Unbotched: A Real Patient's Perspective

Nipped and Toxxed Episode 6: Unbotched - A Real Patient's Perspective - Now Streaming on Spotify, Apply, Google Playlists

Ashley: Welcome to Nipped and Toxxed: episode six, Unbotched - a real patient's perspective. I am Dr. Ashley Robey, and I'm a quadruple board certified plastic surgeon. And with me as always is...

Katie: hello, I'm Katie Reichart. I'm a CPCP, which is a certified permanent cosmetic professional, which is when you're certified by an outside body. So in the state of Indiana and a lot of other states, you can literally just walk into a place and get quote unquote certified. So that means nothing. So that means really you could have had no training. Through what I have, you have to have had fundamental training as well as continuous education. And, you have to go take it an actual exam. 

Ashley: You're legit. 

Katie: I'm legit.

Ashley: Too legit some would say.

Katie: Yes, exactly. 

Ashley: And we have a special guest with us. 

Katie: Yes!

Ashley: Jordan Dunne.

Shay: I'm gonna go by Shay. Jordan Shay Dunne, preferably Shay. I am an experienced surgical patient. I have had five surgeries, I would say Dr. Robey, also my sister, mm-hmm, has performed two surgeries that included a few procedures. I had a tonsillectomy and a few other procedures not performed by Dr. Robey. So I have a lot of surgical surgical experience.

Katie: So with your tonsillectomy, we know why you had that, but for your first surgery, why did you decide that you wanted to actually get the surgery and what was it?

Shay: Ugh, because I was just really unhappy with- I had two kids, but I have to preface this with when I was pregnant with my first child. I told people that people would regularly come up to me and say, are you having twins? And this was when I was like, Seven months pregnant. 

Katie: Mm-hmm 

Shay: And I was telling my in-laws that when we were out to lunch, once in Chicago, that this was always happening to me, 

Katie: Uhhuh.

Shay: ...and I think they kind of didn't believe me, but we walked outside and this guy's like, oh man, you got two babies in there. Congrats lady .

Katie: And you're like, I know. 

Shay: So I was very belly forward. 

Katie: Right.

I would say in both of my pregnancies.

I was the same way with mine. All my children were huge.

Shay: My kids weren't that huge, but my stomach man, It was large. So after they came out, I had lots of skin. 

Katie: So, did you have a diastasis?

Shay: I did. I don't remember...

Ashley: It was like three or four centimeters. 

Shay: Yeah.

Katie: Do you want to explain what that is? 

Ashley: Oh, so a diastasis recti is when you have a separation between your rectus abdominis muscles. So the muscles that give you that six pack look ,if you're thin enough, you can see the muscles underneath the skin, but with pregnancies or weight fluctuations, those two muscles can get pulled apart. And so it creates a separation and they call that a diastasis. 

Katie: Does it actually tear? 

Ashley: Yeah. 

Katie: So it's actually torn down the middle?

Ashley: Well, the muscle bellies are already separate. 

Katie: Oh, okay. 

Ashley: They're two separate muscle bellies and there's ...

Katie: cause it separates so that the belly can grow, right?

Ashley: Right. So everything is stretching. And they usually get better after delivery, but they don't necessarily get to the extent that they were. Yeah.

Katie: Right. 

Ashley: In addition to creating some cosmetic concerns, there are some functional impacts. Your abdominal wall or your abdominal musculature works in concert with your back muscles to provide torso stability. So when you have a separation in the front, you've created a relative weakness and your back can have to overcompensate. So some people will get chronic back pain from it. 

Katie: Mm-hmm .

Ashley: It's not a hundred percent cosmetic/ aesthetic. Unfortunately, insurance companies, even though it does have some functional impact, will not cover that.

Katie: Right. 

Ashley: So, out of pocket 

Katie: aesthetic. 

Shay: Yeah, first Ashley had told me that just losing weight wasn't going to help that abdominal skin. 

Katie: Right.

Shay: I had a lot of skin.

Katie: Cause your belly had stretch. 

Shay: Oh, yeah. Yeah, just like a big sack of skin but I did liposuction first. The best thing about that liposuction was I felt like I had like gotten back to mostly my pre-baby weight, but my thighs were still touching in the middle. 

Katie: Mm-hmm 

Shay: And just that feeling of like ...

Katie: right. 

Shay: ...was really annoying. So I did liposuction on the back of my legs, the inside of my legs and my flanks love handles.

Katie: Mm-hmm. How was that recovery? 

Shay: That was not a big deal. 

Katie: Nothing.

Shay: I would say it. ..I felt like pretty much...

Katie: well, we already talked about this with liposuction, but talking to a real person.

Shay: Yeah. I had some pretty bad bruising on the back of 

Ashley: a real person. 

Shay: on the back of my legs, but it looked way worse than it was. It didn't really hurt. I felt fine pretty quickly. Within four days I felt pretty normal.

Katie: Mm-hmm 

Shay: like, I wasn't gonna go do a hardcore workout or anything, but 

Katie: right.

Shay: That wasn't bad. Yeah. Abdominoplasty seemed like a bigger surgery, so I waited another year to do that and, oh man, I tell people all the time that it was one of the best things I did in my life, blah, blah, blah, blah, blah, marrying my husband- so smart. having my kids such a great decision. Then an abdominoplasty is right up there. 

Katie: Right. 

Shay: I didn't like sitting down and having that skin hang over my pants all the time. 

Katie: Right. And there was no way to retract it. I have seen Kim Kardashian is doing some tightening. She says she hasn't had an abdominoplasty. I call B.S. on that, that she had some skin tightening, something done.

Ashley: Maybe she had BodyTite .

Katie: Oh, maybe. But did you see her when she was pregnant? 

Ashley: No.

Katie: She was giant. There's just no way. 

Ashley: You and I have had this conversation about the Kardashians before, where in which I know few details and you know many details.

Katie: This is the kind of thing that pops up on Google. So I'm sorry Shay, go on. 

Shay: My stomach looks really good now. I went from never feeling comfortable in a bikini to I feel like I rock it. I do. 

Katie: I saw your Dominican Republic pictures. 

Shay: I know. You should probably post those to your website 

Katie: probably should. pretty hot 

Shay: or to your Instagram. The abdominoplasty, from a recovery standpoint, I wanted to give a relative pain scale. Like liposuction, I would give maybe a two or three. 

Katie: Really? 

Ashley: Out of 10?

Shay: Out of 10. 

Katie: What do you compare that to? Like getting a bikini wax? Is that worse? 

Ashley: That's so transient though. 

Katie: What would you compare it to pain wise? So like the soreness after a really bad work-out? 

Shay: What, liposuction? 

Katie: Yeah. 

