Transcript for Episode 09

00:05

Hi, good peeps. Welcome to the flexible neurotic podcast. You know that friend that you can call to ask anything? That's me. Dr. Sarah Milken. I'm known to my friends as the flexible, neurotic. What does flexible neurotic even mean? Let me be neurotic while I take out my golden shovel to dig deep for all the golden nuggets in the hottest topics, from parenting, to education to neuroscience, and maybe even some beauty secrets. So we can all start living more flexibly. Come join us for edgy conversations with rad moms. Innovative thought leaders and well being practitioners helping you find that sweet spot between chaotic and chill. If you're craving that sweet spot, grab your golden shovel with me. You will walk away with nuggets you can start using today.

01:01

Hi, good peeps. This is the next episode of the flexible neurotic podcast. I'm Dr. Sarah Milken, the flexible neurotic. Today I have a very special guest. He is a Board Certified facial plastic and reconstructive surgeon in Beverly Hills specializing in surgical and non surgical facial rejuvenation. His clients on the regular are most or all of the Kardashians precede Teagan I mean the list goes on. Based on popular demand. Dr. Diamond has opened up practices in New York and Dubai. In order to accommodate his international clientele. Dr. Diamond has developed a long standing reputation for making his patients look youthful, yet completely natural as seen on E networks hit reality television show Dr. 9021. My patients don't look done. Dr. Diamond says they just look great. We all want to look the best versions of ourselves. Hi, what a great introduction. Thank you. Oh my gosh, so well deserved. I'm so excited to talk to you. Except not on zoom because I'm a little scared of the lighting because zoom is so scary. But I do have four lights on me. So it's taken away some of the zoom Dracula luck, I hope I wanted to talk about what my intentions are for the episode because I'm so excited to have you on I want to make sure that we cover everything because I know all the listeners have all the same questions that I do and want to pick your brain and how we can not look as well as we are. So my intentions for this episode as it is for all my episodes of the flexible neurotic is for us to dig deep with our golden shit shovels in edgy conversation about how we can and will find our sweet spots between neurotic and chill. In this case, we're gonna find the sweet spot and learning about the basics of surgical and non surgical facial improvements to create the best versions of ourselves. Should that be one of your goals. It's definitely one of my goals. The intention of this episode is to hone in on what the top facial procedures and surgeries are in Dr. Diamonds office, what we should be looking for in the surgeon or practitioner providing the service. We're going to learn how Dr. Diamond built his tremendous Picasso facial touch with racking up 1000s of hours of expert hours with the best of the best. And we will dive into how TV and social media have helped to normalize plastic surgery and procedures yet we have to be aware of false advertising. We talk about what happens to our face after 40 ish. Yes, there are things that we can do. So let's get our golden shovels out. And we're going to dig deep with Dr. Diamond. Dr. Diamond. Are you ready? I gotta get a golden shit show. I know I'll bring you on next time I see you a bit dazzled one for sure. I want to take the first few minutes for you to give us a brief snapshot of what you're known known for as a plastic surgeon. As you know, I'm a facial plastic surgeon so I specialize in surgery of everything from the neck and above. And I do all the non invasive procedures as well. I would say both surgical and non surgical procedures to enhance somebody's facial aesthetic. Got it. So we're basically talking about aging structure, balance, symmetry, correct and skin improvement to which is a big part of the practice that a lot of plastic surgeons leave out but it's but I focus on it because it's essential as well. So all those things, Luskin and I know that I've heard you talk about in other podcasts before that full face lifts with facial implants are your favorite and we're definitely getting to that because that's on my list. Yes. And you love nose jobs. Yes. Would you say that facelifts are

05:00

What got you into your main practice? Is that what started you out? I would say I built my reputation based on my facial rejuvenation surgeries, which is facelifts, brow lifts, lifting of the face. That's really how I made my name and built my reputation. That's where I got became known for that word. He Oh gee of surgeons. Well, I've learned from I learned from the Yogi's, and they learned from their Oh, geez. But yeah, I learned from the mass appeal. That's amazing. I mean, I know that like a little bit of advice story of how I came into Dr. Jason Diamond's office is I saw a friend, she looked amazing. And I was like, wait, what did you do? And she told me and she goes, Oh, you have to go to Dr. Diamond. I'm like, Yeah, but I already go to someone else for Botox. She's like, No, no, no, you have to go to him. Then I run into another friend. And she mentions your name in the same week. And I'm like, God, I'm really like a loyal patient. But I keep hearing about this guy, I want to try it. So then I came into you, and you took away the entire leather texture that was across my forehead with Botox. And then suddenly, I was drinking the Dr. Jason diamond Kool Aid like everyone else's. So thank you. I'm happy to be a part of the Jason diamond office, for sure. You make everyone feel comfortable. I mean, I know I'm not Kim Kardashian. But when I come in, I don't know that I'm not Kim Kardashian for a few minutes, right.

06:32

I know that everyone has an opinion on external maintenance. But with this podcast, I definitely am focusing on internal maintenance and evolution. But I'm still mentioning the fact that maintaining my exterior is definitely super important to me. And I know, everyone has a lot of different opinions on it. And I know it's important to you, but I would love to sort of pick your brain for a second about being in Los Angeles in the smack of the entertainment industry, and what your thoughts are in sort of keeping up your external self. Yeah, well, it's I mean, who said Ice Cube or ice, one of those guys said, What's the point of being in LA if you're not in the industry somehow, right? Like, I've heard that. And everybody's sort of, you know, I mean, even people who aren't movie stars, and they're still with all the social media, everybody sort of is trying to make it in some way or the other and develop some sort of notoriety. And your face is an essential part of your brand. Yeah, and even for moms like me, where I'm not a celebrity, and I just want to look my personal best. I mean, if someone else can go to Jason diamond, why can't die? Yeah, so appearance, you know, confidence, it's, uh, our office philosophy has always been, if you look your best, you feel your best, and you feel your best you do your best. And so you know, your appearance is essential to your to many people's confidence. And that allows you to put your best foot forward. I also think it's interesting with the facial procedures and plastic surgery, it kind of gets into that area of judgment, you know, where some people are like, Oh, I can't believe you do that to your face. And some people are like, Oh, I just age naturally. And I'm like, I don't I just do I have to like, pull my ship back up again. And I'm okay with that. But obviously, everyone has like a different threshold for pulling their shit back together, right.

08:33

But I guess what I want to ask you is, you know, if somebody has something that's really bothering them, or it's bother them their whole lives, what's your philosophy on that? So, it dawned upon me a long, long time ago, I have always been sort of a gym rat. I used to be a seven day a week like Venice Beach Gold's Gym guy. I mean, I was like a heavyweight lifter in the gym, because it just made me feel great. I love looking good. And I don't do that anymore. You don't have time to do that anymore.

09:06

Time and now I need I still work out like crazy. I still take great care of myself. But now I do much more functional, like yoga and pilates for my posture. So I can do my eight hour surgeries without having neck pain and shoulder pain, right with the weightlifting contributed to pains, aches and pains. But at any rate, it dawned upon me back then, like, if you have something that you are self conscious about, Well, you know what I always say before pre COVID at any given moment, there are probably a billion people at any given moment working out in a gym across the world right at any given level. And those people are working out because they want to improve their six pack they want to get a six pack they want to improve their glutes or their thighs or their or whatever it is they want to work on because it makes them feel good. Well, guess what you can exercise away that bump on your nose or that sagginess to your neck or that weekend. Whatever.

10:00

Issues somebody may be having with their face. You can't exercise that away. So what to me? What's the difference between someone going to the gym to develop a six pack versus someone doing a rhinoplasty take the bump up their nose. In both cases, that person is trying to do something to improve their self esteem to improve what they feel about themselves. And so it's no difference to me. And that's how I would ask people to think about that. I agree with you, I feel like I dye my hair, I get Botox. I work out, you know, we all do different things. But I guess it kind of goes back into that kind of trying to step back away from judgment and let everyone live in their own lanes, because what's right for one person is definitely not going to be right for the next. But they need to be able to come to someone like you with reasonable expectations and say, Hey, this is bothering me. Can you help me resolve it and also know at the same time that just because I came into you to get my nose done, I'm not going to come out looking like Kim Kardashian. Right? You're not there to change someone's entire appearance, you're there to fine tune what they have. And everybody's different, what their goals are. And there are different types of practices with different types of niches, but niche is known for you know, creating a very understated subtle change for most people. That's what most people want from me, every now and then somebody wants to speak drastic, glorious change. And we can do that, or people where that's appropriate. But in general, people who see me one a very sort of natural kind of subtle, yeah, you want to look great, but undone. Correct. For me, at least that's what I'm a treat. I should try and do achieve at age 45. Right. Now I know your wife. I've met her once in your office, and she's maybe five years ahead of me. I'm not 100%. Sure. Now, if she wanted to get a facelift, where would you be in that? Well, doing surgery, I've already done some things for her. And it's you know, it's kind of weird operating on a family member. It just has like a weird thing. And so we still haven't crossed that bridge, like, will I be the one to do it or will have my work? Right? But philosophically, you'd be okay with her getting a facelift, if you overcame the fact that it was you doing the surgery or not? Sure. Yeah. Yeah. No, cuz I've talked to my husband about it. I'm like, What do you think we I would like get a facelift. And he's looking at me like, what are you even talking about? But the word facelift seems so drastic and heavy and you call it facial rejuvenation, which I like because it doesn't sound windtunnel you know, the Beverly Hills, women from the 50s with their faces duct taped to the back of their heads, right.

