Dr. Robert Whitfield: Breast Implant Illness Symptoms, Biofilm, and Chronic Inflammation

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[SPEAKER_03]: Hello, and welcome to the C3 Podcast Code Conscious Conversations.
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[SPEAKER_03]: I'm Dr. Lisa Piper, here with Wendy Cona's Born We Are The Founders of Code Health.
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[SPEAKER_02]: Hi, everyone.
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[SPEAKER_02]: Today, we are here with Dr. Robert Whitfield.
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[SPEAKER_02]: He has a board certified plastic surgeon with over 25 years of experience, specializing in breast implant illness, B-I-I, and X-plant surgery.
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[SPEAKER_02]: He's the founder of the Sharp Method, S-H-A-R-P, a holistic recovery protocol that addresses
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[SPEAKER_02]: through genetics, detoxification, nutrition, and hormone optimization.
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[SPEAKER_02]: In 2024, he published his book Sharp and groundbreaking research on biofilm in breast implant failure.
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[SPEAKER_02]: Dr. Whitfield bridges conventional surgery with functional medicine to help women prepare for surgery, recover faster, and reclaim their health.
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[SPEAKER_02]: Welcome to the C3 podcast for so happy to have you here with us.
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[SPEAKER_03]: Dr. Whitfield, one of the things that we always like to ask our guests is this.
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[SPEAKER_03]: When you hear the word consciousness, what does it mean to you?
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[SPEAKER_03]: And what is one way that you intentionally bring consciousness into your work, relationships, or health?
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[SPEAKER_00]: Yeah, I thought about that consciousness, you know, for me, it does have operated almost for 30 years now.
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[SPEAKER_00]: And I think, for me, like, when I'm in the opera and reading it, I'm, it's like being in the moment.
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[SPEAKER_00]: To me, like being extremely aware.
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[SPEAKER_00]: It's sure jury, there's a lot of things happening, a lot of cues and stimuli, and then.
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[SPEAKER_00]: I feel extremely aware of what's going on
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[SPEAKER_00]: So that's, for me, like being in the moment when I'm operating, I'm probably most, as most patients would really want me to be very calm.
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[SPEAKER_03]: Exactly.
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[SPEAKER_03]: I was asked, so you have to have a single point of attention, and it's getting hands.
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[SPEAKER_03]: You have to really be dialed in and everything kind of has to be quiet so that you can focus and do what you do and that's it.
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[SPEAKER_03]: I love that.
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[SPEAKER_03]: That's a great answer.
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[SPEAKER_02]: That's a great answer.
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[SPEAKER_02]: This is why we ask everyone because everyone has their own personal perspective and their own experience with it.
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[SPEAKER_02]: So that's fantastic.
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[SPEAKER_02]: I love that you brought it to the operating room.
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[SPEAKER_02]: So let's dive right into it.
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[SPEAKER_02]: So we're going to have
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[SPEAKER_02]: about what you do and what you are proficient in.
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[SPEAKER_02]: And the real question that I have or the first question that I have is so many women are finding that they are feeling sick and not well.
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[SPEAKER_02]: And their doctors keep telling them everything looks normal, you know, on their blood work.
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[SPEAKER_02]: So if a woman has implants and they're not feeling well,
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[SPEAKER_02]: But their normal, you know, lab works are coming back.
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[SPEAKER_02]: What is the core of the issue?
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[SPEAKER_00]: Well, I think it's an in-depth question and on social media and, you know, forms.
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[SPEAKER_00]: It's called Preston Platinumus.
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[SPEAKER_00]: And so we testified in 2019, plastic surgeons, different societies about Preston Platinumus at the FDA hearings on Preston Platinumus, safety.
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[SPEAKER_00]: And the way I think about it if this helps us, each of us is affected by inflammation.
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[SPEAKER_00]: And information is a function of your genetics, your exposures, and then if you want to think of it probably like your state of health.
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[SPEAKER_00]: And a lot of it, unfortunately, is about where we live, where we work.
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[SPEAKER_00]: And you know, I look at it as recipe illness is a chronic inflammatory process that a medical device playing a role in.
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[SPEAKER_00]: It's not the only thing causing the chronic inflammatory process because you can have folks with muscle activation syndrome, you can have folks with Lyme disease, a very, very bad or chronic mold exposure, viral, you know, things on COVID.
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[SPEAKER_00]: There can be a host of things that make people
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[SPEAKER_00]: all have the same types of systemic symptoms of chronic inflammation and that's why it's super confusing if you go to a provider and if you go to a provider and say I have breast implants, I'm concerned about breast implant illness.
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[SPEAKER_00]: Half of them would not be able to really probably articulate what I just said, and then there would be no real plan outside of a physical examination, which typically would reveal very little, right?
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[SPEAKER_00]: Because if you were to do an exam, if the tissues weren't hard from encapsulation, which is a thickening or tightening of the capsule around the implant, if it was otherwise normal, and the breast exam was normal, and the patient otherwise didn't have problems, you wouldn't really be able to guide
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[SPEAKER_00]: the patient.
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[SPEAKER_00]: And that's probably the biggest point in frustration with providers, either plastic surgeons or rheumatology or inner chronology.
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[SPEAKER_00]: Whoever gets asked about this as a problem and people just get fed up with the lack of explanation.
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[SPEAKER_00]: So the way we look at it is not through the typical Western lens.
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[SPEAKER_00]: So I've been ever since college fascinating with genetics and I'm old enough that the genome project finished in 2003 well after I was out of college and well after I was out of medical school and I already in training but it's fascinating what we've been able to learn from that.
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[SPEAKER_00]: So if you just did an audit of my patients, 83% of them have single liquid-tied polymorphisms or SNPs in multiple genetic detoxification pathways.
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[SPEAKER_00]: oxidative stress.
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[SPEAKER_00]: So free radical formation, O3 is the big thing.
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[SPEAKER_00]: So everybody's kind of probably heard of oxidative stress.
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[SPEAKER_00]: So if you have a problem with that, that builds up and that creates problems with fatigue.
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[SPEAKER_00]: It's also affected by chronic mold exposure.
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[SPEAKER_00]: If you have a bad gluteurotidation pathway, things like heavy metals, things like chemicals, those are build up in your system and equally cause problems.
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[SPEAKER_00]: everybody's heard of in THFR.
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[SPEAKER_00]: It's, you know, the things expression.
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[SPEAKER_00]: It's one of the many methylation genes that can be off about 36% of the population as a problem with in THFR.
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[SPEAKER_00]: I do probably one of you guys as well.
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[SPEAKER_02]: Yeah, we had our genetic test done yet.
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[SPEAKER_00]: Right.
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[SPEAKER_00]: So that's, and then finally, what I think is a really under-appreciated phenomenon in women is problems with vitamin D
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[SPEAKER_00]: If you have genetic problems with vitamin D metabolism, you're going to have osteopeenia, you're going to have osteoporosis.
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[SPEAKER_00]: And the more we understand those things about our patients, and then couple those to what has become kind of standard of care for us, which is to look at a tumultoxicity burden test.
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[SPEAKER_00]: We use vibrant wellness.
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[SPEAKER_00]: We do a little glutathione challenge, and we try to get expression of these from our patients to better understand, you know, what?
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[SPEAKER_00]: What are they faced with?
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[SPEAKER_00]: How do they cope with it and then how can we help them?
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[SPEAKER_00]: Because surgery is not the answer in the situation.
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[SPEAKER_00]: If in fact, you're not trying to care for the rest of the patient.
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[SPEAKER_00]: There's a lot of people who try to monetize this procedure, much like an augmentation.
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[SPEAKER_00]: So when we're unagmoning people or taking their implants out, I know that's just one component of it.
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[SPEAKER_00]: So we look at genetics and talk to the city burden.
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[SPEAKER_00]: We look at gut health, gut health is like probably the hardest thing my patients have to deal with that takes the longest to recover from because it's as you would imagine our food supply has been poor for a very long time and herbicides pesticides things have got into it and the quality has gone way way down so lots of folks have trouble with.
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[SPEAKER_00]: leaky get.
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[SPEAKER_00]: And then we look at obviously the level of sensitivities people have from other environmental triggers or foods and then home run balance.
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[SPEAKER_00]: And so if everybody's listening to the show, I haven't said a word about it.
