Dr. Rady Answers YOUR Questions: From Sleep Apnea to Quick Recovery Breast Augmentations

Welcome to another episode of Plastic Surgery Uncensored. I'm your host, doctor Rady Rahban, and we have a wonderful episode for you. We're doing our Q and A, our monthly Q and A question and answers, and as always, I am joined by Maria, my lovely producer, who is actually here in the flesh. She has joined us here from Miami, here in Los Angeles, actually Beverly Hills.

All right, Marian, Maria, go ahead and read me the questions, and let's give us shout out to you all who have actually sent in the questions via social media. What do you got? Okay? The first question comes from Parissa dot Hannah. Parissa dot Hannah, here's your question. What are your thoughts on lymph massage impacts with consistent treatments from a professional.

So I think you're referring to lymphatic massage and listen, bottom line, I think it's bullshit. People who do lymphatic massage will have be up in arms, they'll probably be picketing outside my office. But I just think this whole idea of lymphatic massage, there is absolutely very little science behind it. And what are we treating and why are we doing it.

People will just do it because it sounds good. So we're massaging the lymphatics to move swelling out because it's stuck. What are we doing? I don't even understand it. So my personal opinion, it's my opinion, is that lymphatic massage is a nonsensical, unnecessary bunch of malarkey and it's super super marketing driven.

Now, I also don't do a boatload of liposuction. I also don't do circumferential three sixty three ten leader liposuctions. So if that's what your surgeon's recommending, knock yourself out. But I sure as hell won't allow one of my tummy tech patients to do it because there's no need for you to do it.

All you're gonna do is destroy the suturing that I did inside. So I think it's mostly nonsense. Well, in Miami is very popular. It's popular everywhere because everything that's trendy is popular.

People love to do shit that has little science. That's what we like to do. Okay, I really laugh at some of your responses. Okay, the next question comes from Benarebbi.

Benarebbi. Okay, the question is can you have a tummy tuck after already having had hernia repair with mesh. Okay, so as all of you know, at least if you follow me, and if you don't, all repeat it again. One of the things that I do often when I do a tummy tuck.

It is very very very common for a woman who's had multiple pregnancies to have diastasis RECTI muscle separation, and within the diastasis for you to have a concommonant that means at the same time hernia, whether that's through the belly button or through some area within that area. Why, because the muscles come apart, the tissue that's in between becomes very thin and shitty, and then you get a hernia coming through because there isn't enough support. So many times these patients go on and get their hernia repaired before they come to me, and it's just a waste of time because they stick a piece of plastic or mesh on top of it, they reduce the hernia, push it back in, and stix some plastic under it. So it doesn't often work because you're putting a piece of mesh or plastic on tissue that's already thin.

So the right way to do it is go get your abdominoplastic in which you fix the muscles through which you fix the hernia because you push the hernia back into the abdomen and then bring the muscles over it, and instead of using plastic or mesh or alader or anything, you're using your organic muscles to cover up the hernia. Now that's not the question. The question is if you had it already done, can you still get a tummy tuck? And the answer is yes. Sometimes I'm able to remove the mesh aka plastic, and sometimes I'm not able to remove it, but I push it in deep and bury it under the muscles so it's not on the surface.

But I've done many many tummy techs in individuals who previously had her near repairs and it works just fine. Okay. The next question comes from then I'm a lily. Okay, then I'm a lily.

I don't know. And her question or his question is what are your thoughts on exercise to change facial structure. So what it means is there are doctors that are suggesting that if you exercise like this, like this, doing facial exercises like lifting weights, it'll lift or change the muscles of your face. Which I think is ridiculous.

So yes, if I work out my biceps every day and I build muscle, it will eat the fat around the muscle and then make my skin tighter and I'll have big arms. But I don't see people working out their face and all of a sudden their muscles or their face become thick, large and somehow magically pulled there. I just don't think it translate to facial facial esthetics. So again my opinion, I think it's a nonsensical concept, and I wouldn't waste my time.

