatever and the crash, they wouldn't have had that breakthrough.

It wouldn't have had that enlightenment and clarity. And a lot of those people are some of the closest people I'm with because even though our arc or our pathway is different, share that similar enlightenment and clarity. And it's really hard to do. And most people you will meet in your life will never do it. And when people just tell you what they want to be, and you look at them like you're so lost.

It's like asking a child, you know, and they say, I want to be an astronaut or a baseball player. It's like they're so dislocated from reality, you know, they're thinking about things like a child. Yeah. Where you really get into the granularity of your psyche and most people are not. By the way, the most valuable thing people can take away, go download a self-assessment tool, sit somewhere alone for, you know, two hours and break your life apart. Mm-hmm. Whenever I have talked about my experience with PCOS polycystic ovarian syndrome, I get so many questions, and I think that's for a few reasons.

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at checkout for 25% off your first month or diagnostic test. Just visit Alarahealth.com slash Ariel for more information. That's www.a-L-A-R-A-Halth.com slash A-R-I-E-L-E. Again, Alarahealth.com slash Ariel. Hey guys, I'm Lindsay Carter, the founder of Set Active, and this is my new podcast, Ready, Set, Spill. Finding the balance between being a mom, running a business, and still maintaining somewhat of a social life is a constant work in progress. We live in a time where social media glamorizes everything that we do. But life isn't always a perfectly curated Instagram post. And that's coming from someone who built their business on a perfectly curated Instagram feed.

Nothing here is off limits. So get ready. Get set. Because it's time to spill. There's something in recovery called like deflation of ego. Like you really have to look at it. Look at all the dark places that you don't want to look at and like have an honest self-appraisal. And, you know, kind of like, I don't know, I guess deflate all. all the things that you think about yourself and your ego and all of that. Like, just break it all apart. And then that's your starting point. And like to what you were saying before, well, ego is the enemy. You know, one of my things to read about. And I'm an avid reader. It's Stoic philosophy. How it applies throughout the ages. And, you know, one of the most common themes

from any philosopher, whether, you know, from Socrates to Epictetus to Marcus Aurelius is always ego is the enemy. And once you get past that, you can really get to a place. where you can handle situations in life. And what you were saying about what you've said before, like one thing I always say to my staff, you know, don't let success go to your head and don't let failures go to your heart.

Like, you know, that is a very powerful statement. Never get it too high, never get too low. Yeah. You know, about a constant path. Yeah. And then outside of like surgery, it applies to the way, you know,

you interact with your spouse and other things. Like, you know, those calm is the key. Most successful leaders' life and in history were cool as a cucumber. I think we're living in a time too where we're like so hyper reactive and it's not, you know, you can't live like that. You really have to be like even keeled. And I think that's something that like sobriety and meditation and stoicism, like all these things have in common.

By the way, if you ask, I mean, this may be a question you want to ask me, but if you ask, if I was asking people, what is the most common traits in leadership, whether you're the CEO of a company or a surgeon or an astronaut or a podcast post. So what? Well, I can just ask you what you say. And you probably ask a lot of people. I know to me what I need in a leader, what I need to be as a leader, what I look for in other leaders, what I connect with other organizations. investments. What do you think the leadership stuff that makes the most tangible difference in organization? I don't think my brain is working fast enough to answer. I'm going to ask you. What do you think? So people always say like what's the number one rule or characteristic of a leader that makes it different. It's not, you know, the ability to work hard because guess what? Everyone works hard. You can all do 100 hours a week. It's not the ability to believe in yourself. Obviously, like there is no success unless you have confidence.

But I think separates from the, you know, the leaders and the pretenders is the ability to rationally and tactfully solve problems and issues from small to big because from the moment we wake up every day, the moment we go to sleep. And while we're sleeping, it is a never-ending barrage of issues. And like you were saying, if you are emotional and do not. have a strategic plan to handle things, you are dead in the water. Because if they're going to come at you and whatever you do in life, you know, whether or not it's a problem with your kids, you know, spouse, work, whatever,

they're going to come at you. They're going to come hard. The more successful with you, they're going to come harder and they're going to come bigger. You get emotional. You give up all your strategic advantage. It is step back and think and have it rational, reasonable strategic approach to solving problems. Make sure you have your poor people that you know who you can rely on to ask questions to,

your mentors, your team in your workplace, your team at home. Like build a team and a strategy for handling problems. Every problem has a solution. You know, just because you don't know something doesn't mean it's unknowable. Yeah.

Yeah, I love that. What are some of your other non-negotiables? Like I know that you're up so, freaking early, doing your workouts, like, I follow you. What are some of your non-negotiables lifestyle-wise that kind of provide that structure along with like your support and your wife and all of that? So remember, these arcs or balance change and like people talk about balance, right? And I think all these balance between work life or whatever changes a different parts of your life. And I'm at a part in my life where my balance, like, I'm pretty out of

balance and like I'll just tell you like I'm really out of balance like I and and I make no excuses and meeting my wife from the same page I am like totally dialed in and I'm at a place where I you know want to not just be the best you know plastic surgeon who does body contouring possible I want to be the best but I you know at the same time be the best husband but they don't necessarily go together so right now I'm working and I'm not making any excuses and like I'm going for it And I'm going to keep going as hard as I can. I know that sounds a little crazy and probably not as fluffy as people want to hear. But like my non-negotiable is like I want to be the best and I want my team to be the best.

