Well with Arielle Lorre - 80: Dr. Jason Diamond - Best Procedures, Biggest Mistakes + The Evolution of Plastic Surgery

Episode Date: October 21, 2020

In this episode I’m talking to world renowned plastic surgeon Dr. Jason Diamond about how Dr. 90210 changed the trajectory of his career and the industry as a whole; the pitfalls of plastic surgery having gone mainstream; the efficacy of threads and other minimally invasive procedures; his favorite surgeries to perform that make the biggest impact; current trends and most popular procedures; the biggest, most common mistake people make when it comes to their face; best things to do if you’re on a budget; best way to lift the brows and so much more.   www.blublox.com/BLONDE for 15% off plus free shipping! www.FXChocolate.com with promo code BLONDEFILES for 20% off your first order! https://alorecovery.com/ if you or someone you know is in need of treatment.   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.

The following podcast is a dear media production. 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. I know there is so much information out there, so I'm here to help you navigate it all and live your best life. Thanks for listening.

Let's get into it. Hi, everybody. Welcome to the show. I have such a good episode for you today. I'm talking to world-renowned plastic surgeon, Dr. Jason Diamond, and we really get into everything in this episode. So we start out by talking about Dr. 902 and O and how that changed the trajectory of his career and kind of the industry as a whole. We also talk about how plastic surgery has gone mainstream with social media and the pitfalls of that. We talk about things like threads, the efficacy of threads and other minimally invasive procedures.

We talk about his favorite surgeries to perform that make the biggest impact. We talk about some celeb surgery situations without really getting into detail. He has a lot of celebrity patients, so you can understand why we couldn't really go there. We talk about current trends and the most popular procedures right now, the biggest, most common mistakes that people are people make when it comes to their faces and so much more. You guys sent in questions. So he covered a lot of those too. And it's just a really fascinating episode. I adore him. He is one of the goats. And I hope you guys enjoy the episode. Thank you so much for being here. I feel like you're the OG of plastic surgery in L.A. You've been around for a while. Yeah, I've been doing this for a long time now.

there's a long history of OGs. And I learned from some of the OGs. I mean, they go, you know, and even the guys who I thought were OG, they tell me about the guys who are OG, you know, so it goes way back. But, you know, I definitely have been on the block for quite a while. And it's funny because I'll be talking to patients now and we'll talk about certain things. And I'll say, you know, I'll refer to, well, you know, the young guys these days, they don't even know about this. And I find myself talking about the young guys. Like it's like yesterday,

I was one of the young guys. Honestly, it feels like yesterday that I was one of the young guys trying to like prove my way and explain to people why, you know, they should trust me and all these types of things. And now all of a sudden, I'm, you know, I'm talking about the young guys and I'm not one of the young guys anymore. It's just kind of crazy how fast time gets. Yeah. So can you tell everybody a little bit about your training and how you got into the industry. And you were kind of a public persona before that was common before social media and doctors were putting patient before and afters out there and they were really out there. So can you tell everyone about that and how that kind of changed the trajectory of your career if it did? Yeah, for sure. So when I came to L.A.,

probably at that time, and still today, the most common way that is, you know, young surgeon might learn the cosmetic craft is by doing what's called a fellowship or studying with a person who is skilled at that craft. Because in residency, you don't learn cosmetic surgery. You learn facial reconstructions. You learn cancer surgeries. You learn tumor removals, all that kind of stuff. And you don't learn the fine points of running a cosmetic practice.

It's a lot different running a cosmetic practice than running a cancer removal. practice there. Even though similar skills are required, much different type of practice. So you typically go do a fellowship, which means you spend a year with somebody who's done it and you learn all the tricks of the trade from that person. Well, I decided I didn't want to learn from one person because I knew that there were many different ways to do things. So instead of learning from one person, I decided not to do a formal fellowship. I decided to create my own fellowship, which is basically where I went from office to office to office for two years and learned from pretty much all the top surgeons. So the thing is, certain docs are really good at certain things and

they're not great at other things. So I didn't want to learn from one guy who might have been good at facelifts and not good at rinoplastys or vice versa. I wanted to learn from the best of the best. So for two years, I went around and I studied facelifts with the best facelps surgeons. I studied rhinoplasties with the best rhinoplasties surgeons. And I studied facial implants from the facial implant surgeons. So I did that for two years. And that's how I learned the cosmetic craft. So I learned all the tricks from the best. At this most super specialized guys, that's how I learned. Okay. So when I first got started, Dr. 90210210 had already been on the air for a season. And it was one of the first of its kind shows. It was a reality show showing plastic surgeons and showing their work. And it had already

been on the air for one season and it was a phenom. It was a big hit. And they got picked up for a second season and they tripled their air time. So the first season, I think, was eight 30 minute episodes. And then they got picked up for 13 one hour episodes. So they like tripled their air time essentially. And so they needed to add what they called. I still laugh at this is they had it called talent. I laugh at the term talent, but they had to add talent. So they were looking for more surgeons to, to, profile. And they were looking for a few roles. They were looking for a woman. And so, because Robert, this guy, Dr. Robert Ray, he created the show. It was his show. So he was going to be a part of it. But they wanted to add a woman. So they picked up Linda Lee, who became a good

friend of mine. And they wanted to add kind of the face specialist. And they wanted like a, you know, an up and comer, like a hot shot up and comer. That's what they said they were looking for. So they interviewed 20 different people for it. And they like, you know, they came to my office. They called, said, we want to concess it. Sure, they came and they liked me for that role. And that's how I got that. You guys know how important recovery is to me. And now more than ever, I've had people reaching out to me asking how to get sober, how to navigate treatment, saying that they need it or somebody that they love needs it. And I just have so much compassion. I know how hard it is. I know how scary it can be to seek treatment. And there is kind of this stigma around it. Like maybe it's a

