.png)
Big Butts No Lies Plastic Surgery Podcast
Big Butts No Lies is a plastic surgery podcast created to help women feel informed, confident, and prepared when navigating the world of cosmetic surgery.
Hosted by plastic surgery consultant and former patient coordinator Mavi Rodriguez, the show offers a rare behind-the-scenes perspective into how the plastic surgery industry really works. With more than 18 years of experience working inside top plastic surgery practices, Mavi understands how surgeons evaluate patients, how procedures are planned, and what recovery truly looks like after surgery.
Each episode features conversations with board certified plastic surgeons, recovery specialists and industry professionals who share their experiences with procedures such as breast augmentation, liposuction, BBL, tummy tuck and other aesthetic treatments.
Whether you are researching plastic surgery, preparing for a procedure, or want to understand the process better, Big Butts No Lies offers honest conversations, recovery guidance, and expert insight to help women make smarter and safer decisions.
Big Butts No Lies Plastic Surgery Podcast
Everything You Need To Know About Tummy Tucks ft. Dr. Andre Marshall
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
In this episode, our host & plastic surgery consultant Mavi Rodriguez is joined by board-certified plastic surgeon Dr. Andre Marshall. Together, they dive into the intricate world of tummy tucks, providing valuable insights and advice for anyone considering plastic surgery. These are some of the key points of this episode:
1. What are the differences between a standard tummy tuck, a mini tummy tuck, and an extended tummy tuck, and how do you determine which one is right for you?
2. Where will your scar be after a tummy tuck?
3. Can fat grafting to the breast substitute implants?
4. Does Aveli work against cellulite?
5. What are Dr. Marshall's professional views on Breast Implant Illness (BII), and how does he address concerns regarding this issue?
This conversation aims to empower individuals with knowledge and guidance crucial for making informed decisions about their plastic surgery journey. Join us for a deep dive into these topics.
Click here to get to know Dr. Andre Marshall:
Andre P. Marshall, MD MPH FACS (@drandremarshall) • Instagram-Fotos und -Videos
📞 Want help planning your surgery?
Book a discovery call with Mavi Rodriguez.
🌐 Visit our website: www.bigbuttsnolies.com
📲 Follow us on Instagram: @bigbuttsnoliespodcast
📺 Watch full episodes on YouTube
Hey, guys. My name is Mavi, and I've spent the last 14 years in the plastic surgery and beauty industry working alongside some of the best plastic surgeons in the country. No, I don't work for anybody. So I have unbiased opinions about hundreds of surgeons from across the world, and I can help you achieve the body of your dreams. Hey, guys, do I have the episode for you? Today I'm bringing back a fan favorite, Doctor Andre Marshall out of Beverly Hills, and we're going to talk all about tummy tucks. Thank you for being on the show, doctor Marshall.
It's a pleasure. Thanks for having me back.
I'm so excited. I know you're a fan favorite because your episode is very, very popular, I hear, in my DM's all the time. Oh, I found Doctor Marshall. I heard him on your show. I went to see him. He did an amazing job on me. Thank you so much. So I love hearing that.
Well, thank you. Thank you. I really appreciate the support that your podcast has provided over the years. And it's only going up and up and up. I love to see it.
Thank you. So today, I thought, you know what? Tummy tucks are such a big part of what we do, right? Mommy makeovers. Abdominoplasty is like, number one. So. But it's also very misunderstood. What? Who's the right candidate for what? So I thought today would be a good idea for us to really go into the different types of abdominoplasties. And who is a better candidate for what? So I hear so many times, and I'm sure you see it in your practice with your very thin moms, or moms who aren't very large, who think that all they need is a mini tummy tuck. But in reality, they're a better candidate for a regular tummy tuck.
Normal. That's tummy tuck. So why don't we go into the different abdominoplasties, and who's a good candidate for what?
Let's just start off with what is an abdominal plasti? And what is that definition? Removing the excess skin in the lower abdomen that constitutes one of the foundations of abdominal plastic. And then muscle repair. We talk about, you may see the term mister diastasis repair. Basically, once those kids have stretched your abdominal wall out, that muscle becomes separated. And not just the muscle becomes separated, but the fascia that holds the muscle together becomes loose all around. So the goal with any abdominoplasty is to tighten the core and bring those muscles back together and to tighten that fascia. To do that, you need wide exposure. You sometimes need to get all the way up to what's called the xiphoid or the breastbone, and we start the muscle repair from all the way up near, between the breast, all the way down to your pubic bone.