And like we're going to do whatever we have to do to get there. And we're going to make some unflattering sacrifice. But what we were talking about. So I don't believe like Nietzsche, I don't know if you like German philosophers, but he talks about the mind thinks through the body. what he's saying there is the healthier the body, the healthier the mind. And I truly believe whether it's surgery or anything else, but especially surgery, which is so hyper-focused on physical and mental clarity,

I won't do anything that interferes with the goal of physical and mental performance. So when I don't drink and I go to bed early and I get it. up super early and my regimen is, you know, to read and get mental clarity, be curious and ask questions. Like I read difficult things. I also read easy things, but I read difficult things and physically fit. It is scientifically proven. When you get into an operating room and you are physically fit, there is less muscle twitch. Your hands are more firm. And when your mind is firm and your hands are firm, like you get into a zenith area where you almost have no consciousness in the operating room. You are not thinking about step one, step two, step three. You are in that zone where you are

not just trying to get through an operation. You own the operation. And that's what I would want someone operating on me, someone who cares that much. And maybe I'm extreme and over the top. But you know what? I like surgeons who are extreme and over the top in terms of how much they care about the way they treat patients. I do too. And I think surgeons, you know, there are certain stereotypes that go along with surgeons and especially different types, you know, categories of surgeons and whatnot. And I'm like, no, I want that person who is like so fucking confident to the point that

it's maybe air comes off as arrogance or whatever. I'm not saying that about you. But I'm like, I want that in the person who is like cutting me open and has my life in their hand. We can all benefit from a daily multivitamin and my absolute. favorite for years has been ritual. Ritual's essential for women 18 plus multivitamin was formulated by exhaustive research to help just fill nutrient gaps in the diets of women ages 18 plus. I know that you guys really care about the science and research and ritual is really heavy on this.

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many different suggestions and supplements and probiotics and prebiotics on the market, but if you don't really know what's going on, you're just kind of guessing and you could be wasting so much money on all of these things. So the best thing that you can do for yourself, and you're just, for your gut is to stop guessing and start assessing. So right now, Keene Health is offering 20% off with the code blonde. All you have to do is visit keenehealth.com and use the code blonde. That's K-E-A-N-H-E-A-L-T-H-H-T-H-K-E. Again, KeenHealth.com, the code is blonde, B-L-O-N-D-E, for 20% off. You want to get to a place, and this is taken from sports leadership. and really from a psychologist at West Point,

who trains, mentally prepares people for special ops. But there is a connecting point where confidence and competence beats that puts you in a kind of an unbeatable position. You know, the confidence comes from doing, like the reason I hyper-focused and do, you know, focus on basically one essential type of procedure is when you start, start stacking these wins on top of wins, you know, the average surgeon does 30 of what I do in a year. I do 800, okay? You start putting that year over year. I'm, I'm 70 years ahead of the person

next to me. That gives you confidence. You've been there, like, I've done an operation more than I've done anything else in my life. Okay. I'm confident. The competence is with the outcome and the training. You know, I've trained, I've done it all. And I'm not saying I know everything about surgery, but when it comes to what I'm doing, I have the training and I have the confidence and I'm putting it all together. So I have a bank account of both of those in my mental bank account of the competence and the confidence. And pilots, surgeon, astronauts, special ops, people who are not allowed to have an off day. Like, we don't have off days. There's no like, You know, I'm not really feeling it today.

You know, that doesn't work. It's, it's a non-negotiable. I'm getting on a plane. The pilot's like, you know, I'm not really feeling it today. I'm just going to get through the day. Fuck now. We're talking about it. We're flying, flying a plane.

Like, you have an off day. 300 people die. Yeah. Same thing with me. There is no off date. There's tolerance for, you know, getting through. We don't, getting through something is like, and mediocrity, it's,

makes my blood boil. Yeah. Well, let's talk about surgery and your approach and something that I appreciate about you. You talk a lot about empowerment and empowering people, mostly women, through your surgeries. And, you know, I think for whatever reason, like plastic surgery, any kind of elective surgery is still so stigmatized. And people... I don't believe that. I think that is just the false narrative.

Really? Yeah. Okay, tell me. Well, everyone's entitled to their own opinion. I just truly don't believe that there is any rational decision that any type of self-improvement, whether it's reading philosophy, improving your diet, exercising, or making a commitment to improve your body through any means, including surgery, has any negative possibility. Obviously, there's extreme.

There's extreme, you know, you can extreme plastic surgery, you can over exercise, you can over diet, you can over everything. but improving yourself to improve that mind-body connection to empower yourself, not going to tolerate that's not positive. I've had plastic surgery. Most people I know and they feel really freaking good about it. Yeah. And I have to.

