Monique Ramsey (00:01):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And today I'd like to welcome back to the podcast Dr. Diana Breister. Welcome.

Dr. Breister (00:11):
Hi. Good morning. Happy New Year.

Monique Ramsey (00:13):
Yeah, happy new year to you. So we're going to talk about a subject that I think is so important to ladies out there, mommy makeovers, and the fact that having children, it's a wonderful thing, but it does kind of wreak havoc as combine that with aging. And so let's talk first about what is a mommy makeover? How do you define it?

Dr. Breister (00:39):
So I define the mommy makeover as usually a combination of procedures that improve the areas that birthing a child can have. So it really encompasses usually breast and tummy procedures, but that could also involve a labiaplasty or really any other combination of surgeries that can improve those areas. So most commonly, women's breasts change. They sometimes deflate, they get more tonic or droopy. As we have children, even if we don't breastfeed, those breast changes can occur. So usually there's a type of breast surgery, which could involve a lift or an augmentation or a lift and an augmentation. And then usually the stomach area or torso can get stretched out. Stretch marks can happen and the muscles can get stretched out too. So usually it will involve some sort of rejuvenation procedure to the abdominal area, whether that be some liposuction or a tummy tuck or a mini tummy tuck. It's a very customized approach.

Monique Ramsey (01:55):
And so it's really, you're saying it's really more dependent on the woman, not so much, there's a definition.

Dr. Breister (02:01):
That's exactly, exactly.

Monique Ramsey (02:02):
Mommy makeover.

Dr. Breister (02:03):
Exactly. Yeah. And I mean, like I said, most commonly it's a breast and abdominal type procedure is the usual classic mommy makeover. So it just usually involves that combination of procedures.

Monique Ramsey (02:16):
And can you do those procedures all at one time, or how many things or how do you sort of define what's safe and realistic?

Dr. Breister (02:27):
I always try to look at the surgery time, and I personally don't like to go over six hours. Now that doesn't mean that over that is not safe. Some people or centers can do that safely, but my personal choice is to keep a surgery six hours or less. And within that time, it's absolutely possible to do the breast surgery, the abdominal surgery as well. And sometimes even maybe a labiaplasty. It just can depend on the extent of the abdominal surgery. Sometimes we do need to flip the patient over so that we can perform liposuction for contouring the back and the hips. Oftentimes we don't. So the breast procedures and the abdominal can definitely be done at one setting.

Monique Ramsey (03:15):
Well, that's nice because healing, especially when you're a mom, depending on how old the kids are running around, it's good to sort of maybe condense that healing into one.

Dr. Breister (03:26):
Absolutely. I highly advocate doing those together because then it's really just one recovery and not two, it's one anesthesia, it's one recovery, and then the next, you don't have to do it again. You can use that for a vacation maybe.

Monique Ramsey (03:42):
Yeah, exactly. Show off the new bod. Yeah. So what percentage of patients would want maybe a lift versus a lift with an implant or how many women might be able to just have a straight breast augmentation?

Dr. Breister (03:56):
So that's a kind of an interesting question. It's just across the board, I'd say 50% of women are going to be wanting just an augmentation. I'd say 50% are going to want some sort of lift. It just depends on where a woman may start with their breasts. Usually women that have larger breasts to begin with are going to have more involution or decrease of actual breast tissue, more laxity of the skin. So if a woman is a C cup, a D cup in her twenties when she has kids, we know that the breasts get engorged, they get bigger, they get smaller, they get bigger, but ultimately they shrink. The amount of breast tissue that's available shrinks, the skin gets looser. So if you're starting out with a C or D cup, it's more likely that you will need a lift. And the other thing is how many children you have, how many children you have breastfed and for how long you've been breastfeeding, because that really creates more and more changes. Some women have four kids, they've breastfed them for a year each. And at the end of all of that, there's definitely some drastic dramatic changes to the breast. Most likely that woman will need a lift and an augmentation. They usually need some replacement of volume and a restructuring of the breast tissue, which involves lifting the nipple up and taking away some of that excess skin.