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[SPEAKER_00]: EKG, it just takes right or any blood work.
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[SPEAKER_00]: Because no my patients typically have problems with any of those things.
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[SPEAKER_00]: And that's why they're considered or deemed to be fine.
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[SPEAKER_00]: but they feel unwell or tired or can't remember things.
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[SPEAKER_00]: And you know, the sit, the list is just like a big laundry list of everything that could be wrong with every system of your body.
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[SPEAKER_00]: So it's once again, it's not super clear to the patients, what's going on with them.
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[SPEAKER_00]: And to the providers who are trying to help them.
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[SPEAKER_00]: So once again, I don't envy the providers trying to figure that out.
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[SPEAKER_02]: mask of questions.
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[SPEAKER_02]: So as far as a genetic predisposition, Lisa and I actually just took a very full genetic panel and learned so much about our genes.
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[SPEAKER_02]: This was specifically for a company that creates a compound based on your genetics actually.
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[SPEAKER_02]: Yes.
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[SPEAKER_02]: and it's brilliant.
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[SPEAKER_02]: So for all of your patients, do you have them do a genetic test before you even take the next step and do the surgical aspect of it?
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[SPEAKER_00]: So since many folks we talked a little bit offline, people are, this is not as a decision people come through lightly and when they make it, they want to get things done.
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[SPEAKER_00]: So I have a group of patients who fall into like like I would say my type A shoppers and they once they've decided I speak with them either in person or virtually and they're immediately moved to just wouldn't come get this part schedule either they've consumed some of our 3000 videos or the books we've written or papers with them or
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[SPEAKER_00]: Talks have given her shows have been on and that helps them, you know, make a choice to come, you know, and spend time with us.
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[SPEAKER_00]: Austin now, I will say this like every super clear, I don't take the case lately.
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[SPEAKER_00]: There's been a lot of fear migrating about the case itself and you can cap select to me and we will touch on that.
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[SPEAKER_00]: First of all, this is not a unsafe surgery.
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[SPEAKER_00]: Like, I cannot emphasize this enough.
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[SPEAKER_00]: I've done several thousand of these.
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[SPEAKER_00]: The number one thing in surgery is always bleeding.
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[SPEAKER_00]: That's the number one thing in any surgery.
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[SPEAKER_00]: It doesn't matter what it is.
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[SPEAKER_00]: you have your toe operator bleeding is still the problem that affects patients and surgeons and causes re-operation so that's number one you'll want to avoid that and we may have one a year or one every other year and that's just there's a you know that happens in surgery because that's number one problem there's been a lot made about injuring the line you're not going to injure the long in this surgery
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[SPEAKER_00]: So that's not an issue and whether or not you should leave the capsule at all frame at this way.
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[SPEAKER_00]: In 2016, I took care of a cancer patient, I did their un-reconstruction, I took down the reconstruction because they no longer wanted to have a breast-reconstruction anymore.
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[SPEAKER_00]: They wanted to be having a static flat closure and flat closures are more and more common now.
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[SPEAKER_00]: And so I did that for her.
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[SPEAKER_00]: My sister is a breast cancer survivor until late last year.
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[SPEAKER_00]: She passed the way after a long, long time with cancer, and I took care of this breast cancer patient, and when we went over her results after I did her surgery at a week, she had no evidence of her cancer.
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[SPEAKER_00]: So every time you take this material out, I was taught through it the same way.
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[SPEAKER_00]: You take all the caps that are material out, which is a scar tissue produced by your body and response to that implant, and you do two things with it.
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[SPEAKER_00]: The second thing is you make sure there's no cancer, right, because I will harm them.
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[SPEAKER_00]: These are just basic concepts, and I did my entire career, so I didn't change it.
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[SPEAKER_00]: So I removed the two issues, send it out.
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[SPEAKER_00]: There's no cancer, which is great.
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[SPEAKER_00]: There's no recurrent breast cancer or none of these breast implants associated cancers that have come up like lymphomas.
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[SPEAKER_00]: But she had an eco-line infection.
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[SPEAKER_00]: And so I ever is sort of e-colour at the, you know, the, you can get through contaminated food, you can get it through urinate tract infection.
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[SPEAKER_00]: All these things, right?
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[SPEAKER_00]: So how on earth did I miss my level of experience and understanding of a problem?
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[SPEAKER_00]: And all the things I've done in my career, a e-coli infection?
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[SPEAKER_00]: Well, so we went back through everything, because obviously we need to know how this got through, you know, the system.
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[SPEAKER_00]: The thing is, and with y'all need to understand it, and every of this needs to understand it, these are occult, meaning they're not out in your bloodstream.
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[SPEAKER_00]: Now, people are going to ask like, well, how does it happen?
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[SPEAKER_00]: So, the number one way something gets infected in our minds or back to our bloodstream is we're going to have a cut that gets inflamed and infected.
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[SPEAKER_00]: you can have a urinary tract infection.
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[SPEAKER_00]: You can have a GI tract infection.
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[SPEAKER_00]: You can have a pneumonia.
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[SPEAKER_00]: Those are kind of like your common common ways.
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[SPEAKER_00]: So.
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[SPEAKER_00]: As we get older, we're a little bit more susceptible to certain things, versus when we're younger, and women are more susceptible things like urinary tract infections.
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[SPEAKER_00]: But as we age, we all get more susceptible to those things.
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[SPEAKER_00]: And we hypothesize that's how she got this problem.
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[SPEAKER_00]: Now, why didn't it go away?
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[SPEAKER_00]: Even if she was treated.
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[SPEAKER_00]: So, bacteria wants it to locked on to a device.
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[SPEAKER_00]: Certain times the bacteria really produce a film or like, like, okay, like, covering.
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[SPEAKER_00]: So, very, very high-produced or bio-filmed with things like staff at Bedermis, skewed-back-term actas.
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[SPEAKER_00]: So, what we found when we expanded over 690 consecutive patients, 29% of them have, bacterial contaminant predominately with, cutie-back-terum actas, or staff at Bedermis.
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[SPEAKER_00]: This has been backed up in other studies, Dr. Methuncina out of Indian University Medical Center,
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[SPEAKER_00]: did a very elegant study where they did excellent specimens analysis and they did blood biomarkers and showed that a particular biomarker called oxylipin tin home kind of like when you get your blood checked and they check your blood count and all these things this is a blood biomarker.
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[SPEAKER_00]: It's higher in patients with more systemic symptoms of chronic inflammation and breast and blood.
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[SPEAKER_00]: So we have a, you know, potential cause and effect here with a bacterial contaminant leading to more symptoms.
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[SPEAKER_00]: So when patients, you know, our providers, uh, tell patients that they don't do a capsule actually made my question is, why?
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[SPEAKER_00]: And then they'll say, well, it's not safe.
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[SPEAKER_00]: Well, yes it is.
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[SPEAKER_00]: And if you're not comfortable with doing it, then you shouldn't go to that person.
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[SPEAKER_02]: Can you explain what that is?
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[SPEAKER_00]: Yeah, okay.
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[SPEAKER_00]: So the cap select me is your scar tissue is formed around the device and that's your body's reaction to it because that's not your tissue your body's trying to exclude it.
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[SPEAKER_00]: So from the time it's placed your body starts to form this little collagen sac around it and that's the scar.
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[SPEAKER_00]: So when we take it out.
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[SPEAKER_00]: It's just like a wrapper.
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[SPEAKER_00]: I always try to describe it to patients as I would try to take it out as a undisturbed Easter egg, right?
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[SPEAKER_00]: So that little shell that then shell makes it easy or hard.
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[SPEAKER_00]: Today I did two of these before I hopped on the show with you all and one was easier than the other and it was mainly due to the thickness.
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[SPEAKER_00]: So think of the scar tissue in layers, kind of like pages of a magazine.
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[SPEAKER_00]: Most people will these days remember listening, I hope still know what a magazine is.
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[UNKNOWN]: So.
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[SPEAKER_00]: A couple pages thick of a magazine makes it pretty easy for me to do.
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[SPEAKER_00]: Things get harder when they're more like a thin layer of cellophane, or glad or whatever, little wrap.
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[SPEAKER_00]: That's hard to deal with.
