Hollywood's Best Kept Secret Behind the Most Natural Faces: Holistic Plastic Surgeon Dr. Few

25 Sep 2025 · 58 min · 18 chapters

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In short

Holistic, natural-looking plastic surgery—how to enhance without erasing; why “overfilling” and perfection-seeking can age people faster; when to choose conservative options; and how GLP-1 medications may change skin (“GLP face/skin”) plus Dr. Few’s skincare product.

Guests

Dr. Julius Few, holistic plastic surgeon with 20+ years in practice (Chicago, New York, Santa Monica). Clinical professor at University of Chicago; clinician at Northwestern. Background includes general surgery training at University of Michigan and plastic surgery training at Northwestern, plus specialized facial/eye cosmetic training (Honolulu, New York, Atlanta). Known for an “85% rule,” understated facelifts, and a thread-lifting technique he developed.

Key claims

Best results look like you—no “different species.” Avoid going past ~85% (e.g., filler). “Distortion vortex” describes addiction-like escalation after initial improvements. For upper blepharoplasty, stabilize the brow first; don’t remove too much skin. Give yourself time after major life stress before elective procedures. Overfilling causes “pillow face” and can be hard to reverse.

Notable examples

Erin Andrews’ nose as a “fits your face” example; Sonia Morgan’s facelift as an early “looks good” case; buckle fat pad removal as a trend that aged poorly; ectropion risk from certain mid-face lift approaches; celebrity privacy and gender bias in speculation.

Written by AI. May contain mistakes. Listen to the episode to check what was said.

Chapters

Tap a time to open that second in VO

Return from Hiatus and News

3:01 to 4:32

Host shares personal updates and upcoming changes for the podcast.

“No one has all the answers, but when we ask the right questions, we get a little closer.”

Introduction to Dr. Julius Few

4:32 to 8:18

Host discusses the philosophy and approach of Dr. Julius Few in plastic surgery.

“In the meantime, I've been in New York City living out of suitcases, which is not my forte because I'm so bad at working out when I'm on the go.”

Interview with Dr. Julius Few

8:18 to 14:00

In-depth discussion about beauty, plastic surgery, and the 85% rule.

“is how can we look our best selves, not like someone else, and definitely not like a shell of one.”

Understanding Fillers and Their Impact

14:00 to 18:00

Learn about the pros and cons of fillers and how overuse can lead to negative outcomes.

“looking done are there certain markers i think the classic marker which is the reason why fillers have gotten such backlash.”

The Philosophy of Natural Results

18:00 to 22:00

Discover the importance of achieving natural results in cosmetic surgery.

“And I was like, okay, maybe technology is getting better.”

Patient Considerations Before Surgery

22:00 to 26:00

Explore key advice for patients to consider before undergoing cosmetic procedures.

“It's so critical because I do believe the stress hormones and so on that go with this, plus just the psycho-emotional parts, you put your procedure at high risk.”

Upper Blepharoplasty and Its Implications

26:00 to 28:00

Understand the nuances and considerations of upper eyelid surgery.

“part of this is you have to, and again, this would be a question to your surgeon, is should I feel that my brows are an issue here?”

Innovative Techniques in Eyelid Surgery

28:00 to 31:30

Learn about Dr. Few's approach to eyelid surgeries and how it improves patient outcomes.

“I've been referred to by other plastic surgeons.”

Trends in Plastic Surgery

31:30 to 34:20

Discover the most requested procedures and the latest technology in implants.

“I want to ask you about some procedures and then I want to talk about your skincare line.”

Challenges in Liposuction and Aging Trends

34:20 to 36:40

Explore the physical demands of liposuction and how overfilling can age patients.

“widget to count on long term in this kind of post-GLP-1 world.”
Show all 18 chapters

Celebrities and the Pressure of Beauty Standards

38:20 to 42:00

Discuss the privacy issues celebrities face regarding cosmetic procedures.

“I'm curious what your take is on celebrities not admitting having work done.”

The Shift in Cosmetic Procedures for Men

42:00 to 44:38

Explore how societal perceptions are changing regarding cosmetic procedures for men.

“I am starting to see that trend shift a little bit more towards men now.”

Genetics and Aging: Preemptive Measures

44:38 to 46:05

Learn how genetics influence aging and the preemptive techniques available.

“indications from diabetes, heart disease, to addictive personality issues, to inflammatory conditions in the body.”

Impact of GLP-1 on Skin Health

46:05 to 48:03

Discover the effects of GLP-1 medications on skin health and aesthetics.

“And it's not meant to make fun of the issue, but rather to describe what everybody's seeing.”

Skincare Routine and Product Development

48:03 to 51:11

Understand the importance of a skincare routine and newly developed products.

“Like you would look at some of these pictures and you would say, this person, the only way this happened is they had a laser.”

Preventative Treatments and Aesthetic Choices

51:11 to 55:18

Discuss preventative treatments for aging and aesthetic preferences.

“I know I only have a few minutes left with you.”

Admiring Aging: Beauty in Maturity

55:18 to 56:00

Delve into the beauty found in aging and the wisdom behind aesthetic choices.

“I was just going to say, I really like that you still have movement and signs of your age in your face, but you look so refreshed.”

Aging Gracefully: Insights from Dr. Few

56:00 to 1:00:20

Learn about beauty standards and procedures for each decade of life.

“If they look way overdone and that's not in line, unless they're going to tell you, yeah, I'm overdone and man, I got carried away with that filler.”
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Transcript

Automatic transcript. May contain errors.

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1:47Soon after, I was in their Kohler, Wisconsin foundry, watching molten iron poured, enamel applied by hand, and the beautiful finished pieces ready to ship. Since 1883, Kohler cast iron has been crafted by incredible artisans and seeing it firsthand gave me a whole new appreciation for their craftsmanship. Now, I'm proud to lend my stamp of approval to my favorite Kohler cast iron products for their durability, beauty, and enduring style. Shop my curated picks at Kohler.com. As the Kohler Cast Iron Ambassador, I say, long live Cast Iron. And now, another appliance triumph from our friends at Grand Appliance.

