Episode 3: Beyond the Butt!

Special Guest: Megan Parken

Dr. Johnny: Welcome back, team, to episode number three of “Plastic Surgery Untold: Beyond Botox and Butts.” Today we’re actually talking about butts. And so I have the great privilege, as usual, of being joined by our two incredible hosts, certified registered nurse anesthetist Travis Osborne, also known worldwide as @celebrityanesthesia, social media influencer and just overall celebrity, Megan Parken, and by popular demand on Bumble, we have Gilberto Saenz joining us again.

Travis: Austin’s most eligible bachelor.

Dr. Johnny: No question. We had such a great episode, if you didn’t hear him on episode two talking about Botox, we thought it was so fabulous, we’re glad that you’ve decided to join us again.

Gilberto: Thank you. Thank you, guys. I’m honored to be here again. I had such a blast last time and I’m really looking forward to, you know, future episodes.

Dr. Johnny: What’s going on in your life? Anything new and exciting since we had you on the show last time?

Gilberto: Yeah, I recently got back from a conference. I attended our annual dermatology conference in Arizona, and that was a lot of fun. A lot of educational stuff going on.

Dr. Johnny: What’s the hottest, newest thing coming out?

Gilberto: There’s some new filler products coming out, some new Botox products coming out. We can certainly get into that later on if you like. But yeah, there’s a lot of really great interesting stuff.

Dr. Johnny: So sounds like non-invasive stuff is just getting bigger and bigger.

Gilberto: Bigger and bigger. Absolutely.

Dr. Johnny: Celebrityanesthesia, what’s new in your life?

Travis: Been traveling a little bit.

Dr. Johnny: Somebody may or may not have celebrated a birthday recently.

Travis: I did. I did. Yeah.

Dr. Johnny: Do you want to tell the world how old you are?

Megan: Happy belated birthday.

Gilberto: Yeah, happy birthday.

Travis: Thank you. I am 31 years old.

Dr. Johnny: Damn.

Travis: My wife actually thought I was 32. She planned this whole trip, it was a surprise trip, all that stuff, and as part of it, she was going to cut out 32 hearts because that’s how many years she thought I’d been alive. She puts them into the bag, and I open my suitcase when we get to Encinitas, and I open my bag and she’s like, “Okay, just so you know, there are 32. I totally messed up and I thought you were 32, not 31.” I was like, “It’s okay. We’ve only been together 10 years and married for 5.”

Dr. Johnny: Does she not have Facebook?

Travis: I guess not. She didn’t have her notifications on.

Dr. Johnny: Megan, what’s new in your complicated love life? For those of you that didn’t check out episode two, relationship expert Megan told us that her current status is complicated. Any update? Any progress or we’ve moved into…?

Megan: I mean, I’m getting ready to go to New York for some business stuff and see some friends and, I don’t know, I’ve been in LA for a little too long, so New York is just a different vibe. So I need to, like, switch it up a little bit.

Gilberto: That sounds like fun.

Dr. Johnny: What are you doing in New York? Is this still with the denim vintage or?

Megan: I mean, yeah, it’s a good place to source for sure. They have a lot of really cool, like, luxury consignment shops and I like to, you know, make connections with different people there and kind of have all that going on. But I actually have a friend that’s opening a restaurant, so they’re doing a big event there and, I don’t know, I got invited. So I’m gonna go up to New York.

Travis: Don’t think that we didn’t notice that you circumvented that little…

Dr. Johnny: Oh, she did. She sidestepped the relationship complicated. I mean, that’s a… G-Berto, any update? Because that last one, you were on Bumble, Tinder and a few others. Any updates? Any love matches since the last time we spoke?

Gilberto: I can’t even keep up with all the matches that I’ve been getting since the last episode.

Dr. Johnny: You’ve been making it rain matches?

Gilberto: Yeah.

Dr. Johnny: So what do you do now to filter all those matches?

Megan: Do you think girls are trying to use you for your celebrity status?

Gilberto: Ooh, that’s a good question.

Megan: That can be tough.

Gilberto: Yeah, that might be a red flag.

Megan: Yeah. [crosstalk 00:03:33]

Dr. Johnny: As a relationship expert, I mean, what advice would you give the G-Berto in terms of kind of screening these?

Megan: I mean, I think you can kind of get the vibe. Like, I think if someone knows a ton about you without actually knowing you, they’ve looked you up and they’re looking into you trying to…

Travis: They’ve googled you.

