Botched (2014–…): Season 6, Episode 17 - Send Me A Mir-ear-acle - full transcript

A young man with a cauliflower looking keloid on his ear hopes Dr. Nassif has a solution to remove it permanently.

Im feeling awful
this morning.

I had all the CCs
you could ever think of.

Im ready to have
a reduction.

I started to develop
chronic back pain.

You know Im angry.

Im feeling
flat chested right now,

and Im very, very upset.

I was born with a condition
called microtia,

which has ultimately left me
with a keloid on my left ear.

The risk of you getting
that keloid back

is still there.



Theres no guarantee here.

I dont know
if this is gonna work.

Again, no ones done this.
Yeah.

Im a singer

and Ive got my reality show.

You did reality TV?

Yes, in college.
In college?

Keeping Up With The Balkjes.

Its very important
to look good.

So I had 500cc filler

injected each butt cheeks.

Of hydrogel?

Yes.

Scary.



Have no idea how much this chair
helps my back.

If I could sleep here,
I would.
Yeah?

Taking all this weight
off my breasts

for my back.

Im feeling awful this morning.

My name is Sheyla,
and I am cuckoo for breasts.

I love breast implants,
and I love big breasts,

but they cause me back pain.

Yeah.

John, you like little boobs
like a orange.

No... little boobs.
I like melons.

Watermelons?
Watermelons.

I just like big boobs.

I grew up in Brazil.

I was unhappy with
the way I used to look.

In 2001, at age 21,

I started going
under the knife

every six months.

It became a habit.

It was like going
to get my nails done

at a nail salon.

I think I was--
Something wrong with me.

I think I was cuckoo crazy.

I have had 32 plastic surgeries
in my breasts.

I had all the CCs
you can ever think of.

I had 145 CCs,

245 CCs, 345 CCs.

I had 555 CCs,

650,

850, 1200...

...and 3500 and 5,500.

After that
I didnt wanna stop.

I still wanna go bigger.

My goal were 8,000 CCs,

but unfortunately--

well, I had a blessing.

I got pregnant,

so that stopped me
a little bit.

The doctor said,
"We have to go back
to this size

because youre gonna
breast feed."

So got my breast reduction

from 5500.

I went all the way down
to 750.

So after Victoria was born
a healthy little girl,

I went back to Brazil
and I say to to the doctors,

"Can you please make me
bigger again?

I cannot live
without my breasts."

I think the less that I have
right now is 2500 CCs.

Im gonna miss my twins.

Im gonna them so much.

But its time for them to go.

Its time to retire
the boob business.

In 2017 I started to develop
chronic back pain.

And Im sure
this has to do

with this unnecessary weight
carrying around.

Couple years ago,
if you ask me,

"Sheyla, go small,"

I would say,
"You know what? No.

Youre crazy."

But today Im ready
to have a reduction.

If I can have
my breasts reduced,

that will be a big help
for my back.

I have to, you know,
make it look better,

but the smallest I can go
is a thousand.

I cant wait to see you
without your boobies. Okay.

Im ready to look sexy.

Whats happening, Dre?
What is going on, man?
Hey, Eric.

How you doin?
Good to see you, man?

How about you?
Have a seat.

Whats up, best friend?

Hey, how ya doing?

Good. Good.
You know what I like?

Uh, yes, sir. Yes, sir.

My name is Andre.
I was born with a condition
called microtia.

Its when youre ears
are deformed

and smaller than normal,

which has ultimately
left me with a keloid
on my left ear.

Some people say that
it looks like a golf ball.

Some people say
that it looks like

a snail,

but no matter
what you call it,

I just want it gone.

Was it always that big?

or did it just--
did it seem to grow?

It was pretty small
when it first started out,

but then it got bigger
each year.

up until now.

So lets say, like, okay,
a year from now

youre completely healed,

like, the keloids gone
and all that,

are you gonna, like, go and,
like, start dating everybody?

Yeah, definitely.

Id be more open to it.

The keloid definitely
impacts dating.

I dont, like, pursue anyone

just because I think
in my mind

Im going to get rejected.

Theyre not going to want
someone with this giant keloid
on their ear.

Middle school was rough,
I remember.

That was when, like,
a group of guys

was just kind of, like,
mean, right?

Was that eighth grade
or seventh grade?

That was definitely
eighth grade.

Its so sad how cruel
kids can be.

I know.

When we were little
I witnessed Andre

go through quite
a lot of bullying.

We had people
even saying things to his face,

like, "Whats on your ear?
What is that?

You have cauliflower ear.

Why is your ear so ugly?"

But we made it.
We made it.

We did.

- Come here.
- What is that?

Put your hand in my back,
upper back.

Youre kidding me.

You have a thing to tell you
to sit up?

So its a little thing.
You stick in the middle
of your back.

