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In this episode, I want to go over 5 of the big reasons people choose to have rhinoplasties and what makes them successful. I’ll go into detail about why people want these changes and what procedures are required to achieve them, as well as some of the pros and cons of some of these procedures and the long-term results you can expect.
Highlights:
Be sure to check out past episodes!
Join us on our website for more information on cosmetic surgery.
Download Podcast transcript
In this episode, I want to go over 5 of the big reasons people choose to have rhinoplasties and what makes them successful. I’ll go into detail about why people want these changes and what procedures are required to achieve them, as well as some of the pros and cons of some of these procedures and the long-term results you can expect.
Highlights:
Be sure to check out past episodes!
Join us on our website for more information on cosmetic surgery.
Dr. Torkian 0:01
This is Dr. Behrooz Torkian. I'm a board-certified facial plastic surgeon in Beverly Hills. Join me as I share the secrets in plastic surgeons and beauty professionals alike on achieving beauty for your face. Good morning, everyone.
Dr. Torkian 0:15
It is Dr. Torkian and I'm here with beauty and progress once again. And I got my coffee in front of me, I'm having coffee with you all this morning. This is a kind of celebratory moment because we had 1000 downloads on the podcast, which is nice, you know, depends on what category of people you're in. Some of you guys are listening, and you're saying 1000 that's nothing? Well kind of depends on what your content is right? Not everybody's looking at this content all the time. Although it seems like on social media, our type of content is getting a ton of attention. It's more of a visual thing, obviously. But it's like all the rage talking about fillers and surgeries and buckle fat pad removals. I just heard that Chrissy Teagan has announced and opened up about having had a buckle fat pad removal. And you know, I have really mixed feelings about that. Number one, I think that it's not necessary to live your entire life publicly. Personally, number two, I think that buccal fat pad removals can be sometimes issues later on in life, you know, you really have to pick and choose the people wisely. In this case, I think that her surgeon did a wonderful job, and it was a good reason to have done it. And she's at the appropriate age where she's already demonstrated what her fat loss or fat gain trajectory is. And that means basically, as we age, everybody ages differently, some people will age with increasing fat in their face, and some people will age with decreasing fat in their face. And if you've gone and removed fat from the face in certain areas where later on that fat might be kind of nice in maintaining the roundness and the shape leanness, and the youthfulness of the face, then you could kind of regret that later on as you lose more fat in the face. So she had already sort of demonstrated that she's not a fat loser. In her face, there are certain areas, of course, that do decrease in volume around the eyes, and then the cheek, the upper part of the cheek and the temporal area. But that lower face was not really getting too thin. So it was the right thing to do. And I think her surgeon did a wonderful job. But I don't think it's a great idea to be a grand dicing that particular procedure and making it seem like everybody needs it. You know, there's a lot of influential people out there talking about their procedures, but not everybody needs to have what they had. So you got to discuss it with your surgeon and or injector, got to discuss it with your advisor and let them be an advisor to you and not just a technician. That is what I always preach. And I practice that as well. Let's make a plan together. Let's create a mission. And let's follow it step by step and kind of see it through we got to stick with it both of us, me and the patient. And we have to trust each other and agree with each other on certain things. And if a buccal fat pad is right, if lip fillers right, lip lift is right, I will advise you and we'll go forward with it. We are not going to do it just because it looks good on somebody's Instagram profile. Okay, so now let's get into the real topic for today. The real topic for today is let's talk about the five big reasons not Top Reasons necessarily, but they do seem kind of like Top Reasons if they're the five that are coming to mind. But five big reasons people have rhinoplasties and people are successful with the results of their rhinoplasty. So Reason number one in my practice is always the appearance. Most of the people coming into my practice for a rhinoplasty procedure come in for correction of a nasal hump. And that's what you see on the profile and what I mean by profile is the 90 degree picture this looking right at the side of your face, meaning the camera is facing directly at your ear. That is a nasal profile and that profile is where we can assess the dorsal hump the most accurately. And so the hum productions are very common. That's something that's been going on for decades but trends have changed in terms of how much hum production is really acceptable, how much production is required for the aesthetic results that people want to get or the aesthetic trends. There used to be some tendency to make humps go down so much that there would be like a dorsal scoop we would call it but you know right now we kind of think that those are overly done and they don't look natural. Although in some cases they are kind of coming back and in in very select cases people will ask for a scoop and when I think it's appropriate for their face, I will comply and I'll agree with