And I've always been really open about whenever I've had a procedure done, which I've done like tweaks over the years. And I'm obviously met with a lot of judgment and resistance online because I'm kind of like putting myself out. There's judgment, resistance, criticism. If you want to be successful and you want to improve yourself, like, welcome to judgment, criticism. Yeah. Yeah. Okay. It doesn't matter what you do. People like to meet in the middle or the lower middle of mediocrity. And it is enticing to complain together and dwell together. And, you know, I had a rough weekend. I'm not working out this, you know, that.

it's seductive to complain together. When someone steps out of that middle, even though you're stepping up, whether you know, stopping drinking, you're dieting, you're exercising, you're not going out late

or you're having surgery. You're already an outcast. You've stepped out. So they want to bring you back, but you got to get to a place. And that's when, like, when someone criticizes or whatever,

it is just fuel. Like, it just fires you up. Like, nothing excites me more. Like, it is like, you know you're doing something right. Yeah. You couldn't care less about what these people think or who they are. Yeah. And if you got to know that person, you're probably excited that they're actually,

they're giving you the right response because they're directly opposite to you. Yeah. The negative is your appropriate response to your positive. Yeah, exactly. Well, and my, you know, my experience with surgery has always been like, I first had surgery when I was a couple of years sober and I was just like, I don't look how I feel on the inside. Like my outside doesn't look how I feel and I want that to match. And I'm with you. I don't think there's anything negative. I think it's a really positive thing. We have one life. Like you want to look as good as you feel. Whatever make that decision, whatever your reason is. I am very excited that one of my favorite brands, Oathouse, is now a sponsor. the podcast. I have been eating their granola butter from the very beginning. It's truly the greatest. You've probably seen me make cookies with it. If you follow me on Instagram, I use it on my morning protein blob that I always make, but there are so many ways to eat it. So Oathouse is

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and my main focus is, you know, modern liposuction. We write the textbooks. We train on all the technology. I write the techniques. We give the master class, me and my associates, and Mommy Makeover is essentially putting together all these operations we do into one harmonious operation. And after we've kind of mastered, you know,

breast surgery and lipo and tucked, we put it all together. And now, My main surgery is my makeover. But let me tell you, and I, you know, anyone who disagrees with me, whatever, you're entitled to your own opinion. You take someone who's had three, four kids, okay? Their muscles are torn, they're stretched. Their skin is torn, their stretch.

Their breasts are deflated. These are, you know, late 30s, early 40s, late 40s, women, their body is broken. They come in to see me with a very low psychological burden. they're like unbreak my body. Okay. Give me back. You know, my core is not right. I do a plank.

Everything falls out. Everything is not what it's supposed to be. And I always make this joke. Okay. If men's units were destroyed in pregnancy, they'd fix them at gas station. Okay. They wouldn't let you leave the hospital with like,

you know, it just wouldn't happen. But women's bodies for some reason, you know, it's a big deal to fix them. When we've put these women back together, whether it's my kind of 19 method of sculpting from minimal to maximal or the mommy makeovers, you see, they walk into the office. I don't look at the body. Look at their face. They come in and they have that, you know, jump in their step. They're ready to go.

They'll tell you, my sex life is better. My work life is better. My relationship with my kids is better because the relationship with themselves is better. And that's part of getting to know you. and getting to know yourself, like, if you are disconnected from the way you look and the way you feel, that's a problem. Now, when you do yourself introspection, you should be able to learn if plastic surgery is the right thing or not the right thing. You know, if you think plastic surgery is going to change your marriage, that's probably, that's not right. You know, we like our patients who are super happy with themselves and they know exactly who they are and they know exactly what.

plastic surgery will do for them. How often do you have to turn people away because they don't meet that criteria and you feel like they are trying to fix something maybe like internal with a surgical procedure? The most common questions I always get are what are like weird things people ask you and how often you're in the way. One of the great things about social media is I amplify a message. It's almost like a dating app. Like people don't they know what I'm saying. They know who I am. like it's not received by those people. I don't get weird questions and I don't get a lot of unrealistic. Like they're very similar,

very sophisticated people who are looking for this, you know, appropriate approach. I don't get people asking me for weird things. They don't make it into my office. Especially most of our patients at some point, you know, this is the pathway.

Almost all of our patients are worded by. Okay. Whether they're from, you know, we have a huge patient base in London, Paris, California, Austin, and New York in the surrounding area. Someone gets my name and then they follow me for a few months in Instagram. They get to know me. Like, they know who I am. Okay. I'm not hiding it.

So when they come in, they're either on board with us or they're not. And they find someone who's on board. I would bet you the way people portray themselves through social, their offices that are full all day with. people who are unrealistic because they probably promote an unrealistic approach. I don't see it. It's not a thing. I guess it gets filtered out before it even gets to you because of what you're putting out there people now. My brand does not swallow that. It's not random. Like people don't come in and they're like, so tell me. It's like, hey, this is who I like, I'm, you know, a 43 year old. I work in a hedge fund. I've had three kids. This is what I want. Like, and this is

I want. And I like the way you do things, Ryan. And my two girlfriends went to you and they're happy. And let's just do it. I'm busy. Just let's go. Amazing. Well, we did get so many specific questions. So I do want to get into like some of the surgical rapid fire. Let's do it. Here's for the Pelican. This is a fantastic product, by the way. And to our friend, mutual friend, Jennifer Fisher, thank you for the salts. But I don't know how you live without sparkling water. And as my son calls it, Spicy water. No what? She drinks coffee and she drinks alcohol.

