Mother Knows Death Presents External Exams with Nicole and Jimmy. Hey everyone, welcome to this week's External Exam episode on Mother nos Death. We've been talking about plastic surgery and in the news over the past few months since we started the podcast, and I thought it would be great today if we interviewed an expert in the field. This is doctor Kelly Colleen. Hi, welcome to the show.
Hi, thanks for having me.
Doctor Colleen is a double board certified plastic surgeon in Beverly Hills and she's also appeared in multiple news stories, podcasts, and TV shows, including her own, which is Doctor nine O two one. Oh. So that is super cool and we'll get into asking you about that experience later, but before we die, I've been too all that. I want to first start out asking you just about how you got where you are today. So did you always know that you wanted to be a doctor?
So I actually didn't. My parents are both surgeons, and.
I think for that reason, I wanted to be.
Everything other than a doctor. And one summer when I was in college, I was home for the weekend. And you are not allowed to do this now, this is very many decades ago. My dad was like, because I was, you know, bored at the house in the house board, and he said, hey, do you want to come watch a surgery? I'm doing aneurism or care. And so I went to the hospital and I got to be an observer in the operating room. I was just hooked. I mean, nothing I have ever seen was as cool as that, and I just.
Knew I needed to be a surgeon. That's so cool. Did you think, oh, my dad's so cool, Like you never really realized what he did until that day. I did.
And I think you hear all the words at home, and you know, you just never think your parents are cool when you're a teenager.
Of course, but yeah, and it was. It was awesome.
And my my boyfriend at the time came as well and he passed out.
And I was like, what are we why?
I'm like, you're wame. But yeah, it was just a cool experience and it kind of set me in the path.
I'm in now. That's that's so great. That's I love hearing people's stories. It was a similar thing with me because when I started working in the hospital and everything, we were allowed just anybody was allowed to go view all top season Unfortunately, it's not like that anymore because that's how a lot of people get there. They're like, Okay, I want to do this for a living, and that's where they get their passion and drive from. And it's just different than watching it on a video or just
hearing about it for sure. So, so you started medical school, and so when you started medical school, you knew you were going for surgery. That was the plan. Yeah, I love surgery. I wasn't.
I didn't really have strong ideas.
I knew I.
Always liked plastics, but I'm I'm one of those students that I love every rotation I'm on, and so I had a little bit of a hard time figuring out what I wanted to do because every field of surgery was so amazing. But there's definitely a surgical personality, like looking back on my friend group, like you know early on, like who's destined for medicine and medicine subspecialties.
And who's destined for surgery. So once you were through with medical school, then you did a residency in surgery, and then when you started that residency and surgery were was that just you didn't really have it pinpointed yet, Like when was the time that you said, Okay, I'm definitely going into cosmetic surgery.
So I've always had an interest in plastic surgery. And I think you have to decide by about your fourth year because that's when fellowship.
Applications go in.
So in I did a full general surgery residency first, so that's why i'm double board certified. It's both of my boards or are recognized boards, so general surgery boards, the American Border Surgery. And then I did my fellowship, so I had to decide by fourth year. And the specialty that I had a really hard time, like going back and forth was vascular versus plastic surgery. I just loved vascular surgery too, but I think for my personality, plastic surgery made more sense.
That's cool, So I think in an important point to say is that if you decided right now that you didn't want to be a plastic surgeon anymore, you could go do other surgeries because you're a board certified surgeon first, correct, right, So I could like go and get privileges to do lap Coli'S her ny repairs and take call.
At a at a hospital. I loved my general surgery training. A lot of plastic surgeons. Most plastic surgeons now don't train in the way that I did. They have now transitioned most plastic surgery training to a shortened program where you do less general surgery and those years are more focused in things applicable to playtics, and so it's kind of an accelerated track through it. Most people don't realize this, and I didn't realize this until I started working in
the hospital. Just how long it takes to become what you consider a doctor, somebody that is working and making good money. And they don't realize that when you're in your residency and your fellowship you really don't.
You don't make a ton of money. It's just kind of enough to get by. But how old were you when the day you started college versus the day you were able to be a real doctor. So I was a little young starting college.
I was seventeen, and I've finished all of my training and was set free to be in attending when I was thirty three.
Yeah, that's really amazing. A lot of people just don't think of how many years of your life that you have to dedicate to that. It's a lot. Yeah, it's it's really cool. So we already went over the double board certified thing, which is cool, I think. I I always like to give that advice to no matter what level of education you're at, that you could if you actually start working and hate what you're doing, that you have kind of a fallback. So I think that that's
cool that you could do the two separate things. And this way, if you just started doing cosmetic surgeries and you were like, this isn't for me, then you have a backup, and that's good at any education level. A few weeks ago on the news, we talked about Black China.
I don't know if you're familiar with her, probably you are, and we discussed that she was getting all of these cosmetic procedures, not only to dissolve fillers in her face, which by the way, she in my opinion, she looks a thousand times more beautiful now just being a lot less of that stuff, but she also discussed that she was having complications from her breast implants. And I think
we hear a lot about people getting breast implants. It's correct me if I'm wrong, but it's the number one cosmetic procedure in this country, at least one of the top.
