Latest / HKB Uncut | A Cosmetic Surgery Podcast / 30. What Makes a Great Plastic Surgeon? Dr. Jeyhan Wood on Natural Results, Surgical Judgment & Patient Care

Transcript

30. What Makes a Great Plastic Surgeon? Dr. Jeyhan Wood on Natural Results, Surgical Judgment & Patient Care · HKB Uncut | A Cosmetic Surgery Podcast

• 0:00
  SPEAKER_03: Jan was the only person I worked with that could de-epithelialize faster than me.
• 0:05
  SPEAKER_03: She would smoke me.
• 0:07
  SPEAKER_03: So she's a better surgeon, is what you're saying.
• 0:08
  SPEAKER_03: She had wicked these wicked little hands.
• 0:10
  SPEAKER_02: Like.
• 0:11
  SPEAKER_02: Gee, that's not saying a whole lot, but I know she's amazing, but it's not saying a whole lot that she's just slightly better than you, right?
• 0:16
  SPEAKER_02: No, I'm serious.
• 0:17
  SPEAKER_02: She's good.
• 0:22
  SPEAKER_02: Welcome to HKB Uncut, the health, knowledge, and beauty podcast.
• 0:26
  SPEAKER_03: On this show, we unpack the newest techniques and trends in cosmetic surgery, how to tune out the social media noise to make empowered decisions about your appearance and what you need to know before you book a procedure.
• 0:36
  SPEAKER_03: I'm Dr.
• 0:37
  SPEAKER_03: Bill Cortesis.
• 0:38
  SPEAKER_03: And I'm Gorov Bahardi.
• 0:40
  SPEAKER_03: We are board-certified plastic surgeons and co-founders of HKB Cosmetic Surgery, an award-winning practice with 11 locations across six states.
• 0:47
  SPEAKER_02: In other words, when it comes to aesthetics and cosmetic surgery, we've pretty much seen it all, and we want to share our knowledge and unique approach to aesthetics and beauty with you.
• 0:56
  SPEAKER_02: Whether you're interested in cosmetic surgery for yourself or want to separate fact from fiction in the plastic surgery world, we hope you'll tune in each week.
• 1:19
  SPEAKER_02: Thanks for being here, my friend.
• 1:21
  SPEAKER_02: We've known Jaehan for a long time.
• 1:23
  SPEAKER_03: Jahan, almost 20 years.
• 1:26
  SPEAKER_03: Is that right?
• 1:27
  SPEAKER_03: I mean, am I wrong?
• 1:28
  SPEAKER_02: No way, because she doesn't look a day over 30.
• 1:30
  SPEAKER_02: So we could not have met her when she was Jahan.
• 1:33
  SPEAKER_03: Jaehan was many, many, many, many, many years junior to you.
• 1:36
  unknown: True.
• 1:37
  SPEAKER_03: A little junior to me.
• 1:39
  SPEAKER_03: Um you know what the but my the thing about Jaehan was?
• 1:42
  SPEAKER_03: Jaehan was the only person I worked with that could de-epithelialize faster than me.
• 1:48
  SPEAKER_03: She would smoke me.
• 1:49
  SPEAKER_03: So she's a better surgeon, is what you're saying.
• 1:51
  SPEAKER_02: She had wicked these wicked little hands.
• 1:53
  SPEAKER_02: Like, gee, that's not saying a whole lot, but I know she's amazing, but it's not saying a whole lot that she's just slightly better than you, right?
• 1:59
  SPEAKER_03: No, I'm serious.
• 2:00
  SPEAKER_03: She's good.
• 2:01
  SPEAKER_03: Like, and I always learn one thing: you don't you don't mess with the Jayhan.
• 2:05
  SPEAKER_03: Like the Zohan.
• 2:06
  SPEAKER_03: Don't mess with the Zohan, you don't mess with the Jehan.
• 2:08
  SPEAKER_03: And I never actually did, but Jayhan is like in the OR.
• 2:11
  SPEAKER_03: She's so talented.
• 2:13
  SPEAKER_03: I love it.
• 2:14
  SPEAKER_02: Thank you.
• 2:15
  SPEAKER_02: I never really got to operate with her that much.
• 2:17
  SPEAKER_02: We were only there together a year.
• 2:19
  SPEAKER_02: So what we're talking about is we all trained together at Wake Forest.
• 2:22
  SPEAKER_02: And then you went to work in Chapel Hill.
• 2:26
  SPEAKER_03: Well, she did a fellowship.
• 2:27
  SPEAKER_03: Fellowship and then a facial fellowship.
• 2:30
  SPEAKER_02: And then you went and work in Chapel Hill at the hospital and then been with us now year and a half.
• 2:35
  SPEAKER_02: Two and a half years?
• 2:36
  SPEAKER_02: Two and a half years.
• 2:37
  SPEAKER_00: Two and a half years.
• 2:37
  SPEAKER_02: Oh my goodness.
• 2:38
  SPEAKER_02: Time flies.
• 2:39
  SPEAKER_02: Time flies.
• 2:40
  SPEAKER_02: Can you talk a little bit about that transition?
• 2:43
  SPEAKER_00: Well, yeah.
• 2:44
  SPEAKER_00: So it was just kind of the right time in my life and with my family and where I was at this stage in my career.
• 2:53
  SPEAKER_00: I actually missed cosmetic surgery.
