Latest / The Dr. Randi Show / What This Plastic Surgeon Is Doing Has the Whole Industry Watching: 7,000 Nose Jobs, 5D Rhinoplasty & the Five Layer Neck Lift — Dr. Anil Shah

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What This Plastic Surgeon Is Doing Has the Whole Industry Watching: 7,000 Nose Jobs, 5D Rhinoplasty & the Five Layer Neck Lift — Dr. Anil Shah · The Dr. Randi Show

• 0:03
  The views expressed in this podcast are for informational
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  purposes only and do not constitute medical advice.
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  This episode of The Doctor Randy Show is proudly sponsored by New
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  Beauty, the ultimate authority in beauty and aesthetics.
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  Ahead of the trends. And discover what's next in
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  Beauty. Now let's get into the episode.
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  Hello everyone, and welcome to the Doctor Randy show.
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  Today I am thrilled to introduce a true trailblazer in facial
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  plastic surgery, Doctor Anil Shah.
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  He is based in Chicago and New York and Doctor Shaw has
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  transformed the faces of lives and thousands of patients,
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  performing over 7000 rhinoplasties and more than 4000
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  face and neck lifts for pioneering and innovative
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  techniques such as the 5D rhinoplasty and five layer neck
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  lift. Doctor Shaw is here to talk
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  about his innovative techniques and setting the standard for
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  aesthetic excellence. Please welcome Doctor Anil Shah
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  to the show. Awesome, thanks for having me.
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  Well, we're excited to have you on board, and I usually just
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  jump right in and talk about what initially inspired you to
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  become a facial plastic surgeon. Yeah.
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  So I think like we're shaped by our past experiences kind of
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  guide us to what we ultimately end up wanting to be.
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  And I was really, really focused on for some reason, I've always
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  been intrigued by the face. And it's something that kind of
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  defines who we are. If we use our iPhone with it
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  unlocks with our face, not our usually not our hand or our foot
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  or some other body part. And there's something about what
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  makes a person who they are. It's so much is seen in the
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  face. So that's one element.
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  And then I have an uncle who is in the UK who is a head and neck
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  surgeon. And I kind of found out about
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  that route. And as I got more and more
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  involved throughout medical school, I think just dealing
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  with faces and having a chance to rotate on facial plastic
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  surgery as a medical student, really it was like, I would do
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  this without getting paid. And the fact that I get paid for
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  this makes it like even more rewarding.
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  That's an amazing answer. So you not only get to change
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  lives, you get to do what you love every day and you get paid
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  for it. So I love that.
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  There you go. We get lucky sometimes.
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  I got lucky on that. Not not everything else, but on
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  that one I got lucky. That's great.
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  And you've performed over 7000 nose jobs.
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  OK, that's amazing because, well, Doctor Shaw, you don't
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  look that old. So I'm wondering how you've
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  packed in 7000 nose jobs. But that's amazing and I'd love
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  to hear about the 5D rhinoplasty.
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  Yeah. So, OK, so patients come in and
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  when I first started doing rhinoplasty, I learned from some
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  amazing mentors. And there's something about
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  rhinoplasty, like when you perform it, patients want
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  something. And then if they go to a meeting
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  and see what surgeons are doing, they're oftentimes patients are
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  less impressed than what the surgeons are impressed with.
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  And sometimes surgeons are like, you know what, I was really able
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  to stick this patient's nose out further.
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  I was able to make this nose like wider and straighter.
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  And if you ask patients which nose looks better, this is me
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  going to meetings and talking to like just people afterwards,
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  looking at different people's results.
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  And yeah, I'm including my own at that time they would say, I
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  don't know if this is better or worse and you're kind of giving
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  up a compromise. So the idea over there was can
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  we have someone eat their cake and have a too?
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  And the idea with this is can I make someone's nose smaller in
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  this direction deproject the nose?
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  Can I make their length smaller? Can I decrease the size of their
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  tip? Can I decrease their bump and
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  strain it all at the same time? And if I measure this and try to
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  quantify this on a 3D program, it's sometimes as much as 7 to 8
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  CCS of volumetric change. And if you're thinking about
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  that, like everyone, most people know it like one CC of fillers,
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  right? Imagine taking 7 to 8 CCS out of
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  someone's face volumetrically from their nose.
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  And to me, that's been like an evolution to figuring out how
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  can I do this because this is what patients want.
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  Not all patients, but this is what a lot of patients want.
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  And being able to achieve that was like, wow, that's really
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  hard. Yeah, so, so that's the 5D
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  rhinoplasty, right? Correct.
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  Amazing. OK.
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  So that's your technique that you came up with?
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  Correct. OK.
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  That. So people seek that out.
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  Do you have people coming from outside of Chicago?