Monique Ramsey (05:27):
I've heard you talk about potentially for some patients using their own breast tissue to add fullness. Is that something that is possible and for what patients?

Dr. Breister (05:37):
Well, so every lift involves their own tissue. And basically what that means is it's a repositioning of the tissue they have. So many times, if a woman has enough volume herself, then we can skip the implant and just reposition her breast tissue. So once again, it just depends on what the patient's goals are, where they're starting from, and how much tissue we have to work with.

Monique Ramsey (06:05):
When you're talking about a lift, what are the incisions that women, what's the trade-off I think?

Dr. Breister (06:10):
You know, you have to put incisions on the breast in order to remove skin. So that's one thing you have to wrap your mind around is that you cannot do a lift. An implant alone is not going to drastically lift the breast tissue. Some women think, well, if I just put an implant, the breasts are going to lift up. Yes, true a little bit, but it's not going to reposition the nipple. And what I tell women who really don't want to lift and need a lift, I say, well, whatever your breasts look like right now, if they're kind of hanging or deflated, you are just going to have a larger version of that breast. So I make it very clear that if you're okay with the posis or the drooping or the position of the nipple, then yes, you can just make that bigger. But if you're really looking for a more youthful breast where the nipple areola is more centered and there's less of that tissue underneath where you can do a pencil test or whatnot that the breast hangs onto the chest, if you're looking to get rid of that, you have to do a lift.

(07:15):
So the lift is going to involve, at the very least, an incision around the areola. So that is called a concentric or a benelli lift. I generally don't do the benelli lift only because I think if a woman needs that, they need probably a little more. And you can definitely get more skin out if you do a lollipop or the standard anchor incision. The lollipop is like it says as lollipop, it's a circle with a vertical component, and then the standard adds underneath component to it. And really I find that most women who are going to need a lift are either going to wind up with a lollipop or a standard lift. I find that concentric or the benelli can leave a scar. That's not a great scar, and that can also cause it can stretch out the areola. So I generally stay away from those. Some people do them, but it's usually my preference to do a lollipop.

Monique Ramsey (08:14):
Now is a lift something that lasts a long time?

Dr. Breister (08:18):
It is not, honestly. I mean, the tissues are stretched out for a reason. The tissues have lost elasticity, and so that lifting is going to last at least a couple years, maybe 10 years, but every woman is going to get some relaxation of that tissue. So it will always be better than if you hadn't done the lift. Okay. It'll always be better, but you have to be very realistic about that, that there is a relaxation of the tissue. And even though we will be placing them very perky and high, there's going to be some relaxation. So it's just a matter of how much a patient can tolerate that relapse. So they may say, oh, that's fine. I'm fine with that. One woman might say that one woman in three or four years might say, oh, I really want them tightened up again. But the majority have a pretty great result that lasts, I would say at least seven to 10 years.

Monique Ramsey (09:22):
Yeah, I'm going to spill the beans to the audience. I had a lift and my own tissue, breast tissue was used. I was that C cup you're talking about pre-kids, and it's been almost 16 years. And I'm like, I think it's time to get the redone. Like in a bra it's fine. It's fine. But it's like, because I think I'm thinking, well, I'm old, I'm 16 years older and my skin, how it doesn't just bounce back like it did when I was 16.

Dr. Breister (09:55):
No. Yeah, 16 years of aging of your breast. So that's the thing, the breast keeps aging and unfortunately the skin gets more lax. So absolutely 16 years later, you definitely are a candidate.

Monique Ramsey (10:09):
It's not just

Dr. Breister (10:10):
Make an appointment.

Monique Ramsey (10:11):
It's not just me like, gosh, you know.

Dr. Breister (10:13):
Not just you.

Monique Ramsey (10:14):
No, I noticed it before, but sort of in the last year is really when I'm like, wow, okay, maybe I'll have to do something about this.

