Mommy Makeover: Timing it Right and Avoiding Regrets

Speaker 1 (00:07):
You're listening to the La Jolla Cosmetic Podcast.

Monique Ramsey (00:15):
Hello everyone. And welcome to the podcast, The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And today we're speaking with Dr. Lori Saltz and talking about mommy makeovers. So, I wanted to ask you before we do that, have you heard from anyone who's listened to your podcast about breast augmentation?

Dr Saltz (00:36):
No

Monique Ramsey (00:36):
You haven't? Oh, well, so I got to tell the audience. It's quite literally the most interesting conversation I've ever had with anybody about breast implants. So if you're here for her take on mommy makeovers, please go back and listen to that conversation too. Because I guarantee you'll learn something and we'll link that in the show notes. So let's just start at the top. What is a mommy makeover? How is that defined?

Dr Saltz (01:00):
Well, mommy makeover is expanding in definition, but traditionally it's been some kind of surgery on your breast and some kind of surgery on your tummy. So, the breast could be an augmentation, an augmentation with a lift, just a lift, whatever you want. Most mommies have breastfed and so they kind of have some laxity, not all, but most of the time there's a lift involved. Then the tummy, it can be anything from a full abdominoplasty with liposuction of your hips, or it can be just liposuction alone. It can be anything that addresses your tummy. Most of the time, I should say, with tummy tucks, there's two aspects to it that are important that you need to look at separately. And one is how much extra skin do you have? Is it in rolls? Do you have a little festoon around your belly button or a hood over your belly button?

Dr Saltz (01:57):
That's the laxity. Then you turn sideways and you look in the mirror and say... When you're not holding in your muscles, which were all trained to do automatically, but just relax them and see how much does it stick out. Now, most people have a little of both, but I've had patients that had almost no extra skin, but a ton of protuberance, we call it. So their surgery was more about the muscle and a lot of people ... some are of both. But some people have more extra skin than they do protuberance, but it's both. And most of us have fat in the back of our hips, so we talk about the 360 now, it used to be, we just talked about one dimensions, what you see in mirror. And now we talk about what people see from behind you, which we don't get a view of, but by liposuctioning, the posterior hips, we can lengthen out the curve of the waist and just make your figure more curvy.

Monique Ramsey (02:53):
Wait now, which are your posterior hips?

Dr Saltz (02:56):
Back, the back, you put your hands back there on your hips and that's right where it is.

Monique Ramsey (03:03):
Got it. Right.

Dr Saltz (03:03):
We get rid of that.

Monique Ramsey (03:04):
We can all feel that.

Dr Saltz (03:07):
I always do along the waist because it's, we all want waists. And we look in the mirror and the waist is from side to side or front to back for us because we evaluate it looking in the mirror. So when you look in the front, then your curve is longer and smoother and it is in the back as well. And by doing that, you do make your tush look a little bigger.

Monique Ramsey (03:30):
Nothing wrong with that.

Dr Saltz (03:31):
Yeah. So nobody's complaining about that either. And then now we're expanding, I don't do this, but Dr. Brami does. To ... something with your feminine area.

Monique Ramsey (03:42):
The lady bits.

Dr Saltz (03:43):
The lady bits and not often, but they can use some tightening sometimes to make life a little nicer now that you're not having kids. So Dr. Brahme does that for us and he's quite good at it, but I think it should be, it's part of what happens when you have children.

Monique Ramsey (04:01):
Yeah. A mom, part of the mommy makeover. And for everybody listening, we did do a lady bits podcast. So you can hear Dr. Brahme and Kara talk about kind of the surgical ways to address that and the non-surgical ways. So let's get back to the breasts and... You know, what percentage of patients in your practice, or maybe in your career, would you say with a mommy makeover have just a lift or a lift with implants or don't even need a lift and have a straight augmentation?

Dr Saltz (04:33):
Well, most patients for mommy makers, especially the ones that have breastfed for any length of time. Most of them need to have their breasts lifted. Now, when you lift your breast, this is an important concept. When you look in the mirror, you'll see the upper edge of your breast. When you have just a lift, you will not have fullness above that line. If you want fullness above that line, you need an implant. You don't necessarily need a big implant. But if you want fullness up there, you need an implant. And I think of ... they are two separate procedures, implants, augmentations, and breast lifting. So you got to look at those both. A larger implant will not repeat, not lift your breast ever.

