Coffee and Cleavage
Welcome to Coffee and Cleavage! A podcast about sex, dating and everything in between hosted by Lynnie Marie, Claudia Fijal and their witty studio producer Gary. Together, they'll shatter taboos, tackle the most risqué topics, and leave you craving for more.
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Coffee and Cleavage
Perfect Or Fake? (Featuring Dr. Khorsandi)
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What happens when beauty becomes optimized?
In this episode of Coffee & Cleavage, Claudia Fijal and Lynnie Marie sit down with Dr. Khorsandi to discuss the evolution of modern beauty standards and how plastic surgery, peptides, fillers, Botox, and social media are reshaping the way people see themselves.
From subtle enhancements to extreme transformations, we explore the psychology behind cosmetic procedures, the pressure created by the internet, why everyone is starting to look the same, and where the future of aesthetics may be headed.
Featuring Dr. Khorsandi
IG: @docvegas
Welcome to Coffee and Cleavage.
SPEAKER_04Welcome, guys. I'm Lenny and I'm Claudia.
SPEAKER_02And a very special guest today.
SPEAKER_04We have, I'm gonna say, top three favorite people in my life. Vifar, Vifar, Doc Vegas, Dr. Corsundi. Number one, just thank you for changing my life. I know I say this to you uh personally all the time, but I think our viewers also need to know you're the you're the man behind my confidence, my finances, my livelihood. So thank you for changing my life, changing my body, and for for being on our show today. Yeah, thank you.
SPEAKER_01I am honored to be here, but it's a very sweet sentiment.
SPEAKER_04It's it's it's very true. And what our viewers don't know is you are the reason behind so many of the most beautiful transformations, not only in Vegas, but all over the world.
SPEAKER_01Yeah. Right. Yeah. Thing about my practice is that it's a fly-in practice.
SPEAKER_06Yeah.
SPEAKER_01And I think, you know, settling here in Las Vegas, I had originally thought, you know, Beverly Hills was the place for me. I'm a New York guy, and you're either a West Coast or an East Coast personality. And California wasn't my place.
SPEAKER_06No.
SPEAKER_01You know, it it was it felt like everybody was acting all the time.
SPEAKER_06Yeah.
SPEAKER_01And I was used to very, you know, straightforward talk. You know, you say what you say, you do what you do, your handshake is good. And I found that that did not apply in Los Angeles in any way whatsoever.
SPEAKER_03No.
SPEAKER_01So I uh I ended up here in 2008. Right. And somehow the city, I don't know, people say, Did you choose it or did it choose you? And I and what's the answer to that? I still don't know. Yeah. I mean, like, there's days when I think that for what I am and the way I approach things, there couldn't have been a better place than most of it for me.
SPEAKER_06Yeah.
SPEAKER_01Um, you know, plastic surgery is such a it's such a difficult field, but yeah. It's it's you're dealing with human appearance, you're dealing with things on the surface, right? And you know, all the other fields of surgery, you can hide your mistakes in some way or another, you know. The gallbladder is not perfectly done. Maybe they know, maybe they don't. Yeah, right. But everything that we do, every stitch that we place is visible in the end. And here in Las Vegas, as opposed to places like LA and New York, um, the work is on full display, right? On a daily basis, without filters. Um this is at the pools, uh the blackjack dealers, the cocktail waitresses, uh in the strip clubs here, which you know we are known for. And so it kind of elevates your skill set because good enough just doesn't get by.
SPEAKER_04No, it doesn't. And so you I mean you've been in this industry for such a long time. How in your eyes has aesthetics and plastic surgery changed over the years?
SPEAKER_01Well, you know, when it comes to plastic surgery, you gotta work on principles, right? And certain principles never change, right? And so if you approach things with a principle mindset, certain things about beauty are gonna be transcended. They'll they'll they'll be there for all of time. Yeah. Certain things about proportions and ratios, the golden ratio. But then there's things that happen throughout a period of time and there's trends, right? And and just like with fashion, you know, you should be um, you know, fashionable, not trendy, right? You should be classic in a certain sense. Um we saw a a a complete rotation over the last four years in some of the aesthetics of the body. Where, you know, earlier on in the beginning of my practice, before we really got into BBLs, which is fat transfers in the one of the things that was very popular was this gastric banding procedure, right? Where people who are a little bit overweight would go in, get an hour-long procedure, band their stomach, lose weight. And then we were dealing with a lot of loose skin. Yeah. Right. So we saw a lot of body contouring come in from weight loss. And then somewhere along the way, people realized that, well, I don't need to lose the fat.
SPEAKER_04I could just move it. Just move it somewhere else. You know, I mean, but that's good, right?
SPEAKER_01Like it is. I mean, to a certain extent. And I and I think with any sort of idea, there are those who take it to extremes, right? And so we saw, you know, exaggerated BBLs that, you know, there's certain, you know, principles again with that that once you violate them, it's hard to go back.
SPEAKER_06Yeah. Yeah.
SPEAKER_01There really isn't a good butt lift procedure. There, there are butt lift procedures, but once you overdo it, once you blow out that tissue, yeah, it's hard to make it back. Yeah. And so one of the things we're seeing now is people reducing those BBLs.
