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#64 - Zol Kryger, M.D.: Navigating the sometimes shady world of plastic surgery—understanding potential complications of common procedures and how to reduce your risk by choosing the right doctor and asking the right questions

Jul 29, 2019 2h 13m 42 insights
<p>In this episode, board-certified plastic surgeon, Zol Kryger, enlightens us about the frighteningly loose laws regulating the industry of plastic surgery, paving the way for a majority of cosmetic procedures being performed by doctors that are not board-certified plastic surgeons. We talk about some of the very serious complications that can occur even in "minimally invasive" procedures, where the incidence rate is only increased by the flood of non-certified doctors who want to offer these procedures to augment their income. Fortunately, Zol provides listeners with a very specific list of important questions to ask a surgeon when considering any of the many cosmetic procedures available. We then go into the specifics of the most common procedures and the risk of complications for each of them, including breast augmentation, tummy tucks, liposuction, Brazilian butt lifts, botox and fillers, facial peels and lasers, and more. By the end of this episode, you'll have a really clear understanding of what these risks are and how you can go about reducing those risks by choosing the right physician.</p> <p><span style="color: #212121;">We discuss:</span><span style="color: #333333;"><br /> <br /></span></p> <ul> <li><span style="color: #212121;">Why Zol chose plastic surgery [7:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">The shockingly high percentage of plastic surgery being done by non-board certified doctors, and the laws that allow it to happen [11:20];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">10 Questions to Ask Your Cosmetic Surgeon (PDF Download) [21:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Complications: Why you must ask your doctor about potential complications and how they would deal with them [24:20];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Zol's first complication, how he dealt with it, and how having a partner to check your work is great for the doctor and patient [32:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Breast augmentation: What you need to know—types of implants, complication rates, and Zol's summary of the safest and most effective way to do it [39:10];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Breast reconstruction following a mastectomy [1:06:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Tummy tuck: How it's done, biggest risks involved, scarring, and how it can address hernias and diastasis [1:13:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Liposuction: How it works, the potential complications and risks involved, and the importance of choosing the right doctor in the "wild west" of liposuction [1:26:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Butt lifts: Rising popularity, major risks, the frighteningly loose laws regulating the industry, and how the butt lift industry is eerily similar to the subprime mortgage crisis [1:37:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">What is it about plastic surgery (and not other segments of medicine) that compels (and allows for) untrained doctors to offer these procedures? [1:49:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Peter asks Zol if he ever feels emotionally conflicted working in an industry that sometimes can feed off the vanity and insecurity of people [1:56:25];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Does Zol ever turn down patients? [2:02:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">The risks involved with botox, fillers, facial peels, and laser treatments [2:07:45]; and</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">More.</span><span style="color: #333333;"><br /></span></li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/zolkryger/">https://peterattiamd.com/zolkryger/</a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Facebook</u></a> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p>
Actionable Insights

1. Prioritize Hospital-Privileged Surgeons

Choose surgeons who have hospital privileges for the specific procedure you need, as hospitals rigorously vet doctors’ training, expertise, and malpractice history, ensuring a higher standard of safety.

2. Research Plastic Surgeons Thoroughly

Approach the selection of a plastic surgeon with the same rigor as choosing a surgeon for heart or brain surgery, conducting thorough research to ensure you find the right, qualified professional.

3. Patient Due Diligence Critical

Since regulatory environments often lack restrictions on who can perform procedures, patients must take responsibility for thorough research and due diligence to ensure their safety and desired outcomes.

4. Understand MD Practice Scope

Be aware that in the U.S., any physician with an MD can legally perform any procedure, highlighting the critical need for patients to verify a doctor’s specialized training and board certification for the specific procedure they seek.

5. Ask About Complication Plan

Ask the surgeon for their detailed plan if complications arise, specifically inquiring about their hospital privileges for the exact procedure you are undergoing to ensure proper care.

6. Inquire Complication Incidence/Management

Ask plastic surgeons about the specific incidence rate of complications for your procedure and their detailed plan for managing each type of complication if it occurs.

7. Understand Complication Costs

Discuss and clarify with your surgeon how complications are managed from a cost perspective, in addition to the medical management, before undergoing a procedure to avoid unexpected financial burdens.

8. Choose Trained Filler Professionals

For filler procedures, ensure they are performed by individuals who are highly trained and experienced in the anatomy of the area, as improper injection can lead to severe harm, including blindness.

9. Skepticism for ‘No Risk’ Procedures

Apply the rule that if a procedure promises no risk, no recovery, no downtime, and low cost, it likely yields no significant or lasting result, and may even carry hidden dangers.

