 Today's episode, we talk about youthfulness, anti-aging, rejuvenation, how you can live a long life and look and feel younger. And we brought Dr. Anthony Yoon on the podcast. He's a plastic surgeon, but he's a holistic plastic surgeon. In fact, he wrote a book called Younger for Life, which talks about all of the nonsurgical ways to make yourself look younger. He's one of the most honest doctors and surgeons I've ever met in my entire life, and we asked him all kinds of questions. He was open to answering all of them in a very honest and authentic way. We became fast friends. We know you're going to love this episode, and you have to check out his book, Younger for Life. Today's giveaway here on YouTube is MAPS PowerLift. If you want to win that program, do this. Leave a comment below this video in the first 24 hours that we drop it. Subscribe to this channel and turn on notifications. If you win, we'll let you know in the comment section. We're also running a sale this month. We put together four workout program bundles, and we discounted them between $300 to $350 off. Here's what they are. We have the new to weightlifting bundle. We have the body transformation bundle, the New Year extreme intensity bundle, and the body transformation bundle 2.0. All of them discounted massively this month only. If you're interested, go to MAPSJanuary.com. All right, back to the show. Dr. Yoon, welcome to the show. Hey, it's my pleasure. This is a privilege to meet with you guys. Thank you. Okay, so you've been referred to as a holistic plastic surgeon. Yes. What's the difference? What's the difference between a holistic plastic surgeon and just a traditional plastic surgeon? Yeah. I went through my traditional training. I did four years of medical school. I did three years of general surgery residency, where I worked in ICUs, and I worked in trauma bays. I did two years of plastic surgery. Then I actually did a one-year fellowship in cosmetic plastic surgery out in Beverly Hills with a top name plastic surgeon. For many years of my practice, I practiced like a traditional plastic surgeon. There are these sayings in surgery to cut is to cure, or the only way to heal is with cold steel. Wow. Wow. Yeah. As a surgeon, I knew that my goal, we were always taught that goal is to operate, is to bring people to the operating room. If you're, let's say, a general surgeon, the goal is to bring people to the operating room. What surgery would you love to do? The big operation is the Whipple. The Whipple is a 10-hour massive cancer operation that if you're so lucky that you can scrub into a Whipple, you know you have made it to the upper echelon. That's when they remove, I had a client that performed this up here at Good Samaritan here in Los Gatos. What are you removing with that? There's a lot of, you're going in here. Mainly it's for pancreatic cancer. That's right. And pancreatic cancer spreads so quickly that this is an operation where you remove basically wherever it is, and it can be literally 10 hours long. You know you don't stop and go to the bathroom in the middle of the operation, like you just plow through it. And so in plastic surgery, the pinnacle of success would probably be the facelift, you know, because people may trust almost anybody to do some lipo on them, but man, if you're going to have somebody do a facelift on you, you got to really make sure that's a good surgeon. So for many years, I actually gauged the success of my practice on how many facelifts I was doing. And I reached a point in my practice where I had a one-year waiting list. I had people flying in from all across the country to see me, and I was doing these faceless. And I thought that I had reached the pinnacle of success. I was like the busiest guy in town and everything. And then I had a patient of mine who had a horrible, horrible complication after a facelift. And it was one that I couldn't have predicted or prevented. It wasn't her fault. Just sometimes as a surgeon, like bad stuff happens. And so it really sent me into a tailspin for months as I honestly like thought about leaving medicine all together. I questioned, Jesus, is this whole practice of cosmetic surgery? Because I do all cosmetic surgery. You know, am I really doing the right thing as a doctor? You know, it's that whole Hippocratic oath of do no harm. And am I now doing harm? So for many, many months, I really thought about it and I struggled with it. And I finally realized that everything that I had been taught about surgery was wrong. Like the goal of a surgeon should not be to bring people to the operating room. My goal should be the opposite of that. Like how do I keep people out of the operating room and still have them be happy with their appearance? And so I started taking time to study things that I was never taught in medical school. Nutrition, skincare. We didn't even spend any time as a plastic surgery resident, I didn't spend any time with dermatologists, believe it or not, because it's a big turf war. So I studied works from dermatologists, from gut health doctors, from alternative medicine specialists, and I came up with this concept of autojuvenation, which is the basis of my new book and this idea of holistic plastic surgery, which essentially is using actual plastic surgery as a last resort. And so that's something I have been for the last, gosh, eight or nine years have been really kind of pushing and have been pretty much at the forefront. And it does, you know, I do get some pushback because, you know, sometimes you're telling people, Hey, maybe you shouldn't get this done. There's a plastic surgeon who had already signed that person up for surgery. They're making money off them. And now I just took money out of their pockets. Wow. So you said turf war between dermatologists and plastic. So what do you mean by that? Because they're both, they're both trying to get the person's skin better. Dermatologists is like, this is what we do. Surgeons like this is what we do. So they're competing for forces. There are turf wars in all of medicine. So with plastic surgeon dermatology, yes, you know, as a plastic surgeon, if somebody has acne issues, I'll send them to the dermatologist. But if they want Botox, they can have it done with me or they could have done with the dermatologist. If there are some dermatologists who are delving into actual surgery, I know some dermatologists doing eyelid lists, some of them even kind of getting into facelifts as plastic surgeons. I have a complete skincare center at my office. We have lasers, we have, I have five injectors. I have two estheticians to do lasers and skincare. So there is that overlap and dermatologists and plastic surgeons sometimes don't like that because they feel competitive. But you see this with other fields too, you know, general surgery, general surgeons used to do all types of, of operations from thyroid surgery to mastectomies, to colectomies, to appendectomies. Now they are limited because you've got colorectal surgeons who do the colon surgery. You've got endocrine surgeons who will do thyroids. You've got breast surgeons who will do mastectomies. So general surgeons are getting actually really down to doing the things that these other specialists don't want to do. Appendectomies in the middle of the night. You know, stuff like that. Trauma surgery, where you have to spend the night in the hospitals. And so medicine in general is a big turf war. Wow. Going back to when you had that moment where there was a complication and it sounded like it was very challenging for you. What, why were you thinking of maybe leaving? Was it because you were just like, okay, this, you know, I have my intentions are good. This doesn't seem to be like, what did that feel like? So, you know, what happened is the exact story is I had a patient who was in her sixties, a woman in good health from what we could tell. She wanted a facelift. She had some loose skin of her neck, some jowling, and she seemed to be a good candidate for it. So I had her cleared by your internal lesson physician. Anybody over 40, I always get them cleared by their doctor. She had clearance by a cardiologist, including a stress test. On a Thursday morning, I perform a facelift on her. The surgery goes perfectly, like no bleeding. We kept her overnight in the hospital, which was at the time routine for me. Um, and then next morning, Friday morning, I went and saw her and everything looked great and I sent her home. Uh, fast forward, I come back to the office Monday morning and I have a message from her daughter and the message was, why did my mom die? Oh my gosh. And I just like get silent in this room, like my, I get this message from my, um, office manager and I mean, I was just floored. Like I had a sick feeling in my stomach. I started to sweat and feeling nauseous because what the heck happened? And, you know, I saw her and she was fine. So what happened is she had a massive heart attack over the weekend. Now I had her cleared by a cardiologist. You know, I couldn't have done anything different. Right. Um, but when something like that happens, and this is the only person that this is the only patient I know of that's ever died after an operation for me, um, it, that sent me into a tailspin because I started thinking, first of all, is this my fault? Did somebody actually lose her life because of what I did? And I went through everything. I went through the old records. Like, is there a medication thing? Cause it took a while for us to find out why she died. I didn't know. And so I poured through the charting. I poured through all the hospital stuff. I could find nothing that I could have done differently other than just not operate on her. Um, and so after that, um, I contacted the family. I, I, it wasn't much to say, just I'm really sorry. I gave them all their money back from the operation. I said, here help, you know, cause they said, look, we don't have much money to pay for the, for the funeral. I'm like, well, here. And, and, and it literally once again, now, you know, story, that's why it sent me into a tailspin. And for months, I just thought, geez, should I just quit? Like, is some, this, something this bad happened. Is it my fault? And I didn't know until really months later after the autopsy of exactly what happened. So give me an example of like a patient that would come in, say today that maybe in the past that you would have done surgery where now you pushed them in a different direction. Like, what's an example of like that? Oh, easily I would have gone under the knife on that situation where now I would tell them to do this. So there are people who will come in. Um, you know, so for example, right now, the good thing is that there's so many things that we can do short of surgery to help people look better. You know, even when I started my practice back in 0304, if you said, Hey, I want to get rid of some extra fat. Uh, I'd say literally all we have is lipo. You know, now we have injections that can melt fat. We've got lasers. We've, we can freeze fat. There are a lot of other options available, but the one thing we cannot do without surgery is get rid of excess skin. So if you've got skin hanging from your neck, if you've got skin that's all over your eyelids that you can't see that well, you know, if you're a woman who's had four children and you've got skin hanging from your tummy with rashes and sores underneath it, there's no cream that's going to make it go away. There's no injection that will make it disappear. You just have to cut that out. So then there, so there are those patients who come to see me and they've got a lot of extra skin and, and, and jowling and hanging skin. Then yeah, they really, their only option is a facelift, but there's that group of patients where there's extra skin there. There's some early jowling and there, you know, it's kind of a gray area. And in any of those situations, I really try to encourage them, look, you know, you got to consider all the risks. Are you sure you want to do this? Let's talk about other options for you. And if we can get you happy and healthy without doing this, then that's obviously the ideal situation. Now you've probably had to really work on how to communicate that because I remember as a trainer, one of the biggest struggles I had early on was people would come to me wanting to lose weight or whatever. They'd have an idea of what they wanted. They would tell me, this