About the Episode
On this episode of Carpools & Cannulas: Modern Motherhood and Plastic Surgery, Dr. Gallus and Dr. Greer talk male plastic surgery: who gets it, and what men usually choose to enhance. Procedures they discuss include Botox®, dermal filler, gynecomastia, and liposuction.
Transcript
Dr. Greer: Okay, we’re on. I did the, like, “Oh, I have time for three more tuck-ins and five more kisses,” and then I’m running downstairs and scrambling, but we’re here, and Dr. Gallus will be here any second. And tonight we’re talking about male plastic surgery, which is fun because, you know, people always think of plastic surgeons as women. Okay. I see Dr. Gallus. Let me pull her on. We got the Instagram working now. Doctor is muted. Hey.
Dr. Gallus Hey.
Dr. Greer: I’m, like, scrambling. It’s my usual, “I have time for one more good night kiss and one more snuggle,” and then I’m like, “Oh crap, it’s 8:30.”
Dr. Gallus: Yeah. I managed to get home a little bit earlier today, so…
Dr. Greer: Nice.
Dr. Gallus: Not, like, literally running up the stairs.
Dr. Greer: No. It’s just like…
Dr. Gallus: And be like slam the door. Hi, bye. Yeah,
Dr. Greer: I know. I’m, like, the queen of I can fit in one more thing. Which I can’t. But that’s okay. How are you? It’s good to see you.
Dr. Gallus: I’m good. How’s it going?
Dr. Greer: Good. Good. I’m excited to talk about male plastic surgery tonight.
Dr. Gallus: Yeah. I mean it’s half the population, they deserve to look and feel better, too. Right?
Dr. Greer: Yes. Although, I will say, proportionally a much smaller percentage of my practice is males.
Dr. Gallus: Oh, absolutely.
Dr. Greer: Yep. But, you know, a lot of them are, like, totally average people who just want a little Botox, or they don’t wanna look angry, or they don’t like the forehead lines. So…
Dr. Gallus: So besides Botox and maybe an occasional filler, what would you say your most popular…
Dr. Greer: Procedure.
Dr. Gallus: …surgical procedure is for men?
Dr. Greer: It’s definitely body contouring category. I would say lipo as a whole if you especially include the chest and gynecomastia.
Dr. Gallus: Okay. Yeah. I would agree with that. So I think I would say liposuction is probably the most popular.
Dr. Greer: Yeah. It’s like those love handles. That’s the area right there.
Dr. Gallus: Yeah. It’s very stubborn. So even if you’re at a healthy weight, it’s your…you know, where the beer and tacos hang out and…at least in San Diego, that’s what it is. Maybe your IPA and tacos are hanging out.
Dr. Greer: Yep. Yeah. We have, what, beer and donuts. I don’t know. Clevelands sell the Midwestern junk food. But yeah, like you said, even if you’re at a healthy weight, a lot of guys have that hip fat that just doesn’t want to go away.
Dr. Gallus: Yeah. A hundred percent. So yeah, it’s easily accessible with lipo. We’ve talked about liposuction before. I feel like for a while men were trying to do the coolsculpt thing because I do think they perceive having a surgical procedure as a much bigger step to take. And so the idea of, like, maybe you could just inject something magical and it’ll dissolve the fat, and I can say I didn’t have surgery is appealing. But really liposuction is the way to address love handles.
Dr. Greer: It is nice. Although I have gotten some really good results on guys. I have a couple who are, like, active military, and so they don’t want any downtime, can’t handle any downtime, and we’ve gotten really nice results with them. But then I’ve had a couple who are like, “Yeah, let’s just do the lipo.”
Dr. Gallus: Right. Right. And yeah, I find sometimes if I have it at my disposal, I’ll use VASER to start with, just because it makes the rest of the liposuction a little bit easier. So for those that don’t know, VASER is just an ultrasonic liposuction cannula, and it uses ultrasonic energy to sort of melt the fat a little bit.
Dr. Greer: Yeah. It’s kind of magical. I’ve actually never used it. It’s just not something I’ve had access to, but it is pretty magical.
