Dr Terry Dubrow on Botched, Ozempic And Plastic Surgery “They Put Concrete In Her Face!”

30:39So all you have to do is show up and be a great physician and a good surgeon and be honest and make sure. And I tell them, first thing I tell these reality TV participants is, okay, there are cameras here. Forget the cameras. This is you and me. All right. Doctor, patient, we're family in this. I go, anything you don't like, you tell me, I will stop it. and you don't do anything that you wouldn't normally do if you were in my Beverly Hills office. Okay. So I just lay down the ground. And so I just practice. I'm not influenced in any way, shape, or form by the production. Like on the Swan, they wanted you to push the envelope.

31:22Do more, do more. No, no, no, no. What do you want to do, I would say to the patient. Of course, the showrunners say, do it all. Take more off your lids. Take that no. What about that nose? And did some of them do it? Did some of them go? What would you say the most shocking transformation you saw on the swan? There was one. I didn't do her. There was one who the surgeon referred to as total facial rearrangement, like taking the furniture in your house and just completely rearranging it. so that when she came out and was unveiled, as far as I was concerned, completely unrecognizable to the point where I'm not even sure her kids would know who she was.

32:08Wow. Yeah. So I don't do that, and I would never do that. There was one person on the second season of the Swan that had a nose that wasn't maybe aesthetically as ideal as others might think it should be. Okay. She didn't want her nose done. The producers were very unhappy about that because that was going to be one of her major transformations. And truthfully, had they known she was not going to elect to do her nose, they wouldn't put her on the show. Right. But she was doing a lot of other things. And she says to me, I don't really want to change my ethnicity. I go, don't. And she goes, well, I'm worried.

32:45I go, no, no, no, no, no. I don't care. You're on the show. I'll operate on you. Let's only do the things you want to do. They were a bit upset with me. Yeah. and they wanted to push me to push her. It's like, there's no pushing plastic surgery. This is as serious as a heart attack. So we didn't do her nose. They kicked her off the show, of course. Well, she lost in the transformation competition because she didn't do her nose. And I thought, okay, whatever, man. So I just stick to what I do. Yeah. And that's how I remember, though, after the first season was so controversial that they invited us to go on Dr.

33:20Phil. and I thought it was going to be a grilling by Dr. Phil. But once Dr. Phil met me and talked to me before we went out, he changed everything and he wasn't going to go in attack mode. But I remember when I did Brinoplasty. Brinoplasty came out and I'm watching The View. And the show was done. Three months later, it comes out. I've already forgotten about it. The first episode comes out and I'm watching The View and it's Joy Behar and Barbara Walters, maybe Whoopi and somebody, conservative person. Right. And have you seen this show, Bridalplasty? And I'm watching in my office about to, I mean, my surgery center about to go to the next case.

34:04Joy Behar turns to the camera and goes, and Dr. Dubrow, you should be ashamed of yourself. And I went, oh, oh, oh. And my nurse walks in, she goes, what? I go, oh, oh, this is not good. This is not good.

34:23And literally, ring, the phone rings, and it's the producers, you're going to New York. You're going to be on The View. I go, no, I'm not. And they go, yes, you are. So I thought, well, what am I going to do? Just let them trash me over the next five weeks or eight weeks? So I got on a plane and went to New York. Did you? Oh, my gosh. I have to pull the footage from that. How did that go? So I went up the service elevator. and the producer with you know the day producer with the clipboards looking at me go so do you kind of feel like you're going to uh you know an accurate uh uh you know a trial a trial by fire and I go I don't know should I she think she goes like this well I would and I went oh so what happened was I went into makeup okay and I walk in to do for them to judge me and Joy Behar, Elizabeth Hasselbeck.

35:22Okay, okay, yes. That's the conservative one. That's the conservative one, yes. And Barbara were there. Yes. And I walk in and they go, whoa. And I said, hi guys. And then I just sort of, I had about 20 minutes and they were talking to me and I charmed them. Wow. I charmed them there was a there was a TV show on HBO about vampires and the vampires would glam you yes remember this True Blood True Blood yes that show was on at the time okay I glammed them so when you went out they were so nice to me oh my goodness you know Terry I go yeah I know that's I tell you the fact that you glammed them I glammed them yeah cause Joy is a tough cookie Barbara Walters Yes.

36:16You know, yeah. She was not gonna be that negative. She was gonna open it up to allow them to attack me, because that's more of her as a reporter, neutral position kind of person. But Joy was really gonna go after me. And Elizabeth comes out and she goes, I love plastic surgery. And she was like, I'm your biggest fan. I went, I love the swan too, and that's how she started. I went, oh, this is going pretty well. And Joy goes, you know, Terry, if you weren't such a nice guy, boom. Wow, look at that. Charmed life, huh? Woof. Lucky. I was scared for you. Thank you. Even in that story, I was scared for you.

36:49Lucky. Jess? Yep, blessed. Blessed. Blessed. Super blessed. Yeah. And so, okay, so that show then must go away. Because I didn't hear it. One season, bing, it's gone. The critics just, you couldn't do another season. It was gone. Wow. I had never even heard of it. Hey, Paul, we've got a surprise for you. You do? All right. Who's it from? It's love from your listeners. We Need to Talk is sponsored by Claude Bionthropic, the AI for minds that don't stop at good enough. So we thought we'd use it to make pull something special from you. Using Claude, we analyzed every comment left on all the 102 YouTube episodes and then prompted it to turn that data into something beautiful.

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39:26Was Botched the next? Yes. But that's many years later. Yeah, Botched was 2014. That was 2009. Okay. Yeah. So then between that, I'm watching my buddy, Paul Nassif, plastic surgeon. Yes. He and his wife go on The Real Housewives of Beverly Hills. And I'm saying, oh my gosh, what is this show? I wasn't really that familiar with Housewives. And I start watching them and I say, hmm, wouldn't that be fun to go on Real Housewives of Orange County? so I say to my wife what do you think about Real Housewives of Orange County she goes yeah never because she was an actress on a TV show she goes I'm never doing that cheesy housewife show ever honey forget it I go it kind of looks fun because Paul goes it's fun so I apply for her and I don't tell her really?

40:20yeah true story by the way oh my goodness so I she says I'm not doing it so I go alright so I devise a reality show of all of her and her high-end friends opening up a restaurant. Get out of here. Called the Pelican Hill Wives. And I thought this is going to make the greatest reality show because one was the CEO's wife of Smith & Wesson. Yes. One was a neurosurgeon. One wife was, and they were all gorgeous and wealthy. So I said, let's pitch a show about opening up a restaurant. So we fly up to Burbank and meet the guy, Alex Baskin at Evolution to pitch him this show about Housewives. I mean, about the restaurant.

