Dr. Michelle Hardaway

[00:00:00] Speaker A: Foreign. This is Rashad woods with the Tron podcast. And today I have a very special guest, a high levels plastic surgeon based out of Farmington Hills, Michigan, Dr. Michelle Hardaway. Thank you so much for your time. [00:00:30] Speaker B: Okay, you're welcome. I'm glad to be here. [00:00:32] Speaker A: I appreciate it. And I. I'm so honored that you carved out the time and schedule and your field of work, plastic surgery. I mean, your training. How did you get into medicine, if I could ask? [00:00:41] Speaker B: I just. It was something I always wanted to do. I always wanted to be a physician. And then in medical school, you rotate through different specialties and that's how you kind of decide on what specialty you want to go into. [00:00:53] Speaker A: Okay. Okay. And so you went to Wayne State University, and then you did your residency over in New York? That is correct. [00:00:59] Speaker B: Right. So I did my undergraduate at the University of Michigan. [00:01:03] Speaker A: Okay. [00:01:04] Speaker B: And then I did medical school at Wayne State University. [00:01:08] Speaker A: That is correct. I'm sorry about that. [00:01:10] Speaker B: That is correct, yeah. Then I did general surgery. Then I did a burn fellowship, and then I did plastic surgery. So back when I was training, even though plastics was 3 of general and. And 3 of general surgery and 3 of plastics, you couldn't get, you know, it was 3 and 2. You couldn't get even an interview unless you had completed general surgery. So I completed a full general surgery residency. Presently they have toned it down to three and three. So you do three, a general three of plastics you can match out of medical school before you did a residency and then you matched into a plastic surgery program. [00:01:50] Speaker A: You know, what I found so interesting was that when I was listening to some of the testimonials from some of your patients, you know, and some of the pictures that I saw and what fascinated me so most much, particularly about plastic surgery, is not just people are working cosmetic, but you reach people in different stages in life, whether they need to get breast reduction, whether they're looking, you know, cosmetically to feel better about situations, but on the other side to it, and I'm curious about when it comes to plastic surgery. There also could be burn victims, car accidents, and people that had other sepsis, separate issues. Do you see those people as well? [00:02:19] Speaker B: Well, I did in the past. So with plastic surgery, you can do cosmetic, you can do reconstructive, you can do hand surgery, you can do cranial facial surgery. [00:02:28] Speaker A: Right. [00:02:28] Speaker B: So initially I did a lot of hand surgery, facial fractures, also burn. Because I used to run the burn unit down at Detroit Receiving. [00:02:38] Speaker A: I saw that. [00:02:39] Speaker B: And so, you know, I kind of did almost a full Array, then you can kind of like, specialize in certain things. So eventually, like right now, I do primarily cosmetic. When I'm on call at some of the hospitals, usually it's some sort of, you know, laceration or sometimes hand injuries. [00:02:58] Speaker A: Okay. And so when I saw about the consultation. So what are there some patients that, for example, that, you know, what criteria do they need to meet to be able to go for cosmetic surgery? [00:03:09] Speaker B: For cosmetic surgery, there's a couple of things. The main thing is you want them to have a realistic expectation. So if a patient, for example, wants to look totally, like, different, like someone else, that may not be realistic. And then there's also some parameters for cosmetic surgery. For example, say someone wanted a tummy tuck and say they wanted to lose 60 or 70 pounds. I would tell them once they get closer to their goal, that's when they want to consider the surgery. [00:03:39] Speaker A: Okay. Okay. [00:03:41] Speaker B: And then with any cosmetic surgery, maintenance is required, meaning you want to maintain the results, especially with liposuction, which is one of the top procedures. Tummy tucks is up there in the top five. There's exercise and diet to maintain the results. [00:03:57] Speaker A: And is that typically. Do you see most women either when they. After they've had kids, in a couple, you know, at certain ages in particular. [00:04:03] Speaker B: In life, for example, a mommy makeover is something that's popular. So. And that could be a combination. It could be. Usually it involves a tummy tuck, because that's definitely changed after having kids. And usually the breasts and which changes after pregnancy. And then you can combine that with other procedures, like with liposuction. So the whole gamut is called mommy makeover. But that could be a combination of procedures. [00:04:30] Speaker A: What's the recovery time for a procedure like that? [00:04:33] Speaker B: Usually, patients are off of pain medication in about a week, but there's other things to recover. Sometimes, for