In short
The Goop Podcast
Episode Title
The Beauty Broker's Guide to Facelifts, Fillers, and Finding Balance Episode Description In this episode, Gwyneth Paltrow engages in a conversation with Melinda Farina, known as The Beauty Broker, a pioneer in aesthetic consulting. They discuss plastic surgery, beauty trends, the psychology behind aesthetic transformations, and the balance between self-acceptance and cosmetic enhancements.
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Key Points and Takeaways
Introduction
- Gwyneth emphasizes the importance of what individuals put on and within their bodies, including bedding for healthy sleep.
- Melinda Farina's background: began her journey in a dentist's office at 13, cultivated her knowledge in cosmetic procedures, and became a plastic surgery consultant.
Melinda's Journey
- Started in cosmetic dentistry and transitioned to plastic surgery consulting after realizing she couldn’t pursue dentistry due to scoliosis.
- Her consultancy approach is agnostic; she does not take financial incentives from doctors she refers clients to.
Individualized Consultations
- Melinda emphasizes the importance of personalized consultations, selecting surgeons based on individual needs and specific facial features.
- She analyzes cases for the best match between clients and surgeons, believing in a customized approach rather than a one-size-fits-all method.
The Psychology of Aesthetics
- The discussion touches on the fascination with beauty and transformations, likening modern cosmetic surgery to ancient practices of beautification.
- Melinda discusses the societal pressures for beauty and self-image, addressing how social media influences perceptions and unrealistic beauty standards.
Ethical Considerations in Plastic Surgery
- Melinda faces ethical dilemmas in her practice, often needing to advise clients against unnecessary procedures.
- She believes in advocating for patient safety, pushing back against the prevalent 'more is more' mentality in cosmetic procedures.
Trends in Plastic Surgery
- The rise of certain beauty standards, such as the popularity of fuller lips and body enhancements (e.g., Brazilian Butt Lifts), and the shift towards "refreshers" over "changers."
- Discusses the evolution of facelift techniques, leading to more natural results and less noticeable scars.
Non-Surgical Procedures
- Melinda lists non-surgical treatments like lasers as effective options, emphasizing the importance of a good practitioner.
- She recommends regular skincare routines, facials, and maintaining a healthy lifestyle as foundational to looking and feeling good.
Costs of Procedures
- Cost ranges for facelifts: $15,000 to $750,000, with the average around $40,000 to $150,000.
- Costs for other procedures can also vary widely, indicating a market driven by demand and varying standards of care.
Aging and Acceptance
- The conversation highlights the challenge of accepting aging and the societal stigma around seeking cosmetic surgery.
- Melinda advocates for individuals to embrace their decisions regarding cosmetic procedures, emphasizing personal agency.
Conclusion
- The episode wraps up with a strong reiteration of the importance of self-acceptance and the need for individuals to make informed decisions about their bodies.
- Listeners are encouraged to explore Melinda's work via her Instagram, @TheBeautyBroker.
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Final Thoughts This episode of The Goop Podcast provides a comprehensive look into the world of plastic surgery, emphasizing the psychological, ethical, and personal aspects of aesthetic enhancement. It encourages a thoughtful approach to beauty and self-care, blending the realities of modern beauty standards with individual narratives of self-acceptance.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Transcript
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1:12When you are pioneering anything or introducing new ideas to the culture, you get criticized. You do? Yeah. Did you hear about that? I didn't find the one. I found someone I respected and we made it the one. In a sort of longing kind of view of love, people understand each other as if by magic. Nothing in itself is addictive, on the one hand. And on the other hand, everything could be addictive if there's an emptiness in that person that needs to be filled. I now know that nobody changes until they change their energy. And when you change your energy, you change your life. I'm Gwyneth Paltrow.
1:48This is the Goop Podcast. bringing together thought leaders, culture changers, creatives, founders, and CEOs, scientists, doctors, healers, and seekers. Here to start conversations, because simply asking questions and listening has the power to change the way we see the world. Here we go. Hi, this is Kelsey from Goop. In today's episode, Gwyneth sits down with Melinda Farina, also known as The Beauty Broker. Melinda is the go-to plastic surgery consultant, helping people navigate the often daunting world of aesthetics with honesty and precision. They cover everything from facelifts and lasers to non-surgical trends, ethical dilemmas, and how beauty choices shape how we feel about ourselves.
2:35Thanks for tuning in.
2:39Hi. I'm so happy to have you on the Goop podcast. I'm so happy to be here. Thanks for having me. I've been wanting to have you for quite some time, and I'm so glad that it finally worked out because I'm so fascinated not only by what you do, but what you've been able to build. So you have this incredible consultancy, plastic surgery consultancy, and people from all over the world come to you for your advice. And I think you have this very agnostic advice, right? Whenever I refer you to people, you know, they're like, does the doctors, you know, like give her money to refer? I'm like, absolutely not.
3:17She's completely agnostic. That's correct. And I want to ask you all about that, but I guess it would be great for the audience to understand how you got into this because until I met you, I didn't even know that this was a profession. And I know you started when you were young in a, like 13 in a dentist's office? 13. Yeah. When I was 13, my mother walked me into a friend of the family who was a dentist and she's like, my daughter needs a job. And I love dentistry. And since I was eight years old, I wanted to be a dentist. So it was a dream to work in a dental office. And she happened to be very close friends with a very good cosmetic dentist.
3:57And so that's where I started. I started in a great office. So I started with really great training and I was just filing charts at that office, really not knowing exactly where life was going to take me. But every year from that point forward, I was just expanding my knowledge in cosmetic dentistry and plastic surgery and dermatology because we were surrounded by other professionals in the aesthetic industry. And you would ask them questions or? Oh, I was the most inquisitive child. I constantly went to work and would just like to kind of pop in and watch what the doctors were doing, what the dentists were doing, the transformations, ask a lot of questions about, you know, the different treatment plans and why they were doing things.
