Monique Ramsey (00:02):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. Today on the podcast, I have a special patient who has had a surgery with us, and she had her surgery with Dr. Luke Swistun, and she had an interesting surgery, a thoracoplasty, which is actually, it's a posterior thoracoplasty, as I learned from Google last night. The front one is totally different than the back one, so it's the back. She had some liposuction and a scar revision, and she's going to tell us about her experience with our practice and why she needed to have a revision. And we're really honored that she's here to tell us. And so I want to welcome you, Regina.

Regina (00:45):
Oh, thank you.

Monique Ramsey (00:46):
Thanks.

Regina (00:47):
I'm looking forward to this podcast.

Monique Ramsey (00:49):
Oh, good. Good. So tell us a little bit about yourself and what brought you here.

Regina (00:55):
Well, it all started, I have a cousin and we're really close friends, and she had breast cancer, and then I had seen her and she had the lipo from her abdomen and they placed it in her breast. And I thought she looked really good, and I thought, oh, wow, I'd really like lipo in a tummy tuck for myself. And so that was the trigger. And then I had researched and I asked for different people and my physicians to recommend someone. And then I got a recommendation and I had my surgery and it kind of failed and it was quite disappointing. And on top of the failure, I got septic. And so then I was in the hospital for two weeks.

Monique Ramsey (01:38):
Oh my gosh. And was that from the tummy tuck or from what part?

Regina (01:41):
Yes, from the tummy tuck, from the tummy tuck. And then afterwards when I got healthy, after the hospital and everything, when I would dress in the morning or shower or do anything, I would look at myself. And I was really disappointed with what had happened that I just wasn't looking right. And then that wasn't what I was wanting. And so I started researching again for doctors, and I got a recommendation actually from my endocrinologist's office, and he's upstairs in this building. And so I came down and I met Dr. Swistun, and then it was like, okay, he's the one for me.

Monique Ramsey (02:19):
Interesting. So how much time went between the first surgeon and your surgery and then?

Regina (02:28):
A year.

Monique Ramsey (02:29):
A year, okay. And was there anything different in your process of looking for that surgeon and looking for Dr. Swistun or?

Regina (02:39):
Yes, a real big thing. The biggest thing actually was I was not aware that a doctor doesn't have to be board certified to do surgeries. And when I found out my first doctor was not board certified, and even the doctor that recommended him didn't know that he wasn't. And so then in the second process, that was the number one thing I would read and look at. And then their previous experiences, and the second part of it was what their personality was like. Did I feel like they were compassionate, caring or was this, this is my art and this is what I do, and I'm so great at it. And I found everything I needed in Dr. Swistun because not only did I find his credentials really good, I also found his personality and the staff here very professional and caring and just was a lot different experience than my first time around. And so I have regret that maybe I didn't find him, but chances are I probably would not have found him. But I'm happy that I did it the second time around and he was my doctor and this was my place.

Monique Ramsey (03:48):
So when you came to Dr. Swistun, what were your complaints that you wanted to and issues on your body that you wanted to solve?

Regina (04:00):
Well, because I had the infection, I had an infection in a couple of different places, and I had one along the incision. And so then it was really wide in that area. And then I had what they call the dog ears on the sides and also under my arms, because I call these things here, the pooches. I had asked my first doctor, I really would like to get rid of the pooches, and that was almost my primary thing because they've always bothered me. And I showed Dr. Swistun the incision, and he really couldn't understand what the surgeon was trying to do the first time around. And so he knew what to do. And I just can't believe how great I feel now. And I look at myself in the mirror, I'm satisfied. I look at my pooches, I'm feeling so much better, and it's just been a really great experience.

Monique Ramsey (04:49):
Well, and you're there with your sleeveless top.

Regina (04:53):
I know. I'm not worried about them anymore.

Monique Ramsey (04:56):
I know. Isn't that the funniest thing? These little things become this daily, especially in the summer, this daily thing is like, can I show my arms or can I not? What can I wear? Do I need to hide them? It's these dumb little things, but it's a big thing. And so did he fixed the pooches?