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3:01Danielle:No one has all the answers, but when we ask the right questions, we get a little closer. Closer to truths. Closer to each other. Even closer to ourselves. I'm journalist Danielle Robay, and each week my guests and I come together to challenge the status quo and our own ways of thinking by daring to ask, what if? Why not? And who says? So come curious, dig deep, and join the conversation. It's time to question everything. Hello! Oh my god, I ghosted you guys for a few weeks. I'm so sorry. I promise it was for a good reason and I also promise it won't ever happen again. I really just went MIA. Usually I'll say something or I'll post older episodes as reruns, but I just, I needed a minute.

3:55Danielle:And thank you for sticking with me through the hiatus. I've been sitting on some news that I can finally start to share a little bit. So thank you for rocking with me through it all. I needed a little breather because two exciting things happened. First, I am filming a pilot for a major streamer and who knows where it goes, but I felt like I should at least tell you about it because I owe you the truth on why I've been MIA. That's been taking up a lot of my time. And secondly, there's a big podcast question everything announcement coming your way in just a few weeks. We are joining a major network, but I don't want to share until it's all signed on the dotted line.

4:31Danielle:So just know that I've been MIA for a good reason. In the meantime, I've been in New York City living out of suitcases, which is not my forte because I'm so bad at working out when I'm on the go. I haven't worked out now in three weeks, but on the bright side, I had some amazing moments in New York. I got to interview Malala, which honestly, this may sound corny and I know I say that sometimes, but it was a feminist bucket list moment. I have wanted to talk to her for years and feel her energy and she was so wonderful. I also got to grab coffees and have a few meetings with people that widened my aperture a little bit.

5:11Danielle:Do you ever have those moments where something that's been foggy for years suddenly feels clear and you wonder like how you didn't see it sooner? That's where I'm at. And I'm starting to put the building blocks in place for what's ahead. I know that's all pretty broad, but this community has some big things popping off in the next six months. And yeah, I'm really excited that you're here with me. So let's get into today's episode. I have said no to every plastic surgeon who has ever pitched this podcast. And not because I'm against cosmetic work. I'm not. I just think most of us already spend plenty of time thinking about how we look.

5:46Danielle:And I never wanted this show to add to any of that noise. We get that from so many other places. And for people who have been listening since the podcast was called Pretty Smart, which I named after reading a book called Beauty Sick, which changed my life, then you know that I've believed that beauty should be one of the things we think about and not the only thing or the thing that consumes us. And too often I think conversations about appearance get stuck at the surface like that. But my hope is that this episode is different. I wanted to have a conversation about plastic surgery that doesn't feed the obsession, but instead it is something that is in the zeitgeist.

6:26Danielle:It is all over my feet. I don't know if it's all over yours, but I'm hoping that this conversation invites thoughtfulness and perspective and a little bit of relief. That said, if talking about appearance is at all triggering for you, please listen with care. Or skip this episode if that's something that you feel is triggering. But I will say that I chose to interview a particular surgeon for this reason. Dr. Julius Few is the holistic plastic surgeon, and he has earned that title. His philosophy is that beauty should honor who you are, not erase it. So over the past 20 years, he's quietly reshaped the aesthetics industry by asking better questions, slowing the process down and treating restraint as a form of artistry.

7:13Danielle:He even pioneered what he calls the 85 % rule, intentionally stopping short of perfect to preserve what's real and human and actually beautiful. He's trusted by celebrities and VIPs across the country with practices in Chicago, New York, and Santa Monica. He's also a clinical professor of plastic surgery at the University of Chicago and a health science clinician at Northwestern University. An impressive pedigree, right? He's the surgeon people go to when they want to look refreshed without looking done. And I asked him all the questions I was personally curious about. What makes a face beautiful?

7:49Danielle:Can you reverse bad filler? Why are so many procedures aging people faster? What's the real difference between looking refreshed and looking done? And when's the right time to consider something like a facelift? What's the most requested procedure in his office right now? We also get into something he's especially passionate about. How GLP-1s are affecting the skin. and the product he's developing that might actually be a game changer. So yes, many questions, but the one we're circling this episode is how can we look our best selves, not like someone else, and definitely not like a shell of one.

8:25Danielle:It's time to question everything with Dr. Julius Few.

8:33Danielle:As a holistic plastic surgeon, you really emphasize keeping or enhancing people's unique traits. And I'm really curious how you think about changing somebody's face while enhancing it. We've gotten much better in the last 25 years at doing our work compared to the days of my training, which it's hard to believe over 30 years ago. And so really, I think what we're seeing is oftentimes an attempt to go for perfection. And technically, you can get much closer. You can make somebody look so close to perfect in a photograph that in real life, they're scary. And I think that this is the reality we're in.

9:18And I really had the epiphany moment when I was on the Museum of Contemporary Art in Chicago, their board of directors. I'm a big art fan. And basically what I realized in meeting all these amazing artists and different media was the idea that the best art had individual expression. And really plastic surgery by definition is a form of scientific art. And I felt like, okay, if we have all these tools to make somebody look better, you don't want to make it look like something that is out of basically a computer. And so that started me on this path of less is more. And I came up with different doctrines over my career that fortunately have been followed by many of my colleagues, like the 85 % rule, which is a simplified concept that even though you can go to 100 % filler is a great example go to 85 % don't shoot not to go past 90 % leave room for imagination and some of my best work over the last decade especially on some very famous faces has been that rule in mind and most of the people in my mind and again I have Midwest roots I know you have Midwest roots, or at least a Midwest history, is the idea that nobody should be able to tell that you've had work done.

10:47At least that's my view. So I've tried to live this approach, and I believe as I've gotten better at plastic surgery, I can get away with that. I know how to do things in a way I can hide. I have a very light footprint, and it's plausible. A lot of my clients are able to say they've never done anything and get away with it. That's my philosophy. It really has more holistic.

11:09Danielle:I'm particularly curious about your philosophy on beauty. And I want to preface the question with my personal philosophy has grown over the years when I was in high school or college, social media popped into all of our lives for the first time. And I did think that beauty was so much more about perfection. And as I get older, when I watch TV or film, I love looking at the imperfections of people's faces. I'm not just saying it, that is what makes them more beautiful. I mean, I'll give Erin Andrews as an example because I'm a broadcaster and she has a very distinctive nose and she's never touched it.