4:40I probably was annoying for them at that point. But they embraced it and they knew that it was a career path that I was very serious about taking. So they became my mentors. From that point forward, I ended up going to NYU and I was set to be in dental school and really excited about it But then when we started doing clinical rotations, I found that every single day I was in a lot of pain I'm like, oh no, what's going on with my back? And I started going to a chiropractor who told me I had really a really severe case of scoliosis And that it would probably compromise my ability to be a dentist in my career and that I probably have a career of pain.
5:20So I really had to reconsider my career path at that point. And I started doing dental hygiene. I got my dental hygiene license at the very least. And at that point, I decided now I can't become a dentist. So what am I going to do? And it was really kind of like a coming of truth moment for me. What do I do? This is what I always had planned for myself. And now what? At that point, I was working with Dr. Larry Rosenthal in New York City. And he's like, you just are great. And what kind of doctor was he? He's a cosmetic dentist too. He's like, you're great with patients. They love you. You should go into consulting.
5:56If you want to stay in the industry, you should go into consulting. You're still going to be working with the doctors. You'll still be working with patients, but at like a different capacity. So I like the idea. I changed direction in education, in organizational psychology, ended up going to Columbia and then decided to start this consultancy when I was 21 years old. So we started in cosmetic dentistry and then I started spending more time with plastic surgeons and dermatologists and going to their offices, watching the procedures, going into the ORs. And these were all friends of Larry Rosenthal.
6:33So he was able to open up all of these doors for me and get me into the ORs and say, hey, this is Melinda. She's wonderful. She's this like young, bright young woman who wants to be a consultant in our industry. you know, have her come in. She wants to learn as much as she can about these procedures. And yes. So I learned by watching the surgeries and it was amazing. I was like so intrigued by the doctors and how everyone did something a little bit differently, even though they were doing the same procedures, they would do it differently. And so I'm like, what, you know, and that, that would really kind of translate into the outcome of what those procedures would look like and what that result would look like.
7:14And so, you know, watching these techniques and these applied techniques and seeing how they translated into the result or the potential result and how each case was a little bit different, each case presented with another need that needed a different technique. And, you know, you start to kind of develop an understanding of who does what really well, and then just fine-tuning that understanding over many, many, many years, you know, and decades that it's been now. Well, I think what's interesting with you as well is that you seem to never recommend the same surgeon or surgeons to anybody. Right.
7:53I know you all compare notes as well. Yeah. I mean, and it's whenever anybody wants to do anything, I suggest that they call you. And it really seems to me that it's hyper individualized because you'll say, you know, your cheekbones are angled like this. so you should go to this doctor or you have a skin issue. So you need that doctor. Like you seem to go down to this micro level of hyper-specificity for someone's particular face or body issue and then prescribe the surgeon. So how is that typical? Like how did, how did you figure that out? Yeah, it is typical. And you know, it didn't come to me right away.
8:33It came to me as I was watching doctors do certain cases and some cases would come out better than others. And I would think to myself, why? Why did the thin-skinned 70-year-old woman come out better than the young, thick-skinned 35-year-old or 40-year-old? And then certain doctors just excel in different case specifications. And once you see the consistency of the quality of the result, you start to understand where that hyper-specificity comes from. And you really start to understand what their niche specialty truly is. And then going and seeing those results and then going into the OR and seeing how they do those procedures and why they're getting the better results for those types of cases, you start to understand why.
9:19These little technical nuances do translate into the result. And it's not just, you know, oh, Melinda's a gatekeeper. You know, she has all these doctors that she likes. I do customize it. I do. It's a matchmaking process. So I really do customize it to the individual. And that's a really important part of what I do. You know, we don't name drop doctors' names on the page for a reason because that would be irresponsible. In my opinion, that's irresponsible to do. Yeah. Because it's not just like, oh, look at this result. It's amazing. I want to go to that doctor, which a lot of people would do.
9:51A lot of the laymen are like, that's a great result. But if you compare the case and you look at the before and the pre-op photo, it looks nothing like that person's case. So that's really not the right surgeon for you to see. And maybe surgeons can make an argument like, oh, she's completely wrong. I could do every case. Well, no, you can't. Right. And you would know that better than, better than anybody. You can't and you don't. And I've seen it fail and we deal with revisions all the time. And, you know, it really is an individualized process and recommendation. Right. So I want to pull back for just a second and talk about plastic surgery as kind of an industry and a fascination.
10:31You know, I think there's something just so inherently fascinating and exhilarating about this sort of Cinderella story that people can have, right? I mean, this is for centuries, we've had this fascination with makeovers, right? Even starting, you know, with makeup and jewelry and Cleopatra's time, like people have always human beings, you know, it's for many, many centuries have, have wanted to do things to improve their appearance. So it seems like this is something that's like deep, really endemic. Like we have this, and you know, it's like everybody's favorite scene in, in pretty woman is, you know, the makeover or like we have this, what do you think, you know, having a degree in psychology, like, what is that?
11:23Where does that start? Because I think the whole industry comes from that very deep desire or fascination. Right. I mean, it's the same fascination of why, you know, all of these photography sites and platforms like Instagram and, you know, the camera phones and the filters and everything has become such a fascination for people. because I think, and again, it's like we are our own worst enemies. That's very true. I think that people want to always look better and feel better. And it's this constant, you know, striving to look our best, feel our best. And so when we see it in the movies, we're like, wow, look at that.
12:06Look at that transformation. It's unbelievable. I want to feel that way. It's everyone's goal. It truly is. Coming from a psychological standpoint, again, I think that we are all very vulnerable individuals and we're very hard on ourselves and we compare ourselves to other people. I think it's like the whole fascination with celebrity plastic surgery is like, how do these beautiful people get more beautiful? We want to know their secrets. And again, having access to now on social media, all of these plastic surgery pages, and you're able to see these transformations every single day, you're starting to understand like, oh, maybe this is what they're doing.
