Painless & Drainless Tummy Tuck — with Daniel Gould, MD, PhD (Ep. 226)

Beauty and the Biz

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and Doctor Gould's 'Painless & Drainless' tummy tuck.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits.

Now, today’s episode is called "Painless & Drainless Tummy Tuck — with Daniel Gould, MD, PhD".

As it gets more challenging to differentiate yourself from your competitors, you have to dig deep.

It’s not enough to be good. You need to be a cut above, but that’s not enough either because you also need to be able to “show and tell” those differences to the consumer layperson, so they see you as the best choice.

This week’s Beauty and the Biz Podcast guest was Dr. Daniel Gould, a board-certified plastic & reconstructive surgeon in Beverly Hills for the past 4 years, who's developed his 'Painless & Drainless Tummy Tuck' procedure.

Here are some of the topics we covered:

• The priceless mentoring he got from his fellowship with renowned Grant Stevens, MD and his work with other heavy hitters in Beverly Hills (Drs. Telai, Ghavami
• and Nazarian), before going out on his own.
• How his Ph.D. in bioengineering has helped him get better results and happier patients. For example, his 'Painless & Drainless Tummy Tuck'.
• His other business endeavors, such as Milk & Honey Spas, that have him thinking like an entrepreneur and much more...

Visit Dr. Gould's website

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Transcript:

Painless & Drainless Tummy Tuck — with Daniel Gould, MD, PhD

Catherine Maley, MBA: ​Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and how Doctor Gould’s ‘Painless & Drainless Tummy Tuck’. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, What Your Patients Are Saying", as well as consultant to plastic surgeons to get them more patients and more profits.

Now, today's special guest is Dr. Daniel Gould, who has developed his ‘Painless & Drainless Tummy Tuck’ technique. He's a board-certified plastic and reconstructive surgeon in solo practice, in Beverly Hills for the past several years. Now, his education included UCLA, Baylor College of Medicine, Rice University, USC for plastic surgery residency, and then he did a very specialized fellowship in aesthetic surgery in Beverly Hills and Marina Del Rey, California run by Dr. Grant Stevens, which is a big deal.

So, he's also authored hundreds of peer-reviewed articles published in plastic surgery journals. He speaks nationally and internationally at medical conferences. That's where we ran into each other. And he happens with all of that to have a PhD in bioengineering, which we'll talk more about; as well as his ‘Painless & Drainless Tummy Tuck’.

So, Dr. Gould, welcome to Beauty and the Biz. I really appreciate you being with us.

Daniel Gould, MD, PhD: Yeah. Thanks for having me.

Catherine Maley, MBA: Sure. So, I don't know how, how did you, where did the bioengineering fit in with the plastic surgery? What came first? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Well, I was a part of an MD PhD program, which is a combination of a training in medicine and basic science.

And as part of that, you kind of pick the discipline that you want to do your PhD in. And at the end of my second year of medical school, which is where you transition into the research years, I did have interest in surgery. And I had a lot of interest in reconstructive surgery. And the research that I did in bioengineering was focused on tissue engineering.

regenerating human tissues, whether it's organs like the brain, the liver, the heart, the lungs, the kidneys, or whether it's the soft tissues like the skin, the muscle, the bone. And so bioengineering offers almost a perfect kind of synchrony or, or connection between medicine and basic re and basic research, because it offers an opportunity to explore how we fix these bigger problems and regenerate natural tissues.

Catherine Maley, MBA: Wow. Okay. So, you went into plastic surgery. You're actually from, I believe, Sacramento. So, that's your, your Sacramento, Northern California. That's right. Then how did you end up? What a great fellowship you did with Grant Stevens. And I believe Jay Calvert down in Marina Del Ray and Beverly Hills. What was that experience like? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Well, it was for me, it was a seminal experience. I mean, I had done a residency at USC and in that time, even as an intern, I had met with Grant and with Jay and had learned a lot about aesthetic surgery. And I wasn't thinking that I was going to be a cosmetic surgeon in residency. Truly. I was very interested in microsurgery, hand surgery, pediatric surgery; all reconstructive aspects. But over time, over the first two to three years, when we really start doing more surgery, I started gravitating towards the concept of aesthetic surgery. It's high stakes. It requires artistry, but also a very detailed understanding of anatomy and an emotional and psychological connection with your patients.

That's far different than any of the reconstructive disciplines. You're taking a big risk when you're telling a patient who's perfectly healthy. We're going to operate on you to make you look better. And I learned a lot about that process and it really did bring me into this concept of what I wanted to do.

And then Grant kind of recruited me and I had done research with him and with Jay. And my third year of residency, he called me, I can't, I remember it very clearly. It was like a Wednesday, the middle of the week in the middle of the night, like 1230 AM, and this was before we had a match process, so they got to.

Pick who they wanted essentially as a fellow all around the world. He called me and said, Hey man, we're offering you the spot. Do you want to take it? It was like 1230 at night. I said, absolutely sign me up. So, I knew as a third-year resident that I was going to be doing this three years later, and then that gave me even more of a springboard to be able to follow my interests, develop my kind of my research and my expertise, even during residency at that early phase.

Catherine Maley, MBA: And at that point, do you know what you're going to do when you leave the fellowship, when you're done with it? Or like, what do you do, like, because if you found out your third year, then you're still there for the fourth year, then you do a fellowship for another year, right? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

So, are you getting —

Daniel Gould, MD, PhD: Actually, you're there fourth year, fifth year, sixth year, and then you do your fellowship.

So, it's seven years total, right? So, it's four or five years in advance where you know what you're going to be doing. But I didn't know that I was going to necessarily have a practice in Los Angeles following the fellowship.

Catherine Maley, MBA: Right. And while you were there, are you learning the business and the marketing side of plastic surgery or strictly the clinical and the reconstructive? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: So, for me, my, my father's a pediatrician, right? He's also Dr. Gould, Dr. Gould Sr. And he's had a practice in Sacramento for the last 30 years, the largest private practice pediatric group in Northern California. So, I've been exposed to medicine and the practice of medicine all my life. And he had a large practice, you know, three different locations, 80 employees, average length of employment, 25 years.

So, I've seen how to run a successful business, a successful practice all that time. But, Being in that point in my residency, I was also exposed to what was going on in Grant's office and in a few of my other mentors, like Sheila had a very busy practice, Sheila Nazarian, I was spending time with her seeing what she was doing.

So, I'd always been investigating, you know, how to build the business behind the plastic surgery practice, but not necessarily thinking that I was going to be running my own at that time. I was more actually, honestly, looking at an academic job and I had plans to do an academic position doing cosmetic surgery and other aspects of reconstructive, namely transgender surgery at that time. But things kind of change. And at USC, they had a hiring freeze, essentially the year that I was looking for a job there and had a few different job offers, but ultimately decided to just stay where I had been for my fellowship and to continue as a general kind of contractor with a concept of exploring, maybe I'll take this practice over, maybe I'll go do my own thing.

Maybe I'll just kind of do what I can. And at the time, just operating a lot, building up my skills and just trying to provide good care and good outcomes.

Catherine Maley, MBA: Is your father crushed that you didn't follow him? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: No, because this is going to sound totally crazy, but pediatrics and plastic surgery are very similar disciplines.

Because in both of them, you're dealing with an anxious person and not always the patient right in front of you. In pediatrics, you're dealing with the same type of patient. It's the mother and the father that you're treating, not the baby, right? Because the baby, you give it a shot, it cries and then leaves.

But you have to spend time talking with mom and dad about what's going to happen. Now that's the same patient that I see in a mommy makeover. They're literally the same patients, right? Same kind of age, same kind of maturity, same kind of questions, same kind of desires, anxieties, all those things. So, it's actually very similar to what my dad does on a daily basis.

And there's a lot of psychiatry involved. There's a lot of understanding what's going on with your patients, personality disorders, stress, anxiety. That's what feeds into the best relationship. The truth is. Good doctors are good doctors, doesn't matter what the discipline is. And to be a great surgeon, you have to be a good doctor first.

Catherine Maley, MBA: But did your dad want you to take over his practice? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: You know, we had conversations about it. And I, I could have, because a physician can own a physician practice in Sacramento, but, or in California and anywhere within the state. But he really wanted me to pursue my own goals, and he never told me to be a doctor, actually.

He was always someone saying, like, you shouldn't do this unless you're really into it. So, I think that some of him was, is proud of me for choosing to be a physician and doing surgery, which is something that he doesn't do. And I don't think that he disapproves of cosmetic surgery or whatever it is that I do within plastic surgery.