SPEAKER_04What are you like reversing the most of? Like, do you feel like it's BBLs or is there something else that like people are like, eh, this wasn't a good idea, actually?
SPEAKER_01Well, now we've come full circle, right? So this is this is how you know trends go in plastic surgery. In the beginning, it was like these gastric bands and sleeves with weight loss and you know, lifting and tummy tucks and arm lifts. And now with the GLP one and two agonists and the black market read a true tide, right? Yeah, which isn't FDA approved, but so many people are on these things. Right. It's you know, peptides. I and when I was growing up and I was working out in the gym, it used to be steroids, right? Yeah. And there was like this very hush-hush thing. And now people are just ordering things. Now, granted, the mechanism of action is a little bit different, but everybody's doing peptides and they don't know where they're getting them from. And most of them are made in China. In China, yeah.
SPEAKER_04And these people are promoting them and talking about them.
SPEAKER_01Like there's so many talking heads on the internet that are experts in metabolism and hormones that they're not physicians. And I mean, they don't, they're not chemists either.
SPEAKER_04I I want to see one of these influencers pushing the peptides. Name four hormones and where they are in your body. And and and and what and what they're doing.
SPEAKER_01They're four organs.
SPEAKER_04Exactly. And and four four functions that they do and like what what their response they couldn't, they couldn't tell you that.
SPEAKER_01So now what we're seeing is that that thing come full circle, right? Where moving fat around isn't really what we're doing because people are coming in so skinny.
SPEAKER_05Yeah.
SPEAKER_01Right. They're they're coming in, you know, you have a person who may be 10, 15 pounds relatively overweight, and they're losing 30. Right. And, you know, like it or not, I'm in the self-esteem business.
SPEAKER_06Yeah, you are.
SPEAKER_01Right. And so nothing boosts a person's self-esteem more than fitting into clothing they couldn't fit in before. Right.
SPEAKER_03Yeah.
SPEAKER_01You take somebody who's, you know, arguably a few pounds overweight and they lose 20 pounds, their self-esteem goes through the roof.
SPEAKER_03Right.
SPEAKER_01And so in the early phase of this, we you know we saw a major dip in liposuction, right? Um, because you didn't need it anymore.
SPEAKER_06Yeah.
SPEAKER_01And then the idea of putting it somewhere else just doesn't exist. You know, we struggle now to find enough fat for fat transfer on patients. And um so back to lifting and restoring.
unknownRight.
SPEAKER_01And and the biggest thing that I've seen in the last two years is, you know, needing to restore breast tissue. Right. So you'll lose the weight, the envelope of the breast becomes kind of deflated, and you can put an implant in there. And sometimes it works. Sometimes you need more than that. And one of the most common things that I'm doing now is using an implant and fat at the same time, right? So we don't need as much fat as we would with a BBL, but you could take the implant and you can inject some of your own fat around it, and then it becomes much more natural. I'm a little familiar with this procedure.
SPEAKER_04And you guys know I'm I'm very, very honest. And you obviously, Doc, know I'm very honest with my procedures with my fans and subscribers. I, you know, I love sharing this stuff with you guys because there's there's so much involved with it. But I recently, what two weeks ago now, I had this done. We actually, Doc took that from my arms and we we moved it to the breasts, and it just creates such a beautiful, full, plump look. We did it over existing implants, but the result is just phenomenal.
SPEAKER_01Yeah, I learned this about eight years ago. I was traveling teaching. I was in Marbella, Spain. There was a teaching course, and one of my colleagues from London was there. And in in England, you know, the idea of a big breast implant is very like, whoa.
SPEAKER_03Really?
SPEAKER_01Yeah. Yeah, 300cc is big.
SPEAKER_03Oh, God.
SPEAKER_01Yeah. Yeah.
SPEAKER_03So that's a starter size. That's a starter kit here.
SPEAKER_01At the introduction period. But, you know, patients would come in saying, and the numbers would really matter to them rather than the outcome. So he's like, uh, more than 300 is too much because there's this common societal mentality, right? But I want cleavage and I want fullness on top. And so, you know, he's a very brilliant guy. And he said, well, let's put the 250cc implant in and let's put 200cc of fat over it.
SPEAKER_06Right.
SPEAKER_01And this was totally acceptable because it looks like a natural breast, right? Feels like much more like a natural breast. So I brought that back about seven, eight years ago and started using that more and more in the practice. And now it's it's my main toolbox for you know, secondary breasts, uh, patients who've lost a lot of weight, yeah, need some volume with some structure. And here's the thing the breast implant itself gives you the form, right? You can't get form by just putting fat in there. Right. The breast will have this 1970s Playboy look, nice and natural, which is fine for a lot of patients, but most people have come become accustomed to having fullness on top, cleavage, as we see today, right? There, there's a reason for that, right? There's an evolutionary reason for that.
SPEAKER_06Yeah.
unknownRight.
SPEAKER_01Um, and you just can't get that with one or the other. You need both now.
SPEAKER_04But it's funny because that woman would never get a 450cc implant, but she'll do the 200 with the 200 fat over it. Of course. It's crazy. Like how how how the brain works.
SPEAKER_01Like well, I think you have stigma over certain things.
SPEAKER_04Of course. Right. Yeah.
SPEAKER_01And I'll do this, but I won't go past this point. Yeah. And it's an artificial number.
