Fat Transfer: 3 Scenarios

Don't have my music tonight. Sorry. This has been a heck of a day here. We've lost power today, regained power today, had a makeshift arrangement put together just in case we couldn't get on. And we had other technical issues, but we are and should be live across all the platforms except we are. Not doing X tonight, so apologies there, but we'll get everybody on. Please send this out. We want everybody to join, take advantage of this opportunity. We're going to share, and then we're going to have a private, uh, guest come on. Do that momentarily. Just gotta get together a couple things. We'll get started in a moment. All right, so we have a brief talk about fat transfer, and then we're going to do a live interview with a patient, and we're going to make sure she gets on before I get started. If there's any technical issues in my circle or on Instagram or TikTok, um, just let us know. We'll try to address those as we can during the live. Sometimes it's a little bit more challenging, I have to say. Get these going. Perfect. So we're good on Instagram now. I can see everything on Instagram. I know that's streaming.

Awesome.

Perfect. So I'm just gonna have to minimize a couple things in order to give our little talk. Just a couple more minutes. Everybody hop on, please share. Sorry it's a little bit late tonight. It was a little, uh, a little bit of a challenge today, to say the least, but it's okay. Sorry, what are you gonna do? Uh, what are you gonna do? It's all right. I should have had my music rolling tonight. It would have been easier, but it's okay. Yeah, we're going to discuss that, Maria. So, um, if you want, go ahead and join Dr. Rob's circle. Um, I'll type it in the Instagram chat. Um, we were having all sorts of TikTok trouble. We'll discuss everything privately that you want to ask. I'll stay on as long as you need to answer questions. Can't really discuss everything anymore without getting some grief. So Trying to answer a couple people here. Everybody join, share it as much as possible. We'll get rolling here in just a moment. Two. All right. If you've ever been told you're too skinny for fat transfer, I hear that routinely, and it's usually wrong. I've had patients come to me after being told by another surgeon or multiple surgeons that there was nothing to work with, that they had to keep implants or that they had to accept being small after having children, just being flat. Or the other alternative that was often told to patients is you need to gain 15 to 20 pounds And then you'd become a candidate. And in most of those cases, that assessment was on a limited physical exam, and it was premature. So that's where we're starting tonight. I'm Dr. Whitfield. I'm a board-certified plastic surgeon. I'm here in Austin, Texas. We're live streaming tonight, and most of what we do is holistic transformations for patients. We do explants, we do explants with lifts. We do explants with fat transfers or explants lifts and fat transfers. We do holistic mommy makeovers where we simply take fat from other areas and rejuvenate the breast with that, with or without a lift. We also do skin tightening of the abdomen. The the biggest you know most important aspects of this. Is, you know, there's, there's like a cookie-cutter type situation to this. So over the next 20 minutes, we're going to go over some patient scenarios. Patient 1, she's been told she's too thin for fat transfer. I'm going to tell you how I evaluate that and why body mass by itself is not the only deciding factor. Patient 2 is having an explant surgery. She wants to have a fat transfer at the same time. She's been told That's potentially not safe. Patient three, she already had an explant. She's gone through her healing journey, and now she wants to have a fat transfer. You know what changes have happened? What what does that look like? And before I need to get into any of them, I'm going to give you just a few minutes of foundation. And this is education only; it's not a consultation. So no one should take this as. Medical advice. I gotta line up my guest here. Hold on, let me just set them up.

All right.

