The Mikhaila Peterson Podcast - March 17, 2022


142. Plastic Surgeon Reveals The Celebrity Secrets To Staying Young


Episode Stats


Length

55 minutes

Words per minute

190.51

Word count

10,592

Sentence count

318

Harmful content

Misogyny

11

sentences flagged

Hate speech

5

sentences flagged


Transcript

Transcript generated with Whisper (turbo).
Misogyny classifications generated with MilaNLProc/bert-base-uncased-ear-misogyny .
Hate speech classifications generated with facebook/roberta-hate-speech-dynabench-r4-target .
00:00:00.000 did you get into this so the reason why i decided to become a a plastic surgeon was it happened to
00:00:07.160 me in grade school so when i was in grade school there was a girl in my class who had a cleft lip
00:00:12.420 and palate deformity and she was on my bus room and kids would torture her it was unfortunate but
00:00:19.480 especially back then because you know now we're very focused on anti-bullying and like you can't
00:00:23.580 get away with the behavior that used to happen when i was a kid but people would throw things
00:00:28.180 at her they would you know alter you know nobody would go near her they would you know it was
00:00:33.820 because she had a facial disfigurement unfortunately and i was her friend i used to sit on the bus
00:00:38.780 with her and the thing is that she had surgery during the time that i knew her and as her
00:00:44.820 appearance started to morph and become more normalized people started to respond to her
00:00:49.680 differently. And I thought that was a very powerful way. Welcome to episode 142 of the
00:01:00.100 Michaela Peterson podcast. I'm Michaela Peterson. I'm backstage at one of dad's show in Denver.
00:01:07.580 As you can see, this episode covers plastic surgery, the real secret to staying young.
00:01:14.620 I mean, there's also sleeping right and diet, hello, low carb, and sneaky tricks like NAD.
00:01:21.660 But if you see a 70-year-old and they look like they're 50, it's plastic surgery.
00:01:27.360 Dr. Andrew Giacono is a world-renowned facial plastic surgeon based in New York City, author and creator of MADE, a minimally invasive hybrid facelift, the secret behind celebrities' ability to never age.
00:01:42.220 I've always found plastic surgery fascinating.
00:01:44.620 If you look younger, do you feel younger? If you feel younger, do you live longer?
00:01:49.580 I don't know. Andrew's the founder of the New York Centre for Facial Plastic and Laser Surgery
00:01:54.700 and the co-founder of TAI, a non-profit organization that helps children in third
00:01:59.800 world countries get free plastic surgery for things like hair lifts, life-changing surgeries.
00:02:05.800 He's been named one of America's top plastic surgeons by Harper's Bazaar,
00:02:09.340 the Consumers Research Council of America, and Super Doctors. He starred in the TV show
00:02:14.760 Facing Trauma as a volunteer surgeon for victims of abuse. Dr. Giacono has been featured on Good
00:02:21.120 Morning America, Anderson, and CNN, to name a few, as well as many publications like the
00:02:26.240 Huffington Post and GQ. His main clients are lawyers and CEOs in New York, as well as celebrities
00:02:32.100 and the average person who knows about this stuff. We talked about the ramifications of social media,
00:02:37.960 the type of person who does plastic surgery the dangers the morality and more i hope you enjoy
00:02:44.100 this conversation this episode was sponsored by paleo valley we need collagen it's like the glue
00:02:50.760 that holds our body together we're talking about plastic surgery in this episode but i did mention
00:02:55.580 diet is playing an important role in aging after we hit 20 we begin to produce less and less
00:03:01.560 collagen a simple way to get a good dose of collagen is paleo valley's bone broth protein
00:03:06.900 something I can actually eat. It's made in a pesticide-free environment and made from 100%
00:03:12.400 grass-fed bones, not hides like a lot of other products. It's also delicious. You can add it to
00:03:18.560 smoothies, baked dishes, your coffee, or just mix it with hot water and a bit of salt, like me.
00:03:24.720 Adding collagen to your diet will not replace a facelift, but it certainly won't hurt. I absolutely
00:03:30.500 love it. It's kind of like coffee. If you haven't tasted coffee in years, it's great and is on sale
00:03:35.740 now at paleovalley.com with code MP for 15% off your first order. That's paleovalley.com
00:03:43.300 code MP for 15% off. I hope you enjoy this episode. Dr. Andrew Giacono, welcome to my
00:03:53.140 podcast. Thanks for having me. I'm super excited to talk to you. Yeah, this is going to be
00:03:58.700 fun. I think, I think what you do is something everybody should know about. So before we get
00:04:02.980 started, can you give a brief background about who you are and what it is you do? Sure. So my
00:04:09.160 name is Andrew Giacono. I'm a facial plastic and reconstructive surgeon, and I practice on Park
00:04:14.280 Avenue in New York City. And I specialize in facial aesthetic surgery. So things that are
00:04:20.760 to enhance people's appearance, both aesthetically to make them achieve their, you know, their goals
00:04:26.900 for their beauty, but also to rejuvenate the facial appearance to make people look younger.
00:04:31.720 and as i get older this becomes more important to me
00:04:35.600 okay so i want to cover a bunch of things i want to cover like what you do and then how many people
00:04:43.200 actually do this kind of thing because i think people don't talk about it and then some of the
00:04:47.780 ethics behind plastic surgery so that's what we're going to kind of get into um so first off
00:04:55.480 yeah how many what percentage of your clients do you think are women versus men like how
00:05:01.980 how frequent do men come in yeah i mean at this point it's changed a lot so i think that you know
00:05:08.100 the modern era and how aware we are of our appearance and that's been obviously accelerated
00:05:12.780 by you know digital cameras you know our social media presence you know using uh you know digital
00:05:20.000 platforms to be able to communicate and work men have embraced plastic surgery at rates that i've
00:05:25.600 never seen before i've been doing this over 20 years and i would say that 20 years ago that males
00:05:31.540 comprised about 10 of my practice but today it's fully a third so that's a lot you know it's one
00:05:37.560 of every three people that i operate on are male patients yeah wow okay again it's not surprising
00:05:44.860 because everybody wants to put their best face forward.
00:05:47.780 And the reality is, is that our face is our calling card.
00:05:51.660 You know, in the modern era, before somebody even meets you, they Google you.
00:05:54.840 They look at your images.
00:05:56.280 They look at your social media content and they make judgments about who you are,
00:06:00.960 how effective you are at your job.
00:06:03.160 And they get a sense of your personality by the way you look.
00:06:06.420 And that's what we do.
00:06:07.380 I mean, it may not be correct, but the truth is, is that today we judge a book by its cover.
00:06:12.180 and it's not right but it's it's the natural tendency because we live in a very visual world
00:06:17.520 now yeah especially with social media so how let's see what age do you think your average patient is
00:06:25.980 well my my age definitely tilts younger I mean older in the younger in the older age category
00:06:33.560 I should say you know I specialize mostly in aging face surgery so that means that I tend
00:06:39.380 to take care of people as their appearance starts to change as they get older. In the past, I would
00:06:46.180 say that that would be an average age of somewhere in the mid-50s. But today, it's really patients
