Botched (2014–…): Season 6, Episode 7 - All I Want for Christmas... - full transcript
Oh yeah!
Turkey? Just in time
for Thanksgiving.
Holiday season
is here.
Darn you Santa!
I have Santa to
blame for my nose.
He hit my on the bridge of
my glasses and broke my nose.
Ive got like a Rudolph nose.
Itll turn red if
Im really warm.
I would
describe the current state
of my breasts as a
shredded meat fest.
Like cobweb.
Like a horror film or something.
Clearly, Melissas
last surgeons
favorite holiday was Halloween.
I hate the
way that my nose looks.
What plastic surgery
have you had total?
I dont know.
I lost count.
Have you ever had
any complications?
I couldnt breath.
I was like.
And you want more.
Mm-hmm.
Well, lets not forget
what started this whole thing.
Santa.
Oh my goodness.
My name is Sara and I have
Santa to blame for my nose.
I told my son there is no
Santa and he broke my nose.
Darn you Santa!
About two years ago,
my son came home,
and hes like, I know
Santa isnt real.
And he said, tell me the truth!
I mean, he was right in my face.
And so, spoiler alert,
I told him the truth.
Santa is not real.
Yeah.
I went to an Ear, Nose,
and Throat specialist
and he said,
you do have a break.
Lets get it re-set.
So that was the first surgery,
they did put me under for that.
When the cast came off,
it looked the same.
And I met with a different
surgeon who said,
we definitely would need to have
another surgery to correct it.
Following that second surgery,
the surgeon commented that
my nose was a hot mess.
I was hoping that that meant
it was a hot mess before,
but it turned out to be
a hot mess after as well.
My nose still wasnt straight.
So I had to have
another surgery.
Following my last surgery,
my nose is even more crooked,
my tip sticks out, and it
turns purple when Im cold,
itll turn red if
Im really warm.
At least I have a party trick,
I dont know.
If you could do
it all over again,
would you not tell Colton
that there wasnt a Santa?
Thats the million
dollar question isnt it?
Yes.
Wooo!
Dont get that on me.
My name is Liziane.
Im from Brazil,
but I live in Las Vegas
for the past ten years.
And I almost died
doing plastic surgery.
So all my surgeries
and everything
like about me is
all over the news.
After six surgeries, I hate
the way that my nose looks,
and my nostrils are not even.
Why do you wanna fix your nose?
Its like its almost perfect.
No its not.
Its all in your mind.
Plastic surgery in Brazil,
people start young, like 16, 17.
My first procedure,
I was 17 years old
and I had a liposuction
and breast implants.
I been like so many procedures.
Botox, cheek fillers,
lip lift, lip fillers,
breast implant twice,
butt injections,
and lipo all over my body.
For my first nose job,
I wanted like
cute little nose
like Angelina Jolie.
I end up, after the surgery,
my nostrils not even.
So I was doing more nose
jobs because I have the idea,
one of these surgeries
Im gonna have my nose fixed.
If I wanna do like video
or something like this,
that is disgusting.
So my sixth nose job,
I went to Turkey
to have my nose fixed and
to have a liposuction.
And then a disaster happened.
I went to do the surgery
and when I woke up,
I couldnt breath.
I was like...
As I couldnt breathe,
I went into a coma
because I had a blood
clot in my lungs.
And I just remember
waking up five days after.
As your friend Im gonna
tell you, you gotta stop.
After I almost died,
I waited for like one year
to do another procedure.
Im gonna do whatever I want to.
Like its my money,
its my body.
And I went to Brazil to
do some botox and fillers,
and after two weeks,
my lips was getting bigger
and my face was like a
huge ball on the side.
That was worst for me than
what happened in Turkey.
I know you guys gonna
say this is crazy,
but if I died, just died.
What if I have to live with
my face forever like that?
I went to the hospital,
I couldnt feel my lips,
and then I start
to take steroids
to put my face back to normal.
Okay, I need some
pictures for my Instagram.
I want Dr. Nassif to, please,
make my nostrils even.
No no no no, dont go for down.
If youre going down,
youre gonna see my nostrils.
I almost died,
but I dont care.
And until I have my nose
fixed, Im not gonna stop.
And if the Dr. Nassif wants,
maybe take some ribs out?
Question for you.
Pop quiz.
one word
or two words, go.
Two words.
Its one word, dumbass.
Yeah, Paul. That whole skipping
third grade thing, not a good
idea.
All right. Patient named Sara.
Past rhinoplasties,
had some trauma.
Okay whats with the bones here?
Collapse.
Did the trauma cause that or
did the surgeons cause that?
Lets actually see her.
Can you please send in Sara?
Hey.
How are you? Dr. Nassif.
Good. So nice to meet you.
Nice to meet you.
Hi Sara. Terry Dubrow.
Hi.
Please have a seat.
Why dont you start and tell us
what happened with the trauma?
It was getting close
to Christmas time.
My son, hes like,
"Mom, I know Santa isnt real."
How old is he?
He was eight at the time.
So I told him the truth.
That there was no Santa?
Mm-hmm.
Wow.
I did at that point.
I mean hes like,
tell me the truth!
And he got so close to my face,
he hit me just right on
the bridge of my glasses
and broke my nose.
He was really upset.
He was really upset.
Sara, small piece
of advice for you,
next time youre asked if Santa
exists, say yes!
So then that next day, I went
in to ear, nose, and throat.
And they put me
under to reset it.
But then it still
didnt look right.
So then that is when I
met with another doctor.
And that surgery ended up
being like five hours long.
And when the cast came
off, it was still crooked.
And then I had this smell
that I just could not
get out of my nose.
I think it smelled like cat pee.
Thats sad that I know what
cat pee smells like but...
By the way, I dont
wanna change the subject
but you smell like
cat pee sometimes.
Ooh.
Yeah and its usually when Im
breathing in that I notice it.
Terry, the only smell coming
from me is a man smell.
A good looking man making
good looking man smells.
The smell, usually that
is a sign of infection.
Its usually of feet.
Thats what I usually hear.
Oh.
Smells like feet inside my nose.
Did they culture your nose
or think that there
might be an infection?
I dont remember
them culturing it
but I know I was on antibiotics.
So I didnt have that yucky
cat pee smell in there anymore
and then I had another surgery.
And it almost looks kind
of smashed right here.
Right.
Your nose collapsed
after the last surgery.
Yeah well that doctor,
when he met with me
after he did the surgery,
he said, I really wish I
couldve fixed that tip.
And I was like, oh no.
Hows the skin of your nose?
Well it turns purple
when Im cold,
red when Im really warm,
Ive got like a
Rudolph nose, you know.
When did that start to happen?
After the last surgery?
Yeah.
That was after the last surgery.
With hearing all that,
examination is the next step.
Sure.
So lets go ahead and do that.
Okay.
Look at this left
breast right here.
Like cobweb scar tissue.
I dont know what to do.
You might still have
something in there.
Oh yeah. Look at...
Is it coming out?
Its making me want to throw up.
There it is. There-
Oh look at that.
All right. That bone is
like... collapsed in.
Yeah.
Lets see your profile.
Yeah this is- oh interesting.
The bone is all
the way up to here.
Long bones.
So her bones been
taken down and short.
I think Sara has a
saddle nose deformity
from an iatrogenic cause.
What that means is
the doctor did it,
just took too much
out of the cartilage,
whether its an
over-agressive septoplasty,
or taken too much
cartilage right here,
whatever it is,
now shes got a concavity.
What Im gonna have to do is
re-fracture your
bone on the left.
Okay.
Try to make it more mobile
so I can get it straight.
Two, your bone is over done.
This has been
brought in too much.
So we have to build that
up from your own tissue.
Okay.
Ahh. Okay.
Whats wrong? Whats up?
I dont know.
Its a lot.
So far Ive only talked
about two things.
I know. Im getting
nervous. Yeah.
Okay. One, fix the
bone and build this up.
I know its just... Right.
And you need that.
Right?
Yes I do. Yes.
The question is
after I put this in,
how much does the tip
need to move back?
Mm-hmm.
What does that look like?
When you say push the tip
back are you saying push?
Yeah.
Ow.
Were gonna do it a little
bit different than that,
but thats the goal,
is take the tip,
and right now its
over projected.
Right.
Were gonna push it
back a little bit.
Since youre already nervous,
were gonna get you a
little bit more nervous.
Ooh yay.
You know the purple color?
Yes.
Possibility we could
make that worse.
Yeah.
When I hear that
a patients nose
turns purple when shes cold,
that means the blood supply
to the nose is not great.
So if I operate on Saras nose,
theres a very very
good possibility
that I could make that worse.
I mean, I wanna
take on your nose.
I wanna do it.
Okay.
Were in?
Were in.