41:05But I already contacted him a little bit about my wife being on Housewives. So we're driving away. We already were going to sign deals with other production companies to do this show. But I'm driving away. They flew up on a helicopter. I drove home in my hybrid because one of them had a helicopter. And he calls me, goes, how about this? instead of doing that show de novo, why doesn't your wife come on as the next housewife on Real Housewives of Orange County and we'll incubate that show on a hit show? You'll have a much better chance because the chance that show is actually going to be picked up is low because it's hard to get it.

41:45So I come to my wife. He goes, so they want to do the show? And I go, well, here's the thing. How about you come on Real Housewives of Orange County? She goes, I am not coming to real. And so I didn't speak to her for two weeks. No. I literally barely talked to her for two weeks. I really did. And then finally she said, okay, fine. If you want me to go on that show so badly, you sign the contract. So Alex Baskin, the producer, is a very famous producer now. Banner Pump Rules, The Valley. Yes. He's huge. Yes. He's calling me the whole time. So she wants to come on. Oh, yeah, she wants to come on, Alex.

42:25I'm lying. I signed the contract. Does she know? No. She said, if you want me to do it so bad, almost passive aggressively. This is a true, true story. Not exaggerating at all. And I said, Heather Dubrow. And I sign it and I fax it back. And Alex goes, okay, great. So she needs to come up and - Can I just go back? So you forged her signature? Totally. 1 ,000%. This is so scandalous. I know. Yeah. And I said, so we're going to go up and meet with the family. She goes, what do you mean? I go, I signed the contract to be on Real Housewives of Orange County. She goes, what? I go, I did. Long story short, she said, okay, I'll go meet them, but I'm still, you know, I'm not, it's not indentured servitude.

43:16If I don't want to do it, I'm not going to do it. So I'd never seen the show. Long story short, I go on my iPad and I go, Real Housewives of Orange County. I've never seen this show at all. I bring up, the only scene I could find was this scene of this girl, Tamara, who we know very well now, who's like the longest running OG housewife there is, throwing a glass of wine in one of the other housewives' face. You ever seen this scene? I've heard of it. Yes, yes. And I look at this and I go, I dropped the iPad, I walk in the kitchen, I go, honey, we're not doing this show. I know, I thought, I don't, you know.

43:50She goes, what are you talking about? I go, I show her this scene and she goes, oh, it's hilarious. Oh, wow. And here we are. My wife's been on the show for like, what? 11 years? Yeah. The rest is history. That is fascinating. And to answer your question, Paul got off, Paul left Beverly Hills. His break, the reality TV show Housewife Curse occurred. He got divorced on the show. He calls me one day and he goes, let's do a show about revisional plastic surgery. because he wanted to get back on TV. And we were specialists in doing hard revisional plastic surgery by then. And I said, that's the worst idea ever, man.

44:31I go, listen, it's going to fail a lot. We're going to, it's going to be, the audience doesn't understand that even if we make it a little better, that's probably good. The fact that it didn't fail at all is probably good enough. They want to see a before that's bad. Massive transformation. Massive transformation. And we'll look like bad surgeons. He goes, no, no, it'll work. It'll work. So we went up and pitched it to Alex Baskin. Yes. He said, let's shoot a sizzle reel, a nine-minute sizzle reel. They brought the cameras out. We looked at before and after pictures, and we were just talking. We had this amazing chemistry.

45:04They showed it to the network. They picked up the series. Yeah, and it became this instant hit. Instant. Yes. You know what it was called initially? No. Can I curse on this a little bit? You can. I can? You can bleep it. The show was called, remember Nip Tuck? Yes, I do. The show was called Nip Fucked.

45:29F asterisk C-K-E-D. Yeah, that's not working. So we were so happy with that name. So a week before the show comes out, we get a call from the executive producer. Hey, we're changing the name of the show. Why? The advertisers don't like Nip Fucked. Oh. because there was a show called Shit My Dad Says starring Will Shatner on CBS. So we thought they would go for it. They said no. They said no. So I go, what's the new name of the show? They go, Botched. I said, Botched? No. You didn't like that? No, because it implies. Right, that you're not, you're going to mess it up. That the plastics, whoever operate on them, committed malpractice or botched them.

46:14Okay. And I said, because 98%, they just had too much plastic surgery or they had a big complication. It wasn't the doctor's fault necessarily. We didn't want to highlight other doctors' failures. And even more importantly, I'm laying in bed at 2 o 'clock in the morning and I thought to myself, I wake up and my wife goes, what? I go, what if we blow it? The headline is, Botched by the Botched Doctor. I go, that's the worst title. And the network NBC goes, yeah, we don't care. It's called Botched. and we went to New York. The first episode came out and back then Twitter was a new thing. Yes. So you could see how well a show was doing by how many tweets.

46:54I couldn't keep up with it. Yes. It was just, oh my, the greatest show. Oh, this is a girl. Oh, he's so funny. It was just, zzzz. And Paul goes, what do you think? I go, I don't know how much of an indication this is, but this might be a hit show. Yes. The next morning they call us and they go, we're picking up the next season. From the second episode. By the second episode. Yeah, look at that. And not only was it, I think, a hit in terms of the viewers, the ratings, that is, but the critical review of it was positive. It was great. And what do you suspect the difference was between, say, Botched and The Swan?

47:32Why was Botched received so well? We weren't glorifying plastic surgery. We weren't minimizing the dangers of plastic surgery. We weren't advertising everybody should have to look, should look, have big breasts. Otherwise you're worth less, right? Okay. Your quality of life. It was about, hey, plastic surgery has its place, but this is a cautionary tale. It can and does go wrong. And we're going to highlight when people have had too much plastic surgery, when they pushed the envelope, when they went for medical tourism, bad decisions. So it was kind of the best kind of plastic surgery show you could ever want to have on television because we were promoting safety.

48:19Yes. Yes. And caution and making good decisions and informed consent and good medicine. And there's a lot of comedy, but we never put down the patients. And we always, you know, pulled the scalpel back. And it was just about giving people who are in hopeless situations hope. Yeah, that's what it was. I feel as if the participants, the contributors, they were inspired. Yes. And not only by how they now looked different, but they were inspired by you. Yes. And Dr. Paul as well. Yeah. And on that note, I want to show you something. I have a few things for you, Dr. Terry. But this one in particular, do you remember this case?

49:03Yes. Okay. That's my most significant case. Oh, really? Ever. Can you tell us why is that the most significant case? So this was a patient who came in the second or third season. Okay. And the way Botched works is there's an A story, a B story, and a C story. And the C story is someone who we can't fix, but we're bringing him on as a cautionary tale, and we're trying to advise them not to have any more surgery. This is someone who went to one of those plumping parties where illegal substances in a hotel room by an unlicensed provider injects people with filler. So she went to a hotel room, this woman, the madam, who injected her with plumbing material, caulking material, literal concrete from a hardware store as filler, which looked initially good.

