Botched is back for season four and board certified plastic surgeons Paul Nassif and Terry Dubrow are back trying to fix the impossible.
The Beverly Hills bromance of two medical peers forging ahead in revisionist plastic surgery to help out people in real distress is a guilty pleasure. It is also an educating look at the bad side of what happens and what can be rectified when you are “overdone” or given bad surgical advice.
The two surgeons are still wise cracking and ready to roll out the latest in off the wall plastic surgery stories for your voyeuristic pleasure.
Tired of those elfin ears? Droopy gauge earlobes? Is your pesky devil horn shifting under your skin and no longer symmetrical with the other? Times change as body modifications and “biohacking” are now added to the boob and butt jobs that they see daily.
The hit E! series will see an 18-episode season four premiering tonight as the doctors each promise us that this will be a “very unique” season.
They took time from their busy schedules and spoke with Monsters and Critics in an exclusive interview where they dished all about the upcoming episodes after we were shown a clip where allegedly a “ripped six-pack” Dr. Terry gently ribs Dr. Paul about his “flabby” abs:
Monsters and Critics: Will you two guys ever broker your own body shaming peace accord or do we have to send in Donald Trump?
Dr. Terry Dubrow: We use to say ‘don’t eat before the surgical scenes,’ this season Paul takes his shirt off a couple times. You definitely want to make sure you are not eating then.
Dr. Paul Nassif: Oh boy. I’m used to that, the constant ragging and teasing from Terry. It’s something that I’ve seem to have gotten used to.
Dr. Terry Dubrow: [laughing] It’s a very hairy season, let me tell you that.
M&C: You got over 10,000 applications, how do you have time for your core practice?
Dr. Paul: We are able to balance as best as we can our family, our skincare lines, our surgical practice … even Terry works seven days a week. Then also ‘Botched’ …we are not used to a lot of sleep, we know how to do it and we are really good at it.
You need to be a good multitasker and at the same point, I think if you are a workhorse, in general, you can try to keep the stress level down which is hard, it’s doable, but it’s not for the weak and faint of heart.
Dr. Terry: My thing is that if you are doing something you truly love, some part of your career [and] sort of at a peak moment of your life like we are with Botched, seeing the hardest cases, it is really easy to stay focused and have a really fun time. In my case, I have a really good wife standing behind me who makes the rest of my life on autopilot so I am very lucky that way.
Paul just goes out with a lot of different girls, that’s how he handles it.
Dr. Paul: Ehhh, Jesus!
M&C: Body modifications and Biohacking, talk about some specific revision surgeries for that alarming trend?
Dr. Paul: Biohacking? I have never heard of that word. I like that, I’m going to use that.
Dr. Terry: This season that’s one of the three things that’s very significant this season, we are seeing a ton more biohacking that’s coming internationally, people are dyeing the sclera [whites] of their eyes and they are putting horns and tongues and all this kind of stuff…
Dr. Paul: They are making their ears look like an elf…
Dr. Terry: Yes so we are seeing Smurfs and aliens and all sorts of…
Dr. Paul: Goblins…
Dr. Terry: Yeah, otherworldly creatures. Here’s the deal. We obviously don’t do that, but if there’s a patient who is doing that, and they are having a major disabling problem from it, then that’s who we bring on Botched… to help them with that problem.
M&C: What do you say to them? It appears like some form of mental illness…
Dr. Terry: You want to hear something? In the 1970s when you told plastic surgeons that there are these two doctors who were putting these silicone implants in women’s chests, you know what the plastic surgeon says? ‘That’s mental illness!’ And now it’s the most common plastic surgery in the United States.
So at some point, body modification goes from being absurdist and ridiculous, like putting fat into a butt, to being the fastest increasing procedure in the country. So at some point body modification becomes routine plastic surgery.
M&C: If one of your children said, ‘Dad, I want to have horns or elf ears,’ what would you do?
Dr. Paul: Over my dead body.
Dr. Terry: I would say go on Amazon and order some elf ears and put them on! Yeah.
M&C: Newest fillers you are most excited about for results?
Dr. Terry: I think the new stuff, a very thin stuff that you can put in the fine lines of the lips. Some of the best fillers are still the ones like hyaluronic acid the Juvederm, Restylane, and Sculptra which induces your body to form scar tissue [collagen] those are the best ones around, but [new fillers] with minor modifications are being made to make them last longer, and [the ability] to use them in small wrinkles.
[Dr. Paul Nassif is recused from the interview for medical consult at this moment]
M&C: Some people just don’t accept ‘no’ as an answer. In some of your more unusual cases, have you ever told a potential patient the truth, point blank? Maybe that they need counseling and to stop having surgeries? If so, how did it go?