SPEAKER_06Yeah.
SPEAKER_01Right. And and it's really driven by other people, like their friends.
SPEAKER_06Yeah.
SPEAKER_01You know, my friend, you know, she got a 400 and it looks crazy.
SPEAKER_06Yeah.
SPEAKER_01That may be because she had about 600cc of natural breast tissue. You stick a 400cc implant in there, and you're at a thousand cc's.
SPEAKER_06Crazy.
SPEAKER_01Right. It's all math, right? It's all math. I know.
SPEAKER_04What is like the craziest request you've ever gotten? That you were just like, I can't, yeah.
SPEAKER_01Yeah. Well, I was doing a labiaplasty on that patient, and um, labiaplasty is, you know, down below, taking off some excess tissue. And um, she had an interesting request. She goes, Can I keep the tissue? And I said, Right? Generally, no, but you know, it's it's you know, it's it's a human tissue.
SPEAKER_04Yeah.
SPEAKER_01You have protocols for disposing it. But I asked why.
SPEAKER_04Was she selling it on OnlyFans?
SPEAKER_01No. Her boyfriend wanted to cook it and eat it.
SPEAKER_02No! Oh my god. Oh, okay, whoa.
SPEAKER_01So I had to pull her aside and I said, you know, are you in the safe relationship? Because uh, cannibalism is something that you know you gotta be a little bit concerned about, even if it's covert. Like, you know, what's the motivation for all this? Wow. So you know, I said no politely, and uh, you know, it was a lot of disappointment. But uh, I was happy I was happy I was happy that that's as far as it went. Yeah. Yeah, you get strange requests all the time.
SPEAKER_03That's crazy. Yeah.
SPEAKER_01Never had a request for a third breast, although you get some of that from you know, science fiction people who are like, you know, they've watched uh Total Recall and they're like, Can I get a third boob somewhere? I was like, no.
SPEAKER_02What's the youngest someone has come in asking for a facelift? Because you know, you see now everyone seems like they're getting a much sooner now in their early 30s.
SPEAKER_01Yeah. So the reason for that is we went through another period of time from 2003, right, to probably 2023 where fillers were just basically everywhere. And I'm talking about hyaluronic acid fillers. Those are your juvenerms, your restolines. Um you know, there's an old saying when all you have is a hammer, the world looks like a nail.
SPEAKER_06Yeah.
SPEAKER_01And so so many providers opened up shop that had no other tools. Yeah, these are cosmetic nurses, uh, nurse practitioners, PAs, physicians who have no plastic surgery training, but they would open an account with one of these companies and they get a syringe in their hand. And the only way to affect change was to fill things.
SPEAKER_06Yeah.
SPEAKER_01And so early on, because you know, I developed a pretty big social media presence in the days when nobody was on social media for plastic surgery. I got a lot of influencers coming by and saying, Well, I'll do some content if you give me a syringe of Voluma or some other product, and you say, Okay, great. And then, you know, they go off, and then you see them somewhere else, and you see them somewhere else. And over the course of a year, they would make their way back to you. And, you know, one syringe turned into like 15 and they started to look like aliens.
SPEAKER_06Yeah. Right.
SPEAKER_01And, you know, we now know that some of that HA filler gets into your lymphatic system in the face and causes this kind of clogging, congestion, this puffiness. And those patients that were really heavy users of fillers in the last 10, 15 years are now my facelift patients. So those who started at age 18, right, and did 10, 15 years of fillers, when you melt those fillers out, yeah, the tissue of the face has now been stretched out.
SPEAKER_04And correct me if I'm wrong, but doesn't like when you that filler weighs something, right? Right. Doesn't that like make the weight of it just make you droop anyway? Like just from the weight of the filler?
SPEAKER_01There's that, but then there's this physiological problem that happens. You know, these are gels, right? Gels, gels are made up of water and something else, which is the HA product. Well, most of these filler products like are like sponges. They pull water into it, right? And they vary about how much water is stuck to it throughout the day. So when you stand up, you're a column of water. Like your toes get the most pressure, your head gets the least. But when you lay down at night, all that pressure evens out and then your face swells.
SPEAKER_06Yeah.
SPEAKER_01And then you stand up. Some patients say, My eyes are puffy. A lot of patients who have lip filler say, My lips are really swollen in the morning. I love the way it looks. That's because you're laying down, all that pressure evens out in your body and your lips get more swelling.
SPEAKER_03Interesting.
SPEAKER_01It's that swelling contraction, swelling contraction over time that loosens the tissue up. And when this filler gets melted away, these patients have seen, you know, they look much older than the stated age. And so that's when you start seeing patients in their 30s. And I I've probably, I think the youngest patient I've done is like 31 or 32 for a facelift, but it's not what you think it is. It's it's there's a lot of jowling. Um, none of the lasers, none of the devices, the threading doesn't work. It's all nonsense, right?
SPEAKER_06Yeah.
