Ask Dr. Hall: Your Plastic Surgery Questions Answered Part 2 (Ep. 95)

Dr. Jason Hall:

0:36

Are you tired of wasting money on skincare products and treatments that don't work? Or are you afraid of looking unnatural after having some non surgical treatments done? If you are then my new book, The Art Of Aging, is for you. In The Art Of Aging, I break down the aging process and talk about treatments that target specific parts of the aging process, what works and what doesn't. Also, I lay out a biology based skin care and non surgical treatment plan that will keep you looking great without looking fake. Check out your copy of The Art Of Aging on Amazon or in any of your local booksellers. Normally with The Trillium show, I'm kind of the one choosing the content based on things that people ask me about and and topics that I think are timely and relevant. Today, we're doing something a little bit differently, and we've taken a bunch of questions from you guys, the listeners, the watchers, the people that follow the show regularly, and so it's going to be kind of an ask me anything. So we've got a bunch of questions here that we're going to go over and get your questions answered directly on this show. If this is cool and popular, we'll do these again in the future. So for now, hope you enjoy this episode of The Trillium show with ask me anything.

Unknown:

1:55

My breast implants are eight years old. Do I need to have them replaced every 10 years?

Dr. Jason Hall:

2:00

Timing of breast implant replacement is something that's talked about a lot on the internet, and I think it's important to remember that you know what you what you see online, is that breast implants need to get replaced every 10 years. And I think where that comes from is that the manufacturers warranty their implants for 10 years. So if something happens to them, if you get a spontaneous tear in an implant, which is pretty rare, that the manufacturers will pay to replace those implants up to 10 years, most of them will the once you get out past 10 years, the chances of having a, and we're talking about silicone implants here, a what we call a silent rupture. So a rupture that you don't know anything about goes up a couple of percentage points every year. Does that hurt you? No. Is that silicone going to leak into your body and cause some weird autoimmune disease? Categorically, no. But, and usually what happens is, if you do have a tear, a silent rupture of one of these implants, is that your body is going to is going to recognize that, and the capsule around that implant is going to get firmer, and so you start developing a late capsule or contracture, which is kind of a sign that there may be a problem with that implant. Do you need to go out and rush and get your implants switched out every 10 years, like you're replacing tires on your car? Absolutely not. Most women have implants that far exceed the 10 year mark. I changed implants that are way older than that out almost every week, and not because women are having problems, because they don't feel like their breasts look good anymore, and they want a lift, they want a new set of implants. It's either bigger or smaller. So do you need to get your implants changed every 10 years? Absolutely not watch them if you're having problems you don't like the way your breasts look, see your plastic surgeon and discuss what your options are. But don't feel like you need to run out and change your implants every 10 years.

Unknown:

4:12

What age is too young for a facelift? So what

Dr. Jason Hall:

4:15

age is too young for a facelift? Really, the question is, better is, who is a candidate for a facelift? I think the important thing with plastic surgery, with cosmetic plastic surgery, is that we don't treat age, we treat anatomy, and a facelift is designed and does very well at treating the lower face, so jowls and jawline, and then most surgeons include the neck with that. So if you have jowls, a saggy neck, a facelift is a good operation. I've operated on patients in their 30s. I've operated on patients in their 80s, and operated on patients all in between that in those age ranges because of their anatomy, typically, if you want to kind of averages, most patients start looking to have facelift surgery in their 50s and 60s. That's kind of the average age range for that operation, but could be earlier, could be later, depending on anatomy, but not age.

Unknown:

5:32

Why is it so hard to get insurance coverage for skin removal after bariatric surgery?

