Reza Keshavarzi, MD - Bariatric Surgeon in Miami, Florida

Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome to Meet the Doctor. My guest today is Dr. Keshavarzi. Tell me how you say your first name so I don't embarrass myself.

Dr. Keshavarzi (00:40):
Reza.

Eva Sheie (00:41):
Reza.

Dr. Keshavarzi (00:41):
Reza Keshavarzi.

Eva Sheie (00:42):
Thank you. And he's a weight loss surgeon, bariatric surgeon in Miami, Florida. And this is the first time we've ever had a bariatric surgeon on the podcast, so I'm very excited to talk to you today.

Dr. Keshavarzi (00:54):
Thank you. Thank you. Very excited to be here.

Eva Sheie (00:57):
Now you're in the epicenter of a wild change in weight loss.

Dr. Keshavarzi (01:02):
Exactly.

Eva Sheie (01:03):
But I want to go back in time a little bit first and talk about bariatric surgery before we get to the hot thing. And curious first how you got into it and what made you excited about bariatric surgery in particular.

Dr. Keshavarzi (01:20):
So it's actually kind of an interesting story. I was born and raised in Tehran, Iran, and my mom worked in a national Iranian oil company. So I grew up going to the hospital, not being sick and having a pleasure of snooping around, seeing different things, going to the operating room, playing with the toys. I always knew I wanted to be a surgeon, but I didn't know what kind. When I moved to us, I pursued medical school, always hung around with the plastic surgeons in the burn unit thinking I'm going to go into reconstruction of some sort. Long story short, I ended up doing a general surgery residency here in Miami. After that I wanted to pursue plastic, but financial and family issues led me into go into practice for a few years and then at one point I decided that was not enough. I wanted to come back and do a fellowship and there was an opening down here with one of the gurus of weight loss surgery, Dr. Moises Jacobs. And by coincident we met, I became his fellow. I learned from him how to do weight loss surgery and I realized what I was looking for was really weight loss surgery. I enjoyed it so much. It was more rewarding for me than doing plastic surgery. And I'm still in Miami, changing people's look, helping them emotionally and physically. And somehow one thing led to another and I ended up doing this as a career and that's all I do these days.

Eva Sheie (02:47):
I'm not going to try to guess your age, but approximately what year was this that you started doing bariatric surgery?

Dr. Keshavarzi (02:55):
So I'm 51-year-old. I had the late start because I had to join the military in order to be the leave the country then getting US visa. So I did a non-traditional track medicine. So I was a little bit behind, but I started this in 2015. I graduated from residency at University of Miami Jackson Memorial Hospital in 2010. I joined the fishermen hospital in the Keys and had a year or two of that and then realized, no, I need to come back and do some training. So 2015 I did my fellowship and then subsequently I started my practice in Miami following that.

Eva Sheie (03:31):
But prior to that, you were a general surgeon, so you were still doing surgery all the time?

Dr. Keshavarzi (03:36):
Yes. And still after doing the training and starting as a weight loss surgeon, I continued to do general surgery as emergency calls. I still was active till my 50th birthday and I promised myself when I turned 50, I'm not going to take calls anymore. And that's coincidentally happened that I broke my shoulder on my 50th birthday and that led to another thing and I used that an excuse and stop calls. Whoops. So I don't do any general surgery since I turned 50, which was about a year and a half ago.

Eva Sheie (04:07):
How did you break your shoulder?

Dr. Keshavarzi (04:08):
Skiing. Skiing.

Eva Sheie (04:08):
That's not something people, okay.

Dr. Keshavarzi (04:10):
Skiing. I dislocated and broke my shoulder on the last day.

Eva Sheie (04:15):
Well, at least it was the last day,

Dr. Keshavarzi (04:17):
The last day, last minute of it. So it was good.

Eva Sheie (04:20):
Okay, so I have more questions. You moved from Tehran. Why did you move to the United States? Was that to go to medical school or was it to get out of there?

Dr. Keshavarzi (04:30):
It was to go to med school, but I had a little short experience in US when I was in second grade. My dad was a head accountant for national Iranian oil company, so we came to New York to close the accounts after revolution. So I went to school in Queens for second grade and half of my third grade was in Orlando deciding that we could should go back or not. Then we ended up going back and then I couldn't leave the country until I did my military service because it was during the war back then.

