Monique Ramsey (00:01):
Welcome to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. Today I have in our studio Dr. John Smoot. He's one of our plastic surgeons. So welcome Dr. Smoot.

Dr. Smoot (00:12):
Thank you. Glad to be here again.

Monique Ramsey (00:14):
So we want to get to know you a little bit, your patients can get to know you a little bit. So let's start at the beginning. What made you want to be a doctor?

Dr. Smoot (00:23):
Well, I decided that pretty much in high school, that's where I wanted to go. I liked science, I liked the biological sciences. And then I had a brother that went into the medical profession who actually two brothers went into medical profession. One was an oral surgeon, one was a plastic surgeon. So it's pretty easy to see what their lifestyle was and what they were doing. And I liked it, and I liked the idea of being able to be autonomous and work with my hands. And then after that, I decided if I really want to do it, I needed to get some real life experience. So the Vietnam War came along and I was going to get drafted, and I thought, well, I don't want to go to Vietnam. So I joined the guard in a medical unit. I became a scrub tech and medic, the National Guard, which then basically that's what propelled me on to become a doctor.

Monique Ramsey (01:09):
Tell us a little bit about that. Where were you stationed?

Dr. Smoot (01:12):
Well, I was the Utah National Guard, and it was called the hundred 44th Evac Hospital. And we were that evacuation hospital, mobile hospital, and we never got deployed. So I was always in Utah doing training, and I was in that for about 10 years and did my time and glad I did it, happy I did it, but it got me to where I am now.

Monique Ramsey (01:34):
So your educational path to become a surgeon, tell us a little bit about what that looks like, how long that takes, and where are you trained?

Dr. Smoot (01:42):
Well, okay, well, don't make this too lengthy, but after high school, I joined the guard and I went on a mission, my church for two years. Then I came back and finished my four year degree. And at that point I applied for medical school and went into the University of Utah Medical School, which I spent four years there. After graduating from medical school, I went to Chicago for a year and then Detroit for three years and then down to Houston to get my plastic surgery training. Since I was a little older, I already didn't start practice until I was about 36 doing all my training during those times. So it was a long road, but it was well worth it. I'm glad I did it.

Monique Ramsey (02:23):
As you were training in medical school or you were doing rotations, I'm assuming you got to sample a little bit of everything, and I'm assuming that plastic surgery was your favorite part, but did you have a least favorite part or some things where you're like, Ooh, I never want to do that?

Dr. Smoot (02:39):
I always kind of wanted to be a surgeon. I was leaning that way. I was going to be a general surgeon. I want to be a pediatric surgeon. And then I got to seeing what the reality of doing those paths were. And with my brother being in plastic surgery, I realized I really like solving acute problems and not long-term problems. And when I was in my residency, I really realized I enjoyed working with my hands. I didn't really like being, let's say, a pill pusher or taking care of chronic problems. So that's how I got to doing it. So I really do enjoy operating, using my hands.

Monique Ramsey (03:13):
And do you have, I feel like plastic surgery takes sort of an artistic medical person. You've got the medical training and the technicalities they're with, but then that kind of 3D modeling and creativity, do you have that in other parts of your life as well?

Dr. Smoot (03:36):
Well, not really. I'm not an artist. I'm not a creator in that sense, but I do think very well three dimensionally. And that's why when I was doing facial reconstruction and things like that, you had to visualize the face and the bones in a three dimensional fashion. I was pretty good at that. I was a visual learner, necessarily an academic, and just learned everything from books. So that's kind of how I got to realize I really did doing surgery, particularly when I was on my medicine rotation. I remember distinctly, someone had some fluid in their lungs and they had to tap it off or during it, and she says, well, who wants to do it? I, yeah, I do. I do. No, I do like working with my hands. That made me decide I want to be a surgeon.

Monique Ramsey (04:20):
Interesting. So you were in private practice prior to joining La Jolla Cosmetic. Talk about how you decided to come to join the group.

Dr. Smoot (04:29):
Well, again, after I left my residency, I came here to San Diego and joined my brother and another couple of other doctors, and there started my cosmetic experience and I did reconstruction for many years and realized I really enjoyed doing the cosmetic aspect, like the aesthetic side of it, which was very, very enjoyable and pleasing for me. And after my brother had passed away, I still had this big office and I said, I don't want to run this anymore. And so happens that one of the doctors here approached me and says, you want to join us? And I said, yep. I get rid of all the headaches running my own practice.

Monique Ramsey (05:10):
You get to do the fun part. Yeah. So tell us about the parts of the job that you love.

Dr. Smoot (05:16):
Well, the part I love most is one, I do like operating, but I really enjoy seeing the benefit I can create for these men and women. Mostly women who for some reason have an image of themselves that doesn't match what they really are looking like. And being able to bring that image closer to the reality is pleasing to see these young women and even older women who have procedures say, yeah, I look better. I feel better about myself. It was a good investment. I enjoy that part of it.

Monique Ramsey (05:43):
So I know you do the whole gamut of plastic surgery procedures, and there's a long list, but are there specific procedures that you're known for you kind of specialize in or that people hear about you and want to come to you for?