With a standard abdominoplasty that most people get, we're talking about removing skin from the top of the belly button all the way down to the pubic area, usually where the hair starts to grow. With that much skin removal and that much elevation of the skin, we can tighten the entirety of the muscles. With that, though, does come what's called, you know, a transposition or moving around the belly button. The belly button stays the same. It's the same skin that you've kept all your 20, 30, 40 years on this, on this earth. But once we pull that skin down and close everything, we make a new hole and bring that belly button up through that hole. And that's just the standard traditional abdominal plastic that usually goes hip to hip. And you see that scar that usually sits nice and low in your bikini line, as it should.
We could talk about the variations of some people put really high scars that are visible.
You know, I think that's a really good. Let's finish this thought, and then let's go into the different variations, because I know my girls are so curious about how come some of them are in the shape of a v, how come some of them are in the shape like they go across. And that's a really good topic for us to touch on.
Absolutely. So that's just basically a standard abdominal plastic. I think what many people think is they want a mini because they think it's a smaller scar. And that's not always the case. A mini just implies that you're essentially not touching the belly button, you're not moving it around, and you're just removing whatever skin kind of hangs over. So when you're sitting down, you may see a little bit of extra skin that, you know, kind of folds over in your lap and where that delineates or where that kind of stops, that's what is being removed with mini abdominal plasti. Could you do it with a small scar? You could, but sometimes as you keep that scar shorter, you end up with dog ears or extra skin on the side. So there are people who've had many tummy tucks, but that scar is just as long as a regular abdominoplasty because you don't want to have dog ears when it's all said and done.
Outside of that, I would say what I more commonly do is something called an extended abdominal plasti. And that's where the scar actually wraps around to, you know, around the flanks or the hips and doesn't go all the way like a 360 or circular tummy tuck, but does go back further than standard because, number one, it helps prevent dog ears. Number two, a lot of people who have lost a lot of have a lot of extra skin from, you know, a lot of flank lip. Well, they'll have that extra skin along their flanks, and that has to be removed. Otherwise you're going to have dog ears. And. And I think dog ears are the most costly mistakes somebody can make during a tummy tumor.
So with the mini, there is no muscle repair. Correct.
A lot of people that do minis don't do a muscle repair. So when I typically just do a mini, I will repair the muscle from the below the belly button all the way down. Because people who carry their kids low or have muscle separation lower in their abdomen, that muscle can be repaired. But if someone has diastasis that goes all the way up to their breast bone, and then you just repair the muscle down low, that may look a little bit funny. You may have an upper abdominal bulge. So, you know, last year I went to Columbia and trained with hoyos and learned his mini abdominoplasty technique, where you can keep a somewhat short scar about the size of the c section, lift up the entirety of the skin, including the belly button. The belly button comes up, and then you tighten the muscle all the way down. It takes some special tools and instruments, but you can still get a full muscle repair.
Take that same belly button, just kind of pin it back down so it looks essentially the same as it did before, and you still have somewhat of a mini type scar. So you can do full muscle repair with a mini tummy tug now, but.
It has to be by a surgeon that's skilled and that offers that.
Yes, it's not easy. It's actually harder, in my opinion, because you're working at a very, very small tunnel, trying to get all the way up to the breastbone as opposed to having all that skin lifted up like normal. So it's not just that everybody can do it, and most people won't offer it because they don't know how to do it.
I 100% agree with that. You have to, and this is for my girls. When you're looking for a mini tummy tuck, you have to be the right candidate for a mini tummy tuck. It's not just, oh, I don't want a long scar. So I'm going to go with this instead of with the longer scar because you don't want to cut yourself short. If you need a longer scar, it'll be hiding in your bikini. Anyway.
I've done hundreds of. Hundreds of tummy tucks. I think last time I counted, it was. It was over somewhere between, like, six, 6700. And I, you know, I have done more tummy tucks in people that have had minis previously than minis. So I've done more conversions from mini to full than just straight minis because most people are not candidates for a mini tummy tuck.
I 100% agree with that, and that's why I wanted to bring, you know, talk about it, because it's a very special, like, not everybody is a good candidate for that type of surgery. And let's talk about the extended tummy tuck. When I had mine, when I had mine, mine was extended. So it goes all the way to, like, the middle part. My kit.
Yeah.
On each side.
When you're looking at yourself from the back, you can see part of the scar.
You can see a little bit. A little bit on that.
I extended even goes even further. I would say if you take one butt cheek and go right to the middle of that butt cheek, that's typically how far it'll go. When I do a true extended. You know, I think, you know, most people are good candidates for an extended. I, most people prefer not to have a longer scar, but I would say more people prefer not to have dog ears when it's said and done. And I would say when you look at tummy tuck revisions, the most common reason for a revision is typically a dog ear.
100%. I agree with that. So one thing, another thing that I often get asked about, and I would love to hear your, your thoughts on it, is the floating belly button.
