A (2:41)

And then I remember this. That's right. That's right.

B (2:44)

It was crazy. I've never had anything like this happen. So I had it booked in 2019, and then it was, like, all elective surgeries were, like, a wash because Covid happened. And they're like, unless you're, like, dying, like, you're not getting surgery. So they canceled it. And then the second time was the Snowpocalypse. Or, like, Snowmageddon. I don't remember what they called it. And, like, the. All the roads in Dallas were iced over, and so I couldn't go then because, again, they weren't doing any surgeries unless, like, you were dying. That's right. And then the third time, I found out I was pregnant, so I had to call them, and I was like, I can't come. And. And I'm glad I did. But I don't know, maybe if I had gotten it done, maybe I wouldn't have gotten as, like, large and in charge. Who knows? But that's the past. So then I had my son, and, like, you know, if I thought my boobs were sagging before.

A (3:33)

Welcome to pregnancy.

B (3:35)

Yeah. And gaining 90 pounds with the child. So, like, you know, I had a blast being pregnant with Taco Bell. And it's funny because I would always say, like, if he comes out like, a little preemie, I'm going to be pissed that I gained 90 pounds for him. I was like, he better come out, like, biggest fucking baby. Guinness World Record, massive child. And he wasn't that big, but he was big enough to, like, you know, be like, okay. And now he's like a tank. Like, my son is, like, 99 percentile height. Weight is in, like, 60, and he's only three.

A (4:02)

He's thriving.

B (4:03)

Yeah, he's huge. It's all the Taco Bell. Anyway, so I felt really, really insecure postpartum in general, but especially, like, with my breast. Like, my nipple then is probably the size of my boob now. The implant we put in sounds about right. No, they were huge. My before and afters are, like, insane. Like, nobody believes it was me, but, you know, a lot of times, like, you were like, okay, like, you know, get to your Goal weight and then we'll do the surgery. And I was like, at that time, you know, it was hard for me to work out because my breasts were so loose that like, I felt like just insecure. And then also like, it just felt like, you know, I couldn't keep them contained. Like they were kind of just going wherever they wanted to go. And I just like, didn't feel confident. So it was like I didn't have that motivation to get into my health and fitness again until I had my breast reduction. Then I was like, oh my God, for the first time, my nipples were not pointing to the ground. I felt so confident that it really kick started this weight loss journey for me and just taking care of myself in a different way. And so it really empowered me to get my health on track. And, um, then I lost quite a lot of weight and then I had no titties. So I'm from having like huge saggy boobs to no tits to now having implants. And I'm really happy with them. They look so good and I just feel more confident now. You know, it's like the best decision I've ever made was definitely getting the reduction. Like I would say that over getting the implants. I love them and they're still like, you know, give me, give me a year to say it's the implants. But I had to go through that to like feel confident, you know. And then now I like have breasts that like feel like how I always wanted to feel with my like actual boobs that I couldn't have.

A (5:44)

You're highlighting so many different things that are so important when we're counseling patients.

B (5:48)

Yeah.

A (5:49)

And now that you've had two surgeries, one for the reduction is sort of putting things back where they belong after pregnancy. And all the changes that happen with breastfeeding and now going to, you know, weight loss journey and adding implants to add shape to an otherwise shapeless breast because of the weight loss. There's a lot, there's a lot to unpack there.

B (6:09)

There's so much. Let's get into it. And then I also did other stuff too, because I want to make sure everyone knows. So the first time when I did the reduction, also, like, I remember right before you put me under, I was like, please let lipo my neck. And he was like, got you. So we did that. And then we also. Do you remember I had like a lot of bra fat bulge here that like even at my skinniest, like when I was competitive dancing, like I always carried fat here and that's normal, right? I want to talk about that for a second.

A (6:32)

It's very common. That's. That's something that we almost always add as part of either a breast reduction or a breast lift. That is definitely a common thing to do. Either right here on the chest next to your breast, or in this little armpit fold.

B (6:45)

Why does that happen? Why do women get that and men don't?

A (6:48)

You know, it's a good question. Fat in adipose tissue tends to be distributed differently. Women tend to carry it in places that men don't. Men carry it more centrally, especially in their belly. Women tend to carry it in their hips, in their breast, and their kind of upper torso, as well as in their butt and legs. And that kind of guides a lot of the different strategies that we recommend for patients. A lot of times you'll see men seeking abdominal lipo, and you'll see women seeking hip and flank and chest wall and axilla lipo. That is just a common thing that you see sort of gender specific fat distributions.

B (7:31)

I love that.

A (7:32)

So when you. When you have that area right there up next to your breast, it's not really something that becomes obvious until you wear the right dress.

B (7:42)

Okay.

A (7:42)

Or strapless bra or whatever it is. It's kind of going up underneath your arm and it kind of crowds that skin. And if you have fullness there, then that can kind of crowd and it can become a bother. So, yeah, a lot of times we'll add that as part of the breast surgery. And it's slam dunk when we do it, man. It's just awesome. Yeah, I'm sure it was the same for you.

B (8:00)

Oh, my God. Like, that, I think alone, like, I was like, I can wear like a sport, sports brawl and, like, feel confident or like, I never wore tank tops. I was really limited in, like, what I wore because of it. Even at my skinniest like that, I always had that. So that, honestly was like, one of the best things. I think the boobs just, like overshined everything because, you know, that was such a big change, like, from going from what I had to, you know, having, like, lifted breasts. Like, that was just like a dream come true. That it kind of, now that I, like, think about it, like, all of them honestly were so life changing. But the breasts, I think at the time, like, were just like such a big deal. But then the second time I did a labiaplasty, and I'm so glad I did that too. That was also. I was like neck lipo and labiaplasty were like, kind of like the little add ons. I'm like, I'm gonna be down. Let's do it. And it's truly, like, the best decision I think I've ever made was doing the labiaplasty.

A (8:55)

Labiaplasty tends to be one of those sort of unspoken operations that people don't really promote very much but is quietly very popular. It is primarily focused on the labia minora. And the whole idea is to reduce the menorah so they are not showing on frontal view. And there's all kinds of other symptoms that can be corrected too, like tugging on your underwear, discomfort with sexual intercourse, abnormal urine streams. There's all kinds of things that can be created by some abnormal anatomy down there, and that can be genetic. It can be from childbearing. There's all kinds of things that can cause excess in that area, and the surgery is designed to both correct those symptoms as well as the appearance.

B (9:40)

Yeah. So he chopped off my meat curtains. Meat hangers.

A (9:43)

Is that what we call them?

B (9:44)

That's what we call them. That's like the Savannah version of. Was it a labia majora?

A (9:49)

Labia minora minora majora is the outside, and the labia minora are in the inside.

B (9:55)

Yeah. So then ers, which, again, was, like, on honestly, super easy healing process. I think the worst part of everything for me is not taking baths, which I think is, like, pretty good. Like, if that's, like, the only downside, because I love my baths. But, yeah, have not tried her out yet. He said I have to be good for eight weeks.

A (10:15)

Let him heal.

B (10:15)

And I was like, honestly, this is like. And y' all know me. I was like, this is, like, the best because, you know, I'm recently divorced. All those things. And then also, I'm opening my spa, so I'm like, you know, if the kitty's off limits, I'll just be focused on work. And Tyler approved that message. He was like, that's actually the best thing you could have done. Um, so I can stay focused. But, yeah, I'm really happy with the results. It looks great. Sorry I won't show you guys a picture of my vagina, but you just have to trust.

A (10:41)

Yep. Everything went so well.

B (10:43)

Mm.

A (10:43)

Let's reel it back a little bit. You said you're opening your. Your own spa.

B (10:47)

I am. Well, new one new spa.

A (10:49)

And it's where? It's in South Lake. Is that right?

B (10:51)

Yes.

A (10:52)

And tell me what's changed.

B (10:54)

Oh, my gosh. More space. Nicer, actually. Have money this time. When I first opened my old SPA, I was 21, and I literally was like, at floor and decor waiting for, like, tile to be under 20 cents so I could, like, finish the bathroom, so more space, money to actually put into it. And now I have providers under me, which is really exciting. So, you know, I've really spent the last 10 years, 19 to now, just building, building, building this practice, and now I finally kind of get to be more on the back end, which is exciting. Like, I'm still going to see clients, but not in the way that I was, and I get to just foster growth for other people.

A (11:37)

As you grow, do you find yourself becoming more of a manager of people rather than a provider?

B (11:41)

Yes. I think that's like, the hardest part is because I always say, you know, you get into business because you're like, I'm so good at what I do. And then you become so good at what you do that, like, you need people to help you do what you do. And then you have to manage those people. And then it takes from doing what you're gonna doing.

A (11:57)

And it's so impressive in your youth, what you've built, you've become such a force in the esthetician and aesthetic space.

B (12:05)

Thank you.

A (12:06)

I think you've gotten a lot of recognition, and it's very well deserved, as have you.

B (12:10)

You made Dallas have the best breast.

A (12:12)

Sure. I appreciate that.

B (12:13)

It's true.

A (12:15)

But, yeah, you should be very proud of yourself, and I'm very impressed.

B (12:19)

Thank you.

A (12:19)

It's been fun working with you. So let's dive into some of the attention that you've been getting for your surgery.

B (12:26)

Oh, yeah, Well, I always have haters, but then of course, like, you know, when you do anything, do you know that? What's her name? Follow your arrow. Do you know that song I'm talking about where it's like, if you can't lose the weight, then you're just fat, and if you lose too much, then you're on crack and it's like, damned if you do, damned if you don't. So just.