is how I want, this is how I want to feel. This is my workouts. Here's my target. And I knew as a trainer, that's unsustainable, your goal is unsustainable. The workouts that you think are going to work for you are way too excessive. They're not going to work for you. But I was always like, but they're not going to hire me if I don't do what they ask. And how do I communicate this? So you've, have you had to work on how you can like communicate to them, like, hey, I'm telling you right now, we're not going to do this, but there's still value in what I'm saying. And here's why. And this is why you shouldn't just go down the guy down the street who is going to operate on you no matter what. So I say two things. The first thing is that I'm very fortunate and then I have a waiting list of over two years for people to come to see me. And so I'm lucky that I don't have the stress that other surgeons may have. But geez, they look at their operative schedule and it's empty and they need to operate to make money. Like I have no worries with that, which is has always been the case in my practice, which I've been very fortunate. But the second part of it is you are 100% true. It is much harder to say no to a patient than it is to say yes. Because it's not like you say no and they go, okay, that's fine. Thanks anyway. Like you don't want them to leave your office upset. And for me, I get patients that say, hey, I waited two years to come see you and you're saying no to me. Yeah. And that because they'll say, you know, I waited to you, I could have gone to Dr. So-and-so and had this done a year and a freaking half ago. Now I'm waiting for you for two years. I pay all this console money and you're saying no. Yeah, I'd be pissed too. So it is, yeah, it is a bit of an art. How do you get somebody where they come in knowing what they want and to have them leave your office actually liking you and being happy with you? And that's something that, you know, I've been in practice almost 20 years and it's taken a long time to kind of figure out that dance that you do with the patients. And it really is being honest with them, but also I think talking with them, I think very, it's honesty and it's also respectfully, sometimes you can agree to disagree. And a lot of times I'll just tell them, look, you know, what you want, I cannot give you. I physically can't give you, you know, do you want to go to the surgery when we know we're going to fail, you know? And they, what are they going to say in that situation? Because sometimes their expectations are so out of line with what reality is that there's nothing you can do that's going to make them happy. And that's the worst situation as a surgeon is to operate on somebody, have them pay all this money, have all this recovery time and stuff like that. And then they don't get the result they want. People get upset. Of course, now you have other alternatives, like you've tried to kind of figure out other procedures and things that are quite as invasive. Do you also work with other practitioners that you've built in a network to kind of address more holistic needs for each one of these patients? To an extent. So I have in my office, I've got a full team of skincare aesthetic, basically everything from literally just encouraging people to get on the right skincare products to actual surgery. So I've got nurses, aestheticians myself. I don't have a dietitian. I don't have a health coach. I have looked into that. I just have, you know, with as much, I guess, interventions and stuff that we do in my office. We just haven't had the I haven't had the chance to bring it in. I've just been so busy, honestly. But that would be the next thing that we have talked about is bringing a health coach in to help people prepare even for surgery. Oh, yeah, I could see a definite fit for that. That would make a huge difference, because I was like I was telling off air, I worked with a lot of surgeons and at one point, once they were my clients, they would send me their patients and the success of their procedures and the recovery was so dramatically improved just because they were fit going in and stronger. I understood correctional exercise that like I never had to advertise at that point because the doctors would just send me patients. The challenge for you is going to be finding someone who's good. That'll be the challenge. Right. It's going to be well. And when you go through traditional training, they don't teach us anything about nutrition about supplements or any of that stuff. And so, you know, for me, as early on in my practice, I knew what I was taught, you know, and I I scored it the highest in all of our, you know, exams and all that type of stuff. I became board certified. I was the top guy in town. And you know what, for probably the first eight or nine years of practice, if somebody would come to see me before surgery, they'd say, Hey, I'm on all these supplements. What do I do? You know, my answer to them was go off your supplements and you'll be fine. And then they'll ask me, what should I do for diet? And like just eat a regular diet, avoid, you know, garlic right before surgery and stuff like that. Because I didn't know. And the fact is, is a lot of traditional doctors don't know what they don't know. And so after this happened with that patient, it really got me thinking like, I've got to I've got to do this differently, because I will not allow this to happen in my practice ever again. And once again, it wasn't my fault. I look, I've never been sued. I've been in practice 20 years as a surgeon. I've operated on tens of thousands of people. But I think really what I realized was I don't know what I don't know. And I started taking a lot of time, I mean thousands and thousands of hours, learning what I didn't know. And interestingly, the first thing I did was I created a supplement system for my surgery patients. So I started looking at the research and combining the readings from alternative health physicians, alternative health experts, nutrition. And then I started actually comparing that to the literature in wound healing and surgical ICU. So I look at, hey, what are they doing for patients who have pressure sores in the ICU, who have diabetic ulcers? You know, how are they giving them nutrition? What helps them? And I combined the two into the supplement system. And I tested on my patients. And since then, I've been using that. And interestingly, what I found over the last few years, as as more and more doctors are being open to the fact that supplements actually help people. And that nutrition really does make a difference in healing is that companies are creating their own products. I never actually put my products out there because I there was I had a thought, okay, I've got this supplement system, I can sell it and patients will buy it because they want to heal from surgery. And a lot of people believe that that will help them. And I do too. But I was worried that some surgeons going to operate on somebody, they're going to get a complication. And oh, here's the easy scapegoat right here. Oh, you got that bleeding because Dr. Yoon told you to take this, you know. And because I don't have studies to back up my specific products because I don't have time to run any of that stuff. I said, hey, I'm just going to keep it in. But now I'm finding there are these companies coming around who are creating supplement lines for pre and postoperative patients. And they have almost the exact same things that I yeah, that I found. So I'm like, Hey, I actually had you want to know it's funny, Dr. You want to funny Dr. Yoon, the sports supplement market will often look at the literature that's done on post operation or burn victims. And they'll look at those and say, Oh, you know, glutamine, branch amino acids, you know, essential matter, they help with burn victims heal faster, then they'll apply it to the athlete and stuff like that. Which is kind of interesting. By the way, do you use amino acids and stuff like that post post surgery or what are the things I have a glutamine and amino acid supplement and then an arginine supplement. Those are the two that we have patients on because that's where all the literature shows now is the arginine for the vasodilation, I'm assuming for the improved blood flow. Is that for before, after or both? It's both. Okay. So we have them start that two weeks before surgery, and then they go about a month or so afterwards. Okay. And then you mentioned something about garlic beforehand. I'm assuming it's because of its anticoagulant properties. Yeah. What are and this is very interest. This is very important for people to understand. There are very common over the counter supplements that you can take, that you do not want to take a week or two before surgery because it caused problems. What are some of those? I mean, the big one is going to be fish oil. Yeah. Yeah. So fish oil is the one now. Fish oil interestingly though, I do give my patients fish oil as a supplement, but we have them all start at two weeks after surgery because there is a risk of bleeding post-operatively for the first two weeks, at least in the operations that I do. And so that's that really is a big one. St. John's wort that may also increase the risk of bleeding. I mean, those are kind of the main ones that we look at. And then the problem is that there are some that we just don't know. You know, we just haven't. Have you looked into creating for its ability to heal the body? I've seen a lot of literature on it for organ health and stuff now, but I don't know how it would affect. Yeah, I haven't looked specifically at it. I know that that's become a pretty hot topic. I know you guys are big fans of it. You know, for me, I think it makes sense though, because what happens when you undergo and a general anesthesia is that your body will break down skeletal muscle afterwards. Yeah. And and it will no matter what. And so part of it really is going to be, hey, trying to get the body enough protein to help counter act that skeletal muscle breakdown, you know, creatine obviously it can play a big part of that. One of the biggest questions we get from our audience comes from our female audience in regards to plastic surgeries in regards to breast augmentation. So and I get I see this all time as a trainer. I don't want to work out my chest anymore because I have, you know, I got breast augmentation. Doctor said can't don't do any chest exercises now as a trainer. My expertise is not surgery. My expertise is not any, but it's an exercise in health and in regards to fitness. And not training a muscle group always felt so wrong to me. Yeah, because of the imbalances that could be caused. I mean, the pectoralis is important for lots of different functions, including helping to stabilize the shoulder girdle. So okay, all of a sudden, we can't train your chest at all. So what are is that is there any truth to that? I know it changes the angle of pull with the peg. Maybe we could talk about that. Like, so the answer is it depends. So implants can be put in two planes, either above the pectoralis muscle, which we call sub glandular or under the glam breast gland, or you can put it under the muscle. Now under the muscle, technically, there's, there's a complete sub pectoral meaning it's completely under the muscle. There's dual plane, meaning it's partially under the muscle and partially not. Those are kind of the main things. And so whenever let's say I get patients who come to see me and if they're body builders and I do a lot of breast augmentation surgery, I will usually encourage them to go above the muscle, because then you're not going to get that distortion. So the issue is if you have an implant that's under the muscle, the benefit of going under the muscle is that it lowers your risk of capsular contracture. Capsar contracture is when the scar tissue around the implant gets real thick and hard. Okay, now whenever you put an implant in the body, no matter what type of implant is, no matter whether it's in your knee and your chin or in your breast, you will get a capsule around it. Capsula scar tissue and that scar tissue can be real thin to the point where you can't even feel it. You can't tell it's there or it can get real thick and in some extreme cases, it can even become calcified like the shell of an egg. So in the most extreme cases, I can see a woman who may have had her breast and