Episode 30: Everything Butt…
Dr. Franco: …our team. Welcome back to “Plastic Surgery Untold.” I’m Dr. Johnny Franco, also known as Austin Plastic Surgeon, and I have a celebrity crew joining us again today and a special guest, Dr. Chike-Obi, who we will get back to in a second and why he’s joining us on this great topic, everything butt. And, you know, as you guys know, I love the butt. We can never talk enough about butts so we brought another butt expert on the podcast with us to discuss butt stuff. But before we get to that fun stuff, let’s catch up with Celebrity Anesthesia. What’s going on with you, sir?
Dr. Osborne: What’s up, you guys? Not much. Good to be back. I feel like it’s been a few…a little bit since we’ve been in the studio but things are good. Actually, we are right now in the middle of selling our house. We actually have an open house today and yesterday hoping to get the house sold and I don’t know if anybody here has sold a house but it is a huge…not to…I feel like it’s a little over the top but it’s a huge pain in the butt.
Dr. Franco: I mean, keep the theme real. But I feel like this is why you wanted to work yesterday. We worked yesterday and do the podcast today because you’re leaving @yourtrendytherapist at home by herself to man the open house. That’s smart. You’re a smart man.
Dr. Osborne: You plugged her before I did. Yeah.
Dr. Franco: You’re welcome.
Dr. Osborne: Yeah. @yourtrendytherapist, plug number 937. She is actually at the house doing the open house with the real estate agent and taking care of both dogs. She’s got the Horse and Cam, carting them around town, trying to keep them out of trouble.
Dr. Franco: Before we move on to Austin’s most beautiful man, can you tell the world about what shoes you’re wearing with those scrubs? Because a little interesting choice to go all black scrubs and like pink…
Dr. Osborne: Are you talking about me?
Dr. Franco: Yeah. Yeah. Your pink sunflower something?
Dr. Osborne: I don’t know if you guys are watching…on YouTube, you all can check them out. They’re some Vans. A little tie-dye action.
Dr. Saenz: Those are certainly some Vans there, sir.
Dr. Chike-Obi: Very stylish.
Dr. Osborne: I saw G-Berto eyeing the calves and he’s looking jealous.
Dr. Franco: I feel like those tie-dye shoes are a great transition to Austin’s most beautiful man, one G-Berto Saenz. What’s going on, G? What’s new with you?
Dr. Saenz: I’m good. No, not much. Lots and lots of work. I did get a fresh new fade thanks to Travis’s recommendation. I went to go see his guy and got my hair a little short. Shorter than it has been. So that’s a bit of a transition but it seems to be going over pretty well.
Dr. Franco: No, you look good, man. You’re pretty. You’re pretty as always. And then, Dr. Chike-Obi is a plastic surgeon here in Austin who does the full spectrum of aesthetic plastic surgery but also does, I would say, a big focus on body contouring, butt augmentation, breasts. Correct?
Dr. Chike-Obi: That’s for sure. So I’m Dr. Chike-Obi and I wanna start off by saying I’m a little bit intimidated to be with such a good-looking celebrity crew. This is a huge deal. So it’s a big deal for me to get invited to the pod and I’m very, very happy to be here.
Dr. Franco: Well, we’re excited to have you because, you know, this is…
Dr. Saenz: Thank you for joining us.
Dr. Franco: This is a topic that I feel, you know, people have a lot of interest in but not every plastic surgeon does this because I think even in your group of several plastic surgeons, the butt’s never something that you really, kind of, do the majority of for even your group.
Dr. Chike-Obi: Yeah, so I’m partnered with Westlake Dermatology and Cosmetic Surgery. So we’ve got, kind of, a great outfit in town. We do a lot of plastic surgery for sure, a lot of dermatology and other things. My particular practice has four, kind of, intense areas of focus. One are the breasts. The other is body shaping like you said. So a lot of liposuction, a lot of tummy suction things and, of course, a lot of buttock shaping, augmentation, etc. And the rest of it is injectables and growing, kind of, skincare kinda segment. But yeah, buttock augmentation is a big part of what I do. I definitely do more than anybody as far as buttock, you know, implants and things within our practice. And yeah, I love it.
Dr. Franco: Because I wanna circle back to this. I wanna hear a little bit more about you before we jump into the butt stuff. But I think people forget sometimes how much of…why the body contouring and butt stuff go hand in hand because just a big butt without some body contouring/sculpting isn’t the sexy figure that most people are going for.
Dr. Chike-Obi: No, it’s not, man. I mean, most people that I see…and I’d love to hear your thoughts on this too because I mean, you’re definitely one of the gurus in town as far as, kind of, butt and body shaping goes. Most people I’ve realized, in talking to, you know, thousands of patients, are looking for balance above everything else. So we’re not looking at the buttock by itself in isolation. It’s more like, “Okay. Yes, I wanna prettier butt.” Usually a bigger but. But, you know, but it’s like if the top doesn’t really match and flow, most people that are not trained as surgeons, they can tell something is off. And so to me, breast and buttock body contouring go hand in hand.
Dr. Franco: You beat me to the punch because when people come in and they’re doing sizing for breast augmentation, I always tell them, “Scoot back and see your whole body because you don’t want some massive breasts and a flat butt. Vice versa, you don’t want this massive butt and then…because it just doesn’t flow. You want everything to be in harmony.”
Dr. Chike-Obi: I think we need to make “scoot back” a hashtag. Scoot back.
Dr. Franco: Dude, scoot back.
Dr. Chike-Obi: Scoot back and take a look.
Dr. Franco: That’s what the ladies always say about G-Berto. They’re like, “Scoot back so we can enjoy the entire view, you know.” It’s just like…I feel like now they gotta say it for Celebrity because they gotta see those shoes. It’s just like, damn, brightening up the world. Before we dive too deep, tell me a little bit about you. How long have you been in Austin? Where are you from originally?
Dr. Chike-Obi: Yeah, man. So I grew up in Nigeria, so I’m Nigerian. And, you know, we came to the U.S. when I was in high school. I was 14, moved to Chicago with my family, my brothers and my parents. And we then basically finished high school, moved to Philadelphia, spent a ton of time there for school, like med school and college and things. And then scooted down to…like people say, I got to Texas as soon as I could. That’s what everyone says and I believe it. So moved down to Houston for training, plastic surgery at Baylor, so that was a six-year affair. And then Austin happened, man. So Austin is, kind of, where I’ve started my practice. I’ve been here seven years and Austin’s a magical city, man. I love it. I feel like it’s fantastic. I’ve grown with the city. The city’s still growing. It’s a total boomtown and just a great place. So that’s a quick kind of…in a nutshell version of my journey to Austin, yeah.