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[SPEAKER_00]: The thicker it is, the easier it is.
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[SPEAKER_00]: Now the other thing is that it's very bothersome to me as people are getting their implants taken out under local anesthesia so they're being dumped in the office.
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[SPEAKER_00]: The incision was put through as being opened and they're being pulled out.
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[SPEAKER_00]: Okay, so there's a couple mechanical things you need to understand.
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[SPEAKER_00]: The shells are all a silicone elastomer, okay?
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[SPEAKER_00]: Whether it's a singing implant or silicone implant, they all have the same shell.
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[SPEAKER_00]: This shell has a whole list of heavy metals in it.
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[SPEAKER_00]: Now, if that shell is degrading over time, which everything does, then it's got to rub up against or be in contact with your tissue.
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[SPEAKER_00]: So if any of that were to shed or come off, and I have a famous example of my patient more embossic, the host of this getting confidential, routinely got into a barrel sauna above 200 degrees for 60 to 90 minutes at a time, and she had the most heavy metals I've ever had in a patient in my entire practice.
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[SPEAKER_00]: So how did that happen?
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[SPEAKER_00]: Well, you know, I got in a shit ton of trouble because we said she was melting her implants.
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[SPEAKER_00]: Well, she wasn't melting them.
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[SPEAKER_00]: She was causing leeching from them.
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[SPEAKER_00]: So if you take a hot water bottle and heat it up and you can get the plasticizer, which is a thalate to leech into the water and you drink the water, you'll increase the thalate level that we can measure in your body.
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[SPEAKER_00]: So this is not rocket science.
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[SPEAKER_00]: It's a well-known fact that you can heat something up and leach the chemicals out of the substance.
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[SPEAKER_00]: So that's what was happening.
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[SPEAKER_00]: Now when you take these things out, if there's any debris left behind, that's going to interact with your tissue, your T cell receptors on the tissue, we're going to recognize that and they're going to continue to signal that.
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[SPEAKER_00]: This is a problem if that makes sense, right?
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[SPEAKER_00]: So you've removed what you think is the problem that, in fact, it's been in contact with your tissue.
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[SPEAKER_00]: So I'll go to that further and say like people are removing these under local and they're ruptured silicone implants.
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[SPEAKER_00]: So ruptured silicone implants depending on the era the implant it can be more like syrup or it can be like jello.
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[SPEAKER_00]: Now that to me I have a real problem with that because there's really no way that all the debris can be removed.
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[SPEAKER_00]: if you leave that, that scar tissue capsule in place because there's going to be something that you can't get off of it.
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[SPEAKER_00]: I don't know if you've ever dealt with a gel, a silicone gel or anything like that.
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[SPEAKER_00]: It's, it can be sticky.
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[SPEAKER_00]: But invariably, just think of it.
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[SPEAKER_00]: Like, I don't think you have to be very, very high functioning notice that what I'm saying, these materials will be stuck against your tissue.
19:08.672 --> 19:14.397
[SPEAKER_00]: Then when your tissue has something that's not your own genetic makeup, your body responds to it.
19:14.777 --> 19:21.163
[SPEAKER_00]: It is interesting where I've seen Pete Articles written, like, this is more of an organ rejection type picture now.
19:21.883 --> 19:27.328
[SPEAKER_00]: And people will push back and go, like, well, no, it's not.
19:27.308 --> 19:28.331
[SPEAKER_00]: Okay.
19:28.953 --> 19:31.161
[SPEAKER_00]: Do you not believe in science?
19:31.201 --> 19:36.880
[SPEAKER_00]: Do you not believe like foreign things interact with tissues and cause a response because that just seems idiotic.
19:37.662 --> 19:39.428
[SPEAKER_02]: I mean what you're saying.
19:39.779 --> 19:53.257
[SPEAKER_02]: is just so basic and elementary, even if you don't understand the science of it, what you're saying just seems like it's inevitable that it's going to happen.
19:53.317 --> 20:04.572
[SPEAKER_02]: And so that is what is so upsetting that there is even the idea that there can be a pushback of this notion, right?
20:04.552 --> 20:10.260
[SPEAKER_02]: So I have a very good friend, and she had something wrong with an existing implant.
20:10.841 --> 20:16.449
[SPEAKER_02]: And I didn't even realize that there was more to it because she said, oh, it was so easy.
20:16.469 --> 20:21.016
[SPEAKER_02]: They just went in and they exactly what you said, right?
20:21.056 --> 20:22.799
[SPEAKER_02]: They went into the existing scar.
20:22.859 --> 20:25.142
[SPEAKER_02]: They pulled it out.
20:25.122 --> 20:33.385
[SPEAKER_02]: And then he took another one and, you know, he put it back in, it was like, and so I, there's so much more to this.
20:33.566 --> 20:35.010
[SPEAKER_02]: And it is so important.
20:35.331 --> 20:35.952
[SPEAKER_02]: Here we are.
20:35.992 --> 20:40.144
[SPEAKER_02]: We're talking about something that is.
20:40.124 --> 20:41.927
[SPEAKER_02]: being put into the body.
20:41.967 --> 20:54.689
[SPEAKER_02]: How different is it than putting, I mean, this is a real open-ended question, but someone that has a device put into their body or an implant into their body.
20:55.811 --> 20:59.517
[SPEAKER_02]: What's the similarity and what's the difference or is it all the same?
20:59.750 --> 21:11.169
[SPEAKER_00]: Yeah, so I'm really listening to understand, like I get asked to select, because you know, this causes a lot of emotion in the people who, you know, pick up this information.
21:11.229 --> 21:12.072
[SPEAKER_00]: So.
21:12.507 --> 21:26.240
[SPEAKER_00]: The tools I use throughout my career to help cancer patients, predominantly our foreign bodies, except for a couple instances, because I used to help orthopedic surgeons who took care of bone cancer.
21:26.881 --> 21:30.084
[SPEAKER_00]: When you have a bone cancer, the bones got to come out, right?
21:30.144 --> 21:33.607
[SPEAKER_00]: So then they're gonna put something in the replace the bone.
21:33.627 --> 21:42.295
[SPEAKER_00]: So that makes it so you can walk and sit and get up and down and to huge deal.
21:42.275 --> 21:52.956
[SPEAKER_00]: So your knee, your hip, and we would keep people from having their leg amputated, and it was a lot of very complicated work.
21:53.897 --> 22:00.350
[SPEAKER_00]: And we all knew that there was great risk associated with doing this when you put a large foreign body in somebody.
22:00.570 --> 22:03.135
[SPEAKER_00]: So if you replace their whole thigh bone, their femur,
22:03.115 --> 22:06.224
[SPEAKER_00]: or if you replace their home knee joint or their whole hip or whatever.
22:06.625 --> 22:10.576
[SPEAKER_00]: But these are life-saving, you know, limb-saving, you know, procedures.
22:11.538 --> 22:16.432
[SPEAKER_00]: And but I always had a really healthy respect for any implant.
22:16.452 --> 22:18.778
[SPEAKER_00]: It didn't matter how small it was.
22:18.758 --> 22:26.033
[SPEAKER_00]: because if you spend enough time taking care of patients, the smallest thing can lead to a big ass problem.
22:26.934 --> 22:36.073
[SPEAKER_00]: And if I was to fix in the finger fracture and put in a tiny little plate and screws in there, even that little tiny thing can get infected.
22:36.654 --> 22:40.682
[SPEAKER_00]: And so when we did breast reconstruction, I did a technique.
22:40.662 --> 22:46.135
[SPEAKER_00]: that I really love and had a lot of passion for called the deep interior of the gastric artery perforator flop.
22:46.155 --> 22:56.981
[SPEAKER_00]: Anyway, the tummy tissue that's discarded in the tummy tuck can be connected to or left connected to its blood vessels and then utilized to help recreate the breast.
22:57.482 --> 22:58.705
[SPEAKER_00]: So that was...
22:58.685 --> 23:05.875
[SPEAKER_00]: always my passion to do microsurgery and help patients with cancer get through that.
23:06.135 --> 23:18.972
[SPEAKER_00]: So making a jaw out of their fibula, which is the small non-weight bearing bone, the leg, recreating their tongue with something from their form, making a breast from their abdominal tissue,
23:18.952 --> 23:21.696
[SPEAKER_00]: I was just always, that it was fascinating.