50:07After about four months, the immune system started to overreact and form a foreign body reaction, what are called granulomas. And she developed these huge masses made out of concrete and inflammatory tissue all over her face. And no plastic surgeon would take her on. So we brought her on and I looked. And I'm sorry, even Dr. Kitt, why would no plastic surgeon take her on? plastic surgeon take her on? Because first of all, it goes from the bottom of the skin, you know, the upper portions of the skin where the blood supply is all the way down to the bone. So it's encompassing the muscle, the soft tissue, the blood supply of the skin, the nerves.

50:52To remove it, you have to remove these entire concrete blocks and you're going to have giant holes and it's all going to die around there okay in addition it's a quiet now but if you go in and operate on it there's the great potential that you're going to over activate or reactivate the immune system and it'll become a massive inflammatory infected mass mess as well so dead tissue holes in face much worse no one would touch her so we turn her down So for the next eight months, I think we had four months between seasons. Okay. I would go to bed. I don't sleep very well. I sleep very little. I go to bed and I sort of do my visualization about cases tomorrow or things I want to happen.

51:45And all I could see every day was her. I felt terrible. She says to me on the way out off camera, you know, I can't even go to a CVS, to a drugstore. kids see me and immediately either scream or point. I can't go anywhere. I go, you don't go. She goes, I don't go to restaurants. I don't go into stores. I go nowhere. And this is before Postmates. You know. Where you can get delayed. Yeah. Yeah. So I felt so bad for her. So I had an epiphany at 4 a.m. that I thought would allow me to fix her. And the epiphany very briefly is this. I thought, why are we taking out the entire concrete mass? If you feel your face, it's bone.

52:30It's irregular bone. And I said, just as long as you can't see it. So I came up with the principle, and plastic surgery, particularly botched plastic surgery, is all based on foundational principles in plastic surgery that you apply uniquely to new problems, hopefully in a safe, effective way. I thought, I'll get orthopedic saw. I'll lift up the skin and I'll saw out the central two-thirds, collapsing these masses. And even though you can feel them, like you can feel your zygoma, your maxillary bone, you might feel it, but you can't see it. Okay. So I took one out in her chin under local just to see to make sure her immune system wasn't going to overreact.

53:13And I said, it didn't. All right. And I took her whole face apart and sawed them all out. And that's what she looked like. Wow. And she healed. That's incredible. And even three weeks ago, she has sent me a text. I just want you to know, this is years ago, nine years ago. I just want you to know how grateful I still am for you. So this is one of my biggest successes. Her name is? Rajee. Rajee. R-A-J-E-E. Yeah. I mean, absolutely incredible. And I would imagine it then changes her life. Oh, suddenly she can join the real world. She can be a participating human being. I mean, this is someone who's, she was telling me she thought a lot about ending things.

53:57You know, I am on this note. There's something I want you to listen to. Okay. Okay. You're ready. This is a, I just have surprises for you. Oh, I love it. Here is one for you. Hey, Dr. Dubrow, Raji Narinsing here, transgender activist, actress, spiritualist, and thanks to you, reality TV personality. I feel so fortunate that you and I were able to cross paths this lifetime. The work that you are doing is extremely transformative. And I know that you had touched so many people's lives in wonderful, uplifting ways, including my life. Because of you, I have so much more confidence to do all that I do in this world.

54:47Oh, my goodness. Dr. Dubrow, I just want to say from the bottom of my heart, thank you again. Thank you for being such a blessing to my life. On that note, you keep shining bright. love peace and blessings bye yeah that's that's sweet thank you that was yeah I mean um you know that's heavy there's there's other reasons why it's also heavy but this is very uh you know I'm just uh so happy I was able to help her I mean I love her and see that's a good example of you know if that would have gone badly See you next time. 11 surgeons told her not to do it. So all of a sudden I do this thing to her and it goes very badly.

55:39That's a God complex. You know, I wrote a check that her face couldn't cash. Right. And so I had to do a lot of soul searching to see whether I wanted to, because one, one could theoretically say that was negligent to even try it. even though I did it in sort of a test. But anyway, that's, I mean, thank you for playing that. I love that. And I'm just so, I mean, you know, I don't know how the schlub got to be such a lucky person in life, but I did. I don't know. I must have done something right in a past life, okay? Hopefully. I think the beauty for me is that I think some people may hear the term cosmetic surgeon.

56:26Yeah. And not understand how profound your work is and how important and life-changing it is. And this is an example. This is just one of many examples of how your work and Paul's work has changed life. And other surgeons have changed life. Oh, yeah. Of many. When you think of other transformations or other moments from Botch that stand out to you, are there any that really touch your soul? There are so many. I mean, I love the ones where they not only have a cosmetic deformity, but they have a real significant functional deformity. Like they can't do something. For example, there was this police officer who had had a nephrectomy for renal cell cancer.

57:19And he got this pretty rare phenomenon where he lost all of the tone on the side of him, on his flank. And because of that, he had a huge bulge. Essentially, his entire intra-abdominal contents would bulge out. He couldn't even wear his police belt. Wow. Okay. And so it was painful. And he couldn't run. He couldn't tackle. people and so on do what he wanted to do. And so I had to come up with a very unique operation to fix that. That one really stands out. And then there's those who have, you know, they had so much tissue loss, they have a big skin graft on their abdomen. And how do you walk around with this giant, ugly patchwork skin graft from your leg and your abdomen when you're a 30-something-year-old woman who wants to feel attractive and be intimate and so on.

58:13Yes. And so, you know, I've been able to find ways. I mean, Botch taught me how to be the Botch surgeon. Yeah. You know? Yeah. And so I learned how to do things that aren't in any textbooks that I just applied, and now I can do them practically with my eyes closed. Look at that. And I believe you. I believe you could. There was one when I was researching for you coming in. There was one particular one that stood out to me as well. And this is Jenna. Do you remember Jenna? She went to get a BBL. I believe it was a BBL. Oh. Yeah, you remember that one. Was she African-American? I believe so. Well, this is the breast implants in her buttock.

59:01Yes. Which that seems to be malpracticed. to me. Yeah, well it was Mexico I think. Okay, yes, yes, it was Mexico. And they were so big and so heavy and so improperly inserted that it caused, and she was thin, right? Very attractive and young. Yes. And it caused her entire buttock to stretch out and what are you going to do with that? Because she was thin. So if you just take them out, You've got loose skin and no volume. And it would be worse looking to take them out. And they hurt. They were pressing on our nerves. Right. But also, too, aren't BBLs the most dangerous? Dangerous. Yes. Yes. Yes.

