Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person, because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor.

(00:33):
Today, my guest on Meet the Doctor is Dr. Doug Taranow, and he's a plastic surgeon in New York City. Welcome to the podcast, Dr. Taranow.

Dr. Taranow (00:41):
Oh, thank you for having me.

Eva Sheie (00:42):
Okay, so to pick it back up from the general surgery part not everybody does general surgery correct training before plastic surgery training anymore, but you did. So can you speak to the kinds of things you learned in general surgery training and how those helped you when you got to plastic surgery training?

Dr. Taranow (01:00):
All right, so first I'll say the latest now that I've heard is that they've gone away from the five years of general surgery and now they've limited it to three years of general surgery and three years years of plastics, which is actually, it's actually very good. It's, it's bad that you don't get those last two years where you refine your, your general surgery training, but you do get another whole full year of plastics training, which is, you know, fantastic. So I think it's a good trade off. I think it's still a six year program, post medical school.

Eva Sheie (01:30):
Was the thinking behind that change maybe that you were doing things in general surgery that you were maybe not going to end up doing later and so?

Dr. Taranow (01:38):
Absolutely. Yeah, absolutely. The difference, also, you have to remember, I, I train, I'm a dinosaur. I trained back in the eighties and so in the 80s we worked you know, 80 hour weeks, 90 hour weeks all the time. There was no 12 hour or 24 hour maximums. And a lot of times we did everything on our own. There, there was no attending available. Now that would never happen. They wouldn't allow you to go to the operating room without an attending with you. So you learned a lot more back then. Now it's much easier. They have pocket computers, cell phones, things that we didn't have to look up everything when we had anything that came in, we had nothing to compare it to other than books. And we all walked around with multiple pockets in our, in our lab coats, and we stuffed them with these miniaturized booklets that would have like CliffsNotes.

(02:26):
Oh. And so if somebody had a high calcium level, you can't remember what caused hypercalcemia or elevated calcium, you'd have to open up this book and do it. Now you can just look at the, at the little, you know, your cell phone or even now the computers, everything, anything that comes up abnormal comes up into different color. We had to have, everything was carbon copy or you had to hand write everything and then put tape in the charts. So there was a lot of wasted time there, but there was also a lot of learning being alone.

Eva Sheie (02:56):
You went uphill in the snow both ways to the hospital?

Dr. Taranow (02:58):
Absolutely. In the middle of the summer through four feet of snow. <laugh>, absolutely <laugh>.

Eva Sheie (03:03):
So where was this that you trained?

Dr. Taranow (03:05):
90% of my training was in New York and mostly in the city. I trained at Peninsula General. And then there was internship and general surgery that was in Far Rockaway, Queens. Unfortunately, that has closed about probably about 10 years ago, somewhere around there. It was another larger hospital that was much more successful. And while I trained there, I went through probably 12 or 15 other hospitals during general surgeon, including Memorial Sloan Kettering, Methodist, Interfaith, Baptist, Woodhull, can't even remember the other ones that I did, just for the general surgery. They would send us out for other rotations, which was great, where you would do rotations with specialists that were known for it. And later after I finished my general surgery, I went right into plastics. So my plastics was originally based through a guy in Philadelphia, Dr. Sherman Leis, a great, great guy who's just retiring now in his eighties. And he let me stay in New York. I did Memorial Sloan Kettering. I was at St. Luke's Roosevelt, and I did a full year at Valhalla at Westchester County Medical Center in their plastics and burn unit.

Eva Sheie (04:14):
Is it really called Valhalla?

Dr. Taranow (04:16):
Well, Valhalla is the name of the town, Valhalla, New York. So unlike the Vikings where we'll all go to Valhalla, as long as you die in combat this is Valhalla, New York. It's called Westchester County Medical Center, WCMC. So I did burns and plastics there, and they did a, they had five physicians in one group. So there was a lot of quality cases and, and varied because each one had their specialty, but there was also a lot of burns.

Eva Sheie (04:43):
I expect that you probably met a lot of people going off to all these different places at that time too. Is that

Dr. Taranow (04:50):
Absolutely. You also learned how to do everything right because God forbid the last guy you trained with knew nothing. Obviously the new guy told you only his technique is the right one. So you were, you were exposed to so many different techniques and then you take a little bit here and there and you come up with your own technique and whatever works well for you. There's certain suturing that there's nothing right or wrong about different techniques. If it works well and the incision looks good, then that's fine. As long as it doesn't take you an hour to close on a case that only took 35 minutes, then you're fine. But there's always, you know, I hate to say two ways to skin a cat, but there's multiple ways for every procedure. And even to this day I'm working with new people and I'll see things and I'll say, wow, that's a, that's a great idea. And he, you know, or she either saw it in a lecture or on a video or something and used it and then it went on. So it's still nice now to, to work with other surgeons.

Eva Sheie (05:46):
Can you think of a recent example where you saw somebody doing something different way?