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  I'm assuming well. I, I practiced in both Chicago
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  and New York and it's kind of like you have these niches of
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  patients who find you. For example, we were just
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  featured in people for Miss Illinois kind of came out and
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  said, hey, guess what, There's a secret to my success.
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  And she said, I, she tried five times to win and then the fifth
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  time she had her vinyl classic in three months later, she won.
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  And I was like, wow, that's so cool.
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  And so I have a lot of patients who just find me out through
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  people who are in the industry, for example, pageant people,
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  there's these like, there's all these industries, like behind
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  the scenes, there's all these major players.
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  You would never know their names.
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  And they're just these major power players.
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  And in the pageant industry, there's like four or five
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  pageant coaches who are like powerhouses that top, top
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  candidates go to them. And if they look at them,
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  they're brutal, by the way, and they'll say, hey, you need to go
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  see Doctor Shaw. So that could be like 1 Nisha
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  patients, actress and actresses have their own people in the
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  know. Like in New York, Chicago has
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  like both. Chicago's bigger for print, New
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  York's bigger for runway and print.
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  So you have a model, some stuff. So that's like a certain
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  percentage of patients and then just word of mouth.
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  So these are just kind of all these people finding you
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  throughout everywhere. I read that article about the
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  pageant queen. So that's, that's a pretty
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  amazing story, right? So she gets one of your nose
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  jobs and suddenly she wins. Well, we, we kind of like, it's
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  interesting aesthetics because we're always our results.
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  They're not always people don't really know that we've done what
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  we've done because behind the scene, but then they get judged.
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  And then when they're able to get judged by people who are
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  beauty experts and then they kind of like you see a result.
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  To me, that's kind of like getting a gold medal in the
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  Olympics because you have a judge and there's some
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  subjectivity and for example, gymnastics, but people kind of
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  know like a 10 is on gymnastics. And sometimes you're like, well,
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  that patient's stunning. They don't always know what it
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  took. And the rhinoplasty, by the way,
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  is just a, it's a small part of what made that person beautiful.
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  It's just one aspect of it. There's so many other things
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  that they're doing behind the scenes, and I'm just such a
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  small part of that. But it's still it's helpful.
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  I'm sure that makes you feel amazing too, right?
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  When you see that she won and you know.
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  Behind the scenes, yeah, but I can't, like, unfortunately, I
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  can't be vocal about it unless they choose to be vocal about
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  it. But behind the scenes, you know
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  when you're super, super happy. That's great.
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  That's great. And then you have another
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  procedure that you pioneered which is the five layer neck
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  lift. Can you that's been gaining
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  popularity. I've also read a little bit
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  about that, so tell us about that.
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  OK. So in neck surgery, there's
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  probably the most challenging area to change is this little
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  floating bone we have in our neck called the hyoid.
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  And the hyoid is what everything connects really deep underneath.
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  So there's these muscles that are below, these muscles that
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  are above and in the middle is this bone, the hyoid.
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  If you were born with the genetic lottery, your neck goes
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  back and you have this amazing jawline and life is easy.
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  However, that's such a small percentage of the population and
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  some people would say, hey, guess what?
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  I can take the fat out in front of it.
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  I can take out the fat around it, but you can never change the
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  highlight. And what I wanted to do is say,
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  hey, guess what? Can I actually change someone's
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  highlight? Can I make someone whose
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  highlight is in a bad position just because of the way it was
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  formed or not even as ideal? And can we actually improve
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  that? And that's the point of the five
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  layer neck. So by being in this deeper layer
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  and we have a study coming out showing like clinical without a
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  statistical significance that that can actually change with
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  just the neck, not even a facelift, which is a game
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  changer. So you like working on the neck
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  I'm assuming right then because you can make that
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  transformation. It's part of a universal
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  beautiful attribute of patients. There's an author, Nancy Adkoff.
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  She went around the world and tried to deem what was
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  considered beautiful, like patients from Africa, Asia,
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  Europe. And essentially what she found
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  was that certain things were universally beautiful in men and
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  women. And one of those is jaw lines
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  and necks. And so for some reason, and I
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  can kind of explain that to you if you want, but for some reason
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  when we see a stunning jawline and neck, we look at this and we
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  look at that person, deem them much more attractive.
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  I would believe that. I think that as a woman of 54,
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  we look at other people's right? It's the first thing that age is
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  right. So I'm constantly like, I'll see
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  a photo of myself and I'll see like the neck and I'm like, oh
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  gosh, it's wrinkling right here, you know, So I and then when I
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  see other women, I'm like, is there's more wrinkled more than
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  mine or less than mine, or is they're still tight or if they
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  had a neck lift. And so I think we're, you know,
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  we look at that right. But when we're young, we don't
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  really look at it. But as we get old, we definitely
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  do as we start aging. But you would be surprised that
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  even in younger patients, again, patients I can see just from the
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  shadows that you have great structure and from there, but
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  some patients when they're younger, they're not born with
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  that and they might say, hey, guess what, my neck is not as
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  ideal. So what bothers us is some, for
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  some patients they had this before and they've lost it or
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  it's gotten worse, but in some cases they've never had it.
