Well with Arielle Lorre - 51: Dr. Miguel Mascaró - Plastic Surgery in the Age of Social Media

Episode Date: April 8, 2020

I talk to plastic surgeon Dr. Miguel Mascaró, MD, about how plastic surgery has changed in the era of social media; the most effective procedures for maximum results; non-surgical solutions for younger patients; trends that need to go away; and how those cat eye surgeries actually look in person. We also discuss lip lifts—Dr. Mascaró performed one on me this January—and we speculate about celebrity surgeries. Produced by Dear MediaSee 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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Hey, welcome to the Blond 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 hope you are safe and healthy. I hope your loved ones are safe and healthy. It is such a strange time that we are living in right now. I personally have been under the weather. I don't think it's you know what, but I also don't know. I've been filling off.

And so I'm just going to jump right into today's episode. So today I'm talking to Dr. Miguel Mascaro. He is a plastic surgeon based in South Florida. And we are talking about surgery. in the age of social media, trends, celebrity surgeries, how cat eyes really look in person, minor procedures that make a big difference, and non-surgical solutions for younger patients. Dr. Mascarro did my lip lift back in January, and you know that I am obsessed. If you haven't listened to my tell-all episode, make sure you go back and listen.

It is episode 45, and I talk all about it. I love talking about this stuff and I love pulling the curtain back about something that is so often stigmatized and kept secret. You might know my opinion on this because I've talked about it before. I think everyone is entitled to their privacy and I also think lying about it can be really damaging, especially to younger people who idolize these women who have bought new faces. But I could see how it would be problematic if they were open about it and then their younger audience wanted to go out and do these procedures. So it's kind of like a lose-lose. Anyway, we get into all of that today. So enjoy Dr. Miguel Mascaro. All right. So welcome. You want to tell them what just happened?

Yes, you guys, we've been trying to get this audio working for 40 minutes and we finally just thought we started recording totally my fault and started like jumping into the. episode and then realized it wasn't recording. So at this point, the good thing was that it was only like maybe five to ten minutes of us talking pretending we were recording. And so it wasn't the whole thing. Oh my God, you've got to laugh. So we're just going to jump right into it. I'm so excited that you're here today to talk all about plastic surgery and beauty and trends and aesthetics and all of that. But to begin, why don't you just tell us about your training and your background? Sure. So I was joking that, you know, I could really talk about this for quite some time.

It's a good thing that you didn't because it wouldn't have been recorded. But, you know, if I was going to, if I was basically just going to jump into it, it starts in college. So originally I was a philosophy and neurobiology major, which is a little weird, but I was always really really. really interested in the brain and how things work and how people think. And I knew I wanted to be a doctor of some point. So I decided to go to med school and I wanted to be a neurosurgeon. And so I did what every neurosurgeon is supposed to do. You get the good grades, your first year of medical school. And then you do research because that's what, you know, you have to do if you're going to get into a good neurosurgical residency training program. And I remember within the first two

days of doing research and neurosurgery, I just remember going home and being like, this is just not for me. This is terrible. I hate this. And at that point, I had that kind of come to Jesus moment when I was like, listen, you're already in medical school. You thought you wanted to do this all along. There's obviously something about it that you like, otherwise you never would have done it, and you're enjoying medical school. So let's try and figure out what it is. And I knew I wanted to do surgery of some sort. The idea of surgery was always interesting to me. And, then I started to think back to kind of what it was that I always liked growing up. And so really when growing up, I did two main things. I either played sports or I was taking a lot of art

classes. My parents put me in art classes when I was six. And I was in art classes from the time that I was six till I moved to the United States when I was 13 because I grew up in South America. And so I got to surgery and I'm looking at surgery and I'm kind of just knocking stuff off the list just, you know, immediately thought orthopedics because of sports. And it just wasn't for me. Like, I liked it, but it wasn't for me. There was just something about it. I was like, I just can't see myself doing this in and out every single day. Not even for the Miami Heat. I mean, that would be really cool. But the training and dealing with everything else, I just could deal with it. It was just one of those things. It just wasn't for me.

And started knocking all this stuff out, cardiothoracic, transplant, vascular, everything else. And then I scrubbed into my first rhinoplasty. And it was, I mean, it sounds cheesy, but if you picture like any traditional Disney movie where all of a sudden, like the lights go out, the spotlight shines on you, the little birds starts like just dancing around your head. That happened. And all of a sudden after that, I was like, this is what I like. And what I liked about it really was that it was a little bit of creativity. There wasn't too much guidance to it. Like there was a lot of jazziness to it.

And I would say this to my patients all the time. And when other doctors come and shadow me and I'm trying to teach them, but sometimes you just have to go by feel. And it's one of those things that you either have it or you don't. And there was a lot of that when you're trying to figure out exactly how much you're doing this, how much you're taking from this. You're playing with lights. You're playing with shadows.

And it just brought me back to a lot of the artistic training that I had when I was growing up. And I loved it. And so from then I did my head-and-neck residency training program because I still had the idea in my head that I wanted to do, like big reconstructions once I figured out that, hey, I want to do plastics, but let me do something more aggressive. So I want to do cancer reconstruction. And as I went through my training, I started realizing that what I really liked about plastics more than anything else was really the cosmetic aspect of it, trying to get things to be improved as much as possible and realizing that, you know, every single outcome is different. And there is no

quite definite perfect. Everyone's a little different and everything's a little bit kind of jazzy, so to speak, you know, you just go by feel and you find the beauty in every single one that you do and everyone's different and every challenge is different. And so that trip took me from Ecuador to where I started, to Virginia, where I went to high school, to upstate New York where I did my college at Cornell, to New York City, where I did my residency and training in medical school, to Alabama, where I did my fellowship training and now in South Florida. So I've been all over the place. I'm curious, if when you were training or if when you you decided that you wanted to go into plastic surgery if there was like a stigma around it

among the medical community or like what that transition was like going from thinking you wanted to do like neurobiology or neurosurgery or something going to plastics. Yeah, absolutely. I mean, I think that when you take a look at the history of plastic surgery in general, especially facial plastic surgery, there's been a huge transition because even within facial plastics, there's a big, big, you know, just just a huge variant of what you can do. to trauma, which we did a ton of in my training. And so trauma consists of mostly like mandible fractures or broken jaws, car accidents,

so what we call pan facial fractures, you know, barfights, whatever you can think of that involves broken bones in the face. That's what you do with trauma. You've got pediatric, reconstructive, craniofacial. So you're thinking your cleft lip and pallets. You're thinking your congenital malformations. So those are a little more involved. and then obviously you have your cosmetic aspect of it on the other end.

