the DIEP end: A Plastic Surgery Podcast

A conversation with Dr. Bill Adams about how he got into plastic surgery, the culture at UT Southwestern, and the ideas that shaped his approach to breast surgery. He also breaks down his current thinking on pocket plane selection, augmentation mastopexy, patient education, and why education and mentorship have been central to his career.We discuss Dr. Adams' path from aspiring orthopedic surgeon to plastic surgeon, the mentors who influenced him, and the lessons he carried forward from UT Southwestern and John Tebbetts. The episode also gets very practical, with detailed guidance on breast measurements, dual plane technique, managing borderline augmentation mastopexy patients, and setting expectations in the social media era.Key topicsDr. Adams' early path into surgeryHe grew up with no doctors in the family and initially wanted orthopedic surgery because of his sports injuries and early exposure to surgeons.A pediatric cardiothoracic rotation, then general surgery, helped him realize he loved operative work but wanted a different kind of precision.A friend, Brett Snyder, encouraged him toward plastic surgery.Why plastic surgery fit his personalityHe describes plastic surgery as meticulous, detail-oriented, and a strong match for his obsessive, highly structured approach.He was drawn to the combination of technical skill, problem-solving, and aesthetics.How biking and friendship shaped his early yearsHe talks about a major Tour de France era biking trip with Brett Snyder and friends.The story highlights the close professional and personal relationships that influenced his development.The UT Southwestern environmentHe credits UT Southwestern for much of who he became as a surgeon and educator.He describes a high-volume, highly demanding culture with strong board preparation, deep pathology, and a strong general surgery foundation.Leaders like Fritz Barton and Rod Rohrich set the tone for hard work, productivity, and academic rigor.Rod Rohrich's influenceDr. Adams emphasizes Rod Rohrich's intensity, work ethic, and leadership.He says the program's culture came from its leaders and that he learned how to work and think like a productive academic surgeon there.John Tebbetts and breast surgeryTebbetts was his biggest mentor in breast surgery and a major influence on his philosophy.Dr. Adams explains how Tebbetts helped him think in tissue-based terms, focusing on the breast envelope and implant fit rather than just cup size goals.He also credits Tebbetts with shaping ideas around patient education and structured planning.His framework for breast augmentationDr. Adams describes measuring breast base width, nipple to fold distance, and skin stretch to guide implant selection and pocket choice.He emphasizes that the goal is to optimally fill the breast envelope with a tissue-based plan.He references the high five process as an extension of that philosophy.Why he prefers dual plane in most patientsHe says he is about 99 percent dual plane because he believes it offers better long-term outcomes.He argues that above-muscle approaches, including subglandular and subfascial, often sacrifice coverage and may lead to longer-term problems.He points out that long-term thinning can make even a technically acceptable above-muscle choice less durable.How he thinks about pocket plane complicationsHe says many problems blamed on dual plane are actually technical errors, such as over-dividing, under-dividing, or dividing too close to the chest wall.He notes that a small subset of very muscular patients may still be better served with an above-muscle approach.Patient education as a core part of outcomesHe says managing expectations is really about education, especially in an era of misinformation from the internet and social media.His process includes a dedicated patient educator, measurements, Vectra 3D imaging, and a structured consultation.He stresses that patients need to understand their asymmetries and plan before surgery so they are not surprised afterward.How he decides when to add a liftHe gives a practical algorithm using nipple to fold length, skin stretch, and vertical excess.He explains when a patient may do well with augmentation alone, when to stage, and when augmentation mastopexy is the right choice.He also discusses choosing between superior medial pedicle and central mound techniques based on horizontal laxity and volume resection needs.Why