A (12:45)

I don't know that song in particular, but I know exactly.

B (12:47)

I want to say it's from Casey Anthony, but that's the child murderer.

A (12:51)

What is it? There are multiple different songs, sources, stories, songs, probably about how women just can't get it right.

B (12:56)

It's always something.

A (12:57)

You're going too fast, you're going too slow, you're making too much money, you're not making enough, you're too fat to have a mom.

B (13:02)

You have no direction in life. A working mom. You're an absent mother. Yeah.

A (13:06)

Yep. You guys have it. Have it really rough when your male counterparts are literally getting away with murder, and it's because it's basically done without shame at all.

B (13:16)

Yeah. And it's funny because, you know, women are always like, oh, like, you know, it's men against women, but it's really women against women. Women are the meanest to each other. And it's sad because if we come together, you know, such amazing things can happen. And I know that's kind of like the name of the game on social media. And it's always that story. It's like, you know, if you share it, it's too much information. Why are you putting this out here? And then if you don't share it, then you're a gatekeeper and you're dishonest and you're lying to your audience, and so you can never win. And I've always just been an open book to a point where it's gotten me in a lot of trouble many times, because I think the more you share, the more you can help other people and the more you can connect. And there's not many people that are as unfiltered as I am and have the confidence to say what I say and not really allow outside opinions from the peanut gallery affect me and who I am when I go to sleep at night. And it took a long time to get there. But something I've always said, you know, God prepares you for the hardest things in life. Young and I went through a lot of bullying and a lot of haters in high school. And, you know, I remember being like, why do I feel like I have a target on my back? Like, why am I, like, just dealing with so much hate? And social media, Instagram specifically came out when I was in seventh grade. I'll never forget it. It was during a field trip. And, you know, that really changed a lot of things, because bullying back then, you'd pass a note or you might say something to someone in the hallway. But social media has made it so much easier for people to make a fake account, hide behind a keyboard, and just say the most awful things that they would never say to your face. And, you know, I give grace because I know for me, like, when I was younger and, you know, I was jealous of somebody or someone had something that I wanted, like, I would try to tear them down to make myself feel better. And so I understand that's, like, kind of the place it's coming From. And I think when you can come from a place of, like, empathizing with the hater instead of, like, being hurt by the hater, it makes things a lot easier. But again, you know, it depends where I am on my cycle. I always am, like, I either don't care, or if I'm, like, PMSing, then I do cry sometimes. I won't sit here and say, like, it doesn't always not hurt my feelings.

A (15:28)

It takes a lot of strength to put yourself out there. It takes a lot of strength, a lot of courage. And the thing that I think you need to keep your eye on is how many people you're helping, not only with your business and your aesthetic treatments, but with how vocal you are. Because I think it's very empowering to a lot of women.

B (15:48)

Yeah.

A (15:49)

Who are probably sitting on the sideline exactly where you felt when you were in grade school and looking at you saying, oh, my gosh, look what she's done with her life. And I think I can do the exact same thing.

B (16:00)

Yeah.

A (16:00)

It just takes putting my head down a little bit, elbow grease and some hard work.

B (16:04)

Definitely.

A (16:05)

And everybody has that opportunity.

B (16:07)

And you can reinvent yourself. I think that's the thing. People get so complacent and like, okay, well, this is the life. I'm gonna be overweight, and I'm gonna have saggy boobs, and that's the life that I'm gonna have.

A (16:17)

And it can be paralyzing.

B (16:19)

It can. You know, and I think it's, like, when you accept less, you hurt yourself. And, like. Yeah, it's scary to go under the knife. Yeah. It's scary to, like, get in the gym, you know, when you don't feel confident. Like, that's like, the scariest thing is starting. And the scariest thing is.

A (16:32)

I think that's so important to highlight is I didn't do all the work. Yeah, I did a couple of operations for you.

B (16:38)

I remember I came in and you're like, did I do a tummy tuck on you? Because I came, like, six months post op, and I was like, you didn't. Which everyone always thinks I have a tummy tuck. I don't. When I bend over, I have some skin.

A (16:47)

I can verify there's no tummy tuck happened.

B (16:49)

I did get my vagina, my neck, and my breast chopped twice and well chopped and then put back in and then. What is this called? Axcella.

A (16:59)

Oh, we just call it axilla. Armpit. Sorry I'm using the medical term there.

B (17:01)

Armpit. Yep, yep. So I would Tell you guys if I did that. But I didn't. But yeah, I mean, I, you know, but it was really, you kick started that confidence for me. And so, you know, I think you just do it. You know, of course, like, obviously, like get to a good weight. Cause there are risks if you're like, you know, planning on losing a lot of weight. Like, you know, I probably would have looked a lot better if I'd never gained weight and just, you know, lift and implants the first go around. But like, I don't like living in the past. Like, I'm so happy with my results. I feel so confident. I feel the most me I've ever felt. And you know, I didn't obviously expect to like have that little of tit at the end of the reduction, but they weren't like that. Like when I first got my reduction, like they were this size, right? They were big. And then I lost so much weight. And like with women, you know, that's why they tell you don't get a breast reduction if you plan on losing weight. I was the case study for this.

A (17:50)

I mean, your breast is made up of breast tissue and fat tissue. So when you lose weight, it's natural that you're going to lose some, some breast volume.

B (17:56)

Oh yeah, I lost all the tit pretty quickly. But you know, it was a good thing because it got me to like a place where I felt really healthy. I felt very active. And then I was like, okay, you know, I miss feeling feminine. Like I kind of felt a little boyish with not having any breast. And yeah, I think after going through a divorce too, you know, you kind of just want to feel more confident. I wanted to change and it had been something I'd been thinking about for a while and then to do the vagina like that. For me, it was really purely cosmetic. Like I had one lip that was like a little bit longer than the other, which now I have no lips. It's great. It looks amazing. But I just liked the concept of like, you know, new era of life. Like new body, like new breast, new vagina. All the genitals got a refresh.

A (18:42)

Would it be fair to say that the surgery helped you with aligning your appearance with your identity?

B (18:49)

Definitely.

A (18:50)

And with your energy?

B (18:51)

Yes, it was kind of like getting rid of the old energy. And you know what's so funny is like I'm a little spiritual too, so you might think I'm crazy, but like when you go through anesthesia, you know, you're like the closest thing to death and Like, I was honestly going through such a hard time before surgery, like with the divorce and everything, and I just kind of felt like I was, like, in this fog. And then when I woke up from surgery, not only having the enhancements done, but just like. I don't know. I think being in that middle ground between life and death is that kind of what anesthesia is. Where are you?

A (19:22)

You're asleep. You don't have brain activity, obviously, so you're like, dad, I mean, you're pretty. I wouldn't say that you're medically dead.

B (19:30)

It's like being in a coma.

A (19:31)

I mean, dead is a. Is a description. I would say more close, closer to. I mean, I wouldn't even say that you're. You're very much alive. You're in a very controlled state.

B (19:42)

Well, I had, like, a literal spiritual experience when I was under anesthesia.

A (19:46)

This very deep sleep.

B (19:48)

Yeah.

A (19:49)

So we. We kind of grade levels of anesthesia by your ability to respond to stimuli.

B (19:54)

Oh, wow.

A (19:55)

So if you're asleep just in your.

B (19:56)

Bed, what else did I knock out? And what was the last thing I said? Did I say anything fun?

A (20:00)

You know, I forgot exactly what we were talking about. I think we. What we typically do is try to create a very calm environment for people as they go to sleep.

B (20:08)

Yeah.

A (20:08)

Did the anesthesiologist ask you to pick up. Pick out a nice vacation?

B (20:11)

No, I don't remember.

A (20:12)

Sometimes I say go to the. Go to that beach. Go to that mountainous. Whatever it is.

B (20:15)

I remember nothing.

A (20:16)

Sometimes we'll ask people to count back from 10 and see how far they can make it.

B (20:19)

Wow. You know, for me, do I take a lot of anesthesia at a knockout, or am I pretty?

A (20:24)

Like, no, I would say that you're. I mean, number one, you're. You're a small person. You're not a drug user. There's all kinds of different things.

B (20:31)

Oh, so if you're a druggie, like, it takes a while for you to go to sleep.

A (20:33)

Oh, no doubt. Yeah. It's well known people that have sort of ramped up systems because of drug use and alcohol use, they. They require more narcotics, more anesthetic agents to. To go to sleep.

B (20:46)

I did not know that. Yeah. That's crazy. But, yeah, when I went through the anesthesia this last time, like, I woke up and I just felt, like, clear, like life was, like, worth living again. And it wasn't just because I had surgery. Like, I just felt like I had this, like, spiritual almost awakening through surgery, which I, like, asked, which they, know This. I have an astrologer and I love her. And she was like, that's like a normal thing. When people go through surgery, you know, you're like, in this, like, space.

A (21:10)

I will say that when you are having general anesthesia, when you. When you undergo surgery, as you're waking up, you do get a bit of a window into somebody's soul. Yeah, it's. That's kind of the spiritual side coming out. But, yeah, when you're waking up, you see people who have internal struggles. They wake up agitated, they wake up suspicious.

B (21:31)

Was I suspicious?

A (21:32)

No, you woke up like an angel. You're very sweet on the inside.

B (21:37)

What's the nicest thing anyone's ever said to me? I'm clipping that and, like, putting it on repeat.