00:06:51.360 primarily in their 40s. So people are embracing enhancing their appearance at a much younger age
00:06:58.000 today than they did 20 years ago in their practice. Obviously, there are patients who come
00:07:03.380 in who are young, who have a desire to change their nose or their lips or their facial shape
00:07:08.400 because it's the, it's disproportionate or imbalance, you know, like a young girl who's
00:07:12.200 18 years old, who unfortunately got her grandpa's nose, you know, like the whole family has a big
00:07:17.180 nose. So she looks more masculine or like male members of her family. And then she wants a
00:07:22.080 rhinoplasty. Those obviously will be younger patients, but on average, I'd say that somebody
00:07:27.740 in their mid forties at this point, early to mid forties. Okay. And what kind of procedures do you
00:07:34.360 do? Like what's your, what's the main, what's, let me, let me rephrase this question. Actually,
00:07:38.720 if somebody wants to have a surgery to look younger, what is it that makes people look younger?
00:07:45.560 Yeah. So the thing is, is that it's not one thing. So this is really the artistic aspect of what I do
00:07:52.880 is that there are multiple things and it's different for every face that create a more
00:07:58.760 youthful appearance. And so as a result, you know, it's often multiple procedures. It's not
00:08:04.420 one big procedure. And that's what I try to stress to patients. It's not like a big facelift or a
00:08:10.220 big brow lift or lots of eyelid surgery. What makes people look youthful, it's not a lot of
00:08:15.240 surgery. It's little bits and details throughout the different proportions of the face. And that's
00:08:20.640 what makes people look youthful, but also natural and normal. Because obviously the biggest fear is
00:08:27.740 is that we're going to do plastic surgery
00:08:29.640 and we're going to look like a freakazoid.
00:08:31.560 You know, people don't want to look like
00:08:33.000 the American true-esque celebrities
00:08:34.640 that they've seen who've had plastic surgery.
00:08:37.480 They want to look like themselves,
00:08:38.900 potentially a little bit more enhanced,
00:08:40.640 but arguably like they did maybe 10 or 15 years ago.
00:08:43.840 So the thing is that often for me,
00:08:45.640 when I'm doing a procedure,
00:08:46.760 it's a combination of things.
00:08:48.440 The thing that I'm most well known for
00:08:50.140 is for doing facelifting surgery.
00:08:52.580 So it's called a deep plank facelift.
00:08:54.580 It's a procedure that I pioneered
00:08:56.100 and I lecture about it all over the world.
00:08:58.040 I publish textbooks on it.
00:08:59.720 But with that is often things that are done
00:09:01.740 like a temporal lift to rejuvenate the upper brow,
00:09:05.020 eyelid surgery to help smooth contours,
00:09:07.580 lip lifts, because unfortunately as we age,
00:09:10.040 the lip groups and the upper lip becomes elongated,
00:09:12.520 fat grafting to add volume to places in the face
00:09:14.920 where people get sunken as they get older.
00:09:17.160 So it's really an artistic endeavor.
00:09:19.840 What I'm doing is I'm looking at the face
00:09:21.640 and I'm creating contour and balance.
00:09:24.800 and that's what makes people look young so it's kind of a difficult question to answer and i
00:09:30.700 apologize that the answer was so wrong well that makes that makes sense though um so when you do
00:09:37.780 these procedures do people come in and they have a whole bunch of things done at one time
00:09:41.740 or do they come in every six months yeah it really depends on the personality of the patient
00:09:47.080 what i definitely notice is that most patients do i'd say 70 to 80 percent of patients do it all
00:09:53.320 at one time. And I think that's just because of the, you know, the recovery time required,
00:09:58.540 you know, if people are going to go and take that much time away from their normal life for
00:10:02.660 recovery, i.e. social activities, work, all those things, they don't want to have to, you know,
00:10:08.040 have seven, seven, seven to 10 day recoveries. They'd rather try to see if it can be done at
00:10:13.500 one time. But those are busy people who have lots going on in their lives. And then there are other
00:10:18.420 people where they're not so motivated. They have a lot of free time and they'd like to chip away
00:10:22.520 and do a couple of procedures at a time or one thing at a time there's no right answer um you
00:10:28.720 know you can do it either way but i think that in modern in modern era and you know what we're
00:10:33.360 dealing with people want to be able to get things done and then be able to move on with their lives
00:10:38.580 and enjoy the outcomes of their surgery not making a project that's going to take them two years to
00:10:43.140 get through you know and 10 weeks of recovery they'd rather be like going to you know st bart's
00:10:48.860 for a vacation versus sitting home and recovering and being bruised for that period of time.
00:10:56.020 So did you say seven to 10 days?
00:10:58.540 On average, most recoveries for most of these procedures, you can get out about
00:11:03.240 seven to 10 days afterwards. It doesn't mean you want to be hosting a dinner party at your home
00:11:08.760 with people that you don't want to know about surgery, but functionally, the majority of my
00:11:12.900 patients, even professional patients, physicians, attorneys, people who are financial bankers,
00:11:17.180 they get back client facing or in front of people at around 10 days. I tell them if they can get
00:11:21.960 two weeks, it's ideal, but you know, it's hard. So you can cheat it in 10 days. And we have ways
00:11:28.300 of making the recovery much faster today that just weren't available 10 years ago. So I have
00:11:33.620 things that I can do, you know, techniques and instruments and, and, you know, and lasers that
00:11:39.200 help recovery, get rid of bruising. You know, there are different treatments that we do. One
00:11:43.320 of them is hyperbaric oxygen treatments, where you go into a hyperbaric oxygen chamber every day
00:11:48.200 and increases the blood supply and the oxygen content of the tissue. So the healing is much
00:11:52.080 faster. And I've learned these things because a lot of my patients need to be back in front of
00:11:57.820 cameras really quickly. I take care of a lot of people who have public faces. And as a result,
00:12:03.120 I needed to figure out a way to get them back to work quicker because they don't have a lot
00:12:07.020 of downtime between, you know, shooting, you know, shooting television shows or other things,
00:12:10.920 you know what percentage of celebrities or people who have tv appearances who are you know in their
00:12:17.860 50s or 60s have had work done do you think oh so pretty much everybody who's post who's 50 and
00:12:23.840 above has had work done so if somebody men too yeah men kind of can cheat until about late 50s
00:12:30.420 early 60s so there's definitely an unfair um you know unfair disparity between men and women in
00:12:36.980 terms of the way they age. Women, generally speaking, around 50 start to age more rapidly.
00:12:42.640 And by 52, 53, their face really changes. That's because women go through menopause on average at
00:12:48.240 about 50 to 51 years of age. And within two years of that change, the facial tissues drop. So
00:12:54.060 unfortunately, there is a big change and a shutoff that happens for women that accelerates their 0.99
00:13:00.340 aging process. So on average, most women will consider this if they don't aren't more proactive 0.97
00:13:06.540 about doing it around 50 because they notice that things just don't hold up nicely the way they used
00:13:10.900 to. Men get a pass. It's usually around 60 that this stuff really starts to come apart.
00:13:16.800 So I usually will treat most men later 50s to early 60s and most men later 40s to early 50s.
