Innovations in Plastic Surgery with Dr. Brent Moelleken

April 13, 2021

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John: Welcome to another edition of the Impact podcast. This is a very special edition of the Impact podcast because today I have my good friend with us today. Dr. Brent Moelleken, welcome to the Impact podcast, Dr. Brent.

Dr. Brent Moelleken: Well, thanks for having me.

John: Lovely to have you today. And you are a world-renowned plastic surgeon with offices in Beverly Hills, and in Santa Barbara. But before we get talking about what you do, as a plastic surgeon, talk a little bit about your background. You went to Harvard and Yale that is very well known. But for most people, those are massively aspirational schools, just one or the other. Talk a little bit about growing up. And what made you want to become a doctor to start with?

Brent: Well, I think it probably started in sixth or seventh grade when we were dissecting pigs. And a lot of people were fainting and I was not fainting. So, I figured I had to be a doctor after that. But I just liked the anatomy and, and everything was kind of pretty to me, even inside the pig, you see all the organs and how everything works. And it was just this whole machine inside that was new to me.

John: Got it. And then so when you were as you were evolving as a teenager and everything, I mean Harvard’s a big swing at the ball, what made you say I want to go to Harvard?

Brent: Well, I never thought I would get into Harvard. I never, I did not even think I would get into medical school. So, I just worked harder than anybody else thinking that this was in the day when it was really hard to get into medical school. Remember the backi case?

John: Yeah, yeah.

Brent: So, he was an older doctor. And he got admitted to medical school. And, he had to fight it in court. And I remembered seeing a documentary once. Well, it was a sort of a documentary on this or a biopic about this blind man who was applying to medical school. And for some reason, I really bonded to that to that picture, because the blind guy who got into medical school is the end of the story. But I remember his trials and tribulations and he interviewed everywhere. And they were saying, “How can we take a blind guy and make him a doctor?” So, it was just something I never thought I would really do. So, I just worked hard all through high school in Davis, California. I got on my bike whenever I could. And then, I got into some universities, and because we moved to West Lafayette, I ended up going to Purdue University for a couple of years. And I was pretty young. So, I graduated when I was 17. I do not recommend that, but I did.

John: Whoa!

Brent: 17 from high school and 19 from college. So then, I had to do something with my time. So, I went to graduate school at Harvard and studied literature, that was actually the graduate school program, in literature in German and English literature. So, I spoke German at the time and, and I loved literature. So, I knew I was probably never going to read a book again, once I got into medical school, which is kind of true. I am sad to say, I have read very little, my wife gets on me for that. and rightfully so.

John: And then you applied from Harvard to Yale medical school.

Brent: Yes. So, then I applied to medical school because I always love medicine. And literature just was not for me. It was too much time in the books and not enough time with patients. So, I applied to medical school, and I got into Yale medical school. So that is where I went for four years.

John: So now you have this amazing and very successful practice. in Beverly Hills in Santa Barbara, how many years have you been actually practicing as a plastic and reconstructive surgeon?

Brent: Well, so after four years of medical school, so after college, you go to medical school, right for four years, and then after 10 years of residency, I did that at UCSF, I know it is a long, long time. So be careful what you wish for but I got into the programs I wanted and UCSF and then UCLA, lots of research and in wound healing, and then then I am in Beverly Hills. So, I have been there 25 years, so 25 years in practice since I graduated.

John: God. And for our viewers and our listeners that want to find Dr. Moelleken, you can go to www.drbrent.com. I am on your website now. It is a beautiful website. There are a lot of before and after pictures, but on our website on the Impact website. Along with this show, we are going to be showing a lot of your before and after pictures that are not even on the website. Doc, one of the things that I like to just start with is, I have always heard about facelifts, I have always heard about tummy tucks. But is a facelift just a facelift, or a tummy tuck just a tummy tuck? Or are there new innovations that have happened during your 25 years of practice? And how have you helped evolve those innovations in the facelift than the tummy tuck?

