Ryan Spivak, MD (license on probation)

Awake fat transfer to breast and SoftSqulpt awake liposuction of Bra Roll, upper abdomen, and fat transfer to breast. Hope to get a tummy tuck down the line. After many many years (18 to be exact) of wanting to fix my breast deformity, I finally chose Squlpt! I chose them because: 1. Their before and afters were amazing for fat transfer! That is hard to find. 2. Affordable 3. I didn't have to be put to sleep 4. I love what they stand for and how they help women with implant illness. I am 10 days into healing and I am really glad that I didn't choose any other doctor. Even though I was awake during the procedure I wouldn't have chosen it any other way. The Laughing Gas they provided was a lifesaver and I shouldn't have been so scared to use it at the start of surgery! Everything was very relaxed and the Dr, staff, my friend, and I were chatting away. Lots of jokes and laughter and the doctor even played my favorite singer for the fat transfer. Such a sweetheart! All of the staff I have encountered have been very responsive from my first consult even to now during recovery. Throughout the process I have been very nervous and have been constantly asking questions . Despite the fact that I feel like I'm bugging, they have continued to respond quickly with patience and kindness! I'm very thankful since I have seen many other stories regarding different care from plastic surgeons, especially ones that change their demeanor after surgery or after pay. This, thankfully, has not happened not one bit with Squlpt! As far as my results, I am still very swollen but still I can see that my breasts are filled up and my rib fat is FLAT!!! Breasts took at least 600cc of fat each side. I cant wait and hope to update you with progress in the months to come. Updated on 24 Jan 2021: Still lots of swelling. Looks like my breasts went down quite a bit, but that is to be expected. My back and stomach are so smooth, rolls are gone, and I hope it stays that way after the swelling goes away. I did start post op lymphatic massages at 2.5 weeks and it moves the pockets of fluid and calms the pain down. It is vacuum cavitation. Many were reccomending to start earlier but I was scared of my open incisions and pain. Now that I started them I want them everyday but have only had 2 so far. My most swollen areas are my underarm side rib area (like a softball size) and the triangular area between my breasts by sternum (kind of where a bra underwire would sit) It hurts most when I get up from laying down. Gravity pulls the skin a different way and it takes a minute or 2 for the pain to ease. The faja makes the world ofa difference because it keeps the skin in one place and gravity has less effect of pulling the skin... It hurts after a while of having it off during showers. Yesterday I tried on a different faja that seems closer to spanks and it started hurting with my skin free to move more. My right arm (the right side is where more work was done due to the deformity) feels stuck, very tight and painful if I try to reach too high. I had about 4 lymph nodes that caused so much swelling and tightness in the area. Its like I have a tight band of muscle in the armpit area that will rip if I extend upper arm above shoulder height. It has slooowly been getting better week by week.

This was my 2nd procedure—-3 weeks apart—-at Elite Body Scupture in Beverly Hills. The 1st (I wrote a separate post) was Lipo Thighs to Knees and Transferred to Breasts. This one was Lipo Stomach, Hips, Bra Roll and Transfer to Butt (300 CCs to each butt cheek)—and a little extra to breasts: 550 CCs 1st Round, 175 CCs 2nd time and also did my Arms! They use a minimally invasive technique where u are awake with pain meds and local anesthesia, which is far safer than being put under. Throughout the procedure you don’t feel much but at the end, they couldn’t give me more pain meds so I felt EVERYTHING for the Fat Transfer to Breasts and IT HURT!!! That was the worst part. The 1st 2-3 days of recovery after are tough but then you feel better each day and after 2 weeks start feeling a little more back to normal. 