11:51Danielle:And she could have because she has a lot of side profiles in her work and on TV. And when I had always considered getting a nose job, I would think about her. And I'm so glad now that I'm older that I didn't touch it. I am so glad you didn't either because I would have been crying. Well, I'll go sideways. It's a very young. No, it would have been your nose fits your face. You have a beautiful face. It fits you perfectly. It's no incentive on my part to talk people out of doing plastic surgery. I mean, I make a living. I'm able to live a lifestyle, et cetera. But at the same time, I've reached a point in my career where I can.

12:35And ultimately, like for you, I would have kicked you out of my office too. I would have said, what are you going for? What are you after? And so on.

12:43Danielle:Do you kick people out often? I do. And my staff will joke about it. Like I will probably once a week in the nicest way, I will say, you know, I got to think about that. And then I'll think about it. I will thoughtfully digest what they're after. I'll look at their pictures. I'll commit the time. And then I will give them an answer. But usually my gut instinct is right every single time. And I can't tell you how many people have come back to me five, 10, 15 years later, and have said, I'm so glad you talked me out of this. I'm so glad for X, Y, and Z reasons. And unfortunately, I have other cases where they go elsewhere because they didn't believe that was the ideal move.

13:28And then they come to me because they know I can fix it, which is harder and it's traumatic and all the things. So I think this whole idea of you, everyone else, like our innate beauty, the secret is finding a way to say okay i can make this subtle alteration or i can preserve where you are in a way so that you age in your best way that you look in your best way and that's

13:58Danielle:the secret in that vein i'm curious what the difference is between looking refreshed and looking done are there certain markers i think the classic marker which is the reason why fillers have gotten such backlash. Fillers are, I think, amazing. They're amazing tools, but they're powerful and they last a lot longer than anybody thought, including myself, and they can migrate. So I think really, to me, in the last five years, maybe six years, that's where fillers got a very bad rap because people were going 110, 120 % of what was there. And when you go that far, I have colleagues who look unrecognizable because they have access.

14:43It's easy. They can inject themselves, et cetera. But literally their eyes have been lost in their sockets because there's so much filler here and they can't even move normally. And it's a cautionary tale of how and where somebody can go too far. Think about it. If you're a dermatologist or plastic surgeon and you can inject yourself, which by the way, I inject myself with Botox as an example. It's not that hard to do Botox. Filler, totally different. I've never tried to do it to myself. It's a totally different paradigm because you're looking at a reflection and you lose all depth perception.

15:22So what ends up happening is you become used to the change and you say, that's not enough. I need more. Well, there are lots of patients who come who have a similar reality where they ultimately lose all perspective on what is good and what is too much. And then they get lost in it. Because this is such an important point you just brought up. The idea of how someone can do too much and get lost in it is what I call a distortion vortex. And what that means is someone sees and feels the excitement of looking better. So they get some put in, whether it's a filler, surgery, you name it, laser. And they look and they're like, I look so much better and I'm so psyched and everything is perfect.

16:19I want more. But the psychology of it is very similar to any addiction. You get this rush of dopamine from looking and seeing yourself transformed. You want another hit.

16:33Danielle:Well, in LA, I always say there's this sort of new ethnicity that's been created here. And it's the ethnicity of plastic surgery face. And there's this look and everybody has the same nose and the same lips and the same cheeks. And they're not all going to the same surgeons. It's just this look and I'm not against plastic surgery, but I am sort of against the look. Making a new species is not the goal of plastic surgery. It is not. And I could not agree more. You are so right. Fortunately, I think we're coming out on the other side of it because I was one of the first, and that's probably why I got the tagline of holistic plastic surgeon.

17:12I was one of the first to really talk about thoughtful plastic surgery and natural results. This goes back almost 20 years. And so I think finally, and especially the new generation of plastic surgeons, if you look at social media, that concept is all over the place now. Like people are moving towards this idea that, you know, less can be more, but it's because frankly, we're scaring away potential patients by making people look like a different species.

17:48Danielle:A few years ago, there was a real housewife named Sonia Morgan who got a facelift. And it was the first facelift that I had seen that anybody had talked about publicly that I thought looked good. And I was like, okay, maybe technology is getting better. Is it possible to have a facelift and still look like a version of yourself? A thousand percent. That is my calling card, is really making things look natural and anatomically appropriate. I think there are different moves, for example, now. Again, this goes to the whole thing I said at the very beginning of technology. There's technology to remove glands in the neck.

18:31There's technology to remove bones and cartilage in the neck or the face. Restructuring, you can do all kinds of things. but the art is in not getting carried away. And there's this obsession now with necks, for example, of where the neck becomes excavated. It's like, oh, I want my neck to look so perfect and there's nothing there. But what people don't realize is that, you know, in cancer surgery, you remove those glands for cancerous reasons. And that is a very specific look. And I have colleagues who are doing things that are reminiscent of cancer surgery. And so to me, it's kind of this thing of should that be the goal?

19:18We have the technology, but should that be the goal? Should the obsession with a neck that is perfect, where you don't see any cords or columns and so on. I mean, I have 18 and 20 year old boys. They have little cords. I mean, am I going to go operate on them? I don't think so. I think ultimately, as I say, it makes so much sense. But if you're somebody coming in, especially in Los Angeles, you have these talented doctors who have capabilities and they're all within half a block of each other. It's hard to number one, know what to do and what not to do. And two, everybody's trying to outdo the other one.

20:00So guess what? That's not a winning battle. So I would tell anybody, and this is where hopefully I can make a consumer friendly announcement, is the idea that, number one, if somebody is thinking about, I want to do X, I want to do this laser, I want to make my face look less tired or whatever it is. The first thing you should do, you tell the doctor, I want to be conservative. That is the first thing you do. Because if you set that landscape, number one, most doctors will be like, thank God. And then the second part of that is they will be able to give you all the options without feeling pressured to hit a home run.

20:45Danielle:And you know, if you're at the right doctor, because I have Botox and I went to a place in LA and said, I'm really conservative. And the look on her face, I was like, we're not a match. And I went back to Chicago to the guy that I always go to because he's conservative about it. Is there anything else that you wish that patients knew coming in? Anything that like they should be asking or things that we should be thinking about? Yeah. I mean, I think there are a couple of things that I think are big mistakes. Number one, I think it absolutely is imperative to at least hear more than one or two options for any given issue, because now we're in a technological reality where they do exist.

