 Hey y'all, this is Jamie with Out of Bounds with Jamie and Abby, presented by Ashley. And on today's episode, we had the wonderful, talented, intelligent Dr. Amaka, who is Jamie's plastic surgeon, but she works here in Nashville at Maxwell Aesthetics, and she was incredible. Oh, I mean, I just, I fell in love with it the day I met her, and just having her answer all of our questions with that big smile, I mean, it was amazing. If you've ever had any questions about any female restoration, you will get them answered today. So we hope you guys enjoy. Thanks first, Dr. Amaka. How do you pronounce your full name? So, as you know, everybody calls me Dr. Amaka. Full name is Neyamaka. Okay. And last name is Wuba. The end is semi-silent. Okay. But yeah, but I just shortened it up to Amaka. First off, you are my plastic surgeon. Yeah. And I am so excited that we can sit here today with you and discuss not only, like, your career, but how you got there. You're my girl from New Orleans. LSU girl, I mean, through and through, that's why we absolutely love each other. Yeah, tell us. So you're from? I'm from New Orleans. Right. So born and raised in New Orleans, my parents are from Nigeria, hence the name. And then I went to LSU for college. Then I, from there, I went to Vanderbilt for medical school. Then went to University of Kentucky for my residency in plastic surgery, which was six years. Then I did a one-year fellowship in aesthetics or just pure cosmetics, just kind of focusing on everything, breast, body, face, vaginal area too. I was actually looking on TikTok at that. I'm like, oh, I wonder if we're going to talk about that today. Hey, you know, like I said, you know, we can talk about it even. And so I did that, then it came back to Nashville. So I really feel like I went full circle. So we've loved it here. It's been great. And that's amazing. And you have two children? I do. What are their ages? So my little boy is six and my little girl's four. They're super cute. It's my favorite in the mornings whenever you wake up and like get your college in ready. And they try to steal it from you. And it's so cute to watch. After this, our followers will get to know your TikTok and your Instagram because it's... I know. And you know, I just had to go live or I go stories and I don't censor anything. So last night, my baby girl had made poo poo and even cleaned her butt in the middle of a video. And I was like, hold on, y'all, I'll be back. Yeah. You know, so no, it's been fun. It's been super fun. I love it. But it's so informative too. I mean, I did a deep dive kind of in preparation for today and I learned so much about plastic surgery. You know, and I think what's cool is it's like what every woman thinks about, you know, especially when you have children and, you know, your tummy's going to stretch out, your boobs are going to sag, you know, people think about it and they don't always look into it. So you just have informative things that make it easy. Yeah. And I think that's why it's so like digestible, you know. And I really started that because when I first started social media, I wanted to... I was like, what is no one else doing in this space when I started maybe three to half, four years ago. And no one was really... I didn't see a lot of people educating necessarily about things. I was like, I'm just going to do that because that simple is straightforward. I don't have to stress out about what I'm going to say. You know, I can educate on all these things I've learned. Also, I've found that... And I get a lot of things from my patients. I found a lot of women come in with... Either they didn't know there was things they could do or they just come in with heavy guilt about like, I'm exercising and this won't go away. So I just do... A lot of my content is based on that just trying to let you know like, hey, like you can't exercise skin away and that's okay. Let me tell you about this lady who had a mommy restoration because we're not calling it makeover because that's not what it is. No, it's not our fault that our bodies do this. Exactly. You know, and that's why for me, I'm a complete open book about everything. I mean, it is what it is, you know. Exactly. But talk about this like kind of the stigma around calling it like a mommy makeover because that still is commonplace all the time and it does feel a little bit like, why are we calling it that? Right. You know. And I realize and I've thought a lot about like, how can we make this less stigmatizing? Make plastic surgery less of a thing like, oh my gosh, like you're having like, you're doing this thing and it's like, it's really okay. And so a big thing I did was think about like the term makeover and what that feels like. And you know what I think about a makeover? It's like you're giving someone what they have never had. Right. Right. And so in some senses, like maybe that happens maybe, but really the goal is to restore. So like the term mommy restoration literally just, I mean, literally I was one day writing a script and it just came to me. It just came. And I was like, okay, I'm just going to start. I'm going to start that. Yeah. And no one else is really saying it or doing it. And I was like, I'm just going to do it and see what happens. And a lot of women reach out to me. And we're like, oh my gosh, like thank you for saying that. Like the reason I, you know, I have patients who come to me because they're like, because you call it a restoration like this. It feels like I'm just, I just want to get back to where I was, you know, like changes that happen with pregnancy or age and things like that. And I get back to where I was before these things happened. So I think just seeing it more like that and the treatment more like that has helped a lot of women. Yeah. I agree. I know it's my journey. I, it was 10 years ago. It was, we were living in Boston. So you didn't, you weren't my doctor yet, but I, after having Bailey, well with both of my kids, I gained 60 and 50 pounds. And one was because I was eating McDonald's all the time. And the other one, we just don't know why. And it really, my stomach, I mean, there was nothing I could do about it. I mean, it was a couple of years to where I finally was, John, what do you think if I go see about this? And sure enough, I went and my abs were separated. And so the doctor, I'd never heard about this before. And he was like, Jamie, I want you to do half of a sit up. And I'm like, okay. I'm going to put my fingers through my abs right here. And I did it. And I swear my hand went through, like, you know, and he explained it to me. And I was like, so there was nothing I was doing wrong. I mean, I was eating. I was exercising. I was almost exercising too much because I was so worried about it. One big question I want to ask you though is with the mommy restoration. So again, I went from being a small person, gaining all this way through pregnancy. Of course, my breasts just, I mean, I can't even explain how big they got. And then after pregnancy, it just, they shrunk so small and it was nothing but skin. But and I went to the doctor and I was like, listen, I just want to be back to where I was. And he told me he was like, with your shoulders, you don't need to be that small. You need to be bigger. And I'll never forget when I went in for my consultation with you, you looked at me like he did what? And and so I came out of surgery just like, oh my gosh, I look like I'm on Playboy. And that was not the intention. Right. So I suffered with that for a long time until I met you. I meet women who have had similar experiences where it's like they, and it's always about listening like what, and I always say this, I'm like, because patients will come and say, do I need this? I'm like, well, tell me about your goals. Like