SPEAKER_01It'll get you temporary improvement, it won't get you correction. But most of the time with facelift, we're not trying to make you look different. We're trying to put things back in place. Right. And um, you know, I I think that that can occur much younger now. And I think the other thing is that in the past, you know, there was much less scrutiny on a woman's face. Of course. Right. You take, you know, I get a I have a Polaroid camera that we take out for holidays, and when everybody's sitting around, you take a picture and you like you kind of make out a face, but you don't see any details. And now with everything HD, like, you know, we're up close, it's the the details, especially for somebody whose business is in front of a camera, yeah, really matter. And so having a little bit of jowling, have a little bit of lines in the face just doesn't cut it.
unknownYeah.
SPEAKER_01Right? Because there's always going to be somebody younger and prettier if you're trying to use your image to attract an audience.
SPEAKER_04Well, and I think one of the biggest negatives, I think personally for me, it's these filters online have completely ruined how I like look at myself. So because I'll put the filter on and I'm like, oh, this looks great. And then the filter comes off and I'm like, oh my God, like the I like and now I need a facelift. Like I've I've bothered you five times about a facelift. You're like, not yet. But like it's these filters, like because you see yourself in a certain way. And now you're like, what the hell?
SPEAKER_01I think you know, the the shock came to me somewhere around like 2015 when like social media was really kind of growing in the beginning.
SPEAKER_06Yeah.
SPEAKER_01And I had a playmate, she was playmate of the year. She came in and she said, um, you know, up until this point, people would bring in pictures like Angelina Jolie, you know, other actresses that they wanted to look like. So give me her cheeks, give me her lips, give me this. But this playmate came in and said, Can you make me look like my photos? And and this is before filters, right? Yeah. And so there was like a wait, what? Yeah, right. And so it seems kind of commonplace now. Yeah. But back then, you know, Playboy was doing a little airbrushing and stuff, and you look way better in your picture than you would, you know, looking in the mirror. And it's not to say that they didn't look like that, but there was a little enhancement, right?
SPEAKER_06Yeah.
SPEAKER_01Um, that was an eye-opening experience. And then along comes filters, right? And now, you know, there's this incredible kind of backwards sort of thinking. For a plastic surgeon on social media, you can't really show before and afters or you get shadow banned. And the rules and the policies of some of these social media accounts say that you don't want to instill an unhealthy self-image. Sure. But the reality is these are the companies that created filters to begin with. Correct. That led to the patients coming in to help correct what they see in the mirror. Crazy. Right. Because what what I do is, you know, try this is something that I realized, you know, why did I use all my intelligence and talents and skills to go and do cosmetic aesthetic surgery? Right. I could have done a lot of things.
SPEAKER_06Yeah.
SPEAKER_01But there is something really satisfying about making somebody's inside match their outside.
SPEAKER_06Yeah.
SPEAKER_01Right. And when you look in the mirror in the morning, I always say there's this like little move we all do. We kind of like comb our hair and then we kind of do this little back and forth to go, uh, that's the person that I want to see for the rest of the day in my head.
SPEAKER_05Right.
SPEAKER_01And you go, that's her, that's him. You turn around, you walk out of the house, and that's carried around as your self-image until you run into the mirror again.
SPEAKER_06Yeah.
SPEAKER_01Right. There are some people that never have that opportunity to get to the point where they say, Oh, that's what I like to see for myself.
SPEAKER_06Yeah.
SPEAKER_01There's a disappointment, uh, uh and a personality kind of becomes stifled when they see themselves in the mirror and they walk out and they're less of a person.
SPEAKER_06Yeah.
SPEAKER_01You know, that inside what they think they should look like and what's actually there don't match.
SPEAKER_04Yeah.
SPEAKER_01And so so much of my work is trying to bring those two into harmony.
SPEAKER_04So, what do you think is like something that like, what is the biggest mistake people make in striving for that perfection? Like, what what what is something like you're like, eh?
SPEAKER_01Well, there's no perfection. That's the first thing. Yeah. As soon as a patient says, Well, I want this to be perfect, go, uh, uh, timeout.
SPEAKER_04I say all the time, one of my favorite sayings in the world is it's not perfect surgery, it's plastic surgery.
SPEAKER_01Yeah, and you said that the other day, and I loved it.
SPEAKER_04Yeah, and it's so true. Because like, even, you know, even us, like we'll go in and like we have this like you know, expectation of what's something supposed to look like, and then it doesn't happen the way you envision in your head, and then a a a patient that doesn't understand how this works will come to you and say, What the hell?
SPEAKER_01Well, first thing, yeah, somewhere along the way, some ancient Greek physician named Patience, Patience, because nobody's patient, right? You know, and it it's it's the nature of our modern society that everything's at a push of a button.
SPEAKER_06Yeah.
SPEAKER_01So there's a healing process. You know it, you've been through it. Anyone who's been through it knows that you have to, you know, a little bit of a bumpy road in between now and the result. Yeah. Um, but I think, you know, more and more people are coming in saying that I don't feel right. And I just want to be better.
SPEAKER_05Yeah.
SPEAKER_01If somebody says they want perfection, I say, look, I'm not the guy for you. Yeah. Right. I can get you to a certain place. And then you also have to kind of want to be, you know, more in love with yourself. Yeah. Right. You've got to accept certain things. And, you know, I think people understand that for the most part. Yeah. You do get some people that will never be happy with themselves.
SPEAKER_04And do you turn those people away? Like, do you do you feel that and and say, you know what, like it's it's going to open up Pandora's box of of an unhappy person and bad reviews and whatever.