3 weeks to resume most activities. The Compression Garment (for this technique only needs to be worn for 2 weeks, not 4-6 wks like typical BBLs) is pretty uncomfortable, a full body suit with pads to absorb fluid the 1st few days plus a piece of foam on the midsection worn for a week. And since I did my Arms, too, wore an additional garment with sleeves. Ugh! No sitting for 2 weeks with this technique instead of the typical 4-6 wks for traditional BBLs except for with a foam BBL ‘pillow’ to put under your thighs & let your butt hang off the back. Then you need to lean forward to balance the weight. I hate using it so I don’t very often. My doctor, Dr. Ryan Spivak—who is amazing—says you can sleep however you want but since I’ve researched Fat Transfers & BBLs to death, I’m paranoid and don’t want to. My huge issue is I had a Fat Transfer to both my Breasts and Butt at the same time so even sleeping on my side would squish my boobs and I was scared to lean back and squish my butt and my arms were too sore to lay on...SO I went kinda extreme an bought a 6” deep foam mattress and had the foam store cut a hole for my butt to go in so here’s no pressure on it. This allows me to lay on my back with no pressure on my boobs or butt. I also bought black sheets & a black towel (for leaking fluid) and another key thing was an inexpensive women’s urinal. The garment has a hole in the crotch and this is so less messy than before I got it. I also ordered a sleeping cushion with a hole fo the Breasts which will like me to sleep on my stomach and with no pressure on my breasts. This is custom made an will take a few weeks to get here. I’ll post pics when I get it. Updated on 6 May 2018: After the 2 week mark, I could stop wearing the full body compression garment and got the ok to start sitting, although just to be extra cautious, I extended the no-sitting for an extra week and now sit only with a boppy pillow or even better, a smaller version is an airplane back pillow under my thighs so my butt hangs off the back and doesn’t put pressure on the seat. I drove for the first time with the pillow at 3 Weeks. I can already see much improvement in my overall silhouette, which was my main goal. That and to be more proportionate, so between my 2 surgeries with Lipo on pretty much every body part and Fat Transfers to both my Breasts & Butt, I am happy with the result so far and hope to see even more improvement as the swelling around my midsection goes down.

I lost 50 lbs. when I was 15 yrs. old the wrong way---by starving myself with no exercise, which left me with terrible stretch marks, loose skin & huge saddlebags of cellulite on my outer thighs, as well as fat on my inner thighs that never go away no matter how skinny I got or with diet or working out. Also, my breasts got completely deflated---less than an A Cup. I had researched all kinds of Lipo for years and knew I wanted it for my thighs one day after I was done having kids. I'm 41 now with 2 kids (but I look much younger and often get mistaken for being in my 20's), eat healthy and workout all the time but all I can focus on are the bulges on my thighs! In clothes I can cover them well and look 'normal' but there are so many things I want to wear that I can't. I know I would benefit from a Thigh Lift or heck, even a Lower Body Lift, but I didn't want something that drastic with a long, painful recovery. I found Elite Body Sculpture who uses a technique they call AirSculpt with a patented tool invented by the founder, Dr. Aaron Rollins that uses the tiniest canula and makes the tiniest hole in your skin. Their motto is: No Needles, No Scalpels, No Stitches! It's minimally invasive, you are awake for the procedure and recovery is quick! Sign me up! I went for a consultation with Dr. Ryan Spivak and felt totally comfortable with him, was excited about the technique and results I could get from it so I booked it! Although I did have to book 2 separate procedures because I had so many areas to work on (for safety reasons, they can only put a certain amount of fluid in your body at once). My 1st Procedure: Lipo Outer & Inner Thighs, Banana Roll (under the butt) and Transfer it to Breasts. The 2nd Procedure: Lipo Hips, Stomach, Arms & Bra Roll and Transfer to Butt! I just had the 1st yesterday (btw, the cost listed is for each procedure, so double it for both). The nurses were amazing and made me feel so comfortable and Dr. Spivak is a rockstar and was so excited about my results to come and was so great throughout the whole experience. Everyone told me the recovery is worse than the procedure and they are right, although it's not terrible. I couldn't feel much during the procedure and now (day after) I am stiff and extremely sore but not in any terrible pain. I even opted not to take the prescribed Pain Meds and went with Advil instead. I have to wear a compression garment for 2 weeks. In 3 weeks, I go in for Procedure #2, which for me is the icing on the cake! Dr. Spivak even told me he may be able to add a little more to my breasts since your body absorbs some of the fat and the size will decrease a bit after surgery. Still recovering. Can't shower for 48 hours. Still swollen so I can't see my results yet (except the obvious size increase in my breasts!) but very excited to see results and will post 'AFTER" Pics when results show. The clinic doesn't take their After Photos until 3 months after and say that you won't see your full result for 6 months, but i will definitely see a huge difference in a few weeks when the swelling goes down and will