Okay lets do it.
After those four surgeries,
its gonna take the
best of the best
to fix what happened to me.
My name is Melissa
and I would describe the
current state of my breasts
as literally a
shredded meat fest.
In order to disguise my current
situation, I wear inserts.
They kind of look like chicken
cutlets but theyre clear.
And then you have
like the cotton pads
and then of course
the extra padded bra.
But you gotta make
sure everythings even,
that nothings showing
too much.
When you have this whole
thing going on, you shut down.
Everything is like done.
I know you shut down.
I would like to see
Dr. Dubrow and Dr. Nassif
because what has happened
to me on the outside
has effected my self-esteem.
Id rather just stay home.
So I have no life.
Melissa has had multiple
previous breast surgeries,
the most severe complications
that you can have.
Look at that right breast.
Look how droopy it is.
Right?
Theres no implants
there though is there?
No. Look at this left
breast right here.
You ever seen this before?
Thats all scar tissue isnt it?
Thats like cobweb-
Yes.
Scar tissue.
Bring her in.
Can you please send in Melissa?
Melissa.
Hello.
Very nice to meet you.
Nice to meet you. Dr. Nassif.
Terry Dubrow, nice to meet you.
Mom.
So what we do know is that
youve had multiple previous
breast implant surgeries.
They didnt necessarily work out
and thats why your left
with this situation.
That is correct.
So what happened?
After my first
year in law school,
I figured Id made
it through first year
which is the toughest
year, you know.
I decided to reward myself
with a breast augmentation.
I had the surgery
in the Summer time.
About three to four
months into it,
it got really hard
and raised up to here.
So you had an early
encapsulation.
Mm-hmm. So I went to another
surgeon and he said yes,
we gotta take that out,
clear out that scar tissue...
Right.
He put different implants in
and honestly they were
fine for 12 years.
Okay good.
Up until, I guess,
one of them ruptured.
I was happy until the
day that I woke up
and there was just a bag.
So did it go flat
right away?
Um... in about a 48 hour period.
Okay.
The average life
expectancy for breast implants,
give or take, is about 12 years.
Unfortunately, theres
nothing you can do
for maintenance or upkeep.
Basically, when they pop,
you just gotta get them
replaced.
That surgeon moved.
So I went to another surgeon
and he didnt even use
the right type of sutures.
The holes where the sutures
were placed were really large.
Looks like a starburst
kind of pattern.
About three weeks after,
stuff started leaking out.
I mean I filled up a
Tupperware container
with just going like
that to my breast.
Puss?
It wasnt a puss.
It was more liquidy.
A little reddish?
Yes.
Okay.
Sounds like you had a seroma.
When you develop
fluid after a breast implant
revision,
it could either be
due to an infection,
which would cause puss,
or it can be due to the leaking
of the surrounding cells
due to a low grade inflammatory
reaction, called seroma.
I went to see a different
doctor who said, listen,
Im taking these things out,
put me on antibiotics...
Okay.
And now, I kind of just
stopped my whole life.
You did because of this.
Yeah?
Shes literally in her room
I am.
And youre living alone
or living with mom?
I moved back in with my mom.
Everything that I was, Im not.
What if you go on a date?
What happens?
Come on, were adults, we all
know what happens on dates.
What would you like
to happen, ideally?
I know Im never
gonna be perfect.
Okay.
I just want to be normal
a little bit, you know.
So any improvement...
Yeah.
Is gonna make you happy?
Yes! Are you kidding me?
Okay um...
I dont know.
I dont know what to do.
This ones pretty
deep.
Look at that.
What to do?
Wow.
Ultimately, its gonna be
about who sutures better.
I was Chief Resident
in General Surgery
and Plastic Surgery.
Oh excuse me.
Yeah well theres no
excuse for you, just watch.
Okay, I want to look very
carefully at that scarring
so let me see whats going on.
Okay so because you
had that seroma,
all that fluid that poured out,
this area has basically healed
straight down to the chest wall.
That is a difficult problem.
Then theres this side.
This side...
It had so much
difficulty healing,
normally when wounds are opened,
they heal by bridging skin
coming from each raw side
and touching, and
closing off the wound.
But you not only healed
a band of skin this way,
you filled the cavity with skin.
Like this ones pretty deep.
Look at that.
What to do?
We could potentially
go to the operating room,
remove scar tissue, and
try not to use implants.
But your breasts would
be rather small-ish,
and I wouldnt be able
to get a good shape.
The most valuable
solution may be
the most dangerous
and risky and that is
take out scar tissue,
make a pocket, put implants in,
and give you, hopefully,
symmetrical breasts
that goes with you
and the social life,
and get you where
you need to be.
Lets do it.
The truth about
Melissas very high risk
breast revisional
situation now is
that the blood supply
has been impaired,
theres a ton of scar tissue,
its gonna be
extraordinarily difficult
to give her symmetrical
breasts with good breast shape.
Thank you so much.
Thank you.
But, the only reason
Im willing to take
Melissas case on
is because she did
tolerate breast implants
for over 12 years
and I think that its possible
she may tolerate it again
if I can find the
right operation.
I was like sweating I was
so nervous, Im like...
Dr. Nassif? Dr. Dubrow?
Can you guys come
into the kitchen?
We have an emergency here.
Whats the emergency
in the kitchen?
Oh Jesus.
Oh yeah!
Turkey? Just in time
for Thanksgiving.
I know you guys are
always giving each other
a hard time about whos better.
Yeah.
Wow.
Ultimately, its gonna be
about who sutures better.
Im gonna bring you guys back...
to just a few years
ago in medical school.
Its on, baby!
Of course Im gonna beat
Paul in a suturing contest.
I could beat Paul with one
hand tied behind my back
and the other hand
up my ass.
I was Chief Resident in General
Surgery and Plastic Surgery.
Oh excuse me.
Yeah well theres no
excuse for you, just watch.
This is fun.
I havent done this in years.
All righty, Ill start
the timer now then.
Ready, set, go!
Do I have to listen
to his humming?
Seriously?
For someone who really hates
it when other people hum,
he actually hums and
sings quite a lot.
Voila.
Im done.
I love having Paul
as a best friend
because you can
always count on him...
Loser!
To be a loser.
Wow. Thats like a Picasso.
Fragmented and weird.
All right.
Cut.
Tell me when youre done.
Now.
So how much faster was I?
By 25 seconds.
25 seconds faster?
Paul, you are a turkey.
Can I take these
home for Thanksgiving?
- Melissa.
- Hey Doc.
How you feeling?
Well thank you.
Excited, nervous.
Excited and nervous?
Yes.
I hate to tell you, me too.
The plan for
Melissas surgery today is to
first remove the irregular
scars around her areolas.
Then Ill make an incision
and attempt to make
a breast pocket
after assessing the amount
of scar tissue on the inside.
And once I do that, Ill place
appropriately sized implants.
Finally, Ill manipulate
the overlying breast tissue,
trying to give Melissa two
full, symmetrical breasts.
Okay so weve got
the external scars
all cut out on this right side.
Now we have to go in
and assess the pocket.
Yeah. So far its just
one, thick scar mass.
Look at this.
All just blown up scar tissue.
And you cant put an
implant underneath this.
It wont give at all.
The key to Melissas
surgery today is my ability
to release the scar
tissue on the inside
to allow me to make a pocket.
A huge, significant
problem is that
the closer you get to
the overlying skin,
the greater the chance that
I could pop through the skin
and thats game over,
or reduce the blood supply to
the overlying skin and nipple
that it all dies
post-operatively.
All right. Let me see something.
Im creating kind of a
semi-submuscular pocket of scar
to elevate the breast tissue
rather than a stiff pocket.
All right. Lets see
what this would do.
Staple this for a second.
We finally have a small implant.
The problem is if I do anything
else with this implant in,
I dont think the
nipple will survive.
The only thing we
can do on this breast
is let it heal and do the
operation that I need to do
in a second stage when
things have healed.
All right. Lets
start on the left.
Now I have the left
breast to deal with.
Look at all these holes
where she pussed out
all those stitches.
Its like a horror
film or something.
Very bizarre.
Clearly,
Melissas last surgeons
favorite holiday was Halloween.
All right lets
see what surprises
await us inside this breast.
As opposed to the right breast,
the old pocket was
able to be found,
I was able to lift it up,
remove some scar tissue,
and easily create a pocket
to accommodate her implant.
Wow. So this side, as
opposed to the right side,
turned out to be very
straight forward.
So were gonna have, hopefully,
a healed breast
with an alive nipple
that we can come back
in a couple of weeks,
and do a tweek that will make
Melissa have a good shape
and the size she wants.
To move forward and
make any more incisions
is not worth the risk of
losing the entire nipple
and potentially all
of the breast tissue.