Shay: No, because it's not a muscular soreness. It's more like a bad bruise. And I didn't have that same bruising on my love handles. It was just the back of my thighs for some reason.

Ashley: Gravity is the reason. 

Shay: There you go. 

Ashley: I hear a lot of patients saying, well, my spouse told me just to go work out more and the skin will get better. Nope, Nope. Right. The skin doesn't get better. And in fact, sometimes working out, if that means you're going to lose a little bit of weight can often make the skin look worse, droopier. So, there's no magic cure for excess skin. Then the question is, is it so much skin that it needs to be removed? And, classically, something like an abdominoplasty would be what you would choose to remove the skin. Or is it a little more subtle and maybe you can do something that's minimally invasive, like you're talking about whatever Kim Kardashian did.

Katie: I think she had a full abdominoplasty. I'll show you a picture of her pregnant. 

Shay: Can you see her belly on belly button?

Ashley: But not every single abdominoplasty has an incision around the belly button. So that leads us to what are the kinds of abdominoplasties? Because this is definitely something that I hear frequently and most people are interested in the prospect of being a good candidate for a mini abdominoplasty. And what a mini abdominoplasty is, is the incisions are still in the same location. So low in your underwear/ bikini line, but the difference is for a mini abdominoplasty that the incision would be shorter in length. The other main difference between a regular and a mini abdominoplasty is that classically for a mini version, you would not have an incision around the belly button and you would also, Katie is showing me a picture of Kim Kardashian's big belly. You would also have ...

Katie: I telling you like that doesn't snap back. 

Ashley: You would also only have skin removed from the lower abdomen. 

Katie: Okay. So what did you have Shay? 

Shay: Well if there's a mini, I guess I had the maxi. 

Ashley: You had the traditional .

Shay: Traditional. 

Ashley: So that involves an umbilical transposition, so the belly button is moved from where it was on the excess abdominal skin and all that extra skin is pulled down and then you make a new opening so you can see the belly button. 

Shay: I'm gonna explain that in real people talk.

Katie: Yes, please. 

Shay: When people ask me about my abdominoplasty and how does it actually work? I take the shirt I'm wearing and I draw a circle around my belly button and I say you cut a hole to free the belly button from the skin. So there's a hole in my shirt. The inside of my belly button isn't moving. You take the shirt, you yank it down. And then cut the bottom of the shirt off and cut a new hole in the skin to let the inside of the belly button stay where it is and free that belly button. 

Katie: Right. 

Shay: Amongst all of the tight skin. 

Katie: I feel like the belly button is art. Like people come in and they pick from a menu of belly buttons?

Ashley: No.

Shay: No, the belly button is the same on the inside as ...

Katie: no, but what people want their belly button to look like? When you look on the, of all these different people.

Shay: We're shaking our heads. 

Katie: I know you're shaking your heads, but ...

Ashley: we need a video of this. 

Katie: When you look at plastic surgery befores and afters, there are some good belly buttons and there's some bad belly buttons.

Shay: Sure. 

Katie: That's what I'm saying.

Shay: So I've seen people with abdominoplasties where, I don't think that you would notice, now, like if you look at pictures of me, you're gonna notice, but, this is how you find abdominoplasties, you look for the belly button scar. And I've seen some bad ones.

Katie: Right? That's what I'm saying. I've seen some bad ones.

Ashley: So the bad things are when you close the abdomen incision, All that skin's under tension. So I think sometimes the surgeon will make the opening the appropriate size, what they think should be normal. And you really need to make it way smaller because as soon as you cut the skin, that like stretches a lot. So that's part of it. You get this stretched out elongated belly button. Hopefully that's something that if you have some experience you pick up on pretty quickly. The other part is I really think that the sutures placed should all be under the skin. Some people will still do sutures that need to be removed. And so you'll have those little poke marks all the way around the circumference...

Katie: stitch marks.

Ashley: ...of the belly button, and it almost looks very much like a sun.

Shay: The way a belly button looks after an abdominoplasty is the mark of whether or not...

Katie: right, that's what I'm saying, whether you or not, you had a good one. 

Shay: Yep. I've had plastic surgery from multiple surgeons so I can speak to the difference of surgeons. So I had a double mastectomy reconstruction. The first half is not the plastic surgery part, but yeah, there are some differences that I didn't expect. Like after that surgery, I woke up without a compression garment on.. And I thought, where is my compression garment? When Ashley did the surgery, I had one and now I'm not wearing one and I had to go buy my own. I just didn't expect it because I had woken up with one the last time .I feel like my belly button looks pretty natural.

Katie: No, I think your belly button looks great.

Shay: It looks like it did before. Except I have a very faint scar around it. 

Katie: Right. I'm just saying, does someone come in and say if they had an outie, are they gonna get an outie again? 

Ashley: Classically, an outie suggests a hernia. 

Katie: Okay. 

Ashley: Classically. Not a hundred percent.

Katie: But what if they're like, I want to look the way I did look?

Ashley: I'm like, I am definitely fixing your hernia 

Katie: but what did they want the outie again?

Ashley: I literally had someone that was mad that I fixed their hernia. 

Katie: Oh yeah?

Ashley: Yeah. 

Katie: They're just used to it. Or what about if someone wants a hooded belly button.

Ashley: There was a study that looked at ideal belly buttons and all the shapes and having a slight bit of hooding and not perfectly round, is considered to be...

Shay: what's hooding? I don't know what you're talking about. 

Ashley: So if you think about a belly button, being able to see a perfectly round circle, seeing all 360 degrees of it ,versus a little bit of flattening at the top, flat from maybe 10 o'clock to two o'clock and then circular. That's called hooding. When I make the new opening for the belly button, I don't create a circle. I actually make it flat at the top. So just to create a little hint of that hooding look. 

Shay: Something I think we should talk about in abdominoplasty, which before I had an abdominoplasty, I didn't know anything about is drains.

Ashley: Mm-hmm 

Shay: Do you wanna talk about drains?

Ashley: Sure.

Katie: Did you have drains? 

Shay: I've had so many drains. 

Ashley: Drains are annoying, I agree. And I am putting in some more quilting or mattress sutures that help close the dead space. 

Shay: I don't understand. What are trying to..., 

Ashley: So dead space is a space between the fascia of your abdominal muscles and the fat underneath the skin that we just lifted up. So that space that we created, so we could repair your muscles and pull loose skin down. There's a open space. 

Shay: Yeah. 

Ashley: People call it dead space. So that's where all the fluid would accumulate. That's a space that the drains sit in. So I wanted to make this a dead space clipper so you could close it off by a absorbable staple and close, close, close. I've kind of tabled that future plan, but you can put sutures and it's just annoying though. 

Shay: Let's explain what a drain is because when I first wanted an abdominoplasty, I thought this was the scariest part.

Katie: Having drains?