You and I don't drink alcohol, so this is our substitution. Okay, cool up. Okay, so we'll start. Let's talk about breasts. This is actually interesting to me because I am having a breast augmentation. I was supposed to have it this Friday. Obviously, that's not happening because of my COVID. I had to push it back end of the month.

but this is a decision that I didn't come to lightly. I was thinking about it for years, and I initially had wanted to do fat transfer. And then I was like maybe fat transfer in a lift. And then I decided, no, I'm going to go implant. But of the questions that we got, this was one of the most common ones. I think people are really scared of breast implants because of breast implant illness.

You hear more and more about that these days. And I think a lot of people are curious, like, what can fat achieve? Who is a candidate? How real is breast implant illness? All of the things. Got it. Well, I like this question. I actually do a lot of breast surgeries. I actually don't, we don't promote it as much because we really like this very specific message. Like, I do most lipo and I do the most talks. But like with the mommy makeovers, I do a ton of breast surgery. Absolutely a ton. And we're just increasing our catchment of breast because we like the way we do things in our team with Dr. Anna Steve, mother of two, after a three-year global recruitment search, she is joining us from

Saskatchewan, Canada. So we have a female surgeon starting in July who's going to be primarily cosmetic breast because I do most of my breast surgery with other stuff. So let me talk about my approach overall. Slam dunk operation, breast surgery, whichever way you're going to go. Most predictable, long-lasting is always going to be important. I like smooth, round, silicone, highly cohesive for gummy bear implants appropriately fit into you. Okay? I like them under the muscles through an incision underneath.

I like it under the muscle and my patients like it under the muscle because many of them are thin. And they like the meat and the patty on top of people. It's like you don't just want the bun. We put the meat in the bun. The way I do it, it's bloodless. We put long acting numbing. These people are moving real quick. And when it comes to the implant, we just like don't go too big.

And it comes to sizing. I see a lot of women who don't have kids. They want to feel more feminine with their breasts. So we pick an implant that fits them. My most common implant is somewhere between 270 and 330 Cc. Post-pregnancy, we see a lot of deflation. So a lot of implants with lifts. Now, I do a procedure called the breast boost, which is backrafting.

Okay, we do a closed system purified fact graphing. Meaning, we're doing the lipo, the fat comes out. out, like Willy Wonka, okay? It goes through a machine, gets cleaned, it's never exposed to air, and then we put it back in. I'll get a little granular on fat wrapping for you guys. If I take my kidney and put it in you, that's a problem, you're going to reject it. But if I take a piece of fat from your stomach and move it to your boob, it doesn't reject it. But the more pieces you move, the less likely little blood vessels are going to grow in. They're like, you know, think of a pile of tennis balls. The ones in the middle of that little pyramid they always have can't get that

blood supplies. You don't get, it's not as predictable. So I tell people who don't like implants, you know, we can do the fat grafting. It's good for size and shape. And we can do that minimally invasive or under general anesthetic. It's good for like a half a cup. We do a lot of patients who want implants, but they don't want big one and they want a little cleavage. So instead of adding more implant, we'll put a little implant and we'll add some purified fat into the cleavage. I do a lot, kind of like a lot of patients who come to me in their 20s. They've had big implants and they're like, I show up for my, you know, pick up at school and I'm just like all boobs. And like, what are we?

So a lot, some of them want to go implant outs and with fat. Some want to go implant out with a little implant and fat. So like we're pretty, I use fat all day, every day, everywhere in my operation. I've got a number of patients who take, yeah, we can take their implant out. for suspected breast implant illness and we'll replace it with fat. And sometimes they need to do it two or three times to get the volume they won't. Guess what? Everyone likes getting more lipos.

So like it's like, oh God, I have to get thinner in another part of my body to make my bigger. Like, God forbid. Let's talk about breast implant illness. So listen, I think if you put things in people, some people's bodies are not going to like it. You know, we all have allergies. We all have exposure to the environment. our bodies are constantly changing

connected tissue diseases. Listen, women come and they say like everything, you know, I don't feel well since I've had my implants. Like, let's take them out. So I don't really make more of it than not a huge, I believe in it and I think if people are sick

and I think it's their implant, take them out. And then go from there. Take them out. If the symptoms go away, you know, you've got it. If they don't, look for something else. Overall, implants are super predictable. Even small ones, we use like 120s. I'm like a lot of women in New York work in fashion or just like really women who are super

scared of having big boobs. I like put in a little hockey puck implant and be a little fat on top of it. But, you know, we like conservative implants here. I'm doing like 210, I think. That's what he is predicting around 2.10. So it's another thing. I make the decision going in. There's no playing around.