So, a few things. One, you know, when we harvest fat, we take it from somewhere. Typically, think of like the inner outer thighs, the flank area, the love handle area, the abdomen. We use techniques that are meant to carefully remove the cells. We use specific sized instrumentation for this. And it's not liposuction where you're just debulking and throwing away. You want to protect the cells, keep them in a closed environment. That way you can process them and return them safely. So that processing is done really to separate the fat from the fluids you use and from blood or any other materials or ruptured tissue debris. And all of that, you know, we want to separate. We do that through a vibration process. And ultimately, We're trying to get the fluid, the products away from the fat. And then the third part is placement. And so the placement's important. So it doesn't go where an implant was before, if you had an implant. It doesn't go in the breast tissue. It goes between the skin and the breast tissue in the fatty plane. So that's the most important, you know, 3 aspects of this. And you're augmenting that fatty plane. That's why it looks natural. This kind of confusion about what looks natural and having a lot of upper pole fullness is really not natural. That's an augmented look with an implant. So we don't do it in a big lump, if you will, or a big bolus of fat because that wouldn't distribute evenly. You want to do evenly distributed passes. This allows the fat to be not clumped in areas, and that matters. The transferred fat has to heal in that position, has to be with and near a blood supply, and it takes multiple days for all that process to happen. It's a very, um, Fascinating process that goes on over the first, you know, month really. And there's a kind of misconception that all the fat's going to potentially go away. We'll get into why that's really not the reality. So prepare the patient, harvest the fat, process the fat, replace the fat. So that allows the patients to have the best opportunity to keep as much fat as possible. So you can be technically great, um, you can harvest and process and place, um, but if you haven't really prepared the patients, I think that's where some, some serious improvements can be made overall. So let's take the first patient, the patient who's been told they're too thin. This is a very common occurrence in my practice. And you know, there's typically we're not going to use really young patients because I don't really see really, really young patients. I'm usually taking patients who've Gone to see a lot of different doctors, either for problems with implant-related issues or chronic inflammation issues, or patients who've found me and want to have a holistic mommy makeover instead of a traditional mommy makeover because they don't like the scarring, they're worried about the downtime.

Hey, Jenna.

Um, so overall Can you take someone who's been deemed, you know, too thin by someone else in a consultation and explain ways to get enough fat to utilize? Now, you're never going to get the same amount as you would on patients who have higher BMIs, more areas of fat, but you still can get usable fat. It's just like, where is it? How to go get it? Identify those locations. I look at metrics like DEXA scans, and then, you know, the same traditional areas of inner and outer thighs, abdomens, flanks, the mid-back, upper back sometimes. And so you can take fat obviously from these areas. Now there's a little confusion— you don't ever take visceral fat or anything like that. So you review their metrics, their DEXA scan, do their physical exam And then I get asked, like, how much are you going to get? So when you're a smaller person, you know, uh, less will go a longer way. And when you're a bigger person, you would need more to get the same visual change, if that makes sense. And there's only amounts that you can take per patient, so there's not some cookie-cutter number that works all the time.

Mm-hmm.

