Plastic Surgery Discussions with Dr Aisha White

Transcript

Chris: 0:00

Welcome to pulse check, Wisconsin.

0:42

Good morning. Good evening. Good afternoon. Whatever it is for you. This is Dr. Ford from pulse check, Wisconsin, and we got a good episode here for you today. We're going to start it off again with one of our cases to help highlight the topic that we're going to discuss. And with that being said, let's go ahead and get started. Patient is a 23 year old female who is presenting to the emergency department with a chief complaint of abdominal pain. The patient arrives and on first look her vital signs look concerning. She's got an elevated heart rate. She's tachycardic, as we say, with a heart rate of about 120. She's also known to be febrile. Her fever is 102 degrees Fahrenheit. Before I went to see the patient, I took a look at past records that I often will do in the cases of patients who present and I'm not seeing any history of any significant presentations to the emergency department. No past medical history, the patient is otherwise healthy. And so I went back to see the patient and the patient looks to be incredibly uncomfortable. She's reluctant to move. And on first look, I see that she has some bandages over her abdomen. The patient later tells me that she recently had surgery. She had reconstructive surgery that was performed. She told me that she had a tummy tuck and a Brazilian butt lift or a BBL. The patient states that the surgery was performed not at any of our facilities here in the state of Wisconsin, but rather she sought care out in the Dominican Republic. She tells me that she's been discussing her symptoms with her surgeon, and she says that she does this via WhatsApp, which is a communication application that I'm sure a lot of folks here in the Pulse Check audience are familiar with. She shows me some of the messages, and in this message log I can see that the surgeon, who the patient was working with, has told her to seek care in the emergency department today. Before this, she tells the patient in some of these messages to go to the ER to have her stitches removed, as well as to have her drains removed. So I removed the binder from the patient's abdomen to get a better look and I see a couple things. First off, the patient's abdomen is very tender. She's what we call peritonetic, meaning that Any slight touch to the abdomen or any movement causes an extreme amount of pain. And it's often reflective of a process or an infection that's going on in the abdomen. She also has the drains that are still intact that the surgeon wanted her to go to the ER for to have removed. And it looks to show signs of infection around the drain site. And there is purulent or some pus like drainage into the drainage bulbs. With the patient looking to be septic and to have an infection in the belly, the decision was made to start the patient on our sepsis protocol, which included fluids, which included blood cultures, as well as to start her on antibiotics. And I walk the patient to the CT scanner in order to get a better picture of what's going on in the abdomen. The patient's abdomen reveals several pockets of infection, as suspected. And at that point I knew the patient needed to go to the operating room. So I contacted several surgeons. I contacted a couple plastic surgeons in the network that I was working as well as general surgery. And there was reluctance from some of our general surgeons to treat the patient or to take the patient to the operating room. Because classically they aren't trained in plastic surgery and don't know the specifics of the surgery that the patient underwent. At the time some of the plastic surgeons that were at the hospital that were on call did not have any privileges in house at the hospital to do surgery. And so as such I made the decision to contact one of the level one centers in the area to get the patient to an OR as fast as possible as I thought that her condition would turn dire and could potentially turn deadly. I was able to get in contact with the outside facility who accepted the patient. Then the patient was transported directly to the operating room. The patient was then hospitalized in the ICU following as she had a recovery that took a couple of weeks given the extent of the infection. So in that case, it highlights a couple of things that we'll talk about with our special guest today, Dr. Ayesha White, who is a board certified plastic surgeon out of Austin, Texas. But what that case highlights is more so some of the pitfalls that folks can run into when you are seeking surgery in an environment that is not typical of plastic surgery. One thing that we harp on a lot in medicine especially here at PulseCheck Wisconsin is that all surgeries should be considered a major procedure. So even if it's an aesthetic surgery, even if it is not an emergent surgery. Those procedures have long standing effects on your body, and it is a major undertaking that you should consider. And so, what we need to do is to make sure that you're doing your homework, make sure that you have a surgeon who is board certified, that'll be our recommendation, and also to make sure that your aftercare is allotted for. You want to spend just as much time researching your surgeon and and making sure that that aftercare is there too, because a lot of time, a lot of patients that we're seeing around the city of Milwaukee, when they go to other places to have these surgeries, they go overseas or even go out of state. A lot of times they're relying on the emergency departments to take out sutures or take out drains. When in a lot of cases, I can tell you in my emergency department, a lot of providers are not doing this. You're not going to be able to have that done. And also you're increasing your risk for infections, things like complications of the surgery, and you may even need to have surgery again. And so for a lot of folks who are seeking this type of surgery, and more so kind of budget shopping on your surgery, we would highly recommend against this, and Dr. Aisha White can speak a little bit more, on this subject as well. So with that being said, I want to introduce Dr. Aisha White. Again, she is a board certified plastic surgeon. She is currently practicing in Austin, Texas and has extensive training and experience in plastic surgery. She's a fellow of the American colleges of surgeons and a member of the American society of plastic surgeons as well, which are very prestigious organizations to be a part of. So she knows the stuff she knows what she's talking about. I wholeheartedly was very excited to do this interview with her, not only to discuss some of the things that we talked about in this case, some of the things that are part of. The dangers and pitfalls that some folks fall into with plastic surgery, but also liked her interpretation and her approach to plastic surgery. And this is a direct quote from her website. She says, I do not subscribe to a cookie cutter model of plastic surgery. For some plastic surgery is about beauty. For me, it's about strength. When you're comfortable in your own skin, you are empowered. She also states, She strongly believes that beauty shouldn't fit a mold and that there is not just one standard of beauty. with that being said, I want to introduce my friend, Dr. Aisha White.

Chris: 8:48

So my name is Dr. Ayesha White. I'm a board certified plastic surgeon practicing in Austin, Texas.

Aisha: 8:54

Currently my practice is mostly cosmetic surgery, but in the past I've done reconstructive and cosmetic surgery. My undergraduate degree is from Howard University. And then I went to medical school at Northwestern, have an MBA from the Wharton School, and then did both. General surgery and plastic surgery residencies at SUNY downstate and the University of Illinois at Chicago, respectively.

Chris: 9:18

Yeah, so and you've had like we talked a little bit before this but you know You've had the ability and the privilege to kind of practice in a lot of different locations in the United States including my hometown of Chicago Which I love You were actually cross paths with Dr. Callie on the south side who was my first introduction into Medicine in general to

Aisha: 9:42

wait. Crazy thing. I swear. I didn't play in this funny thing. That picture in the background. I'm like in my office area. That's me and Dr. Kelly Muthu scrubbed in a case.