silicone implants placed back in the 80s. And they are these rock hard balls on the chest, you bring them to surgery. And it literally is the like calcified to the point where it's white and chalky on the inside. Like literally white and chalky. Wow. And then the flip side of that, you can have scar tissues that's so thin that it's like wispy thing like as thin as tissue paper. Okay. And the ideal obviously is having thinner scar tissue because then the breast is going to feel more natural. Right. So when you put the implant, so the number one most common complication from implants is caps or contracture is this scar tissue other than maybe breast implant illness, which we can talk about as well. Yes. Thank you. And so the best way to reduce the risk of that are one big way is to go under the muscle with it. And we believe that it may be the movement of the muscle over the implant can helps prevent that scar tissue from really getting thick. It could be the blood supply from the from the muscle getting rid of any type of biofilm or bacteria that may be around there. We're not exactly sure why that's what I've heard. I know I know one surgeon will literally soaks the implants and like antibacterial. So we do we do it with all of them. Oh, yeah. Anyway. Okay. Yeah. So yeah. So the goal is you don't want to get bacteria on the implant, but breast tissue sometimes has bacteria in the ducts and in the glands. And so you can get it anyway. So anyways, you can go below the muscle because you want to you can lower the risk of complications. But the negative of going below the muscle is that when you flex those muscles, what happens? Those muscles contract, they flatten on the chest and the implants move outward. Okay. And you may see videos on like TikTok and stuff where women are moving their chest all around. Or you may see people when they're doing posing after, you know, with bodybuilding and you can see this distortion of the chest from their implants. So women who so my patients who are bodybuilders, I'll say, Hey, look, you know, you have a choice. And occasionally they'll choose still to go under the muscle to say, Hey, look, you know, it's not that important to me. I really want to make sure I lower my risk of complications, but a lot of them will go above the muscle because then when you flex that muscle, if the implants above the muscle, it's above the muscle that the muscle flattening is not going to really change it. And so if you're above the muscle, whatever you want to do, go ahead, because that muscle is not going to impact. But if you're below the muscle, what can happen is kind of how like when they flex their their chest muscles, the implants will move outward. And what I have seen in some women where those muscles are really, really well developed is that it can gradually push the implants out to the side and like increases the pockets that they sit in, it pushes them out and you get a wider and wider gap between your breasts, potentially. So when I do them below the muscle, which I do in probably 90% of my patients, I tell them, look, by all means, stay fit, stay tone, just don't work out. Don't don't try to build up your chest muscles. Got it. So yes, you can do some push ups, you can do some benches, but you don't want to have chest day. Yeah, don't do chest day if you've got implants under the muscle. You're not going to cause like a big complication. You're not going to pop your implants or anything like that. But you may notice five years later if you keep doing that, that those implants are gradually moving outward. Now. Okay. So is there like a candidate that you would like steer more towards like over muscle or under muscle or how does that work? Yeah. So really the benefit of going under the muscle, in addition to the fact that you have a lower risk of that capsule contracture is that you can get some coverage of the implant by the muscles. So, you know, the one thing a lot of people don't a lot of women don't like when they get implants is that you can sometimes see wrinkles of the implant, especially people who are really lean and they don't have much breast tissue. So the muscle will cover the top half or so of that implant, reducing the risk of wrinkles that may be visible through the skin. So that's the first thing. The second thing is if women have a history of family history of breast cancer, going under the muscle is a bit easier to see on mammograms. And so that would potentially be beneficial. So yeah. So if you have a female who's thinking about implants and geez, my mom and my grandma both had breast cancer. I mean, number one, you got to consider is that the right thing for you? You know, look into potential genetic analysis to see if you're at high risk. And if you are, do you really want to do implants because that will obscure your mammograms a little bit. And then the second thing is if you do have a family history and you're at all concerned then going under the muscle, probably make it easier to see any type potential. Now, what about the implants that are textured underneath to prevent them from moving? And I've read that there may be a potential increase for certain types of cancers coming from these types of implants. Is that true? Yeah, you got it. You're on top of this implant thing. So yeah, I told you I used to train a lot of doctors. And let me tell you, he knows his implants. Here's why I love training doctors. They used to ask some questions all the time while I train them. So it was like, it was great. So yeah, breast implants come in a smooth surface or a textured surface. A textured surface implant feels like kind of like sandpaper on the top. And a lot of doctors will use that have used that in breast reconstruction where let's say you've got a woman who underwent mastectomy. She does not have her native breast tissue. The textured implants are made to kind of stick in place that sandpaper surface is made to kind of grow into the tissues around them so that they just don't move. Now cosmetically, I never really liked them because most people want breasts that are kind of soft and natural, not ones that are kind of bolted onto your chest. But in certain situations, those implants helped women, especially like I said, in reconstruction. But what we have found is that there is a rare type of cancer, a type of lymphoma and a plastic large cell lymphoma that is associated only with the textured implants. It's rare. There's I think upwards of 500 confirmed cases in the United States out of hundreds of thousands of millions of women with these types of implants. So it is definitely rare, but there have been a few people who've actually died from it. And so the FDA actually banned the use or they recommended banning the use of one of those types of implants that was actually taken off the market. And then there's still two that are still available. And like I said, the benefit of that implant is stability and that it is supposed to stay in place. But we believe that what happens is if you get we and this is a hypothesis, we don't know how it causes cancer, but the belief is that if you get a biofilm of bacteria on it, which is just a little coating of bacteria on the surface of that implant, because the implant is textured, it has these tiny little nooks and crevices and you can get bacteria that kind of grow in there. And those bacteria will then cause your body to elicit an immune response. And if you have that immune response happen, you know, day after day, year after year after year, the average is about seven years where this cancer can develop. We believe it may have to do with that, that type of interaction. Is there is there within the surgeon community, is there a sense of pride around the job that you do? And like, is like, is breast implants really difficult, difficult surgery? And there is a real art form to how well it turns out? Or is it a lot more just genetics and what you choose as far as the profile of it? I think that it's a good question. I think that there is a lot of pride when you are doing fix up jobs, because breast implants can really go wrong. Okay. And one of the things I do a lot of are fix up jobs for breast implants. And it's frustrating because you get scar tissue problems. You can get issues where one implant moves outward to the side, the other one doesn't, you know, you could get. And is that the surgeon's fault who did it before? Or is it? Sometimes, but not always. And a lot of women, they, their anatomy is different, you know, they show up and one breast is real droopy and the other one's real small and not droopy and it's trying to make them as even as possible can be definitely a challenge. Yeah, I see. So, I mean, I don't have nearly as much experience as you have, but I've dated a handful of I've actually had five different girlfriends that had breast implants while we were together. So I actually saw before and after his first hand, right? And one of the things that I realized was it or at least in my experience of seeing this was like it was less to do with the surgeon per se. And more so just genetically what they had before going hand. So like the best job was the girl who already naturally had really good symmetrical boobs before and afterwards, it looks amazing. I basically tell them you're going to look the same as you do now just bigger. Yeah. Yeah, the implants aren't going to move one nipple higher than the other or anything. It's just you're going to have what you have just bigger. Yeah. Unless something goes wrong, then I had I did have a case with one of my girlfriends who had one that was significantly larger than the other and that balanced it out. So that made a massive like a life changing difference for her. And that's very common. Most women have one breast bigger than the other. That's natural. Yeah. Doctor, you mentioned breast implant illness. Okay. So I've heard that this is a myth from doctors and I've heard you know, wellness people say no, it's not. I've had people say, oh, I got mine out and I feel so much better. Right. And then other people saying, well, it probably wasn't that it was something else. Like, is this a real thing? Seems like there's a big movement towards removing because of this. Yeah. So the history of breast implants, I'll just and breast implants, I'll just kind of summarize it for you. Back in the 80s and early 90s, there was a big hub of a big uproar because a lot of women believe that their silicone breast implants were making them sick. So they there was a class action lawsuit. Dow Chemical went bankrupt and implants actually in 1992, the FDA imposed a moratorium on silicone breast implants saying that you can no longer use them unless they're in an FDA approved study. So they were taken off the market in 1992. So from between 1992 and November of 2006, we are only allowed to use saline filled implants. So all the women other than the smaller number of them in the study all got saline implants for that period of time. Fast forward to November of 2006, the FDA lifts the ban on the implants where a silicone implants were allowed to use them again. And a lot of plastic surgeons took this as evidence that implants don't make people sick. The dogma in plastic surgery has always been breast implants don't make people sick. If you have an illness or you think you're getting sick from implants, it's not do the implants is due to something else, whether it's in your head, whether it's autoimmune disease or whatever. And honestly, and my, you know, this was what I was always taught throughout all my training. And I believed it because my professors, my the surgeons would tell me, Oh, the studies show that that they don't create these problems. So, but the big question, you know, is, did I read the studies? Not really. I mean, I skimmed over the studies and that's what they told me. So I assume what they told me was true. So, you know, I ended up believing this for a long time. And after the tragedy that happened in my practice, I started really rethinking everything and questioning everything. And I started seeing these, you know, websites start showing up. And this was at the early 2000s website started showing up where people would congregate, women would congregate telling their stories about their breast implants and how when they hadn't removed, they would get better afterwards. And then fast forward to the 2010s, there are now Facebook groups of tens of thousands of