Webinar 3: Celebrity Plastic Surgery

Board-Certified Plastic Surgeon, Dr. Kevin Tehrani is here to answer everything you need to know about plastic surgery and more in his latest segment called #TehraniTalks – During Quarantine. During this online webinar Dr. Tehrani, will be sharing his opinions on all of the A-listers who went under the knife.  


  (00:00): Okay. So a celebrity, plastic surgery, we’re all quite infatuated with celebrity that for good reason, sometimes not. So good reason. We’re going to talk about some of those issues and and then why we’re so, so a lot of what we’re going to talk about first I want to talk about, first off, I’m a board certified plastic surgeon means that I’m going to mention regarding the surgery. Injection treatments are the CDN. This does not mean that I’ve treated or operated on any of those. And, and if I have had operated on people that were going to mention it, that I can say that you’re non-disclosures that I have signed that, not talk about it and don’t get the laws, vocation privacy, certainly that I cannot say that you get that. So consider everything as a an opinion. (01:14): And we’re going to talk about Mmm. The celebrities coming up. So these are going to be, I almost had to rename this talk. The the Jenner slash Kardashians talk cause the most going to talk about and what people are very impacted with are they Kardashians. Slash. Jenner. So we’re going to talk about mom, Kris Jenner the picture all the way on the left 90 then 2005 and 2015. So during this time a lot of celebrities do Mmm. Maintenance items similar to Botox, fillers, injectables, facials. But then at some point gravity and or aging gets the best of us. And then you have some surgical enhancement. And during that time either before 2005, I was like, she’s had at least a lift and maybe even a second one between 2005, 2015. (02:19): So that’s 15, 2015. She looks the same. It’s not actually a bit better. And her cheeks have fuller. She looks natural. It’s not overly done. Her lips are not huge. That kind of distance between the nose and the lip that sometimes gives away aging is actually better than when she was 1990. So a little bit of net lip enhancement where lift lift chicken has been to fillers and bakes look forward to in between. Can do that under the other thing that they could look, she’s actually had had breast enhancement as well at least before 2005. So that’s Kris Jenner. Okay. Okay. Kim Kardashian. Mmm. Most commonly asked question from patients and a news media is whether or not she’s done anything with her mom. And even though she quasi is admitted, she has not, or she’s admitted that she is not she definitely has had a bottle. Whether it be injections, fat implant and or certainly facial injectables and procedures are in the realm of thing that’s looks like she’s she’s had, is a vinyl breath to make the nose look more well-defined and it looks phenomenal. She’s great. She’s structured, she’s got great lip structure and and body, we’re going to talk about at the very end, the most commonly requested body parts from my celebrity and can K is not always number one. So we’ll talk about that as well. (04:13): Then we have Chloe. Chloe looks like [inaudible] and her bum as well. And those are I guess something that runs in the Kardashian family and has that area. This is Courtney. She looks great. One thing I must mention is even though she looks like your chief fuller here uplifted makeup can go a long way and lighting can go a lot longer. This is a darker picture and this is a lighter picture. So whether or not she’s had some alerts here, which is quite possible lip fillers also enhanced in shirt can be chemical body pictures and we’ll make up in addition to, of course a lot of the, the things that I do or my injectable colleagues do to make better. But that’s important. That’s awesome. Kylie Jenner most number one requested lift in my office and Jenner’s lips, probably not when it was the fullest and something between the two. But she’s had Miller’s done certainly in her lips. She’s had breast augmentation. Mmm. And she looks great. At some point in time she’s kind of been a bit overboard and the lift that we were a bit too big and that’s why we have a discussion with patients and sometimes with the imaging emulate as to what they’re going to look like. And we’ll discuss that in terms of what we would like our patients to look like. (05:51): Kendall Jenner well also she’s the youngest. I don’t think she’s had any in her. She definitely has her upper lip injections. She’s had well her lips. You can use pictures that you can see and I’m sure some sneakers involved there. But in general in terms of enhancement is her lips. What I see from the pictures, well, I had deed had a bit of goopy nose in the path and kind of was a little wide. So she’s had a rhinoplasty to define her nasal tip and she looks a lot more refined there and a slightly elevated the best angle for a woman, her nose is not to be turned down, but ever so slightly up. The tip is about a hundred, at 95 for a hundred. And hers was too Kai, Richard the, this is 2006 and then 2009 smooth. Arguably, she looks better now than there two years prior. Those are all contributed to a facial aesthetic surgery. She has had her autopilot