Plastic Surgery and Body Image: A Surgeon's Honest Take

Rady: Social media was the greatest thing that ever happened to plastic surgery for plastic surgeons, and the worst thing that ever happened to plastic surgery for patients. It is the best form of marketing and advertisement for doctors. It is horrific for patients because you are unable to discern, decipher what the hell you're looking at. Is it real? Is it not real? It's like me sending you postcards every day from this incredible island vacation spot. It literally looks like utopia, yet it doesn't exist. It's just a make-believe postcard I sent you. And all you do is look at your vacation and go, wow, my vacation blows.

Nikkiey: What's going on, everybody? Hey, you guys, welcome back to The WarriorBabe Show. I am very excited for this podcast today. I'm genuinely just fired up to have this conversation. If you've been in this community for a decent amount of time and you've been a listener for a while, you know that we talk a lot about building your body through strength training, through macros, through consistency. But today we're going to go somewhere a little bit different that I haven't ever brought to the show before, and I'm excited, because so many of you have done the work. You've put in the reps, you dialed in your nutrition, you changed your body. But somewhere along the way, you look in the mirror and you feel like it just isn't enough. This episode is for that.

So today I have Dr. Rady Rahban with us. Welcome. He's a board-certified plastic and reconstructive surgeon. But what makes this conversation so different is that he goes way beyond the physical. He is, I believe, one of the very honest voices in this space when it comes to women, bodies, and beauty, and what confidence actually means. We're going to get into the more mental side of things: why so many women feel compelled to fix themselves, and how social media has monetized our insecurities and completely distorted our sense of reality. So this one's going to go deep, and I'm excited about it. It's going to get real. Welcome, Dr. Rady.

Rady: Thank you. Thank you for having me. I'm happy to be here. I'm excited to be here. And I applaud you. I applaud you because so often individuals who are in your space, which is approaching one's happiness through mind, body, and soul, exercising, eating right, meditating, all the wonderful things we think of, those individuals don't want to address, tackle, discuss plastic surgery, because in their world, they've drawn a very distinct, very stark line in the sand that that concept, plastic surgery, is so polarly opposite to what they're trying to accomplish that they can't even have the conversation. So I applaud you, because this is a responsible dialogue, because I assure you that a high percentage of those individuals who are listening to you, following you, participating in what you preach, have engaged or will engage in plastic surgery. And so to not talk about it because, oh my God, that's the enemy, is just foolish. That's just sticking your head in the sand. So bravo for talking about it, and of course, bravo for having me. I appreciate it.

And yes, I have spent 20-plus years really dedicating myself to the art of plastic surgery, the execution of plastic surgery, the surgical aspect, but significantly on the mental side. And by mental, I don't mean I'm some guru or some person who is Zen. I'm just saying we're humans, and psychologically we have components in us. We're a very complex creature and a very complex being, and we have many sides to us. And plastic surgery is indeed one of those sides. And I love the dialogue around it because I think it creates clarity. It releases us from our own internal restrictions of how we approach it. And then it allows us to use plastic surgery, if we feel that it is indicated, in a healthy and productive way. So, long-winded, but I'm happy to be here.

Nikkiey: Yeah, I'm excited to have this conversation with you, and I appreciate your words. I think it's cool what you are doing when it comes to this type of dialogue and conversation. Because like you said, in the plastic surgery space, at least I haven't seen somebody going into the mental side of it and talking about it from the approach of what the people may be going through. So yeah, I'm excited to have this conversation with you. Let's just dive right into it.

The first question that I have for you is: when women sit across the table from you and they say they want a procedure done, are there things you're actually listening to that are behind the physical request of what they're asking for?

Rady: Yeah, sure. Of course. You don't need a PhD in psychology, as a clinician, to ascertain or gather the mental state of who's before you. First and foremost, you cannot have a worthwhile consultation in eight minutes. That's number one. Anytime you go and see a doctor... my wife's had six spine surgeries. I went and saw a cardiologist yesterday. If that conversation is not more or less an hour, it was a waste of time. I believe that wholeheartedly. I've been practicing medicine and plastic surgery for 20-plus years, and every consult of mine is long, long-winded, time-consuming, because we're tackling very large subjects.

So part of, as you said, reading the patient before me is to spend time with them. You come in. 'Hey, how can I help you?' 'Oh, I've given birth and I've breastfed and my breasts are small and I don't like that, and I wish they were bigger.' 'Great, I can help you. We can make them bigger. What size do you want to be? C? Great, I can do that for you. Go talk to my office manager.' How long was that? That was 40 seconds. I don't even need to see you, to be honest with you. I'm at a point now in my career where if you send me your photos, I can tell you what you need. But that was just atrocious. We didn't talk. I didn't ask you about your medical conditions. I didn't ask you what you do for a living, how old your kids are, what stage of life they're in, what you eat.

