TikTok user Saffy540 devotes much of her content creation to personal interests.
In line with the description on her public profile—“Lover of Freedom, Justice, and Equality”—that means, mostly, politics and pressing social issues.
But, professionally, she’s worked with two of the “world’s finest plastic surgeons” for decades, in the heart of the industry.
Amply afloat on word of mouth alone, the practice at which she currently works has no website or significant social media presence, and is “out of the price range of 99 percent of people,” Saffy540, who asked to be referred to as such since she wasn’t speaking on behalf of the practice, told Surgical Times.
Saffy—a plastic surgery patient consultant who makes clear that she’s not a doctor or nurse—defers health-related questions to licensed MDs, but says she’s “taken her queues from” the surgeons she’s worked with.
And that none of them would not agree with the suggestions she shared in a recent video.
The video, aired Sunday, August 28th, is a 0:32-second spot in which Saffy joined a popular TikTok trend: “5 Things I’d Never Do…”
The somewhat controversial clip quickly went viral, becoming her most-viewed video to date.
“Okay, I’m gonna jump on this trend:
“Five things I would never do, having worked in the plastic surgery field for 35 years and having worked for two of the world’s finest plastic surgeons,” she begins.
Eclipsing all other videos on a channel that has appealed to 123,000 followers—which typically garner thousands to tens of thousands of views—this video has been viewed 3.8 million times.
It’s a handful of short hot takes on plastic surgery, and the comments on it “went crazy,” Saffy says, before turning them off. (“My [TikTok] platform has nothing to do with plastic surgery at all.”)
Though Saffy isn’t the first to suggest some of these plastic surgery caveats, the viral video still raised some questions.
“#1. I would never get breast implants.
“#2. Never get fillers in your face.
“#3. Never, ever, get a laser peel.
“#4. Never, under any circumstances, combine a facelift with a tummy tuck, and,
“#5. Most important of all, do not hunt for a bargain in plastic surgery. There ain’t one.”
Surgical Times spoke with the plastic surgery consultant of 35 years early Friday.
On Avoiding Breast Implants
Saffy has worked with plastic surgeons since the late 80s—from “terrible ones,” who she wouldn’t let pluck her eyebrows, to “two of the world’s finest” in Beverly Hills.
It’s one of the latter with whom she works today.
As for why, after three decades in the profession, she wouldn’t undergo what was long its most popular procedure:
Scar Tissue and Capsular Contracture
“The main reason is that when you have a foreign body in your body—and it doesn’t matter whether it’s a breast implant, a hip implant, a piece of glass in your forehead, or filler—your body says, ‘Ooh, what’s this? I have to isolate it.’
“And it surrounds it with an envelope of scar tissue.
“And over time, that gets rock hard, and it tightens around the implant.
“And it causes something called ‘capsular contracture.’”
Capsular contracture can be “painful and distorting,” she says, and correcting it may require another surgery more costly than the first.
“100 percent” of patients with breast implants are going to form scar tissue, but not all will get capsular contracture or require corrective surgery.
“Over time, this capsule shrinks and that’s when you see people’s breasts like up under their armpits and one’s up, one’s down. And you see it over, and over, and over, and over again,” she says.
(Her office, which rarely does primary breast augmentation surgery, sees and consults on capsular contracture in patients who received their breast implants elsewhere.)
At the practice she works—which sees “an inordinate amount” of these cases and other corrections—Saffy conservatively places the number of breast augmentation patients this might affect at 1 in 4, or 1 in 5, not wanting to be quoted on it as her encounters with the problem are artificially inflated.
Her practice specializes at times in correcting other’s surgeries.
“So I don’t know whether I would really rely on that figure, but it’s a lot. It’s a huge number,” she says.
“It’s almost like eventually it’s going to happen.”
In studies, capsular contracture is acknowledged as a “one of the most common complications after breast implant surgery,” and its rate of occurrence is listed variously as anywhere from 15 to 45 percent, or more recently, from 0.5 to 30 percent.
Child Bearing and Cancer Reconstruction
The 35-year plastic surgery consultant says there are instances where she believes breast implants are “totally worth the risk,” and are “worth it,” such as after having children, and in cases where the breasts may need to be reconstructed.