done facelift. And also skincare. Botox is okay. Initial speed, a lot better. [inaudible] Or tiny little wrinkles and area are not gone or gone. And that’s, I think the critical thing is not to eliminate any signs of aging, but to dramatically increase it. So that you know, 13 years later you actually were okay. (07:49): Lisa Vanderpump had that in 2010, quite a few wrinkles in her post the area. He had some good, it’s your hand neck doesn’t look that great. Some sun damage certainly. And you know, we are eight years later with improvement in those areas. Nice, nicer contour. She’s smiling a bit deeper here. So you think that her old are deeper, but Jackie looks very natural and I think that’s a nice facial rejuvenation with a facelift. Okay. Lisa? she’s an example of somebody who actually looks great. Mmm, right now showed on one thing, you had some cheese, her name’s Leybold sometimes with that, and that’s when your team comes in instead of Uber filling the need to move to shoes and overfill the what, but she looks like she’s had his silicone injection in her lips. And that’s a very typical thing that happens to lips if you’ve had permanent fillers injected and you’ll lift silicone being the the worst one as it actually kind of clumps together and makes the, that area look natural. (09:16): And because it’s permanent doesn’t go away. And unfortunately, the only way to address that is surgical. You’d have to have surgery to have that. So the most common lip fillers we use are [inaudible] type family or high learning assets in the lips which are not permanent and the actually suburb and, or removed by different injections. Silicone injections only is not one of those Dolores Pena. This is a quite a graphic improvement body and face, face, lip, lip injection, rhinoplasty breast, the enhancement in terms of lifts and orientation make them look like a different person and in a nice way. And she looks natural, not too uncommonly asked. About wanting to know Melissa [inaudible] nasal nasal enhancements. You had a an a, a, a, a [inaudible] nose and that enhanced nicely with a natural tip upper nose as well as and natural shape. So she looks really good as well as breast enhancement. That’s a shadow of an implant. (10:51): I’m an outlet for a mother of a twins for she’d be a looks great pants man, body contouring. Celebrities are actively opened a bag having typos and having a record and the they feel better about these types of foods and goods. They look better. And that’s what mommy make words and, or facial body and half. That’s all about Victoria Beckham. This is over quite a number of years. She’s been actually opened a bag for us enhancements and as you could see, she was quite flat year and she’s cooler in her blessed on terms of breast alimentation. She’s had facial fillers and and she, she hadn’t, she inherently had had it chiseled jawline and chiseled that cheeks and a mailer area. And that can be enhanced even further with small amounts of filler. And it’s all about you can get natural and doing small amounts of a organization to make things look better. And Naval tip actually looks like she’s had a tiny little adjustments where a tip as well where she still looks very natural without a big change in her overall shape, but improve and pretty H proof at this point. (12:23): It was Swift the has that had a nasal procedure or rhinoplasty to improve the appearance of our nose and nose wider here and not as well find that picture. She’s also has had breast augmentation. Those are implants most likely over the muscle, smaller implants, natural. And she looks great. (12:50): Nicole Kidman is one of those age lists Hollywood celebrities. And over the years, she, she looks great, run the gamut of injectable fillers Botox and skincare and and also with patients, what we call it, skin patch with one or two, which she is when they’re super light, you can actually do quite a bit with peeling of the skin in terms of patrial rejuvenation and with it and getting rid of the the TA and the fine wrinkles of the patient with that actually doing a facelift. So I actually don’t think she’s had a facelift knows, yes, I don’t teach that or facelift. She’s had breast and enhancement, but she’s maintained well up until this picture with with a lot of skincare and injectables nonsurgical containing life author. Hmm, Katie Perry. These two pictures are very interesting cause that they’re about five years apart. She looks like she actually is a bit heavier in 2013 picture then here. But regardless of that, there’s breast enhancement involved there. Mmm, no, surgery is done fillers. In terms of lips as well as facial injectables, Botox, those are mainstay items in terms of enhancement and of course as well as maintenance. (14:19): Okay. (14:21): It is, Alia is actually a pretty chord about famous, just that surgical enhancement with her bum it BBL as well as breast and has been not necessarily in this picture of what she’s open about the fact that she’s had breast augmentation. And she looks great and and this exudes in her and she’s happy talking about it. Most celebrities are not, but it’s nice to see that some actually open about talking about it so everybody else knows that sometimes you were born with a lot of natural love beauty and