Dr. Breister (10:22):
And the other thing is if you lose some weight too, that adds to the, and a lot of women are more, women are losing more weight now with the popularity of the Ozempic and the Wegovy. And some women lose a lot of weight in their breasts. Some don't lose much, but everyone's going to lose a bit. And that also decreases your volume, makes the skin a little more saggy.

Monique Ramsey (10:44):
Yeah, that's usually the only good thing about when you gain weight is you tend to have a little more breast happening. But yeah, no, that's a really good point. Yeah. So moving on to the tummy, you were talking about a mini tummy tuck or a standard tummy tuck. What kinds of tummy tucks do you perform? And then can you also, for women who might've had a C-section or a hernia, can you deal with the scar or how do you deal with those maybe old incisions?

Dr. Breister (11:10):
So there is a whole array of possibilities when it comes to the abdomen. The main thing that we evaluate is how much tissue laxity there is. Is there a hanging tissue there? Is it a hanging skin flap? And is there a C-section scar? So the gamut can run from a scar revision only, where we just can revise a C-section scar and remove a little skin and fat. That would be the simplest thing we could do. And that's assuming the woman has a pretty flat abdomen, her muscles are still intact. So then we move on to what's called the mini tummy tuck. And the mini tummy tuck is really only going to be good for women who don't have any loose skin above the belly button. So if most of your loose skin is located the belly button or lower and your muscles are intact, you can do a mini tummy tuck where we really just take away a lot of extra skin that's below the belly button.

(12:10):
Those are quite rare honestly, most women that have had a couple kids are going to have some skin laxity below the belly button and above the belly button, and they're going to have some muscle laxity too. So the two rectus muscles that have to spread out to accommodate that child, they usually don't go back to exactly how they were in Most women, so many, many women will need a muscle plication, if you will, where we kind of tighten up and sew those muscles back together and create an internal girdle. So we have the simplest is a scar revision. Second would be a mini tummy tuck, and then third would be that standard tummy tuck where we actually lift up all of the skin up to the rib cage, tighten the muscle, and then pull all that skin down and remove a good deal of skin. And that's going to give the woman the tightest flattest abdomen possible. And then all of these can have some element of liposuction as well. So that is often a procedure we are adding to the tummy tuck so that we can contour the hips or slim down some of the tissue on the upper abdomen. So I would say 90% of any of my tummy tucks do involve a bit of liposuction as well to help contour the abdominal area.

Monique Ramsey (13:38):
Now what do you do if you've also got a little hip action happening? Some women are fuller around there or have that I guess love handles for a better?

Dr. Breister (13:51):
Well, that's where liposuction comes in and we can contour that and liposuction, sometimes we'll have to extend the tummy tuck incision around to the hips. If there's actually loose skin, that can be done as well. But that results in a longer scar. Some women will even have that incision going all the way around towards the back. It just depends on if it's fluffy fat, but the skin is pretty in good shape or if it's actually loose skin. So you really need someone, an expert in this evaluating that for you, what is the end point? What's the result you're looking for? Because if you have really lax skin and you're just doing liposuction, you're going to wind up with a lot of loose skin that you may not want. So you have to be wary of some of the centers that just do liposuction. And they may not necessarily be trained board certified plastic surgeons. They're not really equipped to remove skin. Those places may wind up with deflation, but a lot of loose skin. So the hips can usually be addressed with liposuction or sometimes liposuction and actually skin excision.

Monique Ramsey (15:02):
And what about stretch marks? Do your stretch marks go bye-bye in a lot of these cases, or part of them?

Dr. Breister (15:08):
About 80 to 90% will go goodbye because the majority of those stretch marks are going to be located below the belly button. And some women will have some above the belly button and some of those will remain. But I would say the majority do get removed, which is great because as we all know, stretch marks are permanent. They don't ever go away. There are some newer things that claim to help them, but it's a real problem to solve unless you really surgically remove them.

Monique Ramsey (15:40):
Now, is there a time, not limit, but is there a timeframe that you would recommend for a woman? Okay, maybe she's finished having children, she's breastfeeding the last one. When do you recommend that they are able to safely have a surgical procedure?

