The stars of E!’s hit reality show Botched, Dr. Terry Dubrow and Dr. Paul Nassif, are as real and authentic as they come. But when you’re talking about medical procedures and plastic surgeries that have already gone wrong, it’s pretty much a given that there will be some aspects of the process that the doctors wouldn’t necessarily want the general public to know.

From speculation that they can’t use textbook surgeries or consult with other doctors to patients who have called them out on social media, the Botched doctors have more than faulty plastic surgeries on their hands. It’s no secret the dynamic doctors duo has kept the line of communication pretty open as they expose even the ugliest sides of plastic surgery, hitting hopeful patients with a dose of reality they might not have been ready for. Still, there’s also the notion that the doctors get to control what avid fans and viewers see and don’t see on the show. And while it has been successful enough to receive what could lead to a handful of spinoffs (i.e. Botched by Nature), one can’t help but wonder if there is some sort of list of secrets being held captive in one of the operating rooms. Before you get your hopes up and keep reading under the notion that this is a major exposé of Botched, that’s not necessarily true. But it is a list of things that the doctors probably don’t want you to know off top. So take a look!

It’s Gonna Cost You

What price are you willing to pay to not only get a botched surgery corrected, but for it to be aired on national television? Whatever the price, going on E!’s Botched will certainly cost you. One of the biggest questions surrounding the show (of course underneath all of the mumbo jumbo of whether they can actually do the surgeries legally) is if patients get paid for their appearance. The good news to that question is yes. Just like other popular reality shows, the patients receive a stipend for agreeing to be on the controversial series. The bad thing is that they typically have to use that money to pay the doctors for the actual surgery. Hopefully they can break even. Either way, if that’s not a catch-22 I don’t know what is. Dr. Dubrow once said, “We have to get paid to do the surgery. For four days a week we do something for the show.” Understood, Dubrow. Understood.

The Odds Are Terrible

So we all know the odds of actually correcting a surgery gone bad have got to be pretty terrible – maybe even borderline too good to be true. Well Dr. Dubrow and Dr. Nassif have revealed just how likely it is to have a correction of a botched surgery go just as well as hoped – and it’s not looking good ladies and gents. In fact, they have said that there is a 50 percent chance that they can actually worsen a patient’s condition. While they have no problem showing each and every surgery for the show that they tape, the odds of actually having a good one might just be slim to none. Not only is it a high chance that it won’t work, but there’s a half a chance that it could actually leave one in a worse condition than when they came for help? Um, can you say “Yikes?”

They Can’t Do What?!

So because the cases on Botched are considered so unique, the doctors are not allowed to look at text book procedures or even ask other doctors how to move forward. That’s right! When you sign on to the show, you are literally signing your body (and potentially whole life) into the knowledge and expertise of Dr. Dubrow and Dr. Nassif. When you think about it, it really puts their career at more of a risk because there would be no one else to blame if and when something does go wrong for patients who are filled with anticipation and hope after already having a negative experience under the knife. Dr. Dubrow most likely said it best when he said, “As a plastic surgeon, you’re not judged by the before vs. after. You’re judged just by the after.” Well, keep in mind their “after” doesn’t include textbook procedures or assistance from other physicians.

E! Wasn’t Always On Board...

Considering the risky behavior of the surgeries performed on Botched, it’s no surprise that the network, E!, was not always gung ho about being attached to the first reality series of its kind. In fact, the network went as far as only approving eight episodes for the first season as producers were uncertain of how it would go over with viewers. This could be a tad surprising considering shows like Keeping Up With The Kardashians were at their prime when Botched first premiered back in 2014. But nonetheless, Botched showed it could keep up with the famous family and after a successful first season, E! renewed it for a sophomore season including 20 episodes. People were literally coming in droves for help after the first season as more than 6,000 people applied to be on the show compared to the mere 500 for the first season. I’m not so sure Drs. Dubrow and Nassif would be so open about speaking on E!’s doubt in the early stages.

