Dr. Gabrielle Lyon 00:00

Really, only notice when it’s

Kristy Hamilton 00:01

when you’re like I’m struggling, yeah. My whole face is erupted after this laser. Yeah, that’s normal, right? Is it

Dr. Gabrielle Lyon 00:10

distracting if I have this on here? It just lets me see the time, like, is that you’re sure?

Speaker 1 00:17

Yeah. No,

Dr. Gabrielle Lyon 00:18

okay. You are everything’s recorded. You are ready to anything that you don’t like, you can repeat, but

Kristy Hamilton 00:29

okay. Like to be a one. We’ve been doing

Dr. Gabrielle Lyon 00:35

that, that’s what he said. My husband, and I’m just kidding, I’m totally kidding, I Dr. Christy Hamilton, board-certified plastic surgeon, very dear friend, and I’d like to think of you as the resident expert plastic surgeon in the atmosphere and ecosystem of the Dr. Gabriel Line Show. Welcome back,

Kristy Hamilton 00:58

delighted to be here

Dr. Gabrielle Lyon 01:00

since you were here last, GLP ones have come on the scene and completely exploded. We are hearing a lot of GLP one face, GLP one bottom or butt, and just everything.

Kristy Hamilton 01:18

Everything

Dr. Gabrielle Lyon 01:19

has it has it changed practice?

Kristy Hamilton 01:21

It’s revolutionized plastic surgery, not in not only in my practice, but across the board. We have never seen so many patients successfully lose weight and keep it off. So patients would come in all the time, and we’d say, you might not be a surgical candidate, you want the tummy tuck, you want these operations, but we have to get you at a safe BMI, a safe body habitus, before we can do these things. Now everyone is coming in, they’re losing more weight than they necessarily want to, and it’s having implications, dark side,

Dr. Gabrielle Lyon 01:53

the dark side,

Kristy Hamilton 01:54

the dark side, it’s having implications for places that we may not want to lose volume, like the face.

Dr. Gabrielle Lyon 02:01

Okay, what I’m hearing you say is that GLP ones have revolutionized patient results, but also there’s a secondary effect, like I mean, now liposuction might not necessarily be such a thing, is it? And, or if patients are losing so much weight, you do fat transfers. I’ve heard of fat transfers for the face instead of filler, right? Fat transfers also for the breasts, probably for the butt. There’s probably all kinds of places, but without any type of excess fat, what. what’s happening?

Kristy Hamilton 02:40

So we’ve lost some of these reservoirs, and so patients will come in, maybe they’ve already had liposuction, or now maybe they’ve lost all of their fat, and we, you know, a guiding principle in plastic surgery is replace like with like, so ideally we can use fat if fat in the face has been lost. Now what we’re doing is we’re pulling from these cadaver fat products, which is interesting, the zombie BBLs, things like that. No,

Dr. Gabrielle Lyon 03:10

I haven’t heard about that. What exactly is that?

Kristy Hamilton 03:13

So, there’s this product called Aloe Clay, so it is cadaver fat, it’s been processed, it’s been irradiated and washed of DNA, and it looks exactly like fat, because it’s a fat derivative, it’s processed fat, and because it’s been washed of DNA, you can inject it into other people and not reject it, okay, like a kidney transplant, and so we do it in hip dips, we do it for a conservative BBL, or Brazilian Bettlift, you can do it in the breast, you can build a breast or use it to blend implant edges. And then there’s another product called Lipodermal, it’s a softer consistency, and we really like that for use in the face. So fat is always going to be my favorite. If a patient has fat, I preferred it to take the real deal, but now we have some other options for patients who have no fat to give, and this has really not been an issue before.

Dr. Gabrielle Lyon 04:09

Unbelievable. I mean, you’re at the, you’re at a moment in time where there there’s an evolution in plastic surgery.

Kristy Hamilton 04:16

Yes,

Dr. Gabrielle Lyon 04:18

the use of GLP ones, I think they’re here to stay. Do you agree? I mean, they’re not going anywhere.

Kristy Hamilton 04:23

Percent agree. Everyone is on these drugs,

Dr. Gabrielle Lyon 04:26

and because of the reduction in fat, you’re seeing changes in facial structure. Also, if someone doesn’t have fat, the way in which you would use fat within plastic surgery from a health standpoint, like effects like meaning, what’s a better way to say this? If someone wants to inject their face because they’ve lost volume, you typically would take fat, maybe you would take fillers, but you prefer to do it with fat. People don’t have fat anymore. The solution to that is what you are saying is the. Zombie,

Kristy Hamilton 05:02

zombie, BBL, BBL, but the zombie breast augmentation, but the zombie facial injection. You know,

Dr. Gabrielle Lyon 05:07

I did watch Disney’s Zombies. Have you haven’t seen it yet? Because your daughters are too little, but you are in for a treat. It’s called Zombies. The, the idea that it comes from a cadaver is a dead, I mean it’s not a dead body. How would you describe different ways? Yeah, so

Kristy Hamilton 05:29

it’s a donor. So this donor, this is a donor, so it’s donor fat. They actually specify that it can be used in this way. So I think that’s a question that sometimes people have. Do they know that it could be used for esthetic purposes, and and then it is FDA regulated product. It’s not an FDA approved product, because it’s not a drug, so it’s treated in a similar way to how, like kidney transplant or other grafts, like if you use cartilage or tendon and reconstructive orthopedic surgery, things like that,

Dr. Gabrielle Lyon 06:04

you created the Miami Thong lift.

Speaker 2 06:08

Yeah,

Dr. Gabrielle Lyon 06:08

that’s so cool.

Kristy Hamilton 06:09

Yes, so this is another example of we’ve seen patients lose all this volume, they’re working out, they’re following the Dr. Gabrielle Lyme protocol, they’re building the glutes, but when you’ve lost that much fat on top of that, even when you build muscle, patients were finding that they were having a sagging buttock, specific, and this is not a body lift candidate, this is not someone who’s got oodles and oodles of extra skin, but it’s someone who they look at the lower inner quadrant of the buttock and it’s pointing in the wrong direction, so I’ve had patients describe it to me as a diaper butt, which is not the most elegant term, but they don’t like that it’s pointing downward. They want that peachier shape, but they’re not going for the enlarged, exaggerated BBL look of fat injections. So this is like Kardashian 2.0 look, it’s not the 1.0 they want something that just looks lean, athletic, elongated, and they just want the shape. They don’t necessarily want a lot of volume, and so I designed a surgery to recreate that lifted shape, kind of redistribute the tissue higher up on the buttock, so they get a perkier look, and they don’t necessarily have to have it be larger, and some of these patients will combine it with the Allocate Cadaver fat product to add a little bit more peachy volume at the top, but this is, we’ve never had a need for this surgery,

Dr. Gabrielle Lyon 07:34

were you just a new

Kristy Hamilton 07:35

surgery,

Dr. Gabrielle Lyon 07:36

were you in surgery, and you just had this moment where you thought to yourself there’s got to be something to do. I mean, you must have had a flash of insight.

Kristy Hamilton 07:47

I had what happened was it was it was the question I had patients come in, they go, I have this problem now, and I had done other surgery for them, so they trusted me. And then I had a couple patients where they’re like, I will try anything to make this better, and so it’s a surgery I developed since 2021 and it’s, I think, we’ve now perfected it, but it basically started out with a more conservative version, and then we’ve since got it to the point where we’re getting the lift that we want and the long term result that we, what we want

Dr. Gabrielle Lyon 08:18

from a recovery, if you were to take me through what this is, there’s a from what I understand, there’s an incision within the gluteal crease, right, that’s where the thong sits, is that the thong on the on the where the glute would be towards the hip or is it in the between the two and the

Kristy Hamilton 08:42

cheeks, between the cheeks. Okay, so the concept is that yes, there’s a scar. It’s actually, it’s a fairly long scar, but it’s completely hidden where the tiniest bikini or a thong would sit, so the patient will never even see the scar. So it’d only be in the most intimate of settings that someone might notice it,

Dr. Gabrielle Lyon 09:01

and you are finding with the use of GLP ones, there’s excess skin.

Kristy Hamilton 09:05

Yes, because fat is it’s a supportive material for our bodies. Is so in the face we do fat transfer with all of our facelifts, because we want to support the volume that we’ve lost. So our facial skeleton shrinks as time goes on. Our fat pads shrink. It’s the same thing on the body

Dr. Gabrielle Lyon 09:25

when that happens again. This is just really interesting. So, my goal, let me take a step back. My goal to have you on is you’re always doing innovative stuff, and the podcast is on health wellness and medicine. I think it’s very important to get great information from experts that are board certified in what they are doing and talking about, which is, for example, plastic surgery, the use of GOP one. We’ve had multiple episodes on that. And they are amazing, but we haven’t talked about the dark side, and essentially the dark side is this change in from an esthetic standpoint. I mean, there’s lots of positives, probably the positives outweigh the negatives from an inflammation standpoint, from cardiovascular risk standpoint, but the negatives suck.