Dr. Breister (15:59):
So that's a great question. I always would like a woman to be at least about seven months postpartum for their abdominal area. I just believe that it takes at least that amount of time for the tissues to regain their strength and everything to bounce back as much as it's going to. So I would say a minimum of seven months. Now if the woman is still breastfeeding, I like them to be done breastfeeding for at least about four months before they embark on a major surgical procedure because if the breasts are still producing milk, that can be problematic and surgery and they can be engorged. So I would say we're looking at probably at least a year after that last child, depending on if you're still breastfeeding. And the other factor is that that first year of an infant's life, you kind of want to be there.

(16:57):
I don't think you, it's stressful enough to have an infant, but then to have pile of surgery on top of that. So I think it's important for a woman to kind of get through that first year, try to get her body just back to wherever it can be safely, and then think about that type of procedure and then also be very sure that you're probably not going to have more kids because you don't want to go through all of that, all of those changes, and then, oops, I'm having another kid, because that's going to create more changes. And then yes, the other important factor is yet you have a very good support system around you. Even if you're waiting a year or two, you have a toddler, and we all know the amount of energy and psychic energy that those children provide. And you really do want to the luxury of letting your body heal psychologically. You don't want to be stressed out that your kid needs you because if you start doing activities and stuff too soon, that can really create problems. And we need everything to go perfectly smooth. So I say at least a year, maybe more.

Monique Ramsey (18:09):
Yeah, I think that's a really good point because just on the emotional side and the stress side of it, it's not that you can't have surgery necessarily, but is that where you're going to feel most comfortable giving time to yourself, giving permission to heal and not feel guilty that what's going on around you and that support system I think is huge. Now, is there a limit for your BMI? So that ratio of height to weight, and there's numbers and we have a BMI calculator on our website, but you can calculate your BMI, you can go on Google and search it, but is there a limit that you recommend for people?

Dr. Breister (18:50):
I don't stick to hard fast limits myself. I will take cases in individual cases, so sometimes surgical centers will have a cutoff, but I will definitely encourage a woman to get as low weight as possible. And that's essentially the most important part is it makes surgery safer. The lighter you are, the less complications. It's scientifically proven, less infection, less wound breakdown, less chance of blood clots in the leg. So for merely that alone, it's very much worth it to try to get down to the smallest you can become for safety reasons. In certain exceptions. If a woman is pretty healthy, but her BMI is just over, I will make exceptions because sometimes the benefits outweigh the risks.

Monique Ramsey (19:44):
And something that we'll be coming up with and announcing pretty soon is you were talking about the weight loss medications that are so popular right now, Ozempic.

Dr. Breister (19:55):
Ozempic, Wegovy.

Monique Ramsey (19:56):
Yeah. So those, we are going to start making that available at the center, and I think that's a really good tool for women who struggle to lose the weight and to get to that safe weight or to get to as close to baseline as they can and let the surgeon take over from there.

Dr. Breister (20:15):
I think that will be an incredible addition to the services we offer here. I'm very excited to have that. I'm very excited to be able to refer our patients to kind of an in-house management of that because that medication, from what I've seen, seems to be very safe, very effective, administered in the proper hands and monitored properly. It can be extremely powerful. And like I said about the safety issues, it really creates more safety in surgery. And really that's the most important part. We want to get you through surgery with the very least amount of complications possible and hopefully none.

Monique Ramsey (20:56):
Exactly. Now one thing that people are always worried about, is it going to hurt? So if we're talking about the procedures we've discussed so far, the breasts, tummy, is there a lot of pain involved? And what do we as patients receive to help mitigate that pain?

Dr. Breister (21:17):
So there's definitely going to be some pain, no pain, no gain as I say. But the abdominal plication is probably the part that hurts the most. That tightening of the muscle kind of affects your whole torso. But there is a medication that we use called Exparel that we inject throughout that entire muscle at the end of surgery, and it's a long-acting injectable pain medication. So that provides relief for a couple of days. So that is excellent. However, even on top of that, there's going to be pain. There's going to be pain probably with augmentation or skin excisions. Everyone is different, how they manage that pain or how they experience the pain. But I would say 90% of people are going to need some sort of narcotic pain reliever for the first couple of days, two couple of weeks. So any combination is normal. People have different pain tolerances, pain levels.