Ashley: So this is the analogy I used to describe the purpose of drain. So, you know, when you scrape yourself, let's say you scrape your knee, right. It stops bleeding. Right. But then on your bandage, there's still some yellow fluid. So that yellow fluid is called serous fluid. It's the kind of fluid that weeps with an injury once the bleeding has stopped. So you can imagine, for a knee size scrape, how much fluid that collects in your bandaid. For an abdominoplasty, think about the amount of fluid that would collect from a scrape the size of your abdomen but then double it, because it's really the front and back of that surface.

Katie: Mm-hmm. 

Ashley: ...both sides. So it's potentially a lot of fluid. So just like your knee heals after a scrape, it stops weeping fluid. There's more healing present. Your abdomen will heal as well. As those two layers of tissue heal together, you'll stop seeping so much fluid, and those two layers of tissue will be healed. The drains provide an egress point for that fluid. So instead of the fluid collecting in that space, there's a place for it to go. So basically, a drain is a little tube that allows the fluid to be sucked out so that while your body is healing, the fluid is not just sitting there preventing the layers of tissue from healing together. The fluid is going out into the drain, so the tissues can heal.

Katie: Right. 

Shay: So it basically looks like a long tube, part of that's inside your body with a little, I'd say light bulb sized, 

Ashley: Clear plastic grenade.

Shay: Yeah. clear plastic grenade. And post-surgery, you're supposed to empty them, measure the fluid. Measuring the fluid helps you determine how much longer you need to keep the drains in. But, the whole idea of having a plastic bulb grenade attached to your body that's filling with your bodily fluid does not sound appealing, but it sounded like something that like, I don't know if I'm gonna, I'm not a blood person.

Katie: Right? Was there blood in there? 

Shay: It's kind of like a clear to slightly bloody colored liquid, like light pink, I would say. 

Ashley: It starts off red and then it turns pink and then yellow. So it just takes a couple drops of blood to turn an otherwise a serous straw yellow color into either pinkish or red.

Shay: As a patient, when you're sent home, you have to open up the drain, squeeze down the length of the tube to get all of the stuff that's in the tube into the bulb before you empty it. They're not as unpleasant as I thought they would be, but wow, once they're out, it's a relief. And Ashley, how long do you typically keep a drain in?

Ashley: Usually in the range of one to two weeks. 

Shay: I think mine were in for about a week and a half. And then when I had my mastectomy, I had four drains. 

Katie: Oh really? 

Shay: And those were in for two weeks and then three weeks. 

Ashley: That's fun. 

Shay: There's a lot of drains.

Katie: So you said it's a lot of drains. 

Shay: Yeah. I know people that have had abdominoplasty or other procedures where they have really pushed their surgeons to remove them early...

Katie: Just because they're uncomfortable?

Shay: They are uncomfortable, and you want to wear blousy clothing. So have some blousy dark colored clothing prepared postsurgery. Not that I think I only had like a little bit of leakage. 

Katie: One. Are you doing just like sitting around? 

Ashley: No. 

Katie: Living your life with your drains hanging out your crotch? 

Shay: One week postop, I went out and had lunch with one of our friends and actually went shopping.

Katie: Actually one of our friends saw you at the mall and they were like, I just saw Shay the mall. 

Ashley: Yeah. You just put them in a Fanny pack, or what?

Shay: You just wear loose clothing. You could tuck them into things. I had a little lanyard I'd attach them to sometimes. When you're wearing drains, you're still wearing your compression garment, so they're attached to your compression garment. They make all kinds of garments that have pockets in them, so instead of your drains hanging from just your garment, you can actually like put them in a little pocket.

Ashley: For your breasts ?

Shay: This is when I had just a tinge of the breast cancer .

Ashley: Some mild breast cancer issues. 

Katie: Exactly. That's how she told us, you're like, oh, Hey guys, can't come this weekend, got a tinge to breast cancer.

Shay: But I had stage zero. So I thought, oh, this isn't a big deal. 

Katie: I didn't know that was a thing.

Shay: It is. So if it doesn't leave your ducts, it's stage zero. 

Katie: That's amazing. 

Shay: But the treatments are still either mastectomy or lumpectomy. 

Ashley: But lumpectomy with XRT potentially. Radiation. 

Shay: Yes. 

Ashley: In the ideal world, you don't get large doses of radiation to your body.

Katie: Of course.

Shay: Long story short, I called Ashley immediately. I explained my diagnosis, asked her what she would do. She explained all my options. She didn't try to convince me to do anything. 

Katie: Right. It's a good thing you have a sister that...

Shay: I know. I don't know what you would do. Like, you can call me guys. I'll explain it to you. But a double mastectomy, obviously it's different than other cosmetic surgeries, but there are a lot of the same things you experience like the drains. So I had four drains for that.

Ashley: But a breast aug is of course zero drains, and of breast lift is zero drains. 

Katie: Okay. So only because you had the mastectomy, are you having drains? 

Shay: Yes. A breast reconstruction, which I assume is not totally comparable to a breast aug, but there are a lot of similarities.

Ashley: Yeah. Pain- wise, I would say. 

Shay: So after you recover from the mastectomy, you get a breast reconstruction, and I had a prepectoral breast implant, which means over the muscle and I had an inframammary incision, which means underneath the breast .

Katie: Uhhuh .

Ashley: In the crease. 

Shay: Yeah. In the crease. So you can't really see it. And I have breast implants now. They're quite large. 

Katie: They look good though? 

Shay: They're pretty comparable to what my breasts were before.

Ashley: I think so. 

Shay: But I had some fat transfer with that, had some abdominal sculpting, which I heard you guys talk about.

Katie: Yes. Let's talk about that. When did you do that? 

Shay: As they do the reconstruction, because I knew... I'm just so thin guys. So like, where are we gonna take this fat from? I'm really not that thin. 

Katie: Oh, that guy. 

Shay: So he took the fat from my abdominal wall and put it in the top of my breasts.

Katie: In your boobs.. 

Shay: Yeah. To hide ...

Ashley: that transitional change between no implant and implant. 

Katie: To give it a more natural look. 

Shay: Well, yeah, I imagine otherwise it would be like putting two balls...

Ashley: Some people really like that.

Katie: I would prefer a more natural look. I mean, aren't there different kinds of breast implants?

Ashley: Yes, we should do a whole nother podcast on breast augmentation.

Katie: All the things. 

Ashley: It's a very popular surgery. 

Katie: Yes. 

Ashley: You know, what was the most popular surgery in 2020? It was rhinoplasty. 

Katie: Oh really?

Ashley: I know. 

Katie: Interesting. 

Ashley: I wonder if it was because of COVID. Everyone had a mask over the face, and no one could tell they were recovering from rhinoplasty. And also all the zoom meetings. Everyone's getting that immediate feedback like my nose is so crooked and terrible. Both of those things in combination. 

