What GLP-1 Weight Loss Really Looks Like (From a Plastic Surgeon)

Dr. G (00:02):
You're listening to another episode of All the B's with me, Dr. G, and my scrub tech, Bri. Hi everyone. I'm Dr. Kat Gallus and I'm here with Bri. Hey Bri.

Bri (00:14):
Hey everyone.

Dr. G (00:16):
And you're listening to All The B's, our Unfiltered Plastic Surgery podcast where we break down things you need to know about plastic surgery and also unpack some celebrity news.

Bri (00:28):
Most importantly, the celebrity news. Let's be real.

Dr. G (00:32):
And we're going to try not to go dark because there's been some dark stuff on the celebrity side of things in the last week. But we are going to talk about David Harbour from Stranger Things only because this incident happened in our neck of the woods. So I guess David Harbour was accused of stealing a fan's hat outside a bar in Encinitas, which is wild. So I guess he was just on a bar pub crawl in the Encinitas Cardiff area.

(01:04):
And somebody came out to say hi to him and then he ran inside, grabbed their hat and ran back outside like, "Come on, dude." Like this was a scavenger hunt or something? No, he just ran in there, grabbed the hat off his head and then ran back outside and was taunting him, which is wild. What would you do?

Bri (01:24):
I just like, why?

Dr. G (01:26):
I guess he has a history of bipolar disorder. His marriage with Lilly Allen is imploding and I think he was also just hammered. Fair. Which is crazy. So then I think the guy got his hat back without any fight. And then he started ranting about the Iraq war and getting on his knees. And I don't know, it was a thing.

Bri (01:47):
This hat though, this guy could sell the hat now.This is an infamous hat. He's the dude at the bar whose hat was stolen by David Harbour.

Dr. G (01:55):
That is true. There is a merch opportunity there for sure.

Bri (01:59):
Yeah, absolutely.

Dr. G (02:00):
Let's hear from the guy with a hat. No, that's David Harbor looking weird.

Bri (02:03):
Oh, I was going to say, why would he be wearing a hat?

Dr. G (02:06):
Why are you wearing that out?

Bri (02:09):
What venue did he go to?

Dr. G (02:11):
It's like somebody's pub.

Bri (02:14):
Wow. Well, nothing got physical.

Dr. G (02:18):
Yeah. Everyone was safe. It's just probably woke up the next morning like, "Oh damn."

Bri (02:24):
Yeah, I can't believe I ... Imagine making headlines for just stealing someone's hat at a bar.

Dr. G (02:30):
I know. The thing is, that's the night we went out for our Christmas party, but we didn't see any celebrities.

Bri (02:36):
We did not. No

Dr. G (02:37):
Celebrities. We did not come downtown. And we did not steal anyone's hat. No, unfortunately. All right. Well, I hope he gets better or sobers up. Okay. So moving on, let's talk about more celebrity and plastic surgery adjacent stuff. So Amanda Seyfried pledges her undying faith to Botox. Finally. Bless.

Bri (03:01):
I don't understand why more people have not done this.

Dr. G (03:05):
It's funny because she appreciates it more because she was just in some movie where she plays a Quaker, I believe. And so for the movie, she wasn't allowed to do any Botox for a year and she was like, "Whoa." Yes. Sort of like when you get pregnant and you're like, wait, what? No Botox? Yeah, brutal.

Bri (03:25):
Put some Daxxy in. It lasts like six to eight months supposedly. That should last you your pregnancy almost.

Dr. G (03:32):
That's true. That's a good workaround. But for her actual job, she was supposed to emote and be a Quaker and not wear any makeup. And so Botox was not going to fit the bill there. So she said she likes it. She enjoys what it does for her face and she has no qualms about it.

Bri (03:51):
So I do have a question. Why is Botox so bad when you're pregnant? Do they think it's going to travel all the way to the fetus?

Dr. G (04:00):
No, no. It actually has nothing to do with that. It probably is safe in pregnancy, but nobody wants to test it. So anytime you introduce a drug, you'll test it.

Bri (04:09):
If I ever get pregnant again, I'll test it.