I think this is
the best way to go.
If I can get Sara
at least an 80% improvement,
Santa has to give me a
fantastic present this year.
You know, like, another new car.
I wish I could remove my ribs.
Im not lookin at your ribs.
But if I remove here...
So they think that Im
a little bit coo-coo.
So heres your
computer morphing.
You can see how that
tip is sticking out,
so our goal is Im gonna
push that back a little bit.
If I can get Sara at
least an 80% improvement,
Santa hast to give me a
fantastic present this year.
You know, like, another new car.
For Saras surgery today,
my team and I will begin
by simultaneously harvesting
rib and fascia from her scalp.
I will then open
her nose and perform
a medial crural overlay
to push back the tip
before inserting a diced
cartilage-fascia graft
into the middle vault
to build up her profile.
Next, well fracture the
bones on the left side
so I can widen them
and make them straight.
Hopefully giving Sara a nose
as pretty as a
Christmas present.
Now were gonna start the nose.
Rib is out.
Fascia came out, nice big piece.
What were doing right now
is setting the tip back.
Its called a medial
crural overlay.
And we wanna keep eyeballing
the nasal tip skin color.
Obviously, the color that we
dont wanna see is purple.
Sara told me that her nasal tip
turns purple when shes cold.
That means the blood supply
to the nose is not great.
So Im gonna rock and roll
through this part of the
surgery
because the longer I take
the more risk there is
to damaging her nasal skin.
Were now gonna place the
diced cartilage-fascia graft.
Were also gonna
build up the dorsum.
So far the nasal tip skin is
nice and pink.
Go.
The left nasal
bones collapsed in,
so for me to fix this,
Im gonna fracture
her left bones,
put some rib cartilage
right in between there,
thats gonna give it
more shape, volume,
and make it straight.
I pushed
the bone out a little.
You did?
Yeah.
Suction.
Very little bit.
Let me tell you one thing
that Im worried about,
Saras nasal tip is used
to being over projected.
She might even have
to tape her nasal tip
for about four to six
weeks following surgery.
Saras skin has a lot of memory
in the region of the tip.
That means that the skin is
used to being projected out,
even though we fixed
everything underneath it,
but it still likes to be out.
Hopefully, with proper
post-operative care,
her nasal tip skin can
settle into its new position
and forget that it was
ever really projected out.
Okay a lot better.
About 85%.
Were just gonna have
to see how she heals.
Looks great.
I think shell be really happy.
Look who it is.
Nice to see you. How are you?
Nice to see you.
Hello. I will shake
gently if you dont mind.
How are you? Good to see you.
Very nice to see you.
Okay so I have a lot to
talk to you about. Okay?
Yes, please do.
Your surgery was very difficult.
So I was able to create
a pocket. Yay. Good.
Yay.
And able to put an implant in,
but the soft tissue envelope
overlying it was like
hanging off and distorted,
and so I needed to get it to
conform to the breast implant.
Correct?
The problem is if I cut from
the inside dramatically
and I start cutting
from the outside,
whats feeding the nipple?
No blood supply.
This is what I call
that fork in the road.
I got in there, I put
in the breast implant,
and Im gonna let it
heal and chill out,
come back in a
couple of weeks...
Okay.
And do good breast shape
once things have healed
and re-established...
Gotcha.
Blood flow.
So today, I dont care
what it looks like.
Stage one, all right?
All right so lets see.
So remember, its about,
do I have mounds in there?
Hey. Its gotta be
better than what she had.
Ah. It feels so good
just to release.
Okay.
Its this deficient area
that is the area
I have to work on.
But look at this.
Ive got mounds.
Yeah.
And look, theyre happy...
Theyre bigger than
me Meliss.
And theyre soft,
and theyre good.
And look, the nipple is...
you dont need to
be a plastic surgeon
to know thats a pink nipple.
The fact that I can look down
and see fullness of breasts,
Im very excited about that.
And now Dr. Dubrow wants
to go for that second step,
Im all in.
He must have patience of a
God, I cant even imagine,
like he didnt
throw in the towel
and just say forget
it, I cant do it.
Your job is to allow these
breast implants to stay there.
- Were gonna be good.
- All right.
So our next
patient, Liziane,
something about helping
her with her nose.
Here she is.
Wow. Looks like
multiple nasal surgeries.
Yeah. Shes had a
lot of nasal surgery.
Brow surgery.
Shes a plastic
surgery aficionado.
Can you please send in Liziane?
Hi.
Liziane. Nice to meet you.
Liziane, shes obsessed
with plastic surgery
and it gets me worried because
she almost died last year.
I hope the doctors
are gonna help Liziane
to understand its time to stop.
So we looked at your photos
and we know that you
like plastic surgery.
Yes.
And I know that youre here
for something with your nose.
Yes. And I have like, for now,
I have six nose jobs.
Six? Okay.
And I still hate my nose.
What dont you like
about your nose?
Here the nostril
that looks different.
So what plastic surgery
have you had total?
Uh. Oh my gosh.
I dont know.
I lost count. Theres been so
many procedures just...
I lost count.
How many lipos? Ten?
Can I say 20?
Okay. 20 lipos?
Yeah because-
I think thats a
record isnt it?
Where did you have liposuction?
What part of your body?
Oh, everything.
Really?
How did that go?
The lipos well but
the problem was
I got addicted in
doing liposuction.
So if I see some fat
on my body, lipo.
How much do you
think youve spent,
up to this point,
on plastic surgery?
I could drive a Ferrari
if I dont have all
this procedures done.
The other option is
you could have a lot
of plastic surgery
and buy a Ferrari like him.
Actually, Terry, its a Ferrari.
Ferrari.
Engine sounds sweet.
I dont wanna do
lipo anymore but...
Good.
I wish I could remove my ribs.
I think if I remove
this... here.
First of all, Im not
lookin at your ribs.
But if I remove here, Im gonna
look more.
They think that Im a
little bit coo-coo but...
It is what it is.
Shes talking about a lift,
shes talking about
a new nose job...
So its not gonna stop.
Shes not gonna stop.
Have you ever had
any complications?
I met this doctor in Turkey.
What did you go to Turkey for?
For a lipo and a nose job.
Because any doctors in
USA wants to do lipo.
They wont do lipo.
No. And I went in a coma.
What? You went into a coma?
Why?
He said that I have a embolism.
Embolism?
Wow.
A pulmonary embolus...
Yeah.
Is when you have either a clot,
a blood clot,
go into your lungs,
and block your lungs and
gives you shortness of breath.
Did he tell you
where it came from?
Pulmonary embolism comes
from one of the veins,
usually in the
lower extremities,
that goes up into the
right side of the heart,
and then enters into your lung
and causes a big
problem with your lung.
Most of the people that I know
that have had
pulmonary embolisms
arent here with us anymore.
Did the doctor say
you almost died?
Yeah.
And you want more.
Mm-hmm.
Whats wrong with this picture?
There it is, there-
oh look at that.
Oh this is so good!
Dr. Pimple Popper
eat your heart out.
You ready for the second stage?
So ready.
Melissa right now
has about a 63% improvement.
I wanna get a 93.
Thats like an A on the test.
All right lets go.
Let me look at your nose.
Okay so...
Let me look at your ears.
Okay so cartilage has
been removed from here.
Thats not good.
Any filler
in your face?
Yeah.
Does that hurt with
me touching you here?
So you might still have
something in there.
Look. Look it even blots.
Yeah, look at that,
when I do that.
Its coming out?
Oh oh yeah. Look at that.
Its coming out?
Hold on one second.
Let me just see...
There it is,
there-- oh look at that.
This is not hyaluronic
acid I dont think.
Its kind of granular.
Oh my gosh.
Get it all out.
Oh this is so good.
Dr. Pimple Popper
eat your heart out.
Uh. That yellow stuff coming
out of Lizianes face
was very disgusting.
Its making me want to throw up.
Thats some kind of a filler
that your body doesnt like.
Youve never had anything
injected into the nose right?
Yes.
You have.
Mm-hmm.
You have some of that yellow,
junk filler, whatever it is,
in your nose too.
Yeah.
Okay.
All right, your two nostrils.
What I would have to do is
add tissue from your ear,
made out of skin and
cartilage, on your right side.
I would make it a little bit
better, a little bit wider,
but to get that round curve,
you cant recreate that again.
Two, they took all the cartilage
that I can use in your ear.
If I do do it, it could
collapse your ear canal
and then you wont
be able to hear well.
Mm-hmm.
The third thing is you have
all this filler in your face.
Whether youre infected
or not, were not sure,
especially because
of the draining.
Most important thing when
you go back to Vegas,
have that looked at,
maybe cultured,
maybe put on antibiotics,
and watch it.