A (21:42)

Well, it's true. And, you know, you do enough surgeries, you can start to sort of see different trends and there are certain.

B (21:51)

Right, yeah.

A (21:52)

And as you're waking from anesthesia, you can see that internal energy that.

B (21:57)

Wow.

A (21:57)

That it's definitely angelic in you. You're not. It was not agitated or. You're not a fighter.

B (22:05)

No, I'm not. I know I've always said if someone tried to murder me, I'd be like, it's my time. I accept it. That's my fate. But, yeah, it truly has been the best decision. Okay, so I want to talk about a little bit. Everyone wants to know what I. What implants, what size and why. That is like, one of the biggest questions. And why. I guess I can answer personally, which I kind of did. Why did I get rid of them to get them back again? It's. They weren't supposed to ever get that small. I just had lost so much weight that they're like little deflated balloons. And they weren't bad. Like, I did feel confident in them, but I think the coolest thing is, like, you know, you can't go into surgery or you can't go in and like, absolutely just hate yourself. You know, I'm sure you see people come in and it's like, you have to have some form of self love and, like, you can hate parts of yourself or, like, things that you would like to improve, but, like, at the core, like, you have to love who you are because surgery is not going to fix the insides, you know, and for me, it was like, yeah, this would make me feel more confident. Like, this would make me feel more feminine. This would make me feel like a new version of myself, like the highest version of myself that, you know, I want to embrace and Love and live. So, you know, it wasn't that I was, like, super insecure about having smaller breasts, but it wasn't, like, my favorite thing about myself. And it was something that I knew if I improved that, like, I would show up more confident, and that would feed into my relationships, my leadership, the way I show up for work and how I feel on camera talking to my followers. Like, I just felt like that would give me this boost and, like, yeah, just make me feel better.

A (23:46)

So if you look good. Yeah, if you look good, you feel good. If you feel good, you play good. If you play good, you get paid good.

B (23:55)

I like that. That's so nice. And that's the truth. Like, I was telling you when you told me that quote, because I knew the first two, but then I didn't know the play and paid, and now I'm gonna steal that.

A (24:05)

I can't take credit for that. That was Deion Sanders.

B (24:07)

That's really good.

A (24:07)

So Prime Time himself, I would never.

B (24:09)

Know, but now I know, I'm gonna say it's from you still. I would, like, get dressed up for school all the time, because if I went to school and I had, like, my makeup and hair done, I took notes better. I focused better. Like, I was, like, you know, just really, like, into it. And if I came like, a slobber, no makeup on, hair up, like, I would just be kind of, like, dragging ass and feeling tired all day. And I've noticed that in work, too. Like, when I show up ready for work and not getting ready at work, like, I have more energy, I'm more focused, I'm more efficient. I get more done. So there is a lot to, you know, how you look is how you feel, and how you feel is how you look. And I don't think there's anything wrong in taking pride in your appearance. I think we used to do this a lot more often back in the day, you know, like, we would literally wear, like, corsets and, like, rollers in her hair, and women would, like, take forever to get ready. And, like, America has kind of just like, watered women down, you know, in a way, too, where it's like, we're in leggings all day long, you know, like, if you go to Europe and you walk around in leggings, they're gonna think you're, like, fucking crazy. They're gonna be like, you know, there's.

A (25:14)

An elevated standard of dress and the.

B (25:16)

Way you present yourself. Yes, it's etiquette how you present yourself. And so I think, like, a lot of that we've kind of lost as a culture. And I think you should be comfortable, for sure. Like, there are days I look like an absolute slob. So I'm not sitting here saying, I always look great. I could be better. But I do think there is a big part of that, and I see it too, with skin. You know, I have clients come in, and I'm sure you have felt this in consults where you're like, do they fucking hate me? Like, they fucking hate me? You know, like, they do not like me. And then you.

A (25:43)

Slippery slope. You can certainly. You can certainly feel that. And you have to be very careful when talking about somebody's insecurities. And you also have to sort of vet the insecurity, make sure that you're not treating somebody with some red flags.

B (25:55)

Right.

A (25:56)

Somebody comes in and you assess that their insecurity or their interest is not necessarily addressing an insecurity for the right reasons. Yeah, you want to empower the patient. You don't want to reinforce an insecurity that they think is going to fix something else in their life that leads to objectification of that patient.

B (26:17)

Like, oh, if I get breast, my husband will love me again.

A (26:20)

Exactly. Think it's going to save a relationship, or you think it's going to make you more successful at work.

B (26:25)

Yeah.

A (26:26)

This really should come from within. Just like happiness and beauty, everything should come from within. And if you feel like it's going to empower you, then more power to you.

B (26:34)

I love that.

A (26:35)

Yeah, let's talk about your implants.

B (26:36)

Okay. Yeah, let's talk about them. I jump around a lot.

A (26:39)

It's okay. So you have. You have gummy bear implants. They are.

B (26:44)

What does that mean?

A (26:45)

They're smooth and they're around. Gummy bear refers to the gel on the inside of the implant. It's a silicone implant, and it is made of a gel that is cohesive. So what that means it's sticky. Years ago, there were some problems with implants rupturing or breaking inside the body and that silicone leaking into the tissues and then migrating through the lymphatic system, and it would get into their lymph nodes and their armpit.

B (27:09)

Is that where people would say, like, breast implant illness? Is that where that came from?

A (27:12)

That's a little bit different. Implant illness is a. Is sort of a more modern entity. This has been going on since the 80s and 90s.

B (27:20)

And this is post saline. So like the OG breast, the gummy.

A (27:24)

Bear implant is post saline. The saline implant was used predominantly in the 90s and 2000s.

B (27:30)

That's what my mom had at first.

A (27:32)

Yeah. Because of the moratorium that was placed on silicone breast implants because of that leakage that was occurring.

B (27:36)

Oh, wow.

A (27:37)

So the product of that moratorium, all of the implant companies went back to the drawing board, did all their R and D, and they came out with gummy bear implants. Gummy bear implant. If you, if an implant ruptures here on the table or inside your body, the silicone would stay inside the implant because it's cohesive.

B (27:53)

Oh, wow.

A (27:54)

Just like a gummy bear.

B (27:55)

Oh, my God. That makes sense.

A (27:56)

Cut a gummy bear, you unfold it, it's gonna stay inside the shape of the gummy bear.

B (28:01)

I did not think about that.

A (28:02)

So that is why that implant is named and referred to that way. We just call them form stable or cohesive implants in the industry. But they have been named gummy bear implants.

B (28:13)

Wow.

A (28:14)

By the. By the community. So that's what you have. You have 310ccs and they're moderate plus profile.

B (28:22)

Love that. So what's the difference between high profile and moderate and moderate plus. And is there low profile?

A (28:28)

Yep, there's. There's several different. So you cut, you have low, you have low plus, you have moderate, moderate plus high, and extra high.

B (28:35)

Oh, my God. Is that like up here?

A (28:37)

Yep. They stick out like gumdrops.

B (28:39)

Okay. Wow. So mine kind of go. Because mine are not super. Because I didn't want them to be like that. I wanted them to be more like that. So that's why we did that.

A (28:47)

Right, right. And this is, I would say 99.9% of my patient population, they want natural looking breasts. We don't. You can make breasts look fake with either size, with volume, or with profile. So what profile means is for a given width of the implant, how far does it project off of your chest wall or if you're sitting on the table, how tall is the implant? Essentially. And obviously a more projected implant is going to be bigger, but it's also going to give you more upper pull, fullness, roundness, cleavage, all of the sort of fake breast elements.

B (29:21)

Okay.

A (29:22)

A moderate plus implant and down from there. Moderate and low plus and low are going to give you varying degrees of that natural appearance where it just volumizes your breast and it doesn't give you the same degr degree of shape.

B (29:35)

What's the biggest cc they make right.

A (29:39)

In the 800cc mark for a silicone implant. You can get larger implants if you go salient. Or if you custom make the implant.

B (29:45)

Have you ever had a custom made implant?

A (29:47)

No, I haven't.

B (29:48)

Have you ever put an 800cc in someone?

A (29:50)

I have.

B (29:51)

No way.

A (29:52)

So there's two reasons you would do that. Number one, in a larger patient, somebody who's, you know, over six feet and has a really broad chest, an 800cc implant sometimes doesn't make. Make as big of a change as you would think.

B (30:03)

Wow.

A (30:04)

And then secondly, for women that have lost their breast tissue from breast cancer mastectomies, that patient population.

B (30:10)

Yeah.

A (30:11)

You need more implant because you've lost the volume from their breasts.

B (30:14)

I was thinking it was like crazy porn star, like 800cc.

A (30:18)

You know, that's. I would say that that's the. I don't know anything wrong direction for plastic surgery to go.

B (30:23)

I agree.

A (30:23)

And ultimately it's a very small patient population that you see that. And it tends to be in other markets, not Dallas. Yeah, but that's the population that sort of paints plastic surgery with a bad name.

B (30:37)

Exactly.

A (30:37)

And I like to think of plastic surgery more of a field that it restores what is lost with weight loss, with breastfeeding, with age. There's so many different reasons that we do operations rather than augmenting into the supernatural. Like you've never been born with this. No one has ever been born with a breast that large.

B (30:56)

People that try to transform into a real life Barbie or a cat. You wouldn't do that.

A (31:00)

That's right.

B (31:00)

So if I lost my mind and I was like, I want become a cat, you would tell me?

