Nipped and Toxxed

Dr. Ashley Robey, quadruple board certified plastic surgeon, delves into surgical procedures for arm contouring. Dr. Robey discusses various options for improving arm contours, especially for those who are unhappy with the appearance of their arms due to loose skin or disproportionately large arms. She describes traditional brachioplasty, liposuction, the minimally invasive Body Tite treatment using radio frequency energy, and limited brachioplasty incisions. Dr. Robey also reviews some other techniques and tools that surgeons utilize in the arm contouring world, such as laser liposuction, JPlasma and Cool Sculpting. Dr. Robey emphasizes that brachioplasty, typically an outpatient procedure lasting two to three hours, has a high satisfaction rate but carries theoretical post-operative challenges such as scarring and swelling. She also provides an overview of the costs involved and indicates that such procedures can be life-changing for the right candidates.

In this episode of 'Nipped and Toxxed,' Dr. Ashley Robey and Dr. Kelly Killeen discuss unusual and unique requests they receive as plastic surgeons. They delve into procedures not typically within the plastic surgery domain, such as limb lengthening and extreme waist training. They also highlight specific patient requests like body modifications to mimic celebrities or characters, colored iris implants, and dimpleplasty. The conversation further explores minimally invasive treatments for knee laxity, unusual facial procedures, and surgeries reflecting gender identity transitions. Both doctors share insights into the challenges of balancing patient expectations and ensuring safe, realistic outcomes.

In this episode of Nipped & Toxxed, Dr. Ashley Robey and Dr. Christopher Zarella discuss rhinoplasties. They explain the differences between aesthetic and functional rhinoplasties, emphasizing the importance of a balanced approach to achieve both cosmetic and functional improvements. They delve into the complexities of the procedure, including the meticulous planning it requires and the common challenges faced. The doctors also address misconceptions about the surgery, touch on minimally invasive liquid rhinoplasties, and underscore the importance of setting realistic patient expectations. Dr. Robey & Dr. Zarella advise prospective patients to consult with board-certified surgeons who specialize in rhinoplasty for optimal results.

Dr. Ashley Robey and Dr. Kelly Killeen discuss surgery for gynecomastia, or feminized male chests. When does it present, what are predisposing factors, what is the work up, and what are the surgical techniques that are utilized. All the questions and more are answered during this episode of Nipped and Toxxed.

Exploring the intricacies of handling challenging patients in surgical realms, Dr. Ashley Robey & Dr. Kelly Killeen delve into categorizing difficult patient types based on behaviors. Topics include managing deceitfulness, mental health issues, non-compliance, and setting realistic expectations for improved outcomes and professional relationships across plastic surgery and other medical scenarios.

Dr. Ashley Robey & Dr. Kelly Killeen discuss their recommendations for skin care. What are the essential products types? What specific products should you seek out? 1:40 Start with a good cleansing regimen 2:46 Nighttime double cleanse 7:08 Moisturizers 7:30 Spend a little extra on your hyaluronic acid product 11:50 Peptide based rejuvenating products 15:29 Instant topical wrinkle removers don’t work 16:56 Exosomes in skin care 18:55 Hyperpigmentation and dark spot treatments: hydroquinone, tranexamic acids, kojic acid, niacin amide 24:14 Sunscreen 29:37 Antioxidants, vitamin C 30:43 Retinoids: retinols, Retin-A, tretinoin, isotretinoin, adapalene, tazorac 36:39 Eye creams 39:00 Popular Rx-strength skin care lines 41:08 Some price favorable alternatives 46:05 Acne options

