Botched's Dr. Terry Dubrow Says We Should Stop Shaming The 'Miracle' Drug Ozempic - Exclusive Interview
People all over the world turn to plastic surgery to feel better about themselves. Unfortunately, some patients come out of their cosmetic procedures feeling worse than before. When these same people search for a new surgeon to help fix the problems caused by their procedures, that's when they find themselves in the hands of world-renowned plastic surgeons on the E! reality series "Botched."
Dr. Terry Dubrow and Dr. Paul Nassif help individuals around the world correct cosmetic procedures gone wrong. Since 2014, the two have tackled some of the toughest reconstruction surgeries on screen and continue to use their platform to warn others out there about the realities of plastic surgeries gone wrong.
In the midst of an unforgettable eighth season, Dr. Dubrow sat down with Glam to discuss what everyone needs to consider before undergoing any sort of plastic surgery, why he believes Ozempic to be a "miracle medication" when it comes to weight loss, and the cosmetic procedure that he predicts will become the next big thing in the beauty industry.
Here's how you can avoid being botched, according to Dr. Terry Dubrow
Congratulations on Season 8 of "Botched." That's a big deal.
Who would've thought that it would go eight seasons? I never would've suspected that.
To avoid being botched like the patients we see on your show, what kind of research should a person be doing regarding a procedure or regarding a doctor before deciding to undergo the knife?
The basic principles to lean into in order to avoid being botched is:
Number one: Make sure you go to a surgeon who is board certified in plastic surgery, and it's easy to check. You go to the American Board of Plastic Surgery or the American Board of Facial Plastic Surgery, look the doctor up, because anybody can do plastic surgery, any kind of doctor. A radiologist can take a weekend course one weekend and call themselves a cosmetic surgeon the next week.
Number two: Ask the doctor if they can do that operation at a hospital. The hospital vets you [as a surgeon] and will not let you do an operation unless you are board certified, and you have a clean record. Ask, "Well, what hospital can you [perform this]?" Because doctors will fudge that answer. "Oh, I can do [this]," and that might be a urologist who knows how to do kidney surgery, but because insurance isn't paying as much, they start doing liposuction.
Once you get plastic surgery, you've healed. If you have a good result, the enemy of good is better. Leave it alone, because every time you go back in a same body part, the chance of having a complication goes up, even if the surgery is done perfectly.
People need to understand that plastic surgery is as dangerous as any other kind of surgery, and you take on all the same risks, and when you look at the consent form, it has all those really scary risks at the bottom of it that you sign off on, so vet your doctor and then vet your reasons. Make sure that you are doing a procedure that is one that will change your life in a positive way, and you won't regret it later.
Young celebrities are now awesomely talking about plastic surgery regret. Kylie Jenner talked about the fact that she wished she didn't do her breasts or her lips. A lot of celebrities are coming out now saying, "Boy, if I would've known who I would be at age 24, I wouldn't have done this at age 19." Be patient, and think about it.
The important questions that you should be asking your plastic surgeon
After you've done your research, and you've found your doctor, what kind of questions should you be asking at an initial consultation for a cosmetic procedure to make sure that this is something you want to do?
Ask what you can expect, ask for "What can really go wrong? Tell me the worst case scenario." Plastic surgeons are there to do surgery on you, and you go in wanting an operation, and even if you're not a very good candidate, they're going to want to do it. Plastic surgery offices are expensive with a high overhead, so they need to book the cases.
Ask them, "Well, you're talking about scar, you're talking about nerve damage. Give me the worst case scenario." Even if the plastic surgeon is not willing to admit it, they're willing to rag on other plastic surgeons. Ask them about other plastic surgeon's complications, and then once they tell you, that's a complication that you may have.
I don't know that it's that useful necessarily to see their before and afters, because they're showing you the best that they've had. I don't know that reviews are necessarily so helpful, because they're encouraging their patients who are happy to put reviews, and a lot of patients aren't happy with themselves, and they might put negative reviews.
Sometimes their staff will tell you — all of their staff is designed to sell you surgery, but check your gut. When you talk to a lot of the patients who were on "Botched," and you ask them afterwards, they had a bad feeling about it. They almost suspected that something was wrong. Put a lot of sleep between the consultation and the signing up, and think about it for a while.
