Monique Ramsey (00:02):
Welcome to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey, and today I am happy to welcome back Dr. Hector Salazar, board certified plastic surgeon. Hi, Dr. Salazar.

Dr. Salazar (00:13):
How's it going? Monique, it's always a pleasure to talk to you, and I think today we have a very important topic to cover.

Monique Ramsey (00:18):
Yeah, so breast augmentation is one of the most popular cosmetic procedures, and while it can seem kind of straightforward in a lot of ways, being prepared for your recovery is the number one thing that you can do to have a positive experience. And we also want to let you know kind of what to expect because when you're going towards something you've never done before, you don't want to feel like you're in a dark tunnel. You want to know what's going to be coming as you go. So Dr. Salazar, you've done this procedure countless times, probably thousands of times. So what things do you do to help your breast augmentation patients be ready for their recovery?

Dr. Salazar (00:57):
Yes, Monique, I think you have a great point because in just mentioning how many times we have done this, I mean for patients, most likely it's going to be their first time, and all of our staff acknowledges that fact. So first of all, to acknowledge that and to digest all this information for our patients in a way that they can actually understand it, be able to be prepared, I think it's essential to dedicate a good amount of time with the patient before surgery. And then during that initial phone call with our coordinators, they also start to get some information and expectations about what's going to happen afterwards. Then when they come to have their consultation, we always cover at the end of the consultation that topic to give them an idea what's their recovery going to be like, how many days they should estimate that they're going to be down, how much time before they can resume exercise, when are they going to feel fine, when do they expect not to be having discomfort enough that they would require an analgesic, for instance, right.

(02:03):
When is my mind going to be completely clear? So we go over that information. Then after, before surgery, then they have a preoperative visit and that is a full hour interaction with a nurse that's also extremely experienced, and they're going to be teaching them how to nest and how to be prepared for that period after the surgery. And then we follow them up very closely and then we continue to guide them through that route. But by that moment, by the day I see them right before surgery, they already know exactly what it's going to look like afterwards.

Monique Ramsey (02:39):
So let me ask you a question that I think might be on people's minds a lot. Does implant placement where you're putting that implant, does that impact the length of time that you have for recovery? So whether it's under the muscle or over the muscle or dual plane, I don't even know what that really means. So could you talk a little bit about that? Yeah, it does sound fancy.

Dr. Salazar (03:03):
Yeah, absolutely. So it does impact in the immediate postoperative period, those first two, three days after surgery. When you have an implant, normally you don't have anything underneath your muscle. So if you put an implant that an implant gives volume, and that's the main reason why you want that implant inside to give volume. But volume also occupies space and generates pressure. So it'll be generating pressure on your chest is going to be generating pressure on your muscle and the muscle, it animates the muscle, reacts the muscle contracts. So that's the reason why we say if you compare the immediate postoperative period between a patient that has an implant underneath the muscle and a patient that has it on top of the muscle, the patient that has it underneath the muscle will have more discomfort. But eventually, and when I say eventually I'm talking about after a week or so, both patients are going to be recovering equally. So in those terms, yes, it impacts the immediate post-op, but in reality, if the indication is for you to have the implant underneath the muscle, then all the advantages that that will bring will out weight for sure, those two, three days of a slight more discomfort.

Monique Ramsey (04:22):
Now, another thing that I think can contribute to how we feel after surgery is anesthesia. So how long is the typical breast dog under anesthesia, and then how does those medications, how do they impact how we feel after surgery?

Dr. Salazar (04:40):
No, definitely that plays also a role. It is a general anesthetic. So your body is going to go to sleep artificially through medications. You're going to be well protected. Remember that we all only have, as our anesthesiologist associates, we only have board certified anesthesiologists. So that's for the peace of mind of all the audience out there. So they will give you the required anesthesia for you to be asleep for about an hour, and rarely we need to extend that. And afterwards what will happen is those anesthetics need to be cleared by your liver, by your kidney, so meaning they're still going to be circulating afterwards. So you're going to feel a little sleepy, you're going to feel a little tired. You're not going to feel at a hundred percent. But mainly, and probably I would say 24 hours later when we see you in the first postoperative visit, patients are already smiling and pretty much their mind is clearer. But I would say after that day is when they feel at a hundred percent and they go back into like, okay, so if you do the surgery, let's say on a Friday, Saturday, Sunday, by Monday, your mind is going to be very, very clear.

