Episode 15 - Teri Gets The Down Low On The Brazilian Butt Lift From Dr. Frank Ryan

Teri Gets The Down Low On The Brazilian Butt Lift From Dr. Frank Ryan

Announcer: This program is brought to you by personallifemedia.com.

[Intro Music]

Teri Struck: I'm Teri Struck, host of “Beauty Now”, your weekly show for learning about lasers, lipos, lifts. And today we are going to talk about tummy tucks and Brazilian butt lifts. We are going to welcome renowned surgeon Dr. Frank Ryan, who has appeared on TV shows and much more.

Dr. Frank Ryan: It is a fairly significant procedure. So again, stopping smoking if someone is a smoker is essential before a tummy tuck and just having the person in good overall nutritional health. Now that's something that comes into play when we have the gastric bypass patients because oftentimes they can be malnourished if they're not careful.

You know, they have to monitor their diet and this and that because not all the nutrients are coming through because they have had a gastric bypass.

Dr. Frank Ryan: Most top plastic surgeons, we don't send the patients home after a tummy tuck. We send the patience to an aftercare facility, which is similar to a mini hospital in a way where nurses watch them 24 hours a day. My average tummy tuck patient goes to an aftercare facility here in LA for probably three to four days after a tummy tuck.

Dr. Frank Ryan: The problem is men will come in and want a tummy tuck and you tap on their abdomen and it's like tapping on a piece of wood. I mean it's hard as a rock because all the fat is on the inside. So those men you say, “You can't do a tummy tuck. There's nothing to do. Sorry.”

Teri Struck: Because there's nothing hanging.

Dr. Frank Ryan: The most important hurdle is to make sure that the doctor is board certified in the field of plastic surgery. This is something that we tried to educate the public about years ago. We thought we were being smart saying make sure your doctor is board certified. Well, the doctor is board certified - in gynecology.

Teri Struck: Right.

[Music]

Teri Struck: Welcome Dr. Ryan.

Dr. Frank Ryan: Thank you.

Teri Struck: Tell us about a consultation for a tummy tuck. I know that women look in the mirror, they have had kids and they just aren't happy with themselves. What do you tell them?

Dr. Frank Ryan: Yeah, there actually are many, many different types of patients that come in for tummy tucks, all the way from a patient, a very thin, athletic woman who has maybe had a child, has a little bit of extra skin in the lower abdomen that she didn't have before the child. She may have a few stretch marks she doesn't like.

And the one thing that a lot of people don't realize is the babies inside actually stretch out the muscles quite significantly. So what can happen is some of these athletic women come in and say, “I have been doing sit-ups and crunches until the cows come home every single day and I still can't get a flat tummy. Why?”

I tell them that the baby stretched out the muscle. So I mean the muscle is strong but the connective tissue between the muscles is stretched and so you can do - the muscles can be the strongest thing in the world but the belly will still kind of pooch out a little bit.

So anyway you have people that barely need anything coming in for ‘tummy tucks’ all the way on up to someone who has had a gastric bypass surgery and their abdomen is literally hanging down to their knees. And that's called a tummy tuck.

So the word tummy tuck or abdominoplasty is a catchall term that can go anywhere from the little mini procedure that I mentioned all the way to taking a huge amount of redundant skin off of a gastric bypass patient.

Teri Struck: What’s the largest amount you have removed?

Dr. Frank Ryan: You know, I personally haven't removed an enormous amount. But you know, you've seen I'm sure some of the TV shows, the listeners have, that they literally have what we call a panniculus, which is the redundant skin hanging down to the knees. I'm sure that's been the record, someone taking off pounds and pounds and pounds of skin hanging down to someone's knees.

Teri Struck: And we just saw a picture of a famous actress, who is so, so fit and she had a little bit of skin hanging down over her shorts. That would be the downside to being famous, but she is absolutely gorgeous and then had a child obviously and had that loose skin.

Dr. Frank Ryan: Yeah, exactly. That's a perfect sample of someone who is young and athletic and had a child. And what can you do? I mean the skin does what is going to do.