Yes.
Then you have to set
your posture.

What are you--
By the way, my height
actually increased

by about half an inch.

Why dont you just sit up
straight?

The best way to get Paul
to stop slouching

is not by putting a device
between his shoulder blades.

Its by putting
an ice-cream cone

just above his head.

Aah.

So we have Andre,

a young man born with microtia.

Had reconstruction,

and hes developed what?

Keloids.

Keloids.
Oh, poor guy.

Let me show you a photo.

Oh.

In simple terms, a keloid

is overgrowth of scar tissue,

and when you just cut it off,

your body says,
"Hey, theres still
a wound here,"

and it keeps growing.

so its very hard to excise

and not have it
grow back again.

Can you please send in Andre?

Andre.
Hi.

This guys tall.

Nice to meet you.
Andre.

Nice to meet you.

Hi, Andre. Terry Dubrow.
How are you?
Hello.

Nice to meet you.
Nice to meet you.

Hi, Im his mom Malika.

Malika?
Uh-huh.

Dr. Nassif. Dr. Dubrow.
Hi.

How are you?
Hi, Dr. Dubrow.

Nice to meet you.
Come on in.

Have a seat there.

My mom, she was
a single mother.

We have a very close
relationship.

She was always encouraging me

to just make the most
out of a bad situation.

I know that its straining
to her to maybe go through
another procedure again

with the same results.

If Dr. Nassif cant fix this,

then Im just
gonna have to live with it
for the rest of my life.

So youre born with
a problem with your ear.

Yeah.
Okay.

It was a unique situation
when he was born.

There was something wrong
with his ear, and Im like,

"- Is it something I did?
- " No, you did nothing.

Cause I work at a pharmacy.
Its like was it a medicine

I was probably
exposed to before.
Okay, listen.

Listen to me.
Uh-huh.

You had nothing to do
with this.

- Okay.
- It just happened.

This is something
that happens randomly then?
Cause I always blamed myself.

Yeah.
There is not one specific reason
why microtia occurs.

Thank you.
So if youve ever
had any guilt...

- I did.
- Has nothing to do with you.

Microtia could be
a congenital thing,

or it could be environmental.

Many factors can cause this,

but you cant really pick out
one specific factor.

The childrens hospital
referred me to a doctor.

And he examined him.
Hes like, "We cant do
any surgery until hes five.

Mm-hm.
So we waited until he was five.

That was the worst surgery
because they had to get
cartilage from his rib.

From the rib.
Do you remember it?

I do, yeah.
I just remember I was in pain.

How old were you
when you got that keloid?

Nine or eight I would say.

He was like,
"Mom, I dont want anymore
surgeries."

But now, if you can see,
its like literally growing
over his ear

to where its covering
some of his ear.

I can tell this bothers you
just as much as it bothers him.

Definitely. No matter
how much people say that

they dont look at
the outside, they do.
And they judge you by that.

As a mother, I just try to
esteem in him, that hes loved,

hes accepted,
that thats just the outside.

How you are on the outside
doesnt reflect who you are
on the inside.

But Andre is kinda withdrawn
a little bit.

I feel he is limited
by the outside appearance.

Does it interfere with
any glasses or any activities
of any kind?

I wore glasses
and the thing about it is

I didnt really have like pa--
Yeah, rim.
A rim?

So what would be
your goal right now?

Really just to get it
looking

as much like
this ear as it could.

Oh, I would--
I would like it to look

exactly like that.
Yeah.

We want perfection. Yes.

Bring it down a few
notches, Mom. Bring it down.

The doctors are in
a business of making miracles

and mir-ear-acles.

You would be okay with
not perfection, right?

I would be okay
if it-- if we get close to it.

No big deal.
Yeah, of course.
No big deal.

- The incision was very blue.
- Red.

Oh, you know what that means.
Blood supplys not good.
And-- Yes.

I cried. Its like...
I was dying.

That I can kiss my career bye.

Kiss your butt goodbye.

All right, so were gonna take
a peek here.

Okay, okay.
So its attached.
Ohh.

Youre missing the area up here.
And thats right.

- This is the reconstruction.
- Mm-hm.

We got really lucky here
because Andres keloid

is attached to a small pedicle
to the top of his ear.

Its not engulfing
and eating his ear

because if we had
to remove a keloid

that is eating your ear,
then were lopping off
the top third of his ear.

What is our goals
for where you both want it?

You said,
"Can you remove the keloid

and make your left ear
look like your right ear?"

Mm-hm.
Right?

Yes.
Correct.
Okay.

Probably not going to make them
look exactly alike.

Yeah.

No matter what.

Okay.

At all.

So a plan would possibly be

doing a keloid excision

with possible rib
reconstruction.

Okay.

Assuming that the keloid
doesnt grow back.