So there's definitely a stigma when I was going through my training. And so when I knew that I wanted to do reconstruction of some sort, you know, everybody immediately patted me on the back when they thought that, you know, it's like, oh, you're going to be doing big cancer reconstructions. And it's going to be, you know, this real good, feel good thing that you're doing for the greater good and all this. But I didn't find it fulfilling. And as soon as, you know, when I knew that I wanted to do cosmetics and I was applying for fellowships and they were asking me what kind of fellowship you're applying to because even

though there's, when you're board certified in facial plastics, it can mean a lot of different things. So, you know, within facial plastics, like I said, there's all these different tracks and there's specific fellowships. So for cosmetics, there's only 20 fellowships in the country, which means that at any given time, there's only 20 guys or 20 girls that are really going through this every single year. So it's a really, really small pool. And when I was telling people, listen, I haven't doing facial plastics, they're like, oh, that's great. What are the programs you're applying to? And I would say, you know, X, Y, and Z. And I didn't even want to tell them that it was a cosmetic program because I knew what the backlash it was going to get. You know, you could

just see, especially my mentors, my professors, just kind of, you know, look at me a little funny and wonder whether or not, you know, it was the right decision and, you know, trying to dissuade me a little bit from it and push me towards more reconstructive, push me towards more craniofacial, push me towards more trauma stuff. And so it's definitely something that we see in academia, or at least I felt it personally. It may not be, you know, quite as evident now. I think that now that things are becoming a little bit more out in the open, it's one of the great things about, you know, how things have changed with the internet and social media, that it's becoming a little bit more acceptable. Obviously, it has its good and bad because you're also seeing crazy stuff that some people are doing.

But at least when I was coming up, I definitely felt that. And I mean, I say when I was coming up, like it was a long time ago, but I mean, I was 10 years ago. So it's not that long ago. Yeah, you're still a young in. Yeah, yeah, definitely. No, that's really interesting. Yeah. So I want to talk about how it is kind of more openly accepted now, I guess and how it's kind of becoming a little bit trendy. And I also want to talk about the downside to that. Yeah, absolutely. It's good and bad. Good and bad. And like the misleading advertising and all of that. But why don't we kind of begin by talking about your practice and the procedures that you do the most of? Okay. Absolutely. So my practice is located in Delray Beach,

Florida, for those of you that don't know where that is, is just north of Boca Raton. Everybody knows of at least someone who's got a grandparent that lives in Boca Raton or retired in Boca Raton. And just south of Palm Beach Island. So it's right in between West Palm Beach and Boca Raton. And it's a small boutique practice. Basically, word of mouth. We do just about zero advertising, which is amazing for us. And I'll get why that's important a little later on.

But we just do facial surgery. So both myself and my partner, Tom Zika, is all we do is facial surgery. And so the majority of my procedures are basically lip lifts, airline advancements, facelifts. And that's the majority of what I do. Now, part of that has to do with my population. So you have to understand how my practice works. Tom is in his early 60s. He's been around forever. He's the guy that basically invented fat grafting for the face or that kind of figured out how it really works. So all his patients are, you know, in their 50s and to their 60s and 70s that are getting facelifts, fat grafting. He has an exclusive facelift fact grafting practice, which is

incredibly hard to achieve, especially nowadays because everybody's trying to do that. And he's just done doing it for 20 plus years. And so what that means is that my patients, I get the other spectrum. I get the younger patients. So I have a ton of filler, a ton of minimally invasive, patients and I get a lot of lip patients. And so that's probably the thing that I'm most famous for is lip-lifts. And what a lip-lift is really good for is facial feminization and facial harmony. And so that's where hairline advancements come into play because that's another thing that's a great little procedure that does an amazing thing for facial balance and facial harmony. So I do a ton of hairline advancements and then just based on where I am, since I just told you that I live in

practice around a bunch of retired people. We do a lot of facelifts, a lot, a lot of facelifts. Hey, this is Alexis Haynes. Join me every Monday for a new episode of my podcast, recovering from reality, whether you're on the road to recovery, seeking self-care techniques for surviving the capitalist machine, or just need a moment to remember that you're not alone in your loneliness. I'm here to deliver intimate conversations and expert insights to empower you on the road towards authentic wellness. So are you ready to recover from reality? Okay, so let's talk about the lip lift because this is how you and I came to know each other.

And if any of the listeners haven't listened to, I believe it's episode 45, I go through all of the procedures that I've had done, including my recent lip lift that I did with Dr. Mascarro. I guess it was almost two months ago now, I want to say. Yeah, something like that. Yeah. I am obsessed with this procedure in general. I am obsessed with my result that I got from you. It is like, I feel like it's a procedure that a lot of people still don't know exist. I think it's getting a little bit more widely known.

But it makes such a massive difference on the face. It is absolutely crazy. So can you tell us about why you love the lip lift and like who it's appropriate for and the recovery and all of that good stuff? Sure. It's a loaded question because we could just talk about this for hours. I know. It's interesting because the lip lift itself, what it does is it, the best way to even just describe it is just open up your phone, go in the albums and look at pictures of yourself when you were in your early teens, midteens, late teens, early 20s, mid-20s, late 20s. And the one thing you'll see is that as you start losing volume, the length of the upper lip or the pro labium, or philtrum, slowly starts to increase in length.

And part of the reason why that happens is, one, loss of elasticity, two, the maxilla behind it actually starts to resorb. So when you think of osteoporosis, that also happens in our facial skeleton. And what happens is that the dental roots actually come up a little bit as the bony resorption starts to happen. So you've got an elevator going up behind the lip, and then you've got the elevator going down in front of it. So the curtain's getting longer, the window's getting smaller behind it.

It just makes you look older. What does that mean? That when you're talking, smiling, laughing, you just don't see as much teeth. And so teeth has been one of those things that have been imprinted in the back of our brain, in our lizard brain as something that we associate with youth. How can you even associate that? If you were to pull up your phone right now and look at the lips emoji, the lips emoji has a little bit of tooth show. And so we're already even getting that imprinted into our brains from the time we were very little.

So what does that mean? That means that for a majority of the population, as the lip gets a little bit longer, it just makes you look a little bit older. So, you know, we all remember those pictures of grandma, grandpa, and they just look so long and they just look so much older. Picking up the lip, what it does is it restores the harmony of the facial proportions, number one. Number two is we start losing volume from the time we're about 14, 15 years old. That's something most people never noticed, particularly in their lips, up until recently. And the reason why this has become a bigger procedure with younger patients is the advent of social media and online cloud sharing of pictures. So when you think of it before Facebook was around 15 years ago when it really started, how often did you really look at yourself?