Monique Ramsey (05:23):
Yeah, it was that old rock in the sock.

Dr Saltz (05:26):
Yeah.

Monique Ramsey (05:27):
You know, if you put a rock in a sock it's still droopy and it's heavier, so-

Dr Saltz (05:33):
Right. And it, the notch in your throat at the bottom of your throat to the nipple actually is, lengthens. So putting a bigger implant is not going to help you. If you need a lift, you need a lift. If you want an augmentation to give you more fullness in the upper part of your breast, then you get an augmentation also.

Monique Ramsey (05:55):
Okay. So for women who may want their breasts lifted, but maybe don't want an implant. What's your suggestion?

Dr Saltz (06:04):
Well, it depends on their weight. If you've got some extra fat, we can put a little in the upper part of the breast. It's not going to be a lot, but it can often fill in that little ski slope, some and make it a little better, but it's not a good augmentation. It's more about the shape and filling in that void at the top of your breast.

Monique Ramsey (06:26):
So would you say what percentage of women just have a lift with an implant? Most of them?

Dr Saltz (06:32):
Most of them, most of them have both because they want that fullness at the top, I mean, that's what they're missing. They, they don't like their breasts sitting on their abdomen. Everybody hates that. I don't want to feel my breast on my abdomen and I want more fullness on top. And I said, well, then we've got two things to do.

Monique Ramsey (06:53):
Let's talk about the scars real quick on a breast lift. So would you say most of them are the traditional mastopexy scars, meaning around the nipple, down-

Dr Saltz (07:03):
With every lift, you're going to have an incision around your areola because you're going to move it up. We don't just take it off. I mean, we move it up, so you've got to make a space for it above and you just slide it up into place, and then you close the tissue below it. So you will always have a scar around your areola, and yes, we can make the areola smaller. A lot of people ask that because it gets stretched out with breastfeeding and age and all this. So that's just part of the procedure. But then it depends on how much you're lifting the breast. There is what we call the concentric lift, where we just take skin out around the areola and just lift it up a little. It's not really a lift, in my opinion, it really does not lift your breast. It's good if your nipple heights are off and you need to bring one up a centimeter or two, but beyond that, it's really not a lift.

Monique Ramsey (07:57):
Okay.

Dr Saltz (07:57):
Then you come in with the lift. That is the, what they call the lollipop, where it just goes down the center. And I use that primarily on people that have what we call constricted breasts, where the bottom part of the breast is really short it just didn't develop. And they have really short, lower pole and you need a longer one. Sometimes those vertical lines are longer. And when you bring them together in the center, you end up with a longer lower part of your breast. And some people that's going to mean it's too long and their nipples will tip up and you don't want that. Okay. So then you have to add the little wedge at the bottom that you take out to make everything the length from the nipple, the edge of the areola to the fold, you need that to be the right length for your nipple to be in the right place.

Monique Ramsey (08:43):
And that's what they call the anchor, an anchor scar?

Dr Saltz (08:46):
Yeah, an anchor scar.

Monique Ramsey (08:46):
Because it sort of looks like an anchor. It comes down and then under in the fold. Okay. So now getting down to the tummy, I know there's a couple different kinds of tummy tucks. And what do you evaluate to figure out which kind of tummy tuck is best?

Dr Saltz (09:04):
Almost always, if you think of tummy tuck, you need a full tummy tuck, but you look at how much skin you have, how much extra skin. There's two places you have to look. You have to look at what's above and what's below. Now what's above is almost always less than what's below. But we cut around the belly button because it's going to stay right where it's been since you were born and everything else is going to move down. Well, if you don't have a lot of laxity in the upper part of your tummy, that hole that we made around the belly button is not going to get pulled down very far and you will have to close that round hole, make it into an ellipse and close it as a vertical incision or move the horizontal incision at the bottom way up. And let me tell you, it's not a good look.

Monique Ramsey (09:57):
Oh.