A thought
thats entering my mind is,

if I put rib in between
the keloid and the skin,

is that going to act
as a barrier

to prevent further regrowth

of a new keloid?

And, yes, I just thought
about that myself.

Are there other treatments
that can stop the keloid?

There is one thing.

There is something called
5-Flurouracil.

It is an injectable.

It helps prevent the buildup
of scar tissue.

There is a possibility

that this modulator,

which means it tells things
to stop growing

may be effective.

I would inject
the 5-Flurouracil

at the end of surgery
and every week

until hopefully
that initial healing stage
is over.

Ears are basically either
there or not...

Yeah.
...generally.

Name me an actor or actress

who has great ears?

Cant think of any.

You know,
its just not a thing.

There we go. All right.

My names Kasia
and Im from Amsterdam.

Im a singer

and my bass is way too low.

Everyone knows you, you know?

"Kasia, yeah, the one
with the nice butt."

I was always a fan
of the butts,

especially like J.Lo

and Beyoncé and then Kim.

And I thought this is
like a whole evolution

of the butt is getting bigger
and bigger and bigger.

I walk and I twerk.

Its very weird

what butt can do
with your life.

My career was blown up
more than my butt.

Hello!

I look like ballerina?

Ive got my reality show

with two of my girlfriends,

call it,
Keeping Up With The Balkjes.

Notice I have cellulite
on my buttocks?

I remember performing
on the Amsterdam Gay parade.

for 13, 14,000 people.

And Im about to release
my new album.

Yeah, Im out there.

Sounds funny, but my butt
goes with my career.

Okay, so you see this side,
it doesnt look very nice.

Kasia is real known for
her music in Amsterdam

but also for her,
uh, beautiful body.

And also the back,

like you can see
all the fillers,
literally hanging.

Instead of going up,
its going down.

When I was 22,

I had fillers.

Then I feel excited.
I went back.

And I got my boobies.

So I thought its amazing.

Its like I became
a different person.

It was like more
or less like this.

And thats how it
was looking in the beginning.

Yeah.

So after the implants,

I had 500cc filler
injected each butt cheeks.

Your looks are important.

My butt going to be
literally into my knees.

It started eight months ago.

Then I can kiss my career bye.

Kiss your butt good-bye.
Kiss career--

Kiss your butt--

Im doing my music video.

Its very important
to look good.

I hope that Dr. Dubrow
and Dr. Nassif

find a safe solution

to remove the filler

and keep the implants

but also keep my butt
nice in shape.

I hope Dr. Dubrow is going
to fix it for you.

Hes married, I think. Huh?

Oh...
You know how handy
it would be

married to a surgeon?

- Sheyla.
- Hello.

So where you guys from?
Brazil.

Is that where youve had most
of your plastic surgery?

Yes, I want the big breasts,
the tiny waist,

but my doctor told me I had to
a couple of surgeries

to get that size

cause I was flat chested.

Okay, so what did they put
in the first time?

145.

Thats very, very small.

Theyre almost like
a baby breasts.

Yeah, how long did you wait

before you went
to the next bigger size?

I was like every six months.

Surgery every six months--

Thats not something
I would recommend.

The more times you have
a surgery,

the higher the frequency
of encountering

a surgical or anesthetic
complication.

So then after
that I had to have
a special implant made.

And how big were those?

5,500 CCs.
Wow.

But I was pregnant
and I didnt know.

Okay.
So I had to go back
into surgery

to reduce the implants.

So then you delivered,

and you, what, you go back in

and have big ones
put back in again?

I wasnt able to get
those implants

that I had custom made.

They no longer fabricate
those implants.

So he took a 1500 implant
and stacked two in each breast.

Okay.

I told them,
"This is so common,"

and I say,
"They do all the time."

Stacking?

Yeah, I lied.

Yeah, you lied.
...to get away
with my big breasts.

Okay.
So I show him a little video
from Nip/Tuck

because seen on the show.

From the TV show?

Yeah.
Thats fiction.

Thats fake.

So you convinced him

based on fiction.

The fact that Sheyla

was able to convince
a plastic surgeon

to do something unorthodox

by showing him a video

tells me two things--

one, shes very persuasive,

and two, it mustve been
a really good show.

These double stacking implants
was so swollen.

It was infected,

and the incision
was very--

Red.
...blue.

Blue?
It was turning blue.

Oh, you know what that means?

Blood supplys not good.

Yes, I cried.

Its like I was dying.

The area inside my breasts
was black.

Yeah.
Complete,

so they had to remove
grafted skins from the side

and leave me
without the implants.

So when I woke up...
Oh, yes.

...and I had no implants,

and you already know
what happened, now?

You freaked.
I freaked out.

I didnt look in the mirror
for a long time.

Im really interested
in helping Sheyla.

The problem is, is that
when you take a patient

whos had a history of
so many previous operations,
like Sheyla,

it makes you wonder
whether you can ever
truly make her happy.