So what I do is... there's this idea that everything we talk about is so black and white. 'Oh, they have body dysmorphic syndrome.' No, they don't. Those people are so few and far between. They're so easy to identify. What you want to identify is, will this patient be happy? Let me rephrase that. I didn't say, will this patient have nice breasts? Will this patient have a cute nose? Will the abdomen be flat? That's not what we're trying to accomplish. Yes, that's how we get there. What we want to know is, will this patient be happy with what it is that you do? And in order for them to be happy, part of it is you have to execute what you said you're going to execute. Part of it is they have to be a willing recipient, and they need to be satiable.

So how do you distinguish that? First of all, you talk to them, you ask them questions. Number one, if a patient can't make eye contact with me while I'm talking to them, we have a problem. Number two, if they're in the room with another person, i.e. their life partner, and they are deferring, referring, a lot of engaging with them during this consultation, it's a problem, because this is a very independent decision. I cannot tell you the number of revisions I've done over the years where the patient starts with, 'When I was with my ex-husband, my ex-boyfriend...' Which is fine, but that's a shame. 'This wasn't really what I actually wanted.' But of course, you were partners and you want to make that compromise, and I get that. But this is your body, and you want to really make sure it's predominantly what you want. So when I have a partner in the room, which I love, you should always try to bring your life partner, but they're deferring to that partner, or that partner's interjecting too much, very big problem.

When the person's interaction with you is emotional. This is not emotional. You want to say you've worked out, you've gotten super lean, you're ripped, you're in your late forties and now your neck is sagging. It's not emotional. You shouldn't be teary-eyed. You shouldn't be labile. It's pensive. You should be thinking about it. It's a big decision. But there shouldn't be all these fluctuations in your emotion.

And then when you attach way too much value to it. 'This is going to save my marriage.' 'Why are you doing this?' 'Because we're having some issues.' This is not going to save anything. This is going to enhance the quality of your life because you are a stable person who's fulfilling all their other normal needs; all the other checkboxes are done. And no matter what you do, you won't overcome the saggy breasts. So we have to be very clear in how we define this. Plastic surgery is an adjunct. It's a tool. It's not in lieu of, it's in addition to.

So if you come to me and you are a totally normal, and by normal, I'm going to put it in quotes, a 'normal' person, well-adjusted... You don't have anxiety or some insecurity. That's a well-adjusted person. You're just not out in the far norm, like three standard deviations apart. You're married or you're not married. You're stable. You have a job. You're happy. Overall, you're in joy. And you have a legit issue. You have no breast tissue. You have saggy breasts. You have a bunch of loose skin and stretch marks from babies or weight loss. You have diastasis. Your nose relative to your facial features is enlarged. You have loose neck skin. Your eyelids are touching your eyelashes. A legit anatomical issue that I can look at, and you and I go, 'Oh, there it is.' And you are otherwise a relatively normal, stable person. It doesn't make you bad, insecure, horrible, nuts that you want to fix that issue. Diet's not going to fix it. Zen is not going to fix it. Kumbaya is not going to fix it. Going to Erewhon every day and having a smoothie is not going to fix it. It is a part of who you are.

And I noticed that you are in incredible shape. I assume you eat incredibly well. You have a holistic lifestyle, but you have mascara on. Why? Is that your normal, natural hair color? Did you just wake up and your hair looks like that, or did you fix it today? 'Well, oh, that's okay.' Well, why is that okay? Why is it okay that you do these things, you adorn yourself with these sorts of enhancements, yet I, whoever you are, said, 'This is where I draw the line'? That's nonsense. Do you have a tattoo? Why? So all we're doing is just arbitrarily deciding what is and isn't okay. It isn't about what is and isn't okay. It's: are you a good candidate? And mental preparedness is a part of it.

So if you have done everything that you preach on your show, and you come to my office and I have a dialogue with you, and you have a real anatomical issue, and you were totally normal, asking me regular questions, you should, in the 99th percentile, assuming I execute what I said I'm going to do, be over the moon, because it's added to your life. It's not replacing something that isn't there.

So I know that's long-winded. There is no special spidey sense. You just can't do it in a minute. And I can feel it. I've had patients come to me... I had a gal I remember vividly. She was a young girl, in her early thirties, of Indian descent. She came to me for a breast aug. I went in the room, I did a consult. I could tell she was very anxious, and she was not making a lot of eye contact, and a little emotional. And once I see that, then I probe more. 'So tell me what's going on, what's the situation, what drives you here, why you're doing it.' I don't necessarily need to ask psychiatric or psychological questions of everyone, but if I start to see things... And lo and behold, she was engaged. She broke it off. The guy was not so lovely, really made her feel insecure. She wants to do this because she thinks it'll make her feel better, for whatever reasons. Very classic, nothing unusual.

And I said, 'Listen, while you are a good candidate, physically you're a good candidate, you are in a horrible place. No question about it. And chances are, when you're in a better place, you'll still need it or still want it, but you certainly are in an awful place now. Let's make a deal. Why don't you come back to me in one year? And I promise you, if it's something that you still want to do, we'll do it.' And sure enough, she came back to me in a year. She was 10 pounds heavier, which is where she needed to be, because she was so distraught she was incredibly thin. A lot of people eat, but a lot of people don't eat when they're stressed. And she was just happier. She's a happier person. We did the breast aug. Everything went fine. She was wonderful. That is one of many, many stories. But to answer your question, how I discern that and how I know where their psychological condition is, is through engagement and dialogue. And then it usually surfaces.