21:27I think number two is the idea, and this is again where I got the holistic kind of moniker, if someone is going through a major life stress, like a parent died, or there's some major upheaval, divorce, you name it, a big negative event in life, You have to give yourself time to heal before you think about something elective.

21:51Danielle:I'm so glad you said that. It's so much easier to change your face than it is to deal with grief or to deal with like a job loss or whatever. And so to give that time is so important. It's so critical because I do believe the stress hormones and so on that go with this, plus just the psycho-emotional parts, you put your procedure at high risk. I also think really having a clear cut priority list. So all the time I'll get somebody who comes in now because of my reputation, I'll say, okay, my face is yours. What would you do? And I always put it back on them to say, honestly, when you woke up this morning, what stood out to you as not recognizable?

22:35Or if it's somebody who's younger, it's more, well, what was it in your personal journey that led you to say, you know what, I'm thinking about this every day and I need to do something. Like, what is that one thing? You'd be shocked because every time I've been surprised. And I think that's the advantage of somebody who's more experienced. I mean, I earn these gray hairs is the idea that you kind of know the questions to ask to get at the heart of what's going on. Similar to you when you're interviewing somebody, you know how to get me going and probably you may when I shut me down. But it's the secret of understanding those questions.

23:18So much of what is kind of both surgical and non-surgical cosmetic medicine is about what you see and what you're going to do about it. And there's very little time spent to the why. And I'd say that the biggest piece of advice I would give anybody is number one, write down why you're doing it and be prepared to talk about it at the interview before you do a thing.

23:41Danielle:I'm going to brag about you for a minute. You already know your resume, but I was pretty in awe when I was researching University of Chicago Pritzker School of Medicine for your residency. You did general surgery at University of Michigan Medical Center, followed by plastic surgery training at Northwestern University. And then you received a special facial and eye cosmetic training in Honolulu, New York, and Atlanta. So I was particularly interested in your special facial and eye cosmetic training because in LA, the biggest trend right now is upper bleph. For anybody listening, it's like eyelid surgery, right?

24:19Danielle:You kind of take the skin away from the eye. Yes. So my curiosity around upper bleph is, is this going to age well? Because all of these trends that happen, the buckle fat pad, that was a big trend. I don't know how well that's aging. You hit the nail on the head. What's old is new is the saying. Buckle fat pad removal was a big trend in the seventies. And then it largely was abandoned because it did not age well. I think for blepharoplasty, one of the things that I would say is it really depends. And it gets back to that story of why. If somebody is doing it because they don't like the wrinkled skin and that's it, but they don't have any real hooding, it's just a textural thing.

Read the full transcript

25:07Removing the skin is not the answer. The other thing that is often missed, like you have beautiful brow arch. If the brows are heavy, doing an upper blepharoplasty is the wrong thing to do as a standalone. And ultimately, the biggest thing I learned in fellowship, which has aged really well, is the concept that you have to stabilize the brow first before you think about doing anything to the eyelid. If the brow is naturally sitting in a nice arch and it's not hooded, it's not going into the eyelid area, then you can evaluate for excess. Again, though, the most important thing for upper blepharoplasty is not scooping out everything because then that does not age well.

25:52That actually will look potentially haggard as somebody ages down the line. And so that's a huge part of this is you have to, and again, this would be a question to your surgeon, is should I feel that my brows are an issue here? And that needs to be part of the discussion. An experienced ophthalmic plastic surgeon, you know, such as myself, is it's centered on the idea that you have to look at the composite. There's so much interconnectivity between the upper eyelid and lower eyelid and the forehead, and these all are moving parts together. And again, the idea of harmony in terms of these structures is critical, but an upper blepharoplasty is an easy operation to do.

26:38I mean, on surface, meaning you don't have to necessarily be an eye specialist to do an upper blepharoplasty if you're a trained plastic surgeon. The problem is if you are not nuanced, and you're right, there's this big trend of very young women having this done. And again, it's part of the backlash of fillers and Botox. Potentially that plays poorly because a lot of these individuals will find themselves saying, I don't like the wrinkling after, like down the road. And the wrinkling is going to come because in essence, they haven't either addressed the brow or the real issue they were after was the wrinkling around the eye, which could have been managed with things like Botox or managed with other techniques short of surgery.

27:28I think that's kind of how I frame it. And even though I'm a specialist, I've written books about eyelid surgery. I've invented a couple of operations for the eye area. To me, I always look in the back of my head, can I make this person get by with Botox first? That's always what I think. Can I make Botox work first? And if there's a question, I strongly encourage them to try it, to see if they like it. Because there's nothing worse in my mind, and I've seen lots of patients who have had eyelid surgery in all different kinds of places. I've been referred to by other plastic surgeons. And the truth is, had they done a thoughtful assessment, they would have realized that patient would have been more happy with Botox than they would be with surgery.

28:14Danielle:I know that you are a proponent of non-invasive procedures, but I didn't realize that you had invented some eyelid surgeries. That's pretty remarkable. So when I first started out in practice at Northwestern, this was back in 99, 2000, fresh off of my training. And that training was in depth. It was reconstruction around the eye. It was doing things for cancer. I mean, it was in depth as well as cosmetic. At that time, a huge fad surgically was a mid-face lift. The mid-face lift was done by making an incision in the under eye and then lifting up the cheek from the under eye. The problem was the dynamics of the interplay between the lower eyelid and the cheek.

29:00The lower eyelid was not strong enough. So what was happening is there were all kinds of people all over the country that were coming in like this.

29:11Danielle:For everyone listening, the eye is dragged down. It's dragged down. The lower eyelid literally is pulled away from the eyeball itself. And that is called an ectropion. It is any surgeon's worst nightmare. It's any patient's worst nightmare. And so there were hundreds of these people walking around looking like they were accident victims. And so the problem with it is that approach going from the outside, you couldn't fix it. There was no fix. Like I would see people who had 10 operations to try to fix this. Can you imagine you spent your savings to do a surgery that then you become a reconstructive patient?

29:56So what happened at the time, there was only one other person on staff and the entire staff at Northwestern that did oculoplastic surgery. And he had no idea how to manage this. So he was rejecting all of them. He said, I have no answer. You know, there's nothing to do. And so what happened was I developed a technique, which now is a technique used both for this, but also cosmetic, because it's much lower risk, is actually to do the mid-face lift through the inside. So there's a way to go through the inside of the eyelid and then to release those ligaments. And then it's much safer. I won't bore you with the technical detail.