And then got these put it in.

So that was the last surgery.

This was the last surgery.
How long ago?

2012.

So what are your goals now?

A thousand.

Why do you want a thousand?

With the 2500 now

I was okay.
I was fine.

But, uh, 2017 I was working
at a psychiatric hospital.

I was doing program
with a patient.

He got out of control,

and he grabbed me,
threw me across the room.

So I land on my back,

and then I got back pain.

So the breasts
became an issue.

So now you have
a functional issue.

And I have this big gap,

and youre going to see later,
after the exam,

and youre gonna see
the defect.

My breasts have deformed.

They dont even look
normal anymore.

To take the weight off

will require
a lot of skin removal.

The question is,

how risky is it?

So you had a 360 CC implant

and 500 CCs of filler.
Yes.

Scary.

- Okay, so this is what the keloid looks like.
- Wow, its huge.

All right, take a look.

Okay.

Its a mess.

Okay, let me see something
for a second.

Are you sure these are
2,500 CCs?

They seem
a little smaller than that.

My doctor told me 2500.

Okay. Thats okay.

So all right,

you do have some breast tissue
hanging off here.

We call that a dissociation.

But the good news is
you have a lot
of breast tissue.

Its pretty thick.
Yeah, thats good.

Although I have
several concerns

about a patient whos had
32 previous breast surgeries.

The main focus
is on blood supply

to the tissue

and how much internal scaring
there is.

This is what could be done.
Okay.

We could take
the breast implants out.
Okay.

We would have to close down
the pocket

to put a smaller
smaller implant.
Okay. Okay.

If we dont close down
the pocket,

theyll just fall down
into your armpit.

Yeah, please do
whatever you have to.

So you have to close down
the pocket,

put the new saline breast
implants in.

Whether its 800, 850
or a thousand,

thats all about the same.

And then--
A thousand.

A thousand--

And then youre gonna have
a lot of excess lose skin.

Correct?
A fair amount, yeah.

So that has to be removed

and everything
has to be tightened up.

So you need
a significant breast lift.

I think I sort of have
to take your case

because its very high risk.

Yay...
Hes gonna do it.

The number-one goal
is to take care of the pain.

The pain.

And the functional problem.

The number-two goal
is to make them look good.

Yes, yes, yes.

Once he does this,

youre gonna be
a lot smaller.

Are you-- you--
you sure mentally

you are ready for this?

I am hundred percent ready.

I cant wait.

Hello, everybody.

Lets talk about the plant
for today.

The goal is to remove
the keloid,

inject it with
5-Flurouracil and steroids

to prevent it
from coming back.

However, the risk of you
getting that keloid back

is still there.

There are no guarantees
in any of this.

Yeah.
With what you have.

Theres no guarantee here.

For Andres surgery,

I will start by making
an incision

along the left ear

and excise the keloid
from his ear.

The I will harvest
two small pieces of rib

and stitch them to
the tissue on top of his ear.

I will then use piece of skin
from the keloid

to make a skin graft
to cover the rib

and shape the ear
before stitching
the area closed.

Finally I will inject
Andres ear

with 5-Flurouracil

to prevent the keloid
from coming back.

Im incising,
which means making a incision

along the keloid

but making sure
I have extra skin

so we can close ear
together again.

- Okay, so this is what the keloid looks like.
- Wow, its huge.

Lets just carve
a piece of rib

while the rib is still left
in the chest.

We dont need the whole rib,

but not-- were not doing
a nasal reconstruction.

Since we need two relatively
small pieces of rib cartilage,

were gonna carve out the rib

while the rib is actually left
in the body.

Were not gonna take out
the whole rib.

And this is more less invasive.

In addition it should cause
Andre less pain.

So this is the piece of rib.

And Im gonna--

Trying to stitch the skin
on top of that ear.

And I dont know
if this is gonna work.

- Again, no ones done this.
- Yeah.

Were trying to see
if somehow

theres a signal
in the cartilage

to the scar saying,

"Stop making scar."

And we may need to use
the little skin graft

because its pretty--

You know, its--
actually need more tissue.

Because I ended up building
the ear up so much in height

to almost match the right ear,

the skin I left behind,
which was a lot,

is not sufficient to close it.

I need a skin graft.

So Im gonna take
a piece of skin

from the keloid
that I excised,

stitch it all together,

and hopefully everything
will survive nicely.

Im gonna do
a little "injecciones'

of this.

0.65 CCs

out of the 5-FU.

Look at that.

Can you wear
a pair of glasses there?

- Damn right, baby.
- Yep.

This is why Terry and I
do what we do.

We help those
who need us the most.

Andre is a young,
good-looking guy

with the rest of his life
ahead of him.

He should not have to feel
that hes being held back.

