Botched (2014–…): Season 6, Episode 10 - Bunny Boobs & Pooch Patrol - full transcript

If I had to guess,
Ive probably spent over

a million dollars
to look like Barbie.

The big question is if youve
had more plastic surgery

or youve had more
plastic surgery.

Who do you think?

Im a very beautiful man.

[man] My side looks like
I swallowed a football.

[Dr. Dubrow]
This is really difficult to fix

and really unusual.

[Dr. Nassif]
I dont know how the heck
you can actually do that.

These are all
the intestines coming out.



This is a problem, man.
This is a big problem.

In middle school, people started
calling me Scottie Pippen Nose.

[Dr. Nassif]
That skin is extremely thin.

Im just worried that
Im gonna pop
right through the skin.

Oh, my gosh. This is,
like, swollen, right?

It looks to me twice the size.

[Dr. Nassif]
Everything will get better.

[sirens blaring]

[distorted voice]
Get on-- inside of the car.

Ah! Son of a biotch.

[distorted voice]
Get in the back of the car

and shut up.
Oh, my God.

Wait a minute. Wait a minute.
Where the hell are we going?

[male singer]
♪ I wanna be sexy ♪



♪ I wanna be hot ♪

♪ Fix me,
make me beautiful ♪

♪ I wanna be perfect ♪

[female singer] ♪ Wake up
and I live the dream ♪

[man] Nice. There you go.
Thats cute. Yeah.

Have fun. Barbie in the sun.
Yes.

[female singer]
♪ Im living my best life ♪

My names Nannette
and Im the boss bitch Barbie
of Northern Kentucky.

And Im looking to downsize
some of my accessories.

And yes, Im talking about
my boobs. These things.

Theyre so heavy.
So heavy and so big.

And I have loose skin
in the middle.

If I had to guess,
Ive probably spent over

a million dollars
to look like Miss Barbie.

[repeats]
Ching, ching, ching...

And its freaking expensive,
but its well worth it.

And you know what,
I deserve it.

My breasts to my makeup,
my hair,

my tanning, my gym,
my pink car, all my jewelry.

Ive had my upper eye lids done.

Botox in my forehead,
cheek filler, chin filler,

and right at the moment,
I have a lip implant.

Ive had my teeth done
with veneers.

And these H breasts

are 700-CC silicone implants.

Yes. Perfect.
Thats cute.

Sexy Barbie.

Barbie and I--
we used to hang back in the day.

And, uh, she was my idol.

And then 12 years ago,
I had this fantastic idea

that I wanted
to look like Barbie.

Shes the [bleep], you know,
and I wanted to be like that.

With Barbie,
its like, here she is,
but what does she do?

A lot of people judge me
and think that, you know,

I dont do anything, but no,
I cook, and I clean,

and I have a wonderful,
amazing husband

with six children.
Barbie mom.

Being pregnant all the time,
I would always have to wait

and then Id get my Botox ASAP

after I gave birth, you know.

So it was kind of difficult
because, you know,

you want to look a certain way.

[man] Nice.
[woman] You look so pretty.

[woman 2]
She looks so gorgeous.

Shes perfect.
I know I look good.

Like, Im not trying to
be conceited, but in my 40s,

I was Playmate of the Year 2018
for Playboy Slovakia.

Its been a ride and,
and Im still on that ride.

You know, I feel like
you maintenance your car,
you gotta maintenance your body.

So I think Im ready
for my tune-up.

My boobs are so heavy, Im gonna
downsize them to B for Barbie.

To a B?

Youre gonna go
from H to B?
You never know.

I started noticing,
like, uh, my skin changing,

like a little loose skin there,
and it bothers me.

Think it would be smoother
and everything if I downsized
these tatas.

Ta-ta-ta-ta-ta.

[man]
Give me that Barbie smile.

Beautiful.

Let me see your hands.
My name is Wesley.

Im from Cornelia, Georgia,
and Im a police officer.

The vehicles clear of people.
I beat kidney cancer,

but Im left with this
big poochy-pooch on my side.

My side looks like
I swallowed a football.

I always played jokes about if
I was gonna get...

One more time.
Go!

Over.

Stay on that weaker side.
There you go.

Two years ago,
I got married to Amanda.

There you go. Push through.
[Wesley]
Its been the best thing

that Ive ever done
in my life.

My wifes a personal trainer.

Shes been there for me.

She knows the problems
I have with my side.

[Amanda]
Doing good on time, babe.

[Wesley] I love my life as
a police officer.

So its very important
to keep training up

because youre dealing
with a lot of core,

and I have no core strength
whatsoever with my pooch.

[Amanda] Come on.
Keep pushing, keep pushing.

Good job.

[Wesley]
When I was 32 years old,

I started getting
this excruciating pain

right in the center
of my chest.

The doctor said,
"You got kidney cancer,

and its the size of
a softball,"

and it needed to come out,

and it needed to come out now.

I was young,

I wasnt supposed to have
kidney cancer.

I had preop and had it taken out
the following week.

I thought it was over with,
but a couple months after
I was back at work,

my left side where I had cancer
just started poochin out.

I went back
to my kidney doctor,

and he said it was
something cosmetic.

So thats when I seeked out
to a plastic surgeon.

Immediately after surgery
I noticed the pooch
looked a lot worse

than it did before I went in.
I never went back
to another follow up.

I just thought I was
just gonna be deformed
for the rest of my life.

Lets hope and get some answers
and get back to normal.

I cant wait to find out

what they say the issue is.