what are your goals? Because it's not our job to tell you what you need to have based on what we think is an ideal whatever. Right. But I do meet women sometimes who come in and they're like, well, I was told that I have to be a double D. Yeah. Or they, you know, or they went in saying like I wanted this and it came out with something completely different. Yeah. And I'm like, oh my gosh, you trust your body to someone. Right. And plastic surgery, like no matter how we, what way you look at it, like it's, it's a transformative thing. Right. So you wake up and something has changed. Like things have changed. There's a little bit of identity that goes with it. So coming out like that, like I'm often shocked and horrified by some stories I hear including yours. Yeah. I was so upset for so long. But could that be the male versus female doctor thing too? I always wondered that. Because men, you know, if you're a man that likes big boobs, then they're going to be like go bigger. You know, it's like, it becomes personal at that point. But like coming from a female perspective like you, it's like, hey, big boobs kind of suck. Like a lot. Right. They're uncomfortable. You can't exercise as well. You know, so I think I love that you're in the field and like I have to assume that there aren't a ton of female plastic surgeons. Right. They're not, you know, in Nashville you can count on one hand the amount of female plastic surgeons there are. In my training program, there were three, you know, three of us. And so females in the field are very rare, which is interesting because the patients in the field are mostly female. Yeah. Why is that? Do you think? A lot of people, in general, men and women, right? But it scares women more because, you know, you were told that, you know, maybe you can't have a family or you're going to have long hours. Like, you know, you're more, more so you're deterred as women from doing any surgical field. So to be a plastic surgeon, like it's the training is pretty intense. The lifestyle is sort of what you make it, but the training can be pretty intense. And so I think women in general have been deterred from surgery in general for a long time. And that's changing. So the female ratios are getting better, but it still kind of lags far behind. Did you always know that's what you wanted to go into or did you kind of waiver? I sort of wavered. So I thought initially I went into, I went into it thinking I was going to be a pediatric oncologist. Like when I started medical school. Why is that? I had a brother growing up. He was 18 and he died, he died of a brain tumor. Oh, wow. Yeah. And so we were five, now we're four siblings. And so we all pretty much went into medicine. And we all thought, you know, we all kind of felt that we were going to do something oncology related. And it's interesting. We all went into it and realized like, oh, we can't, it was almost like, you know how something happens and it's like too many memories that, and it's almost, it's almost like you can't handle it emotionally. It was too close. It was too close. And so we actually, so I have a twin sister who's a urologist and a brother who's orthopedic surgeon. Wow. So we all went into surgery. And when I think about why, I think it's because we were in a situation with our brother where, you know, it couldn't be fixed, right? Because he ended up passing away, which medicine can't fix everything. But in a way, like we did surgery because we get, you know, that immediate gratification, we can fix things. Yeah. So I think that, I think that might be why we all went into surgery, but. That's incredible. You can all call each other and rely on each other. No, it's so cool. Especially in going through residency was obviously very hard. And having a twin sister I could call and complain to when she had the same exact complaint. You know, you just had someone you could vent to all the time. So that was cool. And y'all are identical too. We are. Y'all too. Y'all look. That's amazing. What a smart family. Hi. How old were you whenever you finished everything? How old were you? Because you're, and how long have you been with Maxwell? Right. So I've been, October 6th will make three years. Okay. And I have been, you know, I was 32. Okay. 32 when I finished all my training. So it was, you know, I often calculated, but I'll forget what the calculation is, but it's like, you know, there was six years of residency, then a year of fellowship, four years of medical school, plus an additional year. So probably about 16 years in terms of like the training period. So I mean, it's, and that's why women are deterred because in their mind, they're like, what am I going to have kids? Right. Right. Because a lot of times I think we think we have to finish everything. It has to be this perfect time when we, I'm going to finish training and then I'm going to do a year of practice. It's like, you just have to let life happen. Right. But that's why, because truly like the, a lot of the training happens during your childbearing years. A lot of it, you know, so. What point in that 16 years did you meet your husband? So I met my husband when I started medical school. Okay. Yeah. So we, we met Ben and we actually did long distance. So I traveled with my family. We traveled to Nigeria and he lived in Nigeria at the time. Oh wow. Yeah. And I was met him and I was like, really loves like no one else in America. It has to be the most complicated thing. I mean really. So we did long distance and then he moved here and then we, we, you know, we kind of stayed together and getting married. We got married my, after my third year of medical school, so between my third and fourth years of medical school. Wow. So my daughter is a junior in high school and she is right now in the process of, what do I do? You know, as far as career wise, she has a lot of medical stuff. So she's always said she wanted to, to do medical. Just recently, she's, well, I don't know. That's a long time. Did you ever go through that? Like question yourself when you were younger? Because I've always wondered if she's just discouraged because of the length. I think the, the length can be discouraging and that's why I like when you're, when you decide to go to medical school and you're in medical school, you're like, gosh, surgery, surgery training is, you know, six to eight years versus something else that might be three years. Yeah. And I think I struggled with that a little bit initially. And at the end of that, what I always feel like is you have to just follow your passion. Yeah. Because if you were, you do less time, you know, let's say you just do something else, but you're not passionate about it. Well, are you going to wake up every day happy to do what you do? Feeling privileged to do what you do, even though it's a little bit longer. It's definitely like no matter what you want to do in life, if you have to just find what you're passionate about, what your heart's into. And no matter, it doesn't matter how long it takes, right? Because in the grand scheme of it, like when you're living life and you're done, like we're all just living life, right? Yeah. And you're done. It's your day to day that's going to matter, you know, doing. At work. At work. Yeah. Yeah. This might be a very dumb question. But do you get paid during training? Like any part of that is a good question. That's a good question. I don't know that either. 