Dr. Gallus: Yeah. I remember being very skeptical at first, though, because we had an ultrasonic liposuction machine when I first joined the Navy, and it didn’t work that well because it was ancient. And like most things, it went away and then, like, got back as VASER, and you’re like, “Are you gonna try and start with ultrasound again?” But they’ve done so many improvements to it. It is really excellent and does…
Dr. Greer: More powerful.
Dr. Gallus: Yeah. Does melt that fat, less concerns about overheating the tissue because that’s the side effect, is heat. And the love handle area on both men and women is kind of fibrous. And so…
Dr. Greer: It is. It is.
Dr. Gallus: …it makes that a little bit easier.
Dr. Greer: Yep. Oh, and that’s an area…I love using a basket cannula, which…so cannulas… We’re “Carpools and Cannulas.” But the cannula is the little metal tube that sucks out the fat. And it usually just has little holes around it, but a basket cannula has, like, a little wireframe around it, and it’s a really nice way to break up the fat mechanically if you don’t have access to a VASER. So a lot of plastic surgeons… And I bet you probably use that when you don’t have VASER.
Dr. Gallus: Yeah. I love that basket cannula. Yeah. I have one…
Dr. Greer: Me too.
Dr. Gallus: …I take with me in case…if I’m at a new place and they’re like, “Oh, we have liposuction, we have canulas.” And you’re like…
Dr. Greer: You’re like, “Need my basket.”
Dr. Gallus: … “Do you have this one? Because I need this one.” Yeah.
Dr. Greer: Yeah. It’s super helpful just to break up the fat, and then at the end, you can kind of redistribute what’s left and get this really nice, smooth result. It’s actually a technique called SAFELipo, which stands for Separation, Aspiration, and Fat Equalization.
Dr. Gallus: Yep.
Dr. Greer: But yeah, those fibrous hips. Which, I’ve had my hips liposuctioned, and it was awesome because it was just, again, like, even when I was at a fairly healthy weight, I just had the muffin top.
Dr. Gallus: Yeah.
Dr. Greer: But I do think guys tend to carry that a little bit more. And then the chest fat, too, can be really fibrous. And with gynecomastia, for those of you who don’t know the technical medical definition, gynecomastia is the glandular tissue that really commonly occurs in guys right behind the nipples. So you’ll feel, like, this firm little lump of tissue. But it also…
Dr. Gallus: Yeah, right here.
Dr. Greer: But – you know, they also get a little extra subcutaneous fat over their chest. So we do liposuction to remove the subcutaneous fat. Sometimes that little bit of glandular tissue is so small that once you get rid of the fat it’s not a big deal. Sometimes we’ll make an incision and actually just excise that as well and do a combo approach.
Dr. Gallus: Right. And that’s…I almost always do a combo approach. I did a lot of this when I was with the military. I would try to do liposuction only, and occasionally, if you don’t address that little bit of breast tissue behind the nipple-areolar complex, and they come back, it looks good, but they feel like their nipples…
Dr. Greer: They can feel it.
Dr. Gallus: …are puffy or…yeah. Or it gives their nipples a puffy look. And so, there are a few instances where…I did one recently in a teenager who’s a little heavier, and we did liposuction only, actually, and added Renuvion for skin tightening to avoid doing a skin excision, and he absolutely didn’t want any, like, visible scars on his chest. Right. And I get that. You just…we have these little holes where we put the cannulas and no one can tell that you had surgery.
Dr. Greer: Yeah. I mean, it could have been a mole, it could have been a cut. I mean, a lot of times you can’t even see it.
Dr. Gallus: Right. So, you know, it’s like every procedure we do, it’s patient selection and then making sure we tailor it to the patient. And then there are a few patients, active duty military sometimes, who are, like, extremely fit, have no body fat, and really just have that little retroareolar breast tissue that needs to be excised. And that can be done without doing the liposuction. I usually directly excise it. I know sometimes surgeons will use weird tools to shave it down or whatever, but I really found…
Dr. Greer: Yeah, I do the same. Like, you just pull it out a little and excise it.