Shay: What was it before that ? Breast augs? 

Ashley: Liposuction / breast augs. 

Shay: Well, liposuction almost seems like a non-surgery to me. It's not a big deal. If your thighs touch, just get liposuction. It's not a big deal

Ashley: One thing we did not discuss about abdominoplasty is the ideal candidate. 

Katie: Okay. 

Ashley: So the ideal person is someone who's already at their ideal weight. Calculating BMI, which is something you could pull up on the internet, is your weight in kilograms divided by your height in meter squared.

Shay: I don't know my weight in kilograms and I don't know my height and meter squared. 

Ashley: That's why there's internet calculators. So if your BMI is less than 25, that's ideal. So 18 and a half to 25. 

Katie: Gotcha. 

Ashley: Anything 25 to 30 is overweight, 

Katie: Right. .

Ashley: Over 30 is obese. So being the ideal weight is going to give you the best results. So someone who is, let's say morbidly obese is not a great candidate for an abdominoplasty. 

Katie: Right.

Ashley: It's not like, Hey, you know what would be great to help you lose weight is an abdominoplasty. No, you can't come in 80, a hundred pounds overweight. and think all I needed is a tummy tuck and I'll look great. Not the case. 

Katie: Mm-hmm 

Ashley: That's a common misunderstanding. 

Shay: I had the abdominoplasty in September 2015, and my son was born in April, 2013, so I tried to work out a lot. I wanted to be as fit as I possibly could be going into it, because I think that that has to lead to a better result., Right?

Ashley: Mm-hmm . 

Katie: It's probably harder for you because you're her sister. She's probably like now you don't need it. 

Shay: That's not true. 

Ashley: I like to keep it real with everyone.

Shay: Yeah

Katie: you do. 

Shay: No, she did tell me. I said look at my stomach. I've been working out. 

Katie: You're like, what do I need to do? 

Shay: What do I need to do? That skin's not going away. You need to cut it off. 

Ashley: I didn't wanna give Shay false hope, right. That her skin was going to...

Katie: By the way, Shay, you look amazing.

Shay: I'm pretty happy. Like I said, one of the best things I've ever done, yeah, it feels good. Feels good to look good. 

Ashley: It's like the end of that movie with Eddie Murphy and Dan Akyroid where they're trading places... looking good Lewis looking good Lewis feeling great.

Katie: I have no idea what this movie is.

Ashley: You've never seen that movie?

Katie: No, God 

Ashley: classic .

Shay: Our parents let us watch that in 1985 and, Jamie Lee Curtis is just dancing around with her boobs out. I was five. 

Ashley: Our parents let us watch a lot of things. 

Shay: Yeah. 

Ashley: They're like, go away. If our parents listen to this podcast, maybe I should be concerned and hold back.

Shay: But do they?

Ashley: I'm quite certain they do not. 

Katie: They're like, what is Spotify? 

Shay: I saw them yesterday. I told them I was coming here to do this. 

Ashley: Yeah. 

Katie: Maybe they're gonna start listening.

Ashley: That's still not going to be enough of a catalyst to get them to listen. 

Shay: They'll never get around to it. 

Ashley: That does not speak well for our viewership. Even my own parents will not listen to this, but you, you viewers...

Katie: Our viewership is growing. And by the way..

Ashley: I guess you can't say viewers, if they're not viewing, right? Listeners. I said it wrong. Sorry. 

Shay: Hey listeners, text Katie. She'll send you all the pictures she's looking at. You know what, just DM me on Nipped and Toxxed on Instagram. And I will show you the pictures I'm talking about.

Ashley: For sure.

Katie: You wanna see what Kim Kardashian looks like pregnant? 

Ashley: All of her pictures are all over online. There's enough Kim K photos.

Katie: Exactly. Just Google. 

Shay: Yeah. 

Katie: So what other, what other surgeries have you had then? 

Shay: So I've had five surgeries, but not all plastic. So I had tonsillectomy. That was the most painful of all of my surgeries. Childbirth is probably more painful, but I had all of the anesthesia. What's your pain level? I'm like, it's an eight. I would say a liposuction was like a two or three out of 10.

Katie: Mm-hmm. 

Shay: Abdominoplasty was probably like maybe a five or six. So, I like to take the drugs after my surgeries.

Katie: Right. 

Shay: But, there's a whole pooping problem. I would like to take them for three days. And then you should really try to wean yourself off.

Katie: And get yourself on Tylenol?

Shay: Tylenol, ibuprofen.

Ashley: Ibuprofen has antiplatelet...

Shay: so you have to wait 

Ashley: effects 

Shay: until like 

Ashley: usually two weeks.

Shay: Two weeks, you can do Tylenol, ibuprofen. Oh, so wait, did we talk about what happens if your drains are removed too early?

Ashley: Seroma. We did not. 

Katie: What's a seroma? 

Ashley: That's when you have a collection of that yellowy fluid we were talking about earlier with regards to knee scrapes, that collects between your fascia and your abdominal flap. 

Katie: What do you do? Go drain it?

Shay: I live in the Chicago suburbs, and Ashley's here in Indianapolis /Carmel. So I drove down from Chicago because I was afraid I was getting a seroma and Ashley said there's basically nothing here, but I can try to...

Ashley: Aspirate

Shay: aspirate! Thank you. It was on the tip of my tongue. Aspirate. 

Ashley: You numb up the skin, you stick a needle in, see if you can suck out any fluid. 

Shay: I would encourage everyone, like I know they're uncomfortable, but just leave the drains in a couple of extra days. Again, I'm not a needle person; I did not like the attempt at the aspiration. So just to elaborate on how much I don't like needles, I don't like getting Botox, but I still do it because ...

Katie: I just shut my eyes. Just don't look.

Shay: I don't like the sound.

Katie: You can hear it? 

Ashley: Shay, as a frame of reference, doesn't like looking at her own tendons in her forearm, so ...

Shay: they're gross. 

Katie: Interesting.

Shay: I don't like needles. I don't like blood. I wish that I could get my Botox when I'm just unconscious. I wish I could. 

Katie: Who does that? 

Shay: Well, I have to have another procedure. 

Ashley: It's hard to justify. 

Shay: Yeah.

Ashley: It's hard to justify. 

Katie: Well, let me put you out for this. Do some laughing gas. 

Ashley: You could do pronox. 

Katie: Do you do laughing gas? 

Ashley: Yes. 

Katie: There you go. 

Ashley: Yeah, I do. 

Katie: That is great. I think that's a bonus. 

Ashley: Yeah, you could do ProNox for Botox, but it's not without cost.

Shay: I've done laughing gas with Ashley. I did the Immortal facial. That's real fun for about five minutes.. 