(22:14):
Some women can take the pain pills for a couple of days and then want to be off of them because they don't like the side effects or how it makes 'em feel. And some people might need that for two weeks. And we are here to monitor that, administer that, help a woman figure out what combination of medications is going to get her through safely as possible. We don't just throw a bunch of narcotics your way, we will use a muscle relaxant, we'll use gabapentin, which is another type of relaxing pain relief. So we use combinations of medicines that really help a woman get through. And we always aim to get the narcotics off as soon as possible because those just cause constipation and other things. But the main message is that we will get you through this pain, we will get you through it, and everyone gets through it. And I find that young mothers are probably the most resilient population. They have things to do, they have kids to take care of. So I find that they are back in action sometimes quicker than we want them to be.

Monique Ramsey (23:20):
Well, I think that Exparel sounds like a really cool thing

Dr. Breister (23:23):
Modality. Yeah,

Monique Ramsey (23:24):
Yeah, that gets you through probably the toughest time that first couple days. That's a wonderful addition to or benefit to help get you over that hump if that's something that you're scared about. Alright, so let's move on to the fun part. So vaginal rejuvenation, women, even if you didn't vaginally birth a child, you could be experiencing changes to the labia. And so if a woman approaches, what kinds of things do you talk about in the consultation and what kinds of things can you do to help?

Dr. Breister (23:58):
So that's becoming a very popular topic now, is the vaginal rejuvenation. Women can have laxity in the area, or just aesthetically the tissues feel a little stretched out or issues from having an app episiotomy. So there are some procedures. Number one is a labiaplasty, which helps to reduce the labia minora, which that is the inner structures of the lips of the vulva area. So that number one can be addressed very simply. There is also a perineoplasty, which is actually a tightening of the vaginal area, and that too can help restore it. And then there are other modalities that can be done to help rejuvenate the lining of the inner vagina different ways.

Monique Ramsey (24:49):
And they do have, in the med spa, they have ThermiVa. And that was invented by a surgeon that I know he's a urogynecologist up in Laguna, and I think he moved to Texas. But coming up with a way, sort of the radio frequency to help tighten inside up the canal and to help even with incontinence. And so it's a very good, and it's super easy. You just do three treatments a month apart and it really can make a good difference to lubrication to a lot of things. But I think if you need extra skin removed, you need extra skin removed. And ThermiVa is not going to help with that. But that's nice that you have a way or different ways to sort of approach that area and make it better, especially if it's uncomfortable if you're riding a bike or you're doing certain things or wearing certain kinds of clothes and there's extra skin in the way. It's hard. It's hard to deal with.

Dr. Breister (25:49):
It's all part of the changes that unfortunately sometimes some women have to experience.

Monique Ramsey (25:55):
Now is that a painful surgery or what's the recovery on let's say a typical labiaplasty?

Dr. Breister (26:02):
Is a very straightforward operation. It's not very painful. The first couple days require a lot of icing, and if that's done effectively, people can get back to their activities if that's all they're doing, not a tummy tuck or breast within four or five days. Now obviously no intercourse for about four to five weeks and no riding a bicycle, things like that. But normal activities of daily life can be resumed after four to five days on that, and the pain is very minimal.

Monique Ramsey (26:33):
That's good to know because it's such a sensitive area.

Dr. Breister (26:36):
I know, I know. It's surprising. It heals up very well very fast.

Monique Ramsey (26:41):
Now if we go back to kind of maybe the typical mommy makeover, some breast surgery, some tummy surgery with a tummy tuck, how do you recommend that women prepare for recovery, whether they have little kids or even if the kids are more a little more grown up, how do you recommend that they approach that time?