SPEAKER_01Sure, saying no is a tough thing because you have patients that come in and say, you know, they they they they uh buff your ego and they say, you're the best, you're you're the only person I know that can do this, and this is what I need done. And you go, you you don't have that problem.
SPEAKER_06Yeah.
SPEAKER_01And they get upset because they know in themselves that they see it.
SPEAKER_02Yeah.
SPEAKER_01And so something interesting about the human mind, it's like when I'm I used to operate and do microsurgery. So you're looking through a mic microscope, yeah, and you're looking at something that's like so small, it's like maybe a couple millimeters across in the microscope. But it fills my whole field of view. My whole psyche sees this entire thing. Yeah. Right. Our brains are designed to do that, right? To focus on things and make them bigger. And the more we focus on it, the bigger it gets.
SPEAKER_06Yeah.
SPEAKER_01So I've had to write on a prescription pad sometimes with patients where they point to something and they go, see this. And I go, No, I don't. And then I call, you know, my staff over and I go, tell them what you told me. And the staff goes, I don't see it. And I call a third person if it's really serious, you know, they they really convinced they have it. And sometimes I'll say, I'll write on a pre a prescription pad. You are not to look at this for four weeks at all. And if you catch yourself, you have another four weeks. And what happens over that period of time of desensitizing yourself to that is that it disappears.
SPEAKER_06Yeah.
SPEAKER_01And a good example of this is like you ever take a picture, right? And you look at it and you go, I hate that picture.
SPEAKER_05Yeah.
SPEAKER_01Yet you keep it, right? And then you go back a year later and you see that same picture, and you go, you know what? I look pretty good there. Yeah. And you knew you hated that one picture and you can't remember why.
SPEAKER_06Yeah.
SPEAKER_01That's exactly that.
SPEAKER_06Yeah. Yeah. That's true.
SPEAKER_01Yeah. Super true. We're we're all susceptible to that.
SPEAKER_04Yeah. Yeah. Or you think, like, oh my God, I was so fat 10 years ago. And now you look back and you're like, I look pretty damn good.
SPEAKER_01Yeah.
SPEAKER_04Like, I wish I was as fat as I am, you know, then. Like I want to be that that fat now.
SPEAKER_01Like, I like well, why do you think that is? Wait, what is it? I I for women, I think, and you tell me if I'm wrong, that women are in such a state of comparison now more than ever before. Yeah.
SPEAKER_04Oh, yeah. Yeah. Yeah. And for me, I think personally, like a big scope of my business personally is video calls.
SPEAKER_05Right.
SPEAKER_04So what do I do all day long, I stare at myself on a screen. I probably look at my screen for seven hours a day of just straight looking at myself. This, you know, it and then what do I see? I gotta nip that. I got to tuck that.
SPEAKER_01And it's, you know, and I'm not you're really good about being realistic about it. I am. I am. You come in sometimes like this face, no Claudia.
SPEAKER_04Yeah, I've I've asked him for a facelift so many times. He won't do it.
SPEAKER_01He won't do it.
SPEAKER_04But the things that you have fixed on me, like we we always have this this running joke doc. And I like every time I get like a like a boob enhancement done, my husband's like, how much more money are we gonna make this this this year because of this boob job? And the first time you you redid my boobs, you were like, you're gonna make 25% more money this year. And I'm like, dog, you're full of shit.
SPEAKER_05Right.
SPEAKER_04It was like 24.7% more money I made that year because of this boob job. So now I'm like, well what if he like tucks my face a little? How much more money was I think and I know and I'm very aware I'm very self-aware and I know I look great especially for my age and I feel great. But women yeah all day we're we're we're scrutinized we're comparing ourselves but like women like us, we shoot content.
SPEAKER_01Right.
SPEAKER_04We we all we do is we look at ourselves all day long.
SPEAKER_01You pick yourself apart.
SPEAKER_04Yeah. And you know what the final straw for me was with this last boob job with you. I was I was denying it for like two years I saw this like weird ripple in my boob. I'm like leave it alone leave it alone leave it alone. And I was talking to one of my fans online and I'm like oh I'm actually going to go see you know Dr. Cursandi and that's all I said. And he goes oh is it for that weird divot in your boob yeah oh when they point it out or they remember it.
SPEAKER_01Yeah and I never even mention this to this person and I'm like okay so that that I think I think that that pushes people over the edge in terms of going in to see somebody is when you get confirmation of a fear.
SPEAKER_06Yeah.
SPEAKER_01Yeah you know there's something that you covertly don't like about yourself.
SPEAKER_06Yeah.
SPEAKER_01And then somebody points it out. Can't right and you're like well it's not just me. They see it people see it yeah and I don't like them seeing that and I don't like seeing it myself.
SPEAKER_06Yeah.
SPEAKER_01So you know what we did is a minor correction.
SPEAKER_04Yeah. But we did add a little bit of volume we did and they look so good. Yeah. A lot of volume. Yeah a lot of volume they look extra great.