Dr. Franco: I feel like we need to combine here because I’ve been trying to campaign to make Austin the number one city in the world. I love this city. People are nice, it’s fun, there’s lots of stuff to do. You can be dressed to the tee like G-Berto or you can be super casual like Celebrity Anesthesia.
Dr. Chike-Obi: Yeah.
Dr. Franco: It just doesn’t matter.
Dr. Osborne: Why did I know that was gonna come back on me?
Dr. Chike-Obi: [crosstalk 00:06:58] It catches the full spectrum and to me, man, I wanted to…let me just say this before I forget. Like I love what you guys are doing with this pod over here. G-Berto, of course, Travis, and you, Johnny. I feel like this is really…like in terms of content…and your Instagram as well. In terms of content and putting Austin on the map, plastic surgery-wise, I think it may not be realized now but when people look back…because the city’s still growing so I think when people look back in like 5, 10 years, I think this kind of an effort will be looked at as like, “Wow. This is kind of when it kinda started becoming a thing, Austin Plastics becoming a thing.” [crosstalk 00:07:39]
Dr. Franco: But wouldn’t you agree? In Austin for the size of the city, the amount of quality plastic surgeons, subspecialists, the things that you can get here is just off the charts. I mean…
Dr. Chike-Obi: Off the chain. Off the chain. And I think it’s just part of that growth. Like when I moved here like seven years ago, Austin was pretty developed but I’ve watched it change so much in seven years. And I think that’s part of it. You have…I mean, and there were good surgeons here to begin with.
Dr. Franco: Oh, for sure.
Dr. Chike-Obi: But I think the numbers have increased and the quality is getting better and better because we have patients who are more sophisticated, who are basically…So I think surgeons are like a…it’s almost like a combination of like nature and nurture, I think. I think part of it is like what you bring to the table as a person, a surgeon, and the other part of it is what your environment kind of like pushes you to do. It’s like a child growing up. So you have patients who like want more and want better and it pushes you to do a better job every time. So every year you just get better and better. And to me, I love it.
Dr. Franco: No question. And in Austin…which is different than in Miami, which is another plastic surgery capital of the world, I think Austin’s overtaken it but, you know, that’s just my humble opinion.
Dr. Chike-Obi: Sure.
Dr. Franco: But the difference here is that I would have no problem picking up the phone and calling you with a question and in Miami, it wasn’t the same kind of collegial environment where, you know, you could call and ask and refer and so forth. And that’s one of the unique things about Austin is you have all these incredibly talented people but I still feel like for the most part, nobody would hesitate to pick up the phone and call or refer or do whatever needs to be done for the patient’s best interest.
Dr. Chike-Obi: Yeah, man. I mean, I haven’t been to…I’ve been to Miami. I haven’t practiced there. You practiced there for a while, right?
Dr. Franco: I did. I did, yeah.
Dr. Chike-Obi: So you were running the game in Miami for a while and you came to Austin. I think that’s part of…that’s kinda…people say it also has a small-town feel. So I think that’s part of that where there’s this sense of, like, hospitality and, like, collegiality and I’ve sensed that too. Like, I don’t feel like people are trying to…sniping each other down for patients. You know, there’s enough people to go around. If you do a good job, a great job, you’ll be rewarded accordingly. So I think I totally agree with you with that.
Dr. Franco: Stuff takes care of itself.
Dr. Osborne: I totally agree with that. I think that’s just Austin in general too. I grew up in Austin. I was fortunate enough to and, you know, like every young kid that was in high school, “I gotta get out of here. Gotta leave my hometown.” And then, you know, now I’m back and came back 10 years later. Couldn’t get back fast enough. And it’s just something about the city where people are lowkey. People are laid back. You wouldn’t know if you’re, you know, sitting next to Matthew McConaughey at a restaurant or if you’re sitting next to somebody who’s never done anything. And everybody’s approachable here. People are just friendly. It’s a laid back town and it’s a good spot.
Dr. Saenz: I think it’s magnetic. I think, you know, people coming in from all parts of the country, you know, just wanna move to Austin. There’s just a magnetism to it.
Dr. Franco: I mean, why wouldn’t you when we’ve got, you know, the world’s most beautiful man in Austin? Why wouldn’t you wanna come just for a glimpse, just for, you know, a selfie, anything? Just for the chance? You know, the chance to meet him.
Dr. Saenz: The chance encounter.
Dr. Franco: But as much as we can talk about G-Berto’s beauty, let’s jump into some butt stuff. If you don’t mind, maybe we can break this up a little bit so we don’t jump around too much and let’s start off with the surgical options and then some non-surgical because I think there are some things out there that people forget about but also what those non-surgical stuff can and can’t do.
Dr. Chike-Obi: Yeah, so…and we chatted a bit before coming on and we talked about, you know, potentially talking about like an algorithm or how I assess patients when people come in the door talking about…
Dr. Franco: I think that’d be incredible.
Dr. Chike-Obi: …making them look…their butt better. So I think algorithm is a great, great word but I try to kind of individualize this stuff like I’m sure you do as much as possible for each patient. That said, for buttocks, to me, options number one, two, and three are fat. So most people coming in who want their butts to look better, which usually means bigger, not always but usually, to me, I feel like fat is the best option and so that includes taking that fat from somewhere else, which is the necessity but also additive to the surgery, especially the area above the buttocks like the…we call it the flank area. When you take that in, it makes the butt pop by itself. So fat, to me, so-called BBL…we call it a BBL in regular speak, to me, is the best option.
The other option surgically is to use some kind of an implant, okay. And most of the implants that we use…they are all silicone implants. There are a couple of companies now. There’s just one I believe in the U.S. that’s active. And then…so implants are basically reserves for…so take a step back. So when I see patients, to me, it’s almost like when you…if you go to a steakhouse, right…assume you’re in a steakhouse, okay, and you’re serving steak. It’s a mistake to assume everyone wants their steak, like, medium-rare, right. You know, when they walk in the door, you gotta ask them what they want and get a sense of what they want. Medium-rare, is it well, is it well done, is it rare? So with buttocks, same thing, talk to the patients. And then to me, wish pics are a huge part of my consultation. So we say, “What kind od look do you want?” and the internet has tons of photos. You know, there’s IG, there’s all these sources of photos. People usually come in with like, you know, dozens of photos to show you.