Regina (05:15):
That's right. He fixed the pooches and then he went around the back.

Monique Ramsey (05:18):
And so, yeah. So tell us about the thoracoplasty and what you were trying to solve there and what that surgery was.

Regina (05:29):
Because I think the pooches went all the way under my arm and then towards the back. So I had a lot of extra skin. It wasn't as much fat as skin. And so when Dr. Swistun listened to what I wanted, and then he looked both back under my arm and in the sides or in the back, he was like, okay, this is what I can do and this is how you look. And he pulled the skin and he put my arm up, and he was very good about showing me what he could do and how to fix what my problem was, and that my original fix really didn't do anything for what I was wanting to address.

Monique Ramsey (06:10):
And it's true that it's like we talk about bra line fat or back fat, and sometimes though, to your point, sometimes it's not really that much fat. It's just extra skin. And it's like the skin on part of our back is really tight, and other skin isn't that tight. It's hanging over and you're like, why is it there?

Regina (06:32):
That's exactly what my problem was.

Monique Ramsey (06:34):
Yeah, I have the same one, so I can totally relate. I'm like, should I be getting on the schedule for this one? The things you don't know you need.

Regina (06:43):
That's right.

Monique Ramsey (06:44):
So he extended that incision around the back. And so where is it and can you see it?

Regina (06:50):
No, he actually, what he did was he went, he just pulled it. I don't know how he did it, but it's just here and up my arm. So he was able to pull all scars.

Monique Ramsey (07:00):
Oh, okay. So it's, there's no scar on the back at all?

Regina (07:02):
No, no. It's basically on my sides and arms. And if somebody sees me from the back, they can't see that I had anything done. And once the scars, the coloration gets back to more natural looking, then nobody will be able to tell.

Monique Ramsey (07:18):
Yeah. Now, to that point, how long has it been since your surgery?

Regina (07:22):
I had it actually, I remember it was March 31st. It was my birthday.

Monique Ramsey (07:27):
Oh, your birthday. That's kind of a good little birthday slash surgery anniversary. That's nice. So it's only been, what, five months? Maybe four months. So yeah, those scars all mature over a whole year. People, it's so interesting to think about scars. It is a trade off, but over time they really do sort of just disappear. It just takes some time to do it. Well, that's great. So your endocrinologist is the one who sent you down?

Regina (07:59):
His staff, he and his staff, because I was actually, I feel that I have kind of PTSD from my prior experience because of the surgery and then the hospitalization for two weeks, and the lack of caring from my prior surgeon. And so I'm still weepy when I get to that point. And so sometimes when I go to the doctor and have visits and they start talking, and then I just get all choked up and everything, and I told them what happened. And so he and his nurse had said, oh, there's this really good surgeon downstairs, and actually they named Dr. Swistun by name, Dr. Swistun. If you go to him, you'll be happy. And so they were kind of my saviors kind of.

Monique Ramsey (08:51):
Well yeah, it would be, I mean, to think about you're going in for an elective surgery, it's a happy surgery, and it's not something you have to do. It's something you want to do. You're trying to accomplish some goals, and it's all a very positive thing, and you don't expect for things to go wrong. And they rarely do, but it happens. And in your case, I mean, to be hospitalized for two weeks and to be septic and to think things can go downhill really fast, right?

Regina (09:27):
Yes. It was a worry.

Monique Ramsey (09:30):
And what sent you to the hospital in the first place?

Regina (09:35):
Well, so my daughter was staying with me. She lives across the street. And so she arranged with her husband that she would come be with me for a few days, and I started developing a fever. And so when we called my surgeon's office, they said, and this is kind of weird, they said, oh, you're just constipated. Constipation will bring on a fever. And so I was thinking, okay, this is what they're telling me. I trust them. They're telling me how to handle this and what to do. And then my cousin is a nurse, and my daughter would call her and she'd say, no, that's not right. That's not right. And I'd be like, no, I'm fine. And the fever went on for a few days and they had me get a bunch of stuff and take it and nothing was going on. And then I started kind of being delusional while I was at home.