As a man,
Im a straight shooter.

Im hoping Dr. Nassif
and Dr. Dubrow

can shed some light and get me
the answers that Im needing.

I wont miss it,
Ill have to tell you that.

Just...
Well, weve got plenty
of pictures.

Yeah. Bye!
So...

[Dr. Dubrow]
Youre a married man now.

Im a married man.
Take a look at this.

Let me see. Wow.
Look how big it is.

Beautiful.

Wow.
And theres a little thing
in there. Brittany and Paul.

And theres a little diamond
inside there.
Wow.

Brittany and I
had two ceremonies,

and our official
wedding ceremony
was held in Los Angeles.

And believe it or not,
Terry was on his best behavior.

I love you. I love you.
You guys are amazing.

So congratulations.
I think youve met your match.
Thank you.

And I just wanna say cheers
to Paul and Brittany.

So went to Santorini.
Okay.

Had our blessing,
65 people there.
Yes. Okay.

Let me show you a few photos.
Okay. Oh, yeah.

It was nice.
[cheering]

Look at that dress.
I almost fell over.
Oh, she looks gorgeous.

Shes kissing me
and I almost fell over.

You can just tell that I was
a fun moment.
Oh, my gosh. Look at that.

Look at the view.
Isnt that gorgeous?
Wow.

Look how pretty
Brittany looks.
Isnt that?

The only reason Paul
had two weddings is because

last marriage,
he only had one,

and hes hoping two
will really make it work.

This case is one of those cases

that requires all nine years
of training to fix.

Let me show you
what Im talking about.

His name is Wesley.
Hes a law enforcement officer.

He had his kidney removed
for kidney cancer.

Oh, jeez.
Okay? So that left him
with this.

I have seen this
kind of thing before

and if its what
I think it is,

this is really difficult to fix
and really unusual.

This is a tough case.
Okay, lets get him in.

Can you please send in Wesley?

[Dr. Dubrow]
Wesley.
Hey there.

Wesley, how you doing?
Dr. Nassif.
Good.

Nice to meet you.
Terry Dubrow.

The last few years have been
really difficult for Wesley.

I have to watch him
struggle every day.

I have to watch him hurt
and he doesnt complain

and thats one of the biggest
reasons I want it fixed for him.

Hes such a strong person.

Tell us about
the development of the bulge.

Once I had my kidney out,
it started to bulge,

and it just kept getting bigger
and bigger in time.

And then I reached out
to a plastic surgeon.
He said he could fix it.

He put two pieces of mesh in
and immediately after surgery,

it seemed like it was bigger.

[Dr. Dubrow]
Immediately after surgery.
Yes.

Was this done at
a major institution?
Yes. Big hospital.

Board certified surgeon,
guy with a lot of experience?
Yes.

[sighs]

The fact that a board certified
plastic surgeon

put on two layers of mesh

and immediately

Wesleys bulge was worse
the very next day

just underscores the idea that
this is an incredibly difficult

and potentially
unfixable problem.

Okay, how do you wear
a bulletproof vest
and a police belt?

I have to wear a binder
extremely tight

that pushes all my insides up

to kind of push the pooch
into my side,

and then I put my bulletproof
vest over it

before I go to work.
Oh, jeez.

And how much does
a bulletproof vest weigh?

Its probably about
12 to 15 pounds.

Your gun belt.
Probably about 40 pounds extra.

Do you realize that?
Those things weigh 40 pounds?

You ever see what they carry
in their gun belts?

Its the coolest thing
youve ever seen.

There are two key questions
I wanna ask Wesley.

One: What exactly is
in your gun belt?

And two:
Can I tase Paul?

How is your core strength?
Its--

I have none on my left side
at all.

Does it hurt?
Yeah.

It does hurt?
It hurts from time to time.

If you dont mind,
Id actually like to see

how lax your abdominal wall is.
Okay.

So is it possible that we can--

you can show me here?
Yes.

So, when youre lying down...

If you were involved in
somebody holding you down,

could you...
No, Id have to roll over

to him when my guns
on my right side.
And you couldnt roll over,

you were stuck?
Right.

When youre a police officer

who needs their core strength

to do some very significant
physical activity...

I cant imagine the stress that
he felt as this was progressing.

So let me ask you a question.
Do you think this is a hard
problem to fix?

Not for you.
Oh.

[all laughing]

I have an idea of what it is.

Ill know a lot better once
I examine you.

So lets go in the exam room
and check you out. Okay?

Okay.
All right. Lets go.

[Dr. Dubrow]
Wow. Look how hard that is
to push back in.

This is a problem, man.
This is a big problem.

That thin skin is one
of the reasons your nose

is so risky
and so difficult to fix.

[woman]
I just want a nose
that has no bumps.

Is that so much to ask for?

♪ I wanna be perfect ♪

[Dr. Dubrow] Do me a favor,
bear down for a minute.

Like push down like
youre gonna have a baby
or poop or something.

Look at that, look at that.
[Wesley] It just got...

[Dr. Nassif] So, I mean--
Look how hard that is
to push back in.

Now relax.

Bear down. Okay.

[Dr. Nassif] No way.
I dont know how the heck
you can actually do that.

Im just looking at it.
Do you know what it is?

Its like
a huge massive wall defect.

And these are all
the intestines coming out.

Is that what it is?
That-- Okay.
Thats partly right.

But theres some weakening of
the wall there or something.

Thats right.
Have a seat for a second.

You have a neurogenic
abdominal wall.