Katie: Can you drive after that. Yeah, yeah. Wears off. Okay. 

Ashley: Yeah. 20 minutes after you're done.

Katie: That sounds like a lot of fun.

Shay: Hey, it was pretty hilarious. Everything Ashley was doing. And I'm like, I don't know if this is gonna work, but it's hilarious, right? 

Ashley: I think everyone's voice sounds very distorted.

Katie: On laughing gas? 

Ashley: Mm-hmm. Yeah. 

Katie: It's been a long time since I've had that, like wisdom teeth.

Shay: Yeah. Well, I like, I like anesthesia. I think that there's something really interesting about waking up. 

Katie: See in my family, we have a allergy to succinyl choline. It's a anesthesia. So my aunt always tells us, you have to tell them we have this in our family, but I've never had the tissue sample to know whether or not I have it. I just know that it happens.

Ashley: But what happens to everyone else?

Katie: It was trouble waking up out of anesthesia. 

Shay: Oh, I have the opposite.

Katie: Oh, you wake up too soon? 

Shay: No, I just wake up very quickly. I think I metabolize drugs quickly. 

Katie: Oh, okay. 

Ashley: That's what happens when you use lots of drugs, develop tolerances and your metabolism increases.

Katie: You have recreational anesthesia?

Shay: I don't use recreational drugs. 

Ashley: Same

Shay: not anymore Addy. I don't use recreational drugs. That's bad. 

Katie: Yes. What's your other child's name? Just in case .

Shay: James. James. Don't do it.

Ashley: James is not listening. 

Katie: He will someday. This is the internet; things live forever.

Shay: Yeah, maybe someday. So, I have a few tips.

Katie: Yeah. 

Shay: Figure out your garments in advance. Your surgeon can give you one, but get them on Amazon. 

Ashley: Oh, I will get my patient the first set of garments. I fit you into garments.

Shay: When I had my...

Ashley: mastectomy.

Shay: They give me nothing

Ashley: fine, your surgeon's a derelict, but everyone else will give you an initial garment.

Shay: They'll give you a shitty binder. Everyone else... I had two friends get abdominoplasties recently. They both got shitty binders. 

Katie: So what do they provide at Robey Plastic Surgery? 

Ashley: A personalized abdominal garment that provides you the ideal level of compression in your postoperative recovery. 

Shay: When I had my mastectomy reconstruction, I thought they were going to give me a garment. I woke up, I had nothing.

Ashley: Not at bra, even?

Katie: Literally, you're just hanging out there. 

Ashley: That's weird. 

Katie: Were you taped?

Shay: You know what, they did give me a crappy bra after the mastectomy. 

Ashley: There you go crappy bra. That sounds plausible. 

Shay: And then an abdominal binder. 

Ashley: That's not terrible. 

Shay: I was not impressed. But, I didn't wake up with it on. They're like, here you go. 

Ashley: Oh, that's weird. 

Shay: I thought it was weird too. So I would say, figure out your garments in advance. 

Ashley: I don't think that the average plastic surgery patient needs to figure out their garments in advance. Sure. Ask your plastic surgeon. Am I going to wake up with a garment? If the answer is no, you can say, why? Do you want me to wear a garment? If they say no? Well, that's another, that's another story. But if they want you to wear a garment, since you're unconscious, I think you should wake up with a garment on.

Shay: Well, even with one or two, I sweat when I sleep, so my husband could always be washing those and delivering to me. He's the best. 

Katie: Right. 

Shay: The one that you gave me was the most comfortable, but I'd never liked not wearing something. So while that one was being washed, It's nice to have some backups.

Ashley: Yes. Logistically having one garment that you're supposed to wear 24/ 7. I mean, think about what else in your life do you wear 24 /7? Nothing. 

Shay: Nothing. 

Ashley: So logistically that would be very challenging. I don't think anyone's gonna freak out if you take it off for two hours. But having another garment, just as a backup... 

Shay: oh, something else I learned is as I was recovering from my last surgery is I was wearing a binder over another garment because I thought that my results would be more optimal the tighter it was .

Ashley: Sounds terrible.

Shay: But Ashley told me that's terrible and not true. It was terrible. 

Ashley: You just want some compression. I have a lot of patients that will get abdominal boards. They read it online or they see it on Instagram? It's just something that you insert between your skin and your compression garment to provide extra compression. There's minimal evidence on garments in and of themselves, and certainly no evidence on boards. And actually, in my experience, I have found that the boards actually create more problems. The boards will create areas centrally that have extra compressions. You have a board running along your midline around your rectus abdominis muscles, but off to the side there's that transition space where you have an overly compressed area next to an underly compressed area. And, it makes people more prone to form seromas in those spaces off on the side.

Shay: Oh yeah.

Ashley: So, I don't really like them. And some people will occasionally just start wearing them on their own. And over the years, I've had a couple of patients after liposuction that have had seromas. And most of them are doing something weird like that... like using the board. There are the occasional patients that just happen to get one out of bad luck. And sometimes it's their immune system, but having a seroma after liposuction is very uncommon. Having it after a tummy tuck is not as uncommon, but either way.

Shay: I think everyone just wants their results to be the best they can be. I liked wearing my compression garments, but the super tight ones with another compression garment on top is probably too much.

Katie: See right now. How do you go to the bathroom?

Shay: So actually the first one I had my abdominoplasty, I had one with a P-hole on it. 

Ashley: Oh, open crotch. 

Shay: Yes. I call it P-hole.

Katie: I mean, obviously gotta get up and go to the bathroom.

Shay: It's just the first two days. Beyond that, you're quite capable. I have also had friends that got the toilet seats that helped them up, or they got a cane because they thought they were going to be impaired.

Katie: Extending toilet seat.

Shay: Or maybe it is just a raised toilet seat. I don't know. Look it's a recovery, but it's not that bad. I will say recovery from my breast implants that I did like to be elevated. So, if you have a reclining chair, that's very comfortable sit in. I actually have one of those old people beds that elevates. That was really nice. 

Katie: You just have that anyways?

Shay: When I bought my bed, they're like, you can get this free thing. So why not? 

Katie: You're like, yeah., I wanna sit up and read. Might as well. 

Shay: Yeah. We never use it, but I did use it a lot when I was recovering from surgery. 

Ashley: So a lot of people think they need to walk in a stooped fashion. And I have patients sometimes buying things like walkers, like you were saying, to try to maintain that. Yeah. Maintain that position. 

Katie: Why would you wanna maintain that position? 

Ashley: I don't know. You're concerned. You're anxious. That's fine. So it's fine if you wanna do that for a few days, but doing it long term is not going to feel good. And, yeah, it's going to hurt your back. 

Shay: I was gonna say, I don't remember ever having problems walking upright. 