Brent: Well, when I was a resident, so I was still a resident in training. And I had a very famous professor and we were doing a facelift together. And I said, Dr. Mathis, “Boy, you really got this down.” And he looked at me and he said, Brent, what I want you to do is in 20 years from now do everything differently from what we do. Now, I want you to innovate, I want you to do everything differently. So, for example, the facelift we did at the time, yeah, there was a high on the side approach. Right now, we take the skin back in a more normal anatomic direction, we were able to lift the deep tissue, which we really were not able to do at the time. Especially in this area of the highest mass, we did not have laser back then now we have a laser. We did not have life though, which is grafts that you put in the face. Now we have those, we did not have hair and nerves during brow lifts. So now we have those we did not have the cheek lift. We could not do anything for the mid-face, the area below the eye. And the other day I was looking at the way I did a facelift with Dr. Mathis, which is still a very wonderful procedure. Nothing is the same. Absolutely nothing is the same. Every single thing is different. So, then I remembered his words. And I thought he is not around anymore. But I bet you he would be proud that we do everything differently.

John: Now, is not that a little bit, almost opposite of what typical medical schools teach you in terms of you do something one way you sort of stick to that methodology, he actually encouraged you to innovate. And that that sounds a little bit more out of the box than typical medical professionals that I have heard before.

Brent: Well, he was an incredible innovator. And he developed many of the flaps that we still use today for reconstructive surgery, and he had the definitive work on how to reconstruct using flaps. So, he was a big innovator, a huge innovator. And he just taught me You do everything with the patient’s own tissue if you can. There is a way of doing reconstructive surgery where you do the least invasive thing that gets the job done. So, all these principles are, they are kind of those are kind of the principles you want to learn. Now in medicine, like in any other field, many people finish training. And they are well, they are very well trained, but they do not keep up. Now, keeping up does not mean just you, you learn what is going on in the meetings, and so on, keeping up I would say would be innovating yourself. So, if you come up with your own procedures, when you see, look, when I am doing it this way, it works better. Or, gosh, there has got to be a solution for this problem, we have to come up with something, for example, for the lower eyelids. So, when I got into practice, everyone’s lower eyelids did not look good. They were all pulled out. So, I figured, gosh, there has got to be a better way of doing the lower eyelids than just taking skin away in fat and pulling the eyelids now because everyone looks done. So, I saw an operation done at a meeting. Did not make sense to me. But it was brilliant. It was lifting up the skin below the eye, like a cheek lift. So, I went to the anatomy lab at UCLA. And I worked on it a little bit on people who did not care if the result came out or not. Those were cadavers. They never complain. In many respects, they are the best patients of all. Anyway. So that is where I perfected the G-clip that I published it and then things were started but that is how I think you want to innovate.

John: You have many things that you have innovated over the years, the 360 facelifts, the face light fill of the natural ear, those are some of the things that you have innovated. Is that not, correct?

Brent: That’s true. So, all of these arise from, I am looking at the facelifts and a lot of people have their ears pulled down. So, you can tell that people have had a facelift or their sideburns really high especially in women but also in men. Or the ear just looks funny as pulled forward. It looks like it is windswept or done. So, all those things have a mathematical reason that you can look at and you can kind of change around. So that is what happened in each one of these things where it really bothered me how it was coming out. I was looking, you have to come up with something new that.