But the, you know, he just wants me to be happy. And I have three other siblings, and they are all outside of medicine, and he's very proud of all of us. So…

Catherine Maley, MBA: Oh, that's terrific. Now, one thing I've watched you do very well, and I don't know if you're doing it strategically or not, you're hanging around with the right people. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

You're still fairly new at this, and for you to get the education from Grant Stevens and Jay Calvert, and then for you to be in Sheila Lazarian's office, and I also think you've hung around with Dr. Gavani and Ben Talei, I mean, you are getting such an incredibly accelerated, real world, Experience of how not just the business but the marketing of it because everyone knows how important that is, especially if you're in Beverly Hills, you've got a lot of competition there. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Were you at all afraid to set up shop in Beverly Hills or were you completely comfortable after hanging with the big boys? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: I've always been very comfortable in my own skin. I know my limitations. I know what I'm good at, and I know what I'm not good at. I've had many mentors, including the ones that you mentioned, but also Guy Masry, and one of my closest mentors is Garth Fisher, who's a well-established, well known, very famous plastic surgeon here.

And I spend time in the operating room upstairs from my office here in, in in Paul Nassif's OR. So, I spend time with Paul. With Charlie Galanis and with Garth Fisher. Now, this allows me to continue to build my skills, but also gives me mentorship and allows me to have people that I can bounce ideas off of.

Aside from those people, I've also worked a little bit with Chachi Keo and learned from him as like a mentor as an independent mentor and another great surgeon, Ritu Chopra, who was another part of the fellowship over here that I did. So, I would just tell you this. I like to collect mentors because those people all inspire me.

They show me what to do and what not to do. And they also serve as a sounding board. If there's an issue, there's a problem. You have a difficult patient, something that you're worried about. You can learn the techniques and the procedures, but you can also learn how they interact with their patients and how they build their practices.

And the truth about it is that although Beverly Hills is an incredibly, competitive market in Beverly Hills. If you're a great surgeon, you don't feel that pressure. So, there's a network of people that are kind of at this level and they're apt to share. They're open because they don't have issues.

They don't have insecurity about their practice. They're not afraid of opening up the Komodo and showing you their good ideas because they know they're already 510 steps ahead of you. You know, Ben and I are close. But Ben's ahead of me and there's no question that that's the case. Right. But there are things that I do now that I've learned from him and things that we do together and things that we do that are different and things that we do the same, that allow me to occupy a slightly different niche.

And, you know, over time, I'm going to be where Ben's at now, but I'm never going to catch him cause he's. You know, six years ahead of me, seven years ahead of me, but the goal is not just necessarily to catch. It's to kind of exchange ideas, learn from each other and kind of grow as teammates. And that's the same thing that I see with him and Chopra.

And the three of us actually talk a lot about our techniques. We go to meetings together, we present together. I'm honored to even be anywhere near the stage with those guys and to be able to spend time with them. But I do have something to contribute my own thoughts kind of within the specialty and they see that that's why they allow me to be there.

They know that I'm hardworking. They see what I do. They see my results and they know that I can produce good for you.

Catherine Maley, MBA: I just I hope everyone's catching that. It's so important that you hang around with others who are. Where you want to be they'll just give you such insight and shortcuts and you're the opening up your mind to the possibilities. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

There's just nothing, it's invaluable hanging around with people who think big and think different, you know, differently than you do. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: It's just like, if you want to get, if you want to get money, you go rob a bank. That's where the money is. If you want great ideas, you spend time with people that produce great ideas, because then you'll be inspired to do the same.

Catherine Maley, MBA: For sure. So, are yours, are you still doing reconstructive or are you completely cosmetic now? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: So, I do reconstructive procedures. I work with a group called ‘Mission Plastico’, which is basically a non-for-profit organization that helps identify women that need breast reconstruction that have fallen outside of the traditional kind of pathway for reconstruction, meaning they don't have great insurance or they don't have any insurance.

Or there's some other reason why they don't have access to resources. Within that group, I actually helped set up the collaborative agreement between MTF, which provides the internal scaffolds that we use for breast reconstruction and that group at ‘Mission Plastico’. So, I helped set up the relationship that now allows our patients in that group to benefit from breast reconstruction outside of the scope of what they could normally.

So, I still do reconstruction, but it's essentially all stuff that's pro bono. I actually have never charged for a reconstructive procedure. submitted a bill for any of the procedures that I've done in my practice, which is kind of special and different. And I've done reconstruction on patients that have come to me for cosmetic purposes.

If they say, I still want you to be my doctor for this, I'm happy to do that procedure for them.

Catherine Maley, MBA: From a marketing perspective, I would definitely make a bigger deal out of that on your website and your Instagram. I did not know that. And women, women love to know that you're on their side. So, of course. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Yeah. And what about surgical versus non-surgical? Are you just completely surgical or do you think there's a, you know, one stop shop kind of business approach to this? What are your feelings on that? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: I like to intermingle the non-surgical and the surgical because the, because I want to get the best results.

And so how do I get the best results for my patients? Well, I'm not just going to do a facelift, I'm going to do all the other things too. Radiofrequency microneedling, CO2 laser, a little bit of neuromodulator, and some fillers, hyaluronic acid and or fat, because that's how we get the best results. So, I do all those things so I can provide them all to my patients, because I don't look at it and say what's the most profitable, what's the best, you know, profit margin.

I say, How do I get the best result for my patient here and now? Because if I can do that, if I can provide excellent surgery and excellent non-surgical services, then I get a happy patient with a great result who's referring me more patients over time. Gotcha.

Catherine Maley, MBA: I think that's the way to look at it, quite frankly. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

But with that comes staff because you need other revenue generators to handle the non-surgical side. So, you can focus on surgical. How has it been for you growing a practice from scratch bringing staff on board? Any tips for hiring, firing, motivating? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Yeah, a lot of tips. So, aside from my practice, I'm also the medical service operator and a shareholder in a company called Milk and Honey, which is a very large private group that is basically a medispa in Texas, California, Chicago, and New York.

I'm in charge of the California side and the Chicago side in terms of business development. So, I've helped hire, inject, and build up the medispa in the California offices. Now, within my practice, so I know how, how to attract good injectors and how to build out their services.

Catherine Maley, MBA: I use that because a lot of people ask me all the day, how do I find a good nurse injector? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: The secret is very straightforward. It's no secret. You have to have a good culture and you have to be focused on the right things. When I interview a nurse injector, I tell them, this is my mission statement. Best patient care always when they hear that and you're really putting your money where your mouth is, they want to work for you because the truth is everybody's going to offer them money.

They're going to have offers for different amounts, but somewhere within the same kind of bracket. Everyone's going to offer them other kind of. perks, but they want to really deliver good care. Most nurse injectors want to know that they can give the best care always. They don't want to feel the pressure of a 15-minute appointment for Botox for profitability over patient care.

So, when they hear that you're really devoted and connected to that message, then they're ready to work for you. Now at Milk and Honey, there was a push where we were there for a while, people were looking at time in the room, and I said, absolutely not, we're going to preserve time in the room because Time in the room is not just quality of outcomes and connections and building the relationship.

It's also the opportunity to talk to patients about other services. So, that's why I still do Botox and radiofrequency microneedling and lasers in my own practice because my time with them while I'm doing the microneedling, although yes, it does generate significant profit, also allows me to talk to them about other procedures, body procedures, breast surgery, abdominoplasty.

Moving down to those other regions. And that's more opportunity for us to connect. And for me to there to them, to be my patient for life. So, there is a balance now recruiting nurses that are injectors, recruiting PAs that are injectors in the practice. It's not that difficult. It's all about mission statement within my own practice.

I have a nurse and she's been helping me. Deliver care pre and post operative care. And over time now I'm developing her skills, teaching her radio frequency, microneedling, teaching her injectables. And over time, what we're going to do is I'm going to bridge my patients so that they see her in the beginning.

And then in the end, she's the one doing the injectables, the microneedling and the lasers. Because then they'll have consistency, trust and expectations with a person that they know. And I like training my own person that's going to be in my office because I can have total control over their knowledge base, over their applications, and how they approach the process of post-surgical treatments.

That's really key. You can't just hire someone off the street. Throw them in a room with a needle and a vial of Botox and say, go make me profit. That's really not the right way to do it. It's what all the private equity firms are doing right now. It's definitely what the MediSpas are doing right now that are not physician owned or oriented because they're focused on dollar per hour in the room, conversion rates, high level business metrics that make sense on paper, but don't equate to a good patient experience.

Catherine Maley, MBA: So, is the Milk and Honey, is that a PE play, or is that some other kind of structure? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: It's individually and privately owned by the two owners so, which, they're a married couple and they basically are the two that are running everything, but over time the goal was for us to grow in many different locations, maybe reach a point where we have as many as 30 locations in California, and then potentially be like the Amazon of aesthetic Medi spa, an example to other injectors and other companies that are trying to achieve what we're doing.

It's definitely not a PE play at this point. We have been approached by many different firms and companies that want to be involved. We've been told to come pitch all those things. We don't need to do it. So, right now what we're doing is focusing on just delivering great care, growing the brand and growing the quality of the experience for the customers.

Catherine Maley, MBA: And is the branding ‘Milk and Honey’, or is it still ‘Gould Plastic Surgery’? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Well, there's two brands here, right? There's my practice, which is Gould Plastic Surgery, and there's Milk and Honey, which is this other thing that I'm involved in.

