Vault: Listeners ask this plastic surgeon questions

Summary

Podcast Summary: The Bert Show

Episode: Vault: Listeners Ask This Plastic Surgeon Questions
Air Date: June 19, 2026
Host & Cast: Bert, Kristin, Abby, Cassie, Tommy, et al.
Guest: Dr. Carmen Cavalli, Board Certified Plastic Surgeon

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Episode Overview

In this listener-driven episode, The Bert Show welcomes Dr. Carmen Cavalli, a board-certified plastic surgeon, to field real-time questions from their audience about plastic surgery. The conversation is lively, candid, and occasionally tongue-in-cheek, with Dr. Cavalli providing expert insights on topics including the distinction between plastic and cosmetic surgeons, tummy tucks, stretch marks, belly button repositioning, breast reductions, and implant removals. The show balances medical advice with humor and relatable anecdotes, aiming to demystify the world of plastic surgery for curious listeners.

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Key Discussion Points & Insights

1. Plastic Surgeon vs. Cosmetic Surgeon

[01:07–01:39]

• Dr. Cavalli: “Plastic surgeons are fully trained in plastic surgery and people who tend to call themselves cosmetic surgeons have typically trained in something else and then have decided to start doing cosmetic procedures.”
• Some so-called “cosmetic surgeons” aren’t even surgeons, but may be, for example, family practitioners performing liposuction.
• The importance of board certification is emphasized for safety and quality.

2. Heidi Montag’s Surgeries & Body Dysmorphic Disorder

[01:51–03:35]

• Discussion of Heidi Montag undergoing 10 cosmetic procedures at age 23.
• Dr. Cavalli: “I wouldn’t have done everything she had done. Especially for someone at age 23. I think her self-esteem is definitely impaired. She may have something that we call body dysmorphic disorder. Or she may just be nuts enough to do it to extend her fame.” (02:08)
• Physicians need to identify and avoid operating on patients with distorted body image, who may never be satisfied post-surgery.

3. Candid on Red Flags and Patient Selection

• Patients with body dysmorphic disorder often “figure out what to say” at consultations, making them challenging to screen:
  • Dr. Cavalli: “Occasionally they’ll slip under the radar, and then it’s just miserable to deal with after the procedure because they’re never happy.” (03:01)
• The importance of turning away patients who are unlikely to be satisfied.

4. Tummy Tuck (Abdominoplasty) Advice

[04:00–05:47]

• Caller “Wendy” asks about needing to be at “ideal body weight.”
• Dr. Cavalli: “You don’t have to be right at it or starving yourself to get there. But you should be doing all you can to reach your goals yourself, because plastic surgery shouldn’t be the first thing you think of when you think about getting in shape. It should be the final touches.” (04:50)
• Clarifies that a tummy tuck is particularly effective for lower abdomen excess, less so for upper abdomen fullness.

5. Stretch Marks & Belly Button Repair

[05:53–07:38]

• Caller “Christy”: Can a tummy tuck fix stretch marks and a deformed belly button?
• Dr. Cavalli: “Both can be fixed with a tummy tuck... Any stretch marks well above your belly button right now will still be there, but they’ll be pulled lower on the abdomen.” (06:08)
• Stretching the skin can make stretch marks less apparent.

6. Belly Button Repositioning

[06:46–08:15]

• Caller “Melissa”: Can you move the belly button down without a tummy tuck?
• Dr. Cavalli: Describes standard tummy tuck technique, which detaches and repositions the belly button:
  • "We kind of drop the belly button inside, pull everything down, and then pop it back up through a new little hole that we make for it.” (07:08)
• Non-surgical or shortcut approaches (like moving just the belly button) can leave unappealing scars.

7. Breast Reduction: Timing and Breastfeeding Concerns

[08:27–10:06]

• CALLER (“Kayla”): Should I wait until after having kids to get a breast reduction?
• Dr. Cavalli: "If it’s critical that you be able to give every opportunity to yourself to breastfeed, then yes, wait... If you want to enjoy your new breasts longer and it’s important to you to breastfeed, but not critical, then you might go ahead and do it sooner.” (09:03)
• Most women’s breast size is stable by age 21, barring major hormonal changes.