Dude. If anything, when you fire your neck, at least your neck, and you do that over and over again, you build the muscles in your neck and you get bands. Again. If you fire, you're in between muscles, you make them stronger and you get lines.

So I don't I'm not sure what this nonsense is. So you get better one thing, but you can get worse than something else. I think it's just a dumb concept. Okay, I wouldn't do it.

Okay. The next question comes from M Frank Oh eight. M frank oh eight, what's the question tattoo skin color to specifically cover scars? Good idea? When to do it okay, great idea. So you don't want to mess with a scar, revise it, redo it, tattoo it, injected you.

I personally think if it let me back up here. If your surgeon does an excellent job of closing you, then you don't want to mess with your scar for nine to twelve months period, because that scar is undergoing natural maturation and change. It's getting red, it's getting thick, it's getting irritated, it's fading whatever. That process should be very mild.

If your surgeon does a shitty job, or basically your surgeon doesn't do the job, but somebody else closes you, then your scar might be horrific and terrible and time will never help you. But if it's closed well after twelve to eighteen months, you should start seeing it's really fading. And if you see that, then you should just leave it alone and let it fade into nothingness. If, however, you've waited a long time and a scar is visible and you seem to have some color meaning I'm a dark person, a scar is light, I'm a light person.

My scar is a little dark, then tattooing for color is not a bad idea, And you can say for example, find an excellent tattoo artist to tattoo the color of your normal skin into the scar, because scar often doesn't have the same color as the rest of your skin. So the scar is flat and the scar is thin, but the scar is a different color, so it's like I can still see it as a very thin line on your body. If your scar is like that, then yes, tattooing it is not a bad idea. When to do that, I'd wait for the scar to mature, and that usually takes eighteen months or two years.

I wouldn't go four months afterwards and start tattooing it because it's changing and you don't know what you're tattooing. So I would wait to the scar is fully matured. And if indeed it's just thin and flat but has a color issue, then yes, tattooing I think is a very good idea. I never even thought about that.

Yeah, that seems like a good idea. Well, I think we should go on a break, and we'll take a break. Yes, all right, that means you're tired. No, okay, all right, let's take a quick break.

We're gonna come back with a whole bunch of other questions. That you guys have asked, and we'll make sure to answer them for you. All right, let's take a quick break and we'll be right back. All right, welcome to the second half of Q and a's we're just continuing on here, Maria, what kind of ques? What else you got for me? Okay? Well, this one comes from Snoobi's nineteen sixty three.

Oh it was born in the same ye, all right, me hebies nineteen sixty three. That's the assumption is that there was the year they were born. Okay. Potosis, I don't know what that is.

Okay, first of all, it's not potosis. What is it? It's ptosis, there's silent Okay. Cytosis is exactly right. Sotosis actually means in medical lingo, sagging.

Oh, so you have tosis of the breast and you have tosis of the eyelid. So I'm going to answer as if it's both, because I don't know what they were referring, because the question saytosis, and I don't know what the hell that means. So some individuals they're eyelid and it's usually one, although it could be both. Sits low in comparison to the either eyelid such that when you look at them and you're looking right at their pupil, the eye on the normal side sits above the black pupil, whereas the eyelid that's affected sits close to the black of the pupil.

And that means that the garage door opener of the side that's affected is a little loose and it goes too far down. So that's tosis of your eyelid, and that gets corrected by a surgeon who then tightens up the muscle because it's a little lax, and then that as it tightens, it makes the resting position when it's open sit a little higher and then match the other side. That type of repair, tosis repair should be an It should be done by an eye an oculoplastic surgeon, an ophthalmologists, because while I do a lot of islid surgery, the islid surgery that's associated with tosis repair is a very sub specific subset and I think it's best handled by guys that do only tosis. So what's the difference between that and when you do the islid skin leftroplasty is not about where your eyelid margin sits, but the excess of skin above your eyelid.