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Because on WithWit, very little is off limits. Subscribe so you don't miss any of the amazing conversations. to come. New episodes of WithWit are available every Tuesday on all platforms. Now, it was still considered very taboo at that time for a plastic surgeon to advertise. The only plastic surgeons that advertised or even promoted themselves were considered like the lowest of the low, right? They were considered like the ambulance chasing lawyers, right? That's what you were thought about. And I knew that. And I had learned from all these giants in the field, these old school purists. These were the giants in the field.

who I studied with and who I learned from. These were my mentors and my friends. And these guys were like, you should not be on TV. You should not, and you should not be out there. This is not how we do these things. And I was very torn because I knew that I was going to be able to expose the best techniques and deliver the best results

that the TV world and the world at large had ever seen because I knew my techniques were. the most sophisticated compared to the things that have been out there before this. So I knew I could, it was going to be incredible for that reason, but I had that other, you know, that one wolf on one shoulder saying, yeah, do the other wolf on the other shoulder, say, no, your mentors are going to hate you for that. Okay. And furthermore, my wife was like, no, you shouldn't do it. My nurses were like, no, you shouldn't do it. Like, on this side, no, you shouldn't do it. Like, this is not what plastic surgeons do. And on the other side, I was like, well, I know I'm going to be able to like break

glass ceilings by showing results that people didn't think were possible because, you know, everyone at that point, up to that point, this is like 2000. Up to that point, everybody thought plastic surgery was just for people like Joan Rivers. Like the world didn't, it was not mainstream. The world did not know, like that cashier clerks and normal people get this stuff to feel better about themselves. And so I knew I was going to be able to expose like beautiful natural results that was going to change things. And so I decided to do it despite everyone telling me not to. And sure. enough, it was incredible. And not only did it help me, but I got emails every single day from plastic surgeons all over the country saying, thank you so much for what you've done. My practice

has exploded because of it. Like, I got these emails every day from people all over the country. So I feel like we brought, this show kind of brought plastic surgery mainstream. I feel like we were part of the revolution that brought it mainstream. It brought it to Middle America. It brought it to different countries and where people saw, wow, you could like look good and natural and you don't have to come out like Michael Jackson or Joan Rivers like this is awesome so that's how that all went and that's how that started so I'm curious what you think about how it is now because now it is so mainstream I don't know I mean I think anybody no matter their their skill can get a following if they're a good marketer I'm not going to name certain names but what do you think of the fact that

it's so out there now and then the other part of that is I think there is still kind of like a stigma around it where people, some people think that getting surgery is so extreme. And like, for example, with young celebrities like Bella Hadid and these girls who, you know, I'm not going to come out and say that they've had surgery. But like a lot of people say, oh, no, no, that's just puberty or no, it's just Botox. And people still think that plastic surgery can't be done naturally. So I guess there are like two parts to that question. So the first part about how do I feel about how may easy it is now to market. You are absolutely right. And I think it's actually kind of terrifying, to be honest, with you the things that I've seen. You're right. There are a lot of popular

providers. And I'm not going to say doctors, because a lot of times they're nurses and dentists and other things. And they get very popular because they're good marketers. And that's fine and good. They may be good at what they do. But the point is sometimes they're not good at what they do. Some people are, you know, but you can make yourself look like a world expert from the way you do your social media. And I always laugh. I see like, you know, you go to these people that have been in practice three months and they're a world expert. And they lecture it, you know, Geneva. And it's like, you know, it takes a long time to be a world to be an expert.

It takes, you know, the 10,000. I mean, it takes you 10,000 hours to become an expert. 10,000 hours. I mean, it could take you 20 years to get 10,000 hours of rhinoplasties or 10,000 hours. You know, everyone says they do, I do 200 rhinoplasties a year. well, that's a bunch of BS because, you know, a good rhinoplasty takes three hours. Most good surgeons will only do one, maybe two max a day, maybe max four or five a week. Do the math.

If you're doing at the busiest guys, if they're doing five rhinoplasties a week, that's the busiest, most successful guys. So let's say they're doing five a week. So let's say that's 200 a year. How long is that going to take you to knock out, you know, 10,000 hour if each one, you know, you're talking 15 years worth, right? So like, you know, so these people who also, I've done, I've done, you know, a thousand Ryan classes. I've been in practice two years.

No, it takes like 20 years to get that and not done. Okay. So anyway, so the point is, yeah, these people really aggressively market, they sometimes can develop pretty big names and they're not even close to an expert. And they, and there's a lot of, you know, sometimes I see things that I know are not real. I see results on certain people socially. I know that's Photoshop. You know, as a full-on expert at this field at the highest level,

I'd say a large portion of what I see is not real, you know, and I can tell. So, so, you know, it puts people at risk of having unrealistic expectations and, you know, and so I think, yeah, I think it's a real issue out there. And that's very proud. And then some of those same people do use celebrity before and afters to market themselves, which kind of, again, with the unrealistic expectations, I mean. Yes. And I have some of my good friends that I'm friends with, they will,

complain to me that these young plastic surgeons are talking about them. Like, you know, this patient who, you know, someone who might be very, very famous, some plastic surgeon will be like, oh, well, look, this is what she had done and he'll talk about it as though he did something on her. And I can tell you firsthand that that's, first of all, what he's saying is false. They never had what these people are claiming they had. And, right, and number two, they never saw this person. But like, like, this goes on all the time, right? like, oh, yes, it's a dicey situation out there. There's no rules of regulations to the way you market on social media. And, you know, there's a lot of fake stuff out there. And that can lead to

big problems. I always talk about one of my ultimate wellness hacks being my blue blocks, blue light blocking glasses. And you guys, I forgot to bring a pair to New York. And it was brutal. I'm on my computer and phone all day for work and school. And I'm telling you, when I don't protect. my eyes from the blue light, there's such a discernible difference, like strained eyes, anxiety, that feeling of my brain frying, so much trouble falling in sleep, which is usually not a problem for me. So as if I needed any more confirmation that Blue Blocks are a game changer, I definitely got it on that trip. So if you're new here and you want to learn more about the effects of Blue Light on our biology, go listen to episode 46 with the founder of Blue Blocks, Andy Mant,