• 2:55
  SPEAKER_00: I was mainly focusing on pediatric plastic surgery and complex facial trauma.
• 3:01
  SPEAKER_00: Loved that, but I was still missing doing, you know, aesthetic surgery.
• 3:06
  SPEAKER_00: And so I've I really um was grateful for the opportunity to renew this skill set.
• 3:12
  SPEAKER_00: Um and I've really enjoyed this transition so far, and it's been a really fulfilling experience.
• 3:18
  SPEAKER_00: Um one of the great things is I'm still actually able to operate on some children.
• 3:22
  SPEAKER_00: So like some of the families have followed me over, and I've done some cleft rhinoplasties and fat grafting to the lip for some of my cleft lip patients.
• 3:31
  SPEAKER_00: Um and I've done several setback otoplasties for kids with prominent ears.
• 3:36
  SPEAKER_00: So it's it's been great.
• 3:37
  SPEAKER_03: That's amazing.
• 3:38
  SPEAKER_03: And you know what, you know, the the complexity of what you have dealt with and the you know the incredibly you know difficult, you know, kind of fine-tuned surgery you've done with like cleft lips and pallets and recurrent redo things.
• 3:53
  SPEAKER_03: It's interesting how those things help and and bring you to this point where you're at now where you know how many things do you do now like you did like when you were like we trained right back in the day coming out awake?
• 4:06
  SPEAKER_03: I mean, uh when I talk to Bill, it's like we don't do anything that way, not because it was wrong, it's just because we've evolved and learned so much.
• 4:12
  SPEAKER_03: And like in in regards to you and how you approach like a necklift now, like all those complexities that you did, and those difficult noses, those difficult clef lips and pallets, like all of that has led you to where you can now perform at the level that you're performing at, you know?
• 4:30
  SPEAKER_00: Yeah, I agree.
• 4:31
  SPEAKER_00: I mean, I think there's a ton of overlap between craniofacial surgery and aesthetic surgery, um, from but you know, in principle and techniques.
• 4:39
  SPEAKER_00: And I use a ton of the principles and um techniques that I've learned over the years operating on kids and complex facial trauma patients that I'm able to implement now in the cosmetic realm.
• 4:52
  SPEAKER_00: Um, like for instance, you know, doing complex facial recon.
• 4:57
  SPEAKER_00: I never knew what I was walking into sometimes, and you know, I had to piece things back together bones, muscle, all the soft tissue of the face.
• 5:05
  SPEAKER_00: And so I think that gave me a really deeper understanding of facial anatomy that I can then um, you know, use when I'm doing facelift surgery, necklifts.
• 5:14
  SPEAKER_00: Um, I used to put tissue expanders in kids all the time in their cheeks, necks, scalps.
• 5:20
  SPEAKER_00: Um, it's the same concept of breast reconstruction, but I would essentially try to expand up the skin so I could take out some significant scarring, or you know, if they had a birthmark on their face or neck.
• 5:31
  SPEAKER_00: Um, and so I'm very familiar with all those soft tissue planes.
• 5:34
  SPEAKER_02: What is your preferred approach for facial rejuvenation of doing a facelift?
• 5:40
  SPEAKER_00: I mean, I like a D-plane facelift myself.
• 5:43
  SPEAKER_00: I think that it it offers really great lift, um, great longevity in the in the rejuvenation.
• 5:50
  SPEAKER_02: What are you doing in the neck?
• 5:51
  SPEAKER_00: In necklift patients, I'm um doing central like platismoplasty, and then laterally I'll do a little sling to kind of give them some more definition um along the jawline.
• 6:03
  SPEAKER_03: And what is your opinion on, you know, when you're doing necks?
• 6:06
  SPEAKER_03: Are is it just a traditional kind of retroaricular behind-the-ear incision line approach?
• 6:11
  SPEAKER_03: Are you doing any kind of different approaches?
• 6:14
  SPEAKER_00: Yeah, so um certainly that's the majority of my patients will have the standard approach, but I've been seeing a lot of men recently who are interested in necklifts, and with them, you can offer them a direct necklift approach, um, which is essentially making incisions in the center part of the neck to really get down to the anatomy.
• 6:32
  SPEAKER_00: Um, I'll do my my uh muscle work and everything, and then um take out the extra skin in a Grecian urn fashion.
• 6:40
  SPEAKER_00: So they end up having um two horizontal lines and then a straight line down the middle.
• 6:45
  SPEAKER_00: Um, but this skin is so much thicker on men and hair bearing.
• 6:49
  SPEAKER_00: So you're allowed to make those scars on the neck and they just blend in over time, especially if a man wears a beard.
• 6:56
  SPEAKER_02: It's a pretty powerful uh operation to be able to do that.
• 6:59
  SPEAKER_02: I've done quite a few myself, and I I'll tell you the patients are extremely happy and they don't realize how easy it is.
• 7:06
  SPEAKER_02: They're like, oh my god, this is a gone.
• 7:08
  SPEAKER_02: Just like that.
• 7:08
  SPEAKER_00: It's amazing.
• 7:09
  SPEAKER_00: And and that's it's one of my favorite things.
• 7:12
  SPEAKER_03: You're doing general anesthesia or local anesthesia wide awake?
• 7:14
  SPEAKER_03: Which way are you doing it?
• 7:15
  SPEAKER_00: So, either way, whatever the patient's comfortable with.
• 7:18
  SPEAKER_00: But um, I think a direct neck lift um can certainly be done with just a little bit of oral sedation and local anesthesia.