Dr. Taranow (05:50):
Absolutely. I saw probably, I'd like to say about three or four years ago, I had had a friend ask to help him on a breast case. We were doing implants and a lift and during the lift he instead of, you know, using the template that we were all taught originally, he hand drew out his markings and then he used a stapler to approximate the whole breast until he had the shape that he liked. And once he had the shape, all stapled sitting up even he drew the circle where the nipple knee rail should be and where everything else was. And then when he took out the staples, he just put A to A, B to B, C to C, D to D. And actually he didn't do that. He just put everything back together. Later I put A, A, B, B, C, C, D, D.

(06:34):
And when I opened it and found that the A was in the top right and the other a was about an inch and a half lower, it was still correct if you put those together. because when it was stapled, even though the breast fell to the armpit area, when you removed the staples, it was correct. And if you did that, the breast would look great. So that was a technique that I put into my own. I tweaked his a little bit to make it fit mine and the case I just did today, I did that. I just find that it, it goes so much better freehanding it, stapling it, once you get it looking perfect or as good as you can now. because remember they're sisters are not twins, but you get it as close to twins of the same family rather than her sister's the same family rather than distant relatives <laugh>. So once you staple it and you have it there, you have a great template and then you just take everything out, mark it and, and go.

Eva Sheie (07:24):
Maybe a silly question, but then do the staples leave holes? Do patients notice the holes from?

Dr. Taranow (07:29):
So you're absolutely right. That's why I never use staples except for temporary holding the skin. So what the staple does, a suture is very, very thin. And that's why in plastics we tend to use very, very thin sutures. A lot of times I don't have the suture go outside the skin, but rather in between the two layers, it's called a subcuticular stitch. So it doesn't leave those needle holes on either side that I call like a railroad track, where you have the metal bar and on either side you have the stakes. So it looks like there's stakes on either side of the incision when it heals. So I almost always do a subcuticular stitch, but the staples are temporary. You do it until you mark it and then when you cut it out, you make sure that you cut on the outside of where the staple hole was. So it's like it never existed.

Eva Sheie (08:14):
Oh, genius.

Dr. Taranow (08:16):
No, I'm just a little smart, you know,

Eva Sheie (08:18):
It is, it's very rare that I hear something that I've never heard before, <laugh>, and I've never heard of this. This is fascinating.

Dr. Taranow (08:27):
It's fun when you when you have the residents at the hospital and you do something like that and then they've never seen it and you're thinking, wow, you know, because a lot of times the residents will teach you things they've been around with, you know. 10 other doctors, some young, some older, and then they'll do something and I'll sit there and they're like, what's the matter? And I said, well, that's definitely one way to do it, but maybe on the other side we'll do this. Or how about trying this? And then a lot of times they're, they're like, they've never seen that particular technique and it becomes their own. So the next one in surgery, there was an old thing way before my time, I never, I never invented this, but they called it see one, do one, teach one. And what it was in surgery back in the eighties and 90s was you saw how to do a particular procedure, an appendectomy.

(09:13):
Then you did one under supervision with the attending where you cut it and you took out the appendix, closed it, stitched it all up. And the next one you were teaching the next resident how to do it. So see one, do one, teach one. And that's still to this day is is very true, is, you know, you see a new technique and you know, sometimes it's nice even on the videos that they have now and anywhere else you could see it as, you can get ideas on how to do it and then make it your own.

Eva Sheie (09:40):
Did you also grow up here in New York?

Dr. Taranow (09:42):
I actually did. I grew up everyone calls it upstate because it's in Rockland County, which is probably about driving wise. It's probably about, starts about 18 miles from the city. So it's if you go up to the top of Manhattan and go across the GW Bridge, George Washington Bridge, you're in New Jersey. And if you turn north, the first county that you enter back in New York, because Jersey is odd shaped, is Rockland County. So I grew up in Rockland County and then later I left and then came back to do my residency. And part of the residency at Westchester was at Valhalla. So I lived in White Plains for many years. In fact, when I finished residency, I moved there.

Eva Sheie (10:25):
I was born in Orange County.

Dr. Taranow (10:26):
Oh. In New York. I drive through it, I drive through it every time I take the Harley out across the GW pardon me, the Bear Mountain Bridge, all the way to the other side.

Eva Sheie (10:34):
It's funny you're saying that because it, I hear about whenever I say it, usually motorcycle is the next thing that somebody says.

Dr. Taranow (10:40):
Oh yeah. It's a beautiful area to ride through. Yeah. Orange County, Duchess County, depending on which side of the water you're on. Mm-hmm. <affirmative> Hudson River.

Eva Sheie (10:48):
I did not get the privilege or benefit of growing up here though. <laugh>, we went to Minnesota when I was little. Oh, cold. Yeah, very cold. And then I got out as fast as I could. How early in your life, you know, did the idea of becoming a doctor occur to you? Like when did that happen?

Dr. Taranow (11:07):
It's, it's funny you never, it's hard to decide when you had an aha moment. So I entered college as a pre-med. So I'm not sure when I decided to do it. I love science and the way to go through science was go pre-med and that did all the sciences. The side thing was, is you got a BS in science, but you also had a second degree in, in chemistry because you had to do regular chem, organic chem, physics, everything. Which was, which was tough. But in order to do the sciences, you had to, you had to enter at least my college as a pre-med. And then you could take it any way that you wanted. So it was went pre-med, applied, got accepted, and then went straight through. I didn't have a plan. If I didn't get accepted, I was not thinking that far ahead.