Nikkiey: Ladies, are you feeling frustrated with body changes you're experiencing during menopause? It's time to take control. If you're between 45 and 65 years old and tired of struggling with body fat and muscle loss, WarriorBabe is here for you. At WarriorBabe, we've helped over 18,000 women just like you lose body fat, build toned muscle, and understand their bodies better with personalized plans based on hormone and thyroid testing and more. Imagine knowing exactly what your body needs to see real results, and results that last. Don't wait anymore. Take charge of your health and join our community of strong, empowered women. Visit warriorbabe.com/apply today to start your transformation. That's warriorbabe.com/apply. All right, let's get back to the show.

Nikkiey: What I hear amongst all of that is that you care about your patients.

Rady: A hundred percent. Very, very deeply.

Nikkiey: And I think that's incredible, because it's not going to be an eight-minute consult where, like you said, you don't have to see somebody at this stage of your career. But you want to. You have the conversation, and you read the individual and the emotional response behind the words, which means that you actually care about the person that you're helping, which I feel is a rare thing. So that's a beautiful thing that you bring to your work.

Quick break. If you're finding this episode helpful so far, it would mean a lot if you could hit pause for just a second, leave a quick rating or a review, or share it with someone who could benefit from it. Your support helps more women discover these tools to build muscle, lose fat, and feel confident. Thank you so much for being a part of this journey with me.

I was going to ask, are there any patients that you do turn away? What does that conversation look like?

Rady: It's not pleasant. It depends on at what point I turn them away. So I meet you, I barely know you... versus I'm about to operate on you, it's the day of your surgery. You see, that's the spectrum. I go on my first date with you, I don't like you: much easier to break up with you. Tonight is our wedding, I don't feel right, I've got to break up with you. Those are two different animals. I have actually, literally a month ago, canceled a case the morning of surgery. She was literally here, IV in her arm, the whole team here. We'll get to that one, because that's really unpleasant. But there are several reasons why I won't operate on you.

Let me back up here for a second. If for no reason other than your own selfish reasons, as a doctor, you want to give a shit. You want to avoid headache. Let's say I'm not an empathetic person. Let's say I'm not a kind physician. Let's say I don't give a shit about the patient. Let's say all I want is to make money and live a happy life. I don't want to operate on people who will then be a headache. If I operate on you and you're emotionally a disaster, I'm going to own you. I don't sell you a purse and you just return it. You're my patient. You're online writing horrible things about me. You destroy my office morale by calling us all the time. Furthermore, any complication you have is amplified through lawsuits. So for no reason other than selfishness, you'd think physicians would care more, but they just don't, because it's time-consuming to care. It's time-consuming.

So to answer your question, the reasons I don't operate on you, or in your words, turn them away, are several. Number one, they legitimately don't have an issue. They come in. 'Hey, Dr. Rahban, how are you doing?' 'Great. How's it going?' 'I'm here for my nose.' 'Wonderful. Let's take a look. What bothers you?' 'This hump. It's crooked. It's not straight. It's not symmetrical.' I examine them, and for the life of me, I'm not really sure I see what they're talking about, or what they're talking about is so minor that in no universe is it worth the slide. The run versus the slide. It's just not worth doing. Those patients require very gentle dialogue and a little bit of reassurance that what they're seeing is not accurate. 'Oh, but you don't seem to understand, Dr. Rahban. Let me show you this picture.' Well, the hell with your picture. Look at you right here, right in front of me. 'Yeah, yeah, I know that, but when I angle...' That's a photograph.

So issue number one is sometimes people identify concerns that are just not valid. They're not crazy. They're not out of their minds. They're just picky people. So I walk them off the ledge. Some of them are like, 'Okay, fine,' and they're all bummed out, because anybody who comes is coming for a reason. They want to operate. So they're bummed out, but they agree with me. And some... I literally just got a DM from a lady. I won't name her, because her name's on there. She blasted me because she came for her revision, revision, revision rhino. Apparently I told her it was a bad idea to operate on it, and she wrote me an essay on what a horrible human being I am, because she found a doctor who operated on her and fixed her, and had she listened to me, she would have lived with this horrible nose her whole life. I got blasted for not operating on her. Look at the universe we live in. You're damned if you do and you're damned if you don't.

The second reason we don't operate on you is because you have the issue, you're just not all there, for all the reasons I mentioned. And that's harder, because I have to, in an hour-long consult, somehow tell you that you're not emotionally stable enough to have this. So I'll guide them, but often it's not my place, or the right place, to have that dialogue, and it usually backfires. So I very easily and gently massage them out of doing it. 'Oh, shouldn't you send them to a therapist?' 'Hi, nice to meet you. You came here for a breast aug. I think you need to see a psychologist.' That's not going to go over well. That's not realistic. But I certainly don't need to operate on you.

Nikkiey: Have you ever had anybody say thank you for that?

Rady: Oh yeah. Listen, you can tell by this... our podcast has been, whatever, 20 minutes. I'm very direct.