Dr. Breister (27:03):
Well, so first and foremost, I let them know that they probably won't be driving around for at least 10 to 12 days. So if they have children that need to get to places or whatnot, they need to have a person that can do that. The other thing is that first 10 days, they're not going to be able to put the child in a car seat or a high chair or anything like that. So first and foremost, they need hands-on to help with the young children. So that's kind of going to be the first requirement. Secondly, it's good to prepare with lots of maybe some prepared foods to have in the fridge so that there are go-to things that can just be heated up. So it's always helpful to have a couple days of meals planned out just so you don't have to worry about that. Some women do find a La-Z-Boy type chair is extremely helpful.

(27:59):
That first week it's pretty hard to get up from a seated position to a sitting position because of that abdominal repair. So a lot of women are very excited just to be in a La-Z-Boy that can help them to kind of push up. They don't have to lean all the way back. So that's optional. But a lot of women do find that helpful. The other thing is if their bedroom is on up above on stairs in a second level, a lot of women will want to do the first week on the main floor. So they set up on the couch or wherever they are so that they don't have to be going up and down the stairs. And then even those first 48 hours, they probably will need hands-on to help them get up from a seated position, get to the bathroom, get back into the bed. So it's really a preparation of support hands-on helpful. If the kids can even just go to grandma's or something like that for the first week, that's going to be the most important thing. And I think without that stress of, oh my gosh, my kid needs this or my kid needs that, they're going to have more psychological space to just heal and do what they need to do. They're not going to be feel pressured to, oh gosh, the baby wants me. I got to get up because that's hard.

Monique Ramsey (29:16):
Now, I've heard people talk about drains when drains are placed either with breast surgery, with tummy surgery, and then you see some advertisements, no drains, tummy tuck. And it's like what is the deal with drains? What do they do? And what is your philosophy when you do surgery about using drains?

Dr. Breister (29:39):
So the drains are very critical in a tummy tuck procedure because we're lifting up so much tissue. There's what we create something called dead space. So it's spaces that have to seal and heal together. And during that process, there just can be extra fluid that's created. So that is essentially what that drain is doing is it's evacuating that serous exudate to give the tissues a chance to seal and heal together. Usually by a couple of days, the first drink can come out and then maybe a week or 10 days later, the second drain can come out. I generally don't use the drains in the breast surgery only if I'm replacing and removing implants and doing a lot of work on the capsules. And it's really not as scary as it sounds. They are just merely some plastic bulbs that need to be open, squeezed out and pinned back on your abdominal binders.

Monique Ramsey (30:35):
And how long are the drains in?

Dr. Breister (30:37):
Up to about 10 days is on average.

Monique Ramsey (30:40):
Now getting back into life, let's say we're six, eight weeks or a couple months after surgery, what do you hear from patients? What are they saying as their past recovery and living with their new body?

Dr. Breister (30:54):
Well, number one, it's a big transformation. They're excited. They feel rejuvenated. They're just feeling back to their normal self. Their confidence is up. They can wear the clothes they want. The tummies are very dramatic because whatever, they usually can't do anything to get rid of the stretch marks or the extra skin. Even if you lost weight, it doesn't go away. So they're very motivated, excited to have their flat tummy back.

Monique Ramsey (31:22):
When you lose some weight or you've fixed your shape that you didn't like and you can put clothes on and they zip up and it's like, oh my gosh, this is so great.

Dr. Breister (31:29):
It's so exciting. It's so exciting.

Monique Ramsey (31:32):
It's like a whole new world.

Dr. Breister (31:33):
It changes your life every day.

Monique Ramsey (31:35):
Yeah, I would think so. So getting into how to start the process, I'm assuming consultation is step number one, whether it's in person or if you're from out of town, you can do a virtual consult. Is that right?

