Bruce Nadler has seen more boobs than you.

No, really.

While he used to favor sticking body parts with knives, this plastic surgeon turned trainer now opts to build aesthetically pleasing physiques through exercise and proper diet with his principles outlined in his new book, The Nip Tuck Workout.

Bruce went under the knife with Nate Green to talk about plastic surgery, his transition, and dead nipples. Aren't you lucky?

Nate Green: Being a plastic surgeon turned personal trainer, you've utilized both the scalpel and the dumbbell to help shape the bodies of your clients — which is more rewarding? Why the change of profession? Where do you think you have the opportunity to make a more effective impact?

Bruce Nadler: I'm actually going to do the unthinkable and tell you the truth.

I have always been fascinated with shaping and enhancing the body. I was very well known to accomplish this by the use of surgical techniques such as liposuction and body implants. I was also known to be knowledgeable about the pharmaceutical enhancement of the body through the use of hGH and anabolics.

I foolishly believed that it would be considered beneficial to guide my patients in the safe use of these substances and perform the blood tests and exams to make sure they were doing it safely. My criterion was to bring their levels to the optimal normal level rather than the barely acceptable level. This is in contrast to the outrageously high amounts people take without the proper guidance.

NG: Wait, were you selling them to your clients?

BN: No, but I did provide prescriptions if I felt it was medically safe. Even though no one was harmed by my advice, the New York State Department of Health did not share these views.

We all know the government's ridiculous stand on performance enhancing substances. By trying to curtail the use of anabolics, I believe they are promoting their abuse. They called me down for several interrogations (I was even in one of those rooms with the one way mirror once). I was questioned by a retired mainstream endocrinologist who felt that I was not adhering to accepted medical guidelines in prescribing these substances. Hell, I remember when mainstream medicine insisted that anabolics did not improve athletic performance.

Finally they blackmailed me into accepting a suspension of my medical license.

NG: So that's what led you to the personal training side of things?

BN: Exactly. I still had an avenue to pursue enhancement of the body. My scientific and medical background allowed me to accurately evaluate the various exercise modalities and determine what made sense and what was just bullshit. I developed my own system that I call the "Plastic Synergy" workout. It is based on the plastic surgical principles of proportion and symmetry — everything that looks 'good' to us possesses the correct attributes of both those principles. Leonardo DaVinci even expressed this in exact formulas based on what is termed the Golden Ratio or Phi.

I do miss doing the surgery, though. I get many calls and e-mails each month begging me to come out of retirement. Perhaps I can have the most impact in trying to change these out-moded ideas. If you don't want to do something illegal, change the laws.

Politicians, however, are usually concerned with only two things that don't risk getting them thrown out of office. One is money and the other is votes. If they can convince the majority of the electorate that they are helping them by inconveniencing a small segment, they will get their votes. Oh yes, let's not forget saving the children.

NG: Who could forget the darling little snot-nosed bastards! All right, knowing both sides of the coin, do you think people should think about plastic surgery before or after trying to utilize exercise and healthy eating?

BN: When I was performing surgery, I would often tell people that they weren't ready for the surgery but should diet and exercise first. I'm sure many went to other surgeons who were all too happy to take their money.

In my mind, the surgery was there to take care of those areas that wouldn't respond to sensible eating and workouts. The only way to maintain the results of the surgery is to eat healthy and exercise. Otherwise it becomes a never ending cycle of one operation after another.

I started combining the personal training with surgery by outlining diet and exercise for them planning to do the surgery after they had gotten to a certain point. I feel this is the only way to obtain the optimal results. I even personally trained some of my patients prior to their surgeries.

When I started doing personal training full time, my first clients were former patients. There was a certain irony in this. These people, you see, were always invited to charity events and awards dinners. When I was their plastic surgeon, I never got an invitation. Not one. You just don't introduce someone as your plastic surgeon.

However, once I was their personal trainer, I got invited to everything. Now I can go places I couldn't go as a plastic surgeon.

NG: I only get invited to TC's house every second Wednesday to rearrange his sock drawer by color and thread count...

Anyhow, I've heard of guys actually getting chest, calf, glute, triceps, and biceps implants. I think they're a bunch of lazy bastards who need a brain implant and a swift kick in the nuts. What are your thoughts? Are most of them getting the implants before or after the exercise 'phase'?

BN: Again, I can only talk for myself. Some of my former colleagues are not the most honest individuals I've met. Plastic surgery is all about erecting facades. Some of these surgeons hide behind the facade of looking like they actually care about their patients.

As you know, some parts of the body are genetically determined. If you have long muscle bellies, exercise can get them to be impressive. If, however, your swim in the gene pool gave you short muscle bellies, you will probably need some surgical help to get the look you desire.

You also have those cases of muscle tears or other injuries that may not have been repaired. Proper implant surgery can disguise the problem. As with all surgery, I believe it is the icing on the cake. It is there to take you past your genetic limits, not take the place of exercise.

