Hey, guys. My name is Mavi, and I've spent the last 14 years in the plastic surgery and beauty industry working alongside top board certified plastic surgeons. Now I'm an independent patient coordinator who doesn't work for any surgeon. This means I have unbiased reviews for hundreds of doctors, and I can help you achieve the look of your dreams, whether that's a supernatural or a video vixen, I use my professional and personal plastic surgery experience to help you look and feel your best.
Join in on the fun as I talk to plastic surgery experts, friends, and real life patients about all things plastic surgery. Should be fun. Hey, guys, do I have the episode for you today? So I am so excited to have one of my favorite, favorite, favorite plastic surgery couples, dr. Andrew and Dr. Ouija on the podcast today. Thank you guys so much for joining me. Absolutely. We're so happy to be here. So, Dr. Andrew, you might remember her from a previous episode. She is the one who did my
breast. So Dr. Andrew is the breast surgeon here in Houston. Like, the way she does augmentation, the way she does augmentation lift, which is why I went with her, is top notch. So one of the reasons why and Dr. Andrea, I think you and I talked about this, why I went with her during my lift was because I noticed that in men's, before and after plastic surgeon, plastic surgery male. Sorry, Ouija, this is in a dig at you. But their breasts
were a little bit more square at the bottom. And Dr. Andrea's breast, when her before and after pictures, I noticed that they were always super round at the bottom, which is what I wanted, which, you guys, I had a breast reduction lift augmentation. I told her I want to look like I was flat and got 500 CC implants. And she delivered. She delivered that procedure. I talked about it a
couple of episodes ago. So for this episode, we're going to talk about breast procedures, breast augmentation, breast lift with augmentation, and the queen here is going to explain who's the right candidate, what procedures we should be looking for, what red flags we should be looking for. She knows how to educate you guys to look the best. Dr. Andre. I'm so excited. All right. I'm excited, too. Yeah. So that's a lot to cover in one quick episode, but we'll see what
we can do. So I guess the first thing you were asking was, who is a good candidate? What makes you a good candidate for a lift versus an augmentation versus lift augmentation? And that's like a really individualized kind of response. It really depends on the patient and what your goals are and all that kind of stuff. With anything that I'm talking about, safety is going to be number one. So there are specific safety concerns where I'm going to say that you're not a candidate for a
lift and augmentation together. But basically with a breast augmentation, if you want your breast to be a little bit larger and you don't have a whole lot of ptosis or your breast hanging down, then you're probably going to be a good candidate for a breast augmentation. Now with patients that are kind of in between maybe needing a lift, maybe not, a lot of patients really don't like the scarring of a lift. So I do have quite a few patients coming in wanting just the breast
segmentation and not the lift. And what I talked to them about is you can get a little bit of a lift of your nipple whenever you add in an implant. The bigger implant, you add in the little bit more lift you get. And then you can also kind of cheat things around with the placement of your implant doing a dual plane or a, uh, sub fashion
augmentation or something like that. So there are kind of technical nuances where you can get a little bit of lift, but really, if you're needing to lift that nipple more than about 2 CM, it's really not going to come up that much. And so if you're in a position where you have a lot of breast ptosis or sagging of your breast, you're
probably going to need a lift as well. Then if you are wanting a lift with your augmentation, if you're needing to lift up that breast a lot and you're wanting to put a bigger implant in, you really run a higher risk of getting a complication or problem down the road with not having your breast look exactly as you want to. There's a lot
of different factors that are going on. Whenever you're doing a lift and augmentation together, you're asking that implant to sit just in the right spot and not to stretch out the tissues that have just been cut and sewn back together and lifted up. Uh, you're asking for all those incisions to heal with the pressure of an implant behind it. So there are a lot of factors going on. For somebody who doesn't need a big lift, then
absolutely. You may be a candidate for people who really have that elongated breast that's sitting way down on their abdominal wall. Maybe they're not a candidate for a one stage procedure. And then with a breast lift, if you have a lot of ptosis, meaning that your breasts are sagging, you're pretty much a candidate for breast lift. And then we can kind of talk about the different types of breast lifts or incisions and all that kind of stuff as well, if we want to get into details.
Are you using a lot of internal bra for your lips with the mesh? I'm doing more and more of that. So the mesh came out several years ago. A lot of people got excited about it and started using it. And then the FDA kind of put out this disclaimer that the mesh was not FDA approved for suspension of the breast tissue. But the thing is, we use things off label
for FDA use all the time. If you're getting, uh, like discord or java anywhere other than the Gabella, a lot of times you're using that off label, like you're using it for masseter, all this kind of stuff, you're using it off label. It costs a lot of money to get FDA approval for each specific indication. And so that is why it's not FDA approved for the breast. So I think that that kind of halted people a little bit, but I've
really been getting more and more into it. I like the longevity that I get for a patient who really needs a big lift. I think that it adds that extra bit of scaffold and that extra bit of support. The best way that I've kind of been able to put in layman's terms is that I feel like if you do a breast lift, if you have smaller breasts or you're perky or something like that, you can get away with using like, a cotton bra, and that will keep
your breast up and nice. But every time that you wash that cotton bra, and it's used over and over and over again, it does begin to lose some of that laxity. But if you use like, a really tight restpandex bra, like something that you would get, like, at a high end store like aloe or lulu lemon, it does give you that little bit extra support. And then as you wash it over and over, it does
tend to hold up better over time. So that's kind of the layman's analogy that I give for using mesh versus just using a breast lift alone. I love that analogy. That is a really great way of putting it. I do like that. I know you do a lot of breast augmentations, too. What profiles are you seeing the most people at liking the most, and what size are you seeing the most of? For me, specifically, I probably see the most moderate and full profile. So we use allerganza we
have moderate, full, extra full. I think the most popular size is full in the city, and I don't have the numbers on this, but I probably put the most moderate number of moderate implants into girls. And I think that's just because not that full is not the most popular, it's just that, uh, there's a group of girls who do like moderates, and they all kind of find each other, and then they're like, oh, I want that look. Dr. Weed is the one