You're trying to do, especially in a patient who's having an explant, as much revolumization to rejuvenate the breast as possible, with or without a lift, depending on what the patient needs. So in patient 2, the one who wanted We'll say to have an explant and a fat transfer simultaneously. The simultaneous fat transfer works, I feel, well in preparation, um, meaning like we run the short method. So the book I wrote about the way we prepare patients, just so it's a very straightforward lower your inflammation type situation, and it can be done in a variety of patient scenarios. We'll just say this patient doesn't have a significant toxicity burden, so there's not a lot to, to do pre-op in that case. And I've had patients, one of them, um, uh, Alexi Panos comes to mind. She really didn't have anything on a tox test. She had just chosen 15 years ago to live a very, you know, healthy, holistic, non-toxic lifestyle and started paying attention to labels when it wasn't really a chic thing to do and started, you know, limiting things in her household because that's how she wanted to live. And she still by far holds the record of the least amount of toxins I've ever seen on a tox test. So in those instances, those patients can have transformations at the same time with or without lifts depending on what they need. And that's a decision based on implant size, breast width. And other just simple factors like that. And the third patient, um, and once again, I'll go back to that. So doing those simultaneously, uh, is not difficult overall in our practice. We do those typically weekly and we don't have issues. I know people have talked about concerns about, um, transfers due to toxicity, and that's why we work our patients up aggressively. Uh, pre-op. Patient 3 scenario is really the patient who's already had an explant, and I'm really glad that people are having— uh, and able to get surgeries in their own areas if in fact they are feeling comfortable with who they've met with and discussed their case and getting, you know, a capsulectomy done with their implant. Because capsulectomy is important for us in that we published a paper that shows it Almost 1 in 3 patients have bacterial contamination. And then there's a huge paper that came out of Denmark last year that talks about really localized immune system activation at the tissue level. And then we're hearing more and more about mast cell activation. So, but the patient's already gone through the process and wants to have a fat transfer later, then it depends on how mobile the tissues are. Sometimes there can be areas of scarring that make it a little bit more challenging, but still, this is all— Very straightforward to do. You'll have a very, very good understanding of the patient's tissues at that point, and their inflammatory burden should be much, much lower, all the way as low as a, you know, in a routine case, hopefully. If they haven't done that, then we'll just pause and get them really set up in our program if in fact they need more help, because you can run our methodology either pre-op or post-op concurrent. We do that for lots of patients here, certainly locally, and anybody who needs guidance, we can help with that. So the difference in the delays can be, like I said, the scarring. And, you know, then you certainly can see if patients have lost 10, 15 pounds of fluid weight, because I feel like that's a not unrealistic goal. The fat then restores the contours, edges, fills hollows, and gives a more natural shape. And obviously there's no foreign body. There's no scar capsule that's going to form, and you can add to this result. And that's unique compared to a device, obviously. And obviously the limitation is it can't project. Fat does not do that. It can't push out and give you profile. It was never meant to do that, so you shouldn't conceptually have that as a thought. And, you know, a cup size change is pretty routine with a fat transfer if in fact you can harvest enough, keep the patient's BMI where it needs to be, and counsel them about rest and nutrition and supplementation. So going across all 3 of those patients, you know, the variable that runs through is it's not a weight factor. And certainly I don't, you know, give much to the age factor, and it's more about, you know, where is the patient in the timing of their, their prep? Are they really, really well prepared, or are they coming in with a lot of inflammation on board that hasn't been addressed? And so here's the part that should actually change, um, what you do this week. If you're interested in things like this, you really have to work on getting yourself ready from a tissue standpoint. And then that— it's not something you either, you know, have or don't have. It's not some magical thing you can get by flipping a switch. You have to put in a lot of work. And, you know, we wrote a book about it. The book's available. It's very simple to read, lays out things in a very clear manner. And it's If, you know, if, if it's something that resonates, then you can get yourself into really good positions for any type of procedure, whether it's a fat transfer or any other procedure. It lowers your inflammation if you run the program. Um, and then, you know, things that we talk about that are easy and actionable always are improving your sleep patterns. You know, stop eating really close to bedtime, stop drinking close to bedtime, get off the computers like we're all on right now. Close to bedtime, and then that allows you to settle down. All the magic happens at night. Your lymphatic drainage of your whole body and a special system called the glymphatic system drains your brain. And if you wake up feeling as tired as you went to bed, that did not happen. The important things are to have that 7 to 9 of uninterrupted sleep. So none of that's super glamorous, but I talk about it a lot because it makes a huge difference. And we'll kind of wrap up in terms of the 3 patients. If any of that makes sense, then obviously you can go in and just comment guide on any of the threads and we'll help you get set up with some information. We have over 4,000 videos on YouTube and 180+ podcasts at this point. And certainly if you want more of this conversation, we're going to bring on a special guest tonight who's had a fat transfer, and, and we're going to talk to her. She has a very unique situation too, and I know she— it depends on who you would go to as a plastic surgeon. Some people would not really want to take care of her in her case because she has a specific, uh, aspect of her history that would bother some, uh, plastic surgeons. Um, but what we're gonna talk to her and let her share as much as she wants to share about her story, and then we'll go in the community, uh, Afterwards and have a little bit of a private Q&A as well. So I'm going to bring her on. Let me move some of my gizmos. If Jenna— Jenna knew how complicated today was too, so, um, she's a sport for, for coming on. Can you hear me okay?

Yes, I can. Oh my goodness, I've got people calling me. My notifications are off now, finally.

Hello.

Hi, so great to see you.

We've been trying to get a show sorted out now for quite a while. So I think I was getting ready to go out of town for my birthday last week. I went to Lake Tahoe because I went to med school in Reno and my happy place is Lake Tahoe. If anybody's not been to Lake Tahoe, you should go visit. And I thought before I left, I'm just going to— I want to do this About fat transfers, and I want to have, uh, I want to have Jenna on to talk about it because one, it's not easy to come to the conclusion that you want to do something, you know, like that, and it's not a traditional, uh, procedure to do. And Jenna has a special thing in her history that would turn off most people in my position. Because she already has an autoimmune disease. Um, and so kind of with that context, I always like patients to share whatever they want to share because it's an important thing for other people to hear how you arrived at a decision, which is obviously something that you thought about probably for a long period of time because you're not a very reactionary person. So I give the floor to Jenna.

Awesome. Thank you. Thank you, Dr. Rob. So, some questions are popping up asking where you're located. Are you allowed to tell them where you are?