Dr. Gallus: Yeah. Right.
Dr. Greer: Although I have to say, so often it’s done through an incision right around the areola. And there was actually a discussion the other day amongst some of our colleagues about doing the incision right across the areola because you can get this weird puffiness at the edge. And I see the advantage there. I think I am probably gonna switch to that and try it, because you don’t want that areola definition, especially in a guy. It’s okay in a woman after a lift. But for a guy, there’s a good argument for going right across the areola and then it blends in a little bit better. I don’t know, have you tried that at all?
Dr. Gallus: I’ve never done it. I’ve seen it in patients a couple of times. Sometimes it’s more…if it heals…
Dr. Greer: More, yeah.
Dr. Gallus: Yeah. If it heals perfectly when you do the areola incision, the border, you know, it’s really hard to see.
Dr. Greer: Invisible. Yeah.
Dr. Gallus: So yeah, I have…yeah. I could see the advantage. And I really do try to evert and, like, kind of make sure that there’s tissue underneath so that there’s less opportunity for things to dip down.
Dr. Greer: Right.
Dr. Gallus: I did work with a surgeon at, you know, kind of in a…it wasn’t a cosmetic setting, who would make the incision, like, straight up on their chest because the argument was that then it doesn’t look like a gynecomastia incision. I’m like, “Yeah, it looks like…”
Dr. Greer: Probably doesn’t really look like a cosmetic surgery incision.
Dr. Gallus: “It looks like they got stabbed, but okay,” in two different locations. Like, it was really insane. And I was like, “Okay, you do you.” I don’t know that I would want that.
Dr. Greer: That’s kind of funny.
Dr. Gallus: Like, you’re worried about people looking at your chest, and now we’re gonna put these two, like, 3-centimeter incisions in random places. I don’t know. And then…
Dr. Greer: That’s interesting.
Dr. Gallus: Yeah. I’ve never seen anybody else do that. And then in San Diego, I mean… Oh, I don’t know, I’m sure Ohio is the same way, but everyone’s tattooed. Have you ever…
Dr. Greer: Oh, yeah. Full sleeves. I mean the anterior neck tattoo, even, is becoming more popular these days. Yeah.
Dr. Gallus: So it always used to…the whole thing about trying to make the incisions as small and inconspicuous as possible, because, right, we’re talking about your chest, and the last thing we wanna do is fix the contour, you know, make the contour better, but then… Like how I’m talking with a hair tie. Fix the contour, but then draw attention to your chest with these weird incisions.
Dr. Greer: Right.
Dr. Gallus: But it was always super interesting to me that some of the guys who were very fit and their concern was gynecomastia, would have, like, their tattoo centered on the center of their chest. Like basically…
Dr. Greer: Like, in between…
Dr. Gallus: …”Look here, look here, look here.” And you’re like, “Why?” I don’t know. It’s subconsciously. Anyway. It’s an easy…
Dr. Greer: Yeah.
Dr. Gallus: It’s a very gratifying surgery.
Dr. Greer: It is.
Dr. Gallus: And I think it’s a common problem, right? I mean, two-thirds of adolescent males will have gynecomastia. But overwhelmingly, it will resolve. So…
Dr. Greer: Right. But in a lot of people, you know, there’s that little bit left, and it’s fine. If you don’t like it, we get rid of it.
Dr. Gallus: Right.
Dr. Greer: Yeah. And it’s not a terrible recovery. I mean, the chest is really sore. I imagine as if you did a bunch of push-ups. I know that’s how my abs felt after lipo, was like I’d done a thousand crunches. And we do put you in compression for a little bit because we don’t want hematomas and swelling, so they make these very masculine compression vests.
Dr. Gallus: Yep. And then, yeah, I tell them to lay low for a couple of weeks, like, not to do anything too strenuous for two weeks, and then you sort of build back into it.
Dr. Greer: Yeah.
Dr. Gallus: And with liposuction, I tend to tell people that it’s like a sprained ankle. So it has that ability to swell for a while, so the compression is great for helping with that. And if you increase your activity, you know, you’re at four weeks out or six weeks out, you’re not wearing compression, you’re mostly gonna swell and then put that compression back on to help your body.