So even if all these
things could be fixed,
theres one huge issue.
You still had a
major complication
because that pulmonary
embolus is no joke.
And you will find
other plastic surgeons
who will wanna do
this, dont do it.
Cause youre gambling a
game youre not going to win.
Youre gonna lose your life.
Do not do anymore
plastic surgery.
I cant say that
more emphatically.
Are you gonna listen to us?
Me and the doctors, we are
in the same page for sure.
Like we think the same
way, but to be honest,
I dont think Lizianes gonna
take the doctors advice.
For my nose... maybe. But do you
understand how frustrating it is
because I wanna fix my nose.
Okay will you make
me one promise?
If you do more surgery,
whatever it is,
will you make sure you go to
a pulmonologist, hematologist,
and figure out
first what happened?
Theyll see if theres
scar in your lung,
theyll see things.
Yeah. Is there anything I
can do to minimize the chance
of it happening again?
Okay.
Will you do that?
Yeah.
Promise?
Im pretty appreciative
what the doctors told me.
Nice to meet you. Bye.
But, sorry doctors...
but Im not gonna
stop doin surgeries.
I just wanna cut it...
You know cut it
and just do like this.
Stop. Forget about it.
Hello.
Hello. How are you?
Good. How are you?
Im well thank you.
Are you ready for
the second stage?
So ready.
I was looking at your before,
and this interim after...
Its like amazing.
Its kind of a little
bit of a magic trick.
Now lets make it a
cosmetic magic trick okay.
All right. Sounds good.
All right. Lets do this.
Today for Melissas
second surgery,
I will begin by replacing
her current implants
with slightly larger ones to
give her a better breast shape
and remove the last
bit of scarring
that she has on the right side.
Its all about just getting
a good, cosmetic result.
Lets take the implant out.
Yeah. A very small implant.
200 and 55 CCs.
Okay.
And what you can see is
that the implant actually,
it really helped us.
It gave us more padding
and a really good pocket.
Okay. Lets put this implant in.
- 310?
- Yeah.
Melissa, right now, has
about a 63% improvement.
What Im always targeting
in these complicated cases,
is that I wanna get a 93.
Thats like an A on the test.
So today, Im gonna
upsize in hopes
of trying to get a good shape.
Look at that.
Thats much better.
Now we have to make this
one look like the right one.
Yeah. This ones nice
and thick too now.
Lets close off the pocket a
little bit on the outer portion
and move the implant
mound to the center.
Lets do exactly what we
did on the other side.
Melissa has come really
far with her two surgeries
and at least right now,
it looks like weve got
a good result brewing
and a high potential
for healing.
Is it me or is this pretty good?
Its very good.
Yes!
Ooh I think I pulled something.
Hi.
How are you?
Im doin pretty good.
Mom. How are you?
This is not bad for bruising,
well at least,
from my other surgeries.
I like to hear that.
Pleasant surprise is that
Sara has minimal
bruising around her eyes.
Usually when you
fracture the nasal bones,
especially when someones
had trauma in the past,
your bruising is a
lot more significant.
Okay let me just take a peak.
Fascia perfect.
Just some antibiotic ointment
on that and thats it.
Yep.
Can I see your ribbie?
Yep.
That looks great. Keep that on.
Its okay to get it wet.
Okay.
Lets see. Head back.
That looks good.
Okay. So lets talk
about the surgery.
Okay.
The difficult part was
the crooked left side
of your nasal bone.
So for me to try to
get that bone out,
I had to put cartilage on the
inside and mobilize the bone.
Oh wow.
And I told you before...
Right.
That it was gonna be difficult,
remember how you talked about
your skin getting purple...
Yeah.
And red. During the whole
surgery, it looked great.
Oh good.
And your skin color
right now looks great.
Awesome.
Have you noticed
any weird colors
of your nose at all, your tip?
Uh uh. Nope.
All right. Well
then you look good.
Well, thanks.
I hope Santa is still gonna
give me a lot of presents.
Dr. Nassif, I think
youre gonna get
whatever you want for Christmas.
I will definitely put in a
word with the big guy for you.
Thank you.
My pleasure.
To think it all started
with Colton and Santa Claus.
Hey, guys!
Look at you!
Hi Mom!
Oh.
Mom!
This surgery has changed
every aspect of my life.
Melissa!!
Look at Melissa!
Look at you!
Girl you look awesome!
This experience
has been amazing.
I have been dealing with a nose
that I didnt like for so long.
You know, after having
my nose broken by my son,
I went through
multiple surgeries
where each surgery I had
a different complication.
So I think its just
gonna take some time
to get used to the idea
that I do have a nose
that I can be happy
to look at now.
To think it all started
with Colton and Santa Claus.
Hey I was young.
Its been quite a journey.
After a year of, really, hell,
going through three surgeries,
I feel like its all
really up from here.
Im in a good place.
Hey, guys!
Hi, Mom!
There she is.
Oh.
Hey.
All right.
Hi, Mommy.
Mom!
Ready for me?
All right.
Ive been practicing my shot
Hi, Mom.
Hi.
My mom looked pretty before
but now shes like
ten times more pretty.
I just want you to know,
I dont blame you.
I blame Santa.
My son swears hes never
gonna do Santa in his house.
He was that traumatized.
Hes like, "How could you
lie to me?" Yeah.
And Mama, you have
been my little
caretaker through everything.
And now were on the other side.
No more surgeries.
No.
Its really good to have
Sara in a good spot,
to have a lot of
this behind her,
Im glad to see her happy and
enjoy what life brings to her.
Its just really
good to see you.
And Im lookin
forward to continuing.
Well good. Youre keeping
me? Youre keeping me?
Im keeping you.
All right good.
Before my surgery, my nose
had a crooked L shape,
one side was caved in,
and the tip would
turn red and purple.
But now, thanks to
Dr. Nassif,
my nose is straight,
the tip doesnt change colors,
and I just cannot
stop lookin at it
and I gotta give a
shout out to Santa.
Santa is the best
part of Christmas,
dont ruin that for your
future children.
All right. Should we play?
Yeah!
Okay lets do it.
I call first.
Just watch your
club there buddy.
We dont need to
mess this up okay?
Ill be careful, Mom.
Okay.
This surgery has
changed every aspect of my
life.
My outlook on life,
period, has changed.
You go from having implants,
then to having nothing,
and, ugh,
I dont even like
to think about
what I looked like previously.
So how does Melissa feel
about everything now?
Does she like whats happened?
Of course!
Well, good.
I mean, now she
takes her bra off,
she looks in the mirror,
and she goes, wow, you know...
Look at me, Mom!
Before, it used to hurt me
when I saw her take off her bra.
Oh yeah.
Hey, ladies.
Oh my god! Look at Melissa!
Wow!!
Oh my gosh! Look at you!
Girl, you look awesome!
Thank you.
Im a different person now.
I actually have boobs.
Theyre very perky,
like incredibly perky.
Like I dont really need a bra.
And I feel incredibly gorgeous
and feminine and I love that.
I was walking down
the street here
and this guys like, nice mmm.
And Im like, do I take
that as a compliment.
Yes you would.
Im gonna take that
as a compliment.
Melissa looks
absolutely beautiful.
I hope that she finds
happiness, love.
I look forward to maybe
even trying to set her up
on some private dates with
some available men that I know.
You know, it takes that
confidence building
to get you to realize
everything that I was missing
in my life.
I moved out of my moms now.
I got my act together.
I have missed time I
need to make up for.
Oh boy.
But I do miss you.
Dont you miss me?
Yes I do... occasionally.
Melissa looks so happy.
Shes smiling from ear to ear.
Shes got her confidence back
and it makes me feel so good.
Its been a long road
but boy is it worth it.
Shes her old self and thats
all I couldve asked for.
Im so thankful to
Dr. Dubrow, like,
he truly did a fantastic job.
He really wanted to see
me happy and whole again.
I truly am thankful.
Hes like a God, serious.
Before my surgery,
my breasts were like
a shredded meat fest.
My nipples were
surrounded by scars,
my breasts were so uneven,
and I had no implants.
I had to wear inserts in my bra
and my self-esteem
was nonexistent.
But now, thanks to Dr. Dubrow,
my breasts are beautiful.
They are scar free,
symmetrical,
and so perky I dont
need any extra padding.
I dont mind lookin in a mirror.
I definitely dont mind
being looked at by others.
Cause I know I look good and
I know they know I look good.
So its all good now.
Happy boobs.
They definitely are
perky and very happy.
Hi.
Shes back.
You might remember
me from last season.
You can wink them or
something cant you?
This looks like a silicone bomb
inside of Christines breast.
Those jackets.
Can we try them on for a second?
Yes!
Okurr.
My name is Krystal
and I have pubic hair
growing out of my cheek.