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free shipping worldwide and 15% off with the code blonde. That's B-L-O-N-D. or go to blueblocks.com slash blonde. That's B-L-U-B-L-O-X.com slash blonde, B-L-O-N-D-E. I want to get into what procedures you actually love and what you're seeing a lot of right now, but since we're kind of on this subject and a lot of people ask this, I need to bring up threads

because threads are one of the things that get marketed as so-and-so, get-so's look with the Fox-E-Threads. And they always use pictures of younger celebrities. And a lot of them are med spa kind of places. And I know they've been around for a long time. But what are your thoughts? Do you like them?

Do you not? Because they're very expensive too. And I've personally had them. I didn't like them. But that's just my experience. Okay. So let's talk about that. And I still want to get back to the second part of your other question about.

So let's talk about the threads while I'm on it. But let's not forget to talk about them because that's important too. Okay. So the threads. The thing that bothers me the most about it is, and when I talk about the marketing that we just discussed, it bothers me when people talk about this, like it's some new thing. And, you know, this is the latest and greatest and don't miss out on this new latest and greatest. The threads have been around since 2000. They've been around for 20 years. I was one of the first people to, and there were about five of us in town using them back in 2000. I was one. And they were called the feather lift at the time. And they would only, you had to. to like sort of take a little course on how to use it before they'd even sell them to you. It's totally different now. Now your dentist could buy them and call them plastic surgeon and do them. Right.

Like back then you couldn't. There were literally only five us in town who were even able to use these things. It was called the feather lift. It didn't work very well. It kind of didn't go anywhere. And then a company kind of changed the design and called it the contour threadlift. And they marketed it like crazy. And the contour threadlift were,

identical to the threads that are out now, except they were permanent sutures. Today, they're dissolvable sutures. So the contour threads were extremely strong. You literally could tie a contour thread to a bowling ball and lift it up and the thread wouldn't break. They were much even stronger than the threads are today. We did hundreds of them, hundreds of them back in 2003, 2003, 2004, somewhere in that range, 2005. And it was very, very popular. And I don't think there was a doctor in town not doing them. I mean, it was because it was so heavily marketed. And the reality was they would give nice results, but they didn't last very long. And there were some problems with the threads because they were permanent. Sometimes people, if there were little

issues with them, you could be stuck with those issues and you might have to go remove those threads. Whereas today, the threads are dissolves. So even if there are, there are issues, which there often are, they will dissolve over time so that the problem will be permanent and you don't need to go in and remove the threat. So that was the difference. But the upside of the contour threads was that they were permanent and super strong, much stronger than they are today. Okay. So over the years, people got away from the permanent ones because of the problems and now do the dissolvable ones. But the procedure is identical.

It is exactly the same as it used to be. You put them in the same way, the same location, the same exact type of, of, of, you know, technique to put them in, only they disappear now. So that's good. Again, if there's a problem, it will go away. The downside is they're not as strong as they even were. And so, you know, having done hundreds of them way back when and seeing the people over, we know they didn't last very long. And so the thing that bothers me about the threads is the false, and I don't know, but the marketing you hear like, you don't need a facelift, just get the threads. The threads will last you two years, three years. It is just, it is just. It is just.

not true. They don't last that long. Now, can you get a nice little lift out of them for a short period of time? Yeah, you can get a nice little lift for a short period of time. So are they appropriate for certain circumstances? Yes, and I do them. I do them. I will always combine them with certain little things to reduce the scar tissue because they do create scar tissue and they do make the facelift that you ultimately need. They make it more difficult because it creates, it creates scar. It makes this surgery more, requires more elbow grease to move things around in the surgery, which creates a longer healing period and doesn't make it quite as delicate as it could otherwise be. So there are downsides to doing it.

And do I do them? Yes. But either the patients need to understand you're going to have a result for a short period of time. It might be really, really good for a month or two and then be okay for a few months. And then I don't know if I really see it at six months. maybe, maybe not, six, seven, you know what I'm saying? So, so, and that is appropriate for a lot of people. It's appropriate, but people need to understand this is not, does not take the place of a

facelift. If you think you're going to need a facelift shortly, you might want to avoid them. And if you don't avoid them, you might want to avoid them so that you don't create that extra scar tissue. And if, if you are going to do them before a facelift, maybe do them once. And then we add a few things to it to decrease the scar tissue formation. So that's what I would say about the threats. They are nothing new.

They've been around forever. We know exactly how to use them. and what, you know, but it's not a new procedure. And what about threads up here in the temporal area or under the nose? People are doing lip-lifts. And I've seen rhinoplasties with threads. Yeah. Yeah, it's the same thing.

Same thing. I mean, we used to do all that the same way. Again, it's nothing to do. And again, they can give temporary results. They can give results that are temporary. Now, I will tell you that the results with threads, if you are going to use threads, you still will always get much better results by still scumptu. sculpting around them and doing other things non-surgically than just relying on that.