Ptosis is where is my eyelid? Where are my eyelashes resting? And they're resting low? Dermatoculasis aka too much eelid skin is that the skin above my eyelid is literally hanging on top of my eyelashes, but my eyelid itself is not sitting low. Okay, great question. Now tosis a breast means breast sack. And when your breast sack, the treatment for ptosis is breast lift.

Breastlift means I'm removing excess skin of the breast such that I'm lifting the nipple. The nipple and the aeriola are what's sagging, meaning the nipple aeriolar complex have drifted down from weight loss or breastfeeding or just frankly gravity. And so when you do a breastlift, you're lifting the nipple hence correcting the tosis. Whether you add an implant or is not relevant.

That's a tip that's that's dealing with loss of volume, and often it's done together. But true breastosis is addressed by doing a breast lift. Okay. So the next question is from let me let me see here, It's from It's MOHI Okay, it's mohai, what does Oh I'm sorry, how can one if they need botox, foreheadlift or upper blepharo one of my eyebrows is a little lower.

Okay, so I think let me translate the question for you. So this person's asking, if one of my eyebrows are lower, how do I fix that? Do I do a use botox, B do a brow lift, C do something with my eyelids, bleferoplasty, D some of the above together. So the answer is it depends. So first we need to describe what causes brows to be a semi trick.

It is incredibly common for people to have asymmetric brows. I would say ninety nine point nine percent of people. If you stare at them and we were to really actually do an analysis, two brows are never the same place. The reason being is the brows are positioned based on muscle movement, and a lot of people raise one eyebrow because they use that muscle more than the other one.

It isn't a static thing. When you stand there in front of the mirror, your breasts are hanging by gravity. That's the only thing impacting your breast when you're looking in the mirror and you're looking at your eyebrows. What's affecting your eyebrows is not just gravity.

It's affects by the muscle. So more muscle pull on one versus the other will affect the position of the eyebrows. And that's not just where they're sitting. So each of these items has an impact.

Botox is a very tricky way to get brows to elevate. Botox is not used to elevate brows, despite what everyone says, Botox is used to get rid of wrinkles in the forehead. When you inject botox, it paralyzes the muscle. When it paralyzes the muscle, the patient can't move their forehead.

When you can't move your forehead, you get no wrinkles. Well, where does the brow lift come from. The brow lift comes from not botoxing the brow. So you botox the middle of the brow and not the sides of the brow, and the eyebrows automatically raise because they're unaffected.

People are always asking me, please inject botox in my eyebrow to make it go up. No botox in your eyebrow makes it go down. It's not injecting botox in your eyebrow and injecting botox in the middle that makes your brows look like they go up, so it's not a really direct way of raising the brow. The next way is removing eyelet skin.

Well, eyelet skin will have no effect on your eyebrow. It affects the skin underneath your eyebrow and in your eyelid. The last is brow lifts and browlers are incredibly effective and highly recommended when your brows are beginning to sag, and there are three or four different types of brow lifts. All you need to know is that the brow position where it sits on your face can be altered by removing excess skin in your hair lines somewhere up top, such that you could do something like when you're young, like Bella hadid all the way up to when you're eighties, and you need to lift all of your brow together.

So it's not so straightforward. It's not so simple. The eyelid and the brow or a unit. And in order to look wow, you're look gray, Maria.

You need to fix the eyelid and the brow together. And there's a certain amount of each of those that you need to do, and that's got to be figured out by your doctor. It looks horrible. When you see these women with the eyebrow up here, you know they've gotten the boatox I mean for me, it's a short sign of the boat.

Yeah, I mean, I mean. Listen, everything that we do has to be done in a way that looks natural. So if you overdo your nose, it'll look done. If overinject your lip, it'll look done.

If I overpull your face, you look done. It's the same thing with your breast dogs. So those individuals are getting shitty work done. Wow, it sucks spend money to get the crazy part.

Many of them think they look good. They like that look god. Okay, this question comes from not jazz, but jazz. Okay, not jazz, my jazz.