8. Breast Implant Removal: What Happens Next?

[10:07–11:13]

• CALLER: Can you just remove breast implants, or does it require replacement or other procedures?
• Dr. Cavalli: “You can remove them... You would need to do at least probably a lift, some sort of skin tightening procedure to get rid of the loose skin.” (10:35)
• Breast shape and tissue adjusts over the years, regardless of implants.

9. Do Plastic Surgeons Have Specialties?

[11:31–11:51]

• Some plastic surgeons specialize (e.g., face), others work head-to-toe.
• Dr. Cavalli: “I am fully board certified head to toe, bumper to bumper. I don’t do noses because I don’t enjoy them. But everything else is fair game.” (11:47)

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Notable Quotes

• On unqualified surgeons:
  “Family practitioners doing liposuction, for instance.”
  — Dr. Cavalli, [01:35]

• On risk with certain patients:
  “Occasionally they’ll slip under the radar, and then it’s just miserable to deal with after the procedure because they’re never happy.”
  — Dr. Cavalli, [03:01]

• On self-image and surgery:
  “Plastic surgery shouldn’t be the first thing you think of when you think about getting in shape. It should be the final touches.”
  — Dr. Cavalli, [04:50]

• On waiting for breast reduction:
  "If you want to enjoy your new breasts longer...you might go ahead and do it sooner."
  — Dr. Cavalli, [09:03]

• On implant removal:
  "You can remove them...you would need to do at least probably a lift, some sort of skin tightening procedure."
  — Dr. Cavalli, [10:35]

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Memorable Moments & Humor

• [01:41] “Is nuts a medical term?” “It is, actually. I’ve written in charts.”
• [07:38] Playful banter about “urine therapy” for moving belly buttons.
• [08:27] Transitioning from abs to “boobies” marks a lighthearted shift in the conversation.
• [11:47] “Head to toe, bumper to bumper. I don't do noses because I don't enjoy them.”

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Important Timestamps

• 01:07 – What defines a true plastic surgeon
• 02:08 – On Heidi Montag’s multiple surgeries
• 03:01 – Spotting and avoiding body dysmorphic patients
• 04:20 – Tummy tuck eligibility and body weight
• 06:08 – Tummy tucks for stretch marks and belly button issues
• 07:08 – How belly buttons are repositioned during tummy tuck
• 09:03 – When to consider breast reduction
• 10:35 – What to expect when removing breast implants
• 11:47 – Specialization among plastic surgeons

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Conclusion

This episode provides straightforward, medically accurate, and sometimes hilariously frank discussions about plastic surgery decisions, the psychology behind them, and the questions real people have. Dr. Cavalli underscores the importance of seeing qualified experts, managing expectations, and ensuring that surgery is pursued for the right reasons. The Bert Show’s signature humor keeps the tone engaging and accessible throughout.

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Transcript

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[SpinQuest Announcer]

Hey, the Birch Show.

[Host (Birch Show)]

Right now we have Dr. Carmen Cavalli in studio again. Good morning.

[Co-host]

Welcome back. Good morning.

[Safeway/Albertsons Advertiser]

How are you?

[Dr. Carmen Cavalli]

Thank you for having me. Great. It's always fun.

[Host (Birch Show)]

She's a board certified plastic surgeon. She doesn't care for the term cosmetic surgeon. Why is that again?

[Dr. Carmen Cavalli]

Well, because plastic surgeons are fully trained in plastic surgery and people who tend to call themselves cosmetic surgeons have typically trained in something else and then have decided to start doing cosmetic procedures.

[Host (Birch Show)]

Gotcha. So like another type of surgeon who says, I could fix a nose or

[Dr. Carmen Cavalli]

not even a surgeon.

