The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision, and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Today on Meet the Doctor, my guest is Dr. Jon Grazer. He is a plastic surgeon in Newport Beach, and I am so thrilled to have him here with us today. Welcome, Dr. Grazer.

Hi, it's nice to to be with you today.

Let's just start with you telling us a little bit about yourself.

Well, let's see. I'm a second generation board certified Newport Beach plastic surgeon. My dad was the first full-time plastic surgeon here in Newport, and I'm an assistant clinical professor in the Department of Plastic Surgeon at the University of California Irvine. And I've been in practice in Newport Beach for about 25 years. And I have my own co-located surgery center, the Newport Coast Outpatient Surgery Center, where I do a majority of my surgery. It's got a really nice ocean view of the the California beach.

So your dad was a plastic surgeon. Does that mean that you kind of grew up in and around his office too?

Yeah, I, I, I did. I mean, I actually had the opportunity to travel with my dad. He did a fellowship with one of the world famous plastic surgeons Tord Skog. They really popularized, uh, facelifts, uh, cleft lip and, uh, dupuytren's contracture. So I went over there with, to Sweden with my dad when he, when I was seven years old. And then after Sweden, he did a fellowship in England at the, uh, Queen Victoria Hospital, which they called the Guinea Pig Club. And it's where all the, the World War II pilots got burned that were the British pilots that did reconstruction. So Sir Harold Gillies and Archie McIndoe were kind of the early pioneers of plastic surgery. And so dad trained there. So I used to go to all the meetings since I was eight years old. And I just knew that most plastic surgeons did great surgery, did fun things outside of surgery.

And my dad trained at LA County Hospital in, in Los Angeles. And so he used to take me to the hospital when I was two and three years old to make rounds and see patients. So I've pretty much been around the medical field my entire life. As a matter of fact, when I was in seventh grade, uh, my dad had a mole on his leg and so he said, "Hey, come inject it". We were at the office one day and, and cut it off and I turned it in as a science project and the teacher didn't believe I did it, but I actually, actually did. And so I, you know, like I said, I grew up in a plastic surgery family and uh, that's really kind of my early auspices. And I have a picture, uh, in one of my exam rooms of me and my sister and I have a stethoscope and, uh, headlight playing doctor.

It was our Christmas card picture. And so, and I was pretty much probably doomed from the beginning to, uh, to be a plastic surgeon. I, while I was in school, I spent a lot of time teaching flying. And really when I got outta school, it's like, you know, I can already fly. Let me go back and finish my pre-med requirements, which I did. And went in and always kept ruling things out and just kept ending up back at plastic surgery. And that's how I pretty much ended up at plastic surgery, is just kind of enjoying what my dad did, but, but certainly expanding upon what he did and looking at the new horizons and actually adopting a lot of the newer techniques and really improving on what he did in the past.

So you were learning how to fly airplanes at the same time that you were headed towards medical school?

Yeah, no, I started flying when I was 13. One of my best friends in, in elementary school's, dad, who was also a doctor, was flying. And he is my, my friend's like, "Oh, he went to Palm Springs, we went to Catalina, we went to Mammoth, it was really cool". And you know, I was kind of like, well, you know, airplanes are kind of dangerous and, uh, so anyway, I'd never really been in a light airplane. I'd, I'd flown a glider. And so I took ground school lessons from when I was in seventh grade and used to ride my bicycle out to the airport. And so one of my dad's friends had an airplane and that I used to fly with on a regular basis. So I built up a lot of time. And then when I went away to school, I really couldn't afford to fly. So I ended up getting my flight instructor's license and ended up teaching. I also flew the traffic watch in New Orleans. I towed banners up and down the beach, towed gliders and flew, uh, charter.

I think there's some interesting parallels between learning to fly and learning to be a surgeon because both take a very, very long amount of time, a lot of hours, a lot of training and a, a ton of commitment. Right?

Well, well it's interesting that you mentioned that when I was applying for medical school, I was down at the University of San Diego and, and the dean of admissions used to be in the Navy, cuz you know, San Diego's a big navy town. And he said that they did a personality profile on fighter pilots and surgeons, and they were almost identical.

Oh, I've never heard that.