Dr Saltz (10:00):
Your little pubic hairs kind of go up with it. Because you can't just pull in one direction. It's pulling in both. So most people would rather have the incision, I like to make the incision really low. So it's under most bathing suits and most people would rather have that in a little vertical scar and sometimes a vertical scar if ... It depends on how much you have laxity, if you have like a moderate amount, it might come all the way off, like ... or we cut right through the hole and it's right at the bottom. You just have this little T or it can be higher than that. It can be anywhere between where you're going to put the umbilicus, the belly button, and where the incision is below. Then you look at what's below and usually, that's where you have more laxity and sometimes rolls of extra, your pubic area is lax and hanging it's down, which a lot of women really hate.

Dr Saltz (10:54):
And yes, it comes up nicely. When we pull up, as I said, we have to pull in both directions. So that comes up, which is a plus. But a lot of times people have a little bit of laxity in the upper abdomen and more in the lower abdomen. And we'll just tighten this look, can you just tighten this lower part? When you pull down in the lower abdomen, it's going to pull on your belly button. It's like a nail in your, in the middle of your tummy.

Monique Ramsey (11:21):
Okay.

Dr Saltz (11:22):
It's just, okay. So the skin above it is not going to come down. Around it, it might come down a little, but it looks really bad to pull the lower part really tight and then leave the upper part where it's not so tight to me that looks just so artificial. So the best people for mini tummy tucks don't have any protuberance in their abdomen, have almost no extra skin.

Dr Saltz (11:46):
Usually, it's people that have had C-sections, you know, these skinny people that have C-sections and we just ... they have a little shelf over there, C-section scar and we just take that shelf off and that's it. We generally don't tighten the muscle because you ... when you do a mini tummy tuck you really need to tighten the muscle from the bottom of your breast bone, to your pubic bone for it to be smooth. Because if you just tighten the bottom, then everything bulges out at the top. So you need to tighten all the way down to have the best result. So there are people that I've said, you know, can understand why you might want a tummy tuck, but you really, I think the benefit you're going to get from it is not going to be worth the scars you're going to get. Maybe we should do a little liposuction.

Monique Ramsey (12:35):
So when patients come to you, then you're going to be able to say that, you know, this is, I don't see that this is going to be a good answer or maybe this other thing is going to be a better answer.

Dr Saltz (12:46):
We have a new answer to add to our armamentarium, and that's the Renuvion because sometimes just doing a little Lipo and the Renuvion, as you know, contracts the skin and it's best used after some Lipo. Now you don't have to do a lot of Lipo, just a tiny bit. And it makes all those ... It takes the fat away from the structural elements, right under the skin. So when we go in with the laser, the plasma, they're exposed and they shrink more. So just shrinks that skin. And I've had a couple of women that had just, one actually had, I thought a lot of laxity, but was really, really thin. And she didn't want a tummy tuck. And I said, "Well, let's try this". And she had a lot of wrinkly skin on the bottom of her abdomen. It got a lot better. Now It wasn't totally smooth, but she was completely happy. So now we can use that on women that really aren't good candidates for a tummy tuck, but they want something to tighten things-

Monique Ramsey (13:47):
To tighten the area. Now, if you have stretch marks the Renuvion, will that help at all or no?

Dr Saltz (13:54):
No, it does not.

Monique Ramsey (13:55):
Okay.

Dr Saltz (13:56):
When we do a tummy tuck, whatever is below, whatever we cut off, we're going to cut off some of those and what's up higher are going to come down. So a lot of times people don't have a lot of stretch marks above their belly button and those will come down and be below their belly button, but they may not come all the way off.

Monique Ramsey (14:12):
So what do you do when you have somebody who has had a C-section before or an old hernia scar, how do you deal with that?

Dr Saltz (14:20):
Oh, the incision that we make is it's always well below the section scar because if you pull up on your abdomen. That's what I do when I'm marking, you got to pull up on the tissues and mark where you want the incision. Because if you mark it when they're not pulling up on the tissues, then when you pull up at the time of surgery, it ends up way too high. So I have them put their hands on their lower abdomen and pull up as tight as they can and then I draw the incision. It's always below a C-section scar. Sometimes we can get a hernia scar off depending on how much extra skin they have.

Monique Ramsey (14:56):
Okay. Now, how long after you're finished breastfeeding, could you have surgery? Do you make patients wait a certain amount of time?