16 years. You get paid very horribly. Yeah. Okay. That's awesome. Because I'm like, that is what sustained 16 years of education. Yeah. So medical school, you know, you don't get paid obviously. And then residency you get paid, but it is like, you know, for as many hours as you work and stuff. Yeah. Like, you know, everybody's like, well, I calculate according to hours and you know, it's like $2,000. It's just embarrassing basically. It's enough to like survive. Like you can survive, but you know, survival. They should just let you like live at the hospital at that point so you don't pay rent. We didn't really go through this. So let me tell everybody how I met you. For a while, I had not been feeling good and tried everything I could to, I mean, I was having body aches. I was losing my hair. I was diagnosed with a form of arthritis. I mean, the list goes on and on and on. And it was a friend of mine from Boston who sent me a sheet that was about breast implant illness. And so I was like, huh. And she was like, Jamie, you check all the boxes and so did she. I mean, even the ear ringing, I still have ear ringing. And I'm like, man, what if, what if this is it? And again, I was at a point in my life from the time that I had my implants in, I had gained 25, 30 pounds. I mean, just because of life, which means my boobs got so much bigger. So I was already thinking, okay, I need to do something, reduce my boobs. I mean, I've just got to do something. And then whenever she brought it to my attention, that's whenever I found out through you through another patient, because that's, I honestly did not realize you had just started that October. So when I came to you in, wait, I came to you right after that for my consultation. Right. You were early on. Yeah. I just realized that. And my surgery was in February. So I made the decision, let's just go ahead and get these suckers out. I just, I don't want them anyway. And I'll be honest, I feel so much better. I feel so incredible. My blood work was completely different. I did blood work before and blood work after. I want to know your thoughts on it. Because, and I was very like, do I ask her? Do I not ask her? Because part of your job is putting implants in. Yes. But do you see this in patients or, I mean. How common is it? Right. And it's an important topic. So, you know, as you said, I put breast implants in for augmentation, for reconstruction. I do a lot of reconstruction too. And so breast implant illness is really kind of came about fairly recently. And it truly is like there are a subset of women who with breast implants develop symptoms. And what we're trying to figure out is like, what exactly is the reason? What is the susceptibility? So you mentioned like there's some already immune in your family. Yes. So we know there's some women who are more susceptible to having it. Yes. And so there can be like things, right? Like things that in some people, they tolerate it fine. Yes. They do fine, they don't have issues. And other people, they just don't tolerate it well. Right. They don't tolerate it. It's like my fake eyelashes. I can't do them. I can't do them. I get rashes. Like I've gotten fake eyelashes. And my eyelashes fell out. So I don't do them anymore, you know. But some people do well. Yes. I've had mine three years on my own. I don't know what's going on. And so it's one of those things, you know. Thank goodness for like the scientific community where we're like studying it a lot. Because we also are curious like, what exactly is going on? Yeah. And there's been different studies done. So and we talked to when we met about the treatment. Right. So I was like, okay, we'll remove the implants. I was like, I'll get as much capsules as I can. Yes. Like capsules stuck to your rib. Like that's dangerous. Yes. Because you can, if you get into the rib space, then you can have air in the lungs and that's, you know, can be dangerous. So there's different studies and things that the plastic surgery community is doing just to kind of understand it more. Gotcha. But there are a subset of women and I do see women in our practice, not necessarily patients that I implant, but patients who come from elsewhere who have implants and I'll take implants out and some will get better and some don't get better. Right. But a lot of them do get better. And so we know there's that it's true. There's a subset of women who, for whatever reason that we're still trying to figure out, are more likely to have kind of this intolerance of breast implants. Yeah. I'm so happy to talk to you about it because it really, I mean, even if it was subconscious in my mind that now that they're out, I feel better. I didn't care because that's how, that's how crazy it was for me. That's how much more I felt better. But I do remember. So whenever you took mine out, I had one stuck. Do you remember that? Mm-hmm. And because you were like, you're going to be bruised because it was stuck pretty bad. You were very bruised. I was. Yeah. And I remember so, you know, Lisa came to see you and she's like, oh my God. I'm like, it's fine. It's fine. She's going to be fine. I was like, she's going to be fine. But do you think that that could be part of it, that my body, it was stuck and my body didn't like it? I've always wondered that. Hard to know. That's hard to know because like I have, you know, I take call for hospitals, some of the hospitals in the city and so like, like I've had a couple of situations where I've gotten called and people who've had implants for, you know, 50, 60 years and they're in the hospital, right? And so I'll make, I'll go and like do, I'll do surgery on them later. And sometimes they're stuck. Yeah. You know, but they don't necessarily have symptoms. Gotcha. So I don't know. I don't know if it's related, but it could be, but I'm just not sure. Right, right. That's the hard thing. That's the hard thing. And sometimes the medicine is like, we like answers, but sometimes it's just. It's unknown. Yeah. I mean. Okay. So what are your top four surgeries you do? Top four surgeries. Okay. Like mommy restorations is like, you know, the most common thing I do a lot of tummy tucks. Okay. Those are the top vaginal rejuvenation. I do a lot. You do. Okay. Okay. Wait. Can we, can you explain us what that is? Yeah. So it's a spectrum, right? Okay. I call them our lady parts because everybody knows what that means. Like, you know, you know, if you've got children around, you know, just to be saying that. It's your duty. Yeah. So it's all about rejuvenating it from the inside out. So I think about it like fertilizer, right? So we always talk about like facial aging and like, you know, our breasts start hanging, our skin on our face hangs. We do micro-needling. The same things happen down there too in our lady parts. We just don't see it as often or we don't talk about it as often. So it's like, you know, hush, hush kind of thing or everybody's not like posting about it on social media or anything else. And so it's all about just rejuvenating it from the inside out. So addressing loose skin, addressing the appearance, addressing hanging skin of the inner or outer lips that bothers a lot of women. Gotcha. But they're just, you know, kind of nerves to talk about. Enhancing things so that you can have a better sexual experience, you know. And so it's kind of all about that. And there are different things we do non-surgically with lasers, but also surgically to help with that. Become more common. You think in the past like five years, would you say? Or what do you? I think it's become more common. Like the technology has gotten a lot better. I also think we're just, think we're talking about it more, but definitely become more common. Also, I think it's just, you may be dealing with something and not realize there's things you can do. And suddenly, oh gosh, I saw this on the internet or I saw this on Instagram. There is something I can do. So I'm just going to go see someone about it. So it's definitely becoming more common for sure. Yeah. I've just heard about it more lately than ever before. So Tummy Tuck. Okay. That's all we're doing for. Is that