23:21.936 --> 23:24.099
[SPEAKER_00]: That's all I wanted to do.
23:24.119 --> 23:33.351
[SPEAKER_00]: And because in this huge country of ours, reconstruction is still not done that routinely.
23:33.411 --> 23:34.412
[SPEAKER_00]: I know that seems weird.
23:35.093 --> 23:38.678
[SPEAKER_00]: But depending on where you are, like, I'm in Austin, Texas.
23:39.379 --> 23:42.563
[SPEAKER_00]: The entire country of Spain will fit in Texas.
23:42.914 --> 23:44.937
[SPEAKER_00]: It will take you 12 hours to drive across the state.
23:45.417 --> 23:47.781
[SPEAKER_00]: This, our country is massive.
23:48.502 --> 24:00.558
[SPEAKER_00]: So when you get outside of an urban area, a center of size, you know, we'll say, to be on where you are, you know, you have to have sophisticated operating rooms.
24:00.658 --> 24:04.804
[SPEAKER_00]: You have to have all the nurses, all the texts, all the equipment.
24:04.852 --> 24:05.153
[SPEAKER_00]: mean.
24:05.914 --> 24:09.600
[SPEAKER_00]: And then you have to find someone trained like me who can execute all that.
24:10.161 --> 24:13.026
[SPEAKER_00]: And those those don't magically appear in community hospitals.
24:13.066 --> 24:18.916
[SPEAKER_00]: So around this country, the number one type of reconstruction is always going to be an implant based vehicle structure.
24:18.976 --> 24:25.628
[SPEAKER_00]: Because if you went through plastic surgery training, you should have the competency to be able to offer that to the patients.
24:25.608 --> 24:42.665
[SPEAKER_00]: But you should also have the competency to explain all the options to the patient so the patient can if in fact They don't want to do that have another choice to be referred to a larger center, which is possible in this country So I would have these It's a long long when it answers.
24:42.706 --> 24:42.826
[SPEAKER_00]: Sorry.
24:43.446 --> 24:50.974
[SPEAKER_00]: I would have patients show up with implant problems and I would convert them to that surgery I did
24:50.954 --> 24:56.683
[SPEAKER_00]: And I was, so I was taking care of this problem before I ever knew it was a problem.
24:56.703 --> 25:03.374
[SPEAKER_00]: Now, anybody can take care of the implant infection because, and I think everybody won't understand why this is obvious, right?
25:03.394 --> 25:11.606
[SPEAKER_00]: If you come in with a red, swollen, breast, either from a cosmetic operation or a reconstructive operation, everybody knows what's wrong, right?
25:11.647 --> 25:13.249
[SPEAKER_00]: Nobody's confused.
25:13.364 --> 25:31.154
[SPEAKER_00]: But because you don't show up like that in these typically cosmetic cases and happens in reconstructive cases, nobody knows, nobody kind of gets clued in and then I published the study to show that we'll basically a third of the time these time back to your contamination.
25:31.174 --> 25:35.862
[SPEAKER_00]: So, two thirds of the time, okay, it's not, but...
25:35.842 --> 25:36.904
[SPEAKER_00]: What else is going on?
25:37.005 --> 25:38.548
[SPEAKER_00]: Like, do you have porgenetics?
25:38.608 --> 25:40.272
[SPEAKER_00]: Do you have to hire a talkspirgin?
25:40.573 --> 25:41.635
[SPEAKER_00]: Do you have livin' mold?
25:42.076 --> 25:42.958
[SPEAKER_00]: Do you work in mold?
25:43.018 --> 25:44.421
[SPEAKER_00]: Do you get exposed to a bunch of stuff?
25:44.441 --> 25:45.704
[SPEAKER_00]: Did you grow up air golf course?
25:45.744 --> 25:48.671
[SPEAKER_00]: Did you grow up in your industrial things?
25:48.691 --> 25:49.853
[SPEAKER_00]: Was the groundwater good?
25:49.933 --> 25:51.357
[SPEAKER_00]: Was, did I have arsenic in it?
25:51.477 --> 25:51.978
[SPEAKER_00]: Mine did.
25:52.379 --> 25:53.361
[SPEAKER_00]: Growing up.
25:53.341 --> 25:57.286
[SPEAKER_00]: There's all these things you get exposed to that lead to, you know, problems.
25:57.326 --> 26:15.010
[SPEAKER_00]: And then if you have a death in the family, lose the spouse, get the voice, like all these big emotional triggers, suffer an assault, like the whole, like, laundry list of things that people experience, it can really, from a wellness perspective, send them on this kind of spiral.
26:15.050 --> 26:20.918
[SPEAKER_00]: They just goes and goes and goes and becomes very, very part for them to recover.
26:21.151 --> 26:23.556
[SPEAKER_03]: So what does it look like start to finish?
26:24.118 --> 26:29.750
[SPEAKER_03]: I call you, I say, hey, doc, I need to have my implants removed.
26:29.770 --> 26:31.814
[SPEAKER_00]: I think it depends on where you're in the journey, right?
26:31.875 --> 26:35.803
[SPEAKER_00]: So usually I get people that have seen sometimes 17 doctors.
26:36.585 --> 26:39.311
[SPEAKER_00]: And some of them functional doctors, they've done a bunch of testing.
26:39.351 --> 26:41.235
[SPEAKER_00]: They've taken supplements.
26:41.215 --> 26:47.786
[SPEAKER_00]: And this is where, you know, people can agree or disagree with me, but like, I'm pretty rigid about what I'll do now.
26:48.447 --> 26:58.664
[SPEAKER_00]: I will, like, test your genetics, and test your toxicity and gut health, and through sensitivities, and, like, hormones, and try to engage, like, where are you in this process?
26:59.125 --> 27:01.950
[SPEAKER_00]: If you don't know anything about how to eat, we have to correct that.
27:01.990 --> 27:05.215
[SPEAKER_00]: If you don't know anything about how to sleep, that's correct that.
27:05.347 --> 27:14.559
[SPEAKER_00]: If you don't understand the quality of everything you put on your body and in your body affects how you feel and and your day to day, we have to have that discussion.
27:14.579 --> 27:22.649
[SPEAKER_00]: So I try to meet people where they are and then help them fill in some gaps and although that's a little weird for plastic surgery, I feel it's very important that they understand those things.
27:22.669 --> 27:23.851
[SPEAKER_00]: Otherwise, it's not a good fit.
27:24.191 --> 27:25.934
[SPEAKER_00]: I'm not going to be everybody's fit.
27:25.954 --> 27:32.502
[SPEAKER_03]: Do you have to get those things all corrected and balanced before doing a surgery like this?
27:32.988 --> 27:37.774
[SPEAKER_00]: For fat transfers, I do as much pre-work as possible.
27:38.355 --> 27:44.603
[SPEAKER_00]: And for ex-plats or unaugmentations and lifts, have what we're doing that.
27:45.083 --> 27:49.629
[SPEAKER_00]: It's more of a, I can do it on a quicker cadence or pace.
27:50.370 --> 28:00.463
[SPEAKER_00]: Folks who want a fat transfer and so we should just clarify this because this also gets completely screwed on the internet where everything's undefeated.
28:00.443 --> 28:27.801
[SPEAKER_00]: So a fat transfer has been around for over 100 years, and it's gotten this wrap of it doesn't work or you lose this or that that that that so in reality if you can't even say hey I want a fat transfer I'm trying to make implants okay so that gives me an opportunity one because somebody's already thought about changing the implant out but adding something back so a little bit of robbing Peter to pay poll.
28:28.068 --> 28:36.397
[SPEAKER_00]: that's good for me because then I have some is really committed to this process and it helps me educate them about what's possible.
28:36.817 --> 28:39.300
[SPEAKER_00]: So I get a dexer on everybody.
28:39.520 --> 28:47.529
[SPEAKER_00]: Dexer is widely available in the United States that looks at your lean muscle mass, your body fat and your bone density and women should know the same way.
28:48.170 --> 28:49.831
[SPEAKER_00]: So that's like a baseline for me.
28:49.851 --> 28:55.898
[SPEAKER_00]: So everybody thinks they're
28:55.878 --> 29:01.170
[SPEAKER_00]: That allows me to then start a process of education for them about their body.
