The Beauty Standard with Dr. Roy Kim

Risks and Realities of Plastic Surgery | The Beauty Standard with Dr. Roy Kim

• Dr. Roy Kim

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In this episode of The Beauty Standard, Dr. Roy Kim explores the intricate aspects of plastic surgery based on recent articles. He discusses the tragic case of a 14-year-old girl who died after unauthorized plastic surgery, the rare but notable side effect of ptosis following Botox injections for migraines, and potential reasons why Botox may seem ineffective. Dr. Kim also delves into the growing trend of medical tourism in Seoul, Korea, emphasizing the associated risks and costs, and explains the benefits and limitations of using fat grafting for breast lifts. Throughout the episode, Dr. Kim stresses the paramount importance of patient safety and thorough informed consent.

00:00 Introduction to The Beauty Standard Podcast
00:30 Tragic Case of Teenage Plastic Surgery
01:27 Botox Side Effects and Considerations
02:36 When Botox Stops Working
03:55 Global Medical Tourism: Seoul, Korea
05:17 Mommy Makeover with Fat Grafting
06:41 Conclusion and Patient Safety

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Join us next week as we explore another fascinating topic in the world of beauty, and remember: your body, your choice, your standard!

SPEAKER_00:

Welcome to the Beauty Standard with Dr. Roy Kim. Hi, this is Dr. Roy Kim, and thank you so much for joining me for another audio podcast version of the Beauty Standard, and that is with me, Dr. Roy Kim. This week we're going to go over a couple articles where I will be discussing the good things, the bad things in plastic surgery. I've been doing this for over 25 years and I really love plastic surgery, but it's important to know the great things, the bad things, the tragedies, the complications, the things to be aware of before you actually get a procedure. So the first part is from the New York Post. So this is a 14-year-old girl in Mexico. Unfortunately, she sort of had plastic surgery, and she unfortunately died after secretly undergoing breast augmentation and a Brazilian butt lift without her father's permission or knowledge, only with her mother's consent. Reports say that the girl fell into respiratory rest, then coma with brain swelling, and eventually expired. The surgeon that did the procedure has been suspended. This is amazing because honestly, this is a 14-year-old girl. She's still developing. In many jurisdictions, even if you're a minor, you're under 18, you get parental consent, this is really sort of a big ask for aesthetic or cosmetic plastic surgery. And I think that we need to realize or really think, what's medically appropriate? Is the patient mature enough to consent? Are there underlying motivations that are going here? And finally, I think the most important thing is the doctor is first do no harm. Next up is an interesting article from the New York Post about a woman who shared a TikTok that after Botox injection really meant to manage her migraines, her left eyelid had a very hard time opening up. The technical medical term is called phosis or eyelid droop. This is a known but rare side effect. The toxin, we think, really migrates into something known as levatored muscle or the levator apineurosis. This is the thing that actually lifts up your upper eyelid. So if Botox goes into it, it cannot lift your upper eyelid as well. The good thing is that this will go away with time. The bad thing is that, of course, this may last for three to four months. Fortunately, she was pretty candid about it. It was a relatively good sport. She said that you might catch her winking for the next 12 weeks. A few take-home points for this are that, of course, technique matters, the injector matters, and everybody's a little different. We can actually place the injection and the same number of units in the same spot, but different people are going to respond differently to the exact sort of same conditions. I do want to remind you that even though Botox is all over the place, it's not a trivial minor thing. It is a medical procedure. Next up is an interesting article from New Beauty. I've discussed this myself on the blog and also on videos. What happens when your box seems to start working? The article in New Beauty explores this. So the Botox or Botox equivalent product may have been made more dilute, it's expired or a little too old, is poorly handled, the injector may placed it incorrectly, the dosing for you might not be optimal, patients may have stronger muscles, high expressors or what we call them, and so on. We rarely see patients that may develop neutralizing antibodies, in other words, true resistance. If that's the case, then you should try a different brand name of Botox. We do use Botox relaxed dynamic lines, but it can't totally erase static lines. In other words, you have a blank, boring expression on your face and you have a line there anyway without any facial expression. What to do when this happens? Definitely talk to your injector, consider switching neuromodulator types. You may want to diversify procedures, including combining your Botox with filler, skin tightening, collagen simulators, different skin care, and so on. And remember, sadly, we're all getting older. So if it's been 10 or 15 years and they have not upped the number of units or dosages that you're getting with your Botox, I'll be honest, you probably need a little more Botox. Another interesting article is one of my favorites, global medical tourism with an emphasis on Soul Korea. We can look at the macro trends where Sol is really becoming very well known for medical tourism, especially in K-beauty, facial injectables, body contouring, and more. So one mommy makeover bundle, which is a lot of surgery, that's a lot of breast surgery, tummy surgery, abdominal surgery, if you will, and liposuction. Clinics will advertise high-skill, lower costs, and aesthetic results. But remember, overseas standards do vary. It's very hard to manage complications from a longer distance. There may be a communication barrier, even though people may say that they're fluent in Korean and English. This is a bigger procedure, and I am actually pro medical tourism and even surgical tourism, but you have to know the risks ahead of time. You have to know the clinic or your plastic surgeon. And for a bigger procedure like this, honestly, you may need to stay in another country for two to three weeks to get the best results and to avoid any complications. You could do the math. If you need to fly somewhere and stay there for two or three weeks, even though the actual procedure may be less expensive or a lot less expensive, when you throw in travel costs and hotel stays, it may not be that much of a cost savings to you. So be wary of that in terms of medical tourism and always look at credentials, the facility standards, the support staff, the emergency protocols, aftercare, and more. Finally, you may have heard of the mommy makeover with a breast lift from fat. So this is very cool where you can use your own fat, what we call fat harvesting and fat grafting, to reshape or lift your breasts without implants. There are a lot of great benefits, including more natural fuel. There's no foreign body, there are no breast implants at all. And you can do two procedures at once. We can sculpt your body and we can actually give you breast volume. There are a couple trade-offs. Fat survival is very unpredictable. Typically, about 20-30% does not take. So that means I have to overfill it and some of it's going to be absorbed. Another issue is that I really can't put in that much fat in your breasts. In the US, we think that the max is around 300cc, and honestly, it's probably a little better to get a touch less. Of course, in theory, I can give you more, but the way the breast is designed, there isn't enough blood flow to relatively how much fat I'm placing to get really good blood flow to these fat cells which have been transferred from somewhere else in your body to your breasts. It doesn't give you dramatic lift if you need a lot of breast sag reversed. So you still may need a surgical procedure for breast lift, and the fat's really meant for volume. When you plan a mommy makeover like this, combining fat graph breastwork as well as an abdominal plasty liposuction or combination of both, I think is fantastic, but not everyone is a candidate. So discuss this with your plastic surgeon during your consultation. Before we close, the most important guiding principle that I always have as a plastic surgeon is patient safety. It's always better to have patient safety above all types of aesthetics, because we never want to sacrifice safety margins. Informed consent is more than just you signing a document. You know, you have to talk to your plastic surgeon, your injector, and make sure that you understand the procedure, the alternatives, the risks, the benefits, and everything like that. Aftercare does matter. Even in smaller things such as Botox or fillers, it's still important to get aftercare to get the best results possible. Thanks for listening to this week's Beauty Standard with Dr. Roy Kim. If you have any questions or topics that you want me to answer, please fire away at the comments below. As always, thanks so much for listening.