Eva Sheie (11:51):
Where was that

Dr. Taranow (11:52):
University of Jacksonville in Florida. I went there and I played soccer. So in the Sun Belt Conference,

Eva Sheie (11:57):
Did you have a soccer scholarship?

Dr. Taranow (11:59):
No. My roommate did. He was a captain of the team. I went there. They only had, they only had I think five positions that were paid. And I wasn't that good. I was also in college. I was probably about 5'2, 5'3. I kept on growing all the way up until I was almost 21. So I was very short when I entered. And there was no way I was going to get any type of scholarship at that height.

Eva Sheie (12:22):
But you were fast.

Dr. Taranow (12:24):
I was fast, right. I was, I was played either a striker, which is a two man line or right wing if we did a four man front.

Eva Sheie (12:32):
And so was Jacksonville the only time that you ever left New York?

Dr. Taranow (12:36):
That was the only time I lived outside the city. Yeah. And then when I went to med school they allowed us to do externship it's called where you go out prior to getting your internship, you're able in your third and fourth year to do different rotations to try and see what you want to do. And also the main thing is once you decide what you want to do, you have to get good letters of recommendation and preferably be working where you'd like to have your residency so they know you. And when you interview, you have a much better chance of getting in. So I went all over. I went to South Florida. I was in Ohio, I was in New Jersey, Pennsylvania. So I went everywhere I was single. Had a piece of crap like 1988 Toyota Corolla. So wherever that would go and whenever it'd break down, I'd fix it.

Eva Sheie (13:26):
What color was it?

Dr. Taranow (13:27):
It was multiple colors. I'd bought it used and yeah, it was the bad. I was on medical school loans. So the, the hood had been repainted and whatever paint they put on it, it chipped off. So it, it was like a matte black underneath and not a sexy matte black. The car was dark brown and the front quarter panel, the driver's side was yellow. So it had been in an accident and replaced and never painted <laugh>. But it was fine because in New York they supposedly never stole those cars. So I had, the battery was actually stolen next to the museum in natural history, right next to it, parked in front. And so the cops came and I I got in trouble. I asked him where I could buy my battery back figuring they know where the chop shops are, where they sell them. They didn't,

Eva Sheie (14:10):
They didn't think that joke was funny.

Dr. Taranow (14:12):
The one cop was cool about it and realized I was a student, didn't have money and I wanted to just buy a used battery. And the other one thought I was accusing him of, you know, being in on the heist and making money. So the one guy told me where to go and we went there and sure enough they had eight or 10 batteries on the floor, used ones. And funny thing, they weren't selling anything when I walked by the the brownie years ago, they were brownies. They used to give out tickets in New York. Now they were traffic guys and they were dressed the same color because they were getting beaten up all the time. Now that they look like police, nobody will ever beat them up. So before they were brownies, now they're the same. And there was one outside just starting to ticket cars.

(14:50):
I into the shop and said, Hey, they're outside ticketing, you better move your car. And about four or five guys ran out to go sit in their car until they went by. And I don't know, the owner or whatever manager, he walked up, he goes, what are you doing here? And I said, "ah, someone stole my battery. I gotta get a new one for a piece of crap Toyota Corolla." So he looked on the floor and he ran a tester and he hooked up a battery charger. He goes, "in 20 minutes when it's done charging, you could take it." And that was it. I got a nice, a free battery. So when I got back, I did that. Went to, they didn't have Home Depot, they had an Ace hardware and I got a metal chain and I ran it through the front of the, I put a loop in the front of the hood and I ran a chain through it around the frame of the car.

(15:31):
So if they tried to take it again, it wouldn't open without a key and a key in the lock. Because I went back, I went back about a week later and the hood was popped, but they didn't get the battery out because the chain held it. What I found out is that they take the batteries and then when they see the car again, they know it has a brand new battery. They come back to steal the new one. So they didn't want the old one. They were stealing all the, the cars that were there, the old batteries. And then they knew when you came back you had a brand new battery to pop it again. The guy in the chop shop told me that, he said, "they're going to come back to take it again." I said, "what do you mean?" He goes, "they know which one they stole when you're driving the car and they know it has a brand batter."

Eva Sheie (16:10):
Because it was the car with the yellow door and the brown, right. And the black hood.

Dr. Taranow (16:12):
They'll remember that one.

Eva Sheie (16:13):
Yeah. Very memorable. So it was a 1988 Corolla. But what year was it when this was happening?

Dr. Taranow (16:19):
That happened in so now, pardon me. It was a 1978 Corolla, a 78 and they stole the battery in 1986.

Eva Sheie (16:28):
Okay. That was a pretty bad shape for only being eight years old. Those Corollas were..