update this will some After Pics then. I did take a few during/right after surgery which I'' put up now---Oh yeah, you can use your phone during surgery! =) Updated on 28 Mar 2018: Day After Fat Transfer Surgery. Breasts are very sore & swollen. Still marked up from surgery. Size & Shape will change over time. Too soon to wear a bra but I couldn’t wait to take a pic to compare Before & After. Dr. Spivak may add a little more fat to breasts during my next procedure in 3 weeks. Updated on 1 Apr 2018: It will really take 3 months to see good results & 6 months til final result, but I am thrilled with what I see so far, the 1st few days after surgery. The Saddlebags on my Outer Thighs are gone, my small, deflated breasts are bigger & more full and I have a bit of a thigh gap for the first time in my life. Can’t wait to see the improvements over the next few months. Updated on 1 Apr 2018: I can’t believe what a dramatic difference this is. I can actually fill out a sports bra now! Still swollen—this is DAY 6 Post Op. Updated on 7 Apr 2018: Still too early to see final results as you really don’t get a good idea of what you’re gonna look like after swelling goes down and bruising goes away until the 3 Month Mark, but these are AFTER photos within the first 2 weeks of recovery. Still sore but I feel a little better every day. At my 1 Week Post Op visit, Dr. Spivak said I was AHEAD OF SCHEDULE on my healing. My next procedure is coming up soon and he says he can go back and revise some areas and possibly add more fat to my breasts. Updated on 17 Apr 2018: 3 Weeks after my 1st procedure, I had my 2nd (which I’ll post separately because it was using the ‘Airsculpt’ Lipo technique on my stomach, hips and bra roll to transfer to my butt, BBL). The doc thought since I’m there anyway, why not add a little more fat to my breasts since the size would probably continue to decrease. I loved the size they were at that time, but knowing how early it was and knowing they could still loose significant volume, I was all for a little ‘boost’! Generally, you can only expect about a 1 Cup Size increase in the end. I started out less that an A Cup and figured the 1st procedure would leave me with a full B-ish. But ideally, I’d love to be a C Cup, so we’ll see what happens. These are pics taken just after the 2nd surgery. No bruising like the 1st time. They are super full now but will soften & go down over time. I do have to say—-and this happened with both procedures—-that I was awake (which is a safety benefit to this type of minimally invasive procedure) and they had given me all the pain meds they could at that time so at the end of this 6 1/2 hour procedure, I could feel EVERYTHING as he transferred the fat to my breasts and IT HURT!!! That was definitely the worst part of it all! Now, they are not as sore as the 1st time, just tender. No pain, no gain!! Updated on 24 Apr 2018: I am 1 Month + 1 Day Post Op from my 1st Procedure which transferred 550 CCs to each breast. Then 3 weeks later had a 2nd procedure transferring to Butt (separate review) where my doc added an additional 175 CCs to each breast, just to give them a little boost! It’s been 10 Days and swelling of the breasts have gone down. They are not as hard & round as they were right after surgery and have softened and dropped, making them look more natural. I love the current size and are just hoping they don’t get any smaller over time, which I know is a possibility. Fingers crossed!! Updated on 6 May 2018: I’m really bummed that my breasts have lost so much volume but I had realistic expectations going into this and knew that with Fat Transfers there’s no telling how much fat will survive and I expected to loose some volume, I was just *hoping* they wold stay that amazing full size I got to enjoy for a short time. It’s kinda like a tease—-you get really used to these nice, full breasts, then they shrink! Well they call this procedure at Elite Body Sculpture ‘Up a Cup’ for a reason. That’s pretty much all you can expect them to increase—-about 1 Cup Size. They are much better than what I tatted with so I can’t complain. My dr. suggested that maybe down the line, if I really loved the fuller size, I can consider getting a small implant. But the reason I went with a Fat Transfer was that I want to void all of the potential problems having implants can bring. I’m sure with a push-up bra I can get the same effect. Updated on 6 May 2018: This pic shows full body since the last few 6 Week photos only showed the breasts and the whole reason I’ve wanted to do the surgery my whole life was to get Liposuction on the saddlebags on my outer thighs. The Fat Transfer to the Breast was just a bonus, although I ended up LOVING it so much! Inner thighs will always have loose skin from loosing a lot of weight years ago but I am happy with the improvements for sure.