Yeah, LiPo such and breast augmentation. Uh was it breast reductions?
Yeah? All right, So I want to get into that because I think we hear so much about all of I mean, all of these people we see that are celebrities and everything. It seems like so many of them have breast implants, but we don't hear too much about the complications that could come with breast implants. And for her, I believe she had like capsular contraction. Can you explain to us a little bit what that is? Absolutely so, and I totally agree with you.
I think one of the biggest things that we have screwed up as a field in plastic surgery is breast implants and educating patients that are getting them.
So, breast implants are not a lifetime device. They are.
We have known this for a very long time, but unfortunately patients are still to this day not commonly told that. And in addition to having a device that requires maintenance, it also requires imaging for watching it and if you have silicone implants, and we just have not been good traditionally at telling women this. So one of the complications that you can get from your breast implants is something called capsular contracture.
And so anytime you put a foreign.
Body in your body, your body recognizes that it's not you, and it walled off with a scar tissue sack. And we call that the capsule. And that's the same for and you've seen as in autopsies, for peacemakers and hip replacements, any type of foreign body, you get a capsule. Now, if the capsule becomes inflamed and sickened, it has the ability to compress the breast implant in a way it can't compress other like fake things in your body because it's soft. And so what ends up happening is your
capsule can make your breast implant firm. That's the first stage. It can make it look weird, that's the next stage, and then it could also make it hurt, and that's the final stage of capsular contracture.
Now, this used to.
Be much more common. You know, twenty years ago the rates were fourteen and some of the fourteen percent of patients in some of the older studies, newer studies, because we know how to prevent it in a lot of patients, it's about one percent in cosmetic patients, which is a huge improvement for women and so basically, when you have this tight scar tissue, like I said, not only does it look weird and seals yucky, it can really hurt you.
And the other unfortunate thing about cancer contracture is we have now identified an exceedingly rare cancer, but it's still a cancer that can come from long standing contractures, and it's called a breast and planet associated swaymouth cell. And we've known for years that sway miss cells come from areas of chronic inflammation like stolach ulcerers in burn wounds, and now we know chronic inflammation around breast implants can
cause cancer too. So it's actually a really significant problem that what women need to.
Take care of. Yeah, I think that's interesting. And I do remember, obviously, like I have this life before I ever worked in pathology, and then working in pathology, so
I just have totally different opinions on everything. And I remember some of my friends saying they're going to get breast implants and they're in their early twenties, and I would think, like, you know, you're going to have to get them replaced a couple more times in your life when you're a sixty year old grandmam or you're gonna
feel like getting your breast implants replaced. And I've seen that with other things like IUDs and stuff like getting them from eighty year old women that just never got the last one taken out, that you just don't feel like dealing with it anymore when you get older, you know. And yeah, just so many complications seen with any foreign
bodies is just a thing. I've even gotten, like the old school silicone implants that have leaked in a capsule that are just sticky glue everywhere, and it's just terrible. And it's good to hear that the technology is improving. I do see on your website you have a lot of before and afters of implant removals. And are these people getting them removed and not getting them replaced or is it a swap out. It's a combination.
And in general, most patients these days that I see for implants, they want their implants out. I think it's a combination of reasons. You know, the esthetic is very different today than it was twenty thirty years ago, and so women when they were in their twenties got very large, disproportionate breast implants and that doesn't age well with you in general. When you're yeah, you can wear really tight things that show your figure out and you know, enjoy
those large breast implants. But women when they're older don't love to do that usually, and so for things to fit the top, it doesn't fit the bottom, and it makes you appear larger than you are, and it's also uncomfortable. So a lot of women have kind of aged out of their breasted liss. There's also a population of patients who just didn't realize there was maintenance, and they're like, I don't want to deal with this, just get them out of me, and I want to be done with this.
I just want my body and I don't want to have to watch anything.
And then there's also patients that are that are a smaller percentage of my implant removals that just they think they're implants are causing health concerns and so for that reason they want them removed. All right, So let's touch on that a little bit more. I think you're referring to breast implant illness. It's a thing that's been really popular over the past.
Ten fifteen years. I guess you would say, what is that has that been scientifically proven to be a real thing. Yet is that something that you believe is a thing. So I absolutely believe it's a thing. We don't have a lot of good data explaining it, if that's what she means. So basically, you know, the kind.