Not that frequently. You'd get a picture taken at the barbecue July 4th. Then the next time you got pictures taken would be Thanksgiving with the family. Then a couple pictures out with your friends at some point in the middle of the day. the night, but you'd have to develop those pictures, and then someone would have to put them in an album. You were never really sharing them. Nobody was really seeing that many of them. It was really hard and complicated, up until really Facebook came about. Once Facebook came about, what happened? So Facebook really started with college kids. All of a sudden, college kids are

looking at themselves every single night. So you're really noticing how quickly you're changing. Like, wow, when I was a freshman, I looked like a baby. Now when I'm a sophomore, I'm looking a little bit older. When I'm a junior, I'm looking how much older. Now all of a sudden, add that, you know, Facebook expands. You're getting a little. a larger population that joins Facebook, Instagram comes around. Now you're seeing yourself every single day. You're seeing multiple pictures of yourself every single day. You're seeing yourself change every single day. And this is something we'll probably get into a little bit later as far as the trends that we're seeing with younger and younger patients coming in. But that's the psychology behind

it is you're starting to see all these people. And you're starting to see all yourselves like pictures constantly reminding you that you're getting older and older and older. Well, and I would argue that the hardest part, at least for me, and I'm pretty open about this, is like Instagram stories. I think that really took it to another level because you're seeing a reflection of your face and nobody looks great in a front camera, right? No, nobody does. seeing your face moving day in, day out. And then the filters come along that change little tweaks. And a lot of those beauty filters make the top lip go a little bit higher. They make your chin a little bit smaller, your eyes a little bigger. So all of a sudden, like, you're dissatisfied with what you're seeing, you know, throughout the day, day in, day out.

And then you're seeing how, you know, how you might look a little bit better. No, absolutely. Absolutely. And that's part of it. And the other thing, too, is that it's almost a backlash to the filler trend. So if you think back to about five, six years ago, you know, everyone was getting filler in their lips. You know, if your lips were slowly starting to lose volume, the thing that you thought was, I need to get my lips pumped. And then what happened?

Then everybody started to think, well, I just don't want to look like a duck. You know, I don't want to look like a duck. I don't want to look like a monkey. Those are two animals that are not the cutest. I don't want to look like them. And so what ended up happening is we're starting to see that as people were taking pictures of themselves, a lot of the fillers, bigger, the fillers that absorb more water started to weigh the lip down and started to drag that lip down. So it makes you look older. And that's a trend that you see with the classic filler

face where it's overblown and you look older than you did before you had any filler at all. So that's how young patients kind of started to get into the idea of the lip lift. For older patients, this is a technique that's been around for years, honestly. And this is something that if you look at the literature, it's been around since the 70s. Now, the thing is, that the technique was not very good. And so the problem with the technique was that it affected your smile, it gave you a bad scar, it wasn't well placed. So people moved away from it. They moved to what's called the lip advancement, which is along the border of the lip. That's only good for a very small amount of people that don't have the right anatomy for, you know, a bunch of role. And then people

said, okay, well, we got to switch back up to putting the scar in different place under the nose. and he started seeing endosal, Italian, gall wings, all kinds of different modifications to different type of lip-lift incisions to get the best result possible. And slowly people started to get better and better results. And like anything else, techniques get better over time. And now we're at a point where we see that, you know, volume is not necessarily the answer. Shape is the answer. And, you know, that's something that we certainly talked about in our consult. And what I tell all my patients all the time is, listen, it's not about getting you big plump lips.

It's about fixing the shape. And once you get that shape right, you'll be fine. Yeah. So a lot of people sent in questions about filler after getting lip lifts. And they were curious if you get a lip lift and then you get filler after, if it's like counterproductive, if it weighs the lip down again. Or if you can get a little bit of filler and get that lift and get volume at the same time. Oh, absolutely. So I mean, I'd say probably maybe 50% of my young patients get a little bit of filler at some point down the line. And what I tell everybody is you need less filler, less frequently. And what you're really doing is you're just lining the lip to give it a little bit of, you know, what I call a little bit of pop because you have to think of it this way. And, you know, this is going to make for great podcasting because I'm using my hands to show what it does. But basically, if you think of a table laying flat, that's how the lip is. laying before a lip lift. And then when you do a lip lift, you're taking that table and you're rotating upwards. So now all of a sudden, that table, instead of laying flat, it's laying at an angle upwards. So if you think of that as the surface area of your lip, now all of a sudden you have a little bit more of that lip showing, which is what gives the illusion of having a little bit more

volume to your lip. Now that the shape has been set, because that's one of the things that we do, is we decide what we want the lip to do, what kind of shape we want to give it to. Then at that point, four or five weeks later, once the swelling's gone down, you can start putting a couple micro droplets along the lip edge. And so for young patients that have a really healthy mucosa in the lip or a really healthy, you know, pink lip, you just line that lip with literally like a tenth to two-tenths of what a syringe of filler is. And it just makes that lip pop.

And it just gives it a ton of definition. And that's what most people need it want. Now, if you were going to get crazy and start putting really heavy products in there, then absolutely you're kind of going two steps forward, three steps back over time. Now, you know, it also depends on how long your lip was to start. If you were just, you know, you didn't have a lot of length and then you're just rolling it a little bit. But if you're starting super long and then flipping it, you don't have much to worry about, you know, I joke with my patients.

Listen, unless you're some sort of mutant, you're not going to regrow eight millimeters of skin and muscle. you know, overnight, but you do have to take care of it, obviously. So do you cut through the muscle or is it skin only? It's actually a little more complicated than that. So there's a couple layers to the lip. There's the skin. There's the connective tissue. There's a fine layer of fascia.