sometimes we can help the nature out of it. And of course, aging continues and regardless of the gene pool improve some of that. (15:08): I’m Nicki Minaj, this is her quite tiny and this is, or not so tiny. She’s had BBL and or implants. And this just does not happen unless you gained more than a hundred pounds. And that’s certainly not effective in directly provide Cardi B has been open about having had liposuction, having that VDL breast enhancement. One thing that has been very open by the fact that she’s had the legal silicone injections this is pre dating the time where she actually was quite famous. And and that’s unfortunately a big get endemic issue where patients for cross reasons are having illegal silicone injections for enhancement over the buttocks area. Sometimes I’ve actually seen it in the breasts and unfortunately it causes a lot of issues similar to injections in the lips. It can cause a granuloma that could cause issues that would require surgery or even cut to remove it or chronic liposuction to the movies. Mm. (16:19): So let’s talk about some men before and after in general unless necessarily needed. They slipped in. Men Chan look a little overly done. And I tried to reserve that for full of absolutely need, especially in the next, especially in the eyelid. Men in general look better with eyelid surgery. Simon has had his lower eyelids on. He has a good look in the after picture compared to the before picture. His eyes are more open, but a bit at a a problem of you kind of see what’s called the coconut with the lower eyelid rule of slanted down and out. And unfortunately when you have that, you ended up with not looking quite right. He’s infectious smile that you see in the before pictures. It sees almost smiling at the same level, but you kind of, it’s not conveying in the eyes because of that. (17:21): One thing that happens with men also, we start aging in Latin, the upper forehead and the lateral part of the brow and occasionally with Botox, and he’s had Botox but he could see blind. They’re not as dramatic. The actually Rob the brow even further. So upper eyelid Raul, it reverses that nicer than lower eyelid surgery alone, which I would suspect him having. Cat would need to have an upper eyelid surgery to kind of bring his, a nice benches that smile back. John Travolta has had a facelift. I’ve had the lower eyelid surgery maybe even upper eyelid, even though he’s get some pooping. One of the nice things about his upper eyelid is the fact that it, it actually does have some characteristic upper eyelid rigid or wrinkles and it looks good in the upper eyelid. Lower eyelids in men usually stop folding out a lot and he doesn’t have that which is a nice issue. And at the same time, you’re not seeing that slanted little eyelid book that could be a giveaway or having had the lower eyelid surgery or a champion, which actually is irrelative it’s a complication of lower eyelid surgery that needs to be fixed. (18:39): Carson I think at this point he’s only had enhancement in terms of injections with lips. Certainly has had back, has had Botox actually it looks like to use a little bit more Botox on the top part of his forehead. Another lip that liked these, been injected with silicone. This is a bit of a silicone telltale sign and unfortunately the only way to get rid of that it would be surgery and then replacement of that volume with with injectables and otherwise it looks great. So why are we talking about all these celebrities and what’s the infatuation that we have with them? A lot of it has to do with what what people perceive as beautiful is, is really what we see on on TV social media, Instagram. And a lot of that comes up as to in the consult room with me. And a lot of patients ask for Jennifer Aniston’s roles as well. Brooke shields knows or eyelids. So now I’m going to talk about body parts that are most commonly asked in my office in terms of what kind of natural things and sometimes so not so natural things people actually ask for. So nos is a primarily Jennifer Aniston and and, and I get a lot of Bookshields as well. (20:08): Okay. (20:11): Breasts, I get that Salma Hayek progressive, very interesting is in New York and Northeast in general, we’re a bit more conservative and the natural look is what most people ask for it. And I would say Salma Hayek is, is actually probably on the bigger end of things of people ask me if we ask for, and more commonly than not, I get that I don’t want them to look like dogging for big, which is a nice relief since I don’t like making that bake yet unless specifically requested. But in general, natural is what we go lips hands down. Kylie Jenner is what everybody asks for. And most people say that they don’t want to go to that extreme, but a bit less than in general with lips. It’s something that I like to do, step why it’s always easier to add more as opposed to trying to take back. (21:06): And it’s all about doing little bits at a time. Eight, most people don’t know you did anything and you gradually increase. And and make that, enhance it a lot better. Now lifts is not always about volume. And one of the things about lifts that’s important is the distance between the upper lip and the and the nose with aging actually increases. And some people even inherently