Of the history of this problem is that in you know, the nineties, women were saying, Hey, I think I'm getting sick for my implants, and the lawsuit started flying and the FDA shut the whole thing down, pulled them from the market, and there was, you know, more than a decade of additional testing on them. But what we what we know is that some women just don't feel well
and get sick and get symptoms with breast implants. There has now been over one hundred and fifty symptoms associated with breast implants, and there's just no disease, no single disease that has that variety of symptoms, and so we
just don't understand what's going on. And so for years, plastic surgeons, mostly men, we're telling patients you're crazy, get a boyfriend, you know, like stupid things like that, and so women became very distrustful of the plastic surgery community, and this, unfortunately allowed people to pray them, and so there became this big community of women with their you know, special experts with no scientific data to support what they're doing,
recommending a variety of surgeries like removing the implant with the capsule tissue in one piece and things of that nature. And so in recent years as a community, and I think this is a very seamal driven think because a lot of the head rees are the big researchers on these studies or women, We said, hey, we need to figure this out.
This is a real thing.
Women aren't crazy, they're not stupid, and we can't let these people pray on them, doing non evidence based things to them.
So there's been some studies.
Now and what we know we don't know what it is, but what we know is that women with breast implants don't have higher heavy metal concentrations in their tissue. We've tested them now in studies against women who have never had implants. It doesn't appear to be autoimmune. We've looked at autoimmune markers in these patient populations. We now know that removing implants and women who believe their implants are
making them ill, about two thirds get better. So we know that implant removal is the right thing to do in this population. We also know that removing the capsule tissue does not increase their chance of getting better, and this has been shown in several studies in several countries now in good studies with control groups, you know, et cetera. So we're learning. We don't know enough, and so the
research is ongoing. We also know it's not silicone because women with saline implants that don't have silicones found in their capsules have equals sometimes higher rates of breast implant illness symptoms. We don't know enough, and so we're continuing to study this entity. I think, you know, I take care of.
My practice is primarily.
Breast you know, hundreds and hundreds and hundreds and hundreds of women a year, and it is not something that is common. And it's in those groups they believe it is because it is a self selected group and so those patients find each other. But in the general population, a vast majority of women in THISS has shown in
studies as well, are happy with their breast inness. So I think it's like any risks when you have a device, you need to understand that this is a possibility, and you need to choose a surgeon who will believe you, trust you, and help you through it if you do develop problems.
This is really interesting to me because when you're doing the studies, is it because some of the symptoms I feel overlapped with something like perimenopause and stuff like I'm like at that age now that I'm going through, like just feel like a lot of things are changing with my body, and if I had implants, I'd be like, Oh my god, that has to be it. It's that's
what's causing me to have this problem. So you are testing groups of people that don't have implants versus implants and seeing that there is a correlation with the implant versus just like changes of life as you get older.
Yeah, there's a lot of overlap with the symptoms of women with symptoms from their breast implants, where the new terminology is SSBI systemic symptoms from breast implants, And that makes all of the studies and the diagnosis even more confusing, and so patients will often come to us. There's been some studies that have shown when influencers are prominent, people with big followings discussed that they have symptoms from their breast implants and remove them. That requests for implant removals
go up significantly in plastic surgery offices. So there's a lot of awareness about this now online where there wasn't before.
And so it's really important as a patient and doctors taking care of patients that you don't jump to the conclusion like you said, that it's the breast implants, because there's a lot of different medical problems, some of which are serious and required treatment that can cause similar symptoms, and so these patients deserve the same cautious, evidence based care that we give every patient that comes into our office.
So when you take a breast implant out, is it kind of like a deflated balloon almost, that you have to do a most reconstructive surgery because the skin is stretched out where for so many years when they had an implant.
Absolutely, And it's so implants do a very characteristic thing, So they are the most projected in the middle and then they kind of fall off to the sides, and so they stretch the skin and tissue and thin it the most in the middle of your breast, right under your nipple, and then less and less. And so when you take your inplant out, your breast is going to
be wider than it started. There's kind of a mountain range of breast tissue and then often a flat or even sulken area in the middle, and so that does require some reconstruction, and it really just depends on the individual patient. The skin, believe it or not, just think of pregnancy will retract if you just give it time, and so it's often a good idea to not do too much at the time of the removal and just see what your body's gonna do, because it can save yourself having a lift later.
Okay, that's really interesting. One thing that I want to note that you just mentioned was about male doctors kind of telling women that they were crazy, which is a common theme that we hear about all the time on my Instagram and in the gross room and on this podcast. But I know from your website that you said that only fifteen percent of cosmetic surgeons are actually female, which I think is kind of is kind of ironic considering
most mostly women get cosmetic procedures. Correct, there's more women that get them than male. Yeah, so why do you think that.
Is Surgery is still to this day a very male dominated field, and I think things are changing. You know, our medical school classes across the country are over fifty percent women. Now, surgical residencies the numbers women are better represented, but we are still not there yet. And so as the years go on, we are going to get closer and closer to things being equal, but as of right.
Now, it is not.
And the studies with women in surgery in general show that our outcomes are superior. And men get very upset about this. I tell them don't, because it's not. Women are inherently better at being a surgeon. We have qualities that make our patients do better, and instead of looking at it like some kind of slap in the face, look at it as a learning opportunity. You know, one of the big series is that women who go through you know, medicine have the quality of good communication because
women have great communication skills. So that means that we're educating our patients about what to expect complications, we are educating them how to behave when they leave the hospital, and that leads to less complications, less returns to the hospital, and those kind of improvements in their outcomes. So I think it's similar when I talk to my male colleagues about how when you look at the data for physicians of color versus white physicians and caring for patients of color,
they have superior outcomes. And I don't lose my marbles and go, no, you don't.