Dr. Greer: Right. Exactly. And that’s true after a tummy tuck, too, you’ll see that puffiness pop up. And we have a question. “Do you think there’s a stigma around gynecomastia or lack of awareness that it’s treatable?” You know, that’s a really good question, Alicia. And, you know, I don’t have my pulse on the male community. I suspect a lot of guys, A, probably don’t realize how common it is, and B, that it’s very correctable and it’s simple surgery that you don’t even have to be under general anesthesia for. I’ve done these cases on awake patients, and they’re very comfortable. So it’s probably a combination of the two factors. What do you think?
Dr. Gallus: Yeah. I think men are shy to come in with a problem or present it.
Dr. Greer: Yeah.
Dr. Gallus: And then I think most people don’t go straight to a plastic surgeon, so you raise that issue with your primary care doctor, and certainly…
Dr. Greer: And they tell you it’s normal.
Dr. Gallus: They’re like, “Oh, it’s normal. So many people have that.” And so that’s the other problem, is that maybe whoever you reached out to with that problem says, you know, “Don’t worry about it. There’s nothing to do,” and don’t appreciate that there’s some options.
Dr. Greer: Right. I mean, because, like, you know, most docs are worried about pathology and things that are harmful. And, you know, “This is normal, it’s not a problem,” is very different than, “Hey, there is a pretty easy solution for this.” And you’re welcome. We love answering questions, by the way.
Dr. Gallus: Thanks, Alicia, that’s a good question.
Dr. Greer: Yeah.
Dr. Gallus: Yeah. So let’s see. What else about male plastic surgery? I mean…
Dr. Greer: I do skin removal. I do, you know, a moderate amount of skin removal, like tummy tucks, and especially chest skin excisions after weight loss. That’s a pretty common one. And even the occasional facelift. Guys like to have a sharply defined jawline as well.
Dr. Gallus: Yes. I did one of those recently as well. And he was down for a facelift and CO2 laser at the same time, and some lids done, and fat transfer, and he did great. Yeah. So…
Dr. Greer: Oh yeah. Chin implants and rhinoplasty.
Dr. Gallus: Rhinoplasty.
Dr. Greer: I actually do neither of those procedures. When it comes to face, I pretty much do eyes, face, and neck lift. But I have a good facial plastic surgery colleague in Cleveland that I refer to, Dr. Ponsky. She pops on sometimes. But she did a facial plastics fellowship. So I send that kind of stuff her way.
Dr. Gallus: Yeah. And I have somebody I send noses to as well. I don’t often do…I haven’t done rhinoplasty in a while, so I think that’s such an important area and it so also needs to be tailored for the patient and the complex. So…
Dr. Greer: And there are a lot of, like, ethnicity subtleties, too, especially with the nose, where it’s really easy, I hear and have seen…like, you don’t wanna give everyone the same exact nose because it’s not gonna fit their face.
Dr. Gallus: Correct.
Dr. Greer: Yeah. That’s a pretty complex procedure that I just didn’t get a lot of training in. So never did.
Dr. Gallus: And then for…from then, I think, especially, like, I remember maybe 10 or 15 years ago being out in Miami and …
Dr. Greer: Aw, thanks, Alicia.
Dr. Gallus: Thanks, Alicia. Yeah. We try to…like, we can’t do it all, but we try.
Dr. Greer: Yeah.
Dr. Gallus: But yeah, and going out and realizing that there were a huge proportion of men in this particular restaurant, bar scene in Miami that all had the same nose, and it’s a very feminine nose, and it was, like, popular at that, you know…
Both: At that time.
Dr. Gallus: …at that time to do. So you don’t wanna over…
Dr. Greer: Yeah. And that’s the interesting thing that people may not realize, there are, like, trends in plastic surgery. And you can look back at the textbooks for… Sorry, if you guys can hear my dog bark. I hope not. If you look back at the rhinoplasty textbooks from, like, the ’70s and ’80s, it was, like, this very narrow ski-slope nose. Like, you can tell what decade.