Now I have patients who have had three children. There is one I have in mind particularly that looks like she has had no children. The abdomen is amazing. Not a single stretch mark, no extra skin, it looks like the abdomen of an 18-year-old. And I have had patients that have had one child and they have just millions of stretch marks all over the abdomen, crinkled, redundant skin everywhere. It's just usually you ask the girl and then the mother had the same abdomen and so it's just kind of one of those things that runs in the family.

Teri Struck: So what about the stretch marks? Does it cure it?

Dr. Frank Ryan: Well, yes and no. Stretch marks can be removed during a tummy tuck simply because you're actually cutting off the skin that has the stretch marks on it.

Teri Struck: Right. Exactly, that's good.

Dr. Frank Ryan: So some will be removed. But the other way that we attempt to remove them - I say attempt because it's difficult is with the laser sometimes. Some stretch marks seem to respond and some don't. So it's something that you see touted on websites – “Remove stretch marks with a laser!”

It's really not true.

Teri Struck: It improves them right?

Dr. Frank Ryan: I mean, I wish it were true but it's just not. So you can have limited success with the laser but oftentimes it doesn't work.

Teri Struck: But they are improved, right? What type of laser do you use for that?

Dr. Frank Ryan: Well, there are different types of lasers that can be used. The most commonly used one is one that is designed to attack blood vessels. That's why the best stretch marks to be treated with the laser are the fresh ones. They are stretch marks that are purplish or pinkish and shiny.

Then there are what we call the mature stretch marks that are just white. So the white ones are very difficult to treat. But the pinkish, purplish, reddish ones that are relatively fresh can be treated sometimes with this particular laser.

Teri Struck: Well that's good news for lots of women.

Dr. Frank Ryan: Yeah.

Teri Struck: What’s the recovery period like?

Dr. Frank Ryan: Well, for the laser it's virtually nothing actually. There are new lasers that really can be used to treat things like stretch marks or broken blood vessels on the face for example that literally - I mean it sounds too good to be true - but literally the procedure is virtually painless and there is no recovery.

So now 99% of the time if a doctor says it is painless with no recovery, I wouldn't believe it. But this particular laser is one of those that are really true.

Teri Struck: Well, in conjunction with your tummy tuck, how does one prepare for the surgery?

Dr. Frank Ryan: Well, in terms of the tummy tuck, of course the biggest thing is that the person is in overall general health because I tell my patients that a major tummy tuck is probably the biggest surgery that we do in plastic surgery. It's very invasive. You are sewing up the muscles, which can be very painful and prolong the recovery. There will be drainage tubes in, draining out any blood or fluid for probably a week after surgery.

It is a fairly significant procedure. So again, stopping smoking if someone is a smoker is essential before a tummy tuck and just having the person in good overall nutritional health. Now that's something that comes into play when we have the gastric bypass patients because oftentimes they can be malnourished if they're not careful.

You know, they have to monitor their diet and this and that because not all the nutrients are coming through because they have had a gastric bypass. So things are not being absorbed through the digestive system like a normal person. So they can easily get malnourished if they are not careful. So it's important to have these gastric bypass patients nourished properly before their tummy tuck.

Teri Struck: Because they lose enormous amounts of weight and they have hanging skin.

Dr. Frank Ryan: Yeah. And in fact, abdominoplasties or tummy tucks are shooting up in popularity recently partly because of the lap band surgery, which is another way of rapid weight loss or gastric bypass surgery. You're right. They lose weight rapidly. The skin can't respond and so they have hanging skin everywhere.

So all of a sudden we are doing tummy tucks on all these people in the last couple of years.

Teri Struck: Are there any side effects from the tummy tucks?

Dr. Frank Ryan: Well, there are a couple of different specific side effects that relate to tummy tucks. One common one is called a seroma, which is a collection of fluid that can occur in the abdomen after the tummy tuck. And that's more likely in smokers or very obese patients or people with other health problems. But if this fluid accumulates after the surgery, what needs to be done is the surgeon needs to take a needle essentially, in the office, and just drain the fluid out repeatedly until there is no more fluid in there.

That's quite common after tummy tucks. I have seen rates of like 40 to 50% of patients get fluid collections.

Teri Struck: Oh, really?

Dr. Frank Ryan: Now there are other risks of course, you know, bleeding, infection, etcetera. And in fact one of the things that the tummy tuck has a higher risk of than other procedures is a blood clot, which of course many people are familiar with. You can get a blood clot in the leg, which can be dangerous in the wrong person.