that puts in moderate. A lot of people come searching for someone to put in a moderate because not a very common it's less common than a full, for sure. Yes. Mostly I'll probably talk about 50 50 moderate to full, and then, um, sizes range from 200. All the way up. I was just telling you before we jumped on the episode that I remember. Okay, so you guys, let me give you a little bit of background why these two are my favorites. So this was my place, this was my family before I quit and
went off on my own and launched this podcast. So these plastic surgeons have a very special place in my heart. And I used to be their coordinator. And when I was coordinating for them, we would measure each of our patients chest. And I always loved how they would explain it to patients, how important it is to get measured. So I really want to, y'all, take the lead on this. Why is it so important to take measurements and to really tailor the breast augmentation breast implant to
each patient? It's not like a one size fits all. So if you could go into that for me, please. I'll kind of take that one. I'm a big fan of what we call biodimensional planning in breast
augmentation. I really like looking at the measurements of the breast because that really gives me the chest in the breast footprint and that allows me to see what is going to comfortably fit in their breast, what may look too narrow and kind of coney like that ball and sock type of look and what is going to just be too wide for that patient's breast and potentially kind of blow out their anatomy. We're at a very high risk of bottoming out those kinds of things. So I take
measurements in the breast. A lot of times I'll do skin pinches as well, take extra note of the anatomy of the breast. I, uh, talk to the patients about their medial cleavage lines and where their muscle inserts and kind of how much cleavage we can expect and if we may need to do something a little bit unique to get those cleavage lines a little bit closer. Like doing a hybrid breast augmentation where we add a little bit of fat grafting media or kind of to the middle part of
the breast to improve those cleavage lines. So I think that that's really helpful in just picking something that's going to be nice and natural. The vast majority of my patients are kind of those mommy wanting mommy makeovers. They're really not wanting to be too big, although we definitely get our fair share of girls that want that little bit
more enhancement. But anytime that somebody is going outside of their parameters or kind of where I measure where I feel comfortable, I have a real discussion with them about we are going a little bit bigger than what your body frame is going to
accommodate for. So there may be some special things that we have to do, like adding in a mesh for extra support or you do run a higher risk of complications such as a lateralized implant, meaning that comes out into your axilla, uh, implants flipping or kind of bottoming out of implants because they're just too heavy for your body. So explain that bottom. So bottoming out is where that implant has really
dropped, where your initial fold was. There's always going to be a little bit of play and a little bit of laxity whenever you put in an implant. But bottoming out is basically where you can almost push your implant down, and it's going to fall well below where that previous IMF or where that previous fold was. Yes. So, you know, you're kind of bottomed out if your incision is under. Well, your implant is under your incision.
Yeah. And that's actually not true all the time because some surgeons, you're trying to kind of cheat their incisions up a little bit because they don't want it lying right in the fold. Because some women, especially like the current trends, are kind of like those crop caps that show a little bit of underboob. So sometimes they like to be able to for women to be able to show that or kind of those string bikinis and you're not able to see the incision underneath. So sometimes
surgeons do kind of cheat it up. And so I've had patients come and see me, and they're concerned about being bottomed out. Whenever I think it was really just the surgeon kind of cheated their incision up a little bit. So that's not always the case. You're 100% right. I agree with you. I have seen that. But a lot of times what I see, especially online from botched jobs from Mexico, they look bad. They look so bad. I, uh, want to help them.
And you being here in Houston and having worked at these hospitals, you saw your fair share of complications coming from across the border. And before we end up with it, would be really helpful, I think, for my listeners to hear from you, a plastic surgeon, doctor we j a plastic surgeon who had to deal with the complications coming from across the border and just what you saw what was happening, because it's not out there. That
information is not out there. And the more women kind of become aware of what's happening, I think the better it is, because maybe they won't go down there to these chop shops where they don't care about their lives. It's kind of a sad, um, situation, to be honest with you. At the end of the day, people are going to get plastic surgery. And if you can't afford it, then you're going to go somewhere you can't afford it. And sometimes that's in other
countries. And the truth is, in those other countries, let's say Mexico or South America, there are surgeons in Mexico and in South America who are way more expensive than surgeons in America. So it's not that there's anything wrong with any of those countries with regards to surgeons. It's just that at the end of the day, these practices that have doing like five, six,
seven, surgeries a day. There's only one way to do it, and the only way to do that is that you have to cut a corner to get that much volume done, whereas we would do one or two, three at the most if they're small cases a day. And then the saddest part is that they have no follow up care. And so, like at the oaks, at elite dermatology of plastic surgery, every single patient gets our cell phone number. They can text us, communicate with us 24 hours a day. I'll see them on weekends. And here,
basically, their follow up is the er. And that's really what it comes down to. It has everything to do with the post stop care. It's just so poor. They just leave. And then for a while, we did like a post office for patients who traveled, and we would take care of them, but it never really the word didn't really get out too much, but, you know, we're always happy to take care of anyone
who's in need. We, um, don't take call or go to emergency rooms, but can always go to our website and say you have an issue and we'll see you for sure. We just want to do it right for patients. I love that part of when I was with you guys, I learned so much, and I've brought that along with me through my journey. And I'm m able to use what
I learned to help other women. And I learned a lot with you guys going through recovery of patients coming from mexico, because in the other offices that I had worked at, I had not seen that before. It hadn't come across m I hadn't seen it, not like that. And that was one of the main i, uh, mean, dr. Andrew, that was one of the main pushes for me, because I was like, I have to stop this. I can help. I can bring more information and bring awareness to this because women are dying.