Chris: 9:50

All the listeners to Dr. Kelly is a plastic reconstructive surgeon on the South side of Chicago. He is like right off of, let's see, that would be Western and 95th. I'm going to say, yeah, so but it has been practiced for him for a number of years. His partner, somebody he went to residency with and fellowship with Dr. John Newkirk was my first introduction into medicine down in South Carolina. When I came back home from undergrad, he said, Hey, you should go see this guy. Dr. Kelly. I haven't seen him since the seventies, but it would be great for you to kind of, you know, continue over the summertime, keep you out of trouble. And so Dr. Kelly is amazing. As well as Gina, Nancy everybody over there.

Aisha: 10:29

Yeah, no, they're incredible. The whole team.

Chris: 10:32

Yeah, so one thing that we do is we usually will talk to a lot of our guests about Their journey through medicine just because everyone's journey is a little bit different in terms of what brought you To plastic surgery what brought you to whatever specialty, that you are Just so folks out there can kind of get an idea anyone interested in medicine, etc tell me about your journey and what brought you to plastic and reconstructive surgery

Aisha: 10:54

So, you know, actually, I tell this all the time, when I started medical school, I was interested in doing OB, and it was actually my first clinical rotation in medical school. I absolutely loved it for like a week. And I think, you know, when you're, when you're young, I think you don't think about all of the many things you need to consider in terms of picking a career. And so OB was amazing. I mean, it was a great feel. I mean, it's kind of quintessentially medicine, you're delivering babies, there's happy, healthy people. But I found it really monotonous and I think it was the first time I had ever considered anything other than like, I like this in terms of, you know, determining whether or not I wanted to do this as a career and it was really an eye opening moment for me because I was like, I can't, I can't do this every day. Like, I can't do the same thing every day. But what it did crystallize for me. is that I did want to do something with my hands, so I knew at that point it would have to be a surgical specialty. And because I thought I was going to do OB and plan that as the first rotation and really didn't care about anything else afterwards the rotations that I had afterwards, it was like psychiatry, pediatrics, it was a while before I actually had Surgical rotation and then when I got into surgery, I loved everything and initially didn't like, commit 100 percent to plastic surgery, which is why I did the general surgery residency 1st, but knew that I sort of wanted that variety. I think for me, that arc has, evolved in, in terms of like why I love plastic surgery. So I probably chose plastic surgery because of the variety and the specialty. But I think why I love plastic surgery is this ability that you have to transform people's lives really make people feel whole again, confident. And particularly, you know, Especially on the cosmetic side, or even for me on the reconstructive side, I did a lot of breast cancer reconstruction. This ability to like empower women, particularly empower them around their bodies and also simultaneously sort of combat some of these like societal like pressures and kind of, you know, accepted norms of like body standards and sort of, you know, doing my part to sort of kind of break that down.

Chris: 13:07

And I'm glad that you brought that up because that's something I want to tease out during this interview. We're going to talk a little bit about kind of those beauty standards and those cultural perceptions that people take with them into going into, you know, making any changes to their bodies or trying to enhance their beauty, et cetera. But we'll get into it. But before we do for some folks who may not know, could you explain to us a little bit about the differences between like reconstructive surgery and the difference between plastic surgery that way? Okay. Folks who may not be in the know get a little bit more information about it.

Aisha: 13:37

Sure. So, you know It's actually a little bit of a trick question Whether you realize that or not because sort of what makes something a reconstructive procedure Versus a cosmetic procedure is the indication not the actual procedure. So for example if someone had a lumpectomy, which is a procedure where, as you know, part of the breast is removed, but now it leaves them asymmetric and you wanted to fat graft that breast or even put a small implant in to make it symmetric to the other breast. The procedure is fat grafting or the procedure is augmentation with an implant, but in that situation, it's a reconstructive procedure versus if someone comes to see me and they're like, you know, I don't like my breasts. I want them bigger, you know, then putting in an implant to make them bigger or more symmetric. Or a fat grafting in that case, it's now a cosmetic procedure, but, you know, many times the way I do the procedure may be the same. Sometimes, obviously, in the reconstructive cases, what you're dealing with is a lot more difficult, you know, because you aren't necessarily dealing with a normal situation, but in terms of, you know, the procedures, they, they, they're more or less the same. And what's making 1 reconstructive and the other 1 cosmetic is the indication.

Chris: 14:50

Got it. Yeah. And, and, and that's, I feel like, especially as I would say, when we're coming up in medicine, it was a lot more popularized in terms of the exposure to plastic and reconstructive surgery, right? Like in the seventies, eighties, nineties, you know, it was kind of underneath the surface, but come to two thousands, you got, you know, Dr. 90210, all these things. And so folks, you know, kind of had that expectation of what plastic surgery was and, you know, had some ideas in their minds about what they wanted to pursue and things of that nature more so than before. Yeah. So. One of the things that, that we talk about too is kind of the specific challenges that folks have in walking that road in order to become a plastic surgeon or in order to become a surgeon of any ilk. You know, I don't know a lot of folks understand kind of the road that you have to go and how intensive that, that, that surgical residency is, this fellowship, et cetera, et cetera. Are there any specific challenges that you face as, you know a trainee as a a black woman in plastic surgery? Because I know, you know, By the numbers, it's not many of us period in medicine, but I couldn't even imagine what the numbers are in plastic surgery.

Aisha: 15:54

Yeah. The numbers are small. I mean, they're really small. You know, it's funny. Like obviously I know a lot of plastic surgeons and I know a lot of black female plastic surgeons because I'm a plastic surgeon. And I mean, a lot is relative. But I think sometimes when people meet me, you know, I am probably the only black female plastic surgeon, maybe any given one person may have met and in a lot of cities. you know, there might be one if there's one at all. You know, yeah, I think it's challenging. I think we all know surgery is predominantly male and it's predominantly white men. And so, you know, there's, you know, fitting into that whole culture. Also surgical training for anybody. Whether you're male or female, you know no matter what your ethnicity is, it's, it's not a kind of warm and fuzzy environment.

Chris: 16:45

Not at all.

Aisha: 16:46

Which is why

Chris: 16:47

Dr. Cal was such a breath of fresh air, right? Yeah, no, no, no, no, no, he's

Aisha: 16:52

an exception. Yeah, doctor, you know what, like, you know, that's almost, I mean, Having the opportunity to meet him and work with him is incredible. But it also, there's a part of me that's like, I hope people who want to be plastic surgeons don't meet him at the beginning of their journey, because I think you will get lulled into this false sense of what, you know, that experience will be like, what the mentoring will be like. I mean, he is, he's truly an extraordinary person and extraordinary surgeon, but just such a kind man. And that is, That is not the norm.

Chris: 17:25

That's a bonus. Yeah, that's a

Aisha: 17:27

major bonus. That's a unicorn bonus. But yeah, I mean, I think it's hard. Like, I think in any field, it's always a challenge when you don't see people who look like you doing something. And being able to have that level of mentorship, I think I definitely relied heavily on my peers for a lot of support and mentorship, you know, people who were in the same year as me as residency, or even maybe people who were just like, you know, a couple of years above or below because, you know, Yeah, I, I didn't have a lot of females or, you know, black males. There was definitely, like, almost no black women. Definitely not in plastic surgery. There were maybe a couple in my general surgery training.