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  So I think it, for me, it's almost like it's age isn't
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  necessarily the factor. It's more what you want your
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  jawline to look like. Got it.
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  Yeah. And I've seen I have some filler
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  done in my jaw years ago and it made like such a big difference,
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  right? They like brought that out a
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  little bit. So you know, the jawline in the
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  neck. Very interesting.
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  Speaking of filler, you are, I know you're a plastic surgeon,
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  but what are your thoughts on filler and are you a big fan or
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  what are your opinions there? You know, I think with like,
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  with everything, we like things to be simple, the way we think
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  about it. And it's usually everything is
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  good or everything is bad. And the reality of that is
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  that's just not the way like life works.
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  It's not the way that, you know, people are.
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  It's more complex than that. And I think when filler first
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  came out, people weren't really having this backlash.
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  But then I think with the rise of Med spas, not that they're
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  all bad, but sometimes they're pushed on profits and they have
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  to push with certain doing a certain number amount of
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  injections for certain patients. Not all are like that, of
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  course. And so patients were getting
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  overly filled and there was a backlash.
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  People were looking at these patients saying they don't look
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  better and they just look weirder.
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  And so that's where the filler backlash came in.
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  At the same time, some surgeons are saying, hey, guess what?
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  If you have filler in your face, I won't do a facelift on you.
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  And that's just not the case. You can operate in some with
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  filler. So the reality is filler plays
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  still a really important role for patients.
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  Too much filler is bad, but too much surgery is bad too.
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  So it's like it's there, but you use it in the appropriate dose.
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  Yeah, I just read an article the other day that said that there
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  are some facial plastics that make you dissolve all your
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  filler before they'll do your facelift right, because they
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  can't really tell what's going on.
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  But you don't make people do that.
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  Well, there's there was this backlash started about a year
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  and a half ago, and it was like, hey, guess what?
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  If you have sculpture in your face, it's going to be really
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  hard for me to operate. Or if you've done radio
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  frequency, it's going to be hard for me to operate.
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  And again, sometimes some patients have just natural
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  occurrences like acne scarring can be just as bad as those.
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  As an experienced surgeon, if you're in the appropriate plane
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  and deeper, it's not really that much of an issue.
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  So I don't necessarily say, hey, dissolve everything.
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  There's certain spots you may want to dissolve depending on
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  what you're working on, but it doesn't really prevent you from
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  having surgery. OK, so let's talk about what,
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  you know, what concerns everyone when they look at plastic
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  surgery. It's the natural outcome, right?
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  How do we keep it natural looking?
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  What are your thoughts on that? What about when somebody comes
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  in and wants something kind of outrageous and we've seen some
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  of the photos of that, right? So what are your thoughts on
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  that and how do you make sure that you stay within your
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  comfort zone of natural looking results?
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  Well, first of all, I think we're somewhat selected, but if
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  someone's stalking us on Instagram and websites and all
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  that aspect of it, they kind of know your style.
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  And so it's like looking, let's say for a car.
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  And if you're looking for a SUV, you're probably not going to go
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  to a sports car and vice versa. And so same thing with certain
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  styles of nose and certain styles of necks and face.
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  You see what certain are theoretically capable of.
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  And sometimes, again, you have to take that with a grain of
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  salt because sometimes stuff out there is not accurate.
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  And so patients coming in, I think they're more informed.
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  I get less outrageous requests now than I did maybe like 10
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  years ago. Before I'd had patients say make
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  me look like Elvis, make me look like so and so.
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  And I think that those patients, their heart was in the right
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  spot. They just wanted, they didn't
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  know how to describe what they wanted.
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  Now with 3D technology and lots more technology to help patients
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  understand things, it's a much more comprehensive and informed
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  discussion. Sure.
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  And Speaking of that, like AI technology and the softwares
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  that show you what you're going to look like, the possible
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  outcome, that kind of thing, what is your opinion of those
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  softwares accurate or not accurate?
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  I'm an AI guy, so I love AI. I've used AI so much in like my
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  daily life. I use it in my practice.
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  I use it in so many different areas.
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  So you're talking to an AI guy. I think it's not a bad idea to
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  use AI to help generate ideas of what you want to look like,
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  knowing that may or may not be possible.
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  And if it's a responsible AI, it can help guide you in some
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  responsible way, knowing that this kind of AI isn't perfect.
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  It comes up, it says wrong things all the time.
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  So it's like having this kind of smart but kind of stupid buddy.
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  And that's what AI is at this point.