women coming forward saying, I think my implants are making me sick. I've had them taken out and I've gotten better. And so I was actually one of the first plastic surgeons to go public after reading their stories. And what I ended up doing is actually looked at the research that they put out on their on their websites, not the ones that we put out, but the ones that they put out. I'm like, I haven't heard of any of these studies. It's because they're in the literature for rheumatologists for internal medicine doctors, not plastic surgeons. Our studies are funded by the implant companies for the most part and are performed by plastic surgeons, a lot of them being paid, some of them over six digits, six figures by these implant companies. And when I actually looked at the studies from the implant companies, they were still, you know, we're surgeons like and we're plastic surgeons. We're all about the surface, you know, and were they asking about hair loss, you know, rashes like all of the 40 plus symptoms that patients may be having from implants? Not really. They're asking more, hey, hematoma, capsaicin, the things that we are aware of, you know. And so I was one of the first ones to go public basically saying that I believe that this is real and that some women get sick from their implants and the backlash was pretty swift. My colleagues were not happy with me, but that's okay because I want to put out information that is true and that's true that I believe is true. So really, what is the truth then? Okay. When you look at studies now and there is there's very little science unfortunately out there on breast and plant illness period. But what we do know is that anywhere from 55 to 85 percent of women who do have these types of symptoms, fatigue, rashes, hair loss, joint pain, brain fog, about 55 to 85 percent of them, their symptoms will significantly improve when their implants are removed. Wow. But it's not a hundred percent. And if it's a patient who comes in and they already have let's say a diagnosis of rheumatoid arthritis or they have a diagnosis of scleroderma or something like that and they have implants and they have all these symptoms. Taking their implants out usually does not make them better. Got it. Okay. So there's a lot more to it than I think we understand. There are studies being performed now and I do credit the societies now in that every big national cosmetic surgery meeting now breast and plant illnesses on the docket to discuss which I think is a huge jump. And it's still pretty rare, right? People who experience these symptoms out of all the people that get implants is still pretty rare. My belief is that the vast majority of women do tolerate implants just fine. But we do not have a statistic. I would love to be able to tell my patients, hey, if you're thinking about implants you have 7% chance that you'll get BII or a 10% or a 3%. But we do not have even that number. Isn't there always that chance with any prosthetic that you're putting in the body of the body rejecting it? Isn't that I mean, but there's a difference I think between rejection because you can get rejection where literally if you have something put in your body like if you get, let's say you get in a car accident or let's say you're on a motorcycle and you slide along the road, you fall off and you get pebbles and gravel to get stuck under your skin. Your body will actually expel a lot of that. It'll actually push it out. And that's what we would consider like more rejecting something. Implants aren't necessarily, I mean they can be rejected if they're, if they're actually infected what will happen is the incision can actually open up and the implant can literally protrude out. But this is different because we don't really understand what's going on. And patients, I have patients who have BII or we believe had BII who have just absolutely amazing results and it's tough because they're so happy with their cosmetic result but they feel crummy and it's like what are you going to trade that? I have a theory around this that the immune response that happens inevitably when you do any type of procedure but with these women, with these implants that that immune response is kind of this, it's just like ongoing systemic low level immune response. And that can cause all kinds of different things. It can cause joint pain and hair loss and rashes and all those other things. That would be my theory is that the body is doing that. Then the other side is how hard is it for you? Because I can only imagine how hard this is for doctors to separate the physiological from the psychological because if someone experiences something, they experience something. So how do you do that? Well the hard thing, I mean the number one thing and what doctors have not been good at is actually listening to the patient and believing them. You know, I had a patient of mine, I did breast augmentation on her, I think like 18 or 19 years ago, like one of my early ones. She accompanied her husband to a consultation with another plastic surgeon in my area and while she was there just as an aside, she's like, Hey, you know, I had implants put in by a different doctor and I think I may have breast implant illness symptoms. And he goes, Oh, we just call a psychiatrist. It's not, it's not, it's not what it is. Like he just dismissed her just like that. Yeah. And this is an old school, older doctor. But you know, I mean really, you know, here we are four guys sitting around talking about this. But the fact is, is that medicine has neglected women's issues for a very, very long time, you know, and has not listened to them. And I think that's the first thing is that we actually have to believe that they have these symptoms and that they know their body. And that I do, I do believe in bio individuality. I think that what may work well for one person just won't necessarily work well for another one. And sometimes it just depends on like what, what level, what type of what stage your life is in, you know, women after menopause, their body acts very differently than it does before menopause. You guys know that. I mean, you train them. And so you can't assume that the bias is going to react the same way all the time. Yeah. I mean, you even if you look at the data on autoimmune disorders and depression, it's very interesting. It's definitely a strong potential connection because and then you look at your, you know, we might be veering off here a little bit, but what you believe it makes perfect sense that your our bodies would evolve to believe what you believe. So if I believe my body's an enemy, I don't like myself. I hate myself. Would my immune system react to that and potentially believe I'm an enemy in some but something, you know, like my joints or my thyroid sounds plausible to me. Yeah. And there are studies being done where you are seeing those numbers actually match up. So people who have anxiety about breast implants are going to have a higher chance of getting those types of symptoms. Oh, gosh. And so it does really follow that. Interesting. There are studies being performed now. It's still, once again, we still just don't have the real numbers that we need, but we're going to get them. And I think in the end, what we'll probably find is that there is a subset of patients that for some reason are hypersensitive to implants and they get these symptoms and they can get better afterwards. As a trainer, okay, I'm going to be quite honest with you. There's one type of procedure that just annoys me and it's not because, I don't think people should make their own decisions. It's not because I think anything other than I'm a trainer and I can do this for you as well, which is butt implants. Yeah, I know you're going. We got a turf war here. Yeah, because it's a muscle like boobs, body fat. Get it. Can't build your boobs. You can build your packs because it's not the same thing. You can build a butt. But you got a butt. You can build it. But let's talk about butt implants. What are they, is it like a breast implant? You got to sit on them. The glutes are strong. Big muscles come in. There's different versions. How much more common is it now? I mean, it's like, I feel like it's exploded in the last decade. It's still, I mean, it has exploded, but it's still relatively small numbers. So when somebody wants to get a bigger butt and they are not happy just doing, working with you guys doing the squats and the exercises, there are three ways that you can get a bigger butt without having to do it yourself. The first way is buttock implants. These are solid silicone implants. These are not the same as breast implants because these are actually solid. There's the same type of implants that we put like in a chin where it feels hard. Got it. Okay. And they're big. The main problem, two main problems with buttock implants. Number one is that that area is not the cleanest part of the body. So you're going to have a much higher risk of getting an infection of an implant in that area than you would somewhere else. Oh, interesting. Okay. So that's the number one thing. And number two thing is implant displacement. You know, you can put the implant there, but you're sitting on that area how many times a day, how many hours a day, there's a high chance that that implant can move. It can flip and go out in place because that area of the body is, you know, you have so much pressure on it and up and down and all that type of stuff. So I'm not a big fan of buttock implants. I don't do them. There's really not a lot of surgeons across the country that do them. Wow. There are people that do, but they're not people. There's, it's not like, like breast implants where almost every plastic surgeon will perform that operation. Mm-hmm. Second way to make the butt bigger. So that's always, buttock implants is all, have always been considered like kind of a niche procedure. Most doctors, most plastic surgeons, the dogma is like, not the best operation. Okay. So amongst yourselves when your buddy says, yeah, I do but, you know, the rest of the, the plastic surgeon's like, oh, he needs money. Oh, he needs money. Yeah, he needs money. Really, it's like, hey, you know what? He needs money. You can have that. Go ahead. But, you know, if you're real thin and you want a big bedonkid dog, that's your only option. Yeah. Okay. The other option is BBL Brazilian butt lift. Yeah, what is that? That's liposuctioning fat from one area and then injecting it into the butt. And for many, many years, that was considered the gold standard of making the butt bigger because, oh, you know, it's at the fat's unlikely to get infected. It's your own tissue and all that type of stuff. But the problem was, was there are a lot of women, women who are typically Florida is the, is the problem place where there are these chop shop places where women go to Florida and they get their BBLs and they die. Oh my God. And there was actually a survey done of plastic surgeons that found a 1 in 3,000 death rate from BBL surgery. Oh my God. 1 in 3,000, which is the, the average death rate in all of cosmic surgery is about 1 in 50,000. And this is 1 in 3,000. Oh my God. That's your 10 times risk here. Yeah, I mean it's, so, and what they found was that, so that really this, this happened, there was a huge uproar of like, and these are all young women who are dying. It's not like you've got like, grandma having this and, you know, isn't bad health and dies. Like this is like a 22 year old healthy woman who freaking dies. So what we found out is what happens is that when you inject fat, for that fat to actually stay in the place and to live there, you need to have blood supply to it. Okay, because if you don't have blood supply to a body part, it dies. Because it's necrotic, right? Yes, exactly. It gets necrotic. And so the, what part of her body has the most blood supply are muscles. Okay. And where are the biggest muscles of the body, the gluteus muscles? So it would make sense then, if the doctors say, well, okay, we want to put a bunch of fat into the butt. The fat's only going to stay if we have blood supply to it. So let's inject the fat into the muscles. So that's what doctors did. But the problem is with big muscles come big blood vessels. Oh no. And the fat would be injected into this muscle. The blood vessels would tear. The fat would go through those tears into the bloodstream. And the way to describe it, it's like you're, it's