Podcast: A Bigger BBL Isn’t Better (Unless You’re Into That)

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Listen:

PSA: If you’re a tiny little stick, you do not need 1000ccs in each cheek, so don’t go to someone who’s about to do that.

In this no-BS convo, Dr. G and Bri tell the truth about the BBL—how to find a legit surgeon, how much fat actually sticks around, and how long you have to avoid sitting on your freshly plumped booty. 

And if you’re super skinny? No, you don’t have to force-feed yourself for a BBL. Between Sculptra, Radiesse, and a little fat from wherever we can find it, we’ve got options.

Trending stories:

Daily Mail, Kylie Jenner reveals plastic surgery secrets in shock response to fan request

Daily Mail, Jamie Lee Curtis reveals plastic surgery she got at 25 that she regrets

Daily Mail, Jennifer Lopez shockingly exposes her pubic area in extreme bodysuit ahead of her 56th birthday

Last Week Tonight, Med Spas: Last Week Tonight with John Oliver (HBO)

BBL-related stories:

People, Stassie Karanikolaou Says She Felt Pressured to Get BBL Surgery but Now Regrets It

Mirror, Katie Price sparks concern with tiny frame and inflated bum in barely-there bodysuit

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Transcript

Dr. G (00:02):
You are listening to another episode of All the B’s with me, Dr. G and my scrub tech Bri. Alright everybody, welcome back to All the B’s. We are here to talk about Bri’s favorite subject, BBLs, the Brazilian butt lift.

Bri (00:17):
I love me some fat in the butt.

Dr. G (00:20):
And now there’s a new option too for those skinny ho’s that don’t have any fat to inject. So just saying, and I also think bigger is not better these days unless you live in a very niche area. So I think there’s some good options for people who just want a little enhancement.

Bri (00:44):
I think that’s trending for sure. It started, there was a solid two years where it was as big as you can get and now it’s kind of like a shaping.

Dr. G (00:53):
Yes. A subtle enhancement. Was she blessed? Is she J-Lo or did she do that?

Bri (01:00):
Exactly

Dr. G (01:00):
Right?

Bri (01:01):
Maybe she was born with it. Maybe it’s Maybelline.

Dr. G (01:06):
But first we got to hit that celebrity news and as usual, there’s tons of gossip, so that’s good. Keeps us distracted from our favorite real world politics.

Bri (01:16):
Yeah, can’t open the news anymore.

Dr. G (01:19):
No, it’s scary. Okay, so let’s talk about, we talked about this on my Insta, but Kylie Jenner reveals plastic surgery secrets.

Bri (01:31):
This blew up as a trend on Instagram where everyone’s now posting what size implants they have, who did it right. They’re not gatekeeping. No.

Dr. G (01:44):
We just needed one celebrity to come out and it wasn’t Meghan Trainor. She already did and no one cared.

Bri (01:52):
Yeah.We needed Kylie.

Dr. G (01:54):
So she had a secret boob job, not so secret. Was it secret? No. I will say since she had it when she was 19, technically those are not warrantied, but it’s fine.

Bri (02:06):
I have a feeling she’s had them redone.

Dr. G (02:08):
Redone? Probs.

Bri (02:10):
Absolutely.

Dr. G (02:11):
So yeah, she had four 445s, correct? Yes. Moderate profile implants. And so I think it’s interesting because she called out 445, which as you know, the numbers all correspond to kind of the brands Mentor brands would be 425, 450. You wouldn’t get a 445. A 445 screams, Allergan Natrelle implants and then even though moderate profile is a name for how Mentor names their implants, but it’s Natrelle and then, so it’s an SRM or moderate their version of moderate profile and then half under the muscle. That’s when I realized if you live in it, you’re like, yeah, I know what that means. But people were confused about what half under the muscle was.

Bri (03:07):
People went off about the half under the muscle thing.

Dr. G (03:11):
It’s pretty much how most people get their implants put in. It’s called a dual plane, which means it’s under the pectoralis muscle, but as you know, your pec muscle doesn’t cover your entire chest laterally and inferiorly. So the bottom and outer aspect of your breast, the pec muscle doesn’t go all the way down there. So when you put the implant behind the muscle, it rides up a little bit and then the kind of bottom half of the implant is just covered by breast tissue. So that’s what we call partially under the muscle dual plane has to do with the technique, which is you’re going to lift the breast tissue from the pec muscle a little bit so that when the pec muscle rides up, it doesn’t take the breast tissue with it and make it look funky. But I mean that’s probably more than the average lay person needs to know. I guess in her case she was just saying they weren’t sub glandular, they weren’t just under the breast tissue. I think if you’re going to put 445s in, you probably need to do it half under the muscle for support, otherwise the whole thing’s going to look like a rock and a sock after a while.

Bri (04:22):
Yeah, No, hers look fabulous.

Dr. G (04:24):
They do look good. I think the other thing that was controversial with her was that moderate. Who was that? Moderate profile.

Bri (04:35):
Oh, she’s the one that asked Kylie Jenner if she could have her implant size.

Dr. G (04:39):
She’s no stranger to surgery.

Bri (04:43):
I think it’s good, I mean everyone knows they’ve had tons of plastic surgery and I feel like they’ve kind of tried to be transparent, but kind of also like, oh, I don’t support it. I don’t want my daughter to think I’m doing this, but just be real. You look amazing.

Dr. G (05:00):
Right. It’s like when Kim went on Oprah and said she didn’t have butt implants but she had fat, so she had an x-ray so that she could show that she didn’t have implants, but that was really only half a lie. Right?

Bri (05:12):
Right. Anyway, she’s like, there’s no implants.