12:46This is how they're looking so good. And I want that for myself. I want to look like the person on the big screen. I want to look like the supermodel on the cover of the magazine. But you know, you know, as well as I do, there's a lot more that goes into that. There's makeup, there's airbrushing, there's a lot of tweaking with photography and camera tricks and whatnot. Again, I just think people hold themselves to a very unrealistic standard. And this is exactly why I think we're seeing a lot of botched cases too. People just go and they think they could just get a transformation. They don't care about the quality of the surgeon and they go and then the result is not up to their standard or what they wanted or it's really, really bad and they're injured.
13:31Yeah, which is absolutely terrible. It's interesting too because I think on the one hand we hold this idea of potential, right? It's like, wow, I could unlock something and be a version of myself that I've always dreamed of. And it's kind of easier to do it externally than internally, right? It's like a lifelong process to become the best version of yourself internally. Right. And if you hate your nose or something and you get it fixed, it's like this immediate instant gratification of, wow, I can be this version of myself. So I guess I worry a little bit about this idea that people can do a physical kind of skin deep transformation and they're leaving behind the work that would help them really accept who they are.
14:23100%. They always leave behind the work. It's not just, oh, let's get a facelift or rhinoplasty and then I'm okay. You know, this is a, an age old dialogue that someone is having with themselves from childhood, from when you're in elementary school and you're, you see the pretty popular girl getting all of the attention and the boy that you like, likes her, you know, and it's that, you know, coming from a place of rejection and a wound that carries with us no matter, you know, what you think. Oh no, I left that behind in the past. No, you didn't. That affected you in one way or another to feel this insecurity that you're feeling today.
15:02So we don't know. Everyone has a different path in life and we don't know what that path has been, which is why we have to be so sensitive to everybody's situation. And when they do look to get these transformations, be so sensitive and kind to it and try to understand why. So every single client that I deal with every single day, and we talk to about 15 to 17 clients a day, I have to sit there and try to understand where they're coming from and what their goals are and why are these their goals? What place is this coming from?
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16:44Is there ever an ethical dilemma for you? Because I remember when I, this is a long time ago, there was a plastic surgery show called The Swan. Yes. And I knew all the surgeons on that show. So I was living in London at the time and I was obsessed with it. Like it was so incredible to watch the physical transformations of these women. And at the same time, it felt a little bit outside the bounds of, I don't know, I thought it really pushed the kind of the ethical boundary because it was like a complete transformation for entertainment. But believe me, I could not look away. Like I was just - We want to see the transformation.
17:23You want to see the transformation. And I wonder if in your view, like was there an, is there an ethical issue with that? Or in your practice, do you ever bump up against something where you feel like this goes really too far? What this person is asking for either in transformation or number of procedures? Right. I'm very honest with my clients. Sometimes I sit them down and they're, you know, they're my age, they're my peers. And I'm like, well, when is this, when are you going to be happy? When will this stop? I think you look good. So let's have a serious conversation about this right now. There are definitely ethical boundaries that are pushed for sure in this industry, which I think is more important to have an advocate, a patient safety advocate on your side that is not working for the doctors.
18:10Right. The doctors, you have to question ethics sometimes, not all the time. There's a lot of phenomenal surgeons that tell patients, no, not going to do this. I don't think you're ready yet. And even though the patient doesn't want to hear it, I really respect the doctors that say no to a patient rather than the guy who gives you the poo-poo platter treatment plan of like a million different treatments in one sitting. That's so unethical to do. Most people don't need that much. The more is more mentality is rampant in our industry and it's not usually the right approach to take when you're dealing with these types of transformations.
18:46The subtlety is key and less is more approach is always the approach that I take with my clients, which is why we get these natural, beautiful results for our clients because I'm able to look at that treatment plan and know how that treatment plan is going to translate into an aesthetic result and take my red pad and be like, we're not doing this this time around. We're not doing this this time around. That is an ancillary procedure. We could hold off on that. Let's wait. Let's shelf that for now. Let's do this and this, see how you heal, see how you feel, and then we'll take it from there. And what do you feel about this standard of beauty that's emerged?
19:24You know, there are, when we were chatting the other day, you said you have clients coming in and showing you a picture of a particular person and saying, I want to look exactly like that. Is that an ethical dilemma for you at all? Or I don't know if ethical is the right word, but I'm sure some of these women that come to see you are beautiful in their own ways. And they are asking to be transformed and to look like somebody else. So what is that like for you? Well, there's limitations with every case. Yes, we can get you close to that. We can't get you exactly like that. But why? You look great.
20:02I mean, I think everyone comes to me and as a plastic surgery consultant, it's amazing to see how people are shocked when I'm like, you don't need this. No. I tell them no all the time. They think I'm peddling plastic surgery over here and usually I'm trying to talk them out of it most of the time. You're beautiful. You don't need it. And then they go onto these platforms and they're like, Melinda's the worst consultant there is that exists on the planet. she said no to me. That makes me feel good at the end of the day, though. I'd rather be known for the girl who says no than the one who says yes when you don't need it.
20:35Or, you know, that you look back when you're older in life and these young girls are looking back at the consultant they work with and regretting everything on their face and body. I'd rather be known for that woman who said, no, you're beautiful. Be grateful and appreciative for what you have. There are certain aesthetic standards that certain celebrities are, you know, setting these expectations that are super unrealistic. That area is really big into like, you know, extreme liposuction, the BBLs, the filler, the lips, the big high cheekbones and the thick eyebrows. Like they have a certain look they're trying to achieve and everyone's looking like a clone of one another.