12:45

So I feel like their facial rejuvenation part definitely makes it sound better. Right? Before we dive deep into some of your cool procedures. I want to talk for a second about your childhood. Everyone's childhood contributes to their identity formation, who they are the good, the bad, the bumpy and I know you have an interesting story about how you became interested in becoming a plastic surgeon. So I'd love to hear about that. And I know the listeners would too. Yes. So when I was in high school, a friend of mine from a different school was involved in a car accident, and he smashed his face up pretty good. And I remember he was really devastated about he would say like, you know, look at me, no one's gonna know girls are gonna date me like, you know, who's ever gonna want to like hang out like he was devastated. It really affected us to, to hear it to see this in here and say that, and he underwent a surgery where they corrected everything. And it was a long surgery. And they fixed him up and pretty much made him whole again. And it was like all those insecurities were gone. And it was like a big relief, of course, for him and everybody else too. So I was amazed at the impact that it was possible to give to give somebody that kind of improvement was I mean, I've never really seen anything that dramatic before. So I was fascinated with that. The other thing about it was he had these Polaroid pictures that the doctors took during the surgery. Remember at the time of self? Yeah.

14:17

I took some pictures, stamps themselves. And they gave it to him. And it was pictures of like a scout pulled down with all the pictures of the bones and the plates and the screws to fix the broken bones and stuff and all the blood and stuff. So he had like 10 pictures or something they took and he and he would bring them in from time to time. And he bring them out all the girls that they'd all run for the hills but I was right and you're like bring out to me I want to see

14:41

I sit there and look at those. I every time I saw I was like do you have those pictures I like love looking at was the weirdest thing. And so I knew there was something weird, like there's some sort of attraction that I had. And so that was my first exposure to this type of thing. And then I went to medical school and that was always in the back of my mind that I was really fascinated with

15:00

That whole aspect of it, I was interested in many different sub specialties of medicine. But that was always in the back of my mind. And then when I hit the rotations in third year, you hit the rotations, I came across plastic surgery, and I loved it. And I ended up spending even more time than was required with the plastic surgeons, even on my free weekends, I would go hang out residents in the ER sewing people up and that kind of thing. And that's just how when I had a natural affinity for it, I had sort of natural ability with my hands. I was a baseball player, I have had good hand eye coordination, I had a natural ability with the soft tissue work and stuff. So I was good at it. I loved it. And the more I love it, the better I got it just sort of spiraled out. Yeah. And I think you have another fascinating part of your story. In the way you did rack up all of those expert hours. And you talk about how you had applied for two residency fellowships. They didn't work out how you had planned, but instead of kind of crumbling and saying I can't do this, you took a huge pivot and changed your plan which ended up being sort of the million dollar plan. Can you tell us about that? So during residency, which is quite intense, as you all heard, right, you're talking 18 hour days, four days a week, and then the days you're off is still 12 hour days, like right like crazy hours, crazy intense, like the most intense time in your life. But I was so interested in facial surgery, I was just in love with it that on my vacations, had a week off, I would come out to Beverly Hills and spend time with some of the Masters in the field because I got hooked up with them is one of my mentors, even when I was back in medical school. So how interested I was and they connect me with their colleagues out here. I was in New York one time they connected me from other colleagues out here in Beverly Hills. So I would come out on spring break and spend time out here that you know, while my other friends were in Cabo or whatever came through, and I was here in an O are like watching the master record. I was just fascinated with that. So when you finish your residency, you apply for fellowships. Okay. residency is five years of doing head neck surgery, which includes cosmetic work includes cancer work, it includes trauma, it includes functional stuff, but you're not necessarily geared up in the finesse of doing a facelift. That is correct, you are not so therefore, when you finish residency, you then go try to do a fellowship, which is a one year apprenticeship with one person, okay. So at the time, when I was graduating my residency, there were probably 50 of these fellowships across the country. And I applied to four or five of them, the top ones in locations I want to New York, San Francisco, LA, I didn't apply to Wisconsin, and there are good surgeons everywhere. But I applied geographically to the places that I wanted to live, I could apply to five of them. And I was assured from the powers that be that I was going to get whichever one I wanted. I wasn't sure Well, guess what? I didn't I didn't get any of them. That's such a good lesson to teach our kids to Wow, yeah, I didn't get him in I was devastated. I was devastated. just didn't work out like one of the guys who told me I'm gonna pick you first. He told me he called me the day and said I had to take one of the guys from my guy from San Francisco. Guaranteed me the whole time. I'm gonna if you pick me first I'm going to pick you for so. Turns out last minute, he had to take one of his gun guys from New York, San Francisco. Same thing happened with one of the Beverly Hills because like, I was told all these things, so I didn't imagine a fellowship. Shit happens. I mean, I was ultra devastated and depressed for like two or three days. I'm like, What am I gonna do? I'm gonna like having to do let er, because I didn't like cancer, sir. I didn't like trauma. I'm like, I'll be stuck in a hospital doing you know, car crash facial surgery car crash. Yeah. And you weren't passionate about it, and you wanted to do what you're passionate about. That's right. And I was like, and I don't know enough. I don't know the finer points to go open up a practice. So that what am I going to do? And it turned out after picking myself up by my bootstraps, after three or four days of just like being totally like, bummed out, I started making some calls to some of the big names in the field that I knew and I said, you know, what am I going to do? I didn't match but I want to learn this stuff. And they finally said, Listen, you know, one of the one of the guys who I owe every I owe a lot to his name Sheldon Kovach or Dr. Walker and he's in San Francisco Oakland area, one of the big names in the building. He was one of the guys and I really wanted to be with he had a partner, and he was willing to call me out to every sale I really wanted you but we had to take our own guy was a political. So I called him like three days later. I'm like, you know, I don't know what I'm gonna do. And he said, Listen, he said, you're gonna do it the way I did. And he was at the time seven years old. So he did his fellowship for you. He said, back when I went through this, we didn't do a formal fellowship we just want to spend time with that seems like that's the best way to learn because you actually you're gonna spend a year with me, you're going to learn my one technique. He's like, there's a million techniques. You will learn from different guys. You're gonna learn a million different techniques, and some

20:00

Better Way to go. So I was like the light bulb went off. And I said, You know what, I've got my connections in LA because I've been coming out here for five years, six years anyway on my vacations. And I just said, screw it. And I just kind of came out like lived in my car basically, and just spent two years basically learning from all the best. So I figured out who the best face lip servers were I learned faces from them, I figured out who the best rhinoplasty surgeons were, I learned rhinoplasties from them. They're different different doctors, I've done it with the best facial implant doctors where I learned and so it was like, you could take the best of what you saw from each person, pull it all together and create your own methods. And that's exactly what I did. And therefore, I knew the best of the best techniques. And that's when my results were so good. And that's why I developed a facial rejuvenation practice really early, they always said you don't develop a face of practice. So you have gray hair, I placed the practice like 32. Wow, it's honestly probably one of the youngest people to ever do it. Because I knew all these masterful techniques from different people. And even though two of the most famous face of surgeons in the world, maybe in the same building one for separate from each other. In 40 years, they've never seen each other do a basement. Well guess what I saw both of them for two years, with every little night. And not only those two, but another 20 of them. So I knew every little trick, every little nuance, and I just was able to put together what I thought was the best of the best. And that's what I did. So that's one of those stories where you know, God definitely probably closed that door on me, you always say like, doors that are closed are just as important as the doors that were open had I matched with one of those guys, I would have learned one probably average technique. But now I know 100 different techniques for the same thing. So it definitely was a blessing in disguise. It's an amazing story, because it's sort of like if you go back to that Malcolm Gladwell concept of you know, 10,000 hours of deliberate practice. And I've heard you say before that, like if a surgeon were to try to get 10,000 hours of practice doing a nose job, it would like take him 10 years or something to do that. Yes. But you were with all of these surgeons all the time in different offices. So you were collecting the information 1000 times faster than everyone else was. I was. So one of the people that I was spending one of the Masters, one of the most famous faces of surgeons in the world at the time, I was spending a lot of time with him. And I met one of his fellows. So I applied for that fellowship, as did 100 other people. Well, he chose one of the one guy got that fellowship, I started to get to know him because I'd see him two, three days a week over at that office, we became really good friends. And the funny thing was, within a month of the start of his fellowship, we start talking on the phone, and he called me Hey, what do you do? I said, Oh, hey, I went to Ed terino. And I learned how to do the turino cheek implants. Man. I'd love to see that the next day. So what do you guys know I went to jack sheet up in Santa Barbara, I learned the jack sheen tip graft. He's like, oh, man, I look with a leg. And the next thing you know, he's calling me every day to figure out what I learned cuz he was watching the same guy do the same things every single day, he learned one of those techniques, one face of technique, never saw a chicken plant never saw a facial fat grafting, my experience was a billion times better than his and he was with the most famous guy that was. But guess what I got to learn from that guy and 100 others as well. So you had a door close in your face, you kind of crumbled for two minutes or three days, you got back up, you open some more doors, made some calls and created a whole different plan that led to where you are today, which is an amazing story for you for plastic surgery. And it's also an amazing story for your children. It really is. And I never even thought about that ever even put it together toward talking about it right now. Yeah, that's a great story. As you mentioned, it's a great story about how you don't let failure stop you. It's just a stepping stone. And I also think sometimes when you have different experiences or cluster, Fox, whatever you want to call them, and you walk away from it for a second, then you put your mind to it, you sometimes come back at it with an even better idea, a more innovative idea. And it sounds like what you did was a more innovative way of learning these 1000s of techniques and 1000s of hours in a consolidated timeframe. And the other interesting part is that all of the bumps that you could have experienced in your own practice you already saw on other people's patients. Totally, the story is most plastic surgeons as they come out. And I'm the only one who does an experience that I know of over the past probably 25 years before there were fellowships 25 years ago, people did what I just did, but I don't know if they do as many people but they did but over the past 25 years, most people just did a fellowship with one person. So the story is you would come out and you start your price and you take all these bumps along the road as you develop your learning curve but I already had my learning curve down. I mean, I didn't