Kristy Hamilton 10:21

Yeah, the

Dr. Gabrielle Lyon 10:21

negative sucks. We see patients in our practice, strong medical, and they say my strength has gone down, my skin looks just terrible, and maybe that’s a bit dramatic, but this is what we’re hearing, that they have no appetite with that, they there are facial structure changes and body changes, I do, I want to talk about not just the muscular changes, where, for example, the diaper butt happens, but also the skin changes on the body, and what, what are the options for that for improvement, so be just to kind of tie up the Miami thong lift, which is extraordinary that you created this. The recovery time is important, and the Brazilian butt lift has been going on for how long?

Kristy Hamilton 11:15

Oh, the Brazilian butt lift, that’s, I mean, a couple decades now, I think, really, really popularized by the Kardashians, so they were early adopters of that, and then I think everyone followed suit, but they’ve since, like, really toned down their look, and that’s,

Dr. Gabrielle Lyon 11:36

and the whole goal was to have more volume, and it was, was it an implant that people were using for Brazilian butt lift?

Kristy Hamilton 11:42

No, there’s fat transfer,

Dr. Gabrielle Lyon 11:43

just fat transfer.

Kristy Hamilton 11:44

So this is a heavier time in America. Wow, right? A lot more material to be shifted, and so the concept was you would take the fat from a less desirable place, like around the midsection, around the torso, and then you would transfer it to places that you wanted more volume, like the hips and the buttock, and so that is how you got that more exaggerated hourglass shape.

Dr. Gabrielle Lyon 12:06

What is the recovery time for a Miami thong lift versus a Brazilian butt lift?

Kristy Hamilton 12:13

So there’s some additional restrictions with the Brazilian butt lift, because this fat has been removed from the body and re-injected, if you sit on it, then there are no, there’s no oxygen or nutrients going to the fat cells that you’ve transferred, and so you cannot sit for six weeks at a minimum. How, how do they have to stand, or you have to lie on your stomach? But you cannot sit for more than 30 minutes at a time, so it’s not just about maintaining the shape, it’s about making sure that the fat survives. So the nice thing with the Miami thong lift is you don’t have to worry about that, you can sit on it afterwards. So patients get back to most activities by two weeks. Any incision for the final scar is going to be a year out, but I would say by six weeks patients are completely back to living their normal life,

Dr. Gabrielle Lyon 13:01

including training,

Kristy Hamilton 13:02

including training. Yes, that’s important.

Dr. Gabrielle Lyon 13:05

That is important. What else is happening with the rest of the body? There’s another thing that you’re doing, which is also very unique. You’re one of 32 surgeons in the US trained to do a pec muscle sparing breast augmentation.

Kristy Hamilton 13:21

Yes, so this is this is very, very cool, especially if you’re into health and fitness in training, which, of course, that’s why we’re here. So this is a wide awake breast augmentation that you can do. It is the most minimally invasive method. It’s called Preserve, and it’s performed through a one inch incision in the fold of the breast, you have to have an intact breast, so this is not for someone who’s had previous breast surgery. And we go in using a specialized set of tools and basically pop in through the IMF, which is the fold, the fold beneath the breast. Okay, so this is this is a ligament and structure, and there’s actually a ligament and structure all the way around the breast, called the circumam or mammary ligament. So these specialized tools allow us to basically like pierce the pierce the ligament part it like blades of grass, go in, expand the space behind the breast, and then place the implant, and then all, all of the ligaments, all of the nerves, all of the blood vessels are kept intact. They are just, they act like a nest, they’re holding the implant in place, and then we remove the tool, and the ligament just pops back together. So it’s a very, it’s the preserves as much of the structure of the breast as possible. Patients are back to full exercise after a week,

Dr. Gabrielle Lyon 14:46

one week,

Kristy Hamilton 14:47

one week,

Dr. Gabrielle Lyon 14:48

which before it was what, four to 606,

Kristy Hamilton 14:51

I mean, if you’re cutting someone’s pectoralis muscle, six weeks, and you’re actually, if you’ve had that, you’re technically not supposed to ever. Use that muscle ever again. You’re not supposed to do push-ups, you’re not supposed to do bench press.

Dr. Gabrielle Lyon 15:05

Wow,

Kristy Hamilton 15:05

this is not compatible. That type of breast augmentation is not compatible for the modern woman who wants to exercise and work out. Now, if you choose to do it, that’s fine, but it’s going to push your implants down and out to the side if you have a submuscular augmentation. So, that’s why you’re told not to do that. You see women who do like to train, and they’ve had a submuscular augmentation, their breasts will shift down and out over time,

Dr. Gabrielle Lyon 15:30

and the traditional breast augmentation places, so the traditional and breast augmentations have been going on for a really long time, places the implant underneath the muscle, right, as opposed to on top of the muscle.

Kristy Hamilton 15:45

Yes, so it’s when breast lip, so the breast implant was actually invented in Houston, Texas. I

Dr. Gabrielle Lyon 15:51

had no idea, which

Kristy Hamilton 15:52

is interesting. So that the lore from residency was that one of these guys was squeezing a saline bag of IV fluid, and was like, oh, this kind of feels like a kind of feels and looks like a breast implant, so hence this, the saline breast implant was born. Is

Dr. Gabrielle Lyon 16:09

that true? That’s just the

Kristy Hamilton 16:10

lore, that was Baylor, I think it technically it was like St. Joe’s Hospital, but like the same, the same group, the same heritage from my training program, so really interesting. So, anyway, so of course, where would you naturally want to place a breast implant? You would want to place it behind the breast tissue to augment the breast, right behind. So that’s what they started doing, and then they started having problems with that. You know, a saline breast implant is essentially like a water balloon, so you see a lot, you see a lot of irregularities in it, and so what they were seeing was when they placed it in that area, they were seeing visible rippling, and then they were also having issues with something called capsular contracture, which

Dr. Gabrielle Lyon 16:54

we talked about, I believe, in our first episode,

Kristy Hamilton 16:57

yes,

Dr. Gabrielle Lyon 16:57

maybe two years ago,

Kristy Hamilton 16:58

yes, so this is abnormal scar tissue that forms around the breast implant, and it’s, it can be painful, ultimately, and it definitely doesn’t look right. It looks like a tight, hard implant. You, we want a soft breast implant, and so that is one of the reasons why we started going behind the muscle, was we knew that the rates of capsular contracture were lower, and it would help cover the irregularities of these earlier implants, so outside of the United States, where they have had access to newer technology, 80% of breast augmentations are performed in front of the muscle. In the US, that statistic is flipped, and 80% are performed behind. Now that’s starting to shift. Now that we have some new technology that we can place in front and not have some of these problems that we’ve had before, but it’s going to be interesting to see how that shakes out as time goes on. Was

Dr. Gabrielle Lyon 17:50

is there a reason why other countries place it behind, is it behind the muscle?

Kristy Hamilton 17:58

No, in front, in front of the muscle, they’ve, they’ve had access to many more implants than we’ve had in the United States, some of which have come and gone. You know, the FDA is conservative when it comes to breast implants here, and that has saved us from utilizing some implants that didn’t turn out to be so great. But these newer implants do not have these rates of capsular contracture, and so you can place them in a, in a place that’s a little bit more anatomic, and then spares the muscle, so that’s great for women who are active, the but basically it was because of

Dr. Gabrielle Lyon 18:30

the restrictions on what kind of implant can be used, and the tools, is that correct, is that right? Yeah,

Dr. Gabrielle Lyon 18:37

when it goes in front of the muscle, does that affect the tissue long term? Are there negatives? For example, let’s say someone is thinking about getting breast implants.

Kristy Hamilton 18:49

Yes,

Dr. Gabrielle Lyon 18:49

and their concern is that if they do an implant on top of the muscle, that it’s going to squeeze and push the tissue, and maybe there’s someone who wants to breastfeed or is thinking about the breast tissue,

Kristy Hamilton 19:06

so whether it’s behind the pec muscle or the breast tissue, you are pushing it, and it can cause some thinning of the breast tissue. Now, from a breastfeeding perspective, the good news is that there are equivalent rates of women with and without implants who successfully breastfeed, so it doesn’t seem to impact that, which is important.

Dr. Gabrielle Lyon 19:27

The if you had a preference, do you prefer before in front of the muscle or behind?

Kristy Hamilton 19:33

I prefer in front of the muscle, because we’re not taking away a very functional, I mean, you know this, right? This is like the pec muscles, the most important shoulder stabilizer on the front of the body. We don’t want to weaken women’s shoulder and chest. There is a downside to going in front, which can be in lean women visibility of the implant edge, so we would combine that with fat transfer, but now that people don’t have fat, we’re combining it. Ballo clay, which

Dr. Gabrielle Lyon 20:01

is the zombie, which is the zombie cells. Yeah, yeah, so

Kristy Hamilton 20:06

the zombie breast augmentation. So, so basically, that what I tell patients is like, there’s no, there’s no perfect plane for placing a breast implant. There’s like, there’s pros and cons, but the con of going in front of this potentially more visible implant edge is one that you can mitigate by adding some soft tissue, whether that’s their own or an off the shelf product, and so that is the downside that I would rather work with personally than being told I can never do a push up ever. No,

Dr. Gabrielle Lyon 20:39

absolutely not, for sure.