Dr. Franco: I love the wish pic. And not even only just for, you know, what their look is. There’s a lot of people that bring in wish pics and I’m just like, “I can’t do that.”
Dr. Chike-Obi: Yeah, yeah.
Dr. Franco: And just so we can be real right off the bat of like, “Hey, I can’t do that. I’m sorry.”
Dr. Chike-Obi: Yeah. Yeah.
Dr. Franco: But I tell them, “I’d rather you be disappointed right now than $10,000 later and 2 months of recovery and X, Y, and Z.”
Dr. Chike-Obi: Yeah, yeah. Pre-op disappointment is much better than like really, really PO’d, post-op.
Dr. Franco: For sure. And I feel like at least…I tell people, “It gives us a reference point because what you think is natural, subtle, big, round, whatever can mean a lot of things to a lot of people.”
Dr. Chike-Obi: Dude. A picture is worth a 1,000, maybe 10,000 words [crosstalk 00:13:33]. It helps a ton.
Dr. Franco: Couldn’t agree more. Couldn’t agree more. Especially for butts where there’s no, like, cup size, there’s no…it’s a very subjective thing. And I don’t wanna skip over…because you made a great point earlier about the whole above the butt sculpting because there’s people who you probably don’t even do any fat transfer and you just lipo their flanks, their belly, and they swear that their butt looks better.
Dr. Chike-Obi: And it does look better. So you’re totally right. You’re totally right.
Dr. Franco: Because that whole shape change and that’s what I think some people don’t understand when you get to your other point about the butt implants is if you don’t do anything to subtract…because I tell people it’s the summation of the subtraction and addition that equals the greatness. And so, you know, just putting a massive implant but if they’re still square and you haven’t done anything, they don’t get that bang, that wow feature.
Dr. Chike-Obi: It doesn’t pop as much. I totally agree with you. Totally so.
Dr. Franco: But for the…and then on the flipside…I know that I’m jumping around a little bit but you’re getting me excited here. You know, but the part that is really hard with the fat transfer, and I’d love to hear any nuggets you have, is with the fat transfer, I do think there’s a limit to how much projection somebody can get, especially if they’re really flat to begin with, if they have a lot of cellulite. I think with the fat, there’s a limit. Sometimes the butt implants do get them a little bit more roundness and projection. I think depending on what size they wanna go, sometimes people either need to be in it for the long haul of maybe around 2 BBL, which hopefully we can get to in a little bit, you know, or a combination. And so some of those limitations. Because I agree 100% with you. If somebody can get a BBL, a Brazilian butt lift, that’s my number one choice because of the full-body sculpting.
Dr. Chike-Obi: Yes. Yes, yes, I totally…go ahead.
Dr. Osborne: I was just gonna say, you know, Johnny and I have talked a little bit in the past about this on previous episodes and even outside of the podcast and Chuma, I know we’ve talked in the OR when we’re doing BBL patients and it’s really that lipo sculpting that changes the figure and it creates that hourglass shape. And then just a small amount of fat transfer goes a long way after you taper the flanks and you really change the shape of the patient, you know.
Dr. Chike-Obi: Yeah, oh, yeah. And liposuction, to me, is some underrated…I think, in plastic…like a lot of surgeons that I know…just my group of people that I know, not everybody, tend to feel like it’s like this, like, add-on thing or like something that’s like kinda just work. But to me, it’s an art form. I think it’s a real art form. I take it very seriously. You know, I love doing it. I think it’s like…it’s just literally sculpting and I think it’s very hard to impart the shape that someone is looking for without doing liposuction.
Dr. Franco: Don’t you feel like a lot of people take for granted how much time of the BBL, the butt, is truly the lipo sculpting? Because you’ll spend 70% of the surgery doing the liposuction but if you don’t get that right, then it’s an uphill battle the entire way.
Dr. Chike-Obi: It is. It is. And I happen to do a lot of awake liposuction. So those patients do know how hard it is. They can tell I’m like going at it for like an hour, hour-and-a-half trying to sculpt it. So they get a sense of that, but you’re right.
Dr. Franco: And catch me up because we had Dr. Levike [SP] on a couple of weeks ago who does a lot of his procedures under local as well. You do…
Dr. Chike-Obi: Great guy.
Dr. Franco: Yeah, great guy. Him and I went to med school together. He’s letting me…I’m living in his basement right now so it’s been great.
Dr. Chike-Obi: Oh, really?
Dr. Franco: Yeah, no, it’s been great. It’s been great.
Dr. Chike-Obi: Yeah, we trained in Houston so we overlapped. Not the same program but he was there and so we’d go to our society meetings and we always had great interactions. Really, really cool guy.
Dr. Osborne: He is a good guy.
Dr. Franco: Just again, all the great, you know, plastic surgeons in Austin.
Dr. Chike-Obi: Flocking in. I love it.
Dr. Franco: But do you do all your fat transfer BBLs under local or does it depend on the amount of fat transfer? What do you do? Because that’d be an interesting topic. Because if we don’t need Celebrity Anesthesia anymore at all…I mean, there’s gonna be a lot of happy people right now.
Dr. Osborne: Whoa, whoa, whoa, whoa, whoa.
Dr. Chike-Obi: No, so Celebrity Anesthesia is…No, we would definitely need his services. I wanna plug him a little bit [crosstalk 00:17:27] because he’s been awesome to work with. Whenever I see him coming to, like, my OR, I think it’s always awesome. But his services are always gonna be needed and there are things that we need to do that require patients to be asleep.
Dr. Osborne: Sure.
Dr. Chike-Obi: I think that liposuction is one thing that can be offered awake in the right patients. They have to be able to tolerate that. It’s pretty comfortable if you have the right setup for it. When you get to larger and larger volumes, it becomes challenging. It’s true. It’s true.
Dr. Franco: Because a lot of ours…a lot of patients, we’re reaching those, you know, 5-liter limits or whatever, kinda, your set is in terms of that, it’s a decent amount, and again, I think some nice people have the false assumption that just because you’re doing it under local, it’s safer. And it’s safer if you’re doing things the right way but like anything, if you’re pushing the limits beyond that, you know, whether it’s local, whether it’s general, you can get yourselves into trouble. And that’s probably what you were referring to in terms of…there’s a limit to how much you can lipo under local. There’s a limit to how much you can do in a specific situation.
Dr. Chike-Obi: It is. I think people have a little bit of a natural bias against anesthesia because they’d be like, “I don’t wanna be asleep.”
Dr. Osborne: Because they haven’t met me.