Why he wants patients to stop requesting Brazilian butt lifts
Are there any common cosmetic procedures that are surprisingly high risk that people should know about?
The one I always talk about is a Brazilian butt lift, which is the fastest growing procedure, where you take fat from one part of the body through liposuction and you inject it in the buttock. It's the most fatal cosmetic surgery procedure, and it's a lot more fatal than many general surgery procedures.
There's very little veins in the buttock that connect directly to the main vein, leading back to the heart, going to the lungs. If you get a little bit of fat in there, and it goes to the lungs, it can plug up the circulation of the lungs, and that can be fatal.
I don't do that operation. I don't think anybody should do it. I don't think any operation that has a fatality rate of one in 3,000 is worth doing for a cosmetic change.
There are other operations that are becoming more popular, like etching abdominal fat in to look like muscle, which may look okay when you're 19 or 23, but as we gain that 10 pounds every decade of life, you're going to be a 40 or 50-year-old person with a chunkier body with these weird carved muscles out of fat, which is very hard to fix. We do have a couple of those this season, where you'll see these abdominal deformities, which we fix, and we have some problems with them.
In the premiere episode, you discussed a type of Brazilian honey that can be used to fight bacteria. You've also talked about leeches on the show. What are some other natural remedies that people would be surprised to know that plastic surgeons use?
We talk about the Manuka honey from those bees. Yeah, that's very helpful.
We use seaweed and alginate. We use things in wound healing that are designed to suck out fluid. You don't want to get a wound, particularly an open wound, too wet. Our certain salves that we have are very useful to make wounds dry, to encourage enhanced healing, and to encourage the body to improve healing.
What people don't realize is that when you have plastic surgery, it taxes your body, and you go into what's called a catabolic state. When you're in a catabolic state, it means your metabolic state is increasing, and you tend to eat up your own lean muscle mass. Lean muscle mass is very important for wound healing.
We encourage people to increase their protein intake a lot, avoid alcohol during the healing process, go for a walk to minimize the chance that a clot will form in your lower extremities. A lot of complications that we see in plastic surgery are completely avoidable if you do the right things before and after.
How his thoughts on beauty have evolved since the start of Botched
What's the biggest misconception about plastic surgery that you've heard over the years from patients?
Assigning cute little phrases to minimize the seriousness of it. "I'm having a little work done." "We're doing a cute..." Listen to this cute one: It's a "mommy." Oh, isn't that a cute word? "Mommy makeover."
Mommy makeovers are the highest risk procedures in all of plastic surgery. I've been a certified expert for the California Medical Board for almost 30 years now, and I do a lot of medical legal work, and those mommy makeovers are among the riskiest procedures in all of plastic surgery.
The biggest misconception is that it's as simple as having your hair and nails done, and you're just having a little work done. That little work may end up being very dangerous.
Since starting on "Botched," has your perspective on plastic surgery or the beauty industry changed at all over the years?
It has. It makes me feel that unless you really think it's going to significantly enhance the way you look and feel about yourself, that — look at those lists of complications, because they happen to the best plastic surgeons. They happen to me. They happen to [my "Botched" co-star Dr.] Paul [Nassif]. They happen to — you know what we call a plastic surgeon who doesn't have complications? We call them a non-operating plastic surgeon, because we induce very significant trauma to make a positive cosmetic outcome, so there's no bypassing that trauma phase.
There's no question that in the future, plastic surgery will change. I went to medical school at UCLA from 1982 to '86, a long time ago. If you would've told me when I was a third-year medical student doing my surgery rotation, that in 2023 — some 40 years later — we're still going to be cutting people open with a scalpel, dissecting their tissue, cutting through nerves and blood vessels, and stitching them up, I would've said, "2023, along with getting to work in the flying car, there's going to be a device that we're going to use to tighten skin to heal wounds with lasers and so on." We're still doing pretty much the same thing. We're just a lot better at it.
Why he believes Ozempic is 'the biggest breakthrough in medical history'
Something trending in weight loss right now is Ozempic. What is it about Ozempic in particular that has people turning to it compared to other weight loss options?
My opinion is it is the biggest breakthrough in medical history. It's going to have the most significant impact in a positive way on our health in that ... When liposuction first came out, people would have it. Put a tube in the body, and vacuum out fat. Everybody thought we were crazy, and then it became something that people would admit to and talk about. When Botox first came out, "Wait a minute. You're going to inject poison in people's faces to get rid of wrinkles? That's crazy." No one would admit it. Now, everyone admits it.