like the death star. And you've got Luke Skywalker shooting those two missiles just to the right place. Right between the valley. Nebulism can go to your heart and lungs and you can die like that. Just like the death star blows up, you can die within minutes. Wow. And this is what would happen to these poor women because these doctors were in these chop shops or just moving and speed is of the essence because it's all about money and these people die. So then what happened is the society's got wind of this and there are people who are even talking about banning the operation altogether. And what now the idea is that you can do it safely but you have to inject it into the subcutaneous fat, meaning the fat below the skin above the muscle. And now even the state of Florida requires you to have ultrasound guidance so you know exactly where your cannula is going. So when you inject it, you're not in that muscle. Wow. And the fat stays there and it just becomes a part of that part of your body. Yeah. So if you get blood supply to it, so some of the fat will disappear about half the fat that you inject, whether it's in the face, reabsorbing the butt or even in the breast, it will reabsorb. And the rest of it will stay as long as you have that blood supply to it. Now, do some of these thin women who want to do that are they told to gain body fat to get more fat? There are some people who will do that. But the problem is, is if you lose the weight afterwards, then you lose the fat too because that fat will go up and down. Hold on a second. This is amazing. This is amazing. Girl walks in, she's skinny. I want a BBL. We need to gain 15 pounds of body fat so I can have some place to take body fat from and inject it. And then they do it and they say, cool, I can get lean again. She's going to lose the fat from her butt. Like she... Yes, exactly. That's terrible. But that doesn't stop some plastic surgeons from telling patients to still do that. Wow, of course that makes perfect sense. Wow, that's very interesting. What is the fastest growing procedure right now that you're seeing? Because all these plastic surgeon procedures seem to go through trends, right? At one point, it's something for the face and the ears and the eyes, whatever. What seems to be on the rise right now? What do we see? Before that, so with the fat injections, does that get pocketed over time? What is the aesthetic of that over time? So that's what we don't know and that's a concern that I have. There are women who are getting one to two liters of fat injected into each butt cheek. And what happens is our skin as we get older and they may be 22, 25, they've got tight skin. What happens 20 years later? Where's that fat going to be? And these are discussions being... They're happening in our meetings now and the people who do a lot of this, they kind of shrug their... That's some weird butts. Yeah, it's a weird landscape out there. I mean, what's going to happen to some of these famous influencers and reality show stars with big butts, you know? I mean, that skin is not going to stay tight like that forever. All right, so popularity, what's growing right now? What is the trends? Well, one thing I should mention because I mentioned there, three ways to make the butt bigger. And this is one thing that's growing in popularity is I don't know if you guys know, but there are devices that will stimulate your muscles to contract 20,000 times in a half hour session. So is this just electric muscle simulation? This is, yeah. And these are ones that, like I have one in my office, they market these to plastic surgeons and stuff. Like that's a safe way to the lazy, safe way to make your butt a little bigger. And those studies show that if you do four sessions over the span of about two weeks, you can gain about 20% of the thickness of the muscle. And so this is technically a safe way to enhance the body. What, that's a crock of shit. No, well, that's the state. 20% of the thickness of that muscle are what the state is showing you. No, that's a fucking way. From E-STEM? Here's where I believe it. Here's where I believe it. Well, it differs in E-STEM versus, I mean, there are those devices that you can buy on Amazon and stuff. Right, right, right. This is different. This is like an agression. Like I bought one and part of me, I don't know, part of me, I wonder if I should have bought it, but it cost me over 200 grand. Ho. Yeah, I mean, these are powerful devices. And when you put them on, like it's powerful. Okay, so here's why I believe it. Yeah, you need to close me on this. No, here's why I believe it. 20% is a big difference. Oh, yes it is. Here's why I believe it. One, what you said, I don't think it's the same machines that they sell, you know, like do 1,000 crunches while you put it on a computer for $19. No, no, these are different. Okay, I think this actually is like you're probably like, oh, it's uncomfortable. But number two, the group that they're using is probably sedentary, like they don't do anything. So you're going to contract the muscle, relax it. You're going to get novel gains. Yeah, 20%. Just like if they did like three squats, you would see a little bit of growth. I don't think it would continue. No, I don't think any of us could use it and see any changes at all because of, you know, how much muscle we've already built. Yeah, that's interesting. That's super fascinating. Yeah, yeah, yeah. But this machine mustn't feel very good if it's causing contractions that hard. So I had it on my abs and I tell you what it feels like is you know when you've got like a stomach flu and you can feel things just moving around in there and you know you got to rush to the bathroom, that's how it feels when that stuff's going on. Oh, wow. But you don't have to go to the bathroom, but it's that like crampy feeling of they're like, oh no. Just work out. Yeah, crazy shit we go through to not work out. I have a difficult question for you because you have to have thought about this. Like how do you reconcile that, and I have no idea the numbers, you obviously have a better idea, of the amount of people coming in to see you that probably shouldn't do whatever it is that they're asking for, right? Like for example, in our space, more often than not, the client that comes in that wants a certain way of training, that's like the worst thing they should do. It's like I know that because they have all these issues and they're using this form of exercise as an outlet or they have some sort of dysmorphia going on, right? And I would imagine people that are getting cosmetic stuff done have, and I'm sure there's a spectrum of body dysmorphia going on here, how do you handle that? How do you reconcile that when you're talking to someone and you're like, they don't need to do that, but they're probably going to go off and go get it from somebody else. Yeah, I'd rather do it because I'm better and safer. There are doctors who will say that. They're like, well, I'm going to do it, but only because I'm the best doctor in town and if I don't do it, somebody else will and they'll screw it up. And for me, I just say no. And I have a woman, really good patient mind and every time she comes in, she wants her lips bigger. And her lips are like Angelina Jolie lips already. And so every time she comes in, I tell her no. And every time she leaves unhappy, then she comes back six months later, I want my lips done like no. And you know what, it is what it is. I mean, for me, I think what I try to do is try to massage the message as much as I can so that they're not upset. I don't want to hurt their feelings or anything like that. But at the same time, I turned down about one out of every five people who come to see me, at least for surgery, just because I don't feel that that's going to be right for them. And sometimes I'll give them their money back for a consultation. Like if it's like, oh yeah, it's obviously I'm not going to offer you, then I'll just give it because it's not a money issue. It's just like, hey, I don't want to do something and put somebody under a risky procedure for what? Not for a lateral move. It's always trying to move forward. If we're going to operate, we want to move you forward. We don't want to do a lateral move. It's like, you know, you've always heard people say things like, who was it responsible for all of Michael Jackson's surgeries? How do you let that guy come in every single and allow himself to keep doing that? So interestingly with him, and so I trained out in Beverly Hills and one of our receptionists actually used to work at the office where he allegedly had a lot of plastic surgery done. And she said that they were- Is it really allegedly still? Well, I mean, I'm not a stocker anymore. She's not here anymore. It's still allegedly. You could barely tell. But she said that she would come in sometimes and they had their own in-office OR and he'd be kind of cordoned off in the corner and then every so often they get a check from MJP, Michael Jackson Productions, basically pay for it. The interesting thing is his plastic surgery and actually went off, reportedly, went off the deep end and was, I think ran for president against Obama at one point and was, yeah, like way off the deep end and yeah, so. I don't want a plastic surgeon that also wants to be the president. You know what I'm saying? Too much craziness can enter this. Yeah, yeah, yeah, yeah, yeah. So Adams would be really, he would be mad if I didn't ask you this, calf implants. Are they calm and what are they- Can I stick your electric machine on my calf? Yeah, that's what he's pointing for. Actually, you can. There, you can put it on your biceps and you can put it on your calves and you can put it on your triceps. Yeah, so technically you can. No, calf implants are even less common than butt implants. I've actually never seen one put in. I have one in my office just because I wanted to use it as a prop occasionally when we talk about stuff. But that also is solid silicone. Got it. You know, it's kind of long like this. And yeah, you put it in the, but I've never actually seen one put in. Are we seeing more men get things like pick implants and stuff like that? Or is that still super rare? No, we're seeing a lot of that and especially what we're seeing a lot of are patients who are men who are undergoing abdominal etching. And there's a lot of different ways to describe it. Essentially, it's liposuctioning the fat of your abdomen to look like muscle. Oh my God, that's all I've seen this. I was wondering about this. I heard all the guy who tattooed it the other day, I thought I'd see it. Yeah, that was amazing. It all looks good until she asked to feel them. Let me feel you hard out. No, stay back there. Yeah, yeah, yeah, yeah. That real quick. So that's actually really common. People now they call high definition liposculpture or moderate definition liposculpture. And the idea really is that you liposuction along your, what do you call them? Your tennis inscriptions. Okay. And along your tennis inscriptions as a way to kind of create those contours. And sometimes, if you're not overdone, it can actually look pretty nice on some people. But the problem is there's some doctors who aren't choosy about their patients. And I've seen guys who have potbellies with this six pack on a potbelly. And so you know that this is. So I'm here. Yeah, there's gotta be, I imagine it would probably look best in somebody who's not that overweight. That's already, they have kind of stubborn fat maybe there. It's going to be somebody who's just a little soft. But they've got a good muscle structure underneath that if you just kind of, you know, just do some tweaks to where the, where your fat is essentially on your abdomen, you could try, the idea is to try to accentuate it. I have a friend of mine who's a plastic surgeon who does a lot of male plastic surgery. And some of the stuff he was doing was really, was really fascinating. Because he was injecting fat into biceps. And when you think about it, it makes a lot of sense. Because he would say, because I'd say, well, okay, you inject fat into biceps. And he goes, well, the thing is, is I would tell my patients that if you gain weight, your muscle actually going to get bigger. And I'm like, wow, that makes kind of sense. Like you marbleize that meat, essentially, you add fat there, they gain weight, the muscle actually gets bigger because it's got the fat inside