29:01.190 --> 29:07.103
[SPEAKER_00]: Like, you shouldn't be worried about what your body fat is, what your BMI is, what your weight is.
29:07.167 --> 29:13.274
[SPEAKER_00]: I just need to understand what it is right now, and then I can help guide you on what is possible.
29:13.794 --> 29:24.145
[SPEAKER_00]: So we borrow fat from Arizona, stubborn like in or out of a thigh area, flank area or low handle area, and admin not arms, you try to avoid that.
29:24.225 --> 29:25.807
[SPEAKER_00]: It can make your arm worse.
29:26.268 --> 29:32.314
[SPEAKER_00]: And then when we transpose that and take out old implants and scar tissue,
29:32.294 --> 29:37.199
[SPEAKER_00]: If you don't need a lift because the nipple position is good, then we add volume back to the upper two thirds.
29:37.259 --> 29:43.385
[SPEAKER_00]: If you just think of a breast from the nipple to the clavicle, the collarbone, that's where the most real estate is.
29:43.985 --> 29:46.248
[SPEAKER_00]: From the nipple to the fold is the least real estate.
29:46.748 --> 29:50.672
[SPEAKER_00]: So most of the fact can go really up to the upper two thirds.
29:51.253 --> 30:00.782
[SPEAKER_00]: And everybody's, you know, trying to achieve typically they tell me like learn basics, because I just raised my nipples as high as you can get up, okay?
30:00.762 --> 30:05.850
[SPEAKER_00]: So that's possible only with a vertical lift and that leaves you with what's called a lollipop type scar.
30:06.411 --> 30:15.767
[SPEAKER_00]: So some people are very, very concerned about scar, and if that's the case then, you know, visible scar and like a lollipop is not what you should do.
30:15.848 --> 30:30.583
[SPEAKER_00]: So if you want improvement in a position really, really to the max I can do it, it's a vertical scar and then you add the volume back to the upper two thirds and that's kind of like to me the most I can do it one time.
30:30.623 --> 30:39.232
[SPEAKER_00]: And then you're going to say, well, why do you say you can do that, but so and so Dr. and Beverly Hills or New York for Miami or the hell it is says you can't do that.
30:39.352 --> 30:39.932
[SPEAKER_00]: It's not safe.
30:40.513 --> 30:41.434
[SPEAKER_00]: Well,
30:41.414 --> 30:46.382
[SPEAKER_00]: It goes back to what I said before, like, if somebody says something is not safe, I'm a little worried, right?
30:46.663 --> 30:48.265
[SPEAKER_00]: Like, is there an experience issue?
30:48.285 --> 30:52.653
[SPEAKER_00]: Is there an experience issue with the surgeon and they're not comfortable with something?
30:52.833 --> 30:54.876
[SPEAKER_00]: They should just tell you, I'm not comfortable doing that.
30:55.437 --> 30:57.681
[SPEAKER_00]: You need to go see somebody like Rob and Austin who is.
30:58.262 --> 31:00.966
[SPEAKER_00]: And so I've been doing fat transfers since 2004.
31:00.986 --> 31:03.250
[SPEAKER_00]: I'm very comfortable with that transfers.
31:04.072 --> 31:07.978
[SPEAKER_00]: And fat goes beneath the skin above the breasts.
31:07.958 --> 31:12.142
[SPEAKER_00]: So everybody remembers the eyes on, sure, you know, with the little pocket.
31:12.923 --> 31:13.063
[SPEAKER_00]: Mm-hmm.
31:13.083 --> 31:14.264
[SPEAKER_00]: So think of like the pocket.
31:14.885 --> 31:19.689
[SPEAKER_00]: You can only put so much fat, or you can only put so much in that pocket, and that's it.
31:19.709 --> 31:26.136
[SPEAKER_00]: So when people say, I want you to judge words for the overgrast me, so I have a bigger boob, like no, that's not how it works.
31:26.636 --> 31:29.059
[SPEAKER_00]: When you put more and more stuff in, you don't make it better.
31:29.519 --> 31:33.603
[SPEAKER_00]: Like everything has to have, you know, talking about consciousness on this podcast.
31:34.144 --> 31:36.666
[SPEAKER_00]: It's a very conscious way I approach the problem.
31:36.646 --> 31:39.590
[SPEAKER_00]: Only a certain amount is going to fit in this space.
31:40.150 --> 31:50.944
[SPEAKER_00]: And people ask me like, well, you know, if you augment a phase, you have to put it very small amount of fat in, and it has to be deep, not superficial, otherwise it'll become visible.
31:51.404 --> 32:02.919
[SPEAKER_00]: In a buttocks, when you're doing a BBL, you're cleaning out the waste, you're shaping the inner outer thigh, to make the buttocks look better before you ever add fat back, and then you add it above the muscle, but beneath the skin.
32:03.359 --> 32:04.120
[SPEAKER_00]: Now what's the difference?
32:04.200 --> 32:05.742
[SPEAKER_00]: What's a bigger compartment?
32:05.722 --> 32:09.067
[SPEAKER_00]: And there's so obvious breast tissue between the glute max and the skit.
32:09.268 --> 32:15.177
[SPEAKER_00]: So when you go to the chest, we're magically things that work because I don't know people say it doesn't work.
32:15.438 --> 32:20.226
[SPEAKER_00]: The only inner-feeding tissue between the skin, the fat and the muscle is the breast tissue.
32:20.366 --> 32:29.080
[SPEAKER_00]: So we don't put fat in breast tissue as that will cause this and make it hard to assess examine and then a
32:29.060 --> 32:34.306
[SPEAKER_00]: do you study is whether it's ultrasound, mammogram, MRI, so we don't, we don't put that in the brush, right?
32:34.747 --> 32:35.788
[SPEAKER_00]: It goes in the fatty layer.
32:36.148 --> 32:44.939
[SPEAKER_00]: Now, if somebody has a cyst that develops or an area that gets firm, that's easy to see on any of the previous things I mentioned.
32:45.099 --> 32:47.782
[SPEAKER_00]: An MRI and ultrasound or mammogram.
32:47.802 --> 32:50.105
[SPEAKER_00]: You're not going to miss a breast cancer because you've got a fat transfer.
32:50.325 --> 32:52.468
[SPEAKER_00]: I used to do fat transfers on breast cancer patients.
32:52.548 --> 32:53.329
[SPEAKER_00]: So,
32:53.309 --> 33:12.415
[SPEAKER_00]: everybody just needs to like this is so old like I was talking about this in 2005 so all this has been worked out over time it's not dangerous to do and you don't hear all this negativity typically out of folks who get facial fat transfers because they're typically doing it with a facelift they're doing it deep
33:12.395 --> 33:14.619
[SPEAKER_00]: similar with the BBL crowd.
33:14.999 --> 33:20.128
[SPEAKER_00]: I don't really hear about people's butts being lopsided or magically, you know, going away on one side.
33:20.609 --> 33:24.916
[SPEAKER_00]: But somehow in the chest, it's this like, you know, we're being skewed.
33:24.936 --> 33:28.362
[SPEAKER_00]: We can't figure out it or whatever, from all you folks from the 80s.
33:29.641 --> 33:31.906
[SPEAKER_02]: We're there, we knew we were going to talk about it there.
33:32.387 --> 33:35.575
[SPEAKER_00]: But that's, you know, fundamentally it's the same type of thing.
33:35.655 --> 33:40.667
[SPEAKER_00]: Now, why do I get results and we'll say others have trouble getting those results?
33:40.747 --> 33:43.273
[SPEAKER_00]: It's just the program I wrote a book about the program.
33:43.293 --> 33:45.979
[SPEAKER_00]: But the program to me is just the way,
33:45.959 --> 33:57.777
[SPEAKER_00]: It blends functional medicine, Western medicine, and my interest in genetics with understanding toxicity and people like brought up the biohacking and peptides and all things.
33:58.217 --> 34:01.142
[SPEAKER_00]: All that stuff was being done, age is a go.
34:01.182 --> 34:07.712
[SPEAKER_00]: And it's just become like in everybody's kind of... conceptualized it and what they're trying to take.
34:07.732 --> 34:08.052
[SPEAKER_03]: All right, yeah.