them and I'll show them what it looks like most of the time you do have an option. You know if you want to scoop you can get a scoop you But the overly scooped noses that used to be a product of some of the rhinoplasties in the mid-early to mid-80s, and maybe early 90s even, that's really not so much a trend right now and we're looking at a little bit more of a natural appearance on production. So hump productions are done in a couple of different ways one that can be done with a chisel, you can reduce the bony part of the bone with a chisel. The cartilage part is usually you know, cartilaginous, so it has to be cut through with a blade. So you have to get access to the bridge of the nose underneath the skin, there's two ways to get there. One would be an open technique, which some of you may know this already, but there is an incision in the call you mela, that thin little piece of skin in between your nostrils. And that allows you to elevate and lift up the skin off of the tip all the way up to the top of the bridge. And with some visibility, you can actually remove some of the hump and reduce the profile appearance of the hump. This can also be done through internal incisions, those internal decisions are made inside just above the tip cartilages are right about the area where your boogers trapped the ones that we are usually most successful getting by picking. And yes, it is okay to pick your nose. But please make sure your hands are clean in this COVID environment. And of course, wash hands afterwards. It's kind of disgusting to do it in public, obviously, but it is sometimes what you need to do to get your airway open, right and things get trapped in that particular spot. So that spot is a really nice spot to Make incisions, it's hidden, it heals really well. But it doesn't cause damage to other structures, except for there is a little area between the tip cartilages and the sidewall cartilage is called the upper lateral cartilages that can and has to be traversed meaning you got to go past that area to get to the bridge. So there can be some undue trauma or you know, undue injury to those areas that you don't need to really cause. So, hum productions, let's talk about this real quick, in general, require osteotomies osteotomy, or what people call breaking the nose. And I'll just put it out there that it is not really a break. I don't like to call it that, although I understand that that's a colloquial term. So I do use it with my patients, I say yes, I need to break your nose, but we call them osteotomy because they're cuts in the bone. And I do them with very sharp chisels. Their chisels are sharpened on the spot, every time I use them kind of like a chef whips out his knife and starts sharpening it before they start to work with it. The chisels are sharpened every day, and they're sharpened every time I use them. And the reason for that is that it causes less damage to the bone, it causes less instability of the osteo tome, which is a chisel that is really designed to make a precise cut. And so you can get a more precise cut so it's more stable, goes through the bone smoothly, I feel like I get less bruising with it and things go better all the time with a sharp chisel. So the osteotomy is need to be done because when you shave down the bridge, you're taking down an arc shape. And that arc shape if you look at it from underneath, when your head is elevated up the arc shapes, the top of it is removed when you're shaving down the hump. And so you need to close the top of that arc again. That is how an osteotomy helps in hump production. And that's why it's necessary if the hump production is not really that much, then sometimes you don't need osteotomy. That's pretty rare. I've never regretted doing osteotomies but I have regretted not doing them. And I've seen a lot of patients in my practice for revision that have required osteotomy is to be done or be done properly that we're not and that was the reason for the failure of their initial operation with their primary surgeon. So next appearance issue that we need to discuss with regard to why people get rhinoplasties and why they're successful in their results is the width. Now the width can apply to a number of different parts of the notes. Let's break it up the width of the bridge, which often with childhood fractures, or sometimes genetic factors can have a excessive width. If you look at drawing instruction books, we kind of like to look at a nice smooth arc coming from the tail of the eyebrow down toward about the tip of the nose. And if the width of the bridge is wide, then that arc is not really smooth, and it kind of looks a little too straight sometimes or it kind of looks a little projected or or more convex, rather than being concave. Either way, it's an area that can sometimes be a problem and occasionally people will come in and have functional issues with it meaning they can't wear sunglasses or reading glasses or vision glasses very comfortably because there are none that are made wide enough to fit the bridge of their nose. So How do we deal with that, usually pretty similar to the bridge reduction, but the instead of reducing a hump if they have one, then that makes it easier obviously. But instead of reducing a hump if they don't have it, then little chunks of bone or little wedges of bone are taken out from in between the midline structure of the nose called the septum. And then osteotomies are done just like we were talking about above, and the bridge is closed back up again. So you open up the ark, take a little bit out of the top of the ark and close it back up again. Now, next width issue is the tip. The tip of the nose is a very commonly to wide appearing area. So people will often come in and say I just have too wide of a