(10:26):
And then my daughter really got worried, and then she convinced me, okay, mom, we have to go to the emergency room one night. Then I had called the surgeon's office and I said, I can't make my appointment. I have a fever. They're like, oh, well go to the ER and get unimpacted from being constipated. I know this is not a pretty topic. So I did go, and that was when I checked in, I said, this is what's happening. I have a fever. I had this surgery. And they said, for me to do this. Well, so then I went through all these tests and then they found that I had an infection in my lower right side, and it was very large. And so then they just admitted me because they said we have to handle it. And then I had to have it drained because there was a lot of infection going on. And by that time it had gone through my body and it was all in my blood and everything. And my hospital was really great. I dunno if I can say where it was, but

Monique Ramsey (11:31):
Yeah.

Regina (11:31):
Oh, it was Palomar. They were the best. They treated me so well, and actually my concern was my doctor was not affiliated with Palomar, so I like, I felt like they were doing me a favor by taking me in because I had this surgery, I had this infection. It was an abscess. That's what I had the abscess. And so I was like, I know I'm not your problem, but I'm grateful because I had the hospital doctor hospitalist, then I had an infectious team, I had a surgeon, and so I had all three doctors coming daily to check on me, and I was just really grateful because they saved me and my son flew down from

Monique Ramsey (12:19):
Literally.

Regina (12:19):
Yes, yes. Literally, my son flew down from San Francisco. He stayed in the hospital with me for days because he didn't know how it would end. So Palomar was really great, and the surgeon there was just this amazing man, and he cared and he made sure that everything was good with me.

Monique Ramsey (12:43):
Oh, that's amazing. And I would think at the part, at the time you got admitted, were you a little out of it to have all that infection going on and maybe, yeah, I can't even imagine.

Regina (12:57):
No, my daughter said that. I had been saying some weird things even once they put me in the bed, she's just like, mom, I was so embarrassed because you were saying the weirdest things. And I'm like, I can't help it. It was not me. But then I got better. I got back to, my mind was back after that.

Monique Ramsey (13:17):
Right. But oh my gosh, two whole weeks to solve that. And yeah, I would think having some PTSD would be part of it, but to be brave enough to say later, I want to fix this and to do it again, to be thinking about, okay, taking that chance and sort of making that leap, was that kind of a hard thing or was that an easy thing?

Regina (13:45):
No, in the beginning it was very hard, and I made my appointment. And the good thing was the first doctor, my daughter did not go with me to the appointments. She said, had she have gone, she probably would've said, I don't think he's the right doctor for you. But coming here, my appointment with Dr. Swistun, and then she went with me and we both felt very comfortable and confident, and he talks to you like a professional, not in giant medical terms, but his knowledge of what to do and how to handle it and what your issues are. I just had confidence right away. And he knew I was afraid because there was lots of crying in his office when I was, I mean every time I came there was crying. And he understood that it was fear, but I also got very confident. And he's just a wonderful man. He's humble yet knows so much about everything, and actually he cares. And that was the big thing. I knew he cared. And so then I'm like, okay, I'm going to let this man handle this because I feel he's going to do a good job. He knows what he's doing and he cares about what's going to happen to me ultimately.

Monique Ramsey (15:01):
And so in the, well, two things, one is I think you can't fake that caring attitude, right?

Regina (15:09):
No, you can't.

Monique Ramsey (15:10):
People can't fake it because it's too transparent whether somebody's actually caring or they're not. And you pick up on that right away. So then I was thinking, okay, let's talk about, so the scar revision, so the dog ears are sort of for people in the audience to picture on a tummy tuck scar, it's almost like they kind of poke out the edges of the scar can poke out and they call it dog ears. So he fixed that.

Regina (15:39):
I had the whole incision redone, not just the dog ears, the entire incision because I had an infection in the one spot. So he kind of took that out, and the second infection was a little higher. So I had three areas of infection, and the second was a little higher. And he said, in order to take that out, he'd have to pull too much skin. So I'm like, that's fine. So my whole incision was redone, and then he did the dog ears and took them off, and then he did my arms and then the back with the lipo. So he had lipo in all the areas too, because I was lumpy, I guess is the best way to put it. And the other doctor offered to do a revision for me, and I just said, absolutely not. I just didn't trust him and just couldn't do it.