Kristy Hamilton 20:42

Absolutely not.

Dr. Gabrielle Lyon 20:43

There’s silicone and saline, yeah, still breast implants,

Kristy Hamilton 20:47

so yeah. Is

Dr. Gabrielle Lyon 20:48

there, if someone’s listening to this, because then we’re going to have to then obviously touch on the obvious, which is breast implant illness, and where the data is with that. Silicone versus saline, is there a preference for one or the other?

Kristy Hamilton 21:04

So, most surgeons, including myself, predominantly use silicone these days, because they have a more natural look and feel. They’re lighter than a saline implant, and one thing I always like to remind people of is that this saline implant is still in a silicone shell, so you’re not, you’re not silicone-free with, with either option, but pacemakers are coated in silicone, knee implants are coated in silicone. The state of the evidence with breast implant illness is that I think we talked about this last time, we

Dr. Gabrielle Lyon 21:39

did, and we’re gonna just remind people,

Kristy Hamilton 21:42

yes, so they, there was a really interesting study done, it’s like a four or five part study at this point, they looked at women who had never had implants, so these were women having lifts or reductions, and they looked at women who had symptoms and were having their implants removed, and then they looked at women who were having their implants exchanged, they left their breast implants, and they never want to be without them, and they looked at everything, right, they, it was a study done in conjunction with NIH, they sent tissue off to be examined, they looked at presence of heavy metals and toxins, they looked at presence of bacteria, and they did not see a statistically significant anything across those raw categories. There was an association with baseline higher levels of anxiety in the breast implant illness group, which is not to say that it’s not real. I think that’s a really, really important distinction, but I will tell patients who come in and see me if they are already a highly anxious person or have a diagnosis of anxiety, we really need to think hard about whether we’re going to go in and place a breast implant, because we know that’s a risk factor for developing breast implant illness. Also, interesting is the brand of implant that I like to use, which is called Motiva. If there’s an inflammatory component to this, which has not been proven, but just in general, to have a lower level of inflammation in your body, that specific implant is associated with the least amount of inflammatory response of any implant. So I like that as well.

Dr. Gabrielle Lyon 23:18

Does breast implant illness have an ICD 10 code,

Kristy Hamilton 23:22

no, because it’s not a medical diagnosis, but it’s a very, it’s, it’s a very controversial subject. It is something that impacts a lot of women, and so that’s why I’m proud of our plastic surgery societies, because they’ve taken this very seriously, they have pushed a lot of our funding dollars towards taking a look at these groups of women and trying to understand, you know, because just because we don’t have a diagnosis or know something doesn’t mean that it doesn’t exist, so these things are under study, and the great news is that all of our studies show that if you just take the implant out overwhelmingly these symptoms disappear in about six weeks, so that’s fantasticness. Yeah,

Dr. Gabrielle Lyon 24:07

unusual.

Kristy Hamilton 24:08

Yes, and you don’t have to do a capsulectomy or cut out like whatever is remaining on the breast to have that happen,

Dr. Gabrielle Lyon 24:16

and both you and I are treading lightly here for two reasons. This is very controversial, and both of us are women, and I would never want to diminish, and also I’m a practicing physician, I would never want to diminish someone’s experience, and neither do you. So I know you personally, I know that that that is really important to both of us. Secondarily, there is a lot of predatory behavior by other surgeons, and these are not words coming out of your mouth. These are words that I am saying because I am seeing it, that we have patients that come in our clinic that have had capsulectomies, have had implants that were not. Not bothering them physically, meaning they didn’t have capsular contracture, they didn’t have problems with it, but they felt because they had been reading, or they’d have all these experiences of what would fall into this kind of group discussion about breast plant illness, breast implant illness, and then they have completely deformed them, their bodies, they’ve become deformed from this, and their symptoms did not resolve

Kristy Hamilton 25:30

right. And then, if you were anxious and depressed before, then you’re really anxious and depressed after, when now your body doesn’t look normal either. And so, then there’s this whole like explant regret group as well, so I think it’s not cookie cutter, it’s not one size fits all. What I like when I have patients come and come in for a consultation with me, I like to cite those studies I just talked to you about. I like to give them their options, and they are some of the happiest patients I’ve ever had. We take out their implants, maybe we do a lift, something just to make the remaining breasts like look pretty, and all of those patients have, you know, they tell me they feel better, and that’s it. We’re done. I’ve yet to have one of my patients come back to me and feel like they have breast implant illness. The longer I’m in practice, the more likely one day that will happen, but it’s just a conversation that is ongoing, and we’re going to be learning more about this as time goes on.

Dr. Gabrielle Lyon 26:27

Very well said. Also, just wanted to mention that, because we’re not saying it doesn’t exist, but there’s also this kind of predatory behavior. Yeah,

Kristy Hamilton 26:36

and I think what you absolutely do not need to do, so if you’re, if you’re a woman, you have symptoms, and or you’re just ready to be done with implants, and that’s fine. You do not need a $30,000 detox program. You do not need to have what’s left of your breast cut out. This has all been proven, and you can have symptomatic relief, and you know, go on to have a nice, normal breast implant free life without complications from surgery, very

Dr. Gabrielle Lyon 27:02

well said, and in addition, we’ve put both our thoughts on the table for breast implant illness. The idea that women in other countries are getting to do implants that are in front of the muscle, so they don’t have to cut the muscle, which you know, I am going to have my physical therapist, JJ Thomas, on the podcast, and she talks a lot about scars, that when that there are these lines in the body, not just fascial lines, but when you cut muscle, it changes the way that you move, and it might be very subtle, but can create a lot of problems, and I do think that as we think about how we age, we have to also be careful as to what kind of procedures that we’re doing.

Kristy Hamilton 27:49

Yeah,

Dr. Gabrielle Lyon 27:49

I mean, it just, it makes a ton of sense. Why are only 32 surgeons in the US that are offering PEC muscle spraying breast augmentation?

Kristy Hamilton 27:59

So you can do a pec muscle sparing augmentation, and in general, so I have been a proponent of that style of breast augmentation for a long time, but this is more advanced or more minimally invasive version of that, and we were invited to train on it in Costa Rica, and then I think most of us found it very compelling working with the surgeons down there and understanding their motivation for developing this, it’s a, it’s a technique, it’s a philosophy, it’s a set of tools, and and it speaks to me, because I like preserving the pec muscle, if possible, you know, I’ll still do the minutes,

Dr. Gabrielle Lyon 28:40

it’s great, and what I love about you is you always find solutions. You’re very innovative in terms of how you think about plastic surgery. You really think about it as an art, and also just taking care of the patient and making sure that they are able to preserve their fitness, which is why I think a lot of our patients have gone to you, including myself, which we’re going to talk about this skin tightening technique, because ladies, I’m telling you, I just, in full transparency, that aging is a luxury, it’s amazing, and not everybody gets to do it, and if we’re lucky enough to do it, there’s all kinds of things that we get to benefit from, which is becoming wiser and watching our kids grow up, and then the downside, which I mean, for some people might consider a downside, others not, but your skin sags,

Kristy Hamilton 29:34

yes,

Dr. Gabrielle Lyon 29:35

especially after babies, your boobs sag, your skin sags,

Kristy Hamilton 29:38

yeah,

Dr. Gabrielle Lyon 29:39

and you know, I’m not a fan of that. It just, for me personally, not a huge fan.

Kristy Hamilton 29:48

I am not either. We, I do

Dr. Gabrielle Lyon 29:51

want to talk about what we did for me, which we did the Quantum RF.

Kristy Hamilton 29:58

Yes,

Dr. Gabrielle Lyon 29:58

and also I’ve done X’s on. For my hair, I do. I want to talk about all of it, because I think that my experience can help other people who are like, well, what do I do? This hair procedure costs, whatever, 1000s and 1000s of dollars, or someone is telling me this skin tightening technique is, is it worth it? And it becomes very confusing and also very costly. So, do you want to say anything more about the pec sparing breast augmentation? I just wanted to, you know, I wanted to bring that up because our audience really likes to get after it. Yeah, and they can return in a week. Is there anything else that you want to mention about the pec sparing, the pec muscle sparing breast augmentation, so

Kristy Hamilton 30:43

I think what is so interesting about Preserve is the type of patient that is coming in for this. It’s patients that have maybe always been interested in having a smaller volume breast augmentation, but they’re moms or they’re super active, they love playing tennis, they love lifting. They’re not going to compromise their lifestyle, and so now they’re like, oh, I can have this conservative, chic, elegant, smaller volume breast augmentation, and I can still get right back to it, whether that’s being like a busy executive, someone with small children, someone who is has a very active lifestyle, or what I find is oftentimes it’s someone who is all three of those things, and so I think it’s it’s met a need for that type of patient.