What does that mean?

Its essentially
a surgically induced stroke

of the abdominal wall.

Its unique to the surgical
removal of a kidney.
Right.

Why it happens,
nobody really knows.

So, why didnt what the other
plastic surgeon do work?

It failed because when
you sew a piece of mesh

from paralyzed tissue
to paralyzed tissue,

why would it hold?
Exactly.

As I feel the side of
Wesleys abdominal wall,

I realized that the area where

its lost its muscle tone
is extremely large.

So I think the surgeon who
attempted to fix it initially

put a patch here

when the patch probably should
have been over this entire area.

You might just think, you make
this incision and do this,

and youre done.
Right.

You have to actually

reconstruct this entire area.

Okay.
Wow.

This is a problem, man.

This is a big problem, right?
Right.

[inhales] You think
I can fix this problem?

I think you can.
Its an interesting case,

which, you know,
I love interesting,

and Im gonna bring my A game,

my B game, and my C game.
You know.

All the games. All the games.

[Dr. Dubrow]
All the games are gonna-- Yeah.

Yeah, lets do it
and Ill be there.
Okay.

Ive had several people tell me
Im interesting,

not in a surgical
type of interesting,

but, hey, if he can fix it,
Im for it,

as long as the pooch
aint there.

Lets bring it.
All right?
Lets do it.

All right, my man.
Im in. Thank you.

My name is Megan,
and Im from Sarasota, Florida,

and my nose is like
a construction zone.

Ive got bumps in the bridge,

its long, its crooked.

Im kind of over it.

For me personally,
its just really hard

to see that you dont see what
I see and everybody else sees,

which is a beautiful woman.

I dont have any confidence.

We really have to make sure
we find the right doctor.

The right doctor.
And I think we have.

Im gonna be looking forward
to see what he has to say.

Yeah, me too.

Its been 26 years

since my first surgery,
and the aging process

has definitely taken
a toll on my nose.

The bumps of my tip
keep getting bigger
and bigger.

Im just afraid
that the bumps

are gonna push
through my skin.

I feel I really--
I really need it,

not just cosmetically

but almost medically

for, you know, my nose and
how its changing and stuff.

I just want a nose
that has no bumps.

Is that so much to ask for?

[Dr. Dubrow]
All right, who do we have?

Megan, beautiful lady
from Florida.

[Dr. Dubrow] Oh.

Obviously very pretty lady
with thin skin.

Thin skin. Wow.

Okay, so obviously you
can see the deformities,

so we need to see her.
She needs your help.

Can you please send in Megan?

[Dr. Dubrow] Megan.
[Dr. Nassif]
Megan, how are you?

Hi. Hi, nice to meet you.
Dr. Nassif.

Hi. Terry Dubrow.
How are you?

Nice to meet you.
Nice to meet you.

What Im looking for most

with meeting the doctors
here today

is just to get
a better understanding

of can what Megans
been going through
get fixed,

and can they stop the pain
that shes been feeling

just by feeling
that shes unattractive.

You know, one of
the most important things

in my life is making sure
that Megan

is happy every single day.

[Dr. Nassif]
Well, welcome.

Thank you.
Thank you.

So we know very little
about your nose.

Okay.
But obviously

wed love to hear your story.

Basically I was
a very happy kid,

and it wasnt about
until middle school

when I realized that my nose
was a lot bigger
than everybody elses.

Teasing?

And then the teasing
started happening.

Yeah, we were
from Chicago area,

and Scottie Pippen
was a well known
basketball player,

and hes well known
for his big nose,

so people started calling me
Scottie Pippen Nose.

It felt awful.

My self-confidence
was going down,

and I begged my mom
for a nose job,

and I was 13 at the time

I had my first nose job.
Okay, a little young.

Getting a rhinoplasty
age 13 is way too young.

You can actually stop
the plates,

or the growing of the nose,

to get to its normal
mature size.

The earliest age in a female
is about 15,

assuming that they have finished
their growth spurt.

Thirteen? Nah.

Now it was smaller,
but it was just crooked
and bumpy.

[Dr. Dubrow]
Yeah. Hmm, okay.

By senior year of high school,

I begged my mom again

to have it fixed.

Same doctor.
Oh-oh...

He did not tough any
of the bumps on my bridge.

My nose seemed more crooked.

I felt defeated.

I decided that I cant do
this again.

Often its not a good idea
to ask the doctor

who gave you
a significant complication

to fix that complication

because fixing a complication

is a thousand times
more difficult

than doing
the original surgery
to begin with.

By the way, is this one
of the most handsome guys

youve ever seen
in your life?

Oh, dont tell him that.

Look at this guy.

He looks like Tom Brady.
You get that.

Ive-- I--
Thats what it is.

You look like Tom Brady.

I appreciate it.
Thank you.

Doesnt he look
like Tom Brady?

Actually my hair, you know,

even though I have
a little bit less gray hair,

my hairs almost like his.
Isnt it right now?

You notice how hes turned it
back to himself?

This is what we call
in medicine

nar-cis-sism.

Is it a coincidence
that both Nassif

and narcissism

both have two "s"s?

Yeah, I dont think so.

Can you give us
a little rundown,

on your nose,
what do you want me to do?

Take out all the bumps

that the previous surgeon
didnt,

and I just want
a straight symmetrical nose.

Its funny. A lot of your
concerns about your nose

are related to the fact

that you can see the underlying
irregular anatomy,

which highlights the fact
that your skin is so thin.

