Speaker 3 (00:07):
You are listening to The La Jolla Cosmetic Podcast.

Monique Ramsey (00:14):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. Today I am welcoming Dr. Diana Breister back to the podcast. She's our plastic surgeon who loves all things mommy makeover. And today we're gonna talk about breast lift specifically. So welcome Dr. Breister.

Dr. Breister (00:34):
Hi, good morning. Nice to see you again.

Monique Ramsey (00:38):
Good morning. Yeah, good to see you. So I think the first question a lot of women might have when they're thinking about breast lift surgery is, what's it going to do for me? And so maybe you can talk about some of the questions that you hear most often from patients.

Dr. Breister (00:54):
Yeah, so as women are breast continue to change throughout our life, that's just the reality. And with having a child especially that really accelerates the changes that happen in the breast. The breasts get very large, many women breastfeed. And then after that process is over the breasts involute usually, which means you kind of lose breast tissue. So that can really result in a lot of saggy tissue, drooping and that sort of thing. And that seems like the biggest sadness for women after they have a kid and they are like, oh wow, my breasts have gone. Or where, where are they? The other thing is that the breasts get really large when they're breastfeeding and they actually like that. So when women come in, usually postpartum or, or maybe not even postpartum, just you know, at some point in their life that their breasts have started to droop, they wanna know, what can I do to restore volume, make these less droopy? So that's really the main complaint or concern that I get is that the breasts have changed over time. Most women want them back to what they were or want them back to what they were and then some. So it's really a lot of times just restoring to what they had.

Monique Ramsey (02:15):
And what, what's the usual age? Is this something that you see across a broad spectrum of ages or is it typically done at a certain time?

Dr. Breister (02:26):
So I do see this across a very broad spectrum. Postpartum can, you know, these days be anywhere from 25 to 45, so all ages I see. And, and sometimes even older women as they age, you know, heading into menopause, they can experience some of these changes too. So I would say the most popular age group's gonna be between about 35 and 40, but it really encompasses all age groups.

Monique Ramsey (02:55):
So is the most common complaint that they've lost the volume or is it a shape related question or the fact that they're pointing <laugh>, they're pointing downwards at their toes. <laugh>,

Dr. Breister (03:06):
I would say it's a combination of all of them. And as women, everybody's breasts are completely different. Sometimes yes, the nipple can start pointing downward in some women, some women just get that loss of shape, you know, that they, they don't like that can be a problem or loose skin is another big problem. So it really encompasses all those problems.

Monique Ramsey (03:30):
Now I think one of the questions I've heard people talk about with among my friend group is, well if I have a lift and they, they see where those scars are, it's kind of the same scarring that or scar placement is that you would have with a reduction. So is a breast lift gonna make their breasts smaller?

Dr. Breister (03:52):
Well, we remove skin when we do a breast lift. So the volume that that skin theoretically takes up is definitely, you know, technically slightly smaller. But since we are trans-positioning the breast tissue up until a higher place, I don't think a woman should really appreciate that they're smaller. What they will know is that they are higher and they're fuller and they're perkier. So the smallness factor, although it is absolutely theoretical and you know, yes you're losing some volume, but really it's no breast tissue, it's only skin. So the amount that you might lose or be smaller is very minute.

Monique Ramsey (04:37):
And do you do breast lifts without an implant? Sometimes I know a lot of women use that opportunity to get that fullness back by adding an implant, but what if a person doesn't want an implant?

Dr. Breister (04:50):
So that decision relies on how much breast tissue a woman has and what are their goals. And some women are very steadfast against not wanting an implant and just wanting their own tissue. And even though they may have not a whole lot of tissue, that's enough tissue for them and they are happy getting that lifted and replaced. So I would say that you can absolutely positively do a lift without an implant and you just realize that I'm not gonna be adding any volume. I'm gonna take the volume that I have existing and put it into a tighter skin envelope and lift it up on my chest. So it's absolutely something I do quite a bit.

Monique Ramsey (05:32):
So you were saying a minute ago if the person doesn't wanna implant and if they're starting with enough tissue, can you kind of shift it? You're shifting it up.