Dr. G (05:16):
Okay, but you have so much stuff injected into your booty, it’s not even for real.

Bri (05:21):
Right, right.

Dr. G (05:22):
Anyway, so her boobs, the other controversy about it was 445 moderate profile, as you know is a pretty wide implant and she appears to have a pretty tiny frame, but if you’re going for side boob, that’s the way to do it. If not, I would say a higher profile implant has a more narrow base diameter so it won’t stick out and give you that annoying side boob. So I think those were the take homes from that. In the group chat for plastic surgeons, one of the thought processes is that she called it out because Garth Fisher, her plastic surgeon that she added or whatever, outed, no, she called out as doing her boob job. It was probably feeling a little sad like, Hey, I’ve done a ton of work for the Kardashian clan. It’s rumored that he probably did Kris’s first facelift and yet when Kris just got her recent facelift, which we talked about on the last episode, she called out Steve Levine. So then you’re like, if you there are other plastic surgeon, you’re like, can I get a shout out please?

Bri (06:35):
Who does all of their work? I’d be pissed too.

Dr. G (06:38):
Although I thought Ash Ghavami did a fair amount. I feel like they spread their needs out amongst the Beverly Hills crowd, but yeah, I mean I would be annoyed too. Garth Fisher is, I famously remember him as a guy that was married to Brooke Burke, but whatever. Moving on.

Bri (06:58):
Well, she looks fabulous. We love it.

Dr. G (07:00):
Yeah, she looks good. I think it really does. It shows that sometimes it’s less about the actual implant and more about the surgery and the surgeon, the technique and making sure that you’re doing what the patient wants for their goals. They understand the risks of maybe putting in a pretty large implant for your frame, but if that’s look you’re going for, you’re not going to do it with something smaller.

Bri (07:24):
Right. I’m all for big implants.

Dr. G (07:28):
We know you are. Okay. You’re not going to put those under local and you’re certainly not going to, how do you say in English? I would a hundred percent put them under the muscle because I think implant that size under the fascia is not going to hold up over time. Cool. Alright.

Bri (07:52):
Good job Kylie.

Dr. G (07:53):
Yes. Good job Kylie. What’s our next little

Bri (07:59):
Jamie Lee Curtis at 25 that she regrets.

Dr. G (08:03):
Okay, so it sounds like, first of all, we get it, Jamie, you don’t believe in plastic surgery. You want to age gracefully, blah, blah, blah. And so you’re going to admit to having what sounds like a lower bleph when you were 25, which to be honest is bananas. But

Bri (08:19):
I’m pretty sure I asked for that yesterday.And I got shot down. I was like, I just need a little excision of my under eye because my skin’s crepey.

Dr. G (08:27):
You want the skin excised? I think she just had a trans, they went in from behind,

(08:32):
Just took the fat out?

(08:33):
From behind the eyelid and took the fat out, which you can do if you have baggy lower lids. I mean it doesn’t look like it in her older photos, but they were probably touched up maybe or that she was puffy. Maybe don’t go out and party hard, which she said she’d used to. So I don’t know. Whatever. I don’t know why you have to talk. You looked so good and it was the one thing someone picked on you about was your lower lids and so you had it taken and why do you regret it? It didn’t actually change the way you look. Just I guess it takes down her ride or die don’t have plastic surgery so she feels like she has to get in front of it. I don’t know, it’s super odd.

Bri (09:21):
I don’t know. If you took out the fat from a lower bluff, could you put filler back in there if you were like, this is absolutely terrible?

Dr. G (09:28):
Yes, but it didn’t look absolutely terrible. So I don’t know what mental toll it took on her, the fact that she did it because somebody called out some insecurity and so then she had it done. I don’t really know what the mental toll is. You had a lower bleph that was done conservatively and looked great and aged with you.

Bri (09:47):
And I feel like that’s kind of the theme of some of the articles we’re talking about today is people regretting certain things or feeling pressured and it’s like, but really are you just coming out with this now? I don’t know. I feel like people only regret it if it doesn’t turn out the way they want or something. I don’t even know.

Dr. G (10:05):
I think she only regrets it because she is a champion for aging gracefully and not doing anything to yourself, which great, I mean at least she’s not telling us that she’s not having plastic surgery and telling us it’s olive oil. I’ll give her that.

Bri (10:20):
Or riding horses.

Dr. G (10:21):
Or drinking lemon water.

Bri (10:26):
The chia seeds.

Dr. G (10:27):
Although I will say our IT guy, shout out to Garrett from the computer admin. So we hadn’t seen him in a minute. He used to be my favorite IT person when I had to call my IT company to help us with the office, which in case anybody forgets, we’re an office full of girls. So we have IT needs.

Bri (10:45):
Literally the first thing I said when he came in, when he had to set up this printer yesterday, I was like, I am so sorry, but we are just an office full of girls who know absolutely nothing It related. He’s like, I got you.

Dr. G (10:59):
And he worked with us through COVID when we had to do some stuff remotely and then he sort of dipped and I was like, man, Garrett was my favorite person. So when I reached out about the printer and he responded, I was like, oh my God, are you back? And he’s like, yeah, I’m back. So then we saw him and remember he’s like, now I’m a believer in clean living. He spilled his guts. I’m married, I have two dogs, I’m 18 months sober and my skin has never looked better. And of course there’s a little sunburn cuz we had a record sunny weekend this last weekend and I was like, good, now maybe invest in some sunscreen. And he was like, yeah, yeah, I know. I know. So anyway, it just made me think of Lindsay Lohan and all the shit she’s had done and then she said it was because she was sober. I’m like, I mean it doesn’t hurt, don’t get me wrong, but also some skincare. But he was like, now that I look so much now that I’ve been sober, I really am starting to think maybe I need to invest in some skincare and take even better care of myself. I’m like, yes, please do.