Eva Sheie (05:00):
What did you think of Orlando as a third grader?

Dr. Keshavarzi (05:04):
It was fun. It was fun. Disney, the oranges that my cousin used to grow in his backyard, all of those are good memories.

Eva Sheie (05:12):
Yeah, I bet.

Dr. Keshavarzi (05:13):
It was fun. And then when I came back, I knew I wanted to do medical school. So my uncle lived in Louisville, Kentucky and he helped me with accommodation and getting my application and all of that. So that's how it started.

Eva Sheie (05:27):
So while you were doing general surgery, you were working in a hospital, what kinds of patients were you seeing there?

Dr. Keshavarzi (05:33):
We see it all. So I did my training here at Ryder Trauma Center. So majority of the general surgery down here was focused on trauma. And then after in the practice, I was in the key, so majority of it was regular gallbladder appendixes, perforated colon hernias and stuff like that.

Eva Sheie (05:51):
People on vacation.

Dr. Keshavarzi (05:53):
Doing a lot of elective endoscopies, a lot of fish hooks in the hand from the fishermen's, a lot of infections, just basically common general surgery stuff.

Eva Sheie (06:06):
So in 2015 in the beginning, bariatric surgery was pretty rudimentary.

Dr. Keshavarzi (06:15):
When I was a resident, it was a totally different ball game. It was mostly bypasses. The stapling technology was new, so we had a high leak rate. The learning curve was still there, was still being accepted and a lot of people were just learning. And most of these surgical procedures have a steep learning curve and now it's completely different. It's nothing compared to what I remember 20 years ago as a medical student, those huge open bypasses leaving two or three drains. Patient was in the hospital for a week. Now the whole procedure takes 20, 30 minutes, five cc, 10 cc blood loss, no drains, drops of glue on the belly. They go home with Tylenol day after.

Eva Sheie (06:59):
What leads people to seek bariatric surgery? I mean obviously being overweight is what, but are there other factors involved here?

Dr. Keshavarzi (07:09):
There are. So gaining and losing weight is, if you look at it from a physiological standpoint, every animal wakes up in the morning hoping they find more food that they need that day so they can store some fat when the food is not available. So we being a mammal and food surrounds us, any mammal is coated in our DNA when the food surrounds us. Our body has one mission to accumulate some fat because it knows the food's not going to be there in the wintertime. But evolution of farming industry and the food industry has been so fast that our body has not evolve. It still thinks there's going to be a winner that the food's not going to be there. So it sees the food there and it will tell every molecule of your body eat more than what you need that day. So hopefully at the end of the day, a hundred grams of fat is stored for the wintertime.

(08:06):
So all the animals, when the food is abundant, they gain weight. When they don't have it, they lose weight. They hope this balance makes them survive. So the weak ones, they can't play that game. The ones that don't have enough fatty tissue to store, they don't get access to good food. That's the problem because our bodies does not evolve. The agriculture and the food industry has evolved. Calories are very abundant, and while that is around us, your mission is to gain weight. Now you want to tell yourself no food is around you don't eat because it's not good for you. So it's a constant battle. So these procedures don't make patients lose weight. They just give them an advantage over that physiological battle. So anybody thinks, oh, I'm going to get a sleeve. I'm going to get too skinny. I'm going to get a bypass.

(08:55):
I'm going to get too skinny. That's not true because ice cream will end of the day still taste better than chicken breast. Now these surgeries don't make ice cream taste bad and chicken breasts taste good. You still have to diet, you still have to exercise, but it's very non physiological to be surrounded by food and expect your body to easily shit weight. This is a battle and most of us have a life outside of losing weight and we put up this battle and the battle cumulatively gets harder and harder as the hormones build up, as you lose more fat. And at one point most of us give up and go back to our normal day. What has happened here is we've restricted our calorie, our body has lost muscle. Now we lowered our metabolism. You gain it all back plus few pounds more. So correct weight loss is difficult. Most of these yo-yo diets end up in losing net muscle and gaining net fat.

Eva Sheie (09:55):
Why does it seem so easy for some people to stay skinny and not for others even within the same family?