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  It's wrong a lot. It's right a lot.
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  And it can give you access to so many things.
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  So if someone comes in with an AI image and says, hey, guess
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  what? I want my cheekbones higher.
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  If possible, I'd love to have my nose a little smaller because AI
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  generated beauty that says I'm going to look better with my
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  nose smaller. I'd love to have my jawline
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  improved. I'd love to have this improved.
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  Say, hey, guess what? This is a great place to start
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  the conversation. Let's just see what we're going
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  to look with the 3D imaging. Let's just take this AI image we
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  have. Let's see what's possible.
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  That's not possible. And let's start this discussion
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  and go from there. And I actually think this was
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  right. I don't know if I agree with
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  this personally, but let's talk about why that's a risk.
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  So I think it's a way of patients to understand what they
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  want. OK, I think so too.
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  I mean, I think it's good to see what you could look like.
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  But I do think it's important for doctors to say it may not
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  look exactly like this, you know, because you're human, so.
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  For sure, for sure. Not exactly like that.
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  What are the hottest trends that you're seeing right now as far
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  as like requests, people are coming in asking for what?
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  So the hottest request right now, it's really about surgery.
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  So the paradigm like we talked about earlier, it's kind of
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  shifted from filler more to surgery and it's really about no
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  downtime surgery. And in particular it's
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  facelifts. And if you can do a facelift
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  without a visible scar with the least amount of downtime,
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  meaning like a few days to a week, patients love that.
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  So that's a younger demographic patients and these are patients
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  before who are going to be filler patients.
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  But that's the hottest trend is late 30s, mid 40s, even up to
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  like early 50s doing these no scar facelifts that essentially
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  no one will can tell that you've had anything done.
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  You need about a week to recuperate and then you are back
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  and people think you look families but have no idea.
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  There's no signs of surgery. Yeah, like you look well rested,
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  right? So what is the average age that
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  people are having their first facelift?
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  I still think it's not. That's not as many patients
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  going for those younger facelift as kind of the traditional,
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  traditional age is still going to be around 505254.
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  So that's like that national trend.
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  It's just a whole new subset of patients going for the other
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  one. So 525455 is where most patients
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  are kind of landing with their first facelift.
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  But I know that I'm hearing on social media, you know, 35 year
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  olds and 32 year olds having this ponytail lift or the eye
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  lift, those kind of things. But if we talk about those,
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  there's a couple weaknesses and some of those techniques.
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  So if we talk about, and I don't want to use anyone's trade
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  trademarks or trade lines, but because there's nothing right or
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  wrong, the classic like no scar lift actually has a potential
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  visible scar. So the technique that one of the
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  techniques you mentioned earlier, I won't say the name,
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  if you put your hair back and in a different hairstyle with your
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  hair back, the problem with that technique is you'll have a scar
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  behind your ear back here and believe it or not, in your
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  posterior hairline. When you put it in your
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  posterior hairline, your scar, believe it or not, you know the
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  one thing you can't wear. Yeah.
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  Wow. And so that's interesting.
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  So the way I've modified my technique is my scar is only
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  behind the ear, only in the crease, not in the back of the
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  hairline, only in the hair. And then I say 3mm above, like
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  behind, under your ear right here.
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  So with that technique, it allows patients essentially to
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  wear any hairstyle they want and not be conscious about.
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  Since you don't have a scar back here, there's nothing to ever
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  be. So even if you say you make
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  beautiful scars, guess what? A scar is a scar.
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  Right, absolutely. It sure is.
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  Well, I do see a little bit of a, you know, it's queuing a
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  little bit younger, but I seem to be in that cone of its time.
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  So we'll see. We'll probably document that
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  whole thing when it happens. So with upcoming trends, what do
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  you see that's going to be coming into facial plastics in
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  the next 5 to 10 years? What do you think will change?
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  What do you predict? I think the biggest issue in all
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  of medicine and what we're going to kind of focus in on basal
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  plastic surgery as well, is fragmentation of knowledge.
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  There's so much knowledge out there in so many different
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  arenas, and even within Emr's, there's so much knowledge that's
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  out there that's untapped, probably like less than 1% of
• 18:37
  information. It's not about getting more
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  information out there. It's about kind of consolidating
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  information so that we understand how things work.
• 18:46
  For example, we don't even know. We kind of know.
• 18:49
  I can tell you that I know that patients who take protein
• 18:53
  probably heal faster and powder greens, but I can't definitively
• 18:57
  say that. If I said, let me power up all
• 19:00
  these databases together and, and let's look at all the
• 19:02
  patients who took, for example, whey protein and powdered greens
• 19:05
  before, I would know definitively like the answer is
• 19:07
  you will recover 15% faster, 14% faster like that.
• 19:11
  So I think the issue is the fragmentation of information.