Chris: 18:11

And a lot of that too, we had on Dr. Jane Morgan during our last episode, our first episode of the season. And she was kind of talking about her experience as an African American female cardiologist being the only one in her hospital and how that really trickled down to her position on faculty. Things that she would be able to say by having the seat at the table, etc And also their experience in working with patients as well How that how that kind of colors that that that interaction and how you can be an advocate and in some cases You know, she brought up a good point to a fault Sometimes we stay at you know as african american providers stay in a bad situation too long because it's like I have to Like I have to be that person. Yeah

Aisha: 18:54

100

Chris: 18:55

Yeah, exactly. How has your experience been, you know, especially in being that advocate and working with patients, African American patients. And how has your approach and kind of your experience kind of coming up? How does that affect your patient care?

Aisha: 19:07

Yeah, I mean, I think it, you know, it affects my patient care in small ways and big ways. I mean, I think it's like You know, very exciting for, you know, women and women of color to often have a doctor who who looks like them treating them, who understands their needs. I mean, on a very deep level in terms of like how you approach consultations and just your interactions with patients. I mean, I think, you know, a lot of women in health care of all ethnicities, Often feel unheard and dismissed. And so I think, you know, this whole notion of like, I wasn't heard. They didn't listen to me. You know, I spend a lot of time with my patients in my practice, listening to them, also trying to figure out what they want. And helping them achieve the thing they want, if it's possible, not pushing my own personal aesthetic agenda, you know, trying to, like, put my biases aside, like, you know, for example, like, I'm not a big fan of big implants, but, you know, all of my patients get the implants. You know that they want as long as it's something that's going to be reasonable for their bodies, you know But you know again, I think that that can sometimes be different from what you may get with another encounter I'll tell you others also other little small things like, you know, when I I had a facelift earlier this year And at the end of the case when you did a facelift, a lot of times there's blood and other things in the hair and you want to wash the hair. And I was doing this face as a black woman and I remember saying to her when I was in the prep era, I was like, Okay, I'm going to rinse your hair but I'm not going to wash your hair. I was like, so I'm going to make sure I get the, the blood out of your hair. I was like, but when you go home, you're going to want to wash your hair because I'm not about to like wash this woman's hair. with Hibiclens, and it's going to strip her hair and dry her hair in a way that it's not going to dry somebody else's hair that has a different texture or isn't permed. And so, you know, but again, you only know what you know. And so, you know, if you don't have that perspective of what it's like to like, you know, wash your hair with a bar soap and know that that's just not going to work for your texture, then you're not going to make a different choice for that patient because you just don't know any better.

Chris: 21:22

You don't know you don't have that context. Right. And that's why it's so across the board representation has only been seen as a benefit, right? As compared to, you know, some common perceptions from people, especially as things get the climate gets a little bit more political as a good thing, right? We want more representation. We want more points of views at the table. Otherwise, we're going to continue to fall in the same pitfalls. But like you said, you having that context, right? And having that lived experience to say, okay, if I put myself in my patient's shoes, these are things that are going to affect her down the road if I do this. Right. And like you said, if you don't have that context, you're not going to be in that position to make that decision. So one of the things that I wanted to talk about here and we, we kind of discussed this a little bit. Here in the state of Wisconsin, I would say myself, as well as a couple other ER doctors have seen a rash of patients who have pursued elective surgery more so aesthetic surgeries, and they've done that on a travel basis, right? And so in Milwaukee here is more word of mouth. You see folks that are going over, you know, they say that they're going to Miami, but they're really going to, you know, Puerto Rico or wherever, um, in order to pursue these plastic surgery procedures. The problem that we run into that we've seen recently, myself personally, I've had three or four young ladies, is that there's complications of these surgeries, right? And so, uh, infections can crop up and there's no real follow up, um, uh, after that. They're, they're literally talking to the surgeon on, on, on GroupMe, right? And so, I, I, I wanted to, to kind of get your perspective. I mean, of course, that is egregious and we know, we know what your perspective would be on that. But more so on, on this, this, this fad, I would say more so, or, um, uh, the travel medicine, uh, uh, culture that's, that's going on right now for these procedures.

Aisha: 23:11

Okay. So, you know, for me, I have, I have several opinions about that.

Chris: 23:16

Which I appreciate

Aisha: 23:18

so I mean, okay. First, let, let's, let's back it up and, and start with like finding a doctor. Okay. So I think that, um, a lot of, uh, patients, whether they're having something like an injectable done or surgery done. Do not know the credentials of the person doing that. And, you know, for those of us who have gone to medical school, gotten board certified by our respective boards, you know, that is a marker of quality and safety. You know, and I think that that's often something that patients don't understand. Um, so first of all, I think it's really important for people to know who they're seeing, you know, and the training that that person has. Now, I will say in the aesthetic surgery world, it gets tricky on multiple levels. Number one, the terminology. So most board certified plastic surgeons who you encounter, even someone like me who only does cosmetic surgery, we will not refer to ourselves as cosmetic surgeons, even if all we do is cosmetic surgery. That's actually Not a real term. I mean, it's real in the terms of that it's English language.

Chris: 24:26

Right.