SPEAKER_01What I like to say is one time we did this on a patient and and you know they had these kind of extra high profile implants and they kind of looked not natural. They kind of looked a little bit pointyish right and I remember putting the fat around these implants and we did one side and we sat the patient up and the one breast looks like an implant and the other breast I was struggling to find the words that describe it. And we're in the OR and I'm like please tell me why these two look different why the one with the fat looks better. And then I finally said you know that breast looks more welcoming than the other ones it's like you know that one yeah looks like it could fight you this one looks like you know it's it's it's a nurturing place right so and it goes back to some sort of biology right and that's what the breast is.
SPEAKER_03Absolutely that's really cool.
SPEAKER_01The breast is something that we're all nurtured by right and um you know there are there are men who are breast guys you know there are men who are other body parts butt guys eye guys whatever you want to call it but the breast you know holds a sort of sacred place in our psychology. It's it's it's what nurtures us it's what we you know get our first substance from when a baby's born they put the baby on the mom's breast for contact time for bonding. And um then evolution did this little trick right and so when we started walking upright we used to walk on all fours according to the theory of evolution and so you know the business was from behind right and so you know you're kind of walking through the jungle and you're like all right there yeah that there's my girl right there. But when we started walking upright we started talking facing each other and um Mother Nature or you know the divine hand decided to give us this kind of butt looking thing up front here. Right. Because if you look at cleavage right I used to do this this this little trick when I did this lecture uh and I used to do it internationally and I take these little windows of a picture and and I would ask people in the audience if they thought it was a butt or a breast right and it would just show like this little cleavage area. Yeah and most of the time people would get it wrong right and and it would be 50-50 and like and as you expand the image you say no that's a butt that's a that's a breast that's a butt. And and you see this this what we call homology you know these two structures start to look alike. Yeah. So why do men get triggered by breasts? Many reasons. One it's the original nurturing place right two it's it's taboo right we we we cover up nipples in this country for women um probably because you know there is this sort of biological trigger but three you know good good good cleavage triggers this sort of reproductive drive in us and says well I want to I want to get in between those those puppies. Those puppies yeah so betwe between I was gonna say you know coffee and cleavage great this is a great name for a body name right yeah yeah between two boobs would be another between two boobs right between two ferns right so yeah we miss that opportunity right when people um go to extreme with surgery how come most surgeons don't stop them or you know I have maybe one or two patients that are body modification people you know where they have an extreme look and um am I one of them? No I mean you know breasts I mean again it's it's part of nature. We see this um and you know cleavage again like I said triggers a lot of things but this is this is a patient that has uh very large lips that goes by this you know moniker that kind of talks about their lips it's their whole social profile but they make their entire living on it yeah and you know I met her like six years ago in my practice she came in and she had really large breasts she had a complication she had to take them out I didn't do the breast implants they were like four three four thousand cc massively right and so she was struggling to support her family you know against me and she had like you know lips and she was getting them bigger and she said will you help me get to this point and I said you know this is like that could be career suicide right you know you you're you're doing something that's so exaggerated. But I've been you know little by little over time I've helped her to get to a place where she can monetize that. Yeah and you know she's the sweetest human being and when I look at it I say well this is this is her goal this is not uh body dysmorphia she's just like somebody getting tattoos I mean there are people with piercings in so many different places nobody gives them a second thought about you know whether they're okay doing that right and we accept that we all have this kind of road that we're on and the way we want to live it and you know within a margin of safety it's okay to treat somebody who understands that this is what it is. Body dysmorphia is a totally different thing. For sure this is somebody that no matter what happens no matter how beautiful they are they never feel it. Yeah you know and that that's a different story. But those patients you have to have some real conversations with. Yeah. And oftentimes you know the sad thing is is that you care about them but you'll lose those patients to somebody who they'll go to and these patients will wave money in front of a number of physicians until somebody says yes I'll do it. And I've then they come back to you and say I shouldn't have done that. And you have to now try to unwind it.
SPEAKER_04And sometimes it's it's really difficult to do do you have any regrets that you've any of the things you've done, any fillers or surgeries or anything that you regret?
SPEAKER_02Um well anything I've filler when I've had it here I've had that completely dissolved. Yeah because I hated how it gave you a different look and like a cartoony with my breast I had yeah for a whole year.
SPEAKER_04She had a whole year of surgery stuff. It was crazy.
SPEAKER_01You know i I think those are cases that I see more and more of it used to be when you start out you know your your patients are really young and you're really young. And as you start getting more you know battle stripes and you learn how to handle difficult cases. A lot of surgeons don't take on difficult cases. But I used to love them because it's like you do this because you want to affect change and you see people who are in distress and you're like I can fix that. I'm pretty sure I can fix that. Yeah I have a plan I you know it and I usually tell patients with complex stuff it may you may have to go back and touch this up a couple times yeah but I generally the touch ups are small but we're gonna work hard to get this to where it needs to be at least get a base and then we can do a little bit better. But you get expertise in that and then suddenly you start getting a referral basis for this and you know you get seventh eighth time redoos and you know breast nose um the nose is a big one right I feel like people have to redo their noses so many times. Yeah I I I think you could stack the number of textbooks for breast uh for rhinoplasty surgery f floor to ceiling yeah because there's no one way of doing rhinoplasty there's so many different roads that lead to a result um and it takes a number of cases you gotta really do a lot of cases to be expert in it. Yeah and because no two noses are alike and I call it like the far scum surgery. You know you look at it from the outside and you open it up you go holy shit well especially if it's a revision. I mean I've I've found a piece of a tongue depressor propping up somebody's nose I've found you find stuff in there that you know you would never expect and then if this is not like something you could say okay we're gonna stop today I'll come back in a week we'll figure out what to do. You have to figure out at that moment what you're gonna do and you've got to get out of there and get something that work works for the patient, looks good. And a lot of guys don't want to do that. A lot of surgeons don't want that pressure for me it was like this is what keeps me in the game. Yeah. This is what keeps me motivated to go back every day. This is what keeps me getting better as a surgeon right so you amass all these crazy experiences of like how did I fix that crazy thing? Okay, I saw this before this is easy now.
