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  • By Dr. Anthony Youn

    Five years ago I set out to write the definitive book about becoming a plastic surgeon – true, unadulterated, unfiltered, behind the scenes, warts and all.  I’m gratified by what readers and reviewers have said so far.  They’ve called it “disarming,” “fast-paced,” “hilarious,” and “touching.”  According to Publisher’s Weekly: Youn’s description of his journey from high-school outcast to rock star plastic surgeon is full of fascinating stories and laced with self-deprecating humor in the midst of dark desperation, providing a refreshing insight into medicine. 

    I hope you enjoy this excerpt from my book In Stitches.

    Excerpt from Chapter 19: Beverly Hills Bloodsuckers

    My last day as a medical student in Dr. Romeo Boulay’sBeverly Hillsplastic surgery practice. Our last procedure. Romeo will perform breast-implant surgery on Michelle, a stripper who’s recently celebrated her fortieth birthday, a difficult birthday for many people, the end of the line for most strippers. For over twenty years, Michelle’s stunningly oversize breasts have been her signature. Now they have literally become weights, causing her severe neck and back pain and brutal headaches. She has gone from performing at prime time in topHollywoodand Vegas clubs to stripping at noon in a dive by the airport. She wants to find a new line of work and needs her breasts reduced.

    The anesthesiologist knocks Michelle out, we scrub up, gown up, prepare for surgery. Before Romeo makes his first cut, we ponder her pendulous breasts, the most imposing mountains of silicone I’ve ever seen.

    “Gigantomastia,” Romeo says. “Okay, I’m going in.”

    He makes a flawless incision around the areola of the right breast and starts cutting down to the implant.

    “Grade-four capsular contracture,” he says as he cuts. “I’ll break down the grades for you. Grade one. Buttah. The way a breast should feel. Natural. Like you’re back in high school. Grade two. Firmer than normal. Looks fine, feels a little firm. Most people can’t tell the difference between one and two.”

    He pulls back, waits, allows the bleeding to stop. “Grade three. Too firm, appears abnormal. We’re talking Nerf football. Not what you’re looking for in a breast. And then there’s this. Grade four. A bowling ball. The scar tissue is so severe it makes the breast round, hard, and

    cold. Here, feel.”

    He puts my hand on her left breast. Massive, rock-hard, cool to the touch. Forget stripping. How did she walk with these?

    “Guys like these?” I say.

    “You can take your hand off now, Tony.”

    I have already.

    “I amuse myself,” Romeo says. He chuckles, resumes cutting into the breast, going farther toward the implant. “I’m at the capsule,” he says. “This scar tissue is thick. Knife, please.”

    The surgical technician passes him a scalpel. With immaculate precision, he works through the scar tissue down to the implant. Finally, sounding like an egg cracking, the implant pops through the scar tissue. Romeo puts aside the scalpel, grabs the edge of the implant, and

    yanks out a slice of clear silicone shaped like a discus, high as two Big Macs. He hands the implant to the surgical tech and peers inside the open breast pocket. “She’s stacked,” he says.

    “She is huge,” I say.

    “No, Youner. She’s stacked. There’s another implant in there.” He grunts and pulls a second implant out of the breast pocket. “You don’t see this often. It’s extreme. Anna Nicole Smith time. Only the truly insane plastic surgeons do stack jobs.”

    “You ever do one?”

    “All right, now for the left side.”

    After Romeo removes the stacked implants in her left breast, he focuses on the scar tissue, which has progressed to such a severe state that it has turned the inside of both breasts into a chalky, calcified mess resembling the plaster of a cast. For over an hour, Romeo chips away

    meticulously, removing every bit of scar tissue, piece by piece, until all that’s left of her breasts is a mass of stretched-out skin.

    He then inserts temporary sizer implants that look like small inflatable balloons. On his count, we raise Michelle to a sitting position so Romeo can determine what size he should make the new implants. We lay her back down, and he begins to fill the sizer implants, inflating her breasts as if pumping up a tire.

    “This looks good. Around a D cup. Two five-hundred cc implants, please.”

    The OR nurse opens two new breast implants and hands them to Romeo. He inserts one into each breast cavity. These implants will never fill out Michelle’s breast in the same way as the stacked two-baggers, which is, of course, the point. Instead they settle into the

    bottom of each breast socket.

    “Rock in a sock,” Romeo says. “That’s seriously what we call it. And now for the breast lift.”