00:13:22.700 So that's when I kind of see it. But if you see a celebrity who's in her early to mid 50s and she
00:13:28.880 looks youthful, she's had surgery. Nobody escapes this, unfortunately. I've been doing this for 20
00:13:35.720 years and I've done about 4,000 facelifts. Nobody escapes this. And it doesn't mean that they look
00:13:40.780 abnormal because with good surgery, people look natural like themselves, but youthful,
00:13:45.960 but you can't be 53 years old and look like you're 40 without surgery. It doesn't happen.
00:13:51.880 Okay. So it's not all olive oil then. Okay. I don't want to comment on that,
00:13:57.180 but it's not a lot of oil. I guess I just did olive oil. It's not regimens. I mean, you know,
00:14:05.040 I give these excuses to my patients. You know, when they say, well,
00:14:08.300 what am I going to say? When people tell me how great I look, I said, well,
00:14:10.480 if you look natural, you won't say anything.
00:14:11.840 You tell people you lost weight, you've been drinking green juice, you know,
00:14:14.540 you've been doing more meditation.
00:14:16.020 People associate a youthful but natural appearance with good health.
00:14:21.020 So it's very easy to blame it on things like olive oil, your diet,
00:14:24.980 your antioxidant drinks, your vitamins, you know,
00:14:28.320 a new skincare regimen, because if you look normal,
00:14:31.660 nobody really gets it.
00:14:32.880 It's only when you have the distortion and the classic look that comes with, you know, more antiquated facelift surgery or plastic surgery that it gets a big alarm.
00:14:42.980 So I give people these excuses all the time.
00:14:45.100 I'm like, yeah, just tell people that you did these three things, you know, or that you had a little bit of Botox or you had some, you know, intense pulse light therapy treatment in your dermatologist's office.
00:14:53.140 It totally throws people off because they're not really looking at surgery.
00:14:57.680 They're looking at somebody who looks good and healthy and youthful and they want to know what your secret is.
00:15:02.700 but they don't think it's surgery. They think it's lifestyle choices.
00:15:06.440 Okay. So what are the, what are the downsides here? Like, is, is this type of thing super
00:15:12.560 invasive? Is it dangerous? Do you need to go under general anesthetic?
00:15:16.960 No. So we don't use general anesthesia. At least I don't. A lot of surgeons do,
00:15:20.420 but we do something called twilight sedation, which is where you get a little IV and they
00:15:23.560 give you some medicine that just makes you kind of sleep, but you're not paralyzed with
00:15:27.920 the tube of your lungs breathing gas. So it's not something where it's like a heavy anesthesia.
00:15:31.900 that's very risky. Obviously, all surgery has risks, so it's not risk-free. But the thing is,
00:15:37.720 is that when you're with an experienced practitioner, your risk of having a
00:15:40.680 significant complication from surgery is probably less than 1%. And even then, those problems,
00:15:46.280 if you have one, can be managed and remedied. It may require another surgery, but nothing is
00:15:52.860 risk-free. But it's not super risky. We obviously have advanced our techniques. We have advanced
00:15:59.240 instrumentation that keeps people safe. And if you can do it with less anesthesia and you can
00:16:04.160 do it in a more minimally invasive way, which we do, you know, old procedures had huge incisions
00:16:09.180 all around the face, you know, they said peel everything off and it was a bigger deal. Now we
00:16:14.480 can work through smaller incisions, you know, with our technology and we can do it in a less
00:16:19.440 aggressive and less invasive way that's less risky, but also makes people look more natural.
00:16:24.420 the downside is it's surgery you know it's not risk-free there is a recovery you know it's not
00:16:30.580 comfortable you know after surgery there's pain involved you know it's it's scary you know and
00:16:36.760 you know that's the truth but when you get to that point where you have a resolve about what you what
00:16:41.920 you want for your appearance and how you want to project your appearance to the world you know
00:16:46.900 people kind of accept those things and they get through it and you know after a couple weeks it's
00:16:51.260 like it's not that big a deal and then you get to enjoy the benefits of it for a very long time
00:16:56.400 interesting okay are there techniques for anti-aging that aren't surgical that you could
00:17:05.280 recommend like does botox botox works do fillers work are there lasers that can resurface skin like
00:17:11.380 does anything else work are there creams yeah there's lots of stuff for sure good skincare is
00:17:17.280 always wonderful and important. But from a skincare perspective, the most important thing
00:17:21.000 from my perspective, and I don't prescribe skincare and I have good dermatology colleagues
00:17:24.620 and work in cosmetic dermatology that I refer to. But the primary thing that I think that's
00:17:29.900 important is you should be on to some kind of a retin-A or a vitamin A derivative. And those
00:17:34.760 are skin creams. Retinol is like an example of it, but retinol is not that strong. But prescriptive
00:17:40.800 retin-A thickens the collagen laser of your skin and it prevents aging. It actually supports
00:17:45.800 thickness of the skin and the protein layers that's tend to thin out as we get older so that's
00:17:50.800 a really important thing to do and it's something that people should do throughout their life
00:17:54.380 because it definitely will help minimize how much the skin falls and wrinkles so that's one thing
00:17:58.880 Botox is wonderful because when you put Botox in if you're not flexing your face all the time you
00:18:04.040 don't develop lines and wrinkles in the forehead around the eyes it helps support the brows so it
00:18:08.600 prevents aging so Botox even though it could be costly over a very long period of your life
00:18:13.520 because if you started younger, say in your mid to late thirties, and you continued on with it
00:18:18.120 for a long time, it gets expensive. But is it worth? Yes, it is. Fillers, you have to be very
00:18:24.400 careful with. And I talk about this a lot and lecture all over the world about it. The problem 1.00
00:18:29.020 with fillers is they create something called a tissue expansion effect. And what that means is
00:18:34.320 as you put filler in, you stretch the tissues out. When you stretch the tissues out, it's like a
00:18:40.220 pregnant women, when they have a pregnant belly, they lose the pregnant belly. There's a lot of 0.99
00:18:43.980 skin that develops and it hangs. So a lot of women get tummy tucks because the skin has been so 1.00
00:18:49.440 stretched out after pregnancy. Similarly with fillers, if you overdo fillers, you will stretch 1.00
00:18:54.660 your face out. And if you do that, it'll actually make it drop more quickly. So one of the big
00:18:59.980 problems that I deal with in my practice is women who started fillers too young because they thought 1.00
00:19:05.080 they were preventing their aging, but they stretched their face out. So they need a facelift 1.00
00:19:09.400 much younger than they probably would have sometimes by even a decade. So fillers are good
00:19:16.560 when done with small quantities with an even hand. But when you start blowing things up too much,
00:19:23.640 unfortunately, this can be a significant problem.
00:19:27.880 Wow. That's something people should really know about because there you go on Instagram and it's
00:19:32.220 like, oh, do the, you know, Kylie Jenner package or something. And it's easy to market and it's
00:19:37.800 simple it's not surgery it's just a couple of injections and sometimes it can look really good