Yeah. So the floating belly button, you got to be careful with that one. So basically, in that situation, you've lifted up the skin and you're not going to make a new belly button. You're just going to pull down the skin and the belly button is going to get pulled down with it. People who are candidates for that, that's typically can be done in a mini, but it's good for people who naturally have a high belly button. So people say, where should my belly button be? If you were to stand up and put your hands around your, the top of your hip bones and grab and bring your fingers together, that typically is where your belly button should sit on your hips. So if you put your hands right on top of your hips, bring your fingers together, that is where in the mirror, standing up, that is where your belly button should sit. If your belly button is at that level or lower, I do not recommend floating it.
Now you're going to have a belly button that's pretty much close to your scar. If your belly button is higher than that by a couple of centimeters or inches, then, yes, you are more of a candidate for a floating belly button. Why would someone float the belly button? Because they're trying to avoid that vertical scar that you often see. And people who have a tummy tuck and they don't want that anchor type scar look because they don't have enough skin to pull all the way down. And so a lot of surgeons, including myself, have to leave a vertical. By doing a floating belly button, you avoid that vertical, but then you end up with a belly button that you can't even see when you're wearing your normal underwear. So you gotta be careful.
I 100% agree with that. So now let's go back to what we were just talking about, about the different incision types, I guess the different ways that surgeons do their tummy tuck incisions. And why would somebody choose one versus the other?
Are you kind of referring to, like, sometimes the scars, like, straight across, and then sometimes it's like it goes up like this. Okay.
Sometimes it's like a v. It's like it follows up. It looks like an underwear line title.
You know, I always tell patients, you know, plastic surgeons, we're not all the same. We can go to the same institution, the same schools, and we're still going to do our work differently. If you put seven artists in a chair and tell them to draw a banana, there's no question that they're all going to look like bananas, but they're all going to have a different flavor and spin on however they drew them. The standard thing is you definitely, with any tummy tuck, you want what's called a pubic lift. If you have a sagging pubis area, or mons pubis, you want to bring that skin up. And so typically what we say is you want to put that scar anywhere between five to 7 cm above the very, very top of that crease that's there in your pubis. When I typically make my incisions, I typically come across, and then I look at the hip bones themselves, because the hip bones kind of determine what kind of underwear a lot of women wear. And so, but my goal is that when you're wearing a standard bikini, whether it be from Victoria's Secret shine shein or whatever it's called, or whoever, I want that scar to be hidden.
And so if you look at some women, they have low hip bones, some women have high hip bones. My goal is to follow the curvature of those hip bones so that any air, underwear you wear or bikini should be well covered. There are some people who just make a scar straight across, and then they pull the skin straight down, and they end up with a scar that straight across. Technically, there's nothing wrong with that, but when they wear a standard pair of underwear, they have parts of their incision sticking out on either side. That, to me, is not an aesthetic that I go for, because I don't want people to know you've had a tummy tuck if you're at the beach. So it's all about surgeon preference. And a lot of times, how they were trained on how that scar goes, the height of the scar. Some people have a scar that when they wear underwear, it's taking out of their underwear.
That's usually due to surgeon comfort. Surgeons will place a scar higher to avoid a vertical incision. After they pull that belly button down, the more comfortable a surgeon is with, you know, a lower scar and getting that skin removed, that scar should be, you know, more well hidden. So it all comes down to surgeon preference, surgeon technique. I actually have patients bring a pair of underwear on the morning of surgery to mark them exactly. Bring your favorite pair of Vicky's underwear, and I'll mark exactly where your underwear line is. So I try to keep that scar where it should be.
I love that. I actually, you know, when I talk to my girls, I always tell them, take a marker with you to your consultation so you can ask your surgeon, can you show me where my incisions will be or where you planned for my incisions to be so that I can go home and look in the mirror and see before I make my decision. Am I okay with these scars? Am I okay with where this is going to be? Am I happy with this location? And that also, one of my other recommendations is bring your favorite pair of caddies or your favorite bikini to your surgeon and ask them to keep your incision within that line. So I love that.
One of the, I will say one of the things that is more difficult if, you know, if you wear those super, super high waisted bikinis, like, you know, that go, like, really, really high, like, from the days of Baywatch, those are that's almost. Nearly impossible to keep this scar like that, because then you're telling me that scar will go like this. More like the bean you're talking about, which nobody really wants that, but any standard pair of bikini underwear should be able to hide your scar well. And I think every console that I do, I actually draw on them. I used to use a marker, and that was really hard to pull, pull off. But now what I do is I use almost like a white eyeliner pin that washes off for makeup, and I draw exactly where the scars are for lipo, the scars for the tummy tuck, and then I have the patient take a photo of themselves in case they want to show their significant other. Are you okay with this? This is where my breastless scars will be. This is where my nipple will be.