Literally. I had with the podcast, I get to talk to a lot of people, and I had somebody recently call me who came across the border with a perforated bowel, and she did not. None of the hospitals between brownsville and dallas would take her, and by the time she ended up in a hospital, it was already too late. So I'm not exaggerating when I tell you all that women are dying. It's real, uh, that completely breaks my heart. And
that's really sad. And another thing that I was going to add to these things is whenever people say that they do their research, and I hesitate when wanting to use that word, because we're coming from a medical background. So research to us means like, this full scientific method is not just going into a facebook chat room and being like, oh, that girl said that it worked out perfectly. And so that's my research. That's not
really doing your research. Use your common sense, because if something looks too good to be true or something looks off, it probably is. You need to trust your gut. If surgery is a third of the price of what it is in the state, uh, you have to remember that in the States we have a lot of rules and regulations for training, for maintaining your certifications, for anesthesia, for facilities for all those things. And all those things cost money to keep up that level of qualifications that
you're needing to. And that's the reason why things cost a little bit more in the States than they do elsewhere, is because they just don't have those policies and procedures in place to keep patients really safe. And so the cheaper it is, the more corners they're cutting or the more that thing of, um, stacking them deep and selling them cheap. You have to be wary of why they're stacking them so deep and what corners are cutting in order
to do that. So use your common sense, use your intuition, and if something seems wrong, probably. Is absolutely that ah, was such a crime junkie line. Trust your gut. Full body chills. Trust your gut. You guys. You really do have to trust your gut because you have your instinct. If something is too good to be true, like, for example, this patient, she was only going for the evaluation and they talked her into it. She wasn't going for surgery. It was such
a good price. They're like, we can get you in as soon as possible. And they talked her into it. And it just breaks my heart. And, um, actually, I'm happy that I have this platform where I can bring awareness to this happening and bring awareness to the doctors who are amazing and can do the procedures here in the US. So let's get back to the topic, which was breast implant. Augmentation, before we go back to the.
Clean breast topics, the last thing I'll say is that traveling for surgery is never going to stop. Um, the first thing I'll tell you is that there are so many good surgeons all across this world. The best breast surgeon in the world is in Australia, and there's a lot of body contouring surgeons in Colombia, XYZ. There's great surge everywhere. So this is never going to stop. And I
think that's okay. But I think what if I could pass any message along is if you're from Texas or you're within 2 hours of Houston, you can establish your post office here with us at Elite Oaks, and we will take care of you. Now, if we have to intervene or do surgery costs, but just antibiotics and food care, there's just your normal, everyday, significant consultation fee. But after that, we'll take care of you. And then you always have someone to take care of you to.
All to give a home. Now, beneath the escalator, we can just deal with it as needed. But I think people should know that once they leave whatever country they came from. And it's not, um, always South America, it could be Europe. And we have resources to help you. So, uh, the one last thing that I was going to say about the bottom now is that a big reason why I do
a lot to prevent bottoming out. Like, I think I've talked about the internal underwire stitch that I use is because if you're bottomed out, if you don't have that nice base for that implant to sit on, you're never going to get cleavage. Because if you can think about somebody trying to push something up in quicksand, you're never going to be able to do it. So you need that base, you need that floor for that implant sit on to ever get any amount of cleavage.
So that's how you do that. You do a little stitch at the bottom. Yeah, so I do a stitch at the bottom. It's a barbed suture. So it's the same kind of sutures that people use for, like, the barb face lifting sutures whenever people do threads. So it's a very similar suture to that. And I put it along the IMF or that fold to really reinforce that fold. And it gives a nice stair step for that implant to sit on. I love my breast. You did such a good job. You
should pat yourself on the back. You did such a good job. Thank you so much. Oh, what is your recommendation for women who have an augmentation lift so that they don't have, you know, how that when your incision joins from coming down the lollipop to the anchor mhm so that it doesn't open there? I think that is ah, every single plastic surgeon's holy grail is to never have a T junction
breakdown. The reason why that area is prone to opening up is just anytime you have three points connecting, there's a little bit decreased blood supply at those very tips. So it's really, really sensitive. And then if you put that on top of the area, that's going to collect any little bit of fluid. Even if you have a drain in place, that fluid is going to collect right at that bottom spot. And then that's also the place that you have
the most weight on the breast. So definitely staying in your post operative bra, definitely kind of taking care of your incisions, making sure to wash them, making sure that they're nice and dry after you wash them, and then not doing too much, I think is the best way to try to prevent it. But if any plastic surgeon knows of a way to 100% eliminate T junction breakdowns, I will give you all my money to figure it out.
That's funny. Okay, so another thing I wanted to ask is, I know that you always recommend for your patients when you're going to do any breast reduction lifts for them. To get a mammogram. Right. Do you do that for all of no matter how old they are or above a certain amount of them? I would love to do it for anybody over the age of 35. However, I get a lot of pushback from insurance companies, from anybody between 35 and 40. It's an absolute must over the age of 40 that
you have to have a mammogram. I recommend it at 35, but let you know that if you don't choose to get it between 35 and 40, there's just a slight risk that we may be missing something, but it is very low. So that's kind of my recommendation. Do you think if somebody's insurance doesn't approve it because this question will come up. If an insurance doesn't approve it, do you think it's worth for them to pay for it out of pocket, to have it before their surgery?
Yes. It's really not that expensive. A lot of places have cash prices just go in ahead of time telling them you're going to be using a cash price. The problem that we often run into. Is that you're going into it with your insurance company, and then the insurance. Company denies it on the back end. So it's not as cheap if you're doing it that way, because then the radiology company and the radiologist charge
what they would charge the insurance company. Your insurance company on the back end says it wasn't approved, and then they don't price adjust. So a lot of times it's better to just go in there, tell them, I want the cash pay, and just pay it cash. Absolutely. That's correct. I think it's, like, $75. Yeah. The cost is so low. I always recommend for my girls, if their insurance doesn't cover it, to just pay for it out of pocket.
Now, that being said, if you're like a 20 year old girl and you're wanting a breast reduction, I don't think that a male grand is necessary in that case. Right. I'm thinking more for, like, my girls who are in their 30s. Like my mom's. Yes. Because, you know, I get a lot of moms, so my girls in their 30s who are thinking about doing the breast procedures. Okay. Yes. It is always best to know that there is nothing underlying there.