Bri (12:02):
Absolutely. I also just want a side note, he taught me yesterday how to open the printer without breaking my nails. So that was a win. I was like, you can stay here.

Dr. G (12:16):
He can come anytime and hang out with us. And he also named our printer what basic bitch?

Bri (12:22):
Basic bitches printer. Yeah. It’s like knew that’s what it is.

(12:26):
So well. Also, you shouldn’t ever leave me in charge of naming anything because the passwords are whack, the printers are whack. That’s just how it is.

Dr. G (12:40):
So anyway, clean living does help, but it’s not, I mean I’m sure Jamie actually is sober, but she looks her 66-year-old self. She doesn’t do anything else except maybe sunscreen. That’s fine. Not judging, just assessing.

Bri (12:54):
Assessing. I will not be one of the people that ages gracefully. I want to be as frozen as frozen can be.

Dr. G (13:02):
Okay. So aging gracefully and aging and putting up a fight. Jennifer Lopez, 56. I mean she looks so good here. I don’t really know.

Bri (13:15):
She does look so good. Maybe that’s why

Dr. G (13:17):
She isn’t shockingly expose her pubic area. She’s just in a, I feel like Cher’s done this before. What are we even talking about? She’s just in a really, really, really high cut, low cut flipping outfit.

Bri (13:29):
That’s why Ben Affleck is trying so hard to divorce her. He’s like, oh, I can’t look at her anymore. She’s too hot. I just need to get away. What did I do?

Dr. G (13:39):
She’s wearing basically the smallest sliver of bikini across the front of her pubic area. So I mean I’ll just, if this isn’t an advertisement for labiaplasty, I don’t know what it is.

Bri (13:52):
I know She looks so, so good. I am almost tempted to go get a Brazilian wax.

Dr. G (14:01):
I mean laser hair removal for the win. She is wearing tight, so that also helps. But yeah, she looks great. And I mean as a segue to our topic of BBLs, I remember when they were first becoming popular like 20 years ago and they didn’t really take off when the guy in Miami was promo-ing them. People wanted the J-Lo butt. Hers just happens to be natural.

Bri (14:27):
You think?

Dr. G (14:28):
Oh yeah, a hundred percent. She’s always looked like that. You can go far back to when she was a fly girl, she had little bitty boobies and a big old booty.

Bri (14:39):
I love that. So you can have a BBL without it looking like you had a BBL. You can do some shaping, you can fill in some hip dips, make yourself look a little more curvy. It doesn’t have to be the Miami BBL. Okay,

Dr. G (14:53):
That’s right. Yeah, I know I’m thinking about putting some stuff in my hip dips, but I might be too old for all of that.

Bri (15:01):
Absolutely not. You are a young butterfly. Don’t forget that in my next annual review.

Dr. G (15:08):
Young graceful butterfly, cool. At least I’m younger than J-Lo, so I guess, but I’m just not running around in a extreme body suit. Sorry.

Bri (15:16):
You could.

Dr. G (15:17):
Not happening. I guess so. It’s not my vibe. Also, it just looks cold. Let’s go back. Let’s just go back to the basics. I’m wearing a long sleeve shirt under my scrub top and I have the heater on so I’m not even sure. See I’m more of the Ben Affleck vibe and that sweater because I’m always cold.

Bri (15:39):
Yeah, a hundred percent. I relate more to Ben Affleck now than anyone. I just envision I had want my cigarette in the mouth just.

Dr. G (15:48):
Yes. Fisherman’s sweater. Kind of tired.

Bri (15:53):
Yeah, I am no longer, someone mentioned this to me last night actually. I was with my girlfriends and she’s like, when I first met you, you had no clothes on. She was like, what are you wearing? I did. But she’s like, you were in the tiniest little things and I was like, now all I have are baggy sweaters and baggy pants and button downs. That’s really sad.

Dr. G (16:14):
I mean whatever.

Bri (16:16):
Drinking my wine to get through summer and girls sleepovers.

Dr. G (16:19):
Right?

Bri (16:21):
Oh my god,

Dr. G (16:23):
I’m bored.

Bri (16:24):
Okay, don’t get me started.

Dr. G (16:26):
Alright, and then this was so well executed, the med spas, I know you haven’t seen it Last Week Tonight with John Oliver because you might not know who that is, but he is this such a funny British guy and he just skews you pick an industry or a thing and he will just do this 20 minute monologue taking it down. And so he did one on med spas and it was, if you’ve got 26 minutes, I encourage everybody to watch it. It sort of breaks down all the things that we talk about all the time, which is safety credentialing, making sure you know who your injector is, making sure you’re not getting counterfeit injectables, how they’re not regulated. They’re regulated by AM spa or am Med spa, which is its own organization. So no one’s regulating these. There are state rules that vary from state to state of who can inject, but in terms of consumer protection, there really isn’t any. And so even just, this came out I think a week ago, a couple of weeks ago, and there was a med spa adjacent place in Boston was injecting with fake or I don’t even know what kind of Botox and they gave people botulism, which is insane. And like what are you injecting?

(18:04):
What counterfeit bullshit are you getting and injecting that because standard Botox from Allergan is too expensive. Girl, get out.

Bri (18:12):
And you know what, back before I started working here and I went to med spas to get my Botox, I don’t know if anyone else notices this, but do you notice that it barely lasts long? I’m like, what do you guys dilute it with? Or I don’t know what it is, but it’s just crappy all around and I want to love med spas, but I’m like, how are you doing these Botox happy hours for $8 a unit when you can barely buy it for $8 a unit wholesale. So it’s like you have to question what they’re actually, is there any Botox?