00:19:42.920 but the problem is is how frequently you do it and how much you do it one time
00:19:47.840 because it can look good the first time and the second time but sometimes after people doing it
00:19:52.240 the fourth fifth or sixth time as they continue to age they're putting more and more stuff in to
00:19:56.920 try to recreate the same effect but our aging face doesn't recreate the same effect with the
00:20:01.440 injections that it did say five years ago seven years ago so people try to use more to get what
00:20:06.360 they used to get but then they only do is they stretch their face out okay and you mentioned
00:20:12.300 something about fat grafting so what's the difference between that and just having a face
00:20:17.860 lift so fat grafting is just like using filler it's just using your own body fat so the thing
00:20:23.260 is is that any place where you can use filler you can do something more permanent with fat
00:20:27.920 similarly fat can cause the same problems that fillers can so it has to be done evenly and not
00:20:34.280 too much but the other problem is is that if you put a lot of fat in the face it can weigh the face
00:20:40.680 down because it has more weight than filler does so similarly with time and age fat grafting tends
00:20:46.340 to drag the face down because it's like strapping two weights into the face so all these things are
00:20:51.780 a matter of degree but it's more common for me not to do fat grafting in younger patients and
00:20:58.540 here's the reason why fat is a hormonally active tissue so when women go through changes and start
00:21:06.580 to have hormonal changes as they age a lot of women start to gain a little bit of weight and
00:21:12.220 it's not because they're not trying hard but it's a lot easier to stay thin when you're 20 than when 0.93
00:21:17.080 you are when you're in your minute to late 40s right for everybody the problem is that the fat
00:21:21.940 that you put in the face acts like the fat from your belly so if you start to put weight on in
00:21:27.380 your body because your metabolism has changed guess what happens to the fat in your face 0.98
00:21:31.560 it grows so what i see is i see a lot of women who are fat grafting in their 30s
00:21:37.480 whose faces now are getting big and distortive and they weren't like that when they were younger
00:21:42.920 because the fat was one size but as they put weight on the fat in the face grows like as if
00:21:49.220 it was in the belly because it grows it behaves like where it came from not where it was placed
00:21:55.240 so the face gets very distorted so for me fat grafting i prefer to use it in patients who are
00:22:01.200 older who have already been through some of those metabolic changes versus trying to use it as a
00:22:06.680 substitute for fillers fillers can be dissolved away fat cannot so when you have a problem with
00:22:12.720 fat grafting it becomes a big surgical problem that a lot of people would prefer to avoid and
00:22:18.600 you learn these this is the thing when you do so much of this and i've done so many thousands of
00:22:23.140 surgeries, I've made a lot of mistakes and I've learned from those mistakes over the years.
00:22:27.880 That's what happens. That's what good surgeons do. So as a result, I know how to avoid more of
00:22:34.340 those problems for my patients. And I know who the right patients are to direct to what treatment
00:22:38.960 is in what amounts at what time in their life. That's wild that you can graft belly fat or
00:22:46.780 something like that. And then it'll gain weight like belly fat. That's crazy. I bet people didn't 0.93
00:22:51.100 expect that that's where it came from it doesn't change its character we're using it to like
00:22:57.300 resupplement but it has the character of where it came from wow okay that's very cool okay so
00:23:06.320 now that we have a bit of a background about all this actually no one question first so you said
00:23:12.320 facelifts used to be a lot scarier than they are and you used to end up with just like scars
00:23:17.980 everywhere yeah very visible scars and very long incision lines so you it would be very very hard
00:23:24.960 to camouflage at least the surgery you know you'd have to kind of wear your hair down and hide
00:23:29.640 everything as much as you could and if you ever had to go and get your hair cut or jump in a pool
00:23:32.960 everybody would see these horrible scars everywhere which is not fun nobody wants i mean even if you
00:23:38.720 look good you don't want to have a visible telltale sign anywhere you don't you don't want your face
00:23:43.340 to look normal but you also don't want to have you know visible scars that tell everybody where
00:23:47.360 you've been and what you've done so what's the difference between that and now like how come
00:23:53.060 there are so many older celebrities that are in their 60s that look absolutely fantastic and they
00:23:58.240 don't look like they have any scars or people can't tell otherwise they'd be you know all over
00:24:02.440 the magazines because they've had good surgery you know there are there are lots of great surgeons
00:24:07.540 out there when somebody's at like an award show and everybody's like holy crap what happened to
00:24:12.360 that person knows they had you know not a great procedure and they probably had a technique and
00:24:18.800 you know an approach that was you know used decades ago but that still happens a lot you
00:24:24.520 know there's a good and high percentage of patients who go to doctors who have those techniques and
00:24:30.060 then there are more evolved techniques and unfortunately probably a smaller percentage
00:24:34.420 of surgeons are educated and capable with those techniques but those are the people that you see
00:24:39.880 who are six years old and a celebrity and you're like, she looks great. Like you don't say, Oh my
00:24:43.960 God, she looks X age. You just like, look at her and you can't even perceive her age because she
00:24:47.800 just looks fantastic. That's the beauty of the plastic surgery. I've always wondered if there
00:24:54.100 was any correlation between looking younger and, and age length, age span. I don't know if,
00:25:00.520 if, or lifespan, I don't know if they've done any studies on that, but I've talked to people
00:25:04.720 who've had procedures done, who've looked, who look now 15 years younger and they say they feel
00:25:10.100 younger too. Yeah, I definitely think that there's health benefits, but I think it's because
00:25:16.840 when people look better and they're more prideful of their appearance, they tend to lead healthier
00:25:23.280 lifestyles. So people who have a better, more youthful looking face will often exercise more.
00:25:29.440 they'll eat more you know more carefully because they want this to match this so i think that it
00:25:36.760 sets in motion habits that make people live a longer and potentially healthier life for sure
00:25:42.980 so that's where i think the link is i don't think it's generated in the brain i think it's generated
00:25:48.560 by habit that's just reinforces better habits and i've seen it over and over again i do a
00:25:54.100 procedure on a patient and then i see them six months later they've lost 25 pounds they look
00:25:57.980 fantastic because they're like, well, this looks great. Like before, you know, my body wasn't my
00:26:04.420 concern because my face really didn't look great. Now this looks fantastic. And now my body becomes
00:26:08.840 my concern, you know, because I want all to look great together. So that's where I think that comes
00:26:14.360 in. Okay. That's very interesting. And then how do you feel about the ethics of, of how popular
00:26:22.760 it's become to surgically enhance yourself and like i guess the costs associated with that and