• 7:25
  SPEAKER_03: Oh, it's so awesome.
• 7:26
  SPEAKER_00: It's a beautiful procedure.
• 7:28
  SPEAKER_02: That is so for men who are interested, let's talk about that a little bit.
• 7:31
  SPEAKER_02: Because again, I've done quite a few, and I know, G, you've done quite a few as well.
• 7:35
  SPEAKER_02: What's the recovery like for them?
• 7:37
  SPEAKER_02: Let's just talk to, you know, I know there are a lot of men who are listeners and and wives that are listening, they're gonna go home and tell their husbands, hey, by the way, do you know you can get this taken care of with this?
• 7:47
  SPEAKER_02: Walk us through the recovery of that procedure.
• 7:51
  SPEAKER_00: Yeah, so the surgery takes about an hour, maybe an hour and a half.
• 7:54
  SPEAKER_00: Um and then I use I don't need a drain.
• 7:58
  SPEAKER_00: Um, I use stitches that need to come out in a week.
• 8:00
  SPEAKER_00: So I'll see you back at a week.
• 8:02
  SPEAKER_00: It's an outpatient procedure.
• 8:03
  SPEAKER_00: Um, the most important thing is compression after surgery.
• 8:06
  SPEAKER_00: So um, you know, they'll go home in a little head wrap and then we'll transition them to a compressive garment.
• 8:13
  SPEAKER_00: But really, the recovery after a direct necklift is just a couple of weeks.
• 8:17
  SPEAKER_00: Um I'll take the stitches out after a week.
• 8:19
  SPEAKER_00: There's some swelling, a little bruising, but really they can go back to full activity um after three to four weeks.
• 8:25
  SPEAKER_03: And then how about when you're, you know, going back to when you're doing a face?
• 8:29
  SPEAKER_03: Um what's your approach to a patient when they come to you and they have, you know, concerns of neck looseness and you know, maybe some jowling.
• 8:40
  SPEAKER_03: What's your approach?
• 8:40
  SPEAKER_03: I mean, do you just focus on those areas?
• 8:42
  SPEAKER_03: Walk us through kind of educating that patient on what's what they need to consider and what options they have for their face in general.
• 8:50
  SPEAKER_00: So I know a lot of facial plastic surgeons like to um if a patient comes in focusing on their neck, you know, they'll point out the areas that would benefit them from having surgery, like you know, because the neck and the face kind of go hand in hand.
• 9:04
  SPEAKER_00: And if you just rejuvenate one area, it makes the other area, it just doesn't flow.
• 9:09
  SPEAKER_00: Um, but I I really like to listen to the patients and focus on what bothers them.
• 9:13
  SPEAKER_00: Um, and I focus on that and I will offer you know other suggestions in the area if they bring it up, but I don't try to point out things that patients that don't bother them.
• 9:23
  SPEAKER_00: Um and so I will just focus on the neck if if they really say, hey, this just this is what I want to focus on.
• 9:29
  SPEAKER_00: That's okay to me.
• 9:29
  SPEAKER_00: I don't think you have to do a face and a neck lift together on every patient.
• 9:33
  SPEAKER_03: Now I know we I know that you love body contouring also.
• 9:37
  SPEAKER_03: What are what are your some of your kind of top cases that you love to do from a body contouring standpoint?
• 9:42
  SPEAKER_00: I do love the body, which is funny as a craniofacial surgeon.
• 9:44
  SPEAKER_00: Maybe it's just because I focused on the face for so many years.
• 9:48
  SPEAKER_00: It's fun to get outside of that box.
• 9:50
  SPEAKER_00: But um, one of my favorite surgeries of all time, ever since residency, has been a good tummy tuck.
• 9:55
  SPEAKER_00: I just think it's incredibly transformative, um, you know, immediate gratification.
• 9:59
  SPEAKER_00: I think we all like that.
• 10:01
  SPEAKER_00: Um, but really helping women who often have the diastasis, they don't have good core strength.
• 10:06
  SPEAKER_00: Um, I just think it's really satisfying, not only to give them a nice contoured abdomen, but they feel stronger after surgery.
• 10:13
  SPEAKER_00: And I've even had patients who've had issues with um bladder control and things like that get better after surgery.
• 10:19
  SPEAKER_00: And I, you know, I don't haven't done any research on that, but I think that it actually is a thing where people um that can improve um just getting their core tighter again.
• 10:30
  SPEAKER_00: But I love body contouring, so after massive weight loss, um, arm surgery, I love a good thigh lift, a spiral thigh lift is one of my favorite things to do.
• 10:39
  SPEAKER_03: Oh nice.
• 10:42
  SPEAKER_03: Another person who's who's good at the spiral thigh lift.
• 10:45
  SPEAKER_03: You know, uh you said something that I definitely um feel is is feel strongly about too, just from patients' experiences that when people get, you know, an aesthetic procedure like an abdominal plasty where you're removing extra skin, you're giving them a better shaped belly button, you're getting rid of stretch marks, getting rid of extra fat, doing liposuction, and tightening their core, they do come back and they do have functional enhancement.
• 11:09
  SPEAKER_03: Not like it's I can't be guaranteed, but almost all of them, like you say, have a stronger core.
• 11:13
  SPEAKER_03: All of them have maybe better posture and gait, they have potentially relieved back pain.