example, a tummy tuck. They may be able to go back in three weeks, depending on their job. If they do a job that requires a lot of lifting, they may have to go back with restrictions. Breast surgery is different. They can go back, you know, a lot quicker. [00:04:54] Speaker A: One of the questions that I was actually curious about, you know, I saw a lot of women. Are there men that actually are coming in for your services at all? [00:05:01] Speaker B: You see more men now than you did like, 10 years ago. Now in my practice, I see most of the time the men is eyelid surgery. I usually see them to remove bags under the eyes. A medical term is called a blepharoplasty. And then the second would be liposuction. [00:05:18] Speaker A: Okay. You know, because I'll be honest with you, you know, I'm 42 and, you know, losing that male weight off the stomach is absolutely the hardest thing in the world. It really, truly is. It is very frustrating when you, you know, I'm going to eat right, I'm going to work out. And then you look in the mirror and you're like, this is still here. And it. [00:05:37] Speaker B: Yeah. See, in a man, a lot of times that fat is inside the abdomen, so you have to do it with diet and exercise. [00:05:44] Speaker A: Right. [00:05:44] Speaker B: You can't just liposuction it off. So that's what makes it a little bit harder for men. But liposuctioning of the back in men is also a common procedure to get rid of those love handles in the back. [00:05:55] Speaker A: It's tough because, you know, I had my own little self revelation, just briefly, about how far I actually, what I thought I looked like versus what I actually was doing martial arts. Somebody videotaped me doing martial arts. And here I was actually seeing the. What I saw versus how I really thought I was. And I reacted with horror. It was absolutely the most, you know, I was like, oh my gosh, this is terrible. I thought I looked so much better, you know, until the video didn't lie, you know. [00:06:21] Speaker B: Yeah, yeah. [00:06:22] Speaker A: So you also were in New York as well too, and you also have been. You were also an assistant professor at Wayne State University. Are there more up? So can you give a little brief talk about those experiences? [00:06:35] Speaker B: What I noticed the difference between New York and the Midwest. I think people had cosmetic surgery at an earlier age. For example, rhinoplasties, maybe 15 and 16. Midwest is a little more conservative. You know, that was the main difference. And of course, the prices, you know, may be higher there, I think, in Midwest and it could be all Midwestern states. I don't think people do cosmetic surgery at an, you know, early age. What you do see is maybe some of the non cosmetic, I mean, not non cosmetic, non surgical, things like Botox, you know, fillers. You see that at an earlier age. And I think the Midwest, we're a little bit slower in the trends, you know, like east coast and west coast, they're a trend. It starts there first. Finally it gets to the Midwest. [00:07:27] Speaker A: And also due to proximity of entertainment, capitals and things of that nature, whether you're right, when you have television and film out there and just. I'm not. This is just an assumption on my end. Whether it's Broadway, Hollywood, et cetera, maybe that has a little more appeal to Those specific areas. [00:07:42] Speaker B: Yeah, that's true, that's true. And I think cosmetic surgery has become more acceptable over the years. [00:07:49] Speaker A: That's one of the questions I was going to ask. Yeah, absolutely. [00:07:51] Speaker B: Yeah. So like in the past people thought you had to have like a lot of money to have cosmetic surgery when they're finance companies that just finance surgery. And so that's made it more affordable. [00:08:03] Speaker A: Absolutely. And, and yeah, I'm sorry, I apologize. I was just going to say it's come to the regular individual that I'm not looking to be a movie star, but I would like to fix some things about myself. [00:08:15] Speaker B: Exactly, exactly. So there's, there's multiple finance companies and that's why it's more common and it's actually more acceptable now. [00:08:24] Speaker A: Got it. Do you often have patients who you say, hey, I, you know, I have, you have to lose a little bit of weight, you have to stop smoking. You have to do certain things in that consultation meeting in order to have a successful procedure done. [00:08:36] Speaker B: Right. I'm glad you mentioned smoking. There's certain procedures that you definitely don't want to smoke. One is a tummy tuck and the other one is something like a facelift. And the reason is nicotine causes small, small blood vessels to get smaller and cut off blood supply. Another one is a Brazilian butt lift, which is known as a bbl where we make the butt larger by injecting fat. Yeah, the blood supply is real important. And since nicotine constricts or makes these small blood vessels smaller and a facelift or tummy tuck, you could actually have skin loss where the skin could