But they can be a useful part of the strategy to give non-surgical lifts. They can be a part. They aren't individually. It's not something I would do. But when we do use them, we often, like I said, we often combine them with things to reduce the scar tissue formation and always use other lifting and contouring methods at the same time to maximize the results. So about the threads, I would say they can be a useful part.

piece of the puzzle in a non-surgical rejuvenation. Got it. Okay. So what have you been seeing a lot of in the recent years? How have trends changed? What are your favorite procedures? All about? Okay. So my favorite procedures, so as you may know, as you know, I'm a facial plastic surgeon. My career, my reputation, my success based on my facial surgeries, right? So, and facelifting was probably what I got well known for first. So that's always nearest and dearest to my heart. Our full facial rejuvenation and facelift type procedures with facial implants.

Okay. So that's nearest and dearest to my heart and always been my favorite. But I love doing rhinoplasties. I've always loved that. I developed my rhinoplasty career after the facelift. The facelifts got me, you know, got me my practice and my, you know, for people to know me. And then from so, so, but I love those as well from a surgical standpoint. non-surgically, I created my procedures known as dinan facial sculpting.

I'd say that's probably the most my favorite thing to do in the office. So based on our surgical results and that success that we created, we're fortunate enough to create, we developed a non-surgical practice, which now has become one of the big ones out there. And I'm very fortunate and blessed to have had that happen because now I love the non-surgical days just about as much as I love the surgical days. So in the office, non-surgically speaking, my favorite thing to do if I had to pick one would be diamond facial sculpting. That is my non-surgical way to enhance bony structure. And I created that based on my facial implant, surgical facial implant experience.

I love to customize facial implants, which is not many of us in the world who do that. But I've been doing this for about 12 years or so where we will create, we'll get scans, radiology of people's faces, and get real replicas of their bony skeleton, and then create implants like from scratch to custom fit their anatomy. So I've been doing this for years just on my, you know, on my desk creating these implants. And one day it dawned upon me, you know, nine years ago, you know, I could probably get that injected in there the same exact way that I would place an implant. And that's how facial sculpting was born. And so it's just the way that I see, the way I see the face and how I inject to enhance the bony structure and make all the features

balance and all that type of stuff. So that's probably my favorite non-surgical procedure. But I love the non-surgical days where I'm running from room to room doing, you know, all the non-surgical things. And I love the surgical days where it's more of a, you know, my surgery sometimes takes seven, eight, nine, ten hours. That's more of a project that day. That day I settle in. Phone gets turned off. Music gets played. And I just settle in. It's more like a Zen day, whereas the in-office days are the exact opposite of a Zen day, they're high-energy days, but I love them both. So those are my favorite things. It sounds almost meditative. I mean, that's how I imagine it because it's so precise. Yeah.

Yes, being the OR is meditative for sure. No question about it. No matter what else is going on, that's my happy place for sure. Nothing can bother me in there. And when I'm in the office doing, you know, room to room to room, once I start the sculpting, then that becomes meditative because I'm sewn in and I'm just, I don't hear anything else when I'm sculpt, but part of the non-surgicalist talking and connecting and that part is not as meditated as the actual technique. So we were talking about how surgery and cosmetic enhancements have become more mainstream, more popular, people are much more aware of it. I think it's a lot less stigmatized. So what procedures have you been seeing a lot of people coming in for? What are they asking for?

What are the trends like in recent years? Yeah. And the trends come and go fairly frequently. And a lot of the beautiful influencers have a lot to do with that. You know, they put things out and they're influential and they're gorgeous and, you know, things look good on them. So they, you know, a lot of when we know who they are, they oftentimes do set the trends. What I'm seeing now, a lot of people are asking for that, that fox eye look where the lateral corners brought up.

Now, the thing is, that's nothing new either. we've been doing that for years as well. But now it's being talked about. And again, like we talked about on social media, you're seeing every other provider show all these results. And sometimes they're showing the result 30 seconds later where, yeah, you can do a little thread and get that 30 seconds later. Let's look at that a month later, right?

Like it's so there, but that's probably one of the big trends now that random people are asking for. Other than that, they're still asking with my practice and I take care of, people are still asking me for. really what they've always asked for, and that's to look their best, to be the most symmetric, most balanced, most sculpted, most lifted, most defined that they can be in a natural, beautiful way, maximizing their own personal beauty. That's what people have always asked me for and still are asking me for more than anything else. But certainly I do see those saying they want the

buckle fat reduction and the fox eye look. And again, those are things we've been doing for 20 years. And before me, they've been doing for 50 years. It's nothing new, but people are asking. for it more because of the social media challenge. Okay, you guys, I don't want to be too dramatic here or anything, but let's just say my wildest dreams just came true. That's because there is a new way to supplement, and that is through chocolate. Yes, that's right. FX chocolate is a supplement company that has chocolate down to a science. They've created six different supplement variations. Exhale, Focus, thrive, defend, superfood, and zen, each one lending targeted support to a specific need.

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use the promo code blonde files at checkout. That's B-L-O-N-D-E-F-I-L-E-S. And, and I-L-L-E-S. And yeah, just go to their website, FXchocket.com and use promo code blonde files, B-L-O-N-D-E-F-I-L-E-F-I-S for 20% off. So when somebody comes in and they say, okay, doctor, this is what I want. I want my brows lifted and I want my buckle fat and they have this vision. Do you bring your own kind of aesthetic into that and meet them where they are? or do you, are there cases where you just say, okay, I'm going to do exactly that? I mean, with your understanding of the face, I feel like every surgeon, and I've had quite a few of them on the show, everyone has to bring their own kind of bias of what they find beautiful into, I mean, that's why somebody goes to you, right?