Its tight.
Ooh thats scary for me. Okay.
Turkey? Just in time
for Thanksgiving.
Holiday season
is here.
Darn you Santa!
I have Santa to
blame for my nose.
He hit my on the bridge of
my glasses and broke my nose.
Ive got like a Rudolph nose.
Itll turn red if
Im really warm.
I would
describe the current state
of my breasts as a
shredded meat fest.
Like cobweb.
Like a horror film or something.
Clearly, Melissas
last surgeons
favorite holiday was Halloween.
I hate the
way that my nose looks.
What plastic surgery
have you had total?
I dont know.
I lost count.
Have you ever had
any complications?
I couldnt breath.
I was like.
And you want more.
Mm-hmm.
Well, lets not forget
what started this whole thing.
Santa.
Oh my goodness.
My name is Sara and I have
Santa to blame for my nose.
I told my son there is no
Santa and he broke my nose.
Darn you Santa!
About two years ago,
my son came home,
and hes like, I know
Santa isnt real.
And he said, tell me the truth!
I mean, he was right in my face.
And so, spoiler alert,
I told him the truth.
Santa is not real.
Yeah.
I went to an Ear, Nose,
and Throat specialist
and he said,
you do have a break.
Lets get it re-set.
So that was the first surgery,
they did put me under for that.
When the cast came off,
it looked the same.
And I met with a different
surgeon who said,
we definitely would need to have
another surgery to correct it.
Following that second surgery,
the surgeon commented that
my nose was a hot mess.
I was hoping that that meant
it was a hot mess before,
but it turned out to be
a hot mess after as well.
My nose still wasnt straight.
So I had to have
another surgery.
Following my last surgery,
my nose is even more crooked,
my tip sticks out, and it
turns purple when Im cold,
itll turn red if
Im really warm.
At least I have a party trick,
I dont know.
If you could do
it all over again,
would you not tell Colton
that there wasnt a Santa?
Thats the million
dollar question isnt it?
Yes.
Wooo!
Dont get that on me.
My name is Liziane.
Im from Brazil,
but I live in Las Vegas
for the past ten years.
And I almost died
doing plastic surgery.
So all my surgeries
and everything
like about me is
all over the news.
After six surgeries, I hate
the way that my nose looks,
and my nostrils are not even.
Why do you wanna fix your nose?
Its like its almost perfect.
No its not.
Its all in your mind.
Plastic surgery in Brazil,
people start young, like 16, 17.
My first procedure,
I was 17 years old
and I had a liposuction
and breast implants.
I been like so many procedures.
Botox, cheek fillers,
lip lift, lip fillers,
breast implant twice,
butt injections,
and lipo all over my body.
For my first nose job,
I wanted like
cute little nose
like Angelina Jolie.
I end up, after the surgery,
my nostrils not even.
So I was doing more nose
jobs because I have the idea,
one of these surgeries
Im gonna have my nose fixed.
If I wanna do like video
or something like this,
that is disgusting.
So my sixth nose job,
I went to Turkey
to have my nose fixed and
to have a liposuction.
And then a disaster happened.
I went to do the surgery
and when I woke up,
I couldnt breath.
I was like...
As I couldnt breathe,
I went into a coma
because I had a blood
clot in my lungs.
And I just remember
waking up five days after.
As your friend Im gonna
tell you, you gotta stop.
After I almost died,
I waited for like one year
to do another procedure.
Im gonna do whatever I want to.
Like its my money,
its my body.
And I went to Brazil to
do some botox and fillers,
and after two weeks,
my lips was getting bigger
and my face was like a
huge ball on the side.
That was worst for me than
what happened in Turkey.
I know you guys gonna
say this is crazy,
but if I died, just died.
What if I have to live with
my face forever like that?
I went to the hospital,
I couldnt feel my lips,
and then I start
to take steroids
to put my face back to normal.
Okay, I need some
pictures for my Instagram.
I want Dr. Nassif to, please,
make my nostrils even.
No no no no, dont go for down.
If youre going down,
youre gonna see my nostrils.
I almost died,
but I dont care.
And until I have my nose
fixed, Im not gonna stop.
And if the Dr. Nassif wants,
maybe take some ribs out?
Question for you.
Pop quiz.
one word
or two words, go.
Two words.
Its one word, dumbass.
Yeah, Paul. That whole skipping
third grade thing, not a good
idea.
All right. Patient named Sara.
Past rhinoplasties,
had some trauma.
Okay whats with the bones here?
Collapse.
Did the trauma cause that or
did the surgeons cause that?
Lets actually see her.
Can you please send in Sara?
Hey.
How are you? Dr. Nassif.
Good. So nice to meet you.
Nice to meet you.
Hi Sara. Terry Dubrow.
Hi.
Please have a seat.
Why dont you start and tell us
what happened with the trauma?
It was getting close
to Christmas time.
My son, hes like,
"Mom, I know Santa isnt real."
How old is he?
He was eight at the time.
So I told him the truth.
That there was no Santa?
Mm-hmm.
Wow.
I did at that point.
I mean hes like,
tell me the truth!
And he got so close to my face,
he hit me just right on
the bridge of my glasses
and broke my nose.
He was really upset.
He was really upset.
Sara, small piece
of advice for you,
next time youre asked if Santa
exists, say yes!
So then that next day, I went
in to ear, nose, and throat.
And they put me
under to reset it.
But then it still
didnt look right.
So then that is when I
met with another doctor.
And that surgery ended up
being like five hours long.
And when the cast came
off, it was still crooked.
And then I had this smell
that I just could not
get out of my nose.
I think it smelled like cat pee.
Thats sad that I know what
cat pee smells like but...
By the way, I dont
wanna change the subject
but you smell like
cat pee sometimes.
Ooh.
Yeah and its usually when Im
breathing in that I notice it.
Terry, the only smell coming
from me is a man smell.
A good looking man making
good looking man smells.
The smell, usually that
is a sign of infection.
Its usually of feet.
Thats what I usually hear.
Oh.
Smells like feet inside my nose.
Did they culture your nose
or think that there
might be an infection?
I dont remember
them culturing it
but I know I was on antibiotics.
So I didnt have that yucky
cat pee smell in there anymore
and then I had another surgery.
And it almost looks kind
of smashed right here.
Right.
Your nose collapsed
after the last surgery.
Yeah well that doctor,
when he met with me
after he did the surgery,
he said, I really wish I
couldve fixed that tip.
And I was like, oh no.
Hows the skin of your nose?
Well it turns purple
when Im cold,
red when Im really warm,
Ive got like a
Rudolph nose, you know.
When did that start to happen?
After the last surgery?
Yeah.
That was after the last surgery.
With hearing all that,
examination is the next step.
Sure.
So lets go ahead and do that.
Okay.
Look at this left
breast right here.
Like cobweb scar tissue.
I dont know what to do.
You might still have
something in there.
Oh yeah. Look at...
Is it coming out?
Its making me want to throw up.
There it is. There-
Oh look at that.
All right. That bone is
like... collapsed in.
Yeah.
Lets see your profile.
Yeah this is- oh interesting.
The bone is all
the way up to here.
Long bones.
So her bones been
taken down and short.
I think Sara has a
saddle nose deformity
from an iatrogenic cause.
What that means is
the doctor did it,
just took too much
out of the cartilage,
whether its an
over-agressive septoplasty,
or taken too much
cartilage right here,
whatever it is,
now shes got a concavity.
What Im gonna have to do is
re-fracture your
bone on the left.
Okay.
Try to make it more mobile
so I can get it straight.
Two, your bone is over done.
This has been
brought in too much.
So we have to build that
up from your own tissue.
Okay.
Ahh. Okay.
Whats wrong? Whats up?
I dont know.
Its a lot.
So far Ive only talked
about two things.
I know. Im getting
nervous. Yeah.
Okay. One, fix the
bone and build this up.
I know its just... Right.
And you need that.
Right?
Yes I do. Yes.
The question is
after I put this in,
how much does the tip
need to move back?
Mm-hmm.
What does that look like?
When you say push the tip
back are you saying push?
Yeah.
Ow.
Were gonna do it a little
bit different than that,
but thats the goal,
is take the tip,
and right now its
over projected.
Right.
Were gonna push it
back a little bit.
Since youre already nervous,
were gonna get you a
little bit more nervous.
Ooh yay.
You know the purple color?
Yes.
Possibility we could
make that worse.
Yeah.
When I hear that
a patients nose
turns purple when shes cold,
that means the blood supply
to the nose is not great.
So if I operate on Saras nose,
theres a very very
good possibility
that I could make that worse.
I mean, I wanna
take on your nose.
I wanna do it.
Okay.
Were in?
Were in.
Okay lets do it.