Dr. Smoot (05:59):
Well, you're kind of asking me to toot my own horn a little bit here.

Monique Ramsey (06:01):
Yes, I am.

Dr. Smoot (06:03):
Alright. No, I've been trained in all aspects of plastic and reconstructive surgery. I no longer do reconstructive surgery. I do cosmetic surgery or aesthetic surgery. I focus mainly at this point because now I'm focusing my practice more and more as I get older to doing the facial procedures, aesthetic procedures, and doing breast procedures and a little liposuction. But that's the bulk of what I'm doing right now.

Monique Ramsey (06:25):
And what do you think about when people are starting to feel just a little bit older on the outdoor look a little older on the outside than they feel on the inside? What do you think in terms of facial surgery is sort of the first go-to that really helps them get back to feeling the right age?

Dr. Smoot (06:45):
Well, there's kind of a strategized approach to that. I used to have a saying, we want to do more with less. So you can start with the simple things of skincare, facial care, spa treatments, those kinds of things to help rejuvenate, make the skin look better. But it gets to the point where you say, well, that's just not going to do it in itself. So you step up to a little more invasive procedures, maybe some grafting, some liposuction. Then you do the more surgical revisions that have facelifts, neck lifts, eyelid, brow lifts, those kind of things. So it comes down to what I tell patients, your result depends on what you're willing to go through for the effort and the risk implied for what it costs to get the result you want. And if all those line up, let's do it. It could be, well, it's more than I want to do. It's more costly than I want to do, but I'm not one to do things because I can do it. I do it because it'll make a difference. And I know most doctors, not most, but there are some doctors will say, yeah, this is money, so I'm, I'm going to push as much procedures as I can. I don't do that. I don't like to do that. And I tell patients occasionally, you don't need this surgery. I don't say that because it benefits me, benefits them.

Monique Ramsey (07:56):
How would your team or your staff describe you?

Dr. Smoot (08:00):
Oh, the most wonderful, patient, loved doc that ever walked the earth. Oh no, I, I'm pretty patient. I don't have a flashpoint. I'm pretty low key. I like things to go smoothly. And the most thing, like my staff, I hope they would say is I'm complimentary to them. Certainly complimentary to me.

Monique Ramsey (08:17):
Oh, that's nice. Yeah. You're not a scalpel thrower in. I don't think we've ever had one, but I've heard things out there. There's some doctors who can be pretty testy and difficult, and I feel like we're so lucky that our team is really just symbiotic and everybody gets along and it's very collegial.

Dr. Smoot (08:39):
It is. There's times in surgery you get very frustrated. It can be very challenging. But I've learned just to take a deep breath and Okay, we'll get through this.

Monique Ramsey (08:48):
Now do you like to listen to music in the operating room or do you like it quiet or do you care?

Dr. Smoot (08:51):
Well, all doctors are different. Some like thumper music, head banging music, I don't, I do like some very soft, gentle, soothing music more for me than anybody else. It just helps me to relax more.

Monique Ramsey (09:07):
So over the years, I'm sure you've learned a lot from listening to your patients. Tell us a little bit about what you've learned when hearing from your patients.

Dr. Smoot (09:18):
What I've learned is every patient's different and they fall in the different categories. They're the people that are thinkers and you have to explain things to them and they want to know the details. The others are what we call feelers. They want to feel that you understand that you feel their problem, you feel like you're going to take care of them. And donating to how to talk to each of those kind of patients makes a difference in how they respond. But mostly I've learned that it's a patience game in the sense that, okay, not everyone's going to be happy, but everyone's going to have a great outcome. And we would just say, I do my best and that's what I can do.

Monique Ramsey (09:54):
Well, I think it requires some teamwork and it's like the patient has to feel like they're part of that team and they're heard, and you have to feel like they're on board with the plan and everybody's got to kind of work together for that common goal of a good outcome and that they're happy at the end of it.

Dr. Smoot (10:12):
Yeah, I mean, I tell 'em, we're a team here. I am not going to tell you this is what I'm going to do. That's what we're going to do. This is what we are going to do, and they need to buy into that program and buy into what I'm recommending so they understand what they're getting into. A lot of patients come and say, oh, the doctors came in and said, we'll do this, this, and this, and they walk out. Okay, well no, I want to hear what you really want to achieve and what you're achieving. Is that realistic? Can we do that? And so we have to manage their expectations to a certain degree. This isn't magic. This is not the surgery center or Hogwarts.

Monique Ramsey (10:48):
But that would be cool if there was one.

Dr. Smoot (10:52):
I agree.

Monique Ramsey (10:52):
But that's really true. And I think, and so my next question, and maybe this kind leads right into it. What do you wish patients knew before they come to see you?