Ashley: You shouldn't have problems walking upright. It's just that it's going to be tight. And I think you're going to feel, oh, maybe it's a little more comfortable hunching over. That's fine. Do that for a few days, but I will assure patients, at the end of the surgery, they are laying totally flat. Everything is intact and closed with them laying flat. So it's not that they can't stand up straight, they may just have a little bit of tightness and discomfort with standing. 

Katie: Right. 

Ashley: But to maintain that hunched over a position long term, not optimal. 

Shay: When I had the breast reconstruction, I did like being a little bit elevated. I don't know if your breast aug patients say the same thing. It's just, I don't know.

Ashley: I think it's a swelling/ gravity thing. Goes back to physics, which I love. 

Shay: Gravity.

Katie: Do you?

Ashley: I do like physics It's so interesting. 

Shay: I had another recommendation though. Another recommendation is ...

Ashley: another recommendation by a real patient now 

Shay: ...was so for my breast reconstruction and my mastectomy, they just recommended colace and you said.

Ashley: Yeah, I like colace. So colace is a stool softener mm-hmm . So it's going to make all of the stool in your large intestine, more water-loving. So it's going to be more plump, not dried out, but the peri part has the Senna. Senna is a laxative. So, it will actually get the things moving. 

Shay: Yeah. So you don't wanna just soften it up. You wanna get it out of your body. 

Ashley: You don't want a colon full of soft poop.

Shay: But that's important. 

Ashley: You want things moving, moving.

Katie: Now, why is this a problem?

Shay: I'm so glad I'm on a podcast talking about my bowel movements. It's a big deal. 

Ashley: Everyone knows that narcotics classically hydrocodone, oxycodone are constipating.

Katie: Is this what happened to Elvis?

Ashley: I have no idea. 

Shay: maybe. 

Katie: he died on the toilet. 

Ashley: And the strain of pushing a hard ...

Katie: That's exactly what happened. 

Ashley: ...BM- bowel movement- did him over. 

Shay: Well, long story short, they just gave me Colace and Ashley said, they didn't even give you any Senna? You need that, too. Yeah. Which you can buy over the counter Walgreens. So if you're taking narcotics, it's a big deal to be backed up after surgery for days. 

Ashley: That's the thing - the pain associated with constipation does not get better with more pain medications. Obviously, it gets worse. 

Shay: Yes.

Ashley: And if you haven't had a bowel movement for a few days and normally you're an everyday kind of person, then that's the source of your cramping, abdominal pain. Not specifically the surgery. 

Katie: I gotcha. 

Ashley: Yeah. 

Shay: I'm a big believer in taking look, if you need to be medicated, take those pain killers. They're good, but I think people probably take them for, look, I did it- for one of these many surgeries I've had. I did it for too long. Try to wean off them after a couple of days. 

Katie: So like after childbirth, how, you know...

Shay: it's very comparable.

Katie: Medicine and, but you know how your first bowel movement is like the worst?

Ashley: Elephantiasis of the perineum is how I would describe it. You had a C-section or three?

Katie: No, I natural giant children. Yeah. 

Shay: But you, you had epidurals, right?

Ashley: I did. 

Shay: Yeah. 

Ashley: Yeah, but your perineum, that's not, again, back to the peroneum.

Katie: Yes, everything circles back to the perineum. 

Ashley: Very swollen. 

Shay: So it's the peroneum.

Ashley: The perineum is the space between your vagina or penis and the anus. A lot of people like to use that term to describe that whole area.

Katie: Exactly. 

Yeah. So, but is it like that after childbirth? After you have your surgery, you're having your painkillers...

Shay: I think it's probably comparable. Like if you've had any procedure or birthing a giant child, like, if you're taking painkillers you probably want to make sure that you are taking a stool softener and a mild laxative. But my other surgeon did not... 

Katie: advise you of that. And, and 

Shay: he was, he was great. He was lovely. But had I been able to choose Ashley to do this, I would've.

Ashley: No, I think he did a good job. 

Shay: He did a pretty good job. 

Ashley: I was trying to provide him gender anonymity, but you've pointed him out. 

Shay: He was pretty handsome too. I kept telling Jim that he was a kind of handsome guy. Sure. You're the husband loved that. And then he was just like all up in everything.

Yeah. 

Yeah, 

Katie: I'm sure it is refreshing 

he was like, I don't think Jim 

liked that. No, I'm talking about your surgeon ones. Probably like, oh, she's really cute.

Shay: don't, you know, well, I do think that the majority, yeah, I, I probably was like, Hey, Hey, if you get your first mammogram and your first mammogram, you get cancer, like I got to you on the younger scale.

Katie: It's better to catch it early because well, the more progressive it is at a younger age. So, you know 

Ashley: how many years of oral estrogens did you...

Shay: I do think we're seeing a much greater incidence of people with breast cancer our age. So I'm now 42. I started taking oral estrogen birth control pills. I started taking when I was 17. 

Ashley: Yeah. So for how many years did think ?

Shay: 17 to age 30. So 13 years. 

Ashley: Yeah. 

Shay: And then after that I got IUDs.

Ashley: Which contained...

Shay: estrogen, but it's minimal, yes?

Katie: Aren't there some that are hormone free ?

Ashley: There's para guard... has copper. 

Katie: Gotcha. 

Ashley: But it's interesting and by interesting, I mean, I guess kind of sad that I'm not sure that's something that's really discussed with someone that's considering oral birth control pills as a means of contraceptive.

Shay: But what's a good alternative. Like what? 

Ashley: I'm not sure.

Katie: But your Catholic, Shay. 

Ashley: Like a patch or something ..

Shay: I'm not Catholic. My kids

Katie: Addie, abstinence- 

Ashley: That's the best way. But it's a well known fact that oral estrogens increase your risk of breast cancer. And so I think, unfortunately...

Katie: For a doctor, but I don't think that's well known for. 

Shay: Yeah, I didn't know that 

Ashley: Unfortunately, that is a fact, whether or not it's well known. And so for all of our listeners out there, for all the people that have been on birth control pills, it's something to consider. 

Shay: You're screwed. No, just kidding. Get your mammograms. Yeah. 

Ashley: With mammograms, you can potentially catch it early. 

Shay: I said to my primary care physician, I'm 40. Shouldn't I be getting a mammogram? And she said, do you want one? I said, well, will my insurance cover it? And if the answer was, no, I probably wouldn't have gotten it because I was so young, so young. But she said, yeah, we could do it .

Katie: You know, I went to my gynecologist and I asked about a mammogram because of you actually.

Shay: Yeah. You're welcome. 