After those four surgeries,
its gonna take the
best of the best
to fix what happened to me.
My name is Melissa
and I would describe the
current state of my breasts
as literally a
shredded meat fest.
In order to disguise my current
situation, I wear inserts.
They kind of look like chicken
cutlets but theyre clear.
And then you have
like the cotton pads
and then of course
the extra padded bra.
But you gotta make
sure everythings even,
that nothings showing
too much.
When you have this whole
thing going on, you shut down.
Everything is like done.
I know you shut down.
I would like to see
Dr. Dubrow and Dr. Nassif
because what has happened
to me on the outside
has effected my self-esteem.
Id rather just stay home.
So I have no life.
Melissa has had multiple
previous breast surgeries,
the most severe complications
that you can have.
Look at that right breast.
Look how droopy it is.
Right?
Theres no implants
there though is there?
No. Look at this left
breast right here.
You ever seen this before?
Thats all scar tissue isnt it?
Thats like cobweb-
Yes.
Scar tissue.
Bring her in.
Can you please send in Melissa?
Melissa.
Hello.
Very nice to meet you.
Nice to meet you. Dr. Nassif.
Terry Dubrow, nice to meet you.
Mom.
So what we do know is that
youve had multiple previous
breast implant surgeries.
They didnt necessarily work out
and thats why your left
with this situation.
That is correct.
So what happened?
After my first
year in law school,
I figured Id made
it through first year
which is the toughest
year, you know.
I decided to reward myself
with a breast augmentation.
I had the surgery
in the Summer time.
About three to four
months into it,
it got really hard
and raised up to here.
So you had an early
encapsulation.
Mm-hmm. So I went to another
surgeon and he said yes,
we gotta take that out,
clear out that scar tissue...
Right.
He put different implants in
and honestly they were
fine for 12 years.
Okay good.
Up until, I guess,
one of them ruptured.
I was happy until the
day that I woke up
and there was just a bag.
So did it go flat
right away?
Um... in about a 48 hour period.
Okay.
The average life
expectancy for breast implants,
give or take, is about 12 years.
Unfortunately, theres
nothing you can do
for maintenance or upkeep.
Basically, when they pop,
you just gotta get them
replaced.
That surgeon moved.
So I went to another surgeon
and he didnt even use
the right type of sutures.
The holes where the sutures
were placed were really large.
Looks like a starburst
kind of pattern.
About three weeks after,
stuff started leaking out.
I mean I filled up a
Tupperware container
with just going like
that to my breast.
Puss?
It wasnt a puss.
It was more liquidy.
A little reddish?
Yes.
Okay.
Sounds like you had a seroma.
When you develop
fluid after a breast implant
revision,
it could either be
due to an infection,
which would cause puss,
or it can be due to the leaking
of the surrounding cells
due to a low grade inflammatory
reaction, called seroma.
I went to see a different
doctor who said, listen,
Im taking these things out,
put me on antibiotics...
Okay.
And now, I kind of just
stopped my whole life.
You did because of this.
Yeah?
Shes literally in her room
I am.
And youre living alone
or living with mom?
I moved back in with my mom.
Everything that I was, Im not.
What if you go on a date?
What happens?
Come on, were adults, we all
know what happens on dates.
What would you like
to happen, ideally?
I know Im never
gonna be perfect.
Okay.
I just want to be normal
a little bit, you know.
So any improvement...
Yeah.
Is gonna make you happy?
Yes! Are you kidding me?
Okay um...
I dont know.
I dont know what to do.
This ones pretty
deep.
Look at that.
What to do?
Wow.
Ultimately, its gonna be
about who sutures better.
I was Chief Resident
in General Surgery
and Plastic Surgery.
Oh excuse me.
Yeah well theres no
excuse for you, just watch.
Okay, I want to look very
carefully at that scarring
so let me see whats going on.
Okay so because you
had that seroma,
all that fluid that poured out,
this area has basically healed
straight down to the chest wall.
That is a difficult problem.
Then theres this side.
This side...
It had so much
difficulty healing,
normally when wounds are opened,
they heal by bridging skin
coming from each raw side
and touching, and
closing off the wound.
But you not only healed
a band of skin this way,
you filled the cavity with skin.
Like this ones pretty deep.
Look at that.
What to do?
We could potentially
go to the operating room,
remove scar tissue, and
try not to use implants.
But your breasts would
be rather small-ish,
and I wouldnt be able
to get a good shape.
The most valuable
solution may be
the most dangerous
and risky and that is
take out scar tissue,
make a pocket, put implants in,
and give you, hopefully,
symmetrical breasts
that goes with you
and the social life,
and get you where
you need to be.
Lets do it.
The truth about
Melissas very high risk
breast revisional
situation now is
that the blood supply
has been impaired,
theres a ton of scar tissue,
its gonna be
extraordinarily difficult
to give her symmetrical
breasts with good breast shape.
Thank you so much.
Thank you.
But, the only reason
Im willing to take
Melissas case on
is because she did
tolerate breast implants
for over 12 years
and I think that its possible
she may tolerate it again
if I can find the
right operation.
I was like sweating I was
so nervous, Im like...
Dr. Nassif? Dr. Dubrow?
Can you guys come
into the kitchen?
We have an emergency here.
Whats the emergency
in the kitchen?
Oh Jesus.
Oh yeah!
Turkey? Just in time
for Thanksgiving.
I know you guys are
always giving each other
a hard time about whos better.
Yeah.
Wow.
Ultimately, its gonna be
about who sutures better.
Im gonna bring you guys back...
to just a few years
ago in medical school.
Its on, baby!
Of course Im gonna beat
Paul in a suturing contest.
I could beat Paul with one
hand tied behind my back
and the other hand
up my ass.
I was Chief Resident in General
Surgery and Plastic Surgery.
Oh excuse me.
Yeah well theres no
excuse for you, just watch.
This is fun.
I havent done this in years.
All righty, Ill start
the timer now then.
Ready, set, go!
Do I have to listen
to his humming?
Seriously?
For someone who really hates
it when other people hum,
he actually hums and
sings quite a lot.
Voila.
Im done.
I love having Paul
as a best friend
because you can
always count on him...
Loser!
To be a loser.
Wow. Thats like a Picasso.
Fragmented and weird.
All right.
Cut.
Tell me when youre done.
Now.
So how much faster was I?
By 25 seconds.
25 seconds faster?
Paul, you are a turkey.
Can I take these
home for Thanksgiving?
- Melissa.
- Hey Doc.
How you feeling?
Well thank you.
Excited, nervous.
Excited and nervous?
Yes.
I hate to tell you, me too.
The plan for
Melissas surgery today is to
first remove the irregular
scars around her areolas.
Then Ill make an incision
and attempt to make
a breast pocket
after assessing the amount
of scar tissue on the inside.
And once I do that, Ill place
appropriately sized implants.
Finally, Ill manipulate
the overlying breast tissue,
trying to give Melissa two
full, symmetrical breasts.
Okay so weve got
the external scars
all cut out on this right side.
Now we have to go in
and assess the pocket.
Yeah. So far its just
one, thick scar mass.
Look at this.
All just blown up scar tissue.
And you cant put an
implant underneath this.
It wont give at all.
The key to Melissas
surgery today is my ability
to release the scar
tissue on the inside
to allow me to make a pocket.
A huge, significant
problem is that
the closer you get to
the overlying skin,
the greater the chance that
I could pop through the skin
and thats game over,
or reduce the blood supply to
the overlying skin and nipple
that it all dies
post-operatively.
All right. Let me see something.
Im creating kind of a
semi-submuscular pocket of scar
to elevate the breast tissue
rather than a stiff pocket.
All right. Lets see
what this would do.
Staple this for a second.
We finally have a small implant.
The problem is if I do anything
else with this implant in,
I dont think the
nipple will survive.
The only thing we
can do on this breast
is let it heal and do the
operation that I need to do
in a second stage when
things have healed.
All right. Lets
start on the left.
Now I have the left
breast to deal with.
Look at all these holes
where she pussed out
all those stitches.
Its like a horror
film or something.
Very bizarre.
Clearly,
Melissas last surgeons
favorite holiday was Halloween.
All right lets
see what surprises
await us inside this breast.
As opposed to the right breast,
the old pocket was
able to be found,
I was able to lift it up,
remove some scar tissue,
and easily create a pocket
to accommodate her implant.
Wow. So this side, as
opposed to the right side,
turned out to be very
straight forward.
So were gonna have, hopefully,
a healed breast
with an alive nipple
that we can come back
in a couple of weeks,
and do a tweek that will make
Melissa have a good shape
and the size she wants.
To move forward and
make any more incisions
is not worth the risk of
losing the entire nipple
and potentially all
of the breast tissue.
I think this is
the best way to go.