And also when I was in, in med school or before I was in med school, when I was in college, I was trying to get a slot with the air guard to be a fighter pilot. And the word leaked out that they had, they had F-4's, phantoms, and they were gonna get F-15's, so they didn't want to hire any new people and spend a lot of money. And then it was a Gulf Oil embargo, so there really wasn't a lot of flying going on. And then I got into med school and I got out and I was too old to be a, a fighter pilot, so I was gonna be a flight surgeon. And I was just about to sign the contract to become a flight surgeon, and that's the day the Gulf War started. And they probably would have drafted me for four or five years, only have to be out of country for 90 days.

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But I could have been a, a general medical officer for, you know, four or five years. So that would've negated plastic surgery. So I didn't sign that contract. But how, when, however, when I was in med school, I did research at the Johnson Space Center my first year and in Houston, at Clear Lake. And then my fourth year I got accepted into the flight medicine or clerkship in the flight medicine clinic, and they only take three clerks into the flight medicine clinic per year. And so when I was in residency, I applied to the astronaut corps and I got a screening physical. So Dave Wolf was one of the last MD astronauts in Mir and the, uh, space shuttle, so most people don't get that far their first application. And I only applied twice. One guy applied actually 15 times and actually got in, I don't know if I that would've gotten me in, but I might've at least got a, a screening interview.

So this last year they had 18,000 applicants and they actually took somebody that was 58 years old. So I should have probably kept applying. Because the way I I, I got a masters of public health degree years ago, I went to the flying physicians meeting with my dad and ran into Story Musgrave who was one of the first MD astronauts. And he's like, "Look, why don't you combine your flying and and medicine and, and get a master public health degree and get board certified aerospace medicine. You can do both". And that's kind of how I ended up getting into flying. But now not only do I fly, I've got about 6,000 hours of flight time and I fly single engines, multi-agency plane, helicopters, gliders, and I teach all of those, except I do, I don't teach helicopters. And I'm an aeromedical examiner for the FAA, which means I do first, second, and third class pilot exams.

So I do, you know, quite a bit of flying and I've, I, in addition to teaching flying and flying with friends, a friend of mine who is a cardiologist in Germany, I taught him how to do spins 35 years ago. And he actually is the aerobatic champion for his class level in Europe. And he's got a really world-class aerobatic airplane called an Extra 300 that he lets me fly in Europe. And so we fly the European Air Show circuit and I announce, so we were, when we went from Frankfurt to Vienna, to second Hungary, to Serbia, to Macedonia, to Greece, and we were training with the Ukrainian world champion aerobatics about 30 miles from Delphy, which is a, a 3000 year old temple in Greece. Then we flew up over Corfu, up over Italy to Milan and then up over Mont Blanc and then back up to Germany. So I fly with, uh, Martin pretty extensively, uh, in Europe and, and like I said, announced at the Tonga Air Force base, Athens flying weeks for a hundred thousand people. And so, uh, it's interesting because, you know, you, you meet people all around the world that fly and they all know people that you know. So it's a very small community, much like the plastic surgery community.

You said a while back you said something about a Flying MD conference. There's a conference of doctors that are also pilots.

Yeah, there's actually, it's called the Flying Physicians Association. And they all have airplanes and they meet and, and they have you, not only do they talk about airplanes, but they also talk about, uh, scientific medical things. And it's nice because it's a whole cadre of different specialties. So when I go to that meeting, I learn in my continual medical education, things from other specialties that I just typically don't follow in plastic surgery. And you meet a lot of whole lot of nice people and, uh, get the opportunity to, uh, to travel to places you, you may not go. As a matter of fact, I, I flew with a friend to Cuba several years ago and we went with the Flying Physicians down there. So we had a chance to, to fly into, uh, Havana and go to a number of other cities throughout the country.

It's the true multi-specialty meeting.

It really, it really was.

Yeah. Wow, that's incredible. So it seems almost anti-climactic to go back to talking about plastic surgery after that introduction to your non-medical, well you've combined them both so well, but to go back to talking about what you're doing in your practice, I'm not even quite sure where to go.