Monique Ramsey (16:30):
Yeah.

Regina (16:30):
Wouldn't risk him again.

Monique Ramsey (16:32):
Yeah, that was nice of him to offer. But no, thank you. We're going to decline.

Regina (16:40):
Yeah.

Monique Ramsey (16:40):
And then how did you feel in the days and weeks leading up to the surgery and then sort of the time postoperatively?

Regina (16:51):
It's really funny because I was fearful, however, I was feeling good about Dr. Swistun because my daughter also had a procedure here, so when we would go to visits, each would go with the other one. So I kind of got twice as many times to see him because I'd come with her and then I'd have my own. And by the time my surgery came around, I felt I really knew him and was confident, and I Googled him a lot. And so then everybody gave me the confidence level that yes, he's good. He's the right man. We feel good that he's going to do the right thing. I was nervous, however, not really nervous. It's hard to describe. I was feeling good. Feeling good, but scared too at the same time.

Monique Ramsey (17:35):
Well, yeah. And that's normal, whether you're having a revision or you're not having a revision, it's so normal to feel nervous and anxious and excited and all the things.

Regina (17:47):
I can't say enough positive things. And I am so grateful that I found Dr. Swistun and that he could fix my issues and I can just live happily ever after and look at myself in the mirror and not be reminded of what mistake I had made, because that was it. It was like I would look at myself and I would be like, why did you do that? It just looks almost worse than it did before. So it was like a mistake, but now I don't have that mistake, so I'm all good.

Monique Ramsey (18:13):
That's interesting. Yeah. You would, I guess be reminded every day seeing it every day, and that's a hard thing. And I think it's a little thing, but it's a little thing that's big, right? Because it's every day and

Regina (18:29):
You can't escape it.

Monique Ramsey (18:30):
Right. And like I say, to me, it's very brave to have gone through something like that and then to be able to say, okay, but I'm going to take the bull by the horns and I'm going to do something. I mean, it is, some people would just admit defeat and move on and be upset. But I love that you were inspired enough, and like you said to, I don't want to call you the Guinea pig, we'll call you the

Regina (18:58):
But it is true.

Monique Ramsey (18:59):
We'll call you the trailblazer. Okay. So you were the trail trailblazer for your daughter. I'll go first as the mother. I totally get that. And so that we make sure that everything goes well. And I'm assuming she took care of you after that procedure as well?

Regina (19:17):
Yes, yes. And she was amazed.

Monique Ramsey (19:19):
I have to think that the post-op was night and day between the two experiences.

Regina (19:25):
Yes. So I had the surgery on a Friday. My first appointment here was Monday. I had washed my hair, I had dressed myself. I came in and they're like, well, when did you have your surgery? I'm like, Friday. And because it was, I felt so good, and it was just so different. And yeah, it was night and day. And the funny thing is my daughter almost watched me like a hawk because she was waiting for the telltale signs, a fever, is she talking crazy? That kind of thing. But luckily that passed. Can I just say one little thing about Dr. Swistun that really impressed me also?

Monique Ramsey (20:02):
Absolutely.

Regina (20:02):
So when I came here, and first Kayla, who is his assistant, was telling me about him, and then I spoke to him about it. And Dr. Swistun, he's not in it for the money because he will not do breast implants because he doesn't think that they're good for a woman.

(20:20):
And he thinks over time you have to have them removed and there could be complications. So rather than start that whole process, he just doesn't do it. And I'm like, wow, somebody that's not in it for the money, he's in it for what's best for his patients. And that too, I learned that right in the beginning, and that made me feel like, okay, this got doctor, he cares, he's compassionate, he knows what's right and wrong. And that really led me also to make sure that I wanted him to be my surgeon. I didn't go to anybody else. It was my first one, and then Dr. Swistun, and when I met him, I knew he was right for me. I was really impressed by that. Anyone that will not do a surgery because they think it's for the best of the patient, whereas, I mean, and breast implants are fine, that's not a problem. But that made me feel good about him, that he feels that there are other things you can do instead of that. Or I mean, I dunno, maybe that's not an appropriate thing for today, but that's what made impression.