I immediately become.
Curious and I want to know why, why are you getting better outcomes with patients who are the same culture, background, ethnic groups you? And that is something that I think we all can work from each other. And that's why diversity in medicine is so important.
Yeah, I mean, I agree with you. I always think about that with just men in general, Like you just will never understand what it's like to feel shitty for a week of the month because you have your period,
Like your body feels good all the time. Ours doesn't, And there's all this it's not even just like physical pain that you feel when you're going through your monthly cycle, but also all of the change in hormones and the emotions and everything, and it's almost like you just can't talk to somebody sometimes it does have a similar life experience as you. You you can, but you can't sometimes.
I feel like, so that's really important. That's why I always prefer having I would prefer having like a female. They when you call to make your gynocologists appointment, they say do you want to mail or female doctor? And sometimes I feel like, well they might understand more what I'm going through that that's just something that I've noticed. Hey, guys, this episode is brought to you by the Gross Room. Starting on February ninth to February twenty third, the Grossroom
will be on Salt for only twenty dollars. For the entire year of Gross you will have access to celebrity death dissections, high profile death dissections, thousands of videos, photos, articles, all the way dating back to twenty nineteen. You definitely need to join this Valentine's Day. Please go to the grossroom dot com for more info and sign up. Okay,
let's get into some juicy stuff. Have you so obviously you've seen such crazy surgeries people have had, and oftentimes I think, like, what surgeon would even do this surgery on a person? It seems almost unethical to me. Have you ever had people come in and ask for something so outrageous and you've had to tell them though?
And that actually happens on a regular basis, And so I think with social media and the internet being what it is. People have access to a lot of information, and patients often have this idea that surgery can make you look any way you want. So they come in in the it's almost like a drive through where they're at a fast food restaurant. They're like, I want this, this, this, this, this, and they have a bunch of of sings that they want. And so my job is not only just to be
a practicing surgeon who does the surgery. I need to educate them and help them and we make a decision together about what the best course of action is. So yes, I say no all the time, the unfortunate reality of life. And I tell patients this when they come into my office and I can see in their eyes they're going to go somewhere else. If you wave a credit card around,
someone will take it. And so what you want in a surgeon is not someone who just will take your credit card and give you anything you ask for, because that is no one should ever want that. You don't want a yes n'am. You want someone who will be honest with you and help you through decisions instead of number one making them for you or number two allowing you to make decisions with no input especially when they're not necessarily a great idea.
So you see people all the time that have normal concerns, like their breasts are sagging or something after childbirth, and that's and then I feel like there's this other line of people that have something called body dysmorphia when they look in the mirror and they're not seeing what everyone else is seeing kind of thing. So, do you have
some kind of ethical obligation? I know you're saying other doctors, if they take a credit card, they'll do it, but just from your board, certification and everything, is there some kind of I don't know where you would exactly draw that line, but I've seen women get in these insane size implants and then them rupturing and just looking at it, thinking, how could a surgeon ever look at this woman and think that this was this was going to be safe
for her. You're putting her in a dangerous situation and she doesn't even really realize it as much as the surgeon would. So do you have some kind of ethics or is it just to your discretion? Like you could do whatever you want.
Basically, it's really to your discretion. It's you know, it's hard, you know what I learned is we would say people do things in poor taste or good taste, but I think that there's really not good or bad taste.
There's just taste.
And so some people have a taste for things that are very extreme, and with that taste becomes more problems in complication. And I think that some of these patients who take it to an extreme, they have something from a mental illness standpoint going on that is leeting them there. Now, I don't know if it's true. Body dysmorphia. You know, body dysmorphia is a real diagnosis that it gets abused by the media either like Kim Kardashie has body doesswork.
It's not body dysmorphia. Body dysmorphia isn't someone choosing something for their body that you don't like. Body dysmorphia is someone who has a hyperfixation on a body part. They spend an hour to two hours more a day trying to camouflage it, staring at it, worrying about it, and their concerns are really out of proportion to what's happening in reality. These patients that do repeated surgeries, extreme surgeries to their own detriment is a different issue, and I
actually don't really know. It would be interesting talk to as psychologists or psychiatrist about what they think about these people. But I think you do have an ethical obligation not to harm people, and you are objectively harming people. And no matter how much someone tells you they understand risk,
you don't have to be part of that risk. So if someone comes in and they're willing to do something that could be petitionally fatal or have a bad outcome, or change their life trajectory for the worst, you don't have to be part of that. They can have that and want that, and you don't have to be part of it. And so, you know, I think all of us should be saying no to people if we think they're harming themselves or their bodies.
So, speaking of extreme plastic surgery, there's been this this one TikTok account that's been rotating the past couple of weeks of this guy. I don't know if you sud to him.