Then there is the muscle itself. And then there's the mucosa underneath it. So what I do is I get right to the border of the muscle, lift up the skin right up in the connective tissue, everything that supports the skin itself, right, on the body. the board of the muscle. And we carry that down to the lip edge. And there's different levels of dissection that I'll do depending on what we want the lip to do. We want to roll and whatnot. And you kind of went through this when I was talking to you, when we're trying to decide kind of what we want the lip to do in different areas where to flip, roll, lift, depending on what we wanted to do,

we carry the dissection a little bit differently. Once we do that, that's when I score the muscle. So what is scoring the muscle mean? It's kind of like you're doing sashimi with fish and you're just making slight little cuts on the muscle. And so what that does is that keeps the muscle intact, but it just allows the muscle to roll in different areas. So it gives you some pliability when you want it to flip in different areas. You want to roll in different areas. But the main advantage of it is that it keeps your smile intact, which is one of the biggest issues with cutting the muscle. But two, it allows you to use that as support when you're lifting it up. So it gives a long-lasting result. So it's the best of both worlds because you're getting a long-lasting result when you're

getting a piece of that orbicularis muscle, lifting it up and getting it to anchor to the perin nasal ligaments around the nose, but you're also doing a little bit of mobility to it because you're giving some pliability. So it's not like you're just folding a stake on itself. And it avoids the potential risk and complications of cutting through the muscle. Because if you're cutting through the muscle completely, you can affect the nerves that give sensation, the nerves that give motion. But most importantly is if it gets reattached in any way whatsoever that's a little bit off center, it will affect your smile permanently. And that tightness that people feel after a lip lift, especially one of my lip lips, that can last

two or three months, that's the muscle readjusting to how it's been flipped and folded and rolled up along with the stitches that are under the skin that dissolve over the span of a couple months. But realistically, that tightness would never go away if you are trimming the muscle. And that's the biggest problem. Right. Is there anybody who is not a good candidate for a lip lift? Yeah, absolutely. You know, just like everything else,

there's some people that are good candidates, some people that are not good candidates. In general, if you have a lot of tooth show, not a good candidate, that's a bone problem. And so I have a lot of patients where they'll come in and, you know, they have a long philtrum, but they also have a long midface. And so a long midface is the space between just under the eyes

to where the teeth are. And that's a bony issue. And a lot of these patients are patients that either have sleep apnea, they have arched palettes, they have basically developmental growth malformations. I don't want to call them malformations, but just changes in their facial skeleton that have caused that area to expand and get longer and longer over time. These are usually the people that, if you think back to kids who are much younger that have a ton of ton of tooth show and then slowly over time they start to get a longer and longer

midface. Now, the solution for that is orthonethic surgery. So orthonethic surgery, what that is is when you're actually bringing the maxilla or you're cutting the bone above the jaw and bringing that up along with adjusting the mandible. As you can imagine, what I just described is incredibly painful and the recovery time on it is exceedingly long. So unless you have issues with your bite, most people don't really go for that just for cosmetic reasons. So those patients are absolute no-nose when it comes to lip-lips because they're not going to be able to close their mouth. So if you can't close your mouth and you're going to go into oral incompetence. And when you get to oral incompetence, particularly with older patients, what that means is that, you know, you won't be able to have your Starbucks coffee in the morning.

You won't be able to have soup. You won't be able to do simple things that you think are, you know, everyday natural normal. and it's going to just, one, look bad, but two, the lips aren't going to work the way that they're supposed to. So those are patients that are absolutely no-goes when it comes to a lip lift. Okay, so I really want to get into listener questions, but before we do that, I just want to ask what other procedures you love that make a big difference? You mentioned hairline advancement before?

Is that? Yeah, I think the hairline advancement is one of those things that makes a huge, huge difference. And most people don't talk about. And so what a hairline advancement does, it takes advantage of the facial proportions. So the same way that we were talking about a lip lift and how it does wonders for facial proportions, hairline advancement does the same thing, but it works from the top down as opposed to from the bottom up. So when you're looking at a patient's face or a person's face and you're looking at it from the side, ideally you're looking at a third.

So from the bottom of the chin to underneath the nose, from underneath the nose to just in between the brows. and then from just in between the brows to the hairline. And ideally, you want that to be close to a third, a third, a third. What most people don't realize is that by lowering the hairline and by bringing the lip up, as well as by defining the nose, you're essentially feminizing the face incredibly. And so you can take someone and just soften the features. And that's usually the words that I like to use is just soft.

offense someone when you bring the hair line down, a centimeter, centimeter and a half, lift the lip up a little bit about, you know, eight, nine millimeters and roll it out. And overall, it just gives you a more youthful look, almost like before your hairlines start to go back, before the hair starts to pull back. And that's just for, you know, the average person that's coming in that's got a slightly larger hairline. That doesn't include the patients who have, you know, the really big foreheads that they were made fun of when they were younger in elementary school. And, you know, everybody told them they had a five head and whatnot. For them, that procedure is life-changing. But for most patients, when I'm talking to them for a consult during lip-lived, I'll usually mention it. Listen, your proportions are good, cheeks are good, cheek with, you know, eye height, et cetera, where the browser sitting. And then I'll mention them, listen, we just have to be careful if we lift your lip up too much,

your hairline's going to look really high. And that's something that most people don't think about. And so there's other patients with them, listen, if we're going to do lip-lift, I'm not even going to touch your lip-lift before we do a hairline. I'm telling you the answer is not a lip lip lip. The answer is the hairline. And it's one of those things that a lot of patients wouldn't think about. And it's a great procedure.

It's quick. You know, it does take a little bit of time to heal until the hair grows through and the scar hides away perfectly. But really, the worst part of it is, you know, you're a little numb for about a month or two in the scalp in your hair. But overall, the overall result that you get from it, you can't compare it to anything else.

Okay, wait. We didn't talk about a hairline advancement. Does that mean I don't need one? Yeah, you don't need one. Oh, okay. I'm like, hey, wait a second. Okay, so are there any trends that you're seeing right now? I mean, we were talking about kind of the prevalence of this certain aesthetic on social media and seeing ourselves and probably becoming more aware of things.

I know for me, like certainly, you know, pretty much exactly how you mentioned. Like, I always wanted a nose job, but it wasn't until I started seeing myself all the time. and I became aware of these other procedures that I was like, oh, I can fix this, that, and the other thing, too. So in the last few years, have you seen certain things rise in popularity? And if so, what are they? Yeah, there's good things that have come. There's bad things that are coming. You know, it's a pendulum.

And it always goes minimally invasive surgery and then surgery back to minimally invasive and whatnot. And so let's talk about the good stuff that's come out. So some of the good stuff that's come out has been some of the minimally invasive stuff, some of the radio frequency stuff. The radio frequency stuff is awesome. When you're looking at younger patients that are coming in and, you know, like yourself, they're saying, like, listen, I'm looking at myself and I'm just starting to see slight differences that are popping here and there.

And I actually just had a patient in consult yesterday. She's 38 or so. I mean, it looks great, super good, and she's telling me she wants a facelift. And I'm looking at her and I'm like, listen, like, no, come on. You don't need a facelift. And she's showing me pictures. She's not. No, actually, she was not for a change.