Katie: And thank you and actually I said, is it bad for me to get a mammogram at this age? And she said, no. And I said, well, I thought it was discouraged. I thought you were supposed to wait. And she said, no, you live in an area where it's prevalent that you can get, you know, a mammogram it's really more about where they discourage you is where they don't have the resources. This is what my gynecologist told me. She's there's no risk to you. Just go ahead and get it. 

Shay: What risk would there be with a mammogram?

Ashley: Minimal radiation. 

Shay: Yeah. 

Ashley: and expense. 

Katie: But I would pay the out of pocket just for the peace of mind. Having had a friend that just had breast cancer 

Shay: pay, especially, if you've been taking birth control since your twenties, teens, whenever. Get your mammogram.

Katie: So I actually just had a her scan, and It's ultrasound ...

Ashley: of your uterus and ovaries?

Katie: No, it was of my breasts. And they said maybe, I don't know if their pamphlet is correct, but they said it was more, it catches more cancer for people with dense breasts.

Shay: So are you saying it better identifies potential risks than a mammogram?

Katie: They said that people with dense breasts on a mammogram, a tumor can look the same as dense breasts.

Shay: I will say that my diagnosis was one centimeter because I had dense breasts. Right. And when they did the pathology after the surgery, it was five centimeters. 

Katie: Wow. 

Ashley: That's big. 

Shay: Yeah. It's pretty big. But, it was all in the duct.

Katie: I'm glad they removed it. So now that you've had your mastectomy, your chances are zero, right? 

Shay: No, not zero.

Ashley: No

Shay: minimal.

Ashley: Minimal. 

Katie: I have a breast implant reconstruction. And I go in every six months, I actually was a little bit freaked out by these things. I visited Ashley and I had her feel them. I said, feel this and you said it feels like necrotic fat. 

Ashley: Oh yeah. You had a fat transfer. 

Shay: So I had a fat transfer to smooth that transition between the implant and my chest wall. I assume this happens with all fat transfers, like some of the fat dies. Right. And so I have these little nodules of dead fat. 

Ashley: No did your surgeon do expansion vibration lipofilling? 

Shay: No.

Katie: Is that what you should do? 

Shay: Can you fix it? Can you get rid of those? 

Ashley: You already sucked out the nodules, right?

Shay: No, they're they're in there. 

Ashley: Oh, did he attempt to aspirate them? 

Shay: Hey, this is insurance covered cancer care. He was great, but like I'm done. He's done with me. 

Ashley: Oh.

Shay: So 

Ashley: sure. I'll do it. 

Shay: Sweet. What would else would you like to talk about about abdominoplasty? It takes a year before my scars looked normal, and they still are visible. For the most part, my scars look like white lines. Obviously I wear bikinis all the time. People can regularly see the scar. So I have a scar around my belly button and also, Ashley, what do you call that vertical scar?

Ashley: Oh, your retained umbilical scar. 

Katie: I never noticed that.

Shay: Back to my t-shirt analogy, they cut a hole around where my belly button was and then pulled the shirt down. But, it couldn't be pulled far enough down- it was still above my bikini line, so Ashley vertically sutured that line. 

Katie: Right. 

Shay: So I have a small vertical scar that...

Katie: I never noticed that. 

Shay: Yeah, most people don't, they're very non noticeable. I will say the horizontal line that's the biggest surgical line, underneath my bikini line of my underwear, that's hidden, but that scar is it's worse than those other two scars. But that just has to be a result of tension. Right?

Ashley: I think primarily that's the main contributing vector, yes. 

Shay: Right. So you're pulling the top skin down to the lower skin.

Ashley: The highest tension is the midline, for sure.

Shay: on the sides, it's not that bad. I regularly wear bathing suits that you can see it in my upper thighs.

Katie: I have to say though, I've seen you in a bikini. I've never noticed. 

Ashley: You can see your incision in your bathing suits? You want me to adjust it? Lower it? 

Shay: Should probably adjust it. Let's just tighten it up again, surgery, number six, 

Ashley: whatever.

Katie: So Shay is a lighter Fitzpatrick skin tone. What about somebody who's like a darker Fitzpatrick skin tone?

Shay: What's Fitzpatrick?

Katie: It's there's a Fitzpatrick scale. 

Ashley: So one is an Irish, pale skin lady, and six is dark skinned, lots of melanin. 

Shay: So, one to six?

Ashley: So two is classically like the average caucasian. 

Shay: Am I a one or two? 

Ashley: Two.

Katie: Yeah, you're on the lighter side. 

Ashley: you're a light two.

Katie: How does it adjust per the scars? Do you see difference in scars the way they heal?

Ashley: I don't think those scales are absolutely correlated, but having more melanin could increase your risk of having a more hyperpigmented scar. Meaning darker .

Katie: Right, right.

Ashley: Mm-hmm.

Katie: Just wondering. 

Ashley: Yeah, sure.

Shay: that's interesting because I would've thought the opposite. I would think Katie would scar less than me and you're saying the opposite because she's more olive toned than I am. 

Katie: No, but more pigmented.

Shay: More pigmented.

Katie: And there's also risk of keloids in all, you know, so what happens with somebody with keloids? 

Ashley: So there is a difference between keloid scars and hypertrophic scars which escapes the average person. 

Shay: So keloid is a raised ...

Katie: mm-hmm 

Ashley: no, keloid scars are scars that extend well beyond the borders of the natural scar. A hypertrophic scar is a scar that made that existing scar wider and raised- both of those things. So most people that think they have keloids actually just have hypertrophic scars, but obviously, there are some people that have true keyloids, meaning they are extending well beyond the boundaries of the scar that was created initially, or that happened initially.

Katie: So if someone says, Hey, I'm at risk for these things, are you saying you're not a good candidate? 

Ashley: Well, I'm not saying that they're not a good candidate, but it certainly involves some additional counseling about the pros and cons. So that person would have some additional cons, meaning they are at higher risk for having thicker, wider, more raised scars. 

Shay: So my scars only show because I like to wear like, kind of tiny bikinis. 

Katie: Right.

Shay: You still can't really see them. If you're never wearing bikinis, like then it's not a problem.

Ashley: Sure. Who does that? 

Shay: Who never wears bikinis? 

Ashley: It's so hot outside -like hundred degrees. 

Katie: I don't know, whatever people's comfort level is. 

Shay: Yeah. Whatever your comfort level is. I didn't like to wear bikinis post children before I had my abdominoplasty. I had all this saggy skin made me uncomfortable.

Katie: Mm-hmm 

Ashley: yeah. 

Katie: So how do you feel now, now that you've had all your things? I mean, I know you have a high confidence level. 

Shay: I don't regret any of the things that I've done. Liposuction - it's a no brainer. Again, to Ashley's point, it's only gonna make a difference in terms of it's not gonna help you with weight loss. But, I had that little part of my thighs that were touching...

Katie: a little bit stubborn that you wanted to....