Okay, Okay. What does fast recovery breast dog mean? And is it significantly different than a regular one? There's such a fast recovery breast dog is marketing ding ding ding ding Ding. It is absolutely no different than regular breast dog. What the f does that mean? It's a regular breast dog.

Listen, guys, If it's too good to be true, it's not true. So what it is is when you do a breast dog, if you do a good job, the patient is sore. If you do a shitty job and there's a lot of bleeding and you cauterize the chest and you shove in a huge implan, then the patient is in pain. So the idea of fast recovery is the doctor is suggesting that they do it so cleanly that the patient seems to be fine after surgery, very quickly, great, wonderful.

It's no different than a regular breastog. If that's the case, every one of my breastogs are fast recovery. But the reality is that you still have an implant put in your breast, you still have an incision, you still have separated the muscle from the chest wall. You still you still you still it's surgery.

And the fact that you're not having significant pain awesome, but you still have to give it the time it requires. So the reason doctors like to label things is quick recovery, lunch time. Why is it that doctors love those terms short scar, mini scar? Why we want your money and the things that prom to minimize a little bit. Exactly what prevents people from doing surgery is fear.

Fear of what fear of scars of pain. Fear is pain and fear of recovery. So if I told you, Maria, I'm going to make you look like you're twenty nine years old, it's not gonna hurt. You have no scars, and you'll be back to work in two days.

I guarantee you you will sign up in a split second. But that's not gonna happen. So we tell you that the recovery is shorter than it is because we want you to do it. If I tell you the recovery is four to six weeks, you're like, ah, I can't take four to six weeks off.

If I tell you the recoveries four to six days, you're like, I can do four to six days. Yeah, it's the same damn surgery. It's just got a fancy name. So that's what fast recovery.

Yeah, they tell us what we want to hear. Yeah, exactly. Okay, okay. So the next question, and this applies to me, Yes, how does sleep apnea affect you when having surgery? So sleep apnea is one of those Again, there's certain diagnoses that are very straightforward, and you know what the problem is, Like, I'm a diabetic, I have my pancreas doesn't generate enough insulin DA DA DA, But like sleeve APPNE is one of those not so sure what it is and what sleep appne is essentially is that when I sleep, in the midst of sleeping, I don't exchange oxygen and I go apnic for a period of time, which means I don't exchange air, and so that means I'm not getting enough oxygen while I sleep, and often it presents as feeling tired the next day and as a result, it throws off your physiology.

The problem is that nobody knows what the causes are. It could be a million things. Often the problem is that when you're asleep, your airway closes down, and it usually is due to a weak jaw, or being overweight, or having a big tongue, or having bad tonsoles. There's hot a number of reasons why when you sleep you do that.

I've heard that, and so as a result those individuals, the treatment for it. Our device is called c PAP, which is essentially positive airway pressure, which is you put a mask on while you sleep and it forces air into your system, which forces your airway open so you can move air and sleep well through the night. If you are a person who is diagnosed and being treated and you're fine. Nothing happens because remember, when we do traditional surgery, we put you under general anesthesia, which means that we put it two in your airway, so your airway is a hundred percent secured.

We are breathing on your behalf. We're bypassing your whole system. We don't give a shit about your tongue, your mouth, your jaw. We have a tube that goes from the machine straight to your lungs, and so it's the safest type of surgery in my opinion, because we are not relying on anything besides the device and your airways.

I suspect, and I don't know this for sure, if you have sleep app now and you're undertreated or undig and you do conscious sedation, which means you're sort of semi await, you're almost like in a really deep sleep, then I suspect you could run the risk of getting app NIC while you're under conscious aidation, because to begin with, when you're not under consciousidation, you're not breathing well, let alone when they put you under sedation. But for general and to tray your anesthesia makes no difference whatsoever. Because I had read an article of someone dying in a procedure and the result was that the patient had not told the doctor that they had sleep apnia. And I read that shit, and oh my god, I gotta tell that to ye again, and I guess and again.