25:00

I've just noticed I didn't have to take any bumps. I mean, I've come across many complications, I didn't come across many techniques that weren't getting great results. I mean, I came out of the box with some amazing results. And that's again, that's how I developed the practice I have now. And I also think, from what I know about you, and what I've read also is that you're able to take different techniques from different people and put them together. So you were saying how you would do a nose job. And then in a few months, there would be a tiny little like crevice on the top of the nose, but instead of redoing the whole nose job, you and other people came up with this idea of filling in the nose with some filler. Yeah, instead of redoing the whole nose. Right? Yeah, I think Come on, I learned that I saw up guys do and he said this a great little trick. He said, you can fix this and your two seconds, and it'll be patiently really happy versus having to go in and do a whole other, you know, and yes, I learned all these things. But it's like collecting information from other experts and putting it all back together. That's what I think is phenomenal about your story. Now in terms of getting into the nitty gritty of what's going on in your practice. I mean, Instagram is blowing up because people like Kim Kardashian are coming to your office, and they're getting two major procedures that are non surgical. Can you tell us what those are? I don't really know what she posted about. Okay, so let's just talk about the Insta facial and the diamond facial sculpting. And if someone wants to go read through your Instagram, and find the M sculpt and all that stuff that all your famous celebrities do, that's great.

26:39

So let's start with the diamond facial sculpting. So facial sculpting is one of my favorite things to do. It is one of the things that people come far and wide for. And I love it is a non surgical procedure. It's my technique of sculpting and shaping the face where I'm enhancing the bony structure. This is a lot different than your usual filler where you're filling under the skin and creating these now I'm going to the bone and I'm enhancing bony structure to create contours and lift and angles and shadows and all those types of things. And this came about because I have learned facial implants from the doctors who created the specialty. Okay, I spent time with not many people have the experience that I've got to learn from these guys. Facial implants is placing cheek implants, jaw implants, chin implants, to Trump implants, it's implants that you put on the bone so that the skin can be supported off of those implants. Okay, so that is a specialty that not a lot of doctors.

27:44

So wait when you get it, I know we're gonna get to this. But when you get a facelift from you versus someone else are some people just pulling the skin back cutting the extra skin out and sewing it back together. Whereas yours is obviously cutting extra skin but also putting implants on to the bone yet, but I'd say 99% of faceless out there are just pulling and cutting skin. If you come to me for a facelift, there is a high probability that I'm going to recommend an implant somewhere because it makes the result better, look better look more natural last longer. So there's a high probability there are times where it's not needed or not necessary. But many times I find it extremely important. And again, it's one of the secret weapons that I have that has made my results stand out. So from my understanding is you do a CT scan, and then you actually create 3d models for the creation of these customized implants yours are customized for that particular patient, whereas some surgeons might just use sort of more generalized one size fits all out of the box implants. That is correct. And I don't know the number of surgeons that do customize implants, but I'm guessing in the states that maybe eight to 10 of us, wow. And I lead the way on that I do more than just been I think all of them, but there's only a small number that customize implants. So I learned the importance of facial implants from the masters of the field years ago. And it was just something I always saw the importance of and I saw how it made the results better than face of surgeons who weren't using right so it was a big part of what I did. And after years and years of creating these implants and designing them on bony skeletons I just hit me like a ton of bricks one day, I can recreate the shape nonsurgically by injecting down and on to the bone and I can create the same shapes or close to it and boom facial sculpting was born and immediately the results were amazing. So far superior to the usual fillers and fat injections and things like that. So most fillers run of the mill fillers are going in right under the skin, right and hence the name what's

30:00

The formal name of filler dermal filler, which means right under the skin, dermal filler, okay? That's even what they're called by the dermatologist by everyone isn't they're called even the companies call them dermal fillers. So the fillers go right under the skin to sort of plump up where you're sinking in. Correct. And you're saying that you're taking the same filler, but driving it down into the bone in a non painful way in the office in and out procedure, boom, boom, boom, and you come out with the facial structure that you want. Correct? That is right. That is like, unbelievable. And so that's how facial sculpting was created. It came from my facial implant experience. Got it? Had I not been creating implants for 1000 people and designing different ones certain people, I wouldn't have even really had the concept of Right, well, what am I trying to do? But I knew exactly what I was trying to do. And I know exactly what I'm trying to do when I do facial sculpting. It's not a random injection, right. So for someone who's not ready for a facelift, they could come into your office, get the diamond facial sculpting in the office in and out and have that same appearance. How long does that in the bone filler last compared to getting a facelift with implants? Like is it something you're doing every six months? Once a year? I'd say on average about one it lasts about a year on average, some people a little less, some people more? You know, I've seen it last up to close to two years. I've seen it go away in seven months, six, seven months, but it's not as quickly as Botox for example. Correct. Got it. And one of the beauties of it obviously is there's no downtime. Correct. There's less downtime with facial sculpting and there than there is with dermal filler. Wow. That's amazing. Okay, so the other in office procedure that's blowing up Instagram is the Insta facial. Facial, correct? Yes. So can you tell us why other than low downtime, why everyone's coming in. And what it is? Well, because it works great, is a facial is my combination of treatments that leads to a no downtime or very minimal downtime, skin wounds that really improve somebody's the glow to your skin and then this texture and tone of your skin and it involves the combination of a light laser, and it might be one of four different lasers we use depending on your skin type is a combination of a light laser, plus using your own blood where we treat the blood to take a waste of metabolism. So you take the blood from the arm in a syringe, you put it in a centrifuge, you get the good parts out.

32:49

And then I will inject that strategically in multiple locations. Sometimes I'll add some amniotic tissue to it. Depending on what I'm trying to do. Sometimes I'll add a little boost of Fetal Stem cells, I will inject that underneath the skin strategically. Then I will lay it on top of the skin and use needles to penetrate it into the superficial layer. And then we finished with the medical grade collagen topical covering and so it's a four part treatment. And it sounds simple, but it works so effectively with literally minimal to no downtime when you're numbed before you're number four so it's very mild. I mean, a lot of people do with no nothing. It's very, very mild. Just so our listeners know if you go to Dr. diamonds, Instagram, like every celebrity in town is actually filming this procedure going on on their face, you could probably see 25 different examples of it. Exactly. Yeah. And all of these women are talking and laughing and moving around and they're just like it's no big deal. What the other beauty of it is the low downtime and you also use it like if somebody is about to go on the red carpet in like four or five days. So you have to know that there is a quick recovery for it. Very much so yes. So if diamond facial sculpting and instant facials are like the thing in your office as we've heard, would you say that facelifts are becoming less popular and people are waiting on facelifts because of the diamond facial sculpting or how's it working? I would say that's probably not an accurate statement. Okay, as popular as ever, because when someone reaches a certain stage of aging of face that is the only thing or a surgical rejuvenation will be the only thing that can really give them a correction.