    He begins suturing the nipples onto their new, higher location. He cuts off the excess breast skin and stitches the incisions back together, working with the concentration of a jeweler. The process takes over ninety minutes. At last he takes one step back. Before us lies Michelle

    and her new breasts, smaller, youthful, beautiful. Together, Romeo and I apply gauze dressings.

    “Oh, crap,” Romeo says.


    “Her nipples.” He retreats another step. “Crap. Look. They’re turning purple.”

    A moment ago her nipples were full and pink. They have darkened to the color of an eggplant. Romeo speaks faster than I have ever heard him. “Sometimes when you perform a breast lift on a woman with implants, the blood supply to the nipples becomes altered. Needle.”

    A small needle appears in a flash. He stabs the areola lightly, repeatedly.

    Dark red blood oozes out.

    “Her nipples are congested. Let’s get some of these stitches out. We’re looking for the nipples to turn pink.”

    We remove a few of the sutures that hold the nipples in place.

    Still purple.

    “Well, Anthony, we got a situation. Purple means there’s blood flowing into the nipple but not going out. The blood is pooling up in there.”

    “Sorry, this means—?”

    “Worst case? Her nipples will turn black and fall off. Instead of a nipple, she’ll have a gaping hole.”

    “Bad,” I say.

    “Yep. Really bad.”

    “What do we do?”


    I laugh. I can’t help it. You have to love how Romeo keeps it loose even during a crisis.

    “I’m serious,” he says.


    “Be fancy. Call it leech therapy. I’ve done it several times. We bring her to the hospital and attach a bunch of the bloodsuckers right there.” He points to each of Michelle’s nipples. “They suck the old blood out. In a few days, her body will create new blood vessels that will take over for the leeches. Hopefully.” He turns to the OR nurse. “You know the

    drill. Call an ambulance.”

    “Wow,” I say. “Leeches.”

    “New technology, my butt. We’re going medieval.”

    . . . .

    Romeo escorts Michelle to the hospital. I stay behind. I say goodbye to Heather and the rest of the staff, then I run an errand onMelrose AvenueinWest Hollywood. By the time I head back towardBeverly Hills, the sun’s starting to set. I drive into the hills, find a spot to park

    onMulholland Drive, and watch the lights of theSan Fernando Valleyflicker on. It looks as if I’m peering down at a second night sky. At around seven, I head to the hospital to check on Michelle.

    As I exit the elevator, I hear a scream. A woman stands in the middle of the hallway and points at the floor. She shrieks again and backs up slowly. I jog toward her and see a bloody trail coming out of Michelle’s room. At the end of the trail sits a huge, bloated leech.

    “It’s nothing,” I say. “Leech therapy.”

    The woman stares at me, horrified, her hands over her mouth.

    I push open Michelle’s door and find her lying in bed, sound asleep, the rest of the leeches locked up in a jar somewhere.


    Beverly Hills.

    Movie stars. Pop icons.


    Anthony Youn, MD is a board-certified plastic surgeon and author of IN STITCHES, a humorous memoir about becoming a doctor.  It can be purchased at Amazon.com.  For more information, visit www.institchesbook.com.

    About Anthony Youn, MD, FACS 

    Dr. Anthony Youn is a Board Certified Plastic Surgeon who specializes in cosmetic surgery. He is a regular guest on the Rachael Ray Show and has been featured on E! Television’s Dr. 90210, CNN, The CBS Early Show, The Doctors, Fox and Friends, America Live with Megyn Kelly, VH1, NPR, The Montel Williams Show, America’s Newsroom on the Fox News Channel, the O’Reilly Factor, the E! Special Celebrity Plastic Surgery, Issues with Jane Velez Mitchell, Happening Now on the Fox News Channel, HBO’s Youth Knows No Pain, Fox 2 Detroit, NBC Channel 4 Detroit, ABC Channel 7 Detroit, Proper Television’s TV Made Me Do It, and others. He is the author of IN STITCHES, a critically acclaimed memoir about becoming a doctor. He’s a regular contributor to CNN.com and has written articles for MSNBC.com, CBS News.com and USA Today. His comments have been featured in US Weekly, In Touch, Life and Style Weekly, More, RADAR magazine, MSNBC, OK! Magazine, the National Enquirer, Star, the Detroit Free Press, the Detroit News, HOUR Magazine, JANE magazine, and the Minneapolis Star-Tribune.

    For more information, go to http://www.dryoun.com

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