Dr. Smoot (11:01):
Well, what they need to know is what is the asking is that's realistic? And they didn't do their homework. A patients that done their homework, gone online, looked at doctors, looked at the procedures, even watched YouTube videos is a lot better to talk to than someone who says, well, my boyfriend wanted me to do this. Okay, that's not quite what I want to hear. Once they, they vested some of their money, their time, their effort, their sweat equity, do this, it makes a whole lot of difference in terms of being able to explain to them and help them through this process.

Monique Ramsey (11:32):
So do you find that when they do some education, do they mostly find good sources online or do they sometimes come in with crazy notions that they heard about on the internet?

Dr. Smoot (11:46):
See, both. Most people are fairly knowledgeable. And nowadays with the internet access, they're fairly what's going on. Occasionally you get that person that comes in and goes, no, this is ridiculous. This is not realistic, nor will I do this. I mean, you just have to watch botched and you see patients that have just overdone it and doctors have done things. It just, why did you even do that to begin with?

Monique Ramsey (12:12):
Yeah, I think being able to say no as a surgeon is a really important trait because every once in a while there's going to be a patient who just doesn't have something in mind that's realistic either for their anatomy or that you can't get from A to B every time. That's right. So what can patients expect when they come to see you for the first time?

Dr. Smoot (12:37):
First of all, they're going to get the breadth of experience from the phone call to the intake to my nursing staff. To me, everyone's on the team to provide for them, and we want to provide a encompassing, comforting, and educational experience. When they come to see me, I really want them to know that, okay, we take this seriously. We want to make them feel better about themselves, but they also have to realize, okay, we have to work from the framework of what they have to work with. Well, that answers your question.

Monique Ramsey (13:08):
Yeah. And do you find that some of the tools to help people create, or I guess the vision, how do you visualize and how do you help patients visualize potential outcome? What tools do you use?

Dr. Smoot (13:25):
Well, we use what's called TouchMD. It's a interactive computer, which I have in a room that I can pull up pictures, diagrams, explain to them what we're doing, find patients that looks similar to them. Because when I pull 'em up, I say, now notice every one of these patients looks different. Not one patient looks the same and you'd understand I'm going to work with what you have to work with. That's all I have to work with. It's when they come in and they say, I want to look like so-and-so I want the Kim Kardashian look, well, did you start like Kim Kardashian? No. Okay. You can't be like Kim Kardashian. So that's why I say that's all, again, part managing their expectations.

Monique Ramsey (14:04):
And what would you like patients to know about you?

Dr. Smoot (14:08):
One, I would like them to know for what I do now is that what I do, I'm experienced at. I know what I'm doing. They don't come to me because I know a lot. They come to me because I've done a lot. I've always said, experience will always trump knowledge. You need to be smart. But once you've been through this before, you know how to avoid problems and see problems and manage those things which are coming down the pipe. When I was in training, one of the doctors said to me, he says, doctor, if you operate long enough and do enough cases, you will see every complication. And I time that doesn't sound right, but now that I've been down that road, that's exactly right. I've been there, I've done that. I've learned where to stay out of problems. I know what things will, what won't work. And I think that's the biggest thing patients understand. That's why going to someone who's experienced is very important. That's how I got all this experience fixing all these caps that are contractures that I'm doing.

Monique Ramsey (15:04):
And so that's really that. And I think we've done a podcast or two about what happens when there's a complication with a breast augmentation where the capsules get hard and you can do so many things to fix that. So we'll put that in the show notes for everybody. So last question is about you personally. What do you like to do outside of the office

Dr. Smoot (15:29):
Rest. No, I have a few hobbies I like to do. Most people don't know that I am really into archery. I've been doing that for 60 years. I love it. I go out and I do a lot of shooting with archery. I go out and do some fishing and hunting and times, and I like to visit our summer home up in Idaho, which is a piece of heaven for me. And then doing family things.

Monique Ramsey (15:56):
When you came to San Diego, how long was it? You were in your thirties, is that how long you've been here?

Dr. Smoot (16:03):
Yeah. I came here when I was 36, so I've been here about 35 years. And most of my patients are referral now. They're coming in from somebody else with their past patients. So I've got plenty of work to do.

Monique Ramsey (16:15):
Yeah, so don't retire anytime soon. Okay. Yeah, eventually.

Dr. Smoot (16:22):
Eventually. It'll happen someday.

Monique Ramsey (16:24):
Yeah, yeah. Well, thank you Dr. Smoot. This was very informative. So for everybody, thanks for listening today and if you have any questions about scheduling or financing reviews pre and post-op photos, check our show notes. We'll have links in there. And please give us a like or subscribe. And then you'll also find links for Dr. Smoot's beautiful before and after photos and some of his reviews, so you can take a look at those as well. So thank you all for joining us today. Thank you, Dr. Smoot.

Dr. Smoot (16:54):
Thank you. Have a nice week.

Monique Ramsey (16:55):
You too.

Announcer (16:56):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla cosmetic is located just off the I-5 San Diego Freeway in the XiMed Building on the Scripps Memorial Hospital campus. To learn more, go to lj csc.com or follow the team on Instagram at lj csc. The La Jolla Cosmetic Podcast is a production of The Axis, T-H-E-A-X-I-S.io.