• 11:17
  SPEAKER_03: But this whole you know, urinary incontinence thing, bladder issue thing, it is, I think, a real thing.
• 11:23
  SPEAKER_03: I can't guarantee it either on them, but like so many of them report that.
• 11:26
  SPEAKER_03: So it's like a it's really nice when you're doing something like a breast reduction, too, where it's it's totally aesthetic, but it's functional and it's sensual also.
• 11:35
  SPEAKER_03: Like we have we have amazing jobs, and these procedures are really are transformative, and they're not just you know, skin deep.
• 11:42
  SPEAKER_03: It's like literally can improve their function.
• 11:44
  SPEAKER_03: So I think there's absolutely something there, Bill.
• 11:46
  SPEAKER_03: I don't mean do you feel the same way?
• 11:48
  SPEAKER_02: Yeah, we see it all the time.
• 11:49
  SPEAKER_02: You know, patients will come in, they won't tell us about their problems beforehand, but afterwards they're like, oh my God, did you realize that this, this, this, and this got better after doing the tummy tuck?
• 12:00
  SPEAKER_02: Like, yeah, that's part of part of it.
• 12:02
  SPEAKER_03: It's so amazing.
• 12:03
  SPEAKER_00: Yeah, and you mentioned breast reductions.
• 12:05
  SPEAKER_00: I think those are some of my happiest patients, you know.
• 12:08
  SPEAKER_00: Coming from the hospital, I've I've done tons of brush reductions on teenagers, and I still actually see a large group of teenage patients for that surgery.
• 12:17
  SPEAKER_00: And I mean, that's one of my favorite things to do, just because it is so life-changing for them.
• 12:22
  SPEAKER_00: Not only their back pain gets better, but you know, these kids, they can kids can be mean and they get made fun of, but they're able to wear a sport, one sports bra and be able to play soccer or whatever when they normally have to wear two, and you know, can they find a normal bathing suit to fit into and not have to go to that custom bra store?
• 12:39
  SPEAKER_00: So I love a good brush reduction as well.
• 12:42
  SPEAKER_03: Such a good surgery.
• 12:43
  SPEAKER_02: It really is.
• 12:44
  SPEAKER_02: What you know, walk us through some of the age groups because I agree with you.
• 12:47
  SPEAKER_02: I, you know, we do a lot of brush reductions.
• 12:49
  SPEAKER_02: I personally do a lot of brush reductions, and I hear the same thing from patients.
• 12:53
  SPEAKER_02: They're like, I'm tired of wearing two sports bras.
• 12:55
  SPEAKER_02: I just want to be able to run, or I can't, I don't really want to buy a large top and then a medium bottom.
• 13:01
  SPEAKER_02: I can't find swimwear that works, right?
• 13:04
  SPEAKER_02: What is your is your uh age cutoff for you?
• 13:08
  SPEAKER_02: Or how do you kind of talk to parents who maybe it's a 16-year-old that comes in, they're like, hey, you know what?
• 13:14
  SPEAKER_02: I think I'm mature, I'm not 100% sure.
• 13:17
  SPEAKER_02: Should I go through this now?
• 13:18
  SPEAKER_02: Should I wait um until later in life?
• 13:21
  SPEAKER_02: You know, because they're not thinking about babies at that time.
• 13:24
  SPEAKER_02: They're not thinking about what life is gonna look like five, 10 years from now.
• 13:28
  SPEAKER_02: How do you counsel them and what do you what do you let them know is appropriate in regards to doing that surgery now versus waiting later?
• 13:37
  SPEAKER_00: Great question.
• 13:38
  SPEAKER_00: I get that a lot from families.
• 13:40
  SPEAKER_00: Um, and so I think first of all, it's important when I go in the room and I'm meeting the patient, and they're usually a parent or two is with them.
• 13:47
  SPEAKER_00: Um, I like to see how mature the patient is as far as like when I ask the questions, do that does the patient answer me or do they look to their parents to answer for them?
• 13:55
  SPEAKER_00: You know, I think that it says a lot when the patient is can speak for themselves and really does seem mature and like they've thought a lot about it, they've done research, they know exactly what they're looking for.
• 14:06
  SPEAKER_00: Um, they can tell me what their problems are that they're trying to fall, you know, fix, like their neck pain, back pain, all the things.
• 14:13
  SPEAKER_00: Um and then I ask them, it's very important to know if they've stopped growing.
• 14:16
  SPEAKER_00: So have they been in the same bra size for at least a year?
• 14:19
  SPEAKER_00: Um, I tell them if they're still actively growing, if they're still, if they bought a new bra last month, that then they're probably they probably need to wait to have surgery.
• 14:28
  SPEAKER_00: Um and then I do talk to them about what it will look like if they if with the amount of life that's left with them, so they have um potential weight changes, pregnancies, will it impact breastfeeding?
• 14:39
  SPEAKER_00: Um, how important it is is it to them to breastfeed?
• 14:42
  SPEAKER_00: Because not everyone can breastfeed baseline.
• 14:44
  SPEAKER_00: Um, and so you know, is it is it worth putting scars on the breast to where if you don't know if it's gonna affect them or not?
• 14:51
  SPEAKER_00: Um but I talked to them about all those things, and then I have a just very frank conversation with the parents and the and the patient together to see if if they are ready for this and what that entails.
• 15:03
  SPEAKER_00: I talked to them about the recovery, what the scars will look like, what potential complications could happen.