Like, certainly it's not like, hey, let's see how it looks. Like, we don't play around. I mean, like, this operation is quick. It is painless. You know, I don't play around with implants. I don't say, you know, it's rare that I'm like, I'm going to, oh, I'll tell you what I think is best.

It's like, no, we're making a decision. We're sticking to our plan and we're going to win this operation. I don't like going into an operation with variable. I mean, it's like taking a plan taking off and saying like maybe we'll land in Denver. Maybe we'll land in L.A. Right. Tell me where we're going. Okay.

How do you feel about what is the name of it? It's like the mesh that goes inside. Gallifflat. Yes. Helpful. I use it for people who are getting lifts and they want holding a implant up. So like an internal broth. Like someone's got their hand inside your breast.

Got it. But I use it on primary cases. I don't like adding things inside a body because it increases the risk. Again, it increases the risk of infection. It's a thing. Like, I want less things in your body. Okay. Well, let's talk about the LIPO aspect of it too.

So I know that it's just like a part of what you, the whole comprehensive thing that you do. But that was another thing that a lot of people asked, you know, is like, that somebody has to be a certain BMI or can you get fat on anybody? So I have a unique practice. Like, there are not a lot of people in on this planet who specializes in LIPO. Lipo, one of the reasons I got into it, it's kind of this procedure. that base guys didn't like and a lot of people thought it was like a throw-in.

They're doing these old techniques, old equipment. And I'm like, why are we doing it that way? Every single person walking can have something sucked or tightened. I can tell you that. So I love doing it. There's a low psychological burden. We all know what flat and tight means. We all know what's sculpted in tightening.

It's not like we're looking at it knows, is this nice or is this not? And I also love the artistic as opposed to other procedures. It is a pure skill in artistry. operation. This operation is about familiarity. You need to have, like, if you do it once in a while, don't do it. Okay. This, when you're sculpting someone's body, you better know what you're doing. So when we talk about BMI, like I have a lot of patients super thin, have an incredibly low body fat percentage, but that small body fat is stuck in their arm, in their lower abdomen, their inner thigh.

I have a lot of patients, you know, who are looking for a jumpstart, who have, you know, gain some weight for whatever reason and I need, you know, a catalyst in their wellness cycle. When we talk about BMI and I write a lot of position papers on safety and plastic surgery, it is not about, you like, I like a BMI below 32. Sometimes we'll go up 33, 34. And the reason for that is safety because we know when you get to a certain level, the risk of complications go on. But I mean, in terms of, you know, are women and men, all ages, all body types, all body parts, you know, I do calves, ankles. I, you know, I do the nooks and the crannies,

as they call it. Like, and by the way, it's not like, if you have knees that are like stubby, I'm not going to get rid of that in the gym. You can't diet your knees. I do calves and ankles from all over the world. I'm telling you, you think women, they've never like been comfortable in high heels, put them into high heels and they have a nice shape, you change your life. Like, I'm telling you, like, what do you mean? They've never worn. They have trouble putting on boots in the winter. They feel like they have tree trunks and now I sculpted them.

I never even thought about that. And then when I was looking at the questions that people sent in, I saw a bunch about calves and ankles. And I guess I have a bias because I was like, well, that's a little excessive. Today, I did a cap and ankle from Kuwait. We did a knee from Austin. I mean, people, it's a big deal and they want to go where someone knows what they're doing. And also loves it.

The passion is everything. Honestly, it attracts people. Definitely. It's definitely magnetic. When you're doing LIPO. And I'm not just asking these questions for myself. I feel. By the way, this is every dinner party of my life is this.

Okay. Like, it's literally I sit down and it's like, you probably don't want to talk about. about it. And then I'm like, all right, hit me. And it's like, name. Okay, let's go. I love. No, because any chance I get amplify the messages, like, I love, I love it. And I love talking about what I'm passionate. The people want to know. They need to know. Yeah, they need to know because I think it's hard a lot of times to find the real information. You don't want to give them what they want. We give them what they need. Yeah, exactly. So my question one, when you're doing lipos, stay in an area like arms, okay, because this is something that I might throw on as well because my arms are my problem area.

I also did two sets of arms today. Arms, the most common procedure I do. Really? My arms grace magazines. I mean, I'd been absolute pleasure to watch TV at night and see my arms on there. And just so many women have these stubborn areas, especially at the top. And I see incredibly fit women from instructors at your favorite local, fitness studio who just can't get the shape. Okay, so here's the deal. This is like my thing, okay? Traditional liposuction, the arm is they just take a little bit of fat there, okay? The arm is a cylinder, you know, like my favorite explorer, Fernand Magellan, you know,

you want to make a difference, you got to go around the world. Okay, so we sculpt around the arm, okay? And the key is the technology. So this upper part here on almost anyone, more connective tissue than fat. Traditional liposuction is just going to hack away at it. doesn't work. I make a little poke in the armpit. We use gentle ultrasound technology. We melt it. We basically turn cheese into queso, get the fat out to get that nice scoop. From there, I can go down to the elbow. And as needed, I can make other little incisions. When I teach my course, we talk about one point, two point, three point access. We do the minimally invasive, you know, when you're awake, because I know how to numb people very gently. We get to listen

to music, dad jokes. And we basically have our own podcast in the operating room or you do it asleep alone or with partners of other operations but young patient arms knock it out of the park when you take what i do i get rid of that stubborn area you put in what you do in the gym it's not one plus one equals two it's one plus one equals a thousand and i i thought it was always diamonds that make women happy it's not it's arms it's skinny and it's cheaper What about the tightening aspect of it, though? Like this is where the judgment is in from the doctor, maturity, okay? You have to know how tissues respond, what you do.