21:19I wonder what then happens if everybody looks the same, if the Overton window of beauty standards like shifts because, you know. Right. Well, depending on whoever they're, you know, striving to look like, if they're changing their aesthetic, then the trend kind of shifts in the opposite direction, which we've been seeing over the past couple of years now. what used to be more the small waist, the big booty, the large breast, a lot of filler in the face. Everyone's undoing their fillers, undoing the BBLs, taking their implants out. So smaller, thinner, a more trim and lean and toned body is more the aesthetic these days than the more extreme look.
22:02And it's hard to undo a lot of these things once they've been done. Let's discuss. So like a BBL, what is that exactly? A BBL is a Brazilian butt lift. BBL could also stand for broadband light. So a lot of people get those two confused. There's a laser called BBL. There's a surgical procedure called a BBL, which is a Brazilian butt lift. And what happens in a Brazilian butt lift? So Brazilian butt lift, they usually do liposuction throughout the entire body to harvest fat. and then they add it to, or they graft it to the buttock area to make it larger and enhance the buttock area, make it more curvy.
22:38They usually add a little to the hip area. They add to the butt area and they're taking from the waist. They're taking from the arms. They're taking from the thighs. So they have enough to graft. And usually when you do a BBL, you have to over graft first because most of it is metabolized with the body. The body will metabolize about like 50 % of the fat that is placed. So you have to take enough and place enough in order to get a significant result. Is it, I mean, it sounds like a very big procedure. It's a big procedure. It's a risky procedure. How so? You know, if done the wrong way and then if they, if it's placed the wrong way, if you're not going to a board certified plastic surgeon who knows what they're doing, patients have died from these procedures, pulmonary embolisms.
23:23Yeah. Terrible. Oh my gosh. so it's a it's a risky one you have to be careful okay oh i have so many questions this is so fascinating so just going back for one second so in your mind are there sort of two camps like people who want to look like themselves exact like they did 20 years ago or whatever right they don't want to fundamentally change their appearance and people who want like a complete transformation. Would you say, is that an overgeneralization? Nope. There's the refreshers and there's the changers. So I put them into two camps. Okay. Okay. And are there kind of trends? We talked about the trends and the changers.
24:05Are there trends in the refreshers? I mean, it seems to me like back in the day of my mom's era, you could really see a facelift. Like you could really tell that someone had had one. And now it seems for the refresh in the refresher category. And now they are pretty hard to detect. They are. So what, what has been the change in technique? The techniques have been practiced over and over and over again. And, you know, God bless these surgeons who are able to go to these meetings and teach these new improved techniques to their peers, because it's come a long way. You know, the facelift used to just be a very like make an incision straight in front of the ear.
24:49You dissect a little under this mass and you pull in the skin in one direction and close it up. And that was a facelift back in the day. Now they've extended into the deeper planes and we extended more into the deeper planes of the neck and we could get a more comprehensive facelift that looks more natural because it's moving all in one vector. It's all in one plane. We're pulling it in a more natural direction rather than kind of, you know, outwards, now everything's kind of going upwards. And they're able to extend incisions so that we don't have any buckling or pleating on the face. So it just looks more natural.
25:23I think over time, doctors have, you know, it's kind of like trial and error. You try something, you see where it could be improved, you try a little bit more. Not to say that patients are science experiments, but every single day we're learning something new about what makes these procedures safer, more natural, more imperceptible, you know, certain sutures to close these incisions, how one makes a difference more than the other, you know, that certain tension, if you put too much tension on those incisions, you're going to get horrible white scarring around your ears. So we can't do that. So, you know, again, less tension.
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26:00And with trial and error, they're learning more and more and more. But it's great that we have these meetings and the continued education and it's constant. It's constant. You know, while you guys are looking at things on Instagram, a lot of these doctors, you know, every couple of weeks are traveling all around the world to teach their peers new techniques or learn new techniques. And they're doing live surgeries where thousands of surgeons are watching and observing and they're talking about it and they're having an open dialogue as to why they're doing certain things on these cases and why they're using certain sutures and why they stopped using this and why they started using that.
26:36So, you know, it's constantly evolving. Doctors are constantly learning. I think they're constantly trying to improve the experience, the techniques. Now they're trying to kind of move more towards scarless and endoscopic. I'm not the biggest fan of that yet. I've had multiple conversations with multiple surgeons about it. They're working on it. They're trying to make it a better procedure. I like to give things five to seven years before I even start sending my clients in that direction. How does a doctor get on your radar? Right. That's a very good question. So I do attend a lot of these meetings.
27:12So I look to see who's teaching the techniques. I look to see who's writing the journal entries. And I look to see who my mentors are impressed by. So we have an advisory board of key opinion leaders, some doctors who are actually retired at this point. So we have doctors that I have admired for many, many years that I asked to be on our advisory board. When we go to our advisory board, we go to them with complicated cases. We bounce questions off of them. And we're also asking them, like, who have you seen who's really good up-and-coming surgeons in the industry? And they usually tell me a list of names that they've been keeping an eye on or that they noticed, you know, they are friends or mentoring or who's doing a fellowship with who and who's a rising star.
27:57So I like to keep my eye on them from their fellowship or even their residency. And how do you take it to the next step? Do you go on their websites and look at before and after? No, I usually reach out and we start having a conversation. And then usually from that point forward, five years later, I'll start working with them. It takes a long time. I like to watch their work. I like to take my time. Again, because we don't work for the doctor, I'm able to do that. I like to watch what they're doing and let them practice and let them get a lot of cases under their wings. And then we sit and we look at those cases together.