59:47And why is that so? So if you take a BBL, as you know, is a fat transfer to the buttock. You take fat from one part of the body through liposuction. and you inject it into the buttock substance to make the buttock larger and more projecting. That sounds all great, right? And sounds like it should be pretty safe. The problem is there are these sort of large but short blood vessels in the buttock that connect directly to the main vein going back to the heart. Okay. And so these gluteal veins are directly connected to the inferior vena cava. And if you, by mistake, because you think about it, this procedure is done blindly.

1:00:33You're not opening them up and laying fat down. You're injecting it through a cannula and going to and fro, and you have no idea where the tip of that cannula is. And if you inject it into one of those veins and it goes, a glob of fat goes to the right side of the heart and then goes to the lung and blocks the pulmonary circulation. That's called a fat embolus. You can die. I see. And that operation is the most fatal operation in plastic surgery, one of the most fatal operations of all because of that potential complication. My goodness, okay. And even a month ago, some influencer died because of that.

1:01:15Yeah, yeah. And so with Jana as well, in that particular case, she had the BBL, but it seems like it wasn't fat. It was a breast implant. A breast implant. So she had augmentation of the buttock using a breast implant. So what do you do with that? First of all, even if you want to do a BBL, she doesn't have any body fat. Right. And if you just take it out, she's got udders. Yes. And she'll look way worse. So I invented an operation. You invented an operation? Yes. Based on surgical foundational principles where I took it out. I did a buttock lift, so I took off a lot of the excess skin. But I took muscle and body fat from her flanks.

1:02:06She had a little bit of a love handle area and the right and left one. and I rotated them down, left their blood supply, their feeding blood vessels intact, and put it in the pocket. Oh, my goodness. And lifted things up. And I don't know if you have a picture of that one, but that one really worked well. I do have a before-after. Yeah. Yeah, that maybe we'll put up here. Okay, okay. We'll put the before-after here. Yeah, I haven't seen it for a long time, but I was extraordinarily pleased with that result. Yes, yes. The note that I have here is that, and we will, we're going to place it right here.

1:02:47So there it is. Look at that. Yeah, I mean, yeah, I mean, sometimes when you do a reconstructive cosmetic procedure, you try to achieve normalcy. It's enough to make them look normal. From horrible to normal is a home run. but to go from horrible to beautiful is wonderful and so you know i use the grade analogy i always try to get a 93 on the exam because a 93 is an a yes out of 100 and you can get into med school with 93s and so if i can take them to a 93 i got an a on the test oh my gosh yeah i think you took or to 100 yeah that was that one was exceeding of expectations yeah in the uk i hear a lot of people say we're going to turkey yes in the states i hear a lot of people say we're going to to mexico that's right yeah and i would imagine because it's cheaper it is cheaper it is in it's a fraction of what it costs in the uk or in the united states the problem is it's not regulated They do have some fabulous surgeons in Mexico City and parts of Turkey.

1:04:00Unbelievable, like they do all over the world. But, you know, they don't really have lawyers there. So they can do things without any kind of, you know, regulatory body overlooking them. So there isn't the same kind of paranoia, appropriate paranoia and fear and controls that there is in our countries. Fair enough. And so you don't know who you're going to get. And the worst part about that medical tourism is that what happens if you have a complication? Because you can go to the best plastic surgeons in Beverly Hills, Manhattan, Miami, Dallas. They all have complications. We all have complications.

1:04:38If we didn't have complications, we wouldn't have you sign a consent form that lists everything from infection, bleeding to death, right? So if you have a complication in those countries and you come back here, nobody wants to touch you. you know, you wouldn't, you're not going to pay them very much because you already had the surgery and nobody wants to deal with another surgeon's problems. Have he said that? I will take them. Yes. I don't care. Yes. So, and you currently, you currently will, even if they're in the throes of a massive complication and they're not even ready for my fix it yet, I'll take them just because, I mean, I'm, I'm lucky.

1:05:19I'm, I don't really operate for money at all anymore. I've gotten so lucky financially in my life for other reasons, and so I just want to help them. You don't operate for money anymore. I mean, I charge them. I'm expensive. Okay. If you can afford it. But what I mean by that is, I mean, I have an office in Beverly Hills now, and I have people, 15 people who work for me. I have to feed the kitty or whatever it is, you know. Yes. But, you know, if a patient has a problem, they have a problem, I don't care. I'll help them. Period. End of story. I see it. Hey there. I just want to say thank you for choosing We Need to Talk.

1:06:06Doing this podcast is one of the greatest joys of my life, and I want to continue to share it with you. So hit follow and the bell icon. It takes just a second and it helps us to continue to grow this podcast.

1:06:23I know that you brought some items in. Oh, yes. Yes, show and tell. This is the show. So I have to say something. This is, I don't know if this is going to get me into trouble, but I'm just going to say it. Because I like, you just say how it is, right? Yeah. So I have never in my life felt a breast implant because those are what those are breast implants. You've never felt an in vivo breast implant or an ex vivo? What's the difference? Well, in vivo means it's been inserted. So I've never felt an in vivo or ex vivo. I've never felt an in vivo or ex vivo, but I've always been curious. Okay. So let me tell you about this.

1:07:07This is a very... Oh, here... So this is a silicone rest implant. Okay. Wow, look at that. It's very interesting, isn't it? Well, this is a very unique... This is a brand new type. Oh, is that different from this one? No, these are the same. It's just different sizes. But this variety has changed everything in plastic surgery. And in Europe, they've been using these for years. They weren't FDA approved. Okay. These have a unique quality to them. The biggest problem with breast implants and the number one complication with breast implants is that your body will form scar tissue around them. And even if you do everything right and they're healthy, 15, 20 % of the time, the body decides after a while it doesn't like them anymore.

1:07:56And just like with Raji, the immune system forming calcium, calcification and foreign body around it, it can do the same thing around these. Okay. And that's called encapsulation. In other words, like capsular contracture are involved. And they become rock hard, painful, squeezing them down and distorts them. This doesn't do that very often. Okay. And recent studies have shown there's less than a 1 % chance of this type of implant from getting hard. Wow, I see. So this is the new hot one that's been in the UK for a long time. Oh, really? This has been there for a while? But we're lucky it's FDA approved now.

1:08:33Can I say the first thing that I think of? Can I actually, I want to see. Yeah, please. So the first thing I think of is, God, these would be heavy to walk around with. Yeah. I mean, it feels like it's, you know, you want to hear something strange? What's that? Large natural breasts on a woman can give them symptoms of hypermasty. In other words, you can get symptoms related to them being very heavy. neck pain, arm pain, numbness, bra strap grooving, giant implants, for some reason, they don't. They don't. Wow. So would this be heavier? So what size is this? So it depends what your starting size is, right?