That thin skin

is one of the reasons

your nose is so risky

and so difficult to fix.

That thin skin,

you know, is scary.

And so what we need to do now,

lets go to the exam room.

We wanna feel your skin

and then make a plan
from there.

Okay? Lets go do that.
All right.

Yeah, even here you can see
the middle vaults

completely gone.
Yeah.

The biggest issue
with Megans nose

is that the doctor

removed too much cartilage.

So now her nose
is falling apart.

Its a complete mess.

This is my Bunny sister Sherra.

Playmates.
Just like a family. Yeah.

[Dr. Nassif]
I got asked to be on Playgirl.
On Playgirl?

The way Paul is getting
into Playgirl

is if they have
a microscopic edition.

♪ I wanna be perfect ♪

[Dr. Dubrow]
Do me a favor.
Come over here.

Hes got the blue eyes.

Hes got perfect symmetry,
the gray hair.

He does look like Tom Brady.
Youre right.

Look at the teeth.
This guys perfect.

So are you in love
with him or something?

No, Im just s--
Im just--

Look, Im a plastic surgeon.
I look at symmetry

and beauty all day.
I know, but you know what?

Since you and I
are brothers...

Are you jealous?
...and we have
our little bromance,

You see-- Is he--

How come you really never say
anything about me?

I must say this is
a sad moment for me.

You know, Im used to getting
attention from Terry,

whether its positive
or negative,

and now Im getting...
no attention.

I only have eyes for you,
seriously.
Thank you.

Um, so were gonna feel
a little bit here.

Boy, thin skin.

Yeah, your skin is extremely--

Its like wafer thin.

Your bones are asymmetric.

Your left bone is wider.

Turn your head that way
for me for a minute.

Yeah, even here you can see
the middle vaults

completely gone.
Yeah.

The biggest issue
with Megans nose

is that the doctor
removed too much cartilage,

so now her nose
is falling apart.

To make matters worse,

Megan was born with
extremely thin nasal skin.

So that means you can see
every sharp point

and irregularity

that the previous doctor
created.

Its a complete mess.

All right, so lets talk
about your nose.

Youre missing cartilage here,

missing a little cartilage
on the right
where its pushed in,

and around your tip we need
to camouflage everything.

So do you know where
I take cartilage from?

The rib.
The rib.

On top of the rib theres
a little piece of covering

called perichondrium.

Im gonna use that to help

build up some thickness

to your skin
right around here.

And when we lift up the skin
thats stuck to your cartilage,

theres a small risk
of necrosis.

You may even wake up,
and I might have a leach
on your nose

if Im worried
about your blood flow.

We have to do leaches sometimes

to help with the blood supply.

Mm-hm.
What do you think?

Do you wanna do this?
Do you wanna take that chance?

Its scary to hear
all those risks again,

um, but I think--
I think I wanna go for it.

If I need leaches,
can I still be asleep

when youre putting them
on me?
No.

I do not want leaches
on my face.

That freaks me out,
but if anyones gonna do it,
its gonna be Dr. Nassif,

and I completely,
completely trust him.

You know, you name your leaches,
like your own pet.

Actually you can make
some photos.

You can do all that
and stuff.
Yeah.

Oh, thats gonna be--
thats gonna be recorded.

Thatll be your first--
Do not worry.

You can get a little collar
for it.

A little weird.
[Dr. Nassif] Pleasure.

Nice to meet you.
All right, well see you.

Great meeting you.
Im glad were gonna do this.

Nice meeting you.
Take care.
Thank you.

So I saw on your Insta story

that you were at
some major event

in the East Coast
this weekend?
Yeah.

It was a fundraiser
for the arts

in East Hampton.

We flew Friday night
after surgery,

get there late,
of course stop and have
my Dunkin Donut

at 11:30 at night,
my favorite.

Saturday morning get up,
you know, we did bike riding.

It was nice.
It was just really relaxing.

So you stayed
in your friends house...
Yes.

in the Hamptons.
Yes.

Okay.
I already know
what youre gonna ask.

Go ahead.

And--
Did I pay for anything?

And had...

a number of meals.

Yeah, go ahead.

And--
And I had to fly there.
Remember that.

You had to fly there.
Oh, okay.

So you had to fly there.
Did I pay for that?

Did you pay for--
Anything.

Did you pay for the flight?

Who paid for the flight?

He did.
What?

He goes,
"I want you to come out

and have a wonderful weekend.

Im paying for everything."

You accepted his payment
for the flight?

Of course.
You didnt pay
for the flight?

Oh, wow.

That was almost a perfect trip
for Paul,

except he had buy
the entire donut.

What happens when you put

very large implants

on a very small person?

Capsular contraction,

death of the skin,
thinning out of the skin

you know, all that.

All of that--
All the bad stuff.

But they can also develop
other unique complications.

This is Nannette.

Nannette has concerns

about the cleavage area.

This is sort of
a unique problem

that Ive seen a few times,

with not the
most simple solutions.

So lets bring Nannette in

and see if we can help her
with her cleavage area.

Can you please send in
Nannette?

Well, hi.

[Dr. Dubrow]
Hello.

Ho-ho,
I didnt notice that.
Plastic is fantastic.

This is me.

I am like this 24/7.

Im 45 years young.

I just goof around all

the time and have fun.

This is my Bunny sister Sherra.

[Dr. Nassif]
Sherra, nice to meet you.
Nice to meet you.

Nice to meet you.
What does that mean?

[Nannette]
Weve been in Playboy.