28:29Do you get inundated by doctors wanting to be on your roster? Yeah. I bet. Yeah. So we get a lot, a lot of emails from doctors. How do we work with you? I'm like, you don't. I'll reach out when I think that you're right for the network. It's a little obnoxious, I think, of me. But I'm very picky about the surgeons who we work with and who we bring on. I'm really particular about the techniques I like to see. I'm particular about the results, obviously. I'm only the consultant. So for me, I have to make a spot on recommendation from my client and get them a beautiful result. It better be meticulous.
29:08And again, if I'm sending you a client, if I'm sending you a case, the only way you're going to get another case from me is if that first case that I send you is perfect. Yeah. And as long as you keep giving me a good result, you'll keep getting cases from me. Does anyone ever get kicked off your list? All the time. Ooh. And what does it take to get excommunicated? All the time, excommunicated. You know, perhaps the experience that my client had wasn't perfect or there's something. There's something in the incision that I'm like not 100 % happy about or, you know, something starts to fall after a year and they go back to the doctor and they have a conversation with a doctor and the doctor's like, sure, I'll do it again, but it's another$150 ,000 out.
29:51Right. Out. That's not okay. Right. You know, again, there has to be some warranty, especially if a patient is paying a lot of money for that procedure. Or, you know, if we start seeing revision cases coming in, new revision cases coming in from surgeons who we are working with. Right. Then I'm like, oh, something's going on. Right. You know, I always say that doctors have rollercoaster ride careers and it's true. Burnout is rampant in our industry. So a doctor really needs to pace himself, only do a certain amount of cases per week because these cases are taxing on surgeons. And I don't care what the doctor says.
30:28I'm the fastest there is in this industry. I could do the most. I've done the most more than any other surgeon. Sure, you've done the most, but 50 % of those cases are really sloppy. I'm not impressed. And I always say speed is great for race car drivers to boast about, not plastic surgeons. I'd rather my surgeons take their time in the OR and be precise and meticulous and make sure that every single suture that goes in is placed by the surgeon, not their fellow, and that they're paying attention to all of the details. You know, one of my mentors, Dr. Hidalgo, always said that the plastic surgery, it's a one-time experience for the doctor, but it's a lifetime experience for the patient.
31:10So every single case you walk into, you have to give it your all. And he's meticulous and he's an artist and I love him. And I mean, he was the first surgeon I ever really wanted to be mentored by because I just always recognize what an artist he was. Wow. And he puts his all into every single case. Wow. Amazing.
31:35let's discuss because you said 150 000 for a revision or whatever what are we talking about here price wise yeah and you know some people really want to get something done and are told like you know it's 175 000 these are astronomical astronomical prices absolutely so what is the kind of banned? Can someone get a good facelift? What is the least expensive price? And what should, for a really excellent surgeon, what should somebody be anticipating? Just take me through it. Right. I mean, the range is ridiculous. It starts at$25 ,000, sometimes$15 ,000. I haven't seen that price in a while, though.
32:16For a facelift, we're saying. Yes, for a facelift. Let's just use that because that's kind of like everyone talks about facelifts all the time. How much is a BBL, by the way. Not that I'm getting one. Those range too. So they can range from like 12 ,000 to 70 ,000. Okay. So we've seen that range as kind of normal. Okay. So going back to the facelift, 25, you're saying probably 25 is the - About 25 starting point. And I've seen them go up to 750 ,000. What? Yes. What are you even saying? That's insane. I know. It's so insane. Why? How? what? Explain. There's one surgeon in LA and he used to charge, it started at$250 ,000 and that is what started these crazy prices.
33:01But why aren't we charging that? We do better work than him. Wow. So then you started seeing the prices, the ticker started going up. And then when he noticed that the ticker was going up, he raised his prices to$500 ,000. This is like a house. I'm sorry, That is insane. It's insane. It's insane. But it's not. It's funny when you talk to these surgeons who are charging this amount. It is completely normal. It's normal. It's bizarre. Wow. It's bizarre. I'm sorry. It's gotten so out of control. And I could say that I've been in this industry for so long. When I started in this industry, a facelift was$12 ,000.
33:41And that was a normal fee. And then even when I started my consultancy and I started really working with the greats, 40 ,000 was a huge stretch. I couldn't believe my eyes when I would see that price tag on a facelift 40 ,000. And now average is what you would say? Average is about 40 to 50 ,000. And I would say, you know, with the more popularized surgeons, you're seeing a hundred, 150 ,000, which is a very normal price to see for a facelift these days. It's insane. I feel bad for people. This is why I like to do what I do because I'm constantly fishing for talent that is affordable. Right. You know, and there are surgeons that no one even heard of before who are just fantastic that are charging normal prices.
34:28Wow. That's really astonishing. But I think what's even like the most astonishing part about that is that they're just meeting demand, right? People will pay that. Like the idea that someone would pay this doctor you mentioned in LA. Right. Someone's paying that, right? Right. I mean, I've had a client go to that doctor in LA and she wanted to see him. And she came back to me,$750 ,000, Melinda. I almost fell through my seat. I said, let me talk to him and get back to you. And then I got that price down to$200 ,000. So again, from$750 ,000 to$200 ,000 is a huge jump. All of it's negotiable. Right.
35:12Nothing is set in stone. So do you recommend that people do that, for example? I'm able, I think I have a certain vantage point in this industry where I have a relationship with these surgeons that I am able to get these fees down because I send them so many cases. So usually I'll go to them and make the argument, hey, I just sent you 10 cases where I didn't ask for any type of a discount on this case. Like, you know, chuck me a bone here. Right. My client really wants to do the case with you and we usually are able to make it happen for them. That's amazing. I think we, especially women in the industry, and this is probably like a whole other podcast, but, and I've talked about this a lot just with aging.
