37: The World of Plastic Surgery with Dr. Lopa Gupta

Welcome to my podcast called you'd Must be Out of youf Mind. My name is Dr. Don Wood. Everyone has experienced some trauma at times during their life. These traumatic events and experiences create a significant impact on how your mind works on a day to day basis. At the same time creates long term effects on your emotional and physical health. It will interfere with your ability to stay present and in the moment. After years of research, I used my knowledge of neuroscience to create what I call a memory reset. This memory reset reduces and eliminates the impact of the trauma and allows you to experience peace and clarity. My podcast will share many stories of people experiencing similar symptoms to you and how their lives have been positively impacted by our TIP program. I can't wait to share with you how the impossible is possible and why you must be out of your mind. And there it is.

Well, welcome to another edition of you Must be out of your Mind. And as you know, we always bring on great guests that have so much to talk about and can share a lot of their expertise on what they do. And then we see how we tie it into what we do as well. So Today we've got Dr. Gupta and she has got a fascinating background and career. So I want to introduce you. Welcome to you must be out of your mind.

Dr. Gupta, thank you so much. It's a pleasure to be here.

Don, tell me a little bit to introduce the audience to what you do and then we'll go into a little bit of the history as well. What are you currently doing now?

Currently, my practice is primarily, I would say 100% cosmetic in nature. That means that I have chosen to drop my reconstructive, my orbital, my lacrimal practice in order to focus on one thing. Because I am not, I can't handle too many things at once and I have a one track mind in a sense and I like to give it my 300%. And I just found I couldn't do everything and be good at it.

That makes sense. It's one of the things I talk about is, in fact, I just did a little video saying that nobody is good at multitasking. Everybody thinks they're good at multitasking but.

Just asks for switching. Right.

Especially when you focus on very detail oriented work around the eyes and on the face like I do day in and day out. It takes not 100% for me isn't good enough. You got to give 200% to each patient.

Oh, for sure. Especially when you're talking about eyes.

Right? Exactly. Yes, right, yeah. Yes, absolutely.

I was always Amazed. A friend of mine, she went in for.

The eye surgery the. That she was going to go, you know, for. What do they call it? I'm drawing a blank on it now.

Blepharoplasty?

No, no.

So the cataract surgery?

No, not cataract, but just for improving your eyesight.

Lasik.

Lasik surgery. That's what.

Yes.

So she was going in to do Lasik and she was said, oh, I found a person that does it. Does it really? The best price. And I thought.

No. If I would think about my eyes and the best price.

Right. Yes. And that brings me to an important point, is that, you know, I always tell patients, you can shop around for a car, you can shop around for a house, you can shop around for anything else, but when it comes to your face and your eyes shopping around, you're not doing yourself a service. And I always say, cheap is expensive. Yep.

She ended up doing Lasik with this person who was cheaper, and she ended up having a problem.

Okay, Exactly.

And so that's why she would even think in that. Like, I wouldn't think about my eyes in terms of my. The cheapest, best price. I would want to go to the best person possible.

Yeah. And, you know, really, it takes me. It took me 30 years to get to where I am right now. And really, what brings me here today is my past. Okay. My past defines me.

Yeah, let's talk a little bit about that. Because you used to be in something different. You were dealing orthomolecular rights and doing that.

Yeah. So I began as an ophthalmologist. I trained at Stanford, and really, my academic passion. And I had fully intended to pursue academic ophthalmology. In fact, Stanford even offered me a position after I finished my residency to sort of be a clinical instructor there. But I think I was drawn to plastic surgery because of the creative aspects of it. In ophthalmology, one has the option to branch off into different, what we call fellowships. Once you finish your residency, which is grueling, it's three years. That's after an internship, which is one year. During the residency, you learn everything about the eye and how it functions. The anatomy, the physiology, the surgery, all the different compartments of the eye. Even though it's a small area, people don't realize that the cranial nerve, the optic nerve, is the only. Only cranial nerve, which is an extension of the brain.

It's not considered a peripheral nerve. Therefore, it does not regenerate. So once something happens to your vision, it's permanent loss.

To understand that eye anatomy, physiology of vision, and all the different diseases that involve the eye, I think sets me apart from any other eye plastic surgeon because I had all that under my belt. But after I completed my residency, I segued into a fellowship in oculoplastics. Why oculoplastics is because it's a branch of ophthalmology. But you subspecialize or what? My mentor said, you super specialize. He said, don't sub yourself. You're a super. I super specialized, as Orkhan would have it, in oculoplastics. And these fellowships are extremely competitive, extremely difficult to get, just to backtrack a little bit. Getting into an ophthalmology residency is a challenge unto itself, really. So I'll tell you an interesting tidbit. It's a personal tidbit that even in the book, I didn't write about this, but I'll tell you. So when I was in medical school, I was in the six year honors program at Northwestern, which is also very competitive, but I met my future husband there, okay. And when we graduated medical school, there was no couples match because he wanted to go into urology, I wanted to go into ophthalmology. So they're very highly competitive fields. And the match, the national match, does not guarantee in those fields that the couple will end up together. Okay? So there's no couples match. And so what happened is that he matched at UCSF in urology, I matched at Cornell in ophthalmology.

I said to myself, all right, no problem. We can handle a long distance relationship. No problem. But the first year called the internship. You can do anywhere. I went to ucsf, did my first year there of medicine. Wouldn't you know it, one month into my internship, I said, yeah, I'm not doing a long distance relationship. I foolishly dropped my spot in ophthalmology for now. I made someone's life, I made someone else very, very, very happy.

Yes.