1:09:21So if you start out as a B, you're going to be one size. If you start as a C, you're going to be bigger for any given implant, right? But if you're, let's say you're a small B, you're relatively small breasted. Okay. That one in your left hand, that's going to be like a small D. Okay. That one's smaller, right? That's going to be like a full C and this will be like a small C. Okay. Okay. Fair enough. You know, also too, with breast implants, something that I'm sure you see this more than anyone is it feels as if the trend if you will has drastically changed yes we've had a few guests on who have told me that they literally saw their cosmetic surgeon and said i want the biggest implant humanly possible yeah we don't like that but that was 10 years that's right but now thankfully really so so things have changed now the trend has changed the trend has changed you know it's funny you look at this there are certain celebrities that we can talk about because they I'll give these back to you.

1:10:23I don't wanna give these back to you, but I'll give these back to you. You can give these to me later. Well, there are certain celebrities that we can't actually talk about because they've admitted to plastic surgery recently that move the needle overnight. I'll give you an example. When Kylie Jenner, who what, has one billion followers or something, maybe 800 million? And yeah, plus a billion dollars. Like, multiple billions. Yeah. When she, at age, I believe 19, had filler put into her lips, which is a verboten thing back then. You're never doing filler, liposuction, breast augmentation on someone under 21 back then.

1:11:05Okay.

1:11:08Overnight, she changed the entire landscape of potential candidates for filler because she came and said, oh, look, her lips just got bigger. And I think she admitted to it. and everybody, every teenager wanted filler in their lips. I didn't do that. I still don't do that. I feel you should be 21, okay? Okay. Look what Kris Jenner did. Kris Jenner de-stigmatized instantly facelift surgery. I mean, a celebrity would have a facelift and, oh, I went to a wellness retreat. Exactly. Exactly, exactly. Right. We had Kathy Griffin on, who's Kris Jenner's friend. Yes. And she told us she had just recently received her third Yes.

1:11:59facelift, however, she said she couldn't afford Kris Jenner's. Right. Because, you know, so in other words, she was saying that she didn't get the same level. She did. But she did. I know her surgeon, and I'm not gonna pit one against the other, but that guy is everything and more. It's top, yeah. I mean, she looked great. Great. She looked phenomenal. Yeah, facelifts now because Kris Jenner, another Kardashian, moved the needle literally overnight. I remember back when National Geographic, there was a picture of Britney Spears with her arm up. And you could see an incision in her armpit. And they showed a picture of her like a year before with smaller breasts and then with full breasts.

1:12:45and it was very clear she had had a trans axillary breast augmentation. Overnight, it became a thing to talk about breasts. Even though she didn't even admit it, it became a thing to talk about. So who has moved the trend to smaller breast size? I think celebrities are doing smaller. I think just the general celebrities are looking smaller by and large. I don't think when you look at these Love Island shows, I don't think you're seeing women with very big breasts anymore. So there's just a different standard, which is so good because the smaller you go, the less chance that the body is going to reject it and overreact to it.

1:13:32Because, I mean, think about it. I mean, I've always had this weird thought about plastic surgery. If you really think about cosmetic surgery, to go from not doing breast augmentation to it becoming a thing in culture, in society, somebody came up with the thought, hmm, let's make an incision in the bottom of the breast and throw some plastic in there. Yes. That's crazy. That's an experiment. Yes. That's wild. How can you ever get away with that? And somebody, you know, at one point somebody said, oh, let's cut the face open all the way around the ears, fillet it like a fish, dissect deep layers near the nerves, and pull it back.

1:14:22Right. Just to make them look younger. I mean, who was the first guy to do that? Yeah. If you think about it, cosmetic surgery is true human surgical experimentation. Yes, yes. Now, when you mentioned the smaller, this whole idea of we like smaller, is this the reason why these GLP-1s have become so popular? Is it because, is that part of the smaller trend? I think it is, but a larger picture, of course, is, and you know, I'm obsessed with the GLP-1 drugs. I don't know if you know this about me, but. Well, my wife told me. Yes. So my wife told me that you microdose. Yes, I do. And she wants to know all about, I'll tell you, you could get me talking for five hours about this.

1:15:14So I'm obsessed with these drugs. This is the biggest, most historic change in the history of medicine, the introduction of these drugs. Because these drugs directly affect the risks of all top four causes of death, which include cardiovascular disease, cancer, metabolic disorders like diabetes, and neurodegenerative disorders like Alzheimer's and Parkinson's. The less body fat you have, the lower your risk of all those causes of death. And it does it in a very beautiful, natural way. I'm so obsessed by these drugs that at this late stage of my life, I actually studied and took all the courses for a year to take the American Board of Obesity Medicine certification exam, and I'm board certified in obesity medicine.

1:16:02Oh, my goodness. And an expert in obesity medicine in these drugs, because this is to medicine as AI is to technology in general. Fascinating. Fascinating. Yeah, and the path that's about to go on, if you want to hear about that, with the next level of drugs coming out is another level. Well, just to talk about the current adoption rate of this, Yes, because this is what I find to be very interesting. So in the U.S., 12 to 18 % of adults have taken a GLP-1, right? Okay. This is according to KFF and RAND. Okay. In the U.K., it's lower. 7 % of adults are now currently using GLP-1s. In the U.K., 1 in 10 women are likely or very likely to consider a GLP-1 in the next year.

1:16:50Right. So the trend is growing. My first question around this is, what is the danger? Yes, okay. There must be some danger in this. There is, but remember, these are FDA-approved drugs. Okay. These are also drugs that have been used for diabetes for the last 14 years. So, diabetics have shown us that they're quite safe and effective. Okay. All right. So we know it's not like it just came out and what's going to happen 14 years from now, you know, is the boogeyman going to appear out of the blue? They've already been used for a long time. The side effects relative to the benefits are crazily overwhelmed, overweight, okay?

1:17:43The side effects are mainly related to slowing down the GI tract. Things like nausea, constipation, GERD, reflux. And every once in a while, there is a tiny, tiny amount of people, I'm not really sure it's true, have visual problems with it. Maybe even some blindness, although I'm not really sure that's true.

1:18:09And gastroparesis, your stomach stops working. Oh, I don't want to do that. It's so incredibly unlikely and rare. And by the way, you can take Tylenol, aspirin, the most common antihypertensive blood pressure medication, and take the list of side effects with those. They're a lot worse and a lot more common. The most dangerous drug we take is Tylenol. Really? Yeah. The number of liver failure, liver transplants that need to be done because of Tylenol overdose is extraordinary. That's the most dangerous drug we take for sure. Yes. So, but they're so effective and the, you know, there's, there's, I don't know if you want me to talk too much about the types you probably know there's the Ozempics.