34:46

So part of the beauty of you I think is like your honesty. So if someone like me comes into you and says oh I really want to get facial sculpting to plump up my face. You will say I would love to do that for you. But I think you're at the stage where

35:00

You need a facial rejuvenation. That is correct. And so this is what I tell people. This is not to pat myself on the back the point of what I'm about to tell you, not that but the point is, it's for information. It's just for people's comfort. Okay. As we've discussed, I'm a facial plastic surgeon, I made my career based on my facial rejuvenation surgeries, it was based on that success, I developed the facial sculpting. And from there it started bringing in all these non surgical people because they were like, I got it. And we developed a very big non surgical practice. Okay, so I take care of tons of surgical patients now, and tons of non surgical patients now. Now, a lot of popular injectors, Botox doctors, dermal filler doctors, a lot of popular injectors might be nurses, that this ends, I mean, you know, people who are nothing like people who went to med school and didn't even do residency, like, it doesn't take any particular certificate to be able to get a lot of people based on marketing and advertising, they can develop pretty big dermal filler practices, okay. And so some of the most popular ones out there, very few of them are surgeons who are doing it very few to none are surgeons, I happen to be one of the only surgeons I know with a big non surgical practice. My point is, I've known some of the biggest non surgical providers out there. And they've told me firsthand, my staff is trained to tell people they don't need surgery. They're trained they know about because this was before I was doing non surgical work before, I would refer some non surgical things to somebody one of the most popular at the time. And he even said, you know, my staff is trained to tell these people they don't need surgery, he said, so when you're sending me someone, we have to make sure my staff knows don't talk down surgery. Don't say, sir, right, right, right. So these types of practices are going to tell you, I mean, sorry, let's pump it with filler. So you pump yourself up with filler, it won't tighten the jello you want, they're gonna say, let's pump you up some more, they're gonna do more. And the next thing you know, you're way overfilled, which can be very dangerous, and will look terrible, and it will correct the issue that's bothering you. I never have to do that. I never will do that. Because I know when I've reached the threshold of non surgical, it's time to go surgical. So I'm never going to make anybody look weird, because I'm never going to overfill anybody because I don't have to. I know looking weird is the hardest part of the whole thing. My daughter keeps saying, like, if and when you get filler, and you look like a weirdo. Oh, my God. And I'm just thinking to myself, Oh, yeah, hopefully that that's it. That day will never come with Dr. Diamonds office. But that leads me into another question. It's sort of expanding on what you're talking about. You know, obviously, not every listener is going to come to your office, you're in Beverly Hills, there are certain prices, you know, and that sort of thing. But there are med spas out there. There are other practitioners there are nurses doing these procedures. If we don't have the financial wherewithal to come to you or we live across the country. What questions should we be asking? What should we be looking for in a practitioner? That's a tough question, right? Right. Here's what people need to understand. The non surgical procedures can be very quick and easy go very seamless. non surgical procedures also can have more devastating severe complications than surgical complications. non surgical procedures go wrong can lead to necrosis of the skin and loss and big chunks in the skin. It can lead to blindness, it can lead to stroke, these things don't happen with surgical complications from a simple little needle going in can be so far more drastic and severe than a complication from an eight hour facelift. Okay. But if you're going to a board certified dermatologist, let's say and getting Botox, you're probably in good hands and should not be concerned. Okay, so what I'm getting at is the facial anatomy, there are some very important structures that need to be identified and understood by the person injecting you. If that anatomy is not understood, you can get these complications of blindness and necrosis and serious, serious life altering complications. So it's important that somebody has an understanding of that facial anatomy, I can tell you as a facial surgeon, facial anatomy is not easy to learn. It's the most complex anatomy on the body. And that's why it takes us five years of residency, doing surgery on it all day long, 18 hours a day for five years to learn that anatomy thoroughly. It's not an easy thing to learn. And so I just tell people, they need to understand that it can be very serious. They should go to somebody who has an understanding of facial anatomy. I don't want to tell you which specialists that are, but I leave it up to somebody to make sure that provider understands that facial anatomy, too.

40:00

Avoid serious serious complication. All right. And so I think it's important to see somebody who's a board certified plastic surgeon, board certified facial, plastic surgeon, board certified dermatologist, I would say those are probably the three board certifications, they at least, you know, have some baseline understanding of the patient.

40:24

Right? So if it were your daughter or your wife, and obviously you were not available in the picture, you would have them at least go to someone who has those qualifications. Yes. And it's important for people to understand, there are many different types of board certifications, people often sound board certified. Well, they might be a Board Certified radiologists that doesn't make them qualified on the facial anatomy to do the facial procedures. And so on board. So you've been you came and asked, Are you board certified? You need to know Are they board certified facial plastic surgeon, board certified plastic surgeon or board certified dermatologist? Those are the three that are true board certifications of learning facial anatomy. Yeah. And I would also say that like this is definitely not to scare people or scare listeners, I just wanted to serve as a sort of reminder or a nudge to do a little homework before we have these procedures done. I mean, you have a very famous client who's come very public on something that went wrong with her not from you, but you fixed it with Kai Bella. Yeah, yes, yes. And I've heard you talk about how keltie Knight had a kybella that went wrong. Yes. And you were able to go in and fix it. I know that M skull ofera threads and Kai Bella are kind of the areas that I would like to cover quickly if we could. Sure. What's the story with Chi Bella, what is it and where is it going wrong? I know it works for some people, but who's a good candidate for it? And why does it go wrong? Okay, so Chi Bella is a fat melter. It's a chemical that disrupts the fat cell and makes it kind of rupture. And most people want to use it under their chins. Correct. That's where it's marketed by the company. Okay. Now, the issue is most lay people who don't like what they have under here, like maybe me and you? Yeah, the turkey gobbler. I hate it. You know, I always talk about it. Well, guess what, both of us complain of that kybella would hurt both of us, it would make us both look worse, because fat is not your problem. It's not my problem. Okay. So if you have extra weight on your body, it could potentially be a good option for you. But if you don't have extra weight, it could be an issue like Kelsey Knight does. So she her body fat was too low to remove body fat or what they thought was body fat. Correct. It's no different than doing liposuction. It's no different. It does the same thing. It's even more aggressive than liposuction. Because at least liposuction you can control the amount of fat you're reducing. And even when we do liposuction on people who need it, which is not many under here. There's many other things we do. There aren't many people who are liposuction candidates. No, you're not many. But even when we do it, we're controlling what we take. There's no control it just because there isn't there also a difference between fat and skin. A huge difference. Yeah, like my skin is sagging because I don't have enough elasticity. But that's not fat. And guess what happens if you melt away the fat that's there, the elasticity gets worse and the skin gets Sagir. So then I have like a beard turkey gobbler. That's right. So

43:47

melting was never a candidate for kybella. That was a complete misdiagnosis by whoever did it and of course, it was not the surgeon or somebody familiar with facial anatomy with some, you know, whoever. So the problem is, it's probably the most common misconception that I see people come in and sit down I had so much bad here. I hate it. I can tell you in all honesty, Sara, nine out of 10 people maybe 95 out of 100 people I see you've said I've switched value don't. So basically if you're listening and you don't have extra weight on your body and someone tells you to get kybella perhaps you need to get a second opinion from a Board Certified somebody. Absolutely. Absolutely. Okay, that's good, because I hear kybella a lot. Yes, if you are overweight, if you truly are overweight and have an excess of subcutaneous fat, then it might be a reasonable option provided that you're young and have good skin elasticity even if you're overweight and have a ton of extra fat underneath your chin but you're over 45 if you remove that fat and don't tighten the skin, the skin is still going to sag because you have no quarter lasticity over 45 if you're 20 or 25 you have a bunch of extra fat

45:00

Well, then yeah, you can help with that. No problem. So Chi Bella is very specific for very specific people.

45:08

I think that's one of the golden nuggets here is sometimes with the marketing of plastic surgery or certain kind of techniques or procedures, you're led to believe that you're going to get a solution. And you might end up with something worse. So maybe do a little bit of extra homework before you end up like a qlt where she has to come in to you and get a small neck lift, because it's the only way to correct the drooping skin from the chi Bella. Yeah, the complications when people have Chi Bella, and they didn't need it. They look really bad. Wow. Okay. And then you have to ask yourself the question. Let's say you are a chi Bella candidate. Let's say you're 25 years old, and you're 30 pounds overweight and you do have a bunch of fat here and you can't lose that weight. And it's not just so Okay, let's say you are a kybella. candidate. Well, then the question is, do you do liposuction? Or do you do Kibo let's talk about them for just a second. Yeah, I Bella requires a series of injections every month for five or six months. Okay, so you're coming for injections. After kybella injections for two weeks. You are extremely inflamed and swollen. You barely are presentable for two weeks after Cabell injection. Then after two weeks, it kind of goes down. So you have two good weeks and you come in you got to do it again. Or two weeks, you look a bullfrog. Right. So for five months, every two weeks, you're pretty much unpresentable. Okay to get whatever question will result you get. If you do liposuction, it's a 25 minute local anesthesia procedure. You have a wrap for three days, and you're good to go. Do you think people are choosing kybella? Because it seems less surgical that they're choosing kybella? Because they seem like there's less downtime when there is 100 times greater downtime if you add up all the hours of downtime with kybella versus submental liposuction. So if it's me and I needed something to liposuction, it's not a question boom, local anesthesia naamyaa. Boom, suck. 20 minutes 15 minutes, painless. WordPress rapper three days, you're off to the races. Yeah, I also think it's a good message. Not that we're trying to promote surgery. But if you're trying to improve your aesthetic, and you want the least amount of downtime with the best effect, I know we tried to avoid the word surgery. But it seems like in some cases, it would actually be more of a positive than a negative. Yeah. Cabela's got a lot of downtime. Tons of hours of downtime. Wow. Going on the chi Bella route of fat burning, there's two other what emsculpt and CoolSculpting. So emsl is a system. It's actually like an electromagnetic muscle stimulator. It is different than CoolSculpting emsculpt creates super maximal contraction to the muscle. So we hook up to the system and I use, yeah, you do it in your office, because I saw Kim Kardashian doing it on your Instagram. I love it. It's called m sculpins. Great. So it basically makes you feel like you did 100,000 setups, but you didn't do them. That's right. The actual numbers and the studies show is that a 30 minutes session on your abdomen, it gives you the same amount of contractions that 20,000 setups would give you. So in 30 days, you're getting a workout that would have taken you however long to 20,000 setups. Same thing when you're putting on the on the glutes, when you do put on the glutes is equivalent to doing like 10,000 squats, I mean, the amount of contraction that you get, and muscle breakdown is significant. So it's one of the biggest rages in cosmetic medicine over the past year. How many times do you have to do it? It's recommended to do a 30 minute session twice a week for two to three weeks. Got it for each body part. But it doesn't take away body fat. It just builds the muscle underneath.