Dr. Taranow (16:33):
It was, it had like 88,000 miles or 90,000 miles. And it was just, whoever had it was not a good driver. In fact, I'll tell you another funny story. I needed new tires. So I was going around, I had the oil change done at an Exxon place in Long Island near med school. And the guy said, "do you need new tires on it?" And I said, "I do, but I don't want to spend the money." And he had Pirellis, which were extremely expensive. And he goes, "listen, about a year and a half, two years ago, this guy paid like 60%, 70%. I bought the Pirellis. He never picked them up." He goes, "they fit your car. It was a small car, small tire." He goes, "I've been up in my attic here the whole time." He goes, "I'll give 'em to you for 35 bucks a tire mounted, cash." I was like, "done." So I went to the ATM, took out cash, I got four new Pirelli tires on a car worth less than the tires. And as soon as he put 'em on, I put it on the street, went up to the curb, and I rode 10 feet back and forth, ripping up the side of the walls of the tires. So that way no one would ever take them. because they were all torn up. because now it wasn't a Pirelli anymore, it was a crappy side, side wall.

Eva Sheie (17:43):
Brilliant. Hey, I'm getting a a theme here. You're an innovative problem solver and you learn from everything that happens to you. I think it's probably the more perceptive.

Dr. Taranow (17:57):
Well now I also, with the police training, you're always thinking two steps ahead of what might happen.

Eva Sheie (18:04):
So you told me this before we started, because I asked you if you drove here to the studio in, in midtown or where? In Chelsea. And you said you didn't drive the Vespa, you drove a car?

Dr. Taranow (18:16):
Right, because it would just be, it was supposed to rain. It had a, oh, it was this morning. It had a 38% chance of rain. And I'm in a suit, which I rarely wear, and nothing is worse than getting stuck on the Vespa scooter in New York City in the rain. It was just, just horrible. So I figured I'd take the car and just park it a few blocks away. I actually parked it four blocks away because the traffic was at a Stan Sill. Mm-hmm. <affirmative>. So I just, you just got rid of it. I just parked it and put the badge in the front and Okay. Came over here.

Eva Sheie (18:46):
That's where I was going. The badge. You're a police officer and a surgeon.

Dr. Taranow (18:51):
Yeah, a deputy sheriff for Westchester County Deputy.

Eva Sheie (18:53):
How did this happen?

Dr. Taranow (18:56):
So 26 years ago, I love to build things. I love to do framing houses, do electrical, plumbing. When we bought a house when I was married, I was always fixing something on it. The water heater, the air conditioner, garage doors, anything that needed to be done, I'd do anything but asphalt or roofing. Roofing I'll do if there's a leak. But I never liked being up on the roof, especially near the edge is just too many people came to the ER that way. So anything else I'd do? So I had never being a Jewish upbringing, we never played ice hockey, we never shot guns. It was just not one of the things we do. So I said, you know, I don't know anything about a gun. So I went to the police station and put in an application for getting a, a carry. This was 27 years ago.

(19:41):
And the guy started talking to me. He says, "you know, we really need somebody to help teach us, you know basic life support, chemical exposures." Remember I did a year in the burn unit with chemical radioactive all burns and everything. He says, "we could really use somebody to give us lectures and everything." And he goes, "if you become an auxiliary, which is a civilian, except when you're on duty, you're in a full outfit with a gun and everything you know, we'll, we have a training place here. We'll actually take you downstairs. We have a range electronic range where you'll shoot and do everything." And at first it wasn't a big deal. I went there, interviewed site sight testing, everything, pass they hired me and then, or, or I volunteered, I should say. And then over the years they required more and more training the academy, you know, 60 to 80 hours and then hand to hand, soft hand voice control, baton OC spray, which is mace people think of.

(20:34):
And and finally the gun and handcuff and everything. So I'd done all the training. So I, I was with him for 20 years and then I decided I would retire. And right before I retired, I was working one day and one of the sheriffs came up and said that they were getting rid of all of the older and upper echelon people. And they were looking for new people that were willing to work. And I had experience. So they asked me to apply. So I applied, did the whole thing again. They took 66 applications. They interviewed 66, they took 14 and graduated 12. So my thought was I wouldn't make it. I was older and why would they want me? And so I felt if I'd make it, then I'd do it. If not, I was fine. I was already retired. I had a retirement badge, I could carry anywhere in the US with that. And lo and behold, I went through, was hired, and that was six years ago. So now I'm actually working tomorrow for a parade from, I think it's probably eight o'clock in the morning till two.

Eva Sheie (21:35):
What parade?

Dr. Taranow (21:36):
Tomorrow's called the Juneteenth, which is usually next week. But they don't want to interfere with other ones. So they have it a week before on this Saturday in White Plains. So there'll be another Juneteenth probably in another town, maybe Mount Vernon or something else a week later. But I'll only work one of them and then go from there.

Eva Sheie (21:55):
Do you enjoy doing that?

Dr. Taranow (21:57):
It's nice. It's a community service. It's a nice thing. And, you know, once again, I had to go back. I did another 80 hours of the academy. That was really hard doing it a second time because I was grandfathered in. And then, you know, the shooting and the handcuffing and everything, it's always nice to learn new techniques and you know, hand to hand and things like that. And..

Eva Sheie (22:19):
Now when you're being a sheriff or a police officer, do they ever need you to switch and be the doctor in the moment?

Dr. Taranow (22:26):
So here's the deal, because of the liability, I'm only allowed to treat civilians with whatever we're trained with, with the sheriff's department, which is minimal. now I'm also a e d trained, so whenever we go out, most commonly I'll have the ad in my car that I take one of the sheriff's cars. so a lot of times that that'll be my extra job. I do take a trauma kit, any of us that anything happens to us, I'm allowed to treat any gunshots, any stabbing, anything I could treat before they get to the hospital. But I cannot treat civilians in the same way. Only whatever level that we're trained as sheriffs, not as a trauma surgeon.