Monique Ramsey (05:50):
So don't do your taxes in the first couple of days.

Dr. Salazar (05:53):
That's exactly right. And sometimes, yeah, absolutely,

Monique Ramsey (05:56):
Because I'm in bed, I have nothing else to do. I'll do my taxes. Right, yeah,

Dr. Salazar (06:02):
Make executive decisions of your business or stuff like that.

Monique Ramsey (06:04):
Yeah. So wait a few days on those important decisions. Now when they're in recovery, you have a special bra for them and then they're going to go home and they have somebody to take them home and care for them. So what does it look like, I guess, for recovery with bandages or Steri strips, or how do they sort of care for the area immediate immediately after surgery?

Dr. Salazar (06:30):
Yeah, that's a great question because it always, I mean, there's always the fear, right, of patients imagine that, oh my God, am I going to be pouring blood? Is it going to be right? I mean, what am I going to do with those gauze? I don't want to hurt the incision, and they just closed it and oh, I don't want to even touch it. I don't even want to see it. So great news, because what we do, so let me be very clear here with what we do after the implant has been placed in, so the implant is placed in, then we close the axis incision and we close it in three different levels. And after that, what I like to do is I like to put a on top of the incision, a liquid that solidifies and ies, so completely insulates the incision from the outside world.

(07:19):
That's called derma bond, and it's something that we add for the patient's comfort and for better recovery. So that's completely covering the incision. On top of that, we put a couple of gauze, and then on top of that we have the bra. So what I tell patients is don't worry. You go home and the same way we packed you and ship you home the same way, we'll unpack you tomorrow. So nothing for them to do because I don't ask them to shower. They should just relax, chill, go home, come back, and we will change the dressings for them. So there's literally nothing for them to do.

Monique Ramsey (07:55):
Oh, that's really nice. Especially, and even for their help or whoever's staying with them in that first 24 hours, those people don't even have to really worry about perform getting in the middle of it. So to that point, how long does somebody need to be with you after they take you home? They're with you that first 24 hours. Do they need to be with you longer to help you?

Dr. Salazar (08:19):
Well, I think it all depends on the setup that you have or if you live on your own completely or if you have more family members. So what I tell patients is that for sure the day of surgery, they need to come drop you off. Don't bring your car to not drive the next, I mean, they're going to be picking you up. That responsible person also needs to be an adult, right? It's like, oh yeah, my 14-year-old kid.

Monique Ramsey (08:44):
My 16-year-old who just got his driver's license.

Dr. Salazar (08:47):
Exactly. So we would try to have a responsible adult always, right? And then it's very important that they stay with the patient overnight. We are in communication constantly with patients overnight if there's anything that's needed. So it's always good to have a person next to you that in case they would need to drive you in case we would need to assess them that they could do that. Then the following morning, if I want to say the number a hundred percent, but you never know, but I would tell you it's very, very close to a hundred percent that nothing happens overnight if not a hundred percent. So the following day they're going to be coming back for their postoperative visit. We like to change the dressings for them the first day, so there's no surprises. So they're not doing that in front of a mirror and guessing, is this correct?

(09:34):
Does it look the way it should look? So we like to do that for them. And Monique, that breast augmentations the day after surgery, they look a little crazy, right? I mean, the implant is writing really high. We prepare patients for that. The way the breast looks that day is not the way the breast is going to look. Eventually they look a little squared at the bottom, and the reason for that is because we're supporting, we're helping their body support the implant for them in a better way so that at the end they have a great result. But so we do that dressing change, so they need that person to bring them to drive them back. So the next appointment is going to be at one week to make sure that there's no infection, make sure that there's no bleeding, that everything continues to heal well.

(10:19):
So if by that appointment they can drive themselves, if they feel that two things are happening, one is that they're not taking any narcotic, and two is that God forbids, there's a kid running across the street and they can actually have a quick reaction. If they cannot do that, then they'll need someone to take care of them and drive them. And it's a usual thing. I mean, you would see 50% of the patients coming back on that week visit on their own 50% patients coming with another family member. So I mean, it depends on patient by patient basis.