But it's one of those things that we're seeing these changes slowly start to happen. We're starting to see a little bit of laxie, a little bit of jowling formation. And so, you know, before it was, listen, you just got to cut it and tighten it up. But if your skin's not lax enough, then you're going to have issues with it. And so that's where some of the other procedures like midface lifts, ponytail lives, et cetera, come into play. And I can talk about those if you want. But the radio frequency stuff's amazing because what we're seeing is that it actually works. And so for younger patients, it's really, really good.

You have to remember that all these minimally invasive treatments, and I think this is the big take-home point, is minimally invasive treatments use your body to create an effect. So what does that mean? That means that if you don't have the best immune system, meaning you don't have a way to create a response to the thermal energy from the radio frequency, or you don't have a way to create that, meaning you're getting older, your immune system's going down, you're on medications that decrease your immune response, your diet's bad, your blood sugar is high, all of these things that can affect

how your immune response actually responds to an insult, you will not get that great results. So young patients who are healthy, who are starting to see slight changes, those are the ones that see the best results with things like profound, with things like thermi, with things like the morphis, which is the new thing that came out. All those, those things are great. Now, is there a difference between them? I'll be honest with you. I don't think so. Now, is there a convenience between them? Sure. I mean, listen, if you were to go to your favorite doc down the road and they have a Morpheus and someone down the road has the Thermi and someone down the road has the profound. Honestly, each one has its pros and cons,

but overall, if you're young and you're a good candidate, you're going to get a good result no matter which one you do. Now, there are specific things about each one of those procedures and machines and technologies that, you know, are slightly better for some things versus others. So I don't want, you know, people to assume that, you know, each one is exactly the same as the other, you know, there's definitely things that the profound is much better at that, you know, than the thermi or the morphous. And there's some things that, you know, I like the thermi for that are a lot better than profound or for the morphous. And there's other things that the morphos might be a little bit better at. So, you know, definitely, you know, you want to talk to your

professional that's taking care of you a little bit in order to figure out whether or not you're a good candidate for it. But the radio frequency stuff's awesome, awesome, awesome, awesome. And, you know, if you're going to quantify it with a number and you're saying, Miguel, tell me, you know, how much of a response can I get. I tell patients you can get about close to a 30% of what a surgical lift would do. And that doesn't sound like much, but it's a big difference when you're talking for young patients and patients who get good response. And we're seeing with radio frequency, even in patients who ordinarily would be getting facelifts and necklifts, you know, 30% people are happy with that, especially if it means, you know, you can go out and about within two, three

days. You're a little swollen and a little puffy, but, you know, it doesn't keep you from going to spin class or going to Publix and getting your groceries, which after a facelift, certainly you can't do after two, three days. Yeah, I did profound. And it was astonishing. It's good. It's good. It improves the quality of your skin. It was crazy. I think I'm even on their website. Yeah. But yeah, it was like life changing for sure. No. Yeah. The radio frequency for for jawline is awesome. And, you know, especially for my young patients, I'll tell them, listen, I'll join up the radio frequency with a little bit of liposuction. And, you know, you come in, you pop in, pop out, it's like an oil change. You're in for 45 minutes. You leave. And then, you know, within a couple

weeks, you start seeing the results. And the cool thing about radio frequency is, at least for me, and the way that, I mean, I don't want to say the way that I kind of tell my patients and how, what to expect is that every single week, you're seeing a slightly improvement in your contour and your shadow and things are starting to get better and better. And you start taking pictures. and you're like, oh, I'm starting to see a little bit of shadowing there. I didn't see that before. I'm starting to see a little bit of that angle there that I didn't see before. And that sometimes is a little bit tricky and a little difficult, especially when we live in like a, like, I want it now.

You know, I can go on YouTube and I can watch whatever I want now and I get tired of just switch it. So some of the younger patients sometimes don't like it because it's not that immediate result. And that's why they turn to fillers, which I'll get to right now, to get that immediate result. But the radio frequency is awesome. Now, the reason why I don't like the fillers when it comes to jawline is because all you're doing is you're just playing to the camera. And this is the thing that I try and hammer my younger patients that come in and they want, you know, they want to get that jawline filled in. And I don't want to say that not everybody needs a little bit of filler in their jawline because they're certainly good candidates for that. But not everybody needs filler in their jawline.

And especially when you're seeing online, all these pictures of these patients that are getting these defined jawlines. you know, you're seeing that hashtag snatched and everybody's super excited about it. You have to understand that you're just seeing a two-dimensional picture of a three-dimensional person. And that is the hardest thing to do. And when I'm counseling people on it, I tell them, listen, just think about all the crazy things you can do with makeup, right? We're just playing with lights and shadows.

That's all I do. That's all any facial plastics person does is we're just playing with lights and shadows. And the key is we want to put shadows in the right place and put highlights in the right place, much like you would be doing with makeup. When you're putting filler in a place, what you're doing is you're creating highlights. And so when you create highlights is you're creating mounds and mountains. So if you're looking at a picture and you can create a highlight in it, that looks great. The problem is that when you're going from looking at something from the side or three quarters and then you look at them straight from the front, guess what? That mountain is sticking out to the side.

So it starts to look a little strange and abnormal. That's why very, very, very rarely, you will ever see pictures on social media of a jawline that gets defined, and they post a picture not only from the side or from three quarters, but also from the front, because it looks ridiculous from the front. It looks like they have tumors sticking out the side of their cheeks. So these are things that I try and show my patients. And if someone even wants to try it out, I'll show them.

I'll just get some saline and I'll do a trial run and I'll inject it for them. And I'll just show them, listen, this is what it's going to look like. It's not that great. It's going to go away within two hours. don't worry. But it's something that, you know, I think that's a trend that is definitely a negative, is the advent of social media and filters in Photoshop. And there's so many people out there that are doctoring their photos. And there's so many people out there that are just showing one picture of one side of the area. And I think that what patients and consumers need to do is,

one, not only just see, you know, one picture from far away, if someone's taking a picture, make sure it's from up close, you know, similar lighting, whenever the white balance is off, you know, when there's different white balances, you can hide different things by hiding the white balance, the width of the flashes, you can hide different things. So there's all kinds of different tricks that you can do and you can play with. And unfortunately, that brings people over. Now, that doesn't necessarily mean that there's also surgical trends that are out there that are not good because as much as I like surgery, there are some things that are out there that are, you know,

I mean, I hate to say it, but they're kind of just trendy and they're just going to be a flash in the pan. So, you know, we're seeing a lot of cat eye. We're seeing a lot of temporal lifts. We're seeing a lot of crazy stuff that's coming in. And those are all things that change your face permanently. And it's going to look cute for a year or two, maybe three, but we don't know what the long-term ramifications of this are.