what we're saying? Sorry. No. No, I love it. I got a deep dive. Okay. We did mom restoration. Tummy Tuck's bad determination. Number four, you know, I do a lot of like LIPO. I do, I love doing like face lifts and rhinoplasty's too. Really? So you do that as well? I do. You did my mom's and I got, I got permission to say this. You did my mom's eyelids. Yeah. They look so good. I know. She did it well. Y'all, she stayed awake for it. She stayed awake for it. She did it. Do you have to? She talked to you during your day, right? You don't have to. Why would you do that? She could save the money. Oh my God. Oh my God. She was like, I'm, I'm, I told everyone I'm saving this much. You know what I'm like? But she was, I mean, she was amazing. Jamie, couldn't you have paid to put your mom down? She didn't want to. So I would do definitely something you can do awake, you know? Wow. Okay. So you do it all? Pretty much. And I do it all. And so I do, I talk a lot about the body stuff because I do that the most. But I do like, I definitely do rhinoplasty. I do facelifts. And so I remember I posted one and someone was like, Oh, you do face too. I'm like, yeah. You know, when I took that additional year after my residency training, it was just to, you know, I was like, I just want to be really good. Yeah. I don't, I don't want to have like this curve where I'm like, you know, kind of learning. I'm like, I just want to come out and be like as good as possible in like everything. Right. And you have your patients come from all over the country. They do. How did they find out about you? A lot. So social media a lot. Okay. So it started off with Instagram because I started on Instagram and then TikTok I started probably about a year ago. Okay. So I get a lot from TikTok and social media. It's like, it's really crazy. And is that how you started with Lisa? So Lisa is her nurse like, so that way I didn't have to go into the office the next day. Lisa came in and checked on me. It was amazing. At home. At home. Oh, that's cool. I don't have to go anywhere. Cause I always like to see people the day after and I used to have them come in and I'm like, this is torture. Like, you know, like, come to the office, sit in a stiff chair and I'll be in the seat, you know, hopefully running on time that day. So like me and Lisa got together and I was like, Lisa, please help. So then at one point I was doing the home business and I was like, well, this is not sustainable. Like, you know, so, so I met, so me and Lisa actually had known each other a while. So now that's pretty much she exclusively does that with me. Cool. I love her. So with the tummy tuck, let's go further. So my sister had twins and she gave me permission to talk about this. And so she just has a lot of loose skin. And so I was like, what would you ask a plastic surgeon interviewing one? And she had a lot of really good question because she's really thought through it. And a couple were like recovery time. How soon after having babies, do you have to be completely done with babies? Right. You know, all of that stuff that's like kind of the nitty gritty that people want to know. Those are all good. So pretty much you wouldn't wait about six months to a year after having babies. Sometimes I've been asked like, can you, can I'm having a seizure? Can I have a tummy tuck at the same time? I'm like, absolutely not. Do not do it. Sounds great, but it's a bad idea. You know, the universe is swollen. Yeah. You know, and so generally six months to a year after having babies is a good time for a tummy tuck. You know, as far as being completely done, I generally would say like if you, like if you can wait, I would just wait until you're completely done. That way you're just like done. Your results are set. You know, obviously barring any weight fluctuations, but if you accidentally get pregnant, it's not like a huge, huge deal. It's just going to kind of ruin some of the work. It can change some of the work. Some people bounce back like some people bounce back and like they're fine, but some people might need a little skin like little skin removal. Some of the skin stretches but doesn't quite bounce back. Okay. What about your abs? Like what's fine being separated and they had to put them back together. If they separate again, I just imagine that hurting so bad. Not particularly. No. Not really. They can separate again. It's the other thing, so you may need to have muscle repair again. If I do have some young patients who are like, I just have to dress the skin. Maybe they've lost a lot of weight and I know I'm going to have children, but I need to dress the skin. I just don't do a muscle repair. If I know that they're thinking about it and we're doing a tummy tuck, I tell them like we're just not going to do a muscle repair because weight loss is the other reason that I do see some muscle separation. Gotcha. And then recovery time is? So recovery time varies. So I generally let everybody know, especially with little ones, you know, for two weeks, you are the dependent. Yeah. So like no one can depend on you. So there's no like household stuff. You're not making anyone meals. Like you need the meals made for you. Essentially, it's kind of like right after you have a baby. Because if you don't have a newborn, you can take narcotics and not worry about it. Yeah. It's better. So that's kind of what I tell people. So two weeks, like it's kind of like your downtime. The first week is like you completely dependent. You need help with everything. Getting to the shower, meals, using the toilet. You kind of start regaining your independence. So you can like get to the kitchen and like make a sandwich if you need to. Generally people are back to work. You know, if you work from home after two weeks. Okay. And then three weeks is kind of like, you know, a big part of the recovery is done. Mm-hmm. But swelling is kind of prolonged. Yeah. I think it was, it was over a year until I actually noticed that my swelling was down after. Yeah. So we can take that long. Yeah. It was, I didn't expect it. So you did tummy and boob? I did. Okay. I'll let once at the same time. It was so funny. So I actually also had a hernia. Mm-hmm. So my mom told my dad, hey, I'm going to fly up to Boston. Jamie's having this hernia surgery. And I think she's going to help like do something with her stomach too. And she, so she was gone for a while. And then imagine the next time my dad sees me and I have boobs out to here. You know what I mean? He never said anything. But I know, I know he noticed. I know he noticed. That's hilarious. I mean, I went from an A pre-pregnancy to literally like, I don't know, an F or whatever, because I gained so much weight. Wow. What do you ever do? You don't need to do it. Well, that's my other question actually. Because I don't have to answer that either. I nursed two babies. So I'm fine with my size, but like they're just saggy because kids just suck the life out of them, I feel like. I don't know what happens. But can you do a lift with no implant? You can. You can. So it's all. Yeah, you can. So often times the question is like, do I need an implant? I'm like, well, let me talk to me about what your goals are. Right. So if your goal is to basically have a lifted breast higher on your chest wall, not necessarily have like upper pole fullness. So upper pole is like if you like looking in the mirror and you look at your breast, where your breasts start from your chest is like your upper breast, right? Your upper breast. So without an implant, you won't have breast tissue above that. Right. So they will naturally hang, but they'll be a little bit lifted on your chest wall. So a lift works great. But, you know, if you're looking for like perkiness and fullness, like when I hear perky, I'm