Shay: oh, and it was great, just to have my thighs not touch anymore. 

Katie: Right. 

Shay: And the abdominalplasty was just the best. My stomach is pretty flat and that abdominal repair that I had done looked like I had been working out a ton. 

Katie: Right. 

Shay: Which I actually in fairness had been, but it was never gonna give you that results ...

Katie: show until the diastasis was prepared. 

Shay: Yeah. I recommend all of the things. My breast implants are not your typical breast implants.

Katie: Mm-hmm 

Shay: I had actually a pretty great chest before, so...

Katie: right. 

Shay: I can't make a recommendation on that. I don't love it, but would I have done the exact same thing? Yes.

Katie: Right. I mean, you had breast cancer.

Shay: But yeah, there's a big difference between breast reconstruction and breast augmentation, because I don't have any fat except for the minimal fat they transferred on top of my breast.

Katie: Right.

Shay: I've seen friends' breasts who had breast augs, and they look great. Mine don't look as great, but I mean, Jim likes them.

Ashley: But you're also cancer free and that's the main,..

Katie: Exactly 

Ashley: endpoint. 

Shay: Oh yeah. I guess.

Katie: I do have to say actually the other day, I don't know if I told you this Ashley, but I was doing someone's eyebrows in the, I was just talking about, our podcast and she goes, dr. Ashley Robey, she did my tummy tuck, my breast lift, a BBL. And I was like, show me all your stuff. And she showed me everything. She looked amazing. I was like, you didn't know that I did this podcast before you came in here for your eyebrows? She was like, no, I know, but it was just a coincidence and it was great.

Shay: I feel like you need to wrap it up .

Katie: That's why I was getting to the, uh, you know, are you glad you had it done? 

Shay: Yeah. Um...

Katie: Because that was a good wrap up. 

Shay: I'm happy with everything. 

Katie: Is there anything else you would do? 

Shay: Yeah, of course. I'm gonna do stuff until...

Katie: until you die?

Shay: Never stop. Never stopping. look, I don't wanna be somebody that looks like they've had a ton of plastic surgery, but I could already see that at some point... so I have to get my implants in replaced in 15 years. I'm automatically going under for that. 

Katie: Right. 

Shay: Uh, we gotta probably get my neck done. I don't know. Uh, if I'll get some kind of like lift anywhere else...

Katie: in 15 years? Yeah, 15 years I'm won it. 

Shay: Then I'll be in my upper fifties. I'm probably old are kids.

They might be like about the verge to get married. You're gonna win a little facelift 

Ashley: thing going down. Think about how your parents look and then extrapolate from there.

Katie: That's a good way to tell. 

Ashley: Sometimes, well times, 

Katie: well, 

Shay: I think my parents look great. They're the best.

Ashley: I agree. Good point.

Shay: But, I definitely do more preventative care just in terms of exercise and facial maintenance in terms of Botox obviously... 

Katie: ...immortal, facial fillers, the Immortal facial, medical grade skin care, TNS

Shay: I haven't had fillers yet, but I would .

Katie: You haven't had fillers?

Shay: No, I feel I, they still

Katie: I'm shocked, you look amazing.

Shay: Oh, thanks. 

Katie: You look like you look plump and nice. 

Shay: Mm, nice and plump. 

Katie: Well, your skin looks amazing. 

Shay: Well, I've had been doing Botox for a long time and I did have the Immortal facial. I did. IPL which, um, that's the laser.

Ashley: Yeah. Intense pulsed light. 

Shay: Mm-hmm intense pulse, light.

Ashley: Um, not a laser.

Shay: It's not a laser. It's a bright light. That right. Is applied to your face. And the only shocking thing about it is you can, with your eyes closed and your eyes covered, the light comes in underneath your skin. And it's so bright. 

Katie: Mm-hmm 

Shay: but your eyes aren't open. That's distracting. 

Katie: I think I've had that done.

Shay: Yeah. That's to remove pigment, right? Ashley? 

Ashley: Correct. The only reason why it's not a laser is because it's multiple wavelengths. So classically a laser is a single wavelength. 

Katie: Okay. 

Shay: But that's, that's not painful. It's just very, very bright. 

Katie: Right? So normally they put goggles on you. 

Shay: No, she does. That's what I'm saying is even with the goggles on, so it's like a tanning bed type Goggle...

Katie: right, right.

Shay: The light comes in from, through your skin and up through, so...

Katie: I always shut my eyes. 

Shay: Katie. I know!

Katie: Maybe I haven't had it that intense.

Shay: It's intense. I feel like you guys next podcast goal. ..Maybe you can get through it without talking about the Kardashians.

Katie: no, this is the funny part. I add the funny.

Ashley: I .Blame Katie. 

Katie: She's the smart person and I'm the layman. I'm just talking about I'm all the normal people out there Googling shit. And I wanna know...

Shay: we're real people, Ashley

Katie: what is real. What is not real. 

Shay: Let's let's sum this up. 

Ashley: Abdominoplasties are a great way to get rid of not only excess skin, but treat some of the excess fat in that love handle or flank area. And especially for a lot of women, it will treat the separation of the rectus abdominis muscles or rectus diastasis. That being said, I don't only do it for women. I also do abdominoplasties for men.

Shay: Nice.

Katie: Thanks for joining us, Shay. 

Ashley: Yeah, that was fun. 

Katie: Do you have anything else to add? You love plastic surgery? 

Shay: Uh, only when Dr. Robey does it. I regret nothing. I will continue to...

Katie: You look amazing.

Shay: Maintain and have surgeries to maintain this banging bod - Body by Robey. 

Katie: That should be a hashtag. 

Shay: Wasn't that a workout, some workout guy? Wasn't like body by Blaine or something.

Ashley: probably 

Shay: circa 19. So what, no one remembers bring it back. Like stranger things, everything retro is cool again. Bring it back -Body by Robey.

Katie: Sounds good. 

Shay: I appreciate you having me. It's been great. 

Katie: You should join us again. 

Shay: Maybe after my next surgery- my next procedure. Maybe I want to do a live surgery. I feel like I could really do another Immortal facial live. 

Ashley: That's easy. 

Shay: Now I'm gonna live forever. Thanks to Dr. Ashley Robey and coming up on a future episode... how to live forever.

Ashley: Episode five: live forever or die trying. A brief overview of anti-aging medicine, but today we're talking here with Shay Dunne about her abdominoplasty and various other plastic surgery experiences, and we thank you all for joining. 

Katie: Thanks, everybody. 

Ashley: Yeah. 

Shay: Thank you. It's been a pleasure. 

Ashley: If you've got loose skin and muscle separation:. Tummy tuck. That's the way to go. 

Katie: She's got you. 

Ashley: Yeah, we've got your back. All right, everyone. Bye.