Oh, yeah, yeah. I don't know why everybody can't figure out I'm in Austin, Texas. All you got to do is click my—

You're in Austin, y'all. So, yeah. So, I think one of the reasons why you felt— why you eventually were okay with working with me because I'm super healthy. I mean, as far as I was diagnosed with type 1 diabetes when I was 17. It's something that I've lived with for since 2000. And I'm just, I'm really active. I eat really, really well. I really take care of myself. I also had something that came back in my, in my tox tests. I, I also was dealing with black mold toxicity quite a few years ago. And so I'm still kind of processing that and removing that. But, but it was great because we were able to, to address it and, and deal with it. And My I breastfed two very gigantic, beautiful boys, and they sucked the life out of my breasts. And I was in a place of not and I didn't I didn't make this choice because I wanted to fix my body, but I wanted to zhuzh it and like just give it some extra love and give it a little boost. And I was in a really good mental space about it. I really I really thought about it. I researched a ton of different surgeons, and you mentioned Alexi Panos earlier. She's one of my closest friends. And I asked her what her thoughts were and I said, well, would you recommend him? And she said, absolutely. So that was one of the reasons why I decided to go with you. I did not have an explant. Alexi had an explant, but I really just wanted to get some volume into my breasts. And me knowing what I know about breast implant illness, I was not wanting to do that, to go that route. So it seemed like the safest bet for me. And of course, I learned a lot about the whole process, but I'm I mean, absolutely no regrets.

Yeah, I think, you know, the, the kind of traditional thing is when you have an autoimmune disease, um, and you have yours under a really tight control— you have to understand Jenna's very motivated and, and takes good, good care of herself and did it without any, uh, GLP-1, which if, if you need help And you have metabolic disease, that's a tremendous asset, but it's very difficult for me to do my job in the face of that medication because it works so well.

Well, I also had to— you asked me to put weight on. So, I think it was a few months before the surgery, you're like, you need to gain 10 pounds. And, I was just working, so I was working out and so lean and so fit. And, you're like, I am not going to be able to pull the fat from anywhere. I'm like, okay, good thing it was during Thanksgiving. So, it all worked.

Well, right. Yeah, it's always one of those things where, um, and hers, you know, um, the, the goal is like to be very honest with patients and always help them kind of clearly understand what's possible. I mean, I, I certainly always, I tried to, in every case possible since, you know, the beginning of You know, training and practice, you always want to just under-promise and try to over-deliver wherever you can for any patients, especially like you said, after having children and breastfeeding and all the things that can, can change and, um, and cause a little havoc. You know, the kids, kids do that. They still do that. They just, they cause it in different ways now. Um, And it's, it's not really, um, talked about probably, but you went with a specific mindset of talking about it. I often have patients, you know, tell me, um, they had never heard of a fat transfer really as an option. How did you arrive at that as even an option? Because that's not normal.

Yeah, um, I, I think it was just learning. I mean, I, I'd been following you. I also, uh, saw what you did for, uh, Lauren Bostick.

Mm-hmm.

And so, I was curious about that. And obviously, I didn't have anything to explant, but I was curious around what it would look like to go that route instead of getting a traditional breast augmentation. So, I did a ton of research and I looked at so many different surgeons and it seemed like you were the best option considering my values. And, I really love your holistic approach. I think it's just incredible how You do this whole testing procedure and the supplements and all the biohacking that you have in your clinic is just incredible. I don't know many surgeons who do that. And, I'm like, this guy is, yes, all of this.

I guess it fits in Austin that we do all this. It does, yeah. And, we don't sit and promote our clinic as a biohacking clinic because there's so many biohacking-type environments around Austin. We don't, um, we just try to take care of all our, all of our folks. But, um, what, you know, Jenna's saying is very true. I think it's important too that once you arrive at that decision, you want to use your own tissue. Like, your own tissue works extremely well. And maybe we'll take just a moment and say, so Jenna has diabetes, and it's— she does a great job with control. Some people don't do a great job For lots of reasons, and the medicines don't really help control them very well, and they get to a point of kidney disease where they need a kidney transplant. And then always the best kidney transplant option is your own. First of all, if you had an identical twin, that would be the best option because that would just be a like-for-like. That would be the exact same genes. Then the next option would be a non-identical twin and so on and so forth until it was a cadaver kidney. And so anytime you're using your own tissue, in this case we're using your own fat, as long as everything is in the best possible condition, like you said, you're taking really good care of yourself. And I always go back to Alexi. Like, Alexi was like a very, uh, you know, like such a good patient that way, like you, in terms of taking care of herself. I never heard like a word out of her either. It's kind of like you, like We have everybody here for a week and they do all the biohacking in the office. They do hyperbaric and red light therapy and lymphatic massage with full presso and the NanoVi therapy and the Human Regenerator and all the things. And then I always tell the patients getting fat transfers, if at all possible, I recommend you continue hyperbaric, you know, for another 3 to 4 weeks after as a practice to help the fat heal and improve If we want to use the word take or what have you, and then use more lymphatic massage to help the areas where we take the fat from. And then you are already kind of obviously very, very switched on about diet and, and getting enough rest, even though you're a super busy person. I follow you on Instagram, and you're in New York, and it was, uh, awesome to see you on, uh, in Times Square.

