Are We Too Casual About Plastic Surgery? Dr. Lara Devgan Explains

0:00Dr. Lara Devgan:A good surgeon should sometimes turn patients away. Absolutely. I think the most important decision a plastic surgeon makes is when and how to say no to a patient. We now have more med spas in America than we do McDonald's locations. So many. And the lack of safety and gating as an entry point into establishing a location like that astounds me. It's not like going to Burger King where you just order off the menu. I'll take a number three with cold tomato and extra pickles. You know, they're asking me for my judgment.

0:35The BILF Pod:Welcome back to the Build Pod, where authenticity trumps authority. I am actually on location. This is such a privilege. I'm here with the one, the only, on per ab, might I add, Mrs. Dr. Devgan. Thank you for taking it. I know you're so busy. You actually have a patient upstairs. So I am so excited to get 15 minutes of your time.

0:56Dr. Lara Devgan:I'm so happy that this worked out. Thank you so much for being here.

1:00The BILF Pod:So we're just going to dive right in. I'm just going to get, I'm just going to get, I'm going to talk about the controversy on everything that people want to know. So let's just talk about medicine in general, you know, plastic surgery in general, people have, and I, by the way, I'm a huge fan of plastic surgery. I love it. I've had, we'll talk about it off camera, but I, I'm definitely, and I believe that, you know, if it's broke, it doesn't matter. It doesn't make you unauthentic. If you've had plastic surgery, it's really what makes you feel good. But, you know, there's a lot of controversy surrounding it and not being authentic.

1:29The BILF Pod:So let's start there. How do you feel about that?

1:32Dr. Lara Devgan:You know, authenticity is how you define it and it's what you make of it. I think in the same way that we should give everybody the grace to make decisions that are appropriate for themselves, we should give people a little bit of space to think about topics like confidence, identity, and how they present themselves to the world. So, you know, But to me, plastic and reconstructive surgery at its best is just meeting a person where they are. And if you can do something in a safe and medically responsible way that means something to you, frankly, what what does anyone else have to do with it? What business of it is theirs?

2:05Dr. Lara Devgan:Yeah.

2:06The BILF Pod:And don't you feel good afterwards? Because some of it's instant gratification, you know, they wake up and like, wow, doesn't it make you feel as a doctor like you really are doing something great for this person?

2:16Dr. Lara Devgan:It's a truly amazing profession because there is such a high patient satisfaction and it's really beautiful to go on these little mini journeys or major journeys with patients and see them through before, during, after the whole process. There's nothing I love more than seeing my happy patients at the end of the line.

2:35The BILF Pod:Yeah. And you have, I mean, an extensive background. I know you graduated from Princeton. Gail. Gail, I have Princeton. Sorry. Oh, look, my people messed up. Sorry. No, no. Yeah. So you have, I mean, you're, you have an extensive background and you, your specialty is you do facial, right? That's your, that your specialty. I know you do everything.

2:53Dr. Lara Devgan:I am a board certified plastic surgeon. So I do operate on the face, breast and body, but I think I'm most known for facelift, lepharoplasty or eyelid surgery and finesse non-surgical facial optimization. So a lot of what I'm dealing with is the tiny millimeter level details that create an optimized beauty. And a lot of that is in the face. It can be anywhere, but, you know, we lead with our faces.

3:17The BILF Pod:Absolutely. That's the first thing you see when you see people. So with that being said, you know, there's a lot of talk about this new facial. Have you seen this, this like new facial technique? Have you seen it? Like it's all over in Asia. There's a new way to do these facial or the facelifts. Have you heard anything about this?

3:34Dr. Lara Devgan:Yeah, there are. Well, a little bit of it is a media cycle and a little bit of it is real medicine and surgery, but there are a number of described techniques for facelift surgery that vary in terms of incision lens, tissue plane depth, invasiveness, recovery, whether you're lifting the muscle, the fascia, the skin, all of the above. So I think one caveat I would say is that there's nothing that's completely new right now, but I think we all stand on the shoulders of prior generations in surgery. And so the techniques today are better than they were a decade ago, for sure.

4:15The BILF Pod:Yeah, absolutely. I would definitely, and I'm sure they're like more refined and people want to have, I think people want more of a natural look. Would you agree with that? That they want that. So what about, let's talk like a little bit about like the stuff you're not supposed to talk about. First of all, what's your favorite plastics to perform?

4:32Dr. Lara Devgan:I love the facelift. I think it's an elegant, beautiful operation. It really shows you every level of depth of human anatomy, the bone, muscle, fascia, fat, subcutaneous tissue, skin. It allows you to convey identity and beauty in tiny little details. So if I had to only do one surgery forever, it would be that.

4:51The BILF Pod:And how do you know when it's time to get a face lift?

4:54Dr. Lara Devgan:Okay, pinch yourself. If you have more than one centimeter of pinchable laxity in the neck, jowl, or midface, or if you significantly feel improved when you go like this with your fingers and lift up, then you can anatomically be a candidate.

5:06The BILF Pod:Oh, maybe it's time for me. I don't know.

5:09Dr. Lara Devgan:You look beautiful.

5:10The BILF Pod:Thank you. I love you even more now.

5:11Dr. Lara Devgan:Thank you.