like, ding, ding sounds like implant. Mm hmm. And they're like, I want to be perky. I'm like, let's talk about that, you know. And so or like, you can go brawless with either. So you can go brawless. That's a big one. That's a big plus. Yeah. You can go brawless with a lift or with a lift with it. You can. You don't need an implant to go brawless. So what about the fat grafting? The fat grafting was because I didn't want to go back to an A because I knew that's what potentially a B, C, I don't know what you would think. Mm hmm. But I asked her, I was like, can you take some fat from somewhere else and stick it in there? Mm hmm. She did it. Mm hmm. That was about work. And she lifted them. Sounds like a dream. It is a dream. It is a dream. It was my dream. And she made it after it. That's amazing. Well, but we should talk about the other side too, which is working with cancer patients or a bronchage. Yeah. Correct. So what does that look like? What percentage of patients that you're doing breast? All right. You know what? That's definitely in the top procedures because I do that a lot. Yeah. I do that about once a week in general. Wow. So I see patients who have a genetic susceptibility of breast cancer. So having the bronchogene or there are other genes too. Or women who have breast cancer. And the thought there is what happens there is basically breast tissues removed through a mastectomy. And then pretty much what you have is skin. You don't have to go to the breast tissue long. You're completely flat. There's nothing there. Or you can be even caved in. So the idea is to reconstruct that with, you know, we do implant base, which is the most common overall. And then there's your own tissue base, which is basically using like abdominal tissue or back tissue to reconstruct. Basically reconstruct the breast. That one's quite a journey. A lot of times what I realize is that it's what I've realized is that it's a very traumatic event, you know, because it's it's a very traumatic event, you know, because it's a very traumatic event, you know, because it's it's a very traumatic event. You know, because it's it's a it's a loss that you didn't have a choice. It's just it's happening to you. Like I didn't, you know, no one chooses to have their breasts taken off. And I think there's sometimes an under appreciation or underestimation of how what a big part of being a woman that is like, you know, you use it to hold up your wedding dress or you nurse babies in your breast and they're gone. Right. So the goal is just that's true. That's true. That's truly restoration. Right. The goal is there to just kind of restore what's taken away. And the best feeling is that you're happy. And I'm thinking to myself, like, why are you happy? Like this isn't this isn't your breast, but you're happy. Like that's great. Yeah. That must feel good for you to help them like that, you know. And so for the because do you remove, do you always have to remove the nipple or no? Not always. Okay. There's nipple sparing and there's different things. So nipple sparing, you know, if you can keep the nipple or not kind of depends on the tumor location. So if the tumor is really close to nipple, you typically can't keep it. Sometimes depending on the situation, I can do a lift, you know, and then come back and do the mastectomy so we can keep it. So there's nipple presentation things we can do if they're candidate for that. Okay. And then it's sometimes the nipples taken off with that. And the idea, my idea is usually to try and make it the most aesthetic possible. So I always, I always try and combine aesthetic and cosmetic and reconstructive principles or cosmetic and reconstructive principles or cosmetic and reconstructive principles or cosmetic and reconstructive principles or cosmetic and reconstructive. I don't really see them as different because I think everybody's goal is always to have the best cosmetic result. And so I try and just make those incisions or scars so when women look in the mirror, they don't feel traumatized. Or they don't see their mind every single time. Is there such thing as an artificial nipple? There is. There is. And they tattoo. I was a little nervous. There is. And they tattoo a lawn which those seem, like I've seen, you know, the major shows I watched. Yeah. They're 3D tattoos. And I mean, they look like nipples. They legitimately look like, I mean, I've walked in and been like, and I'm like, I look and I'm like, I'm pretty sure we did a nipple. Yeah. But like, there's a nipple. You know, so I'm just sitting there like, um, did I miss, did I miss something? I know she had. She's reviewing the chart. She's like, where'd you get that? And there's also the ones that you can like get from the store and put on or like Amazon or, you know, there's ones that really there's temporary tattoos. So like patients can put on that home themselves and they last maybe three, five days. No way. It's so much, it's so many, so much like amazing. You know, I'm going to Amazon just to look and see what they look like. Oh my gosh, you are sending me the link. Um, so with the Broca genome. So and you said there are other genes too. I'm so curious, like, is that recommended? Like, if you know, you have the Broca gene, like, is that hard for you or has it come so far in the medical community that you're like, yeah, this is preventative. You should do it. So it's all about like assessing risk, right? So you look at age, you look at like, okay, how many, you know, like periods, like age administration. So we look at all those things in terms of in terms of determining how much exposure that this person has had to the hormone estrogen, um, which can, you know, increase the risk and things like that. Um, so it's like it's sometimes age dependent. So like what, what patients worry about is because they have to do, if you don't have it, you have to do monitoring every so often. Okay. Or if you feel something, it's like, okay, like is that, was it up to get monitoring too? Right. Um, so it's so risk reducing that oftentimes breast surgeons do recommend it. Okay. And, um, and I've had some very young patients, like 20 years old, you know, who have it and have it done because they're like, I just don't want to think about this. You know, this patient had an elective mastectomy and I'm like, you know, it's no one elects for that. Right. I think it's, it's more so thinking about how we phrase things like you kind of didn't have a choice like because your, your breast, you know, eventually we're very likely going to try and kill you. Yeah. Right. So, is there ever a time that insurance kicks into those things or is that all sort of, I mean, obviously if you have cancer, I would assume it does so usually it does. Okay. Usually it does for the most part insurance will actually cover the mastectomy and the reconstruction in those patients. But not for like mommy restoration type of stuff. No. The eyelid lift, it does too, right? It does too. If it impairs vision. Okay. Oh, that's good. My mom didn't wait that far though. She was like, just get it off. I don't want to wait any longer. Okay. Let's, let's talk about like the no-nose. So do you ever have absolutely not, you're not doing that or like, do you say no to people? I do, you know, I do. Like, honestly, a lot of people I see, I'll say 99% of people I see are pretty reasonable. Right. You know, and I think a lot of that is like people just, it's almost like people who are similar to you come in, if that makes sense. I just see a lot of like very like nice normal people. Well, that's good. Not saying I'm nice and normal, but. You are. But, you know, there are times when people come in and, you know, it's like, you know, there is such a thing as body dysmorphia, like that is a very real thing. And so