‘Botched’ Doctors Terry Dubrow & Paul Nassif On Why Season 8 Feels So Different: “We Are Taking On Harder Cases”

E!‘s long-running reality series Botched returns tonight for the first of ten more episodes in its impressive eight season… well, ninth season if you count their 2016 spin-off, Botched By Nature. In their near decade of reality television, plastic surgeons Dr. Terry Dubrow and Dr. Paul Nassif have comforted desperate people, doled out sound medical advice, performed difficult surgeries, and changed lives. They have somehow remained as passionate about their practice and patients as they were when they first got started.

What makes Season 8 stand out? “Not only have we transformed our surgical skills, but the producers have really transformed the show,” gushed Dr. Dubrow. “There’s a different feel to it.” Dr. Nassif agreed, adding “The show really has the secret sauce.” He continued: “We have these incredible transformations and life-changing stories, but there’s also the right amount of craziness.”

No doubt it’s that special blend that keeps fans tuning in season after season. No matter how extreme the case or the patient may be, Drs. Dubrow and Nassif are unflappable, but have never lost their compassion. “Honestly, I cry probably four to five times in these next 10 episodes,” admitted Dr. Nassif. “If you can make it through this week’s episode without crying, you’ve got to check your pulse,” added Dr. Dubrow. “We hope to do this show for a long time to come.”

Over Zoom, Decider got a chance to enjoy the good doctors’ trademark banter while speaking to them about taking calculated risks and transforming their patients.

DECIDER: I know so many different people who are obsessed with Botched. My father, who is 75, loves the show. Why do you think Botched has such cross-generational appeal?

DR. PAUL NASSIF: You mentioned your father, but my kids—who are in high school—have friends who love watching it too. The show really has the secret sauce. We have these incredible transformations and life-changing stories, but there’s also the right amount of craziness. The other thing that really tops it off is the banter. We’ll call it brotherly love [laughs]. People keep finding the show. Recently, we were on Netflix, and the show jumped right to the top immediately. A whole different audience got to discover how great the show is.

We’re in the middle of Season 8 and the next ten episodes feature a lot of congenital and traumatic defects. One patient we work with was forced to drink acid as a little kid living in Liberia, which destroyed her mouth. Thank God, she didn’t swallow it or she would’ve died immediately. Another patient was in a car accident that killed the driver instantly and forced her to deal with a traumatic brain injury for the rest of her life. Honestly, I cry probably four to five times in these next 10 episodes. Out of all the episodes that we’ve done, these 10 episodes are going to probably be the most tear-jerking that we’ve had in all nine seasons, including Botched By Nature.

DR. TERRY DUBROW: It’s good that you’ve cried, but this is not about you, Paul.

PN: Thanks, Terry.

TD: If I could bring it back to the show [laughs]. I think the reason for the continuing popularity is two things. First, the obvious authenticity sets the show apart. With reality programs, you never know whether the storylines are real, whether the people actually feel this way. Botched is a no-brainer. Everybody knows what the stakes are. Paul operates season on a woman who has had 42 previous failed surgeries. She’s about to lose her eye. She comes out to Beverly Hills, California. This is her last chance. If Paul doesn’t get this right, it’s over. Blindness is on the table. There are real stakes here.

The second reason viewers love Botched is the heart. If you can make it through this week’s episode without crying, you’ve got to check your pulse. This season in particular feels different. Not only have we transformed our surgical skills, but the producers have really transformed the show. There’s a different feel to it. We hope to do this show for a long time to come. We think we have 10 more seasons left in us, even though Paul looks like Kris Kringle at this point.

One of the aspects of the show I love so much is that you consider the psychological impact of these procedures as much as the physical impact for your patients. Why is this so important to you?

PN: You have to be a psychologist at the same time as a reconstructive plastic surgeon. We’ve been trained to do this. We have patients all the time who deal with things like chronic depression, OCD, body dysmorphia, and more. We have to gauge that during our initial exams and make sure their expectations and their physical and mental health are in check.

Terry and I do this on a daily basis. On the show, you see we don’t operate on everyone. By looking at the psychology of these patients, we are actually finding issues that can be very dangerous for their health. In one of the upcoming episodes, Terry says to a patient, “You know what? You can die easily with your next surgery.’ We have to deal with psychology when we talk with these patients.

TD: We are taking harder cases this season, much harder than we’ve ever done before. There is always the great potential that we can make things worse. Imagine the patient’s emotional state after the surgery if we haven’t prepped them properly. We have to factor that in when we consider, and most importantly, when they consider whether we should try to fix their problem.

Calculated, informed risks are something you deal with every day. For example, Dr. Dubrow, you have to get creative when you contemplate moving Chrissy’s nipples from side to side during her procedure. Do these risks weigh on you after a while?

TD: It really does weigh on you. You get a little better at tolerating the risks associated with these audibles that you have to call the day of surgery. You are like a quarterback on a team and the defense has changed positions. However, you take these risks based on fundamental surgical principles. It is really scary, but sometimes you got to go for it based on all the years of experience, training and good judgment.

Though, you’re absolutely right. The last thing you want to hear is, “Wow, I got botched by the Botched doctor,” and there’s always the potential for that. When you see the 10 patients this season, they are the hardest that we’ve ever worked with. These cases are extreme. These people walk into a room, they walk into a store, they go for a job interview, and you know there’s something wrong. The risks and stakes are tremendous this season.

Dr. Nassif, at one point during the premiere, you are one of 3 surgeons working on a patient at the same time. How do you manage it all?

PN: A lot of practice. At one point during the surgery, one of us is taking a rib at the same time that one of us is doing a reconstructive rhinoplasty. We’ve gotten very used to that. In that particular case, we had to call in Dr. Massry to work on the patient’s eye. I have known him since college, and he’s such a fantastic oculoplastic surgeon. Dr. Frederick, who was once my fellow and is now our associate, was able to work on a patient’s shoulder and neck while I got to focus on the nose. With practice and skill, you know how to hold your own space.

TD: But Paul is very gassy. If you’re operating with him in the operating room, there may be a moment of what did he eat for lunch? You have to be really careful what his staff serves him that day.

PN: It’s that good old protein powder [laughs].