But I had nothing. I had nothing in my hands. I threw it away. I threw it away. And so, you know, what do you do when you. You just pick yourself up and say, okay, I'm not going to be defeated. I did this for a personal reason and I'm gonna get my profession back.

Right?

So I got myself involved with research right away. I knew that you had to have publications to get another spot in ophthalmology, one of the toughest fields to get into. So when reality struck, I'm like, oh, my God, what did I just do? But couldn't change my decision. So make a long story short, I reached out to Michael Marmore at Stanford because you have to do, you have to apply 2 years in advance for ophthalmology. So I knew I would have a year and I didn't want to just sit there and do it all and do nothing. So I reached out to Mike Marmore at Stanford and I said, look, I have a year to kill. And he was doing retina research. And I looked in the Bay Area and I said, this gentleman, this physician, this surgeon really intrigues me in the work he's doing. I said, Dr. Marmor, could I please work with you? I have a year off and then I have to reapply to ophthalmology residencies. He's like, sure, Lopa, come on, come on and interview with me. And we hit it off instantaneously. So he's like, look, you can have a spot on my research and I'll even help you get a grant to fund your research. But he said, I can't guarantee you a spot in ophthalmology. I said, oh no, no, I'm not asking you for that at all.

I just became entrenched, if you will, in retina, basic retina research. And I was studying how to decrease oxidative stress to the back of the eye, the retinal pigment epithelium. And I was doing really basic science on you, you know, new guinea pigs. And, and I was just doing a lot of hands on research, right. And, and what happened is that that research sort of got me so entrenched in the Stanford system. I said, this is where I found my home.

And of course I had to go through the match and I matched at Stanford, okay. And, and basically I spent the next four to five years there was, I came out with a few publications with Dr. Marmore and then I did a couple of other. I wrote a book chapter. So I was poised for an academic career in ophthalmology. And I would venture to say they probably would have given me a pretty top position after a while, but I got sidetracked by oculoplastics because as much as I loved ophthalmology and retina retinal surgery, just so people know.

And I have so much tremendous. Like a retinal surgeon is like a neurosurgeon, okay? You're operating through a little people, the pupil or sometimes a little port, entry port. And you're looking into this with, with microscopes, you know, for hours on end trying to peel a retinal membrane or fix a Macular hole. Put a scleral buckle, and it could be six hours, seven hours. You can't move. You can't. Sometimes I would not even breathe when I was assisting Dr. Blumenkrans. It was just very intense, and I loved it. I loved every second of it. But I selfishly didn't get any gratification when the patient would. Even though we did great work, he did great work. The patient would go from counting fingers, vision to maybe 2400. All they could see was Biggie on, which was a huge success. It is a huge success, and I don't want to underestimate or undervalue the importance of that. But selfishly, I wanted more for my patients. Okay, call me selfish. I don't know. But I wanted more gratification. And it was George Paris in Menlo Park. He was affiliated with Stanford, but I went and worked with him, and I fell in love with the nature of the surgery. So that's what led me to a fellowship in oculoplastics. But being that Stanford resident, going to grand rounds doing research, you know, know, in ophthalmology, bench research, I think that's what makes me who I am today. Because, believe it or not, every eyelid surgery I do, I think about all the anatomy. It's. It's like people don't realize when they go to a surgeon, you know, somebody who really is good at what they do. There's 500 things in the brain that are. Are. That are flipped on. The switch is on. Okay? And we have to be mindful of every single one of those things when we operate, whether it's the brain, the eye, or the face, you know, or even other parts of the body. And so, so much goes into even a blepharoplasty, because one false move on my part can make a patient blind.

Oh, yeah, for sure.

Okay. And. And then. So to take it a step further, I loved oculoplastics. Did my fellowship with. With Dr. Stager, who's one of the founding fathers of the field. And then from that, I said, the year I was in my fellowship, the FDA approved the CO2 laser for blepharoplasty. I'm like, wow, this is neat. This is really neat. So I decided when I started my practice, it would be all about lasers. That was the buzzword.

I trained myself because it was uncharted territory. Nobody knew how to do blephar CO2 laser blepharoplasts. We were all learning at, you know, because it just got approved. So I'M like, yeah, I'm just going to teach myself. You know, I know the basics so I can, I can tackle this. So when I first began at Manhattan Eye and Ear and it was a special ASC on Park Avenue, I made sure that they had a CO2 laser. So I just started pounding out CO2 laser blast and I got sort of known locally. And then lo and behold, you know, I got established as a laser blepharoplasty surgeon. Right.

Yep.

And anyway, I, I, I go on and on, so you got to stop me.

No, no. This is fascinating because it's, it just shows how you are different. And I agree with what you're saying is you went from that early days learning a lot about what you're going to end up doing, but now you understand all the background to it. That's what makes you really different.

Yes, yes. There's just so much more. And I don't speak just for myself. I speak for any specialist that's out there.

I want patients, I want readers to understand what it takes to be a doctor. Number one, it's not easy. What it takes to be a fellowship trained doctor because then you're creme de la creme. And then what it takes to be a fellowship trained doctor who's done so much work and people don't realize the long journey we have. And people need to, not that people don't respect us, but they need to respect us more. Okay. It's, it's a really difficult journey. You know, really difficult. And we are not in this business. And I would, I'm gonna go out on a limb. We're not in this business to make money. Okay. That's a consequence, that's the consequence of our work. I, my husband's a surgeon too. And when we talk, we, we always feel like we are, we are commanders of our army. Okay. We are at the, at the vanguard and our whole army is, is behind us. We take the bullets.

Yep.

And, and just like a, a, a war general has to protect this country, we are protecting our patient.

Yep.

And we, we will go to every and any extent to give our patients the safest and.