he favors a horizontal incisionHe says he stopped relying on straight vertical mastopexies because they were less predictable and often left residual skin excess.He now uses a horizontal incision in the crease to better control nipple to fold and improve consistency.He separates pedicle choice from skin incision choice, arguing they should not be bundled together.Leadership in educationDr. Adams talks about directing the UT Southwestern aesthetic fellowship and shaping it into a leader-focused training program.He describes the fellowship's roundtable format, where fellows choose topics and lead discussions instead of being spoon-fed journal club articles.He also reflects on his roles in the Aesthetic Society and its Research Foundation, emphasizing giving back through education.Rapid fire closeHis favorite OR music is classic rock and Motown, often chosen with input from the staff.His favorite instrument is the double ended retractor, which he says is indispensable in breast surgery.Timestamps00:00 - Welcome, conference plans, and why this podcast focuses on surgeon stories01:13 - The question that started it all: what shaped Dr. Adams' path01:29 - Wanting orthopedics, then discovering surgery fits his mindset02:26 - First surgical rotation in pediatric cardiothoracic surgery03:22 - Why orthopedics felt too mechanical and why general surgery opened his eyes03:52 - A biking friendship that helped steer him toward plastic surgery04:46 - Bruce Shack and the moment plastic surgery clicked05:39 - Why precision, detail, and ER reconstruction matched his temperament06:16 - Biking as a major part of life and the Tour de France trip story07:25 - How UT Southwestern shaped his surgical identity08:47 - Landing in a competitive residency and training with strong peers09:42 - Why the residency structure was ideal for integrated plastic surgery11:05 - The transition from division to department and Rod Rohrich becoming chair12:03 - Leadership, work ethic, and the Southwestern culture13:57 - Joining faculty and learning from Rod over eight years as his boss15:33 - The breast surgery questions that shaped the rest of the episode16:19 - John Tebbetts as his biggest mentor in breast surgery17:16 - Resident education and the academic culture at UT Southwestern18:10 - Early breast reconstruction experience and muscle sparing free TRAM work19:13 - What Dr. Adams learned from Tebbetts about breast aesthetics20:12 - Why Tebbetts' teaching style was so direct and technical21:00 - Tissue-based planning and why the breast should dictate the implant22:25 - The high five process and carrying Tebbetts' torch forward23:36 - Why UT Southwestern valued aesthetic surgery and academic influence24:03 - Subglandular, subfascial, or subpectoral: how he thinks about pocket choice25:49 - Why he still worries about long-term coverage with above-muscle placement26:14 - The history of pocket planes and the limits of subfascial claims27:05 - Why dual plane became the modern standard28:28 - Why subfascial and subglandular are resurging, and his skepticism29:56 - His preference for dual plane in most patients30:20 - Common surgical mistakes that create dual plane problems31:48 - When very muscular patients may be better above the muscle32:44 - Why above-muscle placement can reduce blood supply and complicate later mastopexy34:39 - Patient education in the age of internet misinformation35:06 - The process of breast augmentation: education, planning, technique, and postop care36:06 - Using a dedicated patient educator and structured counseling37:29 - Handling patient requests that conflict with anatomy37:59 - Measuring with Vectra and turning asymmetry into a shared plan39:04 - Borderline augpexy patients and how he decides on lift versus implant alone40:25 - The measurements he uses: breast base width, nipple to fold, and skin stretch41:47 - When augmentation alone is enough and when mastopexy is needed42:46 - Inferior mastopexy for long nipple to fold measurements43:16 - The tissue-based triad and deciding between one-stage and staged augmastopexy44:40 - Choosing superior medial pedicle versus central mound45:37 - Why he now favors a horizontal incision to control nipple to fold47:12 - Separating pedicle choice from skin incision choice48:08 - Building the UT Southwestern aesthetic fellowship into a leader-making program50:03 - Why the fellowship avoids traditionSend us Fan MailSupport the showInstagram: @thediependpodcast

