Loading summary
Transcript74 lines
- [00:00]
A
A good surgeon should sometimes turn patients away.
- [00:03]
B
Absolutely. I think the most important decision a plastic surgeon makes is when and how to say no to a patient. We now have more med spas in America than we do McDonald's locations.
- [00:14]
A
So many.
- [00:15]
B
And the lack of safety and gating as an entry point into establishing a location like that astounds me. It's not like going to Burger King where you just order off the menu. I'll take a number three with hold the mayo and extra pickles. You know, they're asking me for my judgment.
- [00:36]
A
Welcome back to the build pod, where authenticity trumps authority. I am actually on location. This is such a privilege. I'm here with the one, the only on Park Ave. Might I add, Mrs. Dr. Debgan, thank you for taking. I know you're so busy. You actually have a patient upstairs. So I am so excited to get 15 minutes of your time today.
- [00:57]
B
I'm so happy that this worked out. Thank you so much for being here.
- [01:00]
A
So we're just gonna dive right in. I'm just gonna get. I'm just gonna get. I'm gonna talk controversy, everything that people want to know. So let's just talk about medicine in general. You know, plastic surgery in general. People have. And I, by the way, I'm a huge fan of plastic surgery. I love it. I've had. We'll talk about it off camera. But I. I'm definitely. And I believe that, you know, if it's broke, it doesn't matter. Doesn't make you unauthentic. If you've had plastic surgery, it's really what makes you feel good. But, you know, there's a lot of controversy surrounding it and not being authentic. So let's start there.
- [01:30]
B
How do you feel about that? Authenticity is how you define it, and it's what you make of it. I think in the same way that we should give everybody the grace to make decisions that are appropriate for themselves, we should give people a little bit of space to think about topics like confidence, identity, and how they present themselves to the world. To me, plastic and reconstructive surgery at its best is just meeting a person where they are. And if you can do something in a safe and medically responsible way, that means something to you, frankly, what does anyone else have to do with it? What business of it is theirs?
- [02:06]
A
Yeah. And don't you feel good afterwards, like the person? Because some of it's instant gratification. They wake up, they're like, wow. So doesn't it make you feel, as a doctor, like you really are doing something great for this person.
- [02:17]
B
It's a truly amazing profession because there is such a high patient satisfaction. And it's really beautiful to go on these little mini journeys or major journeys with patients and see them through before, during, after the whole process. There's nothing I love more than seeing my happy patients at the end of the line.
- [02:36]
A
Yeah. And you have, I mean, an extensive background. I know you graduated from Princeton. Gail. I have Princeton. Sorry. Oh, look, my people messed up.
- [02:44]
B
Sorry.
- [02:45]
A
Yeah. So you have, I mean, you have an extensive background and your specialty is you do facial, right? Is that your specialty? I know you do everything.
- [02:54]
B
I am a board certified plastic surgeon, so I do operate on the face, breast and body. But I think I'm most known for facelift, blepharoplasty or eyelid surgery and finesse non surgical facial optimization. So a lot of what I'm dealing with is the tiny millimeter level details that create an optimized beauty. And a lot of that is in the face. It can be anywhere. But, you know, we, we lead with our faces.
- [03:17]
A
Absolutely. That's the first thing you see when you see people. So with that being said, you know, there's, there's a lot of talk about this new facial. Have you seen this, this like new facial technique. Have you seen it? Like, it's all over in Asia. There's a new way to do these facial or the facelifts. Have you heard anything about this?
- [03:34]
B
Yeah, there are. Well, a little bit of it is a media cycle and a little bit of it is what is real medicine and surgery. But there are a number of described techniques for facelift surgery that vary in terms of incision length, tissue plane depth, invasiveness, recovery, whether you're lifting the muscle, the fascia, the skin, all of the above. So I think one caveat I would say is that there's nothing that's completely new right now, but I think we all stand on the shoulders of prior generations in surgery. And so the techniques today are better than they were a decade ago for sure.
- [04:15]
A
Yeah, absolutely.
- [04:16]
B
I would definitely.
- [04:17]
A
And I'm sure they're like more refined and people want to have. I think people want more of a natural look. Would you agree with that? But they want that. So what about. Let's talk like a little bit about like the stuff you're not supposed to talk about. First of all, what's your favorite plastics to perform?
- [04:32]
B
I love the facelift. I think it's an elegant, beautiful operation. It really shows you every level of depth of human anatomy. The bone Muscle, fascia, fat, subcutaneous tissue, skin. It allows you to convey identity and beauty in tiny little details. So if I had to only do one surgery forever, it would be. Absolutely.
- [04:52]
A
And how do you know when it's time to get a facelift?
- [04:54]
B
Okay, pinch yourself. If you have more than 1cm of pinchable laxity in the neck, jowl or mid face, or if you significantly feel improved when you go like this with your fingers and lift up, then you can anatomically be a candidate.