it's like, you know, like I'll have someone come in maybe and like wave their hands. You're like, look at this. And I'm like, well, if you stop waving your hand and they're like, well, you know, you know, we just kind of chuckle. I'm like, you know, you can pinch anything. You know, it's really like study people when they come in, they're talking to me and just think about and think about like, how much are they pinching tissue? Like, how much is this bother them? Like, is this beyond the surface? Right? Because sometimes I do think there is such a thing as where you seek plastic surgery to correct something that's happening with you emotionally. Absolutely. And you have to be together emotionally to to have plastic surgery because if you're not ready, it is going to expose all kind of things. You know, and we like control in general. So there's like a control where you're healing, you're swelling. Like, when does the swelling go away? We don't know. Like, we know by a year it's going to be gone, but we just, the whole healing process can be very vulnerable time. She's amazing because I kind of went through a little bit of that after it was all over. It wasn't, it was less than a year and I went back to her and I was like, okay, Doc, where you took it out here? I was like, oh, I see something wrong. My biggest thing is I don't want people to know. I mean, obviously I tell people, but I don't want, if I'm in a bikini, I don't want them to go, yeah, she did that. And why did she do that? I'm thinking negative, right? You know, and she was like, Jamie, you're fine. That's a muscle. Yeah, we can't do anything about that. It's a muscle. But if you really want to and I'm like, no, if you think it's normal that I'm fine, but you do, your mind does. It just happens. And I needed her to say, Jamie, it's fine. And I honestly have never thought about it again. Yeah, you just fixated on a specific thing. I did. Well, I think social media is just ruining, especially like the generation below us. It's like, good Lord, I can't imagine what these girls expect to look like and everything's a filter and it just is like scary. I have patients who come in all times and wish pictures and I'm like, and I'm very honest and I'm like, there's no way. You ain't never gonna look like that girl. It's just not happening. Yeah. Not gonna happen. I'm like, I'm very, I'm just so grateful for my gift and like, I love the surgeries I can do with the transformations, but this is not happening. But that's good that you could be honest and just tell us. I'm very honest. A big part of it is just setting expectations, right? Like letting you know what to expect, like what can I achieve for your body type? Patients even come in with wish pictures being my own patients and I'm like, actually, like her bone frame is completely different. Like her waist is just completely different than yours. So like two people can have the same surgery and have different results. Like one waist might be super snatch is the term that the young people use. Snatch? Snatch. Snatch. Okay. Never heard that before. People coming and asking you for snatch waist. Wow. I'm like, your waist will not be as snatch as hers because of your bone structure, I'm like, I'm not taking out wrist. Like I'm just not going that far. That's crazy. Because my goals, I want women to still look like themselves, right? Just to look like a restored version of themselves. It's not goal. Yeah. You know what I love about your Instagram is how you answer questions that people have. Like one of the questions that you did recently was, okay, if you do liposuction, where does the fat go? You know, like, and I've always wondered that even though I'm like, but where does it go when I gain weight? Mm-hmm. So it was interesting. So where does it go? So it's so funny because people come in there like, does it travel? I'm like, where is it going to travel to? I swear I did think that. I was like, oh, it's going to my thighs now. That was like, one in my hands, I'm like, okay. Oh my gosh. The important concept there is like, we are born with a certain amount of fat cells. Like the fat cells are bigger or they'll get smaller, but you don't just spontaneously increase fat cells. So, you know, if you do liposuction like, let's take on your abdomen, well, that is a way to decrease fat cells like, because we're taking out fat cells, so you have less fat cells there. So if you gain weight, you're less likely to gain it where you've had lipos, but you gain it other places. Now, if you gain a bunch of weight, you'll gain it everywhere, but less where you have lipos. Mm-hmm. Oh, interesting. Yeah, it's all the questions that people randomly ask that I just like, I have a little note section today, you know. Well, so I want to ask like, people who don't have access to you, right? Because you're in Nashville, but not everyone can get here. Mm-hmm. Like, what's kind of the checklist on like, they're looking for a plastic surgeon. Right. Like, board certify. Right. Like, that type of stuff. What would be your like, top three things? Right. So the number one thing is like, it's not so, unfortunately, like, consumerism, you know, they've taught, they've learned how to trick people, like, but they've never seen plastic surgery. Okay. Because these days, you can like take a weekend course in liposuction, which is terrifying. Oh, my gosh. So you can have a dentist, you know. Oh, Lord. Wow. An old big guy, like, doing lipo. And you don't know it's a consumer, because you see board certified and, and you know, you're like, oh, they board certified, they do lipo. But it's like in dentistry. And then like board certified is what you'd heard of something else. Wow. Oh, has kind of done started this thing and it's weekend courses it's or it's like you know a few months even a year but it's just not enough you know I mean we're spending like six to eight years learning about this all the time and there are certain surgeries like liposuction that seems like oh it's just lipo but it's not just like well like lipo can be very dangerous yeah if you don't know what you're doing so can you look that up somehow you can certification you can so there's several places you can go to just like the board there's like a the American Board of Medical Specialties you can go there truly like because it's so much work to get board certified in plastic surgery like you know it's always like high and bold and on any plastic surgeon's website okay you're not gonna hide it yeah like your board certified plastic surgeon you're gonna say like board certified plastic surgeon it's gonna be like they're obviously on their bio page okay so you want to go to their the website and then look at the credentials and just make sure it says board certified and plastic surgery okay so that's probably the most important thing okay reviews are important I would definitely you want to look at all the reviews and so including the negative ones and just see what they're saying so you know the majority at some point like somebody's gonna be that's unhappy yeah I mean for whatever reason but you can you can use a read between the lines and I'll give it a brief example so taking call I see people sometimes in the emergency room with horrible complications from plastic surgery elsewhere and I always kind of do a deep vibe and look it up cuz I'm like let me see what they're experiencing so I can educate people on what to avoid and so every time I look it up and go to the website first of all it's not it's usually not plastic surgery board it's usually something else but also there are a lot of negative reviews that say things that are like oh my gosh these are so many red flags yeah reviews are important of course like be careful because sometimes you can have a lot of