Dr. Keshavarzi (10:04):
So those are different reasons. Each of our born with a certain amount of fatty tissue, we can fill and deplete it. We cannot create and destroy it. So I might have a two by two storage and at 180 pounds I might be diabetic heart problems and I will die. And somebody who has a 10 by 10 storage can be 400 pounds and still not have any issues. We run into trouble when we overfill our storage. So our genetic capability, how big can we get that's given to us by our genes? How much fat are you born with? And there's a certain amount of filling you can do before you get sick. So I will never live to see 400 pounds. I just don't have that kind of capability. At 180, I'm sick. At 200 I'll die. So you always see me as a skinny person because if I get up there, I'm not going to live. But some people, most of my patients, 270 pounds healthy walking around, no problem. That means they haven't filled up their capacity. So your body is desiring to fill that capacity, fill your storage for the needy day.

Eva Sheie (11:13):
How would someone know what their storage capability might be?

Dr. Keshavarzi (11:17):
By their body buildup basically you can see you pinch your belly and you know how much much tissue you have there, people that you pinch and very thin, but there's people that have tissue. And you can tell by how overweight you are and how sick you are. So let's say if your BMI is 40 and you're not taking any medication, you have a potential to be one of those super morbidly obese. But if you're BMI is 32 and you're taking diabetic medication and too high blood pressure medication, that means you're spilling over. So your storage is very small.

Eva Sheie (11:49):
I see. So if your BMI was 40 and you really weren't having any issues at 40.

Dr. Keshavarzi (11:55):
That means, yes, you're healthy obese. Your fat distribution, it's in the arms, it's in the legs, it's in the areas that it's not toxic that much versus some people like me, for example, I keep, I'm five foot seven, I keep myself around 165 pounds all year long at 186 pounds, which is about 20 pounds heavier. My hemoglobin A1C goes from 4.7 to six and my blood pressure systolic goes from 120 to 160. So I don't have that kind of capability to get 250 pounds. I'll have a heart attack and I have some pictures of myself on my social media, about 186, very sick looking.

Eva Sheie (12:39):
How did you get to 186?

Dr. Keshavarzi (12:42):
So that was an experiment I did with peanut butter and Nutella.

Eva Sheie (12:45):
Oh no, you did that to yourself.

Dr. Keshavarzi (12:47):
So whatever I do to tell the patients, I try to do it myself.

Eva Sheie (12:51):
Hey, do you remember that weird TV show? Did you ever see that show where the personal trainer would gain the weight and then try to lose it?

Dr. Keshavarzi (12:57):
A lot of people would do it. A lot of people would do it. And this is that experiment we did just to see how much I can gain and I got really sick after 20 pounds. This was 2015, yeah, 2015 when I was just doing the fellowship and contemplating starting this practice.

Eva Sheie (13:16):
How did you end up losing it? What did you do?

Dr. Keshavarzi (13:19):
The science of weight loss is very simple and it makes sense. It really does. So if you understand it, each pound of fat is 3,500 calories. Each gram of fat is nine calories. We use fat because we can put double the calories in one gram of it, protein four calories per gram, carbohydrates four calories per gram, fat nine calories per gram. That's why we use it as storage vessel. It's 3,500 calories per pound. My basal metabolic rate is 1700 calories per pound. If I eat 500 less, I save 500 per day of caloric deficit. Every seven days equates to one pound of fat. That's as simple as that. So with the goal of losing four pounds per month, all I need to do is be 500 below my basal metabolic rate. At 200 of exercise, you raise that deficit to 700 a day. Now you're losing six pounds per month because every five days, one pound. But there's a caveat here. You know what the caveat is?

Eva Sheie (14:19):
I'm waiting.

Dr. Keshavarzi (14:21):
Whenever you go in a deficit, there's a certain grams of protein that you have to consume. That's the difference between starving and thriving. Your body, if you shut down the calorie can, number one think you're starving and goes after your muscle to lower your engine. If it gets enough protein, which is a language of our physiology, that means you're rich, you'll have nutrients in your body. It thinks you're thriving and it will go after the stored fat. So most of the people fall into the first category. They drink celery juice for a month and lose a lot of weight. Body thinks they're starving and all they're doing is downgrading that Cadillac Escalade to a Toyota Prius.

Eva Sheie (15:05):
What's the rule of thumb for protein? I've heard a lot of different ones.