1:18:53Yes. And then, so there's the GLP-1, which is Ozempic and Wagovi. Then there's the GLP-1 and GIP, which is Monjaro and Zepbound, same drug. Okay. And then there's the one about to come out. Retatrutide. People call it Retta. Some people call it retatrutide. It's retatrutide. For those who know that you know. But anyway, retta. It's going through phase three clinical trials at the FDA with Eli Lilly. And it's GLP-1, GIP, and a fat burner. And a fat. Because the big problem with these drugs is you take them, and as opposed to a regular diet, where regular diet, diet and exercise, you lose 75 % fat, 25 % muscle.

1:19:36With these, you lose too much regular muscle. and you don't want to lose muscle. Oh, that's interesting. I didn't realize you lose muscle with these. So the big recommendation for anyone who wants to take these is, okay, you can take it, but you're now upping your protein intake. Every day you're taking your protein and two, at least two and ideally three times a week. Right. Resistance training. You've got to maintain your muscle mass, okay? Reditrutide has a fat burner in it. So it helps to preserve muscle and directly burn fat. So that's the one that's about to come out. What's weird is it's already being made.

1:20:15It's already being compounded illegally all over the place. In Beverly Hills, very few people I know who are on these are on the approved ones. They're all on Reda. Oh, my goodness. Reda. And by the way, if your phone is around, don't get it out because it's listening. Next time you mindlessly scroll, you're going to see nothing but Reda. But Reda. Yeah. It's so effective. Don't use RETA from a compounding pharmacy because it comes from China. Who knows what's in it? But when it comes out, that's going to be the big number one game changer. Do you recommend now that, because you're saying that basically we want to reduce body fat.

1:20:56This is the game. Right. So anyone who's walking around with body fat outside of the ideal percentage, are you suggesting that it's to our benefit? I think here's where it gets, the answer is yes. I think everyone who has obesity, certainly clinical obesity, which is by definition a BMI greater than 30, that's class one obesity. Greater than 35 is 2, greater than 40 is 3. These are people who are much, much more obese than they should be. Where it gets real hinky is that because these drugs not only control body fat, they also control sugar metabolism. them, okay? And they clearly minimize the effect, the inflammatory effect of sugar on the human body.

1:21:42So much so that because of that effect, they're now FDA approved for kidney disease, fatty liver disease. So the question is, should everyone, I'm not advocating this, or am I? Should everyone, even someone who has no need to lose weight, should they be on a low dose of these drugs anyway, just to minimize the inflammatory effect, the big enemy of sugar. Is this why you micro - Is it that you micro-dose? Because my wife is saying, yeah, Dr. Terry, micro-dose. I do. So this is why. So it's not a full dose that you're taking. Correct. Okay. So the question is, what does micro-dose mean? Because it means different things to different people.

1:22:23Let's take Manjaro, the FDA approved one. Zep-bound is also called. The lowest dose is 2.5 milligrams once a week. Okay. Is it an injection? Yeah. It's like this auto-injector pen. It's wonderful. You don't even feel it. So the half-life is seven days. It starts to wear off. You get another one and you start to build up. After four weeks or so, if your appetite isn't where you want it to be, if you're still eating too much, you're not losing as much weight, you go up to five. And then after four weeks, you go up to 7.5, 10, 12.5, 15. so to me if you've gone up to 5 7.5 and 10 you've lost all your weight what do you do do you go off it cold turkey right i think the idea is to for those people consider microdosing which means go down to a lower dose and just stay on that and see how it works on you where it's for some people i'm a real responder i take a low dose i am not hungry it's awesome other people they don't respond the way I might.

1:23:26Okay. So they need to go way up. But for me, a microdose is like half a dose. Now, the drug companies probably don't want me to be saying this. They really, well, they don't because they have FDA approval, which means the FDA approves the marketing of these drugs. So the FDA says you can advertise it for weight loss. You can't advertise it for sugar control. Okay, I see. Like, by the way, Botox is FDA approved for here. You know we put it here. You know we put it here. It's not FDA approved for here. Interesting. Yeah. Okay. But anyway, I'm a big fan of microdosing. I could see it. I could see it.

1:24:11You know, on the Ozempic side too is something. It's interesting. I eavesdrop on my wife and her friends all the time, right? And these GLP ones, they're constantly talking about them. It's the new cosmetic surgery. It is the hottest thing. It is. I heard them once say, what about Ozempic vagina or Ozempic vulva? Ozempic vulva. Or Ozempic face. Yes. They're very different. Are these actual things? Yes. Okay. There's Ozempic butt, Ozempic face, Ozempic vulva. Okay, so Ozempic vulva is when things start to really deflate and hang, and it doesn't nicely look as aesthetic as they might like it to be.

1:25:05Ozempic face is when you've lost so much body fat, you prematurely... Here's the problem. When people, when they lose weight very quickly, they look very deflated and loose and they run into the plastic surgeon's office. You should wait. Okay. Because they will re-equilibrate and they will re-distribute fat so that if you look at those people, even if they lost weight and maintain that steady weight for a long time, they'll put some face of fat naturally back in their face. Don't run into the plastic surgeon's office. where it's opposite of this deflational change is ozempic penis. Ozempic penis?

1:25:47I've never heard of this. Yeah. Tell me about it. So if you think about it, people who are very, men who are very obese and they have a lot of pubic fat and inner thigh fat, if you're really fat, you have what we call buried penis syndrome. You can't find it in there. So if you take ozempic or one of these drugs, and you lose all the surrounding fat, your penis looks bigger. Interesting. So, Ozempic penis is actually... It's a good thing. It's a good thing. Yes. How lucky are we, guys? We are always winning. We don't have to menstruate or have kids. No. You know, the plumbing is always the same, and our penises get bigger when we lose weight.

1:26:34That's what I'm saying. Oh, yeah. Ozempic vulva is bad. Ozempic penis is good. Thank you very much, Eli Lilly. Oh, my God. All right. So another area that we have to talk about, it has become a topic in my household because I have teenage boys. Oh, looks maxing. You said it. Yes. Looks maxing. I'm obsessed with it. Yes. Could you first define it? And then let's talk about it. So I think it's a phenomenon where primarily young boys between the ages of sort of pre or just entering in puberty to about 19 or 20 put an extraordinary amount of emphasis on their looks to the extent where it's their absolute life's focus.