Dr Saltz (15:06):
If we're going to cut into the tissues, like in mastopexy, a lift, or something I usually have them wait about four months. If it's just a breast augmentation, we're not cutting through ducts and stuff, so we can just make the ... we make the incision under the breast and we scoot right under it. So we can do an augmentation. You know, soon after ... I tell people, "You got to wait a couple of months, it takes a while for your breasts to kind of ... Your whole body for that matter". And people say, "Well, how soon after I deliver my kid, can I have a tummy tuck?'. And I go, "Well, you know, it takes six or eight weeks, at least for your uterus to shrink back down and your tissues to kind of shrink where they're going to be. So I would wait like three months".

Monique Ramsey (15:49):
And that's something that people have to think about too. How do you ... to prepare for their recovery? If you've got little kids at home or, and who's going to help you?

Dr Saltz (15:59):
Yeah. The recovery from breast surgery is not that bad. Even with a lift. I don't think adding a lift to an augmentation adds much if anything, to the recovery from an augmentation alone. So that's a no-brainer that's a week, but tummy tuck is a much bigger deal. So when people have both of them, I say, "Well, you're not really going to notice the breast because your tummy's going to hurt more than your breasts". And that is ... a people say, "Well, how long is recovery?". I said, "Well, two or three years, but it's in stages. Obviously the first few days, you're not going to move much". I tell people, "You're not going to eat much. You're going to sleep a lot and you're going to mostly be in bed. But we need you to get up and walk to the bathroom or out to the couch to keep the blood circulating in your legs so you don't get blood clots."

Dr Saltz (16:49):
And for four or five days, you're going to be pretty much most of the time in bed or on the couch. Then you start getting up and getting around a little more and you're going to be walking, bent over. Then your back muscles are going to hurt because they're not used to holding your body out in the air like that. They're used to holding them up straight-

Monique Ramsey (17:07):
Straight up.

Dr Saltz (17:07):
So I warn them your back's going to hurt. And then by two or three weeks, they are standing straighter up. I remember when I had my tummy tuck, I would do great. I'd get in the shower and I'd be nice and tall. And then I'd get in the car and drive to work. And then I couldn't stand up straight again.

Dr Saltz (17:26):
That took another week or so. But then the swelling ...What people get really distressed is the drains come out usually around a week, and then your lower abdomen swells more. And that swelling can last, it does last for months and months, like nine months, maybe for all of it to go away. I've had people tell me, you know, at a year they said, "It's just recently been where I saw it on the day after surgery, it looks really good. Then it doesn't look that good again". And so I tell people, it's going to be a long time. The scars are going to look worse before they look better because they go through a maturation process. And part of that is where they are red and raised. And you say, "Oh my God, what did I do?". And sometimes we put little injections in there if we need to, but it takes two or three years really.

Dr Saltz (18:17):
For those, anybody, who's had a section scar and paid any attention, knows it takes a long time for them to fade and turn white and flatten out. So I tell people, you know, "You start getting your energy back between six and eight weeks" and I call that sort of the turning point.

Monique Ramsey (18:35):
Oh.

Dr Saltz (18:36):
And you start getting back to your life. I say, okay. And then they're fretting about their swelling in their lower abdomen. And I go, "Just don't look at it. Okay. Just go back to your normal life. Don't look at it. It's going to get better, but you're going to drive yourself nuts, looking at it every day and getting upset about it because it's just time".

Monique Ramsey (18:57):
Right!

Dr Saltz (18:57):
So the recovery is longer than people think it's going to be. But by six or eight weeks, you're back to most of your activities.

Dr Saltz (19:06):
I was just talking to a woman this morning who wants a breast aug, she has like a 14-month-old. And I said, "Well, you know, back in my day, we had the sides of the crib went down and it made it really easy to take the kid in and out of the crib, but they don't have that anymore". So lifting a kid, especially a 14 month, up and over the side of the crib is a big deal. Putting them in their car seat... Now that's how Ruth, my nurse, she got a problem at three weeks, she was twisting to take the kid that had just vomited all over the car, out and that twisting motion it shears the flap over the muscle and she tore a vessel and she started bleeding. So you have to think about these things. Twisting motions aren't good, right after a tummy tuck.