A (31:02)

No, no, I tell you to get, you know, get. Get lost. Kick rocks.

B (31:05)

You'd say, go get on, go get some therapy. Savannah, you'd call Tyler.

A (31:08)

Yeah, that's right.

B (31:09)

Tyler. Savannah's lost it.

A (31:11)

You know, we don't, we don't practice psychiatry. I like to think that we can provide some value to life, to people's lives in that, in that realm. But ultimately that's not what we do. Those patients are usually dismissed. And if I see something really concerning, that's something that I would probably like, report, follow up, make sure that that person gets cared for. There are some, you know, pretty crazy things that come into a surgeon's office.

B (31:33)

Like mine for sure. Yeah. I've had people ask me to like zap moles off their penis. And I'm like, I don't think you have that. You just want me to see your penis.

A (31:41)

I think they're after something else.

B (31:43)

I really fear. No, I was like, go see your dermatologist. I can't look at it. Okay. My question is when someone gets. I actually did have this question. I was going to text you with me. When would I want or need to get my breasts replaced? When does that happen?

A (31:58)

You know, there's a myth that exists out there that every 10 years you should have your implants replaced. And it's false. It's a myth.

B (32:04)

It's a myth.

A (32:06)

I believe that that myth is rooted in two different reasons. Number one, all of the long term implant studies that are sponsored by the implant companies have 10 year follow up.

B (32:15)

Okay.

A (32:16)

So I think people automatically assume that if the studies were for 10 years and all the data shows 10 year complication rates, that these things must last 10 years and I need to get them evaluated or exchanged. The second reason I think people tend, on just sort of a trend basis, not necessarily because it's indicated, tend to have something else done to their breast on a 10 to 15 year interval. So your breast can descend a little bit, your implant can be malpositioned. Let's say you want your implant bigger or smaller. That might happen on a life cycle of about 10 to 15 years.

B (32:54)

That makes sense. A lot can happen.

A (32:55)

But let me say if there's nothing wrong, then you don't need to fix it.

B (32:59)

Yeah.

A (32:59)

There's absolutely no reason to go in there and operate on an implant just because it's 10 years old. If it's looking good and feeling good and you know that it's not ruptured, you're fine, leave it alone.

B (33:09)

Okay. That's amazing. Okay. What else about them? Anything else?

A (33:13)

Your implants are under the muscle.

B (33:15)

Okay.

A (33:16)

You had a previous reduction, but typically. So we just use sort of a segment of your existing scar.

B (33:22)

Okay.

A (33:23)

But usually that scar goes underneath your breast. Gives the surgeon most control. A lot of times the submuscular plane is also referred to as the dual plane. And what that means is as the muscle is released, it retracts a little bit. So the lower inferior portion of your breast implant is actually sitting behind your breast gland. And then the upper, roughly two thirds of the implant is covered by muscle.

B (33:45)

Oh, wow.

A (33:46)

So you've got sort of a dual plane going on.

B (33:48)

Okay.

A (33:48)

And a lot of attention.

B (33:49)

Does that mean if you have a.

A (33:50)

Half meaning half under the muscle?

B (33:53)

Yeah. What does that mean?

A (33:54)

Probably the same thing.

B (33:55)

So you're just cutting through the muscle.

A (33:57)

Dual plane? Yeah.

B (33:58)

So it's like a sandwich. So it's like if your muscle was like the top of the bread and the bottom of the bread, the implant's like Hamburger patty.

A (34:06)

The muscle is. It's more of.

B (34:10)

I want to tell your graphic girls to make like a, like a graphic to show like how it looks.

A (34:15)

The implant sits on your ribs. It's on your own, your rib cage.

B (34:18)

Okay.

A (34:18)

The muscle which used to be on your ribs is lifted up and then that implant is inserted underneath the muscle, between the ribs and the muscle.

B (34:25)

Okay.

A (34:26)

When you release it on its inferior attachments there, it will retract a little bit.

B (34:30)

Okay.

A (34:31)

So the lower part of your breast implant is not submuscular. It's right behind your breast gland.

B (34:36)

Okay.

A (34:36)

I think that's what you're referring to.

B (34:38)

Yes. What does it mean to go over the muscle? That's like where some people will see like ribbing. When would you want to do that on someone?

A (34:44)

Right. So that's one of the problems with sub glandular or premuscular plane is rippling. You have a little bit less stability in that plane.

B (34:52)

They're kind of jiggly.

A (34:53)

There's some old school studies that show there's a little higher risk of contracture of the implant, where the scar tissue thickens and starts to contract the implant to where it becomes tight and hard. You basically go in through that same incision and instead of going under the muscle, you create that dissection plane over the muscle. But it's still put the implant in.

B (35:12)

The breast glands are still on of top, correct? Always.

A (35:15)

Yeah. So the breast gland is disconnected from the muscle which underlies it, and the implant goes between the muscle and the breast.

B (35:22)

So most women would never have an issue breastfeeding after getting implants.

A (35:26)

I would say largely, you can never make 100 statements in medicine, but I would say that breast implants in general do not interfere with people's ability to breastfeed.

B (35:35)

It's awesome. Does it hurt a little bit more when they get milk? No.

A (35:42)

I mean, there's a tissue expansion phenomenon that happens over time where your breast accommodates to the implant and it adapts. And sure, if you get really big implants and your breast gets really big with breastfeeding, that's not ideal. You're probably going to end up with a lift in the future because the stretch of both will and as they go down after breastfeeding, you might end up with a little bit of loose skin. But implants in your size range, that's why we, you know, we size them thoughtfully.

B (36:11)

Yeah.

A (36:12)

And it's one of the advantages of getting natural implants.

B (36:14)

What was I before, do you think? Because I never wore a bra ever.

A (36:18)

I would say you're right on the verge of A and B cup. Oh.

B (36:21)

And now I'm like, C. You had.

A (36:22)

A little bit of volume. I would say that you were bigger than an A cup. I would say small B.

B (36:26)

Cool. And now I'm what, like a big C or a small D?

A (36:30)

Yeah, I think probably large C, small D. There we go. It depends on where you shop for your bras.

B (36:35)

I know, right?

A (36:35)

Some of those bra companies will want to make you seem better, but thin and, you know, big. Busted.

B (36:40)

So it's Victoria's Secret, man. They always make you feel bad. Like, you have bigger boobs than you do.

A (36:44)

That's right.

B (36:44)

That's true.

A (36:45)

So I'm curious.

B (36:46)

Okay.

A (36:48)

What is the worst comment that you got on Instagram?

B (36:53)

I think that, you know, just give.

A (36:54)

Me a sort of a general, like, what do people say to you?

B (36:56)

I think, like, this isn't. This is too much information. Like, this doesn't need to be shared. Or that, like. Like, I'm mentally unhealthy or must be, like, spiraling or crashing out to, like, do both of these at the same time. Or that it's vain. Yeah.

A (37:12)

Or do you feel like you did this for vanity?

B (37:14)

No.

A (37:15)

Do you? I'm gonna. This is a leading question, but do you feel like you did this for vitality?

B (37:20)

I do, definitely.

A (37:22)

I think that's a very important distinction to make, because one is empowering and one is objectifying.

B (37:28)

Yes.

A (37:29)

And I think there needs to be a clear delineation there, because empowering women and empowering people in general is important, and that's what you're doing, and that's really what cosmetic surgery and what plastic surgery is intended to do.

B (37:43)

Exactly.

A (37:44)

It's meant to restore what is lost. It's not meant to be vain. Sure, there is some bastardization of some of the operations that we have in our field, but that shouldn't be defining of our field.

B (37:55)

I agree. And that's kind of how my practice is and why I really love you and why I picked you as my surgeon is because. Because, you know, there are sides of the aesthetic industry where it's just, like, you know, making beautiful women even more beautiful, which is also great. But there's also the part of it where, you know, you're helping women gain confidence back, you know, when they show up to work or they show up in their relationships and they don't feel good, they have acne or they have, you know, sagging breasts. Like, you know, I always felt insecure during intimacy, like, even in my marriage, you know, and so being able to feel more confident. I haven't tried anything yet, but I just can already tell I'm gonna be like, I feel like I'm gonna feel more empowered and I'm gonna feel more savannah. Because me in my natural, rawest form, I'm very confident, you know, I'm very confident about my skills, I'm very confident about who I am as a person. I think my body was like the last little piece to kind of make me feel fully embodied of like my truest personality, my rawest form, who I am. So, yeah, it really was more of like a vitality thing and then also confidence booster, definitely.

A (38:58)

You know, do you think that somebody who was say £250, that was good coming in for some liposuction would get the same shame that you did?

B (39:07)

I do, actually. Really, I do. I think they'd say it's the easy way out. You should have gotten in the gym. I think that's the same thing they say about Ozempic. It's like a cheap shot. It's a, you know, getting your stomach or what do they. I wanted to say your tubes tied. What is it called when you do a gastric bypass?

A (39:22)

Bypass or a gastric sleeve.

B (39:24)

Same thing.

A (39:25)

Stapling the stomach. Yep.

B (39:26)

It's, you know, you took the easy way out, you know, but I guess with like boobs, I think the only good thing is like, you can't grow tits.

A (39:31)

See, I've.

B (39:32)

I've found you can't go work out and get tits.

A (39:34)

What I have found is an encompassing statement that tall trees catch the breeze. If you are a beautiful person and you already gain a lot of attention, I think you are more of a target for body shaming.