• 19:14
  And obviously that's going more towards having AI getting
• 19:17
  databases together, having them talk to each other.
• 19:20
  And I think that's where medicines going and I think that
• 19:23
  hopefully facial plastics is going that way so that we really
• 19:26
  get information so that instead of me having a weak recovery for
• 19:29
  patients, I can say I can dial that down to three days or four
• 19:32
  days for patients. Well, that's that's incredible.
• 19:36
  And I do think that we're going to see more advancements and
• 19:39
  quicker healing time. How many days a week are you
• 19:41
  doing surgery versus, you know, filler and whatnot?
• 19:45
  So I try not to do filler and Botox at this point in my
• 19:48
  career. I still do it for some of my
• 19:49
  select patients. So I've known for years and it's
• 19:51
  it's actually more like a social call.
• 19:52
  But really it's surgeries on Tuesday, Wednesday and Thursday.
• 19:57
  And then I do consults on Monday and Friday.
• 20:00
  OK. OK.
• 20:01
  So three days a week surgery, how would you say that?
• 20:05
  We talk about this a lot with facial plastics in general, but
• 20:08
  like, how much do you think social media is affecting the
• 20:13
  desire for surgery and the expectations and some of them
• 20:16
  being unrealistic? You know, do people come in and
• 20:19
  show you pictures? Yeah, it's a double edged sword.
• 20:22
  This is kind of a really deep issue like social media.
• 20:24
  And the problem with social media is I don't know if social
• 20:29
  media is better for us as a society because a lot of people
• 20:31
  who go on social media, they can feel negatively about
• 20:33
  themselves. They can compare themselves to
• 20:35
  other people. A lot of people even what they
• 20:38
  portray on social media isn't actually accurate to what their
• 20:40
  lifestyle or what their how they look.
• 20:43
  And so we get this false sense of who we're supposed to look
• 20:46
  like, where we're supposed to be in society.
• 20:48
  And so I'm, believe it or not, not as big a fan of the
• 20:52
  ramifications of social media. However, I'm not going to be
• 20:54
  able to change that. So that's why I am on social
• 20:57
  media. So I think that it is driving
• 20:59
  patients to perhaps say, hey, is there a way I can prove myself?
• 21:04
  On the other hand, there's some really good things about social
• 21:06
  media. There's a lot of great
• 21:07
  educational formats out there. Patients can talk about their
• 21:10
  experiences with different surgeons, and there's a lot of
• 21:13
  information out there that's helpful, too.
• 21:15
  Right, I do think there there is a good and bad.
• 21:18
  I mean, I think about how I go on Facebook and I'm connected in
• 21:22
  a group with people that I went to elementary school with,
• 21:25
  right, and high school and college.
• 21:27
  And like I would never have stayed connected with these
• 21:29
  people. But you're right, there's also
• 21:31
  this at the age of 54, I grew up without any social media.
• 21:36
  So I never compared myself at all growing up to other people.
• 21:40
  And I see kids today on social media just all like, you know,
• 21:44
  looking at other pictures of other girls and which aren't
• 21:47
  even a picture of them. It's a filter, right?
• 21:49
  So they're comparing themselves to things that aren't realistic
• 21:51
  and then making themselves feel bad.
• 21:53
  So I think you're right. There's the pluses and minuses
• 21:56
  to all. So hopefully we use it for for
• 21:58
  good. I think the other thing I don't
• 22:00
  love about social media is like the judgments that are imposed
• 22:03
  and all of us are naturally as humans, even though we say we
• 22:07
  don't judge people, we we kind of do.
• 22:10
  And we try to do that. And I'm, I'm always about to say
• 22:12
  like trying to build someone up, make someone happy, make them a
• 22:14
  better version of themselves. And I think that's one element
• 22:17
  of social media where there's a little bit of negativity in
• 22:19
  judgment. And I think that there's a good
• 22:21
  and bad, some mixed missions, like you said, yeah.
• 22:23
  Absolutely. I agree with you.
• 22:25
  So are you actively working, you know, patients that are
• 22:29
  celebrities and how does that affect your practice, the
• 22:33
  expectations? You're always working with
• 22:35
  patients in kind of in the spotlight.
• 22:37
  And I think that part of it is when you do enough of a
• 22:40
  procedure, you don't want to alter what you normally do.
• 22:44
  So I think the problem, I think when I'm seen as a patient and
• 22:47
  I've luckily elective non emergent things, when I'm seen
• 22:50
  as a patient, I always tell them like either I don't tell them
• 22:53
  what I do or like I'm in the medical field, or I'll just let
• 22:56
  them know, do what you normally do because when you try to do
• 23:00
  something extra for someone, you know what happens.
• 23:03
  It's not the right thing. So I'd say any patient who comes
• 23:06
  to me, I treat them like, hey, guess what?