have it even though they’re younger. So it’s a bat, not just a lot of volume on sometimes just about adding volume and increasing that distance. Sometimes that needs to happen with surgery called the lift lift to be able to lift that area up. Or even with Botox, hold the lift it. When we do Botox in the upper eyelid upper lip, it actually can flip the upper lip. (21:58): So hands down when it comes to buttocks J loads who we get, this is a very interesting picture of her. This is not a few years ago, but a natural, she’s a little bit has more of a booty now than she did before. And the last Superbowl we saw on display nicely. But she’s definitely one that we get a lot requests in terms of finalizing the shape and look up her bomb in terms of a nice shape curb and like arms. Mmm. Arms and legs. And Michelle Obama gets that. And I get a lot of requests for kind of a chisel upper arm, something that looks natural, not necessarily muscular, but more shapely in terms of athletic and fit (22:52): Abs. (22:54): Here’s Demi Moore who’s had a lack of suction in his lower abdomen, upper abdomen, and she looks great for our age. Overall and I get a lot of requests for her abs looking like that or other models that are much younger but still have added that look like that anymore so that we get a lot of requests from her. (23:17): I’m going to, I’m going to mention if you things about overall rejuvenation, that I do these on my own patients, that we need to show their pictures whether or not being in those jobs, that angle that we talked about, chin augmentation, liposuction of the neck, yet facelift, which doesn’t mean that you have to look 10 years younger, just rejuvenated with the scar that is basically imperceptible. You never see that scar. The wrinkles have gone. The neck console, it looks a lot better. Neck, neck liposuction to bring somebody from a very obtuse angle like that to make them look a lot better. And those are all rejuvenation that need to be done tastefully and naturally. Notice in the previous picture, I have, I didn’t say the most common celebrity facelifts that people are asked for it because the whole idea of a facelift is that you don’t know that they did anything. (24:10): And that’s why it’s all about keeping it natural and making them look good. When it comes to a implantation, it’s a back, natural shape, natural side. If somebody’s got a droopy breast, make them uplifted, make the outer Yola smaller. And either whether or not putting implants inside to lift them, support from the inside with meshes using a fat transfer contour the implants, many options available. Mommy may, Colbert’s, which is probably the number one thing I do my practice or I did before, covert and hopefully be coming back soon. Mmm. His body contouring but liposuction tiny little holes that are hitting the bikini, bringing this cough, this common looks like the me more and I didn’t say anything. And then just bringing the waistline in and thighs, lateral thighs, all contour in and have a shape of working gaps you haven’t worked at at all, but it looks like he’s pretty fit. (25:09): Or a mommy who’s had a abdominal stretch marks from pregnancies as hernias, breast, a small wrap for breastfeeding. Had, you know, I did a tummy tuck, which is in a bikini and a nice Eni. I put implants in through her tummy, Tufts scar incision so that she has no scars on her breasts and, and that’s a big mommy makeover would basically just start here. That’s in the beginning arms. We do a brachioplasty where we remove the extra skin. The scar is underneath here so you don’t see it fat injections with caps and make somebody’s capsule look like Michelle Obama and or implant. Make that look better. Black position obviously with five lifts, different body parts that needs to be removed. Typically in somebody like that is after weight loss with a blocked a lot of weight and it can just walk. And of course, a BBL is the body lifts where we kind of turn people that are quite square into heart shape, still natural, nothing dramatic or big, a huge but more natural looking. So because of COBIT Royal inside now except for immediate postoperative patients. Urgencies like lacerations or open wounds, we’re not seeing patients in the office. And what we’re doing with virtual consultations follow up is using different modality. And I want to talk about that about how that process works. First thing is (26:44): That you would, I would need a bit of information about you as a short online form that you would need to fill that tells us that you’re agreeing to have this consultation virtually for me to take a look at you, take a look at your your history as well as talk about the different options that are available. And you can share those photos online or outtake pictures while we’re on our virtual consultation. And we’ll talk about that a bit. (27:16): Our good patient coordinators that’s Kristen, she’ll get in touch with you within 24 hours to schedule a that virtual appointment on during which I’m going to get on and discuss what we need to do. So we could do that either by FaceTime, zoom, Skype, duck symphony. Now that we actually have an internal way of doing it with our own internal software, keeps it HIPAA compliant and, and, and it keeps it confidential. Initially