of it. And so he would do that in the abs too. Like each individual abdominal, rectus abdominis muscle, he would inject into the fat into it. And then once again, somebody gains a little bit of weight and the muscle actually sticks out more. And then he would ab, etch around it. So what you're doing when you're doing the etching, or getting shakes, or getting jacked, or when they're doing the etching, is you do have to follow their natural lines. Because that would suck if they got lean and the lines were off. But sometimes, but not everybody's lines, as you know, are like perfectly symmetric. No, some people have three on one and two on the other. And so when you do see that somebody has got perfectly symmetric, like crazy defined abs, you got a wonder. So I remember years ago, I was a young trainer. I had a woman come see me and I did her body fat test. Now it was a body fat test with skin calipers and you did the bicep, the tricep. You went by the scapulae and then you did right above the suprailiac crest, right? So I remember I did, and at this point I had done, I don't know, 60, 70 body fat tests. I was a new trainer, but I'd done a few of them. And I remember I did her tricep measurement and I had never seen a leaner tricep measurement than bicep. That almost never happens. People store more body fat in the back of the arm. They do the front of the arm, especially women. So as I did this, and I kept doing the measurement, like this is weird, this is way leaner in the back of the arm than on the front of the arm. And I remember asking her, I said, have you ever had liposuction on the back of your arms? And she was like, yeah, how did you know? And I was like, oh, because of the measurements. So in other words, when people get liposuction, that you're not eliminating or removing their body's ability to gain body fat. You're just removing body fat from one area. If they ever gain a lot of weight, then you start to notice this potentially strange body fat storage or distribution, right? Yeah, so when I try it, the way I explain it to patients is some of us, we have asymmetric or these kind of stubborn areas of fat that we just develop and we can't get rid of. Like that's really the best thing for lipos. Got it. If you've got like love handles, no matter how lean you get, those are still there. Or sometimes you may inherit a double chin and no matter how lean you are, you got that double chin or something like that. Fat cheeks. Yeah, and that's where liposuction can really help, like saddlebags. Some women get these saddlebags and it's just these pockets of fat. And so the way I describe when I lipo, basically, is let's get you proportional. And then if you do gain weight, the hope is that you gain weight in a proportional manner after that. Because you're still going to have fat cells in that area that you remove it, you're just going to have less of them. And so the hope, and I don't know that it's ever been proven, is that if you do gain weight, that you don't gain weight at that problem area worse than everywhere else, but because there's less fat cells there, hopefully it just looks like you gain weight naturally. So much to consider with what you do, because you can't just, you have to consider not just, of course, all the obvious stuff. Are they a candidate? Is this going to be safe? Et cetera, et cetera. But also, how is this going to stand the test of time? How is this going to look if this person gains or loses weight in all these different things? There's way more than goes into what you do than just the procedure. And I would imagine that's a large part of what makes someone good versus someone who's just whatever. Yeah, and I think that that's something that as plastic surgeons we're not the best at, honestly. You know, there's one, you know, injecting fat into the breast is something that's become real popular and a lot of people are asking me about that now because there are people posting on social media like, oh, I didn't get implants. I just had fat injected in my breast. And there are a lot of plastic surgeons who go to meetings and go, oh, this is my technique of doing it. And look, I have a really low complication rate. But one thing that I tell patients that they don't realize that nobody is talking about for a procedure like that is when you have an organ of the breast where you have one in nine women get breast cancer in their lifetime. We know that our fat is chock full of stem cells. What happens when you take a cancer prone organ and you inject it filled with stem cells? What if this woman has got a cluster of dysplastic abnormal cells that are growing that we don't know about because there's, you know, it's not a lump or anything. And maybe it wouldn't turn into a cancer until she turned 120 years old. And you introduce a bunch of stem cells. Now you got a ton of stem cells that you just injected all around it. What are stem cells? There are cells that are so young that they turn into whatever organ that they are in. Are they going to then potentially, now is she going to potentially develop a breast cancer at the age of 55? Because we potentiated that. And that question has never been answered. Now it's a safe operation from a surgical standpoint of risks of hematoma and other types of infection and stuff like that. But long term, are we doing this patient a favor? Are we doing them a service? Or actually, are we doing them a major disservice? Dr. Yeung, do you work with peptides at all? You know, we recently got into the space where we partnered with a company that offers peptide therapy, things like PPC-157 and thymus and beta and all these other. Do you work with those at all to help accelerate the healing process or prevent complications? Or is this still a little bit like? Yeah, not yet. So I do a little bit of peptides with skincare, but I don't do it with the healing. We don't do it peptides for internal use, that type of thing. What about for the skin? What are good peptides for the skin? So I'm imagining topical. That's what you're referring to. Yeah, yeah. So I mean, really, there's a lot of them. I mean, copper is a good one. Gosh, there's Dermaxyl, yeah, there's Dermaxyl, which is another good one. There's a bunch of them. And really, what are peptides? They're basically just cellular signals, cellular signalers to produce more collagen. And so, but what I focus on, peptides are honestly in skincare, they're kind of like the less expensive, not quite as effective option right now. So it's not my top option for anti-aging for skincare. Got it. You know, if I were to put, when you're talking about anti-aging skincare in a list, I would put number one would be the retinoids. So retinol. Number two, you'll probably look at Bakuchiol, which is a plant-based alternative to retinol. Number three would be growth factors, and then peptides would probably be number four. Interesting. So we don't focus a lot on them yet. I think there's a lot of focus on peptides for other things like what you're talking about. Obviously, semi-glutide, you know, that's a peptide, technically. So I think that there's a lot more outside of actual plastic surgery that we're seeing. Do you do anything for hair, for men who are losing hair or thinning hair? Because I know that's a whole nother. I had a friend who went to Mexico, which we could talk about as well, people going overseas to get procedures. But man, I saw him the day after, everything turned out great, which was good, but I saw him the day after. I mean, I was like, yeah, I'll never do that. It just looks scary. His head looked like a big mushroom after. So are there any, what can you do for people who have thinning hair? So thinning hair needs to be separated from bald areas. Okay, so if you've got areas that are just bald and or if you've got a hairline that has receded, then the only real way to treat that is with hair transplants. Now, hair transplants are a lot better than they used to be. You know, it used to be that you would take literally a strip of scalp out of the back of a person's head, and then you would chop it up into what are essentially like doll's hair, like five to six hairs of follicles at a time, and put in actual plugs, and it looked like doll's hair back in the day. That proceeded to then cutting them up into individual follicles, maybe every two to three follicles, and then you make tiny little incisions, and then literally it's like planting little blades of grass, essentially. I've done that a bunch of times, and it is, I hate doing that operation. It's just, it's so tedious. Yeah, it's time consuming. What are you using to do that? It's like a pair of tweezers. And you got like big zoom glasses on? Steady hair. Yeah, and you put one hair in, and then it pops out the hole right next to it. And you go, ah, then you take that one. Were you good at gamer or hair farming? I was, but it's still. Yeah. So we know what doctors do is they hire people to do this for them. And so when I was out in Beverly Hills, my doc, he did a bunch of them, but he didn't do them. He basically cut the strip out, and then he set it aside, and they hired these teams of nurses and technicians that will cut the little hairs up. You make the little pokes in the scalp because you have to do that part of the procedure, and then the other people will put actually the hairs in for you. Wow. But that's all, now the way to do it actually is you don't even have to remove the strip of scalp because the problem with the strip of scalp is you got this big scar on the back of your head. And there are certain celebrities that you supposedly can even see some of that. Now you can actually, you can harvest them one follicle at a time using robotic devices. And there's actually a robot where you can lie down, and the robot basically goes in and pulls each individual follicle out, and then can put the follicle back in for you into the place you want. And so it's like, it's really getting a lot of technological stuff. I don't do that. Like I said, I still feel like it's so tedious. I just, I don't, I'm not a big fan. But that's only if you absolutely need the hair transplant. But there's a lot of things you can do for thinning hair that's, that are natural. So I'm most curious. Somebody that has your skill sets, you have all this at your fingertips. What do you currently do for yourself and what do you plan to do as you age? Like, I'm sure you have thought of like. So actually, right now, one of my big focuses is my hair. Oh really? Yeah, about a year or two ago, I was on vacation in the Caribbean. And you know, years ago, when my wife and I have been married since 2000, and she filled out this survey at one point and was like, what do you, what do you, what attracts you most about your partner? And she plays. She's in hair. She's in hair. In hair. In hair. Oh man, that's just put it right there. So we were on vacation and we were jumping, we're doing this cliff diving and she's, I'm on this, I'm on this ledge below her. She's like, oh my gosh, you're losing the hair at the top of your head. I almost fell off the cliff and hurt myself. So then I'm like, oh man, what am I going to do? And I'm taking mirrors. I'm like, oh my gosh, it's thinning up there. So really, this is what I recommend. Okay. If you've got thinning hair, but you're not bald and you want to try to fight it off, but you don't want to take medications. Because yeah, you can take Propecia. You can use Rogane or Minoxidil. But the first thing you want to think about, number one, is a condition called telogen effluvium. Are you really stressed? Okay. Because just being under a lot of stress can cause your hair to thin. And so the first thing I started doing is I started getting into meditation, started doing some yoga, and really focusing on stress. But as a surgeon, I'm always stressed because I'm always stressed about my patients. So there's only so much you can do. Second thing is I take a nutritional supplement. I take one called Nutriful. Now you can see a functional medicine doctor, maybe some dermatologist will also test you for all your various nutrient deficiencies. There's a lot of nutrient deficiencies that can result in thinning hair. Iron deficiency, vitamin D, zinc, all these can potentially result. So there are these all-in-one supplements that you can buy. And I myself take Nutriful every day. It's basically an all-in-one. That way I don't have to draw the labs and