Eva Sheie (23:06):
That raises interesting ethical questions, doesn't it?

Dr. Taranow (23:09):
I could hold pressure, I could do things like that, but I'm not allowed to go, even though I'm covered by the, you know, by local laws, good Samaritan laws. Unless you do something crazy, you're covered. that you can't be sued as long as whatever care you gave was was normal and standard, you didn't open them up on the side and try and take the bullet out on the side of the street. You could hold pressure, you can put a tampon in the gunshot wound to seal it. You could do anything else like that that's acceptable and something like that I think I'd be able to do. But anything beyond that, I'm not allowed to. Other than..

Eva Sheie (23:46):
It sounds like you've never been in a situation like that where you've had to..

Dr. Taranow (23:48):
Luckily, luckily not. most, I'd say 90 something percent of all police officers are never involved in any shooting. If you ask a lot of guys that have retired, out of four or five guys that I know that are retired, I think one or two of them have ever been in a situation where one drew his weapon, the other one actually fired. But the vast majority of us in White Plains in 20 years, not once, never even had to draw it. And six years in Westchester. Never had to draw, had some situation, but never had to go to a weapons draw.

Eva Sheie (24:22):
You got into all of this because you went to go get a permit.

Dr. Taranow (24:26):
To go find out how a gun works.

Eva Sheie (24:28):
To teach yourself about shooting. And so did you fall in love with shooting and,

Dr. Taranow (24:33):
Well, I do own multiple weapons and I do shoot at least three times a month, usually with several of the same members of the sheriffs, a group of four or five of us that seem to get together, get together often. I'm part of the competitive weapons team for the sheriffs. I'm not a huge gun advocate. I am an NRA pistol instructor and an NRA rifle instructor. So I do enjoy going out and just when somebody's having a problem, just give 'em some hints and most people do there and and they'll just come to you and ask. And I have no problem with, with helping to teach, you know that was great taking that class, although I was never an NRA instructor, a member, I didn't believe in a lot of the things that they believe in. in order to become an instructor, you had to join them. And then also you get the insurance, which is great. But I learned tremendous amount of safety things, even though I've been shooting for years. When you actually take the class and learn how to teach people, that was very interesting and beneficial.

Eva Sheie (25:32):
I think a lot of people forget or never knew in the first place that the nras roots were in safety. And it, that's what the organization was about for for it most of its lifetime.

Dr. Taranow (25:41):
That's what it was formed for. And then now it's more political. And you know, like I said you know, they're so afraid of their rights being taken away that they've gone to the other extreme, which I don't like. I think that there should be, listen, we need a driver's, you know, we need, in order to drive a car, you have to have a driver's license and you have to take classes or whatever, get a permit and do whatever. I think it's terrible that anyone could just go to a store and buy a gun without any training. That's my personal thing. And that goes against all of my friends and the sheriffs.

Eva Sheie (26:11):
Well, I think a lot of people agree with you

Dr. Taranow (26:15):
And, you know, I'm, I'm not big on all these, you know, high capacity magazines and certainly I'm against all armor piercing bullets. You know, I carry, I have a bulletproof vest. I don't want somebody to have something that would penetrate. It defies the whole idea of having something like that just in case. But,

Eva Sheie (26:33):
Well, we've gone down quite a rabbit hole here. <laugh>.

Dr. Taranow (26:35):
Mm-hmm. <affirmative>. Yes. We have, how do we get out of it?

Eva Sheie (26:39):
The pivot? Mm-hmm. <affirmative>. I got it. When you're not being the sheriff and you're mm-hmm. <affirmative> in your everyday private practice now, what kinds of patients are you seeing?

Dr. Taranow (26:50):
I love bodies. I love doing bodies. So I've gone away from doing the face and hand and I do all bodies. I love breast augmentation, breast lifts, breast reductions, liposuction, tummy tucks, BBLs, which is a Brazilian butt lift where you transfer fat from anywhere in the body into the butt. And I found that I was excellent at the body better than most other doctors. Whereas in the face I was very good, but there were people that were better than me and it drove me nuts with my ADD. So I slowly went to only doing bodies. I do a lot of things that no one else does. I still do transaxillary, the armpit approach for breast implants. I do calves and ankles. I have one next week where a patient just came in and she went on five interviews and only one other guy would do her calves and not her ankles. And she felt that he was a little leery in doing it. I was like, oh yeah, no problem. We have to do this and this. You have to to lipo lip lipo them. Liposuction. Yeah, it's a very difficult area and there's a lot of anatomical structures there that you care not to touch. But like I said, if you do everything slowly and smaller cannulas, you know, you try and keep yourself out of trouble.

Eva Sheie (28:01):
It's probably a good thing that they all said no. They probably weren't saying no because of her, but because of themselves.