There were even patients who came for pec implants and I sent them on their way with a new chest exercise routine first.

NG: Your book, The Nip Tuck Workout, compares your exercise prescription to a balanced 5-star meal complete with an after-dinner mint. It also has a very hot girl wearing Ugg boots on the cover (just an observation). Going along with the whole meal theme, what's the worst, uh, dessert (mishap) you've ever seen in the gym and under the knife? I'm talkin' straight-up somebody urinated in the chocolate mousse type of trauma.

BN: The girl on the cover is one of my clients, Ann Markley. She was a runner-up in "America's Next Top Model." She was a real challenge of creating an exercise regimen that shaped but kept her slender. I purposely over trained her to prevent the muscle from putting on too much size.

I had fun setting up the photo shoot. It's like what doesn't belong in this picture, right down to the Ugg boots. We even had a wind machine in the operating room to blow her hair in the right direction.

NG: Next time you're setting up a photo shoot with a hot girl, let me know. I'm very good at erecting... lights. Gotta have good lighting, you know.

BN: Sure...

Well, the worst mishap is the one that happens to you. I had always been involved in the martial arts, even earning a black belt in Shotokan karate. A few years ago, I decided to explore Krav Maga, the Israeli self defense method. I was grappling on the ground with my instructor and he tried to put my left arm in an arm bar. Being a combination of macho and stupid, I levered him off the ground with the left arm, ripping the biceps muscle in the effort.

Since repair meant immobilization for at least six weeks after repair, and I was still doing surgery, I opted to let it heal on its own. It regained almost 100% strength, but I have one of the funkiest looking biceps you can imagine.

In surgery, planning is more important than doing the surgery itself. I was once called in to assist another plastic surgeon in the middle of his performing a breast reduction. He had somehow destroyed the total blood supply of one of the nipples and was watching it die in front of his eyes. Happily I was able to salvage enough tissue and borrow from other areas to construct something that was more than passable.

NG: Nothing worse than a dead nipple, I always say. All right, Bruce. Here's the scoop. I'm a whiny little bitch of a boy with no real plan of attack (shut up, guys). I want to utilize both weights and plastic surgery to get my ideal, aesthetically pleasing body. What am I doing in the gym and what am I getting done afterwards? Make the girls love me, Bruce...

BN: So you want to be irresistible, eh?

NG: I'm already irresistible, man. I just want to irresistible to girls and not random wildlife...

BN: Well, exercise first and then surgery if necessary.

I believe in starting by building a foundation using functional core training. The body should be strengthened as a whole integrated unit before attention is paid to isolating specific muscles. The tools to do this are free weights, especially dumbbells and cables. They allow the body to be exercised in its individual optimal paths.

Machines are like stencils. They guide you to do a specific motion but don't allow much creativity. The important stabilizer muscles aren't developed and the core is not strengthened with exercises that are done seated and supported. I further emphasize unilateral training to further stimulate and strengthen the core as it works to stabilize the body. The body is constantly re-evaluated and the exercise program is constantly changed dependent on how each individual area responds.

NG: Sounds good. What else?

BN: It is only when the body begins to show over-all progress that I will use machines at the end of a work out to isolate and cosmetically enhance a specific muscle or group. This is based on evaluation of proportion and symmetry.

Once sufficient mass is attained, additional cardio can be instituted to further define the muscles.

For diet, I advise the Paleo or hunter-gatherer diet. The theory is that when man evolved, he was a hunter-gatherer. His digestive system was designed to handle protein, whole fruits and vegetables. Although the planting and harvesting of grain allowed man to stay in one place and develop civilization, it was the ingestion of this grain that lead to obesity, diabetes, and other disease states. I follow this diet myself. I have my clients remove all grain from their diet, bread, pasta, rice, potatoes and refined sugar.

No portion control is necessary, you can eat all the meat, fish, fowl, fruits and fibrous vegetables you desire. Of course, I advise eating every 3-4 hours. I always find it surprising that people don't over eat protein. If you are full and some one offers you another slice of meat, you are unlikely to take it. If they offer you another cookie, however...

NG: Not a problem with me, my friend. I eat Low-Carb Metabolic Drive with a spoon.

BN: Well, once you reach the limit to what the exercise and diet can accomplish, it is then time to consider surgery.

Liposuction can be used to eliminate the discrete stubborn areas of fat. It is these areas that force you to sacrifice upper body mass to diet them off. Implants can be used to fill in the genetically deficient areas.

Again the surgery should be used to optimize proportion in relation to the areas that did respond to exercise.

The surgery does not allow you to stop exercising and controlling your diet, it only polishes the gem you work so hard to create.

Now the girls will love your body but charm school or a trust fund may still be necessary.

NG: Girls like me for mybrain, Bruce, but I'll consider that other stuff. Thanks for taking the time for the interview! Where can we learn more about you?

BN: No problem at all! It was my pleasure. You can check out my book here: http://www.amazon.com/Nip-Tuck-Workout-Exercise-Plastic/dp/1419621408