tip, but my bridge is okay, my bridge is fine, I just want to narrow the tip. It's not as common, but it is still very, very frequent. So the tip cartilages, the best way to address them, in my opinion is to open the nose. The open rhinoplasty allows a Fords and approach to the tip of the nose. That is kind of like opening the hood of the car when you're working on it. Like you really just need to see the mechanics under there, you really need to see what's going on to get it right precisions better, visualizations better, and stability and long term results are better. What that means is you do a rhinoplasty, it doesn't quite matter that much what it looks like for the first couple of months, it's almost always going to look better the first couple of months, almost always, even though it's swollen. But then when that swelling goes down and the skin shrink wraps back down on top of the cartilage and bone that was altered by the surgeon. The important thing at that point becomes what is it going to look like then? It continues to change for years on end, right? So
Dr. Torkian 11:49
we always talk about like, what's the healing phase of a rhinoplasty? And when am I going to see my results? Well, generally speaking, by two weeks, you're pretty much healed, you're able to go back to a lot of your normal functions and your normal activities and exercises and so on. But it takes about six weeks for the majority of that initial swelling to go away. then six months later, you see a little bit more definition. And a year later, we say oh yeah, okay, so now all your swelling is down. But in reality, it continues to go for quite a while. And about a year and a half later, two years later, even up to five or 10 years later, you still are seeing some change, and when things quote-unquote collapse. And this is not the medical terminology that I'm using, but more of the colloquial collapse terminology they are because there's too much weakness in the tip of the nose, and what causes that is removal of too much cartilage from the tip of the nose. And what leads to that is limitation in your abilities when you're doing a rhinoplasty with inadequate visualization. So for that reason, a lot of closed rhinoplasties that we do revisions on require a strengthening of the tip addition of cartilage to the tip. Whereas a lot of the open rhinoplasty is that we do nowadays more commonly and more often are using cartilage sparing techniques, meaning we don't have to remove as much cartilage to get the results that we want. And therefore, we spare the cartilage which is the support of the skin inside and outside maintains the appearance of the nose, keeping it looking normal for the long term and giving you a good solid consistent result for the long term. Also, tip positioning is a little bit easier to do with an open approach. Cartilage is usually harvested from the septum and added in between the tip cartilages in order to maintain and stabilize its position for the long term. The tip of the nose can be a little bit more firm after surgery that only lasts for about six months to a year. And then it softens up and becomes more normal feeling and you can touch it and blow your nose and move it around and you can kiss normally and you can embrace normally and you're not really so concerned so much with the firmness so much anymore at that point. Now the next reason that is appearance-based that is now starting to kind of encroach upon the breathing or functional aspects of the nose is crookedness of the nose, a lot of people come in and they just have a tilt of the entire axis of the nose. What that means is if you cut the face in two in a picture, and you try to imagine you know, the left side and the right side, of course, there's always these symmetries, everybody's asymmetric, I'm just gonna put it out there. You're not symmetric, I'm not symmetric, almost nobody's symmetric. And if you looked at a symmetric version of yourself, you wouldn't think that you look like yourself. So let's just kind of accept that. And, of course, when you split the face in half, and you try to imagine like you know, the midline line going straight down the middle. If there was a middle for that were a straightness to that, then the nose, if it's off is going to be tilted off of that meaning relatively a straight line, but coming at an angle to that line. So that type of deviation or crookedness, often results just from development, maybe small minor traumas. I mean, you bump your nose here and there, as we all do. It happens to almost everybody I know. It happens to me on a weekly basis as I play with my kids on the trampoline, or just during exercise or playing with my dog or whatever. It just happens. And then there's trauma that causes a little bit more of a deviation that causes a significant crookedness, and bridge of the nose. Usually those kinds of things are being brought to a physician's attention when they happen, but sometimes they're not. Sometimes they happen in childhood. And because the nose is so tiny, it gets swollen and parents look at and they say, yeah, it's just swollen. And that pediatrician looks at it and says, Yeah, it's just swollen. You can't really tell anything, it's not really that deviated and later on in life as the nose develops more and continues on that crooked path, that it continues to get more and more crooked. So little trivia here. This is kind of a cute thing. But the name Cameron, I had to look at, look this up one time, in the process of naming our kids, I kind of came across this interesting trivia thing. But the name camera and the word camera, I believe in Irish just means crooked nose, or a person with a crooked nose. I think that's kind of cute. I think rhinoplasty surgeon named Cameron is probably a good