good reviews and maybe you pay to get the negative ones taken down you know that's a slippery slope but it's still an important checkpoint yeah the reviews also look at and see what they're saying like are they really long or people saying a lot like you know like if it's just like great experience yeah like a paragraph well who's gonna spend paragraphs you know so yeah look at the nature of the reviews totally that's really good advice that's one thing about reviews I'm always afraid of I mean you can get anybody to do it it's scary out there which which is kind of a big reason of a lot of what I do what I do because it's scary out there and you just don't know what you don't know that's why I mean I found you through another friend and since then you have done multiple friends you know so it's like word of mouth and the one thing that's why Lisa's so good too because so Dr. Amaka has a lot of patients that come from out of town who stay at hotels here and Lisa will come and take care of them and make sure they're okay yeah yeah yeah and she's just like Dr. Amaka okay so reviews and then anything with like price or promises or because I feel like you can kind of get sold right so like in Instagram is a great reference okay careful because you know like you usually put your best stuff on Instagram right like you don't put like oh this patient sometimes I'll I mean I'll be like this patient of complication would you think that I mean because I'm just trying to be open and honest right but like for the most part like people put their best stuff out there right on Instagram so that's you can have someone who's not a plastic surgeon putting stuff on Instagram and it's like oh that looks great I'm gonna go and a lot of people are doing that because there's a lot of kind of the other world of non-plastic surgeons who do cosmetic surgery on Instagram and that's kind of how they're building up everything so Instagram is a okay place but not like that should not be your only you know obviously that should be your only thing but yeah like look at the credentials look at the training look at the training and make sure there was a residency in plastic surgery at some point if you don't see residency plastic surgery then just start you know you should start asking yourself some questions when you set up your consultation if you're not consulting with the surgeon plastic surgeon just ask yourself some questions because that's kind of strange always say that's kind of weird okay so you should see the doctor you should see the doctor your console I mean and I'm maybe I'm biased but I just strongly feel like if someone's like trying to invest their life in me yeah I should be meeting them at their consult yeah because what happens is some of some sometimes you'll see like a consultant who will set your surgery plan you want me to serve you want me to surgeon to the day of surgery like the morning is like hey how you doing okay let me go ahead and Martin and that's like a big red flag wow I didn't even I would assume you would have to meet the surgeon they're just like we know what you want we told him we know yeah it's like truly is like that in a lot of places wow yeah but I think a lot of people fall for that and then I mean I know people travel internationally because it's cheaper which is terrifying and I always say like price is important like you should set a budget but don't let that be the reason you go somewhere like because because that that's never gonna steer you right if you like if you go because of the price right yeah like these are my two options but that price I'm gonna go with that look at other things yeah everything else checks out literally and then it's like okay maybe you know but don't let that be like oh that you know what that's why save for two more months I can't even count the amount of like you know DMs I getting people like hey how you doing like how you set up a console I'm like here's where you go and literally like six months nine months later they're like I have a complication I can't get in touch with anybody I'm like oh my god and because like in all transparency my price is not the cheapest out there it's just not you know it's not the most expensive but it's not the cheapest so many times people price shop and you should not price shop with your life like are you gonna price shop for your nanny yeah you're gonna price shop for your heart surgeon yeah why would you do it exactly so so I have to tell you the story I don't think I've ever told you and Dr. Amaka said a little while ago that they still talk about this to the state it wasn't that it was embarrassing it was so I went in for my consultation and I met with her lovely nurse not Lisa another one that works in office and so I'm just talking to her now I'm getting ready to have surgery the following week and she I was like okay well what do you wear because you come into her actual into your actual office and she was like just something comfortable something loose and I went oh I'm like so maybe like a row and she's like sure he comes through the back door well I didn't know she was joking no oh no so I I came in slippers I came in my barefoot dreams fuzzy road oh that's a good road to go and so I went in for my apartment I knocked on the door in the back and I was not supposed to do that I was supposed to go through the front she's like yes I'm like I'm here for my apartment so she's like oh my gosh okay so I'm like I'm still not realizing that we're all like they hurry up and get me into a room and I'm just sitting there my mom had already left we were probably about 30 minutes early so they didn't have a room or even ready for me so they had to kick somebody else out of their room and so I get in Dr. Amaka comes in she goes Jamie what's under there I said nothing she goes you came from home now granted was only 10 minute drive you came from home with nothing under your robe I'm like yeah you're gonna have to take it off anyway it's so funny now people ask like which I'm like you know I just wear slippers in a robe because it was the easiest recovery because we just slipped on a rope on a rope yeah it would be easy they remember me there yeah I was like so you undressed you basically undressed to come in to come here I don't I probably wouldn't have thought anything of it either like well I'm gonna get in a gown anyway or whatever I'm going comfortable I went out and got some new hugs slippers and all hilarious does it annoy you if people basically have random console consultations with you like at dinner or they're your friend but maybe not that close of a friend you know your close friend you probably don't care but you know like an acquaintance does that happen to you often and how does that go you don't like with friends I don't mind that much with family it happens some and so my mom's terms would be like oh we're coming and what's our discount I'm like oh god you know if you know if you know like it would be like zero dollars you know it's a discount for them but you know it doesn't happen like as often as you think and like occasion people will recognize me out and usually they'll just come say hi but they won't be like what do you think about this that's good it'll more be like hey like you know nice to meet you but it won't be like hey what do you think about my nose do I need to come in you probably know how to shut it down too I can see you being like the person that's kind of like yeah no more questions yeah I usually can read the room like okay like we're at dinner it happens probably more like on social media like all the time oh I bet someone would have surgery elsewhere and they're like we think about my results and I'm like whoa I'm not we are not doing nothing in the DM do you get like brass everywhere in your