Dr. G (04:11):
If you want to get something approved, you have to do trials. And then you can do a subcategory of trials for pregnant women if it's an applicable medication, but it's extra work and money and investment and all that stuff. So because of that, a lot of drugs are off label or not considered safe during pregnancy. So there you have it. It's fair. So I mean, who's going to be like, "Oh yeah, let's test Juvederm." Trying to think of something not Botoxy that we don't test in pregnant women. Well, another classic example is like the silicone implant trials were based on women 22 and older. So they're not warrantied if you're getting an augmentation under 22. Only saline was tested and no one's bothered to go back and do it. But Motiva now is 20 and up. So it was their arbitrary cutoff. And so much in the same way when they came out with Botox or any of the other neuromodulators, no one decided, let's also run a substudy on pregnant women.

Bri (05:14):
I don't see a lot of pregnant women jumping up to volunteer for that either. Untapped more. And then they're going to go and anything wrong with the baby, they're going to blame it on that. Right.

Dr. G (05:24):
Right? Yeah. The informed consent for that would be brutal. But yeah, there's no scientific reason why injecting Botox in your forehead would pass somehow to your baby. It would be nearly impossible. But that's fine. We can all pretend we're Amanda Seyfried in a movie for that period of time.

Bri (05:45):
Yes, we could. I forget all the things that actors have to do or don't get to do for roles. Most recently with all the 50 cent memes coming out, that are so good. Everyone came back to the time where he lost a hundred pounds for that role that nobody cared about. The memes are great if you guys have seen any of them.

Dr. G (06:10):
I have not seen that, but I get it. I thought that would ... I mean, a lot of times you'll be like, "Oh, they learned all this boxing or something." Oh yeah.

Bri (06:21):
What's her name?

Dr. G (06:22):
Sydney Sweeney. Sydney

Bri (06:23):
Sweeney. Yeah. She totally transformed. Yeah. You just forget all the things people have to do for these roles.

Dr. G (06:29):
Yes. So I would say it's more difficult in my mind, although maybe we're going to talk about GLP-1s a lot today, but when actors have to gain weight for a role, so I feel like it was the informant or something, but Matt Damon gained 100 pounds or looked awful. And then, so you do that and then now what? Now you got to work your ass off to get back to where you were. I think that would be tougher than getting into phenomenal shape. There's some stupid dragon movie that I liked with Matthew McConaughey and he is jacked in it. And I'm like, damn, that would have been fun. It's stupid. I don't even remember what it was called, but they fight dragons. I feel like him and Christian Bale maybe. Oh,

Bri (07:11):
I would watch it for Christian Bale.

Dr. G (07:13):
Insane, but they're both very in great shape. But I feel like I remember reading that Christian Bale showed up for the set and was like, wait, what? I thought we were living on the edge. It's apocalyptic. When have you been hitting the gym?This isn't how I read the script.

Bri (07:31):
Protein, protein, protein.

Dr. G (07:34):
Okay. All right. So let's say we have one actress who's in favor of Botox, which is honestly so refreshing because most of them are like Kate Winslet who finds plastic surgery quote unquote terrifying. Don't do it then, I guess.

Bri (07:51):
Yeah. To each his own. I think that's the phrase.

Dr. G (07:55):
Right? To her credit, that has been her stance from the get- go, is that she's not interested in plastic surgery or changing the way she looks or fighting aging. And there are several female celebrity actresses or actors that stand by that and continue to get roles, which is nice because I think it's fair. If that's what you want to do, you should still be able to find jobs in your field that way without getting washed out.

Bri (08:25):
And I guess for acting, it makes more sense because you want to look like an actual realistic person, not a movie star.

Dr. G (08:33):
True, true. I think so too. But a lot of times we just gloss past that. I mean, if you look at the average age of the male lead and the female lead, the female lead's always way younger than reality. Generally. Or you look at, I mean, what were people losing their minds on stranger things because those kids are all in their 20s now. Okay.

Bri (08:56):
Yeah. They're like playing high school kids.

Dr. G (08:59):
I know, but that's been done for the longest time. I know. 90210. That girl was 35. Come on. Riverdale.

Bri (09:08):
Playing a 16 year old.

Dr. G (09:10):
Yeah. That's how it's always been done because the 16 year olds are being 16. All right. Let's move on. I thought this one was funny how Cher 79 would look without plastic surgery. It's frightening, but also I feel like over the top. It's like how Cher 79 would look without plastic surgery and never use sunscreen and maybe smoked two packs of cigarettes a day. Like what? What is this? Jesus. That's the image. Jesus. I mean, I know 70 and 80 year old people that don't look that old. So I feel like it's a little over the top, but I get it. It's an AI group.