34:08.032 --> 34:14.843
[SPEAKER_00]: Yeah, it's just trending now and I'm like, you know, my sometimes people send me messages and you just get on peptides.
34:14.863 --> 34:21.835
[SPEAKER_00]: I'm like, well, you should have hit me up three years ago and it wasn't so much grief about it because I had access to quality.
34:22.015 --> 34:24.279
[SPEAKER_00]: Now, I have no access to anything.
34:24.459 --> 34:26.463
[SPEAKER_00]: So I don't put anybody on peptides.
34:27.304 --> 34:32.132
[SPEAKER_00]: And since we're talking about it, if you're going to have a fat transfer, you need to get off of
34:32.112 --> 34:40.164
[SPEAKER_00]: GL1P Agnes because I don't and I won't fat transfer somebody on those because those all work.
34:40.184 --> 34:41.085
[SPEAKER_00]: They help.
34:41.105 --> 34:42.427
[SPEAKER_02]: Yeah, they're going to be rid of it, right?
34:43.048 --> 34:47.675
[SPEAKER_00]: You burn fat or not eat or just, I mean, come on.
34:47.735 --> 34:53.724
[SPEAKER_03]: So you have the fat transferred like from your abdomen or wherever to the rest.
34:53.844 --> 34:55.307
[SPEAKER_03]: And then you're on a GLP.
34:56.328 --> 34:57.630
[SPEAKER_03]: It will undo it.
34:57.728 --> 35:05.238
[SPEAKER_00]: Yeah, so what I recommend everybody do is if they're entertaining the fat transfer, then my words of wisdom are the following.
35:05.859 --> 35:12.268
[SPEAKER_00]: First of all, if you've been on it, you have to be off of it six months to be considered, you know, for us, for a fat transfer.
35:12.689 --> 35:15.893
[SPEAKER_00]: And then afterwards, during that first year, you cannot use it.
35:16.053 --> 35:19.098
[SPEAKER_00]: Because the thing I'm going to do is I'm going to get your decks of pre-op.
35:19.118 --> 35:20.379
[SPEAKER_00]: So I know exactly what it is.
35:20.419 --> 35:23.383
[SPEAKER_00]: We're going to do all of your work and follow-up.
35:23.504 --> 35:25.947
[SPEAKER_00]: And then we're going to be able to follow it.
35:25.927 --> 35:39.267
[SPEAKER_00]: It's super clear to me and one of the main reasons I get the taxes is I want to real be on the eye and I want to know what somebody's lean muscle mass is and body fat and you know, just like when people would get body contouring or fat removal of eye light perception.
35:39.587 --> 35:42.692
[SPEAKER_00]: People could, I would say, eat their way out of that result.
35:42.872 --> 35:46.938
[SPEAKER_00]: If that sounds proud, I'm sorry, but the opposite is true now.
35:46.978 --> 35:48.400
[SPEAKER_00]: These drugs are so good.
35:48.881 --> 35:54.870
[SPEAKER_00]: Some of them are going to burn up to 34% of these newer ones and are highly effective.
35:54.850 --> 36:01.319
[SPEAKER_00]: and people who have body dysmorphia, they already have disorder eating habits, all these things, it's just going to make your works.
36:01.660 --> 36:02.982
[SPEAKER_00]: It's not going to be better for that.
36:03.342 --> 36:10.713
[SPEAKER_00]: And those are typically the patients who initially may want that augmentations that didn't develop or they don't feel confident enough.
36:11.234 --> 36:15.019
[SPEAKER_00]: It just creates a troublesome situation to me.
36:15.252 --> 36:25.716
[SPEAKER_03]: So about nutrition and things like that, do you work with giving your patients a specific dietary protocol to follow as a preparation and all that?
36:25.796 --> 36:31.850
[SPEAKER_00]: Yeah, I'm pretty harsh on diets, so to recover, first of all, everybody needs prioritized sleep.
36:31.910 --> 36:32.772
[SPEAKER_00]: That's number one.
36:32.752 --> 36:42.324
[SPEAKER_00]: For folks who think they can get 4 and 5 and even 6 hours of sleep and do this, here mistaken, the military showed this a long time ago, less than 6 and a half hours.
36:42.364 --> 36:47.451
[SPEAKER_00]: You really drop off in terms of your ability to concentrate and do things.
36:47.871 --> 36:55.401
[SPEAKER_00]: Now, similarly, for recovery, you have to be able to get enough length of sleep and quality and depth of sleep.
36:55.381 --> 36:56.483
[SPEAKER_00]: I like metrics.
36:56.543 --> 37:02.794
[SPEAKER_00]: I like to communicate with patients about that and, you know, if you have a tracker of some variety, that's great.
37:02.915 --> 37:14.115
[SPEAKER_00]: I don't shame anybody who doesn't, but if you say you sleep well, I'm going to call, call that out and say like, how do you know like what what are you using to.
37:14.095 --> 37:25.516
[SPEAKER_00]: to make that decision because if you have an eight-sleefer, old-true human ring or a loop strap or or some something, then they shall have a data point.
37:25.536 --> 37:36.255
[SPEAKER_00]: If not, I'm going to give you the 321 stop eating three hours before you go to bed, stop drinking a couple hours before you go to bed and get off of your damn phones an hour before you're going to bed.
37:36.235 --> 37:45.307
[SPEAKER_00]: Make the room cooler, get the ambient light out of the room, turn on the sound machine, or a sleep app, or something, and get yourself organized to go to sleep.
37:45.387 --> 37:52.777
[SPEAKER_00]: Women should not be getting under the mill nut to pee, you're not old men with prostates, but you drink things to late in your day.
37:52.817 --> 37:59.847
[SPEAKER_00]: You drink to many staleies of water all day, or you drink wine to unwind at night, or whatever the thing is.
37:59.827 --> 38:02.812
[SPEAKER_00]: That makes you get up in the moment to get paid.
38:02.832 --> 38:04.454
[SPEAKER_00]: Like you should not be getting up in the moment to get paid.
38:04.474 --> 38:07.178
[SPEAKER_00]: Your HRV will suffer if you drink alcohol.
38:07.298 --> 38:08.460
[SPEAKER_00]: It's well documented.
38:08.520 --> 38:10.603
[SPEAKER_00]: If you eat late, your HRV suffers.
38:11.184 --> 38:14.710
[SPEAKER_00]: So I try to give these as just guiding principles to recover.
38:14.790 --> 38:18.315
[SPEAKER_00]: The only time you recover is really when you sleep.
38:18.916 --> 38:20.198
[SPEAKER_00]: So you have to get enough.
38:20.178 --> 38:20.559
[SPEAKER_00]: breasts.
38:21.281 --> 38:25.932
[SPEAKER_00]: I put people on a very simple like starting 100 grams of protein diet.
38:25.993 --> 38:29.702
[SPEAKER_00]: I try to have them eliminate things that I know stimulate more problems.
38:30.023 --> 38:32.689
[SPEAKER_00]: So we have a great restaurant here called the well.
38:32.710 --> 38:33.692
[SPEAKER_00]: We'll give them a shout out.
38:33.772 --> 38:36.499
[SPEAKER_00]: They have a glucofreader free citoil free menu.
38:36.479 --> 38:40.124
[SPEAKER_02]: We actually ate there, it was very good.
38:40.164 --> 38:41.926
[SPEAKER_02]: Yeah, we had to go down to Aaron.
38:42.206 --> 38:43.908
[SPEAKER_02]: Yeah, it was good.
38:43.928 --> 38:48.735
[SPEAKER_00]: So I would like all of my patients to understand that's an anti-inflammatory diet to me.
38:48.775 --> 38:54.502
[SPEAKER_00]: And so we used to give everybody, you know, gift cards and send them there.
38:54.622 --> 38:57.846
[SPEAKER_00]: And the thing is,
38:57.826 --> 39:05.121
[SPEAKER_00]: If you, if it's never been taught that or don't understand that, that's, it's really hard for you to go and feel like, oh, wow.
39:05.441 --> 39:07.826
[SPEAKER_00]: Because it don't, I'm sure you guys have been asked this.
39:07.926 --> 39:13.337
[SPEAKER_00]: You're like, one of my supposed to see if I can't have gluten and dairy and no cito else.