rhinoplasty surgeon to see for that reason. Just because it's meaning has to do with what they do. Okay, so off topic, but we're going to come back now. So the crookedness is that make the bridge of the nose and or the axis of the nose come off of the midline, those are best usually seen from the front, or from the three quarter views. Now the three quarter views are the camera facing you kind of from the side, and kind of from the front, right, so it's pretty much from your side. Most often I call this the social media angle, or the used to be the Facebook angle. Now it's the Instagram angle, and sometimes the Snapchat angle either way, there's kind of an angle, because you're not holding the camera straight in front of you, but you're holding it off to the side a little bit. And people notice that when they're holding it on one side versus the other, they do have a different looking profile to their bridge. So the bridge of the nose can look a little different from those two sides, it almost never looks different from the pure 90 degree profile that we were talking about in the beginning of the podcast, because that should technically just show you a silhouette of the outline of the nose from the side from the very, very side, meaning 90 degrees cameras looking at your ear. And so if you're looking from that three quarter view, and that looks different from the two sides, then yes, you probably have something that's a little off in terms of the axis of the nose, or you have some crookedness in the bridge. This is a very common reason for rhinoplasties. But it doesn't, I'll tell you when you correct it, it doesn't always get corrected to a straight, straight straight line. This is where one of my mentors way long ago taught me something that's really important. When you think about a rhinoplasty, you should always think about terminology that ends in ER, meaning straight or small or narrow, or because it's hard to get that perfect, small, narrow, straight terminology to actually come true and rhinoplasty. Number one, it takes a long time for it to show just like we were talking about earlier with how long it takes for it to fully fully settle number two, it is a very, very difficult anatomical area to get a solid consistent result with the reason is things move around a little bit as they're healing. There are some scar tissue that is made by your body to stick things together, that scar tissue resolves itself and changes itself over time to give you your final results. And those changes are typically a contract dial change, meaning it shrinks down. And as it's shrinking down. Of course, when you have cartilage, sometimes even bone that can be mobile to some extent. Or it can bend or give away or be warped or move around in some way. Then the contraction will pull these cartilages and bone pieces with it. And so that can change the way that it looks from the outside. It's plain and simple when you think about it that way. But in reality, people say why can't you just get a straight? Well the reality is sometimes you can Yes, you definitely can, but it's just not always possible. And so therefore we have to use the ER terminology rather than the absolute terminology. But the cricket noses can most often be fixed with the open technique of course and with newer techniques of cartilage grafting, and proper osteotomies or quote unquote breaking or re breaking the nose and really Having a good assessment and diagnosis of what caused the crookedness to begin with, you can actually get very, very close to getting a perfectly straight nose in most cases. Now, some people, some surgeons will turn away their crooked noses, maybe because in their particular practice and experience, they've had some trouble with striker versus straight, right. And so people complain too much. So they said, you know, what, do cricket I'm not touching it. In my case, I usually don't shy away from the target noses. I like the challenge. And I think I can correct it, I think of the nose as not just a geometrical structure, but an architectural structure. And there's some engineering behind this. There is a wall in the middle. And that wall in the middle is the septum. It's almost always deviated. I'll put it out there the most people have deviated septums Some are not bad enough to cause airway obstruction. Some are not bad enough to even notice, but some cause problems obviously, and, and in a lot of cases, they cause problems with crookedness from the outside, too. So you've got to get the foundation straight, get that foundational wall, that middle wall that kind of sets up the structure or gives support to the midline of the structure straight. So straighten out the septum, then work on the sidewalls work on the bones, put the tip together, boom, and you should have a good recipe for a straight nose. And then that brings us to number four, which is a lar width. What that is, is basically nostrils that are too wide. There's a difference between just correcting the nostrils and doing a whole nose operation in terminology. Just correcting the width of the nostrils, where they attach to the cheek of the nose is called an Lr plasti. And a alarplasty can be done separately from a rhinoplasty which is everything else we've been talking about so far, or it can be done in conjunction with a rhinoplasty. In general, it's done the second way together, because everything goes together in the nose and you have to have a balance, you got to strike a balance. So the alarplasty are generally done with a rhinoplasty together. But sometimes, not often, sometimes people will come in and everything else is just right. Or they just like it the way that it is and they want to maintain it that way and with proper expectations being set and with proper guidance or