Bri (09:56):
They really went for it.

Dr. G (09:58):
Yeah. AI generated image. Thanks. Okay.

Bri (10:02):
Well, she doesn't look like that.

Dr. G (10:05):
So yeah.

Bri (10:06):
Amen to Botox.

Dr. G (10:09):
And plastic surgery. Right. We should scroll up to a photo of her now actually.

Bri (10:15):
Yeah. Do we have one? That's what I was

Dr. G (10:16):
Thinking. Well, that was back in the day. If you scroll. Nope. That's like another AI. There she

Bri (10:22):
That doesn't even look like her though. Those look ...

Dr. G (10:26):
Right? That looks like somebody else.

Bri (10:28):
Not even the same person. She looks fabulous. I want to look just like her when I'm her age.

Dr. G (10:34):
Right?

Bri (10:35):
She looks so good.

Dr. G (10:38):
And when you see the younger pictures of her, you're like, oh, okay. She's older there than when she was 22, but she still looks freaking amazing.

Bri (10:48):
Yeah, she looks so good. She looks amazing.

Dr. G (10:54):
It was just random. Okay. So now we'll move on to stars who've spoken out about Ozempic because this is kind of related to what we're talking about today, which is thin is in.

Bri (11:11):
Thin is back. This really shows the trends. It was like last year was all super thick, big booty. Now it's back to little titties, super thin.

Dr. G (11:23):
Yeah.

Bri (11:24):
Can't keep up, man. Can't keep up.

Dr. G (11:27):
No, no. It's always changing. And I think we can attribute this to the access of GLP-1s. 100%. People are able to get it. And certainly in Hollywood, they've been doing it for probably longer than the rest of us, but they're now ... Some of them are not shy about their transformations. Some of them, this is a really long article where there's like 800 celebrities that are going to comment. Kate Winslet, as you can imagine, is against it, but it is a little bizarre because she thinks it's frightening that you would put something in your body and sort of makes it seem like it's dangerous, but it's actually improves people's health. So I'm not saying that if you're a hundred pounds and you're trying to get down to 95 pounds, that's the way to go. However, we have so many studies that show that it has a positive effect on your health, inflammation, propensity for diabetes, along with the weight loss, you get improvement in blood pressure, all these other things.

(12:34):
There hasn't been, besides the obvious negative side effects like nausea and a full stomach, but there's no systemic problem here. So I don't know why she's so ... It's like when people saying Botox is dangerous, it's actually not. You're fine.

Bri (12:51):
Feel like it goes, there's always that small group of people for everything that always kind of ruin it. You know what I mean? They came out and they're like, " Oh, I started Ozempic and I went blind or something. "You know what I mean? There's a very small population of people- I went blind. Yeah, that come out and they say they have some super crazy side effects and then all of a sudden it's not good for anybody.

Dr. G (13:14):
Right, right. I think there is one celebrity, and I'm using that term loosely in this long list of people who were pissed because it didn't work for them. And I'm like, " Yeah, we haven't heard that in a minute.

Bri (13:26):
I think I know what celebrity you're talking about because she was like, " Well, I out- drink Ozempic. "I don't know if it was the same one, but I was like, " Girl, if you're drinking that much wine, they're like, I was just hoping, but I out- drank it. You got to put the bottle down as well. You have to make positive changes to your life as well. You can't just take Ozempic and let it change your life. I mean, you also kind of can because it does, but you can't just be like, Oh, I'm not going to work out or I'm not going to eat healthy. I'm not going to take vitamins or supplements. I'm going to keep ... "If you're not changing your habits, it's like-

Dr. G (14:00):
Right. Yeah. I think that's the miss. If you just rely on Ozempic to cut down the general amount of food you eat, you consume, of course there's a way to work around it where you can eat less crap, but still eat crap. I feel bad for Amanda Bines. I just can't. She's hoping to get on it and lose 40 pounds. Yeah. I mean, you just have to- I feel like maybe it was, was it Renee? No. I don't know, but it has to be- I can't remember. One of these people was like, " I can't. I couldn't do it. "Some people are like, " Hey, I used it after Megan Trainor talks about using it after the birth of her second kid to get those changes in place. Elon Musk, I can't with him. "But yeah, a lot. There's an endless list of celebrities who have used it.