Dr. Ashley Robey and Dr. Kelly Killeen tackle the challenges associated with the lack of regulations in the aesthetic and plastic surgery industry. 00:17 More demand for procedures leads to more supply of people performing them 01:50 Medical supervisor at most spas is usually not an expert nor is he/she on site 02:30 Inexperienced providers and bad outcomes: HIV transmission in Albuquerque medspa 7:00 Mixed experience levels of injectors 8:46 Unqualified medical providers doing medical procedures: 2 NPs in Indiana performing liposuction 9:47 PA in Vegas liposuctions independently 12:35 Bad Surgery Plan: 1)phone call with sales person 2) book surgery 3) make travel reservations 13:30 Lipo Chop Shops 19:37 Non plastic surgeons performing plastic surgery 24:17 Board Certified "Cosmetic" Surgeons do not have the same level of training of actual board certified Plastic Surgeons 32:22 Check certificationmatters.org 33:39 Med spa providers resorting to FB to help with medical disasters 35:14 Unregulated products: fillers, botulinum toxins, medications 40:56 Seeking providers that will treat patient as a whole and have the ability to say no 42:35 Some plastic surgeons bend the rules for celebrities and attention 47:22 A physician led team is important for patient safety & plastic surgeons are the expert physicians in the realm of aesthetics

Dr. Ashley Robey and Gavy Uppal, NP cover the latest and most popular peptide therapies that are utilized in anti-aging medicine. 1:04 What are peptides?!?! 4:22 Semaglutide - the uber-popular weight loss peptide 12:46 Mounjaro - newest weight loss peptide 14:57 How we determine what kind of body weight your losing 17:09 You are what you eat, so don't eat garbage 19:21 BPC-157 25:47 Growth hormone 27:36 CJC-1295 and Ipamorelin 29:04 Ghrelin and gremlins? 32:24 NAD+ 33:42 What Dr. Kelley said 36:03 Epitalin "fountain of youth" 39:21 Not a peptide, but we still love Morpheus 39:56 Melanotan II, the Barbie peptide 46:22 Skin care peptides 48:12 PTD-DBM - the hair peptide

Dr. Ashley Robey and Alisha Story, Aesthetician, review things that every prospective patient should consider before having a plastic surgery consultation. 01:30 Standard questions you should always ask/know about your surgeon 04:11 Who should come to the consult with you? 05:25 Can I show my surgeon some photos? 07:16 Social medial trends and plastic surgery 08:53 Lies of omission 10:09 Plastic surgery is not a weight loss procedure 11:02 Despite what the AMA says, BMI is a useful tool (it's not racist) 13:07 Smoking and diet 15:40 I'm okay if you meet with another plastic surgeon 20:22 Complete your online paperwork before your scheduled appointment time 22:30 Focus on your top few priorities 25:33 Bring a list of questions you have 28:00 Don't lie to your surgeon 29:42 Optimize health before surgery (e.g. Live Better MD) 31:29 Leave with a plan but also enjoy your time 34:16 Deal breakers in finding the right surgeon 38:01 Get recommendations from surgeon who can offer a full spectrum of services 39:30 Plan ahead & schedule accordingly 41:44 Summary of consult considerations

Dr. Ashley Robey & Dr. Kelly Killeen discuss the world of surgical tourism. 00:21 What is Surgical Tourism 01:48 Why people travel for surgery 02:38 It's always cost 04:08 Who will take care of your complications? 05:27 Life threatening complications 08:28 Shady medical tourism companies 10:01 Faux surgeries 11:07 Non-plastic surgeons doing plastic surgery 20:29 You get what you pay for 22:27 Surgical tourism within the United States 23:16 Safety concerns in surgical tourism 23:52 Anesthesia and in-office surgeries 26:18 Most horrific stories of surgical tourism 28:57 Consider surgeries at teaching hospitals in the US to save $ 33:04 Final words: buyer beware

Dr. Ashley Robey, quadruple board certified plastic surgeon, tackles the subject of breast implant illness with Dr. 90210's Dr. Kelly Killeen. 01:14 What is breast implant related illness? 05:38 Criteria and timing of BII 06:51 17-84% of BII patients improve with explantation 09:55 Chronic inflammation is an energy sink 11:05 Social media and BII 11:49 En bloc capsulectomy not a necessity in BII 14:19 Treatment should do more good than harm 16:07 En bloc capsulectomy vs. total intact capsulectomy vs. partial capsulectomy vs. capsulotomy vs. capsulorrhaphy 19:50 Patient demands for specific surgical treatment 24:04 Sending tissue off to certain labs? 26:30 Finding the right surgeon for your treatment 28:42 Better information, better decisions 29:21 Surgeons going rogue? 32:49 BII community "approved" surgeon lists - not on them. 36:38 Media coverage of BII 38:30 Silicone in lymph nodes 40:57 Who will get better with an explantation? 42:05 When to run for the hills