John: Interesting, for our listeners and viewers who have just joined us we have got Dr. Brent Moelleken with us he is a plastic and reconstructive surgeon with offices in Beverly Hills and Santa Barbara to find Dr. Brent, go to www.drbrent.com. Like I said at the beginning of the show, Dr. Brent, not only one of the great Plastic and Reconstructive surgeons with offices in Beverly Hills in Santa Barbara, but he has also been my friend for about 10 years. And that happened because I had gone into an accident and actually got a concussion, which actually broke my nose in the process. And I needed 40 or 50 stitches on my face that were put into my face in an emergency room setting. And my friends in Beverly Hills said the best guy who does faces and does reconstructive surgery is Dr. Brent Moelleken. They sent me to Dr. Moelleken, 10 years ago, and people who meet me or do not know me and they hear about the surgery after he reconstructed my face and fixed all the stitches, and re-changed my nose around. They say it is very hard to see all the work that Dr. Brent did, which I think he did a miracle job on my face. And I am 58 years old and very grateful for all the great work you did, Dr. Brent, on me. And I also got to know you over the years and I know you do not only just practice for money, which of course we all like to do, and make money to feed our families. But you also have a huge charity side, philanthropic side, you created the about-face surgical foundation and also you do volunteer surgery on Veterans at the West LA Veterans Hospital. Can you share the philanthropic side of Dr. Brent Moelleken for our listeners and viewers, please?

Brent: Yes. So, when I do facelifts, that pay the bills. But it is the reconstructive surgery that I really love. Yeah, and that is when I worked at the VA for 20 years, I am a professor at UCLA. So, my UCLA rotation was to take the residents through surgery and the veterans now the residents are super, super busy. They just are working. You have heard about how hard residents work well; it is all true. But I get a chance of the attending to talk to the patients and it is amazing, these veterans, what they have gone through is just amazing. We talk to them and they are just they had the stories they have to tell just you cannot imagine is as tough of life as we think we may have had. You just cannot imagine what these veterans have done. So, I am honored to have reconstructed some of them there. Many of them have war injuries, many of them have son-based injuries where they got cancers from sun, if you are on a navy ship for year after year after year, and they did not know about sunscreen in the various wars. Or maybe they did not wear it or whatever, but they have cancers everywhere. So that was a big part. And that is how I really learned to reconstructive surgery is operating on many of the people who came through the wars. So very gratifying to do that my surgical foundation. What I like to find as children are victims of violent crime or accidents, and then, I supply the money usually, I am not a very good fundraiser. So, I am the one who funds my charity.

But it is nice to know we had one lady just a couple of days. We had one lady; she was a police officer up in Santa Barbara. And no one’s going to mess with her. Now she has a gun, she has a badge now no one’s going to mess, right. But when she was a teenager, her boyfriend wanted to have sex. And she would not do it. So, he bashed her in the face and broke her nose, and she had this crooked nose that she had to live with. So, she is going all through life. Now she is a tough guy, a tough girl. Right? And she deals with the people that are at-risk kids. But this knows she had she just never had a fixed so she came in to see me and I said, “You’re the perfect person for my charity. We’re going to do this and my charity.” So, we did the surgery. And she was very emotional about it. She was very open about it, too. It was in the newspapers, everything but it changed her life, just changing that nose back, it was not just changing the broken nose back to a nose that looked normal. It was revisiting the event that happened that gave her that nose and every reconstructive surgery that I do every dog by every car accident. There is a story behind it. And often the people are just hiding it within themselves. And it is nice to fix something like that. Because you are not only fixing the wound, you are fixing the person underneath it and you are not completely erasing the memory of the traumatic event that caused it. But you are diminishing. And that is very nice to see. I had a company president, 300 employees, nothing for you. I am sure, you probably have any more than that. But he had about 300. And he wanted me to fix dog bites. So sure, we will do under local, no big deal was not that bad of a start. So, where I am putting the local in, and I hear this, [inaudible] I said, “Are you okay? in trouble breathing?” and he, “I do not know what is happening, I am just very emotional, I don’t know what’s happening.” So, he started crying. And I said, “It’s totally normal, you’ve been through a trauma that you just never really meant it.” So here I am fixing on this is Titan of industry, fixing a lousy little scar, and as for him, but when he was a kid, it was not just a lousy little scar, he is a huge dog had been on the nose and on the face. And when you are a kid is basically like, might as well be as Tyrannosaurus Rex, or a huge monster or something, because that is the way he viewed it.