So before I let you guys off, the most important thing I feel is telling my girls what not to do, because it's almost like you tell them, okay, really don't do this. And Dr. Andrea, you and I have gone through some experiences with our patients, and one of those things that is always going to be on my mind and I'm always going to remember is one of our implant patients who went and got a tattoo, like, I don't know how, maybe like, three days after her breast augmentation.
And then what happened? What was it? She got cellulitis on the tattoo, and then the cellulitis spread systemically, and then she got an infection around her breast. Now, we were able to save the breast implant, but it did get a little bit firm. And I had to treat her with long term antibiotics, monolucas, some ultrasound to try to prevent capsule contractor. They did wind up softening up, and then I still keep in touch
with her to this day, and they're very soft. And that was about four years ago. Exactly. Um, trauma. But yes, there's a laundry list of things that you should not do after a breast augmentation. You should not go, obviously don't go in the ocean. I say that obviously, but I've had so many patients get in the water, and I did my training at UTMB so girls would get their augmentation, they're hot girl summer ready and get into Galveston water,
which is absolutely disgusting. Like, two weeks after the breast augmentation and have, like, a pussed out breast. In residency, we had to deal with breast infections left white and center around spring, uh, break time, but absolutely no water. No oceans. No sand either. No. That's another thing I was going to say. If you go to the beach, if you've ever gone to the beach, you find sand in the most odd cracks and crevices, even whenever you were like, oh, all I did was
stand on the beach for five minutes. That sand gets everywhere. What is sand? Sand is dirt. And so would you rub your incision with dirt? Absolutely not. Don't get in sand. You would think that you guys just don't go to the beach for, like, six weeks after your breast augmentation. One of our patients who was a nurse exactly, the beach who I'm thinking about and got an infection. Yes. And it was like a week or two after her surgery. And it's just she's like, uh, I stayed in my bra. I
didn't even get in the water. I just sat by the edge of the beach. And it still happened. It still happened. So that's why I'm like you guys. But yet there was a picture of her laying on the beach on that side that got infected. This is what happens when you have your doctors on Instagram. Kids are hugging your kids whenever they just got out of the ocean. Water that's still rubbing through your clothes, you're getting a little bit
wet. It's impossible to go to the beach and not get dirt or sand everywhere. Absolutely. Okay, so no beach and no water. Really? No sitting water? Yes. No sitting water. No getting your nipples pierce early after a brush augmentation. That is another thing that can just lead to problems. Piercings get infected very easily. I've seen a patient get their piercing infected because they got pierced, and then they went out into the lake, got in the
lake water. So they did all the things that you shouldn't do, got their piercing infected. Luckily, again, we were able to save the implant. There were. No problems, but all things that you should not do. The other thing that I see patients do a lot is they think I'm doing great. I heal super fast. I hear that all the time. It drives me nuts. You heal the same as everybody else. You still have the same restrictions as everybody else.
Some people heal slower than others, but you didn't heal faster than what the restrictions I told you are. So don't tell me you heal fast. And they start going back to the gym full on at about three to four weeks out from surgery. The problem with that is that you can be creating micro tears inside of your breast. Micro tears are these little bitty mix or tears as the capsule forming. And that capsule is so, so delicate and fine as
it's forming very early. And if you continue to get those micro tears or micro nicks, you're going to get capsuler contracture. Because as that scar tissue forms, uh, after trauma, after trauma, after trauma, that capsule will noted. Do you have any recommendations for people who are dealing with capsuler contracture as far as like, if they're early on, if it's already hard and stage, it's already rock hard recommendations? Yeah, early on, there has been a plethora of
literature written about it early on. The only thing that they really found that helped at all is using monolucas and high dose vitamin E. And then also I think there's maybe something to putting them on like a low dose antibiotic. Long term, uh, sometimes the risk is greater than the benefit for that. Monolucas is a relatively minimal side effect. So I definitely think starting that early
on, keeping with your implant massages. And most of the literature shows that it really only helps with what we call a grade two capsuler contractor, which is where it's just starting to feel firm. Once you've seen distortion of your breast and it's sitting up higher and it's really firm. Almost all of the studies have said that the only thing that's going to be able to treat that is
surgery. And so that unfortunately is going to be the reality is that you're probably going to need surgery by the time that something super noticeable. So I would recommend paying attention to your body. If it feels weird, if it feels different, go see your surgeon or go see another surgeon. They'll be able to give you some advice
on it. Be really aggressive about it early so that maybe you can prevent surgery and then if you have to have surgery, do all the things that you possibly can in order to prevent it from happening again. Because best case scenario, it's still pretty high incidence of it recurring. So some of the new things that we've been kind of talking about in plastic surgery are doing some things to
break up where that capsule would form. So putting in that mesh, that internal bra just to kind of prevent some of that scar tissue from forming all the way around. Seems to have some really good data from early studies doing that. So I'm definitely going to start incorporating that to my practice more often because some surgeons that I really trust have had good results with that. That's great to hear. That's really great to hear. So what are some other things that they do during surgery?
Uh huh. I'm learning stuff too. Not just your. Listener from, um, doctor. Andrea and Doctor. Andrew. Doctor Andre is my girl crush because she's so smart and I love listening to her because I know, I'm like, oh my God, I know. I didn't know some of that stuff for sure. You would have if you would have gone to the meeting that we just came back from. Okay, so on that topic, how is it as a plastic surgery couple, like both of you all are plastic surgeons? How was it going into this? How did you
all even decide, okay, you know what? We're going to go for it instead of joining a practice? How was the Oath plastic surgery even born? So Nandi was really passionate about wanting to start his own practice or Dr. BJ, and I was very nervous about it. It had been quite some time before or, uh, since somebody had basically gone straight out from residency and started their own
practice. There was not a whole lot of information as far as running a business that worked out in residency, but he was really passionate about it. So he was like, I'm going to do my own thing. You're going to join me or you're going to join somebody on the street? My competitor and I knew that, uh, we have personalities that very much balance each other out. He has amazing attributes and strengths that are my weaknesses and vice
versa. And so I was like, look, if anybody can do it, we can because we have a built in partnership. We have so much trust and love and respect for each other. If anyone can do it, we can. So we decided to do it. And luckily, it has worked out far greater than I ever could have imagined it would. We're five years strong now as far as our practice is concerned, like 13 years together. Um,
so, uh, it's been really great. We recently went through a big transition where we decided to take a step back from some of the business things that were mostly consuming my life. And I have three small kids, so I wanted a little bit more time to spend with them. And we've created this really great practice. And so we were able to merge practices with another husband and wife team, um, that are dermatologists, that have really built a great practice. And so it really made the most
sense in the best of both worlds. And now we are able to take care of our patients so well. Both from what Doctor Ouija and I originally brought to the table. But now with ancillary staff and with better facilities and then I can also take care of the patients or the people that are closest to my heart, which are my babies. Now you have more time to be at home.