[Host (Birch Show)]

Oh, really?

[Dr. Carmen Cavalli]

Family practitioners doing liposuction, for instance.

[Caller/Guest]

Gotcha.

[Host (Birch Show)]

Which is when I get my arm extensions, I'm going to a board certified plastic surgeon like Dr. Carmen Cavalli.

[Caller/Guest]

Your arm extensions?

[Host (Birch Show)]

Yeah, I had like really, really long arms.

[Caller/Guest]

Why?

[Host (Birch Show)]

Conversation piece.

[Caller/Guest]

I do. I was gonna say I do not want to know why.

That's bizarre. Very bizarre. Hey, Dr. Cavalli, I wanted to ask you before we take the calls about Heidi Montag and that whole thing about her being 23 years old and getting the 10 surgeries in one day and if anybody came into your office and asked you for that, what your decision would be?

[Dr. Carmen Cavalli]

Well, I think she's struggling really hard to extend her 15 minutes well beyond what it should have been. And unfortunately, I really think this package of cosmetic surgery she had has lent itself to that. And that may have been her main motivation for having it done. I wouldn't have done everything she had Done. Especially for someone at age 23. I think her self esteem is definitely impaired. She may have something that we call body dysmorphic disorder. Or she may just be nuts enough to do it to extend her fame.

[Caller/Guest]

Is nuts like a medical term?

[Dr. Carmen Cavalli]

It is, actually. I've written in charts.

[Caller/Guest]

Well, then, with people coming in with distorted body image, do you seek out counseling for that person or do you go over counseling with them?

[Dr. Carmen Cavalli]

I try to avoid them. Yeah, because they.

[Host (Birch Show)]

You just don't answer the phone. Turn off the lights. Oh, this person's got distorted body image. Turn off the lights.

[Dr. Carmen Cavalli]

Well, actually, I will sometimes. The client with the distorted body image has already been to enough consults that enough other physicians have picked up on those red flags and have refused to operate. That by the time they come to me or to one of my other colleagues, they figured out what to say. So they don't seem quite so nuts. So occasionally they'll slip under the radar, and then it's just miserable to deal with after the procedure because they're never happy. But if you can pick it up beforehand, then that's someone that I truly will refuse to work on.

[Caller/Guest]

Connecting the two questions, do you find that Heidi Montag is just encouraging people who may have that disorder to go to plastic surgeons first and try to get something done like her.

[Dr. Carmen Cavalli]

She's exactly the kind of role model that. That someone with body dysmorphic disorder would pick up on.

[Caller/Guest]

Wow. Wow.

[Host (Birch Show)]

So our first phone call is from Wendy. Who has a tummy tuck question?

[Co-host]

I do. Good morning, burchett. Good morning, Dr. Cavalli.

[Dr. Carmen Cavalli]

Good morning.

[Co-host]

I have been to, actually, several plastic surgeons who have told me that you have to be really at your ideal body weight or like five pounds. But most of my weight is right at my tummy. There's no other weight on my arms or my legs or my bottom.

[Caller]

It's.

[Co-host]

If you were to remove that, you might remove 30 pounds just in itself, because I've had two children back to back. They're both born on Christmas Eve, a year apart. And, you know, I had that big slab there. But I want to find a plastic

[Caller]

surgeon who will, you know, to do that for me.

[Caller/Guest]

Cosmetic surgeon.

[Co-host]

Be within your ideal body weight to have a tummy tuck.

[Caller/Guest]

No, I'm not a cosmetic surgeon. No.

[Host (Birch Show)]

Plastic surgeon.

[Caller/Guest]

Plastic surgeon. Got it. God, I'm all confused.

[Host (Birch Show)]

So it does seem weird to tell someone to get to their ideal body weight in order to have a procedure to remove weight.