Dr. Taranow (28:07):
Yeah. I mean, I do patients with huge BMIs just because in the beginning we had no limits. So I think the largest liposuction I did was 10 and a half liters. And that was in two hours, just over two hours. So very quickly in somebody that was really big,

Eva Sheie (28:22):
Like a BMI of 40 or higher,

Dr. Taranow (28:24):
No, probably in that person was probably like a BMI of about 48. I mean, very high. And back in the day, that's what we did. We do a couple of them a day and luckily, knock on what, we never had a problem. Never had a hospitalization or anything. So I'd like to say we're probably more lucky than good. And so now the limit, at least in New York, is five liters, which I think is, is also very good. That's a very large amount to take out of one person in one sitting. It's more the fluid shifts and not even so much the bleeding where you went into problems that and also the length of surgery. So I also feel that sometimes even if you only take out three and a half liters, but you did a full body lipo, that's more dangerous than doing an abdominal liposuction, taking out five liters in two hours. But that's you know, the more surface area opened and the longer the procedure, the more potential for complications.

Eva Sheie (29:17):
In some places I've seen this marketed as like plus size tummy tuck or plus size liposuction. Is that what you guys call it here?

Dr. Taranow (29:25):
I don't, I just leave it as just standard things. The only, the only thing that I've ever changed the the saying on with somebody that comes in who wants just a, a minor little increase in their hips or the buttock and that we call the skinny BBL, the, that's like four pounds overweight at most and just wants some of the fat from her hips or her belly transferred into her hip dips or her butt. That's like a skinny bbl L and somebody else came up with that Yeah. Designation. I just thought it was a great one. So I stole it and use it without..

Eva Sheie (29:56):
As a former SEO professional, I can tell you that that's what they search for too. Yes. So the only way they can find you for it is if those words are on your website. Mm-hmm. <affirmative>. Yeah. So is there anything happening in the field of body cosmetic surgery that you're particularly excited about right now?

Dr. Taranow (30:16):
There's a few things we've been, we've been using a non-invasive unit called the Morpheus, which uses microneedling and radiofrequency at the same time. It's really worked well for some skin tightening. I wouldn't say that if somebody needs a tummy tuck, they need a tummy tuck. But if somebody doesn't want a tummy tuck or they have couple of kids or they lost weight and they have a little bit of extra skin around the belly button or the arms, it actually will tighten it. So that's something that's great. Non-invasive. One of the only machines that I have, I think a lot of different liposuction techniques that are out there. Listen in the right hands, A good liposuction person doing this standard tomasin technique will get great results. I went back to it. I've done, you know, water jets, I've done ultrasound, I went back to the standard technique.

(31:02):
I was a little afraid when I first heard about the J Plasma and the issues that they had. Now they've got clearance for it. But I've seen very good results and very bad results with it. So the question is, is it surgeon independent or is it technology independent? It's hard to say. The only difference that I have had and I steer away from, is people that come in for BBLs and they're consulting and they're going to people who use ultrasound or laser. The last thing that you want to do is break up the fat cells before transferring 'em. You want them to be taken out in the least dramatic way least amount of handling to keep them alive. So anything that would cause heat or breakdown of anything I disagree with. So these people using the laser and the ultrasound to bring it out. I know when I use those technologies, I got a lot of oil, a lot of thing when I brought it out. So I tell the patients..

Eva Sheie (31:55):
Isn't that the purpose of those devices?

Dr. Taranow (31:57):
Exactly. To, to break it down before sucking it out. So I don't know how that they're doing BBLs with that same technology. It's counterproductive. And the same thing with the J Plasma. I don't know how the cells are that come out with the J Plasma, but I don't know enough about it, about how the cells come out with that particular technology. But the use of that with fat transfers, I tell 'em, if you were getting your kidney transplanted, would you want them to use a hot knife or a laser to cut the edges? Would you want them to use a cold, very sharp knife, cold steel to cut it the least amount of trauma to the artery, vein and ureter? That's just one of the things I tell the patients and when they're shopping, I tell 'em, here's what you want to find out, what technique and, and why they use it and why. And just, you know, would I want more trauma on the cells or the least amount.

Eva Sheie (32:44):
When people come to see you for the first time, what should they expect from that?

Dr. Taranow (32:48):
The console's going to run at least 30 minutes. We're going to be talking about your kids, hopefully not the husband or ex-husband because that takes another five minutes of complaints and just things in general. And then, you know, then we go into where, what is it that you want? We'll talk about that first before I examine patient. Then sometimes, sometimes I'll go more toward the exam rapidly just because we really need to see, to decide what the best way is. When somebody's had several kids or they're in their forties, you know, talking about a transaxillary breast aug or transaxillary approach may not be good for them because they have droopiness or asymmetry or something I can't fix from the armpit. I really need to have direct visualization either through the nipple or underneath the breast. So in those patients, I'll go quicker toward the exam. And on the exams I tell everyone that I'm brutally honest and I don't mean to insult you, but I may tell you you're hate to say it, but shit outta luck.

(33:40):
And I do tell a lot of people that, and not to do surgery. They're going to, they come in, they want lipo and they already have some wrinkling or folds and I'm, there's no magical, you know, liposuction cannula. And now that these guys have the silver bullet that they're going to magically make all of your skin flatten and they will have one picture of somebody in the last 10 years that it worked on, but they won't show you the other, you know, 70 that came out just ruined. And I see more bad work than good work, unfortunately. And the worst thing to tell people now is when they come in, I'm like, whoof, you know, the other worst thing is to over suction the front of the belly. If you leave about a centimeter of fat on top, you may not have all the cuts and everything that people want, but they're going to be smooth.