Nikkiey: Yeah.

Rady: And I'm always direct, because you can never go wrong being honest. It can be uncomfortable. Even if this lady wants to sue me for not operating on her, you can't sue me for not operating on you. You understand what I'm saying? You're never going to get in trouble for telling the truth. I tell that to my four-year-old.

And the third, and the most uncomfortable, is: you went through the first two hurdles. I met you, I had a pre-op with you, and then it's your day of surgery and you're behaving nuts. You're emotionally labile. Last month, there was a young lady. She lost a hundred-some-odd pounds. We were supposed to do phase one of multiple surgeries. She was going to have a circumferential body lift. She had loose skin everywhere. Very, very sort of hostile young lady. Remember, I don't need to love you as my patient. I need to tolerate you. Of course I want everyone to be lovely, but that's not the case. So anyways, the day of her surgery, she was just crazy. She was acting mean to everybody, rude to the staff, reluctant to do things. I walked in and I canceled her. She looked at me flabbergasted. 'What do you mean?' I said, 'We're not operating on you today. Pack up your bags, call yourself an Uber, call my office in the afternoon, and we'll refund you the total amount of your surgery, even though we should charge you, because I have anesthesiologists here. I have my whole staff here. We lost money by having you here. You've got to go home.' And then of course she got really angry and wouldn't leave, and so on and so forth. So yes, I don't operate on people.

Nikkiey: Love that. Well, I love it. Again, that goes into the respect. You care for your people, and you also have respect for the job that you do. So you're not going to operate on everybody. You will turn people away if they're not physically or emotionally fit for the job that you want to do for them.

Rady: Yeah.

Nikkiey: I want to talk about social media. What are your viewpoints on social media nowadays, and how people look at social media and see these filters on people, and then they compare themselves and wonder why they're not looking the way that this person on social media looks? Does that make sense?

Rady: Yeah, a hundred percent. Social media was the greatest thing that ever happened to plastic surgery for plastic surgeons, and the worst thing that ever happened to plastic surgery for patients. It can't get any better than that. It is the best form of marketing and advertisement for doctors. The best. It skyrocketed, because now every single human being is a walking billboard for plastic surgery. It is horrific for patients because you are unable to discern, decipher what the hell you're looking at. Is it real? Is it not real? It's like me sending you postcards every day from this incredible island vacation spot. It literally looks like utopia, yet it doesn't exist. It's just a make-believe postcard I sent you. And all you do is look at your vacation and go, 'Wow, my vacation in Hawaii blows. God, I wish I were on that island. And look at that weather. Look at that palm tree.' So it's a catastrophe. It's just a catastrophe.

There are a few benefits. You get more information out there. People know things exist that they never did before. And the occasional patient who tells their disaster story will kind of warn people. But for the five things that I just mentioned, there are 150 wrong things with it. Number one, everybody is filtering their photos. Kris Jenner, for the love of God, broke the internet because she posted a photo of herself after surgery and she had 30-year-old skin. That wasn't surgery. That was a filter. Secondly, nobody has acne. Third, everyone's ribs are in. Everyone's ass is big. Everyone is fit and muscular. They show a couple of photos of, I don't know, some chia seeds that they eat, and everyone's a fitness instructor, and everyone's a beauty, and everyone's got long legs, and everyone's hair is perfect.

So when you are a regular person, you cannot help this. You will compare yourself to other people. That's how we gauge ourselves. 'You're so honest.' Honest relative to whom? It's all relative. We don't exist in a bubble. You're tall relative to short people. It's all relative. And so when you are constantly comparing yourself to 497,000 images a second, even if you are the most stable, most secure, you are literally Gandhi, you're going to be affected. There's just no way around it, and it sucks.

Nikkiey: I think you could piggyback off of what you're saying here. I want you to dive in a little bit deeper on what you mean by monetized insecurity and how social media has done that to us.

Rady: Yeah. Listen, I make a living operating on you. That's how I make a living. I operate on you by you showing up. You show up because you want something fixed. You want something fixed because, healthy: there's a real issue there that you can't fix on your own. Unhealthy: you see images, and it makes you feel shitty about something that you wouldn't have felt shitty about had someone else not pointed it out to you. Totally different. Social media increases insecurity 8,000-fold, and insecurity drives surgery.

And I don't mind being insecure. It's a reality of humans. You cannot secure yourself into loving your pannus from three kids. I don't care who tells you that. That's just bullshit. 'I had three kids. I do yoga. I eat macros. I'm clean. I do triathlons. What do I do with this loose skin hanging over my pubis?' 'Well, just love yourself. Be Zen.' What? What are you talking about? So I don't mind that there is an issue creating an insecurity that I can fix, that you will love, and then you will kill it. I just don't like when insecurity is fabricated and amplified and doesn't really exist. So yes, it's monetizable. But don't get me wrong, it's not our fault. It's not like, 'Oh, greedy plastic surgeons, you guys are doing it to yourselves.' Yes, of course, doctors are advertising, but this whole phenomenon was the brainchild of social media. We just happen to be benefiting from it.