5:13The BILF Pod:What about the people that can't afford it? Like, what do they do? Is there an alternative? Do you believe in like non-surgical techniques? Like, does all this, listen, I goop my face with all this stuff. I'm like constantly with the skincare. Is that an alternative or there's really no alternative if you need a face?

5:28Dr. Lara Devgan:Well, yes and no. there are so many non-invasive and minimally invasive evidence-backed interventions that actually do truly work. Some of them are totally free, like avoiding smoking alcohol, getting enough sleep, sleeping on your back to avoid positional wrinkles, staying out of the sun. Those things in an evidence-backed way will make you age better and look younger. Then there's a whole realm of non-surgical procedures, judicious Botox, subtle injectables, suture suspension, laser resurfacing, PRP microinfusion. There is a huge body of research to support the efficacy and safety of those techniques.

6:02Dr. Lara Devgan:And the most beautiful results, like for my celebrity patients and public facing people, the most beautiful results involve some combination of surgery and non-surgical procedures. So those absolutely work. And then you don't have to jump from zero right to a facelift. There are many other little tiny tweaks. the temporal brow lift, upper lid left, lower lid left, lip lift, buckle fat, fat excision, submental liposuction. There are so many opportunities to create a bespoke and customized result for a patient that sticks within their goals, their budget, their anatomy, their desires. So it is not a one size fits all type of thing.

6:39The BILF Pod:Would you say people take like they're extreme? Some people are very extreme and then sometimes you have to tone it back. And I mean, society does put a lot of pressure on us. You see, you know, Instagram, you see social media and there's tons. And granted, I know they're filters sometimes, but would you agree that like there's a lot of societal pressure and then people jump the gun and they want to go from zero to 100 a lot of the time? Absolutely.

7:01Dr. Lara Devgan:We're very much living under a microscope. This is the first era in human history where regular normal people have 10 or 20 or 30 ,000 plus images of themselves on their cell phone. Yes. People take more selfies and see their image. They're recorded on camera much more than in prior generations. And we all truly live on our cell phones. Apps like Instagram and TikTok have hours of daily time used per individual. So just the idea that we are dealing with our reflections and our images in a totally different way is totally true. You know, at the same time, we need to counterbalance that with appropriate expectations and reasonableness.

7:43Dr. Lara Devgan:So you shouldn't be chasing the look of every single filter. But at the same time, we are really living in a different kind of world.

7:51The BILF Pod:Absolutely. So I'm going to switch gears because I know you're a mom like I'm a mom. And there is, I mean, I get this mom shame all the time because I really am big into aesthetics. And, you know, I really do believe that the first thing you see is the way people look. That's the first thing. The way you look does dictate a lot of people's opinions. So, and I'm assuming you have a daughter, right?

8:09Dr. Lara Devgan:I have four sons and two daughters.

8:11The BILF Pod:Okay. So how old are your daughters?

8:13Dr. Lara Devgan:They're seven and nine.

8:15The BILF Pod:So they're little. Now my daughter's 18 and my daughter actually just got, she just had a breast reduction. I think she's a little young for anything else. But when your daughter comes to you and is like, hey, mom, I'm really thinking about an augmentation or I'd like to try this procedure. What would be your reaction to that?

8:35Dr. Lara Devgan:As a mother and as a parent, you want your children to feel exactly perfect just how they are. You want them to feel comfortable in their own skin and absolutely like nothing is needed besides their personal development. At the same time, we do realistically confront the world with a first impression that can sometimes make people feel limited or less comfortable. And so if one of my children, daughters or sons, had a consideration where something was really bothering them and I felt that it was a reasonable concern, anatomically justified and safe and appropriate to address at that time and age, I would

9:14The BILF Pod:help and support them through that process. I love that. I think that's such an honest answer. I feel the same way. I mean, you want your children to be comfortable in their own skin before anything and love yourself first. Yeah.

9:24Dr. Lara Devgan:You're perfect just the way you are. If you, this is really, really, really bothering you. That's

9:29The BILF Pod:exactly what I did with my daughter. I knew it was something that was bothering her. It's been something like this for a very long time. She's also 18 years old. So I felt like if this is really holding her back and she felt a lot more secure within herself and then, you know, within, I thought it was reasonable. It wasn't anything, you know, obnoxious and there was no implants. it was you know completely but i do think that sometimes if you feel more if you're in you know if you feel if you feel better about yourself i don't think there's anything wrong with that but of course for our children we want our children to be comfortable in their own skin first yeah

10:00Dr. Lara Devgan:absolutely and people can be so judgmental about that but it's really a personal experience with

10:05The BILF Pod:how you move through the world has there ever been a time where you had to turn a patient down where you're like no girl enough like i know or i think the most important decision a plastic

10:14Dr. Lara Devgan:a surgeon makes is when and how to say no to a patient. And there's absolutely a kind way to guide someone toward appropriate decision making. Because, you know, it's not when someone comes to see me as a patient, it's not like going to Burger King where you just order off the menu. I'll take a number three with hold the mayo and extra pickles. You know, they're asking me for my judgment. There is a consultative process where I'm not only trying to help enable a patient to feel good about themselves and make a decision that's right for them, but I'm also trying to give them advice. And so I think advice includes what is safe, what is reasonable, what is aesthetically balanced or harmonious and all of the above.

10:56Dr. Lara Devgan:So I never want to be unkind or cruel to a patient, obviously, but sometimes an operation is not the right thing for a patient.