Keeping it Re.al

Welcome to My Surgeon Says! We've had a bit of a facelift so if this has popped up in your podcast feed and you have no idea what's happening, the podcast formerly known as Keeping It Re.al has rebranded with a new name, look, and slightly different format. We will of course be keeping to our plastic surgery roots and explaining everything from what to expect as a cosmetics patient to niche surgery-specific questions you wouldn't even know to ask. Okay, introductions aside, we're kicking off with a chatty episode from Richard and Kim so you can learn more about their humble beginnings in an office the size of a closet, the weirdest place Kim has run a marathon, and how Richard may have saved his driving instructor's life.

This week on the podcast, Richard and Kim are running us through the most common mistakes that patients make and how to avoid them. They also tell us about the most important things they learned during their early doctor days and explain the difference between a complication and an actual surgical blunder. As always, if you enjoy this episode, please leave us a five star review wherever you are listening, or share it with somebody who you think would enjoy a peek into the mysterious world of plastic surgery.

Today we're talking twins and more specifically, the impact on the women who birth them. Did you know that the average woman's uterus grows to 500 times its usual size in pregnancy, and that's just single births! Today, Kim and Richard discuss why even though global rates of birth are going down, multiple births are actually increasing. We also cover if it's more likely that you'll need an adominoplasty after giving birth to twins, and if it's possible to still get a good result after doing double the breastfeeding. You'll also hear me spiral in real time as I try to understand when twin mums have time to do literally anything. If you know a twin parent who will enjoy this episode, please share it, and as always, rate and review Keeping It Re.al wherever you listen to podcasts.

Today we're joined by Plastic Surgery Superstar, Dr. Kourosh Tavakoli. Kourosh is based in Sydney and has over 20 years experience in breast and body contouring surgeries. In this episode, Richard and Kourosh revealed just how much disdain other surgeons had for cosmetic surgery 20 years ago. They'd have backs turned on them at conferences and get told they were selfish for taking a medical placement that another doctor could have done something "more worthy" with. They reminisce on advertising in a world of Yellow Pages and discuss how social media has both raised the standards of surgical results, and in the wrong hands, can be used to prey on vulnerable people. It's a great episode and a must listen, especially if you're interested in the politics and intrigue of the surgical world. If you're enjoying Keeping It Re.al, please rate and review us wherever you listen to podcasts and send this episode to somebody that you think would enjoy a peek into the world of plastic surgery.

We often have patients coming in complaining about back fat, and quite a lot of the time it's actually not back fat at all, but an excess of loose skin that has become uncomfortable and cumbersome under their clothes. Today, Richard and Kim chat about the best surgeries to address problems on the back. If liposuction alone can be a good solution, and whether CoolSculpting is just a waste of money or not. As always, please chuck our little podcast, a five star review and share it with somebody that you think would enjoy a peek into the world of plastic surgery.

Today, we're answering the age old question – what's the difference between a lower body lift and an abdominoplasty, aka a tummy tuck? Richard and Kim explain what's involved in each operation, who the ideal candidates are, and what recovery is like for both. This topic is a listener request, proof that if you ask, we will answer! So go on, send us your questions on Instagram and rate us 5 stars wherever you're listening.

The concept of being covered by Medicare for plastic surgery is undeniably confusing. To help, we've recorded a two part series explaining what an item number is, why they exist, and we go through operation by operation to break down who qualifies for the surgeries we perform at RE. If you haven't listened to last week's episode, definitely go there first to get an understanding of how item numbers and private health insurance work for plastic surgery. We also cover all of the qualifiers for breast surgeries in that episode. In this episode, we chat about why conditions primarily affecting women seem to be unfairly targeted, and Richard explains why more surgeries excluded from the MBS could lead to dire consequences for the Australian health system. We also go through the specific qualifiers for Are You Ready? Labiaplasty, loose skin removal, abdominoplasties, lower body lifts, And I lives so enjoy this episode and please share this one or last week's with someone you think it could help.

The concept of being covered by Medicare for plastic surgery is undeniably confusing. To help, we've recorded a two part series explaining what an item number is, why they exist, and we go through operation by operation to break down who qualifies for the surgeries we perform at Re. In this episode, we cover how both the MBS and private health insurance work, what it means to have a purely cosmetic surgery, and we go through the specific qualifiers for breast lifts, breast reductions, breast augmentations, and fat grafting. Definitely listen to this one first for background on how the system works and tune in next week to learn about qualifying for our other surgeries.

Today, we've got a one-on-one chat with Richard to learn more about what makes him tick. We cover a lot, including the proudest moment in his career, something he wished more people knew about plastic surgery, and a memorable moment from his first ever surgery.