SPEAKER_03Yeah.
SPEAKER_01Right. And then as you go along your career you you just become unfazed by what comes your way.
SPEAKER_03I'm sure you know I'm sure you've seen some crazy shit.
SPEAKER_01Yeah and you know the funny thing is people like do you read up the night before do you look over I go I just show up I unzip my bag and I go okay I've seen the patient before. Yeah yeah so in my mind I've said okay I I if I there's never a case where I I'm bringing it up to the OR that I don't have a plan for somewhere in my head.
SPEAKER_06Yeah.
SPEAKER_01But I've seen them maybe a month ago, two weeks ago three weeks ago three months ago and then I open up the bag oh this is this person, right? And then I look at it I go, okay, this is what we're gonna do.
SPEAKER_03You could put it together yeah.
SPEAKER_01Yeah and I think that that comes with time. But the problem is is that there are surgeons that don't have that experience, that dive into tough problems, that don't have any backup or any way of kind of like backing themselves out of a problem. Yeah. And they feel like they have to get it done and they get it done wrong.
SPEAKER_03You know and then you have the revisions.
SPEAKER_01Yeah and then and then and then you go look okay let it heal and you know the the hardest thing is when patients come in and they're cursing their previous surgeon and I never listen I I nod I learned this from my chairman right so when I was in training I was at the Cleveland clinic in like in Florida and the the the program director is a really nice guy from Canada and you would get these patients and you're a resident and you're standing there in the exam room with them and the patient's unloading and he would just sit there and be just nod and just smile at them and I'd be like say something like you know like say something and he would just say mm-hmm and just he would let the patient exhaust himself so I learned that trick and it it's good because really none of that matters. And what you say to a patient that's had a bad experience before is basically look you are here right now. Right. And what I see right now is where we're gonna take it from yeah right maybe you made a bad decision maybe somebody else made a bad decision doesn't matter that's not going to change what we're gonna do right going forward. Moving forward so if you want to pick up the pieces and put that in the past we can move forward from here that's what we're gonna do.
SPEAKER_06Yeah.
SPEAKER_01And so some patients you know they're really looking to assign blame and it's not something that I do.
SPEAKER_04And I think it's managing expectations too right like I I think people have like these these ideas of what's supposed to happen and it doesn't happen. But like your body's like like for example like if a woman comes into you and let's say she shows you a picture of Linny and you know she's naturally structurally wider and like you have to know like you could do all the lipo in the world. You'll never have her build because she's a small build you know like and people don't know that.
SPEAKER_01That's where you know not being afraid to level with patients and lose the patient really comes in handy.
SPEAKER_06Yeah.
SPEAKER_01Right. Because you know I was on a panel recently it's like a it's an aesthetic like innovator panel like I was down in Orange County and you know they asked the same question what do you do turn away patient I said you know there are times when I tell a patient this is what I can do and this is where we're starting and this is what's possible.
SPEAKER_06Yeah.
SPEAKER_01And I go, my job is to be a guide right I give you the facts I give you what can be done. I'm not selling you on it. Yeah I'm not telling you come on sign and one of the comment one of the other people on the panel says well you're not gonna sell a lot of surgery like that Chris and I go my job isn't to sell surgery. Yeah I'm a surgeon right right I'm there to provide guidance yeah experience you know be a guide on the road to get you where you want to be you know hold your hand through the the recovery yeah but I'm not selling you anything right either you understand this or you don't and and I you know the other thing that always is funny is people come up to you say oh you're the best surgeon you're the best and I said well okay that's very nice and very flattering but there's no such thing as the best yeah just like there's no such thing as perfection right and I I learned this on the beaches of Jamaica in like 99 or 98. I was there on spring break and um there were these four guys that just got off work right and they had a boom boom box and they were just like dancing and I was sitting there you know drinking a red stripe and watching these guys in the sunset just kind of like doing the moves and like you know I had gone down to Jersey shore for a bunch of summers and I was like all right which one of you guys is the best and this guy schooled me at that moment. He goes man he goes it's such an American idea being the best he goes it's not about who's best it's all about style. Each one of us has a different style because they all dance in a different way. Yeah and I was like oh shit that's something that I've carried with me a long time.
SPEAKER_06That's cool.
SPEAKER_01I love that because you know when a patient says you're the best I said well that's very nice. Okay. But what it is is I have a certain way of approaching things and you may have seen that person's result where they started.
SPEAKER_06Yeah.
SPEAKER_01And if that style of of taking care of that problem is something that you resonate with, we're a good fit.
SPEAKER_06Yeah.