But we are not God.

Right? Yeah.

Okay. And I just want people to understand how much it takes for us to be where we are. So please don't, you know, think that anything was done just for money. We are good intentioned at heart as doctors, and I speak for us as a whole. Oh.

You have to be, to spend that much time doing something. Right. You have to be passionate and your passion Comes across. Right. Too much about your patients. But that's fabulous. That's what more doctors need to be. Right. The doctor that goes into it because he wants to be. Make a lot of money or be, you know, prestigious in his community or her community. Right. Are not necessarily the best doctors. They. They may have a high profile, but they may not be the best. But your background and everything. And I'm not anywhere near a surgeon, but I did have some background. And we were talking about this a little bit before. My father in law was in the surgical instrument business.

Right.

So I got introduced into some of those areas that you're talking about and realized how difficult and precise the things are. And I talked to you about the Dr. Crawford.

How he came to. Because we were making surgical instruments or we're actually repairing them. I looked for another way to expand our business and I said, we need to manufacture something. So I started looking for doctors that had ideas and I met Dr. Crawford. And Dr. Crawford was telling me about a problem that he had with tear ducts. Right. And trying to get a tube into the tear duct because it's so soft.

Yes.

That I can't. I says it's so hard to get that tube into the tear duct. So he said, can you guys come up with a way to do it? So this came out. And you can love these kinds of inventions. So Dr. Crawford came out and we sat down, he explained it. So we took a piece of stainless steel wire.

Yep.

And my father in law took a little tiny piece of silver and he heated the silver up and then got the silver onto the end of the stainless steel wire.

Right.

And it forms a teardrop. So that teardrop was how it was going to take the wire through. Right. The. The canal. And then attach the silicon tubing Right. To the end of the wire. So then the two push the wire. Because the ball could have opened it up.

Yes.

Then we created a hook that would go up.

Right.

Right. And grab that and then pull it down and through.

Yeah.

So we had a patent with Dr. Crawford in the hospital for sick children on that.

And that's fantastic. And you know, as I was telling you, part of my fellowship, we did a lot of. It's called dcr. Odacryocysto Rhinostomy. Okay. And all that is, is it's a bypass procedure for the tears to drain into the nose in a different spot because there's, there's a blockage. It can be from infection, neoplasm, trauma, whatever the case is. So what we do with DACROCYSTAL rhinostomy is create an opening in the nose.

That the tears don't have to go down. The normal tear duct. We create this little osteotomy in the nose so the tears have a direct passage. Now, the reason for the cropper tubes is that the entrance to that passage is preceded by a canaliculus, which is the tears from the eye go into these little ducts called canaliculi. We don't want the passage to get scarred shut, you know, just to get scarred down. So we put these Crawford tubes in, which were very clever. And your technique, your. Your tubes made it very easy to insert them through these little tiny openings, feed them, so there's a tear duct on the top and tear duct on the bottom, and then they meet in, in, in, in the nose. And then with the Crawford hook, we would pull down those tubes and tie them and cut them short. And that tube, that stent, if you will, would stay in place about six months to assure patency of the, the opening.

Well, I thought you'd find it fascinating because I made those.

I said, oh, my God.

That'S amazing.

Assembled them. We actually had the, the hook. We created that where we cut a slot in it so that it could grab.

Yes. Yep.

Right.

We. I know firsthand, and I always, I always said to myself, like, whoever invented this is a genius. So right back at you.

Isn't that amazing?

That's amazing. Full circle.

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Yeah.

And then you're talking about the surgery. Dr. You know, Dr. Rhoden, he was at the University of Florida. He was a neurosurgeon he asked me to come down. He said, I want to work on some instruments for microsurgery. So he said, I want to show you what I'm doing. So he had me come down to his lab, and they had eight neurosurgeons and myself taking their class on how to do microsurgery. Right. And so we had to. So we. The experiment we used was a rat, and we crowded already in the rat, and then we had to suture it back under microscope. And just what you were talking about is the. The one that I did took me seven hours to suture it. And.

Yeah.

So frustrating, because if you just move the slightest little bit, you're out of the field.

Exactly.

And then it took me one. The. One of the sutures that I put in took me so long, I finally got it in, and I was like, okay. I went and I put the. The force up, down, and it was still stuck to it with the blood, and it pulled it right out.

There you go.

I was like, oh, my gosh, that took.

Welcome to our world.

Well, it was fascinating. Like I said, I don't know if I like. I guess I was young and had really steady hands at the time. But here's the fascinating thing. Of the eight rats, only two lived, and mine was one of them.

Oh, there you go.

See, it was like maybe I had a career in that. I just wasn't interested in it.

You had that magic touch. You missed your calling, Doctor.

I missed my calling, but I thought it was fascinating when you were talking about it. I remember that frustration. And the neurosurgeons, it's so frustrating. They're sitting there and they're so skilled, but that is technique. You have to learn that. And the only way they can learn that is to do it.

Yep. Practice, practice, practice. And, you know, the. The suturing, even, that I do with, whether it's festoon surgery or blepharoplasty, it's attention. The devil's in the details. And every suture, every throw counts. And you have to know what all the different types of suturing techniques, not just know them, but practice them and. And own them. And that takes time. Time and experience.

What was fascinating, though, is the technicians who were teaching us were so good at it. They could do it so fast. Right. But it was. They've done thousands of them in the training, so they were so good at it. So the fact that you have done that, what you're explaining makes so much sense. Why, if you have to go in for that type of Surgery, you want somebody like you who has done this so many times that it's. You just know how to do it. You don't want somebody there for their first surgery.