Well, I think, I think surgery is similar to flying, in that you are kind of like the captain of the ship and you have to make the decisions and you really can't ask anybody when you're doing surgery, you know what you need to do. So you have to plan ahead and planning ahead to make sure you have all of the backups. Just like a surgery. You have to make sure you have the patients optimized for surgery, you have all the backup supplies in case you need to have something and have all the questions answered before going into surgery. Just like flying, you have to do all the pre-flight and inspect and examine and make sure everything is safe, just like flying. So surgery is kind of like, uh, flying in that when I'm doing surgery, I have somebody else's life in my hands, but when I'm flying, I have my life in my hands. So you have to really be very cautious, think ahead and just be very level headed.

The training is all for the day that something goes wrong. It's not for the day that everything goes right.

Absolutely. And that, that's why it's really important in surgery is to make sure you have somebody that's a board certified plastic surgeon, because we do five to seven years of surgical training and it's not necessarily all about learning how to do the surgery, it's learning how to take care of the complications.

I think it's important to understand what you're looking for. And I think also even within plastic surgery, there's a lot of subspecialization. So you still wouldn't want to go to somebody who's board certified in plastic surgery who never does the procedure that you are looking for.

Certainly. They're, they're able to specialize. And I think that's the second question that everybody asks me is, you know, "What do you specialize in?" I do a lot of body contouring and I do a lot of mommy makeovers, but also breast, uh, revision, breast augmentation and an extensive amount of facelifts and eyelid surgery.

There's a lot of innovation happening in the body contouring space around fat. And I wonder if you could share some of your thoughts on how fat is being used, especially as a replacement or as a hybrid for breast augmentation.

Sure. I mean, fat has come a long way and it's still making, you know, leaps and bounds. I mean, the idea is to how do you make fat live? Okay, it's a transplantable material. And you know, back in the day there were some people doing really deep plane facelifts that would take six months to a year to recover from, and their results weren't as good as somebody that does a facelift, and gets skillfully placed fat grafting. So there are a number of ways people are trying to make fat live longer, using platelet rich plasma, using exosomes and using even stem cells. And there are a number of ways to bank stem cells. Now, stem cells aren't allowed to be used in the United States unless they are processed by a company that makes stem cells. You can't make them in your own operating room because it's considered a drug delivery vice by the FDA.

There's people that are trying to, to work with institutional review boards and things like that, but in the big mainstream, stem cells are not FDA approved if you do it on your own. And when you get stem cells, you're getting somebody else's tissue that has been processed to make the stem cells. So ideally it'd be best to have your own stem cells. So, you know, people have been banking, probably for the last, I don't know, 15, 20 years, umbilical cord blood and even fat from fat grafting. But if you're too old or your parents didn't bank your cord blood, you don't have that advantage and it's a little bit more difficult to harvest fat. And it's also more difficult to even take bone marrow. There's actually more stem cells in fat than there is bone marrow. But there is a company now that is based out of Canada that's using, it's called acorn, and they're actually using hair follicles and you, you, you harvest 50 hair follicles, bank the tissue and they can keep that, immortalize it ,for your entire lifetime.

And when you want to have the stem cells, they will actually process it and send you six vials of the stem cells that you can put. Now it's not legal to inject stem cells yet in the United States, but if you use microneedling and put it on topically, or after laser resurfacing, or even use microneedling for hair, it really does a great job for hair growth. So I envision that as stem cells become more and more integral in medical procedures, that eventually we will be able to inject them. So that's why fat is so exciting. Because fat, unlike filler, hyaluronic acid or even some of the, the stimulatory fillers, don't have the stem cells and the natural biological components. So adding that extra fat in there along with the platelet rich plasma, stem cells, exosomes is really gonna boost fat growth. And, and studies are being done as we speak, on how to, to improve the take of, of fat.

Now breast augmentation with fat is okay, but you're only gonna get a cup to a cup and a half, maybe. And have to put some more fat in. But for somebody that has small breasts that doesn't want to, or have a, a breast augmentation with a a breast implant, it's certainly an option. Or people that, that have breast lifts that wanna be able to fill the upper pole of their breast, you could do fat grafting. Or even people that have breast cancer reconstruction, that have thin tissue, that have some irregularities or rippling, you can actually improve that with fag grafting.

When someone comes to see you for the first time, what can they expect from that consultation with you?

