In Search of Excellence: Terry Dubrow – The Truth About Plastic Surgery

Host: Randall Kaplan
Guest: Dr. Terry Dubrow
Date: November 7, 2025
Episode: 176

Episode Overview

This episode of In Search of Excellence features Dr. Terry Dubrow, renowned plastic surgeon and star of the hit TV series Botched. Dr. Dubrow shares his journey through medicine and reality television, discusses the perils and truths of plastic surgery, addresses mental health in the profession, and explores broader lessons on success and preparation. The conversation covers Dr. Dubrow’s rise to fame, the ethics of surgery, trends like Brazilian butt lifts and the Ozempic craze, and candid advice on living a longer, healthier life.

Key Discussion Points and Insights

1. The Road to Fame: From "The Swan" to "Botched"

[01:08 – 08:32]

• Dr. Dubrow got his “TV break” through Fox's The Swan, after being chosen from 250 surgeons.
  • Quote: “I absolutely love plastic surgery. I love it. It's so interesting. I love it head to toe. I love what it can do for people.” (03:12, Dr. Dubrow)
• The premise of The Swan: “Ugly ducklings” undergo transformation and compete in a beauty contest.
  • “The message [of the show] would never work now... It was a major, major television production.” (04:32, Dr. Dubrow)
• Sudden fame: Surge in recognition and surgery volume; Dr. Dubrow was operating seven days a week.
  • “Within two episodes, I could walk into any liquor store, any restaurant...everybody knew who I was. It was instant fame.” (06:32, Dr. Dubrow)

2. Reinventing Reality—Creating Botched

[09:27 – 20:30]

• After The Swan and a turbulent period during the 2008 financial crisis (“Offices were completely empty...nothing to do.” (12:00, Dubrow)), Dr. Dubrow got involved in reality television again, leading ultimately to Botched.
• Original pitch for Botched was actually “the stupidest idea ever”—fixing other doctors’ failed surgeries on TV.
  • Quote: “What if we fail on national television? We're done.” (16:49, Dr. Dubrow)
• Transitioned into taking challenging cases, gaining massive surgical experience rapidly.
  • “All of a sudden we got 10,000 hours doing the most impossible plastic surgery. And it became easy.” (20:04, Dr. Dubrow)

3. Practicing Medicine on TV: Ethics, Mental Health, and Turning Down Patients

[20:31 – 29:57]

• Tackling complex cases on Botched sharpened Dr. Dubrow’s skills.
  • Most difficult case: Removing industrial caulking injected into a woman’s face.
    Quote: “I lifted up her face and sawed out the concrete, and it worked. That was my riskiest and most successful, impossible rescue.” (22:47, Dr. Dubrow)
• Emotional and psychological impact of surgery:
  • “I can't tell you how many times I've had a patient hug and cry and say that I saved their lives and that this is a restart and they can get a job now...” (24:40, Dr. Dubrow)
• Body Dysmorphic Disorder (BDD): “Some patients got to where they got because they have body dysmorphia and they keep going to plastic surgeons...Very few plastic surgeons turn down patients.” (25:06, Dr. Dubrow)
• Turning down patients as a marketing strategy and for ethical reasons:
  • “If I get the body dysmorphia patient who needs ...a thing fixed because it's a true deformity, I go, okay, let's play a game here...If I can come to some meeting of the minds...then I'll operate.” (27:06–29:41, Dr. Dubrow)

4. Plastic Surgery Trends and Risks

[29:57 – 40:39]

• Brazilian Butt Lifts: High risk of fatal fat embolism.
  • “I don't do it. I don't recommend anyone does it. ...It's not worth the risk.” (31:34, Dr. Dubrow)
• How to find a good plastic surgeon:
  • Board certification, hospital privileges, word of mouth, and how much time the surgeon spends with you. “Never trust a plastic surgeon you see on TV.” (35:09, Dr. Dubrow)
• Cost myths: No reason to pay exorbitant fees for basic procedures.
  • Quote: “Breast augmentation is an extraordinarily easy beginner operation in plastic surgery. Don’t spend more than 10 or 12 [thousand].” (36:05, Dr. Dubrow)
• Complications with implants: Most common is capsular contracture (“coconut implants”), often not the surgeon’s fault.
  • Praise for new “Motiva” implants: “...has a very low hardness rate. So my recommendation...is to look at the Motiva implants very carefully.” (39:09, Dr. Dubrow)

5. Fame, Family, and the Double-Edged Sword of Reality TV

[40:39 – 60:59]