Dr. Jason Hall:

5:36

So why is it so hard to get insurance companies to pay for skin removal after bariatric surgery? The short answer is because the insurance companies do not care a bit about you, the patient. They care about your insurance premiums, and they care about keeping your insurance as much of your insurance premiums as they can without paying them out in the form of health care. So that's the truth. The other part of it is that your insurance company doesn't see excess skin as being a medical problem, and for a lot of people, it isn't. Now, there are some patients who have real functional issues after having bariatric surgery, after having lost, you know, 80, 90, 120 pounds, and they've got all of this extra skin, and they get skin breakdown, and they have chronic rashes and they can't move around because this, you know, just the momentum of that skin moving back and forth makes it hard to exercise. And they do have, you know, insurance companies will cover some of that, but it is if talk to any of the patients out there, if any of you watching, have gotten insurance to pay for, you know, post bariatric plastic surgery, it's a slog to get them to pay for it, and you've got to jump through all sorts of hoops of physical therapy and having to be in the hospital and treat rashes and all this. And I can't even remember all the things that boxes you have to tick anymore, because we kicked the insurance companies out of my office a long time ago. But the it is a it is really difficult to get that paid for. It's really difficult to be anything paid for by insurance companies anymore. But so if you have or having bariatric surgery, plan for skin removal and just know it's probably something that's going to come out of pocket.

Unknown:

7:36

Do you offer any subcision based treatments for cellulite. Cellulite is

Dr. Jason Hall:

7:40

a tough problem to treat. I've had these, what we call subcision based treatments. Where we're you go, you numb the area up, you go in, you cut the little bands that anchor the skin to the to the muscle fascia that caused the dimpling. They've been met, you know, in my personal practice, they were kind of okay. Results. The problem is those things, it's hard to get people numb. You have to go to a either light sedation or an operating room to get those treatments done, and the results are, are okay. So do I offer them now? No, only because I don't really think the results justify the expense and the discomfort, but some people use them, they get great results with them. And so I guess there's there's the answer. It's a piece of shit. It's a waste of money.

Unknown:

8:43

Can you talk about blepharoplasty? Are

Dr. Jason Hall:

8:45

you talking we've already talked about blepharoplasty. Blepharoplasty surgery is is pretty common, and a lot of times people end up seeking blepharoplasty because they feel they look tired or sad or angry. And so we end up talking about upper blepharoplasty, lower blepharoplasty, brow lifts, fat grafting, laser treatments, and blepharoplasty can really include any or all of those. You know, if your eyebrows are too low, women, if your eyebrows are flat and they sit at the level of your eye socket or lower a brow lift makes a huge difference in kind of your how your eyes look. Upper blepharoplasty. Surgery often goes with that and involves removing skin and occasionally a little bit of fat from your upper eyelids. Sometimes it involves adding fat to your upper eyelids. If your upper eyelids are hollow and your eyes look hollow, we can actually add fat to your upper eyelids to help soften that out, and it really makes a huge difference for lower eyelids. Younger patients usually show up needing and asking for blepharoplasty surgery because of eyelid bags, and oftentimes it is either because of the way that they were born. It's a genetic thing. Their parents look the same way, but they don't have real high cheekbones. They don't have a lot of volume in their cheeks, and so they get eye bags really early, and we're talking about 20s and 30s early. And so blepharoplasty surgery to kind of. To smooth out those eyelid bags often involves a little yin and yang. It involves taking a little bit of fat out from the inside, and then taking fat from somewhere else and injecting it on the outside of the eye under the skin of the in the that tear trough or eyelid bag, to help smoothing things out and and volume addition, we talk about, talk to patients about lower blepharoplasty and putting fat back. A lot of times are caught back because they're, they think it's, it's that fat needs to be removed. But we actually have to balance the two things, the inside fat and the outside fat. And oftentimes we end up, almost all the time now, end up putting some fat back, and then we we treat the skin either with a little bit of skin removal, or, you know, what's most common now in my practice, is using a laser to tighten that skin of the lower eyelids. So blepharoplasty can be pretty complicated. If it's something you're interested in, please give me a call. We can have a consult, and we can talk through each of these different things and decide which is the right procedure or common combination of procedures for

Unknown:

11:44

you. Why did you pick plastic surgery as a specialty?