So, every reconstructive surgery I do has a story behind it like that. So that is why it is so gratifying to do this reconstructive surgery. And if I can do it, I benefit much more than the patients are doing. I know, that’s cliche, but it is totally true. The veterans, I still can tell just days and days and days and story about what they did. But there is one fella, he was a sniper, sniper in the war. And he had all these confirmed kills. So, I asked him, gosh, did not bother you. And he said, no. So, I am just doing my job for my country. Just the same as the other guy. He is doing the job for his country; I am doing the job for my country. So, I did not lose a wink of sleep over, because that is just my job. And I did my job. And I have always thought that scar, I really do not know what to think of it, it is just, but that is the way he looked at problems. I wish I could look at problems like that. Without letting it you know, because I will probably be a cardiac surgeon, you are not plastic.

John: It is so great thing to work on, not only on people’s faces, because faces, we have become such a society of vanity dogs. And it has even happened in our lifetime. We are about the same age, and our lifetime with Instagram, and Snapchat, and all these social media things. Looks mean even more than I think they did when we were kids. Not that they did not mean a lot when we were kids. But faces are so important to people’s sanity well-being self-worth, and veterans, our group of people that that group that you work on, are people that we have typically left behind American heroes that have protected the great freedom that we all get to share and enjoy in this country. But when they come back home, somehow, they have been a group that has been left behind historically. So, the fact that you work on them, and you donate your time and energy, and efforts to help fix their problems, I think is just beyond amazing and speaks volumes about your character and who you really are. And not just the Beverly Hills in Santa Barbara, plastic surgeon, and reconstructive surgeon, but you really give back a lot and you make an impact on people’s life. And that is the real exciting reason that I wanted to have you on the show not only to just talk about the impact you can make on people’s lives that can afford your services, which is huge itself, me included but also the other work that you do the philanthropic work that you do that is so important, that keeps everybody moving here in society and keeps us all moving in the right direction. So, I am really thankful for all the work that you do on the philanthropy side of your life, Doc.

Brent: Well, I know you understand, you do a lot of philanthropic work yourself. And, I think we both know we get a lot more benefit from our patients than we do for our clients. When we do philanthropic work, it is good to give back and make it feel good too.

John: Doc, we are going to be showing it on our website. And like I said your website has a lot of before and after and for our listeners, viewers to find Dr. Brent’s website is drbrent.com. But on our website as well, we are going to have a lot of being linked to your before and after pictures of moving from the face. Can you go into a little bit of what you have innovated with livefill and how you use life livefill to also make an impact on people’s looks and self-worth and, and reconstruction surgery?

Brent: So, what is life livefill? Life livefill is basically a strip of tissue that you take from a patient’s own body. And then you put it in places to augment the volume. Now, of course, we can do it for cosmetic reasons such as the smile lines, or the temporal hallway, or the jawline or cheeks, because we get more and more hollow over time. And then I do a lot of lip augmentations with my pill tube because it is a very natural feeling it is the patient’s own tissue. It is a better way of doing it, I think than fat injection. So, I have done a couple of studies and published them. Now fat injection, what is a fat transfer? Well, harvesting fat, you put a syringe, you can take it canula, which is a metal tube, and you under a vacuum, you pull the fat from the patient, and then you put it in a centrifuge and spin it down, then you inject it, well, that fat has to go through the needle has to go into the centrifuge, and then it has to go out of the needle again, into the patient. So, as you would expect most of those cells are dead. That is the problem with that injection most of the cells are not living by the time you start. So, then you have to exaggerate the amount you put in. And then how do you know what the volume is going to be? Is it going to be the same on both sides? Well, it turns out that I did experiments you take, take the fat, and then you put it on slides, and I give it to the pathologist and I said well tell me how many are live. So, we put a die, and it only gets into the dead cells, like if the doors open and the die gets in the cells dead. Because the cell with the door open doors dead. So, it turns out that it’s very variable, which cells are alive and dead in fat injection. So sometimes you hear people with that injection saying, I am not happy with the surgery I had because that went away. Well, you have dead cells going to go away. Or it is more on the left side than the right. Oh, if you have in one single syringe, you can have great variability in what you are alive in which are alive. So how do you know when you are injecting the fat? Where the live cells are going? Where the dead ones are going? You do not? So, it can be different from one side to another. And lumpy. Why is it lumpy? Well, if you have dead things that the body cannot take away, it is just going to wall it off. So those are the main complaints with Phanatic. So, I figured there has got to be a better way. So, let us go to the bottom of the album, let us take strips of tissue, the tissue is on nothing has been done to no aspiration, no injection, nothing with this strip of tissue. And when making a pocket and put it in, that’s life. And if the graft is sufficiently small, as good enough surface area, it is going to live if you put it in a place with a good blood supply.