Teri Struck: What are the signs of that? So you go home after your surgery. You are recovering and then how would you know you're getting a blood clot?

Dr. Frank Ryan: Well, that's less difficult. I mean that there can be pain or swelling in the leg. And what the doctor needs to do, which still doesn't prevent it completely but the doctor needs to take precautions. There are these balloons we put on the patient's legs that squeeze the legs during surgery. We encourage them to get up as early as possible after surgery to walk around to get the blood flowing again.

Teri Struck: That’s good advice.

Dr. Frank Ryan: To keep well hydrated - you know, the same thing they kind of tell you on planes. You know there is that problem with people on airplanes getting blood clots. The dry air, they are not moving around, they are not drinking enough water on the flight, so it's kind of the same principle when you are in surgery.

Teri Struck: And then you, after surgery you go home. And then what do you do to recover? What is the best thing? So you move around.

Dr. Frank Ryan: Well, I tell you, most top plastic surgeons, we don't send the patients home after a tummy tuck. We send the patience to an aftercare facility, which is similar to a mini hospital in a way where nurses watch them 24 hours a day. My average tummy tuck patient goes to an aftercare facility here in LA for probably three to four days after a tummy tuck.

Now, I know there are many, many, many doctors that send their patients home, which isn't wrong. It's just that if you really want to have the best aftercare, you send the patient to a facility with nurses.

Teri Struck: Top care. And do you often do tummy tucks if you need a breast lift? Can you do that at the same time?

Dr. Frank Ryan: Yeah, a very common combination is a tummy tuck and a breast lift. Obviously a woman has children. The tummy sags and the breasts sag at the same time.

Teri Struck: I know. It sucks! It's no fun.

Dr. Frank Ryan: Yeah, so we go ahead and do a breast lift. Now one thing the public doesn't seem to realize quite yet, despite all this information out there about plastic surgery, is that a breast lift alone rarely accomplishes what the patient wants because what happens after children especially if there isn't enough tissue in the breast.

You know, so you can lift the breast. But what's that going to do? You really need to do an implant at the same time so I would say about 99.9% of my breast lifts also involve a breast implant at the same time.

Teri Struck: All right. And you get much better results.

Dr. Frank Ryan: Much better results. You can just lift the nipple up and do the lift but without restoring that volume that was there pre-baby, it just doesn't look that good.

Teri Struck: It doesn't look as good. Let's talk about the bellybutton. That is a big question a lot of my friends have.

Dr. Frank Ryan: Yeah.

Teri Struck: Do you remove it?

Dr. Frank Ryan: The bellybutton - what you do with it sort of depends on the degree of the tummy tuck. Now the gastric bypass patients we discussed earlier with hanging skin, essentially in those patients you - it's hard to describe - but you essentially remove the old bellybutton and make a new bellybutton.

Teri Struck: So you make a completely new one. You don't just remove it and reattach it?

Dr. Frank Ryan: No, you actually, you know the old bellybutton itself of course is attached to the abdomen. So what you do is you actually make a new one in the new skin, which again, without visuals is very difficult to explain. In fact I have – it’s one of the hardest things to explain to patients during a consultation is the whole concept of the new bellybutton. So it's a difficult one.

Teri Struck: So it's a difficult thing about the bellybutton, but generally you will get a little circle around the bellybutton. Is that not correct?

Dr. Frank Ryan: Yeah, I mean people say, “Will the bellybutton look like a normal bellybutton?” And I say, “Well it's very difficult to create what God created to tell you the truth.”

Now over the years of me doing it for all these years, I must admit that the bellybuttons I create look pretty natural to tell you the truth. But boy, I have seen some patients coming in from doctors that maybe took a weekend course or something. And boy, they were just disasters. And they are almost impossible to fix.

Teri Struck: Which is a really good point. I stress on all my shows that you want to find a board certified plastic surgeon who has gone to training for this.

Dr. Frank Ryan: Totally. It's just crazy. In this environment today with the market forces and competition in plastic surgery, there are so many underqualified or frankly unqualified doctors doing plastic surgery. It's just crazy.