Yeah, I get tagged at it five times a day for my followers. If it's wild. I have like I'm a weird blastic surgeon because I struggle a lot with some of the things we do. I have a young daughter, and I think I have no problem with people making decisions to alter their bodies in ways that bring them joy. But I think when you're trying to erase who you are and become something or so different, it makes me
uncomfortable and it gives me pause. And this plastic surgeon is doing of surgery on people, and the incisions are not placed well the patients, Like if you see they're not moving their faces properly in the after photos like this is very extreme facial changes and there's no long term photos, and there's people in the comments saying like the photos are great, nobody would go to them and like where are they? Then, if you have great six month photos, you would put those up. You wouldn't just
put immediate post off photos like he does. So it's very concerning. And you know, we're seeing more and more extreme things like this where people are altering their bodies in ways that are not present in nature, and I don't think this is an area that we should be jumping into.
For my feel I honestly have an opinion about that particular guy that those people are either they're doing it either against their will or they're getting paid an insane amount of money. The reason that I think that is because when you look at their before pictures, they don't look like some of them. They don't look like they ever cared about what they looked like a day in
their life. And then all of a sudden, you know what I mean, Like, it's not a person that's had multiple face lifts and wants to get more and more and more. It's like people that look seventy five years old that never had a surgery or anything in their life, and all of a sudden they want to do something this extreme. Is he is he almost doing the procedure. Looks like he's almost doing like a face transplant on the person, like completely removing their face and then putting
it back on. It really does.
I mean, he's got a hairline incision that's placed too low. He always had incisions in front of the ears that go behind, so a full facelift. I it's I don't know exactly what he's doing. He's you know, he's got very exaggerated kantapexies where he's pulling the eyes up very very aggressively at the sides.
It's their ears looking sane. Did you see their ears are like flipped upside down. I know, I was like, what is this guy doing?
I'd be curious to find out what exactly he's doing and then you know, run screaming from it. Never do anything near that in my entire life because it's it's so unfortunate.
Well, he's not practicing in America. I don't believe either. So there's that I don't know what standards wherever he's living. But there's also some other ones that I've seen about women, like removing their ribs to have a trimmer wasteline, and that is something that's done here correct here.
And there's a plastic surgeon. He's pretty prominent on social media and he's a real plastic surgeon. He doesn't I you know. To me, it's I don't ever want to do something that is worry. Cosmetic surgeries have amazing psychologic impact. They make people feel good about themselves and enhance their lives. But I never want to do a surgery that puts you at risk from a health standpoint. If I can, if I can, and people are just say President one not is relaxed. When you remove rids, you are now
taking away protection from your livery or spleen. Your ribs have a job, right, They're doing things, and so I don't love that idea. You know, you can ask yourself other things we do have potential risk, but I think that's a potential risk I don't really want to delve into.
So, speaking of these famous social media plastic surgeons, I actually went to one doctor Miami or Michael salshollower I love. I loved my experience with him. I went there, his office was super professional. Everyone that worked there. It almost was like what he was portraying on the internet and what was happening there was just so professional. It was just it was really it was just a great experience overall. But I've also heard horror story. So one of the
news stories that we talked about was Jackie Oh. She had died from having a brazil like a Brazilian butler slash Mommy makeover. And apparently she went to one of these clinics that are pushed all the time in Miami, specifically that are pumping out these Brazilian butt lifts for
really inexpensive and they're doing multiple procedures a day. And there's also a surgeon, her name was doctor Roxy, who had just lost her license right from doing videos because they were able to prove that a patient had complications because she was kind of it looks like she was doing liposuction and staring at the camera and not even looking where she was putting the canula. How do you feel the internet has both helped and hurt your field?
So, you know, there is it's a hard it's a hard subject.
You know. I'm on social media and I enjoy it.
I try to focus on educating patients and I do silly things and funny stuff here and there, but I try to not do it with I do not do it with patients involved. I think that social media is a very powerful tool for patient education. It's a powerful tool for driving patience into your practice. From a business standpoint, the problem is is that not every person handles social media well. And so there are plastic surgeons with monster followings that are wonderful at social media and they also
maintain their ethics and take good care of patients. And then there's also plastic surgeons that don't have that skill, and doctor Roxy seems to be one of those people. And to be clear, she didn't lose her license because of social media. That made the news stories more solacious. She lost her license because of horrific patient care. And I think that needs to be clear, is that you know she from I don't know her personally, but I
know people who train with her and know her. And she was a wonderful surgeon and did wonderful work in her residency and in her younger doctor life, was very well respected and liked and even in her early life. And I think she's someone who just seeings that social media changed how she cared for patients. And that is if that is you, the following is not worth it. If you are someone like to you, who is an ethical, wonderful surgeon, he's funny with a huge following, then yeah,
social media is wonderful for you. But sometimes it's hard to self reflect and though is this helping me or is this hurting me? In doctor Roxy's standpoint, it really obviously hurt her because now she has lost a career that she worked. Like I said, how long I worked? That fell long she worked to get there. She lost all of her youth training in plastic surgery here practice anymore, which is awful. It's it's it's just it's it's a tragedy.