Catherine Maley, MBA: By the way, I love that name. It's really cute. I will remember that. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Mm hmm. But Milk and Honey is... Product lines that are cosmetic grade products, but also spa, not just medispa and medispa. It's huge. You know, it's a much bigger kind of concept and we're talking like 20 locations at this point. So, that's a different side project for me that I use to focus on and that I also use in conjunction with my practice.

The brands are contiguous, they make sense the brands match, you know, everything from what it looks like in my waiting room to what their waiting room looks like are very similar, so it's easy to, to have crossover, and I send my patients from my surgical practice there, and they send me patients here, so it's a nice kind of back and forth that we do.

Catherine Maley, MBA: Gotcha. And do they do any marketing for you? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: We do within the, within the Milk and Honey brand, there's some marketing and some other opportunities, but I've not really tapped that yet. We've been just growing it up and slowly building it. I just hired a new manager for the West Coast and she's kind of stepped in and slowly kind of gotten it up to steam.

In the next three to six months, I'm really going to be pushing the marketing efforts to grow the practice from the Milk and Honey brand. It's great because those patients are awesome. And you know, they have, Tons of people that use the, that use their facility that come for the, not just the non-surgical treatments, but also the spa treatments that are the right demographic, the right people that we want to see in my office.

Catherine Maley, MBA: And then back to staff, are you bonusing them? Are you just paying them above market? How are you handling that? Because a lot of this has gotten down to, you know, others just poaching, just using money, you know, and bonuses. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: And when I was hiring like when I was looking at hiring a PA from my own office, there definitely was a push towards that.

Everybody's so focused on commission. And the truth is that commission structures are incentivizing, but they can also incentivize. The wrong thing. If you incentivize an employee towards generating profit, your company will be more profitable, but the patient experience may not be as good. So, you have to be really thoughtful about it.

So, in my practice at all the different position kind of player roles, I basically go at the very highest kind of level for reimbursement and for the industry standard. For where we're located which is very high for most of those positions. And then from roles that are critical roles to like patient conversion.

So, for instance, patient coordinator role, there is a small commission involved, but my goal is not to create a commission hungry office. Is to create an office that does the right thing for the patient at all times, whether that's expensive or not expensive, whether that's something that takes time, energy, or cost me money, I want the office to see my behaviors to know who I am as a leader and to know that I am focused and fully committed to that process and to that belief.

So, you know, there are many things that I do in my office on a daily basis where my staff can see that I'm doing that. I'm not charging the patient for that. I'm including in my own overhead. And that sends the right message, the right mission statement to the people that work around me.

Catherine Maley, MBA: And did you bring like a COO on board or at least an office manager to be a buffer between you and the staff, or are you trying to manage all these people on your own? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: It's just me managing my staff. And it's not that, it's great. They have no issues, you know, the staff is well maintained, they're thoughtful. I lead, you know, we have different meetings and things that we, that we get together to do check ins. We have processes in place. I have no issue managing great staff.

The truth is. Most people that work for you want to do a good job, and as long as they're given the opportunity to do that, they're going to be successful at it. So, if somebody's struggling or they're having difficulty and performing in their position, there's a reason. And it's probably because you're not enabling them to do what they want to do, or because there's some other crutch in place that's blocking them from really achieving their goals.

And I've had to fire people just like anyone else, but I actually have never technically fired a person. I don't fire people in my office. Okay. If somebody, what I usually do is I come to them and I say, what is it that you're passionate about? Because it's clearly not this, there's something that's going on that, you know, that this isn't what you're supposed to be doing.

And I have had like, for instance, I have one person and she said, well, I always wanted to be a hairdresser and I was like going to go to school for it, but then I kind of screwed up and now I'm here and it's okay, great. Let's find a hairdressing school that I found three salons within seven square blocks and said, you can go and kind of work in one of these places and they'll give you an apprenticeship.

We'll get you enrolled in cosmetology school. And we're going to free you up for the opportunity that you really deserve. Right? They just move on and they're able to pursue something that they're interested in. It's really going to fulfill them and give them kind of. The desire to, you know, fill all their fulfill their desires to kind of change and grow and to get better and to do the things they want to do, that's what I'm going to do.

You know, if I, if I hire you, there's a good reason I don't hire like that. Right. I spent a lot of time figuring out who the person is, what their motivations are, if they're consistent with kind of my approach, and then I don't have to fire people. I just, you know, talk to them about what's motivating them and what's wrong.

And how do we kind of align those things?

Catherine Maley, MBA: I will say I do a lot of hiring and almost the first question I ask is Not like what are your career goals? But I say where are you trying to get to where are you going with your career? And that when I say it very conversationally and openly, they always tell me and it and if it's not aesthetic You know, like I love working with people who love this industry and they're just trying to get into it because they just love it so much. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

But I mean, I, I've had people say to me, well, I've always wanted to be, she was like a salsa dancer or something. And you should hear that. She doesn't want to be in the office. She wants to be a salsa dancer. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: And you tell them this is not the right position for you, right? Or you say, hey. I need somebody who's 100 percent passionate about being the very best patient coordinator that ever existed, right?

Like you need to be devoted and connected to that. You need to get deeper meaning from it. And it needs to be consistent with your story. Like my current coordinator, she, her dad was a plastic surgeon. She became a nurse. She's been around the industry her whole life. She loves coordinating, lives it, eases it, breathes it, sleeps it.

It's a part of who she is. It's ingrained into her culture. So, when she talks to a patient about plastic surgery, you better believe it's coming from the heart. And that's, that's the right fit. Somebody like that with that kind of background, it just makes sense. When they come to me and tell me, I love being a patient coordinator.

I love. assisting patients through the journey, seeing them happy with their results, following up with them a year later, two years later. It's like, yeah, I believe that because I see it and I see the culture and I understand kind of where you're coming from. So, it all makes sense.

Catherine Maley, MBA: Well, in addition to that, you also on your website on your nav bar, it says the coordinator like meet the coordinator and she gets a full-on photo. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

She has a huge photo, a huge bio about her father being in the industry and all of that. I mean, you are really putting some play behind her. So, she must feel so appreciated and acknowledged for being on the team. I've never seen somebody portray their coordinator as significantly as you have. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Well, it's important because that's one of the people, the one of the main contact people for the office, but one of the people that patients are going to remember over time.

And I think that you really do need to build that person up. They're your right hand in the office. And if you build that relationship well it can last for a long time. That's my intention.

Catherine Maley, MBA: Yeah, well, you're doing a good job there. Hopefully she stays put though. And she's trained, you know sounds like she is, but I spend so much of my time training coordinators because you have to be more than just a pretty face or people, you know, I'm good with people. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

You really have to strategically understand this, the patient and their decision-making process and all of that. So, regarding business, last question, what's the biggest challenge of running a practice in today's world or that you have encountered? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: And I mean, there are so many challenges. The truth is that there are many more pitfalls than you initially think of when you're starting a practice.

Uniquely in California, there's a whole host of regulatory issues around cosmetic surgery, medicine in general, and hiring and firing, and each of them can be a potential severe limiter for success. So, everything from understanding the importance of HR and hiring people, but also maintaining their hours, keeping track of what they're doing and what they're doing when they're off everything from that to understanding the immense regulatory that follows the types of procedures that we do, FDA compliant versus non, FDA cleared versus approved for different devices.

And then understanding the myriad of other things that, that coexist with your growth of your practice. So, where, how to book, you know, like what operating rooms to work in and why the concept of in plastic surgery in Beverly Hills, there's many places to do surgery. Do you need to create your own operating room or can you rent somebody else's?

Are there strategic partnerships that you can create to build up your referral streams, whether that's reaching out to other physicians or other plastic surgeons, even depending on the types of procedures that you offer and the marketing schemes that you use to attract patients. So, I would just say, There are so many pitfalls that, that you can experience in that first year of practice that can really be devastating if they're not worked out in advance.

There are financial issues in starting a practice and having an idea, a clear and concise idea of what it's going to cost. Is really critical having a financial planner, but also a consultant who can talk to you about, you know, overhead basically personnel and then growth will really allow you to kind of target those things and then a great CPA and a tax person maybe even a tax attorney that can help you look at what your strategies are to deal with taxes to make sure that you're compliant, that you're up to date, you're not falling behind which is another kind of important thing to do.

Thank you. All those things are key. I think that a financial officer like a CFO or an outsource CFO can be really helpful for cashflow if that's an issue. But the beauty of plastic surgery is that we do something that costs a lot of money. Okay. And we charge up front. So, a lot of us are collecting at a good rate.

You're able to maintain your practice and float it. If you're doing reconstruction and you're getting paid nine months after you did the procedure, it's going to be really hard to start. I would not recommend starting up a private practice in Beverly Hills. You know, you need to be doing something where you can generate.

Profit, and you can operate on a budget where, you know, you're getting money in and money out in order to stay afloat in times when it's lean versus times when it's not. So, I think that those are the main issues. So, I would say number one is probably compliance and making sure that you're compliant and that you're up to date and you have insurance, that you're safe.

You know, you're protecting yourself from all the bad things that can happen. And number two is hiring. And number three is financial planning.