• Risk of operating on celebrities: “If it goes badly, you got a problem. If you're not famous, you want to operate on celebrities.” (41:19, Dr. Dubrow)
• On operating on family: Only if you are uniquely skilled for that procedure.
• On the Housewives franchise: How Heather Dubrow (Terry’s wife) joined Real Housewives of Orange County (by a little white lie and signing her contract himself).
  • “I basically stopped talking to her for about two weeks...Finally, she goes, fine. If you want to go on Orange County Housewives, you sign the contract. So I signed her name, I sent it off.” (52:13, Dr. Dubrow)
• The cultural obsession with the Housewives: "People love it. It's a comparison...I think it comes down to judgy hatefulness." (55:37, Dr. Dubrow)
• Risks and rewards of reality TV exposure:
  • “Fame is very attractive...but it's very, very dangerous.” (58:58, Dr. Dubrow)
  • Advice to potential reality TV participants: Don’t do it unless you’re ready to risk everything coming out.

6. The Future of Surgery: Technology and Medical Trends

[44:47 – 47:50]

• AI and Robotics in Surgery:
  • “I don't think it's going to have any effect until robots learn how to have hands.” (44:51, Dr. Dubrow)
  • “That's bullshit. They can't. ...To do surgery. Not happening. Not true. Bs.” (45:08, Dr. Dubrow)
• Ozempic, Mounjaro, and weight loss drugs:
  • Dr. Dubrow is board certified in obesity medicine, prescribes these drugs, and says they offer anti-aging and healthspan benefits even for non-overweight people.
  • “I think everyone should be on microdosed GLP1s because of what they do for sugar and the inflammatory effects on sugar and how they are good for aging.” (47:29, Dr. Dubrow)

7. Extreme Preparation and the Keys to Excellence

[47:50 – 51:50]

• The importance of extreme preparation, in surgery and beyond.
  • Quote: “I would study for one and a half hour a day while I was on call. Gunshot wounds to the liver and just visualize it every single day...It was that preparation and only that preparation and visualization that allowed me to do that.” (48:10, Dr. Dubrow)
• Pursuing expertise outside one's field: Board certified in obesity medicine to address criticisms from peers.

Memorable Quotes

• “It's a scalpel, not a magic wand.” (05:39, Dr. Dubrow on his famous TV commercial line)
• “The greatest underrated characteristic to anybody’s success is kindness.” (65:42, Randall Kaplan)
• “Treat your patients the way you would treat your mother.” (63:33, Dr. Dubrow)
• “Find your passion and work like hell to exploit it.” (62:04, Dr. Dubrow)
• "If you could go back and give your 21 year old self one piece of advice, what would it be? ...Buy Apple stock." (64:56, Dr. Dubrow)

Timestamps for Important Segments

• The Swan and Early Fame – [01:08 – 08:32]
• Genesis and Growth of Botched – [09:27 – 20:30]
• Mental Health, Patient Selection & Turning Down Patients – [20:31 – 29:57]
• Trendy & Dangerous Surgeries: BBL, Implants, Price Myths – [29:57 – 40:39]
• Celebrity Patients and Family, The Risks & Rewards of Fame – [40:39 – 60:59]
• AI, Ozempic, and the Future of Medicine – [44:47 – 47:50]
• Extreme Preparation: Secrets of Success – [47:50 – 51:50]
• Housewives: Inside Story and Cautionary Advice – [51:50 – 60:59]
• Rapid Fire ‘Fill in the Blank to Excellence’ Round – [62:02 – 67:56]

Notable Moments

• Dr. Dubrow’s vulnerability about family and regrets:

  • “My biggest fear is that with one of my kids that I won't repair the relationship...to the point where it should be.” (62:52, Dr. Dubrow)
  • On his brother’s death: “He’s an asshole. I mean, he knew better.” (66:28, Dr. Dubrow)

• Direct advice for anyone considering plastic surgery:

  • “Go see a few [surgeons] and see how much time they spend with you.” (34:49, Dr. Dubrow)
  • “Never trust a plastic surgeon you see on TV.” (35:09, Dr. Dubrow, playfully self-aware)

• On what he would invent if he could:
  “A device that would tighten skin without cutting it.” (64:51, Dr. Dubrow)

Final Takeaways

• Success in plastic surgery (and life) hinges on passion, extreme preparation, and integrity.
• Fame is intoxicating—but potentially dangerous. Be careful what you wish for in reality TV.
• Plastic surgery, while powerful, is rife with risks—both physical and psychological—for both patient and surgeon.
• Don’t chase trends blindly (BBL, exorbitant fees, or surgeries you may not need); do your homework and seek out real expertise.
• Kindness and gratitude matter as much as excellence.
• Stay curious, never stop learning, and if you can, contribute to the greater good.

This episode offers a refreshingly candid, often humorous, sometimes sobering look at the intersection of medicine, media, and personal growth—from one of the world’s most famous plastic surgeons.