All around. It's a tragedy for her family, It's a tragedy ten times for her patience families, and it should have never happened in social media. Was certainly to see that that grewm that situation. I think we plastic surgeons, we have unfortunately allowed cosmetic surgeons to take the lead on social media, and it's hurt our profession. It's allowed people who aren't properly trained in plastic surgery to develop
reputations that potentially harm people without proper training. I think that we should have jumped on it sooner, But we do need some kind of better ethics or understanding for how we should behave because I don't think all of us get it right. Yeah.
I think in general, the social media thing kind of creeped up on everyone, and everyone just jumped on it, and now we're all stepping back and saying, wow, maybe it's not a good idea to post pictures of our kids online and just get actually giving training to kids in high school just because you could ruin your life just by posting things that might come up later and everything.
But I feel like no, especially us, like when I didn't even get a phone until I was twenty some years old, like a cell phone, you know, social media not until I was in my thirties already. So I lived a lot of my life not knowing that world and then jumping onto it. I was an educator on how to handle having that amount of attention and followers and stuff within a short period of time, and I think that I think a lot of people don't know what to do with that either. So, yeah, it's intoxicating.
You know, you wake up and you have a million comments and lights and attention and your followers. Though up, I completely understand how that can be something that's intoxicating, but you have to It's it's like an addiction in some ways. Right, It's like some people can drink alcohol and be fine and other people have that genetics where it goes too far. And I think social media is a similar problem.
Yeah, I agree. Okay, have you ever done any surgical You don't obviously don't tell us any names, but have you ever done any procedures on any celebrities? I for have, And that's so that this is interesting to me because I when I worked in the city, we used to have we had like people from the Eagles come in and the mayor, like all these famous people will come into the hospital and they put them in this special suite and they gave them fake names, Jane Doe, John
Doe it was. And we would just get a phone call, We're gonna have a frozen section come down on a VIP. That was all we knew. They sometimes we wouldn't even know the person's name because they're just too afraid that it's going to leak to the media somehow that they're getting treatment at a hospital. So when you have patients that are more VIP, especially when they're not very open about getting plastic and cosmetic procedures and things, what do
you do in that circumstance do you have to? I mean, I understand HIPPA exists, but people break it all the time, right, So how do you ensure that these celebrities can kind of come in and out of where you're doing surgery and not get caught so to speak.
So I am well versed in celebrity surgery because I treated seer signing. So when I started, when I started general surgery at See Your SIGNI we signed a agreement this big and they had basically every celebrity was like at the time. I'm sure it's different now at higher tech, but there was a pager associated with all the celebrity charts, and every time they were accessed, someone would check and
see if it was appropriate access. And you were literally fired off a spot at Sedars if they found you in a chart. And one of my friends was actually that happened to him. He was doing research and he properly opened a patient's chart who was a celebrity for a project that he was doing, and was immediately fired and it took a couple of weeks to get him back on staff. So that's how serious theaters sign I takes things, which is why you rarely have leaks for Cedars.
I'll tell you that celebrities get some of the worst care I've seen in medicine because people do weird shit for them, and I decided early on in my career that celebrities would not be treated differently. In my practice, I do not shut things down. I don't come after hours. I don't do weird stuff because I want them to get the best, high quality care that all of my patients get. I don't believe in VIPs, so in my
personal practice, I don't do anything special for them. Other than I will obviously, we change their names often in the computer, so they have that as an extra level of protection. And we always can accommodate people if they're trying not.
To be seen coming in and out of the office. But other than that, I don't do.
A whole lot, which you know, I think celebrities are funny. Some celebrities really really want to be treated differently, and they're never going to find a home in my practice, and you will find that elsewhere. But I think a lot of celebrities actually appreciate being treated like a regular human.
I huntred percent believe in what you're saying about the
VIPs getting the worst treatment. I've seen it in real life at the hospital for example, Like if they would come down and tell us, I don't even know why they would tell us that we were getting a VIP specimen, because we treat every specimen the same exact way, and in fact, we would do things like normal things that are considered procedure to do a frozen section on like what is appropriate for frozen section versus permanent section, and they would be like, oh, we'll just freeze it, and
we would like maybe we shouldn't do that because we might ruin the tissue. And but they want to give the answers right then and there. And then when you when you skip procedures, that's when things get screwed up. And every week in the gross Room, I write about celebrity death dissections and high profile death dissections, and I really go through their autopsy reports and see, like what
caused these celebrities to die? And every single time, it's because they were getting some kind of extra treatment that is not normal protocol, whether it's showing up at their house giving them drugs they don't need, whatever it is giving them surgeries they don't need. And it's it's just interesting that you say that because I have a thing that I say, like the VIP treatment is the worst treatment. It's it's just really interesting that you see that from
your perspective as well. Yeah, I've seen plastic surgery, general surgery, I've seen it, every specialty. You know, if you are a celebrity listening to this, just you want normal, evidence based care. You don't want something special, because special is never better. Yeah, I one hundred percent agree. I saw on your website that you have some other kinds of medical professionals working for you, including pas and nurse practitioners.