- [05:07]
A
Oh, maybe it's time for me. I don't know.
- [05:09]
B
You look beautiful.
- [05:10]
A
Thank you. I love you even more now. Thank you. What about the people that can't afford it? Like what do they do? Is there an alternative? Do you believe in like non surgical techniques? Like does all this. Listen, I, I goop my face with all this stuff. I'm like constantly with the skin care. Is that an alternative or there's really no alternative if you need.
- [05:29]
B
Well yes and no. There are so many non invasive and minimally invasive evidence backed interventions that actually do truly work. Some of them are totally free. Like avoiding smoking, alcohol, getting enough sleep, sleeping on your back to avoid positional wrinkles, staying out of the sun. Those things in an evidence backed way will make you age better and look younger. Then there's a whole realm of non surgical procedures. Judicious, botox, subtle injectables, suture suspension, laser resurfacing, PRP, microinfusion. There is a huge body of research to support the efficacy and safety of those techniques. And the most beautiful results, like for my celebrity patients and public facing people, the most beautiful results involve some combination of surgery and non surgical procedures. So those absolutely work. And then you don't have to jump from zero right to a facelift. There are many other little tiny tweaks. The temperature, temporal brow lift, upper lip, left lower lip, left lip lift, buccal fat, fat excision, submental liposuction. There are so many opportunities to create a bespoke and customized result for a patient that sticks within their goals, their budget, their anatomy, their desires. So it is not a one size fits all type of thing.
- [06:39]
A
Would you say people take like their extreme. Some people are very extreme and then sometimes you have to tone it back. And I mean society does put a lot of pressure on us. You see, you know, Instagram, you see social media and there's tons. And granted I, they're filters sometime. But would you agree that like there's a lot of societal pressure and then people jump the gun and they want to go from 0 to 100 a lot of the time.
- [07:01]
B
Absolutely. We're very much living under a microscope. This is the first era in human history where regular, normal people have 10 or 20 or 30,000 plus images of themselves on their cell phones.
- [07:13]
A
Yes.
- [07:14]
B
People take more selfies and see their image. They're recorded on camera much more than in prior generations. And we all truly live on our cell phones. Apps like Instagram and TikTok have hours of daily time used per individual. So just the idea that we are dealing with our reflections and our images in a totally different way is totally true. At the same time, we need to counterbalance that with appropriate expectations and reasonableness. So you shouldn't be chasing the look of every single filter, but at the same time, we are really living in a different kind of world.
- [07:51]
A
Absolutely. So I'm going to switch gears because I know you're a mom. Like, I'm a mom.
- [07:54]
B
Yes.
- [07:55]
A
And there is. I mean, I get this mom shame all the time because I really am big into esthetics and, you know, I really do believe that the first thing you see is the way people look. That's the first thing. The way you look does dictate a lot of people's opinions. So. And I'm assuming you have a daughter, right?
- [08:10]
B
I have four sons and two daughters.
- [08:12]
A
Okay.
- [08:12]
B
So how old are your daughters? They're seven and nine.
- [08:15]
A
So they're little now. My daughter's 18 and my daughter actually just got. She just had a breast reduction. Not. I think she's a little young for anything else. But when your daughter comes to you and is like, hey, Mom, I'm really thinking about an augmentation or I'd like to try this procedure. What would be your reaction to that?
- [08:36]
B
As a mother and as a parent? You want your children to feel exactly perfect, just how they are. You want them to feel comfortable in their own skin and absolutely like nothing is needed besides their personal development. At the same time, we do realistically confront the world with a first impression that can sometimes make people feel limited or less comfortable. If one of my children, daughters or sons had a consideration where something was really bothering them, and I felt that it was a reasonable concern, anatomically justified and safe and appropriate to address at that time and age, I would help and support them through that process.
- [09:17]
A
I love that. I think that's such an honest answer. I feel the same way. I mean, you want your children to be comfortable in their own skin before anything. And love yourself first.
- [09:24]
B
Yeah. You're perfect just the way you are. If you. This Is really, really, really bothering you. Yeah. Let's talk about.
- [09:30]
A
That's exactly why I did it for my daughter. I knew was something that was bothering her. It's been something like this for a very long time. She's also 18 years old, so I felt like if this is really holding her back and she felt a lot more secure within herself then, you know, within. I thought it was reasonable. It wasn't anything, you know, obnoxious, and there was no implants. It was, you know, completely. But I do think that sometimes if you feel more. If you're in, you know, if you feel. If you feel better about yourself, I don't think there's anything wrong with that. But of course, for our children. We want our children to be comfortable in their own skin first.
- [10:00]
B
Yeah, absolutely. And people can be so judgmental about that. But it's really a personal experience with how you move through the world.