Dr. Breister (05:40):
Exactly, exactly. It's basically how much tissue is enough for that individual or how much volume. And so, you know, we have a discussion about that and I really try to get to know what the woman's thinking, what her vision is for her body, is she thinking she wants more fullness in that center cleavage area? And really we can kind of manipulate the tissue and see how it's gonna look. And if they really are searching for more volume, especially in the medial area, then sometimes an implant's gonna be necessary to achieve that.

Monique Ramsey (06:16):
And the medial area would be in, in the middle or

Dr. Breister (06:19):
Right down the center where where you would say cleavage is, you know, that's really like where the decolletage is. If you're wearing a low cut shirt and you can see a shadowing of the breast, that is really what we call medial pole fullness. And that is definitely improved with a lift only. However, some women want a more full than what the tissue they have. And in that situation a breast implant might be necessary at the same time as the lift.

Monique Ramsey (06:51):
And cuz we were talking recently about fat grafting, and let's say they want some extra shape. Do you do fat grafting at all with breast?

Dr. Breister (07:02):
Yes. And that is something that some women will request, especially if they don't want an implant and we can, you know, suction fat from somewhere else in the body and then we can inject that into in and around the breast tissue to create more volume. The biggest drawback of fat transfer is that it is somewhat unpredictable in that there is an amount of fat that does go away. We just can never be sure just how much of that's gonna go away. And then the other limitation is that it's a limitation in how much volume you can achieve with that. There's definitely a fluffing up or a perking up, but it's never going to be quite as much as an implant is going to give and it's not gonna be as predictable as an income as an implant. So you just have to kind of weigh the options and make sure the patient knows that the fat grafting is absolutely possible, however, there's some limitations to that.

Monique Ramsey (08:04):
And of the fat, let's say you're putting fat in the breast just to round it out or make that shape that that patient's looking for, is that permanent?

Dr. Breister (08:13):
Well, like I said, some of the fat goes away and then some of it stays. They say maybe anywhere from 30 to 50% of that fat stays, the fat actually obtains a blood supply from the surrounding tissue and should be permanent and stay in that area. It basically is another fat cell in the area. So yeah, the amount of fat that does stay should be permanent.

Monique Ramsey (08:38):
So is there any difference in your surgical approach for a woman who is choosing to have an implant and the one who isn't? Like does it change the scarring? Does it change how you're doing the surgery?

Dr. Breister (08:53):
So it really just depends on the patient. So if we are performing a breast lift in conjunction with a implant, we can put that implant in through those incisions we're making for the lift. So it doesn't create any new scars whatsoever, it's just, it goes in through those incisions that we're making to create the lift. So no, it doesn't create any new scars. We can make that pocket, we usually put it under the muscle and we can do that within the areas that we've already opened up in the breast.

Monique Ramsey (09:29):
Okay. And those incisions, can you walk everybody through where those would be?

Dr. Breister (09:36):
So in order to actually reconstruct or change the breast tissue and have any meaningful change, we have to remove skin and there's a very, uh, basic kind of formula that we have to use. And usually this is gonna go all the way around the areola, so a circular kind of incision around the areola. And then there's always gonna be a vertical component, so a line straight down from the edge of the areola down to what we call the inframammary fold. So in the very least a woman will have what we call a lollipop incision. So it's a circle attached to a straight line and that's gonna be mostly the minimum amount of incisions. There are some physicians that may do just a circle around the areola and in very, very select instances this may be, you know, something that can be done. However, I find that that circular incision tends to widen or stretch out.

(10:42)
So it's not a usual preference of mine to do a circum areola, as they call it, just around the areola. And moreover, it really doesn't lift the breast as much as as kind of needs to be. So the very minimum, there's gonna be a lollipop incision with a circle around the aerial straight line down. And then in women that need more skin, there will even be a underneath the breast incision. So right where that fold is, there could be a, a horizontal line under that as well. And that line is usually hidden by kind of the fold of the breast. So usually that one's not very visible and then the other incisions are going to fade with time healing is always very variable from patient to patient. But we have a lot of ways to help the patient to tend to those incisions and really maximize the healing and get them to, you know, fade away as quickly as possible.

Monique Ramsey (11:44):
And what are some of the things that might make the scar harder to heal or easier to heal?