SPEAKER_01Right? But I'm not I'm not the best. And as soon as you say you're the best, you're done. You're cooked.
SPEAKER_04And I also think you know you you can't say the best or anything or you know because you have your own style and when a a patient comes into you, they already have in their brain what they want to look like. You don't have to sell them. You know it's not like like I always see this meme all the time that's like I'm just gonna walk into my plastic surgeon's office and just sit there and he tells me what I need.
SPEAKER_01Well sometimes patients say tell me what I need and then and then I I drop everything and I go this is what I see.
SPEAKER_04Yeah.
SPEAKER_01Right?
SPEAKER_04If you give me that opening it's kind of like it's like Dracula maybe in that door did that to me once and it's it's actually a really funny story because I was going in for lipo once I've only guys I've only had like three surgeries like I'm making it sound like if it's 60 but I was going in for lipo once and I'm like what else like if we're already doing lipo like what else can we lipo? And you go you have really chubby knees. And I'm like I have a new insecurity I go what about the chicken nuggets? Yeah I'm like I've never I've never had like I've never looked at my knees and thought they were chubby and then when you said that I'm like I do have fat fucking knees.
SPEAKER_01No I didn't say like exaggerating so this is what you heard right in your head. And this is what I said. He said we were looking for some fat right and I'm looking and I go well what about the chicken nuggets? What are the chicken nuggets and I I go that's my name that I've given to that little area of fat on the inner side of the knee and everybody's grabbing their knees at the tear but but there's always about 7500 cc's of fat there. And you know it's it's something people overlook right it's easy get it's easy contouring it never looks bad when you take it out. And you know I put that in your head that there was a problem there but I was pointing out an area that you asked me to find I did I asked you to find it I did ask you and then suddenly you're like oh my God.
SPEAKER_04Yeah and then for like three weeks before surgery I'm like I have fat fucking knees in every photo I'm looking at myself I'm like fat knees fat knee bitch.
SPEAKER_02Like was that you got posted that photo where it looks like a baby ultrasound?
SPEAKER_04It does like I think knees look like like little babies in ultrasound.
SPEAKER_01Yeah that's me it's it's the inner part of the knee it's not the whole knee okay well if you need some fat look at your knees. Look at look for your chicken nuggets.
SPEAKER_04Yeah look for your chicken nuggets. Yeah okay final question because we like to ask all our guests this if you had to tell your younger self something what would it be?
unknownOh my God.
SPEAKER_01You know when I was younger like at 13 you know 10 10 years old I was a latch key kid right and so my mom gave me the bus map she gave me a key to the house she goes you know there's food in the fridge figure out what to do with it and um make dinner for all of us. So I got home and I immediately went to my dad's Playboys and you know I did too probably honestly I mean he had the whole collection from the 70s into the 80s and like I remember you know he was a member of the Playboy club in New York City and they would take us to the Playboy Lodge in New Jersey to go the like the cool key it's still there my brother that's I think my brother gaffed it and like but I remember growing up in that sort of time when you know beauty and glamour had this sort of sense of a mystique to me.
SPEAKER_06Yeah.
SPEAKER_01And you know if you look at the old Playboys you know you thumb through it yeah there's the nudity but there's also the the the the the guide to being a man right you know you had a hi-fi stereo system you wore a certain cologne you drove a certain car you vacationed in certain places and none of these things were unattainable. Yeah you know it's like English leather cologne right you can get it at at the the drugstore but they gave you a sense of you know masculinity and a femininity in in one place and I think we've lost that yeah you know I think you know um society kind of polarizes itself around nudity um I think funny story is like my mom caught me with these things at one point like I had a couple shoved in between the mattress of my bed as if that's the best hiding space for I guess for a Playboy. And I remember my mom got mad but my father was a physician and he said give them back to him that's anatomy right there.
SPEAKER_06Yeah.
SPEAKER_01And you go to the Louvre and you go to museums and you see nudity everywhere. Right. And American society kind of makes a taboo and but the body's beautiful you know and I think you know looking at those images as a kid there was a fascination with it a mystique you know even to this day of the human form of the female form. Yeah why is a curve beautiful why is that curve better than this curve right and and there was a fascination that began very early on and growing up in New York City you get to kind of walk around the city and see beauty everywhere. Yeah you know downtown models Soho all that stuff. So I got you know steeped in all this stuff at a young age and I just I never thought I would be in this position because I said you know at one point I probably got down and he said God surround me with beautiful women all my life and he said done this is going to be done you didn't you didn't specify how now all these women torture me a little bit you know sorry but it it is it is an irony and it's like when you look at your younger self and you look to what life is going to be you you you never imagine that this is the road you're gonna be on. Yeah you know and I I'm happy for it. I mean it's it's been an interesting career it's 18 years now um and you know the next chapter now is really you know developing products you know this and dealing with you know building something really remarkable. You are yeah yeah and so I mean it it it's the next chapter and it's it's a game changer in the aesthetic business.
SPEAKER_04Yeah well we're not gonna talk about it yet but when it comes when it comes out we'll definitely have you on and and and we'll talk about that again. So well cool thank you so much for joining us yeah cheers guys yeah cheers so much cheers to Doc Vegas and the reason his name is Doc Vegas because he he is that good he he runs this town so cheers guys.
SPEAKER_03Cheers