Absolutely, yeah. I use my own aesthetic. I will never do something on somebody that I don't agree with, first of all. If I don't think it's going to look right, I will say no to that person readily. I do bring my own aesthetic judgment. I see when someone talks to me about what they see, put it this way. It's always my favorite situation when they say, Doc, just what do you see? What do you think?

Do whatever you think is going to look best. That's my favorite because then I can enact my vision, you know, undeterred and just do what I, and I'll always do, I mean, people know me for, I'll always give something natural. I'm never going to give an unnatural over-the-top look. People do ask me for over-the-top looks and I say no. I just won't do that. 99% of the time, unless it's some very unusual circumstance. So I do bring my own aesthetic judgment, and I'm just trying my best to, again,

enhance that person's own features to their maximum to make them look harmonious, balanced, and beautiful. So it's been reported that there has been an uptick in surgery during quarantine. Everyone's seeing themselves on Zoom, probably picking themselves apart. Have you noticed this in your practice? I know that Beverly Hills, they really wanted surgeons to open before other things opened, right? It was actually a real, so it was actually a real, I'll give you a little interesting history just for people who hadn't heard this. It was actually really interesting what happened here.

So as you know, the COVID thing started hitting. I think it hit Seattle first and was making its way around. And we were hearing about it. But there were no recorded cases in L.A. for the first, however, long period time. So we heard about places shutting down, but L.A. didn't shut down. There were talks, and I don't know the exact days, we're talking mid-March. Mid-March. There were talks that L.A. was going to have to shut down if cases started to come in.

And they were expecting them and all that stuff. And they were anticipating like, I don't know, a week from now, two weeks from now, LA is going to get hit and we were all like preparing. And literally, like, the next day, any Beverly Hills business owner got an email or contact and said you have to shut down tomorrow night at midnight. Like it just came, boom, like a ton of bricks out of nowhere. And so we're on Beverly Hills. We're like, holy crap.

Like, they didn't even give us, I think they barely gave us 24 hours notice. So, you know, I had service booked out for two, three months, probably. It'd be longer that we had to, like, call these people like, oh, my God, like, they're just shutting us down now. We have to, like, so it was a mad rat race to get all that stuff squared away. But we got that notice way to shut down immediately. Now, that just hit Beverly Hills. L.A. had not shut down. L.A. was wide open still when Beverly Hills had to shut down. So how far away are

service centers in L.A.? Like a mile away, literally a mile away, even less, a half a mile away, Century City, a mile away is West Hollywood. All these surgery centers, Santa Monica, you know, two miles, three miles away. All these places were still open. But right here in this little pocket, we all had to shut down. We're like, what the hell? So anyways, so we got hit first. They shut down probably 10 days later. I don't know. It was a good, there was a good, there was a good period of time where we were all like, that's not fair. You know, how's that helping if we're doing our part to flatten the curve, but half a block away literally, they're not flattening it.

So it made no sense. You could see how disorganized the California government was with all that stuff. That made no sense at all. But then finally, L.A. shut down 10 days later or whatever it was, and we were all shut down. Then they allowed Beverly Hills to open up probably, we all got a thing saying, I don't remember,

there was some city council vote saying, okay, plastic surgery can reopen as of May 1st, and I think they made that declaration like April 30th, literally. Like, okay, Barlowers can open up May 1st, and we were like, oh, my God, like, boom, it came so fast.

I think they thought us to come back maybe five days before L.A. or something like that. So we got shut down first, but we were able to come back first. And I think they made a mistake. I believe they weren't intending to say, say cosmetic surgery can open May 1st. I think they were intending to say elective medical procedures

and what they were meaning by that. I think they were meaning elbows, ease, and like more functional procedures. I think that's what they're attending. I don't think they were intending to say, go get your facelift. Like, that's more important than anything else. I don't think that's what they were intending, but that's what they said. And so we just took it and we said, fine, we'll open and fill out us. And we did. And boom. And then shortly thereafter, everyone opened. But so the point is we were shut down for six months for six weeks and we had a lot of backlog to make up. So we were operating Saturdays and Sundays pretty much for the last five months to still have surgery again this Saturday and Sunday. So we're pretty much just about gotten through that backlog.

But yes, there's a big surgical caseload now. And I think that goes for a lot of people as well, not just. Yeah. Well, it's a great time to do something right now because you're hidden. You're not going into work. You're not going to school. you're not, whatever. Yeah, and the mask.

People can wear masks. Exactly. Yeah. Okay, so what are the top procedures that people ask you for? The top things that, and so as you know, I'm a facial specialist. So the top surgical procedures that people ask me for would probably be facelifts, facial rejuvenations, like just maybe looking under brows, eyes, cheeks and everything, and rhinoplasties.

Those are probably the three most common. And when I say faces, I mean, just tighten up the neck and jawline. So facelifts, full face rejuvenations and rhinoplasties. Those would be the most common three surgeries people ask me for. And the most common in-office things people ask me for, Diamond facial sculpting number one, non-surgical facelift number two, which means whatever that means for everybody's different,

but it includes sculpting and Botox and, you know, regular fillers and all that kind of stuff. And then the third most common thing would probably be skin treatment stone is the instifacial. That's our version of, you know, the sort of minimal downtime, highly effective, make your skin look its best in two-day type of thing. It's the instifacial. And we do that for a lot of celebrities just before they have to be on a red carpet or be

at an award or whatever. It's the best your skin can look in a short period of time. So those are probably the three most common non-surgical things people ask before. Sculpt, diamond facial sculpting, non-surgical facial rejuvenation, and instifacial. Okay. And then I'm also curious, what are the big. mistakes that you think people are making when it comes to their faces and their maintenance of their faces? I'd say that the biggest most important mistake that people make is thinking that they

have too much fat in their face and going and having that fat removed. I think that's probably the most common significant mistake I see. And the way in which they're doing that most commonly is Kaibela. Second most commonly would be like cool sculpting. There's something called cool sculpting for under the chin. And I'm talking particularly

about under the chin and neck. And those would be the two most common ways that people are going to get their neck tighten up. And again, this goes back to this marketing that we see all the time. People showing all these pictures of Kaibela results

where they show like a double chin and then the neck is nice and tight like a like, you know, like Kendall Jenner. Right. Like they show results like that. The reality, is very, very few people have excess fat under their chin at a young age.