• 15:07
  SPEAKER_00: Um, you know, they could have nipple sensation changes, how important is that to them?
• 15:11
  SPEAKER_00: Um, those are things that they definitely aren't thinking about.
• 15:14
  SPEAKER_00: But overall, I think it's also important to know there's not really necessarily a minimum age cutoff.
• 15:20
  SPEAKER_00: Um, I've operated on a patient as young as 12 when she had gigantomastia.
• 15:25
  SPEAKER_00: You know, it just it depends on what how affected they are.
• 15:29
  SPEAKER_00: And so I would I do that right now, you know.
• 15:31
  SPEAKER_00: I don't know.
• 15:32
  SPEAKER_00: I I need to talk to them, but um I do have the option of operating on younger kids at the hospital, which is really nice.
• 15:39
  SPEAKER_03: J-han, gigantomastia.
• 15:41
  SPEAKER_03: When talk about like what's the max, like what are some numbers of tissue like amount of tissue you take off of those breasts?
• 15:47
  SPEAKER_03: How big are those?
• 15:48
  SPEAKER_00: So gigantomastia is different than macromastia, which is what I would say the majority of patients come in with um large breasts.
• 15:55
  SPEAKER_00: Gigantomastia is when the breast tissue is just totally disproportionate to what their uh body habitus is.
• 16:02
  SPEAKER_00: And so the largest breast reduction I've done has been has been taken off 13 pounds of breast tissue.
• 16:09
  SPEAKER_00: So I took off seven pounds of breast from one side and six pounds from the other.
• 16:13
  SPEAKER_00: Um, and she was still left with probably you know triple D, if not larger breast.
• 16:19
  SPEAKER_00: Um, so imagine in that situation, the anesthesiologist actually commented that her um tidal volumes changed and her pressure that it was taking to ventilate her lungs actually got better as the breast tissue came off because it was so significant.
• 16:35
  SPEAKER_00: That's because if you think about all that pressure on the chest, like it's even hard for them to breathe at night laying on their back, but then they can't get comfortable if they sleep on their stomach or on their side.
• 16:45
  SPEAKER_00: It's just it's miserable for them.
• 16:47
  SPEAKER_03: That's insane.
• 16:48
  SPEAKER_03: Jayhan, tell tell us a little bit about how important your team is in providing care and in achieving great outcomes.
• 16:56
  SPEAKER_00: Oh man, I love my team.
• 16:58
  SPEAKER_00: I cannot tell you guys enough.
• 17:00
  SPEAKER_00: I'm so lucky to have plop down and at HKB Chapel Hill from the front desk staff throughout, like top-notch.
• 17:08
  SPEAKER_00: They are key to in enticing people to come see us at in Chapel Hill at the Chapel Hill office.
• 17:15
  SPEAKER_00: Um, but we're friendly.
• 17:17
  SPEAKER_00: It happens to be an all-female staff, if that's important to people.
• 17:20
  SPEAKER_00: Um, it wasn't planned that way, but it just so happens.
• 17:23
  SPEAKER_00: But my nurses, my medical assistant, like I work with the same anesthesia providers that I've known since my time at the hospital.
• 17:31
  SPEAKER_00: So I've known them for over 12 years now.
• 17:33
  SPEAKER_00: Um, it's just it's literally like a family.
• 17:36
  SPEAKER_00: Um, they're not only kind people, they're they care about what they're doing.
• 17:41
  SPEAKER_00: They care about the patient as a pay as a person, not just as a they don't refer to people as their the breast reduction patient or the tummy tuck patient.
• 17:48
  SPEAKER_00: Like they actually have names and we know they're families.
• 17:51
  SPEAKER_00: And um, I just I couldn't say enough good things about my team.
• 17:54
  SPEAKER_00: I think they're invaluable.
• 17:56
  SPEAKER_03: I love it.
• 17:57
  SPEAKER_03: Bill, what makes you happy about plastic surgery?
• 18:00
  SPEAKER_02: I love it.
• 18:01
  SPEAKER_02: Oh, thanks, G.
• 18:02
  SPEAKER_02: Kind of turning around on me.
• 18:03
  SPEAKER_02: I like this.
• 18:04
  SPEAKER_02: Um, for once, it's not G talking.
• 18:06
  SPEAKER_02: So um what I love about plastic surgery, I think one, I think working with such amazing human beings such as Dr.
• 18:14
  SPEAKER_02: Wood and you know, sometimes yourself, but I I think really making a difference in what we do with patients, i.e., like making a difference in their lives, the fact that we can adjust one body part and it changes their whole personality, their whole persona, and their whole demeanor and how they go about living their life.
• 18:34
  SPEAKER_02: It's again, I was in clinic today.
• 18:36
  SPEAKER_02: I can't tell you how many times the patients came up and they're like, You changed my life, you changed my life, you changed my life, you changed my life.
• 18:43
  SPEAKER_02: And it's things that sometimes we take for granted because we've been doing this for so long.
• 18:47
  SPEAKER_02: Like you said, uh Jay Hines, like, all right, we do a tummy tuck.
• 18:52
  SPEAKER_02: You know, at this point we can all do it in our sleep, but we love it, but it's so dramatic for that patient.
• 18:58
  SPEAKER_02: And I like to teach some of these fellows, I'm like, listen, yeah, we do this all the time.