Megan: Yeah, they’re trying to figure it out.

Gilberto: Yeah, it’s the digital age.

Dr. Johnny: So if they’ve gone through and liked all his pictures, is that a red flag?

Megan: Before you guys have talked or?

Dr. Johnny: Yeah.

Megan: I’d say maybe. It depends. It depends.

Travis: It could be a stage five clinger.

Dr. Johnny: Can I tell you one little story that’s hilarious?

Megan: Okay.

Dr. Johnny: One of our marketing people when I was in Miami, she had this on and off boyfriend forever, and I didn’t know women do this, but she was showing his picture to everyone else in the circle. So when she handed me the phone, I liked his picture. She freaked out, because she was like, “We’re off.”

Megan: Oh, she didn’t want you to like the picture. Oh, I mean, yeah, right.

Dr. Johnny: Well, they were off and I liked it, and then she tried to unlike it, but then she didn’t want to unlike it, because then she’d be like, “I liked it then I unliked it.”

Megan: That might be more weird.

Dr. Johnny: You think so? But it’s a little weird if you’re on a break, and you’re going through liking somebody’s pictures.

Travis: Old photos? Yeah. Oh, my gosh.

Megan: I mean, now I’m sure you guys have seen, actually, Instagram did away with the activity page, which used to cause a lot of problems in relationships, because you could go on and see, the guy that you’re seeing is liking a bunch of girls in bikinis or something, you know, like, you could see what people are doing.

Dr. Johnny: I didn’t even know that that was an issue.

Megan: That’s what every guy says. You’re like, “I didn’t even know that existed.”

Dr. Johnny: I mean, for us, it’s just research. So I don’t…

Megan: You can see who every, like, when people follow someone, so if, like, they follow them at 2:00 a.m. on a Saturday night when they told you they went to bed early, like, you’re following some new girl.

Gilberto: Wow.

Dr. Johnny: I just don’t even know who has time to do this, to go through…

Megan: Oh, my gosh, every girl used to do it. It’s a thing. It’s a thing.

Dr. Johnny: Before we get Travis in trouble, as Mary’s probably checking his Instagram right now, let’s get into our topic. So today it’s “Beyond the Butt.” So the butt has become a craze. No question, you know, the Kardashians really kind of got this craze going, I think social media has played a huge role in this, but it’s really become more than that. And so, you know, the most popular procedure out there for the butt and the total body shaping is the Brazilian butt lift, i.e. the BBL. And so, you know, in my practice, it’s one of the most common procedures that I perform, and I think most people don’t realize that there’s a lot of average, everyday people who get this done. They just want to look better, they just fill their little square, they’re working out, they’re doing a lot of good things, they’re eating healthy, and they just want to change their shape a little bit. And, you know, they’ve got the high from the huge butt, but most people, it’s not about just having this massive butt. It’s about having a great shape that fits them. You know?
Other thoughts from this? And we’ll get into a bunch of the details about the BBL, but I want to get Megan’s thoughts as we kick this off about, you know, what her thoughts are about how social media, YouTube, other things have changed this, because I really think that’s what propelled the BBL to become Miss Popularity because it’s been the fastest-growing procedure over the last three or four years in plastic surgery.

Megan: Yeah, I would say with social media and also…I mean, obviously, I don’t think you should get a procedure based on someone else or the opposite sex and what they’re going to think of you, but I think it’s really interesting that, recently, I feel like if you’re going to ask a guy, “Are you a boob or butt guy?” it’s so much more butts now. Like, that just seems like the thing, I don’t know.

Dr. Johnny: Wait, you can go before a first date and say, “Are you a boob or butt guy?” Like, is that a question on your Tinder account or no?

Megan: I just feel like it…I mean, it could be, but I just…

Dr. Johnny: But is it right now?

Megan: No. No. But I just, I feel like…

Dr. Johnny: Is this too personal? Is your complicated boyfriend now a boob or butt guy?

Megan: I think both. Both.

Dr. Johnny: I don’t even know what to say to that except thank you. I mean, that’s a lot of procedures to get to do. I mean, that’s awesome.

Megan: But I think a lot of that is also kind of what you said about Kim Kardashian and stuff. I think there’s just been a lot of, like, media of people having a really nice butt that maybe, you know, has been a little enhanced.