Teri Struck: That’s right. You really want to do your research on that. Do you see a lot of males getting tummy tucks?

Dr. Frank Ryan: Yeah, we have more and more males. And part of the reason is because of the popularity of massive weight loss surgery. In fact a friend of mine and a patient who is very public about his massive weight loss surgery is named Adam Goldstein, who is also known as DJ AM.

Teri Struck: Oh, right. I saw him at Sundance.

Dr. Frank Ryan: And he had his weight-loss surgery probably about three or four years ago. We have done somebody contouring on him. Again, he is one of those celebrities that are very open about it.

Teri Struck: That’s great, right.

Dr. Frank Ryan: Because he tells people.

Teri Struck: I think that helps people.

Dr. Frank Ryan: Yeah, by talking about it.

Teri Struck: Right, so does a male tummy tuck differ from a female tummy tuck?

Dr. Frank Ryan: Well, it does to an extent. Most men tend to retain more fat in the abdomen itself. You know, you have the classic ‘beer belly’ contour. What that is, is a lot of that on the inside near where the organs are, you know? Women typically carry fat on the outside, meaning you can grab it with your fingers and pinch it and you can easily liposuction that.

Now you can't liposuction or remove fat that is next to the liver for example.

Teri Struck: Oh, uh huh. It's dangerous.

Dr. Frank Ryan: The problem is men will come in and want a tummy tuck and you tap on their abdomen and it's like tapping on a piece of wood. I mean it's hard as a rock because all the fat is on the inside. So those men you say, “You can't do a tummy tuck. There's nothing to do. Sorry.”

Teri Struck: Because there's nothing hanging. It's typically hanging skin.

Dr. Frank Ryan: It’s hanging skin. That's what you want. So those men who have had massive weight loss surgery have hanging skin and that is why we are seeing an increase in the tummy tucks for men.

Teri Struck: Well, we need to take a break. This is so interesting and I want to educate the public more about tummy tucks and we are going to be right back because we are also going to talk about Brazilian butt lifts. Yay!

[Music]

[Commercial]

[Music]

Teri Struck: Hi, this is Teri Struck. We're back with “Beauty Now” and Dr. Frank Ryan.

We were just talking about tummy tucks. So Dr. Ryan, how does one decide on a doctor?

Dr. Frank Ryan: The most important hurdle is to make sure that the doctor is board certified in the field of plastic surgery. This is something that we tried to educate the public about years ago. We thought we were being smart saying make sure your doctor is board certified. Well, the doctor is board certified - in gynecology.

Teri Struck: Right.

Dr. Frank Ryan: The doctor is certified - in oral surgery. So every doctor is board certified in something, for the most part. So you go in, “Doctor, are you board certified?” “Of course I am. In pediatrics.”

Teri Struck: Right.

Dr. Frank Ryan: You know? But should he be doing your tummy tuck? I don't think so.

Teri Struck: That would be so convenient. Take your child into get a checkup and get a tummy tuck.

Dr. Frank Ryan: Exactly. So of course, the only board that is really legitimately certifying doctors to do all kinds of plastic surgery is the American Board Of Plastic Surgery. So that is really the board to look for when it is coming to someone getting plastic surgery.

Teri Struck: That’s really good advice. Let's talk about the scars really quickly. Are you able to use a C-section scar at all?

Dr. Frank Ryan: Yeah, for tummy tucks, using a C-section scar is virtually impossible. That's the thing too, again, the market forces and competition in this field is that a lot of doctors will try to minimize the scar unrealistically in order to get the patient to sign up for surgery.

The bottom line is a tummy tuck involves removing skin so you have got to make a scar to remove skin. And usually the scar is from hip to hip. Let's face it. Now the massive weight loss patients, they sometimes have a circumferential scar, meaning the scar goes literally all the way around their body, including their back.

Teri Struck: Now would that be a body lift?

Dr. Frank Ryan: That’s more or less a body lift in most people. Or there is also something called the belt lipectomy, you know not unlike a belt. Just you take that wedge of skin out around the midsection and lift it up. So a body lift is more extensive than that but they are similar.

So again, when it comes to the tummy tuck you just have to tell the patient it's a long scar. We try to hide it in the belly button. We try to sew it carefully to make it as good as we can, blah, blah, blah. However, it's a significant scar.