Dr. Gabrielle Lyon 31:33

We didn’t talk about the volume, you know, we had Dr. Tobias on. Wait, cut this out. What is Tobias’s last name? Cooler.

Dr. Gabrielle Lyon 31:43

Okay, let me stand up. Or is this okay with this kind of move just when she talks? Okay, so guys, so make a note, because we’re gonna talk about breast, like penis size, and then breast size. Okay? Do you know that there are breast implants? I mean, there are penis implants,

Kristy Hamilton 31:58

penile implants.

Dr. Gabrielle Lyon 31:59

Yeah, it’s like, yes,

Kristy Hamilton 32:00

it’s the thing,

Dr. Gabrielle Lyon 32:01

and you don’t get to pick your size,

Kristy Hamilton 32:03

you don’t get to pick your size.

Dr. Gabrielle Lyon 32:04

Oh my gosh, tell me when you’re ready. What? But we got to surprise her with this. Can I sit where? How can I sit? Am I doing okay? Because my hamstring is killing me. Yeah, now you’re fine. Will you stop me if I’m doing it, because Christie’s a friend, we can read. But here’s what I’m doing, I’m just like trying to

Speaker 3 32:25

do it. Okay,

Dr. Gabrielle Lyon 32:26

okay. Well, if that’s the case, can I like relax back a little bit? No, no, okay, fine. All right.

Speaker 4 32:33

Sorry.

Dr. Gabrielle Lyon 32:35

Okay. Ballerina Bress,

Kristy Hamilton 32:39

yeah,

Dr. Gabrielle Lyon 32:39

we did not talk about size.

Kristy Hamilton 32:41

No, we did not.

Dr. Gabrielle Lyon 32:42

Now I was very surprised that you can, well, not us, but one could get a penile implant.

Kristy Hamilton 32:53

This is outside of my wrong area, but still

Dr. Gabrielle Lyon 32:58

you don’t get to pick the size a penalty implant, because it is typically just used for performance, for being able to have an erection.

Kristy Hamilton 33:08

Okay,

Dr. Gabrielle Lyon 33:09

which I was shocked, because you get to pick your size of breast implants.

Kristy Hamilton 33:12

So you’re taking me back to residency here, and on a urology rotation, I think they’re just fitting the size that is there, right, because it’s more of like a support, that’s right mechanism. This is right. Okay, I

Dr. Gabrielle Lyon 33:25

want to, I mean, listen, I don’t want to make a light of the fact of someone requiring a penile implant, sure, because that’s a big deal.

Kristy Hamilton 33:35

Yes,

Dr. Gabrielle Lyon 33:35

and I will say you’re all just get yourself together, because on the female side, you can pick your breast size.

Kristy Hamilton 33:42

Yes, still has to be anatomic. Still has to make sense. Wait a second.

Dr. Gabrielle Lyon 33:46

Okay, let’s just.. let’s just put it all out there on the table. It doesn’t have to be anatomic, because I will tell you,

Kristy Hamilton 33:53

for me it has to be. For you,

Dr. Gabrielle Lyon 33:56

you are like that’s the right size, but we have seen people, and I may or may not have made that decision, that have gotten massive breast implants when they were in their 20s.

Kristy Hamilton 34:13

Yeah, I think there’s implications for all this, like one, it just doesn’t look right. Two, we have a surgery called breast reduction, and we do that surgery all the time, because when you have enormous breasts, it causes back pain, neck pain, like there’s all these.. it’s a medical

Dr. Gabrielle Lyon 34:30

right

Kristy Hamilton 34:30

surgery. So, why would we want to add so much volume that we then create all those symptoms for a patient? It’s a

Dr. Gabrielle Lyon 34:40

hindsight type of thing, yeah. It’s a hindsight type of thing, because there was a time where the Pamela Anderson look was very

Kristy Hamilton 34:48

popular,

Dr. Gabrielle Lyon 34:48

popular,

Kristy Hamilton 34:50

yeah.

Dr. Gabrielle Lyon 34:50

I know, because I was there, that’s all I’m going to say about that. And then there are subsequent challenges with that, and you call your. Our esthetic, the ballerina breast,

Kristy Hamilton 35:02

yeah, and that’s that’s the I would say the favorite esthetic in my practice is just having something that is proportionate, fits the body, not overwhelming. I mean, do we still do a voluptuous breast augmentation here and there? Yes, if I have a patient that you know is six feet tall, broad shouldered, they’re getting a size

Speaker 5 35:22

A,

Kristy Hamilton 35:22

maybe a 600 cc implant is appropriate for that person, that’s going to look tasteful, but you know the average implant I order in my practice is 250 cc’s, which

Dr. Gabrielle Lyon 35:30

would be a B cup, C cup, what is that? It

Kristy Hamilton 35:32

depends on a cup size in general, is about 150 cc’s, but you have to consider how much breast tissue the patient has baseline, so a 250 on you is going to be very different than someone who is 511 and where you would be to begin with, or were you a double A, so there’s you don’t get a certain cup size with a specific implant.

Dr. Gabrielle Lyon 35:53

Okay, I love this. I love that there are options, because I did not know that. I did not know that there are other options other than above and behind the muscle, and I only knew of those two. I did not know that there’s a way to spare, you know, to have a pec muscle sparing technique.

Kristy Hamilton 36:15

Yeah,

Dr. Gabrielle Lyon 36:16

which

Kristy Hamilton 36:17

is awesome,

Dr. Gabrielle Lyon 36:17

and the fact that the return to lifting is one week. I don’t think people know that. In fact, I know for a fact people are unaware of that.

Kristy Hamilton 36:26

Yeah, it’s just a much more pleasant recovery too, because muscle is important, it’s functional, it hurts like crazy if you cut it. Breast tissue, skin, and fat, much more forgiving materials, they do not hurt in early as much, and so that’s what we, that’s what we want out of esthetic surgery these days, is like we, we want to make the adjustments or changes that we would like to do, and then we want to get right back to living our lives, like we, you know, it’s it’s not acceptable to have six week and 12 week recoveries from these

Dr. Gabrielle Lyon 37:00

things, moving on to the topic I’m really excited about, which is the non-surgical skin and tissue tightening.

Kristy Hamilton 37:08

Yes,

Dr. Gabrielle Lyon 37:08

now I have done this. I, after having two kids, and also just training, and I don’t know, all of a sudden I woke up and have like extra skin on my stomach and extra skin on my back and extra skin on my knee, which is annoying. Obviously, I called you and I said, okay, what are the options without cutting?

Kristy Hamilton 37:36

Yes, and can I say two things? One, you could say anything. One, you look amazing. I always tell you, she’s literally.. do

Dr. Gabrielle Lyon 37:44

she’s my friend. She’s supposed to say that. Okay, but

Kristy Hamilton 37:45

two, I would say I applaud you for talking about it, because I think there’s a lot.. there’s this misconception out there that if you are, you know, if you take care of yourself and you’re fit, then you don’t.. you know, you don’t have these issues, and there is no fitter person than you, and yet you’re, you see, some of these skin changes as time, as time goes on. A lot of this is pregnancy related. There was an expansion, you know, even if you’ve been fit your entire life, you grow during that period of time, and then come down, and you actually grow more skin. So

Dr. Gabrielle Lyon 38:20

that’s a design flaw,

Kristy Hamilton 38:21

yeah, it’s a design flaw, and then the leaner you get, the less support you have of that skin with fat, and everything looks looser. So what we did was we went in and used this device called Quantum RF, which is a radio frequency tightening device, and basically it’s minimally invasive, tiny little incisions that you probably don’t even notice anymore, and we go in. In fact, I didn’t

Dr. Gabrielle Lyon 38:46

even know I had incisions because

Kristy Hamilton 38:48

they’re tiny.

Dr. Gabrielle Lyon 38:49

I didn’t, I wouldn’t even know where to look.

Kristy Hamilton 38:51

Yeah, you can’t see them anymore. And so, how it works is that if you look at fat, it’s a honeycomb structure, and the globules of fat are housed in the supportive connective tissue called the fibroceptile network, so that is what we are heating on the under surface of the skin, and it’s cinching up those fibrocept a and getting everything to stick back down.

Dr. Gabrielle Lyon 39:16

Does this have anything to do with cellulite, the quality of the structure?

Kristy Hamilton 39:19

So that’s a different type of fibro septal band, except it connects from the skin down to the fascia, and so those are little tether points, and so you can also see cellulite get worse as skin gets loose, because the skin is then increasingly held up by those septal connections going to the deeper tissue, so that’s why with weight loss you can see those dimples get worse, and that’s what cellulite is.