00:26:28.960 whether or not certain people can't afford them richer people can't afford it and i don't know
00:26:34.220 the morality yeah i mean you know it's a very hard thing to you know i mean i guess it really
00:26:44.860 comes down to your to your politics in a lot of ways right i mean if you're more of an egalitarian
00:26:50.040 you get tweaked by it because you feel like it's unfair that people who have more money have access
00:26:55.080 to this because the truth is unfortunately is that because we judge a book by it by its cover
00:27:00.520 when people are more youthful more attractive their lives tend to be better and i know that
00:27:04.560 firsthand they get more job opportunities they have better relationships they have more confidence
00:27:09.640 it builds a positive spin on their life and it's it's effective for sure and it's not the reason
00:27:17.100 why people do surgery, but lots of things evolve in a very positive way when somebody suddenly
00:27:22.680 looks 20 years younger. Like if you're 60 years old, people tend to think of you differently,
00:27:27.920 how effective you are in your workplace, how friendly you are. People, as they get older,
00:27:33.360 they look sad, they look angry, they look less approachable. People avoid you. You go out in
00:27:38.600 public and you look 40, all of a sudden the whole world seems to open up. So it's not fair that
00:27:46.100 people who have more means get that so i think that if you're more of that camp then i think
00:27:52.180 you haven't you have you feel like there's an ethical uh dilemma there i don't really think
00:27:57.700 that's the case you know for me um there are ways for people to have surgery and you don't have to
00:28:03.380 have a ton of money you know there are lots of options for surgeons surgeons charge different
00:28:08.020 prices there's ways to finance surgery just like you would a car you know buy a hyundai
00:28:15.940 and i would tell you that you can probably get a pretty good surgeon if you finance the cost
00:28:21.540 of a hyundai and i would arguably say that you know the the value to the person in terms of
00:28:27.460 quality of life is probably more valuable than a hyundai depending on where you are and what
00:28:32.980 you're trying to achieve so there's ways of getting it done you don't have to be ultra rich
00:28:38.580 in order to be have to be able to have plastic surgery and you know the the question is is that
00:28:43.780 why do you know why does it matter so much and should we value appearance as much as we do
00:28:50.340 and that's the hard part you know because for me i have four children you know and the thing is is
00:28:57.300 that as a parent it's not like i think everybody should have a type of face i don't think everybody
00:29:02.100 should have perfect balance symmetry and beauty there's a lot of beauty in not having all those
00:29:07.880 things um but you know it's like trying to tame the beast at this point because of our our our
00:29:17.600 our visualization of beautiful people and youthful people and how it's you know pushed on us it
00:29:25.700 really is and we're sponsored eggs that pop up all the time you know everywhere we go you know
00:29:30.740 we're aspiring to look a certain way there's a celebrity we are in a lot of this all this
00:29:34.860 constant visual imagery and that it's not great you know because it makes us feel inadequate it
00:29:40.480 makes us feel less than you know and unfortunately it creates a certain dysphoria that drives people
00:29:47.360 to have plastic surgery but unfortunately i don't think it's plastic surgery that's driving it
00:29:52.700 it's not surgeons like me who are creating the need or want it to happen but we're serving
00:29:58.840 you know we're giving we're providing a service to help people manage the modern era and i don't
00:30:06.960 like it even though it's what i do for a living right so it's what i do and i love doing it and
00:30:12.140 i make people happy doing it i think it's an unfortunate side effect of the society we live
00:30:18.380 in and one of the big things for me when it comes to that is i feel like social media companies need
00:30:25.440 to be held responsible for their behavior and that's something that i know right now
00:30:30.420 is very much important because the truth is is that if social media companies are held
00:30:37.260 accountable for their behavior you can't sue a social media company so if they do horrible
00:30:44.780 about ourselves there's no recourse but what they do is they manipulate content they drive it in
00:30:51.500 front of us. They make people feel horrible. There's tons of studies that show that the number
00:30:57.100 of younger people who are adolescents and young adults who feel inadequate, who have poor self
00:31:02.300 image and body image because of social media, it is a problem. And the thing is, is that they
00:31:07.840 curate content and they know how to drive it to you to stay, keep you linked onto their platform.
00:31:16.280 And they manipulate the hell out of everybody. And it actually creates the desire for these
00:31:21.240 things more than it would exist if we didn't have these things around. So for me, the real ethical
00:31:26.260 transgression is not in wanting to do plastic surgery or executing it. I feel like the platforms
00:31:32.680 and the way we get information today is so manipulated that it's targeting us in order to
00:31:38.960 make us feel like we need to be other than who we are. And that's what frustrates me. Because as a
00:31:44.540 father, I don't want my children to feel like they're not adequate, that their body type isn't
00:31:49.540 good enough, that their face isn't beautiful enough, because there's beauty in all shapes
00:31:54.180 and sizes, but it makes us feel that way.
00:31:57.540 So for me, that's the big dilemma.
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00:33:00.160 remember to hit subscribe I saw I don't remember where it was it might have been a country that
00:33:05.980 said they were going to make editing your photos illegal right I can't remember where that's
00:33:11.220 happening, but, um, I've seen, I've seen the impact of social media on my cousins. I have a
00:33:15.900 couple of teenage girl cousins and it's rough because every single person that they follow
00:33:22.680 edits their photos in ways that humans can't really look and they feel ugly. Yeah. Yeah. But,
00:33:29.100 but you know, what's so funny, these people have plastic surgery, so they've had plastic surgery
00:33:33.800 and then they're editing their photos on top of plastic surgery. So it, it, it absolutely is the
00:33:39.500 case because you feel like, well, what's wrong with me? All these people look flawless. Shouldn't
00:33:45.160 I look that way? Because obviously there's a certain, you know, worship that we have for our,
00:33:50.880 you know, for, you know, the people we look up to, you know, it's, you know, it's in all fields and
00:33:56.520 it's in all ages, you know, maybe a younger person looks up to, excuse me, a, you know,
00:34:02.740 a famous person, you know, I look up to my, you know, my heroes in my, in my professional world,
00:34:08.540 you know the people that are the giants and the people that i learned from you know who made a
00:34:13.500 lot of advances in my field so we all look up to people but the generation definitely looks up to
00:34:18.380 people who are more beautiful and more you know archetypal or you know or are the best in terms
00:34:24.620 of their appearance and it's really unfortunate but everybody seems to manipulate their their
00:34:30.860 images and it's so funny because you look at these magazines sometimes and they always have
00:34:35.420 like little arrows showing where you can see like the edges of a photo looking all like you know
00:34:41.820 janky and like good you know the person sitting there and their waist looks this thin but then