Catherine Maley, MBA: Regarding the marketing part though, because it is so competitive there and there are so many surgeons there, did you have any apprehension about going solo? Or did you want to stay in a practice with others? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Or how did you, how did you jump? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: I jumped very, quite easily. Okay. So, I knew from the moment that I started that there was either going to be the exit strategy was one of two options in Marina plastic surgery, either acquire the practice or move on because he was at a point in his career where he was ready to sell.

And there were some, there were some changes that happened in that first year. So, my first year of practice was great, but then there were some changes in the structure of the practice that happened right after that that basically made the decision for me. So, I said, okay, it's time for me to move on, go do my own thing now in the practice with Sheila's office, which was a great practice and similarly, very supportive.

She's great mentor, really thoughtful surgeon, and also just like a really thoughtful business person. She basically presented me with some options and she really wanted me to come on full time as an employee. And I just decided that I really admired her, admired her practice, but I said, you know, I think that at this point, it's probably better for me to kind of go out there and figure it out.

For myself. And she had always taught me that from the beginning, like the very first day I started working in her office, she sat me down and said, who's your most valuable employee? And I had this whole list. And she was like, you're not on the list. She's like, delete, she's like, rip this up, put your name down.

You're the most like, you're the most important employee in your practice. And you need to be thinking about how you optimize your own practice, your own flow, and how you build that over time. So, it was really inspiring message, which is like, you know, you need to understand that in plastic surgery, you're the profit center, right?

So, you need to, you need to focus on that and build it up. But so, I've been around both of those environments. I knew, I knew that at some point I was going to take a leap and I finished my boards I had moved out of Sheila's office at that point. And then I was looking at, at grant and looking at the Marina and the decision had basically been made for me.

So, then I said, okay, well, I'm going to just start. And I'm going to find a location, start turning the knobs, build up my practice. I had saved every penny from the day that I started my practice. I had saved every penny. I did not spend money on ridiculous things. I drove the same car that I drove in residency, which is a 2013 BMW, which I still have and still do drive.

Because. I understood the importance of cash flow, but also because I don't, those things don't make me happy. You know, I could buy a Lamborghini if I wanted to right now, but it doesn't make me happy and it doesn't improve my patient care. So, it's not something that falls within the mindset of what I need to be able to grow my practice or to be comfortable and or happy.

So, you need stability, you know, you can buy, I bought a house, which was, I think, a very valuable move at the time that I bought it in the midst of the pandemic, there was no question I had to be done because of how. Everything was at, you know, financially at that time. And it's like historically low interest rates and all these other things.

Every, every other decision that I've made financially has been focused on how am I going to continue giving better care? How do I invest more money back into my practice to improve patient outcomes, to improve the quality of the care that I give, to improve the experience for patients, because everything else follows.

You know, money follows care and truth is you cannot, you can never overlook good surgery. Excellent surgery always wins because there's a lot of bad surgery. 90 percent of plastic surgery, I think is bad, is not good. And so, if you're providing good surgery or great surgery, you're already a step ahead of everyone else.

But if you, for one second, think If you forget to realize, if you forget to be critical of your own results, or you for one second think that you can out market bad surgery, or you can, you can put money into a funnel and that's going to just generate patients, like you're, you've already lost the game.

You might as well just take your coat off, hang it up on a door and walk out.

Catherine Maley, MBA: So, when you opened your door to your own practice, did you have a following already or did you start from scratch? And if so, how do you do that? How do you enter a marketplace and position yourself? Okay, everybody, I'm here now. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

I'm in Beverly Hills, and this is me. How do you do that? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: I had been doing it for about, you know, 12 to 15 years. I mean, from when I started doing, you know, my PhD, right? I had been building my brand, building a position online and social media, but also building up myself in academics. I mean, I had written over 170 peer reviewed publications when I decided to make that move.

I presented almost 800 abstracts at national meetings. I've been around the country. I know almost every plastic surgeon in America. You know, I mean, I had been at, I'd interviewed at 28 different locations for residency, not because I thought I was going to go to those places, but because I thought maybe I'd be back for fellowship or maybe as a job as an attending, I had built up marketing from that point.

And, I built my reputation as a resident, so all the orthopedic surgeons know me, all the, you know, surgeons know me, general surgeons, cardiac, vascular, dermatologist, because I was always that guy that they could trust. I was always that guy in the hospital who would show up when they would call for a consult.

I was never a jerk, I was never mean in the operating room, so I had, you know, I built up my reputation with blood, sweat, and tears over a long period of time, and you better believe that that made a difference. Even after my fellowship year, when I started my first year of practice, I did almost 209 cases in my board collection period, which is unheard of.

That's a very large number of cases to do in that period of time in a practice where you're not necessarily being funneled all the patients, right? Where you're, you're a person who's just getting started. And when another person came in after me, the next, that next year with a similar deal, They did less than half of those number of cases because where are those people coming from?

I looked at my numbers, I looked at my patients, their referrals from my friends from residency, their referrals from my family, my friends, people from where I grew up, all those things, you know, your, your ability to grow your practice. It's not just about marketing. You know, at that time I only had 1800 followers on Instagram.

It's not about that. It's about your putting your boots on the ground. It's about relationships with other physicians, understanding what providers are sending you patients and why. Taking great care of the few patients you have because they are your number one source for additional patients, you know, taking great care of the people you have great results and great care are the fastest way to build a successful practice.

Catherine Maley, MBA: So, you were living off of non-competing surgeons who were referring you their patients and it wasn't recon, they were giving you cosmetic patients? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Cosmetic patients. Yeah, you better believe it. That's unusual. So, good for you. Everyone's sending me their wife, their sister, their friend, because I was the guy.

You know, like in residency, they knew, I knew how to do a free flap, you know, in third, you know, I was doing very. high level surgery at a low, you know, they saw my skills, they knew how I thought and I was always right there for them. So, they're going to send me their loved one and they're going to trust that I'm going to do the right thing and that I'm not going to offer them something I don't know how to do.

Right. So, yeah, it was a lot of non-competing surgeons, but also other plastic surgeons and other people. And I'm telling you like you, that your biggest referral source are people within medicine. And if someone refers me a patient, that's a doctor. If a doctor refers me a patient, they have a very high booking rate, like 90 percent because you know, they, they trust that doctor or their family member.

And I've also operated on a lot of nurses and doctors because they see me operating, you know, they're an anesthesiologist who's walked me out and watched me operate there for me, their friend or their sister. They're a nurse who's been in the operating room with me. They come to me for surgery or they send me their best friend because they see how I operate, how I'm with people and what my results look like, you know, branding.

So, there's a difference between like messaging, like your brand versus like your organization or your company. So, let me give you an example Hyatt or Hilton or let's say Hilton, right? That's not really a brand, okay? It's not a brand because you could be in a Hilton and you're in a room and you could be a.

Either at a Hyatt or an embassy suites or Marriott and all feels the same, right? Starwood, whatever, any of those, they literally all feel the same. The only difference is price. When you go to log on and you look to see what it costs for one night in San Diego at the Hyatt versus the Hilton versus the Regency.

But if you're in the room, it feels the same. Now, whereas if you look at Nike. That's a brand, right? Why is Nike a brand? Well, because Nike focuses on athletes and they don't market you the shoes and say, they're, they're 18 instead of the 19 Reeboks they're selling you the brand, they're saying we celebrate athletes, we celebrate athleticism.

We create innovative new technology and we develop the field of athletics in order to improve the quality of athletics, you know, nationwide. So, that's the difference between like a brand and just like a name, right? There's a big difference. The same thing happens in medicine and in our practices. So, I look at myself as the brand and I say, how do I build that brand up?

I don't want to just be any other plastic surgeon. I want to be somebody who's doing something different, something that's unique and innovative. And I also want to be someone who's pushing the limits and the boundaries and who's present at a high level and all those other arenas. That's a huge, that's a huge kind of mind shift.

And you have to really fully commit to it because you can't just dabble when you're saying, I'm going to be innovative. I'm going to try something. I'm going to get out there and get up on stage.

Catherine Maley, MBA: There are a couple of things I noticed on your website that are different. One is that tummy, the painless tummy tuck, because anyone who's been around that knows that's a really tough recovery is probably the toughest one. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

But you're saying, nope, it's painful or painless. And then like the drain lists you know, no drains. Well, is that how you're differentiating yourself? And are you getting any blowback from that, from your competitors? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Yeah, well, okay. So, what I did was I said, Okay, what are the biggest impediments to cosmetic surgery to tummy tucks?

What are the things that people are afraid of when you talk to them about doing abdominoplasty? And the first thing is always pain. And the second thing is the drains, this number one and number two complaints. So, what I started doing years ago was saying, how do we optimize the perioperative pain control?

What are the ways, the strategies that we reduce the amount of pain patients feel during surgery, and why do other surgeons not do these things, or why do they fail, you know, when they attempt to do it?

Catherine Maley, MBA: And what's the answer to that? Because how can you do that when others can't? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: The answer is really straightforward.