So you have to know what melting fat with baser energy does, how well the tightening devices, whether it's Jplasma, whether it's biotin doesn't matter, and how to remove fat. When I'm removing fat, I'm doing different amounts at different levels because the fat is different. Matching that with the patient's goals. Sometimes it's pure lipo. sometimes it's lipo with a little tuck. Sometimes it's lipo with a full tuck.

This cannot be more overstated. This is very difficult, and you have to be obsessed with it. Not wanting to leave people loose. It's not cute. And you want to have real conversations because, you know, we're going to see people with loose skin. You don't want a full time. So we'll talk about what you'll get out of the mini-term and things like that.

So but like setting those expectations, being rude. And sometimes you set the expectations and they say they're realistic and then they're not. But, you know, then you figure out. Let's talk about downtime because I think that there is a misconception that you get these procedures. And for sure, I'm sure, like a tummy tuck and more invasive procedures, you can tell me, are longer than something like maybe like a straightforward lightbo. So downtime is like humor. Okay. Like we all like have a different sense of humor and everyone is going to heal differently. So let's talk about downtime. Patients get the optimal downtime when they prepare for surgery properly, limit alcohol intake, get healthy, anti-inflammatory diet, meaning don't come into

the operating room, fluffy, bloated, blood thin, you know, setting yourself up for significant bruising in spite. Post-stop, if you're going to follow, you know, the diets, garments, massages, and all the little things that we know what is going to do, you're going to do. You're going to to heal quicker. It deal with a lot of overachievers. Like that, you know, they go to work way too early, but they're just spoiled for a while. So let me tell you how it goes from a 30,000 square foot view from minimally invasive. So like, say I do your arms this afternoon.

I did a woman today's going on her honeymoon. Okay. So you're going to leak for a few days. I like to leave these little incisions open. Get the fluid out. Fasting looks like Gullet, but like get the fluid out. foods inflammatory get it out start massages the next day okay your arm is swollen and bruised for about a week but not like unsightly like if you're wearing a garment like you can go out tomorrow

to a restaurant first three weeks you're going to see swollen doesn't mean you look like the michelin man but it might look even worse than when we started three weeks is usually the inflection point meaning like you go from like what did i do to i can't believe i didn't do that's for the minimally invasive Like, we really knock these, you know, most days I'll do like a big case, like a mommy makeover, tummy tuck, breast lifting plant, BBL, all the things. And then we do like, we set to arms, inner thighs, knees, calves, ankles. They heal quick. And like, again, I think overachievers are attracted to us. We don't see people who are like sluggish and lay around.

Like they want to do the things. Like they're empowered. They want to do the massages and follow the. instruction. So average, most people, straight light boat, six, or whatever, I tell them to stay home for three or four days. You can swim in two weeks, go on vacation or something special in four weeks. Results are going to take a full year to max out. I mean, tucks. I tell them, you know, stay home for a week, have someone else look after your kids for week. When we do breast dogs, like two weeks, do whatever you want. Lift your kids in a few days. I don't care. What do we do it? Like, there's no six weeks,

eight weeks, like, we release the muscle. I gently lifted. I put in a proper implant. Like, lift your kids, go to the gym. Like, we're not saying you can't do anything for six eight weeks. But when you choose a plastic surgeon, they need to have a full aftercare program for your operation. It is not like, hey, I think you should get a massage, like go find one or like get garments. Like, we are obsessed. The biggest paradigm shift, one thing I noticed from other offices, the status quo. was the customer service and the hospitality aspect in plastic surgery. Then that's why we've changed our team. Like our front desk comes from the hospitality world hotels.

Patient care coordinators are, you know, patient care coordinators. No sales, it's not commission. Like, for it is best for the patient. Okay. It's not good for the high. It's not good for the B. And we have a huge team of me, other surgeons and nurse practitioners who are solely concerned about the patient experience. It is 24-7 back and forth. I get calls all the time from my wife's

friends or patient's friends who had surgery elsewhere and they can't get a hold in. What do you mean? Can't get a hold in me? Someone just cut you. Like, you need six numbers immediate access. Like, I mean, my patient's always joke, you know, they're glad I'm not, you know, their husband, but they're glad I'm their doctor because my phone rings, you know, I just step away from every meal I'm at, you know, I get three in the morning. I don't care. patient care, everything. The way your team treats your patient is everything. I mean, people are scared.