Thank you.

On the billboard. But that's We can't make excuses about not taking care of ourselves and then expect really, really great outcomes.

Yeah, it really comes down to, I think, the success of anything really does come down to how we take care of ourselves on the other side of it as well. I really was intentional and especially about keeping, retaining, I guess, the mass or the size because I did lose a little bit, but I was really intentional. And, that was something that you You mentioned that was going to happen. You said you're probably going to lose, I think it was what, 30% or so?

Yeah. It's usually between 20% and 30% that can vary.

Yeah. And so, I was prepared for that, but I've also been very intentional around just taking care of myself and not overdoing it and easing back into it. Yes, exercising as soon as I was cleared to do that, but I really have followed all the things and taking the supplements. So that's been very helpful as well.

Yeah. So like when we talked to Jenna, you know, pre-op, um, at that point Violet was here with us in office. Now she's remote and working, but we talk a lot about like taking care of yourself both before and after the procedure. There's this kind of thing where once people get back to their routines, Jenna, they don't really stay on point with all those things. It takes a lot to maintain results. And, or, and I always think of like the, you know, the people who do the— who dance or do fitness or do— they're, they're very difficult activities and they require tons and tons of energy.

Okay.

And they get hurt if they don't take care of themselves. They get hurt sometimes anyway, but it's a very demanding type situation. I feel like these cases for patients are very demanding, and the more they can be disciplined about— it's not even rule following, it's just like making sure you don't create— I like to say you don't create imbalance. Like your exercise, like you just can't be exercising and not getting enough protein calories in or healthy fats, because if you do, then you'll compromise the results. You have to maintain that BMI or improve in a healthy way your BMI, which is totally acceptable. In order for you to have both a really healthy lifestyle and be there for all the things you do, the family, the businesses, and activities and things that you have to do.

Yeah, I think that the main thing also is just— I mean, there are activities that I used to do like going to CorePower Yoga, and those were things that I chose to not do to really just— and I even saw a friend today, she's like, you want to go? I'm like, not ready yet. It's been like, I think like 10 months now. I'm like, Really just keeping the girls in place. So, I am just really enjoying them. My husband is enjoying them. I'm just really happy. Like I said, no regrets. Happy that I went forward with it. And, I think that there was like the— if I could have changed anything, I think I would have done it sooner because I think that there was so much that I got to learn, of course, about just everything. Like you said, I was on a GLP-1 for a little bit and that was one of the things you told me to stop because— and it was helping my blood sugar, but it still continued. My blood sugar really was maintained even after I stopped taking the GLP-1.

Yeah.

But, it was a couple months I was not taking it, gained the weight back, and then you had a lot more to work with. And, that was the biggest help, I think. But, there was also a question that said, what supplements did you use? So, Stacy, I use the supplements that he put me on. So there's like supplements that I was meant to take before and like a whole protocol and also specific supplements afterwards as well. And that's something that he would support you with.

Yeah, we can talk about that because I get asked a lot about all these proprietary blends of things and concoctions. And for everybody who listens to us or has listened to our shows or follows us, we just support patients' normal genetic detox pathways. And we do it with liquid liposomal supplements in a way that makes it just easy. I prefer to have patients not overdo it, but just be consistent. So I try to make it as simple as possible. So most of them are liquid, so I can't get pushback from, I can't take that, it's— I can't swallow it, or I don't like taking supplements because too many pills. I mean, that feedback has been going on forever. So we try to keep it super simple for compliance. And then we always talk to patients about, you know, protein options. We have a, a vegan and/or vegetarian option, and then we have an animal protein option because protein is super important to maintenance of these results. And then obviously healthy fats, which is always hard to do with, you know, nuts and oils and, and just avocado, you know, how many avocados can you eat? You kind of have to walk around with avocados in your pockets.