die in some areas. And a procedure like a BBL or Brazilian butt lift fat may not survive because it can't get a blood supply, you know, because of the nicotine. [00:09:25] Speaker A: That's. [00:09:25] Speaker B: So those procedures, I would tell the patient they need to stop smoking or I probably wouldn't do the procedure. [00:09:31] Speaker A: Now, what about people? Because obviously marijuana is more prevalent now. It's, you know, socially acceptable. Does that have any hindrance to any procedures people get done? [00:09:39] Speaker B: As far as we know right now, I'd say no, unless there's some sort of nicotine mixed with it. Now, something may come out in the future, but right now I'd say no. [00:09:48] Speaker A: Understood. And you know, when you were talking about some of those procedures, you know, I think some of us have seen some of the horror stories that have taken place when people go to these non qualified individuals and locations to get procedures done, you know, and because it's more prevalent to have these Procedures done. How do you combat that? And what do you advise patients who, oh, I'll go to this location out of somebody's house, you know, because I mean, people have died from very, very bad, you know, people who are not qualified to do these procedures, you know. [00:10:15] Speaker B: That'S hard to combat because usually they find these people by word of mouth and either they know someone who has gone there or something like that. And you know, they don't realize that. I don't think they realize the possible complications. [00:10:29] Speaker A: Oh my goodness. [00:10:30] Speaker B: You know what's popular now also is medical tourism. [00:10:35] Speaker A: Yes. [00:10:35] Speaker B: More people go out of the country the problem and they go out of the country because the prices may be cheaper. [00:10:42] Speaker A: Absolutely. [00:10:43] Speaker B: Yeah. But when they come back, it's hard to find a physician that wants to care for them because you didn't do the surgery and any complication then becomes yours. So that's a problem with going, you know, out of the country. [00:10:55] Speaker A: Absolutely, absolutely. And then, you know, I'm imagining they have to have follow ups with you directly, you know, about anything that could take place. Complications. I'm sure there's an excuse. My ignorance could be swelling. Right. If they're not taking proper medication. There are things that happen after medical procedures and if somebody went 3,000 miles away, you know, there's, there's, that's got to be a very tough conversation to have for somebody. [00:11:17] Speaker B: Right. And when they come back, they often can't find a physician who will take care of them. So sometimes they end up in an emergency room. And you know, if it's something that has to be where the patient has to be admitted, then the plastic surgeon who's on call would, would take care of them. But a non emergent problem is really hard trying to find someone to take care of the patient. [00:11:40] Speaker A: Understood. Now one of the questions I have this is just, you know, me, just with my curiosity of your background. Social media has made people really quickly say, I want to look like that, I want to look like that. You know, I know magazines were in the past, but even magazines were kind of exclusive. Now people all have access to their phones. Do you find people suddenly, you know, I need to look like this singer, actress, have this look for any particular reason as it has you seen an uptick in that? Do you see social media pressure from. [00:12:08] Speaker B: From, from that people will bring pictures in and the problem is that's where realistic expectations like you really can't make them look like that person. Of course, you know, or sometimes they'll bring in a picture of someone who say, Has a really small waist, maybe wide hips, but they don't have that same sort of physique. So they have to, you know, you can work with what you have and make it close to it, but you can't make you look like that person. But yeah, social media definitely has done a lot. For sure. [00:12:41] Speaker A: For sure. And do they seem like, I guess this is my inner plastic surgery. Is there an age where like procedures can't get done unless it's medically necessary? [00:12:50] Speaker B: No. Well, if it's cosmetic, none of it's medically necessary. Reconstructive is something different. [00:12:56] Speaker A: Okay. [00:12:57] Speaker B: But for cosmetic, because people are healthier, is not really an age limit. Sometimes you can have a younger person with a lot of medical problems and they may not be a good candidate and you can have an older person with minimal problems. So it really depends on their health. Now the oldest patient that I did, for example, a tummy tuck on was like an 84 year old lady who ballroom danced. And she. [00:13:22] Speaker A: That's amazing. [00:13:23] Speaker B: Yeah, she didn't like the. [00:13:25] Speaker A: Okay. [00:13:26] Speaker B: And she, she actually did great. You know, she