Dr. Gallus: Yeah.
Dr. Greer: And if there’s a surgeon who does the same kind of nose, you can tell who went to him or her.
Dr. Gallus: Yeah. It was uncanny. So that’s another issue with male facial plastic surgery, is really being careful that you don’t feminize features because, you know, 80% of what we do is on women when we’re talking facelift, and when people give huge presentations and show all their before and afters at our conferences, it’s, you know, woman after woman but then you don’t wanna embrace that same technique on a man and end up…you know, you’re not trying to create the graceful S-curve and, you know, the tiny, you know, the eyes and…
Dr. Greer: Well, with eyes, if you do a brow lift on a guy, you do not wanna give ’em arch.
Dr. Gallus: No.
Dr. Greer: You know, women, we fill the cheek, so they’re nice and full. Guys have flat cheeks. And then the sideburn is a whole other issue with facelift because we’re pulling the skin back and then you can end up pulling some hair-bearing skin back onto the front of the ear and needing to do laser hair removal or electrolysis there.
Dr. Gallus: Right. Yeah. It gets tricky with the beard, you know, where you can grow a beard. I have seen…I had a patient who came to me, and we were just letting things settle, who had a browlift done, direct browlift done somewhere else, and they just did laterally, and he looked…
Dr. Greer: Oh.
Dr. Gallus: And, you know, and it’s exaggerated at the beginning anyway. So he looked kind of insane. And I was like, you know…
Dr. Greer: Yeah. Just very perplexed.
Dr. Gallus: Yeah. And I was like, that’s not…you know, they want a straight brow, that is the look. And you can think of examples, Kenny Rogers, or…I’m trying to think of who else. There’s some good examples of people, male actors who’ve just gone off the deep end with their plastic surgery, and you’re like…people might not know, but they just can’t figure out why it just doesn’t look quite right. You know?
Dr. Greer: Right. Well, and facelifts, too. So with facelift and neck lift, the direction of pull is all back here. And if you’re ever wondering… I shouldn’t really tell our secrets. But if you’re ever wondering if somebody’s had a facelift, you look to see if there’s a little tension here. And in guys, especially, it’s tough because they wear their hair short, and the incision hugs along the hairline. And in women, you know, even with our hair down, there’s, like, little wispies, it hides pretty well. But with guys, if they’ve got a close cut, sometimes you can see that scar. So it’s a little more demanding sometimes.
Dr. Gallus: Yeah, absolutely. But they definitely tend to be more realistic about the approach and don’t wanna look overdone. And I think that can be refreshing, too. So yeah, I think it’s just a slightly different patient population with needs, but they wanna look refreshed and not overdone, just like most of us do. And…
Dr. Greer: Exactly.
Dr. Gallus: Yeah.
Dr. Greer: And a lot of…I do have a fair number of guy patients who come in for toxins, like Botox, because, you know, they don’t wanna get crow’s feet and they don’t want the deep frown lines. And with that, it’s, you know, you freeze everything and it looks good. You can’t really feminize people with toxin like you can with filler, thankfully.
Dr. Gallus: Yeah. Definitely. Do you find that you need more toxin than average?
Dr. Greer: Oh, so much. Well, and, you know…so the little vertical muscles here are your glabellar muscles, and they’re called the corrugator supercilii. And women just tend…it tends to be a thinner muscle and a weaker muscle, although I’ve got some women, too, where there’s just these really strong muscles. But men tend to have just thicker, stronger facial muscles. So my toxin doses are generally much higher on men. Do you find the same thing?
Dr. Gallus: Yeah. I still remember, in training, we had an anesthesiologist that was gonna get his Botox done, and they put something like 75 units just in his forehead. But I was like…
Dr. Greer: Oh, that’s a lot.
Dr. Gallus: That’s a lot.
Dr. Greer: That is a whole lot.
Dr. Gallus: I mean, you can usually do my own face with 50-ish.