Bri (14:55):
I mean, pretty much I feel like everyone has used it. Honestly, at this point can't say you haven't.

Dr. G (15:01):
I think Jelly Roll says he didn't because he thinks that because of the GLP-1 side effect of delayed gastric emptying, he was afraid of reflux, gastric reflux, and then that affecting us.

Bri (15:13):
I'm so sorry. He was 200 pounds heavier last year. You were telling me he lost all that weight without taking GLP-1s. I want to believe people at this point, but that's not ... You've been heavy for God knows how many years. And then all of a sudden, within one year, you lose all of your weight just by

Dr. G (15:32):
... Well, I feel like that's the other category of celebrity in this. So there are a few people, I feel like Chloe Kardashians in that mix who's like, " I did it by working hard and gym and exercise and resents the fact that anybody insinuated she used a GLP. "And I'm like, " The harder you scream about that, the more I think you probably used it. Get out.

Bri (15:56):
"Right. If you don't want to talk about it, just don't talk about it, but don't go on it. I mean, there's so many, I'm not going to say telltales, but there are so many. So just if you don't want to say you didn't do it, just say you didn't say anything.

Dr. G (16:13):
Yeah. It becomes this weird thing like, oh, I lost weight the hard way and so ...

Bri (16:20):
I'm just going to start checking everyone's, what did they call it? Ozempic, their scrotal whatever was it?

Dr. G (16:27):
Oh my God, Ozempic penis.

Bri (16:29):
Ozempic penis. You're telling me you didn't take Ozempic or Ozempic vagina to be like, show me your vagina.

Dr. G (16:38):
We're going to need to see your genital area. I can't tell who this is, but this is a person that it didn't work for. Who is that? Candy Burr.

Bri (16:48):
Is she like a housewife or something?

Dr. G (16:49):
She must be a housewife because there's Bravo right behind her. So yeah, so Candy Burruss, Burruss was the girly who's ... I feel like I adjacently know who that is. But then there's certain people who are perfect for it. I feel like Oprah should just stay on it forever, right? She's had so many weight changes over the course of her lifetime and tried so many things and had such a hard time being consistent. And if you can just keep taking the shot and then now they're working on pills that might be not as effective, but in retrospect might be the way to go from the shot to a pill so that it helps you maintain.

(17:33):
I don't know. I feel like that might be what works for her because it's way better than going up and down, up and down 50 pounds. So I think for some people this really is the solution. But how do you think that these medications are changing what we think ... So one of the reasons celebrity is such an important role is like, how does this impact how we think the ideal body should look, right? And I would say it's going to change- It's changing.

Bri (17:59):
It's always changing.

Dr. G (18:01):
Yeah. So we're back to skinny, I

Bri (18:03):
Yeah. We're back to the no but skinny. I honestly feel like baggy jeans also contributed to that because you cannot wear baggy jeans if you have any sort of hips. Also with style evolving, it's just we're going back to the what, Y2K or whatever you want to call it.

Dr. G (18:23):
Yeah. The '90s heroin chick where there was a huge backlash. Why are all our models so thin and why does everybody look so skinny and Kate Moss, that whole era. And now we know it's not going to be heroin and cigarettes. It's just GLP ones.

(18:43):
So it's fine. It's a healthier way of doing it. But yeah, I think that trend of being thin is going to be in. Also, you need to be able to afford it. If you don't meet the ... It's another class thing. If you can't get it covered by insurance, then you need to be able to pay for it out of pocket. So it sort of falls into that. The celebrities, of course, they can afford it. I think they're going to invest in it. And I think it'll be the skinny, rich bitch kind of aesthetic is going to make its round.

Bri (19:16):
And with that being said, do you think the people that go off on the internet, what is it, the she's or hers or his? What is that website? No, I know there's a lot of different compounding pharmacies and stuff. Do you think everyone's getting really kind of the same thing? I know there's criteria and stuff, but do you think people that are doing the $99 a month subscriptions are still getting ...

Dr. G (19:42):
The right product?

Bri (19:43):
Yeah.