Dr. Chike-Obi: They haven’t met [crosstalk 00:18:35]. They don’t know him so…and it’s true, man. Like I…
Dr. Franco: Or they have.
Dr. Chike-Obi: But I can’t tell you how many patients…after Celebrity Anesthesia comes in and we do a full day together, I can’t tell you how many times people tell me the next day or the day after and say, “Hey. The anesthesia was great. You know, Celebrity was awesome.” They don’t call him Celebrity.
Dr. Saenz: I like how he got his Celebrity name back.
Dr. Chike-Obi: That’d be kinda weird. But they always tell me how…and that just speaks to the dedication to his craft and I think that’s amazing. So if everyone does anesthesia like that, then it’s awesome.
Dr. Osborne: I really appreciate that.
Dr. Chike-Obi: You know, then it’s fantastic. But most people have this bias initially, so…and it’s true. So they have the bias and it’s what it is. So when you have that option offered to them, they tend to like it. And then they choose. You know, I don’t wanna force anyone to do anything. I say, “Hey. You can do it this way or that way. Here are the pros and cons.” And then they decide what they wanna do. And I think both options are fine. Both have their pros and cons.
Dr. Franco: For sure.
Dr. Chike-Obi: Yeah.
Dr. Franco: How do you decide who…if somebody comes in…who would you push to do butt implants versus a lipo BBL patient?
Dr. Chike-Obi: Yeah, so you hit on it earlier when you were talking about what I would kinda summarize as structure. Okay? So when someone comes in and they show me these wish pics where the buttocks have a lot of, kind of, projection and fullness, then I tell them, I say, “Listen, fat is usually my go-to for buttock aug. However, fat doesn’t have the structure of a silicone implant.” And I show them my implants. I have a catalog of implants like I’m sure you do. I show them the implants and I say, “Listen, if you had fat that was squirted on the table right now, it would be just running like water and that would not be able to give you what you’re looking for. So you need a structure of a silicone implant to do this job.” That’s how I decide. So the wish pics guide me to what the patients wants and then we talk about implant or fat. And if they agree to the surgery, then we get their butts looking awesome.
Dr. Franco: And then with butt implants, do you…because I do both. I would say the majority of my butt implants now are an intramuscular placement for the implants. Depends, like anything. For breasts, you know what I mean, majority of my breast augs are dual plane, submuscular but there’s an occasional, you know, subfascial or something else. Same thing with butts. Just depends on whatever specific situation, are we doing a site change or something like that? But tell me your feelings. The butt implant recovery’s real for a couple of things.
Dr. Chike-Obi: It’s a real thing. It’s a real thing for sure.
Dr. Franco: Any time you mess with muscle, it’s sore. You know, and we’ll circle back to this and like to get to Celebrity’s feedback on this because we’ve started incorporating Exparel and ERAS and some of these things for the butt implants just to make the recovery a little bit easier. But with butt implants, I typically…unlike fat, if you sit on it and don’t take care of it, you just lose the fat, you know. With butt implants, if you don’t care of this…I tell them, “You’re gonna be sending me a picture of your butt crack every day and it’s literally gonna be a pain in the butt for both of us for the next six weeks.” Because in that area we gotta be a little hypersensitive and a little crazy about taking care of it and making sure we get them through that first portion because if not, you’re gonna have one butt implant and one not butt implant for the next six months.
Dr. Chike-Obi: Yeah. Yeah, that’s totally true. So implants are a lot more involved than BBLs and fat transfer and that’s part of the reason why it’s kind of a number two option for me. And it’s true, you gotta be careful. So first, let’s back up a second. So the recovery is real. That is a total real thing.
Dr. Osborne: Can’t stress that enough.
Dr. Chike-Obi: It’s real and it’s more than like a breast…a breast augmentation, you know, like you described, we typically go in under the muscle for a breast aug, which has its recovery but it’s not bad. Easy for me to say, right? But I’ve seen enough people come back and tell me it’s not bad. With the buttock, the way I approach it, I like to go intramuscular. So it’s not under the muscle like a breast. I’m actually…I’m literally splitting that muscle, the gluteus maximus, like booty muscle, in two from the middle all the way towards, you know, the thigh bone, essentially, not quite there. And so that is a real recovery. So we have to do things to make it as easy as possible for the patient. You mentioned Exparel, which is a great medication, ERAS, a great protocol. But yeah. No, it’s a real recovery. I think that the big issue for me with buttock implants is when you close that incision, or incisions depending on what’s the technique you do, it’s tight. So there’s some tension there. So if someone goes to sit down too early, they put incredible amounts of pressure and tension on an already tense closure and that can lead to problems. Big problems.
Dr. Franco: And that gets to the second part because I agree with you, you know, depending on people’s wish pictures and different stuff, you know, we can lead them in different directions. If people really want projection, I think the butt implant, you know, may be a good option. There’s people who I’ve pushed to do a full BBL, get the lipo sculpting, get as much buffer as we can and then come back and do implants.
Dr. Chike-Obi: Nice.
Dr. Franco: But with the implants, and I’d love to get your take on this, I’ve changed it a little bit and tried to educate and help patients. I tell my patients there’s something called butt greed that they can get. And tell them, “You gotta be careful what you ask for because you might get it.” And so with the butt implants, I really fight people to a size that they can get. And obviously, to your point, depends on how tall, their body frame, and what they can or can’t handle. But if you go too big with a butt implant, those issues of not being able to close, being super tight, risk of implant exposure, I feel like in my hands go up pretty dramatically.
Dr. Chike-Obi: Oh, yeah.
Dr. Franco: I think the butt implants for those people who haven’t seen them or felt them, they’re a little bit heavier and they’re what’s called a semi-solid implant. So it’s not the gummy bear gel that we do for a lot of our breast implants. If you cut it in half, I mean, it’s a solid implant throughout. So the other thing is, one, because they’re solid, if you’re bent over…and our butt’s more of a joint than like a breast. So if you bend over, you know, people can see the outline of the implant. I don’t know if the…I’d love for you to touch on that. If the implant is too big for their body, you can see the edges of it. Even if you’ve tried to do fat transfer…I think we’re gonna get into some sculpture and some other things in a minute with you.
Dr. Chike-Obi: We will. We will, absolutely.
Dr. Franco: But love to hear some of those thoughts because those are some of the reservations I have with patients trying to go with an extremely large buttock implant.
Dr. Chike-Obi: Yeah. No, I think that’s, you know…and, you know, I think in plastic surgery, at least in my practice, I think, excuse me, I feel all…in life in general, actually, I think moderation. Moderation, right?