Dr. G (18:39):
Right. If we know Allergan’s price hovers around anywhere from five to $8 a unit, then you’re either trying to import it illegally from Canada or Mexico or getting it from one of these companies that’s giving you counterfeit Botox. So you’re like, what is this crap? I mean, if you’re going to use Daxify or Juveau or Dysport, some of those have different price points, but again, you want to get the actual product so you don’t get lock jaw or something or your breathing doesn’t stop because some more on injected some $2 a unit nonsense into your face. I don’t understand.

Bri (19:26):
We heard a crazy story the other day from a patient about getting Botox and then ended up being bedridden for six years. Right?

Dr. G (19:35):
Yeah. That was a crazy story. I’m not sure that was all true and related, but who knows. Okay, so since we don’t have time to watch 20 minutes of John Oliver as entertaining as he is, we thought we’d just address some of the comments in here because they’re good and I love the show has taught me that if you’ve ever thought, how is this legal? There’s 99% chance the answer is money. A hundred percent chance the answer is money every time. If you want to get me started talking about private equity and their involvement with plastic surgery, it’s all about the money. And then the last thing that is in line to receive anything is the patient. So if you’re going to be cutting costs, med spa is where you’re going to go. And they’re a $17 billion industry in the US, I mean people can’t

Bri (20:32):
Where people take Ubers to get to the hospital. They can’t afford an ambulance.

Dr. G (20:37):
That’s a wild fact.

Bri (20:38):
Insane and very true.

Dr. G (20:40):
$17 billion a year at med spas, but most of us, or not most of us, a lot of people can’t afford health insurance or don’t have good health insurance. And then America’s aversion to government regulation makes for some mind blowing Last Week Tonight shows. Again, yeah, you don’t want the government regulating things. So then you get, hey, if you can fog a mirror in Texas, you can inject somebody. You need zero credentials because it’s on the patient or the consumer to validate and decide who can inject them. That’s what we’re saying. We’re saying if you don’t want us to regulate it, then it’s up to you to do your homework and then asterisk, no one does their homework.

Bri (21:35):
So then is there disciplinary action when somebody has absolutely no idea what an artery or a facial nerve is or anything and then there’s just nothing.

Dr. G (21:44):
So a lot of times it’ll go back on the fact that medical spas are supposed to be managed, owned and supervised by a physician. A physician doesn’t have to be a physician trained in any of the above. So especially in Texas, I know I keep calling them out, but they’ve had deaths from this. The physician just needs to lend their license so they’re not actually in the same town or they’re not on site. In California, there’s some specific rules that you have to be on site that you need to evaluate the patient before they get injected. Of course that gets ignored frequently and if you get caught.

Bri (22:35):
I’ve never been in, wait, I’ve never been seen by a doctor at a med spa prior to having Botox.

Dr. G (22:42):
So if something bad happens and then you get sued and that hasn’t happened, then it goes to the medical board. So basically people will skirt those rules until it catches up to ’em. But in Texas there was a case where they were doing IV injectables. The person wasn’t trained in anything and gave a relatively famous, I think she was a local newscaster IV infusion and killed her and the owner of the med spa, the physician who held the license was in a different town, wasn’t there. She didn’t survive. They sued, they raised all these issues and concerns at the state level. I have friends that are in the Texas Medical Society for Plastic Surgery and they’ve teamed up with their associated medical societies to try to regulate this and their recent legislative action got vetoed by the governor because again

Bri (23:46):
Oh really?

Dr. G (23:47):
It’s Texas. Live free or die. Live free and die.

Bri (23:51):
They are.

Dr. G (23:51):
They should change it to that. Anyway, so yeah, the person who ends up ultimately responsible is the physician who put their license on the line. So that guy who was in a different town when any of this happened, and rightfully so, you’re just collecting a paycheck from these people who are doing whatever they want and not filling you in. And so if there’s a bad outcome, you’re playing roulette that there’s no bad outcome. So there was a bad outcome and now it’s your license on the line and they’ll probably take his license’s crazy. So it comes up in these physician groups all the time, Hey, I’ve been offered to be a medical director for med spa, and people are like, are you new here? What if you don’t know how to do these things personally? If you don’t know how to treat the complications, then please, please don’t essentially pimp out your medical license to a med spa. But people do it all the time. Yeah.

Bri (24:48):
One of my girlfriends who used to inject way back when at her old place where she did, I mean she didn’t even realize anything such as a vascular occlusion. She didn’t have any reversal agents in the office. There was so many things she had absolutely no idea, but like, oh, our office is supposed to carry this? Oh, I didn’t even know. And I was like, damn.

Dr. G (25:12):
I know.

Bri (25:12):
It’s kind of crazy.

Dr. G (25:15):
I know considering people can’t find dental care and cleaning someone’s teeth with an expired license could get you 10 years in jail. This is just astonishing. Right?

Bri (25:23):
That’s crazy. I don’t understand that .

Dr. G (25:25):
Same thing. I mean, if you’re an aesthetician doing facials, you need to have a current license. Otherwise, again, depending on the state, remember when we got spot inspected by the cosmetology board?

Bri (25:37):
They just show up. They’re like, what’s up?

Dr. G (25:44):
They just show up. And then I was like, really? They have to find something. So I think they found that there were sharps in the aesthetician room, in the sharps container that weren’t consistent with esthetician treatments. I’m like, yeah, because the patient gets a facial and then I go in and do her Botox, so I guess I can carry my,

Bri (26:07):
Yeah, they’re like, you have to bring your sharps container out with you when you leave.