I did not want to do a lot of zoom because of the zoom hacking, but that now that’s been fixed and it’s quite safe where people can bomb the zoom anymore. You would have to be invited in to be able to have something very private. One of the other things that I want to talk about during our Skype or zoom consult is depending on the procedure like rhinoplasties occasionally for breasts and for buttock enhancement. I can actually show you what going to look like with our review software that I can take a picture, upload it, and while we’re on kind of simulate what you’re going to look like after. And that could be a, sent it to you on a secure platform where you a log on to be able to take and look at it. (28:43): Wow. (28:47): So I’d like to open things up for Q and A. Jackie, please moderate the questions and you can answer some of the questions that are audience that (28:57): Great. Thank you so much, dr Ronnie. That was really insightful. We actually have a lot of questions coming in and then we also had some questions that people had written in previously before our webinars. So I’m just going to start with some of the questions that have been written in the chat. So one, the first question, did Kris Jenner do anything to her eyes in the first side? Want to go back? (29:23): I’m going to go to the first light. It’s quite common that you just don’t do a facelift alone. A lot of times we do facelift and eyelid surgery at the same time. And very commonly if you don’t do the lore islet or upper eyelid surgery at the same time, you end up with a basically inappropriate upper eye that can participate and vice versa. If we did that by that, then he didn’t. So between 20 2005 and 2015, I actually think she had had her eyelids done as well. Between 1990 and 2005 maybe not. We could get away with injections quite a bit there, but app in a while, if you have too much loose skin, it would just need to be removed. And between those two pictures she’s had that. (30:12): Okay, (30:14): Good. How, well now if you want to go to Selma Hayak we have a question. You know, based on what you think, how large are her breasts, if if someone wanted to come in with implants to get some implants and maybe they had, they had a fairly flat or chest, (30:34): Right? So first of all I must say, but then most commonly it requests that size in the U S is it eco? (30:44): Yeah, (30:44): In general, the crop especially different manufacturers make different cup sizes and in her case actually would put her in a Victoria secret detox. Having said that Victoria’s secret, you cannot can think of it as a, a European cup size. It’s a bit small. They run quite small. So realistically speaking, she’s more like full C cup than a D cup. But that’s a most common size that’s asked for breast enhancement. Most commonly would go from an eight to a a C cup full C cup, which is where she kind of is. (31:23): Okay. can we talk about fixing job jowls as we age? (31:30): Nope. (31:31): Yes. That’s that one of the very first signs of facial aging is Jacqueline. I’m gonna talk about John Travolta for example, if you see in, in this his younger picture is, he’s got a really chisel Joel on his, just starting to see and [inaudible] that happens because yeah, it’s attachments to the bone is part of the jaw and we don’t have attachments to the bone behind the jaw. So there are a few things we could do. Certainly if facelift once to get a little bit older is the main state to address that and be clean. Facebook and I don’t like to do that on. So patients are probably in their sixties. So he ended up doing it only one time in the lifetime opposed to two or three facelift over time, which were, starts looking done. So there were a lot of things we could do beforehand, like non-surgical training threads to lift up and or filling the front of it. To do that, there was a procedure called a Y lift where we actually inject in, in the area of the of the feeds out of the loop, which lasts about two plus years to kind of enhance and kind of choose a lot that draw a line and also bring out the, the back part of the mandible. (32:50): And injections like that could go a long way in basically holding people over nonsurgical treatment up until that time where we have to do that piece the only one time in their lifetime. (33:06): Great. Thank you. So next question. How do you prevent the rippling in the stomach if you get liposuction or like a BBL in the buttocks? (33:16): That’s a really good question. It’s very a common theme that we’re doing these days in. That used to be that we only could do liposuction, and this is more more like 15 years ago, where we actually really come leaps and bounds in terms of skin tightening. First and foremost, it’s about the artistry of how much fat is in what areas. But in this example, she’s had a lot of fat removed from her waistline, but I’d lift small amounts in the middle. It’s kind of make her look like she has a contour. But most importantly, what we did is we did skin tightening and now we’ll come a whole gamut of different having different modalities skied tiny. The very first one we had was a laser, which was smart light bulb and I’m added for now 15 years almost. (34:05): Okay. (34:05): Then RFIO or a nonsurgical or surgical suntanning