1:27:28And they associate that with their SMV. Yes. Sexual market value, as you know. Yes. Okay. Like their whole worth is in the shape of their, the amount of muscularity in their torso, the shape of their jaw, the distance between their eyes, their hairs, blah, blah. It's that. It's maximizing your look so that you're more valuable and more attractive. And it started out among the incels, as you know. Yes. And that's expanded now and really virally caught fire, primarily due to clavicular. Clavicular, yes. This guy. Who is, I mean, look, if we talk about him, I mean, just briefly. But he's, because he's breaking bones in his face.

1:28:13Yes. He's chewing on all kinds of things through his jawline. He's, I mean, yeah, yeah. He's doing all these things. Yes. And these posts are going viral. Yes. So he's advocating conventional and unconventional things. to maximize your looks, okay? Where the message, I think the overall message is terrible. Do you really want your, you know, entering into puberty young men to be focusing at the exclusion of everything else in their lives, on their physical appearance rather than becoming good humans and learning ethical things and gaining useful skills that will make them important members of society?

1:28:56No, it's the last thing you really want them to focus on. But unfortunately, they advocate doing some things that are really unconventional and crazy and parentheses mostly don't work. For example, bone smashing, where they take a hammer, a blunt object, and smash various places on their face to try to get bony overgrowth. and they confuse it and conflate it with this orthopedic principle called Wolf's Law, where if you put enough stress on a bone with muscle, the bone will grow in response to that stress. It doesn't work with intermittent trauma. All it's going to do is give you many fractures and scars and bone cysts.

1:29:44It's dumb. It's dumb maxing, I call it. It doesn't work at all. And then this thing about the other kind of gymnastics that they have where they put their tongue at the roof of their mouth, and that's supposed to make your jawline and your platysma muscles under here more defined. That doesn't work. And then they talk about a lot of plastic surgery. That's fine. Then they also talk about, unfortunately, very, very early steroid use. Yes. Yes. This is becoming, yeah, absolutely. So that is one, that is illegal, isn't it? Well, it's certainly illegal, but even more so, it's dangerous. And it arrests many parts of puberty.

1:30:30It causes early hair loss, acne, fertility, and stunts your growth. If you use testosterone early on. And this clavicular guy has talked about and discussed and advocated taking steroids as early as 12 years of age. Plus, he takes it also to another level. He mixes that with illicit drugs. You know, he had an overdose recently and had to be taken to the hospital emergently. And so, I mean, the last thing you want to do is listen to this guy clavicular. You know, he knows he's looked up on PubMed, which everybody has access to on the Internet. So he knows a lot of the terminology that we use when we discuss testosterone and its byproducts and aromatase and various medications.

1:31:22So he's sort of superficially talking the talk, but just below that surface is, you know, zero helpful, useful information. He's the last guy to get your medical information. What do you suggest parents? like parents of teenage boys who are now increasingly becoming aware of looks maxing and some beginning to participate. What advice do you have for us? So I think it's really important that you try, don't, as you know, it's the general parental principles of interacting with your kids. You know, find a way to communicate. Find a way to discuss with them without them feeling like you're judging them.

1:32:11Because once you judge, it's like telling them, you know, you're telling them stories about how you did coke in college and ecstasy and drank. You're not going to do coke and ecstasy in college. I did that and you're not going to do it. Well, telling them I'm not going to do it, all that means is they're not going to share it with you and they're going to hide from you. So I think an open dialogue where you talk about it in a very sort of plain vanilla wrapped way without, you're not condoning it, but you're also not overly criticizing it. You're just going, where's your head at with it? Try to figure out if they're even interested in it and have the pros and cons discussion and make them feel like they're part of the conversation rather than you're lecturing them.

1:32:58I know one person that you love, adore, obsessed with is Heather. Oh, my wife. Your wife, Heather. Obsessed. Who I didn't know is from the Bronx. Yes. Okay, because I'm from Queens. Okay. Okay. And when I read that she's from the Bronx, I said, oh my gosh. Yeah. She must be the boss of the house. Oh. Well. Well, she must be running things in the Dubrow household. So I'm just a participant, a lucky participant in Heather Dubrow's world. Yes, I know it. By the way, I'm a very lucky member of Heather Dubrow's world because to live in her sort of orbit, it's a very nice place to be. she's extraordinarily kind funny intense and you better get your stuff together because when I met her she said I said she said what are you looking for in a woman I said I don't know you know a nice chest you said that?

1:34:06no I'm sure I said something that was calculated to have her like me because she was so amazing and I said, what are you looking for, man? She goes, a man with a plan. I said, oh. She goes, I don't want to fool around. If I'm going to be with someone, I'm going to know that they want to do things and they have a plan and they're going to affect that plan and do it right. Heather is a person with a plan and Heather DeBras World is very curated and very dialed and it's a really lovely place to be. I just show up. She says I show up like a surgeon walking into the operating room. Everybody has to sort of attend to me.

1:34:49But it's true. I come home and I just go, whoosh. And I go, okay, what's next? Where are we doing? Okay, you know, it's a really wonderful place to be. She's a wonderful, wonderful woman. Yeah, and you and Heather, you have an incredible family. I've seen the family photos. Yes. As a matter of fact. Oh, you have one. As a matter of fact. Bam! Bam, there we are. Right, the whole crew. The whole crew, four kids. Right there. Yeah, two of them. three of them by IVF, one natural mistake. Both of my boys IVF. Really? It's wonderful, isn't it? Yeah. So do you have fraternal twins or? They're not. Although, you know what's interesting is that - Are they from the same?

1:35:34Yeah, they're from the same. And the younger, I think, is older. Isn't that interesting? Yeah. Isn't that interesting? Yeah, yeah. Yeah. But fatherhood, that clearly, that's also a life-changing endeavor. It really is. It's obviously very high priority. I'm a different kind of father than I bet you are and most people are. I'm much more, I'm being honest now, I'm much more into them as adults than I was as children. Really? Yeah. um as children i love them i would die for i would do anything for them obviously but i wasn't really the i didn't like to go to the games luckily they weren't into it i wasn't really into the hours long of uh reading them books oh i spent tons of time with them um i'm much more connected to them now than i was before so as children i guess i always felt and this is really wrong, I'm just going to say it, I always felt like they're not going to remember a minute of this.

1:36:46So it's going to really count as their memories really become mature and I can really have a long-term effect on it. I know that you never heard a man, sort of a, you know, not politically correct thing to say, but I was great. I was always there. But I didn't love the kid stage. I love this love the stage now the after 14 15 yeah when I can teach them things okay that's it so that's what you most love I love that you can impart these lessons yes from life yes yes because I mean I think I know a lot of things you do when their children form and inform who they become but I really think it's sort of after 13 that they develop into the person they're going to be and And that's where I really started to, hey, let's talk now.