• 19:03
  SPEAKER_02: Yeah, we might do four tummy tucks in this day, but realize, you know, and my analogy is like, all right, we're like Johnny Carson, Johnny Carson, I'm aging myself, or Jay Leno, or you know, one of the new cats out there at the night show, they're all getting canceled anyway.
• 19:18
  SPEAKER_02: But that being said, like every person is like they need to be the spotlight, right?
• 19:23
  SPEAKER_02: Because for them, this is a big event for them.
• 19:26
  SPEAKER_02: They've they've really you know planned their whole year around this procedure, and we gotta focus on that one patient, that one individual, like it's everything.
• 19:36
  SPEAKER_02: Yeah, you might do four or five of them a day, G, but in reality, that one patient that day, that's their everything.
• 19:43
  SPEAKER_02: They've they planned everything around that one event, and they believed and trusted in you to be able to get it done.
• 19:50
  SPEAKER_02: And I know, Jahan, you care about your patients just like we do.
• 19:53
  SPEAKER_02: Because one of the things, not only are you technically extremely gifted, but you go above and beyond and care more than any individual that I know that I know.
• 20:03
  SPEAKER_02: And I know you personally, so I can say that.
• 20:05
  SPEAKER_02: You pour your heart and soul into every patient.
• 20:08
  SPEAKER_00: I do, I really do.
• 20:09
  SPEAKER_00: I get very connected, and I I mean, it's also being part of I think the whole pediatric plastic surgery experience, you know, like how do you not get connected with these little infants and their families that you're operating on and they're trusting you with their baby?
• 20:24
  SPEAKER_00: Um, it's a huge responsibility, and you know, it humbles me that that I get to do those kinds of things for people, and I still have amazing relationships with families from my time at the hospital.
• 20:36
  SPEAKER_00: I mean, they still reach out, it's amazing.
• 20:38
  SPEAKER_02: What defines you as a as a plastic surgeon?
• 20:41
  SPEAKER_02: Or what are what are your defining characteristics?
• 20:43
  SPEAKER_00: Like what you said, caring, empathetic.
• 20:47
  SPEAKER_00: Um I'm a great listener, uh goal-driven, skilled.
• 20:54
  SPEAKER_00: I think the most important part is just I'm a caring person that I truly want to see them, I want to meet their expectations, if not exceed them.
• 21:02
  SPEAKER_00: Um, and make sure that they I'm providing everything and anything that I can to make their the whole journey, the surgical journey, a great experience for them.
• 21:11
  SPEAKER_00: Because it's not just a one and done.
• 21:13
  SPEAKER_00: You know, I think that we as surgeons have a responsibility to our patients to be there for them throughout the entire process, however long that may take, you know.
• 21:22
  SPEAKER_02: I I think there's far and few amazing talented surgeons who are also good ethical people that are morally sound, that do the right thing, and they care a lot.
• 21:33
  SPEAKER_02: I think that subset of individuals is is not as large as people think.
• 21:38
  SPEAKER_02: Somebody a lot of people can be very technically gifted, but they might not have the other qualities that are out there, and you definitely define those.
• 21:45
  SPEAKER_03: And I definitely do think though, as I tell patients, you know, once you once you you know we decide to do something together, you're stuck.
• 21:52
  SPEAKER_03: You're stuck with me, you're stuck with us.
• 21:53
  SPEAKER_03: Like and that's and I think that's the thing is that I think you know, we we have to do like it's our responsibility.
• 22:00
  SPEAKER_03: Like they're they're yours.
• 22:01
  SPEAKER_03: And like, you know, Bill often says this that sometimes we become their primary care docs, like in some ways, like because they see us more than they see a regular doc.
• 22:10
  SPEAKER_03: And um it's kind of crazy.
• 22:12
  SPEAKER_03: I mean, the fun thing is I can already you can tell like none of us like dread coming to work.
• 22:16
  SPEAKER_03: We love coming to work, we like, we like what we're doing, and the people that we're around, and so it's it's fun to do it.
• 22:23
  SPEAKER_03: And like for us, for Bill and I too, it's it's been so special to like share that and get to do that with you.
• 22:28
  SPEAKER_03: And and and when I got to talk to you, you know, not long ago, we periodically just check in and just just hearing that you're happy.
• 22:35
  SPEAKER_03: Like I love that too.
• 22:37
  SPEAKER_03: I guess that's been a new focal point for my career is like you know, having other people be a part of you know what we're doing and and being happy.
• 22:45
  SPEAKER_03: And I I love that, and it's it's even more fuel to kind of push and keep doing what we're doing because we're getting to help people um you know achieve their personal best, and and and you also helping, you know, um surgeons achieve their personal best.
• 22:58
  SPEAKER_03: And it's nice like just to do that on the day-to-day.
• 23:01
  SPEAKER_03: I think like that makes me happy, you know what I mean?
• 23:03
  SPEAKER_03: Is like patients walking in smiling after like a surgery, and then you know, your colleagues being happy also, which is which is you know, it's a different kind of satisfaction, but it's really been a special one.
• 23:15
  SPEAKER_03: So thank you for sharing that with us.
• 23:18
  SPEAKER_02: What do you see on the horizon for for plastic surgery over the next year?
• 23:23
  SPEAKER_02: What do you see changes being?
• 23:25
  SPEAKER_02: You know, are you seeing trends in what patients are asking for, or what um you're you're seeing the aesthetics being?
• 23:34
  SPEAKER_00: For me, I feel like patients are starting to lean more towards natural looking results.