Teri Struck: It’s a trade-off, right? It's a trade-off. You want to get rid of that hanging skin and then you trade it for the scar.

Dr. Frank Ryan: A trade-off. Yeah.

Teri Struck: So is there really something called a mini tummy tuck or is that just a catchall?

Dr. Frank Ryan: Yeah, there is a mini tummy tuck and that is for people who barely need it. You know, they may have a little extra skin in the middle of the stomach after having a baby, you know. It's still longer than a C-section scar but it's not too much longer. And that's if you have just a little bit of skin and you may be need to sew the muscles up a little bit below the belly button and that's about it. That's in a very limited number of patients, let's put it that way.

Teri Struck: And last, what are the risks associated with the tummy tuck surgery?

Dr. Frank Ryan: Well, the risks are anywhere from unsightly scarring to one thing that can occur in smokers, which we haven't discussed yet, which is tissue loss. What that means is the nicotine shrink down the blood vessels. And the carbon monoxide is not good either of course for wound healing.

So you can lose, meaning a section of tissue can literally turn black above the scar and die. And therefore, that needs to be skin grafted or fixed later. And that's from poor blood supply, usually from smoking. So that's a definite risk of not only just tummy tucks, but facelifts and breast lifts and some other surgeries as well.

Teri Struck: So smokers really should wait until they quit to get surgery.

Dr. Frank Ryan: Absolutely. Smoking is very bad in general. But for certain surgeries is really bad, like the tummy tuck.

Teri Struck: Do you have any tips for smokers out there to quit?

Dr. Frank Ryan: I wish I did.

Teri Struck: I know. I know. We're going to have to do a show on that.

Dr. Frank Ryan: Yes.

Teri Struck: I think it's really important that all the smokers stop smoking. It's so bad for you.

Dr. Frank Ryan: Absolutely.

Teri Struck: And when you hear doctors like yourself saying that your tissues die, that should be a real indication of when you're cutting into you.

Dr. Frank Ryan: Yeah, now typically the way to get smokers to stop, I have found, is you don't tell them that it can cause lung disease and cancer. They’re like, “Whatever.” You tell them it can cause wrinkles. They're like, “Wrinkles? Oh my God. I didn't know it could cause wrinkles.” That makes them stop.

Teri Struck: That’s true. I do tell my friends that that smoke. I know it is a huge addiction and it's something we need to cover.

So in the last few minutes let's talk about the Brazilian butt lift. What is it? Tell us all about it.

Dr. Frank Ryan: Now the Brazilian butt lift makes a lot of doctors laugh when they hear that title. First of all, it's kind of a goofy title. And secondly it is a procedure that we have been doing for - I did a ‘Brazilian butt lift’ 15 years ago.

All it is is liposuctioning fat and injecting it into the buttock. It's not like it warrants its own title. It's just common sense. So what is when you get something like the Brazilian butt lift, a doctor who wants more business, typically on one of these TV shows, hires a publicist, comes up with a catchy name and assigns a name to a procedure that is common sense.

So the Brazilian butt lift again is liposuction, taking the fat. You have it anyway. Why not use it and put it in the butt? Anyone would do it if they had a brain. So it's the same thing we do, we put it in the cheek. We put it in the lips. We put it in the jaw line. You know it's just like putting it back there to augment the butt. So it's just a basic procedure.

Teri Struck: So is there anything to augment the butt besides fat?

Dr. Frank Ryan: Well, there are implants and many of us aren't fans of implants. There are very few of us, very few of my colleagues, I don't know a single one of my colleagues in fact that does buttock implants to be honest with you. I mean they're done.

Teri Struck: That’s true.

Dr. Frank Ryan: But they're rarely done because it's common sense. You're putting an implant in something; you're sitting, your horseback riding, I mean it's fraught with problems. Whereas your own body fat, it's your own fat and why not?

Teri Struck: And how long does that fat last?

Dr. Frank Ryan: Well, it's very unpredictable. I tell my patients that you usually need about three sessions to make it last as long as we want. And some fat is going to last forever because the blood supply grows into the fat cells. There are living fat cells back there. That's good and bad because if you put on some weight, your body is going to get pretty big as well because those fat cells are going to grow, which of course they don't seem to tell you about on these TV shows as far as I know.