It's basically a commitment to consistency and spending the money when you need to, and time in the operating room, because it's just as important as the outcome, as the way it looks. Okay, so if you say to yourself, what are my values, and my values are Patient surgical outcome, but also patient experience.

So, for me, my number one value is safety. Number two is the way that the quality of the result, the way they look. And number three is the experience. All of those things are within my value system. So, I look at those things and I put my money where my mouth is. So, yeah, it's going to take me time to develop a strategy to be able to do the numbing medication perfectly.

And it took me years to get that right. Okay. But then once you start getting it right, you start seeing patients that are like just taking one Tylenol. saying I'm not in pain and you're like, holy cow, this really does work. Then you start doing it and you say, okay, now, okay, that it was good. It was good.

Then it was bad. Okay. So, why did I, why was there inconsistency in these results? That patient was bigger. This one has a different metabolic rate with this type of medication. I didn't inject it in the right places here and there. Okay. I'm going to get more consistent at it. More, more, more at bats. I'm going to do a couple hundred of these.

Okay. Now it's really consistent. Okay. Now I'm going to do a study. That's what I did. So, I did a prospective study, 90 patients over three months. 95 percent of them pain scale 0 to 2 out of 10. How did they do that? Well, consistency. Now I published that in an article in ASJ, peer review. They looked at my data and they asked me to review my data because like you said, there's some blowback.

They're like, we don't believe you. They wanted to look at the charts. They want to see the patient information, all that stuff. They did all of that. And they said, wow, this is really compelling stuff. Not just charting that I did, because I also had the nurses recording in the aftercare facility. What's the pain scale on that?

And I wasn't looking at, you know, so this data was data that's there that, you know, we look back at retrospectively to. kind of capture after doing all that. I said, okay, we're able to combine the best possible approaches. So, tricks that we know in plastic surgery, like injecting before you cut, everybody knows that that if the brain doesn't sense pain while you're asleep, that reduces pain, that it feels afterwards.

And yet every plastic surgeon is in a hurry. Okay, so what do they do? They come in, inject, and cut immediately. They don't give time for the medication to set in, or they don't inject, they just cut. And they say the patient's asleep, but then the patient moves, reacts, the anesthesiologist has to give more opiates to control the patient's heart rate, to keep it down, to reduce the blood pressure.

Now the patient's getting more opiates. Now when they wake up, they're more groggy, they're more nauseous. They have all those other complications, right? So, if I can inject before the knife touches and perfectly numb the body before I do anything, then the anesthesiologist doesn't have to give as many, as many opiates, doesn't have to give as many of those medications that are going to create other issues later on.

And then if I inject after everything's done, everything's exposed, I'm looking right where the nerves are. I do a selective nerve block with that long-acting medicine, the X Brow. I can get that same pain control up to seven days after surgery. Now this is a revolutionary approach. So, when I call it. What I called it in that paper, painless, drainless tummy tuck.

I was honestly shocked that they allowed me to publish that because no surgical procedure is painless. Everybody understands that pain accompanies any procedure where you have to cut an incision into the body where you have to basically get a result. But the whole concept was honestly kind of jokingly saying it's less pain.

Like the pain is less, it was kind of like a joke, like play on words initially, but then they adopted it and the editors and people said, well. The goal is to achieve that you don't always get it. Sometimes you're getting zeros out of 10 so you could say what you want. And when I talk to patients, I say no surgery is painless.

I'm quoting this article that I wrote. The whole goal is to make it as less pain as possible. So, at least you'll know if we do the procedure and you are in pain that we did everything possible. Everything that's technically possible that is up to date and scientifically proven to give you the best possible experience.

That does differentiate me in the market. I had a patient today in my office who told me that she saw another surgeon. And he said, I don't use X Bowl because I want you to feel pain because I don't want you to pull your stitches out. I don't want you to mess anything up. I want you to lay down and not move for three months.

I'm like, that's ridiculous. Like you shouldn't have a surgeon who wants you to be in pain. That, that, that actually is, is against the, the pledge that we make in medicine to first do no harm. You know, our goal as physicians is to reduce pain. We want to treat it, prevent it, and produce and reduce it.

So, if somebody's telling you that they want you to feel pain, I would run. That's not, that's not the surgeon that you want to be with. That's somebody who is clearly a little detached from the process of surgery and does not have empathy for your experience if they're not trying to reduce your pain.

So, I use that as a marketing tool. In my own practice, I talk to patients about pain. And I say there are two things that separate me from what other surgeons do. Number one is pain control and number two are the stitches that I use on the inside to recreate the natural shapes. That leads me to the drainless part.

So, I don't care about drains. You can have a drain or not use a drain. That's not the issue. What I care about is how do we get a better-looking result? How do we recreate the natural connections between the body and the skin? Those natural connections that create the line down the middle and the lines down the sides.

Those tummies aren't flat. They have shadows, they have hills and valleys. How do we recreate those shapes in order to give a better-looking result? Because in my opinion, most tummy tucks look bad. Most tummy tucks look flat with a little hole in the middle. There's a little, it looks like a donut or a little circle in the middle, a bad scar, which is too high and a flat result and a square result.

I don't want that. I want to create natural shapes. I want to see the hills and valleys. I want to see the shadows that hint to natural anatomy. And it just makes sense to do that because just like in the deep plane facelift, where I reattach the fascial structures to where they belong, I do that in the abdomen.

I reconnect the skin to what's deeper because there were connections there before. Why wouldn't you recreate them? In doing so, it gets rid of the space where fluid could accumulate. So, you don't have to use a drain. You don't need to do it because there's no place where that fluid can recumulate. And in the studies that I've done, one in 2013 with 417 patients, one in 2015 with 619 patients, and then additional studies that I've published, basically what we found is that there's actually less of a rate of seroma if you do this drainless approach than if you do a traditional approach and put in a drain.

Why is that? Because we get rid of the space where fluid could accumulate. The rate with a drainless tuck is around 2 percent in the published literature, not just in my studies, but in all studies that have been written. The rate in a traditional tuck is 9%, 9%. That's fivefold more. That means you have to treat nine patients with a drain to prevent a seroma in one patient in a traditional tuck.

But if you're doing my tuck, I would have to put drains in 49 patients to prevent a seroma in one. So, it doesn't make sense to put a drain in if you're doing progressive tension sutures, if you're doing the things that I'm doing in the. Tuck. That's why when my competitors say, well, you should just put a drain in anyways, like we just don't want fluid.

Oh, I do. They say I do the same thing, but then I still put a drain. I'm like, clearly, you're not doing the same thing. And if you are that stupid, because you're now subjecting 49 patients to a drain that don't need it. And the number needed to treat is very high to prevent that complication. This is biostatistics.

This is something I learned back in my PhD, right? What is the number needed to treat to get a desired effect? Whereas if you're doing traditional tuck, it makes sense to put drains in nine people to prevent it in one, because that's not a lot of number needed to treat to prevent this aroma, but yeah, I've gotten feedback, even from people like my old mentors saying, you know, talking trash about the procedure, even on their own kind of social media or their own, their own their own sites, but it's funny because if you listen, they're actually saying throughout the concept or throughout the discussion.

Well, you know, yeah, pain control. Yeah, it is good to do the things, but then they'll say something like, but he basically just uses X barrel at the end. It's like, well, then you weren't listening because no, it's all the other things I did before surgery that made the biggest difference. There’re other medications I use that are oral medicines and injectable medicines and topical medicines that I use.

And if you could understand those, then you'll understand how, what I do is actually light years different from what they're doing, but they don't even care to know. They just assume that I'm using it as a marketing ploy. They're not looking into the science or they haven't been to the meetings. Or they haven't read an article in 20 years, which is fine.

I mean, like if they're producing good results and they're doing an okay thing in their own practice, that's fine. But I, you know, like I don't call up innovative people, you know, I don't call out people that are doing innovative things and say, I don't think that's scientifically valid. You know, I just look at what they're doing, do a little more research and make my own decisions about what I want to do in my practice.

And patients are smart. They're going to do the same, you know, patients are not dumb. They're the most well educated they've ever been. These days, they go on a deep dive, they come into my office. They say, I've read every one of your articles. I've watched all of your YouTube videos. I know everything about this procedure and this is what I want.

And that's what I want in my practice. So, the more than I'm messaging into the audience. Into the crowd about a different technique that's superior, that has scientific benefits. And, you know, and these are the risks, but these are the benefits, the better my patients are, the more they want the surgery, the more they're pre-selected to come to me.

So, if they don't want that, I'm never sitting in my office trying to sell them on my technique. They've already come to me because they've found it and they want it. I don't have to separate myself from. All the other, you know, tummy tuck surgeons in Beverly Hills, because the patients have already done that.

They've already said, this guy is innovative. He's got a PhD. He's a thinker. He's doing different things. That's who I want. And it's great. Cause then my brand can go like this. And, you know, people are criticizing what I'm doing or, you know, other practices. It's fine. They, they just haven't separated themselves from their group and they can't because they haven't figured out a new way to do it.

They're, they're, they're by definition doing the same thing everyone else is doing. And that's fine because they want to be mediocre, but I want it to be different.