This week, Richard and Kim join me to chat about the dark side of over-investigating normal post-op bumps and twinges. They share some of the most harrowing patient stories we've heard on the podcast, explain why seeing patients in person is always the most effective way to diagnose, and break down the most common post-op complaints by operation.

We get a lot of questions about post-op garments so here's a quick little episode answering the FAQs. We chat about whether it's okay to take your compression garment off in the early weeks after surgery, why surgeons have such differing opinions on their efficacy, and if there's a limit to how long you should wear your post-op garments.

Today, we're talking about spitting sutures, which is when your internal stitches pop up through your skin… not exactly where we want them to be. It's not as harrowing as it sounds and can often get misdiagnosed as something more nefarious by those not in the know. We explain how common spitting sutures are, how to know if you actually have one, and why we would never prescribe antibiotics just for kicks.

Today we're talking about breasts bottoming out. Never heard of it? Well, welcome. We go through the technicalities of it all, which patients are more at risk, and why we'd never tell you to stop doing chest workouts at the gym.

The world of cosmetic surgery is rife with tricks, dodgy practice, and misleading images so today, Richard and Kim join me to expose the 5 biggest scams in plastic surgery. They explain how to make sure your surgeon is legit now the guidelines have changed, how to spot a suspicious before and after pic, and if high pressure sales tactics are still around.

Today on the pod, we get practical. Richard and Kim chat about the must do's before going into theatre, which common advice you should actually ignore, and their top tips to ensure surgery goes as smoothly as possible.

If you're a bit surprised by this topic, you've obviously never met Mr Richard Bloom, a man fuelled almost exclusively by data sets. Today, we chat about why the surgeons audit each other's work, how it started, and how it improves patients' results.

This week we've got part 2 in our 'Ask An Anaesthetist Series' with our fantastic anaesthetist Dr Arturo Gomez. If you haven't listened to part 1 stop right now and check that one out first. In this episode, Arturo reveals how patients can 'pre-hab' to make the anaesthetic process as smooth as possible, what's different for patients with chronic pain or diabetes, and his insight on the top fear for patients – waking up during surgery. Leave a comment and let us know which speciality you'd like to hear from next!

A lot of our patients come to see us after big hormonal changes like puberty and pregnancy, and today we're focussing on a third one – menopause. We chat about what kind of changes women experience during perimenopause, whether hormone replacement therapy impacts surgery, and common procedures we perform on post-menopausal patients.

Today, I'm joined by anaesthetist Dr Arturo Gomez to answer all your questions about going under. This is such an informative episode we split it across two episodes to make sure nothing was missed. In Part 1, Arturo walks us through what to expect on the day of surgery, the most important part of his job, and what patients are most afraid of, and why they shouldn't be. Tune in next month to get the next instalment and leave a comment when you review us if there's any other specialists you'd like to hear on the podcast.

The attitudes around plastic surgery have shifted massively over the last decade, but we still see plenty of patients who feel guilty about going under the knife. In this episode, Richard and Kim reveal the most common reasons people have guilt-based hesitations, how patient selection and education makes an impact, and how friends and family can help support; not judge. If you like this episode, leave us a review and let us know what topic you'd like us to cover next.

Today we're busting myths about breast reductions. If you're a long time listener you might be thinking, "hey haven't you done this before", but the myths, they keep on a coming so I promise you'll learn something new. It's a shorter episode today so enjoy our little quick fire call and response. If you like this episode, rate and subscribe and as always, let us know what you'd like us to cover next!

To make sure we're all on the same page, today we're defining the terms and concepts we use all the time on this podcast and other videos. If you're a dedicated listener to the pod, don't worry this is still worth a listen – Richard and Kim go on a bunch of interesting tangents and digressions. We explain why we only use silicone implants, define medical terms like ptosis and grafts, and clarify why measurements don't necessarily indicate impact when it comes to muscle separation. If you like this episode, rate and subscribe and as always, let us know what you'd like us to cover next!

The cosmetic industry is rife with claims of miracle cures and devices that'll change your life. So today, I've brought in the experts to reveal what's a gimmick and what's a game changer. From laser liposuction, to deep plane face lifts and Ozempic, Kim and Richard reveal what's worth your time and what to avoid.

Today, Richard and Kim explain all the different ways we minimise risk in surgery, both as surgeons and patients. We run through the safest way to prepare for your operation and debunk common misconceptions that may actually increase your risk.