Dr. Greer: Yeah. I mean, like, if I use 20 on a forehead, it’s a lot. Oh, your husband is resistant to toxin, Alicia. Interesting. I wonder if he never got enough. Yeah. Or if he works out a lot. Some people who are really physically active have zinc deficiencies, and zinc is a co-factor for…I forget which part of the pathway where the toxin is taken up. But if you’re zinc deficient, then the toxin doesn’t always kick in. So who knows?
Dr. Gallus: No. I did have…that discussion came up randomly when…and I looked up the paper for it, which there’s, like, one paper to support zinc. But…
Dr. Greer: By people who sell, like, that supplement brand.
Dr. Gallus: Yes. Right. Right. But I tried to remember to take my zinc on, you know, to try and see if I can prolong my Botox effects. But I just can’t remember to take vitamins. It’s not…there’s only…you know, sunscreen I can do every day, the rest of it is…
Dr. Greer: Yeah.
Dr. Gallus: I have to start triaging my capabilities. Same thing with the supplements for hair, you know, the…
Dr. Greer: Oh, yeah.
Dr. Gallus: Yeah. He might have a vitamin deficiency. People who consume a lot of protein and work out a lot sometimes metabolize it faster. So it’s a… Botox is funny because it’s dose dependent, meaning the more you put in, the longer it’ll last up to a point. So you have to find that sweet spot, and it’s different for everybody. So, but guys tend to, like…
Dr. Greer: Oh, lots of high doses. Yeah. Guys do burn through stuff a little bit faster sometimes.
Dr. Gallus: Yeah. They also tend to run higher blood pressure. So in terms of, you know, surgery, I am a little more cautious with them because we don’t want their blood pressure to elevate, we don’t wanna have any bleeding complications afterwards. So I remember it became…and that’s because they have more testosterone than we do. And I remember… I don’t do much of it now, but I did a fair amount before of top surgery. So that to get…it’s sort of male plastic surgery to go from female to male, to take off the breasts and reshape the chest to look like a male, those patients are often on testosterone supplementation as they’re transitioning. And there was initially controversy about taking them off the testosterone for the surgery to reduce the risk of having bleeding during top surgery.
Dr. Greer: Interesting.
Dr. Gallus: Yeah.
Dr. Greer: That seems like that would be a pretty big deal, though, to stop hormones.
Dr. Gallus: Yes. So just like other things, there’s, like, people who will do it, just, like, the random incision on the chest. Yeah. And I thought, “No, that seems like a big deal, to take…” And I think probably now most people do not take female to male…you know, people who are transitioning don’t say, “Hey, we’re gonna stop this transition hormonally just so we can do the surgery.” Because they feel crappy. So it’s not fun. But it’s interesting that proves the link between testosterone and blood pressure issues and more propensity for bleeding. So you just have to be careful.
Dr. Greer: Yeah. Make sure they’ll manage.
Dr. Gallus: I like to say it’s just because they don’t listen, but…
Dr. Greer: I’ve had female patients do the same thing, so.
Dr. Gallus: I know. I know. I just have been married too long.
Dr. Greer: I’m like, “Really, a 10-mile hike? You’re three days out from surgery.”
Dr. Gallus: Right. Did you need that 10-mile hike?
Dr. Greer: Yeah. Although I have seen guy patients get a little more active, go for long hikes, play radical, they’re like, “It’s nice out.” Yeah. So that’s the important thing, you should always be really cognizant of your instructions and following them because it’s the least you can heal quickly and get a good outcome.
Dr. Gallus: I know. It’s hard to grasp the like, you know, long run, short slide, but you really have to… I try to talk a lot when I’m talking to patients about surgery, to spend a significant amount of time on recovery, because you have to give yourself enough time to recovery, otherwise recovery just lasts longer if you’re not careful.
Dr. Greer: Yeah.
Dr. Gallus: So, yeah.
Dr. Greer: Let’s see. Do we have any other little interesting tidbits to share?
Dr. Gallus: Penis enlargement?
Dr. Greer: I don’t do it. Yeah. No, I know nothing about it. So I’m happy you talk about it.
Dr. Gallus: I feel like we’ve had a couple inquiries and we’re like delete.