[Dr. Dubrow] Playmates.
Just like a family, yeah.

Oh, I get it.

Weve got two
Playmates here.
Fantastic.

Please have a seat.
Thank you.

By the way, I got asked
to be on Playgirl.
On Playgirl?

You got--
No, you did not.
When was this?

The only way Paul
is getting into Playgirl

is if they have
a microscopic edition.

So you were leading
this sort of regular life,

and now you have the doll kind
of look, right,

the plastic-fantastic look?
Oh, sure.

I live a Barbie lifestyle,

and in the future,

you know,
I wanna age gracefully,

maybe a couple of years
to get my face done,

and Id like to get
my butt done.

I think aging gracefully

is a term they usually use

to mean you dont have
plastic surgery.

No, not-not in my case.

Not the way we see it.

Yeah.

If its 60, 70,

hell yeah,
Ill get my surgeries

until Im in my grave.

[bleep]

The new aging gracefully

is lots of plastic surgeries
so you dont age.

Absolutely. Yes.
Exactly.

[Dr. Dubrow] Okay.
Yes. Yes.

The big question is,

if youve had
more plastic surgery

or youve had more
plastic surgery,

who do you think?

Hm... Thats a good question.

Cause youre both aging
very gracefully

in that regard.

Im a very beautiful man.

Im very handsome.

So you have
very large implants

on a very small frame.

Is that giving you
some issues?

Is that why youre here?

Oh, yes, so basically
my breast implants

are just so big,
so heavy on my back,

and I think
with all the weight,

its just the skin, like,
basically in the middle.

Think itd be smoother
and everything

if-- if I would downsize.

I love it.

Regardless, if theyre smaller,

Im still gonna look hot.

Uh-- I agree with you.

You know? And I feel that
as long as I feel comfortable

with myself and everything,

thats-- thats first
and foremost.

We like hearing this.
Oh, we love it.

Oh, thank you.
To really determine

what the best thing to do is,

we need to do
a physical exam.

Sure.
And figure out
the options

and what the risks are.
Okay?

Awesome, thanks.

All right,
lets go have a look.

So you have a little bit
of tightness of the skin here...

Mm-hm.
...with a little band.

Some girls call it uniboob.

You have the right
to be stupid.

This is stupid.

Sir, dont talk back to me,

or Im gonna arrest you again.

♪ I wanna be perfect ♪

[Dr. Nassif]
Wow.

Those are pretty fancy.
Arent they?

Oh, wow, look at that.

Now, Id bedazzled those
myself.

These skates
remind me of Terry.

Theyre loud,
theyre over the top,

and they had their peak
in the 80s.

Or maybe it was the 70s.

Lets examine
where they are...

Sure.

So you have a little bit
of tightness of the skin here.

Mm-hm.
With a little band.

You do-- I mean,
its never bothered you?

You didnt mention it,
and thats good,

but you have some symmastia.

So symmastia is where
they share a pocket.

Mm-hm.
This is called--

Some girls call it uniboob.

On examination,

Nannette actually does have
a very significant symmastia,

which is an incredibly difficult
problem to fix,

and most plastic surgeons

dont have experience
in doing that.

With time, predictably,

this problem
is only going to get worse.

You need a procedure
called a capsulorrhaphy,

which is one in which
you reduce the pocket,

and create walls

preventing the implant
from going to the other side.

So that can be done.

Your skin, once the implants
are dramatically reduced,

would really be loose,

so a lot of skin
needs to be taken.

You would need
so much skin removed...

that that would take
so much blood supply,

which may not allow to heal

without it turning dark black,

losing the nipple circulation,

all that kind of stuff,

so I think this is
one of those cases

where the best thing to do

is to take the implants out

for about six months,

let everything shrink down,

and then you can more safely put
a smaller implant in

and remove skin,

which would be less
skin removal

than if you did it now.
Sure.

Going without breast implants
for six months,

could you tolerate that?

You know, I could do that,

but right now just
with my schedule,

with modeling, right now
I dont have time for it.

Yeah.
But in the near future

I definitely wanna come back,

and you could do my facelift
at the time.

[Dr. Dubrow laughing]

Im lucky if I have time
to have peace and poop,

but I know that Im definitely
gonna come back here
to California,

and theyre definitely gonna do
a surgery on me.

[Dr. Dubrow]
When youre ready
to go smaller,

were here for you, okay?
Thank you.

Great pleasure meeting you.
Thank you.

Well, you brought
Mr. Beautiful here, huh?

The sexiest man alive.
Look, see?

I gotta say, I like it.
Its a good look.

Im trying to be like you.
Its a good look.

You know Dr. Peng?
Yes.

I actually look a little bit
better than you today.

You do. Im jealous.

But today its about her,
so, you know,

just-- just, you know, stop.
Yeah, I couldnt--
can you think about me?

Thats enough,
for Gods sakes.

Im here.
Right here.

Focus on me.
How are you, my darling?

Im super nervous.
Oh, are you? Why?

I just wanna wake up
and, like, someone me

that everything will be okay.
Oh, oh...

Our goal is to take care
of you today.

You know, obviously,
remember the risks?

I hate mentioning that
in the morning,

but the biggest thing is,
you know, the skin.

Yeah.
And that skin roll

is really thin.
Yeah.

And so if you wake up,
and I say you need a leach,

its me being
a little extra cautious

if I need to.

So dont freak out.
Okay.

Well take care of you.

This is a complicated surgery

because the skin
is extremely thin.