was healthy. So, you know, it can vary depending on the health of the patient. [00:13:34] Speaker A: You know, that's what, you know, I was just curious about that because I was like, you know, how does cosmetic surgery work at certain ages and things like that? What is, what are your most common procedures that people are having? If I could ask that. [00:13:45] Speaker B: I said liposuction and then probably breast augmentation. They're like in the top five along with tummy tucks. So those are like the top three that I see. And the other non surgical procedures, of course are botox fillers. People are getting Botox like younger and younger. It's called preventative Botox. So they don't want to get the lines. Yeah. So like for example, those forehead lines, lines around the eyes are crow's feet or the vertical lines between the eyebrows. So that's called preventative Botox. They may come in, you know, in their 20s if they start to see some lines. And that's the term for preventative Botox. [00:14:27] Speaker A: You know, it's, it's so funny because you know, like, like you're trying to stave off age. Right. And trying to stave off those little things in life. You know, I still check for gray hairs up here. Right. And I'm like, well, you know, it's inevitable. Right. I've had a couple that have popped in and I almost passed out. You know, like, it was not an easy, it was not an easy visualization so when it comes to plastic surgery and you know, and you, we talk about the candidates, we talk about the health. Are there any long term things that people have to, you know, aware of, of anything when they do their consultation, they have the procedure done. What can happen, you know, 2, 5, 10, 15 years from now? [00:15:01] Speaker B: Well, I think the main thing with cosmetic surgery, no matter what part of the body, is not going to last forever. So for example, okay, for facial surgery, people will want to know, well, how long will this last? Normal aging continues. So there's certain things you want to do, for example, use your sunblock, maybe do some facial care. [00:15:23] Speaker A: Right, right. [00:15:24] Speaker B: For procedures like liposuction and tummy tuck, people really have to maintain diet or exercise. I mean, there, there are patients where I've done second tummy tucks on because, oh my goodness, you know, they either, I don't know, somehow life got busy and they, you know, gained weight and then they came back because they wanted to look like they previously did. So there's maintenance that, that has to be done. [00:15:48] Speaker A: What about scarring? Like how, how, how does the level of scarring on somebody's body, you know, long term end up looking, you know. [00:15:56] Speaker B: Well, it's, anytime there's surgery, there's a scar. And what we try and do is minimize the scars. And then there is, there are things like silicone sheeting that you wear over scar to help try and keep it flat. If a scar turns dark, which we call hyperpigmentation, we can use bleaching creams. If a scar is close to the color of the skin is not as noticeable, okay. Are patients that will develop scars which are called keloids with any little nick or cut. And what that is is overproduction of scar tissue. And there are things that can be done. We do post op radiation for those scars. So say if someone wanted a tummy tuck and they were a keloid former, we do post op radiation and that's about 90 something percent effective in preventing those stick scars. [00:16:46] Speaker A: Is there a busier time of the year that you have when it comes to your procedures that you're doing for people? [00:16:51] Speaker B: You know, it's, it's, it may not be a busier time, but I see certain procedures. [00:16:57] Speaker A: Okay. [00:16:57] Speaker B: So for example, since spring is coming, I've been doing a lot of breast surgery. You know, a lot of breast augmentation, just, you know, because the weather's getting warm. [00:17:08] Speaker A: Absolutely. [00:17:09] Speaker B: I do a lot of tummy tucks, which is called abdominal. Those are all year round. [00:17:16] Speaker A: Right. [00:17:16] Speaker B: But I think breast is A uptick probably starting in February in preparation for spring. [00:17:23] Speaker A: Got it. Got it. Yeah. And that's, you know, the recovery time from what you. We said earlier was. Was pretty, you know, I don't say minimal, but, you know, it's. That's a little bit, you know, the time can. Someone can recover to be able to go back to normal. Life isn't as. Isn't as extensive. Is that correct? [00:17:38] Speaker B: Correct. So with most of. Most of the breast surgery, probably what requires more as far as recovery are things like abdominal plastis or tummy tucks. The other procedures, there is not much downtime. [00:17:52] Speaker A: Okay. Okay. So, you know, what I found really fascinating is you're in medicine for 30 years, right. And you've always, you know, whether it was burns, you know, when it came to burn victims specifically, just to pivot a little bit, you know, how does that