Dr. Osborne: That’s true.
Dr. Chike-Obi: Moderation is, to me, I think the name of the game, you know. So you can have dramatic results but if you go beyond a certain point, you risk issues.
Dr. Franco: Totally.
Dr. Chike-Obi: With the buttocks, with the way that I like to…the approach that I like and the plane that I like to put the implants in the muscle, sandwiched between the muscle, that space is kinda limited.
Dr. Franco: It is.
Dr. Chike-Obi: So it’s a tight space. So you can’t shove like some giant implant in there and expect it to do well. It just simply can’t work. It’s almost like, you know, if you see an architect and you say, “Hey, design this…build this house that looks like…” And he’ll tell you, “Hey, it’s gonna fall on your head. It’s not gonna work.” And so that’s our…in my opinion, part of our job is to guide patients to say, “Okay. This is not reasonable.” So I do agree. I think that there’s a limit to how big you can make people with this technique. Now, there are some people who like to…some surgeons who like to place that implant on top of the muscle. I don’t offer that approach but some people do. They get good results. My concern with that approach, at least in my hands, it’s what you alluded to earlier, which is implant’s visibility, which means can we see the implant.
And everyone has probably seen this video of, like, this lady, like, flipping her implant. Everyone’s seen this on YouTube. Now, who hasn’t seen this? I’m sure Anesthesia’s seen this and G-Berto. Everybody’s seen this. So to me, that risk is somewhat higher if you’re on top of the muscle and that’s why I avoid it. Not to say you can’t have a good outcome with that. So implant size is important. I wanted to ask you thought just kinda how you approach implant shape because there are a couple of different shapes of implants. There are round implants, anatomic implants. I wanted to pick your brain as to how you approach that.
Dr. Franco: I’ll be honest, I typically try and stay away from the shaped implants. I like the round because I tell people, “Your butt takes a lot more abuse. And then if this shifts, moves just a little bit, then you’re gonna be back revising it.” And I think it’s really hard to tighten that butt pocket and get it just perfect. And so the round gives us a little bit more flexibility. I 100% agree with you. You know, trying to go intramuscular for the vast majority of the implants unless there’s some specific reason not to. But I do fight people a little bit that just because you put it intramuscularly, doesn’t mean that you can’t see the edges of the implant. So it’s not a 100% guarantee that you won’t see them because especially in my practice, a lot of the patients that end up with butt implants are people who are too thin to have a BBL because they have no fat to lipo or transfer. And so you’re already dealing with someone who’s extraordinarily thin and then they’re wanting to put a huge implant in there. You’re already setting yourself up.
Dr. Chike-Obi: Yeah. Yeah.
Dr. Osborne: Compounding issue right there.
Dr. Chike-Obi: Yes, yes. And I think that’s a great segue to…I would imagine, to this idea of who is not able to get a BBL. And that’s…you just said it. I think someone who doesn’t have enough fat stores. And everyone comes in…and we live in Austin so everyone’s like fit and right and…but they come in and say, “Okay, I want to build something.” I’m like, “You don’t have enough fat to give you the size of butt you want.” And they’re like, “Well, don’t you see all this right here?” And I’m like, “No, honestly. There’s not a lot.”
Dr. Franco: I’m glad you have the same conversation as I have.
Dr. Chike-Obi: Right, right.
Dr. Franco: I think this is a great segue to your point about the non-surgical. And I’ll tell you. There is this gray area, and I’d love to hear this as we segment into the non-surgical because I used to fight people a little harder in terms of like, “Hey, if you don’t have enough to do at least 800 ccs of fat transfer per side, then I said you weren’t a BBL candidate.” And I’ve softened on that just because the other options out there are limited. And as we segment into Sculptra, Renuva, Radias, any of these other non-surgical fillers type stuff, if you think about…even if you paid for a surgery and have 400 ccs of fat, that equivalent with an off the shelf filler, you’re probably spending a $100,000 for the equivalent of 400 ccs of fat. Would you disagree or…what do you do with those in-between patients? And…
Dr. Chike-Obi: Yeah, no, that’s great. I actually…it seems like we’re agreeing a lot on this, which I think is a good thing as it sounds like it’s, like, reinforcement here. But I think that…so I mentioned earlier this nature and nurture. So I think our results are a function of like the patients we see and what we are. So I’m downtown, right, Austin and people I see are downtowners for the…not all but for the most part and they’re basically people who are pretty fit. And they may not be looking for…they don’t wanna be Kim Kardashian. They just don’t wanna be Kim, right. They wanna fill out their athletic wear a little better, fill out dresses better, etc. A lot of times they have, like, basically hip dips they wanna fill out, etc. So I’ve coined this idea of like this mini BBL is what I say. It’s a mini BBL for people who are just like, you know, people who don’t wanna get huge but just wanna have that balance we’re talking about.
So I’ve softened in that regard as to who I can offer this thing to. Now some people still don’t have enough fat. They don’t want implants. And so the next step is to consider, “Okay, what can we do that’s gonna get you some form of result without doing surgery?” And so we get to…an option is kind of an array of fillers that exist that can be used to get some formal result of buttock augmentation. For me, the one I reach for the most is a product called Sculptra, which is basically an injectable that stimulates collagen. You know, so it was first released, approved for use in the face but, you know, we’ve started to use it elsewhere. And so that is, in my hands, kinda the best in terms of cost-effectiveness and result way to approach someone who doesn’t have enough fat for a BBL and doesn’t want implants.
Dr. Franco: G-Berto, for the people that don’t know, you wanna just catch us up with what Sculptra is just to make sure everybody knows what we’re talking about here?
Dr. Saenz: Yeah. Sculptra, also known as poly-L-lactic acid like Dr. Chike-Obi was saying.
Dr. Franco: Damn.
Dr. Osborne: Whoa. Whoa.
Dr. Franco: You see why I pointed that to G-Berto? I couldn’t have said that. I couldn’t have said that.
Dr. Chike-Obi: Yeah, that’s a big word.
Dr. Franco: We’re just surgeons. We’re just surgeons here.
Dr. Chike-Obi: We just cut, we just cut. Give me a scalpel [crosstalk 00:31:28].
Dr. Osborne: Blood-brain barrier.