Yeah, I mean, I think that, you know, as, as with any artisan, you know, and being a surgeon is being an artisan of sorts. Right. Surgical art is a very, very fine art in and of itself. And this, this experience, you have to have a fastidious personality. I'm very type. Type A. Okay. You have to. I think most surgeons are. You have to be very OCD and you have to be sort of your own worst competitor.

And in that regard, you know, patients then get the best of what you have to offer and you develop that sixth sense that. You know what I'm saying? And until you develop that sixth sense about surgery or about any art form, you can't really call yourself a master of your craft.

Yep. Yeah, that's true. And so much like some of those surgeons that I would see and I would work with, they were so brilliant. I mean, Dr. Roden was brilliant. You know, Dr. Crawford was brilliant. And you've got a great personality and that's unusual for some of this.

Right. So everything, a lot of them are pretty dry and very, you know, I mean, Dr. Crawford was not a funny guy. He was just a very, you know, driven kind of person. He knew, trying to find it, and a lot of humor. But you've got a great personality, so that's a little different.

I think that that comes from my heritage. My, my parents always stressed. And I hated it at the time. I absolutely, to this day, I hated it. My mom would force us to sit with their adult company and entertain them. Can you imagine a 10 year old, a 9 year old, a 7 year old sitting there with adults for two hours?

Yep.

Okay. But now in retrospect, I realize that that gave me that social maturity, that social etiquette, you know, that, that social sort of savoir faire that I wouldn't have had if I hadn't developed those skills from early on. And I find that that's lacking in this generation. It's not a criticism, but, you know, I'm just saying in my children, I wish they integrated with adults more.

In.

A medical profession at times too. Right. You don't see that. So especially in a lot of the medical profession, they take this distance between. You sound very passionate about your patients, where a lot of them, I know they probably care about them, but the rapport is one of the keys.

At least that's what I It's the. I think it's the personality that for. I think for my patients, in addition to, hopefully my skill set, the personality draws them in, and, you know, it has to be genuine. And they. They see that it comes from the heart. Everything I do comes from the heart because I am here. I took the Hippocratic oath, do no harm. And I. And I want to espouse that, you know, and I want to be their hero. I want to be their. Their warrior. And I don't expect them to know what I know. And that's why they have their faith and their trust in me, and I don't take that lightly. You know, it's. If I'm operating and I tell my patients jokingly, I say, all right, these eyes, they're my property now.

So I said, I'm very territorial. So if you do anything in the future, I want you to call me and ask me if it's okay, because I have a lot of out of towners, and. And so I become very possessive of my work and my patients. And. But that. It's that level of trust. And they do call me like, oh, Dr. Gupta, this, you know, this esthetician wants to do some microneedling, and I say yay or nay, and they will go by what I say. And that, to me, makes me feel so good that they have that level of trust and confidence in me to give me that call.

Well, I think that's the key. And again, when you're doing surgery on people, there's a lot of stress. They're under a lot of stress going into surgery.

Absolutely.

And so if you develop that rapport with them, you're going to make them more at ease, which is going to make your job easier, and they're healing better. That's really what I do because I talk a lot about that, you know, to get the nervous system calmed down, that healing and restoration. But if they're under constant stress, it adds.

Exactly. And I want to take a minute here to talk about de stressing before surgery, during surgery, after surgery. And I cannot say enough about my team.

I have a highly trained staff who basically, it takes me six months to train each staff member. But their whole job is to de stress patients, to treat them with compassion, kindness, and they're very, very knowledgeable about all my procedures. So patients call, whether it's before surgery or right after surgery, they field 99% of all my questions because they know.

And having that support system, not just for me, but more importantly the patient, it's vital. And it's so helpful. So having that ancillary staff that's there to retrieve your calls. I just had a patient from Palm beach who flew up, I did the surgery, and the night of the surgery, she texted my medical assistant at midnight.

Really? Yeah.

That's the level of care that my assistants will give.

But that's the key. I have the same thing. So I have a great team around me because I'm dealing with people who are dealing with depression, anxiety, post traumatic stress. So they're already stressed coming in to see me. So before they even meet me, if the staff has actually started to keep them feeling welcomed, feeling calmer, it makes my job a lot easier. And so.

No, absolutely, absolutely.

You bring me to another topic here. When you mentioned depression, anxiety, ptsd.

I often feel that I'm a therapist with a laser.

And I think most surgeons feel that way, or a scalp, whatever the case may be. But the condition that I treat a lot of and what I wrote the book about, festoons. Yes, it's a physical condition, Dr. Wood, but more importantly, it's a mental hang up.

It's causing widespread depression, anxiety, social isolation. And what these patients who have. And the reason I bring it up is because it's very akin to what you do.

And I do feel like a therapist. And it's all the more important to establish that rapport, that honest rapport with the patient, because they're in a bubble.

Having festoons, which are a lot of cheek mounds, which no makeup, no, no surgery other than mine can take away. There's just nothing that exists for it to help them. It causes them. Because now imagine their flight. They've gone. They've been suffering from this condition for, let's say, months or years sometimes. Okay, they go from doctor to doctor to doctor, maybe seven or eight doctors. Every doctor says, well, yeah, it's your genes, it's your heredity. I didn't do the filler. So you don't have the festoons from that filler dissolve. Blah, blah, blah, blah. Sometimes they don't even know what the festoon is, what it's called. They just see unsightly amounts. So they're just at a total loss. And then that segues into depression because there's nothing, you know, despair, there's nothing out there that can help them. Eight specialists have told them there's no hope, there's nothing to cure them.