Dr. Johnny: I think some of the things…do you mind if we just talk a little bit about what actually a Brazilian butt lift is so that people who aren’t familiar with the terms know? So, a BBL, Brazilian butt lift is basically where we liposuction people, 360 belly, back, flanks, basically taking fat from anywhere you don’t want it and then using it to enhance your overall shape. Typically, fill in some hip dips, fill in your butt, giving you overall shape. The reason it’s become so popular is most of us have some fat somewhere that we don’t exactly love, and then other areas we want to enhance. You’re basically killing two birds with one stone in terms of, you know, removing it, enhancing. The other thing that’s made it so popular is that you’re not using any implants. You’re just using your own body fat. So it does take a little bit of time to recover, but then what you have is your own natural fat, which I think is super enticing to people to be able to use their own fat for the procedure.

Gilberto: So are you saying that it’s more of like a body contouring kind of procedure where you can kind of mold things?

Dr. Johnny: I would say, 100%, it’s a body contouring procedure. And I think that’s what’s made it so popular to the masses, because I think the majority of the population don’t wake up in the morning and say, “I want a massive booty. I mean, I want a big ol’ booty.” That’s not typically what people wake up…people are like, “I want a better figure. I want to look better in my work clothes.” So, no question, getting that waist down and then fill in those hips and so forth, I think are a huge spot.

Travis: I think it’s super interesting, because being in this profession and then, you know, going from doing a lot of hospital stuff to doing mostly outpatient plastics, I was jaded when I first started. I thought that BBL or Brazilian butt lift was just, “Make my butt huge. Make a big butt.” That’s actually one of the smaller parts of the procedure. I feel like you get most of the aesthetic portion or the outcome from the actual liposculpting of the patient.

Dr. Johnny: And in our surgeries, it exactly plays to that because 75% of the surgery is the liposculpting. And most of our patients who, you know, we don’t do any butt augmentation and we only do liposculpting, I actually swear that their butt looks better because of the point you were talking about, getting the waist down, shaping, and doing some of that. And I don’t want people to think out there that this is the only way to enhance your butt. Obviously, squats, lunges are another plus, but there’s other surgical procedures. But the reason that BBL has become the most popular is that it does that. It’s the total body transformation.

Megan: I think, not to be controversial, but definitely on social media, this has been a popular thing that a lot of the fitness girls have actually kind of come under fire a little bit where people have actually figured out that they’re selling a workout guide or whatever to get a really nice butt and then actually, they have had a BBL and maybe, you know, those certain workouts that they’re showing can’t necessarily give you that same look. And I think it’s something to be mindful of.

Dr. Johnny: No question. I think people have, and this goes to the overall social media, of people posting pictures, things that aren’t real, things that are very different. I mean, I think we’ve talked about it before, Gilbert, on some of these things where it’s almost trying to find what really, you know, is doable and what’s not. A friend of mine in LA actually does his little, you know, real and fake on Instagram pictures, because I think it gives people a weird perception of what’s reality.

Gilberto: Yeah, absolutely. No, I couldn’t agree more. I see it a lot in the injectable world where I’m kind of, you know, delving in quite a bit more than what you’re doing in the OR.

Dr. Johnny: And I think that a lot of people don’t realize that it’s fun to do both, you know, because people always ask, you know, “Should I work out? Should I do surgery?” The answer is do both. The more you do one, the better the other one’s gonna look.

Megan: And I think an interesting topic about that is, I remember on one of the episodes of “Keeping Up with the Kardashians,” one of the sisters was trying to prove that her butt was real. So she went in, had an X-ray and, obviously, she’s like, “I don’t have implants. It’s real.” It still could have been a BBL procedure because that’s your own fat. It’s not going to show up on an X-ray as anything foreign.

Dr. Johnny: On that point, can we just do a generation check here? Who else besides Megan has watched “Keeping Up with the Kardashians”? Raise your hand.

Megan: Are you serious?

Travis: Yeah. Not on my Netflix queue.

Dr. Johnny: And again, Megan, I’m glad we have you here to keep us on par with what’s going on in the world.

Megan: I mean, I would say with someone that deals with fillers often, like Kylie Jenner, the Kylie Jenner lips, that’s been a major transformation that’s taken place on social media. People know what she looked like before as a, you know, younger child and now a woman with much larger lips.

Gilberto: I mean, I can’t say I don’t know who they are, you know. I’m certainly familiar with their Instagram posts and stuff, but I can’t say that I watch the show.

Travis: Yeah, I know.

Megan: I mean, I think I’ve read articles that said, like, certain procedures have become more popular in the recent years, and they think some of it may be tied to, you know…

Gilberto: Oh, no doubt.