Teri Struck: Well, actually that is a really good point you just brought up for both tummy tucks, butt lifts and any types of surgery. When you gain weight, do you have to do the surgery over? The tummy tuck for instance?

Dr. Frank Ryan: The tummy tuck not necessarily. If you gain weight it's not that much of an issue. But when you inject fat cells anywhere - in fact there is a girl that came into me. She had a doctor that got kind of aggressive with fat injections into her face. She got pregnant and put on a lot of body weight and her fat blew up like a pumpkin.

And she said, “The doctor didn't tell me that.” I said, “Well, he should have because that fat is going to grow in your face just like anywhere else.” So it's a problem.

Teri Struck: So the fat grows? I'm confused.

Dr. Frank Ryan: Yeah. The fat grows. I mean if you put on weight - see these fat cells that you inject into the lips, the butt, wherever, they are living fat cells. So just like fat cells anywhere else, if you go ahead and gain 50 pounds, your lips are going to get big. Your butt is going to get big. Your cheeks are going to get big because those fat cells grow like fat cells anywhere else.

Teri Struck: I'm laughing because I'm like, “Oh well, if I gain weight maybe my lips will grow bigger. That would be good to get some fat in there.”

Dr. Frank Ryan: That’s right.

Teri Struck: But that's not really good if you have in your cheeks and everywhere else. So if people want to get a butt lift, how do they do that?

Dr. Frank Ryan: Well, when people use the term ‘butt lift’, there are several different techniques out there. Of course we just discussed the Brazilian butt lift, which is simply taking fat and injecting in the buttock, which is common sense and easy. If I do that, that's what I do.

There are other methods of actually making an incision either above the buttock area, sort of where the tailbone is and taking the skin out. And that lifts the buttock to an extent. Now the problem is the scars are extensive and often widened. So the scars aren't worth it. It's not worth the trade-off to tell you the truth. So that's not commonly done.

The other procedure I have done in a few people, massive weight loss people usually, is underneath the buttock, in the crease there, they can have several folds of redundant skin, like a little accordion back there. So in those patients you take a wedge and remove all that extra skin and that looks pretty good actually. Again, a long scar yes, but the trade-off is worth it in those patients.

Teri Struck: So the scar would go completely underneath your butt cheeks?

Dr. Frank Ryan: Exactly.

Teri Struck: And people generally couldn't really wear a bikini after that or they can?

Dr. Frank Ryan: Well, I mean wearing a bikini is tough. See, the thing is that it depends on the patient's expectations. I tell my patients, I have many, many patients that are young, healthy men and women that are perfectionists and barely have anything that they need done to tell you the truth. And they have raised the bar so high for their expectations it's crazy.

I tell them, “Look, someone who has had gastric bypass, they look like a Shar-Pei. They have skin hanging everywhere. They are happy with anything.” You know?

Teri Struck: The trade-off is good. The scars versus hanging skin.

Dr. Frank Ryan: If you remove hanging skin, they don't care about the scar. God, they just don't want their skin to rub between their legs because walking creates a rash, you know.

Teri Struck: Their thighs hang down.

Dr. Frank Ryan: So it's all about what you expect.

Teri Struck: So what is the difference between a body lift and a tummy tuck?

Dr. Frank Ryan: Well, the body lift essentially is just more extensive. The tummy tuck is really addressing just the abdomen for the most part, the stomach area, whereas the body lift theoretically is addressing the entire lower extremities, like the thighs, the buttock, all those things.

It's a much more extensive procedure that is becoming more popular because of massive weight loss. And many of us don't do the body lifts just because it's such a big procedure. It's one of the things that we leave for the guys that want to specialize in that.

Teri Struck: And you would generally need to be hospitalized for that?

Dr. Frank Ryan: Yeah. Absolutely hospitalized. The body lift is one of the biggest things that we do. It's big. In fact there is a doctor that passed away a few years ago - Ted Lockwood - who was sort of like the father of body lifting in Kansas City. I referred many people to him from Los Angeles just because he did it all the time and he was used to this big procedure and all the complications that could go along with it.

Teri Struck: Because many of the patients have had gastric bypass and there are own complications with that. So it would be very dangerous.