Dr. Greer: Yeah. Well, we’ve got inquiries for scrotal pyocele, like if it hangs too low to pyocele… Oh, and that just brings up Scrotox which is… I’ve never done, but there’s the occasional request for Botox to the scrotum, to what’s smooth there, the wrinkles. Yeah.
Dr. Gallus: Not offering that currently either.
Dr. Greer: Not something we offer at our practice.
Dr. Gallus: I do know that there’re people who provide fat injections to the shaft of the penis as an enlargement procedure.
Dr. Greer: I’ve had people call… That just seems like a really dangerous idea to me, unless you’re a urologist. I mean there’s important vasculature and nerves and yeah.
Dr. Gallus: So yeah. So yes, just to be clear, we do not offer those procedures. I have…
Dr. Greer: I’m glad, my nanny just popped on too. So Bridget, if you were wondering, we’re talking about penis enlargement. You hopped at the right time. And that we don’t do it.
Dr. Gallus: Yeah. And then when I… Actually, when I was in the Navy in the hospital setting, I did work with the urologist a couple of times on people who had gone out into town and had some surgeries that were not… Yeah. That didn’t work out well. So it… And I was like, there are four plastic surgery, three of them are guys, and you presented this problem and you guys called me, like give me a break. But yeah, there was somebody in Beverly Hills placing a silicone wrap around the shaft and then, you know, that’s eventually has a potential to erode and then it’s a problem. So…
Dr. Greer: That sounds like a terrible idea.
Dr. Gallus: It is a terrible idea. So yeah, not a longstanding solution. So anyway…
Dr. Greer: No. I think I’m gonna stick with the liposuction and the facelifts and the occasional neck lift.
Dr. Gallus: Yeah. Upper eyelid lift. Yeah.
Dr. Greer: Yeah. I’ll leave the nether-regions to the people that do that.
Dr. Gallus: Who are interested in doing that.
Dr. Greer: Yes.
Dr. Gallus: Yes.
Dr. Greer: “We don’t need that here, but I’m all for it.” Bridget you’re hilarious.
Dr. Gallus: Yeah. If it makes you feel better about yourself sure, I just…I don’t feel comfortable doing those procedures.
Dr. Greer: No. No. I think it’s okay.
Dr. Gallus: I could do it for now. I know Erin who was on this probably a little bit ago, always has to ask me who is it that does butt implants in San Diego. And I only know one guy. I don’t do. I think it’s a terrible operation, so we’ve talked about BBL before, but I don’t do actual…
Dr. Greer: Implants.
Dr. Gallus: Butt implant, which are actually silicone breast implants placed in the butt.
Dr. Greer: And they can rotate. Yeah. They’re not made for sitting on.
Dr. Gallus: No.
Dr. Greer: Yeah. That’s not one I’ve ever wanted to do. I have a friend…
Dr. Gallus: I’ve taken them out.
Dr. Greer: Yep. I have a friend in Austin who does them occasionally. I see him on his Instagram. Yep. He does a ton of BBL and then occasionally some implants. So, I don’t know, some people do ’em. Not that…
Dr. Gallus: Yeah. And calf implant is the other one that I think is just a fraught with problems the procedure.
Dr. Greer: Yeah. The only thing I know about it is the discovery channel show I saw where somebody got necrotizing fasciitis and like lost half their calf.
Dr. Gallus: Yeah.
Dr. Greer: So I don’t know.
Dr. Gallus: Yeah. So, oh. So the other male plastic surgery procedure that’s sometimes done, that is also touted at conferences is hi-def liposuction, which I don’t do.
Dr. Greer: Ooh. Yeah. So that’s for you guys, by the way. That’s where you’re like trying to etch in the muscle pattern by selectively removing fat. And I don’t do it either. And the reason is, I mean, I will do a little more in the midline sometimes just to get a little definition, but trying to etch in those six pack muscles, imagine what happens when you gain weight down the road, it’s gonna be like you have a little six pack of like rolls on your tummy. And it’s not necessarily gonna line up with where your actual muscles are. So… Yeah.