Megan: …certain celebrities and people that are…you know.

Dr. Johnny: I have no question celebrities, social media, those things have driven this. And some of it is trying to get people to what’s safe and what’s not in terms of butt augmentation and figure stuff.

Travis: And I know that BBL has come under some fire over the past couple of years for safety concerns, and rightfully so. I mean, there were people that were doing some things that were downright dangerous. But I think your Society of Plastic Surgeons has done a pretty good job of being out in front of things trying to rein that in.

Dr. Johnny: I think, no question. And so a couple things…and we’ve talked about it before in previous episodes, the last one with Gilberto in episode two about who does your surgery, you know, who does your Botox, and so forth. So I think a couple things to your point. One, there’s an entity called fat emboli, where fat gets into the bloodstream, and that can be really dangerous. So, no question our society has put out statements of things to make this safe. And the problem, just like with any new procedure, I think people saw money in it, and people who were not plastic surgeons, people who maybe weren’t even surgeons, were doing this procedure. I think people didn’t take the time to learn the procedure correctly and just did it and unfortunately put people at risk.
So there is definitely certain guidelines to make this a very safe procedure. And there’s definitely a limit, and this goes to the Kardashian, the social media, when people come in, they’ll bring some of these pictures and I’ll tell them, “Hey, that’s not realistic. There’s a limit to how much fat we can transfer, a limit to how much we can liposuction.” This is stuff that you and I talk about in the operating room all the time. “Hey, how much have we lipoed? What’s our fluid shift?” Because all these things are super important, and people don’t realize how much goes into having an incredible figure.

Travis: Yup. It’s not just as easy as turning on the vacuum, suck all the fat out and, you know, flip it and pump it all back in. that’s not it at all. And there are also some things that you’ve refined technique-wise, at least, that I’ve seen over the past, you know, couple of years that you’ve changed to become safer and to make this a better procedure.

Dr. Johnny: No question. A friend of mine, I’ll give him a little shout out here, Dr. Matt Nykiel, SoCal plastic surgeon out in the LA area, we actually teach a course on BBLs just to try and make this safer for people, because I think, you know, sharing this type of knowledge is super, super important. And so I think giving people a chance to know what they’re getting into, helping plastic surgeons, but it’s also patients taking care of it. The butt is different than a breast recovery.

Travis: Oh, yeah.

Megan: What’s the recovery like?

Dr. Johnny: The recovery is a little bit different because we don’t realize how much we sit until we can’t sit. And so the one hard thing about a butt and, you know, and BBL, is…

Megan: So you can’t sit on it at all?

Dr. Johnny: For six weeks.

Megan: Wow. Okay.

Travis: Six weeks?

Gilberto: Wow.

Dr. Johnny: Yeah. I mean, so it’s a lot of standing, it’s a lot of kneeling, it’s a lot of being on your belly, but staying off that but for six weeks. There’s some special pillows that people use and other things to stay off that butt, but it’s a mission. You gotta be dedicated to this to really get the results. Because if you sit on this fat, you could lose it, you put yourself up for other type of problems. So you got to be mentally prepared.

Gilberto: Can the fat shift if you sit on it and, like, reposition in different ways?

Dr. Johnny: The fat doesn’t really shift, but you can kill some of that fat. Because the great thing is it’s your own fat, but your body needs to grow into it. And so that pressure is going to keep those little blood vessels from growing into the fat and, in the end, you know, cut back on your results.

Gilberto: Yeah, interesting.

Dr. Johnny: You know, as you probably talk about with some of your other stuff, I mean, people have thought about this for a long time. At this point, they’re committed. So you want to do everything you can to make that recovery as good as possible. And maybe, Travis, you can tell us a little bit about anesthesia for a BBL. We work together, and there’s a lot of things, because surgery does take me about four hours, and so some different things you’ve done to make the recovery better for people.

Travis: Yeah, and we’ve spoken in previous episodes. In the breast augmentation episode, we talked about doing a low narcotic technique, running some ketamine infusions and doing other things for these patients that get us out of just giving the standard, give them a bunch of fentanyl and morphine and Dilaudid and, you know, ship them home. Now we’re much more cognizant of the narcotic load that we’re giving to these patients and that kind of stuff. Another thing that we try to do, we do all of ours under general anesthesia. I know some people around the country do them under local. I think you could get away with doing it under local if you’re doing small volume fat transfer and that kind of stuff, but when you’re doing it under a local, per se, the patient is still relatively awake during liposuction, and we really do a lot of liposuction when we’re doing your cases.