Aisha: 24:26

But it doesn't mean anything. If someone like, and it's always to me a red flag if someone says, Oh, I went to so and so and their, their website says they're a cosmetic surgeon, because that is not, um, you know, a term that's regulated. And so, I can't say that I'm an anesthesiologist or a neurosurgeon. That is false advertising. That's representing myself as something that I'm not. But again, that cosmetic surgery term isn't something that's regulated. And so when you have somebody who uses the term cosmetic surgeon, they could be someone who's taken a weekend course and they could be Uh, not to pick on any specific specialist, it could be a podiatrist or a pediatrician or a psychiatrist, you know, And I think most in most states when you have a medical license This is also something that patients don't understand and this is not illegal Most of the time, the medical license will say, you know, state of whatever, physician and surgeon, even if you're not a surgeon. And so when you want to do a procedure, and you know, these are the things that we understand, but patients absolutely don't understand. So if I wanted to do a craniotomy, a brain surgery, and I went and scheduled this, put this on the schedule at the hospital, the OR would call me and say, Oh, Dr. White, we're so, so sorry. We don't have privileges for you for craniotomies and neurosurgery procedures. And then they would say, Oh, you know, did you, did you do a neurosurgery fellowship that we're unaware of? If you did, they sent us that information and we will credential you for that. Um, now of course, then I can't do it. So, but if I had my own surgery center that I owned. I get to determine what I'm credentialed for. And if I wanted to do a craniotomy there, I could. So now that it also gets into the nuance of, um, does your malpractice insurance company know that you're doing these procedures? They may say, no, absolutely not. We're not gonna, um, We're not going to cover you for that. Or they may say, Oh, we'll cover you for it. If you claim you've taken some courses, but we're going to cover you at a higher rate than what we would a neurosurgeon. But, you know, in all situations, it is not illegal for me. If I find a way to do this craniotomy, it's not illegal for me to do it. You know, other people, hospitals, you know, well established surgery centers that aren't individually owned insurance companies, they're trying to do what they can to protect patients and make sure that doctors aren't doing procedures that they shouldn't be. But, you know, again, if you have your own facility, it's sort of like the wild, wild west. And again, you are not breaking the law. And so I think, you know, a lot of these patients are choosing people. that, you know, don't have appropriate training and credentialing. Also, I just want to say, you know, um, that, you know, yes, the standards in the U S are different for how we train. And I think, you know, in some circumstances we are definitely generally speaking better trained than in some other countries, but that's not universally true. You know, I mean, there are good doctors and bad doctors everywhere. And I think often when patients are seeking doctors in other countries. They're not necessarily seeking the best doctor in that country. They're going there for financial reasons. And so they are seeking out another bargain basement surgeon that's even cheaper than the U. S. bargain basement surgeon. And like the old adage, you, you, you get what you pay for, you know? And, you know, I think that, you know, but in this time you're gambling with your life. I think the other piece. of this whole medical tourism thing other than picking a doctor with the appropriate credentials. Let's say you saw the best doctor anywhere, in another state, in the U. S., you know, in another country. I think people have this perception that surgery is a one time thing. Time invent, you know, it's an encounter. I think they're like my surgery day. You know, I say to patients all the time, like surgery is like marriage. And if I get some big red flags, um, ahead of surgery, I don't want to operate on somebody because we are going to be together for a while. And the more complicated the procedure, even if everything goes perfectly, we are going to be together for a while. quite a while, you know, for some of these bigger procedures, at least a year, you know, because you have drains, there can be little minor complications that aren't going to have any big impact on your ultimate result. But like you could get a little redness of the skin, you could have a little dog here, you could have this, that and the other. And you're monitoring those patients through all the stages of their recovery. And if, you know, complications should arise, you're addressing those. And so I think the expectation should be when you decide to fly out of town and have surgery that number one you are going to stay long enough for that sort of initial window of really scary things that could happen because with any surgical procedure, there are early complications and late complications. The early complications are usually the scariest. scary things that can be really bad, like, you know, bleeding, a very, very bad infection, you know, a pulmonary embolism with like, you know, shortness of breath, things, you know, early complications can sometimes kill you. Late complications tend to be cosmetic things, rippling, a dog ear, something that, you know, could be addressed almost at any time. So depending on the surgery, you know, that window of being observed for the early problems. could be a week to several weeks. You know, again, a big mommy makeover. If you still have drains in place, you should still be very near the person who operated on you because it can be challenging to find somebody else who's going to take care of those complications when they didn't do the original surgery. And rightly so, because, you know, they don't know what was done. They don't have all the information. So I think, you know, when you decide to fly away, you need to stay Stay there for some period of time, which also then at some point will neutralize this cost benefit. If you need to stay someplace for a month and have a hotel room or Airbnb or whatever, and then you need to also still be prepared to see someone for follow up. So like, again, for me, for a big surgery, someone might be seeing me, you know, the day after surgery, then they're seeing me weekly until their drains are out. And then we start. We start seeing one another on monthly intervals, but like those patients have several visits with me and always have the ability to pop in If something is going on in between scheduled visits

Chris: 30:47

And bravo, you know, those are all the things that that we try to impress upon patients And that's why i'm glad that you're able to come on and talk to us about this because I think you hit a couple Key points in there. So so first up This is a surgery So a lot of people think, you know, like you said, this is the one and done plastic surgery. It's just something that we're doing cosmetic. This is a major surgery that you're, you're undergoing and you have to treat it like you would any other surgery. If you had an appendectomy, you would have a followup appointment, right? If even if you had your tonsils removed, you would have a followup appointment. Right. And so, you know, to, to have that in the back of your mind is something that you want to make sure that you're planning for, because it can cost you your life. I've had several patients that I have had. You know, to send to the ICU who have had to have emergent, emergent, uh, you know, uh, laparotomy is kind of opening up the belly, et cetera, et cetera, because these pockets of infection have been, you know, developing over time. They didn't have their drains removed. And that small short term complication becomes a long term manifestation of sepsis, uh, or having, and then you're clinging to life in those situations. You know, a lot of patients are, are coming to the emergency departments here in Milwaukee. To have their drains removed, et cetera, et cetera. And a lot of physicians are reluctant to do it. And even the plastic surgeons in town, they're saying absolutely not because for those reasons, like you said, that the way, you know, I don't, I don't know anything about the surgery. I don't know like what complications can ensue and what was done in the OR. So it's going to put yourself in a bad position, unfortunately. Right. Yeah. So one of the things you said is that you you do primarily cosmetic surgery What what are some of the you know types of surgery some of the types of procedures that you do? More so routinely and we will kind of tease out, you know groups and demographics that seek those procedures

Aisha: 32:28

Sure. Um, you know, I do pretty much probably everything except for rhinoplasty. So I do facelifts, neck lifts, eyelid surgery all sorts of breast surgery. I definitely do a lot of breast. I'd say breast is for sure more than 50% of my practice, which is probably true for most female plastic surgeons. So breast reduction. breast augmentation, breast lifts, breast augs with lifts, fat grafting and then liposuction, tummy tucks, labiaplasty, thigh lifts, brachialplasty, like all those, all those things. I do think, you know, one of the common questions, and this is probably what you're leading up to, you'll be like, what's the most common thing you do? You know, a lot of the procedures vary by age and they vary by gender. So for example, in men And younger men, without a doubt, the most common procedure I do is liposuction. It's either liposuction of the abdomen or liposuction of the chest or gynecomastia, which is extra tissue around the breast in men. But for older men, for sure, it's probably neck lift, face lift, neck lift first with Facelift being a close second or combination of both of them. Same thing for women. I do operate sometimes on very young women, 16, 17, 18. Those are almost always breast reductions in young women who are either young athletes and the size of their breasts interferes with their ability to perform in sports, or they're just young girls who have very, very disproportionately large breasts. And then, you know, you get into the 20s, it's still probably a lot of breast surgery, but then it's a mixture of augmentations and reductions. So it really does vary by age and gender what kind of the top procedure is.