Dr. G (19:44):
I mean, I don't know one way or the other, but I think some of them are. If it's working, then you probably are getting the correct product. So yeah, the medical subscriptions like hers or him, I think those are the ones-

Bri (19:58):
Yeah, because there's so many different places you can get it now.

Dr. G (20:00):
Right. And the thing that I think is a little weird or frightening is that they just give you the vial and some directions on how to draw it up, which I feel like is from- Giving back to your mom. Yeah. Fraught with issues who drew up air for the first three weeks and did this anyway, girl. She's like, wait, why am I not losing weight? Because you're not taking any medication. So I think I have one patient that was doing weight loss with us, but then switched to somewhere else because she's like, oh, I purchased the month and they give me the vial. And I was like, okay. I mean-

Bri (20:35):
It's a lot of room for error.

Dr. G (20:37):
Yes, a lot of room for error. We can barely manage it.

Bri (20:40):
And then you start getting creative and making your own doses and doing things and doing more than you should or less.

Dr. G (20:48):
Yes. So yeah, I think that is a way to do it. I just don't know that. I don't know if that's the right way. It's not for us. I'm not comfortable with that. But are the versions of thin different from what people were asking for 10 or 15 years ago? I don't think so. I mean, people just want thin. People still want a snatched waist and skinny arms and skinny legs.

Bri (21:11):
Yeah. And maybe just some big boobs aand a round shaped butt. Yeah. We're just evolving.

Dr. G (21:18):
But I don't know that the breast size is as large as it was before. And same thing with the booty. It's more like a skinny BBL. People just want a little lift or a little roundness, but not, you can see me coming down the street.

Bri (21:33):
Right. Exactly. I feel like my butt was like that at a certain point and now it's definitely ... We're going back to the skinny booty.

Dr. G (21:45):
Yeah. Medically assisted weight loss. I think the concerns people bring to us are a more loose skin, right? Don't you say? Yeah. Because I think the difference between someone who's slowly lost it ... Well, the people who slowly lost the weight through diet and exercise, they still have loose skin just because oftentimes they're losing ... If you lose a hundred pounds or 75 pounds or more than a hundred pounds, I mean, it's almost impossible for you not to have lose skin. So I think that's a category of massive weight loss where no matter what you do, you're going to have lose skin. If you're losing 20 to 40 pounds, it depends. And if you did it through diet and exercise and slow go, then maybe you don't have as much loose skin as someone who took a GLP and was losing 10 or 15 pounds a month.

(22:36):
So I think that's more laxity is coming up. And unfortunately, some of those areas also as patients that are older are doing it, like their arm laxity is a concern. They're like, "Well, I didn't have this loose skin on my arm." And I'm like, "Okay, well, you were going to have that anyway probably even over time just because as you're aging." And then on top of that, you've lost weight. And so unfortunately the methods of tightening skin in the arms and the thighs are ... There's trade-offs. So then the true answer is to do a actual surgical excision, so brachioplasty or thigh lift, and a lot of people aren't ready to hear that yet.

Bri (23:16):
Yeah. I feel like no matter what, you try and do a bunch of different treatments to tighten the skin and just never ... I feel like it always, if you have that much weight loss, always ends in a thigh lift or a backlift or abdominoplasty or a brachioplasty.

Dr. G (23:31):
Yeah. It's just unfortunate. Yeah. I think if it really bothers you, then excision's probably the way to go. And then know that your skin doesn't have the same resilience it did before. So if you have crepey skin, thin skin to start with, it's going to stretch out again too. So we're really trying to do the best we can, but we're fighting aging gravity and maybe not the best quality skin. And extreme weight loss. Yes. People are asking more for Renuvion, which is tightening. And in some patients, that's a good option because it tightens up the subcutaneous tissue and it can help out. But in other patients, it can make crepey skin look worse or exaggerate some loose skin. So it just depends on the patient, unfortunately, and what your goals are. If it's more about, "Hey, I just want to reduce this area and tighten it up a little bit," versus, "I think I'm going to be able to get in a two piece and it's going to look fabulous," then now we're talking about more surgery.

(24:33):
So yeah, that would be the pros and cons of losing weight. Yeah.