35:53You know, it is when you're sort of known as a quote, beautiful woman when you're young and you sort of make your living off of that. It's terrifying to come to the precipice where people are judging you for looking older. It's like you see online some women who are aging naturally and, you know, the comments on Instagram. It's horrendous. It's horrendous. And so, you know, it's like where do you find the balance between, you know, obviously for myself I do whatever I can holistically and with exercise and food and limiting alcohol. All that stuff really does impact. I love everything you do. Listen, I've been a big fan of Goop forever.
36:34Thank you. Even though everyone's like, what's Gwyneth up to now? What is she looking into now? And I'm like, I love everything she's looking into. She's brilliant. Everyone wants alternative options to looking their best and feeling their best. No one wants to do plastic surgery. So if you could try something so, you know, out in left field that no one has ever really, you know, dove into before, why not? Why not? Why not? And there are a lot of things too that, so let's talk about non-surgical interventions too, because I know, because you recommend certain lasers, for example. I'm a big fan of lasers.
37:07You're not a fan of threads. I'm not a fan of threads. I don't love them. I think they don't age well. You know, I think about, it's not just what we do now. And sure, a thread, if you place a thread, it's going to give you a temporary facelift, of course. You're putting something in there that has serrated edges on it, and it's pulling the skin in one direction. The second you start yawning, chewing, smiling, speaking, living, that thread is going to kind of lose its strength. And now you're just stuck with striated scar tissue under the surface. And over time, if you put in, say, like 10, 12 threads in your face, you're going to have this striated scar tissue.
37:49As we lose collagen and laxity as we get older, you will see discrepancies throughout the face that don't really look very natural. And we've seen this occur multiple times over. So I always think, I'm not thinking for you now. Of course I think for you now, but I'm thinking for you 10 years or 15 years later, how is this going to age? What is this going to do for my client? Is this really worth it? Does the risk outweigh the benefit or does the benefit outweigh the risk, you know. So I'm constantly looking at procedures, wondering how they're going to age, like filler. I've always said filler can't be a good thing.
38:25You're putting this like thick jelly in the face. Is the body really breaking it down? And so lo and behold, no, we found out that it stays in the face for upwards 20 years. And women are doing a syringe in their face every six months. And then I have women who come to me after 15 years, every six months putting a syringe. I'm like, you have 60 syringes, you have over 60 syringes of filler in your face. And is it dissolvable? Most of it. There are, you know, different types of filler materials that are very, very difficult to dissolve and they really disrupt the lymphatic flow in the face too.
38:59So you now have a lot of fluid retention and stagnant length in the face. Oh, is that part of why it gets puffy? That's why a lot of people get super puffy. Also because hyaluronic acid just loves to be surrounded by fluid. So it likes to hold on to as much fluid as possible. No one wants a puffy face. Everyone sits there and they have their ice rollers or like the ice mask and you're trying to de-puff, but at the same time you're putting loads and loads of hyaluronic acid in your face. It's like catch 22 here. And what about lasers? What are the lasers that we should be looking into? So there's two camps.
39:33I'm afraid of lasers. I don't know. Why? Tell me about that. I know. Because one time I got Fraxel on my chest for my sun damage. This is like probably 12 years ago. And it didn't work at all. It was so painful. I got an infection. Oh, no. Well, there's different lasers, diode lasers, vascular lasers that serve different purposes. So sometimes it's a matter of trying different things to see what really works for you. Can you damage yourself from lasers? Some people can get hyperpigmentation or hypopigmentation or get third degree burns from it. But you have to go to a great board certified dermatologist that really specializes in lasers.
40:16So I tend to lean towards the dermatologists that have every option available. Like I'll just use, for example, and you could put this. And Dr. Roy Geronimus in New York City, I just think is a fantastic dermatologist. He has literally every laser known to man at his practice. I also refer a lot to Barry DiBernardo in New Jersey, who also has every laser available, known to man, available at his practice. He has different floors with different lasers, different rooms with different lasers that address different issues. Oh, wow. He's brilliant. He also runs all the trial studies on all of the lasers, works with all of the laser companies, and he's doing the trial study.
40:56He actually is the practice that provides the befores and afters for the laser companies because he's doing the trial studies. Oh, that's so interesting. So you want to go to the educators and the doctors who train other doctors on this technology. Hard to find. The average person wouldn't know that. And then you want to go to somebody who's known for that specific issue. When I showed up at my dermatologist office with melasma, I had a really bad case of melasma. I used to abuse my skin when I was younger, my 20s. Me too. Bake and bake and bake on the beach. And I would just, everyone would come up to me like, what are you using?
41:33Your tan is so amazing, Melinda. I was so proud of it. I wore it like a trophy. And then of course, you know, into my 40s, I'm like, great. I have like this mask of darkness coming around my face, bad melasma. I showed up at Ellen Marmer's practice in New York and I'm like, we've got to do something. I'm a disaster. I do this for a living. I'm a mess. I need to start taking care of myself. And she's like, I want to see you every seven days at my office. And every seven days I would go and she'd try BBL, which is broadband light, isolated IPL on the darker pigmented areas. We did a Jesner peel, which is a chemical peel.
42:12And then I would go back seven. And for two months, I walked around with scabs all over my face and things were coming to surface and then sloughing off in the shower. But every time I would go, it would get a little bit more clear, a little bit more clear until it was gone. So I tell everybody, sometimes you go for one round of laser and that's not going to be good enough. You have to go until it's gone, which is what most people don't realize about lasers. But you have to be a good candidate for the type of lasers that they're using. So you could go and do like a test patch kind of thing? You should always test your skins.
42:45They should always do a patch test to see if you hyperpigment and how you respond to the laser. There's also hybrid lasers like Halo by Cytan, which is a non-heat-omitting laser that is good for every skin type. The darker the skin, the more prone to hyperpigmentation. But with these hybrid non-heat-omitting lasers, it's a little bit safer for every skin type. And what would you get that for, for example? We should try a Halo on you. I feel like Halo might be the way to go for you. Really? Great. Because if you had an issue with Fraxel, it could have been too hot for your skin. Maybe. Yeah. I would like to try to get some of the sun damage away.