39:13.317 --> 39:18.123
[SPEAKER_00]: But there's a whole, it's called, like, everything that's got, you know, it's real food.
39:18.584 --> 39:31.620
[SPEAKER_00]: So that's how we began and I try to have people really think of that 100 gram of protein, 100 grams of protein, and that's just kind of the base slide, or ramp it up based on how people are doing.
39:31.640 --> 39:34.363
[SPEAKER_00]: We use amino acids in the form of
39:34.343 --> 39:41.791
[SPEAKER_00]: powder and all of my supplements are predominantly liquid-based liposomal because I have so many people with a absorption of shoes.
39:42.372 --> 39:50.481
[SPEAKER_00]: So I like to get people started early, get their inflammation down, have them cut out gluten, have them cut out dairy.
39:50.521 --> 39:53.805
[SPEAKER_00]: There's so many people who are fascinated by cheese, which in this country is terrible.
39:54.145 --> 39:54.566
[SPEAKER_00]: It's gross.
39:55.126 --> 40:00.132
[SPEAKER_00]: So that's, say, you know, part killed from those people to swallow.
40:00.112 --> 40:02.375
[SPEAKER_00]: and it just takes a fair amount of education.
40:02.735 --> 40:08.962
[SPEAKER_00]: But when they embrace it and they start to see a change, people get super motivated and they'll stick with it.
40:09.402 --> 40:21.556
[SPEAKER_00]: If they have a good, you know, partner spouse, love one relationship that they can do, you know, that at the same time with and get supported that way, I found that would be super important.
40:21.576 --> 40:23.318
[SPEAKER_00]: They got to have a successful,
40:23.298 --> 40:29.769
[SPEAKER_00]: Support group is it's not easy to do all this and Healthy fats are probably the hardest thing.
40:29.969 --> 40:45.977
[SPEAKER_00]: You know today I was operating on somebody and they have a food sensitivity to avocados Disorculate unfortunately, but healthy fats are like the hardest because nuts can have a lot of aflo talks and in it So that's probably where you will have the biggest struggle a lot of people Can you explain that?
40:45.997 --> 40:49.002
[SPEAKER_02]: Can you explain that expand on that healthy fats?
40:49.505 --> 41:01.438
[SPEAKER_00]: Yeah, there's just not a ton of quote unquote options outside of like I don't need you know a lot of other varieties of foods.
41:01.578 --> 41:15.474
[SPEAKER_00]: I like stick to not a carnivore diet, but I'll have just the high protein diet and very little like starch or carbs and then healthy fats that all constants are not on our liking nuts, but I think about it all the time.
41:15.494 --> 41:16.014
[SPEAKER_00]: I want to eat them.
41:16.034 --> 41:16.795
[SPEAKER_00]: I'm like
41:16.775 --> 41:30.938
[SPEAKER_00]: Wonder if I'm getting too many Afletalks in here because that's a way of the yeah, and we have we have we're fortunate in Texas to get a lot of avocados So we eat probably way to me.
41:31.018 --> 41:34.243
[SPEAKER_00]: Oh, God is my place, but yeah, that's the horn parer.
41:34.524 --> 41:40.774
[SPEAKER_00]: I don't I don't really dig a bunch of Carbjom just just not a thing really
41:41.058 --> 41:49.778
[SPEAKER_03]: So what's the recovery time on a situation where you're having an ex-plan and maybe a fat transfer and all of that?
41:49.978 --> 41:55.050
[SPEAKER_03]: Because hopefully if somebody comes in and travels to see you, then...
41:56.093 --> 42:01.966
[SPEAKER_00]: So for the folks who will come in from out of the country, long haul travel, we have them stay minimum two weeks.
42:03.289 --> 42:08.480
[SPEAKER_00]: And the reason being, you know, the more time with us, the better.
42:08.560 --> 42:11.807
[SPEAKER_00]: So I have someone in town right now who's gonna be your month.
42:11.905 --> 42:15.211
[SPEAKER_00]: Now, I understand that's not really practical for a lot of people.
42:15.231 --> 42:18.877
[SPEAKER_00]: They have children, their families, they can't work remote, all the things.
42:18.897 --> 42:23.264
[SPEAKER_00]: So, the short answer is the minimum time we like to have some of you is about a week.
42:23.905 --> 42:25.528
[SPEAKER_00]: So, they come in the day before surgery.
42:25.568 --> 42:32.580
[SPEAKER_00]: So, if I operate Tuesday Thursday, so Monday, Wednesday, we do, you know, pre-ops and see everybody and then we operate.
42:32.560 --> 42:44.113
[SPEAKER_00]: The thing that's a little bit different is, so we've talked about genetics and gut health through sensitivity's, talks burn and all around balance, all that's getting done pre-op, and then the native surgery is super important to us.
42:44.774 --> 42:55.706
[SPEAKER_00]: So I have people come in, they meet with us in person and we go over the plans and get all the final preparations done, and then we start what's called E-RAS the night before.
42:55.826 --> 43:01.993
[SPEAKER_00]: So that's early recovery after surgery, and what that is
43:02.108 --> 43:04.692
[SPEAKER_00]: And so a lot of folks don't want to take medications.
43:04.712 --> 43:05.453
[SPEAKER_00]: They're worried about it.
43:05.853 --> 43:10.620
[SPEAKER_00]: They've read the black box warning on everything and it's all, you know, bad.
43:11.561 --> 43:15.286
[SPEAKER_00]: What we're trying to do is get people in the right situation, right?
43:15.386 --> 43:22.496
[SPEAKER_00]: So we didn't talk about self work, but I'm not going to solve a problem that happened in your life, right?
43:22.516 --> 43:23.497
[SPEAKER_00]: I'm not a psychiatrist.
43:23.517 --> 43:26.802
[SPEAKER_00]: So self works incredibly important, but you need to be doing that.
43:26.902 --> 43:29.145
[SPEAKER_00]: And we all need to be doing a better job of that in general.
43:29.125 --> 43:33.690
[SPEAKER_00]: So, barring that, I'm just talking about what I would medically do the night before surgery.
43:34.170 --> 43:37.433
[SPEAKER_00]: I went to block things that are going to stimulate nerve pain.
43:37.914 --> 43:46.362
[SPEAKER_00]: So we give a medicine call, gap of pentin, we use an anti-inflammatory, and then we use a medicine for nausea because we want to reduce that.
43:46.402 --> 43:50.086
[SPEAKER_00]: Our patients don't have problems with throwing up and all this nonsense that happens.
43:50.727 --> 43:56.112
[SPEAKER_00]: And then, preoperatively in the morning when I see the patient, we mark them as we're doing it.
43:56.092 --> 43:59.519
[SPEAKER_00]: lift or where we're taking fat for him depending on the case.
44:00.040 --> 44:04.429
[SPEAKER_00]: And then anesthesia for me doesn't ultrasound guided nerve block depending on the type of case.
44:04.469 --> 44:09.839
[SPEAKER_00]: If we're just like today, I did two just unogmented implant removal cases.
44:10.320 --> 44:11.162
[SPEAKER_00]: Each of them had lifts.
44:11.362 --> 44:18.336
[SPEAKER_00]: So they do what's called the serenetous anterior block to help the chest get more numb before we ever operate.
44:18.772 --> 44:30.510
[SPEAKER_00]: then they go back and we typically have an anesthesia group that works with our patients to really avoid any giving any narcotic during the case, so they typically don't do that at all.
44:31.311 --> 44:36.499
[SPEAKER_00]: And then they try to keep the patients for really sensitive anesthesia, keep that to a minimum.
44:37.000 --> 44:41.286
[SPEAKER_00]: And then when I'm working, once we have an area
44:41.266 --> 44:44.271
[SPEAKER_00]: clear and think of like a pie chart, everybody knows what a pie chart.
44:44.532 --> 44:52.827
[SPEAKER_00]: So once I have a quadrim or a portion of the pie chart visible and I've removed the scar tissue from the body and I can see it.
44:53.388 --> 44:56.613
[SPEAKER_00]: I'll anesthetize that area with a combination of short and long acting.
44:56.713 --> 45:00.440
[SPEAKER_00]: The short acting medicine is like the stuff you get at the dentist that lasts for a few hours.
45:01.021 --> 45:04.928
[SPEAKER_00]: And the long acting is medicine called expertly last for about five to seven days.