I do. That's that's cool. I love. I love to hear that because I always you know, some people listening to this might right now might say I can't go to college for fifteen years or do training for fifteen years, But there are lesser degrees you can get and still have a place in your field. So what are some things that they're able to do in your field and what are some of their limitations because of their education? Sure, so I shout out to Amy and Christina. Amy is my nurse practitioner.
Christina's my PA, and they are their mind because they're part of my team, not because I busness them. People always get mad at me on social when I say that, but they're both.
Exceptional and this is what they do in their role. So Christina my PA.
She actually has experienced in the emergency room like you, right, I believe, and she did orthopedic surgery before she came in worked with me. So her role on my team is she hangs out with me for new patient consults and helps me take notes to make sure I get all the charts correct. She is the queen of my preop evaluation. She's the one that will be in the room with you for an hour or two hours, however long you need, so that you understand clearly the surgery
and the post op requirements. And then I come in, you know, and at the very end, and patients never have questions because she's so exceptional and answers everything so well. And she assists me in the operating room. So she is my first assist in the operating room. And it's amazing it surgery is so smooth. When you have a good you are only as good as your assistant in the operating room. So that's Christina's role. So she doesn't perform the surgery by herself. She's assisting me in surgery.
But so that's really the main limitation. But I think she has a really important role. She helps me keep my patients safer and she helps me get them out of the operating room fast, which is safer for patients. And she's just exceptional my nurse practitioner, and this is a unique role in my practice. Not many people have this.
She helps me taking care of patients post up. So we have a like an encrypted testing system and we hook patients up directly with her, and so she is immediately available for them for the first month after surgery to help them with anything they're concerned about. And it
was interesting for me. I think I'm a very good educator, and patients would rarely call me at night or after hours, and I was like, cause I'm so good, And as soon as we hired Amy, there was a million calls and I realized that no matter how friendly, nice and lovely I am, there is a power dynamic. I think patients are act comfortable bringing concerns to me, and it's been really wonderful for patients because they have someone who's a little bit separated who can help them with you know,
why is my dressing have blood on it? You know this list looks swollen? Am I supposed to be bruised? Here is my leg's supposed to it?
You know?
Questions they weren't comfortable asking me, They are comfortable asking Amy, And then Amy can help alleviate their anxiety because I always say anxiety.
Is the enemy of feelings.
So both of them have a very important role in my practice and they just allow me to take better care of patients. Both of them also do some laser and aesthetic treatments, so lasers, fillers, botox, that kind of stuff.
They don't full time do it. We do have a.
Nurse practitioner in our practice who does That's all she does is non invasive treatments, but the two that I primarily work with just dabble in it with my patients in addition to other patient care things they do.
I love that actually, because I because I've been a patient before of cosmetic procedure and you always think, like, is this normal. I don't, but I would ever want to bother the doctor with certain things. And I remember when I when I came home from my trip because I had to go to Miami to get my surgery. And when I came home, I went to pet my cat,
and my cat bit my hand. I guess she was just pissed that I had left her for like a week and that was the only time I ever left her, so she just I don't know what happened, but I just went down this rabbit hole of like, oh my god, I'm healing from the surgery. What if I get some weird bacteria infection in my hand? And I went back and forth, and I was like, ah, should I call all right, I'll finally call him. And I felt so guilty because it was like a Friday night or something terrible,
and I didn't want to bother them. But so it is nice to have to have a person that is kind of that you could contact in that kind of situation like that you just just from the patient's perspective. Anyway, I love I always felt. So. I never did work in the eer. I've only worked in the lab, but at the entire time that I worked in the lab, I went from working in just like clinical lab stuff,
blood work and everything to pathology. And I had a high concentration of working with surgeons all the time because of doing frozen sections and doing the gross pathology in surgical pathology. And I always found that the best surgeons were ones like you who really respect your your co workers and the other medical professionals that are working under you, and recognize that they're helping you be and they're just
like a necessory to you being a great surgeon. And trust me, there's been times where we've had doctors come down and talk because us working in surgical pathology were pas too, and they would come down and talk down to us and didn't respect their nurses and their pas, and it just it just shows in my opinion, who's a good surgeon that I would feel like going to, versus not that thinks that people are below them kind of.
I've gotten that vibe off of some surgeons before. Oh yeah, I mean they're just all of these different roles in medicine.
We all make the patient experience and outcomes better while we work together. And if we work against each other, I think, you know, all the truth battles are so silly. We're so much stronger as a team when we all use our talents together to give patients better care.
Yeah, I agree with you there. There's just there's just some mega egos going on with.
Some people, there is, and surgery has the majority of them, as you know.
But I love some ct Like there's some surgeons that I was that would come downstairs and be like, yo, Nicole, what's up? Like that?
Right?