Monique Ramsey (10:56):
Now, you were talking about how that on day one, how the events implants might look kind of crazy. They're riding high, so everything's sort of tight. Is it because of the swelling and then how long does that last?

Dr. Salazar (11:09):
Yeah. I tell patients to not even consider for the first three weeks to go in and enter a bikini contest. I'm sorry. Because definitely what we are looking for is we're looking for all the recovery that happen first. Definitely day one after surgery, the swelling is going to be there. Day one, after surgery, we just closed everything. And the way when we are in the operating room and we set up the patient and we are actually seeing how we are obtaining the look that they desire, because we even sit up the patient, I mean the patient is positioned in the operating table in a way that we can sit them up so we can see how gravity would act on the implants, etcetera.

Monique Ramsey (11:53):
Yeah, it's very cool actually.

Dr. Salazar (11:54):
It's very neat and unfortunately patients cannot participate with observation during this time, but it's really, really good, and that's the moment where the implant's going to look perfect. That's the moment at that moment in time is when we say, okay, she's going to look fantastic. And then what we do is then we start supporting the implant closing cinching things, and then the implant gets pushed up a little bit more than where it was, and then the swelling and then the muscle actually also kind of pulling or being a little stimulated. So all those reasons make the look at day one. It'll have nothing to do with the look at three to six weeks.

Monique Ramsey (12:37):
Now, in terms of pain, what do you find? I know everybody processes pain completely differently, but on average, is the pain sort of because of the muscle being maybe tight or it's like if you do a thousand situps, your muscles are sore. If there's an implant behind that muscle, is that the main source of the pain and how long does that last?

Dr. Salazar (12:59):
Yes, it is the muscles and the tissues that are being stretched, right? Because we just distended a lot, your skin, your mammary gland, then your muscle, and I mean that's exactly where that discomfort comes from. Now, two things, yes, every patient's different and definitely we get patients that look literally like nothing was done the day before, and they come in with a big smile. Of course, I wouldn't set up that to be the expectation for all of our patients. You're talking about probably 10% of the population are going to sit in a spot where they go like, oh my God. They come in and they're wearing makeup and they look, they're ready to go to a party, and you're like, man, maybe we forgot to do your surgery yesterday. Maybe we skipped you or what?

(13:46):
I mean, that's on one hand. On the other hand, you have the patient that probably for a week to 10 days, full week to 10 days requires a little bit more of a narcotic as an aid. But then you also have probably that it's the other 10% of the population down here, and then everybody else sits within the middle. And understanding that and understanding that we don't like narcotics. Patients don't like narcotics. We try to avoid narcotics by all means. So what we do is we have a nice approach in which we attack the pain component and from different angles. So we give the patients an anti-inflammatory medication. We give the patients a muscle relaxant, so that helps with that contraction, with that pulling. We also give patients a nerve ending pain controller, which is, you've probably heard about gabapentin, and that's like to take the edge of that acute sharp pain.

(14:43):
Then on top of that, if patients have some additional pain, they can take Tylenol. Tylenol extra strength would also help. And then if that's not controlling, they always go home with a narcotic. I mean, don't imagine there are going to be boxes and boxes of pills and pills. This is a short period that if they need to use it

(15:06):
You get four.

(15:06):
Exactly, if they need to use it, I mean, they've earned it. They deserve to take a pill. They had surgery. I mean, you can't change that fact. And they're not going to become addicted to any narcotics because of you take three or four pills in the course of in a postoperative course. So for them to not feel guilty or anything that if they need it, they need it, they earn it, as I was saying. But I think our patients are very happy. One thing that I forgot to tell you is that we also put some local anesthesia before we close. So when you go to the dentist and they inject you with some local anesthesia, then they can work on you. So right before we close, we put a little bit of local anesthesia in there for them to also get some more pain relief. So we got them covered.