Chris: 34:03

Yeah. And more so just to tease that out, you know, it seems like as you alluded to before, you don't like to do like the large breast implants. You don't, you, you like to keep things within the purview of, you know, realistic expectations. How do you ensure that your patients have those realistic expectations about the outcome to their surgeries when they come and see you? And how important is that initial consultation again with a board certified plastic surgeon in that respect?

Aisha: 34:28

Yeah, I mean, it's crucial. Like, you know, I tell patients all the time, you know, I'm not here to sell you on the surgery, you know, I don't have to. I mean, that's why you came into the office. I try to spend time, you know, again, giving them a realistic expectation of the surgery what to expect and the potential complications, not in a way. That's going to scare them, but in a way that allows them to make a truly informed decision. I think there's certain things that I hit on for certain procedures that again, aren't necessarily a good or bad, but I want you to understand, like, so for example, for breast augmentation, you know, there's not a single patient who I put implants in. Who is under the misperception that these are lifetime devices? So if you're signing up for breast augmentation surgery you are signing up for a lifetime of maintenance and multiple surgeries unless Until you decide that you're going to have them taken out. But it's not like you're going to have a pair of implants Placed when you're 20 and that's gonna be the implants that you have until you're 100. If it's a breast reduction we might talk about the pros and cons particularly in a young woman who has not Had a pregnancy and has no idea whether or not she wants to ever be pregnant or whether she will ever be able to be Pregnant, but we will have the discussion about the impact of breast reduction on breastfeeding and also the changes that In the breast that could occur after a pregnancy or any significant weight gain, which again, in a young woman, the most likely significant weight gain is a pregnancy and how that possibly sets you up for needing additional breast surgery. So I think it's important, you know. Again, very rarely does someone hear all of this and say, no, I'm not going to have surgery, particularly when I'm 20. But every now and then someone's like, wow, I didn't know that. And I don't think this is the right surgery for me, or I don't think I want to do that. And I think that that's better for us to figure that out early than for you to figure it out afterwards.

Chris: 36:24

Yeah. And a lot of that kind of comes from our popular culture in our society. Right. So there, there, there are beauty standards in every population and their perceptions of culture that it changes from each generation on it, particularly kind of the beauty standards within African American community. You know, how do those perceptions and how do those cultural, you know, standards of beauty, how do those play into the decision to pursue plastic surgery or not in your, in your experience?

Aisha: 36:53

Oh, 100 percent it does. But I mean, you know, again, it does for every culture. I think it does for women in general. I think, you know, sadly, women have much higher rates of body dissatisfaction than men. And those often start in the preteen, you know, puberty years. And so I think that, you know, there's a, even if someone's not thinking about surgery, people are definitely women in particular. often hyper focused on their bodies and in particular what they don't like. I do think that there are cultural differences. There are generational differences in terms of what people want. There are also regional differences. I mean, plastic surgery looks a certain way in California in LA and Miami, and it doesn't look the same way in New York and Chicago. You know so I think all of those things sort of play a role. And, and like you also mentioned, times change, you know, it's like, you know, wide leg jeans are in now and skinny jeans are out, you know, it's like, you know, big breasts used to be in and now sort of looking more natural is getting popular again. And then the pendulum will swing again. You know, I, I'm fine with people doing whatever, as long as it's safe, you know, Again, it doesn't have to all be to my aesthetic. I'm not here to create a factory of Barbie dolls that fit my personal aesthetic. You know, I'm here to let people know, sort of, you know, the pros and cons of the choices that they want to make. And I'm willing to do whatever they want as long as it's safe and reasonable. You know, and again, there are, there are trade offs to the different choices that people make. I just want to make sure that they understand that.

Chris: 38:26

Yeah, and that's a tough job because I mean, a lot of times too, you're not only navigating kind of that, that, that perception of physical beauty, but also that, you know, so that psychology that goes behind that too, and navigating how a person feels about themselves, if this person is in the right mindset to make these decisions about, you know, a drastic change to themselves. That must be a tough thing to navigate as a surgeon and as a doctor, you know, how do you navigate those, those considerations when a patient's desired procedure may not be in their best interest from what you know as a surgeon?

Aisha: 38:58

No, I'm so glad you asked me this question because you know, it's, it's funny. I gave a grand rounds about a year and a half ago in a child psychiatry department on the impact of social media. On body image in adolescence and their desire to pursue plastic surgery and the summer actually published a pop sugar article on like how mom should talk to their, you know, young adult daughters about about plastic surgery and the article wasn't to encourage plastic surgery, but, you know, how to think about this. I mean, it's natural that people are going to want to make changes In their body, you know, and sometimes, you know, again, plastic surgery is so nuanced, Chris, like I'm not trying to say by any means that, you know, everybody should have plastic surgery. I'm not trying to encourage everybody at plastic surgery, but in that same way, you know, I think. Plastic surgery can be highly politicized and I think people have very strong opinions about it. I mean, there are the people who are like, You should be so grateful with what God gave you. You shouldn't change anything. There are people who have body dysmorphia and are doing way too much. And you're right, like on a daily basis. I need to try to figure out like who's in front of me and what am I dealing with? And I think that's why, you know, you want to take the time with consultations. You're seeing patients not only in consultation, but again at pre op visits. And the more you talk to them, the more you're able to sort of tease some of those things out. And if I do feel like there's some red flags, particularly like some, you know, mental health red flags, you know, you know, I will suggest that maybe that patient be. You know referred to a psychiatrist and that could be for a variety of things body dysmorphia It could be maybe somebody with a history of eating disorders, which again isn't a contraindication to having plastic surgery But if it seems like that eating disorder isn't controlled then this isn't going to be the right time To have surgery or if you are seeking plastic surgery because you think it's gonna I don't know save your relationship or you know Things like that like, you know again for the wrong

Chris: 40:57

reasons. Yeah for the wrong reasons Really

Aisha: 41:00

clear or, or, you know, or even unrealistic expectations when people like, am I going to look 20 again? It's like, you will not, you know, if you are 80, but we can have you look better. So I think, you know, yeah, I think I spend a lot of time trying to, you know, set realistic expectations for people and look out for red flags because as, you know, people who. have other issues that need to be dealt with, you know, they're not served by having those procedures. And as an aside, I mean, it's not completely connected to the question you asked, but that's also true for like health things, not just, you know, like physical health things, not mental health. So, you know, if we have, we have BMI restrictions, you know, obviously if people have underlying medical conditions that aren't well controlled, I'm not going to operate on them, you know, because again, I care about your safety and your overall health. Okay. You know, more than getting your money. But again, that's not necessarily the case for all providers.

Chris: 42:00

And that's a good question too, because a lot of times we see folks who are coming to the hospital to get, you know, their screening tests for whatever surgical procedure, you know, gallbladder removed, they're getting a cardiac stress test for whatever procedure in general. In your practice and, and in your opinion, you know, has there been a large number of patients that you've turned away if they don't have kind of that primary care doctor, if their vital signs look to be abnormal, if they have any uncontrolled medical conditions, how do you approach that in your practice?