Quadruple board certified plastic surgeon, Dr. Ashley Robey, discusses the psychology of plastic surgery and the practice of mindfulness with author and psychologist, Dr. Alan Goodwin, PhD. 00:00 Dr. Goodwin's book, Saving Face Without Losing Your Mind 06:11 How do you employ mindfulness and meditation techniques? 11:00 Are patients receptive to a referral to a psychologist? 15:53 Meditation is not stopping; it is fully immersing yourself in your thoughts 21:40 Role of a therapist 23:42 People with depressive tendencies tend to devalue something once it is attached to themself 25:17 Body Dysmorphic Disorder exists but is rare 25:51 Cosmetic surgery to reach preference goals is common 28:18 Desperation for surgery is a red flag 31:16 Online support groups can be helpful 33:19 Who should seek therapy prior to plastic surgery? 37:48 Importance of communication in postoperative period 38:47 Don't personalize the struggles of others 42:53 Compassion is a tool associated with mindfulness 44:11 Cognitive Behavioral Therapy

Dr. Ashley Robey, quadruple board certified plastic surgeon, and 90210's plastic surgeon, Dr. Kelly Killeen, discuss plastic surgery for men. 00:59 Men as a % of Plastic Surgery Patients 02:24 Upper Blepharoplasties 03:20 Lower Blepharoplasties 05:18 Liposuction 07:27 High-Definition Abdominal "Muscle" Sculpting 11:23 Chin Augmentation: Filler, Fat, Implants 12:57 Submental contouring 13:46 Rhinoplasty 14:30 Avoiding murderous patients 16:47 Neck Rejuvenation 17:22 Skin care for men 18:36 FaceTite 19:49 Facelifts 20:34 Anterior neck lifts 22:06 Gynecomastia - feminine male breasts 25:55 Hair Rejuvenation 26:45 Abdominoplasties 27:37 Abdominoplasty Scar Length 28:15 Mons Ptosis & Hidden Penis Phenomenon 28:49 Genital Fat Transfer 30:34 Post-bariatric Contouring

Dr. Ashley Robey, quadruple board certified plastic surgeon, reviews breast lifts: 00:13 What is a mastopexy? 01:57 How much ptosis is ideal? 04:34 Categories of breast droop 05:15 Pseudoptosis 06:51 Minimally invasive breast lift using BodyTite 07:21 Crescentic lift 07:47 Circumareolar/ Periareolar Lift 11:33 Lollipop vs. Anchor Pattern Lift 12:56 Breast pedicle?? 15:08 Secondary pedicle or auto-augmentation 16:25 Spiral flap 16:41 Mastopexy vs. Reduction 17:55 Will scars go away? 21:19 Mastopexy risks 24:44 Tool for improving symmetry 27:20 GalaFLEX mesh in lifts 30:32 Avoid Snoopy deformity 31:37 Breast Lifts can be Aesthetically Helpful

Dr. Ashley Robey & Dr. Kelly Killeen discuss lasers in plastic surgery - what's new, what they like, what they have, and what they use. 0:40 What is a LASER? 00:51 LASER vs. LOSER 2:06 Ablative vs. Non-ablative Lasers 3:10 Fractionated vs. Non-fractionated Lasers 4:05 Intense Pulsed Light/ IPL 4:55 Pulse Dye Laser 5:30 Diode Hair Removal 7:44 Complications of Laser Treatments 10:02 Post-laser peel recommendations 12:30 Luxurious Mouse Hair & Red Light Therapy 16:04 Marky Mark Has All the Cool Stuff 16:20 Tattoo Removal 18:08 Fraxel & ResurFX 20:55 A Bit About Noninvasive Body Contouring: Evolve, Cool Sculpting & EmSculpt 24:40 InMode's Morpheus 28:59 Maintenance of Beauty 29:50 Candidates for Laser Resurfacing? 36:38 Watch out Botox - Daxxify is new Botulinum Toxin Coming Out 37:53 Alma Hybrid is new go-to for facial resurfacing