Dr. Saenz: I needed to make my mark somehow in this episode. No, but like Dr. Chike-Obi was saying, Sculptra is a…it’s a product…I think we talked about this in a previous episode where it’s essentially kind of like suture material that gets diluted with saline. And correct me if I’m wrong, Dr. Chike-Obi, but when you’re doing buttock augmentation with Sculptra, there’s a lot of saline volume that goes into that procedure. And basically, what it does is it stimulates collagenesis or collagen production. And I’d be really interested to find out what your thoughts are on Sculptra like for its use in butt augmentation and what your experience has been, what kinda outcomes you’re seeing. I personally don’t do it in our practice but my supervising physician who’s a Mohs surgeon, he’s been doing a few cases of Sculptra for butt augmentation and it’s kind of interesting to see that, you know, in a dermatology practice where I would typically see it more so in, like, plastic surgery.
Dr. Franco: Can we do just a little disclaimer here because I don’t wanna confuse people because…and correct me if I’m wrong but you’re not saying that Sculptra is a replacement for 1000 cc BBL? Correct?
Dr. Chike-Obi: Oh, for sure. Definitely not saying that. I think…And so thanks, G-Berto, for asking that question…comment. I feel like, you know…I was saying earlier when patients come to see us, you know, they deserve to hear kind of a menu of what’s possible. And so I think Sculptra is on that menu. For those who want real volume, you know, it’s like the appetizer instead of a steak.
Dr. Franco: No, that’s a great way to put this so people have a perspective of…because it does make a difference but it’s not the same difference.
Dr. Chike-Obi: Not the same difference at all. You know, sometimes it can be approached and subtle. And when you look at the overall cost of this thing, the way I like to offer Sculptra for those who…you know, I see some patients who maybe they have a body mass index of like, you know, in the low 20s, which means they’re thin and they don’t want an implant. Then they’re kind of…they wanna do something. I’m kinda stuck with that Sculptra or injectable option [inaudible 00:33:52] or the other products that exist. And so the way I like to approach it is I offer, basically, a serial injection, which means two sessions. And I tell patients they need to commit to a minimum of six Sculptra vials per session. So that’s 12 vials total. Now, the cost of that…
Dr. Franco: So you do three on each side or six on each side?
Dr. Chike-Obi: Three on each side, session one. Three on each side, session two. And that’s the minimum, you know, before I even engage anyone for Sculptra.
Dr. Franco: I think that’s super important. So we’re talking at least six vials on each side as an absolute minimum and that’s really just to get them started. You’re not making any promises that this is end goal of where they wanna be.
Dr. Chike-Obi: No. And it becomes…you know, when you look at the overall cost of the thing, you know, for us…like Sculptra retails an average of $1,000 a vial, right. So if someone says, “I’m spending $12,000,” they have to really understand how limited the results will be compared to what they’ve seen on IG as like a BBL or an implant.
Dr. Osborne: But again, like you said, you know, those BBL results that they’re seeing are probably 25, 30 BMI, and plus, patients where they can get those real results from tapering the waist and doing 1,000 ccs per side. Completely different than the volume of Sculptra that you’re able to inject.
Dr. Franco: Because one of the things that you see on IG and other things, and I feel like unfortunately even in some websites, is that you see a lot of people who post before and after pictures but immediately after the Sculptra injection. It goes to G-Berto’s point that he mentioned where…you know, and again, it’s not a plastic surgery or they’re not trying to cheat anybody by diluting it out with the saline or lidocaine. There is some method to that madness of diluting it out because you’re trying to get an even spread and it’s actually been shown to decrease the granules and the lumps if you mix it ahead of time, if you mix the volume.
Dr. Chike-Obi: That’s correct.
Dr. Franco: So these things are done on purpose but, you know, there’s some false, you know, fulness there, for another term, because then it goes down. After about a week, it looks like nothing happened, and then that’s why you do the serials because it takes a little bit of time to see the results, see where we’re at, and then keep tweaking.
Dr. Chike-Obi: Yeah. So I think, you know, for those who are considering this technique or approach, wherever you are in the country or in the world, I would ask whoever is treating you to show you, you know, photos from, you know, a couple of months out. You know, three months to even longer ideally, six months out to say, “Okay, this is the before and the after.” Because you are right. All that fluid that’s injected, it goes away by the next day. Everything’s gone. You know, and it’s like nothing happened. And then the Sculptra works over time by telling your body, the cells that make collagen in your tissues, to make more. And that just takes a long time.
Dr. Franco: And I like…my personal bias for this is I like Sculptra. There’s also a product called Renuva, which is a processed fat which I like too. I tend to use them more for like little touchups, people that have had a BBL, they have a little dent, one hip that’s a little bit bigger than the other. I feel for small touchups, lipo touchups, it works really, really well. Again, to your point, just because it’s a volume that I can work with and just trying to be super real with people about what we can and can’t do for them because it sounds like your goal’s like my goal, just trying to be real with patients so that they’re happy with us over the long term. You know, it doesn’t do anybody any benefits to, you know, pay us and then be disappointed.
Dr. Chike-Obi: Yeah, man. We’re trying to be real with patients and I sense that you’re the same way. I’m trying to get the best result possible. Every single case, best result possible. And to me, that includes some, like low, but some touchup [inaudible 00:37:28]. You know, it’s like if we’re sculpting people, if someone comes and they heal in a way that you say, “Well, there’s a little bit I can do here,” I think a product like you mentioned that’s processed fat is a good way to say, “Okay. Let me just inject, you know, 1.5 ccs here, 3 ccs to get that result.” You know, and not to imply that perfection is possible but I think certainly pursuing that in every case and trying as close as we can to get to that I think is the way I like to approach this stuff.
Dr. Franco: G-Berto, what about in your practice, do you do any…? I know you said you don’t do any of the full butt injectables stuff but do you do any kinda touchup things, lipo, little dents? Because I do wanna touch a little bit more on the hip dips before we move on to, kind of, our last segment here because I feel like the hip dips has become its own, like, beast.
Dr. Chike-Obi: It’s come alive, man. I’m telling you.
Dr. Saenz: Yeah. No, I’m afraid not. Not in our practice. Since we’re more dermatology, typically what I’m doing is if patients have questions or concerns about either their procedures that they’ve had done that maybe they feel needs a little bit of tweaking or something, I’m usually actually referring them more over to you to see what you can do to them.
Dr. Franco: Well, I appreciate that. Thank you. That’s funding this podcast so thank you, G-Berto. Before we move on to some of kinda the new devices out there for butt stuff, what about the hip dips? Because I feel like it’s taken on a world of its own and I’d be interested to hear your thoughts. But I bet a lot of your mini BBL focuses on some of the hip dips and that body, little tweaking. Is that correct?