They need clarity. They need access. It's something Melinda talks about all the time. Part of the reason I get up at 4 in the morning every day is when we do a tuck or a left, I go see them every day. And we have patients, you know, I think I have patients in five hotels as of today. You know, that's a lot of continental breakfast for me. So I go to the hotels and I see them or I go to their apartment.

I see them. I need to know. Like, I don't understand how someone doesn't want to know what is happening. These are big deals. Yeah. That's my obsession with the end result. And the end result is a lot more than the physical appearance. It's the emotional experience of the patient and the husband or whoever's you're right. You know, it's nice when they see, hey, the doctor's here at 445 in the morning. Like, who cares? Yeah. And that is the hardest part of surgery, I think, at least for me, I think for most people. He's the easiest part of surgery for us and then no one wants to do it. The customer service is literally, and then, you know, I got Mitch motivates.

He's dropping flowers off. He's running Aaron. So last week, Mitch is still here. Mitch is in the background. He's motivating. Mitch, we had a patient last week from Chicago. I'm not going to mention any name.

We did a mommy makeover. Brought her mother in. The mother was super nervous. Mitch took her mother for a walk in Central Park and out for breakfast. Oh. We got back. We were done the operation. Okay.

If you don't have a hind, he's willing to do the things that no one else even think of. I mean, what do you even do it? I love it. I want to have surgery with you. That's why I want to open my own place. I just, you know, I break down the silos, break it all down. Why can't it be a highly positive emotional experience? Why can't you speak to someone when you need to?

Why can't Mitch, you know, drop flowers off at your apartment the morning after surgery? If you need an air and run, that's one. will do that. If your mother needs, like, it's super nervous, it needs to be taken for breakfast, can do it. But that's why we have a global reach. I mean, people who want that from all over the planet. It's exciting. I know that when people come to you, they know what they want. They want. They know what they want. They want what they know. Yeah. Are you seeing any changes in, like, the trend of what people are asking for? I know, like, everyone's talking about, oh, the Kardashians are skinny now and they're getting their BBLs. So I never made big bucks. I was never a big butt guy,

and I do not lie. Shout out just for Mix a lot. You know, listen, I was always a better, not bigger pub. So, like, we've been doing, like, elegant BVLs for a long. You know, baby VBL with the mommy makeover, it takes a little droop. I've been doing that for a long time. So that's nothing new. I am seeing reverse VBLs all the time.

Like, Dr. Funderberg is doing them. I'm doing them. We're now going to be writing our own paper in a textbook chapter on how to undo BBL. It's a staged approach. you know, think about like movie Armageddon when we're trying to kill the asteroid from the inside. So, you know, we're taking

these ridiculously big butts, like insane. Like these women cannot walk by a construction site. And we're trying to heat it from the inside and shrink it. But we're fighting gravity, you know, the top and the bottom, you know, gravity is hitting us in different ways. So, but we're getting results. They go to places

down south, you know, call wherever you want. They trust someone and someone takes a lot of fat, and puts it all in their tushy, and it's not a nice tachist. So, you know, it's heartbreaking because it's like they really damage these girls. And also it's like incredibly expensive to like have like four more operation, not just the cost of our time and like we do what we can. But like the downtime, like a couple weeks off work every time.

It's a lot. So we're reversing BVLs. And like, let me tell you, implant. The every day I'm seeing women with. Big implants, wanting to go smaller. We're taking it out completely. I've always been elegant, long, lean, you know, athletic. That's my aesthetic.

Elegant, long, lean, athletic, okay? And maybe it'll change. The trend now, smaller implants. You know, they like them high and tight, you know, nice. But not big, smaller, better butts. That's aggressive sculpting. I mean, this has been who I am from the beginning. but that's why I think, you know, our foundation is strong and, you know, we're busy,

but we love being busy. How busy are you? When is a consult with you? So I operate every day, okay? Most surgeons do a couple days. I operate every single day because there's nothing in the world I love more than operating. So I never understand when surgeons say they have a two-year wait list or one. Like, that's like me, like I'm not booking a restaurant reservation for two years from now.

It just makes no sense. Like, I don't get it. I know Miguel is listening to this right now and his consults are booked out until 23. So Miguel, take notes. Miguel and his team have come to visit us and we've given them exactly the formula. So listen,

you can read Harvard Business Review. If you have more than a three to four week waiting list for whatever service you're providing, you're doing something wrong. So charge more or scale. Okay. So three to four weeks, that's my answer. Yeah.

But like, listen, I get people, hey, I'm friends and friends. Like, I'm in town. I want to be seen this week and I want surgery next week. My response, no problem. Listen, there's a price. I charge a lot. But if a lot, you get a lot. You want surgery Sunday morning at 6 a.m.

No problem. We'll give it to you. We'll be there with bells on. So we make moves. We like operating. I have me. I have Dr. Fund. And we're going to have Dr. Anna Steve from Great Canada. So yeah, we don't do like, we like this turnaround.

Also, it's an emotional thing. Like people like they want it and they want it now. Yeah. Most people, not in the summer right now, 90% of patients want surgery within three weeks. So they hear two years, you know, yeah. I don't care of Da Vinci like, you know, no one's waiting three years from Mona Lisa. Well, and then they're going to go somewhere else in so many cases. They'll go somewhere else. and have it done not correctly and then need a revision. Well, that's not true. I find someone who is also very good that just has their practice structure in a different way. Yeah.