We need a good piece
of perichondrium,

which is the tissue
overlaying the top layer

of the rib, and with that,

well be able to cover the tip,
and this is going to be a thing

where I know Im going to get
some improvement.

I just dont know how much.

For Megans surgery today,
well open the nose

while simultaneously harvesting
perichondrium and rib.

Next, Ill remove bumps
from the dorsum,

fracture her bones to close
the open-roof deformity,

and use spreader grafts
to straighten the middle vault.

Then Ill use dome grafts
to round out the nasal tip

and articulated rim grafts

to make her nostrils
more symmetric.

Finally well place
perichondrium
on top of the bridge

to help camouflage
any irregularities.

Okay, making my incision

into the skin around the nose.

So this is going to be
with the telling part of this,

is can I lift up the skin
without injuring it?

Every time I make
a little cut,

Im just worried
Im gonna pop
right through the skin.

Okay, did I make a hole
in the skin?

I didnt make a hole,
but look at that skin there.

That skin is extremely thin.

[Dr. Peng]
So we got a nice piece
of perichondrium.

[Dr. Nassif]
Let me see it.

Thats a long,
beautiful piece.

[Dr. Peng]
And the rib is going
to come out now.

Oh, thats a beautiful
piece over there?
Yeah.

Okay, so Ive lifted up
the nasal skin.

Now lets do a septoplasty.

Go, go, go.

When youre performing
any rhinoplasty,

you have to fracture
the bones first

before I look at
the middle vault of the nose,

which is this part,
and with Megan,

the left side is collapsed

a little bit more
than the right.

I need a thicker spreader graft

on Megans left side.

Then a little smaller one
on the right.

And our goals to make it nice
and straight and even.

Our next step now is to put
small pieces of cartilage

and tissue on top of the dome,

and thats gonna help smooth out
where the bumps are.

After we do that,
theres still asymmetry
of the cartilage

around the nostrils.

We gotta work on that

to give Megan more of
a symmetric nasal tip.

The tip skin is status quo.
It hasnt turned purple.

Its still really thin
and delicate.

Were watching it
throughout the case.

At first I thought Megan
was gonna need leaches

immediately after surgery
because of her skin color,

but now at the end,
her skin is nice and pink.

We dont need to bother.
No leaches.

Did I miss anything?

No.
I think its like
almost everything

we can put into a nose
is in Megans nose.
We did.

Yep.
Fantastic.

Excellent job.

In the next 48 hours

we wanna keep monitoring

Megans nasal tip skin.

We did a lot of work
on Megans nose,

and I know
that shes gonna like it,

but I really wanna make sure
that Nick likes it.

Hi, Nick.

Take a peek.

Oh, my gosh.

This is, like, swollen, right?

It looks to me
twice the size.

Everything will get better.

This is crap tissue.

Looking like a hundred-year-old
ladys muscle.

[bleep]

[groans]

♪ I wanna be perfect ♪

[Dr. Dubrow]
Todays the day, man.

It is.
How are you?

Good. How are you?
Good. Good to see you.

Good to see you.
How do you feel?

Feeling good.
Excited.

Yeah, me too actually.

Ive been thinking
about your case

ever since I met you.
Awesome.

You know what they say
in mixed martial arts?

Im going to impose
my will on you?

Right.
I have cut weight.

Im gonna really go
with the MMA analogy.

Uh, clearly.
All right?

Ive been working
on my ground game.

Okay?
My stand-ups ready to go.

If it goes to the ground,
Im re-- okay, enough of that.

[woman] I know.
I know, that was stupid.

I just wanna get after it.

I just w-- Im just--

This is-- Its on.

All right?
Thats right.

For Wesleys surgery today,

Im going to build
what I call a muscle sandwich.

I will start
by making an incision

through his previous scar

and identify
the healthy sections

of his abdominal wall muscles.

Next I will bypass
paralyzed muscle

and stitch together the robust
internal oblique muscle

and transverse abdominis
muscle.

I will then sew
a piece of mesh

on top of that

followed by another layer

of healthy external
oblique muscle.

Finally I will remove
any excess skin I find,

hopefully giving Wesley
a bulge-free side.

Okay, so first plan of attack

is to open up the skin

and see what I can find.

The question is,
what am I gonna find?

The ability to do
this operation

really depends on the ability

to identify the different layers
of the abdominal wall.

The issue with Wesleys muscles

is that his abdominal side wall

has become paralyzed

from the previous
kidney surgery.

To try to fix that,
the plastic surgeon

put the mesh on top
of the muscle

rather than reconstructing

the abdominal wall muscle,

putting the mesh
on the inside,

but now that the mesh
is in there,

its become incorporated

into the muscle

and is impossible to remove,

and fortunately it doesnt need
to be removed

to get a good functional repair.

This is the upper layer
of muscle above,

which contains
all three layers of muscle,

and this is the below layer.

The only issue is,

how good is this muscle
up here?

Its not very strong.

Wispy nothing muscle.

[groans]

This is crap tissue.

Looking like a hundred-year-old
ladys muscle.

And this... [bleep]

If Im unable to find good,
working muscle tissue,

then this operation will be
a total failure,

and that muscle sandwich

will be unfortunately...

a [bleep] sandwich.

Hmm...

come on, baby, separate for me.
Show me.

Well, some parts,
theyre better than others.

It kind of peters out up here,

but I have ribs right here.

Its not gonna herniate
through the ribs,

so at least Im protected
by ribs right there.