Those are for cosmetic purposes. What if I told you that the number one risk factor that causes cardiovascular disease, diabetes, and cancer is obesity, and that we have a miracle medication that allows you to rapidly and safely, if you do it properly, reduce that risk? You not only look better, but your chance of a stroke in a heart attack is dramatically reduced. That's what studies are showing.
This is the greatest thing. Forget Botox. This is the greatest thing since antibiotics, since general anesthesia, since doctors went to medical school. This is it, ladies and gentlemen. The problem is that Ozempic shaming. We don't know precisely how to use it, because everybody's reaction to it is different. If we admit it and share, we will find out very quickly: Don't drink alcohol. Don't eat these kinds of fried foods. There's a half-life of a week, so you do it once a week for every week for seven days, and then you do it again.
The sixth day, right before you inject it again, you can eat a little more, but once you're three or four weeks into it, and you're building up your blood levels of it, don't drink anything the day after you have it done. People are being admitted to the hospital with pancreatitis. They're not even telling their doctors they're taking it, because they're so embarrassed.
There's this Ozempic shaming. Celebrate it. Share it. By the way, whether you like it or not, it's here to stay, and it's a fantastic thing. Embrace it. It's amazing.
What everyone needs to know about taking Ozempic
Are there any serious side effects or long-term issues that people should know about before taking Ozempic?
Some doctors will tell you, "We don't really know because it hasn't been around long enough." We do know. There's Ozempic, Wegovy, and Mounjaro. There's a new one coming out that's even better, composed of three hormones.
Ozempic and Wegovy are the same. Wegovy is only used for weight loss in non-diabetics. This argument about "They're taking it away from diabetics" — nobody's prescribing Wegovy for diabetics. You can't get it. It's for people who need to lose weight.
Ozempic has been around since [around] 2014 in diabetics. A friend of mine has been on Mounjaro, which is only used for diabetics, for 13 years. I remember him telling me 10 years ago, "I've reached a stage in my life where I'm at my high school weight. I don't seem to gain weight anymore. I'm awesome." I thought, "How did you do that?" He was on Mounjaro for diabetes, but he never put it together how useful it was.
Long-term, it's safe. There was a study done, published in June in the most important prestigious journal in America, the New England Journal of Medicine, where they tested Mounjaro for non-diabetics for weight loss. It had minimal side effects, just as long as they minimize their alcohol intake and they ate properly.
The key thing is this: If you're going to go on Wegovy — by the way, Mounjaro is about to get an FDA approval for weight loss. They're in phase three clinical trials. It's going to come any day now.
If you are going to go on these miracle weight loss drugs, you lose weight differently than you do with diet and exercise. With diet and exercise, you go on a diet, 70% of your weight loss is fat, 30% is lean muscle mass.
When you go on these miracle weight loss drugs, as much as 60% of your weight loss is lean muscle mass and only 40% is fat. You're skinny fat. If you're going to go on these, you have to increase your protein, and you have to lift weights. Then, it's safe, and you don't drink in and around the time you inject it on that weekly basis.
Very soon, it's all going to be in pill form.
This cosmetic procedure is what he believes will be the next big beauty trend
Are there any emerging beauty trends that you're starting to see that you think are going to be the next big thing?
The big thing I like is the microneedling with radio frequency. Little needles are put in the skin, and those needles are connected to an energy transmission device that's not only going into the deep dermal layers, but the energy transmission device is causing an increase in growth factors, and that's tightening skin. The side effects are very limited.
That's the direction that cosmetic medicine will go in very quickly. I did it two weeks ago. I still have some pigmentation, but I did it.
One of the things that made it hard for Heather [Dubrow, my wife] to tell that I was having a problem [on August 3 when I had a transient ischemic attack, when there's a blockage of blood to the brain that resembles the symptoms of a stroke] was that I had just done one of those procedures, so I was swollen and red and weird looking. As I'm slurring my words, she's going, "Well, you look weird, but you looked weird, because you just had this thing done 24 hours ago."
The non-invasive needling and energy transmission devices is the future of cosmetic medicine, and it's going to be amazing.
New episodes of "Botched" air on E! Thursday nights at 10 p.m. ET/PT.
This interview has been edited for clarity.