Hopefully that skin graft
doesnt die.

Yep.

What do you have going on here?

This is an interesting,
difficult patient

who has a buttock problem.

Her name is Kasia.
Pretty girl but obviously
likes to do enhancements.

Yeah.
She has foreign material

in her buttock.

I dont know exactly
whats been injected,

what procedures shes had.

So lets bring in Kasia.

Can you please send in Kasia?

Kasia.
Hello.

How are you, Kasia?
Dr. Nassif.

Im fine.

We kiss.

Thats how we do in Holland.

Terry Dubrow.
Pleasure to meet you.

Hi. Hello, my name is Cindy.
Please.

Nice to meet you.
Have a seat.

Wait a minute.
What did you say?

Those are free kisses
from where?

Holland.
From Holland.

Holland.

My wifes parents

lived in Holland for 11 years.

How do you say "hospital"
in...
Ziekenhuis.

Ziek-- Is that great?
Ziekenhuis.

My wife and I always say,

when I dont feel well,
I go,

"I need to go
to the "sicky-house."

Sicky-house.
Sicky-house.

Feel sicky. I need to go
to the sicky-house.

So, Kasia, what do you do?

Came from, like,
reality show TV programs

and then finally I fall
in love with the music.

So youre a singer.

Yes.
So wait.

You did reality TV?

Yes, in Holland.
In Holland?

What was it?

Keeping Up With The Balkjes.

How was that?
It was cool.

It was, like, five seasons.

Five seasons.
Yeah.

You were really famous
in Holland.

Everyone more or less, Yeah.
Many people knows me, yeah.

Wow. Did the Keeping Up With...

The Balkjes.
The Balkjes

reality show come to you

because of the buttock,
or did you have the buttock

done because you saw
the Keeping Up With The...
show here?

Yes. We found all the pop
stars...
Yeah?

...all the movie stars
and reality stars.

So I start with J.Lo.
Then I saw Beyoncé.

Ah...
Right? So I went, like, larger.

Then I saw Kim.

So you had it done.

360...

360.
...CCs.

And they look good.

Yeah, back then, yes.
Good.

But then along the road
I thought, "Okay..."

Ah, here we go.
More is better.

Yeah.

How can I have larger butt,
right?

And I went, like, to injecting
permanent fillers.

Permanent.

Hydrogel, 500 CC each.

Of hydrogel?
Yes.

In each cheek?
Yes.

So now you have--
Thats huge.

So you have a 360 CC implant.

and 500 CCs of filler.
Yes.

Scary.

Hydrogel is a very common
filler in Europe

thats used to cause
soft tissue expansion.

But Ive never seen
someone have 500 CCs injected

in one anatomical area.

So that could really predispose
you to very significant
complications.

Lets look. All right?
See if we can help you.
All right.

Okay.
Thank you.

Sure.

Cant just make an incision
and go

like its a zit.

You have to cut
the whole section out.

Okay, here it comes.

Does this look
like 2500 CCs to you?

No.
Exactly what
I was worried about.

God damn it!

Welcome to our sicky-house.

Ziekenhuis,

...ziekenhuis.
I like sicky-house better.

- Sicky-house.
- Yeah.

All right, lets get serious.
So do me a favor.

Stand up.
Yeah.

And let me see
whats going on.

All right.

Turn this way.

The buttock implant
is here,

and its obviously
on top of the muscle.

Youre just lucky
it hasnt moved around
too much.

And then you have this area
thats starting to change color.

Its the area where gravity
has its greatest effect.

Okay, so have a seat.

Do you know
what thats indicative of?

A reduction in blood supply.

I think the shape change
were seeing

in Kasias buttock
is due to the hydrogel
moving around.

Over time that reduction
in the blood supply,

due to that large volume

could lead to very
significant problems,

like infection, necrosis,

and, unfortunately,

loss of large segments

of her buttock skin.

You cant just make
an incision

and go
like its a zit.

You have to cut
the whole section out

because the fillers

incorporated into the tissue,

so the way Ive treated
these things

is I remove that,
I do some tucking,

to take up the loose skin,

but I also do a buttock lift

to bring it up,

which means a scar
across your back.

Whats the, um...

The healing time?
The healing time.

It could be
three to six months.

Okay.

What do you think?

What do you wanna do?

Im really gonna just take
a moment,

finish the things
that Im working on.

You cannot do this right now,

I think, because of the music

and the videos and everything.

When I would be able to take

enough time to rest
and heal...

Mm-hm.

Come to me.
I will work some magic

on this. Okay?
Yeah.

Kasia should never have had

500 CCs of hydrogel

put into her buttock,

but sometimes celebrities

get whatever they want.

The good news is
she can come back to us

and get the proper solution.

Lets go get some wine, okay?

Im really looking
forward to it.
Okay.

Wining, wining.