So the piece of bread
on the outside of the sandwich

is this layer brought together,

Then well put
a mesh over that.

And then well take
this layer

and put it over that,
and well pray.

Rather than use a synthetic mesh

that Wesley may have
a foreign-body reaction to,

Im gonna use a biologic mesh
thats really strong,

made out of pig.

So if you really think
about it,

Im gonna make a delicious
BLT sandwich,

that I hope he loves,
as much as I do.

Okay, so check this out.
All the excess skin is removed.

The laxity has been repaired
in three layers.

And if you test this
with the bulge test,

thats really intact.

Okay, so lets close him up

and get him in recovery.
Okay?

Thank you so much.
That was really hard...

and really fun.

[Dr. Nassif] Nick!
[Nick] Hey!

How you doing, buddy?
Good to see ya.

Hey, whats happening?
How are ya?
Im good.

Oh, how are you?
Oh, Im okay.

Look how the blue shirt
brings out his blue eyes.

[Nick] I mean, you know,
thats why I wore it.

I wore it. I hoped he noticed.
And Im glad he did.

[Dr. Nassif] Now, first thing,
peel off that little cast
of yours.

[Dr. Dubrow]
That looks great.
Looks great.

I dont know if you
remember her profile.
Well, you fixed it.

I wanna look at her profile.

[Dr. Dubrow]
Yeah. Yeah.

Does it look good?
[Nick] Yes. Looks great.

Now...

take a peek.

Wow.

Oh, my gosh.

Hey, this is, like,
swollen, right?

I mean its--
will it get--

Of course its swollen.
Okay.

Honestly, the way
my nose looks right now

is freaking me out.

It looks to me,
twice the size.

This phenomenon that
youre experiencing right now,

we actually have this graph

that shows a smiley face
the day before surgery,

a super happy face
the day after surgery,

and then a week later,
a totally unhappy, frowny face.

Thats where youre at.

Its a very common place to be.
Okay.

It looks big.
[Dr. Dubrow] It looks weird.

It-- Yeah,
it looks kinda weird.
It doesnt look big.

This is what your nose looked
like at the end, you go, "Ughh."

Right?
Right. Right.

So...
Sorry.

Dont worry. Trust me.
Okay. Okay.

It looks great.
Remember,

the skin is gonna shrink
over it.
Okay.

Im not a patient patient.
Im not.

Youre gonna reassure her
about the swelling? Okay.
[Nick] Everything looks great.

Cause I dont want to go
through this again.

[Nick]
No. Youre not going
through it again.

Everything will get better.

Okay.

[Dr. Dubrow] Hey!
[Dr. Nassif] How are ya?

[Wesley] Good to see you.

Good. Doing good.
Good to see you.

So the operation was a massive,

at least in my mind,
a success.

The question is,
did it work?

Do you want him to stand up?
[Dr. Dubrow] Do me a favor,
stand up for a sec.

By the way, your mesh
is made out of

whats called STRATTICE,
or pig skin.

Biologically, thats the best
mesh you can use.
Yum.

Youre part bacon now, dude.
Yeah, if a criminal
calls you a pig,

you cant deny it now.
Guess not.

Call me pig all you want,

and Ill still take you
to jail.

[Dr. Dubrow]
So, remember this bulge?

Huge bulge right here.
Lets see whats cooking within.

[mutters]

Look at that.
Look at that.

[Amanda]
Oh, my God.

[Dr. Dubrow]
Look at that.

Looks really good.
Look at that.

Awesome.

Now youll be able to go back
and kick some ass.

Thats right.
[Dr. Dubrow] All right.

So you happy?
Im very happy.

Yeah.
Yes, sir.
Pleasure. Congratulations.

Thank you.
Thank you.

Okay. So keep healing.
Thank you.

And by the way,
youre a tough man.
Youre a big boy.

If you went like... boom!

You could break this whole...
[makes ripping sound]
all my stuff.

Have about 250 stitches
in here, okay?

So dont break it.

Oh, Im not.
Im gonna be extra careful.
I wont let him.

Im really impressed
with Terry on this one.

When I first saw this,
I said theres no way

hell be able to fix this.

But now looking at it,
it looks fabulous.

Good job, my brother.

Oh, my God.
That is so awesome.

I can not believe
how good that looks.
It is, isnt it?

Thats flatter than this side.
Its--

I know. Im gonna need to
go back and do this side now.

[Megan] When I first saw
my nose after surgery,

I was really,
really freaking out.

There she is. Oh, my gosh.
Look whos back!

[Wesley] Just got to pat him
down. Make sure he dont
have no weapons on him.

[Dr. Dubrow]
Hes heavily unarmed.

[all laughing]

Terry, you can make fun of
my package all you want.

But I have a concealed-weapon
permit...

♪ I wanna be perfect ♪

[female singer]
♪ Feeling so anxious
and nervous ♪

♪ But I knew that
you would be worth it ♪

♪ More than I ever dreamed ♪

♪ I guess this is happening ♪

[Megan] When I first saw
my nose after surgery,

I was really,
really freaking out,

and the doctors told me,
"Its really swollen,

its gonna get smaller.
Be patient."

I will get the results
that I want.

So glad that you guys are here.
I felt I havent seen you guys
in so long.

I know.
I know. Its been so long.

Were excited everybodys here,
and I cant wait--

cant wait for her to come down
and share some time with us.
Absolutely.

I know. I cant wait to see her.
Cant wait to see her.