follow it. I just take this. Third thing that I would do would be a low-light laser therapy helmet. So there are helmets that have hundreds of lasers on the inside. And essentially, the way that you describe it is that the energy from the laser will cause your hair to grow into a growth phase. And these are scientifically proven. Like there are tons of studies in literature showing like this. So like red light therapy? Yeah, we work with a company that uses red light therapy. Yes, so red light is also used a lot for the face and for skin, but it's really good for the scalp and for growing hair. And that's where there's a ton of studies for it. And then the next thing I recommend would be like dermal stamping or derma rolling. There are people who are rolling for beards. There's like little tiny needles on the thing, right? Yep, that seems to help. Especially if you follow that up with an application of some sort. Now you can follow it up with like Rogaine or Minoxidil. There was a small study that compared topical Rogaine slash Minoxidil to rosemary oil and found very similar results for thinning hair and for thinking of hair with topical rosemary oil. So that really is a favorite in the holistic community. So you can take like rosemary essential oil. You want to mix it with a carrier oil and then use that on your scalp or there are some commercially available versions as well. But what the study found is very similar results between rosemary oil and Minoxidil. But the difference was is much less scalp irritation with the rosemary oil. Yeah, I used, I tried Minoxidil for a bit but I felt terrible. I think it was absorbing too much of it. I know Minoxidil was originally researched as a blood pressure medication. Yeah, something like that. So I don't know if that's what it was but it made me feel really weird. So what else we, okay we're working on your hair. What, I mean, what do you foresee? What is there any sort of facial surgeries or lipo or any, what would you do as you age? So one thing that I'm doing, what I'm worried about right now, so I'm 51 and I know that once you hit your 50 is that's when the skin starts to sag. And that's my biggest fear is like, I don't want to have too much loose skin. You got a really good skin though. So I work on it. So the one thing that I do, I mean, I do, I have a skincare regimen that I do and I brought you guys some products, you know. Thank you. So skincare is one thing. But the second thing is I do a treatment called Morpheus 8. It's radiofrequency micro-needling. And essentially the way it works, you know, it's kind of like what you guys do. It's, it's, it's hormesis for the skin essentially. Oh, interesting. So all of the treatments that we do for the skin, whether it's laser treatments, chemical peels, or this one's radiofrequency micro-needling or just micro-needling on its own, work by creating a controlled trauma to the collagen or to the, to the skin, specifically the collagen, the skin. And when you traumatize the skin to a certain extent, the collagen, which I liken to the logs of a log cabin, the collagen makes about 70 to 80% of your skin. And that's what caused your skin to be tight and youthful. And as we get older, we lose about 1% of the thickness of our collagen every year. And women after menopause, that goes up to 2% a year. And that's why I say women who are in their 60s and 70s and 80s with like tissue paper-thin skin that can even tear. So what happens is that the collagen, it gets thinner and the treatments that we do then to tighten the skin basically will damage that collagen. And when the collagen is damaged, it becomes tighter. As it heals, it becomes tighter fibers. And it's kind of like the hormisa. It's like when you break the muscle down from working out and it comes back stronger, the same thing happens with our skin. Now lasers do that using light energy, heat. Chemical peels do that using enzymes and acids. And the easiest thing in the most cost-effective way to do it is with using needles, micro-needling. So micro-needling can be done with the dermal rollers, which most doctors aren't big fans of because it can create some kind of tearing of the skin. But we can do that in our office using an automated device. It's not very expensive. So the treatment can cost as little as $100 to $150. And what you're doing is you're making tiny little pokes into the skin. By creating those tiny little pokes, you create that acute trauma and the skin heals tighter afterwards. You take that to the next level and you add PRP. So you take blood, you remove the platelets. It's chock-full of growth factors. You make those tiny holes in the skin and then you apply the PRP to the surface and that will seep into those holes, causing the skin to essentially rejuvenate from the inside out due to those growth factors. Morpheus 8, which is what I'm doing, takes that even to the next level, where the needle that goes into your skin is actually insulated all the way up to the tip. And that tip emits radiofrequency energy or heat. And that heat, when it's applied to the collagen, will cause that collagen to become damaged and it tightens up even more. And so that's what I'm doing to try to tighten up the skin under my neck. And really, right now, that's the gold standard for non-invasive skin tightening. Anybody who's in their 30s, 40s, 50s, and they don't need a facelift but they're finding things are getting a little bit looser, that's really what a lot of people do. And how often would you do something like that? So usually, we recommend a series about three to four treatments. You space about a month or two apart and then maybe once every six months or a year or so. Oh, that's not bad at all. No, it's not. Let's talk about how you've gone so big on social media. So you obviously, look, you're a doctor, very successful, long wait list. What made you go to social media? What's that been like? Has that brought you more patience? Has it been good, bad, both? Yeah, I think, I mean, it's been great. I mean, so I did a lot of TV for a long time. I was on Rachel Ray shows like 25 times. She had a talk show. I was on Dr. Oz and the doctors and all that stuff. And kind of like an actor that's getting older. I started seeing that they started bringing younger, better-looking surgeons than me on the show. Okay, man. What's going on, man? So I'd send them like, oh, I got this pitch for this segment. And then I see somebody like 10 years younger and better-looking than me do it. And like, okay, I could see the writing on the wall. So I pivoted to social media many years ago. And then what happened is, and I did fine, and I was the plastic surgeon on social media and I had decent amount of followers. And then the pandemic hit. So March of 2020, pandemic hits. And my office shuts down, where we had to shut down. The government or the governor ordered it. And I found myself in an empty office with 11 employees that I told them I would, I will pay you for as long as this goes, I will take care of you. But I had just paid off all my taxes. I did not have much money in the bank. And so I started thinking like, how am I going to make money to pay for my employees? Because they're all sitting at home. And I have no patience now. And the only thing I was making money off at that time was from social media. It was like Google from YouTube and from Instagram and TikTok and all that. So I started thinking, okay, well, why don't I create more content? And I had this feeling that I wanted to help in some way. I mean, I'm a plastic surgeon. I actually did volunteer at my local hospital. And I said, look, if you need me, call me. I'll come in and I'll help out. But God forbid, if you've got COVID and you're in the ICU, you don't want me taking care of you. Like, you know, it's like Armageddon then. Like if I'm there taking care of you. And so they never called on me, thank God they didn't need me. But I wanted to do something to help in some way. And as plastic surgeons, if you look at plastic surgeons, social media, it's like, oh, here am I before and after photos? Let me talk to you about breast implant surgery and stuff like that. And I did a lot of that type of content for a long time. And I started not worrying. I'm like, you know, I'm just going to put stuff out there to maybe entertain people for a few minutes. Or even if I could take people 30 seconds out of the horrible, crazy, scary, lonely time that it was, then that would be a privilege to do that. Right. And so when I stopped worrying about acting like this doctor who wants to talk about my practice and stuff and just started creating stuff that I thought was interesting and fun and entertaining and educational, everything just freaking exploded. Did you have a single one that really took off? What was like the first big video that took off? So I had one where I was showing how strong a saline implant was. And I was trying to pop it. And the thing actually popped and like exploded in my hand. So that was probably my first one that went viral. So either it was weak or you're real strong. I was following your guys' recommendations. And then the second one was when the show Squid Game came out. I supposedly looked just like the main actor of it. Oh my God. I know you say that. Oh my God. I just watched the game show version of it. Well, I almost went on that show. Did you? I was, they basically offered me a spot on it because I went viral with this, there's this plastic surgeon on TikTok. And I would, people would say like, oh, are you on Squid Game? And I'm like, yeah, sure. I was on Squid Game. Like, really? And you're a surgeon? And I literally gained on TikTok like a million and a half followers in the span of two weeks, just off of people thinking I was on Squid Game. Like it was insane. And so that was it. And what was I going to say? But that really... Oh, we were talking about the viral video. So the press and plan exploding, the Squid Game. That really exploded it. And it's been fun. I mean, it's just, it's a great tool to help educate people now. And I mean, there's so much hate there too. I mean, I get so many people that attack me. What are the biggest attacks against you? People say that they think I had a ton of work done. Like I've had people like, oh, you look like a 65 year old Thai woman who's had too much work done. That's pretty funny though. That's brutal. That was one of them. That's pretty good though. That's really... You gotta like it. A lot of thought. I love it when I get hit with something that's clever like. Somebody insults me while I like it. Oh, yeah, no. I find it hilarious. I mean, people are like, oh, you know, how do you live with a forehead that long? You gotta have thick skin to be on. Well, what I do now is I've got teenagers who are, you know, they're in high school and they're on social media, but they're not on any of my stuff. Because I know, I mean, I could imagine being like a 15 year old girl and somebody writes a comment like, you're ugly. How horrible that makes you. So what I do now is I compile all these insults and I show them to my kids. And like, look at, look, daddy gets this and daddy feels fine about it. Oh my God, that's brilliant. That's actually great. All the poor things they're saying about dad and all that, daddy does not care, you know, because it doesn't mean anything. I gotta do that. So we all have kids. I think that's, that is really, really smart idea. I'm so glad you said that. Because some days somebody's gonna say something really mean to them and they're gonna look back and be like, you know, my dad. Oh, my dad used to get that all the time. Yeah. And look at my dad, you know. That's actually really, I don't know. I don't know why we've never thought about sharing. I'm gonna 100% do that. Yeah. And that's a really good question. How many kids do you have? I have two. Yeah. So I have a senior in high school and a sophomore. How is it being so busy and working the way you do? Does your wife work too? Yeah. So she's a pediatrician. Wow. Two doctors. Oh, yeah. So are your kids just like, oh, we gotta become doctors. No, it's not like, medicine is not like it used to be. Really? Yeah. My dad was a doc. He was a private practice doctor. I mean, I'm a plastic surgeon, but I'm more of an entrepreneur now than a, I mean, I still treat, I mean, I operate two days a week. I've got a full practice, but I've got other types of things I'm doing. And I tell my kids, I'm