Dr. Keshavarzi (15:08):
So everybody's individual. It depends on how much muscle you have. I have 77 pounds of muscle and my basal metabolic grade is 1,700 calories per day and every time I go to deficit I need 140 grams of protein per day. And that was by trial and error. Less than that, I would lose muscle. More than that, I'd sometimes actually gain muscle. Females average about 80 to a hundred. It depends on where their testosterone is of course, and how their hormones are, thyroid function. If everything is optimized in a deficit, average female responds to 80 to a hundred grams of protein per day. It's typically two shakes, two small meals and a high protein snack.

Eva Sheie (15:51):
Okay, so let's say you're doing that and you're great at it, you don't cheat, you follow the process and you discover that it's still really, really, really difficult.

Dr. Keshavarzi (16:03):
Nobody said it was easy. I said it's possible. I didn't say it'seasy. Is being something as possible versus something as easy. You can run a flat terrain. It's easy and possible. Climbing a mountain, it's not easy, but it's possible. So same thing. So weight loss is not physiological.No matter what, it's not going to be easy because you are going to fight your buildup. It's just any animal is designed to gain weight. Losing it is not natural. We're the only one that have that problem. Nobody else has that problem. So it's not easy. But with proper guidance, with proper knowledge and with proper tool, it's possible correct weight loss. There's a science to it. It's not easy, but it's very doable. The motivated patient person that wants to change their life, it's very doable and it's very rewarding because our society does judge you. Things are difficult for most of these patients. Simple things like crossing legs, tying their shoes, being comfortable in an economy seat in an airplane, all of those things. Most people don't realize that how difficult it is when you're overweight and the judgment that people do the looks that you get, everything in life becomes difficult and it's not their fault. And most the society thinks they're lazy. It's just very physiological to gain weight. Healthy people gain weight. It's a normal function of being a person.

Eva Sheie (17:36):
Yesterday I was reading about an 18-year-old who could power lift or Olympic lift far beyond what anyone had ever done before. And the point was not that he worked harder, he did have a genetic advantage and it does exist, but it's very rare.

Dr. Keshavarzi (17:54):
Very rare. Most of us are not that gifted. We have to work on it. But they are ones that are born with six pack and they're going to die with six pack because they just don't have any fatty tissues in their body and there's just nowhere to store it.

Eva Sheie (18:09):
So you started doing in 2015, the primary surgery you were doing at that time for weight loss was a lap band or a gastric sleeve or what was it?

Dr. Keshavarzi (18:22):
So when I was training back in 2000 early 2006, it was lap band and bypass. I trained with Dr. Moises Jacobs and he at that point has abandoned everything. He's one of the pioneers in this field of weight loss surgery and he trained very great fellows and he at that point was just doing gastric sleep and he believed that most people with proper follow-up can get same benefits if not more from gastric sleep. So I heavily trained on gastric sleep and the technology of the staplers were very good. We were barely seeing any issues with patients. And then I set my practice up solely doing gastric sleeves. Bands never only remove them and I don't believe in bands at all. They were horrible. Bypass is a malabsorptive procedure, has a lot of consequences and I don't choose it as a first line of defense. Gastric sleeve is anatomical from mouth to anus. Everything stays the same. We just remove an excess portion of the stomach that causes hunger and excessive storage of the stomach. So in the good hand, patients don't have a whole lot of symptoms. They achieves the control that they need to get and with proper follow-up and education, it can be very successful but not easy.

Eva Sheie (19:45):
And then a number of new and interesting technologies came along and I happen to, because I've been going to plastic surgery meetings since the early two thousands, I see the bigger things kind of come over to this side to the plastic surgery side. So I saw when the balloons came along and actually knew the rep for the balloon because he lived in Austin, the Apollo endo surgery is here and so I was familiar with them and what they were doing.

Dr. Keshavarzi (20:11):
So I do the highest number of balloons in the East coast, at least I used to. Now there's a lot of people doing it. So I started doing that in 2016 and one year we did, I think the highest year I did almost 200 balloons. Balloons are good in the right person, but it's not for everybody.

Eva Sheie (20:31):
Who's the person that it's good for?