00:34:46.540 you see like the bricks like having distorted pattern around them because they just crushed
00:34:50.220 the pixels so it's like sometimes it's really goofy and obvious but again you know getting
00:34:57.180 bombarded with that imagery over and over again really wears away your brain and makes you feel
00:35:01.740 inadequate. Yes, a bit of a pickle. It's definitely a bit of a pickle.
00:35:09.320 Yeah, but it's a pickle, but I think it's a pickle that can be solved,
00:35:13.140 you know, because once these companies are held accountable for their behavior,
00:35:16.980 they will change their behavior. Because if you can imagine the financial downside of a class
00:35:22.420 action lawsuit of tens of thousands of families who had children who wound up with mental illness
00:35:27.220 or suicide it would be in the number of trillions of dollars but the thing is is that right now
00:35:32.820 there is no repercussions they can do whatever they want whenever they want and there's nothing
00:35:38.420 you can say about it so once that happens i think that they'll be more responsible with what they do
00:35:44.580 and they can even enact policies where can you know and come on we have such technology
00:35:49.540 they should have the ability to use technology to make sure that those kind of images are not
00:35:53.220 allowed to be posted like that's a possibility why should that be allowed you know if we know
00:36:00.480 it's causing significant pervasive public mental health problems which it does why don't we hold
00:36:07.360 people accountable to make a difference we should that's a very good idea that's a that's a very good
00:36:16.400 idea i don't know why that wouldn't have been i guess everything is so new social media is so new
00:36:21.580 It hasn't been around long enough for people to...
00:36:25.440 Yeah, but I think that the reason why is at the end of the day is that all of these companies, all they really want, they're not concerned with ethics.
00:36:34.180 They want more eyes, more volume, more clicks, and more ability to then, because of the volume of traffic, be able to sell advertising.
00:36:43.300 It is a business.
00:36:44.740 So if a altered image gets more attention than an unaltered image, they prefer the altered image.
00:36:51.580 right? Because if it's going to get more views and clicks, then that means more revenue. And
00:36:57.500 that's really what they are at the end of the day. They're for-profit companies, they're publicly
00:37:00.700 traded, and they're motivated by profit like all corporations are. But when it has pervasive
00:37:06.120 mental health complications for us as a society, I think that we need to take a step back and hold
00:37:13.180 people accountable for their behavior. And this is like getting way off target from what plastic
00:37:18.080 surgery is. But I, you know, because of what I do for a living, I see how devastating it can be
00:37:25.140 over the long term to people, young and old. Do you have people come in that show you pictures
00:37:31.560 of clearly altered faces and say, I want this? Absolutely. So especially younger patients,
00:37:38.700 they come in with their iPhone and they have like a file of screenshots of people whose
00:37:45.340 appearance they covet i like this nose i like my lips this way i want this like this and this like
00:37:50.060 that and obviously you can't transplant those things on patients so you need to be educated
00:37:54.940 and you have to go over with them what's possible what the limitations are because not every nose
00:38:00.120 and every face can just be made into something you know you can get parts of things it has to
00:38:04.640 do with what you start with um it's not like you can just plug things on it's not plug and chug
00:38:09.760 it doesn't work that way but it is very very common for people to show up with that kind of
00:38:14.440 that kind of information to a consultation do you have advice for people who are potentially
00:38:22.120 interested in this on how to avoid bad surgeons yeah i mean i think that you know
00:38:30.040 you know where we live we live in a modern era and people have access to information
00:38:36.300 so it's very i think it's pretty easy i mean people do deep dives on everything right people
00:38:41.820 going to buy a vacuum cleaner when they go online and they read about the vacuum cleaner they look
00:38:45.900 and read about people's online reviews of what their experience is like with it you know you
00:38:50.540 can get a lot of information out there so i think that's one of the first places to start
00:38:56.300 is by doing that kind of deep dive and research into people you know people have different
00:39:00.780 expertise if you want a rhinoplasty and you know you go to a doctor you see that mostly what he
00:39:04.620 does is breast augmentation it's probably not a good idea but you know this is the kind of
00:39:08.620 information that you can get by just spending some time and then after you do that um you should
00:39:16.380 you know see a number of doctors and i always say this you should go with your gut because you know
00:39:22.520 sometimes you can be intimidated we're in a situation where somebody's supposed to be you
00:39:26.120 know a very you know well-known or professional person um and it can be difficult because you're
00:39:31.740 like well this person's supposed to be so great i really just have them do it but you really need
00:39:35.440 to listen to your internal compass because you know beyond you know doing your deep dive not
00:39:41.800 every you know doctor is going to be the right fit for you and obviously the doctor just doesn't
00:39:47.120 have to be a good technician but they need to be a good person because they need to see you through
00:39:50.300 the recovery phase of your surgery and be able to address concerns as they as they arise and if
00:39:55.900 somebody seems to be short arrogant you know doesn't want to answer your questions or for
00:40:00.200 just some reason you guys don't get along this is like a marriage you know you know you're you're
00:40:05.860 you're this is like oh this is almost like speed dating like you know you get a sense of your gut
00:40:09.700 right away like this isn't going to work it's not going to be any better after a surgical treatment
00:40:13.960 so i think it's important to listen to your instincts as well um but you know obviously
00:40:20.160 referrals from other doctors referrals from people who are happy patients all these things
00:40:23.920 are nice but it's not always easy to find those things so you have to be your own detective i
00:40:28.540 I think, in a lot of ways. Why did you get into this? So the reason why I decided to become a
00:40:35.660 plastic surgeon was it happened to me in grade school. So when I was in grade school, there was
00:40:41.980 a girl in my class who had a cleft lip and palate deformity, and she was on my bus room, 1.00
00:40:47.320 and kids would torture her. It was unfortunate, but especially back then, because, you know,
00:40:52.040 now we're very focused on anti-bullying and like, you can't get away with the behavior that used to
00:40:56.400 happened when i was a kid but people would throw things at her they would you know alter you know 0.91
00:41:02.400 nobody would go near her they would you know it was because she had a facial disfigurement 0.99
00:41:06.780 unfortunately and i was her friend i used to sit on the bus with her and the thing is that she had
00:41:12.880 surgery during the time that i knew her and as her appearance started to morph and become more
00:41:17.860 normalized people started to respond to her differently and i thought that was a very powerful
00:41:23.860 that's the reason why i want to do a plastic surgery wow that okay so that um because i think
00:41:33.680 of who my dad is i've done a lot of reading about different personality types and what kind of