This week, we're chatting about what plastic surgery looks like at different stages of life. Richard and Kim reveal the main differences between our typical patient demographics—both in types of surgery and patient attitudes—and maybe more importantly, their similarities. We discuss the pros and cons of having surgery earlier vs later in life and there's a great story about a very agile 80 year old that should probably be a lesson to us all.

Today, Kim and Richard chat about the psychology of postponing surgery. There are plenty of reasons patients delay surgery, from deep seated anxieties to unexpected pregnancies. We discuss the most common reasons and why sometimes, the surgeons need to postpone the operation on your behalf.

Today on the podcast, Richard joins me to explain how best to achieve facial harmony when going under the knife. We chat about why some facelifts look like a patient's been caught in a wind tunnel, how combining facial procedures can lead to a smoother outcome, and why a conservative approach can be the best option in the long run.

This week, we're chatting about changes in nipple sensation after breast surgery. Kim and Richard explain why there can be a change in nipple sensation after breast surgery, if there's anything that , and why some people could maintain erotic sensation even with nipple numb to the touch. I learned things in this episode I've never even thought to question so I highly recommend giving the full episode a listen and let me know in the comments if you have similarly niche topics you'd like us to cover

Today we're talking about how 3D Imaging and virtual reality are shaping plastic surgery. If you've had a breast augmentation with us, then you probably already know about our swanky Vectra machine that uses a simulation to help patients test different implants before committing. The Vectra is great for other surgeries too, like breast lifts to correct asymmetry, mastopexy and augmentations, and rhinoplasties. Today, Richard and Kim explain how exactly 3D simulation works, what the limitations are, and what the future of plastic surgery looks like in terms of AI and virtual reality.

If the term “holistic plastic surgery” immediately sets off alarm bells, that's fair. Some practitioners use it as a way to describe what they do which is almost always *not* plastic surgery. But holistic medicine as a practice is about considering the patient as a whole and working with different practitioners as a team to solve the condition, not just ease the symptoms. So in this episode, Richard and Kim discuss which parts of holistic medicine are key to recovery and good results, and which ones you can skip…

We're back to our roots today, giving you a peek into the mysterious world of plastic surgery with anecdotes - think your favourite Reddit AMA thread. Richard and Kim reveal when they've been the most concerned in theatre, the funniest thing they've seen while operating, and Kim shares a story so graphic I still haven't fully recovered. If you like these kind of episodes, leave some of your questions in the comments on YouTube and we'll cover them next time.

We first met Jess after she lost 100 kilos and came to have her excess skin removed over multiple surgeries. What we didn't know was Jess was in the midst of a decades long battle to be diagnosed with endometriosis. In today's episode, Jess generously shares her endo journey: from doctors telling her to “just get pregnant” at 23, to no one taking her unbearable pain seriously until she lost weight, and the devastation of only finding out her first surgery was a failure after 2 rounds of heartbreaking IVF results. Jess' story perfectly shows just how frustrating it still is to be taken seriously as a woman by medical professionals. A warning that Jess is very open with her IVF journey so if that's not for you, maybe give this one a miss. But otherwise, I hope you enjoy Jess' story and her prevailing message to always, always self-advocate.

This episode is a must listen! We're joined by Dr Angela Webb, a specialist plastic and reconstructive surgeon and she shares some amazing stories. As the Head of Plastic and Reconstructive Surgery at Peter Mac—a renowned cancer centre in Melbourne—she's operated on just about every part of the body, top to bottom, inside to out. Angela also led the first and *only* hand transplant in Australia. So sit back and listen while Angela reveals the most rewarding and most difficult parts of working in reconstructive surgery, trauma surgeries that have stuck with her and the most common misconceptions about her work.

Today we're back to busting myths, this time on tummy tucks/abdominoplasty. We chat about *reverse* tummy tucks (as wild as it sounds), whether you get a new belly button with an abdominoplasty, and if going to the gym is the alternative to removing loose skin. So, sit back and get ready to have some myths debunked…

Today we're chatting about how breast surgery can impact screening for breast cancer, both before and after the operation. Every patient who has a breast reduction or lift with us has the removed tissue sent to pathology who test it for a variety of things, including cancerous cells. Richard and Kim reveal how common it is for this report to come back flagged, how reductions or implants can impact your future mammograms, and why genetic testing could affect your decision to get an abdominoplasty.

Today we're talking about scarless surgery. Right up top you should know: if you plan on having cosmetic surgery with effective, impactful results – you're going to have scars. Instead we discuss how we conceal scars, how to minimise them in recovery and which areas tend to heal the best.