with radio-frequency. And the newest one is removing on OJ platforms. So these are all procedures that are done after I do the liposuction and Apple controlled the area, then we attack the skin and go inside on the inside of the skin, the laser radio frequency or skin tightening with Ruby, you know, gene plasma. So you have to combine these modality and if you just did liposuction, you are going to get your regularity that you need to tighten the skin overlying not a deflated area. (34:44): And actually a similar question someone has asked, it seems like there’s a lot of disfigured belly buttons when people get liposuction or even a tummy talk, you know, how has that prevented? (34:56): That’s a really good question. And I think her, that question is, it’s about redoing it belly button when you do a tummy top. So the belly button really doesn’t change the belly button. That’s not changed because I didn’t do anything to the belly button, although I did make an incision just to get access to a tiny little hole for a or liposuction. But in a tummy tuck, you redoing the entirety of the belly button. So basically the inside of the belly button will remain the same, but on the outside make it run. And then that’s the arch history of how you make that. For that whole, I have a very specialized technique that I teach my fellows how to do, where you spend a good an hour or so just on the belly button front of perfect that cause that’s kind of a telltale sign of not having had a good tummy. And it’s about really making it any, in bringing it in and also developing a bit of an upper hoodie to a camouflage scar and not make it too tiny or sometimes you see like a mushroom coming assets made, it was made too big and it’s not uncommon to actually revise some of the belly buttons or scars. (36:08): Okay. (36:11): Okay. Great. So moving on. Some people have some questions about lip lifts. So the question is really is, is it possible to do like a preview during a zoom console of what your lookbook would look like? (36:29): How would you go about that before that possible to do that at the right angle, especially if it’s a profile lip look that’s necessary. There are different kinds of lift lift. The most common one is one where it’s almost like ADR and mustache, industrial moving the upper eyelid upper lip, the younger that you are, the less likely that you would need that. And sometimes the Botox can be better, but with aging that distance increases and yeah, we can do a preview of what it would look like. Where did it, so you said that Apple can make that happen. (37:06): Okay. Awesome. That’s good to know. So someone said, I’ve read about gummy bear implants, do you use those? And if I’m not, you know, what are the most natural looking options for implants? (37:18): So in general gummy bear implants overall are considered silicone implants. There are different levels of cohesiveness or thickness of the implant and I use them all depending on the on the indications of what the patients need. In general, the majority of the implants I use are gummy bear silicone implants. I occasionally do salient implants. The most common reason to use a saving implant do avoid any scars altogether going through the belly button. But that has to do with the ratio of the future breast compared to the rest of the patients before surgery. And if that ratio is the majority implant I would recommend him go with silicone, which is more natural in terms of shape and feel for the most part. Whereas in terms of not having a scar, it’s nice to do go through the buddy bond when you have to use the same and implant, let’s say in implants are just volumizer. So if somebody wants to go from an eight cup to a B cup or maybe it’d be come to a C cup, just a one cup size increase, it makes it a really good option for that. (38:29): Okay, great. So, Oh, this is about celebrities. So if there are, do you have any celebrities in mind that you would consider considered to be an unsuccessful surgery or enhancement? (38:43): I think we’ve talked about that, Simon. Being one of them in terms of, you know, how his eyelids look. And they’re, they are other ones that are out there. And I wanted to kind of keep this positive and did not talk about someone, then they get negativity about some some patients some celebrities was had they don’t look as good as you’d like them to, but in general over the overly build is what you see a lot of. And it’s kind of trying to bring that back in and making them more natural, but most people want. (39:29): Okay. Yeah, I think that’s, that sounds great. So next question, can you remove fat from around the mouth and put it into Phil scars and you know, another patient also asks about fat transfer to the face instead of fillers kind of all goes together. So can you speak a little to that? (39:51): Yes. Fat, fat injection to the face is a common procedure. I don’t like to do it in patients who add who have not had any other floors before a find injection to the face. Vantage is the fact that it’s kind of a proportion, about 40% of the fat that injecting your face basically becomes your own tissue and transplanted in that area. So it’s, it’s inherently a really nice thing to do. Two bad things about fat is one, you need a trip to the operating