This is where my tummy tuck scar will be. And then we wash it off. It's here in Beverly Hills. Some people will drive down and do multiple consoles and say, I walk in and they already marked up a purple marker. Oh, you just had a consult. So. So. Okay, well, my scars here, I see where they put theirs, but.
So I prefer to get something that washes off easily. So that's my secret, is the eyeliner makeup.
I love it. I love it. You're so thoughtful.
Yeah.
So, you know, one of my favorite questions to ask, and I think I'm also going to ask, because we know you love bbls and you do amazing bbls. So one of my questions that I like to ask is if you're team dre or team drainless.
I'm team drain. I've done both. There are surgeons who do a lot of liposuction, and there are surgeons who do minimal liposuction. There's nothing wrong with either one. But when I'm doing tummy tuck, I typically use five to six liters of what we call tumescent fluid for liposuction, and I use vaser. All those things are slightly more traumatic to the body, but I do it for better results. And so when you do and add all these adjuncts to surgery to get better results, you're going to have more fluid accumulate. I know there's people who do a lot of drainless, but rarely are they doing true Lipo 360 that I've seen.
I don't have a problem with either one, but I just noticed that the people who tend to do more aggressive lipo, such as myself and other surgeons, I know we tend to use drains, and so I have a lot of patients who fly in from Texas, from Florida, from New York. And I've heard people having issues with drainless and getting seromas and fluid built up, and I don't like to take that risk, and so I prefer to have a drink.
I love that you guys, if you're a listener, you know that I'm totally, 100% teen drains. And that's why I always like to ask, because there's a lot a large population of patients who are scared of the drains. They're like, I want to have a tummy tuck, but I don't want to have to deal with the drain. And it's something that I feel is also kind of a marketing tactic. Like, oh, you don't have to worry about a drain over here. We do drain less. But what I like to say is, just because they're doing drainless doesn't mean that they don't have fluid accumulation or seromas that have been after. And I understand with you, what you're saying is since you have a lot of patients who are flying in, you want to avoid that possibility by making sure that you have that drain.
Most of the fluid is out before they fly out.
That's exactly right. You nailed it.
See, I like to. I like to explain things. Doctor Marshall, do you use drains for your lipo BBl?
It's 50 50, so I actually will give the patient the option. I actually have pictures when I do a consult or pre op, and I have a picture of somebody with a drain in and then somebody with no drain in. I do. Even if I don't leave a drain, I leave a little. It's called the Penrose drain. It's a little, tiny, little piece of plastic. There's no bulb or. But it just keeps the incisions open to help get all that fluid out a lot faster.
So it's 50 50. Some people would rather have a drain to avoid some of the messiness, and there are people who prefer no drain. So I can do it both ways, and I give the patient that option.
That's nice. At least they get to choose. I would probably choose with the bowl just to avoid getting it all on my faja or getting it on my sheets or anywhere.
Yes. Very messy.
It is very messy. So I don't remember if the last time we talked about it, I had you on the show, if we talked about, what are you recommending for your patients as far as post op care? With massages, how soon do you allow them to get a massage? I think it's very interesting how each surgeon is different with when they allow their patients to start getting lymphatic massages. My question is, do you let your tummy tucks get massaged and how soon?
Yes, I like it. That's also a very controversial thing. So first off, I'm team lymphatic massage with just lipo or lipo BBl. We start on day two, not day one, day two. And typically do about two to three massages a week with tummy tucks. I do lipo just the same as I would with, without a tummy tuck. And so I usually have them start on day two or three. And the massages are typically occurring only on the back and the flanks.
I don't allow any abdominal compression or manipulation for about the first three weeks. A couple reasons why is because those sutures holding the belly button together are pretty sensitive. I can't control for every masseuse, and if some people just go in there and start really going at it, they could disrupt those belly button sutures. The same with the abdominal incision. My sutures are pretty strong, and so most people can't rip those apart. But I usually just prefer to stick to the sides and to the back and or arms. If I lipo the arms with a tummy toe. But, yes, at three weeks, they can start massaging the abdominal area.
I love to hear that. Let's talk about arms, because arms, I feel, are becoming more and more popular that patients want those really nice, defined arms. So tell me about it.
What we do with lipo, we're contouring your body. So with lipo 360, I do the whole armpit, bra roll area, the entire stomach, the pubic area, and the entire back. And I'm really trying to really, really, like, remove as much fat as safely possible or snatch them up. And I want people to look good. A lot of women will come back to me and say, I feel like I gained fat in my arms, and I didn't put any fat in your arms. They're the same exact weight, or maybe a little bit less than they were at surgery, but I call it addition. By subtraction. I've made everything else in your body look small, so now your arms look big.