• 23:38
  SPEAKER_00: They don't want to look like they've had anything done, they don't want to be over-tightened, they don't want to be overly volumized.
• 23:44
  SPEAKER_00: Um, and so I think that we're gonna slowly progress more and more to just a more natural appearance, like especially with breast implants, preserve is becoming more and more popular, um, really like minimally invasive procedures that give the most bang, you know, with the quickest recovery times, what's people seem to be looking for.
• 24:03
  SPEAKER_01: Gee, what do you what do you see as trends or nuances in the field of plastic surgery?
• 24:09
  SPEAKER_03: I agree.
• 24:10
  SPEAKER_03: You know, I think um, you know, there's a lot of technology out there.
• 24:14
  SPEAKER_03: Um I think a lot of the the technology that's there is just kind of reinventing itself over and over again.
• 24:20
  SPEAKER_03: Like it's so it's not really not really iterating that much.
• 24:22
  SPEAKER_03: It's like kind of old plays on things that have been available.
• 24:26
  SPEAKER_03: So I'm I'm hopeful there'll be more progress in some technologies.
• 24:28
  SPEAKER_03: There have been different technologies that have evolved that are getting better, like microcoring now is gonna be even more advanced, and we're gonna be able to do bigger areas on the body.
• 24:37
  SPEAKER_03: So I think that's important for us.
• 24:39
  SPEAKER_03: All of us here on this Convo, we love using energy-based liposuction.
• 24:43
  SPEAKER_03: We all love Renouvion, we all love Vasor.
• 24:46
  SPEAKER_03: Um, so I think those things are gonna continue.
• 24:49
  SPEAKER_03: Um, but new things, I think, you know, the regenerative space is continues to be big and blowing up.
• 24:55
  SPEAKER_03: And I think a lot of people use that term just kind of loosely, and no one really knows what they mean by it.
• 25:01
  SPEAKER_03: Um, so I think that's gonna, that's gonna I think that's gonna expose itself more and more going forward, right?
• 25:07
  SPEAKER_03: And I and and maybe you can add to it because you're pretty big in that area, like how we as you know aesthetic surgeons are going to actually embrace and hopefully potentially control that next transition into that for the betterment of patients.
• 25:23
  SPEAKER_02: Well, I think we're we're on the forefront because I think we understand the aesthetics better than than a lot of individuals, but we're getting in this realm now where we're learning more about genomics, right?
• 25:34
  SPEAKER_02: And so we understand the genes that are associated with aging.
• 25:37
  SPEAKER_02: And we're actually doing trials now for anti-aging with with gene modulation, which is going to be really interesting to see what ends up happening there.
• 25:45
  SPEAKER_02: We also have all these you know potential peptides, right?
• 25:48
  SPEAKER_02: Some may be good, some may not good.
• 25:50
  SPEAKER_02: We don't exactly know yet the research there, and we're waiting to see what the FDA comes down with, what's available, what isn't available to us, but can have a pretty significant impact.
• 26:02
  SPEAKER_02: We already know one particular genre of peptides have changed everything in the US.
• 26:08
  SPEAKER_02: And they've been for the positive, right?
• 26:10
  SPEAKER_02: People don't realize GLP1s are a peptide, right?
• 26:13
  SPEAKER_02: And these peptides have revolutionized kind of the aesthetic industry.
• 26:18
  SPEAKER_02: And how many patients well I'll I'll tell you, the patients I saw today, I'd probably say 70% were on GLP1s that I saw today.
• 26:26
  SPEAKER_02: And probably unbeknownst to all of us, there, you know, a vast majority of our patients are on it.
• 26:30
  SPEAKER_02: And I will tell you in the next six months, my guess is over 90% of patients will end up being on some version of a GLP one, be it either a microdose or a full version of one.
• 26:40
  SPEAKER_02: And then in addition to all these other potential peptides that we have on the horizon, I think people are care more about their health and wellness.
• 26:47
  SPEAKER_02: Um, I I see that being a big push into this kind of this next genre of what we do.
• 26:53
  SPEAKER_02: And we're gonna really hone in on our nutrition here.
• 26:56
  SPEAKER_02: I think as you see, kind of the the trends in the US, we've eaten poorly as a society over the past 20, 30, 40, 50 years.
• 27:04
  SPEAKER_02: And I think we're moving more towards, hey, what are we consuming?
• 27:07
  SPEAKER_02: What are the nutritional values of the things that we're putting into our mouth?
• 27:11
  SPEAKER_02: I think we're gonna see a huge change in in the direction there.
• 27:16
  SPEAKER_02: It's all gonna impact kind of how we look.
• 27:18
  SPEAKER_03: Yeah, and and I think the only of other two things that I think are gonna come, and I don't know exactly how long, but it's already in the works, is that we're gonna have there's tissue engineering that's happening.
• 27:28
  SPEAKER_03: There are uh polymers and constructs that we're gonna be able to use to, you know, for breast enhancing, where we're gonna virtually get rid of implants.
• 27:37
  SPEAKER_03: We're gonna put a construct into a patient and it's going to have signaling to it and it's gonna be replaced with tissue.
• 27:45
  SPEAKER_03: We're gonna probably use more of this other allogenaic substitutes, like, you know, there's products like RANUVA, there's products like um alloclay, which are, you know, cadaver um fat constructs that are really interesting that are gonna get better and better.