Dr. Breister (11:52):
So the number one issue with scarring is tension. So if there's too much tension on a, on an incision that can lead for a bad scar. So number one, we wanna walk that line of, you know, tightening things up but they can't be too tight either. Now that being said, it's very important in the postoperative period for a patient to really lay low. If they start doing too much too soon, it can create swelling within the breast and that puts more tension on the incision that can result in poor healing and poor scarring. So I would say those are the biggest factors that can influence, um, healing as if, if there's too much tension from swelling or what, that can lead to a poor scar. So it's very important for a patient to relax and not do too much after their surgery. That being said, also, you know, different patients, we all heal a little bit differently so one person's gonna heal faster than another and some of those things can't be controlled, but there are some scar silicone sheets and creams that we can recommend and some women also even do laser that can help a scar to heal faster. So there really are some methods that can really be effective.

Monique Ramsey (13:07):
Yeah, I saw in our gallery, our web gallery and I think we put it on social media a while back last year there was a, a patient who had come in to have her scars lasered from her lift and, and wow <laugh>, I had no idea that you know that. So that if you don't heal quite right and like you say, everybody heals differently and makes different scars, that there is something sometimes that can, can help that. Now a lot of women don't realize that asymmetric breast, you know, one breast being bigger than the other is kind of a normal thing. Is that something that you can correct with a breast lift?

Dr. Breister (13:46):
Absolutely it can be addressed. Absolutely. That is very true. Most women's breasts are not absolutely identical. One might be a little bigger, a little wider, a little longer, a little less volume. So with the lift we do have the liberty to take a little more skin out of one side versus another. And the other thing we can do is add an implant that might be a little bigger on one side, you know, to help compensate for differences. But you always have to remember even though we will, we will do everything in our power to try to get them as as symmetrical as possible. The body's imprint of that breast on the chest usually is always gonna be a little bit different. So even though we can definitely compensate and do a very good job to correct that asymmetry, there may always still be a little bit of, uh, asymmetry to those breasts.

Monique Ramsey (14:36):
And the other thing I noticed, I saw a really great before and after of yours the other day and I was like, oh, the patient's areola, they were both really kind of large and with that lift, not only was the breast more lifted and pretty, but the areola was smaller. Is that a common request?

Dr. Breister (14:56):
Very much so. Yeah. The areolas can be large and especially after childbirth they can stretch out and most women will say, Hey, can, can we make the areola smaller? And that's absolutely something that we always, we we can do very, very easily.

Monique Ramsey (15:13):
Now when we're thinking about the day of surgery, how long is this surgery and how long, you know, is the patient under anesthesia typically?

Dr. Breister (15:21):
So depending on if they have an implant or not, I would say the average amount of time for this procedure is gonna be about two and a half hours of surgery time. So it's fairly quick, which is good. It's not a whole lot of time under anesthesia. And then after the surgery when they wake up from that surgery, they're going to have on a very nice snug compression bra. And as we spoke earlier, this compression bra helps to reduce swelling. So there is one thing after breast lifts, there's quite a bit of swelling within the tissue because we're doing a lot of manipulating and maneuvering of the tissue. So, so swelling is something that, you know, we, we know is gonna happen. So by putting on a nice compression bra that can really help reduce the swelling and then having the patient be very calm and laying low for, you know, five or six days after surgery can really help. And that's really the most important time for the patient to be really laying low is right in the beginning.

Monique Ramsey (16:20):
I'm gonna ask something that I don't know if, if this is just straight from my own experience, my own body. So you know, as we get older <laugh> things are looser, the skin is looser. What about the side of the breast where it's kind of sometimes you end up with like pooches under your arms. Is that something that you can move and tighten up during a

Dr. Breister (16:43):
Well, you know, we can absolutely address that side area. A lot of women tend to collect a little bit of fat over there. A lot of women think that that's actually breast tissue over on the side. It's usually not breast tissue, it's usually just some subcutaneous fat. So although you know it's not breast tissue, it can be liposuctioned during the procedure. Sometimes we also take out a little bit extra skin in that area if there's actually a skin roll. So the answer is absolutely that lateral fluffy tissue can be absolutely addressed. Now some of that though is the width of the breast. A woman may have quite a, a wide breast and that footprint or width of the breast can't really be changed. But we can do a lot to help tighten that up and make the effects of that a lot reduced because we can lower the volume and tighten up the skin and help to pull that tissue in in a certain way. So it can absolutely be improved and addressed.