[Megan] Now, after
a couple of months,

it definitely
is getting smaller.

It feels good
to look in the mirror now.

It just looks so smooth
and straight.

Now Im gonna go hang out
with my hot husband.

[woman] Megan!
[man] Oh, my gosh!

Hello!
Oh, my gosh.

[woman]
You look amazing.
Oh, my gosh.

I think Megan looks beautiful.
I mean, I loved the way she
looked before.

I love the way she looks now.
Im just-- Im happy for her.

And I think she looks amazing.

Oh, you look great.
Thank you. Hi, Kel.

You look beautiful.

Hi, Jess! Thank you.
Oh, you look amazing as always.

Why, thank you.

Before my surgery,
my nose was like

a construction zone.

There were bumps on the bridge,

it was crooked,

and I had zero self-confidence

because I felt like people were
always focusing on my nose.

But now, thanks to Dr. Nassif,
that nose is gone.

The bumps have been removed,
my nose is straight,

and I feel like
Im in the spotlight
instead of my nose.

Now Im getting all
the attention

instead of my hot husband.

Well, you must be so happy

that there are so many things
that they fixed.

Yes.
They did a lot
to improve things.

They did a lot, you know,
not only cosmetically,

but, more importantly,
medically.

[Jessica]
I think Megan looks great.

Ive seen her before
her first surgery,

when we were 13, that she was
really unhappy with.

And all those things
have been resolved,
and her skin looks great.

It definitely feels so good
to like be more myself again.

I just want to thank Dr. Dubrow
and Dr. Nassif for doing
a great job with Megan.

Its been such
a great experience.

And, guys, just give me a call.
Call me.

So glad that you guys are all
here to celebrate with me and...

[Kel]
Im so happy for you.
Lets have a fun night.

Lets go celebrate.
Definitely.

[all]
Cheers!
To a great night.

[male singer]
♪ Im going all in! ♪

♪ Im going all in! ♪

[Wesley] I love my life
as a police officer.

After living with a bulge
for the last seven years,

now that its gone, I go to
work without any limitations.

My core strength has increased.

Im not afraid of getting in
a scuffle

and not being able
to protect myself.

Ive been waiting for this
moment for a very long time.

[Dr. Dubrow]
There he is.

Oh, yeah. Oh, yeah.
Look at that.

[siren blares]
Lights are blaring.
Look at that.

[Dr. Nassif]
Oh, look at that.

[Dr. Dubrow]
Hey, man.

Uh, oh.
Hows it going?

Oh, look hes-- hes actually
gonna bust your ass.
Whats happening?

How are ya?
Good. How are you?

Its good to see you.
How are you?
Good to see you.

Im doing awesome.
How you doing, buddy?

Back on full duty
and doing good.

Full duty?
Yes, sir.

Is the bulge
still completely gone?

Its completely gone.
Completely gone.

Completely gone.
Yes.

Can we see it?
Yes, sir.

Are you gonna take that
belt off?
Imma take the belt off.

Do you mind if I put it on?
Go ahead.

Seriously?
Look at this thing.
There you go.

Put that on. Lets see
how much weight that is.

This is awesome.

[Dr. Nassif] Careful.
Yeah.

Whoa. Let me see that.

Look at that.
[Dr. Nassif] God, even
the scar healed well, too.

[Dr. Dubrow]
Thats so good.

Awesome.
Im very impressed with it.

Really?
Yes, sir.

Before my surgery,
I had a bulge on my left side

the size of a football.

I had zero core strength

and I had to wear a binder
around my side

just to fit in to
my bulletproof vest.

But now, thanks to Dr. Dubrow,
the bulge is gone.

I am able to do ab workouts
and I fit in to my uniform.

And Im ready to protect
and serve my community.

[Dr. Dubrow]
Do they make it in double XL?

Well see if Ive got them.

Open it up a little bigger.
So this is actually
not that heavy.

[Dr. Dubrow] No?
No, its hot though.

Yeah, its very hot.

[Dr. Dubrow]
Okay, so hold on a second.

Since-since
Im wearing this...

Okay?
Yeah.

Im the new sheriff in town.
Yeah.

All right?
Show me how to arrest someone.

Come over here.

If torturing Paul is wrong,

I dont want to be right.

Do it gently, dont hurt me.
How do you do it?

You just reach over.

Yeah.
Easy.

Aiyah, jeez.
That already hurts.

[Wesley]
And thats loose.
[Dr. Nassif] Oh, my God.

You have the right to be stupid.

Anything you say
will be ignored.

You know this is really stupid.
This is stupid.

Uh, sir.
Dont talk back to me

or Im gonna arrest you
again...

You see what other... he does?

...and charge you
with indecent exposure.

Now you put him in the back.

Back seat?
Yes.

You walk him to the...

You have the right
to be a moron.

Shut up, you dick.
Youve obviously
expressed that right.

You gotta watch your head
when you get in.
Get in the back of the car

and shut up.

Hes heavily unarmed
with that small package.

[wheezing laughter]

Terry, you can make fun
of my package all you want,

but I have a concealed-weapon
permit...

Its hot in here.
Let me out of here.
What are you doing?

Im back here with you.
No, lets get out of here.

Oh, my gosh...
Wait a minute--

Its super uncomfortable
back here.
Hold on, wait a minute.

What are we doing? No.
Have you ever been
arrested?

By the way, you put me
back here with the dog?

Seriously?
[barking]

How can you?

[over megaphone]
Officer, the dog in the back

is starting to smell.
[siren chirps]