Dr. G (26:11):
I can bring my needles to another Sharps container. They’re like, yes, that’s what you need to do. I’m like, okay, that sounds great. Thanks.

Bri (26:20):
Yeah. So do they not do that at med spas? They don’t just show up.

Dr. G (26:25):
Well, because if they are doing Botox at the med spa and they don’t have a nurse on site, then they’re just, they know enough to hide the needles, I guess, or I don’t even know what’s happening. I mean, there was a girl that was doing stuff out of her car up in Poway, I think.

Bri (26:38):
Stop.

Dr. G (26:38):
And she keeps getting shut down or reported and then starts all over again. I mean, that’s sort of, okay, would you really go and get your Botox out of someone’s car though? Who are these people?

Bri (26:50):
I don’t know, but people are desperate and they want a deal man.

(26:54):
I need to know, is this dollar Botox?

Dr. G (26:58):
Yeah, it is dollar Botox. We have reusable needles. Luckily we’re deregulating everything. So you can just take this med spa example and you don’t need a vaccine or anything really. But not to get too off topic. Let’s see if there’s more comments. We want to scroll down. I think somebody’s like, I’m going to go sit in a med spa waiting room and listen to this loudly.

Bri (27:30):
That would actually be super funny.

Dr. G (27:35):
Yeah, so anyway, yeah, it was really such a good little, I’m headed to Home Depot for Shop Vac and then I’m going to open up my own liposuction med spa. Thanks.

Bri (27:46):
Same.

Dr. G (27:49):
Yeah. He shows some Instagram posts that are just not in good taste. And then I, yeah, it’s just frightening on so many levels. Okay. I think we’ve the healthscape of Med spas,

Bri (28:07):
I like that the RN, if you go up a little bit, she said she went and got her injectable right there. I’ve never done, I’ve never felt comfortable. The process was pretty bare minimum. They just sign off. So that’s why important, you go to somebody who knows what they’re doing. The first time, actually, I went to this med spa and got the Botox that didn’t last a while. The girl told me this was the first time when she was nervous and I should have left right then and there it was on Botox, happy hour, $8 a unit. And I was like, oh, you really shouldn’t be telling me this. Eric and I got in the car and we’re like, wtf?

Dr. G (28:46):
I know I have a friend who’s a nurse practitioner and she’s also a pediatric nurse practitioner, but she’s done multiple things and at one point she got hired by a med spa and she was doing lasers and she felt adequately trained on the lasers, but then they’re like, we just need you to do this lady’s lip filler while she’s here. And she’s like, I don’t have any training in that. They’re like, it’s fine. And she’s like, no, no, no, no, no, no. That’s not how it works. I would need training. So like that RN who got certified, I mean there’s people who are risk averse and appreciate that. And then there’s people who are like, oh yeah, sure, I’ll give it a go. What could go wrong? And that’s at an RN level, not at a, I’m a high school grad.

Bri (29:31):
Right.

Dr. G (29:33):
Who’s next?

Bri (29:35):
Jesus.

Dr. G (29:36):
Alright. Anyway, so again, since it’s so unregulated, I cannot underscore how much research you should do before you get a treatment anywhere.

Bri (29:47):
Yeah, agreed.

Dr. G (29:48):
Make sure your people are serving thought I am the testimony. Okay. And then we have a segue into our often discussed post surgical.

Bri (30:02):
What can we do after surgery?

Dr. G (30:04):
Yes.

Bri (30:05):
Nothing. Nothing. Bitch, you stay home.

Dr. G (30:10):
Stay home. Sit down, watch some love island.

Bri (30:13):
Stop traveling. Stop parachuting. Stop skiing. Stop

Dr. G (30:19):
Tap dancing. No, pilates.

Bri (30:23):
What does it say in this article?

Dr. G (30:24):
Well, it’s just a question in the Bust Mob, which it’s a site for women considering breast surgery. I’m really interested, I have Cedar Point season passes and wondering what the roller coaster restrictions are after implants.

Bri (30:41):
Why are you wanting to ride a roller coaster right after?

Dr. G (30:45):
I love this freaking wait. I can’t. Eight years. I don’t know.

Bri (30:52):
How big is this roller coaster also?

Dr. G (30:56):
No. No. You know how it locks you in. Why would you do that?

Bri (30:59):
Oh yeah. Don’t smush it. You’re going to be going forward. You’re going to be,

Dr. G (31:04):
I would say three months.

Bri (31:06):
Don’t do none of that.

Dr. G (31:08):
And then even then, maybe not.

Bri (31:11):
I want to love rollercoasters as much as this woman does. Yeah.

Dr. G (31:17):
It’s not something that’s so once in a lifetime, are you kidding me? No. Just hold everyone’s purse while they get and their hats and sunglasses. You be that person. That’s what you can do.

Bri (31:27):
People think they have surgery and I swear to God, it’s their time where they feel like they need to live again. And I was like, calm down. I’m going to plan my whole life in this month I have off.

Dr. G (31:42):
Okay, so moving on. Stassie Karanikolaou says she felt

Bri (31:47):
This is Kylie Jenner’s best friend. So of course.

Dr. G (31:50):
She felt pressured to get a BBL surgery.

Bri (31:53):
Okay, see, this is what I’m talking about, right?

Dr. G (31:55):
I’m so tired of these people. We have people that want to do things and can’t afford it. So I feel like it’s tone deaf for all these celebrities to be like, I wish I hadn’t gotten it. I wish I hadn’t spent that $15,000.

Bri (32:09):
Right, which you probably didn’t pay for. I’m sure she didn’t pay for it. But also on her Instagram for years, I mean all she did was post her butt and now that the thinner body is back in style, all of a sudden she regrets it.