Monique Ramsey (15:50):
Yeah. Okay. So let's go to that extreme 10% or even 25% of the people who feel really good after a couple days. What's the caution? I know if you feel really good and you've got time on your hands, you might start doing things more complicated than your taxes, like cleaning out your closet, or what do you want them to really pay attention to after surgery, despite you might feel great, but

Dr. Salazar (16:21):
Exactly. So I mean, I tell them, especially when I see the patient that I described that she looks like she's ready to go to a party. She's like, oh, Dr. Salazar, hey, and she almost gives me a high five or they feel so good and it's red flag alarm, alarm, alarm. We actually got to educate this patient a little bit more and we've got to reassure her that everything went well in surgery and that there's no reason why she will have a complication. And I tell them this, I tell them, you're going to have time in your hands. You block some time from your life, from your business, from your work, from your kids activities or any other thing that's going on. And then you get bored because you feel fine and you're like, okay, so I'm done with Netflix, I'm done with social media, and you know what?

(17:09):
And you're sitting there and you're looking at your closet, and then you start shifting things or you know what? That wall, I still have that bucket of paint and I'm going to start painting it. And another classic one is that by, I dunno, around six, seven days, they've really got bored. Why am I not doing anything? So you know what? I'm done with this. I'm going to go to Whole Foods and I'm going to do some grocery shopping and I'm going to pick up a couple of heavy bags and then I'm going to feel a pop, and then one breast is going to look double the size of the other one. I always remind them about that on their first visit. And I say, if you bleed, it's not there. You're going to be bleeding outside. You bleed inside because we created a cavity there that wasn't there before.

(17:55):
So if your heart rate goes up, your blood pressure goes up and imagine that you open a little bit more that water and you're holding the hose here with your thumb. So you increase the pressure and then all of a sudden you're going to start bleeding inside internally. And I tell them, it's not the end of the world. You just come to our center again, we make sure that you haven't had anything to eat or drink. You're not going to feel well, we're going to get the anesthesiologist here. You're going to go to sleep, we're going to reopen the incision, take the implant out, clean the blood, control the bleeding, put the implant back in, close it, wake up from anesthesia and we hit the reset button. Nobody wants that. Everybody's eyes open super wide and they said, I'm not going to be there. And Monique asked me, my patient population, since we are very cautious with this, they tend not to bleed. So they behave. They behave well after they hear all this because it's their recovery and it's their experience. And plastic surgery, especially cosmetic surgery, which is what we do, has to be a happy journey. And that includes your postoperative.

Monique Ramsey (19:08):
Yeah. So is it true that you can't lift your arms after surgery or what do you kind of tell them and for how long before they can work out or go on the treadmill or take a walk around the block that let's say the perfect journey of a post-op patient in terms of activity, what would you like to see?

Dr. Salazar (19:31):
Right, like for them to do things like a T-Rex like don't move, right? No, no. Actually what I tell them is that it is okay for them to move their arms and shoulders, elbows, hands, wrists to do regular activities of their daily life. If you say, what would that be? Okay, can I shampoo my hair? Yes, absolutely. I mean, bring your arms up enough so you can shampoo your hair. Can I brush my teeth? Absolutely. Angle your elbow the way you normally do it. You might feel the implant there. You might feel like a little funny sensation, but for applying makeup, it's perfect, right? I mean, you shouldn't be lowering your head to try to allow your arms to reach, but it is not okay to go ahead and get rid of the bowling ball that has been sitting on top for years of your closet. So it's not okay for you to grab some heavy frying pan from your kitchen. So to do regular activities is perfect. Can I walk my dog? A chihuahua maybe, but nothing bigger than a chihuahua because your dog is going to be pulling, that's going to create and generate effort on your side, and then you're going to feel a pup and then you can start bleeding. So not worth it.

Monique Ramsey (20:56):
Yeah, definitely not worth it. So that's good to, and I know that at that pre-op visit, we really getting to depth in terms of that immediate post-op period and getting back into life. And I think that's a great thing for people to think, oh, well, I'm just walking my dog, but yeah, the dog can pull on you or sure, I'll put ankle weights on my, because I didn't have any surgery on my ankles. That'll be okay. But that goes to your point about the heart rate is that that more effort means there's the higher heart rate and then the blood's pumping sort of stronger.

Dr. Salazar (21:31):
Exactly. Exactly. So as I was explaining to you, the way we control bleeding in the operating room is we cauterize it. So we create, imagine this very nice little crust on top of a bleeding vessel, and that's how we control bleeding and patient's not bleeding. But if your heart rate goes up, maybe that little lid of a crust that we created, then that's not going to be enough, right? And there's no other way. So the only thing is no exercise, nothing that gets your heart rate up. Do not win the lottery, do not watch the Super Bowl and get too passionate about it. You've got to try to avoid all those things and have your normal life. I would say resume it after the weekend or a week after, and then exercise, real, real exercise. We tell them three weeks.