room to do it. So have a little bit more downtime than say just having a wrestling or a Juvederm dump. But a lot of times I do it when the patient’s already going to be in the operating room, facelift or any other so that’s it’s biggest drawback. The second thing is I would over inject to counteract the fact that you would have to leave a portion of that fat about 40 to 50% and get the floor over injection means more downtime. So typically people will have fat injections in addition to pulling in the operating room, even though it’s on the local anesthesia and you move from other areas, there’s at least about a week of downside before they’re normalized. It’s fillers. You don’t have that downtime. So I’d like to kind of tailor that to every patient and special. (41:09): Okay. And I mean, can you also remove fat around your mouth? Is that an option (41:14): That that could be done as well? Yes. (41:18): Next question. What can you do for a sagging neck? (41:23): Bagging neck is actually one of the probably second parts of a facial aging that happens. The neck is probably more important than the rest of the face in terms of rejuvenation. So the neck is a lot more difficult to keep the address non-surgically. Okay. So the neck could be done non-surgically, which is basically lifting up the neck line with non-surgical rejuvenation like thera completely nonsurgical where, and, and then you could use tightening surgically, but minimally invasive. And that’s combination of liposuction with with either a radio frequency or a over nutrient for skin tiny, for example. Let’s go to this patient of mine that we did that on. So one in the younger patient as a QTI, I did liposuction with skin tightening and one a bit older patient where we did some tightening with a wood Ray radio frequency and not as nice as the surgical one. She’s had a proper face and neck lift, but still a dramatic. (42:47): Okay. Thank you so much. Let’s see what the next questions are. How do your patients do with fat transfer to the breast? This person said that they’ve read that they’re more prone to regular mammograms. (43:02): Okay. (43:03): In addition to the breast is a good option for people that have some good inherent breast tissue. It’s a good option for patients who had implants and have free expansion. So once we take them out, we can replace that from their own fat. It’s not good for somebody who’s very flat. Like for example, this patient is super flashed with an eight cup. She wants to grow from eight to see fat injection is not a good option. If you want it to go from a B to a C, that would have been a good option. So when we do fat grafting in the face and just talk about the face or anywhere in the body, a portion of that fat is your mammograms purposes. That absorb part that can on a mammogram can look like breast cancer, did not breast cancer but could look like. (43:46): So you would have to then now let your mammographer know that you Pat fat injection new press every time you have an a mob, not necessarily more often. You still have it once a year and as long as they know what they’re looking at, it’s perfectly fine to do it. And that, I don’t like to do it in patients who have had history of breast cancer and that’s because it actually will put them at high risk of needing unnecessary breast biopsy that basically shows that it was fat and but short of that it doesn’t cause breast cancer. Nor does it decrease that detection in somebody who’s not had a history of breast cancer. (44:26): Thank you so much. Next question. What kind of implant is good for a (44:33): In general, if body builders should not have them find some place under the muscle. But I can put implants over the muscle so that the movement of the implants is not going to be dramatically reduced with with bodybuilding. So for that reason, I like to use general funds and most gummy bear of all implants. And those placed over the muscle will not ripple, which is one of the issues that you can have with with implants over the muscle. And we’ve had great experience with that and occasionally even combining it with what I call a composite or natural breast enhancement where we put the implant over the muscle, but that’s the bit of the own fat around the implant, kind of camouflage over the muscle. I’m going to go back to Taylor Swift. As you can see, you kind of see the edge of the implant. She’s pretty skinny, but it wasn’t the implant for the muscle. This edge shows a bit and putting a tiny bit of fat in that area, camouflage that really nice. (45:49): Okay, that’s good to know. So next question or more of a statement this person wrote, I would like to know more about the nouveau diet. (45:59): So like anything else losing weight dramatically improve quite a few things, abdominal girth, waistlines and and that’s something that set and medical a great diet that we have in our patients typically for patients undergoing surgery. So I’d like to have patients of go to newer diet 40 days and lose 30 pounds before surgery. But now that a wall at home and we all have had the Qubit 15 pound weight loss weight gain rather that diet could be administrative home. It’s a very low fat diet. A strict adherence to that low fat and, and to the program will make it move weight 30 pounds and 