Host: Hey, guys. We are back in Beverly Hills for the RealSelf Botched after show with facial plastic surgeon, Dr. Paul Nasiff. Let's talk about Mike.

Dr. Paul Nasiff: Mike.

Host: I've never seen anything like that and I work at RealSelf.

Dr. Paul Nasiff: With this tissue expander, you have the tissue on the back of the scalp which is very tight. The tissue expander is a balloon, like a boob implant, as he said, and the whole goal is to stretch the skin because the skin will stretch. So that when we take it out, our goal is to be able to cut out that scar so there's no tension on the skin when we stitch it back together. It just didn't come out great so he probably needs to have a little bit of micro hair grafting still in some of the scar.

Host: Let's say Mike is considering a facelift in the next 20, 30 years. Is it possible to do that with a receding hairline given the associated scars?

Dr. Paul Nasiff: You have to look at the genetics to find out where some of the family members are losing their hair. We have to know where they're going to lose their hair again. Usually the temporal, this hair is pretty much intact, but I'll do faces on men that have no hair, that are bald or made themselves bald. My goal when I do these scars up in the temporal or in the back in the scalp way back here, I have to do it in a way that they are camouflaged beautifully by doing what we call a running W or something.

Host: Dr. Deroe is constantly teasing you on the show. You have got to have one tiny little embarrassing fact that you could share with RealSelf about him just to get back at him.

Dr. Paul Nasiff: All right. I could tell you something about the housewives.

Host: Okay.

Dr. Paul Nasiff: So Heather, his lovely wife, calls him TV Terry because he always wants to be on TV, especially with the housewives. But now, honestly, we tease. I just do it a little bit less on national TV, but we tease all the time and we do have a good bromance.

Host: Michelle got her facelift in the Philippines, and we do see this on RealSelf, people considering medical tourism. What are your top recommendations for someone who wants to get their plastic surgery done in another country?

Dr. Paul Nasiff: Let's say me as a facial practice surgeon. There are international facial plastic surgeons everywhere and they do have their own board certification, so it really depends on who you go to. She went to the Philippines. We don't really know what type of doctor. We don't know what kind of board certification, and basically she got botched pretty much, which I don't think they showed it but I redid her whole chin. She had an implant that I removed and then she had a witches chin where the chin was hanging down. She always had some bad scars right here. So you have to be careful with what you do, whether it's a European facial plastic surgeon or a South American plastic surgeon. There's great plastic surgeons across the world. You just got to make sure you get in the right hands.

Host: Michelle said she had about 10 procedures on her face. I'm wondering how many facelifts can a patient expect in her lifetime?

Dr. Paul Nasiff: I don't think she was having facelifts all the time. I think she did have one or maybe two and she had some chin work, and then she had some reconstruction of her cheek and her eye and all those. But just going back to the question about the facelift, the first thing is you don't want to do it too old. You want to do it while you still have good elasticity of the skin. You want to do it when they're in their mid to late 40s to do maybe a mini lift. You might want to have another one 7 to 10 years after. The average amount, usually for someone who wants to take care of themselves that someone will do, is two. See you guys later. See you next week.

Host: Bye. Thanks so much for joining us, Dr. Nasiff. We'll see you next week, and don't forget you can catch Dr. Nasiff on E! on Botched following the Kardashians Sunday at 10 p.m.

Botched Season 1, Episode 6: "Boob Implant" in the Head, Medical Tourism, Dr. Dubrow's Embarrassing Nickname

Dr. Nassif gives RealSelf exclusive scoop on what we didn't see in Botched Season 1, Episode 6. He talks in-depth about what it's like to have a "boob implant" in the back of your head and gives tips for those considering medical tourism.