summaryIn this episode, Dr. Susan McKinnon shares her remarkable journey in plastic and nerve surgery, her leadership philosophy, and insights into high performance and mentorship. Discover how her story and principles can inspire your own career and personal growth.keywordsPlastic Surgery, Nerve Surgery, Leadership, Mentorship, High Performance, Medical Career, Surgical Innovationkey topicsLeadership in SurgeryMentorship and Building TeamsLevels of High Performance and MindsetCareer Development in MedicineInnovations in Nerve and Plastic SurgerytakeawaysMentorship is about empowering others to be better than you.High performance is rooted in awareness and managing your mindset.The levels of human consciousness influence how we lead and innovate.Abundance mindset fosters creativity and collaboration.Storytelling and family history shape our values and resilience.Send us Fan MailSupport the showInstagram: @thediependpodcast

Episode: Dr. Jesse A. Taylor, Surgeon-in-Chief,  Chair of the Department of Surgery, and Chief of Plastic Surgery at The Children’s Hospital of Philadelphia (CHOP)Hosts: Dr. Hank Davis, Dr. Saïd AzouryEPISODE SUMMARYRecorded just weeks into his new role, this episode of “The DIEP End” sits down with Dr. Jesse Taylor, who was named Surgeon-in-Chief and Chair of the Department of Surgery at Children’s Hospital of Philadelphia (CHOP) effective July 1, 2026, succeeding Dr. N. Scott Adzick after his 31-year tenure. Dr. Taylor also continues to serve as Chief of the Division of Plastic, Reconstructive and Oral Surgery — a post he held for eight years before taking on the top job — and holds both the Peter Randall Endowed Chair in Plastic Surgery and the C. Everett Koop Endowed Chair.Hosts Hank Davis and Dr. Saïd Azoury trace Dr. Taylor’s path from a childhood in Springfield, Illinois, watching his cardiologist father build a practice from scratch, through a personality test at Vanderbilt that steered him toward plastic surgery, a residency at Johns Hopkins, and a formative craniofacial fellowship in Mexico City under Dr. Fernando Molina and Dr. Fernando Ortiz Monasterio. After several years on faculty at Cincinnati Children’s Hospital, he was recruited to CHOP and Penn in 2010 — a leap of faith he credits largely to his wife, Maggie.The conversation moves through the mentors who shaped him — including the late Dr. Linton Whitaker, Dr. Paul Manson, Dr. Scott Bartlett, and Dr. Joseph Serletti — and lands on Dr. Taylor’s philosophy of leadership: humility, preparation, and the belief that “none of us gets anywhere in life without a ton of help.” He also shares his vision for the future of pediatric surgery at CHOP, from precision medicine and gene therapy to what he calls the “sacred” relationship between a pediatric surgeon and the families he treats for decades.WHAT YOU’LL LEARN IN THIS EPISODE• How a psychometric personality test at Vanderbilt Medical School pointed Dr. Taylor toward plastic surgery over his father’s field of cardiology • The story behind a fellowship-changing phone call to Mexico City — and what a year training under Dr. Fernando Molina and Dr. Fernando Ortiz Monasterio taught him about creativity under limited resources • Why Dr. Taylor believes “none of us gets anywhere in life without a ton of help,” and how that shapes his approach to leading a surgical team • The leap of faith behind leaving a thriving practice at Cincinnati Children’s to become “a small fish in a big pond” at CHOP • Lessons from mentors including the late Dr. Linton Whitaker, Dr. Paul Manson, Dr. Scott Bartlett, and Dr. Joseph Serletti • How Dr. Taylor is thinking about the future of pediatric surgery at CHOP — including precision medicine, gene therapy, and the goal of curing conditions like cleft lip and palate and craniosynostosis • His approach to preventing burnout, building a team, and starting every day before 5:30 a.m. • Advice for young surgeons: believe in yourself before you have the evidence to prove itMEMORABLE MOMENTS• “None of us gets anywhere in life without a ton of help.” • On his craniofacial fellowship abroad: “I was able to see there are lots of ways to skin a cat.” • “I don’t just make guesses, I make hypotheses — it’s an educated guess, not just a guess.” • On the parent-surgeon relationship in pediatric plastic surgery: “Dare I use the word sacred — it’s a sacred relationship.” • “Whenever I feel myself getting burned out at work, I say to myself: you just need to read more.” • “I want people to say he left the place better than he found it.”ABOUT THE GUESTDr. Jesse A. Taylor is Surgeon-in-Chief and Chair of the Department of Surgery at Children’s Hospital of Philadelphia (CHOP), a role he assumed July 1, 2026, succeeding Dr. N. Scott Adzick after his 31-year tenure. He also serves as Chief of CHOP’s Division of Plastic, Reconstructive and Oral Surgery and Co-Director of the Craniofacial Program, and holds the Peter Randall Endowed Chair in Plastic Surgery and the C. Everett Koop Endowed Chair. A graduate of Washington and Lee University and Vanderbilt University School of Medicine, Dr. Taylor completed his residency in general and plastic surgery at Johns Hopkins Hospital and a craniofacial surgery fellowship in Mexico City. He was recruited to CHOP and the University of Pennsylvania’s Perelman School of Medicine in 2010 after several years on faculty at Cincinnati Children’s Hospital. Dr. Taylor has authored more than 370 peer-reviewed articles and serves as a director of the American Board of Plastic Surgery and in leadership with the International Society of Craniofacial Surgery.KEYWORDS (SEO)Jesse Taylor CHOP plastic surgery podcast pediatric plastic surgeon CHOP Surgeon-in-Chief craniofacial surgery Peter Randall Endowed Chair C. Everett Koop Chair cleft lip and palate surgery Children’s Hospital of Philadelphia surgery mentorship in surgery N. Scott Adzick Linton Whitaker craniofacial Perelman School of Medicine plastic surgery academic surgery leadership The DIEP End podcastSend us Fan MailSupport the showInstagram: @thediependpodcast

