5-WEEK FOLLOW-UP TRANSCRIPT:

So we are five weeks from a comprehensive lower body lift with thigh lift, my normal procedure. Our patient is about to go back home to her home state, and she's been healing remarkably well five weeks out. So tell me a little bit about your history of all your surgeries that you've had.

I had two different weight loss surgeries, including a severe one, duodenal switch. Yes. Lost over 200 pounds, and I'm just very little. I had an entire body lift and skin removal, and tummy tuck, and breast reduction, and arms done, which were all done improperly by one of the top surgeons in our state. Properly or improperly? Improperly. Improperly. By one of the top surgeons in our state.

And I've been looking for over 15 years, and every single leg surgery I've looked at from every surgeon across the United States, they've still left them wrinkled. Dr. Agha is the first doctor I have ever looked at his work and saw that I could actually have smooth legs again. And it's truly a miracle for someone who had spent a lifetime of bullying and body image issues.

So he is truly a miracle doctor. I felt safe with him. I knew I was in great hands, and the results truly, truly speak for themselves. Just when the Band-Aids came off this time, I just sat in tears because it's the first time I could probably wear a skirt. I haven't worn one my entire life.

So kudos to Dr. Agha, and if you want the best surgeon, probably in the entire United States, maybe out of the country too, I don't know, I haven't looked, but you need to go to Dr. Agha. It's worth everything. Thank you. And you like your legs? I'm thrilled. It's a miracle. There's no way any other doctor could have brought them from the shape they were in. I actually have smooth calves. Yeah. It's incredible. Literally. Yeah, it really is.

So we did a comprehensive body lift, like the ones I normally do. That entailed a tummy tuck. We lifted, look at this skin, lifted this up here, here. We still need to do additional work. The inner thigh lift hasn't been done, and it wasn't done because it would've been way too much surgery for Kara, and we had to consider her healing and the fact that she had a duodenal switch, which is a very aggressive weight loss surgery.

It really makes you nutritionally deficient, and people do have healing problems when they have that surgery. I've done a lot of research on that. Her age and also her status and work, because she is highly professional. I can't tell you what she does, and she needs to go back to work very soon. She works for the government. That's all I can say.

And then we did a buttock lift and buttock enhancement, and we still need more fat for her buttocks. These areas need a little bit more fat here and here. I'm going to probably get her to gain about five, ten pounds before her final surgery, if I can convince her, so that we can continue to put more fat into her buttocks and make them rounder.

We also liposuctioned her calves, and these are from the foam pads that we just removed. This is nothing, but you can see how smooth her calves are.

SURGERY PLAN TRANSCRIPT:

Doing a lower body lift redo and a thigh reduction redo. Our patient is no stranger to plastic surgery and has had a lot of work previously done in her home state, which is not California, but she has kindly flown here to undergo revisions. Some of these procedures were done many years ago, right? Right. Okay. So on the front, we're going to be cutting her thighs and removing excess skin.

So she's going to get a vertical incision that starts around the pubic area and goes past her knee. She's got incisions there. We're going to remove her old scars and essentially give her a new incision and more correction. This is a thigh reduction, so we are reducing the width or the circumference of the thigh.

If you look at her thighs right now, they're asymmetrical. The right one is bigger than the left. I'm sorry, the left one is bigger than the right one. She's got more fullness here than here, and her saddlebags are obviously bigger on the left than the right side.

So not only are we going to be correcting the contour, the skin laxity, and the cellulite, but also we'll hopefully make them far more symmetrical by the end of the surgery.

She then wants to do a lower body lift, and I have kind of split her lower body lift into two surgeries. She's had this abdominal surgery done previously, and with this, I think it'll be too much healing for her. So what I'm planning to do for her is to do the buttock lift portion and some of the outer thigh lift today, and then once she's healed, bring her back in, of course, and do more.

So I have this really high and straight incision that was placed on her back many years ago for her buttock lift, but you can see that she really didn't get much of a buttock lift from that incision.

And unfortunately, when you come for a redo, sometimes I can do a complete redo and correct everything, and sometimes I can't. Today, I can't because this incision is way too high. So I have to use this incision.

I can't start another incision here because then there is no blood supply to the skin in between, and that skin will ultimately undergo necrosis, and she will have healing problems.

So essentially, the person who put this incision this high has kind of dictated that this incision is going to be this high, and now I have to cut it out and bring her butt higher. And I can't even curve the incisions and make it the way I normally like to do it. I've been dealt this hand, and I have to use it, and there is no other way to get around it.

So regardless, we're going to put this straight incision. We're going to do a buttock lift. We're going to do a buttock enhancement. She told me she wants a cuter, smaller, perkier, and rounder butt. Not too big, but mainly central fullness, and that's what we're going to do.

And in the process, we'll start her outer thigh lift today, and then in the future, I'm going to finish her surgeries and do the front part because I feel that with the thighs, it's just too much going on.

And again, the surgeries are not difficult. I've done hundreds of these. It's always the healing, the healing, the healing, and the healing and recovery dictate the results. If you heal well, you're going to have a great result. If you don't heal well, we're going to have openings.

And these are big incisions, and it's not infrequent that people have minor openings, and rarely they even have larger openings. And there's nothing I can do because I can't live with people and stay with people for a month and make sure that they don't do too much, and sometimes they do.

Okay. Ready? Let's do it.

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