Dr. Gabrielle Lyon 39:46

And is that genetic? I mean, in my mind I’m thinking if it’s a structure is because some people have cellulite and some people don’t,

Kristy Hamilton 39:53

but overwhelmingly people have cellulite. They do. It’s like 97 or 98% of women have cellulite. So it is when you, when you meet a woman with that cellulite, that is a very special woman, very lucky. Most people have it to some degree.

Dr. Gabrielle Lyon 40:07

Okay, the honeycomb structure of the skin, and again, we’re not talking about fat now, we’re talking about the skin that then changes, right?

Kristy Hamilton 40:18

So we’re talking about the subcutaneous fat underneath in this, like there’s the skin, then you have different layers of fat, actually, but within those flat, like surrounding those fat globules, is the spiral septal network, and so when we cinch that up, and that’s what the

Dr. Gabrielle Lyon 40:37

radio frequency does,

Kristy Hamilton 40:38

yes, and so if we go in on the inside through a two millimeter incision, we can heat that structure to a much greater degree than we can when we’re doing outside lasers or other tightening treatments, and so we heat it to a degree that if we were doing that through the skin it would burn you, but only on the under surface we can heat

Dr. Gabrielle Lyon 41:00

it, and I want to frame this up for people. I asked around to a lot of different people. Obviously, this was before we were friends, and I said, okay, well, what do I do for the skin on my knees and the skin on my back, which, again, this I didn’t even know I had it until I looked at a video, and I thought to myself, wait, I didn’t even know I had it. Where did that even come from? This, you know, I was just wearing workout pants, and it was just kind of over. And when I went to various individuals, what they told me was that I could do micro needling that I could do something called a J wrap. I could try lotion. I mean, I went through a series of here are my options. I don’t know if you are aware of some of the things that are being just to clear this up for people, because I don’t want them to have to go through that and waste a ton of cash and just waste a ton of time on something that isn’t going to work. Can you lay out what if you feel comfortable laying out things that are being promoted for skin tightening, because there’s facial skin tightening, and then there’s body skin tightening.

Kristy Hamilton 42:17

I think a lot of it comes down to, first of all, the diagnosis, or what we’re working with, when we look at someone like you, you do not have oodles of extra skin, you’ve got some laxity, so that’s where we

Dr. Gabrielle Lyon 42:30

say some laxity. Sorry to interrupt you. For someone who’s at home thinking, okay, well, am I a candidate? Are they pulling an inch? Are they pulling two inches?

Kristy Hamilton 42:37

So, if you have an overhang, let’s just talk about the abdomen, because it’s kind of easy with women after having kids. If there is tissue overhang, you are not a candidate for these tightening machines. So, I think I

Dr. Gabrielle Lyon 42:50

feel like I had tissue that was above the elastic band, and maybe we can show a before and after picture. So, I’m going to work with Matt. We’re going to see if I can show a before and after picture, but I

Kristy Hamilton 43:01

think yours, that was from, I think you were wearing something tight, and then the skin would kind of come over,

Dr. Gabrielle Lyon 43:06

which in your 20s or before today doesn’t, doesn’t happen, doesn’t happen,

Kristy Hamilton 43:09

so, but that was like laxity, so when you stand up straight, like you look fantastic in tone, and you can see all your abs, and then it was like a movement thing, if you would lean over, you would see it, yeah, wearing

Dr. Gabrielle Lyon 43:22

skin or clothing,

Kristy Hamilton 43:24

right,

Dr. Gabrielle Lyon 43:25

or a sports bra,

Kristy Hamilton 43:26

sports bra, yes, but if you stand up and you look in the mirror and you see that you already have an overhang of skin, then that patient needs to have a tummy tuck,

Dr. Gabrielle Lyon 43:38

and Tommy Tuck is different than they’re not taking fat, it’s not liposuction, it’s just the skin,

Kristy Hamilton 43:44

the tummy tuck. I always do some liposuction with it to create natural hills and valleys, but we are removing the differences about how much skin we are removing, about this much skin off of the abdomen. For

Dr. Gabrielle Lyon 43:57

someone who’s listening to this, that’s six inches. Yes, it’s a joke, but it really is about six more.

Kristy Hamilton 44:03

It’s a huge, it could be more. It’s a huge amount of skin, so that is like a removal. So that’s why, if you’ve lost a tremendous amount of weight, if you’ve got pooling skin, like none of these tightening devices, don’t waste your money. Do not waste your money

Dr. Gabrielle Lyon 44:19

on someone that says we’re going to do radio frequency on your body, it’s not going to work.

Kristy Hamilton 44:25

Minimally invasive devices where you are not removing skin are not going to address a major skin issue. This is a great device for patients who are not a tummy tuck candidate, or they’re not a buttock lift candidate, or they don’t need an arm lift, but they want to do something, and which is appropriate.

Dr. Gabrielle Lyon 44:44

Okay, ladies and gentlemen, if you’re at home and you are again noticing I had my friend who was saying, you know, what did you do for your skin, because when I’m in the push up. Position, I’m seeing skin hang down. Is it? Would you say an inch to two inches can be addressed, or is that too? Is that too much skin, too much laxity? So, sorry, you guys have to cut that out. I keep saying so. You should say Gabrielle, shot collar me.

Speaker 1 45:19

I’m really

Dr. Gabrielle Lyon 45:22

trying not to say so. If an individual pulls, because I feel like I could pull an inch, is that

Kristy Hamilton 45:30

yeah,

Dr. Gabrielle Lyon 45:30

is that true? But I don’t. I feel like I could. My hair just fall on my face, so cut that out too. I feel like I could pull an inch. I don’t know if I.. if it was two inches, that’s probably

Kristy Hamilton 45:41

more like I could pull two inches off of you, more than two steps, but it’s, it’s really about the fact that your, like, your skin fit the form of your body, and you didn’t have overhangs, so that’s the best way I can describe it to patients. So this is, is good for that, this in-between patient, the patient who’s not on a not a full on excisional candidate and someone who, sorry, not lost my train of thought. Basically,

Dr. Gabrielle Lyon 46:11

what I’m trying to do for people is I trust you, I want them to come to you, and I want them to not be a victim of going to someone that’s going to say you’re going to a med spa, because this would happen. I would ask around, and they were like, “Oh, come in, you know, here’s your package, and it’s going to cost you $10,000. I would have been completely out of line and out of cash if I had again just on topical,

Kristy Hamilton 46:43

yeah,

Dr. Gabrielle Lyon 46:43

and that’s, and that’s really where I’m going with this. I want to, yeah, and then Matt, we’re going to do before and after, yes, and you have the before and after pictures.

Kristy Hamilton 46:49

So I think a skin treatment, skin treatments are fantastic, they’re going to treat the skin, they’re going to treat texture, they’re going to treat tone, they are not going to transform structure. So then, okay, then we’re moving into things that can adjust structure, like quantum RF, and then most importantly, surgery. Major surgery is going to provide the most significant transformations, but I think what can be helpful is going to someone who, under, who offers all of those things, that may be one way to be safe is to go and see, you know, if all you have is a hammer, everything by definition, definition is a nail. I don’t think any skin treatment is going to treat structure, and so that is that’s where a lot of people run into trouble. They’re like, do do microneedling, and that’s going to give you a facelift result. Like, no, micro needling is going to enhance the quality of your skin, but not tighten it and reduce wrinkles as well. It’s going to reduce wrinkles. I don’t know that I wouldn’t say that it’s going to tighten it, you know. Now, if you add some, if you start adding in heat, so radio frequency microneedling performed at a more shallow depth, or then we move into bigger guns like co laser, which I tell that cinching of the skin, but still it’s a predominantly a skin quality treatment. Once someone needs a facelift, or we see jowling, like loss of neck definition, none of these surface level treatments are going to address structure, and that is that’s just the absolute truth, so if someone is trying to sell you like a package of skin treatments to give you a facelift result, that’s just never going to work. Radio frequency uses, is it heat, aka energy? Yeah, so when you look at with all these energy devices, and there’s different kinds: ultrasound, radio frequency, laser, or

Dr. Gabrielle Lyon 48:41

soft wave,

Kristy Hamilton 48:43

yep, soft wave is ultrasound. They’re all trying to heat tissue to a certain temperature, which is going to stimulate collagen induction. So, it doesn’t really matter what type of energy you’re using to get there, it’s all about creating heat, that’s what creates this controlled injury, and that is essentially what gets your body to start working on healing itself.

Dr. Gabrielle Lyon 49:08

And if we were going to say there’s levels of skin laxity, I’m sure there’s graded levels of skin laxity.

Kristy Hamilton 49:16

We don’t have a. we go more by scales called ptosis, so it’s levels of sag, so we have better, yeah, so we have eyelid ptosis, we have breast ptosis, if your nipples are at your breast fold, or if they’re in your knees, if they’re below your breast fold, it’s a two, once they’re pointing to the floor, it’s a three, okay, nipple ptosis, nipple ptosis, but we don’t have a.. I think laxity. You would define that in surgery by how much tissue you remove.