So that is the whole premise of life is no miracle. It is just a graph that you put in. And now I started to use it for scars. So, we had a piece we did once on a model who had a terrible scar on her face. And the scar was depressed and it was disfiguring. Even for a normal person to look at, you would say, Wow, that was a big scar. But she had a lot of trouble with her model. So, if you lift up the scar and revise it, but then you put in the live fuel to fill in the lost volume, you will get a better result. So that is it is perfect for that I have people with heavy facial atrophy. It is a condition where this one side of the face does not grow fat. So, you have this really strange-looking face for one side is super hollow, and the other side is normal. lupus can produce that to a very hollow emaciated book. So, I have used livefill on those patients to fill in the missing tissue that was in the reconstruct applications, of course, lots of cosmetic applications also. But now I am using my field and I am really excited about this for breast augmentation. Really if I am doing a tummy tuck, right so at first, I started I put the live fuel just above the muscle, but it is all the patient’s own tissue and it all lives and then I put it above and below the muscle. Now it is not like getting a 300-cc implant. It is more like half a cup. But for patients who are not, I do not want an implant. Do what you can I just do not want input.

What do you think? And I say, “Well, let’s think about livefill”. If we can put it in those two planes, there is lots of blood supply there. Now, grass is not anything they have been around forever; everyone is heard of skin grafts. skin graft, you take the burn. If someone has a burn injury, you cut it off, and you replace it with the patient’s own skin. That is how a graph works. Now, the graft works best if the skin graft is nice and healthy, cannot be damaged. So, if it is nice and healthy, then it is going to survive. And if the blood supply where the graft is going is good, it is going to survive. So those are all the same premises as I use for life. It is nothing new. It is just a different way of doing it. And the graph that that there is a super-smart, Dr. Diamond, but he came up with a dermis that actually took the dermis of the skin or the dermis of the skin. That is the top layer of your skin. Very, very inflexible. Also, it is it needs an incredible amount of fuel to keep it alive. There are all these things going on in the nervous so I figured let us not use the dermis. So just the fat mustache.

John: How many years ago did you innovate the livefill?

Brent: So that was 20 years ago, and I have been using it ever since.

John: So, when someone like you innovates that do have do you teach that to your students at UCLA and or do other doctors with similar experiences as your start barring that innovation or learning that from you? Or how does that work in your profession?

Brent: Well, anyone’s Welcome to use a technique. Mostly it is the UCLA people who would see me do it or I teach the residents. So, the younger doctors that I teach at UCLA, they will have that technique and they will be able to use it. They cannot call it lifestyle, but they are welcome to use it.

John: Got it. Doc, I know you have also innovated and you created the hybrid tummy tuck. What does that mean? Compared to the classic tummy tuck that used to be done in plastic surgery?