Well, I take my time with patients. Okay. My tagline is really, I'm always as close as the phone. And I mean it, if you've got a question, call me, you know, three o'clock in the morning, I can answer 95% of my calls by the phone and the extra 3% if I need to see you, I'll see you at two o'clock in the morning. So I spend a lot of time with my patients. So when somebody comes in, I, I know why they're there, but I wanna hear from them why they're coming in. I want them to tell me in their words what they're coming in for. Then I already have a health history, but I've skeletonized their main past medical history. But I I, I go through everything and ask them, obviously I start out first with their, their allergies and their medications. And nobody likes to tell you how much they weigh, so I get their height and weight.

Then I wanna find out what nationality background is cause I wanna see how their, their skin handles the sun and how much sun damage they have. Cause especially in Southern California, there's a lot of, lot of sun damage and environmental damage that I need to take care of. Then I wanna find out what their medical problems are and what their social history is, whether they smoke, whether they drink, what kind of recreational drugs they may or may not do, and what their family history is. So I, number one, I can tell if they're gonna be safe to do surgery. This whole business is about safety and trying to manage expectations. I want people to be happy, so I wanna make sure that I'm gonna be able to deliver what they want and they're gonna be happy with their surgery.

So after I go through the whole history, then we sit down and I usually start with my skin health talk and talk about how it takes 42 days or six weeks to make a new skin layer. And as we get older, the deeper dermis gets thinner and there's a number of ways to correct that. And I tell people that if you went to the gym with Mr Universe today and hadn't worked out, you would come home, feel 10 times worse, wouldn't see a change. And it's just about the same thing with skin health. It's gonna take six weeks to make one layer, 6, 12, 18, 24. You can't go weeks to see a change. So you can't go to the gym and get six pack abs in one day, just like you're gonna not gonna take, you know, 40 to 50 years of sun damage and improve your skin.

It takes a while to get there. So I I I give them my skin health talk and then we talk about, you know, a lot of people in their third, fourth and fifth decades may not be ready to undergo, under the knife and have surgery. So they wanna try to, to optimize all the benefits they can using, you know, fillers, even fat grafting, skin health and our different, uh, cream programs or even doing laser resurfacing. So I I I give them the options and we start with the simple and work to the, the more involved invasive surgery and let them make the choice. And I can kind of guide them into what direction will be most beneficial for them. And you don't have to do everything. And once you can start, you know, one step at a time and get used to doing things, and oftentimes people don't know what plastic surgery is about, or they come with a picture and say, I wanna look like that. It's really not possible to turn somebody into somebody else.

What would you like your prospective patients to know about you if they're listening to this podcast today?

I think that I would like people to know that I'm as close as the phone and that I'm very honest. Ask me what you wanna do and I'll give you the answers. It may not be what you wanna hear and you may not want to proceed in that direction, but at least I'm gonna give you my honest opinion. So I think what I'd like patients to know is I have a breadth of plastic surgery. I've been around this my entire life. Now I'm the past president of the Orange County Plastic Surgery Association. I'm also an assistant clinical professor at Department Plastic Surgeon Irvine. So I work the residents so I can stay on top of the cutting edge procedures and you know, I go to meetings around the world. And so I have the, the advantage of having a long history of plastic surgery to not only give me the foundation to, to work with, but the ability to look at the newer procedures out there and work with the leaders in the field to really, you know, develop some cutting edge surgery. I look at all of the new procedures that are out there and I'm, you know, a relatively early adopter. So if there's something that looks interesting, I'm gonna go look at it and really find out about it and like to offer to my patients so I can give them the cutting edge results that they're looking for. Because I have a, a number of international celebrities that always wanna keep looking their best and that's my job is to give them that confidence and that expertise to keep them looking good.

If I might offer an update to your tagline?

Yeah.

You're not as close as the phone. You can fly there in a plane yourself.

Okay. Yeah.

Where can we find you online? Um, tell us where your website and where do you post photos?

Sure. Dr grazer.com and you could also find me on Instagram on john underscore grazer underscore md. And I'm also Dr. Grazer on, uh, John m Grazer on Facebook. So you can find me there and social media and also on, on YouTube.

Thank you Dr. Grazer. It was really a pleasure getting to know you better. I'm so excited to have brought this story to the audience,

Yeah. Well, thank you very much. It was a pleasure talking to you.

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