43:21Yeah, for sure. For sure. But we spoke about that before. So I think that one, there's a couple of really good ones on the market now too that are also very kind of like light to start with. I would start you with like a clear and brilliant, something really just easy. Fantastic. I'm a little bit of a wimp. So I think I'm ready for that. Okay, good. For sure.
43:51What are the most popular procedures right now? Like in terms of you've 13 or 15 people a day, is everybody asking for the same thing? Facelifts. I mean, I think I've become really known for facelifts. You know, it's funny because on social media, they don't really allow us to put many body photos up. We get shadow banned for putting befores and afters of body photos. So more people are posting like face procedures in their galleries on social media. I would put, we get tons of bodies too, lots of mommy makeovers. We're seeing because there's been an uptick with semiglutide and the trisipatides and all of these skin laxity, but like body lifting cases.
44:34What? Okay. We have to discuss. What is a body? First of all, what's a mommy makeover exactly? So a mommy makeover is usually a tummy tuck and a breast lift or a breast augmentation. At the same time? At the same time. Okay. Most women come after they've had their babies with diastasis recti that need to be repaired. You know, they have that partition in the muscle on their abdomen and we have to tighten that up and then we have to pull that stretched out skin down. I have to tell you, some women come to me though after four children and they need like the tiniest little bit. I'm like, how? You've had four babies.
45:09Amazing. I'm like, I haven't even had a baby and I think I need a tummy tuck at this point. But it's incredible how some people bounce back. But then there's women who come to us that completely their bodies are wrecked. They've breastfed. Their breasts are deflated. They're like, I can't. So it's like reconstruction. I feel defeated, Melinda. So it is a reconstruction of the torso, of the breasts and the belly. Okay. And what's a body lift? And the body lifts are for the people who lose. Like, have you ever seen The Biggest Loser, that show? I actually have not seen that. I haven't watched that where these people lose hundreds of pounds and then they just have this like skin suit that is just sagging.
45:49So that's usually like a circumferential lipectomy where we do a tummy tuck that continues around the back. Why does it have to go around the back? Because they have all that skin hanging. The butt is sagging. Oh my God, this sounds so painful. I know, I know. It's awful that they've done the work to lose all of this weight or, you know, they found a medication that's working for them and they lose hundreds of pounds. And now they need to do thigh lifts, brachioplasties, their breasts, the belly, the back, and they're cutting off all of the skin. And now you're kind of stuck with all these scars on you.
46:23What are the scars? I saw on your Instagram the other day, you posted a lady who had had like the bat wing. The brachioplasty. Yeah. And so what is the scar from that? So that scar kind of goes from, you know, on the inside here of the elbow, and then it goes up to the armpit. But if done really well with a really meticulous surgeon, you don't really see that scar. So it's not really that, you know, it's not noticeable. You can't really see it. You can't see it from behind. You can't see it if you're looking at the person in front. It's only kind of when they raise their hand. Over time, those scars get more and more, you know, kind of imperceptible.
47:02They turn into like a more skin tone or a white, a fine hairline white line. Right. Right. Can you tattoo them if they're white? You can. If it's white, you can tattoo it. If it's dark and a lot of darker skinned women, you know, will scar darker. So we're always kind of taking a look at scars and we have scar protocols that we put everybody on. You have to kind of guard, guide a scar, how to heal. So usually with our scar protocols that we do for our clients, we take a look at what scars are doing, you know, every single month. And we tell a patient, okay, it's time to go see a dermatologist right now.
47:37Let's do some vascular laser on the scar. It's a little red. And then that will calm down and be a little bit more pink. And we'll use some tranexamic acid serums on it, or we'll use silicone strips. So we'll get them on oral tranexamic acid that helps kind of break up pigmentation internally. God, you have so many tips and tricks. There's all these, you pick all these, after three decades of doing this, you start to talk to these brilliant dermatologists and plastic surgeons. And you're learning, you're gaining so much wisdom and experience and knowledge from all of these incredible surgeons and dermatologists all over the world that now I just feel like an encyclopedia of really, really good tips and tricks and little things that make a difference, especially with, you know, healing from surgery, which could be a pain in the ass.
48:24I mean, usually, I usually tell everybody it will look amazing at two years. the first year you're going to hate the incisions, especially on bodies. Bodies take longer than faces to heal. So now there are so many women who are kind of like mid-50s and older who look incredible. They look like they're 38 years old or whatever. And a lot of them are not public figures. A lot of them are public figures. But is it safe to say that if there's like a 60-year-old woman that looks like she's 40, it's not, you know, Pilates and retinol? Listen, first of all - Or are there some, like, just complete, are there some women who are really able to fully stay off that kind of - You know, that's, and I'm glad you said that.
49:15Like, is it, you know, that they're not doing Pilates or retinol? Listen, nobody, nobody on this planet is exempt from aging. We are all going to age. So if you want to look at the 60 year old and be like, oh my God, she did a facelift. Like you'll be 60 one day too. You know, I tell this to everybody, especially when I see commentary. Oh, she got a facelift. How dare she? It's like, how dare you? The audacity of you for doing something that makes you feel better. Come on. What is this stigma all about? I'm so over it. It's so like, I mean, 10 years ago, like let go of it. People are going to do things to make themselves feel better about themselves no matter what.
49:56And then you have, you know, people again in the public eye who want to age gracefully. And there's no problem with that either. But, you know, unless you walk in that person's shoes and, you know, you've lived that person's life, you can't pass judgment on them for wanting to do something to feel better about themselves, especially if it's done really well. Like God bless them. They found a great surgeon or a consultant who helped them. And they look amazing and good for them. Yeah, I think absolutely. I mean, I believe that every woman in person should have complete agency to make the right decisions for her.