40 days. (46:48): Okay, good to know. (46:52): Up we have if, if a patient is susceptible to capsular contracture, will using Gallo flux help prevent it from reoccurring? (47:04): So there some evidence to show that bringing new tissue to the breast can improve capsular contracture. Now capsular contracture is one of the biggest issues with breast orientation. If you have a capsule around the implant and the implant gets hard, you ever hop somebody that you feel the implants that probably have capital contractor and that can happen different, varying degrees. Mmm. I don’t jump using ABM or mesh to improve capsular contracture unless patients have failed other methods on nonsurgical methods like Aspen or release or removal of the capsule first or refractive patients. Patients have failed those options. I then introduced ADM or a mesh and that’s mainly for the reasons of patients having difficulty with both. Basically rejecting this mesh when higher risks of infection if you jump to do that right off the bat. (48:11): Okay. (48:12): Thank you. And another question around that same subject, if you’re not quite ready for a traditional breast lift, are you still able to use the internal bra breast lift? Can you do something like that to help that using implants or, you know, going the traditional route? (48:31): That’s a good common question that I get from a lot of younger patients. That may be thinking about breast feeding and or pregnancy and they want to have breast augmentation. And what we do is a little bit of a shortcut, right? Internal lift with or without a mesh and put the implant over the muscles, trying to give them some enhancement to look time where they will be ready after 10 years of class or whenever that may be to have a formal lift. So it’s kind of an in between thing that it can have done prior to committing to that. Having said that, if you’re dramatically need of a lift, nothing replaces lift and a at least the great majority of patients, 80% plus and continued breastfeeding and have sensation with a traditional a breast lift whisk barn. And we have a comprehensive program that addresses the scars to make them look as best as they can even though they’re going to be there. (49:32): Okay, (49:33): Great. Couple more questions. So this one does using implants over the muscle still leave the breast sagging? (49:43): Not necessarily, and it has to do with how the pocket is how the internal lip is done inside the breast. It has to do with how much and if that’s not the case where your patient doesn’t need a traditional, it doesn’t have to actually the two additional hanging. (50:07): Awesome. so this person said she’s not overweight and she has fit arms, but she said, I’m sagging skin. What is, do you have any options to help tighten that area up? (50:22): So either it traditional arm lifts, remove the extra skin if it’s not saggy or just skin tiny with that fat removal, a lot of people actually have some fat in the back of the arm that bothers them. Kind of like the Jennifer here, this upper part of their arm, they have that liposuction and skinny tiny would either remove on or laser dramatically increase that. And that’s something that we do on the local planet. (50:53): And next is besides arnica, what vitamins do you recommend prior to surgery to help speed up the healing process? (51:00): There is no magic potion. Arnica and bromelain are two items that have been shown losing vitamins that AC and E sorry, AC and D can actually help dealing as well. As long as your body needs a lot of protein, G lap the surgery, as long as you get actually happy and you have your vegetable, you body feel the thing not to do or more important things to do. And that is smoking or even being around somebody that smokes caffeine. Those are the things that we talk healing and that’s why we meet at least twice before surgery went through some specific things that you would need before surgery. (51:46): Okay. so we’re doing a lot of cardio effective breast lift. (51:56): No, I don’t think cardio will affect the breast at all. Having said that, obviously if you’re running the breath, whether or not you have an implant that could take a gravity effect. So you would have to have some sort of a a sports for our to be able to help with fall. And I think most people do that. But in general, I don’t think in and of itself effected short of massive weight loss. (52:28): That’s really it. I mean, we have one more question, which I think I can answer. Do we offer any free consultations? So right now there is a fee for our consultations, but for anyone who has joined this webinar, if you mentioned that you watched our celebrity plastic surgery webinar to our patient coordinators, we’re going to be offering you $50 off your consult fee. And then, I mean, you know, we had some nice comments. Hope you and your family remain safe during the COBIT 19 and we can’t wait to see you back in the office again. Dr Ronnie, thank you is fantastic. We love you, dr Johnny, (53:06): Thank you so much and I appreciate everybody joining us. Looks like turn the corner and hopefully before we know it, we’ll back at the office to be able to see you guys in the meantime. So you online. (53:17): Thank you.
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