an Lr plasti. Without a rhinoplasty can be that sometimes it can be done in the office depending on how the patient can tolerate the pain or the stinging feeling of the of the numbing injections, but you can get it numb enough to do it in the office. Or you can be under sedation or anesthesia if you prefer to some stitches along the edge of the nostrils where they attach to the cheek, generally within the crease. And with that usually 99% of the time, I always tell my patients that there's one to 2% chance that there's something wrong with that incision. But generally 98 to 99% of the time, it is good, not visible within a couple of weeks even and sometimes gets a little bit more read and a little bit more thick as the wound healing progresses, and then settles down by about five, six months and is almost completely invisible. Now next reason is breathing. People who have breathing issues are not always thinking rhinoplasty, there's deviations of the septum. There's something we called vestibular stenosis, which is when you breathe in really deep, it narrows the bridge of the nose. And there's something called inferior turbinate hypertrophy, which is kind of a overgrowth of the tissue inside of your nose that acts as a valve mechanism or as a congestion mechanism. So it causes you to get congested there are times Believe it or not when it's okay to be congested. And it's probably good for you to be congested. But when it's not working properly or if those tissues are too big, then you have obstruction. And for those and inferior turbinate reduction is generally speaking I do inferior terminate reductions with almost every rhinoplasty or septoplasty or airway procedure. And the reason for that is that I prefer that my patients breathe better after surgery than before. It's not a negative thing. I think it's a good thing, right? So everybody should be breathing better. And everybody's nose function should be overall better, despite the fact that they weren't even necessarily always looking for it. And one of the things that I noticed is that often when I'm correcting a deviated septum, or vestibular stenosis or inferior turbinate hypertrophy, people don't even really know how good their breathing can be or how dysfunctional it was before they had surgery. And so those are three things that in almost every one of my rhinoplasty procedures I address, I look for them. If they're there, if they're problematic, I fixed them. And that way, we know that down the line, they're going to just be breathing better. Most of the time. You can't always predict but most of the time and almost all the time people will say I never realized that Could be, never realized how easily I can breathe. So why what brings people's attention to breathing issues? Sometimes people come in and say, Look, I feel like I breathe, okay, but I look in there and they have septum deviation, and they don't even realize they're only breathing through one nostril. So one one is basically me telling I'm or someone telling. The second is bad allergy or congestion symptoms that just don't go away with traditional congestive therapy or anti congestive or anti-allergy therapy. And then an allergist or primary care physician looks in there and says, I think you have a deviated septum or I see a polyp in there, or I see a inferior turbinate hypertrophy in there. So in those cases, then they're referred or they come looking for someone like me to correct it. And then another is, they actually feel it, right. So this can sometimes happen. Like if you take a yoga class, and your yoga instructor says breathe through your nose, only through your nose, and you're trying to do it and you say, Man, I really have trouble breathing through my nose right now. Another is when you're exercising or running, and you expect to be able to breathe through your nose a little bit longer. And you try and try and try it but you can't you have difficulty. In those circumstances, people will come and say, Hey, I have trouble with exercise, I have trouble with yoga, I can't do it. And you know, we'll look in there and find invariably something wrong. Sometimes though, I have to say, with running or exercise, if you're reaching a level of aerobic activity, or an oxygen demand that is up to a certain level, you're not going to be able to make that happen with a even optimal nose. Right. So if you're really getting a good workout, and you're doing a hit exercise, for example, that stands for high-intensity interval training, I think you guys pretty much all have heard this, by now, you're not really always expected to be breathing through your nose the whole time. So I often often have to tell people that after I've done an operation on them, they say, Well, when I still still can't really breathe through my nose, when I run, if you can breathe for the first mile, you're fine after that you're expected to breathe through your mouth. Because you're getting a workout. Okay? That's how it works. So that's not always the best determinant. But it is often something that brings people here. And then the next one is disruption of breathing in sleep, or excessive snoring and sleep or just noticing that when they lay down one side is better than the other one side is worse than the other, not being able to sleep on one side, for example, those things come up very, very often. Now that brings in interesting things that need to be noted, this is often a good time to be talking about snoring and or sleep apnea with your surgeon. A lot of surgeons have no knowledge of this, and they're just like, let's just fix your nose. Okay, well, that's cool. But you have to take the whole patient into perspective, you got to take the whole breathing function into perspective. And sometimes you have to address