Dr. Chike-Obi: It is, it is. So liposuction is a cornerstone of my practice. And so over time, like we’re trying to say, “Okay…” I guess my practice evolved from, you know, the kinda more typical, “Okay, what bothers you? Is it the flanks and the abdomen? Let’s treat it.” So now when I meet someone, I say…I tell them, I say, “Listen, the reason you’re here is because you wanna look your best, I’m assuming. I assume that.” And I tell them if they don’t want that, then they can probably go somewhere else perhaps.
Dr. Franco: Because you’re only gonna make them look their best.
Dr. Chike-Obi: That’s my goal. That’s my goal. No. and I’m not saying I get that every time but when I work…you know, it’s like if you play basketball, you go out, you wanna win the game. You know, you don’t always win but you try. So I say, you know, “This area here, I’m taking out this fat from all these areas. I can throw it away or we can use it in some way to improve your shape.” And so that’s the menu and if someone says, “I don’t care. I wanna throw the fat out,” then that’s fine. It’s awesome. But if they say, “I wanna have that optimal shape,” then I say, “Okay, let’s use it here.” And the hip dips is a very common area that a lot of people have. You know, it’s the area below kind of the flanks where there’s like a little bit of a volume. And people wanna have more of an hourglass shape generally. People I see, anyway, in the practice. And then if they wanna get it addressed, then we address it with a little bit of fat.
Dr. Osborne: When you said throw fat away, I saw Johnny cringe a little bit. He had a little chest pain.
Dr. Franco: There was a little…I don’t know if you can see. If you see, I had a little tear. A little tear rolling down. Yeah.
Dr. Chike-Obi: It hurt my heart to say it. It hurt me to say it, actually.
Dr. Franco: But I love your point about this because even in our tummy tucks, you know, most of them will…because, you know, most tummy tucks, we do some lipo at least of some areas because you can leave them very square if you just address the tummy and not the love handles. But do some targeted fat transfer to those hip dips because I tell people, “It’s more of a three-dimensional body sculpting now that we do.” In the old days, it used to just be let’s just pull the skin down and make them as tight…and it used to be that way for facelifts and stuff and now we do fat transfer for that because just nobody comes in and says, “Hey, I was in my convertible. My face was like this and I wanna look like that all the time.”
Dr. Chike-Obi: Yeah, yeah. No one wants that. It’s like the wind tunnel sucked in…like no one…that’s like, you know, from the ’80s, you know.
Dr. Franco: We’re running out of time so I wanna get one more thing in here because there’s a whole new kinda segment, paradigm, of plastic surgery in terms of these muscle-building devices. And we have the Emsculpt in our practice, which was one of the first devices that helps stimulate building muscle. Butt was one of them, abs.
Dr. Chike-Obi: Sure.
Dr. Franco: Correct me if I’m wrong but I think your practice has CoolTone.
Dr. Chike-Obi: CoolTone. We have CoolTone.
Dr. Franco: Which is very similar.
Dr. Chike-Obi: Very similar. Yeah.
Dr. Franco: What are your thoughts on that? Because now there’s two or three devices out on the market that do this muscle-building and get your thoughts about that for butt augmentation.
Dr. Chike-Obi: Yeah, so I think, I feel like, to me, I love that innovation and that push by, you know, we’ll call it industry and some of our colleagues who are like, you know, involved in industry on a high level to find better ways to get our patients happy and delighted and pleased. So Emsculpt and CoolTone basically stimulate muscle. So they work on a different tissue than all our techniques that we have other than these two. So they [inaudible 00:42:15] muscle. It’s almost like if you wanted to go work out, like, a lot, the muscle contracts a lot and the muscle gets bigger and grows. So to me, I think there’s a role for it. Excuse me. The question is, you know, how long will the result last? And is the patient okay with the idea that it won’t last forever? They have to maintain it. And if they buy into that idea…which people buy into the idea of getting filler on some schedule, six, seven, eight, nine months. If the patient understands that, then I think it can be a great addition to the work that we do more invasively with fat and implants.
Dr. Franco: I couldn’t agree more and I think it falls…I’m glad you brought up the combination of filler because I feel like it falls into that same category of more subtle differences, some kind of maintenance stuff, a little bit of tweaking. I have a lot of patients who do BBLs and they just want a little bit more and so those are great ones. Some of the patients who are great for this I think are those patients who are too thin for a BBL. They’re so tiny that even a little bit of muscle gain is gonna show up nicely on them. So I think those are good patients for it. But to your point, it’s people who are looking for a little bit more subtle, long-term gain, you know, over a period of time than some dramatic change.
Dr. Chike-Obi: Yeah. And I feel like with the CoolTone or Emsculpt, when you…it’s almost like this new dimension. And again, it’s probably not perfected yet. Probably like in five years it’ll be even better. But when people get their abs done with Emsculpt, they’re a good result…or CoolTone, they’re good results, you know, you can see the definition really nicely. And so if someone is, you know, like a fitness trainer and they have some event coming up where they wanna look their best for that, there’s a role for these devices where you say, “Okay, I want these abs to really pop or my butt to really, you know, be nice and tight.” Because the muscle is gonna be working more for a period of time. The issue is if someone thinks it’s gonna be like some long-term thing, which it’s not.
Dr. Franco: Yeah. Yeah.
Dr. Chike-Obi: So there’s a role for the tech.
Dr. Saenz: I have a question.
Dr. Chike-Obi: Yeah.
Dr. Saenz: So in incorporating these different, you know, modalities like CoolTone, Emsculpt, how long after a patient has a BBL can they start doing these treatments or safely anyway?
Dr. Chike-Obi: Yeah.
Dr. Franco: I would make people wait at least three months. I changed mine…I did…Last thing on the butt stuff because then we’ll move on to a little anesthesia and a couple of fun stuff here. Because I don’t let people sit…when I first started doing BBLs, I only let them…I had them not sit for two weeks. And I’ve increased that to six weeks because the results have just been better the longer I’ve been able to keep them off that butt. So something a little bit more intense like the Emsculpt or CoolTone, I would probably push them three months out before doing that.
Dr. Chike-Obi: Yeah.
Dr. Franco: That’s not based on any science. Just…
Dr. Chike-Obi: Yeah. But it’s based on your practice, which has a lot of value. So I like to wait like six months. You know, to your point, even with fat transfer, I’ve noticed the same thing. I typically tell patients, “Look, it’s hard to not like sit for like, you know, a long time.” So I tell them, “Listen, for two weeks, if you avoid sitting and laying on your butt, it’s gonna help you result. That’s the minimum.”