Brent: A classic Tummy Tuck is still done. So, if you have a ton of extra skin and it is just hanging down there, then the classic Tummy Tuck is perfect. But what about for all these fit marks, they barely gained weight during their pregnancy, they kept their weight down. They are very fit many of them jog or worked outplay tennis, ride your bikes. So, they go to the doctor’s and 99% of doctors will say, “Well, what you need is you need a full tummy tuck. So, we’re going to make this super long and soon that’s going to go head-to-head.” And the women just about drop their jaw, saying like, “Look, I barely need anything, I just have this pooch from my babies.” They say, “Well, sorry, we can do the mini tuck, which starts at the belly button, or we can do the full tummy tuck and you’re going to have the wall scar, that’s what we offer.” I figured there has got to be a better way. So why not use the C section incision, and tighten the whole fashion all the way up and down. fashions the lining of the muscle, that’s when ladies have babies, there is usually a bulge because you put a basketball in there, you take it out, and God forbid you do it two or three times, there is going to be some trouble.

So that is what the hybrid Tummy Tuck is good for. So, it is a smaller incision, it is low down. And now there are all sorts of in-between operations between the full tummy tuck, and the hybrid tummy tuck that I use also, hybrid tourniquets with a vertical, full tummy tuck with, with modified incisions. It all depends on the patient. So, it is nice to be able to offer especially fit moms, this operation where they can have basically a low incision that involves tightening silver for fashion. So, the first time this happened one of my patients came to me gorgeous, had two kids. She was unbelievably disappointed that her 24-inch waist went to 26. I know, right?

John: Good problem.

Brent: Good problem to have, but she did not like it. She did not like that bolts. So, she said, “I want to fix this. And I do not want a full tummy tuck. And I have a C-section scar. So, I want you to use the C section scar and figure out a way to tighten that fashion. And I’ll see you Monday.” So, I was chewing my fingernails. There is a big pile of fingernails on my desk all weekend. So, I told her this has not been invented, what am I going to do? So, she came in Monday and I said I thought about it a little bit. So okay, I am going to try to tighten this as far as I can no promises. So, I opened the C section I tightened it all the way up to the belly button, which is when you are looking up in this little tunnel, there right in the middle leg. This is the belly button. So that is what you see is nothing but a belly button.

John: Wow.

Brent: So, you have to get to one side of the belly button and the other side of the belly. So, I figured a way to go opened up two tunnels, one to the one side and one to the other side. And then I took a stitch on one side, and I passed it underneath where the belly button shadowed, and then picked it up from the other side, and then passed it backward and I tied a knot. Okay, that was the first one, I got about an inch above the belly button. Let us do another one. I got two inches above the garden, I got three inches above the garden, I got four inches above the bed. And luckily, I had this surgical technician who was a bodybuilder. But by the end, he was shaking like this, because you had to hold up, hold up the surgery the entire time. So, he is a big guy, he was literally shaking like this with his hands because he had to hold up the retractors. So since then, I got some robotic arms that I fit into my table they are making in Switzerland. So, I got these robotic arms, which lift up things for me. And for a while, I used an endoscope, an endoscope, and something where you look in the camera and you are doing the surgery. But you can do it that way also. So yeah, it has been a fun journey. But the hybrid tummy tech people come from all over and they are always fit moms, they even told by their doctors. So eventually the doctor is going to get tired of and start doing high returns.

John: And there will be pictures of the before and after of those tummy tucks on the impact website. And also, on you can find those same pictures of before and after on Dr. Brent’s website www.drbrent.com. You talked about people coming from all over, I have been in your office so many times dozens of times over the years. And there are always people in from all over the world. Doc, when you are at conferences or meeting other great Plastic and Reconstructive surgeons from different parts of the world and also the country is what the clients are looking for similar, regardless of region or are doctors in South Beach doing something different from doctors in Dallas, our clients in New York asking for something different in Beverly Hills? What do you see on a regional and international basis because I have met people and patients of yours from all over the world in your office?