Bri (24:44):
Now with social media and trends and losing weight, do you think when patients come in here and you're doing a consult, I know at least in my perspective, some patients come back and think they're going to be like this 20-year-old self. What are your thoughts on social media affecting the way that weight loss drugs have come into play?

Dr. G (25:04):
I think social media itself is really influencing what people think is influences your normal, what people think they look like or should look like or what that standard looks like. And I think it's really hard because that's not what everyone looks like in real life, right? I mean, just take, for example, makeup, contouring and lighting is already an improvement, but you add a filter. Yeah. I mean, I think it's just not reality. And then the people creating the content are usually a little bit outside the bell curve anyway. And a lot of it's like posing. I love the poses where they show sitting one way and then sitting another way and how it looks different and you're like, "Oh my God." These are things that the people doing this for a living, no, and the average person doesn't. And so you're like, "Why don't I look like that?

(25:57):
Well, because you're not standing at this really awkward position trying to figure it out and know what your angles are or whatever, how to take a good photo. So I think that can be jarring in your head. I mean, how many times have you seen patients be like, "Well, at home, you can see it."

Bri (26:18):
Oh, they'll come over and be making all these weird poses. And I'm like, "Well, of course it's going to look that way when you make those weird poses or you're bending over or upside down." You're still human.

Dr. G (26:31):
Right. And then they stand in our mirror and they're like, "Well, I mean, I swear you can see it at my house." And I'm like, "I know, but if you can't see it in just regular standard lighting, then it's probably fine." So I think we're a lot harder on ourselves than we need to be. And I think social media contributes to that so much, unfortunately.

Bri (26:52):
Oh yeah, absolutely.

Dr. G (26:54):
Definitely have to be comfortable in your skin and have to have realistic expectations. So I love the patients that are like, "Well, I am 70, so not looking to do X, Y, or Z, that's fine." Or, "I'm accepting the fact that I am my age." But it's harder when it's somebody that's younger and they're like, "Well, I'm 34 and I didn't realize having these back-to-back pregnancies was going to wreck me or losing all this weight was going to do this because I feel older than I am." Then that's a different conversation, but oftentimes their skin's a little bit better and easier to work with. So pros and cons.

Bri (27:32):
I also feel like a lot of people that come in for surgery who are still on a high dose of weight loss drugs, right before surgery, they always just want to cold turkey it and then they get really, really hungry. I feel like it's important if you do come in for surgery or you do feel like you're getting surgery in the next couple months. I think it's really good. Nobody really talks about the way you taper off of the drugs or taper down. Don't be on 15 milligrams and then go to zero and then they call a week after surgery and they're like, "I need to start. When can I start my weight loss drugs again?" Because you also need, if you're not eating, you need protein to heal. You need to eat, you need nutrients to heal. And some of these people that want to go right back on it, if you're planning on having surgery, give your body a break, slowly go off of it, plan on eating a little bit, that way you're not just ...

Dr. G (28:25):
Yeah, going into surgery in a starved state. That came up at that symposium I went to. Somebody asked because they said, "Well, what's the real recommendation? Do people really need to come off of it for two weeks?" And I've seen some people are like, they have to come off of it for six weeks or four weeks, but two weeks was kind of the reasonable goal from an anesthetic standpoint. Well, now anesthesia's like, maybe they could go a little, maybe a week or two days. The problem is that you tell people a week and they take a shot like six days before surgery. So there's that compliance issue. And then in the conversation we were having with all these other surgeons was also, you don't want to go into a ... You're not eating, so we need you to be nutritionally topped off at the time of surgery.

(29:19):
So two weeks is safe for that reason as well. And then going back on it, same thing, like, sure, you could start your shots the next day, I guess, but again, do you want to be nutritionally depleted while you're trying to heal from surgery? So that's really the reason for the two weeks before and two weeks afterwards. And sure, we could adjust it a little bit depending on the patient, depending on the type of surgery they had. But the one person who was asking the question is like, "Well, some of these people, they come off of it for the two weeks and they just eat for two weeks before the surgery, and then they're mad that they lost or they gained 10 pounds, and that's part of what you're saying, which is like, hey, you You know you're going to be hungry, but eventually you want to come off this medication, maybe try and taper down up to that point or don't be on a high dose and then come off of it or at least be prepared to eat a little bit and gain a little weight and know you have the tools and the ability to take it off later.