1:37:38Whereas when they were six, I was going, okay, let's play catch. How much longer is this catch going to go on here? And then I remember sitting down in my son's bed at 15. He was very not into school for a period of time and unfocused and didn't want to do anything. I said, what am I going to do with this kid? And I started to threaten him. You know, this life is not your life. This is our life. And I realized that, because I try to teach through kindness and I'm sweet. Yes. And so I thought I did that. I go, that's not going to scare him into being a better human and finding his focus in life.

1:38:20So I walked in the next day. I go, you like this life? He goes, I do. And I go, okay, I'm going to teach you something. Ready? I'm going to teach you about money. And he goes, what do you mean money? I go, we're going to talk about money for an hour. He goes, okay, tell me about money. I go, okay, assets, liabilities, mortgage, interest rates. And he was like, zzzz. And I got him a stock account that you can get at Charles Schwab for your kids. Yes. And, you know, my parents didn't have any money. And Heather's parents had money, but it was verboten to talk about money. And, you know, our parents didn't manage their money well when they got older.

1:38:57I think, and so now I teach them, you know, money and the effectiveness of money. And, you know, money doesn't buy you happiness, but lack of money sure buys you unhappiness sometimes. That increases. You know, my father literally this morning sent me a message around the importance of money giving you options. That's it. Yeah. That's everything. Yeah. This is it. I have a final surprise for you. Oh. You ready for this? I hope it's a cat. I found the cat. This one is better than breast implants. Okay. Okay. ready okay envelope on my name on it i would love for you to read that all right if you could

1:39:45terry i don't know i could read this

1:39:51you've been in my life for almost three years i stand by the fact that i've never met a smarter human being my entire life which is both incredible to witness and incredibly infuriating to argue with Who knew all those years ago that we would build this extraordinary life together? Marriage, four amazing kids, books, podcasts, television shows, skincare lines, businesses, brand deals. And somehow through all of it, it still feels like we're figuring it out side by side in real time. One of my favorite things about you is the enthusiasm you bring to absolutely everything you do. You're like a dog with a frisbee in the best possible way.

1:40:24Laugh out loud. Once you sink your teeth into something, you refuse to let go until you've mastered it completely. That kind of drive is rare. and even after all this time, it still amazed me to watch. What's even more incredible is your ability to evolve after accomplishing absolutely everything you could have in general surgery and then plastic surgery. You pivoted and became board certified obesity medicine because you were genuinely fascinated by it and wanted to help people in a bigger way. And then somehow, as if that weren't enough, you built this whole other career as a medical legal expert, completely immersing yourself in the law and all of its complicated layered nuances because you truly love learning and mastering new things.

1:41:03I think it's so interesting that our daughter, Max, originally thought she would follow in your footsteps into medicine, but ultimately end up following you in a legal world instead. It makes perfect sense. Our children are a mix of both of us, but they truly got the best parts of you, your curiosity, your drive, your humor, your discipline, and your ability to care deeply about the people around you. You work harder than anyone I know, but you also laugh harder, dream bigger, and love your family fiercely. There is something incredibly comforting about being married to someone so relentlessly passionate about life.

1:41:36We are so lucky, almost 30 years later, and somehow it still feels like yesterday. Thank you. You are amazing, by the way. You are. You are. that letter is so beautiful and to me it is a depiction of who you are you are so you know what my impression is when i go back and tell my wife because she's the first thing she's going to ask me is not how i was she's going to ask me how you were right i'm going to say he's one of the most relentlessly passionate people about life that i've ever met i i don't know i just can't You know, this has been, I've done many things, interviews, podcasts, TV shows.

1:42:29This has been one of the most amazing experiences I've ever had, and I thank you for that. I've learned so much from you. I've laughed. I've laughed so hard I cry. I've learned, you've taken me through every emotion, and I truly appreciate your time. Truly appreciate your time. I wish you all the best. When you and your family are in London, I want you to add a certain match. I'd love to. Oh, yeah. We were going to be right there on the pitch. Yeah, it's so obvious why you're so successful. You're such an amazing human being. Thank you so much for this opportunity. Thank you. Thank you. Now, you get the one final question.

1:43:11Everyone gets this. Okay. It is, you have had some incredible conversations in your life. Yes. When you think about the most memorable, who was it with and what did you learn? I mean, I, you know, I'm sure people say this, this is one of them. I know that's not the answer you're looking for, but this is one of them. We accept it. Thank you.

1:43:41I think I had a conversation with my mentor, Dr. Malcolm Lesavoy, when I was a general surgery resident in his laboratory, about being a doctor and being a plastic surgeon and what it meant. and he basically told me it's not about the surgery anybody can do the surgery it's not about the money it's not about impressing people it's about what you can do with the skills that you've acquired through incredible amounts of hard work and then ultimately talent to make someone's life different better than you possibly ever they ever possibly thought it could be and that's the power of being sometimes a plastic surgeon where you can take them to a place they never thought they could go and give them not only more confidence but potentially, it's funny that I became the box doctor, an absolute new lease on life.

1:44:55And that's, and that conversation is ultimately what sort of structured informed me as a physician, as a surgeon and a human. So that. Dr. Terry Dubrow, thank you. Thank you.

1:45:41Dr. Terry Dubrow. literally how deadly it could be. He had an assistant with him, and I asked her, what's Terry doing now? Is he going back to the office? She said, no, he's probably going to work out. He works out seven days a week. And it's interesting, he practices what he preaches, and that's another reason why I have so much respect for him. He is by far one of the most fit, mentally sharp bright youthful 67 year olds I've ever met I love him I love him you know my wife arguably loves him more than I love him but after this conversation I could love him more than my wife loves him I'm not blaming my divorce on the Real Housewives of Beverly Hills the truth is the biggest question I have is This episode is brought to you by ChatGPT.

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1:48:49I can't believe we're sitting here still talking about it. It's just nonsense. I wanted money. I wanted status. It is. But the madness hadn't started yet. What caused the implosion of everything that you had built? Me. They're casting for the housewives. I'd never seen the show, didn't know anything about it. But I believe that I had the most beautiful, charismatic, ferociously ambitious wife, and I wanted to show her off. I knew how to do it. So we did it. And the rest, unfortunately, is history. They create these scenarios that just didn't happen. Are there any that you want to address? Suddenly, I'm looking at my wife and saying, who are you?

1:49:29Wow. Do you love yourself? Not yet. Are you proud of yourself? Nope. Do you respect what you've created? Nope. You don't? The only real victims are gonna be the kids unless we're f***ing careful. So I'm gonna do all I can to protect them. Maybe I do need to talk.