Dr. Gabrielle Lyon 49:50

Sagging, I didn’t have ptosis is laxity,

Kristy Hamilton 49:55

ptosis is droopiness. But I’m sorry. Sorry, let me say

Dr. Gabrielle Lyon 49:58

that again. You guys have. To edit that ptosis is drooping, aka sagging, or laxity would be both.

Kristy Hamilton 50:06

Laxity is refers to just like a loss of elasticity in the skin or associated structures. Tosis is used to describe droop, but of specific structures like eyelids or the brow or the nipples.

Dr. Gabrielle Lyon 50:23

Okay, radio frequency internally was something that I was new to, because a lot of the radio frequency machines are on the surface. We used quantum radio frequency. Does someone take me through what kind of result that they can expect, because I want to do another, another round, because I think that I got a fantastic result, and I think that we could probably.. it’s probably time for a little bit more.

Kristy Hamilton 50:52

Can work on it again. Yes, it’s something we’ve been doing is an initial round, and then a second round at six months, so it is a 25 week total. I don’t want to say recovery doesn’t take 25 weeks to recover, but 25 weeks to see your entire result. At that point, also everything softened up again, that you could go back in. I do,

Dr. Gabrielle Lyon 51:12

I don’t remember. I feel like, oh wait, I remember. Oh, yes, I remember. Can you tell the story? Oh man, I did this, and we did. My, we chose to do it under general, right? Yes. Let’s, let’s take people through what their options are.

Kristy Hamilton 51:30

You don’t have to do it under general, but you are someone with a very tight schedule, and we had a limited time frame to do this, and so if, if you’re going to do this treatment awake, that’s fine, but there’s only a certain amount of lidocaine that you can inject into someone safely in one session, and I didn’t

Dr. Gabrielle Lyon 51:46

want to do that,

Kristy Hamilton 51:47

and we could only have then done your thighs and knees, or your back, or your front, and that’s not how you live your life. You’ve got one one timeframe, one window of opportunity, and then you have to be like in perfect shape, like a couple days later, no pressure, no pressure. So we chose to do you under general anesthesia, just so that we weren’t limited by lidocaine and how much we could inject into you. To be fair, we

Dr. Gabrielle Lyon 52:12

don’t take that lightly, and it’s very safe. There’s quite a bit of concern and conversation around general anesthesia. I feel like, and I think the data suggests that it is very safe, especially if it is done under controlled conditions, rather than, for example, for my case, to go and get a ton of lidocaine. I mean, that’s there’s only so much that can be utilized.

Kristy Hamilton 52:35

Yeah, and there you just, you just have to go to people that know what they’re doing, like, go, like, you know, I only work with amazing board-certified anesthesiologists. A lot of these procedures are done in these outpatient settings, where if you can numb everything with lidocaine, that then means, like, you don’t have to do it in a hospital setting, and then all of a sudden, you know, in a med spa setting, someone may be given a toxic dose of lidocaine, they may not know it until 10 or 12 hours later, when it peaks, they’re at home, your heart stops, and then that’s just a tragedy. So, that aside, that’s not what that’s not what we were doing, we’re not doing that, and so we were able to get, I would say, like a 20 to 30% reduction with this device,

Dr. Gabrielle Lyon 53:20

more. Well, then, yeah, got to do, okay, you do it again. and then what is that?

Kristy Hamilton 53:24

That’s what I say, because I think we always hit that, and I think some patients feel like we get more than that, but I think it’s 20 to 30% reduction as like a good solid expectation as a baseline for patients. And then I think a lot of people do do better than that, but there is a little bit of variability in terms of response.

Dr. Gabrielle Lyon 53:42

Okay, good to know. The, we’re about due, we’re about coming up on six months, I believe. The totality of treatment after the second treatment, is it typically more than two, or after two, you say I know what to expect.

Kristy Hamilton 53:57

Yeah, I think after two, that is great. Patients are happy with that result. Then aging will continue, and then again, to your point, it’s a luxury to get older. A certain point we’ll see laxity again, and then we can do that again. But this is not – it’s not a treatment that wears off, it’s that aging continues.

Dr. Gabrielle Lyon 54:16

How long? And then is there an average improvement that you see when you could pull my skin, maybe it was two to three inches of last year, which is insanity. Probably now it’s.. I don’t know, I haven’t measured it, but we’ll measure it after this. Maybe it’s one to two inches. I haven’t..

Kristy Hamilton 54:35

I haven’t pinched you after the fact, but

Dr. Gabrielle Lyon 54:37

we’re gonna.. we’re gonna determine. And then would you say people get 50% better conservatively, 20 to 30% after that first treatment. After the second one, is it doubled? Is it 40 to 60, or it’s

Kristy Hamilton 54:50

again? So, I guess it depends on another measuring, yeah, another, another 20 to 30. So, it’s, it’s a, it’s a really nice option for this gap patient.

Dr. Gabrielle Lyon 54:59

Mm.

Kristy Hamilton 55:00

Someone who doesn’t need excisional surgery, but has meaningful access to, and wants to improve upon it, and so it’s been, it’s been very popular. I’m excited to do it for myself too.

Dr. Gabrielle Lyon 55:09

I would say I’ll do it for you, but I would definitely do what I’m doing. We’re also going to use it on my face, because I want to try it for the skin, you know. I’m not a facelift candidate, I haven’t had plastic surgery on my face. Yes, I would love to try the radio frequency underneath my chin on my face. I don’t know where we can do it. We were,

Kristy Hamilton 55:32

we were talking about using it

Speaker 6 55:34

in this

Kristy Hamilton 55:34

area, so kind of what we call the submental region, or the under the jawline region, just to cinch that up, so for this area, and I’ve told you this too. If you were someone who was interested in having a facelift, or needed a facelift, which you do not, in the next one to two years, I would say do not do this. It’s going to kind of complicate things by creating inflammation and some scar tissue in that area, but if you’re someone who may not have a facelift for another five to 10 years, or we just keep on collagen banking and improving things and trying to avoid that entirely, then this is a, it’s a great option, because it’s going to do the same thing, it’s going to cinch up this area and tack everything, it’s similar to the what I was describing with the knees, for you, we were like, okay, we can’t just go in and treat the knee, we’re gonna treat the whole thigh, because it’s like pulling four corners of a blanket. So this is a cinching procedure, so we have to make sure that we’re cinching across a larger surface area to get that so-called tightening effect. So same thing, we’re gonna, even though you just have this tiny area of concern, right, and here’s

Dr. Gabrielle Lyon 56:43

what I would say to the to the ladies. I was irritated about that skin for a long time, and I wish I would have just dealt with it instead of just say, okay, well, that’s

Kristy Hamilton 56:58

just that is what it is,

Dr. Gabrielle Lyon 56:59

because I’m, I just appreciate the fact that there was something to do about it. Again, take it or leave it. I’m not telling anyone what to do, but I would heed for someone to be on the fence and then do something, and go, my gosh, why didn’t I just do that in the first place?

Kristy Hamilton 57:16

I mean, these are happiness-inducing procedures, and I wasn’t trying to minimize your area of concern, but what I meant was, is relatively small. Matt always tells me I look like a

Dr. Gabrielle Lyon 57:24

turkey with under my neck. I’m kidding. Yeah, he says,

Kristy Hamilton 57:30

but what I meant by that is, like, it’s a small area relative to this whole area underneath your neck. So, the whole key is that we have to heat the entire under neck area, so we can have the blanket effect and pull that across.

Dr. Gabrielle Lyon 57:43

Someone would then wear a garment after.

Kristy Hamilton 57:47

Yes, you know, I love some garments.

Dr. Gabrielle Lyon 57:49

Oh my, okay, goodness. And then do the other things that you recommend. I highly recommend that people learn about this. This radio frequency, this quant is quantum the only device that is doing it that is underneath the skin. Are they? It’s the only

Kristy Hamilton 58:08

one in my mind that has ever worked this well. So I’m very skeptical of the tightening machines. There’s millions of them out there. We refer to most of them as a very expensive coat racks, because a lot of them just don’t work. This one was developed by a very dear plastic surgeon friend of mine, Dr. Alfredo Hoyos, and that’s what got me interested, and actually made me try it, because I was like, well, if he puts his name on something, it’s probably trust him, I trust him, and it does,

Dr. Gabrielle Lyon 58:43

and it, and to clarify, it works different than the topical radio frequency. For example, quantum was not used topically, is it

Kristy Hamilton 58:50

correct? Because if we heated things to that degree, burn

Dr. Gabrielle Lyon 58:54

everything,

Kristy Hamilton 58:55

you would be a burn victim, and you have scars all over your face. So that’s why we have to go inside, otherwise this would cause tremendous issues,

Dr. Gabrielle Lyon 59:03

and a garment, a compression garment,

Kristy Hamilton 59:06

yep,

Dr. Gabrielle Lyon 59:06

has to be worn for how long?

