Hey guys, Sandra Lee, M.D. (aka Dr. Pimple Popper), here!

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TLC Season Finale: Dr. Pimple Popper’s Behind The Scenes Commentary

Here it is… my recap of the season finale of our first TLC season! I’m SO EXCITED to tell you guys that we’ve been signed for a second season, and those new episodes will air at the beginning of 2019! So THANK YOU for all your love and support, I know it seems like forever to wait until then, but here’s a little something to tide you over!

Patient 1: John

I’ve met lots of characters on this TLC adventure, but John is definitely one of the biggest characters of them all. It cracks me up how much he calls his lipoma a boob and loves to make boob jokes, but I know that the growth really affects him. He’s been living with this C cup-sized third boob for 20 years! Even though it’s not physically painful for him, I actually found out from talking to John that his growth has gotten in the way of one of his passions and hobbies, which made me so sad for him! I had to remind myself exactly this term, but John is a LARPer, which stands for Live Action Role Playing, and it’s when people act out role-playing games, usually the fantasy kind. So he loves to LARP and wear metal and iron outfits (just like in Game of Thrones!) but he hasn’t been able to wear all of the costumes beause of this boob that’s grown on his side.

Here’s what John’s side looked like almost immediately after surgery – the swelling on his incision will definitely decrease as it heals!

Helping John, who was so scared to come to a doctor and be operated on, it really shows me and reminds me how important it is to do this for my patients. I think sometimes these procedures become so routine for me, I don’t always realize just how appreciative people are when they have a benign condition. Just because something isn’t life-threatening or painful doesn’t mean it doesn’t affect their life, and that’s a real, different kind of pain, even if they brush it off.

I will also say, that was one gorgeous lipoma! Did you guys see how beautifully it came out, too?!

John brought me a copy of the Maui news, and he also had me sign his wrap bandage, which was very sweet!

Patient 2: Noelle

For many years, Noelle had huge gauges in her ears. It’s not an uncommon trend to stretch your earlobes, but just like many people, she has definitely outgrown that phase of her life. She’s just not that person anymore, and I totally get and respect that.

I know you guys see so many cysts and lipomas and dramatic bumps, but ear repair surgeries are actually one of my favorite procedures! I mean, just look at these results!

To me, helping someone to fix their stretched ears is like this really fun puzzle. It’s like Tetris or Jenga, and it becomes this challenge to fit all the skin back together and repair the earlobe with as little scaring as possible. It’s a creative surgeon’s challenge!

It’s never easy operating on someone that close to their face, let alone their ear, but Noelle was such a trooper! So happy she can wear her hair up and she’s no longer self-conscious about her earlobes!

Patient 3: Taylor

I know that I’m probably not supposed to pick or choose favorites, but Taylor is definitely one of my favorite patients of the season, although I feel like I could say that about a lot of the patients this first season on TLC!!

Taylor’s “Lizzie” lump is actually a condition that really is so much more complicated than just an embarrassing bump on her behind. You guys probably just call this area her booty or butt crack, but the official name for this area is the gluteal crease, which is the top of the gluteus maximus.

I’ve never seen this type of growth in person on an adult before. Although come to think of it, I’ve never seen it in a child either, and that’s because usually the diagnosis of a growth like this is made at birth or within the first few years of someone’s life, so it’s usually seen by a pediatrician. When this type of growth is diagnosed during childhood, it’s what we call a “marker” for a possible case of spinal dysraphism. This could be a sign that she has a congenital abnormality, and it’s perhaps something that occurred during fetal development.

So how did I know that a lipoma in this area is a marker for spinal dysraphism? I actually distinctly remember it from my dermatology textbooks and reading about it while doing my residency and preparing for my board examination. All that schooling really does come in handy!!

Hands down, without a doubt, this is something that should have really been caught by other doctors, well before Taylor saw me. It’s actually pretty shocking to me that various other physicians have seen her throughout her life and never questioned the fact that she has had this bump since birth. Those two words were all she had to say for me to hear alarm bells in my head. But of course, as a good doctor, I really never want to show deep concern to my patients until I do more research and know what’s really going on.

So, as you guys saw, we ordered an MRI, and it was confirmed by the radiologist that this is a lipomeningocele. That’s a fancy word for what is basically a little tiny strip of a lipoma inside her spinal canal. It’s actually creating a tethered cord, meaning Taylor’s spinal cord (which normally free floats in the spinal canal for all humans) is being pushed to the side by this lipoma and is now stuck to the side of her spinal canal. The radiologist said it was an absolute miracle that she wasn’t showing any negative signs because of this… damage to your spinal cord in this area can create bowel and bladder problems, nerve function, even difficulty in walking… and all that could be permanent!

To me, it’s CRAZY that it took a dermatologist to discover this, but on the other hand, I’m pretty proud of this discovery and getting to the bottom of Taylor’s problem! Becoming a board-certified dermatologist required extensive training, and we are SO much more than “pimple poppers”!  I didn’t finish my training until I was almost 34 years old – and this is pretty much the norm for a board-certified dermatologist.

Anyways, giving Taylor such stressful news was so tough, it’s just the worst part of my job, always. But I was so, so happy I could help her at least with the cosmetic aspect of this growth. Debulking is such a funny word, but that’s really what I was doing for her!

Also, I LOVE this little clip of her checkin’ out Lizzie post surgery. She is too cute! 

Here’s a photo of the area healing – there’s still a bit of swelling, but it’s much flatter than it was before!

I’m also SO happy to report that now she is connected with a neurosurgeon where she lives in St. Louis and will likely be moving forward with having spinal surgery. This type of surgery will help Taylor to fully address the lipoma within her spinal canal, which is super important so that she can prevent any problems that may occur in the future! I truly adore her and wish her the best of luck!

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