No, there are people who are overweight for sure. And if you are properly overweight and you have an excess amount of fat, then yeah, if you're young and your skin elasticity is good, maybe you would benefit from just some straight up fat removal. But so many people come in and they don't like the contour of under here and they'll grab their skin and say, I don't like this, I want to get the fat removed and they'll go to their dentist or their med spa and have Kaibel injected. All that's doing is melting fat that doesn't need to be melting.

And that just makes the skin super thin and creepy. And then that can be very, very, very difficult. A good example that I can use of this because she did a whole thing for her TV show on it is Kelty Knight from the lady. I was thinking of her. I can say, because she did a whole second. I went on their show and we were talking about you and she was talking about her necklift. I was like, I need to go see him.

Yeah, right. So Kelty's a perfect example. She went to some of those places, said, you know, I want to be a little tighter here. They did Kybella. Kelti has no body fat at all. Like there was no body fat was not an issue. The fat under here becomes your best friend in that situation because that keeps skin healthy. Well, they chew up all her fat with Kybel and Jackson. The next thing you know, she's got a big sag there. And that required surgery to fit. And so I'd say to answer your question, that's probably the biggest mistake I see people. people make it saying oh i'm just going to go i saw that meds buy advertising kaibele i just go get kaibella if you if you don't have excess fat with which a vast majority of people don't

that's just going to hurt you and make things right sometimes you can't even fix it once they've done it it's a disaster so that's probably the biggest mistake i see that's a good tip what do you think about things like ulthera or well yeah what do you think about althera because i know that's been kind of controversial lately for that same reason yeah same reason althera was very popular for a while. It's definitely less and less popular. Althera sort of indiscriminately cooks the deeper layers of tissue and that too can chew up some of your own fat. And again, again, if you're really overweight, you have a ton of fat that you can afford some to be chewed up, then fine. It's probably okay. But I, you know, people with thinner skin, it may tighten you

for six months while you're slightly swollen. I've seen plenty of people. The most common thing I seen with Otheris, people say, yeah, you know, I felt like it was pretty tight for six months, but then all of a sudden, I don't know what happened. Well, what happened was you were swollen. When you're swollen, things can look tight, and all there is pretty intense. You can have slight swelling for months and months and months, and things can look tighter from that swelling, but as soon as that swelling is gone, if you, if it's melted to any of your own fat, you'll sag more, you'll droop more, you'll get indents and stuff. And so I would, you know, I don't like that for that reason. So the techniques that we use are ones that don't chew up the deeper

fat layers. So I think you have to be very careful with that. I'm realizing now in my 30s, how important the fat in my face is. It's so important as you age because that's one of the first things to go, right? It is so important. And so like I was saying, are there people who you just want to remove fat on? Well, there are a few. Those would be the same people you would want to do liposuction on. And who do you do liposuction on? You do liposuction on people where they actually have an excess of subcutaneous fat, and they have good skin, good skin elasticity. Because if you do liposuction on someone who's got poor skin elasticity, you're going to create a worse problem. You're going to create all the saggy, ripply, crepey skin. And so who are people who have good skin

elasticity? They are younger people. You lose your skin elasticity once you hit, you know, it starts to really decrease once you hit your mid-30s, late 30s. And the concept for people to understand what that means in lay terms. Well, think about a young woman who has a baby. Her skin stretches out to the wall, right? She has a baby literally three months later. She got a six-pack again. That's because her skin retracts in and it's got good elasticity. And so that's a young woman who's in their 20s can do that. Try doing that when you're 35. Your skin ain't stretching back the same way. Try doing it on when you're 40. Your skin ain't going to be totally destroyed after that. And there's no, you know, because this elasticity has gone. And so it's the same. So you have

to think like that when you're talking about, am I going to remove fat from somebody's face? If their skin elasticity is really good, oh, it might contract in nicely to accommodate for that. And if the skin elasticity is not good, that's not going to happen. So people who hit, you know, mid-30s, 40, you don't want to be removing fat from here without tightening the skin at the same time. You'll just make them worse. And it's an important concept for people to understand. And how would you tighten that, like a platysmoplasty or a facelift or?

Many different ways. Many different ways. There's many different ways. But yes, all those things and other things. I think we all want instant gratification, right? And we can be feeling fine and then open up our phone and see a picture of Kendall Jenner or whatever and go, oh, I want to do that and go in and do whatever the easiest, fastest thing is that you can do. And oftentimes those kind of quick fixes have long-term ramifications. That's absolutely right. And that's why it's important to see somebody who knows their face and knows what they're doing. And, you know, again, I'm not going to sit here and tell you that some nurse can't be a good Botox injector. I'm not going to tell you that some dentist can't be a good Botox injector. But when you're talking about all this anatomy and stuff, you want to make sure whoever's taken care of you knows the anatomy well. And it's not that some of them are. Some of them know the anatomy well and some of them are great injectors. But, you know, the point is with all the social media marking, you don't know who.

who you're looking at and what their qualifications are. And every single person is a world expert. Let's pull up. There's 80 million world experts. Like world renowned best in the way. It's crazy. And so you just, you know, I like to say you need to see a specialist for your face. You know, if you're going to take care of your face, see a specialist if you can, a facial specialist, you know.