49:00

And are you sore like is if you did 20,000 Yes, you are. Or

49:07

no pain no gain, right? No pain, no gain, right? Okay, so that's m sculpt in your office. You don't do CoolSculpting No. Direct like hi Bella. Well sculpt melts fat, it just freeze it still melts it Okay, and I just don't listen, I melting fat. If you're going to take away fat for me it's much more predictable and safer to do with liposuction because you can control what you're doing with a liposuction expert. Again, it takes 30 minutes there's minimal downtime. It's much more predictable. I don't like machines to melt fat because I think the risks are too high. And so I don't want that that melt in procedures. Got it. Okay, now another Biggie that everyone seems to be talking about. And you know, I've asked you 475 times his threads. Yeah, threads. Yes. Can you define what they are? Tell us what the ranges and tell us

50:00

What the upsides and downsides are? Yeah, threads had been around a long time. I started doing them in 2002, when they were called the feather lift. It was the first version of threads. This is before the people are putting on Instagram or even knowing, right? And then I'm coming to your office asking you about it. Like it's like a new fucking thing. And you're like, Sarah, it's like been around for like, 20 years. Right? We live in 2002. And there were five in LA, I think doing it at the time. You're like, been there done that Sarah, like 1000 times over.

50:36

So the feather lift in work, okay, it just didn't work. So after six months, we realized that these results aren't holding, it's not working. So then the company changed, the feather looked around, and they turned into what's called the contour red lip, the contour thread lift was all the rage in like 2005 2006, they put millions and millions into marketing, and they had every TV commercial and billboard, you couldn't go anywhere without hearing about this Concord breath. Right? They got it on a, you know, good morning, American, or whatever, or whatever the big show at the time was, I don't even remember which one. Now it's Instagram. renounces it, right. But it was a thread lift. I was on the show, Dr. 902. And oh, at the time, and I was the last one that show the contour thread lift made it even a point to come to me, they wanted me to be either champion of it here in LA. So they were teaching courses, they had several courses around the country where they had this one guy who says he developed it. And he would go around the country and teaches courses at hotels where hundreds of doctors would go to and you live demonstrations, whatever. So they wanted me to be his backup here in LA. So they started sending me all this free bread and give me all this extra little instruction. So and I already knew how to use it from the featherlight. I already have done the I was one of the few guys who did the Federalists already knew about the idea. And conceptually, I liked the idea of it. So I did a lot of these contour red lips. And the reality was, they weren't great either. They were these permanent, very strong reds, and they came up really powerful lit. But even with these permanent, powerful threads, the results were still very mediocre, one side would fall the other one, you know person would have a great result for three years and all sudden they laugh and they kept popping, it would be the thread releasing like all this kind of stuff. And then a lot of people develop these problems with them. And because they were permitted, we'd have to go and surgically to remove them. And so as much hype as this contour threadless got it when I took off like a like a bomb, a rocket died probably just as fast. So in 2007, you never heard about it again. It was gone. I went just right, because everyone had all these unhappy patients, and they were spending money and they you know, they're like, why did I do this one sides up and so it's down. And even in the best case scenario, maybe somebody would see a result for three months, maybe four months. I think I'd have you back in the data of 100 people. I think I saw someone who thought they still had to resolve that like at a year, like one out of 100 people probably most three months it was gone. Okay, so we've died, he didn't hear about again till like 2011. Then they rebranded and called the silhouette lift and then whenever a year and then that came back for like eight minutes you heard about it. Then in 2016 somebody else rebranded call it something else and boom, you know, up and down and now it's rebranded again. So now the difference is now they're dissolvable threads. So they used to not be dissolvable. Now, they are dissolvable. So, the benefit of dissolvable threads is that when you have a complication or a problem, well, it's going to go away. So you might be stuck with little pucker or a dimple or a visible thread for pure tablets gonna disappear. Whereas with the permanent ones, we had to go in surgically and remove it. Yeah, but who wants a pucker or weird thing, even for a couple months? Right. But more importantly, those permanent threads, you could put a permanent threads on a space and they were so strong, you can literally lift them in the air like a crane. They will so

54:03

oh my god, these things are not even close, not even a fraction as strong as these permanent threads were. And even with those super strong permanent threads, the results last three months. So with these less strong, dissolvable threads. I mean, if you're expecting to last, there's just not longevity. Are some of the people using it because they don't want to get a facelift. Yeah, well, there's any reason somebody might use this cheaper because they feel like there's less downtime. Now I can tell you, every time these things come around, I test them out just to see what the advances or changes are. So we test them out and we use them and I've used even the latest version, the ones that are out right now I've done 15 people with them and I can tell you if they don't last. I haven't seen someone get a result over a month with them. And I'm going to tell you, I'd say 50% of the people who do it have almost as long downtime as a facelift pain, discomfort, bruising that literally can last as long sometimes even a little while.

55:00

than a mini facelift. And so, you know, we still do them for people, like I understand it's gonna be three weeks, but I'm getting ready for wedding, I just, I need this gel lifted for three, you know, just to get me through my wedding great, like there are indications for it. But I hear it advertised the last two years it tastes a place in the face. And that's just all his job.

55:19

But there are some instances. I mean, I haven't done it yet, but I've heard you talk about it on another podcast where you will use it with sort of as like a mini brow lift along with filler as sort of like a combo thing. Along with along with some combination things and facial sculpting certain things you probably can like enhance the results, potentially a facial sculpting a little bit for a period of time maybe like there are indications where I find it can be helpful, but to think you are getting a facelift result that's going to last you it's just there's so much misleading. And is that how people are getting that Gigi Hadid like cat I look is that with threads? Yeah, you can do that with threads. But the important thing to understand is literally that results last week, if you're lucky a week, I should have asked you for that when I came in, just to see your face just to see her face like Sarah mom, we come home with some cat eyes. I don't know about that.

56:18

So in your opinion, they have some instances of being a decent solution for a very temporary amount of time. I would say it's a very good summary of it. My biggest problem with threads is the advertising I see and these people posting. And I've seen the popular Instagram posts with threads, listen to them, show them five minutes later, show them a week later showing two months later, there's no results. Now that's good information to know.

56:46

They show me a minute later. Sure you can make you can really give a good cat I look A minute later, that cat I resolved literally the threads is one week tops, you can get a good cat I look with surgical procedures, not with the threads not not more than and then when you don't want the cat eye anymore, then I don't know what to say. Yeah. Now I want to jump back for a second to Dr. 902. Enough. I mean, I actually remember that which is funny. I don't even know how old I was when Dr. 92 when it came out. I'd have to do the math on that one. But you were one of the first like high level doctors, plastic surgeons to go on this sort of reality type TV show. And I've read that there were like so many people in your life saying no, no, no, don't do it. Your wife was like, don't do it. But you are adamant about doing it. It ended up being sort of like you're a million dollar idea of studying with the Masters this going on a TV show, even though everyone told you not to it seems to be like that's a little bit of your Renegade trend. It's like I'm doing it the Jason diamond fucking way. Right? Yes. And it ends up being like the million dollar way. So tell us what happened with the 90210 show and why you did it and why you renovated your way through it. Okay, so the first season I know Toronto was in 2002 I believe it was 2002 the very first season and it was like this monster like all you heard about to Robert rate. I don't know to you. I thought I haven't I heard about it, too. It was 2002. Okay, I watched a few episodes of it. And I saw that there were some very limited basic, most of it was about breast and body stuff. But the facial stuff I saw it was you know, some very standard techniques. It wasn't the stuff to the level that I had learned. And it was very basic facial stuff. And I was thinking man I could like they should be showing some really, really advanced things and they're not showing that stuff. So I had that in my mind while watching that first season. So after the first season, which was 830 minute episodes, it was such a success. They got picked up for a second season and they tripled their airtime. They went from 830 minute episodes to 13 one hour episodes. So they now instead of having 24 hours of time they had tripled their airtime. So they were looking for more they call I still love this. They call this town they're looking for talent, right? for doctors. I always loved that term. And so they were looking for a woman to compliment Robert Ray and they got Linda Lee who became a good friend of mine and they were looking for like the hot shot up and comer and they there were probably 20 of us in town every year there's 20 new Hutch up and comers. And they interviewed all the different guys and they liked me for they came they called they said we hear you we heard about you and they came they interviewed me and they liked me for it. So that's how I got that spot. Now, like you had said, I had learned from the old school or masters in the field and it was so taboo to advertise to promote yourself. It was like it was like cheeseball and like why would you do that? Why would you put yourself on that basic of a level? That's right and so I never talked about it with these guys, but I knew the minute like I had gone on one of these shows these guys are all disowned me. I know

