Dr. 90210 - Season 6, Episode 6


by iEnhance.com | October 20, 2008 @ 10:00AM

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Aired October 20, 2008

Dr. Robert Rey

Dr. Robert Rey is still dealing with a visiting mother-in-law, Brenda, and things have gotten even tenser in the Rey household. The famous plastic surgeon has been spending extra time at the office to avoid going home. Although his work is stressful, he prefers that to dealing with conflicts at home.

After his wife, Hayley, asks Dr. Rey why he has been working so late, he gives in and explains his feelings to her. He describes that he feels undermined and uncomfortable in his own home; therefore, it's just easier to wait until Brenda is asleep to come home.

Having grown up in a rocky family situation, Dr. Rey desperately wants peace at home. Even though he doesn't like her, he decides to talk to Brenda to try to resolve the issues he's facing. He apologizes to his mother-in-law, explaining that he doesn't trust people very easily, yet she doesn't seem to understand.

Patient #1 & #2:
Mandi & Heidi

Surgeon: Dr. Robert Rey


Breast Augmentation, Breast Implant Replacement, and Breast Lift Surgery

Heidi, 30, and Mandi, 26, are sisters who do everything together, including having their daughters three weeks apart. Their next joint venture is breast augmentation. The two are going to Dr. Rey for their enhancement surgeries, hoping that he will provide them with the fuller breasts that they desire.

Heidi previously underwent breast enlargement surgery nine years ago and is having her saline breast implants replaced with silicone implants. Additionally, she is having a breast lift, which she feels she needs due to the toll that two pregnancies have taken on her figure.

Mandi will be having breast augmentation for the first time and, as she explains it, is looking forward to being a "hot mom," rather than a "minivan mom."

Pre-Op Visit:

Heidi's examination reveals that her pregnancies caused her breasts to become saggy; however, her breast implants stayed in place, causing a "double bubble." Her surgery should be pretty straightforward, Dr. Rey explains. She will have her breasts enhanced to a full D cup and potentially have a breast lift, as well.

Mandi's breasts, she feels, are too small and deflated. Dr. Rey observes that the top of her breasts aren't as full as the bottom. To help both areas of the breasts look more even, she will have her breasts enhanced to a full C cup.

Mandi's Surgery:

Because Mandi's procedure involves breast augmentation only, Dr. Rey performs her surgery first. She's a little scared for the procedure, but mostly excited. She has selected to go with 400 cc silicone implants inserted through the areola. Stage1: Dr. Rey makes a crescent incision on the right areola. Stage 2: Using a hook to open the incision, he then creates a pocket for the right breast implant by cauterizing the skin. He is very careful that the milk ducts aren't damaged so that her ability to breastfeed isn't impaired. Stage 3: The right breast implant is inserted. Stage 4: Dr. Rey creates a pocket for the left breast implant (performing these stages the same way as the right side). Stage 5: Next, he inserts the left implant. After both implants are inserted, he sits Mandi up to check for symmetry of the breasts. Stage 6: Since both breasts are even, sutures are placed in the breast.

Heidi's Surgery:

Her second time undergoing breast surgery, Heidi is anxious to have the procedure but not nervous. Dr. Rey had been thinking about her surgery the night before and was a little apprehensive of doing a breast lift and augmentation. Because her first augmentation involved incisions beneath her breasts, and this one around the areolas, he was concerned that there would be a lack of blood supply to the nipples. His decision is to perform an augmentation only, which will lift the breasts greatly. Stage 1: Dr. Rey makes a crescent incision on the right areola. This stage is very critical because he doesn't want to damage her arteries. Stage 2: He then creates a pocket for the right implant, removing the previously placed saline implant. Stage 3: The right silicone breast implant is inserted. Stage 4: Dr. Rey sutures the incisions on the right breast. He verifies that the blood supply to the nipple is still in tact. Stage 5: A crescent incision is made on the left breast. Stage 6: The pocket for the left breast implant is created and the existing implant is removed. Stage 7: Dr. Rey inserts the left breast implant. Stage 8: He finishes the surgery by placing sutures in the left breast.

Total Surgery Time: Mandi-1 Hour, Heidi- 44 minutes

A day after their breast augmentations, Mandi and Heidi visit Dr. Rey for a follow up appointment. Heidi's bandages are removed first, revealing that her right breast is swollen. She will have to wear a wrap to help push the implant down into place, as well as avoid strenuous activities. She's excited about her results and is going to be careful so that her breasts can heal properly.

Mandi is in a little better shape; she doesn't have any bruising, but does have slight swelling. She's a little concerned that her breasts are too large, but Dr. Rey explains that since she's swollen her breasts appear 30% larger than they actually are. Once she understands that, Mandi feels more confident and expresses that she loves her boobs.

Double Take

Seven weeks after their surgery Mandi and Heidi are thrilled with their results. They both have perkier, fuller breasts. Mandi is thrilled that her breasts aren't "long" anymore and that she doesn't have to wear a bra. Heidi's breasts also healed well and both are even. She's also happy because she and her sister do everything together and now she feels that Mandi won't feel like the flat-chested sister anymore.

Patient #3:

Surgeon: Dr. Gary Alter



Marco is a female to male transsexual who is seeking a metoidioplasty to complete his gender reassignment process. This surgery converts the female genitals to that of a male's. Last year, she underwent breast removal surgery and began hormone therapy; this procedure is the last step of his transformation. Marco never felt like a woman, even though he gave birth to four children and was married to a man. Finally, he realized that he had to be happy and pursue his life as a man, which includes getting married to his fiancé (a female).

Pre-Op Visit:

Upon meeting with Dr. Gary Alter, Marco explains his situation. In turn, the plastic surgeon examines Marco and explains the procedure and predicted results. The penis that will be created won't be long and intercourse may be a problem, but he will have a reasonable genital experience. Marco has been taking testosterone pills that increased the size of his clitoris, creating the appearance and functions similar to a penis. Dr. Alter is confident that the metoidioplasty will be a success.


Marco patiently waits to begin his surgery. He is glad to be nearing the end of his journey. Stage 1: Dr. Alter carefully frees up the clitoris by making an incision on the bottom of the tissue. This frees the tissue obstructing the clitoris, allowing the remaining tissue to experience a straight erection. Stage 2: The freed clitoris is wrapped with the labia minora (inner vaginal lips) to form a penis. Stage 3: Dr. Alter makes an upside down "V" incision on each side of the labia majora (outer vaginal lips). These cuts will be used to form a scrotum sack. Stage 4: The silicone testicle implants are inserted, frist the right, then the left. The pockets are then closed. Stage 5: The remaining excess inner labial lips are removed.

Total Surgery Time: 4 Hours 8 Minutes

Marco and his fiancé visit Dr. Alter five days after surgery. The patient is having his bandages removed; neither he nor his partner has seen the results yet. Once the results are revealed, the couple is elated. There is mild swelling but the outcome will only continue to improve.

Confident Inside and Out

One month later, Marco is happy with how everything looks and functions. He finally feels complete as a man. It's his wedding day, but he's not nervous. Instead, Marco is happy because he's been waiting for this day.

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