Fat transfers to the breasts can also be done in lieu of breast implants, she says, though that procedure has results less certain than placing an implant, and not all surgeons perform it.
Fat transfer “also takes a lot of time. And if you’re going to a doctor—and unfortunately, there’s a lot of them—that’s just banging these surgeries out, then they don’t want to take the time that it takes to put fat in a breast.”
Implants Eventually Have to Be Exchanged
“These implants also need to be exchanged at some point, which a lot of people don’t really understand. Silicone leaks out; saline implants are awful—if you get a rupture with one of those, your breast is ‘gone.’
“With the silicone, you may not know you have a leak until many, many years later. And if you want those implants taken out, it’s a very long arduous surgery.”
On Doing Multiple Procedures in One Surgical Session
As to why the plastic surgery consultant says she wouldn’t get a facelift and an abdominoplasty on the same day, she shares an anecdote of a patient from some years ago.
“My previous surgeon [had a woman who came over], and she said ‘I want a facelift and an abdominoplasty,’ and the doctor said, ‘We can do both of those, but not on the same day.’
“But she wanted to do them on the same day.
“And she went somewhere in [nearby city] where she lived, had the surgery, and died of a blood clot five days later.
“So, number one, combining those surgeries exponentially increases the chance of a blood clot.”
Facelifts, a major surgery, should be given adequate time and space.
“An abdominoplasty is another long surgery; it should take a long time to do that surgery.
“If you’re going to do a tummy tuck, and a facelift on the same day, it’s ill-advised and you shouldn’t have time to do it.
“You could do your face and your eyes, your face and your nose, you could do your eyes and your nose, your breasts and some liposuction. But there are limits to what you can do.
“A good surgeon is going to take all day to do your face, and that’s why there’s no bargain in plastic surgery.
Manicurists Can’t Cut Hair Without a License, But Dentists Can Perform Plastic Surgery.
The long-time plastic surgery consultant points out that in some regards, barbers are more regulated in California than is the practice of cosmetic surgery. She shared how to avoid choosing a poorly qualified surgeon.
“The number one thing that you should look for in your surgeon is that they are certified by the American Board of Plastic Surgery,” she says.
“That way, at least you know they’ve had the right training.
“It doesn’t matter if they’ve had a thousand other certifications. If they don’t have that one, they are just practicing outside of their specialty.
“Second, how long have they been practicing?
“And talk to other patients.
“Pay for a consultation. Don’t go anywhere that offers a free consultation. You just see so much bad work out there.”
“Do they advertise? If they advertise, no, you don’t want to go there.
“It’s because, you see, the profession has become a business.
“And you don’t want a businessman operating on your face, you want a professional, an artist.
“[You want] someone who’s in this because they—they’re artists. And you’re their canvas.
“Not like, ‘Oh, I trained in dermatology but you know I can make a lot more money doing facelifts.’
“Or ‘I’m an ear, nose and throat doctor; I can make a lot more money doing rhinoplasties than I can taking people’s tonsils out.’
“And in California, you know, if you do nails, you can’t do hair unless you’re certified, but if you’re a medical doctor, you can do anything you want.
“You don’t have to have any training, you could just do it.
“So look at pictures, ask lots of questions, and go to multiple doctors.
Finally, “Look at the staff. Do the staff all look related?
“Not a good thing,” she says.
On Celebrity Plastic Surgery
“There’s something disturbing with the aesthetic these days.
“People are gravitating toward unnatural work. And if you want to look unnatural, I suppose you would…be disappointed if you didn’t look like that.
“In my career, I’ve had two women say ‘I’m a little bit disappointed because I don’t look like I’ve had a facelift.’
“No, you don’t. You just look 20 years younger.”
“They seem to want to all look the same: Big lips, big cheeks, crazy brows that are high up.
“It’s difficult, because if that’s what you want, you’ve got to go to one of these guys that is willing to do that to you.
“But if you want to look natural, start with [asking] your dermatologist [for a plastic surgeon referral] because there’s a lot of back and forth between them.
“You see [celebrity artist]. I’m pretty sure I know who she went to—goes to—and he does a lot of celebrities and they all end up looking like that. She was a unique-looking, beautiful woman, and now she just looks like a clone and it’s tragic.
“And she paid a lot of money for that.”