Today we're talking about travelling for surgery. Recent AHPRA guidelines have drastically changed accessibility for patients who either live regionally or want to travel interstate for cosmetic surgery. Richard and Kim explain how the changes impact you and what the new policy looks like at Re. We also reveal the major red flags to look out for when it comes to cosmetic tourism overseas. The biggest lesson? Cheap can be very, very expensive…

Look, we've all woken up at some point with giant bags under your eyes – maybe from a big night or allergies just showing you who's boss – but it's definitely not an uncommon experience. But some people have really noticeable bags that just never seem to go away, no matter how many cold spoons they press in the morning, and it tends to get worse with age. That's when the humble lower blepharoplasty steps in. In this ep, Richard and Kim explain why under eye bags form as we age, how a blepharoplasty can help, and in what cases the surgery could actually cause real damage.

A labiaplasty is a surprisingly common surgery that doesn't get the same airtime as our other operations so, it's time to change that. There's a misconception labiaplasties are the quest for a designer vagina, and while that may be the case in some places, our patients are overwhelming trying to overcome discomfort and pain. Richard and Kim join me to explain what a labiaplasty actually is, what kind of down time you need, and why it's not something to be embarrassed about in any way.

Patients who've had C Sections are always keen to hear how it compares to an abdominoplasty (tummy tuck) or lower body lift. In this ep, Kim and Richard will explain the differences between the surgeries, what happens to a C Section scar during a tummy tuck, and whether a bigger scar means worse pain.

“Is it too late to go back???” This week, we chat about which trendy operations you can forget ever happened and which ones are forever (spoiler: it's bad news for buccal fat removal and BBLs) We also chat about how fashion can inform surgical techniques, how to spot a fad surgery, and the biggest changes Kim and Richard have seen while they've been operating.

Today I'm joined by dermatologist Dr Alice Rudd, founder of Skindepth in Melbourne. Skindepth is not your usual dermatology clinic – they focus heavily on holistic treatments so they can tackle skin from the inside and out. Alice has curated a team of exclusively female dermatologists, started an in-house vulvar clinic with a gynaecologist, and believes the principles learned in her yoga training can help mitigate some of the effects stress has on your skin. In this episode, we chat about the fact that issues don't need to be life threatening to make a huge impact on your sense of self, what exactly a vulvar clinic is, and how stress can manifest in rashes and perioral dermatitis.

Internal bra is probably a term you hear a lot, but what actually *is* it? Does everybody get an internal bra who has breast surgery? Which breast surgeries include an internal bra? Why do some people need one more than others?

Today, we're unpacking revision surgery. Revision is a pretty loaded word and, in this case, can cover anything from some slight dog ears after a tummy tuck to completely overhauling a prior surgery that didn't deliver the promised results. Kim and Richard chat about what exactly revision surgery looks like for different operations; the most common types of revision surgery they need to perform; and red flags to watch out for before going under the knife.

This week, we're joined by the inimitable Professor Wendy Brown to tell us all about bariatric surgery. She runs through the different types of weight loss surgeries, the reasons most people struggle to keep weight off once they've lost it, and why it's time to change the way we stigmatise obesity.

Body Dysmorphic Disorder is a dark, all-consuming mental health condition. A fixation or obsession on flaws in your appearance — flaws that are either minor or completely unseen by those around you. In this week's episode, we're joined by clinician and mental health professional Roberta Honigman who specialises in body image disturbance. We're going to chat about the difference between negative body image and BDD, its symptoms and what to do if you think you or someone you know is experiencing something similar.

Today's flavour du jour is Ozempic, a diabetes drug some have started using for weight loss. We're going to chat about how it works, IF it works, how much it costs in Australia, and you even get a rant about insidious body image trends, free of charge!

Today, we're talking asymmetry, from women who have hugely disproportionate breasts, to how often we perform surgery on just side and how few women actually realise they have *any* asymmetry until they're looking at those clinical photos dead on.

When it comes to implants, we can use some pretty obtuse language about projection, medial planes, profiles, and CCs. In this episode, we're breaking it down to answer the one simple question: breast implants, should they go over or under the muscle? This episode has parts which are pretty visual but can definitely be an audio-only piece! I'd recommend checking out some of the short clips on YouTube though if you'd like to see what the surgeons are referring to when they're doing a show and tell.

Does the sound of a face peel send shivers down your spine? Are you too afraid to ask what words like 'tyrosinase inhibitor' and 'retinol' mean? We're here to help! We're giving all the tips and tricks in simple terms to help demystify the world of skincare and help you have healthy glowing skin in no time.

This week, we're calming your nerves against the surgery scaries. We're covering the heavy hitters, like what are the chances of waking up during surgery, what happens if you get your period on D Day and, the far and away most common question we get: what are the chances of dying during surgery?