1:00:00

That, and I had great respect for these guys. And they were my mentors and I owed everything I've learned these. So I took very seriously what they thought about me. I did, I took that very seriously. And my wife was like, No way cuz they all knew that was the old slick, I was learning from the best. And my wife's a doctor she knew was taboo to advertise. That was the equivalent of ambulance chasing lawyers, my nurses, old school nurses, same thing everyone around me was like, now you can't do this, you're going to be a geo, it's cheeseball, it's ambulance chasing, you can't do it. And I was really torn because I knew I could come on and blow away the results that TV had ever seen. I knew it because I knew my techniques had never been seen on TV before. And the results would change things a lot. What was the time lapse between doing a procedure and then they're showing what the results were just out of curiosity? About six weeks or so? I see. So you had enough time for like the recovery part? Yeah, yeah. Okay. So I was very torn. I took a long time to decide whether I was actually doing it after they offered it to me. And I finally decided, you know what, I'm gonna go out on a limb and I'm going to do it because I just knew I had to. But how do you make that decision when every single person in your life is saying no, including your wife? Like, what's the Jason diamond Mojo here? Everyone says no. And I say yes, I knew that I was going to be able to blow Middle America away with these results that I was gonna be able to make people think, Oh, I thought a face of major look like Joan Rivers, like, I didn't know you can look beautiful and natural and undetectable. Like I knew I was gonna be able to have that effect. Were you always like that as a kid to like, Did you always go out of the box? Or was that like an adult thing? A little bit? I was a little bit sort of out of the box kind of guy. Yeah. Cuz I mean, I've told you this before about my son, my 16 year old is exactly like that. He's like, you tell me no, I'm gonna do it differently and do it better. You tell me this. I'm gonna do it better. And no, he actually does. That's the funny part. But it's it's a very unique out of the box. thinking mind? Yes. And it reminds me of that a little bit. It's like, Don't tell me No. Yeah, I was like that to some degree. But when it came to medicine, I was very, you know, you don't want to deviate from like, metal, you know, he's right. But you you go by the book, but then you build it better. That's right. So it's like what you did with plastic surgery. It's like, you learned all the basic shit. And then you did it better. That's right. So So I went out of the box, despite what everyone told me, because I knew I just knew it in my heart. So that was like an intuition thing that was like Jason is telling me, I'm telling myself that this is gonna work. Yes. That's a key thing. We don't always listen to it. Yeah, that's another lesson for your kids, your boys. You know, it's like if something inside of you is telling you that it's right. 99% of the time. It's right. Yeah. Well, I mean, that's, um, thank God, I listened to that and did it because I was it was it was 5050. And you were willing to take the risk, too. So you jump into nine, Dr. 90210. And then what happens? Exactly what I thought would happen happened. I mean, it blew up. You know, I always say it was part of the revolution, because we brought this to the mainstream, because again, before, you know, this show was seen in 150 countries all over, it was one of the highest rated cable shows. So millions of people saw this. And I think up to that time, I think people thought a plastic surgery, I think they thought Michael Jackson doing rivers like this is for Hollywood.

1:03:33

elite. I think that's what people thought about it. They didn't realize on a mass whole that it was for everybody to feel better. It was for anybody who wanted to look better. And they would naturally and they didn't have to like Michael Jackson, right? But what happens to someone in the middle of the country who wants to get the effect that you're putting on a 902? And now, but like, there's no one in wherever that's going to be able to do a job like that? Well, what I can tell you is if there was any social media time, I would get emails, I'm not kidding you probably three to 10 a week from plastic surgery practices around the country saying thank you so much. What you've done is made my practice explode. Wow. I think it just boosted people's understanding. And there are a lot of concerns around I've learned from the best but there are good surgeons all over the place. And I think it just increased the numbers of people who were looking for this kind of Yeah, it normalized it it made it less taboo. Yeah. And it was like we talked about at the beginning. It's like if you have something that makes you self conscious, why live with it, if you can, you know, save up the money or you have the financial wherewithal to fix something that's actually going to change the way you feel about yourself and the way you sort of act in the world.

1:04:48

I mean, I think that that's a really important thing. So your 90210 Renegade thing work, it put you I guess even more on the map than you already were, is that when your practice like exploded

1:05:00

Yeah, that's what that's when it exploded. Yes. And when did the Kardashians and all of that craziness roll in, like all the celebrities and people putting it up on social media and all of that. So as a facial surgeon at the time, I wasn't doing much of the non invasive things I was because I hadn't developed facial sculpting yet. I was doing the face lips, and then rhinoplasties and the brow lips and the facial implants, but I wasn't doing the nonsurgical thing. And it didn't take long for some pretty good la people to start coming to see me right. So I started to I was taking care some celebrities, how are people talking about it openly? Oh, they were not talking about it because it was surgeries and people were so oftentimes still are so secretive about surgery. Yeah, I noticed that the same people I was taking care of, they would go on to their dermatologist website who was doing their Botox. They would put themselves out there on their like dermatologist websites or their whatever, whoever you like that kind of because at the time, there wasn't social media, but they would talk about the Botox and fillers. But they weren't talking about the surgeries. So I wasn't getting that kind Not that I was cared or was asking for it. But I just noticed That's odd. They're willingly talking about the Not that I really was more willing to talk about non surgical and surgical things. But I was taking care of that crowd for quite a while. And I was late to the Instagram game. By the way, I was very late to it. You're not any more late than I am. I started a month ago. Does that make you feel better? Oh, you're behind me. But

1:06:36

yes, I know. I know. But your your Instagram is like insane. Well, but still even so I was always late to the social media game. So back when I was doing Doctor 90210 That's right. When I think was MySpace at that time, but MySpace and Facebook. Were just becoming popular at the time. And I'm not kidding you every day. I get 20 invitations for Facebook, and I ignored all my Never did I still to this day, to be honest with you, Sarah, I don't even know if I think we have Facebook, but I've never really looked at it. I don't know how to get on Facebook. I'm actually having an assistant help me figure out how to get on Facebook, because I've never even used it. I mean, I'm embarrassed to say that. But you know, I will admit I look at Instagram because I have a practice. Yeah, I look at Instagram too. And I have an account now because of this flexible neurotic podcast. But I'm like, I'm so new to this that I'm like, Oh my god, what's happening? Right. So Facebook I never looked at but the point is back in that day, I mean, had I been on top of that I would have had a million Facebook followers. I don't know what you call Facebook people. But I did. I didn't do it. And the same happened with Instagram. I didn't get on Instagram till probably three years ago, four years ago. But the point is, once I got on Instagram, that's when people were willing to come on and I still to this day, I don't ask people to do it. They they offer it because it's good for their brand. You know, they it's good for their stories and things like that you have like three people a day getting on there like showing their whole time at your offense. Yeah, it's become just like a cultural phenomenon. It's, but it wasn't until the Instagram that's it that people started talking about these things. So before the social media, though, I was taking care of a lot of these people, but they just never quite got it. Obviously social media is amazing for so many reasons. And it has its downsides, too. How do you think social media plays into what we think we need our faces to look like? And how do you manage those expectations? Because that's like a clusterfuck. It's like, I come into you. And I show you a picture of Kim Kardashian and you're looking at me going Wait, you think that if I do these fillers and this isn't this like you're gonna get to the parking lot look like Kim Kardashian, what? How do you manage the expectations? A comes from a lot of experience and knowing the power of the procedures I do. Part of the success of a doctor is understanding what your procedures can do. So I have to be realistic with people and tell them this is what I can do. This is what I can't do. And I know my procedure so well. It's like knowing your dog, you know, your dog is gonna bite that person, but not that person. Like, you know, right. Like, I know what my procedures gonna do. That's part of the success of a successful doctor is knowing. Well, it's like if I bring a picture to my hairdresser, and I'm like, I want my hair to look like Jennifer Aniston. And he's like, but Sarah, you don't have Jennifer Aniston's like texture or thickness. Like what are you talking about? No matter what I do, you're never gonna have Jennifer Aniston's hair. And there's like certain realities that we have to accept it all of this. That's right. With Instagram, I use the term Instagram phase. It's kind of this homogenous, ethnically ambiguous phase with the aggressive angles. Yeah. And it's like the filters and you don't end like I come to you and I'm like, Oh, I want to get all the melasma off my face. And I want to look like this Instagram filter. It's like what I mean I'm guilty of it, too.

1:10:00

I think it's important to enhance to create the contours around the positive features of your face and maximize your facial aesthetic, right? That's how people look their best is maximizing their own facial aesthetic, when you start to try to like, take something that's not going to be natural and you and make it that you're trying to fit a round peg into a square spot, it doesn't often look as good as it could. So it's important to understand what a given person strengths, our weaknesses are, and work with those and maximize what that person can look like. And I guess being honest with people and just saying, like, I know that this is your goal, but this is what's best for your symmetry and your bone structure.