Aisha: 42:30

Yeah, no, I mean, if let's say if somebody doesn't have a primary care physician, you know, there are, as you know, as a physician, people who think they have no medical problems, it's just those medical problems haven't been diagnosed. So, you know, for sure people get sent to the doctor for medical clearance every now and then you have people who push back. Like I don't often get a lot of pushback on the medical clearance, but sometimes I'll get pushed back, for example, on the mammograms, you know, because there are women who don't believe in mammograms who. want thermography and things like that, then I'm like, no, the standard for diagnosing a breast cancer is still a mammogram. And that is something that should start at age 40, unless you have a family history of people having breast cancers much earlier, then the recommendation may be 10 years prior to that age of diagnosis. I will not operate on breast of women over 40 without a mammogram and it is non negotiable for me. And I do a lot of breast surgery and, you know, I'm, I do a really good job at a lot of breast surgery and there have been patients who've sought me out and they'll say, Oh, well, I really want to have surgery, but I don't feel comfortable with that. And like, will you just take an ultrasound? And I'm like, no, I won't take an ultrasound. And let me explain to you why, you know, like an ultrasound diagnosis, different things than a mammogram, which also diagnoses different things than an MRI. Again, the gold standard for, you know, diagnosing, diagnosing breast cancers and screening is a mammogram and if, and I, and I'll say to patients, I'll say, you know, by all means, I support your, you know, your right to choose what you want for your body, but I'm not going to then be able to do your surgery. So if you're not comfortable having a mammogram, you don't have to have that mammogram, but I can't be the plastic surgeon for you.

Chris: 44:14

And that kind of harkens back to Dr. Weiss point of the, this is a surgery, right? And there are consequences related to this. If you go into the surgery, if you're doing a surgical procedure and you don't know what the risk associated with it. And so by operating on someone with a potential breast cancer, you have, you, you increase the risk that that can metastasize. You can go into a lymphatic system, et cetera, et cetera. And that can end very quickly. Poorly for the patient and, and having a surgeon do that due diligence is actually what you want, you know, in, in the moment, if you really want that procedure, it feels terrible enough, but that, that is something that could be potentially life saving for you. And that may not be something if you're, if you're going to like, like Dr. White was talking speaking to some of these institutions overseas or wherever that you may not have that board certified plastic surgeon able to do that procedure for you. You may be putting yourself at that unwanted risk.

Aisha: 45:06

No, absolutely. Absolutely. You know, and I, I mean, I love plastic surgery and I love what I do. And like I said, even, I think people think, Oh, this is so superficial, but you know, the impact on people's lives can be really great. Like Chris, I will say to, to people who are, you know, just, completely anti plastic surgery and not just anti for them because I'm fine if you're anti plastic surgery for yourself, but people who have this sort of sweeping generalization of what they think it is. And, you know, I'll say, you know, look, it's like people who have dental work, like imagine if you had like, you know, really not great teeth and they were crooked or you were missing some, and then like you were really self conscious about smiling. And so it impacted how much. You talk to people or you always covering your mouth and then all of a sudden you have dental work done and like you smile all the time and how you engage with people is different like that can be the impact of people addressing something that's always bothered them, always made them feel self conscious and you know, people go out into the world more confidently. They have more. Confident and intimate interactions with their partners because they feel better about themselves and their bodies. I mean, it can be good. But again, I'm not naive. It can also be bad. But you know, again, you want to make sure that like, if like for me, you know, if I'm doing this, because these procedures that I'm doing now, are not procedures that people need. They're, they're not things that are going to save your life. They are not only elective, meaning they don't have to be done emergently, but they are cosmetic, meaning they don't need to be done at all, you know? And so I, for me, the safety bar is even higher, you know, if it could be than when I was doing, you know, reconstructive or general surgery procedures. I mean, again, I've always cared about safety, but, you know, sometimes you're like, okay. You know, if someone comes into the ER, for example, with, you know they're super sick and their appendix needs to come out, but their blood glucose levels aren't well controlled. Well, you don't have time to wait for the glucose to be controlled. We gotta go. You have to go. But like, I'm not taking you for an elective procedure unless you're as perfect as you could possibly be. Because, you know, the other option is just to not have the procedure.

Chris: 47:20

And we've seen, unfortunately, again, in popular culture, some folks that unfortunately have had adverse outcomes and have passed, you know, down to West was like kind of the biggest one in pop culture that we saw as well. And so it really harkens to the fact that you, you have to do your due diligence and you have to make sure that you're in the safest environment, putting yourself in the safest situation as possible. Yeah. In plastic surgery, there's a ton of misconceptions, right? That social media is rampant, you know we, we, we get reality television, we get all these things, fillers, et cetera, et cetera. People are having these Botox parties, you know, wrestling, all these things, right? What are some of the biggest misconceptions about plastic surgery that you see in your practice and how can we help address them?

Aisha: 48:02

This is, I think this is the biggest kind of general one. Like if I had to put like an umbrella over everything, I think people judge plastic surgery by what they see and know. And again, Chris, this is not a commercial for people at plastic surgery, but I think you'll appreciate this analogy that I use for people. Like I've lived in New York and I've lived in Chicago. Both places have amazing pizza. I like them both depending on what I'm in the mood for. And I will say to people, like, imagine if you've never had pizza, but the only pizza you've had was like some grocery store frozen pizza, and then you decide, Oh, I don't like pizza. And I'm like,

Chris: 48:40

what?

Aisha: 48:41

It's like, dude, you don't know.