Dr. Terry: We do that all the time. We do it routinely. But what we try to do though, is if a patient just as you’re describing comes in, if you just blanketly tell them, ‘You need counseling and the answer is no,’ and you are too abrupt about it? They will go down the street to another plastic surgeon who is having a slow month and get it done.
What we try to do with those patients is tell them why and try to convince them to listen. ‘This is a bad idea for so many reasons’ and then try to appeal to their intellect and emotions.
I call it the fox guarding the chicken coop. Because… plastic surgeons… it’s still a business. That’s how they make their money. If you throw enough money in their face, they are going to do a procedure even if they don’t think it’s a good idea.
M&C: This season, what are some of the notable revision surgeries you tackle?
Dr. Terry: I would say the fastest increasing procedure is the butt augmentation. The Brazilian butt lift is where you take fat from one part of the body and you inject it [in the buttocks]. It is exploding in popularity, obviously due to some reality stars that we are seeing.
It is probably the most common cause of death in all of the plastic surgeries. You [people seeking the operation] are going to untrained people who are injecting way too much fat into the butt, and it is killing the tissue and getting into the pelvic venous system transferring to up to the lungs and causing a fat embolism and real horror.
In fact, there were two death cases in Florida last month. So the butt augmentation has become sort of the big challenge of season four. Fixing complications related to that operation.
M&C: If you had to trade places – hypothetically – with another medical or surgical discipline, what would it be based on your personal interest and curiosity?
Dr. Terry: I went to medical school to become a heart surgeon. Because there is no more fundamental organ that controls your body than the heart. You stop the heart, within less than a minute you are dead.
I would probably be a heart surgeon, but in my second year of medical school, I met a plastic surgeon, a professor at UCLA where I went to medical school who basically showed us head-to-toe plastic surgery that included cancer reconstruction, burns, gunshot wounds and everything else including putting digits back on that were amputated.
He said: ‘Plastic surgery is the last true Renaissance field of medicine.’ That’s what got me hooked.
M&C: What is the most rewarding surgery you have performed?
Dr. Terry: There are two operations that come to mind. Number one, I was doing a breast augmentation on a healthy woman who, while I was opening up her [chest cavity] pocket…she was about 40 years of age…I always do a standard examination of the inside because that is the best time to look for things.
I found an incredibly small sand pebble sized thing that I sent off to the lab and it turned out to be breast cancer. And because it was so small, and so early [to be] identified it was a complete and total cure. That’s one.
And then number two, on ‘Botched’ there is a transgender woman named Rajee Narinesingh who went to pumping parties where she had concrete injected into her face. She was turned down by 10-15 plastic surgeons because the risk was too great.
We turned her down yet brought her back the next season, and Paul and I said [to each other], ‘We cannot let her live her life like this,’ because she looked like the Elephant Man!
We took her to the operating room… and [then] over the next two years she developed a little problem. So we bring her back this season.
M&C: Touchy subject. One board certified plastic surgeon I interviewed in the recent past told me he refuses to work on transgendered patients, saying that to him, the rates of depression and suicide makes him completely avoid the entire sector. How do you approach it?
Dr. Terry: I treat them like any other patient. I do not see it as a mental illness. I see the transgender and transitioning world is one in which is becoming more recognized as being not a mental illness, but a part of the fluidity of biology and sexuality and everything else.
I determine if they are of sufficient mental state to undergo a plastic surgery procedure. I listen to what their goals are. What stage of transitioning they may or may not be in. And if they pass the sniff test, and they answer the questions appropriately then I help them as much as I can.
To me, that attitude is very 25 years ago. Really, it sort of underscores the fact that some plastic surgeons are living in the dark ages.
Times and things change. Our appreciation of gender identity has clearly changed in the last several years.
M&C: What’s the one operation you would like to see retired or at least diminished in requests?
Dr. Terry: There are two operations I do not think are very good operations. One is the inner thigh lift, it’s not a good operation. It doesn’t work very well and is not reliable.
I would also say, very large breast implants should be retired because although some women like large breasts, the chance of a complication is so extraordinarily high and plastic surgeons are not being honest.
Are you ready for this? If you have a breast augmentation of a significant size, the chances you will need another operation to fix the complication because of that is 60% within the next eight years.
That’s too high. That’s too much. The chances you could severely and permanently ruin your breasts from doing that is just overwhelming. I would like to see big breast implants go away.
Botched returns tonight at 9 p.m., only on E!