Dr. Johnny: Tell me, when you say general, for the people out there, what does that mean?

Travis: Yeah, so general anesthesia means completely asleep with a breathing tube, 100% asleep and unconscious for the entire procedure.

Dr. Johnny: We’ll save this for “Behind the Bovie.” And a little nugget that I think sometimes people forget, but we’ll talk about some more stuff. We can’t give away all our nuggets this early in the show. Tell me some, Megan, other thoughts, questions you have about the BBL that our people should know.

Megan: So would you say you could all…like, for you, specifically, can you tell when someone has had it versus not?

Dr. Johnny: Oh, yeah.

Megan: Okay. Interesting. So there are certain things that you can tell?

Dr. Johnny: There is a certain look, you can just tell.

Megan: Interesting.

Dr. Johnny: And it’s funny. I was in Miami probably about six months ago, we were actually at a meeting, and we were walking around and I was like, “Yes, no, yes, yes. No, no.” There’s a lot more yeses, obviously, in Miami the nos, but yeah, for sure.

Gilberto: Are there varying degrees of BBL where, you know, it might be a little bit more difficult to tell if someone’s had it done?

Dr. Johnny: Oh, no question. You know, because there’s even an entity that we call Skinny BBL so, you know, some people are really thin and so we just have a little bit of fat that we want to do to those areas. And I think also too, people forget, you know, BBL obviously is the most popular butt augmentation procedure, but there’s other things, you know, we do but implants if people are too thin or looking for a little bit more extreme look. There’s also some stuff in terms of Emsculpt, which is a new paradigm of building some muscle that people do as well. And then some filler stuff, and I don’t know if maybe you’ve done some of this. We get a lot of people asking us to do Sculptra, Radiesse, some of the other fillers for butt augmentation. Is that something you’ve done at your practice or?

Gilberto: Personally I have not, but it is something that we do in the practice. Some of my colleagues in the practice have done Sculptra in the butt to kind of help create a little bit of a lift for those individuals that maybe quite aren’t ready to commit to a full BBL.

Travis: And just so everybody kind of knows and so that I understand a little bit better, when you say filler, what exactly are you talking about?

Dr. Johnny: Yeah, fillers are products and most commonly used in the face. There’s hyaluronic acid fillers for the lips, and then some other fillers were used for the cheeks, and so they’re basically off the shelf products. And again, you got to be super careful because to your point, yes, and definitely more in Miami than here, but there was a lot of people who were getting illegal fillers at the motel aids or other places, which leads to a lot of problems. So again, you got to be super careful about what you want to do. I mean, nothing is worth getting a selfie of a huge old butt, you know, of something that’s going to cause problems for you down the road.

Travis: Totally.

Gilberto: Absolutely. Couldn’t agree more.

Travis: I think another thing that you touched on a second ago is when you said gluteal implants, or when we were talking about butt implants. Sometimes you marry the two a little bit too. You’ll do tapering the waist and doing liposuction, and then you’ll inject a little bit of fat outside of and around where that butt implant went in.

Dr. Johnny: No question, you know, whatever we can do to get people’s aesthetic goals. And sometimes people don’t have enough fat, sometimes people just want to be a little bit bigger, and you can do those type of things. And not to get completely off the injectable topic, but I feel like it’s become really popular. The one thing I find hard and you tell me is that, you know…and this goes again to the social media stuff. You see a lot of videos of people doing these fillers for the butt, but you don’t see a lot of before and afters. In my personal experience, people need a lot of filler to see a big difference.

Gilberto: Absolutely. I couldn’t agree more. I think it’s a matter of setting realistic expectations with your patient if they’re going to go the filler route, because fillers can do so much for the body and the face, but, you know, there’s also only so much it can do.

Travis: You’re not going to achieve a BBL result from having Sculptra.

Dr. Johnny: You gotta get that out of your mind right now. Right now. And 100%. And most of the time, I’ll say it that frank in the office because I don’t want people to be disappointed afterwards. I tell them, “Think about it. You come in and you do like two syringes of filler for your cheeks, for your lips, you know, and you’ve already done a couple. Your entire butt you’re trying to fill, like, that’s a lot of filler.”

Travis: Oh yeah, yeah.

Dr. Johnny: Have any of you ever had filler?

Megan: In my butt? No.

Dr. Johnny: Megan, we don’t just have to talk about your butt all the time. If you guys haven’t noticed, Megan likes to be the center of attention here, but that’s fine. No, no, Megan.