You know, there's indications for this. those surgeries. And by indications, I mean, there's reasons for you to do those surgeries. And, you know, the majority of the reason to do those surgeries is not to make someone's eyes look like a cat. You know, and I have, I've had four patients in the last month that have come from outside the country for me to take a look at them and revise their lip lift they have done outside the country. And they also had their cheek done and their pat-eye surgery done at the same time. And it's one of those things that it looks okay in pictures and looks okay with makeup on. And when someone's sitting in front of you and they have no makeup on and their face is overly widened because that tissue's been brought up and their eyes overly tightened and pulled, it just doesn't look normal.

You know, you get into that area where things just don't look right. So at the same time, you have to be careful about what it is that you want and what you need. And it's hard because then you have to be your own best advocate. And it's tricky because obviously doctors and particularly cosmetic surgeons, we have a financial incentive to get you to do our procedures. I mean, that's the bottom line. And it's hard finding someone out there who's honest and will tell you, listen, don't do it, don't do it, don't do it. And when you find someone that tells you, no, don't do that, that's the person that you kind of want to listen.

too because otherwise there's people out there and I've heard from patients of other doctors and in the States and particularly overseas you got to remember that being South Florida, a lot of my patients, whenever they're going to get surgery, they'll go out to Colombia, they'll go to the Dominican Republic. And so my patient base is a little different. I get to see stuff that people do in other areas. And they'll come back from a consult that they had in Colombia or Brazil or Dominican Republic. And I'll ask them, well, what do you want to do?

And it's funny because the doctor, that I saw just recently didn't ask me what I wanted to do. They asked me how crazy did I want to go? And what does crazy mean? Oh my God. And so at that point when I told them, I'm like, listen, whenever someone tells you, so what exactly is crazy for you, that means they're willing to basically mutilate you for you to give them a paycheck.

That's not okay. You know, we all take a oath to do no harm. And at some point, you know, you have to realize that if someone's telling you that, You got to get out of there. You got to walk out that door. That is horrifying. Yeah, that leads me to a listener question. What is the craziest thing that a patient or potential patient has asked you to do?

There's a couple. The one that comes off top of my head, I had a patient of mine. He's older. So this one's a little different because it's an older patient. And what this older patient wanted, he had been losing his hair forever. And he'd had maybe like eight or ten hair transplants. I mean, it just looked bad. and it was at the point where he didn't have any.

He was starting to lose his eyebrows. Like I said, he's 80 or so. So everyone just slowly starts to lose your hair. The hair follicle slowly start my off. He wanted me to transplant his pubic hair to his eyebrows. Oh my God. That was pretty wild. And his wife was there with him.

And she was like, yeah, no, it's totally fine. It'll match the rest of his hair. It's okay. And I was just remember thinking, like, you got to be kidding me. I thought I was getting punked. Like, it was one of those things where I was just waiting for my staff to pop in any second and say, like, we were just like, we're just like, kidding, don't worry about it. We just got them

to pop come in and talk about that, but that one was pretty crazy. And then other than that, I had I think the crazier ones are, you know, usually when people ask me to put like permanent implants in, in their things like they want a bigger ridge across the middle

of their forehead because they want to look a little bit more caveman-like. So that was a weird one, right? Yeah, and the thing is that the surgery itself is not, it's not the problem, is that there's you're changing someone so permanently. And it's one of those things where I told them,

I was like, why don't you think about this? Seriously. They're like, no, no, I just really like the way that this celebrity looks. And I'm just like, well, you know, the celebrity looks a certain way because they're facial structures like that. You don't look like that.

You are pretty in your own way. Like, we don't need to focus on how somebody else looks. We need to focus on how you look and what we can do to help you achieve the best that you can be. You know, you don't need to look like somebody else. That's not the right answer. What is the most requested celebrity that you get when people come in and ask for things? Madison Beer.

Really? Yeah. What do you think she's done? Lip-lift, brow lift? My guess, my guess would be definitely lip-lift. Probably a temporal lift, but not an aggressive temporal lift, like not a mid-face lift, like the ponytail lift or anything like that. Just like temporal lift. Well, not because she's like 18, right?

Yeah. I was going to say there's some people out there that are more than happy to take a pretty big, big chunk of money and do that for people. And then definitely fillers. It looks like sculptra. So, you know, the thing that I tell most patients and how you can tell that people have sculptor is because it changes the quality of their skin. Sculptor actually improves the quality of your skin. That's one of the few things that most people don't know about Sculptra. And it's one of the really cool things about it because it's a collagen inducer.

It's not a traditional filler. And so it actually gives you, you know, Galderma, the company that makes sculptra and Resteland, they call it the sculptor glow, which I think is so cheesy. But it really does make your skin glow in that area. Sounds appealing, though. Yeah, no, absolutely. Because, you know, it's a filler that will last you four or five years. It's subtle.

It's natural. It's not overblown. And it's your own collagen that gets stimulated. So it really does kind of turn the clock back a little bit, especially when you realize that it improves the quality of the skin, too. It's pretty cool. Okay, so regarding the eyes, since we talked about the temporal lift, do you, do you, what do you think is a better procedure? And I know this varies individually, but for maybe a younger like 20s or 30s, do you like a brow lift or a bluff or both? Oh, it depends. Depends. Depends. Depends. Depends. One, it depends on what they look like. I think that the thing that most people don't realize is how much a brow lift can change your appearance for good and bad. And it's one of those.

things that it will definitely open your eyes. And for that, it's very good. But you need to find the right procedure because there's a couple different ones. You could do a temporal lift, and that just lifts the corner of the eye. You could do a full brow lift that lifts everything. You can do, when you do your full brow lift, you can actually pick up the, you can give a little bit more of an arch. So that's nice if you're trying to change that. There are some patients whose whole families have heavy brows, and they've always had heavy brows, and they like their heavy brows. And for those patients, they come into the office, and I'm thinking, you just need a brow lift. And you mention it to them. And they're like, no, I like the way that my brows frame my eyes. This is kind of how my family's

always been, and this is what it is. And for those patients, you have to realize that a blephroplasty may not be the best option either. So you have to remember that the browlift and the blef go hand in hand because you're framing the eyes. And when we look at patients and when we look at people, when you look at your friends, the first thing you look at are their eyes. And that's why the most common thing is you look tired or you look happy. You look bright. You look rested. And they're not commenting on the rest of your look.