Dr. Breister (31:51):
Yeah, absolutely. We offer Zoom consultations. I would say if these are things you're thinking about, probably at that 7, 8, 9, 10 month mark after your child, if you're really motivated, it's good to get the consultation just to kind of start getting a framework of what you might need, what your goals are. So I think it's good to get that consultation sooner than later because it can start your planning. You can really start thinking about it. Then you have hard facts, hard data. You know exactly what it's going to take. If you can muster up the strength to do that or overcome a lot of fear. Many women are scared of surgery. So it takes a lot of guts to go through that. So there's just a lot of factors that I think once you have the consultation, you get the facts, then you can really start moving forward to figure out is that for me?

(32:48):
And it may not work out right away, but it may work out a couple years later. And then they also can get a quote too, so monetarily they know what they're looking at, what the best options they need to finance it or whatever that may be. All those facts make it more of a reality of, okay, let's really, I know I'm thinking about this and dreaming about it, but is it something that can I really make this happen? And that really can be very illuminating to women because they're not surgeons. They don't know, oh, I thought I could do that. Or, oh, I thought just lipo was going to work for me. There's a lot of obviously insight and knowledge we bring to helping that woman create the customized plan that she's going to need.

Monique Ramsey (33:37):
And I think mommy makeovers more than maybe a lot of things we do at the center are so customizable. It's hard to wrap your brain around what that number might be for the quote, because it is so customized and you won't know really how many hours in surgery and which procedure variations you need until you have that consultation. Whereas if it's like upper and lower eyelid lift, it's kind of going to be pretty standard. Standard where this is really a bigger number.

Dr. Breister (34:09):
It's very hard to ballpark it.

Monique Ramsey (34:10):
Right. Well, and I think something that's a really great tool is on the website, we have a finance calculator under the financing page. So you can play around with figures if you wanted to put this much down and finance this much, what you'd be looking at for a monthly payment, like a car. We don't all go and plunk down $30,000 for a new car. We finance it. And so it's the same thing with surgery. And I think a lot of people don't realize that we can make it affordable for you. We don't want money to be a huge barrier. And our patient coordinators are so good about helping work with, we have several companies we use so that even if part of your surgery is going to be financed, then that's something that we can help with. And then also the other tools on the website I think that are really helpful are before and after photos.

(35:05):
That gallery where you can look at other patients, where they started, how they ended up, and get some ideas of, oh, this is what a breast lift looks like, or this is what a extended tummy tuck looks like, or here's tummy tuck and lipo to the flanks. Those are things that we don't really know what they look like until we see them. And one of the things that we also have during the consultation, some patients don't want to share everything on the web. They don't want it out there on the web, but they will allow their before and afters to be shared in the consult with the doctor. And so when you have your consultation, there's a whole bunch more photos that are

Dr. Breister (35:48):
Available.

Monique Ramsey (35:48):
Yeah, and I think that's a good tool too.

Dr. Breister (35:51):
Yeah, absolutely. It shows incisions, it shows incision placement, it shows different stages of healing. There's a whole host of information that can be visually obtained by looking at before and after pictures. I'm a very visual person myself. So seeing those speaks volumes, it's just you can describe things all you want, but once you see it, you have a better sense of what it could be.

Monique Ramsey (36:17):
Thank you so much, Dr. Breister. This was illuminating so much fun.

Dr. Breister (36:22):
Oh, good, good.

Monique Ramsey (36:23):
I loved speaking with you about all the things you do because your patients just adore you and your results are beautiful. And so thank you.

Dr. Breister (36:31):
Thank you.

Monique Ramsey (36:31):
I appreciate you coming on. And as a mom yourself, you understand it.

Dr. Breister (36:36):
I do. I do. Yeah. I really enjoy what I do. I love making women feel good.

Monique Ramsey (36:43):
Okay. So thank you so much. And to find information about our prices or to see those before and after photos to see other videos that we've done, you can go to our website, we'll put links in the show notes and how to reach us. You can schedule your consultation, call and ask one of the patient coordinators about pricing. We can help with all of it. You have a wonderful team and they're there for you whenever you're ready. So thank you again, Dr. Breister. I appreciate your help today.

Dr. Breister (37:12):
My pleasure.

Announcer (37:13):
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, THE AXIS. io.