Dr. Keshavarzi (20:33):
It's good for temporary weight loss. Let's say postpartum wants to lose 25 pounds of pregnancy weight. You have a knee injury, you can't go to gym, you need to lose 30 pounds before you get your knee replaced and then you can go to gym for a lot of weddings. People just wanted to look good for their wedding and they put that into their wedding package prices. You drop four or five dress size for your wedding. That was a lot of people I saw using it for that. But if you want change your life, balloon is temporary. It goes in there, it gives you control for six months with proper diet, 500 deficit per day, four pounds per month, 25 pounds with diet and exercise, six pounds per month, six months, 36 pounds. Average female lose 25 to 36 pounds. Good for certain people, but most people when they remove it, they eat again, they gain it back because nothing has been altered. But for plastic surgeons is good. They do it a lot before tummy tucks, they need to lose 30 pounds before they do their tummy tuck. The patient's BMI is too high. They need to drop it to get for that tummy tuck, BMI, they use it a lot.

Eva Sheie (21:40):
So let's get to the medications because that's, over the last year has just completely exploded.

Dr. Keshavarzi (21:47):
It's exploded. Our volume is less than half of the people that used to get surgery. Now they're on medication. So the medication, would you want to know about it? They're horrible if you ask me.

Eva Sheie (22:01):
Well tell me why you think they're horrible.

Dr. Keshavarzi (22:03):
So this is again another temporarily. So the weight loss and weight issues are permanent issues in most people. They're not just this year. The next year will get somehow better. When you start these medications, they're not helping you lose. I mean, let's take a step back. Only one way to lose weight and that's basically eat less than what you burn. So you can those, to get rid of those stored calories. All of these bariatric procedure one way or another, trying to help you tolerate that either by putting a foreign body in your body that makes you fool by manipulating something that helps you tolerate small calories. Beta HCG was on 500 calories a day. So basically all of them boils down, you need to control what goes in. So these medication hit your satiety center, make you less hungry, hit your gut. GLP receptors make him move slower.

(23:02):
So now you're less hungry and when you eat, you stay full longer. Same thing with the balloon. Less hungry. Stay full longer. Same with the sleeve. Less hungry. Stay full longer. So basically it's the same thing chemically. So anytime you control anything in your body with chemicals, your body always upregulates those receptors. You block it, body makes more of it. So it's called tolerance. Point five becomes one milligram. One milligram becomes two milligrams to get this certain effect. Then at one point you're putting $500, $800 of medication every month into your body just to maintain your weight loss. Now your insurance will drop you because you started at the BMI that was indicated. Now you're normal. Your insurance will drop you. You have to pay the money. Guess what? As soon as you stop it, what happens Now you'll have 10 times more receptors. All those receptors are screaming, feed me, feed me and everything to eat goes through you a lot faster.

(24:01):
So you're always hungry. So you gain pound rapidly. And guess what? Most of these people that are ozempic, they're not in a practice like minds that they're watching their muscle mass watching their BMI. So all of them are losing muscle, also known as Ozempic butt, Ozempic face.Now all of these people going to be hungry, muscular, and also metabolism damaged, gaining a pound a day while they get off of it. So I have no idea. Next year probably it's going to be millions of people coming in for surgery now. And these medications have consequences. Unfortunately, you trust, putting your trust in the pharmaceutical companies in America as far as the patent is up, they won't tell you anything. As soon as that 10 year patent goes and they get their marketing and research and all of that money out of you, they'll tell you, oh by the way, it does this, it does that. It causes this just like Nexium purple pill was the best thing since sliced bread. Now they say, oh it causes heart problem leches your magnesium cause osteoporosis and all those bad things. Everybody was on purple pill. You went to the doctor said my tummy hurts. There you go Nexium. Same thing. You go to your barber, now they're offering you some Chinese semaglutide. You think that barber is watching your muscle mass, giving you correct nutritional advice. No, you're going to lose some muscle, some water weight and most likely you're going to gain it back. You cannot address permanent problems with temporary solutions. It's good for companies, not good for the patients. I see a lot of people losing weight on it though.

Eva Sheie (25:37):
One thing I've heard a lot of is about food noise that it calms your mind down from being hungry all the time and thinking about food all the time. It does. And that seems beyond what's happening physiologically with your stomach.

Dr. Keshavarzi (25:52):
It does, but are you going to take this for rest of your life? Also, other things that people don't think about. It's very clear on this says if you have MEN multiple endocrine neoplasia, MEN type two, it will cause medullary thyroid cancer. It will cause pancreatic cancer. Medullary thyroid cancer and pancreatic cancer are the most deadliest known of cancer in men. And nobody goes ahead and checks these mening genes before dispensing this medication. And it's clearly there. If you have history of MEN 2 in your family, you can get medullary thyroid cancer. So tell me why Somebody pays $500, $600 inject themself on weekly basis with poisons that can cause medullary thyroid cancer. When they have an option of doing a 20 minute surgery and go home with Tylenol with proper training, change their life back. I'm baffled. I just don't know what people think.