I would also add that it was definitely like my desire to start all this thing but at the end of the day, it was mostly Dr. Andrew who was the reason the boat floated for two years. So I gave her uh, all the credit for that.
Doctor, we just something that I really love that you did whenever I was with you guys was that you have always placed Doctor Andre like on a pedestal and have really shown the light on her because you're like, this is besides that, she's my wife and my partner and the mother of my children. She's also a really amazing plastic surgeon and I really admired that about you when I met you guys because he was always talking about the spotlight. Always Dr. Andrew. Always Dr. Andrew. Everything
the best. Anything that it is, it goes to Doctor Andrew. She's the queen, the master of everything. And I think that's so beautiful in a partnership because as women like for Dr. Andrew, as a female plastic surgeon, she already has to come out the. Gate swinging to earn her spot 1000%. I think. Um, to add to what you said, the truth is that plastic surgery industry should be in theory, probably should have more female surgeons and it's 98% female patients just like OB GYN. I see this
future. I can always predict it. And um, we have talented female surgeons. They should rise to the top and they should stand on the top. She's the generation. And maybe to show that there's a lot of respectable female dr. Cash. Camille cash. Dr. Andrew. Of course. Dr. Andrew is in this new generation. Ah, and we're just super excited for the future and more doctors and more leadership
and yeah, it's been great. It's been having some foresight and knowing that is why we've been so successful and lucky and fortunate and even more fortunate to birds with elite and we're so thankful about everything that happened to us. It's been great. It's been um, a, ah, roller coaster for sure. Starting your practice, not really knowing like, okay, we're starting from zero because where they were, they couldn't bring their pictures with them. So it's like really
starting from zero and having that commitment. Dr. Andrea I had her busting her butt. We were busy. I had her in surgery every day. We were multiple surgeries a day. She was telling me, mommy, I'm tired. And I'm like, go to work, go to. Surgery. I would say thank you for saying that because you're right about all those things you said. But in addition, you have been a part of the journey, especially at the beginning of it all. So
that's why we're here on this podcast. That's why we'll always be a part of your life, because internally and forever grateful for being a part of that very like that startup mode where everyone the founders mode, metaphorically speaking, that you were there. And we meet a lot of young surgeons, and they ask, how do you do it? And the truth is, they don't want to know the truth. The truth is it's not fun. Really hard. Really hard. Not fun. A lot of work. You have to have grit. You
have to have passion. You have to really look at yourself critically and take apart every single result that you have and look at it through. You cannot tell yourself that you're great. That is just not going to make it. You have to tell yourself, that looked like garbage, even if it didn't look that bad, just to make yourself better and better and better. And then you just have to work your butt off. You have to say yes to a lot of things. You have to say no to something that's
unsafe. You have to do the right thing for patients always. And so that's how you make it. And I do want to say thank you so much for your kind words and saying that, uh, I was the flotation device or whatever. But at the same time, I do want to say that Dr. Luj kind of putting me on the pedestal, saying that future of plastic surgery is female. I think that's a huge attribute to him as well, just because that's the way that he treats women in general. That's the
way that he was raised. That's one of the reasons why I buried him. And that's the way that he treats his patients, too. And that's why he's also very busy, is because he has so much respect and care for women, and he wants to help them, not objectify them or anything like that. I will say that's another reason why we're so successful is that we truly keep the patient center and really important as well.
I cannot agree more. And Doctor we jay, we haven't really talked about what you're really good at and what you love to do, which is tummy tucks. So I know you have your signature tummy tuck. Why don't you tell me a little bit more about it? Yeah, I mean, I got into tummy tucks early, just to be honest with you. I had a passion kind of for Facelift. Two of my mentors were facelifters. And then I realized when you start your own practice, all these very elegant older ladies are not going
to come to this younger guy. So I realized my patient population is going to be more around my age, which resulted in more of a breast dog tummy tuck practice. And then when you're building a practice, you have to operate and do the patients that are safe, that you can do because there's just not faceless volume. So I started doing a lot of tummy tucks, and I realized that this was going to be a lot of my business, and I started fine tuning it to a point where obviously, like Danny
said, never be satisfied. But I do feel biased that Dr. Andrew and I in our practice, we give one of the best belly buttons in Texas, let alone the country. And so we feel, like, very passionate about that. When women have tummy tucks, whether they have a good result or a bad result, everything relies on the belly button, right? Oh, my God. Yes. You can have your skin cut off, and then your belly button looks bad, and then you can't wear a
toothpaste bathing suit. So every single patient on our Instagram, we have really cute belly buttons. And that's what we focus on. We have signature ways of doing it. We have residents. We teach them. Um, there's no secret. We teach people. And I just fine tune the tummy tuck to a place where I feel like we can get the most important thing for a tummy tuck, specifically, versus, like, a breast lift, because breastlift there's so many moving parts. It's origami there's
an implant. There's so many different sides of implant. I mean, there's such an individualized process for a breast lift and an augmentation like Dr. Andrew does, but with a tummy tuck. I think what makes us very powerful is that we do a result that can be replicated. And so it doesn't matter what size you are. You're going to have your version of, uh, the signature tummy tuck. And you can see that on Instagram. Everyone has different
sizes, but they all have the same result. And so I think that's one of the most powerful things about our practice, and specifically me as a tummy tuck surgeon, is that I'm not just showing you one out of ten teachers, I'll post anybody. I'm so proud of all the results. Not just showing you, like, the home run results. These are all the results are all the same. And we're very brutally honest
with our patients and consult. Like Dr. Angel says, we're always honest and truthful, and, um, we give them great expectations about the results. That's why our patients are super happy. Let me talk about the details of the exact results are very hard to kind of go over, of course, but. Yeah, a lot of my patients, when they're looking, they tell me whenever we start working together and I'm helping them look for their surgeon, wherever they are, they always, always tell me,
the belly button is the most important to me. My belly button has to look good. And they're like, I don't really care about anything else. Uh, a lot of them some of them don't care. Some of them are like, my most important part is the BBL or my liposuction. Yeah. So everybody's different but for tummy tucks. When women are looking for tummy tucks, belly buttons are definitely at the top of the list of why they go with a certain doctor. I do a lot of tummy tucks as patients come
specifically for our belly buttons. That myself and dr. Andrew do. You know, belly buttons probably is the tell tail sign of all tummy tucks. When you wear a bathing suit, you could have a great result. But if your belly button does not look good, everyone knows you had a tummy tuck, and it's okay to have a tummy tuck, and people know, but you want that belly button to look good.