1:10:45

Which is I'm sure a hard thing to swallow sometimes. Now in terms of like filler versus fat. I know I've never tortured you on this subject. So I guess I can torture you now. What's the download on the filler verse fat thing? so fat grafting has been around for a long, long time. It's been around since I think 1960 I mean like I have like a whole muffin top. I could donate to that. I mean

1:11:08

is a great procedure. I do with almost every facelift I do I do with almost every blepharoplasty that I do. Wait blepharoplasty is the eyebrow lower? Oh, lower lids, okay, yeah, or lower lids but at smoothing out the fattier, I often will liposuction a little fat out of the abdomen and create little little contours to it to maximize the eyelid contour. The point is, it's one of the most common procedures I've ever performed in my career is facial fat grafting. But what I tell people is facial sculpting can you've every bit if good as good a result if not better, honestly, if not better, a result in facial fat grafting can give and it takes five minutes and you walk out and there's no downtime. It looks great. And just to remind people, that's the filler that you use deep down into the bone. Yes. So if it's just about adding you know something to your face, I tell people you're best off trying facial sculpting first in most cases, because it takes me five minutes you will look good when you leave the office and there's no downtime versus fat grafting we have to put you to sleep liposuction fat out injected in you can be swollen bruise for two to four weeks, oftentimes with a full facial fat grafting procedure. And guess what? facial fat grafting can go away in as fast as fillers can. Oh, yeah, that was gonna be my next question is the fat forever. It sometimes is it sometimes isn't. And so that is you could go through a process surgical procedure with anesthesia and healing. And your result might only last you a year as well. It's less currently, but it doesn't always it's unpredictable. And so I love facial fat grafting but my philosophy has become if you're already asleep or something else, then let's facial backtrack. If you're not going to sleep for somebody else I'd rather do the facial sculpting is what I would do for myself and my wife and my family. Yeah, right. Okay. Going back for one second to the threads. I read somewhere that you said that people who thread repeatedly create a lot of scar tissue. So then when you go into go to do the facelift, you're like, oh, there's a lot of shit in here. How do I? Yeah. So can you just give us like a couple seconds on? Like how many times you actually think you can thread before you dive into like facelift drama? Yeah, I would not even even if you are of the mindset, okay, let's do a thread and hope to get three months out of it. Even if you're that person, and that's okay, I won't throw stones at you for that. Even if you are that person, I wouldn't do that more than a few times. I wouldn't be doing that every three months for five years. Because if you're doing that, you know you're going to be have a facelift in your future. If you are really concerned about that, you're going to make your face have much more difficult, much more difficult, much longer healing and many more issues to deal with. I had never heard that before. So that's why I wanted to mention it because I know a lot of my friends do thread. I just haven't started that project that. Yeah, maybe do it a couple times. Right. Okay, maybe I'll get the Gigi Hadid eyes for like a week. Yeah, that might be cool. Yeah. Oh, by the way, let's make sure we say I'm not saying Gigi had that. We're talking about how to get that look. Yes, yes, yes. Sorry. 100%. What I see on Instagram. So you said that if you were going to do a facelift, you would throw the fat in at the same time because you were already going to be asleep. I got that part. We talked about the longevity being the same for fat versus filler. I guess just on a personal level. I know you have two sons that are in that like teenager years because we have like a good time talking about teenage nightmare. It's actually not a nightmare. Just like the funny stories with them.

1:14:46

I know you don't have a daughter. I have a daughter. If you had a teenage daughter in this world that we live in and being who you are. How would you handle that? The pressure of certain expectations of how you love

1:15:00

And Instagram and social media. I mean, your wife is pretty centered has her shit together, like how do you stay centered when you're in the middle of it? And what would you do for your daughter? If you had one? Yeah, I mean, it's tough. It's really tough. I mean, I think it starts at home with trying to instill confidence at home and your family values, try to have a kid be as centered with your family values, to the best of your ability. It's hard because we lose them to this social media, we lose them to tik tok to the internet. So they're off seeing who knows what the hell they're seeing. I mean, when they're rude for eight hours at a time, but yeah, exactly. Right. But I think the more centered they are with your family values, the less affected they may be, hopefully, by the stuff they see out there. And all these, you know, other videos of kids talking about how important it is to live a certain way. But it's tough. Still, my kid comes every day. I don't like this. And I don't like this and I don't like, right. I know. And like, what do you do? If you had a daughter who was like, you know, I really don't like my nose. At a certain point, would you be like, oh, okay, like, this is something that's bothered you for 10 years. Let's talk about if this is a possibility for you to actually go in and fix like, would you be open to that? I certainly would. Yes. If it's something that's affecting their self esteem, I see how important it is for these kids to feel good about themselves, too. And so if it's something that's affecting her confidence, I absolutely would support doing it in a conservative way. It was interesting during this COVID time, just as soon as we opened up, I probably did more 15 year old girls than I've done in my career. I mean, I'd go I've done rhinoplasties forever, but it's usually 17 year olds, 20 year olds, I had a run and probably 1015 year old girls. Wow. And they all were self conscious about certain little things. And I said, you know, and I determined that they were doing this for the right reasons. And they were healthy, and and you consulted with their pediatricians and their parents. Yes. And yeah. So I understand the importance of feeling good. And you know, not having something you're self conscious about. It's an important time for his kids development. Yeah, no, I see that. It just is interesting to me. Like, if you're like the master plastic surgeon, and your kids are seeing that, like, how do you define that? Like, do you say to them, like, I'm a plastic surgeon, and my goal is to help people feel their best. Yeah. It's not about being the prettiest or being the most defined. It's about everyone feeling their best. I just tell them, I help people with things that bother them. That's the extent of it. I can say I'm the lamest person. They there's no Oh, my kids are cringing with the podcast. My kids are cringing with the Instagram. I feel like they're super proud of me. I'll say that. But like, they'll see that I like posted a story of them. And they're like, oh, and I say I have to show people that. Like I'm a real fucking person with real children. I'm not just this like blabbing voice talking to experts. And they're like, Kevin, you didn't have to, like show me at the dining room table and like, okay, honestly, nothing I'm going to do is gonna be fucking right for you right now. It's like, my daughter's like, your voice is too loud. But don't leave the room. I'm like, okay, so I have to stay on the fucking sofa. But I'm not allowed to speak. Like, I've so many rules and regulations. But I get it because even my mom, I adore my mother. She lives three blocks away. But like she'll say something and I still cringe. And I'm 45 years old. So I'm like, Oh, my God. Yeah, this whole thing. Okay, so wait, I have a few funny questions to wrap up. It's called fun shit about Dr. Diamond. Are you ready? Yeah. What's next on the bucket list? Well, I would say a safari. I have been dying to go on a safari. I'd love to do that when COVID ends. Hopefully, that would be the next. The next thing on the bucket list. We did that. And it was amazing. We actually did like a community service project as part of it. And so my kids got a lot out of that. The animal situation is like, unhinged. Yeah. Okay, anything that you've learned that's now on your bucket list after quarantine?

1:19:10

Yeah, I just want to steer away from drama as much as I can. Got it. I don't want anything to do with it. I know. I put a quote like that on my Instagram. I'm like, didn't we already live through middle school? Right? Like, I'm not reliving Middle School. I did that once. I'm not doing it again. And I'm reliving it with my daughter right now. I'm just like, I can't and she's not even a dramatic person. But I still get to experience the middle school drama, but I'm like one school starting again. When zoom school gonna be over. She's like your voice is too loud in the house. Okay, do you have a secret pleasure or tricks bars? Twizzlers? I don't know. I will have many food, secret pleasures. But one of the things that I like to do that no one really knows about or ever sees is a weird thing. I like to lay on the floor.

1:20:00

My house or wherever I am, and take either football or baseball and lay on the floor and throw it up and try and get as close to the ceiling as I can with it and have it come down and see if I can get like a millimeter away. And I'll sit there for 30 minutes. It's like an upside down Yo, yo. No to throw it. Yeah, but I'm saying it's sort of like you couldn't get the same effect from a yo yo, like not touching the floor. I don't know. I just like to throw I like to lay there and throw What is your ceiling look like? Why have a high ceiling. Okay, so you like a lot of like wiggle room, I get it. That's an interesting one. When I interviewed Pamela Salzman, she's the like holistic food person. And she has this like foot slapping thing where she slaps each foot 36 times in the morning and evening, and it like creates a blood flow situation. So everyone has like a kind of a fun answer. That's why I ask it. Okay, favorite beauty treatment. I mean, like, honestly, who's like a better person to ask than you? I'd say the insufficient visual score. I do it on myself. Amazing. Okay, what whoo things do you do meditation crystals standing on your head? Anything? I do meditation? Yes. I could see you like listening to like Tony Robbins or something like something really inspiring. No, I don't do that. I'm okay. I would be okay with that. But no, I meditate