If I can get Sara
at least an 80% improvement,
Santa has to give me a
fantastic present this year.
You know, like, another new car.
I wish I could remove my ribs.
Im not lookin at your ribs.
But if I remove here...
So they think that Im
a little bit coo-coo.
So heres your
computer morphing.
You can see how that
tip is sticking out,
so our goal is Im gonna
push that back a little bit.
If I can get Sara at
least an 80% improvement,
Santa hast to give me a
fantastic present this year.
You know, like, another new car.
For Saras surgery today,
my team and I will begin
by simultaneously harvesting
rib and fascia from her scalp.
I will then open
her nose and perform
a medial crural overlay
to push back the tip
before inserting a diced
cartilage-fascia graft
into the middle vault
to build up her profile.
Next, well fracture the
bones on the left side
so I can widen them
and make them straight.
Hopefully giving Sara a nose
as pretty as a
Christmas present.
Now were gonna start the nose.
Rib is out.
Fascia came out, nice big piece.
What were doing right now
is setting the tip back.
Its called a medial
crural overlay.
And we wanna keep eyeballing
the nasal tip skin color.
Obviously, the color that we
dont wanna see is purple.
Sara told me that her nasal tip
turns purple when shes cold.
That means the blood supply
to the nose is not great.
So Im gonna rock and roll
through this part of the
surgery
because the longer I take
the more risk there is
to damaging her nasal skin.
Were now gonna place the
diced cartilage-fascia graft.
Were also gonna
build up the dorsum.
So far the nasal tip skin is
nice and pink.
Go.
The left nasal
bones collapsed in,
so for me to fix this,
Im gonna fracture
her left bones,
put some rib cartilage
right in between there,
thats gonna give it
more shape, volume,
and make it straight.
I pushed
the bone out a little.
You did?
Yeah.
Suction.
Very little bit.
Let me tell you one thing
that Im worried about,
Saras nasal tip is used
to being over projected.
She might even have
to tape her nasal tip
for about four to six
weeks following surgery.
Saras skin has a lot of memory
in the region of the tip.
That means that the skin is
used to being projected out,
even though we fixed
everything underneath it,
but it still likes to be out.
Hopefully, with proper
post-operative care,
her nasal tip skin can
settle into its new position
and forget that it was
ever really projected out.
Okay a lot better.
About 85%.
Were just gonna have
to see how she heals.
Looks great.
I think shell be really happy.
Look who it is.
Nice to see you. How are you?
Nice to see you.
Hello. I will shake
gently if you dont mind.
How are you? Good to see you.
Very nice to see you.
Okay so I have a lot to
talk to you about. Okay?
Yes, please do.
Your surgery was very difficult.
So I was able to create
a pocket. Yay. Good.
Yay.
And able to put an implant in,
but the soft tissue envelope
overlying it was like
hanging off and distorted,
and so I needed to get it to
conform to the breast implant.
Correct?
The problem is if I cut from
the inside dramatically
and I start cutting
from the outside,
whats feeding the nipple?
No blood supply.
This is what I call
that fork in the road.
I got in there, I put
in the breast implant,
and Im gonna let it
heal and chill out,
come back in a
couple of weeks...
Okay.
And do good breast shape
once things have healed
and re-established...
Gotcha.
Blood flow.
So today, I dont care
what it looks like.
Stage one, all right?
All right so lets see.
So remember, its about,
do I have mounds in there?
Hey. Its gotta be
better than what she had.
Ah. It feels so good
just to release.
Okay.
Its this deficient area
that is the area
I have to work on.
But look at this.
Ive got mounds.
Yeah.
And look, theyre happy...
Theyre bigger than
me Meliss.
And theyre soft,
and theyre good.
And look, the nipple is...
you dont need to
be a plastic surgeon
to know thats a pink nipple.
The fact that I can look down
and see fullness of breasts,
Im very excited about that.
And now Dr. Dubrow wants
to go for that second step,
Im all in.
He must have patience of a
God, I cant even imagine,
like he didnt
throw in the towel
and just say forget
it, I cant do it.
Your job is to allow these
breast implants to stay there.
- Were gonna be good.
- All right.
So our next
patient, Liziane,
something about helping
her with her nose.
Here she is.
Wow. Looks like
multiple nasal surgeries.
Yeah. Shes had a
lot of nasal surgery.
Brow surgery.
Shes a plastic
surgery aficionado.
Can you please send in Liziane?
Hi.
Liziane. Nice to meet you.
Liziane, shes obsessed
with plastic surgery
and it gets me worried because
she almost died last year.
I hope the doctors
are gonna help Liziane
to understand its time to stop.
So we looked at your photos
and we know that you
like plastic surgery.
Yes.
And I know that youre here
for something with your nose.
Yes. And I have like, for now,
I have six nose jobs.
Six? Okay.
And I still hate my nose.
What dont you like
about your nose?
Here the nostril
that looks different.
So what plastic surgery
have you had total?
Uh. Oh my gosh.
I dont know.
I lost count. Theres been so
many procedures just...
I lost count.
How many lipos? Ten?
Can I say 20?
Okay. 20 lipos?
Yeah because-
I think thats a
record isnt it?
Where did you have liposuction?
What part of your body?
Oh, everything.
Really?
How did that go?
The lipos well but
the problem was
I got addicted in
doing liposuction.
So if I see some fat
on my body, lipo.
How much do you
think youve spent,
up to this point,
on plastic surgery?
I could drive a Ferrari
if I dont have all
this procedures done.
The other option is
you could have a lot
of plastic surgery
and buy a Ferrari like him.
Actually, Terry, its a Ferrari.
Ferrari.
Engine sounds sweet.
I dont wanna do
lipo anymore but...
Good.
I wish I could remove my ribs.
I think if I remove
this... here.
First of all, Im not
lookin at your ribs.
But if I remove here, Im gonna
look more.
They think that Im a
little bit coo-coo but...
It is what it is.
Shes talking about a lift,
shes talking about
a new nose job...
So its not gonna stop.
Shes not gonna stop.
Have you ever had
any complications?
I met this doctor in Turkey.
What did you go to Turkey for?
For a lipo and a nose job.
Because any doctors in
USA wants to do lipo.
They wont do lipo.
No. And I went in a coma.
What? You went into a coma?
Why?
He said that I have a embolism.
Embolism?
Wow.
A pulmonary embolus...
Yeah.
Is when you have either a clot,
a blood clot,
go into your lungs,
and block your lungs and
gives you shortness of breath.
Did he tell you
where it came from?
Pulmonary embolism comes
from one of the veins,
usually in the
lower extremities,
that goes up into the
right side of the heart,
and then enters into your lung
and causes a big
problem with your lung.
Most of the people that I know
that have had
pulmonary embolisms
arent here with us anymore.
Did the doctor say
you almost died?
Yeah.
And you want more.
Mm-hmm.
Whats wrong with this picture?
There it is, there-
oh look at that.
Oh this is so good!
Dr. Pimple Popper
eat your heart out.
You ready for the second stage?
So ready.
Melissa right now
has about a 63% improvement.
I wanna get a 93.
Thats like an A on the test.
All right lets go.
Let me look at your nose.
Okay so...
Let me look at your ears.
Okay so cartilage has
been removed from here.
Thats not good.
Any filler
in your face?
Yeah.
Does that hurt with
me touching you here?
So you might still have
something in there.
Look. Look it even blots.
Yeah, look at that,
when I do that.
Its coming out?
Oh oh yeah. Look at that.
Its coming out?
Hold on one second.
Let me just see...
There it is,
there-- oh look at that.
This is not hyaluronic
acid I dont think.
Its kind of granular.
Oh my gosh.
Get it all out.
Oh this is so good.
Dr. Pimple Popper
eat your heart out.
Uh. That yellow stuff coming
out of Lizianes face
was very disgusting.
Its making me want to throw up.
Thats some kind of a filler
that your body doesnt like.
Youve never had anything
injected into the nose right?
Yes.
You have.
Mm-hmm.
You have some of that yellow,
junk filler, whatever it is,
in your nose too.
Yeah.
Okay.
All right, your two nostrils.
What I would have to do is
add tissue from your ear,
made out of skin and
cartilage, on your right side.
I would make it a little bit
better, a little bit wider,
but to get that round curve,
you cant recreate that again.
Two, they took all the cartilage
that I can use in your ear.
If I do do it, it could
collapse your ear canal
and then you wont
be able to hear well.
Mm-hmm.
The third thing is you have
all this filler in your face.
Whether youre infected
or not, were not sure,
especially because
of the draining.
Most important thing when
you go back to Vegas,
have that looked at,
maybe cultured,
maybe put on antibiotics,
and watch it.
So even if all these
things could be fixed,
theres one huge issue.