Monique Ramsey (22:24):
Now in terms of exercise and those upper muscles, so I know a lot of bodybuilders get breast implants, and most of us aren't bodybuilders, but for them and for us, do the implants hinder our ability to do certain exercises at all?

Dr. Salazar (22:41):
No. There was a study that measured the strength of the muscle and by physiologically precisely with numbers. And also there was a survey that was given to patients. So the bottom line is that a computer can detect a very small difference in the performance of the muscle, but patients cannot detect that difference in performance of the muscle. So in reality, your ability to paint a wall or to lift some heavy weights, it's not going to be diminished by your breast augmentation. That being said, some patients say, I don't want the muscle contracting on top of my implant. I do this, I do that. I have whatever activities or exercises they like to do. And then yeah, you can go ahead and put the breast implant on top of the muscle, meaning behind the gland, and if that's a good option for them, then we can offer them that option as well.

Monique Ramsey (23:44):
And sort of wrapping it up on terms of healing, when do you tell them to expect to be fully healed?

Dr. Salazar (23:54):
When can I call fully recovery? When I exercise, okay, three weeks. What about when I can do all types of exercise after my surgery? Because after three weeks, what we do is let's start with cardio, right? Get back onto your rhythm and then the following week, try some weights or some upper body exercise or whatever yoga pose requires you to do more effort with your upper body, with your torso. And if you feel like it's fine, keep on going. If you listen to your body there, if you feel it a little uncomfortable, it's going to take some time as well for your body to integrate those implants. So think about this, you're wearing headphones right now, but you forgot about it. I mean, it took you two to three seconds to put the headphones and then you forgot about the headphones. There's going to be some moments in which you're going to be feeling them, but you're not constantly thinking about your headphones. So the same thing with the implant. It's not going to take two, three seconds is probably going to take about two to three months for you to completely forget about the fact that you have implants. Your body, your mind, your brain, your muscle, everything will kind of integrate and you're not constantly thinking. So for them to know that if you call fully recovery whenever I'm not even going to notice my implants or something, then you probably are talking about two to three months for you to your brain to integrate all that information.

Monique Ramsey (25:20):
So following the directions in your little pre-op booklet and listening to your doctor and your nurse, then if you follow that most, 95, 99% of the time, people are in great shape.

Dr. Salazar (25:34):
Absolutely. Then another part of recovery, and again as well fully healed would be the incision, right? So the incision, incision, number one, as I was explaining to you, we closed in several layers. The skin is approximated perfectly, it's opposed like the two edges of the skin. They're touching each other and the sutures that we put in are all dissolvable. Then on top of that, if, I mean, I know that some doctors prefer to put Steri strips, which are tapes, and in my case, I like to use the derma bond, which is that liquid that plastifies and completely insulates it. So they don't have to see in reality or deal with any change to gauze or open wound or nothing like that. Just leave it alone for guess what? Three weeks. And so for three weeks, and after three weeks, I normally clear everybody to be able to be submerged in water, whatever that means to them, meaning pool, sauna, jacuzzi, ocean, three weeks of why? Because at that point in time, the strength of that incision, it has reached a point in which there's nothing bad that can happen to it. And all the epithelium, all the layer, the superficial layer has completely healed and there's nothing that can get in there.

Monique Ramsey (26:57):
Okay. And then do you have them once that derma bond either falls off or goes away after three weeks, or does it take three weeks to stay on there or does it?

Dr. Salazar (27:07):
It's really good stuff. So what happens? It's really good stuff. So what I tell them, because normally I would say 99% of the time at three weeks, it's still there. So I tell them to, as they're showering when everything's wet, little by little start peeling it off, and then at that point again, nothing back can happen. So they just peel it off. And that's a very important moment because at about three weeks, when they peel it off, then is when I like them to start with the scar therapy to help a mold and help your body in that process, because you have the first six months is when you're going to have the most impactful chances to improve the scarring. And the most important thing is that patient, when they do the massage, they do it with pressure and that they actually do it. Those are the two most important factors. And then the third one is what they use in our case that we use elastin for the recovery of the skin and the scar, and we provide that for our patients. So some patients actually after they use it and they run out of, I mean the second or third, they can purchase it in our surgery center.