1:21:19

on it. And are you mantra or do you listen to apps? No, I mean, I have an app, but it's not mantra it you know, it's, I can do without sometimes these Yep. Sometimes they don't worry. I've done the mantra thing. I've done the TM. I've tried that. I like it better without a launcher. Got it. Okay, favorite TV show that you probably watched 100 years ago because you've been working, but I shouldn't old favorite TV show or current one? Yeah, I'd say Seinfeld. Never Episode 100 times that. I still don't want to bed. We'll turn it on just because it's comforting. And I don't have to think about it. It's just I don't know. It's just not so yeah, it's just there. I got it. Okay, what was the last thing you ordered from Amazon? A blue man Halloween super my nine year old? Are you guys gonna do like a whole family version of that? Oh, no, not a whole family version now. Okay. My daughter used to dress up with me every single year. And then I think it hit like third grade. And she was like, This is so awkward. I'm not doing this anymore. Okay, we've talked about intuition with you a little bit, but I was gonna ask you was intuition natural? Or did you have to work at it? No, pretty natural. I mean, with your Jason diamond Renegade moves. That sounds pretty natural. Okay, what is the smallest thing we can do today to start our shift towards self recreation, smallest thing to start towards self recreation, I would say probably realize that you're doing things for you. And not and this is a big thing we've seen in COVID people realizing they're doing because my world used to be getting people ready for events, red carpets, additions, performances, whatever. Now none of that's going on. So people were busier than ever. It's people not doing it more for themselves. And so I'd say you realize you're doing things for you to make yourself your boss. I like that. That's a good one. What would your bottom line advice be for finding the sweet spot in the second half of life? I think you already said it. I think I would say spend more time doing the things that are important and less time worrying about the drama and the morphologist thing. Yeah, the middle school drama. I also think it's interesting for someone like you who's working a million hours a day that at the beginning of quarantine your home, that must have been very strange for you. It was it was awesome. I loved it. It was great to be home, I had to spend time with the kids and do all kinds of stuff with them. And it lasted six weeks, and it was I really enjoyed being home. But then we're going to be back at work. And now we've been at work for six months. And I was very happy back at work. But I definitely learned to appreciate being more still. And I know not always running. I think all of us there are some silver linings to this for sure. I mean, obviously it's a horrid time. But there are some silver linings in terms of just the golden nuggets of spending time with family and having more meals together and things that we take for granted. Yeah, well, anyway, I have loved digging deep with you with our golden shit shovels today on this podcast. If listeners want to find you, where can they find you? our Instagram is at Dr. Jason diamond. There's so much good stuff there. What's most common with people? Yeah, and you also have a website? Yeah, Jason v diamond.com. And all of this will be in the show notes. But I want everyone to think about what should they can start doing today. One small step. I want to thank Dr. Diamond for explaining some of the facial aging process, what we can do to look as our best version of ourselves and things to ask when looking for a provider. This is all inspiration and ideas for the second half of life and hence this podcast Dr. Jason diamond. Thank you so much.

1:25:00

Thank you. That was so fun. Thank you. Hi, it's me again. I listened to this episode with Dr. Jason diamond. So I could summarize the golden nuggets for you to have actionable items to start using today. I know that when I listen to a long episode, I'm like, Oh, I love that. But now I can't remember the specifics. This is why I come back and do the Golden Nugget summary. Also, if you go to my website and click episodes, then show notes. It's all written out and the links mentioned in the episode are there too. In this episode, we found the sweet spot and learning about the aging of the face. We learn Dr. Diamond's philosophy on the art of plastic surgery, the benefits of certain procedures versus others, augmenting our facial structure and things we need to know as red flags. Before we commit to letting work be done on our faces. We also cover stigma as it relates to Facial Plastic Surgery and procedures and how social media has helped to normalize it yet also created unrealistic expectations at the same time. Golden Nugget number one, do whatever makes you feel best. Don't let judgment stop you. The most important lesson from Dr. Diamond is that when you look your best, you feel your best. So if that comes from going to the gym or getting a nose job, it doesn't matter. Do what makes you happy and don't let the judgment stop you. People's appearance is often central to their confidence and you want to put your best foot forward. Dr. Diamonds office philosophy is if you look your best, you feel your best and if you feel your best, you do your best. Golden Nugget number two, be realistic about your expectations when it comes to plastic surgery. When you go to a plastic surgeon or go to get treatments and procedures done, people often come in with unrealistic expectations of what they can really change. We need to keep it in reason and be open to the opinions of the doctor. In my chat, I said to Dr. Diamond that sometimes I could come in with a celebrity photo and expect to come out looking like this. It's up to the plastic surgeon to understand the ratios and proportions of your face. You can't go into it thinking that you're going to get your nose done or get plastic surgery and think you're going to come out looking like a specific celebrity. Dr. Diamond is not there to change someone's entire appearance he is there to fine tune what they have. Dr. Diamond says his specialty and niche is known for creating an understated subtle change and that's what most people want from him. Golden Nugget number three, there are surgical facial procedures and non surgical facial procedures to consider. In addition to Botox and some others, the two most popular in office non surgical procedures in Dr. Diamonds office are the diamond Insta facial and diamond facial sculpting. The diamond Insta facial Dr. Diamond says we call it the Insta facial because it's a combo treatment with lasering to make the skin except the next components that are coming. Then we take your blood we spin it in a centrifuge we take it in, lay it on the skin and roll it with needles. Then I will inject some of the blood in strategic areas to stimulate collagen. It's a very well tolerated procedure with low downtime and the risk is low. Diamond facial sculpting Dr. Diamond says I'm a facial implant specialist designing and creating implants to maximize everything. One day 10 years ago it dawned on me that I could probably inject filler onto the bone and that's how facial sculpting was born. The normal name of fillers was dermal fillers only under the skin. I go and deep enhancing the bony contours very deep creating the same types of shapes that I can create with facial implants. My filler goes way down into the bone not just under the skin. Golden Nugget number four. Do your research before you walk into an office that provides facial treatments, procedures and surgeries. know who you're going to in their credentials. It is important to research the place that you are going are you seeing a registered nurse Are you seeing a dermatologist, a plastic surgeon, someone who went to medical school just because someone went to medical school doesn't mean they know faces symmetry and potential complications. He says this is not to scare people. It is just to have people know who they are going to because there can be severe complications from non surgical procedures if they are not done properly. And it is extremely important to go to someone who is board certified and has been trained properly in facial anatomy, such as a board certified plastic surgeon, a Board Certified facial plastic surgeon and a board certified dermatologist. The board certified part is the key Golden Nugget realism the episode for the details again. Golden Nugget number five there are a few

1:30:00

You tell tale signs of aging. Over time are full and tight faces lose facial fat and bone density, we lose volume in the face under the eyes, the gel area under the nose starts caving in. You get loose chin pads floppy ear lobes does not sound fun. Dr. Diamond also says people say their noses seem a little bit bigger, but it's not that it's just that the cartilage under your nose is breaking down a bit so your nose isn't being held up as strongly so it's dipping down. The temples on the side of your forehead can really cave in a bit. The good news is that many of these things can be improved if you want to Golden Nugget number six, social media has been incredible in reducing the stigma of facial procedures and plastic surgery in general, normalizing it so people don't feel so self conscious about it. The downsides to social media are that sometimes there are unattainable images that it shows that are augmented by Photoshop or filters. People come in and they want their face to look like this social media filters. The other tricky part is that some practitioners and doctors are posting photos that are not their own work. Just do your homework. Golden Nugget number seven facelifts are becoming more popular for even younger women because they're less detectable from better techniques and less downtime. Golden Nugget number eight. Some common treatments that can be great for some and not others include kybella, threads and ofera. In cases of when to use filler versus fat. re listen to the episode and know some of the questions to ask your doctor or practitioner before you go. Golden Nugget number nine, learn to do things for you. Dr. Diamond says realize that you are doing things for you COVID more than ever has made us realize that my world used to be getting people ready for events, red carpets, auditions, performances, whatever. Now none of that's really going on. So people are busier than ever working on themselves just for themselves. And so I'd say you realize you're doing this for you to make yourself feel your best Golden Nugget number 10. Don't let obstacles or detours stop you come up with something better. Jason diamond is a perfect example of this. After his fellowships didn't materialize, he was able to turn it around and become the best plastic surgeon and find the silver lining. Instead of having to learn with one doctor in a traditional fellowship, he instead was able to pick up techniques from a million different plastic surgeons and learn all the tricks of the trade. It could have been disappointing to not get the fellowship right out of medical school, and it could have made so many people crash but instead he turned it around. Dr. Jason diamond said this. Don't let failure stop you. It's just a stepping stone. The gold is dripping off these nuggets, grab it, use it. The resources and products mentioned in this episode are in the shownotes go to the flexible neurotic.com click on episodes and then click on show notes. share this episode with a friend and subscribe to the flexible neurotic for more golden nuggets. And please write a five star review. It helps me grow as a podcast.

1:33:20

Good peeps. Thank you so much for listening. If you enjoyed finding our sweet spot today, and digging through layers of shit with your golden shit shovel, Subscribe, Subscribe, subscribe. DM me on Instagram at the flexible neurotic. Tell me which golden nuggets resonated with you. The ones that you're going to start using today to start getting your shit together to find our sweet spots. screenshot it, send it to a friend. This is Dr. Sarah Milken, the flexible neurotic, inspiring you to gather, curate, incorporate, maybe even meditate.