- [10:06]
A
Has there ever been a time where you had to turn a patient down where you're like, no, girl, enough. Like, enough, or.
- [10:12]
B
I think the most important decision a plastic surgeon makes is when and how to say no to a patient. And there's absolutely a kind way to guide someone toward appropriate decision making. Because, you know, when someone comes to see me as a patient, it's not like going to Burger King where you just order off the menu and I'll think of number three with hold the mayo and extra pickles. They're asking me for my judgment. There is a consultative process where I'm not only trying to help enable a patient to feel good about themselves and make a decision that's right for them, but I'm also trying to give them advice. And so I think advice includes what is safe, what is reasonable, what is aesthetically balanced or harmonious, and, you know, all of the above. So I never want to be unkind or cruel to a patient, obviously, but sometimes an operation is not the right thing for a patient. Yeah.
- [11:04]
A
You have a fiduciary responsibility to tell, as a doctor, you take a note, you know, you want to do the right thing.
- [11:09]
B
Yeah. You want to do the right thing.
- [11:10]
A
Yeah, absolutely. What do you think about people's things? Now, I know you have your own brand. I mean, you've defied all odds. You are a mom, you are a businesswoman, and you have a skincare line as well. So is there ever. Do you ever get any pushback from, like, the medical field, any of your colleagues? Like, oh, she's trying to brand herself, or, oh, she's trying to capitalize over here. I mean, is that ever something that you've come across or.
- [11:31]
B
I have not come across that particular sentiment. I think part of the reason is that I have a background as a clinical scientist. I've done an NIH pre doctoral clinical research fellowship. I spent time doing surgical outcomes research and bench based science at Yale, Johns Hopkins Medical School, Columbia Presbyterian, and at the National Institutes of Health. So I have a very strong background in the molecular and cellular basis of aging. That underlines the thesis for the whole skin care line. In addition, every one of my products uses high potency ingredients that have proven and demonstrable benefits in the widely available scientific literature. So you can go on PubMed and type in a couple of search terms and find 100,000 articles proving the efficacy of high potency, vitamin C and improving skin quality. So I'm not shilling some fake snake oil. These are actual products that create a demonstrable improvement in skin quality. And I think having a little bit of that scientific anchor and medical ethics about it has saved me probably from some of those criticisms.
- [12:36]
A
Yeah, I love that. I mean, obviously you have an extensive, extensive overachieving background over here, but I'm going to have fun with you real quick. Okay, so you've been in this industry for decades, so I'm going to throw out some statements and you tell me true or false. And I want your the surgeon's answer, not the Instagram ready answer. Okay, so first, most people who get cosmetic procedures are insecure and should be in therapy, not surgery.
- [13:00]
B
False.
- [13:01]
A
Yeah, I know it's not true. The rise of social media filters in. The single biggest. Is the single biggest driver of cosmetic surgery demand right now.
- [13:11]
B
I would say false. I think social media is certainly a contributing factor, but it's also the lionization of individuals who are putting their own experiences into the world. And I also think that we're seeing the curtain come down and people are understanding a little bit more about the process of how someone is maybe not born genetically blessed, but presents a certain way or looks beautiful in a certain way. People get it more because there's more transparency.
- [13:35]
A
Yeah, absolutely. I would agree with that too. A good surgeon should sometimes turn patients away.
- [13:40]
B
Absolutely. As I said, discretion is the better part of valor. It's my favorite Shakespeare line and so important in my daily work as a plastic surgeon where discretion or holding back a little bit is part of the job.
- [13:53]
A
Women who get procedures are craving to the patriarchy.
- [13:58]
B
No, I think we have for so long we have dichotomized this idea of being a person of substance who contributes to the world and being a superficial plastic surgery junkie. But this is a false dichotomy. You can be a person of substance and you can be killing it in the boardroom, the courtroom, the operating room, and still want to present your best self to the world. We both have totally different lives. We're both wearing different colors of lipstick. It doesn't undermine the years and degrees and the experiences and the ability to present. So I think this is part of a continuum of human nature and I think that is part of the judgment that makes this a difficult place for people.
- [14:35]
A
Yeah. And I think, you know, for women, even though we haven't progressed as much as we should as a society, I think women now are not afraid to be who they want to be in the boardroom. You know, I'm not a traditional boardroom CEO at all. Zero and I'm okay with it. Whereas, you know, 20 years ago you had to be a little bit more conservative. You know, you're looking to what everybody else thinks. And I think finally, women especially are like, you know what, this is who I am. Either you like me or not. Doesn't mean I'm under educated. It doesn't mean I'm any less misinformed. But this is who I am. So I love that. Non surgical treatments, fillers, botox and lasers are just as risky as surgery. People just don't know it.