...Neither Was Dr. Terry Dubrow

That could probably be because Dr. Dubrow wasn’t always on board with the series either. Fans were already familiar with Dr. Nassif after he starred in Bravo’s The Real Housewives of Beverly Hills with his ex-wife, so it was easy to see why he was ready for a new reality show; especially one in which he’d be the star. But when it came to him trying to sign on his longtime friend and colleague, Dr. Dubrow, it’s safe to say he was a little more difficult to convince. He initially turned down the opportunity to be on the show, Dubrow admitted he was really hesitant to take on extremely complicated situations, especially considering they are often seen as unique cases that no one in the world has experienced. Talk about pressure! I can definitely see why Dr. Dubrow wouldn’t want that on his shoulder. But now he and Dr. Nassif are going strong and saving bodies one episode at a time.

The “Complications” Are Inevitable

It’s only a matter of time before Dr. Nassif and Dr. Dubrow face their next complication. In fact, the two doctors teased that in the upcoming season, they saw quite a bit. It’s no surprise when you think about the attention and calls they get now that their show has been labeled a juggernaut success. Still, the complications that arise cannot be denied or swept under a nose job. “So we ran into complications,” Dubrow said in an interview earlier this summer. “You know how we always say in previous seasons that there’s a 50% we can make you worse, 50% we could have a complication? We had those things happen this season. Sometimes we had blood supply problems, tissue gets infected; we had some serious problems. We needed leeches, we needed antibiotics, we needed hospitalization. We went through some really scary, extreme, dramatic moments on this season.” Well hey, the upside is that it makes for good TV, right?

Did Dr. Dubrow "Botch" His Own Wife?

Well, this is awkward. So Dr. Dubrow has operated on his wife, Heather, to remove a growth from her hand. Even Dr. Durbow was unsuccessful in the procedure multiple times. So she went to his office to see what was really going on. “You know what, it must be I’m not getting the root of it when I destroy it.” Fortunately for him his wife was all smiles and even joked, “You might even say you botched it!” She may have been kidding but that was enough for the famous doctor to do it correctly this time around. “I got to make sure I get it right this time because last thing I need is a patient, who’s my wife, unhappy with me.” It seems he wouldn’t have to worry about that as she was pretty forgiving. Thankfully, it was all fun and games. But what doctor would want their patients to know about it?

Even The Botched Doctors Know There Is Sometimes No Hope

Whether you’re Botched By Nature or just Botched, Drs. Nassif and Dubrow seem to be very in tune with reality and know they can’t be everyone’s fixer. If Olivia Pope can’t, no one can. (Just joking.) It’s easy to see how they are their own worst critics, but in actuality, some things just can’t be fixed. Dr. Nassif said in one interview recently, “There is a patient I’m working on right now, and I don’t want to give away too much, but this patient, despite numerous procedures, you know there is some improvement, but not nearly as much as I’d like to help this patient.” Interestingly enough, it seems to be their past successes that keep them trying to push for perfection with all of their patients, even the ones who are suffering from situations that are viewed as hopeless. “We can’t even figure out what’s ‘good enough’ now because we’ve been able to sort of blow through our own expectations with many of these patients.”

What Makes Them Just Say No?

When thinking about the riskiness and level of complications involved, it’s clear that the Botched doctors can’t accept every surgery. Faithful viewers (and even some who catch the show while channel surfing), have seen them turn away patients who have gone under the knife one too many times. But what is it that makes them draw the line in the sand? “Well, we say no if their expectations are either unrealistic, they want something that’s gonna put them at even greater risk if they have another operation, or we say no if they have some psychological weird red flags.” Still, anyone who has tuned in knows the patients are not necessarily ecstatic when they are turned away. But they aren’t completely heartless. “Some of those situations who we wouldn’t normally operate on – they’re having giant problems – so we can’t leave them disabled with catastrophic complications. We have to try to help them.” Fair enough.

When Dr. Dubrow Was Called Out

A woman named Taylor Lianne Chandler, who just happened to be dating Olympic swimmer Michael Phelps at the time, had no problem calling out Dr. Dubrow when she had a bad experience on the show. “Everything was a go on Botched,” she revealed in a telling Facebook post. “That’s the problem every hoop you jump through you are on a show and then another obstacle. You quickly learn it’s [crap].” She then named Dr. Dubrow and added, “Terry was amazed by my story and how I was botched by illegal silicone after my car accident to be normal again. I had necrosis of the inner and out tissue and silicone was going to make it right.” She said that Dubrow not only didn’t want to operate, but accused him of causing more issues physically. It’s not clear how Dubrow’s refusal to do the surgery led to more problems but she was pretty serious about calling him out on social media.