Nikkiey: That's pretty spot on. It's pretty wild what social media can do to our minds.

Rady: Listen, look at your own career. What has social media done for you? Would you even exist 10 years ago without social media? You wouldn't. You just wouldn't. You'd have no followers. No one would know you exist. You're amazing and you're worthy of that following, but you wouldn't have it, because there'd be no eyeballs. So it is a double-edged sword. It is a gun. It is a knife. It helps and it hurts. It's just unfortunate that there are no guardrails for the hurt part. So if you are a vulnerable person, and sadly we know half the population is, it will suck. And if you're a good person and healthy, you're like, 'Oh my God, look at that girl. She's crushing it. I want to follow her. I'm going to get my shit together.' Awesome. Benefit. We love it.

Nikkiey: Yeah. To piggyback off what you said, there are a lot of women that come into the WarriorBabe program who have already done liposuction, but then they gain the weight back. They went into it kind of like what you were talking about earlier, with more of an emotional response. They thought that they would be happier after their surgery happened. They weren't happier, and they came out more frustrated, with the same eating habits they had beforehand. Can you talk about that psychological process a little bit deeper, in terms of people coming in wanting to be happy, but coming out on the other end not happy?

Rady: Sure. So let's be specific about what it is that you do, which is being in shape. No cosmetic surgery, none, no tummy tuck, no breast lift, no body, nothing ever takes the place of you being in shape. I am a fitness freak, not because I look it, but I love muscles. I love tone. I love the tightness. I like the physique. I like the torso. I like the posture. There's nothing more attractive in a man or a woman than being in shape. And you cannot buy that. You cannot operate on that. You can't do shit to that.

So if I have two candidates, mom one and mom two, both have had three kids, both have undergone the same cycles. Mom one comes in, has been doing yoga and Pilates, is in shape, has the bulge associated with diastasis, which means there's no amount of crunches that's going to fix that flattening, has some loose skin and flat breasts. And patient two is the same person, but is 25 pounds overweight because, shit, she threw in the towel. 'There's just no point. I can't get ahead of this ball. I'm so far behind.' Patient one will crush it in my before and afters, and they will be the ones that I post, because once I fix them, they're killing it. They're flat, they're ripped, they're toned. Patient two will do well, and relative to where they started, they'll be better. Patient three, the one I don't operate on, is overweight. When patients come to my office and they are overweight, I send them out. Why? Because they will look shitty. They will still look frumpy. It will not work. So before, they'd have to go and work out and eat better. Well, we both know that that's just a huge obstacle for people. Well, now there are GLPs and all those things, and we'll address that at a later point.

I almost never, and this is going to be really important to everyone listening, I almost never do liposuction. I hate liposuction. I loathe liposuction. I speak out against liposuction. So let me elaborate on why that is. 90% of our surgeries, rhinoplasty, upper eyelid, facelift, nose job, breast aug, breast lift, tummy tuck, I could keep going, have great results when you're a great candidate. The candidacy for liposuction is so small that there's probably one out of a hundred that come to me.

So let me tell you why that is. Let's talk about the procedure. I don't give a shit what the doctor tells you. I don't give a shit what type of lipo they advertise as world-renowned, no one has ever seen, the newest technology, came out last week. It's all a lie. Liposuction is a very basic procedure. We poke a hole somewhere. We then stick in a long tube with an opening, called a cannula, and then we pluck out and suck out fat. And it will be irregular 100% of the time, because we're plucking out fat just blindly. And when you're done, you will have fat in a canister. That's sweet, I love that. You will be smaller, transiently, yet you will be looser. You think sucking out fat makes your skin tight? In what universe does taking a pillow out and putting a smaller pillow in make the pillowcase tighter?

Oh, we know it doesn't work. So then we start doing extra things like J-Plasma and Renuvion. Those are all technologies where we go in after we've lipo'd you, and, excuse my French, we stick in another product that heats the skin from the inside, praying to God it makes it tight, because we know we just loosened it. And 100% of patients will have irregularities: some divot, some ripple, some dent, contour, something. Why? Because I removed your fat in little chunks. I didn't take it out with a wand or cut it out. I just plucked it out.

So the reason I don't like liposuction is it looks good at the beginning. All the photos you see on the table on social media are useless, because they're literally swollen on the table. All photos within the first six months are useless. And anyone who shows their photos is always overstretching. If you look at someone who is showing their abdomen after lipo, they're arched, because they're concealing the loose skin. Lower abdomen, loose skin. Inner thigh, loose skin. You know how many tummy tucks I've done on women who've never had a child, because they had liposuction a couple of years earlier? Probably a hundred. Because liposuction is a shitty technology.

Now, surgeons who make a living doing liposuction will tell you, 'Oh, it's because they don't know what they're doing. They need the right technology. They haven't mastered it.' I know what I'm doing. It has nothing to do with skill. It's a shitty technology. It just is. It's like shooting an arrow with a broom. It just doesn't work. So I only do liposuction selectively. 'Oh, look at you. You're so fit. I love it.' 'Yeah, but I have just this tiny amount of fat stuck here.' Great candidate. A tiny amount of fat targeted in an area that is easy to remove. I'm not going to take you at 200 and make you 150. Second of all, your skin matters. 'Oh, I've had three children.' Don't do lipo. 'Oh, I've never had children. I'm 22 years old.' Okay, better. Your skin is better. So it's a small amount in people with good skin, as opposed to the overwhelming majority of lipo, which is large amounts in shitty skin. And the more you remove, the more issues you have.