There's so many different types. There's, like, a slit belly button, a circle belly button, a hooded belly button, a closed belly button on accident. So there is some patient preference to that and some surgeon preference to that. But ultimately, through our research, we found that if you look at supermodels and celebrities and, um, belly buns, all alight, all belly buns in a very fit person, tend to have on the top a hooded appearance that then dives into, like, a cave like structure on
the lower end. So through special techniques and design, during the tummy tuck process, we try to replicate that appearance, and we have special techniques that we do during the tummy tuck on the skin side and on the internal side to give us that particular result. Even though we do it the same way for every patient, people do get very similar results, but everyone has different fat, different thicknesses, umbilical, hernia scarring through
the, umbilicas, from laparoscopic surgery. So it's very challenging to have a very consistent result. That's why when you look at our instagram, you can see that our belly buns are very replicable for the most part, and we're very proud of what we do. We also use special devices and techniques within our belly bun, so as it's healing, we can keep that scar tissue soft and the belly bun open. And to help the belly bun shape into its specific ways, you should definitely there's videos online
that we can show you on how surgery is done. It would be hard for us to describe the surgical technique. It's something maybe a plastic surgeon would understand when we talk about it. But, yeah, we just appreciate the signature belly button so much, and it means so much to our patients and why we focus so much on making sure that we deliver a really pretty belly button. Yeah, and we have devices that help make it heal and stuff. They're not FDA approved on the market.
They will be FDA, uh, approved on the market that help make other surgeons have shapes that look good. But the main thing with the belly button is just if you do a lot of tummy talks, you just get really good at it. And I'm, um, basically a two trick pony. So if you do the same surgeries over and over and over again. You just get really good at that procedure. Yeah, definitely. Practice makes perfect. I would argue that obviously BBL is the most dangerous procedure, but
tummy talk is the number two. Or if you read the literature, in theory, the number one most dangerous surgery that plastic surgeons perform of all the surgeries. And so BBL kind of more, but really, tummy tuck is the most dangerous procedure. You can have pound for pound, and people underestimate how dangerous tummy tuck is. And so I think it's like a nothing burger. It is the biggest surgery you're going to have. And I
think it's important to go to surgeon. Does tummy tuck a lot, because we have very strict protocol. Our protocols for tummy tuck are so strict. We do all our surgeries in a hospital. We have overnight stay, we have ICU care, we have everything at our we. Don'T have to use the ICU care, but it's available. I'm explaining you to the level of care that we provide our patients. Like, this is not ah, we're at the same place that someone would have a triple
bypass, is my point. Right. And tummy tucks, the main risk of a tummy tuck is a deep vein thrombosis, which is a blood clot in the calf. And so because we have strict protocols, we do all the safe tummy tuck protocols and everything like that. It's also more than just the belly buttons. People want belly buttons. But you're talking about having tummy talks overseas. Uh, the truth is you should have a person who does a lot of
tummy tucks so they know how to do it safely. And not the surgery part, the postop. Care part, all of it. The post op care part, the hospital part. What I've found through my consultations that I have with women is that they're having these procedures, like, across the border. They're like back office places like, oh
yeah, we just showed up at this building. And, uh, the first floor was my consultation, and the second floor was my surgery, and the third floor was my recovery home place where I could have stayed. But then they don't even stay there. They end up going home. So they're having these facilities, some of these surgeries in places that they shouldn't be having surgery at. Hospital setting for tummy tucks, you're already in the spot where you would have to be if something were
to go to wrong. At least that's how I always thought about it. Yeah, for sure. And there's surgical facilities, like ambulatory surgical facilities that are great, who have great anesthesiologists, who have great protocols as well. It's not like you can only do it in a tummy tuck, but every doctor is different and you have to find the doctor. That what they're saying
resonates with you. So if you're hearing a surgery setting for, I mean, hospital setting for your tummy tuck and that resonates with you, and it's something that you want, then that's what you should look for. For a surgeon who does their tummy tuck in the hospital setting, if it's something that you're like, well, it's not really that important to me, then that's part of your
consultation and interviewing process. So you find a doctor that you trust 100%, and you know they're going to take good care of you. That's exactly right. And Dr. Andrew and I did tell me that the same way over time, we found some tricks and stuff here in this way. So that's been that's the best. Here's the other thing. The best part about Dr. Andrew and our practice and and not necessarily all group practice, but a group practice where there's so much camaraderie is that
we learn from each other. We teach each other. Today I went to her operating room and see how she does things. Like, you pick up things and you fine tune things, and everyone learns kind of what's the best way, um, that's education. We continue to grow. We don't stay stagnant. Yeah. And I think that's a really important attribute to look for in your surgeon. Are they going to meetings? Are they staying up to date with what's the newest technology and studies, or
are they really stuck in their ways? And they do things which also, like, for example, facelifts. If they are doing amazing facelifts, do not question anything. If they're doing great work and you see their before and afters and you trust their work and you trust them, follow them however they do their things, they, uh, have it down to a system, probably. That is such a huge point, mavi. Can I reinforce
that? Is that whenever you go to a plastic surgeon and you request them to do something completely differently from what they do, you're setting yourself up for disaster. If that surgeon doesn't do it the way that you want it done, and you're insisting that they change their ways, that should not be your surgeon. You should just go to somebody who does it the way that you want to do it. Because taking somebody out of their comfort zone, having them change it completely, is not
going to work well for either party. The surgeon is probably going to be frustrated, the type of surgery, and then they may not get you the result that you want. So it's so important, just let your surgeon do it the way that they want to do. Have some trust in them, or have that conversation for hand. And if you all don't mesh, then you all don't mesh. It's not a big deal. Just go to another surgeon. Yeah. You just find somebody who's the right fit for you.