• 23:08
  This is the best I can absolutely do.
• 23:11
  And I do this on every single patient that comes in,
• 23:13
  regardless of, of, you know, whether this turns into
• 23:16
  something this way or that way, I don't really care because that
• 23:19
  to me is the most important thing.
• 23:20
  Because for example, one patient I operated on the patient's mom,
• 23:23
  the patient's dad, the patient's sister.
• 23:25
  Like I've operated on so many people, even though that person
• 23:28
  isn't a celebrity, they're treated like a celebrity.
• 23:31
  Because I mean, if someone's a celebrity or not, it doesn't
• 23:34
  really matter. It's just like the idea that
• 23:36
  everyone's a celebrity when they come in.
• 23:37
  Right. Well, that's good.
• 23:39
  If you treat everybody like a celebrity, that's good.
• 23:42
  So what would you say is your biggest accomplishment so far in
• 23:45
  the field? Oh my goodness.
• 23:48
  I think what I'm trying to do, and I don't think I'm alone,
• 23:52
  there's a lot of people doing this, but is really trying to
• 23:55
  put together more scientific, like backing to what is being
• 23:59
  done and why certain things work and certain things don't work.
• 24:03
  So it's kind of that synthesis, that gap.
• 24:05
  You'll see a lot of surgeons talk about being very artistic
• 24:09
  and trying to like especially in the field of plastics, but not
• 24:12
  showing the scientific part of it.
• 24:14
  And I think you kind of need both.
• 24:16
  If you've ever met a real life artist, not the plastic surgeons
• 24:20
  who say they're artists, you look at their work and say, my
• 24:21
  gosh, you're not an artist. You have to sit, you have to put
• 24:23
  both together. And if you think of like
• 24:25
  Leonardo da Vinci, I'm half Italian, so I'm going to be
• 24:27
  biased towards him. It's really art and science were
• 24:30
  always together. And I think putting science with
• 24:34
  what we do with the artistry together is really the most
• 24:36
  important thing. So it's kind of synthesizing
• 24:38
  these ideas and then that's what leads to different procedures
• 24:41
  and techniques that, you know, kind of coming up with.
• 24:45
  So do you do any non surgical procedures other than Botox and
• 24:50
  filler? Use any devices in the office or
• 24:54
  anything that you we have. A lot of devices in the office
• 24:56
  and to me I think this is a complementary aspect of like how
• 25:00
  patients can heal. And I was way more involved in
• 25:03
  the non surgical elements of this.
• 25:05
  And the reason this is important is because I think that those
• 25:08
  tools can help patients heal faster and having them all in
• 25:12
  the same office can really help patients.
• 25:14
  For example, I don't love having bruises, but having machines
• 25:16
  that can kind of of make a bruise instead of lasting 2
• 25:19
  months, lasts 4 days is really nice to have.
• 25:22
  Having hyperbarics in the office, having cool sculpting in
• 25:25
  the office which is good for non invasive things.
• 25:27
  Having hair transplant in the office is really helpful for
• 25:29
  patients to know that hey, guess what, if I'm doing a hairline
• 25:32
  court lowering procedure, if we don't love your scar here or we
• 25:36
  want to go even lower, we can transplant above it.
• 25:39
  So having these complementary services that are involved, I
• 25:42
  think it really helpful. Yeah, that's, that's great.
• 25:46
  So you've got everything integrated there.
• 25:48
  So ultimately, Doctor Shah, what are you hoping is your lasting
• 25:52
  impact on facial plastic surgery?
• 25:56
  I'm going to go probably more towards there's like there's a
• 25:59
  few elements. One is individual lives that
• 26:02
  you've changed. And to me, this is really,
• 26:06
  really like, it's when you affect lives.
• 26:09
  This is probably my number one thing.
• 26:11
  I just saw a patient this week where I did her nose in 2012.
• 26:16
  Now she's married, amazing marriage, amazing guy.
• 26:20
  They're they're super successful in multiple ways.
• 26:22
  She came back for something else this week.
• 26:24
  And so to me, having patients enjoy success, having the best
• 26:27
  life is great. And then the other level is
• 26:31
  coming up with techniques and advances that patients of every,
• 26:35
  not just me, as the surgeon can appreciate and having the ways
• 26:40
  that patients can get more consistent results that when
• 26:42
  patients come in for a neck and say, Hey, guess what?
• 26:44
  I had my neck done and I did this maneuver where I did this
• 26:49
  new technique that we talked about.
• 26:50
  And I did this because I saw this article published by Doctor
• 26:53
  Shah that was amazing. I, I get a lot of actually a
• 26:58
  text and messages when I presented meetings.