Some people say, did you do something to my breast? My breasts look bigger. I didn't touch your breast, but by removing all the fat around your breast, now they look bigger. So I typically encourage people to do their arms. I don't force them because that hurts the most, I think out of all the areas that do lipo, because I'm really going in there really contouring. But if you don't do them, you may notice that they look slightly different from the rest of your body. You have these chiseled abs and chiseled back, and all of a sudden, your arms aren't so chiseled. So I usually encourage it, but I don't make it a requirement. In Colombia, it's already included.
You don't even get the say anything about it. Like in Colombia, when I train with boils, your arms are included with your lipo. They just do it. They know it's going to give the patient the best result. And this is. I don't know if you've heard this before, but I have my own theory as to why women have more fat in their arms. I believe that during the Stone ages, or whenever, it was really, really cold and women had to keep babies really, really warm, that that extra fat was needed in their arms to help keep their babies warm. So that's why I feel women tend to carry a large amount of fat in their arms.
And it's a great source of fat for, you know, skinny girls getting bbl, or anybody going back for round two. But that is why women have so much fat in their arms.
I like to hear that theory. And you touched on something super bad. I know when girls want to talk, want to hear about skinny bbls, and where do you. Because I've seen your pictures, and I'm like, where did he find the fat for that?
Yeah. I can tell you, in the skinniest girls, it's usually the arms that are the key. Typical bbl you may put in anywhere, like a thousand cc's of fat, sometimes less, sometimes more. In these skinny girls, sometimes the arms will have about three to 400 cc's each. And so I tell them, if I hadn't done your arms, you wouldn't have gotten that result. And skinny girls, I usually encourage them to do their arms. The thighs, you can do the thighs, inner thighs, but most people don't carry a whole lot of fat there. And if you're standing all the time after bbl, your thighs are going to swell a lot, your knees are going to swell.
So I usually discourage that, but usually it's the love handles and the arms. And I see a lot of people who have had previous light bulbs, say 50% of my cases are revision. A lot of surgeons leave this fat right here. They never take the fat on the side of the breast. And I don't understand why. That's why those people look like they have wide backs. And I don't like, you know, that wide back look. And so a lot of people have a lot of fat right there next to their breast.
A great source for the skinny bbls.
So if you're listening and you're considering a skinny BBL, lift up your arm and start feeling around. Do I have. Do I have some there that I could give?
It's usually the fat. If you grab, it's usually a lot of people will grab, like, right here underneath, but it's usually from the side. And if you can pinch and grab right there from the side, that's where the meat of it is. Because a lot of surgeons, they do lipo, and they just cover kind of this area right here. And they'll do it from the armpit or from here, and then you'll see these girls that have had lipo, but when they're walking, they're like, they got super wide arms because the turkey never really dressed the outer part of the area. And so when I do arms, I do arms 360 as well, not 180 or 270.
Dang. Did y'all hear that? Arms 360. I like to hear that. So that's how you get those pictures where you can see the muscle definition, right?
Yeah, exactly. And there's different degrees of definition. Some people don't want any. Some people do want to look like they've been working out, and so we can adjust for all of those things. But if you're getting Lipo 360 and you can afford the add on for the arms, I highly recommend it, because. Cause if you come back later and just do your arms, that's gonna cost you.
I like to tell my girls, when you're having surgery, a lot of that upfront cost is just getting into the or being in there. Adding additional procedures is cheaper when you're already in there doing something else versus coming back in and doing just one thing 100%. So, plus, it adds to your recovery.
Yeah, it does. It does. I tell people I had most of my patients come. They drive at least an hour to get to where I'm at. The consult, the pre op, the surgery, the follow up, follow up, follow up, follow up. Like, I try to combine as much as I can so you don't have to go through all of that again. Most people are moms. They have kids.
They work, they have responsibilities. It's not easy just to find somebody to take care of, you know, your kids, your. Your job. And so the more we can get done at once, the better for you.
I 100% agree with that. So, Doctor Marshall let's talk about garments. How long are you keeping your patients in garments and how long should they wear a garment on their arms?
Great question. Minimum garment use is three months or about twelve weeks, and that's 24/7 after that, I recommend that you slowly taper off and do something maybe like twelve to 18 hours a day. And when you're no longer swollen, like, that's when you can stop wearing it. Some people will take off their garment, go to dinner, and the next day they're just like really bloated and swollen. You know, you're not ready to be out of your garment yet. For the arms, I typically do about six weeks on the arms. You know, since the lymph node basin that collects a lot of fluid is right here in your armpit, the arms tend to recover a lot faster than the rest of the body in 360. So three months, 24/7 on the body, at least six weeks on arms.