Dr. G (32:21):
And her butt looks great.

Bri (32:23):
Her butt looks so good. You have a perfect round. You don’t regret it. It’s just no longer trending at this moment.

Dr. G (32:32):
What’s trending is to talk about your regrets.

Bri (32:35):
Yes. Yeah.

Dr. G (32:35):
You’re done. Say no more.

Bri (32:37):
Yeah, you’re done. There is a tasteful way to do BBLs .

Dr. G (32:41):
And she doesn’t have an distasteful one. That’s the part. Speaking of, I think we can just move on here. Speaking of un tasteful, can we go to Katie Price who you and I have never heard of and probably

Bri (32:50):
So good.

Dr. G (32:51):
We’ll never see some British girl who looks like a meth addict with these stick legs and this giant booty and the boobs are also out of control. But I mean it’s just a mess. I don’t even know what’s going on.

Bri (33:13):
What is she singing also? Is she a singer?

Dr. G (33:16):
I don’t know who she is.

Bri (33:17):
I could have put some more clothes on. Couldn’t I?

Dr. G (33:20):
I just, why is her, she looks like a skeleton with butt and boob implants. It looks.

Bri (33:27):
Yeah, she has a big torso.

Dr. G (33:29):
This is not the goal. This is not, I just wonder what aesthetic goal she’s trying to achieve here. I think Tell me, you have body dysmorphia without telling me you have body dysmorphia. I feel really bad for her. She just looks a mess. And then you sent that picture of her where honestly she looks better, but speaking of people who can’t,

Bri (33:54):
She’s at a pool with her bloody facelift scars.

Dr. G (33:56):
Yes. In terms of things not to do after surgery. She clearly had a facelift and she has all the paper tape and blood on her ears and she just at the pool.

Bri (34:08):
In a bikini just chilling. Also, you want to keep, she’s not even wearing a hat. You want to keep those incisions out of the sun. A you don’t want to even fall in a pool. I don’t know. That’s disgusting. And that’s dirty. Don’t go near a pool. Proper sun protection, just like Garrett. Here she is. Where’s your hat?

Dr. G (34:27):
Her sixth facelift. Oh, on holiday in Turkey where she goes for all our stuff.

Bri (34:33):
That’s insane.

Dr. G (34:34):
Oh she’s 46. Wounds on her face from her grueling surgery.

Bri (34:42):
Yeah, there’s another one. It’s literally blood and I just don’t, don’t understand. I don’t understand this. I know I’ve said this in so many podcasts, but post-op care should be just as important and you’re not taking care of your new face.

Dr. G (35:00):
Nope. Yeah, she’s a British TV personality and model.

Bri (35:07):
Why are you posting that? And that’s not even transparency, that’s just,

Dr. G (35:12):
She’s just detailing her journey. Okay,

Bri (35:16):
More or less

Dr. G (35:18):
In the sun. I mean I don’t that any of it except the sun is ridiculous. She clearly had a lip lift too, but good for her. I don’t really care. It’s just why are you out in the sun and in the pool?

Bri (35:33):
What is that one week post-op? Day one?

Dr. G (35:37):
She does have a unicorn tattooed on her abdomen. So I love that. I have nothing to say.

Bri (35:43):
Okay. What have we talked about for BBLs that we haven’t, besides that, we’ve discussed, don’t feel pressured to do it if you don’t want it. I mean, I feel like that’s an obvious answer for any surgery. Go to a credentialed place.

(36:07):
Yeah, do something that’s also matches your body type and your body shape. Don’t go and put a thousand ccs of fat in each cheek if you’re a tiny little stick. You know what I mean? Not that you’re going to get that off a skinny person, but just go to somebody who, unless that’s the look you want, you can go to Miami and get it done and risk of fat embolism. But

Dr. G (36:31):
Which circles back to credentialing again.

Bri (36:34):
So what do you do to minimize the fat, know, but what do you do to minimize the fat embolism? Stick it in the muscle.

Dr. G (36:43):
Yeah. Proven that the cause of the embolism is usually injecting into the gluteal vein. Sometimes the artery, but mostly the veins which travel in the muscle. So it’s a hundred percent recommended not to inject in the muscle, which most of us can do by feel. But there are great studies to show that you can get in these deep fat compartments on ultrasound. So I like to do it under ultrasound. It’s easy. You put the ultrasound, you can see the pocket, you can see the muscle, you can see your cannula and you can watch the fat go in. And then you’re also not, the old way of doing it was kind of moving the cannula around and kind of dispersing it in the fat. But if you know where all these little separate fat compartments are, then you just can inject in each compartment and get a much better shape for less fat.

(37:41):
You don’t need to just willy nilly put fat everywhere and pray. You’re really getting a more precise look and shaping with ultrasound. And like I said, you can do that. You can do the nonsurgical with either Radiesse or Sculptra. Obviously you’re not going to get as much volume with either of those. And now coming to market is Alloclae, which is fat in a syringe. So that is another option, which is nonsurgical. But again, you either have to have a ton of money to do that because it’s expensive. It’s like 12 to $15,000. You don’t have to have surgery, but you’re going to get a hundred ccs of fat for that. But you can do it. It’s good, it’s probably better for hip dips and cleavage because then you’re using less fake fat and so you’re avoiding surgery and you don’t need to harvest anything. But if you have the fat or I can usually find some, we can definitely put it in and get a little bit of a better result with the ultrasound. And not only does it give you a better result, it’s safer period. Full stop.

Bri (38:48):
So if you’re super skinny, do you recommend gaining weight for this procedure?

Dr. G (38:55):
No.

Bri (38:55):
I did. I don’t recommend it either.

Dr. G (38:58):
It’s stupid.