So I needed to give you that little bit of a synopsis on liposuction, because a lot of people who are working out get frustrated, and then they're like, 'Fuck this, I'm just going to go do just this little area.' And then that little area becomes a huge issue, because then they get a dent and a divot, whatever. Every time I post anti-liposuction, I get 20, 30% of the people going, 'You don't know what you're talking about. My liposuction was the best thing I ever did.' And then they tag their surgeon. And I get 70% of the comments going, 'Oh my God, this is exactly what happened to me. Holy shit. I wish I'd never done it.'

To me, if I came in to do a procedure, spine surgery, heart transplant, and I told you that there's a high probability, and to me high probability is anything more than 5%, that that surgery is going to have an issue, I wouldn't do it. We don't have those issues with breast augs and nose jobs and eyelids. Just lipo. So that's really important, because people look at lipo almost as a lunchtime thing. 'It's not even really surgery. I just went in for a little suck.'

So that is my philosophy. The reason people come out overall unhappy is they were the wrong person doing the wrong surgery. 99%, I swear to God, of my patients are elated, over the moon. Cards and gifts and chocolate. 'Dr. Rahban, we love you. You're so amazing.' 16-year-old nose jobs, 82-year-old facelifts. It doesn't matter who they are. If they are a good candidate physically and emotionally, and you do what you said you were supposed to do, no complications, you execute the surgery that we talked about, 99% of people will be ecstatic. When they are unhappy after surgery, it's because they were a bad candidate physically or emotionally, or you did a shitty job. And then of course you're not going to be just unhappy. You're going to be devastated. You spent all this money.

Nikkiey: Yeah, I appreciate you elaborating on the liposuction side of things, because there are definitely going to be a lot of women listening to this who resonate with what you said and are like, 'Yeah, dang, I should have never done it in the first place.' So elaborating on that is good. And I feel you on the attacks you get on social media, because once you bring your truth and directness to something that you firmly believe in, you have people chirping in. Me in the fitness space, I just talk about the basics. I talk about eating well, working out, getting movement in, drinking your water, prioritizing your sleep, and X, Y, and Z. But as soon as I go against GLP-1s, or I go against the new crazes that are coming out, I get cooked for it.

Rady: Yeah, you get cooked for it because people feel guilty, because we all know the basics. You did not invent exercise. You did not invent nutrients. You did not invent rest. You did not invent hydration. This has been known since, I don't know, probably the time of the Greeks. Way back. You have not invented any of that. But when you say, 'Okay, these basic things,' which everyone has access to, it's free, it's not even about accessibility, and people are unable to because they're unwilling. This is unwillingness. This is not 'I couldn't afford it.' Unwilling to do it. And they find another route. They feel shame and anger because you're basically turning the mirror on them.

Nikkiey: Yeah. We could totally continue down this conversation, but I do want to bring it back. If a woman is considering a procedure, what questions should she ask herself first, before she goes forward with booking a consultation with you?

Rady: Yeah, great. Number one: who am I doing this for? So you think to yourself, 'I'm doing this...' The first person that should pop into your mind is me. We don't live in isolation. We are not selfish creatures. If the second person is my husband, my boyfriend, I don't think that's terrible. I don't think it's terrible to say that I love myself and I want to enhance my relationship with the person I love. I'm traditional. I'm not of the new wave of 'it's me, me, me, fuck everybody else.' I'm of the tradition that my wife and I are partners, and we do things for ourselves and we do things for each other. And so the first thing they need to ask themselves is, who am I doing this for? And front and center, it needs to be you. If the answer is, 'Well, my husband and I have conflict, and maybe if I fix the way I look, it'll re-spark our marriage,' I think that's a dangerous and slippery path.

The second thing is, where am I in my journey? When it's facial surgery, it doesn't apply, but when it's anything body-related: where am I in my weight? Have I even bothered to try to lose weight? As I told you, the outcomes of a leaner person versus a heavier person in terms of the aesthetic outcome, forget about everything else: which one of these two people looks better? The thinner person does better from cosmetic surgery. The overweight person doesn't do as well from cosmetic surgery. So you don't have to be skinny, but you can't be overweight, at least in my office. Third, if you go somewhere and someone doesn't tell you you're overweight, and you know you're overweight, walk out. Run.

And then you have to make sure that you are in a space where you can be selfish for a period of time. There is a massive concept of mommy guilt. I have had women bawling in pre-op. Pre-op. We met. You showed me your huge diastasis, your big old hernia, your skin touching. We met, you agreed, you come to pre-op, and I can tell they're really nervous and unhappy. You should be ecstatic at that point. I always say it: the beauty of what I do, and why I went into what I do and didn't go into oncology, is I want to be involved in fun, good, exciting things. I want a hug and a big old chocolate or something as a gift. Why? Because I made your life better. So if you come in and your anxiety is a 10 and your excitement is a two, we've got a problem, because this is elective. If you come in and your anxiety is a two and your excitement is a 10, I love it, because you're normal. You're having surgery.