• 27:00
  One of them is like, for example, the non pain
• 27:02
  rhinoplasty. And I talked about this because
• 27:05
  I don't care if I'm like the only no pain rhinoplasty
• 27:08
  surgeon, but I want more and more patients to not have pain.
• 27:11
  And doctors will honestly detect me, say, Oh my God, I'm so glad
• 27:14
  I'm using that technique because this is to help my patients have
• 27:17
  less pain. And having patients use less
• 27:20
  narcotics, it's like a greater good.
• 27:22
  It helps everyone. And if more patients are happy
• 27:25
  getting rhinoplasty and you're saying, hey, guess what?
• 27:28
  I had no pain from this. And a surgeon who did this says,
• 27:30
  hey, guess what? I use your technique.
• 27:32
  I'm like, great. They don't have to even credit
• 27:33
  me. Most of the patients don't even
• 27:35
  know that's happened. I was just going to ask you, are
• 27:37
  you comfortable training other physicians on your technique?
• 27:42
  I trained them on something. Some things I still don't have
• 27:45
  them observe me with, like my rhino technique and my neck
• 27:48
  technique. I'm still slightly and maybe I
• 27:50
  have to kind of love on that. I released segments of it.
• 27:53
  So I'm releasing another segment of my neck technique.
• 27:55
  And so I haven't released everything on that.
• 27:58
  And I think I'll have everything I have a plan of like when I
• 28:01
  release certain things for surgical stuff and my nose
• 28:03
  techniques, I've released a few things of it, but not all of it.
• 28:07
  And why do I do that? If I speak at a meeting, I don't
• 28:09
  want to be presenting the same thing year after year.
• 28:12
  Partly because it's kind of cool to see people embracing a part
• 28:15
  of your technique, then embracing another partique.
• 28:17
  And it's kind of like a ladder up idea for it.
• 28:19
  So that's kind of another part of it.
• 28:22
  Sure, got it. Well, it's been a great episode
• 28:26
  having you on the show. Is there anything else that
• 28:28
  you'd like to share with our audience?
• 28:31
  I think it's we're. In such a wonderful age of like
• 28:36
  I say that if you don't like something about the outside,
• 28:39
  that is the easiest thing to change.
• 28:41
  And we can almost change anything on your outside, which
• 28:45
  is like the most amazing thing. So if you don't like something
• 28:47
  about you, you should never lose sleep over that.
• 28:49
  Just find someone who's really good and do that if that was
• 28:51
  something you want to do. But changing the inside,
• 28:54
  changing who we are as a person, that is something that takes we
• 28:58
  always discount how hard that is to be a good person to acquire
• 29:02
  skills and knowledge over time and do what that is.
• 29:04
  So I think that changing the outside, if that's the vehicle
• 29:07
  for you to be more successful in life, go for it.
• 29:09
  If you don't need to change it, don't change it.
• 29:11
  That's life. Whatever makes you happy, right?
• 29:14
  That's that's a great. Way to look at it.
• 29:16
  The changing inside is much harder, like you said.
• 29:19
  Well, it's. Thank you so much for being on
• 29:20
  the show. If you have another couple of
• 29:22
  minutes, we'd love for you to stay for our speed round, which
• 29:27
  is where we get to know you as well as some of your ideas
• 29:30
  around plastic surgery and a very quick a 5 minute take.
• 29:33
  Are you in? Yeah, let's go for.
• 29:35
  It OK, OK, so let's. Dive in the first surgery you
• 29:39
  ever performed. It was probably a.
• 29:42
  Tracheostomy and it's putting the tube to help someone breathe
• 29:45
  in their airway. I'm exposing on the neck, OK?
• 29:49
  Most commonly requested procedure.
• 29:53
  It's going to be a. Tie between a neck and a nose.
• 29:56
  At this point, about 5050 the most difficult.
• 29:59
  Surgery you do probably. Septal perforation repair, when
• 30:05
  patients have holes in their nose and you repair them, it is
• 30:08
  one of the most challenge and usually it's a revision
• 30:09
  monoplasty. On top of that, it is one of the
• 30:12
  most challenging procedures to do in rhinoplasty and a lot of
• 30:15
  people don't do those. Interesting.
• 30:17
  OK. Injectable nose jobs in or out?
• 30:21
  I think they're. Kind of out.
• 30:22
  They're overhyped. Yeah, I think so too.
• 30:26
  Agreed. Music or silence in the OR.
• 30:29
  Oh, you have to have music. You have to create that mood OK.
• 30:33
  Longest surgery you have ever done.
• 30:35
  Number of hours probably going to be about. 9 hours?
• 30:39
  Wow, what was that? That was.
• 30:43
  A revision rhinoplasty with septal perforation repair with
• 30:47
  rib cartilage. The patient had essentially
• 30:51
  nothing in the nose, like nothing, and had to create
• 30:54
  everything from basically from air that you want to find out on
• 30:57
  my website or anywhere because I don't want to keep doing that
• 30:59
  surgery, I'm sure. OK, laser treatments, yes or no?