45:05.093 --> 45:11.543
[SPEAKER_00]: So we do that sequentially around and then finish one side, do the other side, repeat.
45:12.244 --> 45:20.136
[SPEAKER_00]: And so our patients once they get to recovery, they're not having problems with pain, it's nothing sharp or stingy, it shouldn't be.
45:20.496 --> 45:28.489
[SPEAKER_00]: Cause we've done all this work, like they're eating others, sleeping better, they come, they understand the plan, they shouldn't be anxious.
45:28.609 --> 45:32.755
[SPEAKER_00]: I mean, people always ask if I get enough sleep, I sleep just fine.
45:32.735 --> 45:33.736
[SPEAKER_00]: they're always worried about me.
45:34.036 --> 45:38.941
[SPEAKER_03]: It's very sweet, but how long does the whole process take?
45:39.962 --> 45:53.634
[SPEAKER_00]: So we usually, for just a removal, we'll schedule about an hour and a half if we add a lift that's more of that hour and a half and it really just varies depending on how thick or thin the scars are.
45:54.215 --> 45:57.338
[SPEAKER_00]: I've done so many of them now, sometimes it goes pretty quickly.
45:57.758 --> 46:00.801
[SPEAKER_00]: We just try to leave ample time,
46:00.781 --> 46:06.174
[SPEAKER_03]: It seems pretty quick, but now we're in a half, doesn't seem long, and then what about with over side?
46:06.615 --> 46:06.976
[SPEAKER_00]: Yeah.
46:06.996 --> 46:16.237
[SPEAKER_00]: So we have a couple hours for removal about three-ish for removal on the left, depending because of glyphosominary, and then when I do a fat transfer case, it depends on the number of areas.
46:16.658 --> 46:19.144
[SPEAKER_00]: Most of us will take a little bit around four-four-and-a.
46:19.411 --> 46:28.182
[SPEAKER_02]: I think, for me, the key is really the pretty, the whole, it's not even the pre-op.
46:28.342 --> 46:39.276
[SPEAKER_02]: It's really preparing your body and your mind and your everything that is going to allow you to recover faster.
46:39.336 --> 46:48.388
[SPEAKER_02]: And your approach is really why aren't more surgeons doing this.
46:48.368 --> 47:03.492
[SPEAKER_00]: Well, yeah, we started this program right this book and I'm trying to get the program to be embraced, you know, how you want to say this is a good sound by most plastic surgeons or narcissistic asshole
47:06.492 --> 47:10.578
[SPEAKER_00]: I was always very humbled by the people I worked with especially for cancer reconstruction.
47:10.999 --> 47:18.170
[SPEAKER_00]: I worked with extremely gifted people who are very motivated in multidisciplinary groups to help patients survive, like cancer diagnosis.
47:18.791 --> 47:23.638
[SPEAKER_00]: So when you work in those groups, like everybody's really talented, right?
47:23.658 --> 47:26.783
[SPEAKER_00]: So do you spend too much time patting yourself on the back?
47:27.384 --> 47:29.928
[SPEAKER_00]: You're not there to serve the people in the group.
47:30.249 --> 47:32.432
[SPEAKER_00]: Like I was always like
47:32.412 --> 47:44.070
[SPEAKER_00]: very motivated to go to work on a Wednesday morning to attend a multi-disciplinary sarcoma group meeting because it was like EES being one of most conscious.
47:44.090 --> 47:54.066
[SPEAKER_00]: So outside of operating in the outside being the operating room now, those meetings was one of the most conscious that made
47:54.299 --> 48:15.345
[SPEAKER_00]: all the, you know, years of training and stuff I did, very worked well because it truly was like, uh, I like solving problems and so those were the biggest problems and it took everybody's attention to detail to solve those problems to get that patient, you know, from A to B.
48:16.574 --> 48:26.703
[SPEAKER_00]: and we didn't lose people, or our goal was to help make them be able to live and have the best quality of life they could with a chronic disease.
48:27.024 --> 48:37.013
[SPEAKER_00]: So if everybody understands that, so would your rather loser love one or would you have someone, you know, with a skill set like mine and others, try to give them a disease they could live with, so you could have them there.
48:37.253 --> 48:40.216
[SPEAKER_00]: I think everybody would try to have them there for the best of their ability.
48:40.256 --> 48:45.180
[SPEAKER_00]: And those are the best times.
48:46.308 --> 48:59.068
[SPEAKER_02]: time speaking with you, getting to know you, it's really been a pleasure because I really hope that our audience, and then it goes beyond our audience.
48:59.589 --> 49:06.139
[SPEAKER_02]: Here's the way that you are speaking so passionately and
49:06.119 --> 49:22.204
[SPEAKER_02]: intently on how you are helping people and approaching such a serious matter and doing it in such a beautiful way with intention, with
49:22.184 --> 49:30.319
[SPEAKER_02]: consciousness, and with all of the things that Lisa and I really talk about and want to share with the world.
49:30.359 --> 49:32.904
[SPEAKER_02]: So thank you so much for your time.
49:32.944 --> 49:37.934
[SPEAKER_02]: If someone wants to learn more about you, how do they do that?
49:38.896 --> 49:45.508
[SPEAKER_00]: I think the easiest way, if it's really interested in a conversation, then you're going to go to,
49:45.775 --> 49:49.620
[SPEAKER_00]: Dr. Robert Wittil.com and schedule a discovery call.
49:49.640 --> 49:50.040
[SPEAKER_00]: They're free.
49:50.060 --> 49:51.001
[SPEAKER_00]: You can talk to my team.
49:51.682 --> 49:59.531
[SPEAKER_00]: And if you want to learn about either our free materials, we have 150 podcasts.
49:59.611 --> 50:03.256
[SPEAKER_00]: I think over 3000 videos, we have a free downloadable guide.
50:03.276 --> 50:05.678
[SPEAKER_00]: You can access either on our store, Dr.
50:05.698 --> 50:08.462
[SPEAKER_00]: Rob Solutions, or on the website of mentioned previously.
50:08.482 --> 50:12.947
[SPEAKER_00]: I did three little mini courses, one on BII, one on
50:12.927 --> 50:15.770
[SPEAKER_00]: the sharp method, which we already discussed, and we're not fat transfer.
50:15.790 --> 50:33.286
[SPEAKER_00]: We have the sharp method book, we have the BI book, and then we have a group program that if you x-plant with somebody else or unognet with somebody else, or fat transfer with somebody else, my team can help you with the pre-opt and the post-opt care remotely running the sharp method of programming.
50:33.866 --> 50:41.533
[SPEAKER_00]: And then of course, if someone wants to, you know, as we discussed previously common and work with us,
50:42.003 --> 50:45.888
[SPEAKER_02]: adding that to the list, exactly, exactly.
50:45.909 --> 50:47.791
[SPEAKER_02]: No, it's really quite amazing.
50:48.011 --> 50:57.505
[SPEAKER_02]: You know, it's something that, as women, you know, it's very important, it's very important.
50:57.685 --> 51:06.778
[SPEAKER_02]: And I think even the things that you talked about that you speak to your patients about in what they need to do,
51:06.995 --> 51:08.016
[SPEAKER_02]: to prepare.
51:08.036 --> 51:12.802
[SPEAKER_02]: I think these things are so important and I know I'm speaking for Lisa as well.
51:13.182 --> 51:17.287
[SPEAKER_02]: They're so important to do just in general, right?
51:17.968 --> 51:24.596
[SPEAKER_02]: So we don't have to be having a surgery to do all of these things very important.
51:24.656 --> 51:25.337
[SPEAKER_02]: So thank you.
51:25.858 --> 51:27.680
[SPEAKER_02]: Yes, thank you for being on our show today.
51:28.301 --> 51:29.442
[SPEAKER_00]: Thanks for having me online.
51:51.123 --> 51:52.813
[SPEAKER_01]: lines that create
52:54.185 --> 53:08.987
[SPEAKER_01]: Beyond convention they dare to explore Breaking barriers open indoors With every step they lie the way by an earsome
53:50.969 --> 54:07.948
[SPEAKER_01]: One mission, lighting away, transforming the future with love every day With science and spirit that journey unfolds Restoring balance as the future unfolds