I’m not sure that I had any type of expectations going into surgery. Now I wish I would have. I totally get that every body is different, but my biggest goals were to get rid of my rolls on my stomach and feel confident wearing crop tops and bikinis. I liked Dr. Spivak. He knows a womans body well and how to shape it. I wish I could go back and ask for more fat removal and bigger breasts. My advice would be to go bigger than you think you want. The initial consultation was done online and was good and made me excited. Although there was something weird that happened to the final payment and they "lost" it somewhere. I’m still not sure what happened, but at least I wasn't charged twice. I flew from CO to LA for the surgery because when I researched surgeons in CO I couldn't find anyone who did this procedure that I liked their results. So thought if I want to best, lets go to LA where everyone has cosmetic surgery! The day of the surgery Squlpt had asked for me to come in an hour early, totally fine. (From the day of setting the appt to the actual appt day, the appt time changed 5 times! I went with it since I was coming from out of town and didn't have anything else going on) We had the whole morning planned around eating a good lunch like they recommend before the surgery. Since the office was 45 minutes from where we were staying that took out any time that I would have had to eat. So I had some nuts in the car. All this is totally fine except the fact that they left me sitting naked in a room for a hour once I got there. Every once in awhile someone would come in and have me do something. I wish I would have stood up for myself and just ate a good meal and came at the time I was signed up for. I also do wish I knew more about the pills they gave me too. I hardly ever take anything, even aspirin. So my body wasn't happy later with that. Surgery went by fast even though it was 4 hours long. It was pretty painless and I would say you do feel whats happening but its not bad. I remember I kept saying "this is fun!" obviously the laughing gas was doing its job. The first night was so rough. Way harder than they made it sound. I was so out of it and at this point and we had to find somewhere to pick up the prescriptions and supplies they recommended. Not easy when you’re from out of town to figure that out. It would have been nice for them to have it for me so it was all ready to go when finished with surgery. I then proceeded to throw up multiple times in the night and ruined the hotel bedsheets with the fluids that were leaking out of me. I felt terrible! Keep in mind that since I wasn't able to eat before the surgery I had nothing in my stomach and was too sick to eat after. I think you would definitely be better off than me by getting a good meal in before surgery. The next day I felt ok. I didn't do much except walk around and went to get water down the street and back. Day 3 the pain meds wore completely off and the feeling of being in a the garment was hard. But I was able to take it off and take a shower. Best shower ever! The new problem was my stomach was hurting so bad from the antibiotics they had me on. I was hardly taking any pain pills since I didn't know what was causing the stomach pains at that point. Day 4 I flew home and I would not recommend that until maybe day 6 after surgery. Those next few days were pretty miserable. I worked a half day on Day 5 (I’m a hairstylist) and also wished I would have taken more time off. It was doable but my back and body was in pain. The worst side effect was my brain and memory. I had a hard time forming sentences, focusing and driving. I even hit my garage while trying to park! That lasted for about a week and a half after surgery. I assume it was the laughing gas but really have no idea. The follow up with the nurses was kinda a joke. I had so many questions but found that it was luck of the draw who wrote you back or answered the video chat. Some were great, others not so much. At 2 weeks I stopped wearing the garment during the day but still wore it at night for 4 weeks total. 3 weeks after surgery I took a gental yoga class. 4 weeks out I took my normal pilates class. I eased into both, but felt good after each one. My worry was burning the new fat that was put in. I measured myself pretty frequently throughout. I lost about 3cm totally from the horizontal across my nipple measurement. Not terrible, but I loved how they looked when they were swollen and really high on my chest. I followed the diet plan exactly how they said to. Biggest thing I was worried about was giving up sugar. But I still haven't gone back to eating it and am happy that was a positive change that I made from having this done. I did have a yeast infection for 3 months from the antibiotics, very frustrating. The whole healing process I questioned why I did the procedure. It was a lot harder and mentally challenging to go through than they led on. I felt guilty spending that much money on something superficial. I didn't enjoy the discomfort that sometimes I still have. And to not have the confidence or body that I had hoped for from the beginning is a big letdown. Some days recently I have actually felt skinny and fit so overall I don't think my body would look like this even if I were to go to the gym 7 days a week. I already workout 4 days a week and eat super clean. Working out any harder or longer wouldn't be sustainable. Around the 4 month mark my breast started getting pretty squishy and started to sag again, so I recently have started using Naturaful cream and BustMaxx supplements and within a few days I started to notice and feel a difference in firmness and perkiness. So for anyone reading this, maybe try starting with those two products to see if it grows your breasts if you’re hesitant about surgery. I do want to get my nipples repositioned so they are even for my next procedure.As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway. Updated on 7 Jan 2022: Pretty disappointed about the fat transfer, my breasts are almost exactly where I started. Back in my old bras even. But the lipo looks real good. Would definitely use Squlpt for lipo, just not for fat transfer.