30:38But it is, again, when my colleagues read about this, because I've published it in textbooks and medical journals, everybody looked at it as, of course, that's obvious. Because it is. It's like an obvious way to go. It is less traumatic. You have less swelling. There's less risk. And it's incredibly versatile. The only issue is it's a learning curve. But I saved probably 100 people who had this condition that otherwise would have had nowhere to go. And so we published our data and this became a workhorse technique, but now it's been modified over the years to be a workhorse for cosmetic reasons.

31:18And it's a much safer way to go. You're not going to change the shape of the eye, which is the second worst thing you can do. And so it's really, again, it goes back to my core tenet of you want to look like yourself still.

31:30Danielle:I want to ask you about some procedures and then I want to talk about your skincare line. And it has very beautiful packaging, by the way. I'm a big packaging girl. It's really well done. And it's heavy. It feels good in your hand. It has some stock to it, for sure. Okay, so what is the most requested procedure in your office right now? Well, I'm known for kind of a couple of things. Eyes are certainly one of them. A specific form of thread lifting I developed, which has become kind of the standard approach, certainly in North America. And then facelifting. I'm known for the more understated facelift that still looks really damn good.

32:09And those are the three things that I get the most requests for. It's funny, though, lately what has happened, and it just shows how long I've been doing this. I have patients from my early career that were breast patients who either their kids or relatives, they're referring to me because they've said basically, you're the only person I would let my child have breast surgery on. Like on Monday, I have a couple of patients who kind of fall into that category. You know, I've done tens of thousands of breast surgeries, so I'm not a stranger to it. But, you know, I'm very particular about the nature of the surgery.

32:47At this stage, I don't want to do any surgery or any treatment where I don't feel like I can be 100 % capable.

32:54Danielle:What do you think about the technology of implants nowadays? I had a friend in L.A. do a fat transfer into her breast instead. and the implants seem difficult because you have to change them out every 10 or 15 years, right? So that is one of the common myths. You don't have to necessarily change the implants out. They don't have a set expiration as long as they're functioning the way they're supposed to. And it's pretty easy to follow them with an ultrasound. I think where implants get a bad rap, it's similar. You're going to hear this theme. They get a bad rap when in particular, women try to go much bigger than their body can tolerate.

33:33You're going to get all kinds of weird risk and complications that are, in my opinion, totally unnecessary. And fortunately, again, we're seeing this trend of going to, they call it the yoga breast, I guess, or you hear all these terms, but it's like this more petite breast. So for me, it's this whole idea that, you know, know, you want it to match the body. But in general, implants are incredibly safe when they're done in a thoughtful way. Fat transfer is another incredibly good tool if you have it. But in this world of GLP-1s, that's increasingly difficult. And by the way, if somebody is on a GLP-1 and they do a fat transfer, they're going to lose a lot of that benefit.

34:17So the fat transfer is a trickier widget to count on long term in this kind of post-GLP-1 world.

34:25Danielle:What's a procedure that doctors hate doing? I don't want to get in trouble, but I'm going to tell you it's liposuction. Most plastic surgeons do not like doing liposuction, especially big volume. It is a ton of manual labor. It's really hard on your body. I have colleagues who've had to have their shoulders replaced. It's no joke. It is the most physically disruptive thing that you can do to yourself. It's just an unnatural torque of the shoulder. And so I really do very little liposuction though. It's not something I run to. Thanks for being honest. I appreciate that. I don't want to get any hate mail from my colleagues for saying, wait a minute, you're giving lipo a bad rap because liposuction still statistically is the most common plastic surgery procedure.

35:12Danielle:What is a trend or an aesthetic procedure that you think is aging people faster? Honestly, I think the biggest one is overfilling. Overfilling the face is guaranteed. And there are some people, I'm not going to say who in popular culture that have been accused of looking older than they are. It's like the pillow face, right? It's the pillow face. This is the quickest way. And I've got a lot of research to explain why, but it is the quickest way to make somebody look older. Can you reverse bad filler? Are you stuck with it? So that's where the challenge is. You can reverse it, but then they look even older still.

35:49I had a series of patients I just recently did where I had to melt their filler and then I did face lips on them. Everything literally sagged as a result. And they were people who I think had they done something a bit more conservative, they would not have been in the same predicament.

36:09Danielle:Before we come back from break, a core pillar of this podcast is the belief that we rise together. You all support my dreams and I am here to support your dreams. And that's why I hop on a Zoom with a listener or sometimes two or three just to connect every week. We swap stories, we chat, and I see how I can support you. And a few weeks ago, I met Andrea. She's a career transition coach who helps high-achieving women reimagine their careers in a way that feels good and still pays the bills well. And the reason I wanted to share Andrea's work with you is so many of you DM me saying, I feel stuck or I can't figure out what I really want to do.

36:49And I'm

36:51Danielle:happy to hop on a Zoom. But a lot of times what I think could be more helpful is an executive coach, a career transition coach. And I was so impressed with Andrea. I felt like if any of those questions that I feel stuck or I can't figure out what I want to do resonates with you, email Andrea. I put her information in the show notes, but here's a little bit from her. Do you find yourself questioning everything lately? Who am I? What am I doing? What's next? If so, you're not alone. Hi there. I'm Andrea and I've lived in that space between where everything looks fine on the outside, but nothing feels quite right on the inside.

37:31And clarity didn't come from having the perfect plan. It came when I stopped asking myself questions rooted in fear. Questions like, what if I fail? What if I have to start over? And instead, started asking questions that were beating in my heart. That's when everything changed. Because the questions that we ask ourselves don't just describe our reality, they have the power to shape it. And as a career transition coach, I help ambitious women stuck in the messy middle learn to ask themselves better questions. The kind that reconnect them to who they are and what they actually want, allowing them to move forward with alignment, self-trust, and clear next steps in life and career.

38:13If that's you, I invite you to download my free 21-day guide, Reclaim Your Next Chapter,

38:19Danielle:filled with powerful questions to help you reset, reconnect, and rise.