(34:26):
And the worst thing you could do is take too much out and leave them look like they lunar surface, like the surface of the moon. They come in and I'm telling 'em, "well, you know, maybe we could take a little fat out of these four areas that are high and maybe we should put it in the low areas." But they're, you know, it's very hard once there's fibrosis or scar tissue to get the fat into that area to stay and to get smooth surface again. And I see more and more of over suctioning than under suctioning. It used to always be under suctioning. Somebody would come to me to get that cinched waist or whatever and I would take out, you know, three months later they'd come to me after their first surgery and I would take out another 1.1 or 1.2 liters of fat from their abdominal sides and it shouldn't be there in such a short time.

(35:11):
So it wasn't aggressive enough and that was the old way. And now the new way is, I see many more times where I tell 'em not to do any more surgery or to consider an abdominal plasty or something like that to try and fix it. Or even maybe the Morpheus, but the Morpheus won't, it really won't cure a lot of those lunar landing stomachs. It may make it look a little bit better. Is it worth $3,000 to do it? Usually not. I tell 'em, you know, it's going to make it a little bit better, but it's not going to make you happy. So you have to decide, you know, how much money you want to put into this. And, you know, using these fillers I'm against using the fillers and the butt or these other areas. They're not permanent. And you know, you have to figure that when we transfer things on average, even when we're doing very small transfers, you're doing 10 cc syringes at a time into most areas.

(36:01):
The Juvederm, the Radiesse and everything are either 1 or 1.5 ccs unless you dilute it, which is still diluting it. So even if you're putting five ccs in, you took a one cc or two ccs and diluted, it's still only two ccs of material and it's going to be absorbed. I know there's some collagen growth, but not enough to, to fill it to where these people pay, you know, $8-10,000. I've had them and then come in and I said, really, I do nothing. Or use the fat and just realize it'll be better but not great. So I'm very honest with patients. That's the one thing that some of the RealSelf employees have told me, that I get people writing things that I'm brutally honest and my mom's 91 and reads the all the things I don't see, I don't look at any of my reviews.

Eva Sheie (36:47):
Your mom reads your reviews?

Dr. Taranow (36:48):
Yeah, she reads 'em lets me know. I won't read them because I'm always afraid of getting a bad one and then being very upset. So I don't read them and she lets me know and then she gets upset when they write something. Like I was brutally honest that I have to be nicer. But I figure if you're coming in and spending 5, 10, 15, $20,000, you should know the good and the bad and know what percentages of what I can tell you. I think it's going to be, because nobody knows. We all know that there's a three to 5% infection rate throughout the whole US and any procedure that's done, luckily in most offices it's lower than that. However, that's a known possibility. And you know, in anything that you do and you know, lumpiness, things like that. I've had, I've had a couple of patients with multiple kids and you know, where you take out a lot of fat and even when you leave a decent amount in the front of the belly, the skin has issues.

(37:39):
It's like the same now the biggest thing now is the Manjaro and mm-hmm. <affirmative>. Ozempic, oh Ozempic. And it's great. The patients are dropping a tremendous amount of weight, but these skin issues that they're having are going to be the, the same as either post-delivery or post major weight loss. So they're going to have to do something for them. And as a side note for that, I just learned now after several patients, anyone on that, I stop it for a month. They have some gastric reflux with it that they don't know about. And under anesthesia, they actually have some regurgitation. So on all the patients now that for safety, luckily we never had a problem. I asked 'em all to stop at one month in advance and it's not written yet. That's starting to get following now. The anesthesia society suggested two weeks, but they don't know yet. They're, it's still out there, but I think it really is three to four is safer.

Eva Sheie (38:33):
That's a good piece of advice.

Dr. Taranow (38:36):
That'll be good for your next podcast on Ozempic and Majaro, the hot topic. Yeah. Yeah. And Wegovy or whatever, which is the other one that they synthesize.

Eva Sheie (38:46):
Yeah. I think we're going to see a lot more people with massive weight loss.

Dr. Taranow (38:50):
Absolutely. And, and

Eva Sheie (38:52):
A lot less people having gastric bypass and mm-hmm. <affirmative> and, and really invasive bariatric surgery.

Dr. Taranow (38:56):
Absolutely true. It's an amazing medication. The only issue is when you stop it, your appetite, the way that it works is it really suppresses your appetite. I know a bunch of people that are on it and I've gone out to eat with a bunch of friends that are on it and they, they'll take two or three bites and then they're done. So it's great if they order something, I find out what they're ordering first knowing that I'm going to eat that whole steak. So I'll get the fish, which I really don't want, but I want a little bit of it so I can eat their steak free. But that's, oh, absolutely. I immediately say, say they're very smart and they never take it home because they're never going to eat it later. So I always get their doggy bag.

Eva Sheie (39:33):
Again with the always learning.

Dr. Taranow (39:35):
No, it's everyone for themselves. Mm-hmm. <affirmative>, I'm, I'm a bachelor. I I have no problem with taking the steak home.