Chris: 48:44

Tombstone ain't Geno's East, man. Tombstone ain't Luminosa. Oh

Aisha: 48:47

my God. Oh my God. Like the cornmeal crust. I mean, shout out to Geno's East in the South. Spinach, the spinach for me, but yeah, like seriously. And so I think, you know, you look at like, I'm sure this question is coming. So I'm going to just put it out there. Like, like the BBLs. Okay. I think that's the big thing now. I think you know, people, so there are people with BBLs. Like BBLs and lip filler, I think are the two biggest things where people like, Oh, like there's some people who are like, I kind of want that, or I can do that, but I've seen that. And I'm like, well, yeah, you know, you only notice bad plastic surgery. The good plastic surgery, you don't notice because you think it's somebody who's good genes, you know? And not. every BBL is exaggerated. Not every lip filler looks like duck lips, but those are the ones that, you know, your untrained eye, you know, notices. But for every single procedure, whether it's a facelift, a breast augmentation, there's a natural version and there's an over exaggerated extreme version. And so, you know, I'm, again, not trying to convince people about plastic surgery, but I do want you to make good decisions and informed decisions. And if you are making your decisions about plastic surgery based only on bad plastic surgery results, then that's unfortunate, you know, because that's not truly making an informed decision. I, I, I think one of the other things that's a big problem is like, you know, especially with the celebrities, they have things done and with big things, you know, they have something done and they go away and then you see them once they're like fully recovered and healed because you didn't know they had something done. Or even when you're looking on our websites or social media, we're posting results once people have fully healed. So there are three months, six months, a year down the line, depending on what the procedure is. And I think patients think that they're going to have something in. The next day, it's going to look like this. There's not going to be any downtime that there aren't any Potential complications. I think Yeah, and I think the last thing I'll say about misperceptions is which sort of ties into this like people not understanding the process I Think that for a lot of plastic surgery people's perceptions is it's gonna it's almost like Going to the mall and getting your makeup done and then you come out and now your makeup is done or going to the hairdresser and having your hair done. Like, no, no, no, it is not that immediate and there's a process and also it is a serious medical procedure. Even if we're talking about something like lip filler, you know, you can occlude a vessel and someone could necrosis. off part of their lip. You know, this is not like going to have your makeup done. And you know, it's why, you know, I emphasize, it's really important to know the credentials of the person who's treating you.

Chris: 51:38

Yeah. And that's a good point too, especially, you know, the, the private equity, you know, situations are cropping up everywhere. You go to a Medi spa and they get all these things that are available for you and not to knock them because you know, some of those places do have medical directors and they are certified and they do, you know, rigorous training, et cetera, et cetera. But I, as Dr. White said, I would always be a bit apprehensive to, if you don't have that available to, you know, at your fingertips in terms of how that person is credentialed, how they're certified, what hours of training they had, et cetera, et cetera, et cetera, because these are major procedures, even if you're doing injectables, as Dr. White said, you know, some of these areas that you're injecting it, are not very, you know well perfused areas. So you can get that necrosis, you can get, you know, some, some ill effects that'll be devastating. And then you may down the line have to do more invasive procedures in order to kind of correct those things.

Aisha: 52:31

Yeah. And you know, and I mean, Chris, the reconstructive techniques have definitely advanced and I think we can do some really amazing things with reconstructive surgery. But, you know, when you're doing reconstruction, It is not like doing an aesthetic procedure and there are results that we're proud of. And we're like, these results are great. But, you know, reconstructing somebody's lip is no matter how good it looks, it's not going to look like you were born with, you know, and, you know, I've seen this, like, you know, I, I remember when I first moved to Texas, I saw a young woman who had had something probably like non medical grade silicone. injected in her buttocks. And when I saw, when I saw her, this was probably a year or two after that encounter. So she had been treated at a trauma hospital in Houston, where they had, where I guess she ended up having like infections, pockets of that silicone and tissue loss. And so they debrided it and they essentially removed Probably all the buttocks that she had and then the muscle, the gluteus maximus muscles were skin grafted because they were exposed. And, you know, she was coming to me to see like what could be done. And I mean, unfortunately I didn't have anything that I could offer her. I mean, you know, she had already been reconstructed to manage the wounds. So, you know, from a medical standpoint, she's stable, but from a cosmetic standpoint, she'll never be able to have something. That looks normal, you know, if you put a butt implant in under that muscle You still have the skin graft on top of the muscle. There's not enough tissue there to fat graft and you know It's so unfortunate because i'm sure no matter how much she didn't like her buttocks before she probably would give anything to have those original buttocks back instead of what she has now because what she has now looks quite, you know, abnormal and deformed because it is essentially a reconstruction after a traumatic thing. You know, it is not like having you know, a fat, fat grafting BBL or, you know, a butt implant. Like it is not, It's not the same procedure. It's not

Chris: 54:50

the same. And that kind of talks about, it morphs into our next question too, you know, obviously there, especially with the aesthetic procedures with the elective procedures, there is a price tag that is associated with it. And a lot of folks, you know, kind of. Grapple with that and that is a look the allure of some case in some cases to do this travel medicine to do You know kind of the spa medicine, etc, etc But as you spoke to that the way, you know, if you are are cutting corners in that respect You may pay for it down the line Absolutely. So, you know, what, what, what has been, you know, what is your advice to folks who say that, you know, maybe I won't be able to afford this now, is it for someone who should wait or maybe, maybe find other ways to finance that versus kind of undergoing a drastic travel or you know, a questionable procedure.

Aisha: 55:40

Right. I mean, most practices, my practice does most practices offer financing. So that's always an option. But yeah, if you really can't afford it, you should wait.

Chris: 55:48

You should wait,

Aisha: 55:49

you know, because, you know, you don't want to risk your life, you know, for something that's super cheap, you know, you it's just, it's just not worth it. Chris,

Chris: 56:00

you know, that that's, that's one of the biggest reasons why I wanted to do this episode too, because I see predominantly, especially in our Milwaukee population. I see over and over again these adverse outcomes and you know These are cases that they almost seem predatory in some in some respects, right? And I misspoke before I said puerto rico is actually the surgeon the quote unquote surgeon has a license based out of florida, but actually practices in the dominican republic So for anyone out there that's listening, you know Just just know that you're you may be putting yourself in a bad situation And it's a situation that as you said before there there there is that risk associated with it You may end up in a reconstructive situation where now you're dealing with something that you're dealing with less to kind of do the repairs or you may also lose your life too. So we want to make sure that we get that message out there.

Aisha: 56:46

Absolutely.

Chris: 56:47

Yeah. You know, what, what advice would you give anyone who is considering plastic surgery at this time? And, and, you know, what are, what are some of the stories that you may have for folks that, you know, some of the, the memorable experiences, some of the positives that you can see to highlight the importance of plastic surgery.

Aisha: 57:05

Yeah, I think, you know, again, if you, if you're considering plastic surgery, I would say, you know, first do your research. I mean, I feel like Dr. Google is, you know, I have a lovely relationship with Dr. Google, but I mean, I think there is some good information out there. That's at least a place to start. And you could gather information about the procedure. You could gather information about costs. There are again a lot of groups on social media, Facebook and other places where you can interact with other people who've had procedures. I also think that like while you're doing that whole process of discovery on the procedures, I think it's It's also a good time to be doing some self reflection and figuring out what you want, what your goals are. Because I think ultimately only you will be able to answer those questions, you know, and I think you, if you're prepared with that, you're less likely to be bullied by a provider who's maybe pushing his or her own agenda in terms of, you know, aesthetic things like, like I'll give you an example that happens all the time. Like, I had a a woman who saw me here. Probably about six months ago, and she was coming to see me for a breast lift, and when someone comes in and tells me, like, whenever someone comes in and asks about a procedure, which is normal for patients to do this, they're like, I want this procedure. I always like to back it up and say, okay, well, Tell me what's bothering you because sometimes the procedure that you're coming in and asking for isn't actually the thing that will get you what you want or what you need. And so this particular woman said she wanted a breast lift. And so I'll always say, okay, just so that we're on the same page. You're happy with the size of your breasts. You just want them lifted to a more youthful position. She said, yes. So we go through the whole consultation and. Talked about everything and at the end, I'm like, Oh, so you have any other questions for me? And she says you didn't you didn't talk to me about an implant and I said well You didn't say you wanted your breast. Remember in the beginning We went through this and you said you just wanted a lift and She was like, well, I saw another plastic surgeon and he said that it's not possible to do a lift without an implant. I was like, well, it's possible to do a lift without an implant. I was like, if you don't want to be bigger, then you don't need the implant. I was like, but if you do want to be bigger, then by all means, we can talk about the implant. And then she goes, well, You know, that makes sense because when I saw him and when I opened up my robe for him to examine me after examining my breasts, he like took my belly like this and jiggled it from side to side and said, we can fix that too. And,