B (39:47)

For sure.

A (39:48)

We find it all the time when there's a, you know, by societal standards, somebody who is considered beautiful is enhancing their body because of probably a well justified and very normal interest in cosmetic surgery. Those people are a lot more prone to getting body shamed than somebody who's coming in for, let's say a 48 year old man wants me to address his gynecomastia. Do you think he's getting body shamed? Oh, gynecomastia is man boobs.

B (40:14)

Aw.

A (40:15)

We had an adorable man that came in and he was in his mid-60s and he said that he didn't like going to the beach with his family because he had.

B (40:24)

That's gonna make me cry.

A (40:25)

Because he had large breasts, he had very feminine looking chest. And we changed his life by taking off that tissue.

B (40:31)

Wow.

A (40:31)

How Is that any different than doing an operation for somebody that looks like you? And what I'm saying is, tall trees.

B (40:38)

Catch the breeze, 100%.

A (40:39)

And I think he's in the shadows. He doesn't get the same attention that you do. And when somebody sees you enhancing yourself, you're just a bigger target. And you're gonna catch more.

B (40:51)

More shame than 100%, because you can't have it all. People don't want to see someone that has it all, rather than seeing someone that has. And I don't have it all. But, you know, I think people compare a lot, and they're like, you know, when I was bigger, people liked me a lot more. Like, Tyler's ran my analytics. I got way more likes. I, you know, way more people were interacting with my content when I was larger. And, you know, I think that was a part of one of the reasons why I kind of stayed that way for a bit. Cause I was like, okay, like, I can't be successful, you know, have this amazing life and then also be skinny and healthy. Lord forbid. You know, it was like, you have to have something that people can relate to. It's like, you know, my mom kind of. It's just. She was trying to protect me, but it really kind of was something I had to unlearn, was like, you can't be smart, pretty, and skinny. You know, like, you have to pick two, like, people, like, the fat friend. You know, you can be, like, super smart and super skinny, but then if you're, like, a little bit ugly, like, in the face, like, people will accept you more. Or, you know.

A (41:53)

You know what I would say to those people? Hold my beer.

B (41:55)

Yeah, watch me. And I. Long time. Like, here we go. I'm like, okay, you're right, Mom. Like, I can't put. She's like, if you have everything, you have a target on your back, and people are gonna hate you. And here I am now with a target on my back, and people hate me. But again, even when I was big, I had haters. And I think that's kind of was like, why would I want to stay unhealthy? And also piggybacking off of that, getting divorced. One of the reasons I wanted to stay in my marriage is because I didn't want people talking about my personal life. I'm like, why can't it just be about skincare? And knew that it would gain a lot of negative attention and people forming their own opinions about what happened in my marriage. Why did my marriage fall apart? And it, you know, I was like, why would I stay unhealthy? And why would I stay in an unhealthy relationship? Because of five trolls having to say something about me.

A (42:39)

You know, it's good to illustrate that because it's the minority of people that you're making that decision for.

B (42:43)

Yeah. And you let it hold so much weight.

A (42:44)

The vast majority are very supportive of your decisions.

B (42:46)

Exactly. Like Tyler will say, he's like, why are you looking at these, like, three mean comments when you have 300? Amazing.

A (42:53)

Because that's human nature. That's what we do.

B (42:55)

Yeah.

A (42:55)

We get drunk, we get drawn down by the negative, and we almost ignore the positive to the point where somebody says something nice about you, and it's like, okay, thank you.

B (43:02)

Yeah.

A (43:03)

But then you dwell and you stay up at night thinking about all the people, the minority, saying negative things about you.

B (43:09)

Exactly.

A (43:09)

And that's just human nature.

B (43:10)

Yeah. And I think, you know, surgery in general, like, it. I think it's become less taboo, I think injectables in general. I think just anytime anyone wants to do something better for themselves, like. Like, I think it triggers something in somebody who maybe, you know, can't or doesn't want to or isn't ready to or has. It's projection. You know, I always say, like, that comes from a place of projecting their own feelings and insecurities onto me. And, like, that's not for me to carry. You know, I'm happy. I feel confident. You know, I'm not murdering puppies. I'm not trying to take down a small village.

A (43:44)

You're just thriving, Savannah. That's. That's what you're doing. And I think. I think it's important to illustrate that. But have you heard of Maslow's hierarchy of needs?

B (43:52)

I have not.

A (43:53)

So it's a psychiatry concept, and it is a pyramid to illustrate basic human needs. The first one is for sustenance, for food and water. The second one is for safety. And each of the growing needs and as they become more specific, builds on the foundation below it. So you're not gonna be concerned about your safety if you need to eat, right?

B (44:16)

Yeah. Yes.

A (44:16)

Like, you're gonna go out and you're gonna find something to eat, even though it puts your life at risk, because you know that if you stay cooped up, you're gonna die. So food and water's at the base, safety's at the next. Then it's health and wellness, and it's looking to build your identity. And then at the very top is self interest. It's in beauty. And you could see in this psychiatric pyramid, this Maslow's hierarchy of needs, that beauty is not a sign of vanity. Beauty is a sign of vitality. Beauty is a sign of health and wellness and of a thriving person or a thriving society. You see it on both levels. You see somebody who wakes up in the morning and combs their hair. That person has already taken care of all the fundamentals. And the same thing you see in society, when you see tall skyscrapers and clean roads and fashion and art and all the things that you see in a developed city, compare that to a developing country. You don't see those things because they're still working on their very basic needs.

B (45:21)

Food and water.

A (45:22)

Food, water safety. You see death and destruction. You see lack of infrastructure, you see corruption. Beauty is not to be something that is shamed. Beauty should be rejoiced because it's a sign of wellness. It's a sign of a thriving society or a thriving person.

B (45:41)

That's a really good way to look at that. I love that. That's amazing.

A (45:44)

We would see this in the ICU occasionally. We would see. And this is something that you kind of gather as you go through training. But there's a general feeling when you walk up to a patient's bed in the icu, if the patient's all splayed out, they're sweating, their hair's a mess, their gown is halfway covering their body. That person has very basic and fundamental needs. Right. They're in there because they're sick and they need to get better. And then you go to the next room over, and you see this older lady that has already overcome her illness and she's combing her hair and she's reading the newspaper with her legs crossed. Without even looking at her vital signs and discussing her ICU record, you could probably discharge that person from the icu.

B (46:27)

Yeah.

A (46:28)

Because she is now at the top of the pyramid.

B (46:30)

That's amazing.

A (46:31)

Wow. And you can tell that this person is no longer sick. And you. You can see that on. On so many different levels. We discussed seeing that in a societal level in my industry. You. You see it. You see it everywhere.

B (46:44)

And if you crazy.

A (46:45)

If you analyze any life example on that Maslow's hierarchy, hierarchy of needs, then you can. You can. You can see that really, in any habit.

B (46:56)

That's amazing.

A (46:56)

Yeah, it's neat. It's a neat thing to apply, right?

B (46:58)

No, it really got me thinking. I mean, that's so, so. It's so true in so many ways. Like, it applies to so many different things.

A (47:06)

Well, it applies to your situation, I would say, most. Most relevantly right now. And it's a. It's from the standpoint of all these people kind of throwing shade at you. It's almost like they're using the. The beauty piece to kind of go in the opposite direction.

B (47:28)

Yes.

A (47:29)

And I think that's.

B (47:31)

And transparency, too. I think that's. The other thing is, like, you can't expect transparency, but then cast judgment, throw stones when someone's being transparent.

A (47:40)

Right. And where I was trying to go with that is I think. I think that people project some of their own insecurities.

B (47:45)

Yeah.

A (47:46)

When they have more fundamental needs and they see somebody else thriving, I think sometimes that shame will come from a place within themselves where they're not totally secure, totally happy with themselves, and they will shame other people for. For achieving that.

B (48:01)

Yeah. And I think, too, I had sent one person comment, like, you could have announced this, like, in a more professional way. And I was like, do they want me to, like, put my hair in a slick back mine and be like, today I had my labia minora chopped off?

A (48:11)

Like, that's your. That's your style, though, and that's why people love you.

B (48:15)

And it's.

A (48:16)

That's why people keep coming back. And I think that's. That's. You don't ever change.

B (48:20)

I will never change. And, you know, I am transparent into a fault. I'm always going to be honest. And, you know, I've had so many women reach out to me about the labiaplasty more than my breast. You know, that was a really big thing where they're like, you know, I feel so uncomfortable even, like, allowing someone to look at it, you know, and it's like, yeah, it's kind of. It can be uncomfortable, for sure. But, you know, I think when you realize, like, you've seen everything, you know, like, I literally was like, I have a skin tag on my butthole. Can you, like, cut that off while you're down there, too? And he did. You know, I think there's just. Just. You have to put yourself out there. And like, also I think that's a hard thing for women, too, is, like, feeling comfortable and feeling, like, seen and safe. And like, that's something that I really appreciate. Appreciate about you, is I've always felt so safe. I've always felt taken care of. I've always just felt comfortable and safe with you. And, you know, I think a lot of surgeons, like, especially when I first was, like, trying to, like, get assessed like there had some that I consulted with that I was like, I. You know, they don't feel like they cared one or like they were like weird or. You know, I think that's like a big part of it. But a lot of women, like didn't know about that you could even do that or that was even an option. And you know, I had a lot of people say, you know, when they are working out in their leggings, like, you know, it kind of like it's uncomfortable when they're riding a bike if they're a cycle class girl or I mean, just day to day sex, driving, sitting, whatever sports they do and how it looks in tighter clothing is. It affects a lot of women and no one cares about it.