00:41:38.200 people become surgeons or ceos and generally speaking from what i've read it's very disagreeable
00:41:45.220 people who are low in compassion who become surgeons and really go up to the higher levels
00:41:50.300 and businesses universal there's a higher percentage it's not that that's the majority
00:41:55.320 of us but like the thing is is like for example you know the rate of sociopathy you know people
00:42:00.940 who are sociopaths who are people who are stockbrokers you know physicians politicians
00:42:06.500 certain specifically is much higher than the average person out there but it doesn't mean
00:42:12.020 it's the majority of people who go into that profession you know what i mean so it's a little
00:42:16.340 bit skewed, but it's definitely, you know, hundreds of percentages more than the average
00:42:24.380 person who has a job that's outside of that field. You know what I mean? But there are a lot of
00:42:29.700 surgeons who are very compassionate. But the thing is, is that there's a lot of physicians who
00:42:33.680 meet that more aggressive personality type, if you will, as surgeons, you know, physicians in
00:42:39.560 general, not necessarily, but people who are drawn to these kinds of fields and plastic surgery,
00:42:44.760 orthopedic surgery things like that tend to be more like that interesting so do you still do
00:42:50.040 cleft palate do you do cleft palate surgery yeah i do so when i don't do it in my private practice
00:42:55.800 what i do is is i go on two missions a year to south america where i do congenital birth
00:43:02.720 defects or anything so i know how to do it you know it's not my focus in my private practice
00:43:07.140 you know my passion in my private practice is doing these kinds of rejuvenate procedures it's
00:43:11.580 what i publish you know studies on it's what i lecture about it's you know what i do every day
00:43:16.060 um but the thing is is that you know i stay true to that and that one thing that kind of got me
00:43:21.800 here which is to do that surgery you know when i go to these countries in an average week we'll do
00:43:26.840 like about 100 kids and we'll do surgery on them so i go to aquito ecuador every year and then i go
00:43:35.340 to columbia in south america every year and i go to the same locations because they're endemic
00:43:41.420 they have areas where they have high rates of these genetic birth defects. So high rates of
00:43:46.320 cleft lip and palate deformity, other things. And I go there and I do it twice a year for like 10
00:43:51.700 days. We have to go, we have to screen the patients, we do the surgery, do the post-operative
00:43:56.240 care, and then we're out and we go back every year so we can see the kids. And we have doctors
00:44:00.580 back in those countries who will see them through their recovery phase, but they don't have the
00:44:06.660 expertise to do the surgery, unfortunately. And as a result, we keep going back there to do the
00:44:11.260 work that is so amazing like i've seen some of your before and afters for cleft palate surgery
00:44:18.840 and that like you said would completely change somebody's life completely well it does because
00:44:25.960 like literally within an hour procedure it's really you know very um it's it's like mind
00:44:33.120 i mean when you do the procedure and you hand that child back to their parent
00:44:36.580 looking normal again it's pretty crazy oh wow yes it's pretty wild wow okay that's fantastic
00:44:46.720 i'm glad to hear that um okay i think another let me ask you another question here so you
00:44:52.440 talked about lasers a bed and you said lasers to help bruising so what kind of you've actually
00:44:57.680 seen evidence of some of this is it low level light therapy no it's something called a pulse
00:45:02.680 multi-laser you can't really use it yourself it's a very expensive piece of equipment it's called a
00:45:07.640 b-beam the one that i use and it uses um this particular wavelength of light it gets absorbed
00:45:13.860 into purples and then it actually breaks up the body can reabsorb it so you know it's not something
00:45:19.540 you can do at home like a light therapy or an led therapy or something like that unfortunately
00:45:23.920 it needs to be executed by a physician who has this kind of equipment and most doctors
00:45:29.120 don't have it because it's you know say a couple hundred thousand dollars for the machine
00:45:32.780 so most people like oh the bruising will go you know for me my patients they really need to be
00:45:37.860 able to get back to things quicker so we have a bb when we treat our patients with it you know
00:45:42.320 post-operatively to get rid of it yeah does that does that stop any of the healing that happens
00:45:47.540 with bruising yeah the bruising doesn't create healing it actually makes it worse because when
00:45:53.040 you have blood that sits in the tissues which is what bruising is it takes more time for your body
00:45:57.640 to wear away at it. So it slows down the healing process. So being able to break it up with this
00:46:02.220 technology actually makes the healing faster. Wow. That is so cool. Okay. That's fun. And
00:46:09.400 how about these, do you know anything about the lasers people can use at home? Like these low
00:46:13.880 level light therapy lasers? Have you seen anything effective or those red lights? Is any of that real?
00:46:20.260 Yeah. It's for me, it seems very anecdotal. So what I mean is, is that I have lots of patients
00:46:25.660 who do it and they, they, they feel like they have great results. You know, there aren't a lot
00:46:31.220 of studies that show that it's really effective in a way that we would look at it scientifically
00:46:35.300 as doctors. Um, but you know, the problem with these things is, is that there's something called
00:46:41.720 the placebo effect, which most people know. And the placebo effect means I give you a sugar pill
00:46:46.620 and it'll make people's like, for example, if they have high blood pressure, 30% of the time,
00:46:52.420 it'll make their blood pressure drop. Now it's just a sugar pill, but the idea in our minds,
00:46:57.020 our minds are so powerful that it can really make physical changes in our body by the mere
00:47:02.260 suggestion that it is going to be helpful to us. So if I took these light therapies and I gave it
00:47:08.040 to a hundred people and I convinced them that it was going to make them look better, 30% of the
00:47:13.400 people would actually look better. And it would have to do with their body's reaction through
00:47:18.480 through their mind and change their physicality. So when we look at the effectiveness of a
00:47:24.040 treatment, it needs to be greater than the placebo effect. But most things are just the
00:47:29.940 placebo effect. That's why we take vitamins and we feel better. Does that mean that it's better
00:47:34.160 than taking a sugar pill? No. But the thing is, is that 30% of the time we start a new regimen
00:47:38.320 and it sets a neurologic biophysical thing that happens within humans that actually makes things
00:47:46.380 better so that's why i think that we get drawn to different remedies whether it's a drinking a tea
00:47:52.860 using a light therapy taking vitamins you know even doing you know you know certain types of
00:47:59.660 rituals they can make us look and feel better and it's real so it works but whether you should
00:48:06.300 invest a lot of money in it or not is the question that effective you know and i know that that data
00:48:12.960 it just isn't there for those treatments but it's okay it's not bad to try them not going to hurt
00:48:18.120 you and if you seem to benefit with them i say continue on with them so what does a day in your
00:48:24.780 life look like like how often are you in the operating room how many hours do you work when
