Speaker 1 (00:03):
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.

Eva Sheie (00:32):
Good afternoon. My name is Eva Sheie and I'm the host of the Meet the Doctor Podcast. And today I have my guest, Joshua Jacobson from Beverly Hills, who is a plastic surgeon. Welcome Dr. Jacobson.

Dr. Jacobson (00:44):
Thank you Eva.

Eva Sheie (00:46):
So tell us about yourself a little bit and just give us a sense of what your everyday life is like as a plastic surgeon in Beverly Hills.

Dr. Jacobson (00:55):
Yeah, sure. So as a plastic surgeon, what I typically am thinking about during the day when, when I'm thinking about work stuff is how can I do my job better? And also what can I do to prevent stuff that that makes me unhappy? You know, like unhappy patients, poor outcomes. And so it's always sort of like the curiosity of how to make it better and the stress of what can go wrong. And I think that's the balance between the two. And a lot of times for people like myself who are in private practice, we're thinking about how to acquire more, more patients, how to make the office more patient friendly and how to run things better. So that's what I mostly do. One of the things I like to do when I'm not that busy is go through my before afters and criticize myself and see all those little things that I missed last time I saw, just to see how I can make them better. Well it's, it's sort of like a, the plastic surgery is a customer focused trade. So it's not like you just take out someone's appendix and no one sees what's going on inside. You know?

Eva Sheie (02:06):
That's true. I had my appendix out and I do not remember who did that.

Dr. Jacobson (02:11):
There you go.

Eva Sheie (02:13):
So obviously we know that you're trained on everything and that you have the skill to do pretty much everything. But within plastic surgery, and especially in Beverly Hills, a lot of people specialize in just a small set of things. And I wonder if that's something that you're doing and if so, what would those procedures be?

Dr. Jacobson (02:32):
True. Early on in my practice, some of my colleagues told me, well, you know, your patients will really tell you what's your niche gonna be. And that was sort of the evolution of my practice. I was sort of doing everything, you know, face and body, but I did like tummy tucks a lot and liposuction and sort of body contouring. And the patients also liked it. Everyone was telling me that they like my scars and belly button shape and all that stuff and I'm like, well, I like it, they like it. So why don't I just do more of this?

Eva Sheie (03:07):
Belly button is such an interesting topic. How do you think about the belly button?

Dr. Jacobson (03:12):
It's sort of like the achilles tendon of tummy tuck. You know, you can hide the whole scar except for the belly button. And I've seen videos on TikTok where people are saying, well, you know, if it just weren't for the belly button scar, I would get a tummy tuck. That's why for me, that's one of the most important parts of the surgery. So I watched, uh, different people do different techniques and I sort of experimented with different techniques and I was just, I would spend a lot of time in in the operating room adjusting and cutting a little bit and suturing and until I developed a technique that I'm comfortable with and it hides the scar on the inside and you can't really see and it gives that hooded youthful look that they usually talk about in belly button.

Eva Sheie (04:01):
So if you were getting a mommy makeover and you were sitting in front of a plastic surgeon, what is the question you would ask about the belly button in order to understand how that surgeon is going to make your belly button look?

Dr. Jacobson (04:17):
So that's a good question. I think a lot of it is sort of like technical and if you want the plastic surgeon to describe it to you, they'll just uh, throw some technical terms. But what you could ask them is, can you show me some before afters of your belly buttons that sort of looked like me. Because obviously it all depends on where you start. So if I were going to a plastic surgeon getting plastic surgery, I wouldn't take just an after picture and say, I want to look like this. I would say, show me someone that's similar to me and show me what you did with them. People who are reasonable plastic surgery patients think that way. Unfortunately there are people who come in and they just bring in after and they just say, make me like that. And I mean if it was a clay class, we could sort of shape things into however you want it, but we are working with whatever we're given. And if anyone tells you, "oh, I'll make you however you want", they are not being truthful to you. And I have definitely lost patients because I told them, "Well, you know, with your body you can't get this". But at least I didn't disappoint them.

Eva Sheie (05:31):
So if I got a tummy tuck somewhere else and I didn't like how my belly button looked, is that something you could actually revise and fix?

Dr. Jacobson (05:38):
Yeah. So that was the, the second stage of sort of my progression. Then I started getting some of these cases where patients weren't happy with their belly button. Either it looked too wide or the scar was too obvious and they wanted it revised. So it's, it doesn't look like they got surgery when they're on the beach and we can definitely revise that.

Eva Sheie (06:01):
Well that's good news because it means all is not lost if your belly button did not turn out the way that you wanted it to. Does it sometimes change while you're recovering? Like are you not always sure what it might look like in six months or a year?