Monique Ramsey (28:18):
It's good stuff.

Dr. Salazar (28:19):
It's really good stuff, and it's even good stuff to have, I mean, just in case God forbids, you have scratch or you have something, then after it heals, you can start working on your scar. But that three week visit, it's crucial because you're going to be released to start doing activity, you're going to start removing the coverage of the incision. You're going to start working on your scar therapy. And then another thing that I like to do is I like them to massage their implants starting at about three weeks. And that we can talk about that if you have that question.

Monique Ramsey (28:49):
Well, and if you have a moment, let's just talk about what does that look like? You actually train them at a visit?

Dr. Salazar (28:56):
Exactly. So that three week office visit I think is really important. What we ask them to do is to hold their implants and hold their breasts together and hold them for 10 seconds and then do 10 repetitions of that and the same thing up, so in and up. And what you're doing by that is your body is going to form a capsule around the implant. And that is because the implant is a foreign object. It's a foreign body. And I mean, 90% of the time, over the first 10 years, that capsule will remain nice, soft, imp pliable. And that's doing that massage can favor to maintain that naturality or that softness of the capsule around the implant. And we ask patients to start doing that at about three weeks as well.

Monique Ramsey (29:43):
And then last question, how long will implants last?

Dr. Salazar (29:49):
Oh, that's great. So implants are manmade objects. There's no difference between an iPhone, an implant, a car, a refrigerator. So they are manufactured products. They do not have a true expiration date like milk that it's going to start decomposing. And that's something that the FDA recommends that every 10 years you exchange your implant. And that's official recommendation. In reality, 10 years and one day or 10 years and 50 days, there's nothing magically that will start happening to your implants. There's like no evil mastermind at the implant company pushing a button, and then your implants are going to start melting or they're going to start disintegrating and fusing with your body, and then you're going to start getting intoxicated by the implant. Absolutely not. Right? On the other hand, are those meant to be forever? No. Again, we talked about it, it's a manmade object. I mean, during the period of 10 years, how many iPhones you go through, how many cars are you going to have?

(31:05):
Even maybe we can ask ourselves, how many and how many different addresses are you going to live? So having and leaving an implant for 20 years or 18 years or 25 years and not even caring about it or having, let's say it updated, remodeled, brought back to life, whatever. It makes sense. It makes sense for you not to get, I mean, I can assure you that if you're 25 and you're getting an implant surgery, that's not going to be the last implant in your life, and it should not be. But for me to at 10 years start chasing patients and almost with a scalpel and say, Hey, you better come here because your implants aren't going to go bad. It's not like that's, they can make some time, make arrangements. If they don't have any problems, there's some problem, it makes sense to change them. But in a patient that has zero problems, everything's fine. It's not a must, but it's a good practice for them to put that in their calendar somewhere around after 10 years, 10, 11, 12, that it has to be changed.

Monique Ramsey (32:10):
And then if something goes wrong, and I don't even know what that would be, the implant companies have a warranty, I believe, for a certain amount of time at the very beginning of how the implant fails. What does that look like? Or what does that mean? And what does the time period?

Dr. Salazar (32:28):
And I'm going to defer it for the exact terms to our coordinators that they're extremely knowledgeable there. But one thing is that the company that makes implants, they trust so much in their product that telling you that if within the first 10 years there's a rupture that they would compliment the implant and here's a new one, because they firmly believe that the implant will not get ruptured. And then encapsulation of the implant and other things, that there's also a warranty that kicks in. And I mean, that's a completely different topic, but for patients to feel and know that their implants come with a warranty because the company trusts their product, and it's extremely rare. I mean, to see an implant rupture, it's very, very rare. There needs to be a high force involved or encapsulation of the implant with some for a long time, and then the implants start getting ruptured, et cetera. Within normal conditions. You're not going to be concerned that someone opened the door and hit you in the breast and then, oh my God, got to, I'm concerned about my implant. It needs to be, I mean, a car accident in the freeway, like 70 miles an hour, a fall from second floor, or some sort of trauma that's significant for you to be concerned about the integrity of your implants.