like, look, this is not the doctor life. This is an entrepreneur's life. I'm more of a businessman in some ways, and a doctor with the way that you see me live my life. I mean, I have taken ER call for 20 years. I just stopped where people get bit in the face by a dog. They get in a car accident. They would call me and I go in the middle of the night to treat them. But it's like, I've done 20 years of it. Then I'm finally like, okay, I think I'm done doing that now. Like I feel like I've given back enough. Yeah. Yeah. But it's different. The practice of medicine is very different now than it was when I started. Is that because the cost, the regulate? Because I noticed one thing. This one thing that I've seen now is the smaller practices can't operate anymore. Yeah. They're all becoming these huge megaliths now. Yeah. And even the hospitals are all combining to become these masses. And that's because of the way these regulations are put forth. It's like, makes it almost impossible for you, right? Yeah. A lot of it is, it's a combination of regulation with a reduction in pay. And so it's harder and it's more and more paperwork to practice, but you get paid less and less. And what they'll do is they don't pay you more. If you do the paperwork, they just don't penalize you. And it has to do with insurance. Now, as a cosmetic class surgeon, I'm so fortunate that I don't have to deal with that. You're all private. And I did insurance for a long time. And I still technically take insurance, but what happens is even to get paid, you have to have employees that do all the paperwork for you. And then you submit paperwork to get paid and then they reject it. And then you've got to fight them. And it just becomes this just tough process. What's crazy to me is that it's gotten so wild that, oh, my daughter might have an ear infection. All right, your first appointment's in four weeks. What? That was never the case before. And I think it's because of all these wild changes. I think part of it, though, too, is there's disruption going on in health care, which is necessary. And so that's changing. As a physician, it may make it harder because you have non-physicians who are delivering health care. And so it used to be, oh, you've got a sore throat. You go see your doctor. But now you can go to CVS or a drug store and see a nurse practitioner there and get your prescription and stuff. And I think with AI what's going to happen is you're going to go to, let's say, a drug store. You have a sore throat. You put your symptoms into a machine. It spits out your diagnosis. It spits out your prescription. You walk it over. You get it filled. And then you don't even see anybody because so many people now are doing telemedicine. A friend of mine who's in LA, she does all telemedicine. She doesn't even, like, no hands on the patient, nothing. Yet she's diagnosing them and treating them. And I just find it, I don't know how you do that. Like, I was in the training of where you put your hands on the patient. You listen to them. You figure out what's going on. But I mean, we watch training evolve like that. That's very exciting. Personal training. I would, shit, now it almost seems like half the people we talk to are online for training seems crazy because most of our job was so hands on helping people. I think the way to go to, I think it's, I mean, I have a lot of friends and they do well. They're successful. So they can do this, but they do concierge because they're like, you know, I, then I need something that's right there. I could talk to my doctor. Yeah. Otherwise I had the best health insurance in the world and it was still terrible. Yeah. But eventually it's going to be AI. It's going to be like, you go into this place. They'll take your temperature. They'll may look into your eye. You know, you can turn. Maybe they'll be able to see into your ears, see if there's renders in there and stuff. I mean, that's going to be on the horizon. There's certain, and there's certain specialties like radiology. I mean, you got an x-ray and you've got a machine reading it versus a human reading it. You know, they're less human error even. Yeah. Well, the x-ray, the machines are going to be able to look at every single pixel of data. Whereas a human is your human eye, you know? And so if anything, that's going to be a, especially that's really going to, I think have a hard time. So if somebody wants to go into medicine, what are the best fields then in that case? Because some of these fields, like I remember at the time, this was a long time ago too, so I'm assuming it's worse now. Right. If you're advising your kids, your teenagers right now, that if they were interested in that direction, what are you advising them? Yeah. Because I remember being told, oh, you want to be a primary care physician. We're going to graduate with a quarter million dollars of debt and you're only going to make this much when you come out. And it doesn't make any sense type of deal. I mean, so for me, I mean, obviously I'm partial to my field because I have complete control over everything I do. I can set my prices. I can work whenever I want. I made the decision to take ER call for 20 years, but I didn't have to. I could have worked out of a different hospital and not take any call at all and just do all cosmetic. So for me, I feel like it gives me the most control over my life, but at the same time, there are people in my field who take that control and they don't, I mean, it just comes down to money. There's a reason why I'm practicing in Detroit and not LA. When I was out in LA, I had an offer to stay there and work in Beverly Hills and it just, I was like, yeah, this is not me. Like it's just all about the money and the competition and it's just, I mean, people are, the doctors out there, it's just, it's a whole other world. We'll talk about that. I'm curious considering that you have, you have the experience to LA, which I would think is like the epicenter of plastic surgery, right? So what, how is it different there versus where you- It seems like a broad spot to- So I mean, some of the stuff, yeah, that I experienced, I mean, some of it was fascinating- Is it very niptuck? Because you would see a lot of like celebrities and stuff like that, which was really interesting and it was kind of fun and everything. But some of the stuff that you'd hear because it's so competitive, there are stories of surgeons sending patients to other surgeons' practices as a way to sue them afterwards to try to hurt their business. Holy cow! I knew of one doctor who was calling the local TV stations lying and saying that, that their competitors had somebody die in their operating room and like, oh, you didn't hear it from me. There was a show back then called The Swan where there was a doctor, there were two plastic surgeons doing that show and I heard one plastic surgeon actually, I was around and when I heard a doctor call and say, hey, you know, I'm not telling, I'm a plastic surgeon in town, I'm not telling you who I am, but I heard that so-and-so died in that doctor's operating room because they were jealous that this other doctor got a TV show. So yeah, I mean, that's, it's nuts. Wow, that's crazy. Well, it's really, I mean, look, I tell you what, you know, I have a lot of friends that are doctors and all the ones that I know personally, every single one of them really generally does it because they care about people. So I know there's a lot, you know, it's really popular right now to say, you know, Western medicine, this, that and the other and I have my, I definitely have my issues with, you know, how it tries to treat certain things. But in my experience, the people I've worked with are amazing and it's great to hear someone like you with obviously so much integrity. It's amazing, especially in plastic surgery because I bet if we ranked, if you took the average person, he said, rank doctors in terms of who has the most integrity. I bet plastic surgery would be- Near the bottom of that barrel. Yeah, near the bottom. Probably deserve it too. You don't see urologists dancing in the operating room on social media. Is there a case or specific surgeries that you've done that they're most rewarding? Like what's the most rewarding patient to help or to work on? You know, I had a patient several years ago who came to see me. She had lost a bunch of weight and she had a tummy tuck surgery by a different doctor and basically she was what we call a, what we, a train wreck, basically a medical train wreck. So she came in and I looked at her chart. She had everything you could consider. Hypertension, she was diabetic. She'd had a history of a heart attack. She had a stent place. She was on blood thinners. She was massively overweight and she came to see me and she said, Dr. Union, you're my last hope. I've been to 12 other surgeons. Everybody has turned me down. And she goes, I'm in such chronic pain and well, what's going on? And she said, I had a tummy tuck done by this other doctor and everything fell apart afterwards. I was in the hospital for months. I was in the ICU. I had tissue that died. It was necrotic. And I had basically this wound that took like four to six months to heal. And now it's a huge scarred mess and I'm in such chronic pain. I can't do anything. And she had tears in her eyes and she's like, Dr. Union, I don't know who else to ask. She goes, all I ask for is I just want to play with my granddaughter again. That's all I want to do. And so I look at her chart and I examined her tummy and it was a mess. I mean, like I said, she was really overweight. So she was not in good health at all. She was on blood thinners and everything. And every part of my body and my mind was telling me, like, don't operate on her. Like, this is an elective operation. You don't have to do this. Just tell her no like everybody else. But every once in a while, in a doctor's experience, you have situations where you just know what the right thing to do is. And for me, I think it's from a higher power. I feel like I was being told at that time that you need to take care of this woman. And so I said, look, you know, I will consider doing this for you but there's a chance you can die. There's a chance that everything will fall apart again. Are you sure you really want to do this? And she said, yes. I really, because my life is over anyway. She goes, if you don't do it for me, I don't have a life anyway. And so the night before her surgery, I prayed that everything would go well with her operation because I was really, really nervous. I didn't sleep well that night at all. So the next day I performed the operation and the operation went super, super smoothly. Like everything went well. And she came back to see me a couple of weeks after surgery. When she first came in, she had a cane and was hobbling in. She came in with no cane, walking in with a cake that she baked for me. And she said, Dr. Yoon, I know that my insurance rejected the claim on the operation, which they did. They said it was cosmetic, which it wasn't. So she said, I know they're not going to pay you for it and I don't have any mind to pay you but will you take this as payment? And I tell you, I have a rule that I don't eat food made by my patients that they bring in because I don't know what their kitchen looks like. There could be cats pooping on their counters and stuff. So I don't eat it, but I'm like, okay, I actually was one of the few times I actually ate it and it was really delicious. But that was one of those where it really told me, like sometimes you get these times. And yeah, I get patients who are trainwrecks and I'm just like, I'm not going to operate here. Like it's not worth it. But this was one of those few times where it was like all the cards were stacked against me but I knew in my heart that it was going to work out fine and it did. And she said, you know what, Dr. Newell, I'm actually able to play with my granddaughter again and she had tears in her eyes as she was telling me this. And I was like, wow, that's, I mean, it's worth more than money. Well, that's great, Dr. Newell. It has been an absolute pleasure talking to you. I really appreciate you coming on the show and your book. I hope our listeners check your book out and look into some of the stuff that you do. But it's great talking to you. I really appreciate coming to the show. Yeah, thanks for having me on. I really appreciate it. Thank you.