A (49:52)

You're several weeks post op now.

B (49:53)

Yeah.

A (49:54)

Or how far? Two weeks, Two and a half? Something like that. Two now. Life outside or sort of past the discomfort of surgical recovery. Which part of the aesthetic operation did you appreciate the most?

B (50:09)

Both. I can't. I can't pick. I think they're a package deal. But like, definitely the boobs because I think that like is more seen, you know what I'm saying? Like, confidence wise, like, I have more of a shape here. Like, no one would have known what my vagina really looked like unless they were in bed with me.

A (50:26)

Sure. But there's, you know, there's functional and aesthetic components to that operation.

B (50:31)

Yeah. I feel like she's cleaner down there too. Like, I feel like that's another thing too. Like, Like I feel like it's just easier hygienically and. Yeah, it just stays where it needs to stay because where it needs to go. Like, I feel like I used to have to like tuck a lip back in once in a while out of like my panties. Like, I'm not kidding. Like, you know, I'd be sitting. Sorry, Tyler.

A (50:51)

That's.

B (50:51)

No, that's secretly, like, I literally, like, you know, my underwear don't have underwire on your underwear. So sometimes, like during a busy day, I'm walking around, you know, like, I would have half my vagina with my labia minora would be like out and about saying, hey. So now it stays in one place. I stay tucked.

A (51:11)

Yeah, that's. I mean, that's actually probably a problem that a lot of women share.

B (51:15)

Yeah. I didn't know you could fix it.

A (51:17)

That people are probably either ashamed to discuss or didn't even realize it was an option.

B (51:21)

Yeah.

A (51:22)

So it's just a big secret. Labiaplasty is a very standard operation. And it's something that leads to very, very high satisfaction rates.

B (51:29)

It is. I heard it's one of the most. Most highly. What is it? The most patient satisfaction is with labiaplasties.

A (51:35)

That and breast reduction.

B (51:36)

Really?

A (51:37)

Yeah. Breast reduction's up there too.

B (51:38)

Wow.

A (51:39)

It's all the ones that have the functional and the aesthetic benefits.

B (51:41)

Yeah. I mean, my breast reduction, like, changed my entire life. Like, it really. Tyler's like, yeah, I mean, it. The way I showed up, the way I was confident. Like, I was so confident post breast reduction that I literally was walking around Highland Park Village after, excited, you know, the neck lipo at the same time, literally with a neck wrap everywhere. Cause I was like, I feel so good about myself. Like, I don't even care. I recorded this podcast with a neck wrap on. People were like, did you, like, get your wisdom teeth out? And I'm like, no, girl, I got neck lipo. And that's, like, one of the best things I did. And you can't even see where you went in.

A (52:12)

No, it looks amazing.

B (52:13)

I mean, that truly was also so wonderful. So if you're in Dallas, or even not in Dallas, you gotta fly out. I mean, you can do, like, could you do. Technically, I wanna know, could you do a breast reduction implants, a labiaplasty and neck lipo all in one procedure? Is that like, too many things?

A (52:29)

No. From the timing standpoint, it's totally fine. The thing that you kind of run into trouble with is breast reduction and augmentation at the same time. And a lot of times that operation has to be split up into two.

B (52:39)

Okay.

A (52:40)

Because if you get a breast lift, which is essentially a reduction without removal of tissue, and you put implants in. If you already have large breasts and. And you try to accomplish that in one operation, it's going to make your breasts bigger.

B (52:53)

So I want to know what's the difference between a lift and a reduction? Like, you just move the nipple on a lift.

A (52:58)

The incisions are exactly the same. You just make the cuts deeper for breast reduction and you take out tissue rather than just take off skin.

B (53:06)

Oh, okay. So for a lift, you're taking skin. For a reduction, you're taking tissue out.

A (53:10)

That's correct.

B (53:11)

So I had both.

A (53:13)

You had a reduction, what, three years ago?

B (53:15)

Yeah, in lift. I did both. Right?

A (53:17)

Yes. So the reduction and the lift are.

B (53:19)

And he made me a brand new nipple.

A (53:21)

Both have an inherent lift and we reduced your nipple.

B (53:26)

So do you, like, get like a cookie? Like, do you, like.

A (53:29)

Yeah, that's exactly right. It's a cookie cutter.

B (53:31)

What do you do? You just take the nipple off, and then you go to the side and you're just like. And you put it back on.

A (53:35)

Exactly.

B (53:36)

What?

A (53:37)

Well, no. So the nipple doesn't come off. You imprint the stencil. It's like a cookie cutter, and it's a circle, and it's 38 millimeters in diameter.

B (53:47)

Wow.

A (53:48)

There's also a 42, but 38 is more common. So you imprint that on the skin. You put the skin on, stretch, and then you incise, and you remove everything on the outside. And then you move the new nipple or the downsized nipple up to the better location on your breast, and then you suture it back into place.

B (54:05)

That's amazing. I want to know what's your favorite surgery to do if you had to pick one case, like, mommy makeover. Because that's, like, everything.

A (54:12)

So, like, I mean, I like, I want to know.

B (54:15)

Fun to perform and most rewarding, like.

A (54:17)

For you, most rewarding is surgeries that make big changes.

B (54:22)

So mommy makeover.

A (54:23)

I like mommy makeovers. I really like doing drainless tummy tucks. Breast augmentation is fun, too, because that tends to make pretty big changes.

B (54:32)

Which one? Do you feel like you're, like, a master at your craft? Like, you're, like, really feel like you're cooking in the kitchen? Like, you're, like, having, like, you just feel like you're, like, just killing it. You know, the kids on TikTok, they're like. And you enter a flow state. It's like, you know when you're listening to jazz music and you're like, like, cooking pasta and, like, your dog's licking your leg and you're like, in a flow state. Just like, namaste. Like, what is that for you?

A (54:51)

I would probably have to say the top of that list would be a tummy tuck.

B (54:54)

Okay.

A (54:55)

Yeah, we do. You know, your community kind of tells you what your specialty's gonna be.

B (55:01)

Really? I didn't know that.

A (55:02)

In a way. So you can do a bunch of operations, and what you're good at is going to stand out, and your community is going to come to you because of those results that you've posted. And in that. So in that way, your community is kind of telling you you're a tummy tuck guy.

B (55:19)

So you're a tummy tuck guy.

A (55:21)

Yep, I'm a mommy makeover kind of kind of surgeon.

B (55:24)

I love that.

A (55:25)

That is a. That is a focus of my practice. And because we've gotten good results in that operation it has sort of become self reinforcing.

B (55:35)

I love that.

A (55:35)

So more people kind of seek you out because you're good at something.

B (55:38)

Yeah. Did you ever want to get into more facial plastics like when you first went into residency?

A (55:43)

I mean, I do facial surgery. I don't do rhinoplasties.

B (55:46)

I want to do like a little fat transfer here one time. Tyler wants to get his neck cut off one day. You have to stop the viola.

A (55:53)

He already told you that might be kind of tough. You got to hold that.

B (55:57)

I know.

A (55:58)

So the only facial operation I don't enjoy doing is a rhinoplasty. So we will send those out. But facelifts, mid face lifts, brow lifts, upper left, lower bleph. That's your eyelids. That's a big part of our practice too.

B (56:14)

I love that.

A (56:14)

Yeah. And that tends to happen in a different patient population.

B (56:17)

Yeah.

A (56:19)

People in my demographic, meaning, you know, 30s, 40s, 50s, are right now are doing tummy tucks and breast surgery.

B (56:26)

Yeah.

A (56:26)

I will probably age with my community and with my patient population and kind of ease into more of a facelift practice towards the end of my career.

B (56:34)

I love that. I'll come to you. I want to get one of my.

A (56:37)

Like one patient number one.

B (56:38)

I'll be patient number one. Um, I wanted to get.

A (56:41)

Let me do a bunch of facelifts before you're. Before you can deal.

B (56:44)

Deal. You can do Tyler's first. He's done for the count.

A (56:48)

We've actually done a ton of facelifting and I'm. I'm pretty good at that operation. It's just. It's just not something that our community has.

B (56:53)

That's what you do every day is.

A (56:54)

What you're told me what I do.

B (56:56)

Yeah, that's right. I love that. That's exciting. Have you ever done anything to you?

A (57:01)

I have not had any cosmetic operations besides Botox.

B (57:03)

Like.

A (57:03)

But you've had like Botox non surgical stuff.

B (57:05)

Sure, yeah.

A (57:06)

I've had. I've had boto, had some lasers. Men don't do well with pain. I know.

B (57:12)

I literally. My personal assistant Maria, who's also a dear friend of mine, she post procedure, she's like, you just are thriving. I was doing it. I was fine. I do really well with pain, actually. I think women do. And I think I've had a C section, so I think. And I already had neck lipo. Honestly. I'll say lipo hurt more than the labiaplasty and breast reduction and breast augmentation.

A (57:36)

Lipo can suck. Some people tend to underestimate Lipo. But some people walk away and say, that's no big deal.

B (57:43)

Yeah.

A (57:44)

And some people have kind of an easy time.

B (57:46)

My boobs, the first round, nothing. Fine. I think for me, it was like. It was definitely the lipo. It wasn't even the neck lipo that hurt. It was more like the arm area.