Sometimes I see women and they're really pensive, and I poke and I poke, and they start bawling. 'I have three kids. Is this irresponsible of me? What if something happens to me? I'll never forgive myself. Mommy didn't make it because she was vain.' And they start really beating themselves up. You think your husband will have that dialogue in his head when he goes to get his hair transplant? He doesn't give a shit. That's not the way men are wired. 'And then maybe this money... we're not that wealthy. I should have put this in their 529 account.' So much weight is being carried by a woman who has children. And I love it. That's the definition of motherhood, but it's inappropriately placed.

Women who love themselves because they feel empowered and beautiful and attractive and confident crush it as wives, crush it as moms, and crush it at work. I can tell you no fewer than 1,000 stories of women who've come back to me post-surgery saying the following things. 'My relationship with my husband, who loved me and adored me and who told me I didn't need it, is through the roof.' Why? You think he's looking at you and going, 'Wow, my wife's a hot piece of ass now'? No. You are so confident in intimacy, showering. A thousand women have told me, prior to surgery, 'He's not allowed to see me naked. We've been married 25 years, lights are off. He is not allowed to touch my abdomen during intimacy.' So the reason it works is because you have a loving partner who loves you the way you are. You're the one that doesn't love yourself. You do the surgery, you're like, 'Wow, I look good.' You start wearing sexy underwear, turn on the lights, and your intimacy increases.

The second thing that happens is that you feel better as a mom, because unconsciously you have guilt. You are angry at your children unconsciously. I know that sounds horrible, but they're the ones that made you this way. And so when you are beautiful to yourself and your kids are there, you've got a win-win. And then at work, obviously no one sees what's underneath there, but you feel powerful. That's why undergarments work. Who cares if you're wearing Fruit of the Loom or you're wearing La Perla? You care. So the psychology of empowerment, when done correctly, is so large that you couldn't even fathom the exponential nature of it. And I know that because I've experienced it a million times. I've had women tell me the most intimate secrets of their personal lives, and it's so touching that I could be a part of that, and they could have never accomplished it through diet and exercise. That's why I like what I do. I am necessary.

Nikkiey: You clearly think very differently about all of this, on a much deeper level than most, when it comes to your practice and how you go about it with your clients. What do you want women to walk away with from this conversation today?

Rady: I want them to be open, not to create any line in the sand. It's a fluid dialogue. What you do and what I do synergistically make the best version of you. It is not, 'Well, no, you shouldn't do plastic surgery. Plastic surgery? That's so gross. It's vain. You're going to cut yourself and pay for it.' The way you're looking at it is so negative. Conversely, you can't be like, 'Well, you don't need a workout. Just take a GLP and just do some surgery. Fuck it.' It's not going to work. There's no way in hell... none of my patients look like you. They're not fit and lean and ripped. And so we're tools together, and synergistically, in the right person, you can have the best version of yourself.

In many instances, patients take your path, because it's usually the first path, not always, but the first path, and they don't need me. Great. Awesome. High five. Wonderful. You love yourself with all of your flaws, which we all have, and I'm happy I never met you. And then there are some people that take your path, they do everything they're supposed to do, and they hate their saggy breasts, and they hate the loose skin on their stomach, and their diastasis will never... and I'm going to say this right now: anyone who says otherwise is full of shit. No trainer, not you, no one is fixing your diastasis. What you're doing is reinforcing your obliques and your core. I am a world-renowned diastasis expert. I don't say that loosely, because I'm never self-promoting, but in the area of diastasis, I am. And millions of women have come to me telling me, 'I've spent 12 years in so-and-so's fitness rehab program.' It's foolish. You must work your core. You need the obliques and the rectus muscles to be strong, but there is a gap, and that gap is not going to magically sew back together.

So after they've done your lifestyle program, if there are things that they're still unsatisfied with, and they have the means, they're not selling their house, and they have a stable environment, and they find a reasonable surgeon wherever they are... and there are many. There aren't thousands; most are not great, but there are certainly great surgeons throughout this country. Then I am, naturally, a huge advocate of plastic surgery, because I am the lucky one that has seen the inevitable benefits of it.

So I think that's the key message: don't be so dogmatic. All or none, one or the other. It's all of it. And each person is very specific and very unique, and we need to tailor our conversation. Plastic surgery is the variable. Your part is universal. There is not anyone on the planet that doesn't need to exercise. There is not anyone on the planet that shouldn't eat well. There's not anyone on the planet that shouldn't remain hydrated and rest. So what you're preaching is the organic baseline. The question that then remains is, once you've done that, do you or don't you need additional assistance? And that is individual, and for each person to decide.

Nikkiey: Yeah, I definitely agree with you on that. People can all go about taking a health and fitness journey, as everyone should, as health is very important, and eating well is very important, and working out for the long term. But there's a path where some people will do that work, yet they still want to make themselves beautiful, and they want to feel a certain way about their body because they put in all the work. And they come to you, and...