(26:51):
It clearly affected our clients, it affected everybody. I'm blaming it on the economy, not on the medication, but I know deep down it's the medication because all those people that needed to lose 40, 50 pounds now they're on medication. So how long they're going to stay on it, what's going to be the long-term results? I have a feeling one of these lawyers are going to have an add-on TV saying if you'll have semaglutide or whatever, whatever for weight loss and you'll know somebody who died, give us a call for a class action lawsuit in the next few years. That seems to be classic.

Eva Sheie (27:28):
I was at the plastic surgery meeting in the spring and in the room in one of the big, big courses like where everyone was in the room, a thousand doctors. They said, how many of you are on it in this room? And 80% of the room raised their hand.

Dr. Keshavarzi (27:46):
I know everybody's on it. They're making millions and millions of dollars and it's not cheap medication. And the counterfeits coming from China, from Canada and God knows what's in that stuff because nobody's looking at it. And there's no regulation. There's no regulation. You're just buying a white powder and you're putting it in your body. And most people, I don't know, our body's the most precious possession we have. If they buy a Ferrari, they they buy expensive car. I'm not even going to go Ferrari. They put the most expensive thing they spend money on cleaning it. Their body, they go look for the cheapest food on the aisle. I don't know why most people don't have respect for their body. Just think it's given to 'em for free and it's going to work perfectly for the rest of their life.

Eva Sheie (28:32):
Yeah. There's clearly a lot more to unpack here. So we're going to have to come back and do some more on this topic.

Dr. Keshavarzi (28:39):
I would love to. I would love to. I was thinking about starting my own podcast too, so I'm in the process of it.

Eva Sheie (28:46):
Oh, you are.

Dr. Keshavarzi (28:47):
But it's a great idea. I felt very comfortable talking like this, but I just don't like sit in front of camera and talk.

Eva Sheie (28:54):
Before we wrap it up, what do you like to do outside of work? You have a family, you have kids, but what do you do for fun?

Dr. Keshavarzi (29:02):
I have one son and a family, but my passions are two things, skiing and cave diving.

Eva Sheie (29:08):
Not going to give up the skiing even after you took your shoulder out?

Dr. Keshavarzi (29:12):
Absolutely not. That actually ignited more fuel into it.

Eva Sheie (29:18):
And cave diving. Did you say cave diving? There is nothing that terrifies me more on planet earth than scuba diving in a cave.

Dr. Keshavarzi (29:27):
Oh, you should watch on Bahama Cave videos. Bahama and Mexico have the most beautiful decorated caves on earth. Stalagmite lactite, beautiful rock formation.

Eva Sheie (29:39):
Do you have photos of your own cave diving adventures online anywhere?

Dr. Keshavarzi (29:45):
Not a whole lot. I didn't used to post a whole lot of cave diving, I think because of life insurance issues. <laugh> But at this point I don't care. So I have one on my private Instagram, it's called Vegan Surgeon and I posted something there.

Eva Sheie (30:03):
And you're vegan too. We didn't even touch that.

Dr. Keshavarzi (30:06):
Yeah, so actually I started, after breaking my bones, I started adding some more animal products. Yeah, I started adding, but I was very, very strict vegan for now four years and now year and a half of partially. The joints hurt, that was what I noticed. I needed to add some collagen peptides to my diet.

Eva Sheie (30:33):
These are all things I put in the category of youth is wasted on the young and the things we don't know until we need to know them. Well, thank you so much Dr. Keshavarzi. It was a pleasure getting to know you today.

Dr. Keshavarzi (30:49):
Oh, you're welcome. This was a pleasure.

Eva Sheie (30:51):
If someone's looking for you and wants to potentially come see you, where can they find you online?

Dr. Keshavarzi (30:57):
We can find us on www. miami vip surgery.com or on Instagram Is Miami VIP surgery our handle on Instagram.

Eva Sheie (31:06):
Perfect. Thank you.

Dr. Keshavarzi (31:07):
Alright, good talking to you.

Eva Sheie (31:12):
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