38:27Danielle:At the beginning of our conversation, you made a really great and funny comment about how you've done some work on celebrities that pretend like they haven't had anything done, but obviously, you know that they've had something done. I'm curious what your take is on celebrities not admitting having work done. I could write a book about my experiences, whether it is going to their homes or finding very nondescript ways to meet or doing things in certain ways where their confidentiality can be assured. I think the problem is, and it's worse now than ever, social media is brutal. It's ruthless. A lot of the folks that I've had the pleasure of taking care of are some of the nicest, most genuine people you could hope to meet.

39:16And they are ravaged. Their kids are ravaged. People say the cruelest things. And so if you're that person, And the last thing you want to do is say, well, yeah, I had plastic surgery or admit to having plastic surgery because still then they're going to be ruthless on that. And so I just feel like everybody deserves privacy. And just because you make a living being a public persona, you're doing a job. Your job is acting or musician. And that doesn't give anybody the right to pick into your private life unless you want to give it up. But I think that's the challenge. And I'm fully on the side of the actor or musician that is famous because they deserve their privacy.

39:59And that's why you will never hear me theorize about who did what or whatever. Because the truth is either I may have done it or I want to not even make a theory as to why they did it. It's not my place. And I think it's the most rude, lowbrow thing somebody can do in my profession. And the thing that gets me, you got me on a roll, is there's some people that I've taken care of where I flip through social media. I don't follow these people, but I'll flip through. And often it's somebody in another country that is theorizing about one of our well-known American actors. And they'll proceed to list all the things.

40:39And I'm watching this and I'm thinking, I know exactly what they did. And you are full of shit. You're so wrong. It's like a game I play. I look on my phone. I look at Instagram. I'll watch. They'll list a thing and I'll say, wrong. They'll list another thing. Wrong. It's one of these things where people deserve their dignity and privacy. And I think maybe if society as a whole were a little kinder to the celebrity, maybe they'd be willing to give it up. There are celebrities who are open about some of the things they do, but that's an unusual constitution to be that way.

41:17Danielle:So one of the reasons that I don't feel like we are owed the information is because I find it still very sexist because we don't really ask men about what procedures they've had done. And once a woman comes out and says they've had something done, it's everywhere. It's in every magazine. We all know we think about the surgery before we think about their project or them. And so I agree with you. I don't think we're owed anything. But I particularly don't like the gendered practice. of even asking. Pun intended, it's two-faced. And I agree with you. The gender bias of how you have to keep up as a woman compared to a man, it is unfair.

41:58And that's part of this thing. But again, it's interesting. I am starting to see that trend shift a little bit more towards men now. Like where you as a man, because of the technology, if you're an actor, you can't exactly cruise like you could have. And that's an interesting reality. We're seeing some of that for sure.

42:18Danielle:Well, I've heard this thing. I don't know if this is just a thing you hear in Hollywood that there's the leading man jawline that people have had for years that they would get an implant and would redo their jaw, the A-list actors, but men just wouldn't talk about it. So maybe now people are talking about it a little more. Also, I love that your silent smile right now. I have no comment. I will make no comment. How much of how we age is genetics versus how much we can actually influence? I think genetics are everything. One of the big deciders that I use to help answer the question of should somebody do something now versus later, as I say, look at your mom or your aunt or your grandmother and how they played out.

43:05It is especially true for the eye area and the neck. If I have somebody who comes in, they have a slightly fuller neck, but it's not bad. But looking at their mother or grandmother, they have like this really heavy, like double or triple neck. I've said this, I've said literally, you know what, let's remove the fat there because it's not going to age well. And that's a preemptive strike. And that is doing something in their best interest. It's one area where I will do liposuction and feel good about it. I actually developed and invented this technique called a chin tuck, which involves doing a form of a limited neck lift.

43:42It involves repositioning the skin under the neck as well as the deeper structures. It's a modification of what's called a submental neck lift. This is something much more limited, but the results are significant. It's something I'm getting ready to write up in our medical journal, but basically it's one of those limited access techniques that actually delivers huge results in a discrete fast recovery way. Also, I think it is a technique that I love to use in that person who is genetically predisposed to a double chin.

44:19Danielle:Are there any advancements in technology or procedures that haven't hit mass market yet that you're excited about? Well, that kind of dovetails into my skincare. I think the biggest thing that we're seeing, which is only going to increase is GLP-1 use. And GLP-1 use is everywhere for all kinds of indications from diabetes, heart disease, to addictive personality issues, to inflammatory conditions in the body. I just heard somebody talking about using low dose or micro dose for hypertension, the list goes on. And so as of middle of last year, it was estimated one in eight Americans are on a GLP-1.

45:06That number is exploding for all these reasons, off-label use and so on. Plus we expect to have a pill and or an inhalational version of it coming out soon, probably by the end of this year. So the reality is I started researching this effect over the last two years because I noted the dramatic change to the skin itself that seemed to be independent of weight loss. And this research over the last couple of years, and I have a lot of experience in kind of scarring, wound healing, and immunology, I use that experience to come up with a likely mechanism for why the skin is significantly directly impacted by GLP-1s.

45:51And we just finished to study that is in the process of being submitted for publication. But the net effect is that there is a dramatic effect on the skin itself. I've come up with this term that I call GLP face and GLP skin. And it's not meant to make fun of the issue, but rather to describe what everybody's seeing. There are men and women that are taking, you know, low dose with a 10 pound weight loss or less, but their skin looks awful. And there's a reason for it. The GLP-1, which is an amazing anti-inflammatory agent, much like steroids are for certain conditions, but it impairs the skin's natural protective power on a number of levels.

46:40We've specifically mapped out specific cytokines, which are basically the communicators between the cells and the skin that are affected by this and really have developed an explanation for why the skin is much more sensitive to the sun on a GLP-1, why the skin is much more likely to look dull and sagging on a GLP-1, even with minimal weight loss. And so this is the reason why I actually developed a product that is designed to reverse some of this. and we just finished our clinicals. And when I say you're going to be blown away by this, that is an understatement. And I do believe based on what we saw in our study, it's a six week, it was a placebo controlled, meaning one side of the face had placebo that looked and felt like the active product.