Well, it's actually interesting. What I say though, too, Dr. Gupta, is I talk about depression as a function of the brain, not a dysfunction. And what I Mean by that is the brain is shutting down to stop the pain. It's not actually a dysfunction, is trying to protect them so they can't fix what the mind has been trying to get done. So that the mind is saying, we've got this pain, we constantly are looping through this pain. So the way it protects them is it basically shuts down.

That's down. So it's like a defense mechanism.

That's what I believe. And all you do is resolve the problem that the mind has been trying to fix. And if it's from my side, when it's trauma, they're looping through the trauma. Their mind wants it to be different, they can't change it. So the mind creates. A lot of times what I say is depression is anger. The mind is being very angry and wants something to be different. It can't fix it. So it actually goes into a depressed state because the emotion of anger has not worked. Depression is the absence of emotions. The emotion hasn't worked. So it stops using anger and shuts down.

That's very interesting.

Once we resolve the trauma, the depression lifts because now it's resolved the problem.

And that makes a lot of sense because then when they come to me in this state, sometimes I find that depression, I think one feeds off the other. I see a lot of anxiety as well. Loss of self esteem. Okay. And that sort of segues into, you know, loss of personal relationships or dysfunctional relationships at work, at home. And, and they just. I have some patients who are completely isolated in their room for years.

Yep.

And. And you know, by chance they stumble on my website.

Once they realize what they even have, and then they see some, you know, they read about me and then they come to me from near, from afar. And then during the consultation when I say that, you know what I. I believe your journey will end with me. That immediately. Like, oh my goodness, there's hope.

Exactly. And that's what I do all the time. I had a lady in yesterday and she's been dealing with years of depression. And you know what she's been told is there's something wrong with you. You've got a chemical imbalance in the brain. Right. And I said, and this is what I say to everybody. There's nothing wrong with you and there's nothing wrong with your mind. Your mind is going into a depressed state for a reason. Let's get to the root of the problem. Depression is not the problem. Depression is the symptom of the problem. I see, but they focus on the symptom. And trying to treat the symptoms, that's the issue. Let's go to the core issue and get that resolved. The depression will lift. And so just what you're talking about, as soon as you tell them you're going to fix it, and I do the same thing, I can fix it. No one's ever told them that. They think they have to live and manage and cope with this for the rest of their life.

In my case.

What's up?

No, I'm sorry, go ahead.

So I'm sure a lot of the people who are dealing with this probably go to doctors and they're told, you know what will give you Botox? It will give you something to bring the inflammation down, but that's not solving the problem.

You're 100% right. You hit the nail on the head. And that's what these, these patients do. They go from. Do and invariably one or two doctors, sometimes it's not even doctors, it's nurse, anesthetist, you know, any cosmetic professional, let's say. So they will come to camouflage tactics or they'll do surgery that's sort of incorrect, that makes the festoons worse. So it's a temporary, sort of temporary pill, but it's not the cure. And sometimes it actually makes the condition worse. And if it helps, it's only temporary. But you're absolutely right, that's what happens.

Yep. And I get the same thing. So people come in and they're on SSRIs for depression or all these different things that they've been doing. Another lady came in with four different medications for anxiety. And I said, well, how's your anxiety? She goes, it's terrible.

Oh, goodness.

Well, that sort of tells me the medication isn't working. Oh, it would be much worse without the medication. And I said, why is your mind anxious? I'll guarantee you've got a lot of events and experiences that have created this fear. And your mind is trying to protect you. So it makes you anxious because it thinks you're in danger.

Right.

And so let's get to the root. What caused that? There's some events and experiences that are looping, activating your nervous system. Once we get to that root cause, we can shut that down and the anxiety will go away.

That's fascinating. You're absolutely. I couldn't agree with you more.

That's why we're getting the results we're getting. We can eliminate post traumatic stress, anxiety, depression, all of these things. Don't have to manage it. Right.

Yeah.

Sort of what I've been Similar to you is if they go in and they get a steroid injection or Botox or something like that, they'll go, oh, okay, I guess that looks better. Well, no, it didn't fix the problem.

You're 100, right?

Yeah. You're getting to the root.

Yes, yes. And. And that. That gives them hope. And. And my whole sort of. Again, by default. I stumbled into this. If you had asked me 20 years ago, this is what I'm gonna be doing, I would say, are you nuts? But this is. You know, it's sort of like it's a domino effect. One thing leads to another. Right. And. And so what I have evolved into right now, even more than a surgeon, even more than a festoon surgeon. You know, I have a niche, niche, niche practice. But I think the most important thing for me in my career right now is that I am the beacon of hope. Yes.

Yep. I absolutely agree. And that's what I think the difference is. So festoons. Can you explain? Because some people may not have heard that term or may not be familiar.

Absolutely.

And I know you've got a book on it as well, if you can show us the book and then maybe.

Yeah, so here's the book. I don't know. Can you see it?

Yep, yep. Festoon.

Yep.

Awesome. Gets a little blurry, but. But we will put it in.

Okay. Yeah. So basically, the book is called Killer Filler and the Festoon Pandemic. Okay. And the title itself has a lot of impact, and I'll tell you why. So Killer Filler is referring to this cosmetic revolution that we're in right now where everybody wants to get fillers. And fillers are basically substances. They're just, as the name implies, they fill a hollow area or a line. Okay. And they're usually made out of hyaluronic acid, which are the most popular ones, like Voluma, Juvederm, Restylane, Belotero. Those are all hyaluronic acid fillers, which are made of complex sugar molecules. Okay. And then you have other ones like Sculptra. You have Radiesse made out of other substances. But the most popular ones right now are hyaluronic acid fillers. Another natural filler are. Is autologous fat grafts. And that's where, you know, surgeons will take some fat from the abdomen or the thighs, you know, centrifuge it, and then inject the fat into the face for natural volume.