[Dr. Carmen Cavalli]

True. And I don't typically tell people they need to be at their ideal Body weight, they should be reasonably close to it. And to me, reasonably close is 20 to 30 pounds. So you don't have to be right at it or starving yourself to get there. But you should be doing all you can to reach your goals yourself, because plastic surgery shouldn't be the first thing you think of when you think about getting in shape. It should be the final touches. It sounds like you have, like, the typical apple shape, Wendy, and that maybe if most of your weight is in your abdomen. There are different ways to carry weight in the abdomen, and a tummy tuck really does a great job when most of the weight is on the lower abdomen or the hips and the waist. When it's in the upper abdomen, like, literally coming out from under the ribs, that part you can't really treat with a tummy tuck. You can help it, but that thickness is still going to be there. It's just going to be pulled lower on the abdomen. So that may be what those other surgeons are looking at.

[Host (Birch Show)]

Hey, Christy. Welcome to the bird show.

[Caller]

Hi. How are y'? All?

[Narrator (Hershey's Ad)]

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[Host (Birch Show)]

How are you?

[SpinQuest Advertiser]

Good.

[Caller]

My question is I've had three children, and I have stretch marks galore on my stomach, and my belly button is deformed now. And I want to know if this is repairable.

[Host (Birch Show)]

The stretch marks or the belly button?

[Caller]

Both.

[Dr. Carmen Cavalli]

Both can be fixed with a tummy tuck. That's exactly what it does. Now, any stretch marks you have that are well above your belly button right now will still be there, but they'll be pulled lower on the abdomen. And just the act of stretching. A stretch mark, as odd as it sounds, makes it look less apparent. You don't have the crinkly skin.

[Caller]

It looks tighter. But, like, I have, like, Kate on John. And plus eight, it's like a flat stomach. I mean, it's really bad. Had my children so young.

[Dr. Carmen Cavalli]

That's perfect for a tummy tuck.

[Host (Birch Show)]

Hey, Melissa. Welcome to the bird show.

[Caller]

Hi.

[Host (Birch Show)]

I think we're sticking with the tummy tuck theme.

[Dr. Carmen Cavalli]

Awesome.

[Caller]

Well, I'm wondering if it's possible to move my belly button. I don't need a tummy tuck. I just want to move my belly button down.

[Dr. Carmen Cavalli]

Why?

[Caller]

It's too high on my body. Like, when you. If someone were to guess where my belly button was when I have a shirt on, they would be about, you know, a couple inches out of my. The wrong direction. It needs to be lowered because I look funny.

[Dr. Carmen Cavalli]

Well, there are a couple of ways to do that. The easiest and least obvious way would be to do a tummy tuck in which you. Well, typically when we do a tummy tuck, we leave a scar around the belly button and then a little smiley face scar along the lower part of the abdomen. And we kind of drop the belly button inside, pull everything down, and then pop it back up through a new little hole that we make for it. And so that leaves you with a scar.

[Host (Birch Show)]

All right, so that leaves you with

[Dr. Carmen Cavalli]

a scar around the belly button.

[Host (Birch Show)]

Can you fix that? Can you just move your belly button by drinking your own urine?

[Dr. Carmen Cavalli]

Oh, my God.

[Caller/Guest]

Urine therapy?

[Co-host]

Yeah.

[Host (Birch Show)]

Is that what we learned yesterday on the show?

[Caller/Guest]

No.

[Caller]

Yeah, that's right, yesterday.

[Dr. Carmen Cavalli]

But there's another way to do a tummy tuck in which you don't release the belly button from the outside, you release it from the inside so it gets pulled down along with the rest of the skin. So, yes, you can lower your belly button. You would do a tummy tuck if you have enough loose skin to do a tummy tuck. And the other way to do it would be to literally just cut around it and move it down, but then you're left with a scar in the original position of the belly button. So that's probably not the best way to go.

[Caller]

So basically, I should wait until after I have children and then do the tummy tuck and lower the belly button at the same time.

[Caller/Guest]

Or just eat a lot. I would be at McDonald's every day.

That'll move it down.

Yeah.