Monique Ramsey (21:23):
But I think, yeah, but it all lends into your experience with him and how the different factors that made you feel that you could trust him. And he does a lot of implant removal. There's a lot of people who, for whatever reason, whether they're feeling bad or they just don't want them anymore, he removes a lot of breast implants. And so he's seen patients who have been negatively impacted by symptoms from the breast implants. And so for him, that's just an easy decision to say, sure, they're good for some people, but for my patients, to your point, you can do other things. You can put fat in, you can augment the breast in other ways. Yeah, so it's absolutely how you felt in the things that he said and the things that he did. And I think the ultimate test of a surgeon is if they'll turn you away because they can't help you. If whatever is happening, I remember a very beautiful older woman coming into the practice one time, and she was just drop dead gorgeous and perfect. And she saw one of the doctors about some facial surgery, and the doctor said, you're beautiful. Go home.

(22:45):
Literally you don't need anything. And some doctors might say, oh, yeah, let's do a little filler, or let's do Botox, or let's do this, or let's do that. Or I can revise your eyes or do a mini lift. No, go home. You're gorgeous. Enjoy your life. And so it comes down to morals. And I feel like I've now been in this industry for 33 years.

Regina (23:10):
Oh, wow.

Monique Ramsey (23:10):
Yeah, it's a long time. But it does matter who you're working for and what are their morals of the kind of person they are. And we have that shared value system too, within the practice. And I think to your point earlier about the staff and their experience, and it's not inexpensive to have that kind of staff around and have the kind of accreditation for the facility and to have the anesthesiologists and all those things are not inexpensive. But at the end of the day, we want our patients to have the very best experience and the very best outcomes. And the best way to get there is going to be having staff that have been around the block a little bit. And surgeons have good moral value system and who are really good at what they do. And we have a lot of team who have been around for so many years, and Ruth, who's in the OR, she's,

Regina (24:15):
Oh, she's great, I love her.

Monique Ramsey (24:16):
She just celebrated 20 years with us.

Regina (24:19):
Oh my gosh.

Monique Ramsey (24:20):
And then we have so many people like that and that shared value system. But yeah, isn't she fun? And she knows,

Regina (24:27):
Yes, she's wonderful.

Monique Ramsey (24:27):
She knows so much. And Kayla, everybody around each of the surgeons, it's a family for us, and it's also,

Regina (24:37):
It feels like family. It really does.

Monique Ramsey (24:39):
And it is. And it's that mutual respect, I guess. So I feel good about it, but I'm glad you felt good about it, really.

Regina (24:46):
I do.

Monique Ramsey (24:47):
At the end of the day, how do our patients feel, the fact that you trusted us to not only take care of you, but your daughter as well?

Regina (24:56):
Yeah, that was the big concern because she had seen me the first time around, and so she was actually much more nervous. And so for my second than I think I was, but then when mine went well, and then Dr. Swistun did a wonderful job on her. She is amazing the way she looks right now. So I'm really happy. And I'm older, so of course it's different. But she has her whole rest of her life now that she can look great. And so I'm glad she did it now rather than waiting

Monique Ramsey (25:29):
And feeling confident. Yeah. Well, I think from my own experience, do it earlier because you enjoy it longer.

Regina (25:37):
Yes. Exactly.

Monique Ramsey (25:40):
Why not? And then it's something you're just not worrying about anymore. You're not thinking about it because it's a non-event because you've already had it. You feel good, and you can take the clothes out of your closet or put the makeup on in a certain way that you feel really great. That's all about, it's only you that matters. I think at the end of the day for it is how you want to spend money. There's nobody else's business or your time. Well, thank you, Regina. This was such a good discussion. I had no idea where we were going at the beginning. I didn't know we were going to end up at Palomar Hospital. And then having Dr. Swistun come in and make you all feeling good and being able to wear the clothes you want to wear.