Right.

So in my practice, the number one cause of filler festoons are. Ha. Fillers. Hyaluronic acid Fillers done under the eyes and in the cheek area. Number two, cause are autologous fat grafts that people have, sometimes with a facelift, sometimes independently. So what are festoons? Okay, festoons are cheek mounds that sit right here, right in the middle of the face. Very noticeable, very unsightly. And you know, sometimes people just hide in glasses because glasses and with the COVID pandemic, the masks were covering the festoons, but people don't want to be wearing glasses all the time, especially if it's evening. They don't want to be in a mask all the time. Not that masks have come off. And so we are in a festoon pandemic right now, whether we realize it or not. And the reason festoons form. Let's talk primarily about ha fillers. Okay? Ha is hyaluronic acid. Okay? When I say ha, that just means hyaluronic acid. So when ha filler is injected, let's say in the under eye area or in the cheek, it's not going to sit there, it's going to move. One thing for one, okay, it's going to be dislodged, it's going to be displaced. Sometimes it ends up here, sometimes it ends up higher in the eyes. Sometimes a cheek filler ends up in the eye. It's going to move over time. That's point number one. Point number two is that the filler, contrary to popular belief, and I repeat, the filler, contrary to popular belief, does not all go away. It does not dissolve completely. Okay? There is almost always, I want to say always some residual. And if that residual sits in, in a good location and it's not causing too much drama, it will just be a great volumizer. And, and no, you know, nobody will mind that. But if that filler has moved or it has not enough of it has metabolized away, it becomes a water magnet. Okay? So what happens is that this is a complex long chain like molecule. As the body gobbles it up into smaller sugar molecules each time it gets dissected, okay. Or cleaved, let's say there, it opens up more water loving parts of the molecule so it draws more water molecules in. Okay? Does that make sense? So that's why some people don't see festoons right away. They'll see them sometimes years after, sometimes as early as months after. But it could be one injection that was done 15 years ago and now that patient has festoons. Wow, okay, I have seen that time, time and time again. And so that that filler becomes a water magnet. That's sitting there and it gets trapped. Now there is an enzyme that we have called hyaluronidase, which when injected promptly, if somebody notices excessive swelling after injection, you go to your injector right away and say, please dissolve this. And it'll dissolve almost completely if you get to it right away. But most patients don't realize the long term consequences, nor would I expect them to. But I do expect doctors. Now, it's been 15, 20 years since injectables were first hit the scene. I do expect doctors and any injector of the face to know that fillers can segue into festoons short term, but also long term. We need to own up to that because patients are suffering, patients come to us and everything is done unwittingly. I'm not saying that any doctor does this on purpose, but we need to raise the awareness. We need to improve our knowledge base about what festoons are. And that's why I'm doing this saving face campaign, because I find that there is not enough awareness on the part of the patient as well as a doctor or the injector. So festoons result because there's a very tight ligament here, like a tight wall, that prevents that fluid buildup from going down into the lower part of the cheek where it's thicker and it just gets absorbed into. Nobody would notice it. But because of tight ligament called a zygomaticocutaneous ligament or the zcl, fluid bubbles up.

Makes sense.

Okay. And if. And the amount of fluid called what we call edema can depend on whether you've had a high salt meal, whether you're on an airplane, whether you had an allergy attack, whether you had a drink last night. Because these are potentiators of that ha filler sitting there. So it's just going to draw in more fluid.

Yep.

There's going to be a party. Okay. After your party, there's going to be a party here. So, and I don't mean to like belittle the importance of that, but this, it's basically what's happening. There's so much going on here that any kind of potentiator will exacerbate the swelling. Some people wake up in the morning, they don't recognize their faces because the fluid, you know, when you're lying like that fluid can, it'll go sort of, it'll, it'll go all around the eye. You wake up in the morning, first thing you see in the mirror is, is a face that you don't recognize.

Yeah. What's the Long term consequences if they don't deal with this festoon. Can it also go migrate?

Yeah. So festoons. Basically because of this ligament. It stays localized, but it becomes like we were talking about. It's never going to affect your vision. Okay. It's not, it's not like you're gonna go blind from it or anything, or you're gonna have, you know, numbness or any kind of nerve damage. It's not like that. It becomes a mental, A psychiatric psychological problem.

Yep, that makes sense.

Okay. And. And that's why I, I feel like with every festoon sufferer that I see, I, I also, and I need to take lessons from you. I need to learn from you. I have to be a therapist.

And last time I checked, I didn't do any training in psychiatry or psychotherapy. So I kind of, you know, I. Out of using all the compassion I have and all the knowledge I have, you know, I, I do my best.

No, it sounds like you do and you do a great job. I love the way you're describing it as well, is that it could also be psychological.

Right.

That what they're dealing with, but that's itself in a lot of different ways. They could end up then overeating, over drinking, you know, get into addiction. There's all kinds of things that their mind will try to do to stop the pain. Depression is just one of them.

Yeah.

So depression is a resource the mind uses to protect them, but they could use multiple resources. They could end up with a problem not even knowing that it's coming from that.

Exactly.

That simple. And I love sports as a great analogy. You know, sometimes a pitcher will end up, you know, going in for, you know, treatment because his arm. Right. He's got swelling in his arm and they're saying, oh, he's got an arm issue. And what they didn't realize is that he had stubbed his toe two weeks ago. And so now when he's pitching, he's landing different on his foot, which changes his arm slot, which then creates an injury. And they focus on the arm injury when it was actually a foot injury.