In this episode, we explore the origins, growth, and future vision of the Mediterranean Conference of Plastic Surgery Innovations, led by Dr. Kokosis and Dr. Kaoutzanis. Join us as we discuss the importance of international collaboration, innovation, and cultural exchange in advancing reconstructive and aesthetic surgery.Key Topics:The inception and evolution of the Mediterranean Conference to foster regional collaborationChallenges and opportunities of planning a major international conference outside the U.S.The role of artificial intelligence in reconstructive and aesthetic microsurgeryBuilding a global network of top surgeons in plastic and microsurgeryThe synergy between aesthetics and reconstruction within conference agendasHow technological advancements like augmented reality and pattern recognition are shaping the future of surgeryPersonal insights on maintaining long-term collaborations and the significance of community in medical innovationSend us Fan MailSupport the showInstagram: @thediependpodcast

Send us Fan MailSupport the showInstagram: @thediependpodcast

Send us Fan MailSupport the showInstagram: @thediependpodcast

summaryIn this insightful interview, Dr. Sam Lin shares his unique journey through plastic surgery, blending microsurgery and aesthetics, and discusses his leadership role as the editor-in-chief of the PRS journal. Discover his perspectives on training, innovation, and the future of plastic surgery.keywordsPlastic Surgery, Microsurgery, Aesthetics, Medical Education, PRS Journal, Surgical Innovation, Leadership, Career Developmentkey topicsDr. Sam Lin's career path and training in plastic surgeryThe integration of microsurgery and aesthetic surgery in practiceLeadership and vision as editor-in-chief of PRS journalThe role of social media and AI in patient expectationsFuture directions and innovations in plastic surgeryguest nameDr. Sam Linkey frameworksCross-disciplinary trainingInnovation in surgical techniquesLeadership in academic publishingaction itemsReflect on your training path and seek cross-disciplinary opportunitiesStay updated with social media and AI trends affecting patient expectationsConsider pursuing leadership roles to shape the future of the fieldSend us Fan MailSupport the showInstagram: @thediependpodcast

summaryIn this engaging interview, Dr. Shereene Idriss shares her journey from medicine to skincare entrepreneurship, debunks common skincare myths, and discusses the importance of a holistic approach to aging and skin health. Discover expert insights on skincare routines, social media influence, and innovative treatments like nano fat transfers.keywordsdermatology, skincare, anti-aging, skincare myths, social media, skincare line, aesthetic procedures, skin health, skincare ingredients, patient educationkey topicsJourney from medicine to skincare entrepreneurshipCommon skincare myths and misconceptionsThe role of social media in skincare educationInnovative treatments like nano fat transfersImportance of holistic skin health and agingguest nameShereene Idrisskey frameworksHolistic Skin Aging ModelTimeline-Based Treatment Planningaction itemsWash your face nightly with a gentle cleanserAlways wear sunscreen daily, rain or shineFocus on lifestyle factors like sleep, diet, and hydrationPlan cosmetic treatments according to your long-term goalsSend us Fan MailSupport the showInstagram: @thediependpodcast

Send us Fan MailSupport the showInstagram: @thediependpodcast

summaryIn this in-depth interview, Dr. Vu Nguyen shares his insights on plastic surgery education, competency-based training, wellness, and career development. Discover practical advice for residents, program directors, and aspiring surgeons navigating the evolving landscape of surgical training.keywordsplastic surgery, medical education, competency-based training, residency, wellness, career development, academic leadership, surgical training, mentorship, residency programskey topicsCompetency-based training in plastic surgeryMentorship and academic leadershipResident wellness and resilienceFuture of independent vs. integrated residency tracksResourcesPitt Plastic Surgery ProgramCompetency-Based Medical Education (CBME)American Board of Medical Specialties (ABMS)ACEPS ConferenceJeff Janis's Plastic Surgery Boot CampSend us Fan MailSupport the showInstagram: @thediependpodcast