Eva Sheie (39:41):
You're a bachelor. Mm-hmm. <affirmative>. But you have kids?

Dr. Taranow (39:44):
Three, yeah, I have, my oldest is 30. She's here in the city. Yeah. And my two boys, the older one was in the army, got out now he's a police officer in Florida. Mm-hmm. And the youngest is in the army right now. He's actually recovering from the a concussion he got on Wednesday. He parachuted and something happened and he dropped 20 or 30 feet. So we're waiting to see, I just got the call today. Yeah. So we're waiting to see what's up.

Eva Sheie (40:11):
I'm sorry to hear that.

Dr. Taranow (40:12):
But otherwise hopefully a couple of days we'll see how the recovery is.

Eva Sheie (40:19):
If a patient's listening today and they want to reach out, learn more about you or possibly give you a call, where should they find you online?

Dr. Taranow (40:27):
They should go to RealSelf. They should look up there. It's the best modality with the patient reviews and everything. top rated, I know I'm 500 in the nation, but supposedly I'm way below that in New York, and nationwide I know I'm, I'm always top 500, but way below. And they could always call. I I'm a little d different than most doctors. I see all my patients personally. I talk to them, I examine them during the surgery. I do all my own surgeries. I have no other residents with me, no other doctors post-op. I call all my patients personally. Every patient gets my cell number. They could call me anytime. They don't have to call the service and post-op, I take out my own stitches. I do have a full-time nurse, but she's just learning in the suturing. She's been doing it for 10 years. But I love seeing my patients take out my own stitches. I know exactly what's happening. And then every one of my post-op gets a dozen roses for the last probably 26 years out of 28. I don't think I did it the first year or two. But then we started and it's gone forever.

Eva Sheie (41:30):
That's such a nice touch.

Dr. Taranow (41:32):
It's funny, some of the patients I gave roses, several times told me that the fir last time they had roses was like 15 years ago. And I go, "wow. 15." She goes, "yeah, well my son was born." <laugh> I was like, "wow, that's a, so I said you had to have plastic surgery to get another dozen roses." I said, "or have another kid." She says, and they're like, "no, I don't think,"

Eva Sheie (41:51):
So. Does anyone ever misinterpret the roses by accident?

Dr. Taranow (41:54):
<laugh>? I would definitely say that that has happened more than once and it's not, it's not so much the maybe one or two patients or several more than that. They talk to my Beatrice who's been with me eight or nine years. So she sets 'em straight where that, we do that for everyone. But I've had a lot of jealous boyfriends and husbands.

Eva Sheie (42:12):
Is there anyone else on your team?

Dr. Taranow (42:14):
Steven, who's my tech has been with me 22 years. He is big Jamaican guy, very handsome. When the patients start getting their anesthesia, they never go, "oh, Dr. Taranow." They go, "oh Steven." So I've learned not to get jealous of that. I can't compete with a six foot four handsome Jamaican guy. And I have, Kate is my new nurse. She started only a month ago and she was with another doctor who's retiring. She was with him for over 10 years. Beatrice has been with me probably nine years and my anesthesia group is the same group. the guy who started it retired about four or five years ago and his partner stayed on. So I'd like to say I have five years, but truthfully, this guy was working with him for years before I stayed with the same company. So probably about 10 or 11 years the same or 12 years. Same anesthesia group.

Eva Sheie (43:05):
So solid team.

Dr. Taranow (43:06):
Yeah. I, you know, most people stay with me. Steven, my tech and I, he took me to Jamaica with him. He's from Jamaica. He hadn't gone back in a bit because of Covid. And when he went, he invited me and I was like, "I'll go." He didn't believe I'd do it. So I said "Buy two tickets, I'll pay you back." And then we stayed together and went out with a bunch of his friends that he went to school with and went around. We were in an all inclusive, but we went out. His friends picked us up and drove us around the island in a monsoon.

Eva Sheie (43:32):
Oh, so you got the real feel of Jamaica.

Dr. Taranow (43:34):
Oh absolutely. The guy was driving, texting with one hand and drinking white rum in the other hand.

Eva Sheie (43:40):
And driving with his knees.

Dr. Taranow (43:41):
<laugh> Yep. Driving with his knees in a rainstorm that you couldn't see more than maybe 50 feet in front. And it floods because it's one of those island storms and you have to drive. He was driving the wrong side of the road texting and drinking. Steven and I were at the back of the van putting our seatbelts on, so

Eva Sheie (43:57):
Oh, I'm glad you survived that.

Dr. Taranow (43:59):
Yeah. That was an experience. Yeah.

Eva Sheie (44:00):
You'll never forget it.

Dr. Taranow (44:01):
No, I will tell Steven the next time we go back, we're not telling Cadogan to drive us. We'll take our own car. Yeah.

Eva Sheie (44:08):
Good plan. I'm so glad to have heard so many of your stories today and I really appreciate it. Thank you for joining us.

Dr. Taranow (44:14):
Oh, thank you for having me.

Eva Sheie (44:19):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to more, are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at meetthedoctorpodcast.com. Meet the Doctor is made with love in Austin, Texas, and is a production of the Axis, t h e A x i s.io.