Chris: 59:42

you

Aisha: 59:42

know, again, I think it, you know, again, depending on the providers who you're interacting with, people are trying to upsell people, people, you know, like I'm not, you know, you talked about. Earlier, we talked a little bit about like, you know, cultural body standards. Like I'm not here to body shame somebody, you know, like, and again, I want to give you what you want. There's some women who will come to see me for liposuction and in my head, I'm thinking, Oh my God, they have the cutest little curvy shape. And they're like, I want these hips liposuctioned. I want to have like an athletic kind of like straight shape. Other people will come in and say, Oh, I want some liposuction to my abdomen. But don't touch my hips. Don't touch my butt. I like that. Or I want my thighs thick. You know, again, you should be able to have whatever you want with your body. And so I think if you know what you want for yourself, you're able to better articulate that to the person who's going to provide you care, but you're also in a better position to avoid the person who's pushing their own agenda. Because then when they're like, Oh, well, you need an implant, you know, then you can be like, well, and I don't want to be bigger. And also I've done some research and it seems like it is. actually possible to get a lift and not have an implant placed, you know? So I also think that, I mean, you know, nothing is about choosing one or the other, but like, I care most about credentials and safety, but a very, very close second is also personality fit,

Chris: 1:01:02

you know?

Aisha: 1:01:02

I mean, so there are, you know, I'm not going to be the right doctor for everybody. And again, my feelings aren't hurt by that. And it's not a bad thing. I mean, I think. Certain people want certain things, and so I think that, you know, finding somebody who is well trained, who listens to you, and then, you know, again, sometimes there's just those, you know, little things that you just kind of know, like, I feel comfortable with this person, I think this is the right person for me. I also strongly encourage people to, To get second opinions. Like when somebody sees me, if they feel like they're not getting the answer they want, or even if they do feel like they're getting the answer they want, but they're a little shocked. I'm like, shop around, go meet some other people. You know, like, because sometimes you don't know, you know, until you see someone else and you're like, Oh my God, you know, like this is a completely different experience. This is a completely different consultation. I didn't know it could be like this. The other ones weren't like that. So yeah, I think there's nothing wrong with that. Yeah.

Chris: 1:01:57

Yeah. Like you said, you know, the, the, the, it's like a marriage. Right? Like you're going to be involved with this person for more than a one shot. So it's better to. Have that rapport with them and also to be your own advocate. That seems to be kind of the recurrent theme in a lot of these specials and a lot of these episodes that we're doing, you know, you have to be your own advocate, you have to have in the back of your mind, what you want and stick to your guns and make sure that you do that research and make sure that you're trying to get the outcome that you're trying to achieve there. Yeah, no, absolutely. So dr. White, you know, we're going to close out here I know a lot of our listeners are going to want to Reach out to you. Maybe look at look up more of your information. Maybe even come down to texas and see you how do they get a

Aisha: 1:02:42

Don't come from Milwaukee for a day. Don't

Chris: 1:02:45

come to me if you're looking for your stitches to be taken out. Am I going to tell you?

Aisha: 1:02:47

Yeah, yeah, yeah, no, exactly, exactly. Come for a while if you're visiting Texas.

Chris: 1:02:53

Exactly. So, how can they get a hold of you and, and, and, and what information would you give them?

Aisha: 1:02:58

Yeah, so my practice, I'm practicing at Synergy Plastic Surgery in Austin. We have multiple locations and I see patients at several of those offices. Also you can find me on social media on Instagram, I'm at DrDR. AishaWhite, so my full name. So yeah, and you know, feel free to DM me, reach out there too and I can answer questions or connect you with the office staff as needed.

Chris: 1:03:23

Awesome. Bye. So thank you so much. I appreciate it and looking forward to speaking more in the future and yeah, I hope you're staying warm down there and we'll be good.

Aisha: 1:03:34

We're staying warm here. We'll be staying warm all year. Like, you know, I'll, I'll call you and check on you and see if you're staying warm in like February.

Chris: 1:03:42

You know, I went to undergrad South Carolina, all my friends tell me like, boy, Chris, you know, you don't have to live like that. Like, I know, I know. I just love it. I love it up here. I love

Aisha: 1:03:49

it. I love it. I love it.

Chris: 1:03:51

It's a deep love, right? It's a marriage to Wisconsin. No, it

Aisha: 1:03:54

has to be a deep love. Because let me tell you something. I have a deep, deep love for Chicago. I mean, for the longest, I'm from New Orleans originally, but for the longest, like, Chicago had been the place that I'd spent the most time outside of New Orleans. And, I mean, Chicago is, Magical in the summer. I mean, there's a reason why we say summertime shy. And it's just, I mean, everyone's like outside riding bikes and they're on the lake and it's so beautiful. But those winters will break you. They will break you.

Chris: 1:04:24

It changes things. Yeah, absolutely. Well, thank you again, Dr. White. I'll see you.

Aisha: 1:04:29

Yeah. Thanks again.

1:04:32

I want to thank everyone for listening today. I want to thank Dr. Aisha White for taking the time and meeting with us in order to share some of the salient advice that she did, not only on plastic surgery, but on our concept of beauty standards in general. I want to thank you all for listening and I want to extend to you the invitation to look on Dr. White's website. She has a lot of good information on there. If you yourself are considering plastic surgery and things to look out for when you are and if you are considering plastic surgery. Now, with that being said, everyone's own standard of beauty is their own. And the point of Dr. White's mission statement is that she wants everyone to feel comfortable in their own skin and feel beautiful in their own skin as well. So either if that is going the route of plastic surgery or even wellness in general, eating better, doing all of the things to take care of oneself, both mentally and physically. And even if that doesn't include surgery, that is the goal. Looking forward to seeing you guys next time. We will be covering the subject of wellness in our next episode. So very excited to roll that one out soon. And with that being said, as always take care of yourselves, take care of each other. And if you need me. Come and see me.