Monique Ramsey (33:50):
Or, you just did your, so Dr. Salazar, for our audience, you have these great reaction videos with our patient care coordinator, and the one that just came out last week was about a breast implant that stopped a bullet, I think.

Dr. Salazar (34:09):
It slowed down enough.

Monique Ramsey (34:11):
Slowed down the bullet so she didn't get hurt. So there's a trauma to the implant that nobody was expecting, but tell us a little bit about that.

Dr. Salazar (34:19):
Right? No, yeah. I mean, anybody penetrating trauma, of course will cause an injury to your implant, and then that needs to be replaced. And on that video, that was so funny, we're reacting to videos. We don't know the video that we're going to be watching. I mean,

(34:32):
Oh, you don't?

(34:33):
No, because then it's, it's not going to be authentic, so it has to be live.

Monique Ramsey (34:37):
I didn't realize that.

Dr. Salazar (34:38):
So our creative team, actually, they do a fantastic job at gathering these videos and then surprising us with those. And yeah, this one here was of a patient that actually suffered a gunshot wound, and because of the presence of the implant, the bullet slowed down enough that didn't reach the thoracic cavity. So it didn't injure the lung, didn't injure the heart. And I mean, I think in the video we reacted by saying that that's not the main purpose of the implant clearly, but it helped.

Monique Ramsey (35:03):
Bulletproof vest. How crazy. I love that though. But so your reaction videos, I don't know how often you do. I see 'em every few weeks or every month, but they really are great. So if you tell everybody your Instagram handle so that they can be watching.

Dr. Salazar (35:19):
Oh yeah, exactly. Hector Salazar, md, check it out, check those videos out mean, and also in our account from L-J-C-S-C, what we are creating. I mean, we have fun creating it. And I think that gets reflected. And it's partly educational, partly, I mean, always respecting how serious our profession is because it is a serious profession, but giving it a little bit of flavor so we can all have a little bit of fun with it.

Monique Ramsey (35:45):
A little tajin on the rim, right?

Dr. Salazar (35:47):
A little tajin, a little tajin. A little tajin. Not only salt, but a little tajin. Yeah.

Monique Ramsey (35:51):
Well, this was so exciting to learn all these different facets of breast implant or breast augmentation recovery and what to expect. And so Dr. Salazar, any last thoughts you have before we wrap up?

Dr. Salazar (36:04):
No. For patients that are considering having surgery to know this, it's going to be their first time, but definitely it's not going to be our first time. And for them, and that's exactly how they feel when they come. And it's normal. If you're facing something that you've never have done before, you're going to have that level of anxiety. And our goal is to shave that off to, no, I mean, when you see us and you see that this is what we do, that this is what we do every day, and then your level of anxiety starts going down, and then the more we explain to you how things work, then that level of anxiety completely disappears, and then that's turn into a level of excitement. So that's what we do with our information to turn that anxiety into excitement about the next step that they're going to be taking. So I invite them all to stop by, consider us as a viable option to do their breast augmentation, and for them to see, invite them to look at all of our reviews, to see all of our results, and see how patients are extremely happy after their breast augmentation surgery.

Monique Ramsey (37:19):
You can look on our website, you can see all the reviews on each doctor profile, but when you go to the procedure page, so the breast augmentation procedure page, you'll scroll down and you'll find all kinds of great information and links to videos and links to the gallery, but you'll also see reviews about breast augmentation from our own patients. So they'll all be sort of clunked together and you can read them. And I think it's that level of you're talking about that anxiety switching to excitement. It's that the more you learn about where you're going, who are the people you're going to be partnering with and that you feel you can trust them, that's when it sort of jumps from anxiety over to excitement. And I think I've decided on this three week rule, because a lot of things happen at three weeks. We're going to call it three weeks to fabulous.

Dr. Salazar (38:12):
Exactly.

Monique Ramsey (38:13):
Stay in that three weeks, be really good for three weeks, and then you're going to be in great shape. So thank you again, Dr. Salazar, for joining us and giving us all these wonderful insights into breast augmentation recovery.

Dr. Salazar (38:26):
Thank you so much.

Announcer (38:28):
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.