Dr Saltz (19:53):
So you have to pay attention to how are you going to get around all these things? You have a kid that wants you to pick them up all the time? You're not going to feel real comfortable doing that. I tell people, "You need to bend down and put them on your hip and then stand up using your legs", which is how we're supposed to do it anyway. But nobody does, but you're going to have to do it that way. And also when you have little kids, you got to think about it. Now, if they're really little, it's not so much a problem. If they're still three or four months old, they may be in a cradle next to your bed. And that's not a problem.

Monique Ramsey (20:25):
Yeah well and I think this is something, as you're telling these stories, it makes me think, you know, you and I are both moms and you know, that's one of the thing that the guys can't say they haven't been there, done that in the same way. And like you and I both know, and all the ladies listening, what, having kids, what it does to your body and you as a woman, kind of know like how you want to be put back together. So I think you said before we started recording that you've had a mommy makeover yourself.

Dr Saltz (20:51):
Right. Not all at the same time, but yes.

Monique Ramsey (20:55):
Did you, you didn't do it to yourself, right?

Dr Saltz (20:57):
No, I didn't do it to myself. Now that's how I learned about the markings. Because I marked myself in the mirror before surgery and I wasn't lifting up on my tissues. Nobody said anything about that. And so my scar is higher than I wish it were, but I just ... I got over that a long time ago. Because my scars are really thin and white. It's like, oh well, whatever. But that's where I learned that you have to do that. Because I learned on myself and I learned a lot of what I do or what I tell patients I've learned on myself. And I think that's what makes it an advantage to be a woman that's had kids and ...

Dr Saltz (21:34):
I've had breast augmentations and I've had tummy tucks and I've had liposuction and... I've been through it and I had two C-sections. So I know what it's going to be, I know how long it's going to take, and I've seen it in my patients for a long time and I always am warning them. It's going to be longer than you think, but the results are going to be worth it because that's for the rest of your life.

Monique Ramsey (21:54):
Right. That is definitely true. So back to pain, you were talking about pain. What is done for pain?

Dr Saltz (22:04):
What is done for pain... We have a drug called Exparel and it's like a long acting local anesthetic. And when ... once we've tightened the muscles and before we pull the flap down and cut everything off and start closing, we put this solution under the covering on the muscle right along where we tightened it, because that's where it's going to hurt the most. And along the bottom of the ribs, because that's where a lot of nerves are and some along the incision and it lasts for a couple of days. Now it does not eliminate the pain, but most patients end up using fewer pain medicines than they would've otherwise.

Monique Ramsey (22:44):
That's nice.

Dr Saltz (22:45):
So that really helps.

Monique Ramsey (22:47):
Very cool. Then when could people go back and maybe it depends on what kind of tummy tuck they're having or breasts or ... but back to exercising, like when do you clear them? Usually?

Dr Saltz (23:01):
Well for my breast augmentations, I don't let them exercise at all for six weeks, which is a whole long different discussion. But with tummy tucks, they're not going to feel comfortable exercising other than maybe walking for good six to eight weeks and they're not going to be doing sit-ups. You know? So they'll start with the biceps and the triceps and lunges and you know, those other things that do your backside and you know, all those. If they don't have their breasts done they can be doing those pulldowns and lats and stuff, but most, if you have had your breast done, you're not going to be doing that right away. So it's a gradual return to exercise because every time you go to do something that uses your core, you're going to feel it. So the pain does go away. I promise. I promise this is not going to last forever. And we'll just hold your hand until you get through it. So you just have to be patient. Patience is the key to a mommy makeover. If it includes a tummy tuck.

Monique Ramsey (24:04):
Yeah. And now getting to what patients say to you after once they're healed and they're living with their results.

Dr Saltz (24:12):
Well, once they're through the healing process, which takes about a year, then they're starting to get really excited. But a lot of times they notice improvements right away and they get excited about it. But you swell and that swelling weighs a lot. Water weighs a lot and we all women know that. So I tell people, "Do not get on the scales for at least a couple of months".

Monique Ramsey (24:36):
Oh.

Dr Saltz (24:36):
Because you're going to weigh 10, 15 pounds more than when you ... before you had the surgery, because it's all water, weight. It's heavy. And you're not going to fit into your jeans right away because of the swelling. It's a process. And that swelling is going to take time.