Bri (30:18):
But also from an anesthesiologist's point, our anesthesiologist specifically, because it delays gastric emptying, he's not just because of increased risk of aspiration, he's not going to do your case if you have not been off of it for two weeks.

Dr. G (30:33):
Yeah. So when you look at national guidelines, sometimes they're trying to incorporate, I'm scheduled for my hernia repair or I have appendicitis. Those are all different types of surgeries. If your appendix is burst, you have to have surgery. It doesn't matter what you're on, we're going to have to deal with it. If you have a scheduled hernia repair, it's maybe semi-urgent or something like that, then they might make some other accommodations or breast cancer surgery or something like that. But yeah, we're doing fully elective. So taking the safest possible route is kind of the way to go. It's silly to not.

Bri (31:13):
Right. Yeah, exactly. We also had an outside surgeon one time come in who had done, I think he did a facelift or something, and he was like, she went right back on it right after the surgery and all of a sudden some of her skin started to die. He was like, "You have to eat protein." So she started to eat protein and it got better. But you just ...

Dr. G (31:34):
Nope. I had seen that in my vegetarian patients too where I was like, "This one area is slow to heal. It's been a problem." And I was like, "You've got to get some protein in. " And thank God for those Shabani yogurt drinks. I was like, "Can you just suck one of those down or two down a day?" Because in the past we had Ensure, which was sugar and a little bit of protein. Those post-op nutrition drinks were terrible. But I was like, "If you can do yogurt, which you can if you're vegetarian, please just knock back a couple of those. It's easy. It's not a protein shake. It tastes good." And then sure enough, after a week of that, she started turning the quarter. It really does matter. And I think we're talking with somebody about that in January on our podcast about all the things for making sure you're optimized for healing.

(32:23):
I aways say even with when you're getting a BBLs, you got to feed the fat. I mean, don't go and eat a cheeseburger and a milkshake, but have enough protein to where you're given your fat, you feed it, give it a chance to survive.

(32:37):
Yeah. You need to support your body while you're healing for sure, whether it's a fat transfer or incisional surgery, whatever it is. So yeah. And I think figuring out what your true goals are important. If that's your aesthetic, that's fine. But remember, it's regional, it's heavily influenced by social media. And so it needs to still be true to you and your lifestyle. So if you want larger breasts and you're not an active CrossFit girly, that's probably works for you. But if you come in and you say, "Oh, I love doing pushups or I'm horseback rider, I run a lot," then maybe putting in larger implants is not the right fit. Maybe you want to downsize a little or, I don't know, figure out what your aesthetic is.

Bri (33:28):
Right. I don't know. Everyone's different.

Dr. G (33:31):
Yeah. We don't all have to look like a Kardashian. It's fair.

Bri (33:35):
But with that being said, we do need to get Botox with all the wrinkles.

Dr. G (33:41):
Everyone should do the Botox. Yeah.

Bri (33:43):
I feel like you see it in your face first when you take Ozempic and stuff like that. It really, really- It does thin out the face.

Dr. G (33:51):
I know. It does thin the face out for sure.

Bri (33:54):
Yeah. It's giving Bradley Cooper.

Dr. G (34:00):
Yeah. So that thinning of the face, that's definitely something to consider. You can offset it with some fillers, although fillers are less and less popular right now, but it is an option.

Bri (34:11):
I feel like people are going for the 30-year-old facelift.

(34:16):
I know.

Dr. G (34:17):
That's the new trends are.

(34:21):
Facelift at 30.

Bri (34:23):
Yeah. Great. Honestly, I feel like I could do a little something, something.

Dr. G (34:28):
I mean, always we could do something, but got to figure it out. Okay. Well, if you're listening today and you have questions about GLP-1s or how that might impact your plans for surgery, let us know. Drop some notes or comments and we're going to scrub in.

Bri (34:47):
And scrubbing out.

Dr. G (34:51):
If you're listening today and have questions, need info about scheduling, financing, reviews, or photos, check out the show notes for links. Restore SD Plastic Surgery is located in La Jolla, California. Learn more about us, go to restoresdplasticsurgery.com or follow us on Instagram at RestoreSD PlasticSurgery. If you enjoyed this episode, please share it and subscribe to All the B's on YouTube, Apple Podcasts, Spotify, or wherever you like to listen to podcasts.