Can we take those one with us?

Yeah.

♪ What I wanted,
what I needed ♪

Hi, Sheyla. How are you?

Hello, Dr. Dubrow.
Good to see you.

Nice to meet you.
How do you feel?

I feel a little bit nervous.

You do.
Mm-hm, yeah.

Todays my 33rd breast surgery.

I have mixed emotions.

Because, honestly,

I need to get
a breast reduction,

but I wish I
couldve kept them.

I love them.

Downsizing should relieve you
of a lot of pain.

Okay, so we think you have
2500 CCs.

Its possible
that I get in there,

and theres not 2500.

In fact its possible
I get in there,

and theres
substantially less.

Okay.

If theres substantially less,

Im gonna have to work
with what it is

and what I need to go down
to get enough laxity

so that I can lift you up.

But my goal is a thousand.

So let me ask you this,
finally.

I may freak out
when I wake up.

Well, let me tell you this.
I go in there,

all you have left
is an 800 CC silicone.

If I take 800 and put 500...

Youre gonna have crazy person
getting up surgery.

Hold on a second, Sheyla.
Okay.

If I reduce you
by only 300 CCs,

youre still going to have
all that back pain.

What I want is a thousand,
but if it gets that

and a thousands not possible,

youre the professional,
youre the doctor,

do whatever it takes.

Have you ever said this
to a doctor before?

No.
The first time.

Although Ive operated

on someone whos had multiple
previous operations,

this is the first time
Ive done someone
whos had 32.

This could be a much
more difficult operation

than Im even suspecting,

and Im suspecting
a very difficult operation.

For Sheylas surgery today,

Im going to make incisions

under her areolas

and remove her old implants.

Next, I will access

the breast pockets,

downsize her implants,

and manipulate
the breast tissue and skin

to give her a better
overall cosmetic result.

All right, lets find out
whats going on inside.

Okay, here it comes.

Pull--
Oh, my God.

Its just a super overfilled
saline implant.

Does this look like 2500 CCs
to you?

No.
Nuh-uh.

Thats exactly
what I was afraid of.

Oh, my god.

So I need to know how much
is in here.

What-- What was I worried about?

What if theres only 1500 CCs.

What if its much smaller?

Yeah.
What if its a thousand,

and I have to move it
down to 500.
Yeah.

Yeah.
Remember that?

This could be 900 CCs.

Thousand, tops.

Thousand, tops.

Im calling that 900.

This is silicone.

Its silicone?
Yeah.

Its no saline?

No, it looks like theres
a valve on the inside.

Do you see that?

This made be a weird
European double lumen.

Double-lumen implants
were originally designed

to have a silicone
inner shell

and a saline outer shell

that allows you to change
the size of the implant

intra-operatively

so you can adjust
for any breast asymmetries.

All right,
so that part is silicone.

Yeah, this part has saline.
Look at that.

What?

Its unusual that Sheyla has

an outer silicone lumen

and an inner saline lumen.

This totally defeats
the purpose.

Ive never seen that before,

and the only thing
I have to say about that is

its kind of weird.

Okay, so a thousand.

So w-- its a 400-CC implant.

660 CCs of saline, right?

Yeah.
So its a thousand--

Its basically
a thousand-CC implant.

Were gonna put the same thing.

Sheyla has about
a thousand-CC implants,

which is what she wanted
to be reduced to.

If I dont reduce her
any further,

she wont have
the functional improvements

in terms of the back pain.

And if I do,

will she freak out on me?

Its exactly what
I was worried about.

God damn it!

Okay, so now what?

Uh...

I started to clean up
the ear with the peroxide.

Mm-hm.

The peroxide on tissue,
it actually kills it.

Youre 20 hours out
from surgery,

and youre already asking
for bigger implants

just because of a number?
Please, Dr. Dubrow,

Ill do whatever you tell me.
Let me see what they look like.

Im feeling
flat chested right now,

and Im very, very upset.

Its basically
a thousand-CC implant.

Okay, so lets do this.

Do me a favor.
Get me a 560 extra full

silicone implant.
Okay.

Lets put it in and see
what it looks like.

Lets just test it.

By the way,
going from a thousand to 500

is proportionally
about the same

as 25 to a thousand, right?

So its the same thing.

So were essentially
achieving the same thing.
Im in.

I just dont want her to freak
out because of that.

Yeah, well, you know,
were here to do a job

thats based on safety
and aesthetics,

and this allows us to do both.

See, thats a much healthier
implant-to-pocket relationship.

The only concern I have

is will she freak out

or-- yeah,
shes gonna freak out.

Sit her up,
see what it looks like.

Okay, so theyre symmetrical.

Theyre lifted.

Theyre actually
really pretty.

This actually
should give her both.

It should give her pain relief

And it gave her much better
cosmetic appearances.

So this achieved
both of our goals.