They were like so cool? And then I would go look them up and I'd be like, holy shit, that guy's a big deal. Like I can't believe he's so cool, you know. And I I a lot of them that that I would go to. I mean, not that I have any kind of like kidney problems now, but like, I know who I would go to if I did, because I'm like that dude was awesome, you know. So I'm glad to hear that you're that you're like that and given shout outs to your PA and your nurse practitioners.
That's really cool. So what's let's hear before we wrap this up, Like, what's going on in your life right now? You you have kids? You said I do.
I have two kids. My daughter is and was is eleven.
That's cool. Yeah, there's they're they're the best.
It's having kids is the wildest journey because you get to watch like things about yourself. You're like, oh my god, I do that too, should not do that? And then the good things about yourself too you get to see in your kids.
It's wild.
And I have a hobby. I have Dalmatians, and I have gotten into the world of showing and dog sports the last that's so cool. And my daughter started doing it, so she's I'm doing junior handler or junior showmanship showing one of our dogs. So yeah, I mean that's kind of what I have. I always have something going on. I need, like I like to hyper.
Fixate on hobby.
So I'll probably do this for a couple of years until they retire, and then I'll have a new hyperfixation hobby.
So what you got into the TV world? How did that first start? So?
You know, LA is an interesting place because the second I moved back home about nine years ago, you get calls three times a week at least I do, people trying to hunt around for people potentially on shows.
And so when.
I I've been in LA for maybe a year and I got a call and they were interested in me for a show and they didn't tell me what it was, and I did a zoom interview or whatever zoom was back then it was the Skype or whatever, and I didn't hear from them for years.
It was just like I did.
I made it to the last step and then you know, everything fizzled out. And I've done lots of this sense, so this is kind of how you know one percent of what they.
Do actually makes it.
And then a couple of years later, I got a call from the casting producer and he said, hey, you know, E fired a bunch of people. There's a new person in charge who really loved this show years ago, and she wants to revisit it.
Are you still interested?
Is like four or five years later, and I was like sure, and he said, I don't think we need to refilm anything because you were great in the first audition. I said, okay, fine. And then about four or five months later, in the middle of clinic one day, I got a phone call from an unknown number and I answered it and everyone's screaming and I'm like, I don't know who this is, what's going on? And it was the producer and he said he picked a us up for a full.
Season and they want you.
We had a bunch of candidates and they chose you from the stack, so I got to be on the show.
That's how it happened.
It was very you know, that's so cool. It was very cool.
Yeah, you go to work that day, it's just a normal day and you go, oh, I got some news be on a television show. And it was a great experience for a couple of reasons. That the first reason it was great, I made a very dear friend. Michelle Lee is one of the other surgeons on the show, and her and I are very good friends. And that's the best part of a show is gaining a wonderful lifetime friend like.
That, and then I just I love reality TV.
So I love the.
Process of like knowing how it works. I love the crew. Some of our crew worked on like RuPaul's Drive Race and the Kardashians, and it was fun hearing all their behind the scenes story. Our showrunner, what Lori Gordon, was a Emmy Award winning, our producer did the original Doctor nine or two and zero and if botched, Like it's just the cast of people we worked with was so incredible. It was really fun part and it just sucked. It
was a you know, Casulty of twenty twenty. You know, e was bought by Peacock and they just kind of canned everything that didn't have another season already in the work, so, you know, one season show.
But it was a good time. So you so it sounds like you'd be interested in doing something again if the opportunity arose. Yeah.
I get offered things here and there, but I think that had such a powerful experience with that it would be hard for me to take something that didn't live up to that expectation. They were really great about allowing me to show the things that were important to me, like breast reconstruction and dealing with people with like chest wall deformities, and to show more of what I do and not just the typical fluff.
Plastic surgery that you see. Yeah, which I think is important because people need to know that some of the complications that lots of women go through and how and how they could be fixed. It's not the end of the world if it happens necessarily. All right, Well, thanks so much for being here today. It was so nice meeting you, and I think that everybody got to learn
a lot about this. I'm sure people listening right now have implants and maybe didn't even hear all of this from their surgeons, so it's really awesome, and I think you explained everything in a way that's very easy for everyone to understand. Thank you, Thank you so much for having me. This was really fun, awesome, Thanks thank you for listening to Mother nos Death. As a reminder, my training is as a pathologist's assistant. I have a master's
level education and specialize in anatomy and pathology education. I am not a doctor, and I have not diagnosed or treated anyone dead or alive without the assistance of a licensed medical doctor. This show My website and social media accounts are designed to educate and inform people based on my experience working in pathology, so they can make healthier
decisions regarding their life and well being. Always remember that science is changing every day and the opinions expressed in this episode are based on my knowledge of those subjects at the time of publication. If you are having a medical problem, have a medical question, or having a medical emergency, please contact your physician or visit an urgent care center, emergency room, or hospital. Please rate, review, and subscribe to Mother Knows Death on Apple, Spotify, YouTube, or anywhere you
get podcasts. Thanks