Monique Ramsey (17:48):
Good to know <laugh>. It's the thing that you don't really have when you're in your thirties or forties. It's like now I'm in my fifties, I'm like, wait, where's where are these things coming?

Dr. Breister (17:56):
Yeah, it kinda comes outta nowhere that that middle, the middle stuff. Stuff in the middle <laugh>.

Monique Ramsey (18:01):
Yay. So I'm assuming like most of the surgeries that we do at La Jolla Cosmetic, they can go home the same day?

Dr. Breister (18:10):
Absolutely, yep. It's outpatient.

Monique Ramsey (18:12):
And then when do they see you for the first time again?

Dr. Breister (18:16):
Um, usually between one to two days after the procedure they, we have them come in, we open the bra, we check, we make sure everything's looking good. At that point we usually just close the bra back up and women are probably gonna need to not shower for about three to four days, keep the area dry and then they'll probably come back about five or six days after that. And at that point we take off some of the ster strips that are on the incisions, replace them and just, you know, make sure everything is healing up great.

Monique Ramsey (18:46):
Is this something that, because there's a lot of incisions and maybe an implant or not, do people have a lot of pain with this procedure or not really?

Dr. Breister (18:57):
Well I think the lift in and of itself is not extremely painful because that part, we're not doing anything under the muscle. So the lift in and of itself is not painful. The implant can cause some discomfort because we usually place that under a muscle. So I would expect a moderate or amount of pain with an implant and without an implant it's very tolerable. Most of the time a patient just kind of sits still, they're not gonna be experiencing a lot of pain. So they can usually get by with just one or two days of a pain pill and then they're usually weaned off to something like Tylenol or Motrin after that time.

Monique Ramsey (19:37):
Now do the patients have a drain placed? I know with tummy tucks a lot of times there's a drain.

Dr. Breister (19:45):
So usually I do not use drains in lifts or augmentation. So unless I'm doing an extensive amount of liposuction or if that woman is getting an implant replaced, meaning an old one is removed, a new one is put in, a lot of times if that replacement is happening, I will do some work in the pocket and that's called a capsulectomy. In that case I do use a drain, but for the woman who is walking in and doesn't have a breast implant already, if they're getting a mastopexy augmentation, which is that lift plus a breast implant, then they will not have a drain. And usually for the woman just getting a breast lift, they will not have a drain either.

Monique Ramsey (20:28):
Now what do your patients say when they feel the difference? Like is it immediate on that day too or does it take a little bit of time?

Dr. Breister (20:36):
Well I think that, you know, the first few days after surgery they're just kind of trying to get through it. It seems to be a little, you know, it's a whirlwind, they don't really know what things look like, but you by two or three days, once that bra comes off and they, they lay look down, they're, they're pretty excited to see, you know, the transformation of what they have and very excited to kind of get their groove back, if you will. <laugh>.

Monique Ramsey (21:00):
Yeah. And because there's a fair amount of scarring depending on the patient, walk us through sort of scar recovery, like what does that look like? When does it start to get less red maybe?

Dr. Breister (21:13):
So, you know, the first four weeks of after surgery those incisions are gonna be covered up with a very special flesh colored tape called a Steri strip. And that Steri strip is very instrumental in supporting that incision. As we spoke about, the tension on a wound is extremely important. So this Steri strip really alleviates some of that tension. So for the first four weeks the woman's not even gonna see the see the incision because it's gonna be covered up with tape. Now after that four week period, we then peel off those tapes. Any small little stitches are removed at that point the scar really looks like the finest line ever. It looks amazing, you know, initially, and it only is after some time that that incision starts to turn a little bit red and that can last up to one to three or four months depending on the patient.