Megan: I thought that was a question.

Dr. Johnny: No, no, let’s talk about Megan.

Travis: That’s hilarious.

Dr. Johnny: I’ve done Botox, I’ve done some PRP. I’ve haven’t done any filler yet. I feel like I already got some luscious lips. But it’s just kind of interesting how fillers and stuff have gone everywhere, including the butt. Do you guys mind if we talk a little bit about Emsculpt to round out the butt?

Travis: Yeah.

Gilberto: Yeah, that’d be great.

Dr. Johnny: You guys see what I did right there?

Travis: I see what you did. Round out the butt.

Dr. Johnny: Because Emsculpt is a whole new paradigm of plastic surgery. And anybody familiar with this on the show?

Megan: Not really, no.

Travis: It speaks to what you were saying earlier about noninvasive stuff. I mean, that is sweeping the market right now. That is taking a huge hold in the market for plastic surgery.

Dr. Johnny: Yeah, Emsculpt is a machine that helps build muscle, and it’s actually the first device ever FDA approved for that type of treatment. In plastic surgery, we’ve done fat, we’ve taken skin, we’ve done those things, but we’ve never been able to build muscle, and this goes to the point earlier about some of the fitness people and other things doing stuff. And there is a area, because there’s a distinct look, honestly, of people who have a muscle…

Megan: A butt that’s made of fat or muscle.

Dr. Johnny: Which kind of makes sense.

Megan: Yes.

Gilberto: Oh, yeah.

Dr. Johnny: And so I think Emsculpt is great in that it helps build muscle, but I always try and rein people in, “Just like the fillers.” There’s only so much muscle you can have. I mean, you can have these type of muscles, but this dude wasn’t created overnight. This is a lot of working out, a lot of things that you do, correct?

Megan: So could you potentially have a BBL and then use the Emsculpt, or would that mess with the fat transplant?

Dr. Johnny: I actually think it’d be phenomenal. You got to give it a little bit of time and wait that six, eight weeks to let…

Megan: Once it’s healed, right?

Dr. Johnny: Yep, exactly.

Travis: Let the fat heal [crosstalk 00:22:33], right.

Dr. Johnny: To let everything heal. And this is, again, I think where having a good provider helps guide you through some of these things. No question. Any other butt stuff you’d like to talk about, Gilberto?

Travis: [crosstalk 00:22:46]

Gilberto: Well, no. I do want to say, though, that I actually had a wonderful experience using Dr. Franco’s…

Dr. Johnny: Using your butt?

Gilberto: …using Dr. Franco’s Emsculpt machine on my abs, which was great. I did a series of four treatments. But now, after this conversation, maybe I have to come in and visit you and get some Emsculpt on my butt. I don’t know.

Travis: There you go.

Dr. Johnny: I mean, this would be…we should do a little study, you know? So we should have you do… see how many Tinder dates you get leading up. Then, do Emsculpt to your butt and see if that changes your profile status. I mean, you gotta kind of do like a full-body Speedo.

Gilberto: Like a double-blind study?

Dr. Johnny: Yeah.

Megan: Do you have men come in for BBLs, or is it mainly women?

Dr. Johnny: We definitely have men that come in. It’s funny. I think men, overall, has gone up, and definitely something we should talk about in the future. I definitely see more men in my office doing liposuction, doing BBLs, doing any type of butt augmentations.

Travis: Brotox?

Gilberto: Brotox, yeah.

Dr. Johnny: Brotox, for sure. I mean, we do a little Brotox.

Travis: There we go.

Dr. Johnny: Can we do a little segment called “Behind the Bovie?”

Gilberto: Oh, yeah, let’s do it.

Travis: Oh, yeah. It’s one of our favorites.

Dr. Johnny: Travis, take us away. A little “Behind the Bovie” segment here.

Travis: Yeah, so “Behind the Bovie.” A bovie is one of the little instruments that we use in surgery, or Dr. Franco uses during surgery to zap the little bleeders. And what our idea of “Behind the Bovie” is is we’re talking about stuff that happens behind the scenes, stuff that you guys might not know about. So, yeah, so today on BBL, anything that you can think people need to know that they might not know about BBLs behind the scenes.