You could go outside looking homeless, which is usually how I dress. And most people, you know, they're looking at your eyes and saying, hey, listen, like, you've got bags under your eyes or, you know, your lids are heavy. Or conversely, you know, you have no shadow under there and things look bright and peppy. So when dealing with the brows, you have to think about the eyes too. And those patients that have the heavy brows, if you just do a bluff, it's going to pull the brow further down. You know, you're not going to create any youthfulness to it. So, you know, what I normally tell my patients that are looking at doing their eyelids or their blef is send me some pictures of yourself five, ten years ago. And then that way we can make that decision together because I can point out little things about your proportions and where they were.

You may just need a subtle temporal lift and a bluff. Now, realistically, most people just... just need a blephoroplasty. Younger patients don't need a blephroplasty. Younger patients usually need a brow lift or a temporal lift. But overall, it's usually a combination of both. And nowadays with Botox, you can do a chemical brow lift and kind of get you an idea of what you'd get with a temporal lift.

Now, you know, there are limitations where they're only getting like a millimeter or two millimeters here and there. And everyone's a little different. And, you know, to pick up the brow, you've got to put a lot of product in. And then you're saying like, wow, I'm wasting seven, eight, $900 to kind of look like this for about four months at best. Is that really worth it? And, you know, that's really what comes into play when you're making that decision. I love the pictures of Bella Hadid that circulate the internet with doctors advertising Botox.

Yeah, that's not possible. Seems really, that's like wishful thinking. Yeah, that and like threads that, you know, they talk about, oh, just do the thread lift here. there. I know you've talked about threads already and I mean, I feel the same way about them. But, you know, my, my usual... Other podcast topic. No, well, in general, what I tell people is this, is use your common sense, right? So if this thing, if they worked, everyone would do them. There would be no need for surgery, right?

Does it make sense that people are still doing surgery if you have all this other alternatives that's minimum? I would kill to have something that my patients could come in. I do it in, you know, 15, 20 minutes, and then it'd have results that last for seven years because then, you know, we wouldn't have to cut them. And you can charge thousands of dollars for it. Right, exactly. You charge thousands of dollars for it. And then all of a sudden I'm having someone come in every 30 minutes for it. Like it makes perfect sense. But the truth of the matter is they either hurt because they're put deep and they have big, big barbs or they're put superficially and you get dimpling. They affect the way you talk, move, smile. They don't last that long. So you look good while you're

swollen for like a week. And then after that, all they do is they create scar tissue. And so, you know, it's, I mean, I think it just leads to disappointment. And at some point, you have to realize, listen, guys, like, you're actively just creating harm for the patient down the line. It's not good. And so. Yeah, I feel like it's a trend that's probably going to, like, just work itself out of popularity because of those facts. Like, enough people are going to go and do it and realize that it doesn't work. And then they're just not going to do it again. And eventually there's going to be nobody left, right? Yeah, no, absolutely. And the thing you're seeing it is, I mean, it's a big push for med spas, you know, just because, you know, it's something that they can offer their patients. But, you know, at some point, you know, people come in and they're looking at before and after and they're saying like, okay, I'm not seeing much of a difference at all. And you're showing me this immediately afterwards. What do they look like at three months, six months a year? Because I hear they don't last a year. And so it's, it's definitely a trend. I mean, listen, they were threadlets a long, long time ago. And they went away.

and now they're back. And so it's going to, you know, weather the storm and then they'll go away again. And, you know, there's lots of things like that. And I mean, we talked about this too is the plasma pen. That's one of those trends that I think is crazy. This is, again, files under the, you know, use your common sense. So if it was that simple and that easy, wouldn't everybody be doing it? And there's a reason why, you know, people aren't doing it.

And so for those that don't know, the plasma pen, what it does is, they basically use an electrical current to charge some nitrogen gas and create a plasma field to destroy the skin. It sounds super technical. Why can most people use it? Because the electric field and plasma that's created will only go down to the level of the epidermis. When it goes to the epidermis, it stimulates the fibroblast in the dermis to start tightening and creating collagen. So they call it, you know, a plasma pen fibroblasting or some nonsense like that. And so the issue that I have is that there's a very limited indication for it.

Now, again, I'm not saying that, you know, it's bad for everybody with this. And listen, there's certainly some patients that get good results with it. But to blanket say that, you know, this is an amazing option in replacement for like a blephoroplasty or a replacement for, you know, skin tightening with laser is, you know, it's absurd. And so you just have to be smart about it. And I mean, I've certainly seen some outliers as far as really bad things that have happened with a plasma pen. Now, listen, that doesn't mean that, you know, bad thing doesn't happen with, you know, traditional lasers, et cetera. You know, those things obviously do happen.

But, you know, when someone's telling you that it's super safe, it's no downtime, you get amazing results, you really need to think about it and say, well, does this make sense? Because it doesn't sound like it makes sense. Okay. What are your thoughts on filler versus fat to the face? Depends on your age and what you're shooting for. I mean, the fat is great. Fat works really, really well, especially as you get older. It's really, really nice.

The things to remember about fat is that fat has memory. So wherever you get that fat from, it's going to have that memory. What does that mean? That means that if you fluctuate and weight a lot, fat is probably not a good idea for you because that fat will gain weight and it will get bigger disproportionately to the rest of your face. So this is probably one of the most common questions because people say, Well, does fat even work in the face? Does fat even last in the face?

And, you know, the answer is yes. When you do a facelift on someone who's had fat grafting, you know, five, six, seven years before that, you can see the different colors of the fat that come from different parts of the body. And so it's distinctly different than the facial fat that's there. So we know it lasts. And not only that, but like I said, it has memory. So if you have a patient that you did fat grafting on and all of a sudden they lose 50 pounds, then that fat in their face goes away. They complain about it. it. And then all of a sudden they go on crazy binge. They gain another 50 pounds. And I mean, I'm giving extremes as far as how they're shifting. But their face where you put the fat in will disproportionately gain that weight. We see that too in patients that get fat grafting and then they get pregnant. So, you know, everybody always gains a little bit of volume during pregnancy, but it's disproportionately so after fat grafting. So the fat crafting is great. And it lasts longer. It's a good thing. Now, that being said,

You got to remember that the fat molecule is very big. So it's good for a large volume restoration. When you're looking at fine lines, tweaking for definition, things like that, the filler is still much, much better. Also, you have to remember that the filler is a quick pit stop. You know, you pop into my office. We do filler five minutes later. You're gone. You see your results.

You get that instant gratification, which is great. And, you know, yeah, you're swollen for a day, but that's it. Fat crafting is surgery. So you get lipo, it gets centrifuge, you get put in your face, you get really puffy and swollen. You look like a pumpkin for about two, three weeks and then slowly starts to go down. You know, you definitely question things. You can question things for five, six months, whether or not you did the right thing. I mean, it can take a long time for it to completely settle.