A Former Botched Patient Goes Too Far

While the death of Tobias Strebel was not related to his previous appearance on the E! show Botched, he was known for his 15 minutes of fame on the reality series. Many fans remember Strebel as the patient who spent $100,000 in hopes of looking like the one and only Justin Bieber. When Strebel died, the autopsy report revealed he had Valium, Xanax, the sleep aid Temazepam, as well as alcohol in his system. Even though the Botched doctors clearly had nothing to do with this, I’m sure they wouldn’t want to be associated with any of their patients’ dangerous and fatal activities. Strebel had also appeared on TLC’s My Strange Addiction. His manager, Gina Rodriguez, reiterated that “he didn’t seem depressed in any way,” when he died. The doctors have not spoken out about the incident. The network also remained quiet and decided not to cover the story about his death.

Then There’s That Lawsuit

While the Botched doctors clearly were not related to their former patient’s passing, Dr. Nassif was named in a lawsuit filed by Eric Klein after Klein appeared on the show. He couldn’t breathe properly so Nassif performed a nose job in an earlier season. But Klein didn’t waste time when he pointed out his eyelid couldn’t close the way it should. Nassif did speak on it with him and said that it was simply a result of swelling. Klein said things only went downhill after that. Interestingly enough, he said in his lawsuit that Nassif referred him to a coworker who said the eyelid issue was due to a problem Klein already had before the surgery. Still, Klein found out that a “medial canthal tendon was displaced during the surgery” when Nassif broke his nose before fixing it. He also said Nassif’s colleagues attempted to keep the nose job gone wrong a secret to keep his reputation intact.

How Scary Plastic Surgery Really Is

It might be the way of the (Hollywood) land, but plastic surgery is a bigger risk now than ever. And while doctors like Dubrow and Nassif wouldn’t necessarily want their patients to know that, they actually admitted it. “The difference between this show and other plastic surgery shows is that we’re not glamorizing plastic surgery. In fact, we’re providing a scare about plastic surgery,” Dr. Dubrow said in an interview." Dr. Nassif echoed similar sentiments in the same interview. “Unfortunately, people like to watch train wrecks. But if you can take a train wreck and then add the inspirational aspect of having a good result or a happy ending, I think that fills a void [in reality TV].” Still, there are cases when the doctors turn away a patient despite how great of an episode it could be. “If I were a doctor on a reality show I wouldn’t be doing plastic surgeries all willy nilly like that either.

The Woman Who Was Booted Speaks

The show might not promote the glitz and glamour of plastic surgery, but one transgender patient tells a story after the show refused to air the episode. The patient, who goes by Nicole Sanders, taped an episode of the show that featured her getting a breast reduction. While it never aired, Sanders said she “dedicated her life” to the show and ended up losing her apartment because of it. Apparently she missed two months of work which subsequently led to her not being able to pay rent. Sanders took to Facebook to share her side of what happened. “I lost everything,” the post reads. “I’m very distraught with everything that’s gone down with the TV show Botched. Dr. Dubrow fixed my breasts and I’m grateful for that but in the midst of the whole TV show I lost my apartment.” One insider combated that story and said Sanders was “difficult to work with” while on the show. The network added that they have no “obligation” to air every episode taped.

Is Shading The Kardashians/Jenners A No-No?

I say this with the utmost respect – the Kardashians have brought the Botched doctors at least a handful of patients. This hasn’t been clinically proven or anything but even one patient, Jordan, whose episode aired previously, said he had gone too far on lip fillers in hopes of looking like Kim Kardashian. I can’t imagine him being the only one in hopes of a Kardashian/Jenner makeover. Still, the Botched doctors didn’t mind throwing a bit of shade at Kylie Jenner amid speculation that she received plastic surgery of her own. “Anything that Kylie does, the whole world follows,” Nassif said in an interview. Dubrow added, “When she moves the needle, overnight she made it acceptable, under the age of 18, to have lip injections. We don’t agree with that.” Still, Nassif couldn’t help but admit that Jenner’s plump lips don’t look bad. I wonder how many patients have gone to their office carrying her picture hoping for a similar appearance?