Dr. Ashley Robey, Katie Reichart & Dr. Chris Crawford discuss bariatric surgery & post-bariatric contouring. Check out the summary of episode content below: 1: 16 What BMI Should You Be for Bariatric Surgery? 3:11 Wiring the Mouth Shut 4:43 Orbera Intragastric Balloon 6:06 Weight Loss Medications 7:27 Weight's Set Point Theory 10:37 LiveBetter MD Anti-aging Medicine 12:38: Vertical Band Gastroplasty & Gastric Band 16:07 Sleeve Gastrectomy 17:27 Roux-en-Y and Duodenal Switch 18:36 Surgical Tourism in Bariatric Surgery 22:32 Panniculectomy 25:19 Predicting Excess Skin after Surgery 32:14 When to Do Post-Bariatric Contouring 37:32 Poor Scar Placement 39:04 Just Like a Video Game 40:44 Long Term Side Effects/ Complications 43:27 NO SMOKING 44:48 Weed, Alcohol, etc 47:16 Post-bariatric Transfer Addictions 49:03 Celebrity Bariatric Surgeries

Dr. Ashley Robey, quadruple board certified plastic surgeon, sits down to talk plastic surgery with Dr. Kelly Killeen of E's Dr. 90210. They address both myths and controversial topics in the field of plastic surgery Here is what they touch on: 0m: Intro 1m20s: Bigger Implants Instead of Lift 3m10s: Liposuction is Good for Weight Loss 5m00s: All People Claiming to Be Plastic Surgeons Are the Same 8m30s: Nipples are Cut off and Reattached During a Breast Lift 9m44s: A New Belly Button Can Be Selected During a Tummy Tuck 11m44s: Breast Implant Illness Debate 15m40s: Need for En Bloc Resections 20m45s: Explant Regrets 21m13s: ALCL - Anaplastic Large Cell Lymphoma 25m30s: Plastic Surgery Tourism 29m12s: Is It Fat Shaming if Your Plastic Surgeon Asks You to Lose Weight? 34m40s: Gender Affirming Surgery in Kids 41m47s: Brazilian Butts for Everyone? 45m10s: Standards of Beauty 46m15s: Not Down with That Commentary

Dr. Ashley Robey discusses anesthesia with board-certified anesthesiologist, Dr. Darin Dill. Learn more about anesthesia, how safe or risky it is, and what your best options are if you are considering plastic or other types of surgery. Summary of Podcast: 1m: types of anesthesia 5m: risks of anesthesia 9m: awareness under anesthesia? 10m: side effects of anesthesia 14m: how to reduces your risks of anesthetic complications 17m: is IV sedation safer than general anesthesia? 20m: CRNA vs. board certified anesthesiologist 25m: how long to recover from anesthesia? 29m: celebrity complications 35m: anxiety before surgery 36m: questions about anesthesia

Dr. Ashley Robey & Tara Covey, NP discuss benefits of being at one's ideal weight and strategies to help get there. 00min - Intro & Statistics 02min - Causes of Weight Gain 09min - Gut Microbiome 17min - Intestinal Lining 19min - Immune System 20min - Stress 24min- Identifying Causes of Weight Gain 27min - Dietary Recommendations 28min - Diet Medications 29min - Fasting 32min - Peptide Therapy 36min - BMI, Body Mass Index 38min - Fit 3D Body Scan 42min - Low Hanging Fruit 49min - Implementing a Healthy Lifestyle

Dr. Ashley Robey & Katie Reichart, CPCP, discuss breast augmentations, one of the most popular plastic surgeries. Brief summary of podcast: 0m Intro 3m Implant Types 5m Capsular Contracture 8m Sizing Implants 12m Breast Lifts 14m Under vs. Over the Muscle 16m Fat Transfer to Breasts 17m Anesthesia for Augmentations 19m Old Implants: Remove, Replace, etc. 20m Warranties 21m ALCL 22m Breast Implant Illness 24m Symmetry Concerns in Breast Augmentation 25m Types of Mastopexies 29m Internal Bra with Galaflex 30m Breast Feeding 34m Postoperative Recovery 37m Postoperative Medications