If you're going to take care of your breasts, see your breast specialist. You're going to take care of your, you know, if you're going to take care of your butts, see a butt specialist. carry your heart, see a heart specialist, right? So, yeah. Okay. So we had a ton of questions. I put something up on Instagram. We don't have too much time.

So maybe we can do like kind of a rapid fire Q&A, as rapid fire as we can be with some of these answers. I know some of them need a little context. How young should somebody start Botox? Well, Botox can, I mean, for certain like kids with cerebral palsy, you'll start Botox at, you know, early ages for spasms. So, you know, it's safe to start, you know, for certain things at an early age, but in general, for anti-aging purposes, in general, we probably start, you know, in the late 20s for certain models and things who are out in the sun and they can't be squinting, you know,

we'll do it. You know, I've done it on some 19, 20-year-old, like swimsuit people who are out in the sun and they just, you know, but in general, people start, I'd say on the early side, people start coming in in their mid to late 20s, if they really are hyper expressive and start to see creases for them, then I'd say it's appropriate. Best thing to do for your aging face if you're on a budget. There are a lot of different ways to go. If you're on a budget, you want to get on, if you're on a budget, you probably want to at least get on some, use some good products and live a healthy lifestyle, avoid the sun, you know, eat healthy, keep yourself in shape.

That's probably the best way to deal with yourself if you're on a budget because all those things help and they're pretty cheap to do. Yes, I was a sun worshipper when I was younger and I thought I would never age. And again, like in my 30s, it's all showing up. So sun protection is huge. I know people who have been so vigilant about it and they look like babies. So, okay, average age for a blephoroplasty or for a facelift. So I know that that is very dependent on the individual.

That is very independent. dependent on that individual anatomy. I'll just say I've done blephroplastys on people in their 20s who just have genetically heavy lids or puffiness. I mean, you've seen five-year-old kids with big puffy bags under their eyes. Why make those people wait until they're 50s? So I've done that in people in their 20s, but that's not the average.

I've done facelips on people who are 30 who've had a bunch of weight loss. They've lost 100 pounds and another dollar sagness. I've done facelps on 30-year-olds, 31 notes, but that's not average. I would say the average age for somebody to come in for a procedure like that would probably be around 47, 48, which is plenty of 41, 42, 43s, and plenty of 55, 56. Is it average, it is out to just under 50 probably? So with a facelift, I'm curious, is it, do people do them when they start to see issues with like jowling maybe and in their neck in their later 30s, early 40s, mid 40s and then do them again? or is it better to wait until things get to a certain point so that you get a better result?

How does that work? Here's how it works. And that's a great question. People ask that. It's probably the most common discussion I have with people. What my answer is, is, you know, when I first started, you know, I was taught like, yeah, you know, wait until you're, you know, you hear people say, yeah, wait till you're 50 or 60. But it always was like, in my mind, like, that's just an arbitrary number. what does that mean?

Like, why make somebody wait if they see something that they're self-conscious about? So my answer to that question now and over the years has become, when I can fix what bothers you, that's the time to do it. So if you're 35 and you have terrible jowls that are making self-conscious and are affecting your quality life and I can fix it, why wait until you're 50 to fix that? Why not do it now? So it's a case-by-case basis. If there's a non-surgical way to fix that, sometimes there are, and somebody wants to give that a trial and maybe rightfully so, then yeah, sure, if I can make you better with a non-surgical technique, then let's give that a shot.

If that works great for you and you want to come back next year and do that again, great. And you want to do that every year for the next 10 years until you feel like you want to do the face-lift, great. As long as what we're doing non-surgically isn't going to affect the facelift result. And some of these things can. you don't want to do threads every year for 10 years. If you're going to do a facelip, that's for sure, because that will make the facel very difficult to do and affect the result. So, you know, it's my job to understand how these procedures that we're going to do affect your aging down the road.

I can see that whole picture because I do it from all sides and I've been doing this for long enough now to see everything. So if I can give you a non-surgical improvement that's not going to negatively affect your aging or negatively affect your facelip that you know you're going to want to do, yeah, then we'll do that for as long as it makes you happy. But at some point, it's not going to be enough to make you happy. And then we'll do the facelift. If right off the bat, I know what you need is surgical because the non-surgical things aren't going to help you. Then I'll have a discussion with you about that.

And you make the decision, you know, this has bothered me bad enough. I need to stop avoiding my photos and stuff at 35. And I want to do it. Then great. Then let's do it. Right. So I'll see you in three weeks. I'm just kidding.

Okay. Best way to lift brows without surgery. I mean, there aren't many. The first way that I would go about lifting the brows without surgery would be the non-surgical browlifted, and that would involve a combination of Botox and filler. Doing a combination of Botox and filler and a little sculpting to the high temple area, you can get a pretty darn good brow lift without having to put anything, you know, any kind of thing that might fail in there.

And that would be my go-to first line. treatment. If that didn't work, then I would talk to you about potentially doing some threads in combination with some other things. And that may give you a reasonable result that makes you happy for a short period of time. And if that didn't work or you didn't want a short period, that you didn't want a temporary thing, then we would do a little mini-brilip procedure. And that will work and give you a long-lasting result. And that honestly heals sometimes faster than the threads heal. Sometimes the thread you can be black and blue for 10 days. That brow lip procedure, five days and you're good to go.