sleep apnea and or snoring as well. snoring by itself is not a problem. It happens in a lot of people. It's like 80% of men over 40 and some high percentage of women over over 40 as well. So it's one of those things you kind of have to deal with, eventually reading glasses or changes in vision or whatever, right. But sometimes it can be a problem if it's a problem for your sleep partner or spouse who sleeps next to you and they can't sleep because you're too loud or something like that. And sometimes correcting a nasal airway can help that but not always, when these issues come up. If you have a sleep partner or a roommate, for example, even that's in a different room that hears you snoring a lot, but thinks that your snoring sounds scary, because it sounds like you're gasping or having a hard time breathing, then in those cases, you may have sleep apnea, you should have this assessed with a questionnaire initially. And then after that, if the questionnaire is showing positive signs or high likelihood of sleep apnea, you can have a home sleep study, which makes things a lot easier than what it used to be having
Dr. Torkian 29:00
to go into a hospital-type setting and sleep on a hospital bed with a whole bunch of probes attached to you. You can just do it at home and it's relatively easy to do they send you an instructional video or a link at this point because everything's online to a video so you can see how to hook it up and you do what it says basically sleep wake up, send the machine in, and then they'll tell you in a couple of days whether you have sleep apnea or not, it's great. So if you do have sleep apnea, a rhinoplasty or septoplasty on its own usually can't help you so you're going to need something else. Different topic for a different day. But that's what sometimes comes up during these discussions of breathing, septum deviation, vestibular stenosis, so on the vestibular stenosis, I should say as a last thing is a particularly interesting topic. One reason is that of course in sleep it can cause disruption and make it harder to sleep on one side versus the other. Sometimes people will prop up their their face on their face or on their hand in a certain way to pull their cheek out so that they can stabilize the vestibular or sidewall area of their nose, so that when they breathe, it doesn't collapse in when they're taking deep, deep breaths, and that helps them to sleep better. But also vestibular synthesis, the area that we treat for vestibular stenosis is usually related to cosmetic appearance as well, that nice curvature or the curved line that we were discussing that comes in from the tail of the eyebrow, and sort of curves in along the arch of the eyebrow, and towards the nose, and along the bridge of the nose down towards the tip. When you're doing drawing instruction. For example, if you're trying to draw a face, that nice curved line depends upon having a very smooth transition between the bone and the cartilage of the bridge when you're looking at it from the front. So the sidewall has a bony part and it has a cartilage part. And those two areas if they're not smoothly attached to each other, it looks funny. In the old days, when, when this area was kind of ignored and not treated. That area was frequently responsible for an issue that in pictures look like a upside-down V-shaped shadow along the bridge of the nose. And for that reason, it was called an inverted v deformity. And so those things are now avoided by putting in little grafts that come from the septum. And or maintaining a proper width ratio between the bone part and the cartilage part of the bridge. And that's one of my pet peeves. When I see noses that I'm doing revisions on when it hasn't been done, I say well, they should have done it right. But you know what, sometimes, it's doesn't seem like it's the right thing for the patient. Or sometimes surgeons believe or are misconceived, or even patients have misconceptions that grafts like that can cause widening of their nose. Whereas in reality, if they're done appropriately, they don't cause any whitening at all, but they cause a nice smooth transition between the upper and the lower part of the bridge and prevent breeding problems down the life. So there it is, in a nutshell, the five top reasons that I do rhinoplasty in my office and the little instruction on each topic on how it's done, why it's done. pitfalls, benefits, so on. If there are any questions, a consultation for your nose at my office would be the right way to address them. It's kind of hard to answer questions, here and there for individuals. But if there's any overall questions or basic questions, please don't hesitate to email them to us at Hello@drtorkian.com. And of course, thank you for the downloads. Let's try to hit 2,000 by next month. Let's try to hit 4,000 the next one after that and then double them exponentially from thereon. So that all the questions that I answer can be heard by the entire world that would be awesome. World domination of answering questions by Dr. Torkian over coffee on Fridays, please don't hesitate to call my office (310) 652- 6673 for consultation, or like I said Hello@drtorkian.com. And I can answer questions that way as well. And I'll probably sometimes do them on a podcast because of questions come up often then many people want to hear. Don't forget to follow us and subscribe to our podcast beauty in progress by Dr. Torkian. on Spotify, Apple podcasts, Amazon or wherever you get your podcasts. Thank you and have an amazing week. Great weekend and see you next week. This is Dr. Torkian for beauty and progress signing off. Please don't forget to follow me anywhere you get your podcasts including Apple, Spotify, or Amazon
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