Kristy Hamilton 59:08

Just for a week, or until the swelling comes down. So, this is it’s not like liposuction, where you’re creating all these spaces, removing fat, and it’s filling up with fluid, but we want to tack everything down and get that swelling down faster, so that you can go back to normal life.

Dr. Gabrielle Lyon 59:23

If someone chooses not to do that, does it affect the end result?

Kristy Hamilton 59:27

No, but you’re just gonna be so swollen and so uncomfortable, like you really want to do that, just so that you recover faster.

Dr. Gabrielle Lyon 59:35

What about face asking for a friend myself? How long does someone have to wear a wrap

Kristy Hamilton 59:42

for one week,

Dr. Gabrielle Lyon 59:43

for one week? Okay, is there anything topically that can then help the laxity of the skin, retinoids, vitamin C, anything that we. Should think about red light therapy. You did some kind of red light thing on me, which I think it was awesome. Any of this work to extend the quality of the tissue? Yes.

Kristy Hamilton 1:00:12

So, retin a tretinoin, we think about our face all the time. You can put, you can put that on your entire body,

Dr. Gabrielle Lyon 1:00:21

and that will help with elasticity,

Kristy Hamilton 1:00:22

and it helps, it increases collagen in your skin, and we know this for a fact. I made people angry when I said this last time, but sunscreen, that not to not go out, did you make people angry? I did make people angry about saying the word sunscreen, and I’m not saying to not go out in the sun ever, and obviously, we need, we need sun to live, but we know that excessive sun exposure is going to break down collagen, so

Dr. Gabrielle Lyon 1:00:50

sun exposure going to, because I look at your skin, I look at my sister’s skin, you guys never go in the sun without a hat, and, and sun’s great, but

Kristy Hamilton 1:00:58

we look, but we live in Texas, so we’re still gonna.. my

Dr. Gabrielle Lyon 1:01:01

sister lives in New York, okay?

Kristy Hamilton 1:01:02

But you live in Texas, so we’re getting.. we’re getting plenty of sun from like a vitamin D level just by like living in this very, very bright, very, very hot place. So I don’t feel like I need it anymore. I’m super fair, so skin cancer is like more of a concern for me, and of course I like to keep it looking nice, but I believe very strongly in the concept of collagen banking. We were texting about this the other day, it’s like collagen is not something that we don’t just do a treatment and leave it, we don’t just do a skincare skin regimen and leave it, we are constantly working on building collagen in our skin, and so that’s why the co lasers, the micro needlings, the red light therapy, the retinae, all all of these things are like I’m constantly working on my skin, I’ve been doing these treatments since I was 27

Dr. Gabrielle Lyon 1:02:01

I mean, you look great for 27 You must finish last year. All of these are there things that help with wrinkles versus laxity versus something else.

Kristy Hamilton 1:02:12

These are, they’re going to help across the board. It’s going to help with texture, tone, pigment, wrinkles, elasticity, but it’s not going to do a structural reset of your skin,

Dr. Gabrielle Lyon 1:02:25

and there’s nothing. Is there anything that someone can do to prevent the structural changes?

Kristy Hamilton 1:02:31

You can’t, you can’t prevent aging from happening, but you can slow it down, and you can. You just have to spend a lot of time and effort building collagen in your skin,

Dr. Gabrielle Lyon 1:02:42

and when you say effort, you mean micro needling

Kristy Hamilton 1:02:46

procedures, procedures

Dr. Gabrielle Lyon 1:02:48

there. What about co

Kristy Hamilton 1:02:52

my favorite?

Dr. Gabrielle Lyon 1:02:52

Okay, yes. And those are guys I’ve done this. I think I do a co laser every couple, every six months or so. Would you say

Kristy Hamilton 1:03:00

yeah?

Dr. Gabrielle Lyon 1:03:01

I want to talk about pain, and two pieces of advice. Number one, make sure you use product after.

Kristy Hamilton 1:03:11

Do not like looking at you, looking at the viewer. Do not let your skin dry out after co ladies. Don’t, that is not a fun experience. I

Dr. Gabrielle Lyon 1:03:21

was crying in a corner in the shower because I didn’t listen to the directions. I kid you not, I was legitimately crying in the corner. Doctors

Kristy Hamilton 1:03:30

are the worst. Oh my gosh, just

Dr. Gabrielle Lyon 1:03:33

do the just get the appropriate skincare afterwards, keep it moist. You did give me something called Geronex.

Kristy Hamilton 1:03:41

Gernavix,

Dr. Gabrielle Lyon 1:03:42

wait. Okay, so say it,

Kristy Hamilton 1:03:43

Gernavics.

Dr. Gabrielle Lyon 1:03:44

Okay, edit that part. Pain. People will say, is it gonna hurt? What do I have to expect for pain? And you gave me a medication, the I think I took it the night before, and maybe the morning of, and it completely blunted anything.

Kristy Hamilton 1:04:02

I am very passionate about this drug. Okay, I think the

Dr. Gabrielle Lyon 1:04:06

drug

Kristy Hamilton 1:04:07

is it’s it’s called your Navix.

Dr. Gabrielle Lyon 1:04:09

Drenabics,

Kristy Hamilton 1:04:09

it is the first new class of medic pain medication in decades, really.

Dr. Gabrielle Lyon 1:04:16

It’s a whole new class, a

Kristy Hamilton 1:04:17

whole new class. So what we’ve mainly had is another kind of narcotic or another kind of NSAID, we haven’t had something new. This is a drug that works on the sodium channel receptors, specifically in the peripheral nervous system. So, it has, it does not change anything in your brain, so you’re not, there’s no euphoria, there’s no like there’s no change in your level of consciousness while you’re on it. It doesn’t, it’s not addictive, it’s not addictive. So I have been loving this drug specifically for in office procedures, but also any of the more on. Comfortable surgical procedures like tummy tucks, we put, we put patients on this afterwards. It is incredible, and I will say, I took it myself a couple months ago, after I had the baby, and did my most recent co laser, and I was like, this is such a pleasant experience. I was like, had a pleasant, I had a pleasant experience, which is co laser hurts. Okay, yes, it does. It works extremely well. It’s the gold standard for skin rejuvenation, but it is not for the, you know, like the occasional or faint of heart or the occasional dabbler, which you are literally burning your skin. But it has made it so that we can do stronger treatments for patients who have done it before, or just to have patients be able to do it at all, so the only other option we had before that was to give people general anesthesia for a laser, which feels a little excessive, or just to give them a bunch of narcotics to kind of zonk people out during the treatment, so it’s great. We really like to avoid narcotics if we can, because there’s so many issues with that. So, it’s a fantastic drug. It’s indicated for acute pain, so whether that’s surgical CFD

Dr. Gabrielle Lyon 1:06:08

indication.

Kristy Hamilton 1:06:09

Yeah, is

Dr. Gabrielle Lyon 1:06:10

there anyone that shouldn’t take

Kristy Hamilton 1:06:12

it? It’s a CYP inhibitor and also an agonist, so if you are taking a bunch of medications and stuff to make sure that it doesn’t interact with that, but it’s very safe.

Dr. Gabrielle Lyon 1:06:26

That is interesting. So, FDA is genomics, FDA approved for acute pain. How long is the time of onset?

Kristy Hamilton 1:06:37

So, just, just a couple hours, technically two hours, but I usually have patients start it the night before they’re preloaded.

Dr. Gabrielle Lyon 1:06:44

Could someone who is coming in for a basic procedure in office procedure take it? Would there be any downside? Is what I’m asking.

Kristy Hamilton 1:06:54

No,

Dr. Gabrielle Lyon 1:06:56

could potentially make things much more comfortable in general.

Kristy Hamilton 1:06:58

Yes, and then you get a better result. So, a lot of these, you know, you have to consider the level of treatment that you’re getting when some, when you hear about someone saying, like, that didn’t work, it’s like, well, was the patient able to tolerate the procedure? If you never got the level of energy to what you wanted, then they’re not going to get the result that they’re expecting. So you have to get patients comfortable enough so that you can do the type of treatment that you want to have,

Dr. Gabrielle Lyon 1:07:22

which I want to run through a few things before we close out the things that I want to touch on, or who it’s not for, and this is just all of it. The Miami thonglift, who is that not for? It is

Kristy Hamilton 1:07:37

not for someone that has so much excessive buttock skin that they need a traditional body lift, so it’s for someone who specifically has laxity in the lower inner quadrant.

Dr. Gabrielle Lyon 1:07:56

It’s a very specific population for a very specific need, is that fair to say?

Kristy Hamilton 1:08:03

Yeah, it’s for it’s for a specific phthalotic shape, but it’s one that we see increasingly now. We

Dr. Gabrielle Lyon 1:08:08

are, I would like to see a picture of this. We’re going to put some visuals up.