A (57:53)

The arm, yeah. Yeah. Lipo can be that way. It's variable. It just. There's pain threshold playing there. There's, you know, amount of lipo, the aggressiveness with which you do it. But some areas hurt more than others.

B (58:06)

I want to know, because I've been asked this too. What's the difference between, I don't know if Airsculpt, if that's a trademarked thing or if it's just a type or a machine.

A (58:14)

Yep. Airsculpt is just a trademark. It's just a trademark. This is something that's common in our field. So surgeons, or doctors in general will try to brand something that is done literally by everybody. Like the dual plane, for instance. So do you remember when Jenner, Is it Kendall that just recently got a breast dog?

B (58:35)

Yes.

A (58:36)

So Kendall Jenner had a breast augmentation. And for probably about two or three months after that, patients came back in or would come in and they'd specifically ask for a dual plane breast augmentation. And it was purely because Garth Fisher did a dual plane submuscular breast aug, which is very standard. So what I have, that's what you have. Everybody that has in the U.S. i would say 99% of people who have a sub muscular implant have a dual plane breast.

B (59:04)

August.

A (59:05)

And it's just the fact that he highlighted that in his surgical description that has created this market hype. But it's already something that people do.

B (59:12)

Yeah.

A (59:13)

So just because something is named something differently doesn't mean that it's something special. So what airsculpt is, is essentially a proprietary liposuction technology that has replicated one that is used widely called micro air or power assisted lipo. There's a reciprocating handpiece. Are you talking about laser assisted lipo?

B (59:35)

Yeah.

A (59:35)

So there's been all kinds of different energy technologies that have been combined.

B (59:40)

It, like tightens while it takes the fat or something.

A (59:42)

Yes. In a way, that's what it's meant to do. I would say the only lipo technology that actually leads to any real skin tightening is vasor, which is ultrasound. And ultrasound's complex in terms of understanding exactly how it works. But let's just suffice it to say that it delivers energy to the tissue and can lead to some tightening of the substructure as well as the deeper layers of the skin.

B (60:08)

I want to know, would you ever. Have you ever and would you ever do bbls? I will ask you for a friend.

A (60:15)

I will fat graft somebody's butt for contouring. But BBL is like, not like a.

B (60:23)

Tacky, trashy way, but like in, like, if they have hip dips or.

A (60:27)

Sure. So that's contouring. Exactly. For shape, a BBL has the connotation that you are making somebody's butt bigger.

B (60:34)

Yes.

A (60:35)

And I do not use fat grafting for augmentation.

B (60:37)

Okay.

A (60:38)

I think there's a delineation that has to be made. Fat grafting fragmentation can be dangerous.

B (60:44)

That's what I hear. Because people, like, get infections and have issues.

A (60:48)

You can have what's called a blowout where all the fat dies because you've put it under too much pressure.

B (60:53)

Necrosis.

A (60:53)

Necrosis, essentially, yes. So it's when you graft fat, you disconnect it from one part of the body with liposuction. You kind of strain it down, and then you re inject it into the buttock or the breast or wherever you're putting it. If you exceed the pressure of the blood vessels that are trying to feed it with blood supply and give it oxygen, it will die. And that's how you get full. We call it a blowout, but that's how you get full necrosis of the entire graft that you transferred. I would say the more concerning complication following fat grafting in large quantities is what's called a fat embolus. A fat embolus is a dreaded complication. It can be fatal. It is when a little bit of the fat will leak from the tissue that you've grafted in your buttock into a vein, and it will travel up to your lungs. And your body doesn't know what to do with fat inside your blood vessel, so it basically stays there. And if it's large enough to cause compromise, then you can. You can see immediate issues.

B (61:50)

And that's so scary because people are doing, like, they're just like, trusting anyone, you know, that'll do it the cheapest, the quickest, the fastest, or they'll fly, you know, no doubt weird places and do it.

A (62:00)

We see. We see patients frequently that have tried to either save money or, I mean, it's really what it is. You're trying to save money on it.

B (62:10)

And you always end up spending more and coming back and that's what I've always said with skincare, which is not as like do or die, you know, as surgery. But you know, it's always when people try to like, oh, I'll go, you know, do this for free. And then they get like a staph infection or.

A (62:22)

Right.

B (62:23)

You know, they end up with more damage or more pigment because the person doing it and you know, you charge for skill at the end of the day and like your credentials and how many you're doing and also cost of like good supplies. That's the other thing. It's not just charging because like, you know you're good. It's also like the quality of what you're using.

A (62:39)

There's a lot of things behind the scenes that people don't realize that they're paying for.

B (62:43)

Yeah.

A (62:44)

And in a very obvious sense. What about operating room sterility? People get crazy infections because surgeons in strange areas and are that are trying to save money because they've dropped their price so low to attract those patients, they're reusing equipment that hasn't been properly sterilized. And people can get life threatening infections and some serious issues from that kind of stuff.

B (63:08)

That's insane.

A (63:09)

That's just one example. You're paying for training, you're paying for experience. And a lot of times you don't need those things because surgeries go well. But when you do need it, sometimes it can be life or death.

B (63:20)

I think what my biggest thing I want to know because I recently learned this because there's this guy, I'm not gonna name names, but there's a guy in California who like has killed a couple people and he's like not a surgeon. He's like has like a certification but like people don't know the difference of. So like it sounds like he's a surgeon, but he's not a surgeon. He's just a doctor. I mean he's not just a doctor. It's really hard to be a doctor.

A (63:41)

Yeah. If you're practicing medicine without a license, that is 100% a criminal offense.

B (63:45)

You know what I'm talking about? What do they like call themselves? It's like a cosmetic.

A (63:50)

There's. I don't know if there's a name for it. I would just call that person a criminal.

B (63:54)

Okay. You know what I'm saying? Like there's people that are not. Not plastics, like so you to be a plastic surgeon.

A (64:00)

So there are. So in the definition of the practice of medicine, they leave it up to the doctor to decide what the scope of their safe practice is no way. So any doctor, a radiologist, an internal medicine doctor, a pathologist, a plastic surgeon can perform a breast augmentation.

B (64:21)

You're kidding.

A (64:22)

I can go to my operating room tomorrow and take out a brain tumor.

B (64:25)

You're kidding.

A (64:26)

That patient probably wouldn't do very well because I'm not trained in intracranial surgery. But from the standpoint of me offering that to a patient, the way that the medical laws are written, like they.

B (64:38)

Hope that you are smart enough to become a doctor, to know your limitations and to know what is ethical. And you take an oath too, I'm sure.

A (64:44)

Correct. They leave it to the doctor to determine their scope of practice. Now, residency training and board certification are all things that verify a surgeon's training in the scope with which they should be practicing. And that's why it's important to check board certification.

B (65:00)

This guy was like a dermatologist doing like.

A (65:02)

Right.

B (65:02)

So I see what you know and like breast augs and stuff in California. And he got like an. He like started people.

A (65:09)

Yep. So that happens because, I mean, frankly, some doctors are not trained.

B (65:13)

But people didn't know he wasn't a plastic surgeon.

A (65:15)

They can be very good doctors because.

B (65:16)

He would like from. It was a cosmetic. Something I don't know what he called himself, but it wasn't. He was not a plastic surgeon.

A (65:23)

So there's a. There's a difference between what people will call themselves. A cosmetic surgeon or a plastic surgeon.

B (65:30)

Yeah. What's the difference?

A (65:31)

So there is. Plastic surgery is considered a specialty by the American Board of Medical Specialties, the abms. The ABMS is a licensing authority that delegates board certification to different. Different specialties within medicine. The American Board of Cosmetic Surgery is a private entity that licenses people that. I don't know how long the course is. I would imagine it's probably several weeks. But they're taking people and teaching them how to do liposuction, and they're giving them a designation of American Board of Cosmetic Surgery. And if you are a board certified cosmetic surgeon, that sounds really good to the general public who doesn't know, but that sounds like what you're talking about.

B (66:14)

Yeah, I think that's what it was.

A (66:15)

So if you're a cosmetic, a board certified cosmetic surgeon, you've essentially taken a course and you've gotten a paper to hang on your wall, but you're not a surgeon. You could be very good and you could be a very. You could be a very responsible surgeon. You could be delivering great results. But ultimately you're not board certified by the core board of medical specialties. So an internal medicine could be boarded in cosmetic surgery and performing liposuction and breast augmentation and.

B (66:40)

And no one would ever know unless you asked.

A (66:42)

That's right. And it's not necessarily that all those people are bad at what they do.

B (66:47)

No, it's.

A (66:47)

Some of them make very good decisions. It's a matter of experience and training. Yeah, that's right.

B (66:52)

A lot of safety and regulation. We would want to know that. And also if they're charging as much as like you who have gone through so much training, residency, all of that.

A (67:00)

Like, it's like there was a really funny story. So when all this sort of, sort of came about, coming about, there was a, A billboard that the Utah Society of Plastic Surgery put out on, I guess on a highway somewhere that it showed a woman crying. She had a tear running down her face and she. And the caption on the billboard said, I didn't know my cosmetic surgeon wasn't a plastic surgeon.

B (67:24)

Wow, that's a good ad.

A (67:25)

And it sent waves through the community.

B (67:27)

My bad.

A (67:27)

It was a big deal. I wouldn't know that either because I would imagine. I don't exactly know how the litigation went, but I would imagine. And the board of Cosmetic surgery saw that as somewhat defamatory.

B (67:37)

Oh, so they got pissed.