Chronic sleep apnea, you've had sleep apnea for years, no one knows about it, you haven't been diagnosed. Leads to other conditions like high blood pressure and all these things. So the assumption is the person has sleep apnea, they know about it, and they're being treated for it. Right.

If that's the case, you should be fine. But I think from when it comes to people who are doing I would bet you that person was under conscious adation. I would bet you they would be. They were twilight and their airway was not controlled.

But when we do general anesthesia, your airway is protected in other ways. We don't care about anything because your airway is has a tube and in breathing on your behalf. Does that make sense, yes, But if you noticed I told you that very quickly. Yeah, I'm not concerned about it at all.

Good, good, good good, Nope, that's we've got all the questions. Let me, I'm trying to see. I know that we've had comments. We have a common home.

All right, we have a comment. It better be good. Ye hear informative. This comes from a Victoria.

See a Victoria See we love you. Thank you for sharing the positive. Yeah you know how you always say that at the end of each episode, share and share it says. I started listening to doctor Robond's podcasts in order to gain more information and insight into the world of plastic surgery.

I was interested in a few different procedures to address my pregnancy and breastfeeding altered body. This podcast us was pertinent in aiding my research, determining which procedures suited me and what questions to ask potential surgeons and consultations. Doctor Roban is detailed, oriented and offers honest information up to several consultation months of research and listening to this podcast, I'm happy I chose doctor Robond to be my surgeon. Also, she chose you.

That's great. So the goal of the podcast, and I love what she wrote, is for you to get information from which you can go out into the world and make informed decisions whichever surgeon your heart desires. Never once is at our intention, were ever once suggested that you need to come to me or to our practice, but rather if you're going to go and you're gonna be in Wyoming or Germany or South America, these are the things you need to know when you go and ask questions. If you come to me, all the better, We're so honored.

If you don't, great, go get it done somewhere else. Make sure you make a good choice. That's great, it makes me happy. Perfect.

And then the last comment I have here is from Malu underscore V. I've been following doctor robann In for a few years now, and I truly enjoy how he always speaks frankly about the good and the bad of plastic surgery. I especially love his candidate approach to love. I mean, I crack up someone that sometimes I hear you love his candidate approach to explaining each procedure and his reasoning for choosing or not to take on a client.

He never leaves you with more questions than answers about anything. I'm a registered nurse and I always learned so much by listening to doctor Ruban Well. I appreciate that. Yeah, I mean, our job is to be transparent.

I happen to have my own style of being transparent. But the key is to truth is the truth. There's no other version of the truth. Some of it is my opinion, and you'll always hear me preface it.

This is my opinion because I never want to mislead anybody. I certainly wouldn't speak about something that I don't know. And then some things are just my experience. So we have opinion, we have experience, and we have science, and together that should be what you rely on in order to guide people and give him, you know, put him in the right direction.

Classic surgery is amazing. I love what I do. It's it's like it's like magic, but it has fall out and there's a ton of people trying to make a ton of money, and people are vulnerable, and so you just all I do is I put it out there and I hope people get hold of it. That's all all right.

Well, that wraps up another episode of plastic surgery Uncensored. I hope you enjoyed that. Q and A session. As always, the two parting information and number one, go write something nice.

Look how beautiful those comments are. They make us feel good, makes us want to keep doing these episodes. So write something nice and yes, yes, and lastly is to share and download these episodes, share them with people you love. You just never know when someone's in a company and be like, oh shit, I just had this surgery done and it's terrible, and you're like, oh my god, I didn't know you wanted to even do this.

Share it before you realize that it's too late. It's valuable information, and I guarantee you one day someone company like, hey, by the way, thank you so much for sharing me that Plastic surgery Uncensored podcast as always a pleasure. Thank you so much. Until next time, I'm your host, Doctor Rady Rahban signing off on Plastic Surgery Uncensored.