And what about your massages? I remember you were recommending three to four massages a week. For how long?
Yeah. So I typically say you need a minimum of ten. And then I tell people at that point, do you feel like the massages are still helping you? I don't want to know if they feel good, because any massage you get anywhere is probably going to feel good 100%. But if you feel like they're still helping you after that massage, your recovering faster, your swelling is going better, then continue them. I have some patients who do upwards of 30. I do say, you know, those of these massages do come with a cost, so make sure that's factored into your, you know, your whole surgery plan and bundle up front. But a lot of what you know is done if you can no longer afford it. Do you have a caregiver who can replicate some of these techniques? If you just go to YouTube and type in lymphatic massage techniques, you will learn some things.
I don't necessarily recommend that from the get go, but I do say if you are still benefiting from lymphatic massage, continue indefinitely. And most people will do some point, like maintenance massages, where they'll just go maybe once a week, once every couple of weeks or once a month. I have my, my own staff who, they've had surgery two, three years ago by me. They still go and get maintenance massages, you know, every now and then. So I think it's very important you.
Know who I had on the show recently. I have the Faja doctor right after she did her Ameli treatment with you. So tell me.
Oh, my goodness. I love her so much. She's great.
What kind of results are you seeing with the valley in your practice?
I love it. I've. Cellulite's always been a problem for surgeons, especially for surgeons who work on the buttocks. And I see the cellite before surgery, I see it after surgery. And there's been things such as selfina, which I used that in training, didn't like it. There was an injectable that came out recently, I believe it was called whoa. I never hopped on board for that because I just. I just.
I'm a maximally invasive guy. Unless something is actually in there removing fat or cutting bands, I don't necessarily believe in it. So a veli I do believe in, because I've seen the results of it. And let me tell you when. This is one of the most common complaints that I think BVL surgeons will hear. Why do I have flat spots in my butt after surgery? And they think, oh, the surgeon didn't put any fat there. The surgeon messed up. If you have really, really tight cellulite bands, no matter.
The best surgeon in the world will not be able to fix that. Unless you go somewhere where they inject that into the muscle, and then you expand that muscle, it rounds out, and that will essentially eliminate those bands. I don't inject muscle. There are plenty of surgeons who do. You can go really south of the border, they'll do it other countries that will help eliminate some of the cellulite, but I do not inject muscle.
So I recommend it.
I don't. I don't recommend it, but I recommend. A lot of patients will do this valley treatment three to four weeks before surgery, help release those bands, and that will allow the skin to stretch more. So your butt is not as flat in some of those tight areas. Post op. If you're going to do it before surgery, I recommend at least three to four weeks before. If you're going to do it after, we usually say about three to four months afterwards. But, yes, I love it.
It works. I tell people you'll see approximately 70% to 80% improvement in your cellulite. We don't take all the bands away because then you're gonna end up on those diaper booties or a booty that sags a lot. And I don't recommend doing it at the same time as BBL. Some surgeons do, and that's fine, but with a lot of the higher volumes that we're doing, it's too much stress to do it all at the same time on the skin.
I love to hear a good review on something with cellulite because, I mean, for so long, it's been like the number one complaint. Yeah, cellulite. How can I get rid of my cellulite? And it's been creams.
I'm not paid by, you know, revelle or I'm not paid by anybody, you know, that has to do with this device. But I'm literally seeing the results. And you come to my office, you're not gonna see a bunch of lasers and a bunch of fancy things coolsculpting because I only use things that I believe in and I see the results of it. I have renuvion because I see that it works. I have ability because I see that it works. I don't have a bunch of fancy tools because they don't always do what they promise. And then doctors just sit in their office with all these things collecting dust and they use them as coat hangers. So I love of le.
It worked. Huge advocate. We're doing one right now, actually.
Well, I love to hear that. I was considering having it, and now I'm like, I think I'm going to do it for sure. So, Doctor Marshall, I am so thankful that you came on the show today with me and shared all of this knowledge with us. And I'm sure my girls are enjoying this episode because abdominoplasties, everything that you do is what they're interested in. Oh, you know what? Before I let you go, two things. What are you doing with fat grafting to breast and how are you liking it? Do you see an improvement that is significant for women who are considering it? The reason why I ask is because you do a lot of fat transfer, and in order to be really good at fat transfer, you have to do a lot of it. And I feel like fat transfer to the breast gets some bad rap because the surgeons who are trying to do it aren't really fat grafty masters. You know, they're kind of.
It's an addition to what they do. So I'm really curious to hear with you, with all of your fat grafting experience, if you're seeing a different difference in your practice as far as fiber.