50:30And that's fantastic. It's no one else's place to pass judgment on that person. I think for me, what I think about is that thing of, wow, if I'm not happy with some aspect of myself. Like, why is that? And, you know, what kind of healing internally do I need to do? You know, sometimes I look at these women who don't do anything, you know, they don't, it's like, they've never had a drop of, you know, anything. And, but it's amazing to me that they are so fully embracing of every transition and what's happening. And I think I also envy that, Like I would love like whatever decision I decide to make about my face and body, totally fine.
51:18And that's that is my absolute right to do. Right. But I don't want to make it from a place of lack or I'm unacceptable if I'm aging or if something's falling or something's sagging. I would personally like to, in concert, be able to work on those aspects of myself and truly love those aspects of myself. It's really hard. It's really hard. We're so used to seeing ourselves a certain way. And then when age starts to hit you, it's hard to see those changes, especially when you don't feel like that on the inside. You're feeling one way on the inside and you're looking another way on the outside. I know I, for one, am 45 this year and the grays started coming in.
52:05And I started noticing these platysmal bands popping out. At least you know all the surgeons. You'll probably get a freebie. They're the worst. They're like, oh, Melinda, look at you, that neck. And I will always admit I'm the most self-deprecating human being that there is. I'll always poke fun at myself or use myself as an example in my consultation. So definitely when this starts to get worse, I'm going right to my surgeon and he's doing my face. Who are you going to go to? I'll use Sam Rizk for my face. Yeah. Sam and I have, you know, he was my first surgeon in my network and he's been with me forever.
52:39He always gives a consistent result. I just love him so much. I mean, he, he's fantastic. You know, I'd say he's like a role model surgeon that other doctors should really watch and look at the way he does his surgeries and how he carries the procedure out, but he cares about a good result. He does one surgery a day. He just, he hasn't lost the passion for what he does. That's beautiful. Yeah. And I'm excited for him to do my face. He did my rhinoplasty when I was 19 years old and it was like the best thing I ever did for myself. Wow. This thing was tremendous and it sat in the middle of my face and I hated it.
53:14Well, it's more power to you. Yeah. I'm not ashamed of it.
53:24okay so i guess my my last question would be sort of around what are the things that you do personally or recommend to your clients like non-surgical ways to feel good to look good for vibrancy do you feel like there's a correlation between vibrancy internally and how people look Listen, the pillars of anti-aging and looking your best are getting good sleep, keeping your stress levels low, diet, and exercise. No wonder I look so fucking old. Get out of here, please. So stressed out. Really? We're going to have to work on that. But no, those are the four pillars of anti-aging. So it starts with that.
54:04And every single person I talk to, I ask them about their diet, about their habits. What are you doing for exercise? Are you getting enough sleep? What are your stress levels like at home? all these moms who come in who are just exhausted they're working full-time jobs they have multiple children they're taking care of their husbands they're taking care of their home they have a lot going on some of them are taking care of their parents so those things are taxing and again another reason why we shouldn't pass judgment on people who maybe aren't feeling or looking their best we don't know what's going on at home that's right so again it starts with taking an hour a day to take care of yourself whether it's meditation or taking a nap or just getting an extra hour of sleep in a day.
54:43I always say one facial a month has been, you know, has kept me from - I've got to start doing that. One facial a month. There was like a while where I think five months had passed and I'm like, I haven't gotten a facial and I felt like shit. So I try to get my one facial a month and I do microcurrent with that, a little microdermabrasion, one laser a year, you know, maybe a clear and brilliant or a Fraxel laser or a halo laser just to do a little resurfacing. If you can't do laser at all, a very light chemical peel, have a good facialist on hand, have your dermatologist on hand. You should be seeing your facialist routinely and you should be seeing a dermatologist like twice a year.
55:19Okay. Twice a year. So start with that. And I think that would make a huge difference. And then again, talk to doctors who have a healthy view on aesthetics and don't want to just fill you with hyaluronic acid filler or stuff like that. I really am opposed to that stuff. We've actually proclaimed our whole entire consultancy a filler-free consultancy. Wow. That's super interesting. I just think that volume is not what we should be focusing on. As we age, things fall down and in. And, you know, in order to reverse that, we have to move things up and out. And that's more, you know, the lifting procedures.
55:56So what about like, you know, lip filler is so popular. Right. That's a different story. So, and, and, you know, lip fillers, we don't even consult on anymore. I just did away with all fillers in my consultancy. We really talk about more surgery or lasers and skin procedures that will help, you know, rejuvenate the skin. But yeah, so if you want lip filler, that's totally... Go to someone else. Yeah, go to someone else. I'm not... There's other consultants out there you can talk to about that. Well, this has been the most fascinating and most quickly passing hour I think I've had. It goes so fast.
56:32There's so many things to talk about. I know. Thank you so much for coming on the Goop Podcast. Thanks for having me. I love you. I love you too.
56:43That's all for today's episode of the Goop Podcast. We hope you enjoyed Gwyneth's conversation with Melinda Farina. If you want to learn more about Melinda and her work, you can find her on Instagram at The Beauty Broker. and as always thanks for listening and we'll see you next week this has been a presentation of cadence 13 studios i hope you'll listen follow rate and review all of our episodes which are available for free on apple podcasts spotify odyssey or wherever you get your podcasts
From the publisher
In this episode, Gwyneth sits down with Melinda Farina, better known as the Beauty Broker and a pioneer in aesthetic consulting, about the ins and outs of plastic surgery, modern beauty trends, and the art of aging well. Together, they explore the psychology behind aesthetic transformations, the world’s evolving beauty standards, and the delicate balance between self-acceptance and cosmetic enhancements.
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