47:34The results were staggering in terms of the subjects, their reported benefit, They all chose the active side. Everybody was blinded to which side was which. And everybody chose, and it was obvious, the dramatic benefit of the active product. So I've been excited about a lot of things professionally. I am beyond excited about this product coming out. And I think it's going to revolutionize the way we look at this issue. Like you would look at some of these pictures and you would say, this person, the only way this happened is they had a laser.

48:09Danielle:So usually skincare clinicals have, like I see a before and after and it's better, but it is sort of like a limited difference. This has a more dramatic before and after? It is beyond dramatic. What do you use on your face? So I'll tell you my routine. I was plagued by acne. I mean, as a kid. You have no scars. It's a miracle. I had a very strict mom that would not let me pick. but in any case, that was a struggle. And it was a struggle to find skincare. And most of my adolescent life, I spent stripping my skin and over drying it and then dealing with hyperpigmentation. And it was like around and around.

48:51So my products are engineered to be really seen as nutrition for the skin. If I oversimplify it, that's really the way somebody should look at my products. We have engineered them down to the cellular level to be seen as clean food for your skin. So it allows the skin to do what it knows how to do best. I think it's ultimate arrogance to think that we as a human being can figure out a way to do better than what centuries of generations have done to engineer the skin's resiliency. So that's the concept. And so really my skin, what I love using, I actually developed an eye rejuvenating serum with SPF because it's really hard to get sunscreen around the eye.

49:42I mean, I have some pigment in my under eyes, but it is much better since I've started using this product. It also helps with puffiness. It helps with fine lines and wrinkles. So that's one that I use in the morning. I use our tinted mineral sunscreen, especially on my bald head. Number one, it makes it not so shiny, but also doesn't cast a ghost. You can see it's not like ghost or powdery. It's good for all skin tones. You can have the fairest skin or the darkest skin does not matter. The micronized kind of physical sunblock works the way that it needs to. There's no artificial chemicals. So you don't have to worry about chemicals that are, you know, harming the skin are causing other problems, which have been talked about.

50:26And then my favorite product, which is our cheapest product and probably the most underrated or least talked about is our gentle exfoliating cleanser. This has been my savior in preventing breakouts because prior to me coming up with this, I still would occasionally break out. And so I use that as my wash. Then I We have a sheer moisturizer because my skin favors being oily. And it sounds like a lot, but it's honestly, it's five minutes in the morning at night. I'll use our Supreme Oil Serum for my bearded area. And that's it. As I'm closer to 60 than 50, I'm not just somebody who talks about it.

51:08I actually follow it. I live it.

51:11Danielle:Okay. I know I only have a few minutes left with you. So I'm going to do a little rapid fire if you're okay with that. I'm ready. Let's do it.

51:21Danielle:okay what do you wish more people did to take care of their face before ever seeing a surgeon i mean honestly i think it is prevention of sun exposure over beating the skin with sun and then expecting to have an easy solution the second would be just good skin care do you think skin care really matters i do i'm living proof of it you know you do a little bit of skin care it'll carry you in the most dramatic way just morning and night not going overboard if you get to the point where you're spending more than seven minutes on skincare, you've gone too far. I'd say five to seven minutes. I know you're super busy.

51:58I'm crazy busy as well, but I can get five minutes of self-care.

52:03Danielle:Okay. Lasers. Like if someone walks into your office and wants sort of like a fresh face cleanup, what's the laser? I love, love Cytan is the name of the company. They have the best lasers. They're all made in the U.S. They're actually based up north in Northern California. Two brilliant founders. They engineer everything. They have figured things out. So broadband lighter BBL. BBL Heroes, their new product. It's a game changer. Halo laser. You can use it in my skin. You can use it in your skin. An amazing tool with fast recovery. you're talking to somebody who grew up on CO2 laser. People think, oh, that's like such a great treatment.

52:51It's like hitting its fad moment. Now that thing is a blowtorch. You can do so much damage. Again, what's old is new. It's like the buckle fat pad with CO2. You're going to change the nature of the skin if you're not careful. I mean, listen, they're very experienced derms and plastic surgeons that know how to do CO2. But man, that's like driving a car that doesn't have anti-lock brakes. The steering is no good and the tires are bald. And basically in the winter, it's a scary technology. So I think their platform, Moxie, is also one that is amazing. Man, they have come out with hit after hit and you can dial it in or out.

53:34Danielle:That's really nice to hear. I did a really intense laser a few years ago. I forgot what it was called. And I really regret it. First of all, I was in so much pain. I was red for days, but I did it to get rid of some spots on my cheek and they came back like a month later. This is the thing. Like if you look at BBL, there's no real downtime. How often do you do them? So BBL typically, if, and again, this is the caveat, be good with sun protection. It doesn't mean you have to hide from the sun, but be good with using sun protection. Ultimately it can last for two, three years. If somebody is out in the sun and they're maybe not so diligent or religious about sun protection, then you're probably doing it every year.

54:18Danielle:Are there any treatments that actually prevent aging or are we all just chasing collagen dreams over here? No, I think the biggest treatment, and again, where I don't think it gets enough credit is Botox, XMN, Dysport are the number one ways I do it myself. Like I tend to favor a crease here. It would be 10 times deeper if I didn't do Botox to the muscles down here. My analogy is it's like a folding piece of paper. If you're softening or weakening the way that paper folds, the crease is not as deep and you're going to age better for it. I mean, you can see lots of, again, actors, if you're looking at like the forehead, for example, that will give away age.

55:04But also you have to be thoughtful about not over Botoxing. So like I can raise my brow, I can still frown, but it's doing it softer. The goal being you still can move, but you're helping aging.

55:19Danielle:I was just going to say, I really like that you still have movement and signs of your age in your face, but you look so refreshed. You don't have Botox face. If I have Botox face, when you meet me in person, there's something that's gone really wrong. But a lot of people, like you said, in your industry, I went to a dermatologist and his skin looks like glass and his hair was so perfectly quapped. That actually is a secret for, and this is probably an important cautionary tale. If you're going to a dermatologist or plastic surgeon and they don't look the way in terms of the way you would want to look philosophically, you probably don't want them to be the one doing your treatment.

56:01If they look way overdone and that's not in line, unless they're going to tell you, yeah, I'm overdone and man, I got carried away with that filler. I wish I didn't do it. Then you need to really think about it.