(22:08)
There's usually a pink hue around the incision and that, like I said, can take any amount of time. Now some incisions can get more thick than others, but during this time, after that four week is when we are really advocating a silicone tape strip to lay down on that incision and that silicone has been shown to really help take away the redness and help to keep the scar flat. So I would say after two or three months things should be pretty well calmed down. Still healing is taking place but I think, you know, the majority should be starting to fade and getting flat.

Monique Ramsey (22:49):
So talking about the tension on scars makes me think okay, <laugh>, that means if swelling, they're not going to lift weights right away or going out for a run or when do you sort of advise your patients that they can get back into some sort of exercise?

Dr. Breister (23:07):
Yeah, so I would say probably about the three week mark if everything's looking pretty good, I will allow my patients to start doing some gentle walking, nothing bouncing, just get out, get fresh air, get a little bit of cardio just so you don't go crazy, you know, sitting in your house. So you know, light, light cardio is usually okay at about three weeks and then by anywhere from four to six weeks, women can usually start going back to their normal jogging or Pilates or even weightlifting at that time. By six weeks the wound should be stable and very secure at that point. So usually it's okay to to resume full activity by six weeks.

Monique Ramsey (23:54):
Now because we're such a sun and water loving community here in San Diego, like say you're a, your patient is a snorkeler and they love to go snorkeling in the ocean, do you have any rules around when they could go in a pool or when they could go in the ocean?

Dr. Breister (24:14):
Yeah, so once an incision theoretically is completely sealed up, it should be safe for them to go in. Now technically that should happen about 48 hours, but I would not advocate anyone getting it wet before that time. So I would say at two to three weeks if a patient has a vacation that they're just dying to go on and they wanna dip into the ocean, it should be fine if the incisions, like I said, are healed. Now, usually though dipping into the ocean goes along with a lot of other active activity. So a dip into the ocean is one thing, but like paddle boarding and surfing or you know, that would be a no-no. But the incision, you know, if they have a pool in their backyard and they're just so hot and they just wanna get in a dip in, absolutely fine. But the more vigorous water activities, like I said, should really be on hold till about four to six weeks.

Monique Ramsey (25:05):
And is there any seasonality to this surgery at all? Does there need to be?

Dr. Breister (25:11):
Um, it just depends on the woman. There's really no seasonality. I, I find with most plastic surgery that women are getting, you know, most women have very busy lives. They might have kids, they have a career and so it's really when can they put all the ducks in a row to have the support to do this when their husband's gonna be around or when you know, their mom can come into town or when they have work off or time off or they have an extra week here. So I find that most of the time it doesn't really go along with seasons it, but it does go along with when they can get time off and you know, I guess that would be sometimes in the summer people have a little more time off. Sometimes around the holidays, uh, people have time off. So those are very popular times for procedures because they, they do have some time and usually some family backup to help at that point.

Monique Ramsey (26:02):
And if, you know, this is sort of a, not everybody would be getting a breast lift because they're a mom <laugh>, but a lot of breast lifts are because you've had pregnancies and breastfeeding. What do you advise in terms of lifting your kids if you have a two year old or a 18 month old or,

Dr. Breister (26:21):
Yeah, you know, depending on the weight of the child, obviously I would say you need to wait about three weeks or so and then even at that time, you know, if you can avoid doing it repeatedly all day long, that would be helpful. But yeah, you do need to give yourself a little bit of time that you're not doing those strenuous things because as we talked about, the wounds don't have their tensile strength at that point. And you know, sudden movements or you know, strenuous things can have an incision pop open, but you're kind of balancing that, you know, kids want to be with their mommies, they want to hug 'em, they want to, you know, so a lot of times I'll say just, you know, sit down, have someone put the baby on your lap or the, you know, toddler on your lap and you can get the cuddles in. But but the repetitive into car seats and into uh, high chairs and into cribs, you know, that that really should at least be on hold for about three weeks.

Monique Ramsey (27:16):
And if the patient is like, let's say they're, they've had two children, they're not gonna have any more children and they've been breastfeeding, how long do you want them to be post breastfeeding before you operate on them?