Dr. Jacobson (06:16):
So definitely exactly, especially the first two, three months, it's still healing, it's still maturing. And the scar sometimes in darker patients can still look a little bit pigmented and they start worrying. But usually after six, seven months it gets its final shape, which pretty much most of the time people are happy with.

Eva Sheie (06:37):
So I wanna ask you one more tummy tuck question.

Dr. Jacobson (06:40):
Sure.

Eva Sheie (06:41):
Scars are such a big issue and the placement of them in the tummy tuck has shifted and changed over the years and I think a lot of us have seen photos of those scars and wondered, "Why would you do that to yourself?" So I wanna ask you where you hide the scars and how do you make sure that they're in a place that no one can see them later on the beach?

Dr. Jacobson (07:05):
So I'm glad you brought that up because I definitely have seen those scars where they just go straight across and you sort of have to wear like granny panties to hide those. And over the years I've actually brought my incisions lower and lower so that you have to wear a thinner panty to hide that scar. So I bring the scar just above the groin fold and also just above the mons. And I make the mons small because every woman says make it as small as possible. And as a male plastic surgeon, well we do learn what's aesthetically pleasing, what people like, what's beautiful, but obviously things change with time and also with preferences. And some of those are just surveys in certain populations. So I am not embarrassed to ask my staff in the operating room, "What do you think, should we change this, like this? Should we change that this way?" Because I mean, I don't care about my ego as long as the result comes out good and the patient is happy, that's what boosts my ego.

Eva Sheie (08:10):
You're clearly an expert already in the tummy tuck procedure and the beautiful belly button. What led you to aesthetics and how did you get here?

Dr. Jacobson (08:20):
Well, when I started in medical school, I wasn't even sure if I wanted to do surgery. I was still exploring different fields, but then I started having anatomy and uh, surgical rotation and I started loving working with my hands and making things. And so I went into different surgeries just to see what each one is like, you know, orthopedics, urology, neurosurgery. And one of them was a case where a young woman had breast cancer and she had a mastectomy and she was getting breast reconstruction with an implant. And afterwards when I saw her in follow up, she was so happy was she was changed. And my mom had had breast cancer when I was in undergrad. She had mastectomy, but she never had reconstruction because she just wanted to get it over with as soon as possible. And so I called her up and told her, "You know, I saw this surgery, it's low risk, it's easy, you can get back to work pretty quickly and you should look into it". So she consulted the plastic surgeon and and she got the surgery and she was so happy and she said, "Oh, you see, I couldn't wear these clothes. Now I can wear them". And it changed her a lot. So I saw plastic surgery is not always just about someone who's addicted to knife and wants to get their fourth facelift and their third rhinoplasty. You know, there are many patients who are just unhappy about one thing, which is reasonable. They come in, they get it done, and they're very happy.

Eva Sheie (09:49):
I can tell from listening to you that you're a great listener and you probably spend a lot of time listening to your patients and figuring out what it is that will make them happy so that you can deliver.

Dr. Jacobson (10:01):
Yeah.

Eva Sheie (10:02):
When you meet new patients for the first time, can you talk a little bit about what they can expect from you in that first meeting?

Dr. Jacobson (10:11):
Sure. So I always tell them, I've heard about you from my staff, but I want to hear from you firsthand what you want. And usually they, they start telling me, you know, well I started not liking this aspect of my body since this and then this has been happening. And so I just let them give me that sort of like introduction because everyone always has the whole spiel to give about what their concern is. And then usually there are two types of patients, some that feel comfortable about getting plastic surgery and some that because of the stigma of it, try to justify that, oh, you know, I feel like I need to, I should do this for myself. And a good example of it is breast reduction. I have had patients to say, well, you know, people blame me for having big breasts and they say You should exercise, but I've exercised and it doesn't go away.

Dr. Jacobson (11:06):
And I'm like, yes, it's breast tissue, it's not fat, it's not gonna go away. So a big part of it is just validating their concerns. There are a lot of patients who've been pregnant and uh, have loose skin in their abdomen and they've exercised a lot, but the skin just doesn't go away. And again, they're sort of having to have that, that stigma in their head. So then I sort of address that and then I ask them, well, what is it that that you wanna look like afterwards? There are some that bring in pictures and say, I want to look like this. There are some that just, uh, say, you know, as long as my breasts are smaller, as long as my belly is flatter, but I still tell them until the day of surgery. If you find pictures of results or pictures of anyone on Instagram that you feel like you want your results to be like that, bring it to me.

Dr. Jacobson (12:00):
And I do that because I don't want them to think, okay, well he'll probably make me look like that, you know, obviously, that's natural. I want them to bring it to so that we can discuss whether that's something that's reasonable for the patient or not. And also to put me in the same mindset as them. Do they wanna have a big breast or a small breast? Do they want to have all the fat taken out? Do they want a lower scar? What's so primary to them? What's and what are some misconceptions that they might have about the surgery? And then I show them some of my before afters and I tell them, "Well, I think this is what you're talking about. This is what you want to look like and this is what you don't want to look like", just to check and make sure we're on the same page.