Well just have to wait
and see

if Sheylas happy or not.

One things for sure,

Sheyla will let us know.

All right, lets close.

- Hello, Dr. Nassif.
- How are you?

Good, how are you?

Andre.
Hi.

Hi, how are you?
Nice to meet you.
Hey, buddy.

So I havent seen Andre
in a month,

and we did his surgery,

his post-op checks were great.

After the keloid was removed,

and I put two nice pieces
of rib in there,

so really would be
a lot easier

for you to wear your glasses.

We have to be careful
about making sure
that skin graft lives

Two, I want you to keep
that dry.

Just leave it alone.
Dont touch it,
dont instrument it.

Two days ago
he sent me a photo

which showed
that his skin graft

was separating
from the top of his ear.

So whats happening?

Well, um, I was in the shower,
and then I got out,

and then I started to clean
the ear with the peroxide.

Mm-hm.
And then scab peeled off
completely,

and then thats
when I yelled, like--

I was like, "Mom!"

Peroxide.
Yeah.

Is that bad?

Or--
Yeah.

But peroxide on tissue,
it actually kills it.

Well, let me take a look.
Okay?

Okay.

It looks like theres
a piece of rib

that Dr. Peng can work with

to prevent the keloid
from growing back.

Okay.
Okay?

So were gonna prep it,
give you a little shot there,

numb it out,
and then stitch it.

Its not gonna take long.

Okay.

When the skin graft came off

after the shower,

I was petrified

because a keloid

does have potential
to grow back.

Hopefully we can just get
this under control

and it just stays away
for good.

The first part Im looking at

is kind of the piece
of cartilage.

Uh-huh.

Im gonna see how much of it

we can save,

but I took out
the top layer of it.

Were all done.

Oh, really?
Yeah.

Lets take this off.

Whats happening?

You know Im angry.

Uh-oh.

How are you?

First of all,
youre not happy.

Im sad.
I already cried so much--

Okay, let me ask you
a question.

Whats upsetting you?
I saw the card.

You sent me with a card
to carry with me.

Okay, so you saw the card.

So youre concerned
that I took you

all the way from 2500
down to 560, right?

Im feeling flat chested
right now.

And Im very, very upset.

There is no way in hell

that I will keep 500 CCs.

2500 to a 500--
thats a lot.

It is but what if you had 1060,

1,060 CCs in this one

and a little bit more
in that one?

How do I know?

Cause we measured it

extremely carefully.

Remember this discussion?

I actually anticipated
this possibility.

Do you remember I said,
"Hey, what Ive been thinking
about, Sheyla,

is that what if I go
in there and you actually
dont have 2500--

No.
We never spook about any--

Its possible
that I get in there,

and theres not 2500.

In fact its possible
I get in there,

and theres
substantially less.

I couldnt have done the lift.

I couldnt have shaped
your breast

because it was too tight.

In addition,

you told the reason
to downsize them now...

To fix them.
...is because
youre having pain.

Yeah, back pain.

So I did exactly
what I needed to do.

I dont like 500 CCs.

These are just numbers.
Forget the numbers.

But the end--
Numbers--

I know but can you still make
these big a little bit more?

Dont go there.

You had to have this operation.

I assume that Sheylas
previous surgeon

knew she was obsessed
with size,

so thats why they told her
what they told her.

but thats not the kind
of doctor I am.

I want to relieve her
of her back pain,

but Im gonna do that

and tell her the truth.

Youre 20 hours
out from surgery,

and youre already asking
for bigger implants

just because of a number?

Please, Dr. Dubrow.

Im really sad now.
Let me see what they look like.

I mean--
They look pretty amazing.

Will you come here, my man?

Take a look at that.
I dont wanna look.

This part is more beautiful
than before.

- Beautiful-- so its beautiful.
- Look at the shape.

Dr. Dubrow,
please put in more.

Please?

Dr. Dubrow,
he did the best job.

When I saw the real boobies,

she looked great.

Its amazing.

Dr. Dubrow,

can you do me something?

Make this smaller
because, you know,

Hold on a second.
...I used to have skin here,

so now its flapping
because the blood was poor.

Are you trying to talk me
into doing a tummy tuck
on you now

to make your breasts
look bigger?
No tummy tuck.

No, just some lipo I want
a little bit around here so

my breasts look bigger.

You recover without
a complication,

and well talk about it.

Well talk about it.

- I love you.
- I love you.

Its okay. Bye-bye, ciao.
Ciao.

Thank you.

This is the first time
in my life

that I have two
normal looking ears,

and its just kind of like
a rebirth.

Oh, heres Andre.
Hi.
Hi.

The last time I saw Dr. Dubrow,

I was pretty upset,

and I still have
a lot to say to him,

and hes gonna hear it.

I wanna talk to you.