Mm-hmm.

All those things are super important, and it's probably— talk about like How do you, like as a busy busy mom and an entrepreneur, do the diet part so that I almost make people walk around with Stanleys full of protein just because I don't want to hear or have the feedback of like it's too hard to do?

Yeah, well, I definitely did. I was really on top of the the powder supplement that that I got from your office that was really helping with aminos, and I just. I ate a ton of steak and eggs and everything I possibly— beef bone broth. And, I went to The Well. I mean, I could literally— I swear, the amount of zeros in my food bill at The Well is just insane. So, I would go there and I would get steak and beef bone broth. And, my husband's like, what are you spending all this money? I'm like, but it's The Well. It's good food.

Yeah.

But, I just really made it A priority. I made it a priority to take care of myself because after having invested time and energy and money into having this procedure, I saw it as a continued commitment to really make sure that I was putting the best of the best in my body and taking care of myself.

I think too then you probably saw how big of a difference it makes overall because when you're consistent and intentional about how much you put in your body and the quality of what you put in your body and the quality of the products, as you know, you put on your body, things change dramatically.

Yeah, yeah.

They can really improve. They really do. So, um, I think, you know, Jenna is, like she said, about 10 months out, and we get folks out a year and we'll reassess where they, where they are. But we want everybody to have these, uh, results, uh, are long-lasting. But I think you hear it's good that I brought Jenna on because she's— if you follow her, she's such a busy, motivated mom and takes care of her family, but it's an entrepreneur who's incredibly busy. So when people start making excuses, I just magically have Gina or Jenna pop in my head as I think about like, no, that's not really a good— no, you can't do that.

Yeah, that— I mean, it's just, it's literally what, what we— my husband and I have a leadership academy and we teach people. We have— I am unenrollable in anyone's excuses or Victim complex. It's just I, I really empower people to know that they are the authors of their lives, and everything is a choice. And if we want to have a specific outcome, then the choices that we make must reflect what we say that we want. And so we really just stand for people to embody that. And so of course, I get to walk my talk. And I think the the diagnosis of diabetes came after being in a head trauma accident, and I woke up from a coma with brain damage. And so that recovering from that really is. inspired me to understand what it means to be resilient and, and knowing that, that the choices that we make are so important. So, um, so yeah.

You know, I've totally forgot to do this, Jenna, but we've, uh, done this across all platforms now, and I didn't really take it into my private platform. Um, I totally kind of got talking and just didn't do it. Um, so, uh, what I did, and Jenna knows this because she knows I got censored quite a bit, um, We created a platform that's private, and I'll go in there. Um, I know Jenna is extremely busy, so she has a few more minutes. Uh, we'll, we'll steal her for a few in the, in just the circle. But everybody who's in the circle, uh, and I don't see that many right now, I think there's 9 or 10 people there. Um, and I've— for a Thursday night, it seems kind of thin, although, uh— Oh, Austin's playing tonight. Yeah, that's part of the problem. Um, Do this. We'll take a couple questions here. We'll see. Uh, can I get a tummy tuck at the same time as a fat transfer of the breast? You can, Holly. I just don't do tummy tucks anymore because I can't stand the scars, um, and/or the downtime for the patients. That's just such a, a difficult ride. Um, but we can talk about options like the Holistic Mommy Makeover. Um, and we do have skin tightening options. Location? Austin. You already answered that. And then With supplements. Now, I did block out the Instagram screen, so I have no idea what's going on over here. Um, I think we just have a lot— oh, there we go. We just have a lot of people watching.

Well, I'm open to answering any questions if any of you have them.