• 27:59
  SPEAKER_03: And the other thing that we know we're gonna we're just starting to embrace in the US and a couple states is you know, use of stem cells, you know, core blood-derived stem cells versus, you know, uh bone marrow ones.
• 28:10
  SPEAKER_03: And it's kind of the wild, wild west right now, but I think there's gonna be an interplay of all of that with the aesthetic sector, and um, and you know, I think we just need to be aware of it and um obviously only do things that are safe for our patients, but it'll be great.
• 28:24
  SPEAKER_03: And one day I think we'll be able to do scarless surgery, but we're we're far away from it, but hopefully we will one day.
• 28:30
  SPEAKER_02: Do you think we're gonna be replaced by robots?
• 28:32
  SPEAKER_02: If you ask Elon, he said three years.
• 28:33
  SPEAKER_02: Well, you think do your job's gonna be obsolete?
• 28:36
  SPEAKER_03: Absolutely not, would never trust a robot.
• 28:39
  SPEAKER_03: I'd have a robot assist me.
• 28:40
  SPEAKER_02: I hundred percent will tell you I think we're gonna end up having first assistants as uh robots will be our first assistants.
• 28:48
  SPEAKER_02: There's no doubt in my mind, and it'll probably be in the next few years.
• 28:52
  SPEAKER_02: Them taking over my job, yeah, maybe in the future, but they have to be trained.
• 28:57
  SPEAKER_02: And who's gonna train?
• 28:59
  SPEAKER_02: Right?
• 28:59
  SPEAKER_02: So, like the the only way they can get that somebody would have to train them.
• 29:03
  SPEAKER_03: We'll see.
• 29:03
  SPEAKER_02: You know, I think we can protect our space here with the robot thing.
• 29:06
  SPEAKER_02: You know, they're paying housekeepers to wear cameras to watch their activities, to watch their activity so they can train robots, right?
• 29:13
  SPEAKER_02: So, in essence, right, they're gonna be able to take footage from what we do to train surgery.
• 29:19
  SPEAKER_02: So again, it's it's all about protecting the space and doing it the right way.
• 29:22
  SPEAKER_02: Now, if there's a better way to take care of patients, I'm all for it.
• 29:26
  SPEAKER_02: Right?
• 29:26
  SPEAKER_02: I think we all would be, right?
• 29:28
  SPEAKER_02: I I think if if there's a zero complication, if there is a way to have AI or robots help to have a zero complication procedure, I'm all in on that.
• 29:39
  SPEAKER_03: Well, I think the thing is though, is you know, you if you guys have probably all used like DaVinci, got under there and played with it and used it.
• 29:45
  SPEAKER_03: I mean, once you get to where you can use it and you use that, that's robot assist.
• 29:49
  SPEAKER_03: But if there's a robot performing a task, a mechanical task that has to be done over and over again, there's no doubt that robot is gonna do it every time to a level that you or I can never match.
• 30:02
  SPEAKER_03: So I mean there's probably a there's probably a place for this in surgery, like all day long.
• 30:07
  SPEAKER_03: I'm not saying that they can maybe make the kind of artistic kind of decisions and and the marking and planning and doing all this stuff, but it who knows what's gonna be what's gonna be available, you know.
• 30:18
  SPEAKER_02: I think we'll use them as assistants, there's no doubt in my mind.
• 30:20
  SPEAKER_03: I think for sure we'll have them as assistants.
• 30:22
  SPEAKER_03: But there could be things where you could have robot you and more for like functional surgical interventions like in the Amazon or somewhere like and you have to like if someone has an emergency, they there probably could be a a remotely driven robot doing the surgery, you know, and having like a little somebody there, like they do with you know, um like the Da Vinci system.
• 30:42
  SPEAKER_03: But we'll see.
• 30:43
  SPEAKER_03: I mean, the way things have progressed, something's gonna happen, and it will be part, it'll probably be part of surgical care, one way or another.
• 30:51
  SPEAKER_03: TBD.
• 30:51
  SPEAKER_03: Maybe at HKB.
• 30:53
  SPEAKER_03: We'll have some robot assistance.
• 30:55
  SPEAKER_02: I'd love to get uh a robot that had G's hair on it.
• 30:58
  SPEAKER_02: That'd be great.
• 31:01
  SPEAKER_03: I just have that robot I want that I just want a robot to like.
• 31:03
  SPEAKER_03: I'm wondering what a robot would do here for us.
• 31:05
  SPEAKER_03: I have a robot just running around picking me up healthy food.
• 31:11
  SPEAKER_03: All right, well, Jayhan, this has been an amazing time talking to you.
• 31:14
  SPEAKER_02: We we gotta have you back on.
• 31:16
  SPEAKER_02: Thanks, guys.
• 31:16
  SPEAKER_03: We appreciate you so much, and um, I'm sure all the listeners will get a lot out of this.
• 31:20
  SPEAKER_03: And if they have any questions or comments, they'll um reach out.
• 31:24
  SPEAKER_00: Perfect.
• 31:24
  SPEAKER_00: Thanks, guys.
• 31:26
  SPEAKER_03: Thank you.
• 31:30
  SPEAKER_02: Thank you for listening to HKB Uncut.
• 31:32
  SPEAKER_02: If you enjoyed this episode, please subscribe to us on Apple, Spotify, or YouTube.
• 31:36
  SPEAKER_03: To book a surgery consultation or med spa appointment with our team, visit our website at hkbsurgery.com or head to the links in our show notes.