Brent: Well, every plastic surgeon is different. It is almost like artwork. So, one style may not fit all. But some patients come in, let us say a facelift, some patients come in and I want my face so tight, you can bounce a quarter of it. Well, I am not your guy. Because it does not look natural. And my first premise of every surgery is if it does not look natural, I am just not going to do it. I am not going to harm the patient. The enormous buts count me out. Besides the danger from the surgery, it is not a good look, for me. It is not something that I want the patients to have to contend with later when they gain a few pounds. And they have this, and then the Kardashian, their influence will not be forever. So, when that happens, and people are walking around with enormous bubble butts, what are they going to do? So, I do not want to be the doctor who is creating those.

John: What are people asking for most right now? And not as a secondary question. We are still living during this tragic COVID-19 period. Talk a little bit about the COVID-19 in the weight gain that people are doing? And also, what is being called the zoom boom in the plastic surgery industry. Are you seeing some of that? And will we see more of that in the months and years to come? Because zoom is going to obviously stay with us? And we are taping this over zoom today? What are your thoughts on what do they ask you for currently? and What does COVID-19 mean to your practice now and beyond?

Brent: Well, let us start with the zoom boom, the zoom, everyone has to look at their own picture. It is not just a glance in the middle in the morning and a glance in the evening. But you are looking at that picture all meeting. And for most people, or for many people, it is sort of a horrifying experience. Because we all think of ourselves, we work out we take care of ourselves, and do all this stuff. And yet, the person in the zoom looking back at you come on this is the bad joke. It must be the lighting. Right? Right must be the lighting. And I too. I had my eyes were getting very heavy. And I said, I just had some salt yesterday. Maybe it was a glass of wine I had. But then I realized it is every day. It is not going away. It is me. So, I had my eyes done and I had them conservatively done, but that is the way it is. So, zoom, now it is ubiquitous, all the students are using it and all the business people are using it, meetings are conducted over Zoom. Now, you mentioned a bunch of things that plastic surgeries use, you know the appearance of competence, things like that. Sure, but there is a big, big role for beauty and youth as a commodity. It is like money, right? So, if you have beauty and you have youth You come to the meeting with more than if you did not have that. That is the sad truth of life. But beautiful people get treated better. And young people get treated better than old people, that people assume if you are old that you are lazy, you are behind the times you do not innovate. Well, nothing can be further from the truth what many of my patients, they are just some of the titans of industry and huge innovators. And they have foundations, and they are just the most interesting people, but they are not perceived that way they have to overcome this, this pre-ordained thought that they are not worthy of the job or the right contract, or the whatever.

So, they look at it as it is just something you do, you got to wash your car and keep it clean. Otherwise, people think you are a slob. So, the same thing with your face, they keep their face up, they do periodic procedures. Now many of the people in Los Angeles in Hollywood, they are in the business, in the business of entertainment. And if you are in the business of entertainment, you are not usually playing your age, you are usually playing under your age. So, you have to look beautiful, you have to look well taken care of. And that is a necessity. It is not a luxury, it is not, you want to look good for the parties. This is the necessity of business. If you do not look good if you do not look well taken care of. If you have had bad surgery, you do not work anymore. It is true. You literally do not get a phone call, it does not ring, no one will tell you that the phone will not ring anymore.

John: I know you are always thinking and you are still a young man and have many, many more years to practice. What do you foresee as some of the next trends, not only what the clients are asking for, but from the innovation side of what you are doing? What are you excited about what gets you out of bed in the morning, in terms of innovative plastic surgery and reconstructive methods, and what is going through your mind right now that you can improve upon in the next five or seven years to come?

Brent: Well, the biggest innovation right now is in the field of minimally invasive things like lasers, radiofrequency, all therapy, things like that, that are done through the skin or with minimal invasiveness. Now, I think we have all the devices of course, and we use them when appropriate. But the companies get a little overboard in hyping what these minimally invasive techniques do, we do all the techniques from Botox and filler to minimally invasive procedures, to full-on surgeries. For me, I like to offer the patient the very best. And I will say, “For your minimal problem on your jawline, and a little fat here, let’s do some neck tight, with a little wand underneath the skin to tighten and some light, perfect, you’re funny.” But then for the person who has very looseness of the muscle, then we want to offer them tightening of that muscle also. So, it is not all one shot, one method fits everybody. You have to graduate things and be able to do all of them and offer them all to the patient.