Rady: Yeah, and it's really, really enjoyable, because you kind of feel like you made it to the vista. Who the hell wants to climb Everest and just fall short of the peak? Very disappointing experience. So if you climbed 85% of that goddamn mountain and you can't make it up the last 15, and a helicopter comes and picks you up, take the goddamn helicopter.

Nikkiey: Yeah. And if that's something that's going to make you happy at the end of the day, then I totally... yeah, a hundred percent.

Rady: Well, that's why I said bravo to you before we started this process. So many people are afraid of this dialogue because they feel that it would undermine what they're doing. And the reality is that that's not the case at all. So good for you, because you have a listenership, people follow you, they respect what you have to say. And for you to be able to have this dialogue openly, I think it says volumes about you, because you are allowing them to think freely throughout this entire experience.

Nikkiey: Yeah, I appreciate that big time. And just to piggyback off of what you said with Mount Everest, because there are people that are going to be okay where they are at 85%. But the main thing you talked about throughout this entire conversation, and how you started it off, was that with the patients you work with, at the end you want them to be happy. That's the main thing. So people can be happy at 85% and not work up to the top of Mount Everest. But if they want to get to that peak and they have the means and the ability to do it, that's when they'll come to you as a tool to finish out the whole outcome.

Rady: 100%. We are not to judge what makes you happy. Listen, I don't agree with it, but if you're 350 pounds and you're happy, okay, that's your life. That's your choosing. It just so happens that most people aren't. It's not rocket science. The people who take the healthier path tend to be happier people. So whatever works for you, we're here to facilitate it. That's just the bottom line.

Nikkiey: I know you're on social media everywhere, and I want people to be able to find you and follow you, and if they ever want to come get a procedure, find you.

Rady: Yeah, of course, I appreciate that. First and foremost, since 2019, so that's seven years now, I can't believe how long it's been, I've had a podcast, painfully, once a week, 300-some-odd episodes, with this exact same type of approach about every goddamn thing you can imagine. Patients, complications, surgery centers, board certification, because plastic surgery is treacherous. It's confusing. It's misleading. And it's not accidentally that way. It's by design. If we confuse you and you can't figure it out, you'll be more likely to make a choice you wouldn't have otherwise. So my podcast is called Plastic Surgery Uncensored. You can find it everywhere: Spreaker, Spotify, everything.

And then you can find me on social media, and that's an easy way to just follow. It's D-R, as in doctor, and then my name, which is very ethnically odd. It's Rady Rahban, R-A-D-Y-R-A-H-B-A-N. So Dr. Rady Rahban is my handle. And yeah, those are the two easiest places to find me. And if you like this concept and you're like, 'God, now I'm curious about breast lift, facelift,' whatever, there are 25 episodes about that particular thing, with patients we've operated on, people who've had complications. Much like, I'm assuming, the people who follow you are learning about nutrition and health. They're not just following you. They're learning, 'This is how you count your food. This one has a low glycemic index. When you do this particular exercise, it needs a longer recovery.' There's knowledge, and you're providing it. We do that for plastic surgery.

Nikkiey: Love that. Guys, go check out the podcast. And if you ever need... you're in the Beverly Hills area?

Rady: Yes. And that doesn't mean we're crazy expensive or only for celebrities. It backfires. People are like, 'Ah, Beverly Hills. I can't see a Beverly Hills plastic surgeon.'

Nikkiey: I can't imagine the people that come into your office.

Rady: We get a variety. What I love about the practice is your personality as a clinician draws the patients you see. Since I'm probably kind of like... everyone asks if I'm from New York; I'm not. I draw every walk of life. So we have everyone from CFOs and CEOs and celebrities to nannies and housekeepers. We have everybody. We love it.

Nikkiey: Well, thank you so much, Dr. Rady, for being here and for speaking your honest, direct truth. I appreciate that big time. And for spreading more of the mental side of the game when it comes to plastic surgery, making sure that you're going into it with the right mindset, and ultimately wanting to leave everybody feeling happy and more confident at the end.

Rady: Indeed. And I appreciate you giving me the opportunity and the platform. The more we get the message out, the more we can sway the pendulum toward the better half of plastic surgery. As I said, it's a knife, so it cuts both ways. And we really want people to be happy when it's all said and done. It saddens me when people pursue plastic surgery and have a bad outcome. It's really a shame. It really tarnishes our profession. So bravo.

Nikkiey: Well, thank you again for being here. Anybody that enjoyed this episode and wants to share it with somebody, go share it with one of your friends. All of your links will be in the show notes below as well, if anyone wants to follow.

Rady: Awesome. Bye-bye.

Nikkiey: Hey, really quick, before you go, I have one small favor to ask. If this episode brought you value or sparked something in you, take just a moment to hit that review button. Your rating and review make all the difference, helping more women discover the tools they need to transform their fitness and their confidence. It takes less than a minute, but it can change the path of someone else's journey. Thank you so much for leaving that review. I appreciate you so much.