Catherine Maley, MBA: But if you're getting different results and you're showing them, that's what the layperson needs. They a lot of people aren't going to read the medical articles, but if there's some way you can communicate this to patients where they get it, and the best way to do that is with photos. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

So, if you're showing peaks and valleys or grooves and curves and the others are showing the square, I mean, that just says it all right there. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: So, the patients make the decision for you, just like exactly what you're saying. But so that's, that's, those are the things that I do that are different, you know, the pain control and then the drainless approach.

Now, the other thing that's really important about. The drainless approach. It's not again, not about taking out the drains about the stitches inside. The other thing those stitches inside do that's really important. You basically pull the skin down, put a stitch, pull it down, put a stitch. So, you put tension across the skin as you're bringing it down to do your closure.

And then in the bottom, once you've, once you've taken all the tension off and you remove the skin, that's between these two layers and you go to close them, there's nothing pulling them apart because all the tension has been taken off. You just. Close it like the little incision gets closed, right?

Tension is what creates a thick, upraised, or wide scar. So, if there's no tension, there's no thick, upraised, or wide scar. So, they get a much better scar, a much better healing incision, and they can stand upright because they don't feel like they're about to rip apart when they stand up because the tension's been taken off.

So, these stitches on the inside are doing so many great things. It's not just about being drainless or removing the drain. It's about changing the way that the tummy looks, making it look more natural. offsetting tension for the best possible scar incision and allowing the patient to have a quicker recovery.

And when I talked, when I talked to patients about that, they're like, duh, this is what I want. Darker skin patients want it because they don't want a bad scar. Patients that want the most pot, like this is technically the most skin you can remove. So, patients that you, in most times you'd have to leave a small vertical incision where the belly button was.

I get, I'm able to get that out in many cases where many surgeons say that they could not. Because a drainless approach gets between six and eight centimeters, more of skin out by stretching the skin. As you bring it down, it also is technically the only way, the way to remove the most amount of skin that you can remove with this procedure.

So, like, if I have a patient that comes back and they're like, do you think you could have taken more? It's like, no, absolutely not. And I can show them videos and pictures on table where we bring it all out. We, we first show them where it would be if we just did traditional, and then we show them how much further we get when we get those techniques.

And that's really a compelling story too, to show them, wow, you're by putting tension across the skin, you're stretching. it. You're actually dynamically changing the skin and that's what's giving you a much better result. That's fabulous.

Catherine Maley, MBA: And pain free is a big deal. Painless, minimal pain. People remember pain forever. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: So, yeah. And you know what else they remember? They remember when they had none. So, like I had a patient in my office today, who's day 10 and she has a dinner party scheduled at her house this weekend. And her friend came in today for a consult. And she said, my friend. Who you just did a tummy tuck on is hosting 25 people at her house next weekend.

How is that possible? Is she going to be able to walk? And I was like, well, she walked, she drove herself to the visit today. She looked pretty comfortable. I think she's going to be great. So, that kind of endorsement, she's going to have this party. Everyone's going to be there. Wow. Your body looks great.

I'm only two weeks out. People literally do not believe it. Like people will not believe her. She has to show them the incision and they actually think it wasn't a tummy. They're like, no, that's not what you had done because there's no way you'd be standing, walking, doing those things. So, it's like wildfire.

If you do it right. And they're in very, and they're very comfortable. They, they tell all their friends, everybody sees it and they know, you know, the husbands love it because they're like, I was so worried my wife was going to be crying, all this stuff. And she's, they're telling everybody, you know, that it creates a rapid conversion effect.

It's like, it spreads like wildfire because people don't believe them when they tell them what happened.

Catherine Maley, MBA: Yeah, I noticed another thing coming up with patient trends and the wants that the wants they have, the likes and dislikes. Another one seems to be this anesthesia. How, I know you've done some videos on what you can do under local and Twilight versus general. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Are you, how are you handling anesthesia and addressing with the patients? And do you find that a lot of them, they're not interested in general? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Yeah, so the most advanced approach to anesthetics these days is something called total IV anesthesia. It's basically the use of IV only medications, which reduces the toxic effects of some of the gas or let's say inhaled anesthetics.

It can reduce nausea, it can reduce downtime, and it's a very comfortable way to go to sleep. sleep and to wake. So, propofol is kind of the basis for TIVA, but there's other medications that are part of the ‘Total IV Process’. When I talk to patients about surgery, I always focus on those three things that I brought up before, right?

Safety, outcome and experience. Now, the safest possible anesthesia that you can get. Is anesthesia where you're asleep, and there's a tube in your mouth to assist you with breathing. That tube may not necessarily be breathing for you, but it can be maintaining the openness of the airway, so you're breathing on your own, but you have an airway in place, so that if there were any kind of issue, you would have control over things.

That's what I do in my practice for most of the surgeries that I do. Now, of course, There is a move towards non anesthetic based procedures, or we'll say topical anesthetic only, topical analgesia, not anesthesia, or the use of trochees and all these other things, you know, like oral medications and injectable medicines so that it can be done, you know, in the office.

And I think that a lot of influencers and kind of famous people have been actually, interestingly, Doing these things at shop shops, okay, and advertising them saying that this is the way to go because I don't want downtime. I want to do under local and all this other stuff. The truth is, the quality of the results, let's say for liposuction, is not as good if you do it under local.

I don't care who you're going to give me that argument with, but I'll tell you why. Because when you take a cannula and you put it in the body, if you reach the fascia, and the fascia is not numb, or even if it is numb, it, it bothers the patient. It hurts, it tickles. ‘tickle lipo’, whatever you want to call it.

But what's the first thing that I do if the patient says, ow, I stop. So, the quality of the result is not as good because you're balancing patient experience with the aesthetic outcome. And anytime you're balancing things, it's 50, 50. It's not a hundred zero, right? So, the outcome is, it's not going to be like this, right?

The outcome patient experience, it's going to be here. And that means outcomes not as good, but patient experience is better. Now, when the patient's fully asleep, I can do this because the patient's asleep and we're numbing them using those medications, but they're not moving. They're not reacting to the movements.

So, I know I can go as deep as I want and create the deepest hills and valleys. True high-def surgeons. Most of them, people are doing VASER. They're doing high-def definition, really high quality. Liposculpture are doing it asleep because VASER hurts like hell, even if you're numbed up. Right. And skin tightening procedures like Renuvion and body tight, those create a tremendous amount of heat under the skin.

Those can create pain too. The last thing you want is your patient saying, Holy shit, this really hurts. Or like. I might be, you know, the doctor was torturing me during the procedure. So, if you look around at the high-level surgeons that are producing really great results, that's what they're doing. If you look at the chop shops, they're advertising, no anesthesia, do it under local, all this.

They're not showing you good results. Okay. They're not doing that, but they're showing you a cheap price. And a fast turnaround time. The other thing that they're doing is they're saving the anesthesia. They're not paying an anesthesiologist. They're not paying for that time in the operating room. And they don't have to go to an operator room.

So, in many of these practices, you look into the person who's doing the procedure. Maybe they had their medical board suspended. And so, they don't have access to a hospital. They're not allowed to be credentialed in a hospital. So, they have to do it in, in their office under local with some pronox, right?

Or they have some other issue associated with their practice, or they're not a plastic surgeon, you know, heaven forbid, they're not, they're not. even, you know, qualified to do the procedure. That's, those are the people that are promoting those concepts that are promoting local anesthesia in the office because they can't go to a surgery center.

They don't have privileges or they can't go to a hospital. I've seen it so many times that I'm a little jaded. So, when a patient comes to me and says, Oh yeah, you know, this guy, and then we say, okay, Google that page. Let's look it up. What are their, what are their credentials? Now, Google medical board and figure out whether or not they've had any, oh, oh, so they don't have a medical license.

Okay, or their license has been suspended or temporarily under probation. Maybe that's why they're offering you the procedure in their office, you know, under local anesthesia. It's not really about the patient's needs. You know, as a doctor, you got to think what's the best experience for the patient and what's the safest thing.

And that really is TIVA with a tube in a setting where there's another person. Now, this is the last thing that's really important. If I'm operating in a surgery center, And there's a board-certified MD anesthesiologist taking care of the patient. That's another doctor that's in the room that's looking at what I'm doing.

And they're ensuring that the quality of the outcome is good, but also that patient safety is really good, but also that the outcome is good. Because if I'm like doing something and it doesn't look good, they're going to be like, That doesn't look good. You know, are they like, you're really going to stop right now?

You know, the people that are around you are going to be critical of what you're doing. So, the more, the more standardized that procedure, that protocol and that setting, the safer that setting, the better the outcomes, because there are people all around that are scrutinizing what you're doing. If you're doing it in your back office.

Over lunchtime with a little bit of numbing and there's no one else in the room or maybe a nurse. There's no kind of quality, you know, control that's happening right in front of you. And there's a lot of risk associated with that. And the most dangerous thing in liposuction is not actually anesthesia.