♪ In an instant
life can change ♪

This is the first time
in my life

that I have two
normal looking ears,

and its just kind of like
a rebirth.

Growing up with microtia

and the keloids

and being bullied constantly.

Its always been a factor

and something
thats held me back.

This is my first spring break,

that Im going on a trip.

For now Im just feeling
optimistic

about meeting new people,

maybe even find myself a date.

I am so excited for this trip.

I cannot believe were
finally going on it.

I feel like I can let go now.

Yeah. Yeah.
Yeah.

- I feel relieved.
- Yeah.

Seems, like, unreal.
Like, really.
Yeah.

Yes, it does.
Its like a dream come true.

Got to have fun and play.
For both of us.

Oh, heres Andre. Hi!
Hi!

Hi, Andre.

Hi!
Look at my baby.

Oh, my god, you look so good.
Youre still my baby.

Hi.

Are you ready?

I feel so excited.

I get to go on spring break

with a brand new ear.
Yeah.

A difference
that I have seen in Andre

is the way he carries himself.

Before the surgery was
"I want to be able to do this,"

"I wish I could do this."

Now Im seeing and hearing

a lot more "When I do this,"

"Im doing this,"

"Lets go do this."

His whole demeanor
has honestly changed.

I have a little something
for you.

Oh, wow.
Oh, boy, lets see
what it is.

Open it, open it.

Aw.
Oh!

Thats so nice.

Try them out.
Try them out.

Oh, wow, look at you.

Ooh!

Okay, now were jiggy. Yeah.
Now you can go.

Before my surgery,

I had a big, horrible
snail-looking keloid

on my left ear.

I would constantly get stares

and questions about my keloid

that made it impossible
to forget about it.

And I couldnt even wear
glasses,

but now, thanks to Dr. Nassif,
Im keloid free,

and instead of feeling
ashamed of people staring,

Im now wearing my shades
all day.

Now look at me.

- Wow.
- Oh!

Damn!
Who is that?

Im just really excited

that I get to go
to beautiful cities

like Paris, looking beautiful

for the first time.

Have fun!
Bye.

I miss you.
Oh...

Yeah.
Call me five times a day.

No.

Its been weeks since
I had my surgery,

and I had
some unexpected results.

I never thought
I would be walking around

with the small breasts
like this.

The last time I saw
Dr. Dubrow,

I was pretty upset.

He says heal, rest, recover.

Then well talk.

Well, Im healed.

And I still have
a lot to say to him,

and hes gonna hear it.

Okay. All right, thanks.

You expecting a Sheyla,
one of your patients?
Yes.

Uh-oh.

I wanna talk to you.

I owe you an apology.

Aw.
Oh, this is gonna be good.

Im rockin my world
with my new breasts,

and I love it,
and Im--

You love it?
I love it.

Youre not totally unphappy?

Im not, actually.

Okay, I can go on
with my day now.

Im super excited that I
actually got through to Sheyla

that huge breasts
dont need define her.

Sheyla looks really good,

and Im really happy for her

but much happier for me.

It was kind of like shock
for me at the beginning.

Then I came to realize

how many doctors
Ive been through.

And you were the only one

that ever said no to me.

And my back thanks you so much.

Your back pains gone.
Its gone.

Thats so awesome.

I look so nice and beautiful.

Before my surgery,

my breasts was a hot mess.

They were disfigured

and so large,

they made my
back problem worse.

I was so obsessed with surgery

and make my body perfect

that I didnt realize

the impact it was having

in my health.

and my life.

But, thanks to Dr. Dubrow,

now my breasts is the size

that they should be.

I love the shape

and my back pain is gone.

I dont need huge breasts

to feel sexy anymore.

I feel sexy.

Lets go, Dr. Nassif,
because--

By far, yeah.
Where am I going?

...we have something
to talk about.

Yeah, youre gonna do a face--
have a facial consultation.
No, youre not.

Yeah, yeah, go for it.
Shes a great patient.

Really,
I recommend her highly.

Bye.
Bye.

Mwah, yeah, Ill see you--

you know, Ill see you
when I see you.

Buh-bye, Sheyla.

See ya.

Plastic surgery

is exactly what I need.

Dr. Nassif and I are back.

Ow!

Whoa!

You know what that
looks like to me? Death.

With tougher cases...

Wait a minute,
I cant even wrap
my brain around it.

Gets you a little nauseated,
doesnt it?

I wouldnt be surprised
if the thing falls out

while youre sitting here.

Dont say that!

The emotions run high.

Its not fair.

I was dysfunctional.
I couldnt take care of my kids.

Surgeries get even scarier.

Oh.
Full blown rupture.

The nose completely collapsed.

But its all worth it
in the end.

Thank you.

Youre welcome.
Hes my super hero.

This is what happens

when you go to
the a great surgeon.

Oh.

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