Dr. Jason Hall:

11:49

Wow, so why did I choose plastic surgery? Probably because I'm masochistic. I enjoy being in training for years. Now, I went to medical school with the thought of being surgeon, and wanted to be a pediatric surgeon, actually, and it wasn't until my general surgery rotation, when I was an intern, some of my friends were in the plastic surgery program, and I got to see all the stuff that they did, and I was like, man, this is really awesome. Like, they're, it's all these, like, really intricate, delicate little surgeries. Course, it was like they were doing these at like, three and four in the morning on a Tuesday, but they were still, you know, putting fingers back on and, you know, facial fractures. And, I mean, it was just really cool. I also fell in love with the pediatric side of plastic surgery, so cleft lip and palate and all that, I said, that's what I'm going to do. I've since done all the training. Did you know five years general surgery, two years plastic surgery, year of facial surgery fellowship at Stanford, and it's all been great, I love what I do. It is the intricacy, the delicacy of doing everything, the attention to detail that you have to have as a plastic surgeon, because everybody sees what you do. There's no There's no hiding, there's no stitch that can't be just right, because you see it especially working, you know, doing a lot of facial surgery, which is over half of what I do. You know, there's no hiding any of that. You know, it has to look good, it has to be right, and it just satisfies my kind of type A personality.

Unknown:

13:33

What is your favorite surgery to perform?

Dr. Jason Hall:

13:37

My favorite surgery perform is whatever I'm doing next. I think that has to be, that's, you get that question a lot. You get that I get that question a lot. And all of I love plastic surgery for the breath. You know, it could be, I could be doing breast cases one day. I could be doing a tummy the next day, I could be doing a breast and a face on the same day. And so the being able to kind of operate different parts of your brain, different side, different parts of the body, is really gratifying. But with that, the focus is on the patient that you're operating on, right? Then there are so do I have a favorite surgery? Facelift is probably my favorite surgery. But the surgery that I'm focused on is what is, is the person who's on the table, or is going to be on the table, you know, tomorrow, because that person deserves you know me at 110%

Unknown:

14:40

What does skin resurfacing do to your aging process? It's kind

Dr. Jason Hall:

14:42

of an interesting question. What does skin resurfacing do to your aging process? Kind of an interesting question. And I think where whoever asked this is coming from is that they rightly know that laser resurfacing, chemical peels, things like that, do cause your skin to thin. And thin skin is one of the things that we try and combat with all of our anti-aging treatments. And so kind of taking that to the next logical step. You know, thin skin means, makes you look older. But a lot of times when we're doing resurfacing, especially deep resurfacing, it's a balance. We combine when we do, I do combine treatments, so we'll do deep resurfacing, but then. Also do fractional resurfacing to help build collagen. So while we're thinning the skin from the top, we're building it from the bottom to help grow collagen. We also have patients on growth factors to help build collagen throughout this process, so we're not thinning their skin artificially over time and making them look worse. Now you can see people who have not done that and whose skin is paper thin from having one too many CO2 resurfacing procedures. But I think if we're careful and we plan our procedures right, we avoid thinning that skin and making it look bad over time and just get you looking

Unknown:

16:19

great. Do you prefer drains or drainless tummy tucks? So

Dr. Jason Hall:

16:23

do I prefer drain using drains or drainless tummy tucks? In my practice, I've done both. I continue to do both. I prefer drainless tummy tucks. I do more tummy tucks with drains, because the complication or the negative outcome that you're trying to avoid with a drain is a seroma fluid collection under your skin, and drains largely prevent that. In my experience, I've done drainless tummy tucks. I do drain less tummy tucks when we're not doing a lot of liposuction, when it's mostly skin removal, and they work really well. But I found that in my own patients, when I'm doing a lot of liposuction on an abdominoplasty and avoid using drains, there's a lot of fluid that ends up trying to come out of the areas we've done liposuction in, and we end up without a drain, developing a seroma. So I typically will use a drain when I'm doing a lot of liposuction with an abdominoplasty. Do

Unknown:

17:31

you have a surgery playlist?

Dr. Jason Hall:

17:34

Is a pope Catholic? Of course, I have a surgery playlist. The I've been building my surgery playlist on Spotify for the last 10 years. It's up to like 900 something songs, and you can check it out. It's public. We'll link it in the show notes, but it's got everything. If you like Sinatra, there's some Sinatra on there. You like Dave Matthews. We got that. You like Britney Spears. We got that. You like a little bit of EDM dance music. We got that, like some old school country, Hank Williams Jr., Dave and Alec. We got that too. So, you know, it's, it's very eclectic. It kind of bounces back and forth. You can have, like, Drowning Pool, and then it jumps to Sinatra, and then Brittany after that. So it's it's cool, it's fun. It keeps it lively in the operating room.