It's the anesthetic. It's the analgesia. Because the lidocaine, the concentrations and the toxicities associated with those medications are the most, are the most difficult things to overcome. And when people are doing high def lipo or high volume lipo awake, they got to use very high concentrations of lidocaine.

Lidocaine is a very toxic medication. And at high doses, it can cause cardiac conduction abnormalities. It can cause seizures. It can cause all kinds of problems. And it is one of the reasons why people have had deaths and other issues with liposuction. So, those people that are saying this is safer, they are just Not they're not being honest with you because local lipo can be just as dangerous as anesthesia as general anesthesia If it's not monitored properly Remember that is the thing like those types of procedures are would have led to very famous celebrity deaths because of overdoses and lidocaine fluid shifts changes in the fluid balances and not doing it in a setting where you have an Anesthesiologist taking care of the physiology while you're taking care of the patient.

Catherine Maley, MBA: I'm going to push back a little bit though.

I've I personally have had a deep plane facelift under the local ‘Twilight’, like a colonoscopy. And that was amazing because I also had a, had one under general. And frankly, I get sick as a dog under general and I can't, I can't regroup fast enough. And I loved the local twilight, whatever that was called. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Right. So, you said just like a colonoscopy, right? So, what do they give you with a colonoscopy? Propofol. TIVA. Total IV Anesthesia. So, the difference between what you had and what I'm saying is simply placing a tube and you probably did have an oral airway or some other device in your mouth during the procedure so that if they needed to, they could intubate you.

I'm saying I just put a tube in there that helps to assist that process, whether it's a you know, an endotracheal tube or whatever it is that you want to call it, but that is what I'm doing. But I don't tell patients, this is twilight. You're going to be awake because they're not going to be awake.

They're going to be asleep. You don't want to be awake. Yeah. No one wants to be awake. So, what you're describing is what I'm talking about. Teva. And that's not just with facelift. That could be with all different types of surgeries. The concept is using the IV based anesthetics. So, that's a very comfortable process.

Like you said, better than the general that you're used to, because. traditional general anesthesia, they use a lot of inhaled gases that can be, that can cause other, you know, nausea, other kinds of issues. But it's not just about what we do during surgery, it's also about what we do before and after. I use something called Amend before surgery.

It's a pill that every patient takes an hour or so before surgery. It's been shown to prevent the nausea that can occur from the anesthetics. This is a breakthrough medication that's 15 or so years. But it really does make a tremendous difference. We also use Zofran and the other medications that are injectable IV medicines.

But this makes a huge difference and prevents nausea in my practice. And most surgeons that are using it will tell you they swear by it. I've only had one nauseous patient in the last like three years because of this medication. So, it's not just about General versus TIVA versus Twilight. It's also about what are the other things that the doctor's doing as part of the perioperative management to reduce those other types of symptoms and issues.

So, I would just say, we tend to oversimplify things. We tend to say the red pill or the blue pill. What about the green pill? What about the yellow pill? You know, what about the purple pill? All the other pills that you take, it's not just blue or red. It's how all the other medications we use in conjunction with the experience with the facility and with the other physicians and extenders that we're using.

How do those equate to giving you the best possible perioperative experience? I would even say hyperbaric oxygen chamber treatment, nutrition supplement, all that makes a difference in terms of the outcomes and the experience.

Catherine Maley, MBA: Yeah, I'll just say as a patient, the more comfortable I am, the more likely you are to see me again for more surgery, but just saying so we have to move on to social media because I'm assuming you have a very nice website. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Google's been messing around with everyone's search rankings. So, where are you at with marketing channels? What are you using to attract new patients to you? What efforts are you going through? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: I'm really an organic guy so I, I don't really spend money on marketing and social media. I have an Instagram page with about 13, 000 followers, and I'm on TikTok with around 92, 000 followers.

In both of those platforms, I utilize the platform to spread education. I don't run over an implant with my car, I don't dance. I talk about procedures with clarity and with transparency. And talk to patients about what the experience is like and why. And I try to dispel rumors and talk very openly about plastic surgery and results.

I talk about procedures that work and ones that don't. That's what I do. And with that organic approach, I'm able to generate plenty of new patients that come to the practice. Now with my website. I do use Google appropriately, but I don't target SEO terms that I think everyone targets. I target slightly different terms that help to improve the kind of show.

I used to be one of the guys, one of the few guys doing deep plane, but now even people who do traditional facelifts say they're doing a deep plane facelift and market that or they market that term so that they can capture the share. The truth is Google is the worst place to put your ad spend if you're trying to market your practice because SEO.

Is highly questionable, like you said, the algorithms are all over the place. The best place you're going to get identification and kind of, let's say the best way to increase your ranking on Google is to have authentic organic content that accurately reflects your practice and what you do, because that's how you build that kind of lily pad within the internet and within the world.

But I've been doing that. Actively building it for the last 15 years and in my practice, I've been heavily focused on building up reviews because reviews are where patients can see the quality of other patients experiences. And when I talk to patients about reviews and ask them to reviews, I do reviews on multiple platforms.

So, patients have reviewed me on everything from you know, vitals to WebMD, to Yelp, to Google, to RealSelf, all those places. And each of them has its own SEO that they're paying for. They're spending millions of dollars to increase their SEO on Google. So, I just piggyback off of what they're doing. I just say, great, thanks for promoting yourselves, put my reviews on that platform.

Now I'm visible, right? Because I don't have to pay Google to find me. I just have these other sites where organic reviews are done. I'm not paying for, and they're, and you're able to find me in those locations.

Catherine Maley, MBA: And that's enough? That's not enough to do in your area in Beverly Hills. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Yeah. Yeah, because what's the most important thing?

What's the thing that separates me from other surgeons? What's the one? What's the most important thing to building your practice?

Catherine Maley, MBA: Patients being able to find you online. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Great surgery and great care. Patients being able to find you online is important. But guess what? 70 percent of my patients right now are referral and if they click the box and say, I found you online, they didn't find me online.

They were referred to me by a friend and then they Googled my name and then they found it, right? So, you're right. I think they were able to find me by Googling my name. They were able to find me.

Catherine Maley, MBA: I'm the biggest proponent of word of mouth. I'm just saying you guys don't want, you don't want to hear that. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

You want to hear; how do you find more online? So, I'm just saying you, a good marketer can absolutely serve a really skilled surgeon for the short run. But in the long run, it fails because you take it. So, you get a thousand people in your office and your results are mediocre. And 30 patients are really unhappy. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Now you've just lost thousands of patients to come, right? Each patient is an opportunity to grow your practice by a hundred patients or to lose a thousand. Okay. Because if you're not delivering great care, great results, great outcomes, you're going to lose. You're going to lose you're going to lose big.

Okay. Because you can't hide, you can't hide only for so long. Can you hide crappy reviews?

Catherine Maley, MBA: Well, you know why else you need social media is just to have a larger reach because I'm assuming you're, you're going out of town or out of the area and you can only do that nowadays with social media. So, is that one of your marketing strategies? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Yeah. I mean, I market outside of my community and probably about 60 percent of my patients fly in from outside of California, you know, so. I think that that's very, that you're right. That's very it's, it's about access and reach, but actually the most important and most critical component of social media, the thing that it does is it actually gives your patients a little insight into you as a person, and that actually improves your ability to connect and it improves your conversion rate.

Because let's face it, if this is the marketing funnel, I don't want patients up here. I don't want patients right here because the most expensive leads. Are up here, awareness, right? Identifying your practice and who you are. These are very expensive leads. You pay a lot of money to be able to say, Hey, I'm Dr.

Gould, and there's all these other surgeons, but this is me. And this is what I do. Right. And then only one out of a thousand of them is going to make it down the funnel. And then the ones that are here, they're ready to make their decision. They're very inexpensive leads. Okay. They are ready to book and you don't have to spend a lot of money to find them if they've already found you.

So, I don't focus on a traditional funnel. I don't, I don't create a traditional approach. I don't mark it up here. I mark it down here. My marketing is focused. Patients have already seen a surgical result of mine. And then they book with me. So, I do my patients that are with me. I focus on those relationships.

You know, they say, Oh, I've got a friend coming away. Oh, really? What's their name? Okay. This is their book. Okay, great. I'll reach out to them and talk to them. And I'll build up and then I go back to the person who referred to me. Thank you so much for sending your friend for a facelift. I'd like to send you to Milk and Honey for a massage and a facial on us at Dr.

Gould Plastic Surgery. And this is just a great a great a great way for me to say thank you for sending another exceptional friend. You are a wonderful person and all your friends are going to be wonderful too. And I thank you for helping me build my practice.

Catherine Maley, MBA: Right. How much time do you think you're spending on social media per week? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: At least four hours a day. Yeah. So, probably, probably 21 hours a week, and that's a lot.

Catherine Maley, MBA: That's the part that's, that's messing with my head because I used, as a marketing consultant, I used to say, come on, you surgeons can't afford four hours a day or, you know, that kind of time. But then again, you, you, you're almost forced to, because if Google's not going to rank you online and, and they're not going to give you the reach you want, you are kind of stuck with that. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

But have you thought about like outsourcing it or using agencies or? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Yeah, I'm terrified of that. I have a person who films for me and does editing. Yeah. But I create all the content and all the ideas are mine. And I'm terrified of what would happen if I turn over the brand on social media to someone else.