Dr. Gallus: Like it’s cheating. But I mean…
Dr. Greer: Yeah.
Dr. Gallus: I feel like that question always gets asked when someone presents these crazy results where someone is obese and looks like they’ve never seen a gym. And then they have this hi-def lipo result that makes ’em look ripped. And the answer is always that now these people are so motivated that they go to the gym and they stick with their routine. But I would say based on human nature…
Dr. Greer: Unlikely. I can tell you, I did not have a six pack after my lipo, and there was not much fat left. It’s just like, you gotta get the muscles. Yeah. I would love to see those hi-def lipo pictures, like 20 years down the road, just like the BBL picture. I wanna see what that looks like 20 years down the road.
Dr. Gallus: Yeah. The one or two liters per side. See what happens there.
Dr. Greer: Yeah. There was another video I was watching where they were doing fat grafting to the pack after liposuction gynecomastia, just to build up that pack definition.
Dr. Gallus: I saw that too. I think I saw that because they really do etch out the pack muscle, but it’s like, you can’t just do one body part if you’re gonna do that. So you do all that to the pack, but then the deltoid look a little, you know, less the cut.
Dr. Greer: Yeah. Or the…
Dr. Gallus: So then you go and define that and then you just keep following along. And then 20 hours later you’re done liposuctioning. So yeah. Kind of cheating with the adding the fat where muscle should be, but…
Dr. Greer: A little bit.
Dr. Gallus: …you know, it’s okay. It works for some people and there’s definitely… There’s patients who are good candidates for it as well and surgons who offer that. So…
Dr. Greer: Yeah. Cool. Well what should we talk about in a couple weeks?
Dr. Gallus: Oh, that’s a good question. I think… I don’t know that we’ve done the breakdown on tummy tuck yet.
Dr. Greer: Yeah. I don’t remember. We also haven’t talked a lot of face stuff either.
Dr. Gallus: No, that’s true. We could talk about eyes.
Dr. Greer: Like facelift or eyes. Yeah. I love both of that.
Dr. Gallus: Or the neck. Everybody wants to know what you can do for your neck.
Both: Yes.
Dr. Greer: Yeah. We can definitely talk about that and definitely like non-surgical stuff too. Because I get a ton of questions about that and I’ll be honest, I don’t love the non-surgical options, so…
Dr. Gallus: Right. But there’re tons of options.
Dr. Greer: Yeah.Let’s talk about the neck.
Dr. Gallus: Let’s go for…
Dr. Greer: There are.
Dr. Gallus: …the neck. What can we do about the neck?
Dr. Greer: Awesome. All right.
Dr. Gallus: All right. Have a great couple of weeks. And thanks for agreeing to talk at WPS.
Dr. Greer: Oh my gosh. I’m so excited. I have total impostor syndrome. It’ll be awesome.
Dr. Gallus: Oh no, it’ll be fantastic. Yes.
Dr. Greer: But if there’s one thing I know how to do, it’s talk. So I am excited to be…
Dr. Gallus: That’s awesome.
Dr. Greer: I’m really good at talking. I’ll bring some pictures too.
Both: All right.
Dr. Greer: We’ll see you guys in two weeks.
Dr. Gallus: Bye. Have a goodnight everybody.
Dr. Greer: Bye.
About Restore SD & Dr. Katerina Gallus
As the Director of Restore SD Plastic Surgery, board certified female plastic surgeon Dr. Katerina Gallus has over 15 years of experience helping San Diego women enjoy head to toe rejuvenation with face, breast and body procedures. After a successful career as a Navy plastic surgeon, Dr. Gallus founded Restore SD Plastic Surgery with the intention of creating a welcoming space for anyone seeking cosmetic enhancement.
Restore SD Plastic Surgery offers popular facial rejuvenation procedures like facelift & neck lift, facial fat grafting, and eyelid lift; breast augmentation with implants, breast lifts or breast reduction; body contouring procedures such as tummy tuck, liposuction, mommy makeover, and Brazilian butt lift (BBL), as well as aesthetician services, BOTOX, injectable fillers, and laser treatments.