56:15Danielle:What's a sign of aging that you admire? I have seen some of the most extraordinarily beautiful women who have salt and pepper hair. I think it's one of the most interesting subtleties that you can see. There are women who I think look better in that light than they did when they had their natural dark pigment in their hair, that is. I also think another thing that actually looks really interesting with age in particular, we can say for women, is when there is just a little bit of loss of volume in the cheek area, a subtle amount. I think that can be really sexy. And it shows that they may be in an older age bracket, but at the same time, they still look good.

57:02The one last thing is not erasing all wrinkles. I think that's the last thing I would say.

57:09Danielle:Thank you for sharing those. I was thinking, as you said, the cheek thing, I was thinking of Demi Moore because she has that and she's still so beautiful and sexy. Okay. Your future face. What's one procedure I'm going to go through the generations or through the decades, I should say one procedure you can think about in your twenties, if you're going to do anything? In your 20s, it's Botox. How about your 30s? 30s, it's going to be laser consideration and strategic Botox still possible super conservative filler. 40s. 40s, you're going to be looking at the things to non-surgically lift, thread lifting, energy-based technologies like Softwave or Althera just came out with Althera Prime, You know, there are a variety of radiofrequency devices that non-surgically lift.

58:01Goal being easier to treat something early than waiting for a tall breakdown. 50s. 50s, you get into the striking zone of thinking about surgery.

58:11Danielle:Are 50s or are 60s the facelift years? 50s and 60s are ripe facelift territory because the techniques are much easier for recovery and downtime, but also you get this incredible ability to look really good in a way that trying to overdo with fillers will not. People are so afraid of surgery to the point where they're willing to overdo a non-surgical treatment that's worse. And then 70s and 80s, does that get to a point where it's a little bit scarier to go under or no? No, I just had a series of patients in their 70s, late 70s included, that have done little strategic nip and tucks. Again, goal not being to completely erase, but just to nudge.

59:03And that's typically an easier procedure to get through. It has lesser downtime, and it can be a really nice adjunct. Plus, if somebody's in their 70s, they scar beautifully. Like they won't scar. You don't have to worry about a scar. If somebody's 70, you have to really be out of bounds to cause a scar.

59:23Danielle:Why is that? This is part of the way the keratinocytes and the cells in the dermis actually behave. They're not as robust in their activity. So that's good news, bad news. Bad news is you're going to be more likely to see wrinkled skin. Good news is you're going to scar much better. What's a book that you've read that you think everybody should read? I think everybody should read essentialism. And what's one thing that everybody should try one time? Sushi. Dr. Few, I respect you so much. I really like you. You're so fun to talk to. Thank you for sharing so much of your time with me. It is an absolute pleasure, Danielle.

1:00:04And I feel the same, especially having been out in LA as long as you have, you've kept your feet on the ground. So it's been a lot of fun to get to know you.

1:00:12Danielle:That's really kind. I'm still a Chicago girl at heart. I love it. That's a gift.

1:00:20Danielle:Okay. You know what time it is. Today's a good day to have a good day. I'll see you next week.

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1:01:12Danielle:Okay, here's the thing. Life doesn't exactly slow down, and neither do I. Between work and travel and podcasting and everything else on my calendar, I need clothes that can keep up. That's why I'm all about cotton. It's natural, breathable, soft, and doesn't shed microplastics when washed. Plant, not plastic. So whether it's a perfectly worn-in t-shirt, elevated loungewear, or the cozy cotton PJs that you'd prefer to wear all day long, cotton always delivers. It's comfortable, makes getting dressed easy, and then it somehow always looks good. Cotton, the fabric of our lives. Shortly after I enrolled at Rasmussen, I was diagnosed with breast cancer.

1:01:49Danielle:It was like a bomb had just been dropped in my life. I reached out to Rasmussen. They immediately were like, Rosa, take what time you need. You can come back when you're ready. We are cancer-free today, and I'm just so grateful for Rasmussen, for all of their support throughout my journey, and for my own village. Rasmussen University. Find your seat and start now at rasmussen.edu. 250 years ago, America made a promise of life, liberty, and the pursuit of happiness. Since 1903, Harley-Davidson has been living it, out on the open road, at the next exit ramp, with old friends, new ones, and the next generation of riders.

1:02:32Danielle:Because the best part of any promise is keeping it. Harley-Davidson Motorcycles. Ride.

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From the publisher

What if the secret to great plastic surgery… is knowing when not to do it? In this episode, Danielle chats with world-renowned holistic plastic surgeon Dr. Julius Few, whose philosophy LESS IS MORE has quietly shaped some of the most famous (and untraceably beautiful) faces in Hollywood. With over 30 years of experience, groundbreaking surgical innovations, and a skincare line backed by clinical trials, Dr. Few isn't just changing faces, he's changing the conversation. From his pioneering "85% Rule" to his thoughts on "GLP-1 face," Botox addiction, and the illusion of perfection, Dr. Few shares the questions he asks before ever picking up a scalpel and why the most powerful tool in his office might be the word NO. This episode goes way beyond aesthetics; into identity, restraint, aging, and what it really means to enhance your natural beauty.

Dr. Few shares:

  • Why the best plastic surgery is invisible
  • The difference between looking "done" and looking refreshed
  • What not to do if you want to age gracefully
  • Why filler might be aging you faster and what to do instead
  • His unexpected take on facelifts (and how they've changed) and when is the best time to get one.
  • Why he turns away patients weekly + how they often come back to thank him
  • The truth about "distortion vortex" and the addictive cycle of overdoing it
  • The most underrated skincare step and the one product he swears by
  • The procedure he invented that changed eye surgery forever
  • What GLP-1s are doing to your skin and the skincare he created to help
  • And why he believes imperfection is the point

Follow Dr. Few on Instagram @Dr.Few

Book recommendation: Essentialism by Greg McKeown.

Explore his skincare line + learn more about his work: www.fewinstitute.com

Andrea is a Career Transition Coach dedicated to helping high-achieving women cultivate healthy, fulfilling relationships with their careers. Check out her free guide Reclaim Your Next Chapter + get in touch with her on her Website!

See omnystudio.com/listener for privacy information.

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Hollywood's Best Kept Secret Behind the Most Natural Faces: Holistic Plastic Surgeon Dr. FewQUESTION EVERYTHING · 58 min
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