Dr. Jacobson (12:50):
And then once we do that, then I tell them what to expect after surgery, how their recovery's gonna be when they can get back to work. Because everyone's concern is, when can I get back to work driving? Should I be sleeping in, uh, in bed for two weeks? Should I not move my arms, uh, for a month? And I tell 'em, no, it's not heart surgery, it's not brain surgery. You don't need to be lying in bed. You need to start walking from the time you get home after surgery because we wanna prevent blood clots and we want to get you back to your regular self as soon as possible. And the sooner you move, the better you are.

Eva Sheie (13:32):
You mentioned pictures. Do you use any kind of imaging tools or other patients before and after photos when you're in consultation to illustrate or demonstrate anything with your patients?

Dr. Jacobson (13:44):
So I use mostly my before afters to show them, well, this is what I can deliver and this is what I think you want. Unfortunately, I haven't had good experience with these simulation, uh, softwares. I know some people have used it, but from what, what most people have said, it may give you what you may look like, but it can also give you the wrong expectations. So that's why I'm not a big fan of those. But I think the before afters are the best.

Eva Sheie (14:20):
I do wanna hear about where you went to school and I think sometimes people might say, well, why does it matter where you went to school? And it really, it almost doesn't, except for there are so many people trying to do cosmetic medicine now that it is important that we bring up credentials and training and at least explain why it's important that you check somebody's credentials and, and their training. So, um, will you tell us about your educational path and really try to help the patients who are listening understand why those things are important?

Dr. Jacobson (14:59):
Sure. So I'm an LA native. I went to U C L A for undergrad and then I really wanted to live in New York City. So I went to Albert Einstein Med School in New York and finished med school there. Went to residency there and once I finished my residency, came back to LA to practice. And now what you mentioned is what to look for to sort of know how to trust a plastic surgeon more and the, and their training. So after we finish our training, we go through a rigorous process of getting board certified by the American Board of Plastic Surgery. And this board is one of the 24 specialties that's part of American Board of Medical Specialties. There are other boards that are not necessarily part of this vetted group, but going through that process was really regressed and it made me always think, well, what's the right thing to do?

Dr. Jacobson (16:04):
What's, how to stay safe? And they do a really good job of making sure they put their stamp on people who are ethical and safe. And if I were to get plastic surgery, I would want them to have gone through that filter at least. Obviously once you get that, you may not practice plastic surgery the best, but at least that's baseline. But I could say pretty much all uh, plastic surgeons who've been board certified are great plastic surgeons. It just becomes sort of you finding which one does the surgery that you want the way you want it.

Eva Sheie (16:51):
I really appreciate that explanation because I think too often we just hear, find a board certified plastic surgeon, but don't understand the meaning of what it means to be a board certified plastic surgeon. So thank you for taking us through that.

Dr. Jacobson (17:07):
Yeah, of course.

Eva Sheie (17:08):
What would you like your listeners to take away from listening to this podcast?

Dr. Jacobson (17:14):
I think one of the things that I would want them to know is not just go by the hype about a plastic surgeon and also not assume that the plastic surgeon will do a good job with anything I give them or they'll do what I want. I think it's best to, well, do your research obviously, but talk to your plastic surgeon and describe to them what it is that you want and think about it is that you want, so that afterwards you won't be disappointed. Bring some pictures just to see if that's possible or not. If you say, "Well, which one of these do you think is is more reasonable for me?" I think that would be a good approach. And that really helps us explain to the patient what's possible and, and set realistic expectations. And I think, and pretty much everyone says, a huge part of plastic surgery is setting the right expectations for the patients. It's not setting low expectations, it's the right expectations.

Eva Sheie (18:22):
So if, uh, we want to find more information about you, where's the best place to see your work and your belly buttons?

Dr. Jacobson (18:31):
<laugh>, You can see some of my info on, uh, my website drjacobson.com, d r j a c o b s o n.com. Um, you can also see some of my work on my Instagram. My Instagram handle is JoshJacobsonmd and I put some of my work on realself.com. You can look up there as well.

Eva Sheie (18:55):
Those are great resources. Thank you.

Dr. Jacobson (18:57):
Sure.

Eva Sheie (18:59):
Thank you for joining us today. It was really nice getting to know you better.

Dr. Jacobson (19:03):
Thank you. Thank you for this opportunity.

Eva Sheie (19:06):
You're welcome.

Speaker 1 (19:09):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor Podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor Podcast? Book your free recording session at MeetTheDoctorPodcast.com. Meet the Doctor is made with love in Austin, Texas and is a production of The Axis, the axis.io.