You still had a
major complication
because that pulmonary
embolus is no joke.
And you will find
other plastic surgeons
who will wanna do
this, dont do it.
Cause youre gambling a
game youre not going to win.
Youre gonna lose your life.
Do not do anymore
plastic surgery.
I cant say that
more emphatically.
Are you gonna listen to us?
Me and the doctors, we are
in the same page for sure.
Like we think the same
way, but to be honest,
I dont think Lizianes gonna
take the doctors advice.
For my nose... maybe. But do you
understand how frustrating it is
because I wanna fix my nose.
Okay will you make
me one promise?
If you do more surgery,
whatever it is,
will you make sure you go to
a pulmonologist, hematologist,
and figure out
first what happened?
Theyll see if theres
scar in your lung,
theyll see things.
Yeah. Is there anything I
can do to minimize the chance
of it happening again?
Okay.
Will you do that?
Yeah.
Promise?
Im pretty appreciative
what the doctors told me.
Nice to meet you. Bye.
But, sorry doctors...
but Im not gonna
stop doin surgeries.
I just wanna cut it...
You know cut it
and just do like this.
Stop. Forget about it.
Hello.
Hello. How are you?
Good. How are you?
Im well thank you.
Are you ready for
the second stage?
So ready.
I was looking at your before,
and this interim after...
Its like amazing.
Its kind of a little
bit of a magic trick.
Now lets make it a
cosmetic magic trick okay.
All right. Sounds good.
All right. Lets do this.
Today for Melissas
second surgery,
I will begin by replacing
her current implants
with slightly larger ones to
give her a better breast shape
and remove the last
bit of scarring
that she has on the right side.
Its all about just getting
a good, cosmetic result.
Lets take the implant out.
Yeah. A very small implant.
200 and 55 CCs.
Okay.
And what you can see is
that the implant actually,
it really helped us.
It gave us more padding
and a really good pocket.
Okay. Lets put this implant in.
- 310?
- Yeah.
Melissa, right now, has
about a 63% improvement.
What Im always targeting
in these complicated cases,
is that I wanna get a 93.
Thats like an A on the test.
So today, Im gonna
upsize in hopes
of trying to get a good shape.
Look at that.
Thats much better.
Now we have to make this
one look like the right one.
Yeah. This ones nice
and thick too now.
Lets close off the pocket a
little bit on the outer portion
and move the implant
mound to the center.
Lets do exactly what we
did on the other side.
Melissa has come really
far with her two surgeries
and at least right now,
it looks like weve got
a good result brewing
and a high potential
for healing.
Is it me or is this pretty good?
Its very good.
Yes!
Ooh I think I pulled something.
Hi.
How are you?
Im doin pretty good.
Mom. How are you?
This is not bad for bruising,
well at least,
from my other surgeries.
I like to hear that.
Pleasant surprise is that
Sara has minimal
bruising around her eyes.
Usually when you
fracture the nasal bones,
especially when someones
had trauma in the past,
your bruising is a
lot more significant.
Okay let me just take a peak.
Fascia perfect.
Just some antibiotic ointment
on that and thats it.
Yep.
Can I see your ribbie?
Yep.
That looks great. Keep that on.
Its okay to get it wet.
Okay.
Lets see. Head back.
That looks good.
Okay. So lets talk
about the surgery.
Okay.
The difficult part was
the crooked left side
of your nasal bone.
So for me to try to
get that bone out,
I had to put cartilage on the
inside and mobilize the bone.
Oh wow.
And I told you before...
Right.
That it was gonna be difficult,
remember how you talked about
your skin getting purple...
Yeah.
And red. During the whole
surgery, it looked great.
Oh good.
And your skin color
right now looks great.
Awesome.
Have you noticed
any weird colors
of your nose at all, your tip?
Uh uh. Nope.
All right. Well
then you look good.
Well, thanks.
I hope Santa is still gonna
give me a lot of presents.
Dr. Nassif, I think
youre gonna get
whatever you want for Christmas.
I will definitely put in a
word with the big guy for you.
Thank you.
My pleasure.
To think it all started
with Colton and Santa Claus.
Hey, guys!
Look at you!
Hi Mom!
Oh.
Mom!
This surgery has changed
every aspect of my life.
Melissa!!
Look at Melissa!
Look at you!
Girl you look awesome!
This experience
has been amazing.
I have been dealing with a nose
that I didnt like for so long.
You know, after having
my nose broken by my son,
I went through
multiple surgeries
where each surgery I had
a different complication.
So I think its just
gonna take some time
to get used to the idea
that I do have a nose
that I can be happy
to look at now.
To think it all started
with Colton and Santa Claus.
Hey I was young.
Its been quite a journey.
After a year of, really, hell,
going through three surgeries,
I feel like its all
really up from here.
Im in a good place.
Hey, guys!
Hi, Mom!
There she is.
Oh.
Hey.
All right.
Hi, Mommy.
Mom!
Ready for me?
All right.
Ive been practicing my shot
Hi, Mom.
Hi.
My mom looked pretty before
but now shes like
ten times more pretty.
I just want you to know,
I dont blame you.
I blame Santa.
My son swears hes never
gonna do Santa in his house.
He was that traumatized.
Hes like, "How could you
lie to me?" Yeah.
And Mama, you have
been my little
caretaker through everything.
And now were on the other side.
No more surgeries.
No.
Its really good to have
Sara in a good spot,
to have a lot of
this behind her,
Im glad to see her happy and
enjoy what life brings to her.
Its just really
good to see you.
And Im lookin
forward to continuing.
Well good. Youre keeping
me? Youre keeping me?
Im keeping you.
All right good.
Before my surgery, my nose
had a crooked L shape,
one side was caved in,
and the tip would
turn red and purple.
But now, thanks to
Dr. Nassif,
my nose is straight,
the tip doesnt change colors,
and I just cannot
stop lookin at it
and I gotta give a
shout out to Santa.
Santa is the best
part of Christmas,
dont ruin that for your
future children.
All right. Should we play?
Yeah!
Okay lets do it.
I call first.
Just watch your
club there buddy.
We dont need to
mess this up okay?
Ill be careful, Mom.
Okay.
This surgery has
changed every aspect of my
life.
My outlook on life,
period, has changed.
You go from having implants,
then to having nothing,
and, ugh,
I dont even like
to think about
what I looked like previously.
So how does Melissa feel
about everything now?
Does she like whats happened?
Of course!
Well, good.
I mean, now she
takes her bra off,
she looks in the mirror,
and she goes, wow, you know...
Look at me, Mom!
Before, it used to hurt me
when I saw her take off her bra.
Oh yeah.
Hey, ladies.
Oh my god! Look at Melissa!
Wow!!
Oh my gosh! Look at you!
Girl, you look awesome!
Thank you.
Im a different person now.
I actually have boobs.
Theyre very perky,
like incredibly perky.
Like I dont really need a bra.
And I feel incredibly gorgeous
and feminine and I love that.
I was walking down
the street here
and this guys like, nice mmm.
And Im like, do I take
that as a compliment.
Yes you would.
Im gonna take that
as a compliment.
Melissa looks
absolutely beautiful.
I hope that she finds
happiness, love.
I look forward to maybe
even trying to set her up
on some private dates with
some available men that I know.
You know, it takes that
confidence building
to get you to realize
everything that I was missing
in my life.
I moved out of my moms now.
I got my act together.
I have missed time I
need to make up for.
Oh boy.
But I do miss you.
Dont you miss me?
Yes I do... occasionally.
Melissa looks so happy.
Shes smiling from ear to ear.
Shes got her confidence back
and it makes me feel so good.
Its been a long road
but boy is it worth it.
Shes her old self and thats
all I couldve asked for.
Im so thankful to
Dr. Dubrow, like,
he truly did a fantastic job.
He really wanted to see
me happy and whole again.
I truly am thankful.
Hes like a God, serious.
Before my surgery,
my breasts were like
a shredded meat fest.
My nipples were
surrounded by scars,
my breasts were so uneven,
and I had no implants.
I had to wear inserts in my bra
and my self-esteem
was nonexistent.
But now, thanks to Dr. Dubrow,
my breasts are beautiful.
They are scar free,
symmetrical,
and so perky I dont
need any extra padding.
I dont mind lookin in a mirror.
I definitely dont mind
being looked at by others.
Cause I know I look good and
I know they know I look good.
So its all good now.
Happy boobs.
They definitely are
perky and very happy.
Hi.
Shes back.
You might remember
me from last season.
You can wink them or
something cant you?
This looks like a silicone bomb
inside of Christines breast.
Those jackets.
Can we try them on for a second?
Yes!
Okurr.
My name is Krystal
and I have pubic hair
growing out of my cheek.
Its tight.
Ooh thats scary for me. Okay.