Dr. Franco: Yeah.
Dr. Chike-Obi: “I beg you…I beg…I literally like beg you to do another, like, week,” and every week I’m, like, begging them to do more because it just helps the fat retention. It’s simple.
Dr. Osborne: For sure.
Dr. Franco: A hundred percent.
Dr. Chike-Obi: And I wanted to get your opinion actually, Johnny, on this substance called PRP and your thoughts on the role of that in BBLs.
Dr. Franco: I like it. I’ve actually incorporated it into our practice. I tell people I think, you know, the studies are small and PRP was kinda thrown at everything, you know. And so I think they’re gonna still find more discrete roles for it. But I do think it gives them a small increase in fat retention. I think of everything. I think the not sitting is the number one thing that they can do to stay off that butt. But I do like it. I do think it helps. I think, for most of our patients, they wanna keep as much fat as humanly possible, especially our skinnier patients. And so I think anything that can even help, even if it’s just 5%, 10% tends to be…when you’re talking about a 1,000 ccs, that’s 100 ccs so I think it’s something. I think it’s something.
Dr. Chike-Obi: I like that. I like that. Cool.
Dr. Franco: I know we’re running a little short on time but can we talk a little bit about anesthesia and butt stuff? I mean, we touched on the Exparel, we talked on the ERAS, especially for the butt implant stuff. You know, Celebrity, anything that we missed that you’d like to…or correct us on?
Dr. Osborne: No. I mean, you and I have talked to ERAS protocol. That is early or enhanced recovery after surgery. We’ve developed a couple of protocols that have piggybacked off of other ERAS studies from around the country that just really aim to reduce the amount of narcotics that we’re giving patients. We use other antinociceptive agents and other pain-blocking agents during the cases. I would say now I’m probably doing 80% of our BBLs that are just straightforward BBLs without any narcotic at all. The patients are doing great. They wake up quick. They don’t have a lot of nausea post-op and it’s been really good. Unfortunately…
Dr. Franco: Just to that point, for patients, the benefit is that they’re less sick, that they’re up and moving a lot faster. That’s why they care.
Dr. Osborne: And you and I have talked about this and you’ve told me anecdotally that you’re getting far less calls after hours saying, “Hey, I’m sick. Hey, can you call me in [inaudible 00:47:31]? Can you get me something to make me less nauseous?” And we’ve had a lot less of those callbacks.
Dr. Franco: Can we jump to a section that I like to call our, I’ve stolen from producer Donald, Behind the [inaudible 00:47:44]? Dr. Chike-Obi, can you give us a little something, anything in the world of butt augmentation, something behind the scenes that people don’t think or know about with the butt that would be a cool little nugget for them to take home from this?
Dr. Chike-Obi: All right. I’ve got one.
Dr. Franco: Okay.
Dr. Chike-Obi: If you get a BBL, make sure your surgeon works with Celebrity Anesthesia. You have to fly to Austin from wherever you are. I don’t care if you’re in Paris, L.A., come here and get it done.
Dr. Franco: I think that’s a good one.
Dr. Saenz: That’s the best plug of all.
Dr. Osborne: Yeah, that was good.
Dr. Chike-Obi: Seriously though, like…so to me, I think the idea…I think part…So this push by people to show like before and afters and stuff, I think has…People misunderstand that fat…people don’t understand what fat is because they’re not, like, surgeons and that’s fine but sometimes there’s some real loss of the fat and the results end up being less than they expect. And so the idea that in some small group of patients, they may need additional fat to be injected, I think is one that I think people don’t typically get until we explain it to them.
Dr. Franco: And maybe if the rest of the cast is okay with it because we didn’t…I feel like there’s so much stuff we didn’t get to. Maybe in the future, we can have you back and we can talk about round two BBLs, butt revisions. I feel like you can never talk enough about butt stuff.
Dr. Chike-Obi: Yeah. Well, listen, I had a wonderful time. This is…
Dr. Franco: Well, we’re not done yet. You can’t leave yet.
Dr. Chike-Obi: Oh, okay. I thought that was your close.
Dr. Franco: No, no, no, no. No. Just trying to rub you in while we still got you to commit to another episode in the future.
Dr. Chike-Obi: Okay, rub me in, bro.
Dr. Franco: Can we get a quote of the day? Is G or Celebrity gonna help us here?
Dr. Osborne: I got one.
Dr. Saenz: You go for it.
Dr. Osborne: We touched a little bit on perfection a while ago and this one…and it’s Sunday, which means football so…
Dr. Franco: Is the sky gonna be the limit when there’s footprints on the moon or is this gonna be something else?
Dr. Chike-Obi: Oh, what’s that about?
Dr. Osborne: This is…Vince Lombardi said this. He says, “Perfection is not attainable but if we chase perfection, we can catch excellence.”
Dr. Chike-Obi: Oh, wow.
Dr. Osborne: Which I think is super pointed as far as what Dr. Chike-Obi was talking about. He aims for perfection every time with patients. So does Dr. Franco. I do too with every anesthetic. I know that it’s not gonna be perfect but if I chase that…falling short, it means that I’m gonna land on excellence.
Dr. Chike-Obi: I love that.
Dr. Franco: I mean, it’s just what you were talking about earlier about how we all keep pushing each other to get better. We share ideas and it keeps moving forward. We’ve changed just in the last three years how we do some of our pre-op meds, how we do our post-op protocols just to keep trying to make things better like, “Hey, here’s a problem. What can we do to make it better?” I love it. I love it. That’s a good one. G, you got your work cut out for you on the next episode. No pressure.
Dr. Saenz: I know. Actually, I had that one in mind but…
Dr. Osborne: Oh, get out of here.
Dr. Franco: Well, I appreciate everyone being here. Dr. Chike-Obi, I appreciate you coming in on your day off and spending some time, dropping some nuggets. I truly hope you’ll come back for another episode in the future.
Dr. Chike-Obi: I had a blast. I’d be happy to. Thanks for having me, guys. I really appreciate it.
Dr. Saenz: Thank you for joining us.
Dr. Osborne: Yeah, thanks for coming.
Dr. Franco: Guys, don’t forget, please download us anywhere you can get your favorite podcasts. “Plastic Surgery Untold,” it’s on iTunes, iHeart, wherever you can download your favorite podcast. We love it. Number one podcast as voted by us. See you, guys. Bye.
Dr. Chike-Obi: Brilliant.
Dr. Osborne: See you.