[Host (Birch Show)]

All right, now moving on to boobies. Hi, Kira.

[Caller/Guest]

Oh, my God.

Boobs.

[Co-host]

Hi.

[Caller]

How are you?

[Host (Birch Show)]

Good. Turn your radio all the way down.

[Co-host]

I'm sorry, what?

[Host (Birch Show)]

Turn your radio all the way down for us.

[Caller]

Okay, it's down.

[Dr. Carmen Cavalli]

Sorry.

[Host (Birch Show)]

You're on with Dr. Cavalli.

[Caller]

Hi, my name's Kayla.

[Co-host]

I am 21 and 5.

[Caller]

5.

[Co-host]

And I'm a little bit bigger than a triple B. And I've always wanted a reduction, but I have friends who tell me that

[Caller]

I'm supposed to wait until after I have kids because it could affect breastfeeding. And so they should wait until they plateau and are done growing.

[Co-host]

I guess I was wondering if that's true.

[Dr. Carmen Cavalli]

Well, at 21, your breasts are probably done technically growing. They will still change as your body weight changes over time. As you have hormonal changes over time or with future pregnancies in general, if you have triple Ds, they're not going to get smaller over time. They tend to stay the same or get bigger. And even with pregnancy, they tend to get much larger and then might deflate some, but you still have roughly the same volume that you started with. The answer to when to do a breast reduction is really very individual. Yes, it can interfere with breastfeeding, but there are some women who just aren't able to breastfeed successfully having never had surgery. So you really have to decide how important that is to you. If it's critical that you be able to give every opportunity to yourself to breastfeed, then yes, wait until after you've had your children. If you want to enjoy your new breasts longer and it's important to you to breastfeed, but not critical, then you might go ahead and do it sooner.

[Caller/Guest]

Lord bless your heart, honey,

[Caller]

thank you very much. Sure.

[Caller/Guest]

Sure.

[Host (Birch Show)]

Lee, welcome to the Bird show.

[Caller]

Hi. I have a question about breastplant removal, implant removal.

[Host (Birch Show)]

Everybody's going in the wrong direction today.

[Caller]

I've had them for 10. I had a lot of body issues when I was younger and I'm just kind of over them now. And I wondered if you could just absolutely remove them or if you had to have some sort of exchange, you know, so that you wouldn't look like horribly like a raisin or how does that work?

[Dr. Carmen Cavalli]

You can remove them. And just as I told Kayla, the last caller, your breasts change as you age and with weight changes and even with implants in, your breasts still change the way they would have even if you had never had implants. So you may have more breast tissue or less now than when you started 10 years ago. It just depends on how your breasts have changed. Yes, you can remove implants. You would need to do at least probably a lift, some sort of skin tightening procedure to get rid of the loose skin that has been left from the stretch that the implants have caused.

[Caller]

Okay. All right. Thank you.

[Dr. Carmen Cavalli]

Sure.

[Host (Birch Show)]

You know what, the questions today are all going in the wrong direction. Jeff, I just don't understand.

[Caller/Guest]

Be respectful.

[Host (Birch Show)]

How do people get in touch with you?

[Dr. Carmen Cavalli]

Dr. Cavalli, 404-250-3333 is our office number and my website is drcovalli.com d r k a v a l I dot com.

[Host (Birch Show)]

Do plastic surgeons have specialties? Do you have a specialty or are you like a one stop shop fixing anything?

[Dr. Carmen Cavalli]

I'm some do. Some like ENT facial plastic surgeons only do surgery above, you know, the clavicle in the head and neck. But I am fully board certified head

[Host (Birch Show)]

to toe, bumper to bumper.

[Dr. Carmen Cavalli]

I don't do noses because I don't enjoy them. But everything else is fair game.

[Caller/Guest]

Okay.

[Host (Birch Show)]

Okay. Well, thank you for your time this morning.

[Caller/Guest]

Thank you.

Good job.

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[Dr. Carmen Cavalli]

But just as I was able to

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