10. Prioritize Patient Well-being

Seek out healthcare providers who prioritize patient well-being and ethical treatment over financial gain, as this indicates a commitment to genuine care.

11. Seek Humble, Honest Surgeons

Look for surgeons who exhibit humility and honesty, especially regarding mistakes or complications, as this is a sign of a good and trustworthy practitioner.

12. Expect Doctor Honesty

Expect and seek honesty and open communication from your doctors, especially if a complication arises, as this fosters trust and better management of your health.

13. Choose Doctors Embracing Complications

Select doctors who openly discuss and ’embrace’ their complications, rather than hiding from them, as this indicates a commitment to learning and patient care.

14. Inquire About Surgeon Experience

Ask potential surgeons how long they have been performing a specific procedure and how they acquired their training for it, looking for extensive experience.

15. Verify Surgeon’s Training

Inquire about where a surgeon trained and in what specific medical field to ensure their background aligns with the procedure you are considering.

16. Request Patient Referrals

Ask the surgeon for referrals to previous patients who have undergone the procedure, allowing you to discuss their experience and satisfaction.

17. Review Before/After Photos

Request to see a surgeon’s before and after pictures of their work to evaluate their aesthetic results and skill, ensuring they align with your desired outcome.

18. Apply Surgeon Selection Questions

The questions for selecting a plastic surgeon are valuable and applicable to choosing any doctor for procedural medicine, including surgical and dermatologic procedures.

19. Minimize Anesthesia Duration

Recognize that longer anesthesia duration increases complication rates, so seek efficient surgeons, especially for larger procedures, to reduce your exposure.

20. Choose Surgeons Managing Complications

Select a surgeon who is capable and prepared to manage any complications they might create during a procedure, indicating comprehensive skill and responsibility.

21. Exercise Extreme Caution

Due to lax regulations and profit-driven practices in some areas of plastic surgery, patients must exercise extreme caution and conduct thorough research to protect themselves.

22. Patient Research Responsibility

Understand that the primary responsibility for researching surgeons and procedures falls on the patient, especially in less regulated cosmetic fields.

23. Use ASPS Website for Research

Utilize the American Society of Plastic Surgeons (ASPS) website as a valuable resource to gain knowledge about procedures and their associated risks before undergoing any cosmetic treatment.

24. Liposuction Not for Weight Loss

Do not consider liposuction as a primary method for weight loss, as it is designed for subcutaneous fat removal and not for addressing overall body weight or visceral fat.

25. Prioritize Diet & Exercise

For weight loss, prioritize diet and exercise over liposuction, as gradual weight loss leads to better health, appearance, and is a more effective use of resources.

26. Recognize Body Dysmorphic Disorder

Be aware of signs of body dysmorphic disorder (e.g., SIMON: single, immature male, overly narcissistic, fixated on a body part), and understand that counseling, not surgery, is the appropriate treatment.

27. Accept Surgical Refusal

Be prepared for a surgeon to decline a procedure if they believe it won’t address the root issue or is not in your best long-term interest, even if mechanically possible.

28. Avoid Badmouthing Past Surgeons

When seeking new surgical opinions, avoid immediately badmouthing previous surgeons, as this can be a red flag for new practitioners and suggest unrealistic expectations.

29. Be Aware of Filler Blindness Risk

Understand the severe risk of blindness associated with facial fillers, especially when injected near the eyes or in the forehead/eyebrow area, due to arterial obstruction.

30. Caution with Vampire Facials

Exercise extreme caution with ‘vampire facials’ (PRP treatments) due to reported cases of HIV transmission from inadequately cleaned and processed equipment.

31. Correct C-Section Scars

A tummy tuck procedure offers the additional benefit of correcting issues arising from C-section scars, such as scar tissue, indentations, or skin overhang.

32. Skepticism for ‘Magic Wand’ Fat Loss

Be skeptical of non-invasive fat reduction technologies like CoolSculpting that promise easy results, as their efficacy and safety are often questionable and may lead to contour irregularities or burns.

33. Understand Psychological Impact

Recognize that cosmetic procedures can address not only physical concerns but also significant psychological issues, potentially improving a patient’s self-perception and quality of life.

34. Seek Holistic Problem Assessment

Look for plastic surgeons who critically assess whether a problem can truly be fixed surgically or if it requires alternative treatments, indicating ethical practice and patient-centered care.

35. Reset Plastic Surgery Expectations

Understand that plastic surgery is a serious medical specialty, not a service where a ’technician’ can be summoned on a whim, and should be approached with appropriate respect for medical rigor.

36. Synthesize Top Performer Learnings

Actively synthesize knowledge gained from successful individuals to apply to your own life, aiming for a higher quality and more fulfilling existence.

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