A (67:38)

So they got pissed. Right. And they said, this is degrading to our specialty. And it's like, what specialty? You mean internal medicine? Which one are you talking about?

B (67:46)

Internality.

A (67:47)

Because it's not plastic surgery.

B (67:48)

That's crazy.

A (67:50)

And I'm pretty sure the plastic surgeon is one on that side.

B (67:52)

I'm sure. 1,000%. That's wild. Actually, I had no idea.

A (67:56)

It's pretty wild when you sort of peel back the layers and look at how medicine, medicine is regulated. There's a lot of room for self determination of your scope and delegation. Those two things have created a sort of wild west. And there's a. I mean, it's a billion dollar industry. Med spas more and more.

B (68:18)

And that's the thing is people want a piece of the pie because insurance, you know, isn't really in our industry. And so I think, you know, that on top of just the way the world is now, everyone wants to get something done. People are more. It's less taboo. And I think we're just. People want to take care of themselves. And so that's where you kind of run into that kind of stuff. People are trying to give you the cheapest price and they might not even Be a plastic surgeon and you run into a lot of risk.

A (68:44)

The last thing you want is a hungry doctor. Yeah, you don't want to see a doctor chasing the money.

B (68:50)

So if I like, if you go to someone, like, I can get you in right now, you should run.

A (68:54)

That's true. Yeah, that too.

B (68:55)

Like same day lipo.

A (68:57)

No way. I wouldn't walk. I'd run away.

B (69:01)

That's amazing. I want to know, as we start to wrap this up, what has been your most fulfilling case?

A (69:09)

It stands out. That's a pretty easy question to answer. So there was this lady that came in. Her abdomen was completely ridden with scars. She had scars all over. And it was because she had in young childhood and infancy, a condition with her intestines that required multiple surgeries to relieve bowel obstructions and removal of some disease portions of her intestines. And I do not know why, but the surgeon seemed to use a different incision on her abdomen every single time they would do the case. And she probably had 25 operations before she was 18. And it left her abdomen. I mean, as you grow and as you age, the skin has a hard time looking normal because you've got so many scars. Each scar was a tether point from her skin down to her muscle. And her abdomen was just ridden. I mean, she couldn't even wear, you know, tight fitting clothing because of the way that it looked.

B (70:06)

Wow.

A (70:07)

So you can't do a tummy, a traditional tummy tuck on somebody like that because the skin will have a really hard time surviving. So what we did was we did what's called a vertical tummy tuck.

B (70:17)

Wow.

A (70:18)

Where I went from her sternum all the way down to her pubic bone. And I encompassed probably 95% of the scars and we excised them and I closed it with one single midline scar.

B (70:29)

Wow.

A (70:29)

And what it did was it eliminated most of the scar burden on her abdomen. It gave her a scar that is a little bit more acceptable, cleaner. And she was given the opportunity to wear clothing, swimsuits, all kinds of things. A level of confidence that I don't think she ever even knew was possible for her. So a very clear, you know, top, most rewarding case.

B (70:55)

I love that. So I do have a question about scarring for. Is that like a hard thing to do? Like sutures is like, what would you say out of all, like the part of the surgery, what's the easiest, like stitching it up, putting it in, like measuring what is like the most, like the most difficult?

A (71:16)

I would probably say dissecting through an operative plane, meaning like tissue that has been dissected before.

B (71:24)

Okay.

A (71:24)

And is.

B (71:26)

Is like my scars, like when you had to go over my scars. Was that hard?

A (71:30)

No, that was, that was easy. Dissect. So I'm talking about like re. Entering on a, on a, on an operation that has been done before. The scar tissue can, can be, you know, prolific and it can, number one, it can disorient anatomy. It can pull vessels or nerves into places where you wouldn't expect them to be. And it can also be very challenging to get through. You know, dissecting through, through concrete, essentially. That's probably the hardest part of operating.

B (71:59)

Okay.

A (72:01)

Because there was one of my mentors in surgical training told me that surgical hesitancy is rooted in anatomical ignorance.

B (72:11)

Wow.

A (72:12)

And if you think about it, that's absolutely true. If you feel timid on your approach into an operation, it's because you don't know what you're doing.

B (72:19)

Yeah.

A (72:20)

And that has stuck with me throughout my entire young career. And dissecting through an operative plane that has been dissected multiple times with scar tissue, by definition, there's anatomical ignorance because everything's a little bit disoriented.

B (72:36)

You're like, what am I going into?

A (72:38)

But from that standpoint, you do it enough and you know to go slow, you know when to, you know, slow down when you can, when you can be a little bit more decisive and you just kind of figure it out.

B (72:48)

Are some people's skin easier to cut through than others?

A (72:52)

I mean, all skin's relatively easy to cut through. I would say that most. Yes.

B (72:58)

They're like tougher meat.

A (72:59)

There are. I prefer people that have more dense skin. It's easier to operate on.

B (73:05)

I don't.

A (73:06)

My breasts didn't you had, you had good skin. I did, yeah. So. So largely there's people who have lost weight and people who have not lost weight. You do see a little bit reduced integrity of skin when people have lost weight. But I mean, there are some people that you are what you eat. And if you, if you've, if you've basically spent your entire life eating non nutrient containing food, caloric dense, but not nutrient dense food, your tissue just doesn't handle well during an operation. And you can definitely tell how people eat based on how their tissue handles.

B (73:38)

How do I. My tissue handle it handle well, thank God. I do like my hot Cheetos once in a while.

A (73:44)

Right. I heard you talking about Taco Bell earlier.

B (73:46)

I know that was my pregnancy diet. Tyler worked there in high school and he shamed me my whole pregnancy. But that's what the baby wanted.

A (73:54)

Yeah. So that's. I mean, that. That's something that you're prepared for, though.

B (73:58)

Amazing.

A (73:59)

It's.

B (73:59)

I learned so much. I feel like I could be a certified. What are they called? A cosmetic surgeon now?

A (74:05)

Sure. Right. Yeah, let's. Let's get you started. All you need to do can do it. Savannah Boda, cosmetic surgery.

B (74:10)

There we go. I think I can do it. No, just kidding. No, that's amazing. And you guys, if you are thinking about getting anything done, I highly, highly, highly recommend you go see Dr. Dawa. Like, so happy with everything. It's amazing.

A (74:25)

I appreciate the endorsement and I'm so happy that everything is amazing. It's flattering that you say things like that. Thank you.

B (74:31)

It's true. You do such an amazing job. Like, I mean, yeah, I want everyone to come see you because. And as so many people have since, like, I did my reduction, you know, so many people are like, oh, my God, he did my boots too. Or like, he did this on me. So, like, he's the man of Dallas. So I think it's just so important who you choose and like, not only like, being skilled, but like a good person. Like, that's another thing too. Like, you have a good heart and soul. You're a family man. Like, you're a good guy. Like, that also makes me feel safe with you. I think, you know, your profession can get like a little like sleazy red, you know, and you're just very integrity based, ethical, honest, authentic and genuine. And like, that's hard to find.

A (75:11)

So I appreciate that. Thank you.

B (75:13)

It's true. It's so true. I think that's like, what drew me to you. I was like, he's like a little golden retriever. Like, he doesn't have, like an evil bone in his body. Like, he's just sweet and kind and, like, you're excited. You can tell you're very passionate about what you do. I think a lot of surgeons are kind of like another one, you know, gotta do it. And it's like you still have that, like, light in your eyes where you like, actually, like, are in it to win it. And like, you treat every patient like it's your first. And I think that goes a long way.

A (75:40)

You know, that's something that comes up in consults every once in a while is somebody will say, what would you do for your wife? And. And I never changed my answer because if I was doing something for you that I wouldn't do for somebody that I loved. Somebody was important for me, then I'm not doing the right thing for you, am I?

B (75:56)

No. Exactly.

A (75:58)

So I think you have to practice like that. And it doesn't matter if you're doing cosmetic surgery or changing tires at a discount tire. You have to treat people with the level of respect and thoroughness that you would treat your family.

B (76:10)

Exactly.

A (76:10)

And you need to make decisions for humanity without discrimination. So I think that's really important.

B (76:16)

That is. And you are living walking proof of that. So.

A (76:21)

Well, this has been wonderful.

B (76:22)

Thank you. We'll have to have you back now that you're so close by. I'm trying to make him have his own podcast.

A (76:26)

This sure would be fun. There's a lot to discuss.

B (76:28)

I know. It's a good time. Thank you so much. I'm sure we're gonna get a million people having questions, so we'll have to bring you back because they're gonna want to know some juicy things. And just, like, you know, I think just really breaking down the barrier of plastic surgery. Cause I think think again. It is taboo still for some people. And people are very dishonest, even celebrities, which is crazy to me. It's like, we all know, right? But you did something. So, yeah, I think just living authentically, doing what feels good for you. And, like, the biggest message is, like, confidence, the way you show up in the world, you know, taking care of yourself. It isn't vain. It's vitality. I love that.

A (77:04)

It's vitality, not vanity.

B (77:05)

I love it. Yay. Thank you guys so much. We'll see you next Monday. And wait, how can they find you? What's your Instagram?

A (77:12)

Instagram is doctordoctor.philipdawa P H I L L I P D A U W.

B (77:19)

E. There you go. All right.

A (77:21)

Plastic surgery.

B (77:22)

Thank you so much.

A (77:23)

Thank you, Savannah.

B (77:24)

Thank you. Bye, guys.