So, if I adjust minimal advice with all the surgeries bad because I do minimally invasive, or like was a, “Whoa, minimally invasive bad because I just conservative.” Well, if you do everything, then you can offer everyone the right thing. So minimally invasive is, is really increasing. But to some extent, it is predatory thinking that is making itself successful. So, the doctors and maybe they believe it, I do not know, but they tell patients to look, you do not have to have a Facebook, you can have this device that tightens your skin through the skin or underneath the skin and it will be just like a face. Well, of course, it is not. But they have had the procedure once they find that out. So, everyone I see now who has a facelift, they have got some threads in they have had old therapy, they have had some, you know, whatever, laser light bows to the neck, some tightening attempts, and now they are 12-$15,000 for an even facelift, which they need in the first place. And it was predictable they needed in the first place. So why not tell people the honest truth. I think people appreciate it more if you are honest with them when you tell him like this is the best thing for you. This would get you this result that result, but it will not be the same as this. So that is, that is my thing, but that is definitely the new up-and-coming area in plastic surgery.

John: So minimally invasive, using some of the new technologies that exist that are being invented out there in combination with some of your other classic surgeries and giving the options to your patients. So, they can understand the spectrum of opportunities that they have in front of them.

Brent: Well said, well said! You must have gone to Harvard too.

John: No, I have not I am not a Harvard guy at all. But I have been with you enough. I have learned from you how to understand this stuff, that is for sure. So, Doc, I had you on the show, because now that you are my good friend, but you really do make a big impact on someone’s life. I am a business person, I do this podcast and even when you change my life and made an impact on me by fixing my face after my accident, just normal people have accidents, accidents are part of life. And they also have tragic other events that happen as you said, with veterans and other events like that the policewoman from up in the Santa Barbara area. So, I am just so grateful for all the important work you do. Both on the philanthropy side, and also on your day job in Beverly Hills in Santa Barbara, but your work with the about-face surgical Foundation, working with the veterans in West LA is so important. And I want to give you the last word for our listeners out there they can find you at www.drbrent.com. I want to give you the last word before we have to sign off for today.

Brent: Well, I get contacted a lot by people coming up in the medical field who know students or, or even residents and they and they want to know like, what is it like? What is it like being a doctor? So, I tell them many of the things that we have talked about today and the interesting stories now I can talk all day about this. It is just so interesting in these people, you are dealing with people, people with problems, and you can fix a problem that a person has if there is just nothing more gratifying. It is just I do not know; it is just a great deal. And you can never do it well enough. That is the thing about surgery. There is always a better way.

John: And I get to talk personally about you because you have worked on me with great results. And I am very grateful my family’s very grateful to you. But also, I know a lot of other people in LA that sent me to you, originally 10 years ago that also sing your praises, and I have met your other patients and, in your offices, and you just do great work. You are very special. You are not only a brilliant scientist but also a very talented artist. And I know what you do is both art and science. And that is very unique. And for our listeners out there again to find Dr. Brent, go to www.drbrent.com. Doc thank you for making a positive impact on my life. I encourage all listeners and viewers if you want to change or make a positive impact in terms of your own looks going see Dr. Brent, thanks for making the world a better place, Doc. You are really a special person. And thanks for joining us on the impact podcast today.

Brent: It was my pleasure.

John: This edition of the Impact podcast is brought to you by the marketing masters. The marketing masters is a boutique marketing agency offering website development and digital marketing services to small and medium businesses across America. For more information on how they can help you grow your business online, please visit the marketingmasters.com