Dr. Johnny: I think people don’t really realize how long we’d liposuction. And it’s funny because, on my Instagram stuff, people will say, “Oh, you know, it took four or five strokes to take all this fat.” Just because we only show you four or five strokes, like, for anyone who’s been in surgery with me, i.e., @celebrityanesthesia, I’m a sweaty machine. I mean, so this surgery takes us about four hours and a lot of time. And so I think people think that this stuff just comes easily, but there is actually a decent amount of grunt work to just get that in shape just perfectly.

Travis: Do you want to explain kind of the process that the lipo and tumescent…or the tumescent, then let it sit, then lipo, then…I mean, there are more steps than just…

Dr. Johnny: I’ll explain this, but just for those of you that are avid followers on our Instagram @austinplasticsurgeon, when Travis claims that I say the same things over and over again…and would you like me to do it or would you like to take a stack at being Johnny Franco again?

Travis: Go for it. I don’t know.

Gilberto: Johnny Junior?

Travis: Last week, I messed it up.

Dr. Johnny: Yeah, he did. He did. He’s like, “And then step three.” So we do something called SAFE lipo where we put some tumescent in, which is basically saltwater with some epinephrine so people don’t lose enough blood. And then we also put some lidocaine in there to make people comfortable. Even though they’re completely asleep, we’re trying to make people comfortable afterwards. No question. This is part of the whole process of limiting the narcotics stuff. Then we do the liposculpting, which actually for a certain area, it probably takes about 45 minutes. And then it’s SAFE lipo because then we come back again and use this special cannula without suction to smooth everything out. And then the funny part that people don’t realize is how many people go into taking care of you. You have an anesthesia person who’s with you the entire time, which isn’t true at all practices, but definitely, at your facility and where we do our surgeries, you have someone who’s dedicated to just doing your anesthesia, you have the surgeon, and then several other people who are helping in terms of processing the fat, a nurse who’s here to take care of you, and so forth like this.

Travis: We got a preoperative nurse, an operative nurse that’s going to be in there the entire time to help open instruments and things like that. And then you’ve got a tech that’s helping you the entire time, anesthesia provider that’s going to be there that’s either a CRNA, or an anesthesiologist that needs to be there the entire time that you’re completely asleep. Yeah, a lot goes into it. And then multiple position changes throughout the case, and then at the end, injecting the fat takes what, maybe the last 30 minutes of the four hours.

Dr. Johnny: But for the point of the “Behind the Bovie” segment is that I’m working hard. I’m working really hard for your butt. So just want that take-home message to go. So to summarize a little bit of the BBL butt augmentation is I think it’s an incredible procedure. I think there are some very, very key points you have to do to keep this safe. I think, like too, we’ve talked about in other segments, you know, is making sure you pick the correct provider. Any other take-home messages you’d like for all your fans listening?

Travis: Pick a good provider, pick somebody that is board-certified, pick somebody that’s going to sit down with you and go through your goals and your expectations and somebody that’s going to be realistic with you. I mean, you’re very realistic with patients, and I hear you talk to them in pre-op. And, you know, I’ve heard you in your office as well. So I’m not, “Hey, this is what you can expect. This is what it’s going to be like afterwards.” And also set up realistic expectations for yourself with recovery, make sure that you have a good support system at the house. You need to be up and moving around, but we also don’t want you to be doing too much and trying to get after things too quickly after you just had a BBL.

Gilberto: I would just probably add, you know, bring questions, you know, have questions for your provider, for your surgeon, and maybe bring someone with you, because they can also take notes and keep track of things that maybe you overlooked, you know, it’s a lot of information overload when you go in for these consultations. Maybe someone who comes with you can kind of pick up on other things that you may have missed.

Megan: And I would say if someone has the title of the BBL king, he might be someone good to go to.

Dr. Johnny: That’s what I’m talking about. Yes. And speaking of that, let’s get to my favorite section called “Little Fact or Fiction.” So those of you that don’t listen all the time, it’s one of my favorite times. This has nothing to do with surgery at all. This is just something to get you to know us a little bit better. We start with @celebrityanesthesia. Fact or fiction, you guys got the royal treatment at your birthday trip because of your celebrity wife.

Travis: That is 100% true. That is fact.

Dr. Johnny: Tell me a little bit something. You guys got upgraded to some, like, massive suite.

Travis: We got upgraded to a massive suite at this place called Tower 23. My wife @yourtrendytherapist hooked it up. That was awesome. Also got to go surfing with a pro-surfer, a guided tour in Encinitas. It was unbelievable.

Dr. Johnny: Fact or fiction. I get you in trouble with Mary all the time saying crazy stuff.