Bri (38:58):
I wish I didn’t.

Dr. G (38:59):
If you lose the weight, you’re going to lose whatever you transferred. I mean, if you want to gain the weight and hold onto the weight, sure. But if you want to gain 15 pounds and then lose the 15 pounds, all I did is take the 15 pounds of fat you gained, put it in your butt, and then you lose the 15 pounds and your butt gets smaller. It doesn’t make any sense. It never did.

Bri (39:19):
No.

Dr. G (39:20):
So if you want to not have to gain weight for your BBL, then I recommend that you do something else like Sculptra or Radiesse or Alloclae. Those are all good options. Or mix it together with a little bit of fat you do have. That’s also an option. And I can usually find fat like the lower back, lower flanks, inner thighs.

Bri (39:42):
You can get fat from anywhere.

Dr. G (39:44):
Right. That’s right. But I mean almost everyone, I saw somebody who had implants that needed to come out her BMI was 16 and I was like, Nope. That was the one time I was like, actually I have nothing to offer you.

(39:58):
You literally don’t have.

Bri (39:59):
I really can’t help.

Dr. G (40:00):
a fat cell anywhere. Yeah. So being safe is important. Ask your surgeon. How are they injecting the, I mean, any board certified plastic surgeon is going to use an ultrasound and if they’re not, then you don’t even want that person. Tell ’em to kick rocks. In Florida it’s mandated because that’s where most of the deaths happen is in Florida and it’s mandated that they use an ultrasound and I think they’re trying to regulate it. So you can’t do more than three a day or something crazy. I’m like, who’s doing more than.

Bri (40:32):
Well, so if you’re doing more than three a day, guess what? You’re

Dr. G (40:36):
Sweat shopping it.

Bri (40:38):
You’re not doing the whole surgery. You’re maybe going in lipoing stepping out, lipoing somebody else stepping back in to inject the fat. You’re chop shopping in it.

(40:49):
Yeah,

Dr. G (40:50):
Which is just disgusting.

Bri (40:51):
A hundred percent.

Dr. G (40:53):
That’s not the kind of care we deliver here.

Bri (40:57):
No. Geez.

Dr. G (41:00):
Hi, I’m your surgeon. I’m going to meet you five minutes before your procedure. I’m going to just stand in a line and then we’re going to do everybody’s BBL today.

Bri (41:07):
Yeah. We just go and inject fat. Each person laying down in the same place.

Dr. G (41:12):
I mean I’ve heard some of these places we’ll do. Yeah, multiple women in a room, which is

Bri (41:19):
That’s crazy.

Dr. G (41:20):
Crazy. I’ve not seen that myself. But I think it’s safe if you’re using an ultrasound, you’re being conservative. It’s as safe as any elective procedure. Right.

Bri (41:32):
So what percent of the fat takes when you transfer? Is there a percent? I know that’s hard to tell.

Dr. G (41:38):
It’s 60 to 80% basically.

Bri (41:41):
But it’s never a hundred.

Dr. G (41:42):
Not a hundred percent. So you have to over graft. Yeah, I think that’s, you’re going to have to over graft and you’re going to lose some of it. And it’s not stable with weight loss and weight gain. So there’s that.

Bri (41:57):
So what do you do to avoid that diaper butt?

Dr. G (42:01):
Oh god. People often ask for fat in that lower part of their booty. You should not be injecting there. I don’t care how good you think it’s going to look. So it really needs to stay in those deep pockets and then that lower part of the butt, if you inject there to try and fill it out, it’s going to sag over time and that gives you diaper butt. That and just overfilling the butt in general. It’s so bad. And yeah, maybe it’s a trend that’s over, but I think with Alloclae, a skinny BBL or a less, what’s the word I’m looking for, less obvious enhancement is going to become more trendy.

Bri (42:44):
Yeah.

Dr. G (42:45):
I don’t think it’s going to go away completely.

Bri (42:48):
No. I loved my butt when it was super trending and then I lost a bunch of weight and now it’s perfectly shaped.

Dr. G (42:56):
That’s great.

Bri (42:57):
Except for that.

Dr. G (42:58):
Well, except for that one dent.

Bri (42:59):
Dimple you’re going to fill in.

Dr. G (43:01):
You have that one dent, but we’ll fix that.

Bri (43:03):
Yeah. Thank you.

Dr. G (43:06):
I need to put you on the schedule like your earring piercing.

Bri (43:08):
I know. I finally got my ear pierced after her sewing it up after like five years. Okay. So is a skinny BLL feel like we’re really harping on skinny BBLs here easier to recover from than a regular BBL or is it pretty much the same recovery?

Dr. G (43:26):
It’s the same because I have to scrounge for fat. So really the part that hurts is being sore from the liposuction

Bri (43:32):
And no one ever thinks lipo is going to hurt. It’s going to hurt. I just want you to know, go in with the mindset that lipo is uncomfortable.

Dr. G (43:40):
You’re going to be sore.

Bri (43:41):
Yeah. After I got my, I could barely also don’t lipo your arms and your legs at the same time.

Dr. G (43:49):
I feel like you’ve covered that. It’s just,

Bri (43:51):
But don’t do it. I laid there like a stick and I could barely move. And I had also got, I think, I don’t remember if I got my breast lift down at the same time I did. So I could only lay on my back. My back was killing me. I couldn’t lay on my stomach. I was laying there like a board. I ended up getting this big giant inflatable pool float with a little butt cut out for BBLs. Super helpful, highly recommend, but just know it is uncomfortable. You will be moving slow. Don’t sit on your butt.

Dr. G (44:26):
Yeah, because you don’t want to squish the fat. So that is true.