I've heard that a second fat transfer tends to take And not the first. I'm always perplexed about these. These I've heard these things. You know those people? They, they seem. They see. Yeah, they seem to know everything. I'm just a little curious about them. So Emily, fat transfers obviously do work on the first take. That's why we're interviewing Jenna so she can share her experience. And I did them for cancer patients about a hundred times a year, and they would typically. Typically have a more difficult time than someone like Jenna because they're on medications that would block some of their hormones, and they're typically a little bit from an immunosuppressed standpoint; they're more challenging. So, and you can get good results in those patients the first time and/or the second time, of course. But it's not the second time is the magic trick; it's more about preparing the patients, and you want to get everybody as healthy as possible, like Jenna was describing in her case. Uh, somebody is interested in fat transfer. They had an explant. Not happy with my aging breasts. Super healthy 70-year-old. Yeah, we don't do the age discrimination in my practice or on my channel. I think that's gross. So yeah, we take care of everybody. This one is, my weight won't go away, sadly. I've been trying to lose 10 pounds Cutting weight. I think this is just somebody talking about weight. Well, I think everybody's just kind of venting on this. It's not really— there's not a lot of questions. Let me see if I have something on YouTube here. Yeah, sometimes I get folks who just want to Share a little anger. Let me see if we have any in the group, and then I'll get you out of here. I really appreciate your time.

Oh, I'm happy to be here.

We've been trying to arrange something for a while.

If this is how we're gonna hang out, then fine. We're both so busy. It's like, geez, I run into you at the well. It's the only time I get to see you.

You prompted— well, I'm sitting there and I saw your Times Square post, and I was like, I just have to I'm so glad you did.

It's great.

I have to see if we can make it happen. So let me see if we have any more questions here. Usually the TikTok and the Instagram questions are pretty good. And I did the live last Wednesday because I was going out of town for my birthday, and this is back to the usual time. Today it was a little bit— we had, obviously I said the power was out at the office, which is always fun.

And, um, but you made it happen. No excuses for you.

No, no, no, we're gonna get it done no matter what. Um, all right, well, I look forward to seeing you out at the well or in the office.

Yeah, sure.

Um, thank you so much for joining. We look forward to— we'll have a separate really long discussion when you're When time allows.

Yeah, absolutely. Well, thank you so much for inviting me. It was so great to see you and everybody else. Dr. Rob is awesome. So I'll see you later.

Bye. Thank you, Jenna. Bye-bye. Oh, Carla, we'll see patients. Uh, is, is needed after explant. Um, you can always do a discovery call with my team and we'll help get you taken care of. So don't, don't worry about the timing, you know, that's okay. And Stacy, did we answer your question? Oh, Stacy, I have inflammation support bundle. I'm sorry. So we have a bundle that is really meant just to lower inflammation before surgery. So if you want to go to either my main website or even in drrobscircle.com, you can access those resources to it for sure. Uh, Kaylin is asking if there's 3/4 cup to a cup size expected, is that the final result? Yeah, it varies a little bit, Kaylin. You know, what, what Jenna was describing was typical. You want to get a result where you're maintaining 70 to 80% of the fat transfer, which is a very good amount. And the way to do that really in my practice, the way I feel about it is through a lot of preparation. So we evaluate sleep, nutrition, supplementation. We look at multiple tests including genetics. Toxicity burden, gut health, food sensitivities, hormonal balance. We look if someone's had a parasitic infection, and we have to look at that. We want to get as many of the things taken care of for you and out of your system, if you will, before we do anything to the best of our ability to help you. I think a fat transfer—I always kind of in my head—I'm looking at a cup size, and you can add to it if you need to. But many patients. You know, that's that's a big change for them, big improvement for them. But yeah, sorry, I almost need a sip of water. I got like cotton mouth tonight. Any other questions? Really appreciate y'all hopping on. Always, we're gonna do a live every Thursday night, and this one, like said today, I had trouble in my office, and it was a complete mess. We had the power out. There was some transformer that. Went out next to us, and ay ay ay. Mess all day today. My office was burning up. Oh, Cindy, I'm sorry. Oh, you're welcome, Carla. I'm glad you can follow along. Make sure if y'all want to join the circle, just go to drrobscircle.com. It's free to join. If you have questions, you can put them in the chat there. We'll get to them. We have about a couple minutes left, and then I'll shut it down. And and let me see. Yeah. I think that is about it. Let me just double-check to make sure I've answered everything. Let me look on TikTok here. Hi, Rose. Yes, I remember you. You taught me how to teach patients to wrap by themselves. Yeah, we should do a little. Video call and just see what we can do. Oh, you're too kind, Rose. I did the surgical part, but you definitely— you did all the hard work after. So thank you though, appreciate it. Just making sure. Uh, let's see, make sure I answered everybody else here. Hi everyone, I, I hope, um, you know, you were able to get a lot out of this. We'll post the replay, uh, in my private community and then it'll go live in about a week on our show. So we're gonna shut it down tonight. Thanks for joining. Okay. All right. Bye-bye.