I agree. You know, because you have to be very cognizant. And most of the great surgeons are producing their own content. They are. At least are very tightly in control of it. Like Mike Nyack. Still does all of his own stuff, you know, he does all his own videos, all his own stuff. I mean, Ben has a whole army, a whole squadron behind what he's doing, but he's very tightly controlling the messaging, the 'befores and afters', the way that those go out.

Catherine Maley, MBA: He's meeting them every week and they are strategizing, yeah. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Oh, every day. I mean, he's not advocating that. Yeah, no. So, so, but what you said about surgeons not having enough time to do that. Well, I'll just tell you this, like tomorrow, my day starts at seven and it ends at eight, eight 30 PM in terms of my booked time on the books with patients.

But then guess what I'm going to. Do after, I mean, I'm going to go to the gym at 4 30 in the morning and then after seven or whatever at night, I'm going to head home and then I'm going to sit on my computer and do about two and a half to three hours of work looking at the social media, looking at the different things that have come through there, catching up on emails, connecting, doing those other things.

I can outsource some of the other marketing. I can outsource some of the direct consumer marketing, some of the marketing within the practice, all those other things that build the other more traditional kind of pathways without sacrificing what's happening in that social media kind of realm. But for your social media to be good, you have to interact with it every day.

And if you don't, it's not going to, it's not going to fly. It's not going to go on the algorithms. It's not going to be bumped up on the for you page, even worse. So, in plastic surgery, because plastic surgery gets shadow banned because we put before and afters. So, I just created two new pages on Instagram faces by Dr.

Gould and bodies by Dr. Gould to be able to show people those outcomes and to do it on a private page. So, it doesn't get banned because on my page. It's really interesting. I was doing stuff and I can see how the waves of kind of what I can do go up and down. And then I look at like, I'll do like a reel and it'll get like tons of views, but it's still not on the for you page.

But if I put my account from pub from a professional account back to a private account or to a personal account, then all of a sudden, their views go way up. So, I know that the algorithms are looking at what we're doing. They're not dumb. They know what we're trying to promote on Tik TOK.

I've had several times where I have a video that's going viral, it's catching fire, and then just wham, it just slams, they just slam it down because they, they, the algorithm sees that it's plastic surgery and they are trying to quote unquote create body positivity and they want to do that in their space.

It's just shocking to me because you see all the other content that's on Instagram on TikTok that's not surgical that would be user generated basically pornography or you for you type stuff that is designed to Moves people from the TikTok platform to fans only, or those other pages and the, and the algorithms are totally okay with that.

And the reason why, because of money, right? Because the group that's behind only fans, they're, they're multi-billion-dollar conglomerate. They're spending money, they're paying TikTok to be able to promote those ideas. And the influencers that are, that are with agency, they're spending a hundred to 200 K a year.

To promote themselves and their brand. So, Instagram will let them do whatever they want. So, if you're a doctor and you're worried about getting shadow banned, there's a really simple solution. Pay Instagram 150, 000 a year. I have several people who've done this. They will give you your own Instagram insider, a person within Instagram who can help to direct your clientele, your traffic, all that stuff.

And all of a sudden, our videos will start to get a hundred thousand views to 200, 000 views. It's very simple. You got to pay to play a

Catherine Maley, MBA: phone number. When your site goes down, you get the red phone number, the red phone, then you can call and it goes right back up. Otherwise, you're dead, right? How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Because Zuckerberg needs money.

They're badly struggling. Meta is struggling since they developed the platform. They lost a lot of, a lot of money and time and marketing, several platforms that have not worked. What they've come out with threads is like mediocre at best, and they have to generate a ton of money to be able to get the money that they need.

To push what they were trying to push the, the new space for meta kind of in, you know, basically the virtual reality platform that they were trying to develop and that's failed miserably. And all the other places have failed, you know, like the open seas failed all these NFTs where they were trying to sell property online have failed.

So, they had a ton of money they invested. So, now they're trying to recoup some of those losses or pay for some of those things by pushing people into a corner so that they have to pay for marketing on Instagram. And once you understand that, you realize that the most valuable platform is not Instagram and it's not TikTok.

It's actually YouTube because the YouTube videos can be promoted on many different platforms. YouTube is Google. Google gets paid every time you leave the site. So, YouTube will incentivize people to click off of your video to your website. And they're perfectly okay with that because. But, you know, pay for click is what Google is all about.

So, I think that in a modern world, you have to look at all the different social media sites, assess them, assume how they're going to work in your practice, and then be present in at least two of them. And, you know, there are places that are, that are real estate that's expensive and places that's real estate that's cheap, right?

So, expensive real estate is Instagram. It's like Beverly Hills. You got to pay to play very expensive, but very effective. Inexpensive. Snapchat, LinkedIn, all these types, Lemonade, all these other types of sites where there's nobody on there, but you could be the only plastic surgeon that's on there, you know, or there's very, there's like tons of real estate that you can buy.

It's not very effective, but you can all of a sudden be the biggest voice in that space like, you know, chat rooms and things like that. So, I've actually experimented with all the different, you know, areas and I'm in, in all these different areas because I like to see, okay. Is there a deal to be had over here, you know, and in a chat room style, you know, website or on Twitter or one of these other places, or, and then also have a little bit of a platform on Instagram and big following on Tik TOK.

Cause that's a viral location. And now I'm in the process where I'm building up the YouTube. So. YouTube for me started a couple of years ago, they came to me and they gave me verification as one of the very first plastic surgeons is verified on YouTube. And I haven't really fully expanded that platform, but they did that because of my work with the editorial board with ASJ.

They saw what I was doing. They saw the research that I was doing. They said, this guy is like a voice for knowledge and plastic surgery. And I connected them with ASJ. We created a whole account there to build up how we, how we get content out there. And because of that I got kind of the check mark in YouTube at a very early stage for plastic surgery.

Now my goal over the next three years is to build that up and to really make the YouTube channel something that I'm proud of that really provides not just marketing but knowledge. We're really adding knowledge to patients about the experience of surgery, transparency to see what it's going to be like, and a real understanding of what it'll be for them when they go through the procedure.

Catherine Maley, MBA: Very nice. We're going to wrap it up now because I'm pretty sure we're past an hour. Last question, tell us something we don't know about you. How did or does this relate to or impact you developing your ‘Painless & Drainless Tummy Tuck’ technique?

Daniel Gould, MD, PhD: Wow. Well, there's, I mean, there's not much to know about me outside of medicine. I think the thing to know that people don't know is that, you know, for me this, there really is no other thing that, you know, I'm not a great golfer.

I'm a terrible, I mean, I grew up fly fishing. I'm a good fisherman, but I'm a terrible athlete. Like I'm not good at basketball. I'm I don't, you know, I played baseball, football, I lift a lot of weights, but that's just to stay in shape so I can be better in the operating room. For me, the main thing is the main thing.

I am fully focused on plastic surgery. I am obsessed with it. I'm passionate about it. I want to make it better and I want to be a leader. And in the next five years, I want my name to be heard. You know, I want people to know my name as a household name. I am fully committed to that. And because of that, all those other things kind of go away.

I'm not married. I don't have kids. I'm really focused on this one thing. And really trying to perfect it and be as good as we can at it. That's something that it may sound kind of strange or a little bit robotic, but the truth is I'm fully committed to that idea. And I know that it takes a lot of energy.

I give all of my time right now, and that's the most valuable resource that we have, but there is nothing else for me at this point. Now there's other businesses and things that I'm involved in, but they're all in the aesthetic space focused around improving patient care and getting better outcomes.

Catherine Maley, MBA: Good for you. I would focus while you can, especially while you're young and you're still trying to figure this out to add a family to all of that can be complicated. So, so I'll, I'll be interested to watching you grow and your career. You're off to a very good start. By the way, if anybody wanted to get a hold of you, which there's a chance they will, what would be the best way?

I know your website is Dr. Gould Plastic Surgery and Gould is spelled G O U L D. How do you say it? Gould?

Daniel Gould, MD, PhD: Gould. Yeah. Some people say 'Gold'. I'm okay with that. You know, synonymous with plastic surgery. It's my midwestern accent. Yeah, the best way to reach me is through the website. So, via email, [e-mail] or through social media on Instagram @drgouldplasticsurgery or on the TikTok, drgould.

Catherine Maley, MBA: Nice. All right, we're going to wrap it up now. Thank you so much, Dr. Gould, for attending Beauty and the Biz. I really appreciate it.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on Dr. Gould’s ‘Painless & Drainless Tummy Tuck’ procedure.

If you’ve got any questions or feedback for Dr. Gould you can reach out to his website at, DrGouldPlasticSurgery.com.

A big thanks to Dr. Gould for sharing his story on developing the ‘Painless & Drainless Tummy Tuck’.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

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-End transcript for “Painless & Drainless Tummy Tuck — with Daniel Gould, MD, PhD”.

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