Can to breast, will I do it? Yes. Do I advocate for it? No, because I have to get, you know, I have to understand your goals. If you're a B cup and your goal is to be a D cup, I'm not going to recommend fat grafting. I'd say if I put a 400 cc breast implant in you. In five years, I come back, you're still going to have that 400 cc implant, whether it's 510 years, two months. If I put 400 ccs of fat in you, you'll be lucky to keep 100, 150. And then what happens? The rest of that fat? Well, we know a lot of the fat dies, and that's called fat necrosis. That's not necessarily a bad word.
A lot of your body can come and eat up any of that excess fat or that fat that did not survive. However, in some women, though, that fat may become cysts or they may become hard lumps. If you felt a hard lump or nodule in your butt, to me, that's less concerning than if you felt it in your breasts. And so now you're forever having to go get ultrasounds or mammograms to assess what is this little nodule or lump. And so I like patients not having to worry about that. In general, with fat grafting to the breast, you have to be careful not to use large volumes, because the more you use, you're not going to keep, you're just going to end up losing more. So people who want a dramatic change with just fat, they actually need multiple procedures. They have to undergo lipo with fat transfer, let their body heal, and then go lipo, more fat transfer, and then lipo, possibly more fat transfer.
That's a lot of work. That's a lot of money just to say, you know, you have a fat in your breast. So I never give someone that first option, have a lot of people come and ask me about it. I have great results from it, and I have so so an average results. And I always show people the two different results. I was like, look at this girl. She had a great result, but this one had a so so result. Are you okay if you end up with this so so result? That may be a possibility, but with implants, if I put an implant in, you know exactly what you're getting.
You're going to pick the size. Here's a girl that has 400, 350, and I can show you kind of exactly what you're getting. So it's a, it's a slippery slope. I will do it, but I don't technically advocate for it, especially just taking the implant out and putting fat in. That, to me, is very, very risky because even less fat will survive. Same with butt implants. Taking butt implants out and putting, putting fat in right away, less fat is going to survive. So you need to stage those procedures, in my opinion.
I love to hear your honest and real opinion. I'm thinking about my girls who are really looking for fat grafting to breast, because what they don't want, what they've heard and what they're fearing is Bii, and what they're fearing is having something for it in their body. So I can hear. I can hear them. Oh, but I really don't want to have an end plant because of the silicone. So I'd love to hear your take on Bii. What's the newest information?
So I personally, I've done, you know, hundreds and hundreds of implant cases, and I haven't had any patients come back to me with Bii. I've removed implants in patients that were placed elsewhere years ago. And did they say they felt better? They did, 100%. So I believe it's real. I hundred percent believe it's real. And there's some people who just don't like her bodies, just don't like foreign things inside them, 100%. I think the nice thing about an implant is you can put it in, you can take it out. There's really not much damage done.
It's essentially completely reversible. So, you know, it's not that I'm trying to advocate for implant. I want you happy. At the end of the day, if you come in expecting to walk out with add and you walk out with a, b, or c cup, you're not gonna be happy, and that's gonna translate to your frustration. It could be to you not sending patients. To me, my whole goal is to make sure you're happy at the end of the day. So I'm gonna give you the best recommendation to help you be happy. I find that implants are very safe.
I say I'm only gonna do something for you that I would do my own family. I would put a breast, silicone, breast implant, saline, breast implant in my own family. And if they started feeling bad afterwards, any signs of breast implant illness, I would take that implant out. Like I said, I think it's pretty rare. It's just that, you know, the thousands and thousands of people who get implants, there's a small subset who don't feel well afterwards, and that becomes amplified. If people really knew how many breast implants were used every day, not just in the cosmetic world, but also in the cancer and the reconstructive world, they would realize that the subset of people getting Bii is extremely small. Extremely, extremely small. So I find it's very safe, and I'm still gonna recommend it.
I agree with you, actually, and we talk about this on the show. I've had doctor Christy Hussak on the show, and she was talking about the studies and the actual data that's coming out about the patients who are having reactions or what they believe to be some sort of reaction to the implants and her or what we thought was, well, like, people have allergies to gluten, people have allergies to eggs. There's people that have allergies to all types of things. And it makes sense to me that it could be a patient who just is allergic or has some sort of reaction. Their body just does not. Just does not like the material, the silicone casein or whatever the material is.
Absolutely 100% okay.
Doctor Marshall, you know what's one thing that's super common, and I think we should really talk about it, is liposuction at the same time as an abdominoplasty or a tumor tip. Why don't we go into that?
So, traditional teaching would say that you weren't supposed to lipo the abdomen. It's too risky. You're gonna hurt the skin flap. The skin could die. And there's some truth to that. But what we found over research is multiple published papers is that it's not so much the liposuction that injures the flap, but how much undermining or how much of the flap you undercut before you pull it down. And so a lot of people, a lot of surgeons will do no liposuction with the tummy tuck. That's completely fine.