Dr. Breister (27:33):
Yeah, so I think that there should be at least about four to six months of not breastfeeding before they undergo breast surgery. You know, the milk ducts kind of stay active and open for a little while. We want those things all to be shut down because there can be complications if a woman is still lactating, that can be a big problem infection or even something called a milk fistula where, you know, milk can start coming out of a drain if, if necessary. So, you know, the recommended time is probably at least about four to six months of not having breastfed. The other thing that I will advise to women is it's gonna be best if you can get as close to your desired weight because as we all know, you know, weight fluctuating can cause fluctuations in the breast as well. And if you have the surgery and then you go on and lose 20 pounds, your breasts may shrink, they may droop a little more and you may wish that you had a bigger implant. So definitely done with breastfeeding for about four to six months and as close as you can to your pre, your desired weight.

Monique Ramsey (28:40):
So the price range for moms, so we just, for everybody in the audience, we do have our prices and, and they're in ranges because of course there's different variations depending on what kind of lift and with an implant, without an implant, what kind of implants, but it looks like the range starts without an implant around $10,500. And then with an implant it's more like $14,500 and up. And so when they come in for the consultation with you, you're gonna be going through, you know, you're examining them, but you're gonna be going through, you know, if, if they wanna lift with an implant, probably what are their choices and you all select in implants and, and do you have kind of a way for them to visualize what that might look like on them?

Dr. Breister (29:35):
So we do have a fitting that we can do with a woman. We have these shaped that can go into a bra and it helps a lot to help visualize what that added volume is gonna add to their body. So we usually have them put on kind of a form-fitting t-shirt and a special bra and then we can, you know, we can experiment is it 200 of ccs of volume or is it 400 they need or what they like and they, so, so there is a method that I like to use that is pretty accurate in helping to nail down just how big they want to become. So we do that with implant sizers.

Monique Ramsey (30:18):
So if a patient is not living in San Diego, you know, we get a lot of people who come to San Diego sort of for a rejuvenation vacation and we'll have surgery here, but can you do a consultation, let's say virtually from wherever they might live and what would that look like if they were gonna then come to come to San Diego?

Dr. Breister (30:41):
Yeah, so we can do, you know, a Zoom consult and we can really get them all the information and see if they're a good candidate. We have, you know, HIPAA encrypted, you know, email where they can send some pictures that are totally secure but we can, we can evaluate what they need and they could come into town, they could have their pre-op, you know, a day or two before the surgery, undergo the surgery and then stay in town. I would say 10 at the very least, but 10 to 14 days is probably gonna be recommended before you get on a plane and travel. And that's because we just want to make sure that all those wounds are very secure and everything is on its way to healing by time you go back to wherever you are. So we don't want you to have a problem, you know, somewhere and then we can't really help you. So I'd say about 10 to 14 days of staying in town for that surgery is gonna be, uh, recommended.

Monique Ramsey (31:36):
And one of the last questions I was thinking of, and it's not very common here in San Diego, but there are people who smoke and I know smoking can be a complicating factor. So can you kind of go through some of the, you know, what smoking does to patients. Or to healing and maybe some other things that are also risky behaviors?

Dr. Breister (32:01):
Yeah, so you know, vascularity, which is uh, the blood supply to a tissue is of utter, you know, extreme importance here because we're literally taking apart the breast, putting it back together and especially in a lift we are lifting skin flaps and kind of removing them from their blood supply. So smoking is the number one terrible factor for wound healing. It just is a disaster honestly, that smoking causes, you know, a vasoconstriction of the vessels, that means the vessels get tinier so therefore you're delivering less blood to those areas that desperately need it for healing. So smoking is an absolute no go. If a woman wants a mastopexy that and basically a facelift are basically non-negotiable, those procedures should not be done in smokers. And that being said, I think they should be not smoking for probably around two months before the procedure to really maximize their chances of healing.

(33:04)
Well even then their, their vascularity can kind of be permanently distorted in a way. So even if they've stopped smoking you, I would warn them that there still could be some wound healing complications. So that in and of itself is, is one of the worst. Too much activity too soon is gonna be terrible for wound healing and diabetes can also be a problem, especially an uncontrolled diabetic. We know that there's a lot of microvascular changes in diabetics. So that is something that if someone is a diabetic, we need to make sure at least that they are very well controlled. But there are methods, you know, if someone does have some wound healing problems, we have now hyperbaric oxygen therapy that can really help to deliver more oxygen to the wounds and help them. But the first and foremost, it's better just to not be smoking <laugh> before the surgery.