It's interesting because I, I'm open about everything I've done. I've had a nose job, lip lift, brow lift, blephroplasty, upper blephroplasty. And then I also had threads in my cheeks. And I found the whole process of getting threads to be so much more traumatic than surgery. And, you know, I loved it when I was swollen for like three weeks. And then it kind of, the swelling went away. and there was no discernible difference. And my experience with the endoscopic brow lift was, like you said.

It was like five days. I mean, I had black eyes, but it was nothing. I didn't even get a headache. I think that people hear surgery and it's like, ah, this huge thing. And it is a big decision, but that procedure, I always tell people just get the surgery. I will tell you for sure. The brow lift will heal faster than the threadlift for the brows. There's no question about it.

It'll heal faster without any irregular. more predictably almost every time versus a threadlift. The black eyes you had is very unusual. It probably happens to one out of 20 people, maybe less frequently than that with the end of scuba grel. He probably just got unlucky, but that shouldn't have, I mean, not that your guy didn't, you know, not that anything went wrong with it,

but that shouldn't happen most of the time. And so, yeah, it's a fast healing, great procedure. I do little things to make it for those people who want that fox eye look. tweak the endoscopic brow technique to give a little more lateral fox eye look, you know, that kind of thing for those people want that. It's a great procedure and for sure it's a predictable, long lasting, and very fast. Yeah. Yeah, I think it's my favorite of everything because I can just, it's night and day. Can really open up the eyes. Are fillers the only way to add volume to the face? No, fillers are not the only way to add volume to the face. We can,

using some of the bioregenerative techniques, using, you know, amniotic fluid, some of the amniotic tissues, some of the plasma, we can do that, which aren't fillers, and they can add volume to the face and stimulate some of your own collagen production to help with volume. Of course, you can use fat grafting for the face, which is probably the best way to do it for some people, where we, you know, we'll take fat and put that in. you can do with implants. I should say implants are the best way because they're permanent. You can create the sculpting that you want.

But that's a surgical procedure and does have some healing. When you're talking about doing cheeks and jaw implants, those can take a while to heal. But that would be the best way to add permanent volume to your face. So there are many ways to do it, but the most common way would be fillers for sure. Can we talk about fat grafting for a second? Who's a good candidate?

And what's the ideal case for that? There are. So there are several different versions of fat grafting. and I've done these for a long, long time. So for people with very thin skin, cravy skin, typically older people, I really like the, I really like using what's called nanofat for those people. That's where we take the fat and we filter it back and forth so that we turn it into like liquid, basically.

That can be injected through a needle. We make a real liquidy, so all the particles are taken out of it. I really like that to inject into really fine lines and then to like lay on the skin and needle it in just to get that activity in there. We call that nanofat. I really like that for like really poor skin. It's one of my favorite ways to deal with really poor skin quality. You know, so that that's a good procedure for that type of person. As far as just pure fat grafting to volumize the face, I would say that it makes sense to me in my mind to do that if you're,

are already going to be asleep for another procedure. So I do that with almost every single facelift I've ever done. So fat grafting is probably the most common procedure I've ever performed because I do with every facelift. I do it with a lot of rhinoplasties. I do it with a lot of facial implants. So it's good if you're already asleep. Now,

people often ask, should I, you know, I want to do fat injections. Can I go to sleep for fat injections and just blow my face? And it certainly is an option. But I would tell you, I would always try facial sculptor.

first. For many people, I would consider facial sculpting first and some of the in-office things first because I can give you just as good a result in office without having to put you to sleep in liposuction fat out. And with the facial sculpting and the non-surgical facelifts, they're very predictably know pretty much exactly how long they're going to last. So I can tell you how long that's going to last. Whereas if we put you to sleep just to blow your face up with fat, I cannot tell you how long that's going to last. That's unpredictable. That may last six months. it may last 10 years. And so to go through a facial, to be put to sleep and go through a full facial

fat grafting procedure when that's the only reason you're being put to sleep, I would try in office things first. And if they didn't work and give you as long as you want, then maybe graduate to let's do the fat grafting and hope it lasts a long time on you. So for me, the ideal facial fat grafting candidate is someone who's already going to be asleep or something else. We're already there. It's quick and easy to get that fat out.

Because we're already asleep. It's easy to liposuction that out. and then graft the fat graft the face. Does that make sense? Yeah, totally. Well, I know our time is almost up. So I'm just curious, what are you excited for in plastic surgery? Where do you see things going in the next few years, if you can say? Technology keeps improving. The, you know, those non-surgical devices keep improving. I use the latest and greatest, and I really like those a lot. But they have their role. They have their role in the non-surgical cosmetic improvement. category. They're rarely a standalone procedure, but hopefully they keep improving and we can do

more and more with them. I really excited about the bioregenerative techniques, including, like I said, the amniotic tissue, the plasma, letting your putting the things in to allow your body to do its own healing and own repair. Your body can do it sometimes better than we can do it with other methods. And we get great results with those things. It's one of the mainstays of my practice and I'm mixed you know I just we keep kind of pushing the envelope with that and and learning better ways to we keep honing it and you know I've been doing this for years and I've got it to where I really really like it but I keep you know you always look I'll keep proud when I stop trying to improve is the day I'll retire I'm going to try and keep improving

to the day I retire so even though I love where we're at I'm going to keep trying to make it better and better and so that's what I'm most excited about or what we can do with those types of treatments. Amazing. Well, I wasn't kidding. I'll see you when I can get an appointment when I come back to town. And thank you so much for coming on. It was so great talking to you. My pleasure. Good to see you. You too. 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.