surgery actually, you know, accident victims, I know that's not your current field right now, but what level of how does that all take place? Because you always see movies and television shows about people who have burns or accidents. [00:18:16] Speaker B: Probably in real life, it's probably a little bit worse than what you see on television, especially burn victims, because they often have to undergo multiple, multiple procedures or skin grafts. And it's a lot of discomfort or pain involved in the recovery. And then after that, there's some disfiguring of the body. Even when you do skin grafts, that area still looks different from the other skin. So they may always be disfigured, you know, with burn victims. [00:18:45] Speaker A: Yeah. And like I said, you know, I just wanted to touch on that because I know that you had done that in previous field, and you also were an assistant clinical professor as well, too. What were the size of the teams that you led and the upcoming people who had, you know, that you taught, the teams that you were in charge of. Can you just give a quick rundown of your experience in that. That was so extensive. [00:19:04] Speaker B: So like, on the, on the teams, you of course, retrain plastic surgery residents, and we often had medical students also. So in plastic surgery, when it was only two years, you had a first year and second year. Since it's three years now, it could be a first year, second and third year. And so at some of the hospitals, we would have a resident clinic where the resident would see the patient and then the attending would come in, you know, see if we agree with what they want, want to do. And then if it's cosmetic, the patients would get like a discount if the resident did the procedure. Now, as Far as reconstructive surgery, like at some of the hospitals, it would what plastics would normally see lots of hand injuries, whether it's tendon injuries, broken bones in the hand. We also did facial fractures. And so there's certain specialties. Like we would rotate with ear, nose and throw rope. Maxillofacial surgery and plastics, we would be on a rotation as far as seeing facial fractures that will come into the emergency room. As far as hand injuries, we were on a rotation with orthopedics. So you would have a, you know, an entire team. Now sometimes there's emergency surgery that has to be done. Then, for example, say a finger was amputated or say someone was in an injury and they cut the vessel, say in their hand or something. Those are surgeries that have to be done then. And it would be a whole team. Microvascular surgery, for example, placing the finger back on or fingers sometimes. That could take anywhere from, you know, four to six hours because we're using a microscope to try and reattach the vessels and then we're using drills to reattach the bone. So that can be a very long surgery. So you have like a whole team of people. And then in a residency program, the residents may rotate through the various hospitals, say every three months. So, you know, they'll rotate, for example, at one hospital where you see mainly trauma, and then they'll go to rotate to a hospital where they'll see mainly reconstructive. So you have a rotation of residents, you know, coming through. [00:21:19] Speaker A: One last final question. Do you see a lot of athletes like, or, you know, that come in, you know, because they get injuries to us, particularly like I do martial arts, you know, people like boxing, mma. I know it sounds like an off the wall question, but do you ever see like, athletes that have to multiple scar tissues above eyes or things of that nature? Do you or, you know, sports injuries, anything like that? [00:21:39] Speaker B: No, I don't see a lot of sports injuries. I may see some, like car accidents with cars, but I don't really see that many sports injuries. [00:21:47] Speaker A: Okay, I was just curious. [00:21:49] Speaker B: Athletes. Yeah, got it, got it. [00:21:50] Speaker A: You know. Well, did you have any questions for me? I mean, this is. I really appreciate your time. I love the insight and your field of work is so extensive and the expertise that you have in it. I'm so grateful that you carved out time to be on the Tron podcast. But you know, I gotta be honest, medicine was so fascinating and the work that you do, I can't. It's wonderful the lives you've impacted, and I saw some testimonials, and you have a lot of grateful patients and clients. [00:22:12] Speaker B: Okay, well, thank you. Now, where can we find your podcast? Say, if I wanted some of my patients to listen to your podcast. [00:22:19] Speaker A: Com. We're also on all the major streaming platforms as well, too. Apple, Spotify, all of the other ones as well, too. And then on YouTube. I have a YouTube channel as well. [00:22:28] Speaker B: Okay, well, thank you for the interview. It's very nice. [00:22:31] Speaker A: Well, I really appreciate your time and have a wonderful day. And again, thank you so much. [00:22:35] Speaker B: Okay, bye. [00:22:36] Speaker A: Bye.