Bri (44:29):
Want all the fat.

Dr. G (44:31):
So compression on the fat is no good for fat survivalm cuz it is a graft. So we give people like a booty buddy or a BBL pillow so that they’re not sitting directly on the areas that we’ve injected.

Bri (44:42):
Yeah. How long would you suggest not to sit on it?

Dr. G (44:46):
I would say, and

Bri (44:48):
Then multiply that by five.

Dr. G (44:49):
Yeah, at least two weeks. But if you can do six weeks, probably better.

Bri (44:53):
I did six months. I was very committed. I was like, I worked so hard for this fat, I’m going to keep it. And I was committed. I wore my garment, I sat on my booty buddy. I was like, Nope.

Dr. G (45:05):
I think, I mean that’s ideal. Some of the best patients, I just saw somebody we did minimally invasive neck lift for and she has such a phenomenal result. But she was such a good patient post op and was

Bri (45:20):
So on top of post-op care.

Dr. G (45:21):
The garment and the compression of her neck and the massage. It was just, I mean, that’s how you get a good result.

Bri (45:31):
Right. With any surgery, especially lipo and having your butt done at the same time, that requires your post-op care. Get your massages. Don’t sit on your butt, wear your garments. Do you.

Dr. G (45:46):
Maybe don’t go on a roller coaster.

Bri (45:48):
Don’t go on a roller coaster. You’re not going to feel like it.

Dr. G (45:52):
Yeah. Don’t plan to go, I don’t know, to a tropical vacation within the first couple of weeks. You’re not going to want to get in the water. All of those things should be avoided. I know. It’s crazy. People travel for these things and then what are they going to do? They’re going to get on a plane and sit on their butt. I guess they can bring a pillow with them, but it’s crazy.

Bri (46:12):
And what’s the fluffing? Explain the fluffing.

Dr. G (46:16):
Of the BBL?

Bri (46:17):
Yeah. It’s a term. They say, oh, your fat fluffs from three to six months.

Dr. G (46:24):
Yeah, because it’s all compressed and squished in there with the fluid and as it looks over swollen at the beginning and then that fluid gets absorbed and then the fat gets in growth from the surrounding tissue and then kind of fluffs up a little bit. So I think that’s what people are talking about. It’s just a natural arc of change over swollen and tight kind of deflated and then kind of comes back to the new normal and it takes three to six months.

Bri (46:52):
It really does. Every surgeon’s different. Literally again, once my experience, but when you go first, get it done, it’s super tight, it’s super hard, it looks kind of square and then it just give it time and it just turns into this. I want to show you my butt right now, but this beautiful fluffy.

Dr. G (47:10):
Yeah, it looks good. But again, with everything, I mean I just had to coach somebody through labiaplasty on day three. This area is swollen and I’m like, oh my God, it’s day three. Please don’t look.

Bri (47:23):
It’s going to be swollen

Dr. G (47:24):
For two weeks and the swelling’s going to change and it’s not going to all decrease exactly the same on every little aspect. Healing is a process.

Bri (47:33):
Amen. Jinx you owe me a Burkin. I really upped it from Diet Coke.

Dr. G (47:43):
I know. I don’t know how that happened. Okay, well I think we can wrap it up.

Bri (47:48):
Oh wait, I want to go on the BBL trends really quickly. There’s an Atlanta surgeon that’s marketing BBL reversal. Is that just lipoing the fat back out of your butt?

Dr. G (47:58):
Yeah, I don’t know

Bri (47:59):
Then you would have a saggy butt?

Dr. G (48:01):
I mean if you do it I guess slowly and carefully and then maybe let the skin retract and then do a butt lift if you need it. That’s how you were going to, it just depends on how much stretch you have to start with. So my recommendation is to start with just a little bit of lipo, see how it goes, let your body recover, and then either lipo again, or if you start developing laxity, then you could do an excision of extra skin. You could throw Renuvion in there to tighten as you lipo. That would probably be the winner. Yeah, winner winner.

Bri (48:38):
Chicken dinner.

Dr. G (48:41):
So I mean, I guess we could advertise for BBL reversal, but you know how I feel about reversing other people’s.

Bri (48:46):
Let’s not.

Dr. G (48:50):
Okay.

Bri (48:51):
Way to put it there. Alright. Yeah. So if we have not answered a question that you have about BBLs, please reach out and we’re happy to talk to you more. And then check the show notes for links. Also watch John Oliver’s Med Spa.

(49:08):
Yes. I’m going to watch that after this.

Dr. G (49:10):
That’s your homework.

Bri (49:12):
Yes.

Dr. G (49:13):
So I think we can safely say that we are now scrubbing in.

Bri (49:16):
And scrubbing out.

Dr. G (49:20):
Bye y’all.

Bri (49:20):
Slay.

Dr. G (49:23):
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. To learn more about us go to restoresdplasticsurgery.com or follow us on Instagram @restoreSDplasticsurgery. 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.

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About Restore SD & Dr. Katerina Gallus

As the Director of Restore SD Plastic Surgery, board certified female San Diego plastic surgeon Dr. Katerina Gallus has over 20 years of experience helping patients enjoy head to toe rejuvenation with face, breast and body procedures. After a successful career as a Navy plastic surgeon, Dr. Gallus founded her San Diego plastic surgery center, 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 transfer, nanofat grafting and rhinoplasty; 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 non-surgical aesthetician services, BOTOX, dermal fillers, laser treatments, and weight loss injections.

Dr. Gallus and her highly-experienced aesthetics team are here to help you look and feel your best! To schedule a personal consultation, please contact us online or call our office at (858) 224-2281 today. We proudly serve the San Diego and La Jolla areas.