• 31:04
  Love them. OK.
• 31:06
  One word that patients use to describe your results?
• 31:10
  Impactful. Ever declined a?
• 31:12
  Patient's request all the time, every day.
• 31:17
  Most. Popular non surgical procedure
• 31:19
  at your clinic. Under eye filler.
• 31:23
  That's a hard one, but it's weird stuff people come to you
• 31:25
  for, not the common stuff as much.
• 31:27
  Yeah. What do?
• 31:28
  You believe is the ideal age for the 1st facelift 40?
• 31:33
  647 Typical. Rhinoplasty recovery in days.
• 31:39
  Complete recovery. Mm Hmm.
• 31:42
  Well. To take months, right?
• 31:44
  But where you can be outside and doing your, oh, we'll say 10
• 31:47
  days. OK.
• 31:49
  Most surgeries you've ever done in one day.
• 31:53
  Oh my gosh. Earlier in my career Oh small
• 31:56
  procedures is going to be high 1718 wow that's a long.
• 32:00
  Day smaller procedures though too so.
• 32:03
  Kind of a mixed in, OK. Preventative Botox yes or no?
• 32:07
  I'm not into it. Coffee or energy?
• 32:09
  Drink before surgery. No, I don't do caffeine.
• 32:12
  All right, all right. I'm caffeine free too, but we're
• 32:17
  very rare breed. That's right, filler or fat
• 32:20
  grafting. Actually, surprisingly, I'm.
• 32:24
  Going to go. Depends on the area, but I
• 32:26
  actually might go filler OK. What is right now the top
• 32:31
  requested celebrity facial feature?
• 32:36
  Jawlines and necks are in OK. One skin care step that patients
• 32:42
  should never skip. Use your retinol every day.
• 32:47
  Best. Quick fix for a sagging jawline
• 32:51
  or is there one? Muscle my muscle patients hold
• 32:56
  on to their necks better and I see this in guys so you.
• 33:01
  Mean like working out this area, like kind of just generally make
• 33:05
  yourself a. Stronger hold on to muscle and
• 33:07
  patience their necks hold up. It's the opposite of what you
• 33:10
  think. You don't want to put Botox in
• 33:13
  your neck because you want this muscle.
• 33:16
  There's all, there's like a 2 hour discussion, but it's like
• 33:18
  you want your muscle in your neck, the muscle in there to be
• 33:20
  as strong as possible. I see the I get these.
• 33:23
  Ads for like these apps to exercise your face and the
• 33:27
  muscles in your face. Is that a thing or no?
• 33:29
  I don't love it in the face. But I don't mind it in your
• 33:32
  neck. Having a really strong muscles
• 33:34
  in your neck actually can help in some ways.
• 33:36
  OK, I'm going to go look. Up neck exercise.
• 33:40
  OK. Micro needling yes or no?
• 33:43
  By itself, no. Are you a night owl or an early?
• 33:46
  Bird early. OK are more.
• 33:50
  Men having facial plastic procedures, Yeah, for sure.
• 33:56
  You got to keep up. With the women.
• 33:57
  OK. And.
• 33:59
  Are you seeing young, more younger patients than ever
• 34:02
  before for. Sure, it's become a thing.
• 34:06
  OK. And.
• 34:07
  What's your favorite snack to have in between surgeries?
• 34:12
  I try not to eat but I'll have a ketone drink in between.
• 34:16
  OK, how many? Hours of sleep do you get.
• 34:19
  I try. To get at least 8 hours And
• 34:23
  what's the? First thing you do when you get
• 34:24
  up, I take my first. Supplement.
• 34:28
  OK, good for you. And what's the last thing you do
• 34:31
  before you go to sleep? I take my last.
• 34:33
  Supplement. See, we're.
• 34:35
  We're getting to know you. And last but not least, just for
• 34:39
  fun, what's the emoji that you use most on your phone?
• 34:43
  I'll keep it clean. I'm usually a thumbs up though.
• 34:46
  It's a positive. Hey, let's let's get Skip a
• 34:48
  good. Well, thanks for joining.
• 34:50
  Us for the speed round people get to know you a little and we
• 34:52
  get the answers to all the hard questions so you've been an
• 34:55
  amazing guest Doctor Shah, thank you so much and we look forward
• 34:59
  to having you back again in the future This was amazing thanks
• 35:02
  So. Much, Doctor Randy.
• 35:04
  Boyett holds a PhD and is a recognized leader in the
• 35:07
  aesthetics and medical industry. She is not a licensed medical
• 35:10
  doctor. All commentary and product
• 35:13
  recommendations are based on industry expertise and are
• 35:16
  provided for informational purposes only.