Regina (26:20):
That's right. No more pooches.

Monique Ramsey (26:23):
Exactly. Exactly.

Regina (26:24):
That was a big thing.

Monique Ramsey (26:25):
Yeah, no, it is. And like I said at the beginning, those are little things that are big things because it's all that matters to you and what things you're looking to accomplish. And the fact that he was able to do something that's just a little bit different and solve the problem and get you to your goal in a safe way.

Regina (26:47):
Yes, in a safe way.

Monique Ramsey (26:48):
In a safe way. And I would encourage everybody, we'll put some links in the show notes because to your point, at the very beginning of board certification, so doctors can be board certified in a lot of different things. They might be a board certified dermatologist, but that's not a surgical specialty, that they're there for skin. But there's no law that would prevent a dermatologist from doing liposuction or an eyelid lift or any of those things. And you would think that you would just assume as a lay person, sure, there must be laws against that right there. And so they can go to any three day course.

Regina (27:31):
No, I know what you mean.

Monique Ramsey (27:32):
And get a certificate, but it doesn't mean that they're board certified in plastic surgery and that they've gone through all the testing and knowledge that you have to have to be board certified and to have a board that's acknowledged by the American Board of Medical Specialties, the ABMS. So there's 26 boards I think, that are recognized. And then you can go on their website and we have a whole link, we have a whole page on our website about it, but we'll put the link in the show notes of where you can go look up your doctor, because sometimes we don't know. They market it in a certain way that they say, I'm a board certified cosmetic surgeon. And you're thinking, okay, that's right. No, it isn't.

Regina (28:17):
They market themselves in a lot of different ways. After my situation, and I learned about that, I went home and I looked up every single one of my doctors, and I decided if any of them are not board certified in whatever their specialty is, I just won't go. And the funny thing is about the doctor I had, if you call their practice and you ask about, one of the doctors is board certified, the other doctors are not. And I think they have three or four additional ones. If you ask about a specific one, they will say, well, they are board eligible. When you say, are they board certified? Board eligible means they can just go sit and take their board exams. It does not mean anything more than they can attempt to do it. But when you hear board eligible, oh, that sounds like, okay. We don't know enough, but now I know.

Monique Ramsey (29:12):
Right. Well, and at the very, very beginning when they come out of residency and they have to practice for two years before they can take their boards, they are board eligible. And it's not a bad thing, but that means they also don't have a lot of experience. But it also means they could sit there indefinitely and never take their boards. And that's also kind of the scary thing. But yeah, I think doing that homework ahead of time, and thank God for the internet, right, because when I started in this industry, there wasn't an internet. And how did you know? Unless you asked the question and people didn't even know to ask the question at the time. And so now at least you can do some homework and really in your own spare time, do that. Do that, the investigatory process to make sure that everybody taking care of you, not just the surgeon, but what's the facility? Is it accredited and by whom? And who are the people in the OR with you who's doing your anesthesia? All those things, are they kind of at the highest level? Because things don't go wrong very often, but as you know, they can go wrong. And if they do, who's that team there to take care of you in that less than 1% of times that things do go wrong.

Regina (30:31):
But it was a learning experience, and I just learned much more coming to La Jolla Cosmetic. So I mean, I tell everybody I know, oh, if you need a plastic surgeon, I know, or if you need a center, I know where to go because.

Monique Ramsey (30:46):
Oh that's so nice. That's so nice. Well, I'm so glad, again, Regina, that you're here to share with us and that you're telling your story for other people because it does matter for anybody out there who might be on the fence or not knowing, it's all about education and you sharing your story really helps bring that to everybody out there. So I thank you, thank you from the bottom of my heart for doing that.

Regina (31:16):
Thank you.

Monique Ramsey (31:17):
And for everybody listening or watching, we will put all the links in the show notes. And thanks for listening today, and we'll look forward to seeing you on our next episode.

Announcer (31:27):
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 ljcsc.com or follow the team on Instagram @ljcsc. The La Jolla Cosmetic Podcast is a production of The Axis, theaxis.io.