Show notes
Dr. Lisa Cassileth is a breast surgeon in Beverly Hills, which, according to her, means encountering “so many bad boob jobs.” But repairing someone else’s questionable handiwork happens to be one of Dr. Cassileth’s specialties, along with innovative reconstructions and other thoughtful surgical developments that prioritize positive patient outcomes and well-being. Dr. Cassileth was the first female chief of plastic surgery at Cedars-Sinai Medical Center and has started two practices of her own.
“Women aren’t really getting breast reductions as much as they used to,” Dr. Cassileth tells Jessica Cruel, host of the Perspectives podcast and editor in chief of Allure. That’s largely due to the impact of GLP-1s. “[Patients are] getting breast lifts because after the weight is lost…it’s really now a skin problem.” Breast lifts are aided by an absorbable mesh, which can hold the breast in place while scar tissue and collagen forms to support the newly tightened skin.
Dr. Cassileth discusses this and other trends and technological developments in the breast surgery space, including improved implants, fat transfers for augmentations, the use of peptides for expedited recovery, and the influence of AI. Her office uses AI-enhanced modeling to preview surgical outcomes, but Dr. Cassileth and other cosmetic and medical providers are also facing the reality that patients’ expectations are being skewed by AI-generated images. “Even though I’m a plastic surgeon,” Dr. Cassileth says, “and I have a lot of tools at my disposal, not even natural humans can achieve what AI is achieving.”
Still, a lot can be achieved. Dr. Cassileth talks through the essential steps for safe and sterile breast reconstruction or augmentation, and explains why patients seeking breast reductions are her favorite to work with. She also details the expectations she has for mastectomy surgeons in hospitals, calling out high rates of mastectomy flap necrosis, which happens when skin tissue dies due to lack of blood flow, complicating reconstructions. “You can have plastic surgeons that are fantastic, but if the mastectomy surgeon who removes the breast tissue is still making a big line, or if the overlying skin dies at the time they do the mastectomy, because the skin is thinned out too much, then,” Dr. Cassileth asks, “how does a plastic surgeon do a good job?”
Perspectives is a new series exploring the topics that shape women's lives today with honest, nuanced, and deeply personal conversations. The first season examines the cultural significance of breasts through intimate accounts and expert interviews, hosted by Allure’s editor in chief Jessica Cruel.
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