Yes. Yeah, I see what you're saying. Yeah. Absolutely agree with you 100%.

Yeah.

And as I said earlier, then having somebody look you in the eye and say, your journey will end with me and giving them that hope, you. I see an instant, I'm telling you, and I kid you not, an instant transformation of their inside. Like I can almost go inside and see and it elicits a smile. And to me, that smile means everything.

Yep. It's like I had a conversation one time with a lady who was dealing with schizophrenia, and she was functioning, going to college, but she dropped out of college. She started to isolate because it was getting worse. And they asked if I could at least speak to her. So when I talked to her just over the phone, and I said to her, I said, you've had a lot of trauma in your life. She goes, well, you have no idea how much trauma I've had. I said, well, I have a pretty good idea. Because schizophrenia is the most extreme response to trauma. The mind.

I didn't know that.

Yeah, it becomes very disorganized, and so the brain just can't handle the disorganization. So then it becomes really dysfunctional. I says, but the trauma is the root cause of it. And I said, if we can get the trauma resolved, I said, you can start to see the symptoms start to change. And so as I was talking to her and I was explaining, I heard her starting to cry. And I said, I can hear you crying. Are you okay? Like, what's going on? She says, for the first time in my life, somebody's given me hope. That's what she was looking for. They told her, you're just going to have this. There's nothing you can do about it. You're going to have to manage this with medication. And I said, I don't believe that. Here's something you'll love. Because of the eye, right? Schizophrenia, which I believe is the most extreme form of response to trauma. There's never been a documented case in history of a person that developed schizophrenia that was born blind.

And what I believe, and I found this in my research, that the, the cause of all of these psychiatric issues is memory trauma being stored in memory. And it keeps looping, so the mind keeps activating the nervous system because it's looking at trauma in real time, which then thinks it needs to respond to it physiologically, starts changing. But the fact that no one has ever developed schizophrenia that was born blind tells me that they never recorded it.

That is fascinating.

And what we found is the 0102 area when we do QEEGs on people.

The occipital. Is it the occipital lobe?

Those two areas are lit up when somebody's dealing with post traumatic stress.

And when we, and I know as an ophthalmologist, that's where. Yep, that's where vision happens through the occipital lobe.

And so when we resolve the trauma. So when I started doing the research and I realized why Are those areas the occipital lobe, so active with somebody with post traumatic stress is they're reviewing trauma in real time. They're actually seeing it. Right. Not what they're seeing currently in the present. It's the old data running. And when we can resolve that, we stop the post traumatic stress. Isn't that fascinating? I thought you would love that, what you do.

I could listen to you for hours. You are so interesting.

Yep. And that's what we find. So what I do in the four hours, I do a four hour session. I can eliminate post traumatic stress because I can reset the memory so it stops activating the nervous system. So I almost do the opposite of what they did with the wizard of Oz. They take this, they record it in black and white, and then they colorized it. We're doing the opposite. We're taking the intensity out of it. And we can do that very quickly when the mind feels safe. That's why I use four hours, because during that time, I get the mind into a very restorative place that it feels safe. Then when we bring in the traumatic, I'll ask for a minute, two minute highlight reel of the trauma. And I don't even need to know what it is, Dr. Gupta. They don't even have to tell me what it is. I just have them starting to review it and I take them through a process that resets it and then they can talk about the trauma without the shaking, crying, emotion.

Is that similar to exposure therapy or is that different?

A little different. I don't really like exposure therapy. I think it actually reactivates the trauma. So what I'm doing is by the time we get to the trauma, they're in such a very relaxed, focused state. That would be bring in a minute, two minute highlight reel of it. The mind can reset it in the current state that it's in, which is relaxed and focused.

Wow, that is fascinating, isn't it?

Where traditional therapy, if you're in talking to your therapist about a traumatic event, you're only in there for an hour. So your chances are you're almost in the same state you were when you experienced the trauma, especially when they keep talking about it.

Yes, that makes sense.

Very hard to make changes in a highly active state when you're in a highly active state.

Yep. Understood.

Yep. And so that's why it works. Yeah, isn't it? So that sort of ties in with what you're doing as well.

So I guess six degrees of separation, my dear.

Yep. Yep.

I think we're all interconnected all the work we all do, you know, we're all connected and that's what it's all about, that we learn from each other, we grow with each other and from each other. I learn from my patients every day. Every day. And my patients are so smart. And I find as a doctor that if you talk to them eye to eye and don't dumb me down, they can understand everything. And the more they understand, the more we have a mature sort of two way relationship based on trust and respect.

And that's what I do. The first two hours of my session is all about science and education and why I say, here's why. There's nothing wrong with you. If you have these traumatic events that are continuing to run in your subconscious mind, your subconscious mind's fully present in the moment. Right. It has no connection to time.

Yeah.

So when it. So something looks like, sounds like, smells like it. It's literally doing Google searches all day long about the incoming information, comparing it to your experiences. So if you had an experience with something that looks familiar, your mind will start looking at the old data, confusing the old data with something that's happening now. And then it goes into activation. And when I explain all of this, people like, they'll go, this is making so much sense. And I said, how could your mind not go into a response if it thinks there's a threat? It's automatic. Is your autonomic nervous system responding in real time to old data? It's a glitch. It's an error message.

So may I ask you, Dr. Wood, if you have had patients who come in with a diagnosis of schizophrenia and you do your magic and they're off all their pills? Yeah.

Well, schizophrenia is harder. It does take more time. So I don't really do a lot with schizophrenia, but I do a lot with post traumatic stress. Anxiety, depression, even panic attacks. I can eliminate panic attacks in four hours.

Wow.