And always what I tell my girls is, we do so much homework before we book with the surgeon that by the time we book with them, however they do things, we're okay with it. Like, we're good with however they do things because we have to trust now, we have to trust them that they're going to take care of us and deliver the results and the post office, how they do it, how they do things. Another thing that I kind of want to touch on because I don't think I've touched on it in any of
my previous episodes. But Dr. Andrea and I, we've talked about this and I know Dr. Weejay is very familiar with this too, about when you go see a surgeon and you are asking for something and if you are pushing your surgeon out of their comfort zone, what do you think is going to happen? M like, Dr. Andrea and I talked about this, where people are starting to do procedures that are unsafe, right? Like, how are we getting there? And the answer was the patient is pushing for these
types of things. Like, for example, I remember a patient calling me and telling me, like, I want there to be no fat when I pinch my skin, when I roll my skin in between my fingers, I want there to be no fat. And it was just like, huh, we talked about it and I definitely I'm not blaming patients. No, of course not. Should not say yes. But I think some surgeons just get trapped because it is very expensive to run an
office. A lot of plastic surgeons feel the need to kind of keep up with the Joneses and drive the flashy cars and have the flashy lifestyle and all that kind of stuff. And I find that surgeons are also very much deaf people and so they want to make people happy. So when they have these patients that are showing them before and after that they are probably filtered or at a certain angle and these patients are demanding, you have to make me look like this or I'm not coming to
you. And so I think that surgeons get trapped into pushing the boundaries too far and surgeons are the ones that are responsible for saying yes and not holding true to what we know to be safe and saying yes. And that culture just really needs to change and shift because it should be a culture of safety, not a culture of, um, trying to one up the other person's results. We need to deliver good results for. Patients first and foremost.
Absolutely. In addition, I think having we have a group practice and our group is going to be growing very soon. But having a group practice helps you not be on a metaphorical island. And so when that baseless comes that you don't do you have another partner that you're really close friends with and they're better at doing that surgery. Just like anytime someone wants an augmentation with an implant, I literally go, I
got great news for you. We got one of the best surgeons to do that and it hurts on the kids. Tomorrow I had that luxury to pass that surgery off to someone who does it better than me. And I think we're in a very unique situation where they had an option that was uncomfortable for them that they could pass it along. Absolutely. Dr. Andre and Dr. Weejay, I am so glad I got to have you guys on today. This is the first duo episode of many. I will bring you guys back on
when we can talk about so many other things. I don't want to go over our time, but man, before and after pictures and the fake stuff that is online on other plastic surgeons pages. Like, it's not uncommon. So one of our really good friends that we went to residency, he Dr. Nick Holland. I think that he posted some of his stuff before.
Yeah. Uh, he did a great little series one time where he did a bunch of before and after, literally somebody posing in a different way and showing how you can have this amazing before and after result by just posing or lighting something different. Yes. So informative. Such a great topic. So, yeah, we can talk about that later, but definitely go back. I mean, it's been a while, but Nick Holland
is a great person to follow. He's up in Utah. He's a great, great surgeon, a good friend of ours, and has done a lot of fun, uh, little, like, green, some of the salted and plastic surgery. I love it. I'm talking to his office about when we're going to be doing our episode together, so I'll keep you guys posted on that. He's so fun. You're going to have fun with him.
Yeah, I'm so excited. He's been amazing. I've already sent him, like, three or four of my patients, and they look so great, and they are so happy. They told me he was so amazing with his bedside manner and so kind and that they love their results. So I am very excited to have him on. Okay, so the one thing that I want to talk about before we get off this, because I have this written down, the importance of massaging after, uh, your breast augmentation. We haven't really talked about that.
We have not talked about that. We come full circle back to the breast stuff. And so I think that massaging is definitely important for keeping that capsule nice and loose. I am very strict on my protocol. I show my patients exactly how I want to do it. Every surgeon is a little bit different. I like to wait about a week just because I don't want to call it those micro tears or micro traumas. But again, every surgeon is very
different. So it's just important to listen to your surgeon and do what protocol they found to feed up for their patients. So your, uh, breast surgeon could give you instructions in, like, a post op instruction folder. Sometimes they hand it to you. Sometimes they give. It to you when you're leaving the surgery center. If you don't find it in your post op instructions, talk to your doctor's coordinator, talk to your nurse or whoever's
taking care of you and ask them about it. If you are like, three weeks post office and nobody has talked to you about your implant massage, talk to your doctor's office and get instructions from them on how to do it or how they want you to do it, but reach out to them. I specifically do not tell my patients how to do it before surgery because I don't want them doing it after surgery, because sometimes they don't reach
the word for word. So what we do in our office, we show you how to do it and go over it with you a. Week after your surgery. Okay, perfect. Also go to your follow up appointment. That's very important. Yes. Follow up appointments. Not just doing great. What drives me crazy when a picture. Is like, I'm doing great, why do. I have to come in? Because there are certain things that I. Need to check that you don't know you're supposed to be checking for. Exactly. And then whenever you show up six.