- [15:13]
B
Sure, fault true. I think you don't know what you don't know. And we now have more med spas in America than we do McDonald's locations.
- [15:23]
A
So many.
- [15:23]
B
And the lack of safety and gating as an entry point into establishing a location like that astounds me. Facial anatomy is some of the most complex anatomy on the body. There have been cases of not only tissue necrosis, facial paralysis, blindness, even death and stroke. Horrible complications. We would never have a situation where you teach someone how to fly a plane in one day and then the next day there they are in the air. You would never have a situation where you would show up in a little pop up shop and get a colonoscopy or a cardiac catheterization. Like the lack of seriousness around the concept of beauty totally astounds me. We have a very well established training path for how to be safe at doing these kinds of procedures. And it's called a plastic and reconstructive surgery residency program.
- [16:15]
A
I love that. You're absolutely right. You see med spas, I mean literally, you type it in, there's like 100 in your nearby location.
- [16:21]
B
It's Crazy.
- [16:22]
A
How do you vet it, though? That's a good. A great question. How do you vet. What's a good med spa versus when you probably should stay away from?
- [16:28]
B
I mean, my unpopular opinion is what I just said, which is that we have a training program and a pathway for how to know somebody is safe with every one of those tissue layers from the bone to the skin, and how someone is knowledgeable about facial anatomy and cross sectional anatomy and so forth. In that training program. Unpopularly is a 10,000, 20,000 hour, 6 to 10 year training program. Yeah, that's what makes you safe, that, you know, if you want someone to remove a tiny little tumor from your brain, there's a six to seven year training program pathway that makes them safe to do that too.
- [17:01]
A
Yeah, absolutely. Well, all right, you. I mean, what's next for you? Because I feel like you've done it all. I'm sitting in your office in your podcast. You run a podcast, you have a skincare line, you're about to perform surgery. You have children, your wife, your mother. I mean, what, there can't be anything? Is there more?
- [17:18]
B
Well, I am so excited to announce that I am writing a book about my experiences as a plastic surgeon that will be forthcoming next year. I'm continuing to develop really cool innovation with the skincare line. We have our first fragrance coming out called Pheromone that's based on the neuroendocrine concept of attractiveness. Like what subliminally draws you to somebody.
- [17:42]
A
Like you can wear it at a bar and attract. Like you're.
- [17:45]
B
Yeah, like, like bees to honey. And. And then we're working on products with greater efficacy, more ingredient heavy, amazing products. I'm writing up some of my surgical techniques for minimal incision access, my signature zip stitch for eyelid surgery, some of my running intracuticular stitches that I use for lip lift and facelift surgery. And then I'm continuing to do what I love every day, which is besides spend time with my family, spend time with my patients. And I feel very fortunate that my job allows me to think and physically do so many of the things that I feel are uniquely special about me.
- [18:25]
A
I love that. I really. And you're giving back. I mean, in a sense, it is hope. It's helping other people every day feel better about themselves. And you get to come to work and experience that. I just love that for you. Now, if anybody wants to find you, where would they find you?
- [18:38]
B
You can find me on Instagram or TikTok at laradevgan, Maryland. You can find the skincare line at drlauredepkin.com and at major retailers all over the United States and world.
- [18:49]
A
Wow. I thank you for. I know your schedule is insane, so I thank you. And if you have not noticed, this woman is the real deal. You know, if anyone says that women can't do it and have it all, that is not true. So if you're watching out there, ladies, you really can have it all, do it all, but more importantly, you know, save lives while doing that. So, as a a renowned surgeon, where do you see plastics going in the future?
- [19:14]
B
I predict a few changes in the coming decade. First, we're going to see less and less invasive surgical procedures with tinier, more vanishing incisions and less downtime. Second, we're going to see more emphasis on longevity with respect to aging. So it's not just going to be about fixing it up and spackling it on. We're going to really be thinking about molecular and cellular health. How do we keep our collagen and elastin? How do we keep our hair on our heads? How do we keep our bone density? And how do we keep our bodies working and functioning? And then third, I think we're going to see a widespread acceptance of some of these ideas that we talked about earlier that are good for overall health on some level. The dermis or skin is just a manifestation of everything below it. So people who live well with good cardiovascular health, who are eating properly, sleeping well, avoiding toxic habits, those are the people who have that super luminous, glowy skin that takes so many serums to create in the absence of this thing.
- [20:14]
A
So true. I'm blown away by you. As you guys can see. I mean, this doctor has it all. If you're in the New York area, you have to check it out. But if you like today's episode, I urge you, like, subscribe. You know what? If you don't like it, unsubscribe, but tell a friend. And if you like this episode, please tune in to the Bell pod to see more episodes. Thank you, doctor, for Spending Syndrome.
- [20:36]
B
I appreciate you, really appreciate it. Thank you.