Travis: At least once a week. That’s a fact.

Dr. Johnny: You’re welcome. I apologize, Mary. Fact or fiction, Megan, even though you’re our relationship expert, you avoid all the questions about yourself.

Megan: Fact, possibly. Yes.

Dr. Johnny: Fact or Fiction. You’re up when we’re trying to start our day. You still haven’t gone to bed.

Megan: I mean, definitely a fact. But I’m trying to get up earlier.

Dr. Johnny: Fact or fiction, for those people who have missed previous episodes, shame on them, but your 2020 resolution is actually to be up before 10:00 a.m. every day.

Megan: Yes, it is.

Dr. Johnny: Not just one day but all seven days a week.

Megan: Fact.

Travis: We’re moving in the right direction.

Dr. Johnny: We’re making some big life changes.

Megan: Making progress.

Dr. Johnny: Fact or Fiction, Gilberto, you have belly-flopped every blind date I’ve set you up on.

Gilberto: That is a fact.

Dr. Johnny: Fact or Fiction. You once double-stopped a Uber drive, so that I got stuck with the date that you didn’t want to, and then I ended up having to host them.

Gilberto: That is 100% true.

Megan: I don’t get it. How is the Uber related?

Dr. Johnny: We were in an Uber and we were coming from a dinner and then it was gonna take us back home, and him rather than getting out with us, like, all four people getting out, he said, “Oh, I’m just gonna take a double stop, you guys get out.” And then he stayed in. So then…

Megan: Did they not ask where is he going?

Dr. Johnny: He just so matter of factly was like, “Do you mind doing a double stop?”

Megan: Oh, my gosh.

Dr. Johnny: So that may have to be another topic of red flags.

Megan: You might have been a red flag for her that night, I guess. If your date gets out before the date is supposed to end.

Gilberto: But I’m the one that asked for the double stop.

Dr. Johnny: He jumped ship.

Megan: No, so I’m saying you are the red flag to her, like, you ended the date.

Dr. Johnny: He pulled the parachute cord.

Travis: He’d already cut her loose.

Megan: Oh, she already knew [crosstalk 00:30:52].

Dr. Johnny: He cut his losses. He pulled the parachute cord.

Travis: [crosstalk 00:30:55]

Dr. Johnny: But what he did is he left me in the awkward situation, so here’s me in the cab with these two girls, like, “Hey, see ya.”

Gilberto: Hey, I don’t know too many guys that would complain about being left in the cab with two girls.

Dr. Johnny: So moving on to our positive quote of the day by Travis Osborne, let’s take it home.

Travis: Quote of the day. Let’s see what we got today. George Bernard Shaw, “We don’t stop playing because we grow old. We grow old because we stop playing.” 100% believe in that, and that’s one of my life mottos. I try to stay active, exercise. I am a huge fan of extreme sports, and I’m constantly trying not to hurt myself.

Dr. Johnny: What’s one extreme sport you play?

Travis: I like to wakeboard, snowboard, mountain bike. Anything I can hurt myself on.

Dr. Johnny: Megan, I know you’re only 24, but what do you do to stay young?

Megan: To stay young?

Dr. Johnny: Or to keep playing?

Megan: I guess I just don’t take life too seriously. And I learn from things, definitely.

Dr. Johnny: Gilberto?

Gilberto: Yeah, I used to do a lot of long-distance triathlon, Ironman distance racing and stuff. That kept me pretty active. But I got a little burnt out so I’ve kind of taken a break from that recently.

Dr. Johnny: I mean, you can’t be an iron man all the time. Well, team, I think that’s gonna wrap it up for us. I think this was an incredible talk about Brazilian butt lifts and butt augmentation. Overall, I’d like to give us a little plug for our next episode, which is going to be “The Mommy Makeover.” I feel like rolling into the New Year, new year, new me. So that should be, I think, an incredible topic.

Travis: New year, new mommy.

Dr. Johnny: Boom.

Gilberto: Dude, I like that.

Dr. Johnny: Boom.

Travis: You’re welcome.

Dr. Johnny: Lastly, I’d like to thank everyone who’s listening. I’d like to thank all of you. And, of course, I’d like to thank producer Donald, i.e. @tallgamer. Thank you. Boom. See you, guys.

Gilberto: Thank you, guys.

Travis: Boom.

Gilberto: Boom.

About The Author

Dr. Johnny Franco
Episode 2: Frozen Fetish or Fabulous Features?Episode 4: New Year, New Me!


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