00:48:29.780 you wake up i wake up at about 4 30 in the morning i'm in the office early i usually start my first
00:48:36.540 surgery about six o'clock in the morning i try to do two surgeries a day like in bigger surgeries
00:48:41.820 you know um i do one in the morning because you know i take my time i take a break
00:48:46.700 and then i do my second procedure in the afternoon and then i usually finish with
00:48:51.840 surgery sometime in the you know the the early evening and then i see patients and do consults
00:48:58.980 so i have to see my patients who i've done surgery on different phases of healing but i usually
00:49:04.140 finish with work probably somewhere around 8 30 9 o'clock at night i try to work only on average
00:49:09.940 depends on the week but at this point in my career I try to work either three or four days a week
00:49:14.600 so I don't work five day weeks I work and when I'm here I'm doing that so I'm a surgeon that's
00:49:20.600 what I do and every day that I work I operate that's what I love to do but I don't do it I
00:49:25.480 don't operate five days a week I don't operate six days a week I do three days a week and then
00:49:29.920 the next week I'll do four and then I'll go back to three and the reason why I do that is because
00:49:34.660 in order to be able to stay focused, creative, and desirous of my profession, I don't want to
00:49:40.140 be exhausted by it. And I love what I do, but I also love not doing what I do. And taking time
00:49:45.500 and space to be able to focus on other aspects of who I am as a person actually makes me a better
00:49:51.360 surgeon. So the thing is, is that I like to do lots of creative things. I like to draw, I like to paint,
00:49:57.160 I like to sculpt. You know, I like to be outdoors. I like to do lots of stuff. But doing those things
00:50:02.960 give me the space and the ability to think about who i am and what i do and how i do it
00:50:08.160 but being too entrenched and too focused and working too much it actually starts to make you
00:50:15.800 sort of lose you know you know the the creative process that's required to be good at what i do
00:50:25.480 for a living because you should always be evolving and changing but if you're just
00:50:29.880 hammering away all the time how can you have the time and the space to reflect just isn't there
00:50:36.760 and then everything you do turns into an obligation right instead of something you
00:50:40.920 want to do yeah it becomes an obligation it becomes a burden you know you can work a 15
00:50:47.240 hour day but if you love it and you have a time for it but you have a time away from it 15 hours
00:50:53.720 is nothing but if you're doing 15 hours a day six or seven days a week it becomes a problem
00:50:59.880 So, yeah. How do you think, uh, how do you think you're able to look at a face and
00:51:07.000 see what could potentially enhance it or make it look younger?
00:51:11.540 Yeah. I mean, that just comes with a massive amount of experience and having made a lot of
00:51:16.800 bad judgment calls. You know, the reality is, is that when it comes to these kinds of pursuits
00:51:22.480 and a lot of professional endeavors is an old saying that I love to say over and over again,
00:51:27.740 because I teach a lot of surrogates and I have fellows that they teach is that, you know, judgment
00:51:33.060 comes from experience and experience comes from poor judgment. It takes a lot of time, a lot of
00:51:41.200 reflection and a lot of mistakes to become excellent at what you do. It doesn't just happen.
00:51:47.160 It's not a matter of learning. It's a matter of the process. And as you go on, you get better and
00:51:53.120 better at what you do. It's just like looking at artists over the arc of their career.
00:51:57.740 Because I do think this is a very artistic endeavor.
00:52:00.700 Work changes so significantly throughout the course of their lives and their career.
00:52:06.060 There's like the early work, the mid work, and then the stuff that usually is more defining, which is their way to work.
00:52:12.600 And it's an evolution.
00:52:14.420 It's a process.
00:52:16.320 So it's not like I can really teach somebody to have my vision for what I see when I'm going to operate on somebody.
00:52:23.600 Of course, I try to.
00:52:24.760 And that's why I write textbooks and I publish papers.
00:52:26.680 I want people to be able to have techniques and tools in their belt to help them make them better.
00:52:32.280 But really what we're doing is we're creating an artistic endeavor when we do surgery on patients.
00:52:38.020 And it's something that comes from my brain, my eyes, and my reflective experience over thousands and thousands of patients.
00:52:44.640 So as a result, it's very hard for me to explain to you because it's not like I look at a face and I have a formula.
00:52:51.320 Like I measure, I do that, and it's not formulaic.
00:52:54.300 it's that i see things and as i see them i can see what's off and what needs to be created
00:53:01.320 and what needs to change to create a more natural more beautiful appearance and of course i discuss
00:53:06.220 that with the pages i like they're my canvas so i just do whatever the hell i want but the thing
00:53:11.020 is is that you know my hit rate is very very high because of the fact that i've had those
00:53:16.940 experiences i've learned from them fascinating okay well
00:53:23.480 if people want to learn more about this is there a website they can go to or a book they should
00:53:30.280 read where can people find you online yeah so a couple things so i have a book that i published
00:53:35.540 it's called the park avenue face you can get it in bookstores or on amazon and it goes through a
00:53:40.160 lot of this stuff it talks about techniques and procedures what works and what doesn't what things
00:53:44.720 to avoid that talked about fillers all the stuff is in my book it also talks about facial proportion
00:53:49.320 beauty and all you know it's it's a little bit like a crash course but it's very much
00:53:54.820 made for the lay public and i use you know the language that i use is really so that people can
00:54:00.600 engage it as a lay person who's not a doctor because i publish for the physicians but then
00:54:06.540 i publish for the lay public to educate them so they can avoid making the pitfalls and the
00:54:11.400 missteps, getting treatments or surgeries that are going to create problems for them,
00:54:15.640 you know, with that in mind, serving the patient. So that's a great thing. It's called the Park Avenue
00:54:19.860 Face. You can get it on Amazon. You don't have to go to a bookstore. Otherwise, you can find me
00:54:24.920 on social media. I have a big Instagram following at Dr. Giacono. It's D-R-J-A-C-O-N-O. And then my
00:54:30.780 website is really long. It's NewYorkFacialPlasticSurgery.com, all spelled out, no abbreviations,
00:54:38.580 no periods new yorkfacialplasticsurgery.com and i i i got that url you know 25 years ago when i was
00:54:47.800 a resident so i never changed it and i never will i'm like one of those people like once i make a
00:54:53.780 decision i stick with it when it comes to both kinds of things that's not a bad url for what
00:55:00.160 you do yeah it's not but it's too long it has got to be something that's more brief catchy and
00:55:05.580 memorable but like thinking about typing that in n-e-w-y-o-r-k-f-a-c-i-o-p-l-a-s-t-l-s-u-r-g-o-r-y.com
00:55:13.740 it's a little bit much okay well uh thank you doctor very much for coming on my show
00:55:21.540 that was enlightening it's a very interesting topic yeah well it was great talking to you
00:55:26.280 hopefully it didn't overwhelm you with all my thoughts it's a little bit much sometimes a
00:55:30.880 There's a little bit too much going on period.
00:55:33.880 No, no, no.
00:55:34.880 That's good.