Because a panic attack is a combination of psychological and physical. So it's not. So when I started doing the research, I actually got a patent on it. I got a patent that we can eliminate panic, anxiety, post traumatic stress. But a panic attack is very unique. So the mind is feeling uneasy about something, but you're not consciously aware of it. So it's like an unease, but it's below your conscious awareness. So physiologically your body starts to change because it's getting prepared. Your mind is sending signals to start getting ready. We think there's a lion somewhere in the building. In essence, that's what it's trying to find. It's trying to find the lion, but there's no lion. So physiologically, it starts to increase, but you're not feeling it yet. It's on a very low level. Then that happens to then start sending signals from the body to the brain about the change in oxygen, CO2, lactic acid. Right. All of these things start sending more messages to the brain that's already getting stressed. And so those messages about the changes physiology physiologically. Right. Start to bring confirmation that the problem must be real. It creates its own crazy loop.

Right.

And then it eventually builds up that it's actually starting up to an hour before. And so I have a device that you can wear in your ear that will measure the physiological changes and alert you to it, and you can shut it down.

Fascinating. Wow. Yeah.

And so that's what we got the patent on, is that we're not monitoring vitals for the sake of monitoring vitals. We're monitoring it to alert you that below your conscious awareness, your system is going into an activation mode. And if we can catch before it activates, I give them the tools to shut it down and they can shut it down instantly. So I've had people. One guy with 30 years of panic attacks gone. Another guy, 45 years of panic attacks gone. Wow. Wow. Because we just show them how it's working and once they get that education about why it's doing what it's doing, it's like, oh, well, that makes perfect sense. Yeah, of course it would. And I found a study at a Southern Methodist university that had 2,000 of hours of data on panic attacks. And they had 13 people experienced a panic attack during the study. All 13 people said the panic attack came on instantly, but they had them all monitored for all these different vitals and it was showing all these changes. So after I had written my pan or my patent, I found the study. I added the study into the patent and it validated the patent.

Amazing. Yeah, amazing. Wow. Your work is fascinating. Yeah.

And yours is too. Like, I. I love what you're doing as well. So now I've got a new resource. If I have anybody come in.

As do I. Yep.

So we definitely.

My daughter's. My daughter's studying psychology right now. She's doing a master's at Northwestern. And I can't wait to talk to her this evening about everything I just became educated on. It's fascinating.

You should be fascinated with what we're doing. In fact, we're now actually measuring. One of the things that I have just started to do is Measure the brainwave activity while I'm clearing the trauma. Now, I knew the brain was doing fairly active. Right. But I wasn't sure how much. So now we have a band that they wear that's measuring the brainwave activity. So as I was doing the trauma clearing for about an hour with somebody, I was actually watching the monitor. And the very first one I did was just about a month ago. And I said, I went. I went home, I said to my wife, if I saw what I think I just saw, this is scientifically significant. I saw in the last half hour, an explosion of data processing. Wow. Mine was processing that. That trauma in a very. Which is amazing. And doing it a lot more than I even realized how much it's doing. That's why people are feeling these profound changes after the session.

Well, you know, you have. In this world of social media, these young people.

You'Ve got a whole generation of anxiety, depression, and it's nothing but visual stimulation. Think about it.

It is totally.

So you're onto something very, very big here.

Yep, that's. That's our hope. The big question is just getting the messaging out, as, you know, you know, people need to know about what you're doing. If they don't know about it, they'll suffer with it, Right?

Yeah. Yes, absolutely. I think you and I both, we need to reach the younger audiences to. To be more preventative, let's say, or to nip it in the bud, at least.

Yeah.

And that's why I decided to do. To go onto social media to reach those younger audiences, because you have an established practice. Have an established practice, but we really need to reach out to the. The younger generations to, you know, if they don't want to take our advice, that's. That's so be it. But at least we want to be able to offer it to them and be heard.

So that's what I'm doing now is actually tick tock videos. Right. That's what they have me doing to reach that audience.

Yeah, yeah. We really have to do our best to reach that audience because these are our future, you know, leaders and thinkers, and we need to make them as mentally and physically healthy and fit to brave the future that we, you know, we have to do our parts.

It's a different world. Different world than when we grew up.

So very different. I almost feel like. I don't feel like I'm in the same world that I grew up in. I feel like, what planet am I on sometimes?

You know.

And then Covid really, you know, had a Big effect on these young people as well. So I mean, up to a tsunami of mental health crisis in this.

Exactly. Yeah. Agreed. Agreed.

So how do people get a hold of you? So tell us what they would do and then where they can get your book if they.

So the book is on Amazon and they can also buy the book from my offices, but it's, it's probably easier for them to get it on Amazon to get a hold of me. We. I have two offices, one in Manhattan and one in Westchester. I may be going to Miami soon in the. Not Miami, Florida soon in the Palm beach area. But that's in the works. Okay. And I think, you know, probably my, my staff is all like, they're old fashioned like me. We're all about talking. So we love for you to call the office and as much as you can email the office to schedule appointments. You know, my websites are drlopagupta.com and I just festoonsurgery.com and then we have another one called saving face. Co a wealth of information on all those three websites. So easily accessible, I hope. And we, we welcome, you know, anyone who wants to learn a little bit more about what I do. We welcome their call.

Well, this has been fat. I have learned so much. This has been amazing. So I. You definitely have a fan in me and somebody from. I hear of anybody who's dealing with this. You're going to become that resource that I'm going to send them to.

Well, I feel the same. Right back at you. I learned a lot from you. Thank you.

Thank you so much for being here and thank you everybody for listening to another episode of you must be out of your mind. And there it is.

Thank you so much.