This is complicated for me to write. On one hand I’m mostly happy with my results, on the other I feel nearly traumatized from my experience. In short, Dr. Spivak is a good surgeon and horrible at running a business. He often runs eight hours behind. He does two to three surgeries a day and the person set to go next is often waiting for… hours. The reason he runs so far behind is because he leaves the surgery room multiple times throughout the procedure to do consultations for potential patients and to do follow ups. So you are left alone in a room, drugged, calling for nurses to help you. You are awake the entire time and aware of what’s happening. There is a heavy rotation of nurses. He can’t seem to keep them around. They speak rudely to you. One told me it was okay that she was rude, because I wouldn’t remember. I remember. Dr Spivak continually cancels the day before and morning of. I’ve driven to the office to be told he wasn’t coming two different times. I know several people who have used him. No one has bad results, but no one feels good about their experience He also *forgot* to do a portion of my friend’s procedure. (Bra roll.) She has a bulge on her back worse than before the procedure from removing fat around it but leaving that spot. When she was set to meet with him to discuss next steps, he didn’t show up. She also said that during her procedure, Spivak couldn’t find a nurse to help him, so he had her boyfriend, who was in the room with her, hold up her arms with go gloves on, while Spivak did the liposuction/soft squlpt. He’s just… a hot mess.

I wasn’t sure I would ever write this review if I’m being honest. I don’t dislike the results (wish they were better for suuuure) which made me feel guilty about saying something negative but the truth is that this experience traumatized me. First off, my start time was supposed to be 1pm and I followed instructions for arrival time to the t. I waited for five hours before I was even getting prepped. The nurse didn’t know how to put in an iv and dug with the needle under my skin four times before getting someone else who put it in my wrist by my thumb???? When they started fluid through it I felt shooting pain and they said “it shouldn’t hurt” I had to argue to have it moved. Once the procedure started I realized quickly I could feel a lot and it only worsened as we went. When I was in tears they finally offered me more pain killers when Dr. Spivak sarcastically said “remember you asked for this” in the meanest tone I could imagine at that point. I don’t know why I could feel it all, but I could. I’ve had my boobs done and no pain I’ve felt will ever come close to that. I actually broke my thumb two weeks ago and laughed it off because my idea of pain is so extreme from this procedure. They force you to have arranged pickup from the surgery and I even used the service they suggested where they call the facility when you’re almost done and the driver picks you up….. at 11pm during my surgery they asked me to deal with the driver being confused about pickup….. because my picky was 6pm and it was 11pm!!!! Wow. I didn’t get out until midnight at which point they literally slapped pads on me and stuck me in a garment completely covered in blood and chunks of fat. I spent 1200 for my room that I only got to stay in for a few hours because I selected a window based on me being there at 6pm. You might be scared to go under but if it’s between that and Squlpt…. Save yourself from a horrific experience and get better results in the process.

I’m not sure if the doctor that came up when I typed his name is accurate, which it says this Doctors license is on probation, due to his office’s lack of professionalism and crappy results I’m afraid to say this may be him. But his name was in fact Ryan Spivak and he works at Squlpt Body Shaping in Agoura Hills, CA. First off, my appointment was at 1pm , the office manager Sarah texts me at 12:45pm to tell me that the doctor is running behind and asked if I could come at 2pm instead. I told her that I had driven an hour to get to the office and I was about to pull up so I wasn’t going to turn around. Keeping in mind I am from out of state , I’m from the east coast and traveled on a 6 hr flight the day before to do this procedure. When I got there and expressed my irritation with the situation , all I got was a fake smile and an empty promise that they were “going to take extra special care of me” they didn’t!!! Turns out my procedure didn’t start until 3:30pm!!! I sat around all that time from 1-3:30 super annoyed. They did nothing to compensate my time didn’t offer me reimbursement or travel cost, nothing. Sarah is a ditz to be an “office manager” . I felt ALOT of pain during my procedure and that 3 day recovery time they advertise is definitely not true!!! I’m almost 3 weeks post op and my results are terrible! I have lumps in my stomach that make me look disfigured, my BBL didn’t come out as I had hoped. I told them my inspiration body was more Jenner style, not what I got. I admit the shape is a bit better than my natural form, but still not what I was expecting . I wore the garment for the full 14 days and followed the diet they provide. I used and am still using the pillow , not sitting in my bum for the full 3 weeks, got the massages they recommend…..I’ve done EVERYTHING they tell you to do to have the best possible results and it didn’t work!! I’m botched!!! Regret choosing this place and if your smart don’t go here.