DM and I'm not doing this there was a time like early on I was like sure and I'm like no this is this is not like medical legal I can give you medical advice in the DM you know oh that's a way I have a question and this may be embarrassing and I may decide that we don't say anything like this but men do you do any plastic surgery for that area no I do not it's like you know like the other day someone's like dude I was like no I don't I'm sticking to you're like I'm very talented and I get to pick and that is not part of it there was a point of training where we do things for like you know like if you had like a buried penis yeah you know you do things to release it. Wait. Oh, what? Barry. Oh, what? How do you bury a penis? Well, it's not, you know, it's just that the skin becomes so heavily encapsulated over the over the gland, like the head of the penis. So you do things to release that skin. Gotcha. Yeah, but I don't do that now. Gotcha. You're like, I got enough of that in my training. Done. You know, the cool things you come out and you're like, okay, what do I actually want to do? Yeah. In training, you just do it. You do everything. Like you get called at 2am. Yes, ma'am. Yes, sir. You know, but in when you're finished, you can be a little bit more selective. Can I ask you, I don't know if HIPAA or whatever, but what is the worst you've had to do? Like what is the worst case scenario? Surgery? Like, in general, I'll give you a scenario. So I was, I was pregnant with my son. And I was about eight months pregnant. And I got so we in training, we got called for a lot of like infections and things. So it was a really bad hand infection and they tend to smell really bad. So it had quite the odor pregnant, pregnant. Oh, you already know what this is going. So literally, I go in and I'm like, okay, you know, I numb everything up so numb it up so that they can't feel obviously. So then I make my little and this was we did all this stuff awake, like an emergency room and it's at like 2, 3am all the time. So I made a little hole to drain infection and it just comes out and smelling. So literally, I like every 10 minutes, I run out vomit in the hallway, go back, you know, clean up a little bit, go back vomit. And so that just happened and the nurses just like what and I'm like, I don't know what else I can do. You know, oh, my God, that was very memorable. Oh, I can't imagine. Yeah. Oh, my God, that makes me want to vomit. I had the worst nausea when I was pregnant. I cannot imagine. I did too. And I was nauseous, like all the time. Me too. You know, my gosh. And so, oh, wow. I was just in and out like I'm like, okay, be right back, vomit, be right in it. You know, I just had them put the trash can right outside of the room. So I could just, you know, not have to go all the way to the bathroom. Well, we're almost out of time, but I do want to ask a little bit about work life balance just because we touched on like the female plastic surgeon stuff. But I can imagine like there are different expectations for a female over like a male plastic surgeon. I don't think he's getting called for a kid at school or whatever happens. Can you talk to talk to us about that a little bit? Sure, yeah. So you know, I had so I had my kids in residency and fellowship. The key has really been I had my husband's so supportive and so great, like it would be impossible without him. And so when I think about balance, I think it's I think it's less about like just waiting for balance to happen. You have to just create balance. And so I kind of separated into three areas I think about self care family work. self care is actually at the top. And I didn't realize that at first. And so I kind of fell off on the self care wagon because what I found is that you can't pour in other people if you're empty, you know, you can't be a great mom, a great surgeon. Sure, you can you can function right because the surgeons we learn like no matter what the circumstances, you can just operate almost like almost like in a machine like fashion, right? But you want don't want to be a machine, you want to empathize with people you want to kind of help them along their journey. And so and so I prioritize self care. And so for me what that looks like is I wake up really early in the morning and that's kind of my me time. So I'll do like meditation. I'll that's when I exercise and all that. What time is that? I'm scared. Oh, okay. I was I was scared. That's early. That's really early. Okay. But it's just it's just like my quiet time and it has been like it's been amazing. You know, for as far as family life, like it's and this other thing too, I realized talking to a lot like a lot of women and people about this, I think a lot of times we like, you know, it's like, how do you do it all? I'm like, I the answer is going to shock you. I do not do it all. Like you can't do it all, right? So when I'm at work in operating room and I'm in a surgery runs late, like I'm not at home. I'm not picking up my kids, right? So you have to accept that you can't do it all. There's going to be some things you're going to miss. And but it's all about I think it's all about just realizing that some weeks work life balance is going to be better than others. Sometimes you work life balance. You can be like, gosh, that was a rough week. Like, you know, I try to get home for dinner every night. Sometimes I don't, you know, but it's all about having that goal and, you know, doing the best you can until you can do better than when you know better, you do better. So that's kind of how that how that balance looks for me. And and I'm in certain things like one of my big hobbies is cooking. So I do a lot of cooking at home, you know, and for my families, but that's a hobby. And that's sort of my release time, even though it may look like she's working. She's cooking. Yeah. I'm like, no, this is enjoyable. Yeah. No, that's John. He loves to cook. That's his. That's my release. Yeah. Yeah. So just incorporating hobbies into doing things with them. Yeah. And I've been like, so I've been better about like my phone. Like sometimes I'm attached to my phone because I'm like, oh, social media, I'm replying to this or I'm posting this. And when I get home, I try and just take my eye watch, put my phone upstairs and really try and unplug and be there with family. Yeah. And and that's kind of one thing I've started doing when I realized, like, gosh, like, it's nine o'clock and I'm sleeping and I didn't really spend time with them because I've just been so busy doing this and doing that and doing this and doing that, you know, so just being very intentional is a big thing. That's great advice. I've enjoyed the past couple of years watching you with your self-care because you really have you between your collagen and just the way you exercise and the way you cook. I mean, like, I've noticed and it's amazing to watch and it's it's an inspiration for sure. Absolutely. It's almost like, you know, like if anybody can do it, like it's not about like, oh, I have to do this or I have to get to do this. Like, you get to do this and, you know, like, you have to make time to do it. Otherwise, it's never going to happen. You have to make time. None of us have time. Like, you know, like, how much time do you have? None. You have to make time. Yeah. And it's awesome, too, because your kids see it. I mean, your little girl does it with you sometimes. And it's so cute. She's so little. And so it's it's not just for you. It's it's for your kids. It's a demonstration, you know. Yeah. You have a great great role model. Well, thank you. Speaking of, we're keeping you out past dinner. Let's let you have your balance. Thank you so much. Well, thank you all. This is I appreciate it. Yeah. Thank you so much for having me.