Listen, but it's also, and this goes back to the beginning, in your purpose. Okay. So not going to mention name. Some people are unwilling to operate at the case that I do. Not a lot of people operate five days a week and in the winter, six days a week. And they'll tell you it's, you know, it's too much or they get too tired. I freaking love it. I have the best team in the world.

My favorite place is to be in the operating room. I have the physical and mental stamina to do it. But listen, we do like seven, like three, four, we're done. This isn't like set, like we're going around the clock. Like, we do a normal workday. But like, why can't I do a normal work day in operating every day? trust me, I got the stamina for it. We love it.

I absolutely love operating. It's an obsession. And I do everything myself in the operating. You know, people always think there's someone, you know, we do it yourself. We love it. Why would I never want to give up my ability to what I love to anyone else? I love it. I love your enthusiasm.

I like to ask my guests, one thing people should stop doing and one thing they should start doing today. And I'm very curious to hear your answer. It doesn't have to be surgical related. It can be anything. That's a great question. So if I tell people what they could stop doing, stop living your life in survival mode, meaning just like trying to get through every day and make an each problem is like a huge big deal, right?

Like you wake up in the morning, maybe you wake up late and you miss your tax, you know, maybe you miss your boss or your subway and you're just trying to survive, right? Every little thing is like life or death to you and a week goes by and you. you just got through the week. I can't stand it when I got through this week. I got through that it's like, you know, those are people who, you know, you die at 20,

you're born at 80, okay? Get over yourself. Things are going to happen all day, every day to you. Having in survival mode, start thinking bigger and like, what do you want out of life? Stop worrying about the little things that happened

that everyone has to deal with. Like, so that's one thing I would, to tell people this topic. And to start, honestly, something that's been that's new for me in the last few years is an absolute obsession with reading. Like, I really think it's easier to go through this, you know, dark path of life or this dark cave with the light of history. And like, the more you read, the more you realize, like thousands of people for, for thousands of years have been through everything you were going to. Literally, you'll, I can tell you quotes

And you'll think it was like your father who told you. And I'd be like, no, that's Epicetus. You said that 4,700 years ago. You know, like, you know. I had Ryan on my show, Ryan Holiday. It was like one of my favorite episodes. I love all of that because I get that same feeling like, oh, I'm, this is so insignificant. By the way, I have like become friends with Ryan, social.

Like, and he's someone that's like motivates me, you know, he says read a book. I'll read it. Yeah. And reading has really opened up and it's almost like chatt like whimsical. Like I love, you know, reading a book on Napoleon. I want to like be back there and Churchill or go back and, you know, whichever you want to read about it. But the more you read, the more functionally literate you become, the more you sense yourself and your place in the world. What are you reading right now? Today I am reading from Tim Grover. I am rereading it. This is. This is another thing.

When you, like, people read the Bible every day, right? Same book in religion or whatever they're reading. So while I'm always trying to read three to five new books, so maybe a couple hundred books a year, there's a couple that like you just want to reread, reread, reread. And I'm rereading Relentless by Tim Grover. Tim Grover was Michael Jordan's personal trainer, but this is not about, you know, Michael Jordan. It's not about personal training.

It is about the key attributes to find success in life and to help it helps you explore yourself to get there. And I love it. I've read it like three times. Amazing. I heard him on a podcast and he was great. So I'll check that out. Yeah. He's amazing. Well, thank you so much for coming on. I feel motivated right now. I don't know to do what, 7 o'clock Monday I have COVID, but I feel motivated. There's so much you can do. Yeah. Yeah, listen. Part of also what I like to do, and like my patients, my team, my staff, it's like, I'm trying, I'm here, like, leading should inspire people.

Yeah. I have staff members who, you know, have lost a ton of weight that they're reading and like they're making significant different changes in their personal life based on what I do. And I take that as an incredible honor and responsibility. Coronite in Central Park, nights of class surgery is having our, what is it, Wednesday workout, Tushy Tuesday or workout Wednesday. Yeah, we always invite, like, local people. I'm inviting my inner Franks coming, and we're going to have a team workout, and we bought them all leopard print gear, and it's going to be awesome. Fun. Well, I don't know if you're inviting me, but I wish I wasn't sick because I would love to do that.

Another time. Yes, for sure. It might be a Tissue Tuesday next week, which is a lower body focus workout in the park. Okay, perfect. I think I'll be good by then. All right. Perfect. Thank you so much. Where can everyone find you?

You can find me at 5th and 58 on the 12th floor of both for Indoorfieldman. That is where the dreams are made, baby. And you can follow me at Dr. 1919 on Instagram or at 19classic Surgery.com. Thank you. I hope you enjoyed that episode. If you liked it, and if you like the show in general, please take a second to rate, review, and subscribe. It goes a long way. and it's actually the best way to support the show.

Also, if you want to see more about each episode, you can head over to The Blonde Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Ariel Laurie.