Kristy Hamilton 1:08:12

Okay,

Dr. Gabrielle Lyon 1:08:12

if you guys are listening to this, we are going to put visuals of the Miami thong lift, because number one, I would like to know what that looks like, and number two, you invented the procedure, which very cool, the ideal candidate is for someone who wants a very specific look, who is it not right for anybody in particular?

Kristy Hamilton 1:08:36

I think it’s as long as you are a candidate and like, need a butt uplift. I think everybody can be a candidate for it. You obviously have to be good surgical candidate in general and be healthy.

Dr. Gabrielle Lyon 1:08:49

What about the zombie BBL, zombie breast augmentation? Again, this is aloc clay,

Kristy Hamilton 1:08:58

aloclay,

Dr. Gabrielle Lyon 1:08:58

aloclay, which is donor donor fast

Kristy Hamilton 1:09:03

process donor fat

Dr. Gabrielle Lyon 1:09:05

social media, you might see it as the zombie, which is a terrible name.

Kristy Hamilton 1:09:09

Yes,

Dr. Gabrielle Lyon 1:09:13

are there any safety concerns with that?

Kristy Hamilton 1:09:16

So I think the main question I get asked is, are there long-term studies, and no, because it’s a relatively new product, so that’s something that the company knows, and they are working to get studies like in breast, specifically things like that, because right now we are placing it in the subcutaneous tissue of the breast, because that is what the on, that’s what the on-label indication for is, like, any, you can place aloc anywhere there is fat, so there’s fat of the subcutaneous tissues, but we’re not necessarily placing it in the gland of the breast. Esthetics

Dr. Gabrielle Lyon 1:09:48

is unusual in the way that medications and other agents can be used off label, but it seems in the world of esthetics that it has to have the. And you have to use it for what

Kristy Hamilton 1:10:02

is esthetics, is the wild west, always the wild west, the wild west, people do crazy things all the time.

Dr. Gabrielle Lyon 1:10:08

Okay,

Kristy Hamilton 1:10:09

so like maybe

Dr. Gabrielle Lyon 1:10:12

cut that part out. I thought that that’s why it was, oh, so it was just the delivery,

Kristy Hamilton 1:10:17

yeah,

Dr. Gabrielle Lyon 1:10:17

of mechanism. Okay, we’re almost done doing great, so you guys can cut that part out. Be in the world of esthetics, someone can use drugs, and can they use drugs off label? Obviously, there’s certain off-label medications.

Kristy Hamilton 1:10:38

Wait, I think we have that. We have that flexibility as physicians too, so there has to be an on-label indication for it somewhere, but then we can choose to use it off label, and we can choose to use our physician medical judgment for that

Dr. Gabrielle Lyon 1:10:54

in the world of esthetics. What I have seen is that there seems to be a different look. I was in New York, and Lancome, by the way, that’s how you pronounce it, Lancome, if you’re, if you’re in the US, or you sound like you’re from New York, like me, but Lancome, but if you’re front, very refined, and I was at the event where they, you know, I’m on their advisory board, and they have a new MD Absolute MD, which is a longevity product for skin, but what struck me was that the event, the younger girls, it’s a totally different look than I don’t know, I think last year, or even kind of when we were younger, it’s almost the no makeup makeup look, the esthetic is glass skin, it just is different, and I’m curious as to what you think is going to be the next iteration next year,

Kristy Hamilton 1:11:58

I to me it’s like this French girl skin, or like this clean girl skin. I think that’s that’s the key. For a long time, it’s been putting on a ton of makeup, covering up the skin. Obviously, I’ve got makeup on today because we’re filming, but I like to rely on the low maintenance look, which is, if you not low maintenance, though, really, really, it’s very high maintenance to get the low maintenance, the

Dr. Gabrielle Lyon 1:12:23

undetectable error.

Kristy Hamilton 1:12:25

So, I am, I’m doing massive co lasers, so that my skin looks great without makeup, so that on a daily basis I don’t have to do a lot of camouflage. It’s about having healthy skin, so I think that is the look, you know, you just want to keep people looking normal and human, and just the prettiest version of themselves, this like elegant version of themselves, but we want to, you know, respect anatomy, maintain proportion, just keep people looking normal. I think esthetics, like, really veered off course for a while, where everything was just like, you know, big lips, big breasts, big butt, and it’s like, no, what are the lips that look right on you?

Dr. Gabrielle Lyon 1:13:08

The do you think that we’re getting back to the more natural era?

Kristy Hamilton 1:13:14

I do. I do definitely in my office.

Dr. Gabrielle Lyon 1:13:19

Yes, and I think we’re seeing that it’s people perhaps are not overdoing injections. Again, I don’t know, but at least that’s what I saw was surprising and beautiful. There was a lot less makeup, and you know, I say that I have a ton of makeup on, because again, when filming, I’d love to get to the place where a makeup bliss look looks great on on camera, if you’re interested in that, you can see stories, not so pretty, but whatever. What you know, you had mentioned the Kardashian body, and that ideal is shifting. You call the new version Kardashian 2.0 is a more toned athletic look. What is it that your patients are asking for now that they didn’t say perhaps three years?

Kristy Hamilton 1:14:08

So I think I mean it’s just how your popularity has skyrocketed. Like, I think people want to be healthy and fit. I mean, when you see style icons, right, they usually last about a decade. The Kardashians have been relevant for much longer than that, and I think it’s because, like, they are savvy enough to evolve with the time. So, look at them now, like they’re very, very fit. They’re training, you are, they’re all, you know, on their show, they’re always in the gym. People want this toned, athletic look now. It’s the best version of them.

Dr. Gabrielle Lyon 1:14:43

What I love about it is it’s a version that, while we’re talking about plastic surgery, there’s a component that sets you up for great results that you cannot buy, can’t pay for it, you can’t, I. Um, inject it. You actually have to be disciplined, less distractible, and put in the work to have toned muscles to do all the things that I think create better outcomes for patients. Do you find that the fitness-oriented patients, do they struggle with one thing in particular? From

Kristy Hamilton 1:15:24

skin, it’s skin, it’s always the skin. They, I will tell you, they are phenomenal patients. They cruise through recovery because they’re so healthy, they’re so fit, they’re on your, you know, your, they’re on your diet, so they’re all eating tons of protein. They, they heal very, very well. We tend to see very few wound healing issues in that group of patients, which is great for me and also great for them, but it’s skin, because, like, the leaner you are, the less fluff that you have, the more you’re going to see that laxity. Would you agree with the statement that people are paying more attention to it now because of the use of GLP ones? Yes, because it, because it’s – we’ve, I, we talk about this in our plastic surgery conferences, like plastic surgeons, we’re going to be busy for the next few decades, just trimming skin away, you know? People have lost so much weight so quickly, and that’s part of it too, they lose weight so quickly on the GLP ones that everything kind of just collapses, and it doesn’t matter how much you exercise and how much muscle you build, there is no way to exercise loose skin away, and in fact, the more you exercise, the longer you get, the worse it becomes, and so that can be very, very frustrating to patients, and so I think a lot more patients are pursuing surgery now because they’re really excited about their bodies, like they’re excited that they’re stronger, they’re excited that they, you know, they’re seeing these changes in their lives, like now that they have this healthy body that can carry them through their day, and then when they, they want to, they want to see that as well, and so then if we can trim away the extras that they can actually see their core again, the muscle is there, but now they get to enjoy it, and that is it’s fun for me as the plastic surgeon to be, you know, like the last step on this journey, because they’ve already put in a ton of work to get there.

Dr. Gabrielle Lyon 1:17:20

Speaking of journeys, you just opened a brand new surgery clinic, which is so beautiful. Why?

Kristy Hamilton 1:17:32

So you may relate to this, like I want to have complete control over the entire patient experience from start to finish, like there’s a certain way I like to do things. I want to curate that entire patient experience and the results, so I feel like I have to have control over the entire process. So that was the main motivator.

Dr. Gabrielle Lyon 1:17:55

You are a phenomenal surgeon. You are a phenomenal friend. You are what I would consider the resident lion plastic surgeon, which is why I love having you on. If you are listening to this, or you’re watching this, and you are considering undergoing some type of procedure, there is not one person that I recommend more than Christie Hamilton, you are extraordinary. You are an absolute superstar, and not just in speaking about things, but also your dedication to your craft and your trustworthiness as a physician. I couldn’t be broader of you. So, thank you so much for coming on the show.

Kristy Hamilton 1:18:39

Thank you so much for having me.

Dr. Gabrielle Lyon 1:18:40

Where is your new surgery center? Your new office,

Kristy Hamilton 1:18:45

so is that 2311 Bissonnette? 20 down the street, 2311

Dr. Gabrielle Lyon 1:18:49

Bissonnette, just down the street from our studio. We’re gonna put the address, all the links to find you. It’s beautiful, and I hope you guys have a really good coffee machine, you were working on that, and just thank you so much for coming on.

Kristy Hamilton 1:19:11

Thank you for having me.

Dr. Gabrielle Lyon 1:19:14

Okay, you ready? Do you feel good? No.