Dr. Frank Ryan: Yeah, I mean the gastric bypass patients often times aren't the healthiest patients really. So that procedure by itself is somewhat risky in those patients. And then secondly, as you were saying that the body lift maybe pretty risky as well.

Teri Struck: But you could actually do it? I mean there's hope. You can do it. I would say have a tummy tuck or have an arm lift or have a thigh lift. You could actually spread it out over a year, right?

Dr. Frank Ryan: I'm glad you brought that up because when my patients come in after massive weight loss surgery I tell them this is going to take probably three plus procedures. You need to what we call stage it. You're right.

We'll do the tummy and the breasts. Then we'll do the arms and the back. Then we'll do the thighs and the whatever - facelift or something. That's definitely the way to make it safer.

Teri Struck: That’s the safest way.

Dr. Frank Ryan: Yeah.

Teri Struck: And that's what I want to educate everybody about, just to be safe to but also to get the best looks that they can get.

Dr. Frank Ryan: Absolutely.

Teri Struck: So in closing, what would you recommend patients if they want to try to come in? How much does it cost?

Dr. Frank Ryan: Well, depending on the procedure and depending on the doctor and depending on the part of the country, the costs vary wildly depending on those different factors.

But the one thing that I see patients comment on is a consult fee. Now the top doctors all have a consult fee. So sometimes patients will come to me and say, “Oh my god Dr. Ryan, you have a $500 consult fee.” It's like, “Well yes, and if a doctor doesn't have a consult fee, it's not good.”

So the first thing is don't be surprised if you call a top doctor and he has a consult fee of a couple of hundred dollars. That's just normal. You know? And secondly, the better doctors frankly charge a little more than doctors who aren't so good typically. It's just the way it is in life.

Teri Struck: That's true and you don't want to mess with your body.

Dr. Frank Ryan: Exactly.

Teri Struck: There are ways of financing surgery, correct?

Dr. Frank Ryan: Yes, people finance their surgery and all that stuff, put it on credit cards. It's just I wouldn't skimp. Like you were saying when it comes to your face or body that's insane.

Teri Struck: Right. It's insane, especially on your face.

Dr. Frank Ryan: Yes.

Teri Struck: Where people are going to see you every single day. You don't want to go and get the best price.

Dr. Frank Ryan: Absolutely. And again, the last thing to say is don't be fooled by publicity. You read a doctor's name in a magazine. Great, he paid a publicist $3000 a month to get in a magazine. Congratulations. You know?

You see a doctor that's on a TV show. Great. He begged and pleaded and his cousin worked at E or something and got him on a show. Great. I mean –

Teri Struck: It’s true.

Dr. Frank Ryan: So you know nothing if you see publicity about a doctor. It can just mean he's got a publicist.

Teri Struck: And I saw a gynecologist actually that was run out of Newport Beach where I grew up. And he ended up being on “The View”. And it was for surgery. It was for liposuction. It was unbelievable. I wanted to call in. I could not believe it.

Dr. Frank Ryan: Absolutely. There's a doctor on one of the TV shows currently who is a gynecologist who had his license pulled. It's probably the same doctor for all we know. But it's shocking because the thing is the public doesn't know.

Some people say, “Well how did those doctors get on the show?” It's like, the producers don't care. What do they care? They don't know. They just want a doctor to come up with a catchy name that will draw viewers, you know? If he's a fraud or not, what do they care?

Teri Struck: Yeah, they should care. They should care. I think that's the best service we can do today too is educating the public about this. Because you see somebody on a TV show, that doesn't mean they are qualified.

Dr. Frank Ryan: Exactly. Far from it sometimes.

Teri Struck: Well, thank you so much Dr. Ryan for being with us today. I want to have you back on the show to talk more about surgery and other procedures. I really appreciate you giving your time today.

Dr. Frank Ryan: Thank you.

Teri Struck: Thank you. This is Teri Struck with “Beauty Now”. If you want any transcripts for past shows, please go to www.personallifemedia.com. We will link you to Dr. Ryan if you want to have a consultation with him. He is in Beverly Hills.

If you have any questions, if you have any ideas, please email [email protected].

Announcer: Find more great shows like this on personallifemedia.com