Monique Ramsey (33:58):
Right, right.

Dr. Breister (34:00):
And we don't wanna get to that point where you need hyperbaric oxygen.

Monique Ramsey (34:03):
Exactly. And is there, so really smoking and maybe uncontrolled diabetes, any, any other things that you try to advise patients about?

Dr. Breister (34:15):
Vitamin E, fish oil, red wine, these are all things that can make your blood a little bit thinner. So we try to have them abstain from those things for about 10 days beforehand. Also, there's a lot of different supplements and herbs and things out there now and I generally tell the patients to stop taking all that stuff just cuz we just don't know what's in it and we don't want anything else to complicate that, that wound healing. So basically off all supplements that aren't really necessary and especially the vitamin E, fish oil, red wine, aspirin, you know, Celebrex, Motrin, we have lists of things that can all cause bleeding problems. So the nurses are really good about going through all that with the patient before the procedure.

Monique Ramsey (35:02):
Yeah. And that pre-op visit I think is like just golden because you really do go over everything and you get your little booklet, you know, what to do, what not to do prior to surgery, you know, immediately.

Dr. Breister (35:15):
Very comprehensive.

Monique Ramsey (35:16):
Yeah. Immediate post-op and then sort of getting back into life. So, so Dr. Breister, is there anything that we didn't cover that you wanna make sure the audience knows about breast lift surgery?

Dr. Breister (35:27):
Well, I think that, you know, I think if a woman is thinking about it or just kind of looking down, I think that they should really owe it to themselves to at least consider it, put themselves up there with priorities because, you know, our bodies are our temple, you know, we, we need to feel good in our bodies and it can be so defeating for a woman to, you know, have these beautiful kids and then just feel like they just don't feel very pretty anymore. So I really would encourage women if they're even thinking about it, at least go get a consultation just so you know the information, you know, what are the options, you can think about it, let it percolate. You know, do I need an implant or not? Um, but don't wait too long because life is going by and once those surgeries are done, it really opens up an entire new world of, uh, clothes you can wear and feel good in bathing suits. You know, it's just can be really, really uplifting and especially after, you know, getting through all the kids stuff. It's pretty wearing and exhausting. I think that most women owe it to themselves too, to, you know, put themselves number, number one for a little bit and take care of themselves. So I would encourage them to just go for it.

Monique Ramsey (36:47):
Yeah, I think it like can just add so much to your own self-confidence again.

Dr. Breister (36:53):
Absolutely. Even if, even if you wear a baggy sweater for the rest of your <laugh>, you know, you still feel, you know, what's under the baggy sweater so you feel better about yourself and that that's what's most important.

Monique Ramsey (37:04):
Well, thank you so much Dr. Breister. It was fun to talk to you about this. You're, and I know this summer we've got, um, coming up, we're gonna be talking with you on one of our live events where we're gonna talk about mommy makeovers, so we'll talk about breast lifts, but we'll also go into other things like feminine rejuvenation down there.

Dr. Breister (37:24):
Exciting.

Monique Ramsey (37:24):
And some tummy tucks. So we're going to look forward to having you back for that.

Dr. Breister (37:28):
Can't wait.

Monique Ramsey (37:30):
Um, yeah, thanks, thanks for joining us today.

Dr. Breister (37:33):
Thank you so much for having me.

Monique Ramsey (37:35):
All right. And if you're listening today and you have questions and need information about scheduling or financing or, you know, wanna see before and after pictures, you'll have in our show notes, we'll have links to before and afters and all of the good things about how to pay for it. And our patient coordinators are great with helping with financing, which really can help you get what you want now <laugh> and, and pay for it as you, as you're healing and enjoying your results so that that's something that we, you know, don't be too shy to ask about. Because one in three of our patients, and this has been for years, one in three uses some financing. So we'll put all that in the show notes and then you can also find links to before and after photos of Dr. Breister and all our wonderful surgeons. And thanks again for joining us today.

Dr. Breister (38:25):
All right, have a great day.

Speaker 3 (38:35):
Take a screenshot of this podcast 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.