It can take a full year before you're happy. So you need to be mentally prepared. And this is something we talked about, you know, where, you know, the devil sits between your ears, with all facial cosmetic surgeries. And you need to make sure that you tell that little devil to shut up and not pay attention to them. Because the last thing you want to do is start listening to them and you start getting yourself in quicksand. You start trying to do more and more procedures to fix problems that are not there. And then before you know it, you're sinking.

And once you find yourself sinking, it's really, really hard to get out of it. So a big part of this is being mentally ready, mentally prepared. And with fat grafting, certainly so, more so. than with filler. Yeah, I was also going to mention quick fat, just because people are probably thinking, why do you have to inject so much fat? On average, so this is a good way to think of it, especially for patients that are familiar with filler.

One syringe of filler is equivalent to three syringes of fat on average. So if you're thinking, wow, I get, you know, one syringe of filler under my tear troughs, that would mean that you would need three syringes of fat, which means that you're going to Is that because it draws water? Yeah, so because there's a lot of, so even after you centrifuge the fat, there's a fair amount of tissue within it that gets resorbed. And so all those nutrients slowly give the fats some of that plumpness. And that gets resorbed. Then the fat cells get some blood supply to them and then they start to perk back up again.

So it ends up being close to about a three to one ratio. So it's anywhere between two to one, three to one ratio. So if you're thinking, wow, listen, I mean, I usually get, you know, for example, like me personally, like I have one syringe of volume in each cheek and one syringe of wrestling under the eyes. So that would be two syringes of volume in the cheeks. So that's six syringes, six to seven syringes of fat. And so when I come out of the operating room, I'm going to look crazy. And, you know, until it all settles down, it takes time.

It takes time. Okay. Let's close out by talking about what the majority of my questions were about. which is the scar. Everybody wants to know about the lip-lift scar, if it's inevitable, if you're going to have it forever, if people who are more prone to scarring, are going to have a tougher time with this procedure,

what they can do, all of that. Now, you told me, I think, or maybe I just saw it on your Instagram, I can't remember these days, but something about, you have an analogy about not crashing your Ferrari. So you can do your part, and then we have to do our part,

part. Yeah, absolutely. You know, I tell everybody this, you know, it's my, it's my cheesy line. You know, my promise to use is when, even when the stitches are in place, you'll have a pencil thin line that's impossible to see. And, you know, I think that's part of the reason why it's really cool that people come from all over the world to come see me. And, you know, obviously, right now I'm having some postponements on some of those patients from all over the world that have travel bands. But, but it's really cool because they can see the difference. far as when, you know, other doctors finish their work and when I finish my work, which is kind of cool. And I like that. Can I ask you not to interrupt? Yeah, go for it.

But why do you have that outcome? I mean, what is it about your technique? Or can you not say? Yeah. No, no, of course. I don't care. Yeah. No, I mean, it's a lot of little things. So, again, this goes back to like sports. It's, you know, if you make little improvements along the way, you make a little improvement here, a little improvement there, a little improvement there. It adds up to a very, very, very, very large improvement. And so when I was learning how to do lip lifts, the thing I hated most was swelling and how swelling people were. And I mean, I just kept thinking there's got to be a way that people aren't so swollen. And so, you know, then you start not being quite as aggressive, but then your results aren't as good.

And then they're still swelling up. And so there's different things from what stitches we use, what instruments we have, what coterie we use. use, what settings on the pottery we use, how we handle the tissue, the amount of stitches we place and where we place them. So it gets very, very detailed. And this is obviously something that is

constantly changing. So, you know, for example, like, big thing that we use is, I use a special coterie that does not cause as much thermal damage or as much thermal damage, as much thermal injury as traditional bovi-electropottery. So what does that mean?

That means that if there's not as much thermal injury to the tissue, the tissue's not going to swell as much and the tissue is going to be able to recover quicker. I also, you know, inject not as much fluid. There's so many little tiny things. And so, you know, when doctors come and shadow me to see lip lift, they're just like taking notes constantly about, you know, all the little things are like, oh, I didn't think about this. Or like, oh, you're injecting this. Oh, you're injecting how much, that little, just that? I'm like, yeah, you just got to let it sit. And like, I put pressure. How are you dissecting? what instrument are using for dissection. I never thought about using that instrument for

dissection. So it's all about kind of putting everything together. So it's a lot of little, little things. And it's funny because, you know, people, like yourself, you say, you know, is it a trade secret? And it's funny because, I mean, you kind of get this more than anybody else. You can hand out the recipe to as many people as you want. The cookies won't taste the same. You know what I mean? Great analogy. So, you know, that's why I always sell people because, you know, especially when I started getting really, really busy with lipos and people were starting to come from all over the world. And you started to get a lot of requests from other doctors to come see me. And people are like, are you really going to just teach people?

It's like, number one, at one point, I didn't know how to do this. So I think that it's my job to try and teach other people too. You know, you're not that cool. You know, at some point, at some point someone taught you how to do it. Like, it's your job to keep that going. Two, you know, a rising tide lifts all boats. So, you know, the more people do it, then the more people are going to know about it, people are going to know that I taught them.

And so then they'll come to me. But three, like I said, you know, you can hand out the recipe to everybody, but the cookies won't taste the same. So, you know, from my end, like, my cookies are pretty good. So I'm not worried about it. Amazing. Well, I adore you. I could keep talking to you well into this Corona Quarantine podcast.

Yeah. Yeah, the Corona Quarantine. Yes. Thank you so much for coming on. I would love to back and keep this going. We still have so many questions. Yeah, I know we didn't talk about a lot of the stuff that we were probably going to talk about. But if, yeah, people have questions. Definitely. Send them out and we can do a supplement or something and answer some more. Yeah. We'll do part two. So in the meantime, where can everybody find you? The easiest way to find me, like any good young doctor is Instagram, probably the easiest thing. I'm really bad about updating my website and really bad about updating anything else just because. I'm too lazy. But if you just go to Instagram and add Dr. Mascarro, it's probably the easiest way to find me. Amazing. Thank you so much. No problem. My pleasure. And I'll talk to you soon. Okay. I hope you enjoyed that episode and learned something. And I would love to continue the conversation.

So make sure you check my Instagram and the Blonde Files podcast Instagram for posts about this because I love to have conversations with you guys in the comments. in DMs. And as always, if you enjoyed this episode, if you enjoy the podcast in general, please rate, review, and subscribe. And of course, share with your friends and share on social. I'll make sure to repost you. And I appreciate you.