It's completely safe. Some people will only get liposuction of the flanks, and that's just kind of the love handle area. And a lot of time that's just done with you laying flat on your stomach, the surgeon kind of reaches around and whatever lipo they can get of your flanks, that's it. I typically always do Lipo 360 with my tummy tucks, and that's where I lipo the entire back, the love handles, and the entire front. Yes. That takes me more time. It adds about two and a half hours to the case, but it's going to give you a nicer figure overall. I also lipo the upper abdomen.
Now, I do about probably 60% to 70% of the lipo I would do if you weren't having a tummy duck, because I am cognizant or aware that I don't want to injure the blood vessels, but it is safe to do liposuction of your abdomen with a tummy tuck. And your sides and your full back. So when you're looking at surgeons, don't just look at what's the cost of the tummy tuck, make sure you're actually comparing. Am I getting Lipo 360? Because a lot of patients come back, they've had tummy tucks elsewhere, they look good, but now they need Lipo 360. So now they're paying for an additional operation which could have been combined into one.
So that goes to prove the fact that waists are made from the back.
That's so true. Extremely true. You're exactly right.
So for those girls who are looking for a really snatched look. Snatched, I love that word. They're adding liposuction to the back, to the whole back. Like Lipo 360 is key to getting that really curvaceous look. Right.
That is, that is true. Like I said, a lot of surgeons don't do it and that there's nothing wrong with that because those patients end up coming to me for BBL and they've left all that good fat. So it actually works out. My favorite. But yes, when I do a tummy tuck, Lipo 360 is just standard with it. The only people who would not need that are people who have had previous Lipo 360 by me or elsewhere. They have no fat to remove and it's just skin only. That would be the exception, but that's rare.
So yes, tummy tucks, in my opinion, should include Lipo 360 to contour the entire torso.
So, okay, before I let you go, if you were, I like to ask this to all of my surgeons. If you were talking to your best friend or your sister and your mom, and they're going to go on their plastic surgery journey, what's one tip that you would give them?
The most important tip is not to look at the social media. The website's helpful, but the number one tip is actual. Talk to actual patients that have had surgery with that doctor. Believe it or not, if you sometimes, if you just go to Instagram and you start scrolling through the comments, people will comment on that doctor's post and then hop in that person's DM's. Talk to them. Hey, can I, can I call you. I have some questions about this surgeon. Actually talk to actual patients.
Real self is good about that, too. But that's what I would suggest. Because when you come to the office, obviously everyone's on their best behavior, right? The before and afters that doctors show, they typically don't show you the worst. I try to show people the best, the average. And some of the worst, because I want you to know what's possible. But I think the best advice is to actually talk, message actual patients and get their whole experience from the start, from the consult process, from booking to the aftercare. That's really important. I understand a lot of places they do the surgery, and then once you're done, get on the airplane, you're gone.
And that's kind of important. What's the plan? 3456 months down the line. So talk to actual patients. Read the reviews. Those are great. Read, you know, go to the website, go to Instagram, do all those things, but talk to actual patients, you'll get way more information about the scoop and the skinny than anything else.
One harder to say. You know, that's why I really love doing my free discovery calls where patients are considering having surgery and they need help finding a surgeon. I'll talk to them for 15 minutes for free. And I love it because I get to hear all the juicy details about, oh, well, I went here, been trying to get ahold of this guy, and I can't talk to them or this place did surgery on me, and then they never called. I can't talk to the doctor ever yet. So I love hearing all of those details of, like, patients actually going through the process and because when I'm calling or when they know somebody who's in the industry is calling, they're on their best behavior. But for patients who are actually, for example, trying to book a consultation and receptionists are rude, coordinators won't call back, they can't get a quote, like, all of these things are happening and they just, where are they going to go give their reviews? So I really love having those insider calls and getting to hear all the Jason details. So I love that, too.
Important.
Thank you so much for being on the show today. Doctor Andre Marshall. So if my girls want to come see you, where can they come?
They can see Beverly Hills, California. But I would say I have people from all over the world, all over the country. And so we do virtual consults through Zoom or, you know, not a complimentary photo consultation where you submit your photos, submit your history, I'll review them, give you a plan. And most people do that, just kind of figure out the pricing and what's possible all at once. So we have multiple ways to get a hold of us.
I love it. Thank you so much for being on the show, Doctor Marshall special, and hopefully I can have you back soon.
I'll be happy to come back anytime.
00:42:00 - 00:42:03Exclude
0:06 - 42:04
And for the rest of you ladies, I will see you all next week.