Months later and you're like, well, this isn't exactly how the way that I wanted it. And whenever I look back, you didn't go to a single post operative appointment. Yeah. There's probably a reason. Why there's, uh, so much that goes into this plastic surgery journey. Really. I think when
people go and they're like, oh, you know what? I'm going to go get surgery, and they decide from one day to another, and then they really don't realize what they're getting themselves into, like for tummy tuck recoveries or libo suction recoveries, or even breast augmentations, they think it's going to be a really quick, one done procedure, and it's really not. There's a lot of preparation for the surgery and recovery that really you can't
rush it. It's not quick, not a fast recovery, and you need to be patient with yourself more than anything. Okay, so before we sign off, dr. Andre and Dr. Ouija, I want both of you to give my listeners, if they were your sister, if they were your best friend, a tip on their breast augmentation journey. So maybe a red flag, something to look out for, something that they can do to make sure that their results last longer. Anything for mine? I will be having my guest
journey very soon. I've pressed that three kids and just need a little tweak. I'm like one of those people on the cusp of needing a lift versus not. But, uh, for me, it's important for me to have a lift. So my biggest suggestion and what I'm going to do for myself is I am m going to stage my lift and my augmentation. It's just safer. It allows for that tissue envelope to really peel down well without the pressure. Of the implant pushing against it. And then it also allows for everything.
To kind of settle out in that new, higher position, and then you can really take out your implant better. So I think staging the breast augmentation and lift if you need a lift is my biggest takeaway message for people. I would for your patience, just visit www.classics.com. That's my biggest takeaway. We'll take good care of it. I know, I know you guys will. I have loved have you all taken care of your patience. And one of the things that I love is that you guys give out your
cell phone number. And trust me when I say that I have been there answering messages with them early in the morning and the crack of dawn very late in the evening. Like the way you want your surgeon to be dedicated to making sure that your recovery is going well and that everything's fine. Peace of mind. Yeah, 100%. Okay, you guys, so that was it for this week's episode. Do you have something else to add? Thank you for having us. It's fun.
Yeah. I'll have you guys back again soon, and maybe by then, Doctor Andrew will have her work done and she can tell us a little bit more about it. That's like on the three year plan, mavi. Uh, in a rush. We'll for sure have you on before then. I have to decide, uh, who's going to do mine. That's the problem. Dr. Weejay, I think you should go to Doctor Cash. You guys getting scheduled for an hour of their time. Like, look at this call. You guys heard ambulances, you heard car doors
beeping. This is the only time I have one thing here that I don't want to forget to talk about, which is dental work at the same time as a breast implant and why not to do it. Don't do it. Don't do it. You have an increase. You have systemic infection which can microserv your implant. You may not get, like, an overt infection, but you can get, like, this low lying, undetected infection that leads to capsuler contractor. And we just talked about how tough it
is to treat a capsuler contracture. So why put yourself at a risk for something that's going to, um you don't know how many patients I've had to explore because they have had four capsuler contracture revision surgeries and they just keep getting a capsuler contractor no matter what all four disorders did. And so they just wind up explanation. A lot of them had implants that were way too big, put in their breasts beforehand, and now they're just left with, like, deflated bags and it's just.
Do everything you can to prevent a capsuler contractor. Do everything you can. So stay away from getting a tattoo. Don't get a tattoo for at least six weeks, maybe more. What do you think? No. Like six months. Tell me that you do not need a. Tattoo. Uh, you have your entire life to get a tattoo. You have your entire life to do a lot of things. You do not want to spend more time than necessary in an operating room getting your capsule removed. It's just not worth it. And worst case scenario?
Worst case scenario, you get your breast. Implant infected, and it gets removed. And now you have one boob implanted and one boob flat for, like, six. Months while your infection goes away. And then you get re augmented like that. And if you've had an infection now, you have an increased risk of getting capsuler contractor. And now you're just set up for disaster. So just do everything right the first time.
You don't wind up in no tattoos. No tattoos, no dental work, no nipple piercings, no beach, no sitting water, no working out, no heavy working out too soon. Anything else? Yeah, the usual. No spanos, no, um, aggressive adult. Time. No aggressive adult time. And also, for the love of God, this is actually this happened. Dr. Uh, Andrea, I didn't ever tell you that this happened from one of our patients that got an infected implant. But she told me in private that it might have been her husband's
dirty mouth, like, around on her nipple. That could have caused that infection for. Sure. Six months, and then two years to life. Six months. That's what I tell my patients. They're so eager to go, like, just give me three or four months of your life, and then they're yours forever just to take them right. That's all it is. And then they kind of, like, realize, okay, fine. I'm like, you can do whatever you want in about
four months. Just don't push anything. I mean, those things you should just tell patients, like, it's expensive to go back. It's more expensive to fix things than it is to do it. Just let yourself feel right the right first time. Absolutely. And when you go back in there, you don't know how the outcome is going to be. You don't know the layout. Things are different. Scar tissue is different. You want to get it right the first time, especially with breast, like breast,
uh, tummy. You got to get it right, because fixing it is a lot more expensive than doing it right the first time. Right? Okay, you guys, that's the end of the episode. Thank you guys so much for being with me, and I will see you next week. If you enjoyed this episode, please go on Apple. Write me a review. It's the best way for other women who are just like you, who need help, who are looking for information, valuable information on the Internet. This is how they're going to find
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Juice. You all know I have my Bruise Juice 30 coupon code for y'all to use if you're having a BBL, if you're having liposuction, if you're having a Tummy tuck, if you need to be using Bruise Juice all over your body, stop using those other brands that are not tailored for your post op recovery. Bruise Juice is formulated for your recovery. It's amazing. It nourishes your skin. It helps your fat transfer live. Don't sleep on bruise. Juice. Bruise Juice 30 is the code. And don't
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