Monique Ramsey (24:56):
And I think that's something that you and Ruth do so well is helping because you both had the surgeries. You both had kids and you know how long it takes and you see all your hundreds and hundreds and thousands of patients coming back. And so as long as we women are prepared for what's going to happen, we can rise to the occasion.

Dr Saltz (25:16):
Occasionally people wobble on that path and we have to rush in and hold them up and give them a pep talk. I did one of those the other day and she ended up giving me a big hug. "Oh thank you, you really helped me". But we just keep reminding them. I keep telling them, "Remember I told you this before surgery and now we're in the middle of it and you will get through it".

Monique Ramsey (25:36):
Yeah. So now do you do your consultations mostly virtually?. I know with zoom, we started, you know, during COVID we were, we had to do zoom consults. What have you found in that process? Do you like doing zoom consults or do you do some in the office?

Dr Saltz (25:54):
You want me to tell you honestly?

Monique Ramsey (25:56):
Yeah.

Dr Saltz (25:58):
I'm an introvert and I don't talk easily to people. Ruth is an extrovert and as she said, she's the mouth and I'm the hands.

Monique Ramsey (26:06):
Oh.

Dr Saltz (26:06):
So, but she says on zoom, I'm home, I'm in a room, nobody else is home. I have skylights over me. So it's light. I have all my computers here. I don't have to run back to my desk all the way down the hall to type a note or anything. It's all right here. So she says, "You're much more personable on zoom".. So I like to do the first consult on zoom because mostly it's just talking and telling them how the procedure works, telling them what implants there are, all this stuff, just getting all that talking out. It's quiet. It's nice. It's just a lot more calming for me.

Dr Saltz (26:44):
Then the people who want to go forward, then I have them come in for a consultation in the office. And we don't have to do all that talking so we can get right down to examining them, measuring breasts, sizing them, if they're going to have augmentations, doing all the fun stuff. So I tell them all that, the second consults, a lot more fun. And then you've ... I've kind of built a rapport with them because we've talked and we'll get chatting like girls do, especially when Ruth is there, and because she likes to chat and we get into some really fun stuff. So I do a lot better with zoom and that's worked out well for me.

Monique Ramsey (27:23):
Well, and I would think a lot of your patients really kind of like that, because they're not having to drive and traffic and park and have the kids be taken care of by somebody... You know, they can do kind of the nuts and bolts part from home also. So they might be more relaxed.

Dr Saltz (27:40):
Right. And so that's when I tell them on zoom is, "You're going to have more questions" because every time we go through information, we think of more things and we have more questions. So I tell the younger ones, put them on your phone. I tell the older ones to write them on a piece of paper. And when they come in for their second consult, we're going to go through all those questions and then they're going to have a pre-op. So I said, "You have three opportunities, to ask all your questions. We want to make sure all your questions are answered before you go into surgery, and that you feel comfortable with what you're doing".

Monique Ramsey (28:13):
And do you, during that consultation process, do you show them any before and after pictures of other patients or diagrams or-

Dr Saltz (28:21):
Yeah, we do that when they come into the office because we have so much on Touch MD that and Ruth is good at zooming through the ... she knows where everything is and she could just zip through.

Monique Ramsey (28:32):
Yeah, we have in all the exam rooms, we have a big screen, 42 inch screen or something. It's huge. It has a bunch of information on it. So there's before and after pictures and probably showing how incisions are made and things like that. So some good educational tools.

Dr Saltz (28:50):
Yeah.

Dr Saltz (28:51):
We do a pretty thorough job in educating people. I think, because I just think I want to know what's going to happen. So it's just like in our booklet we tell people, you, a lot of people get really depressed around a week, five to seven days and occasionally they'll come in crying and saying, "What did I do?".

Dr Saltz (29:10):
And that's just because you know, we know hormones, and they get kind of out of whack when you have big surgery. And it's not uncommon for people to get depressed and down at some point and you look at their husbands are looking like deer in the headlights and you're going, "It's going to be okay, just hold her hand and tell her it's going to be okay in a few days it will pass. She's not going to be like this for the rest of her life". But just knowing that that can happen and people will come in and say, 'You know, I read that in the booklet and I'm so glad that it was in there because then what happened to me, I knew that this was, could be normal and not to worry about it".

Monique Ramsey (29:46):
Yeah. Yeah.

Dr Saltz (29:47):
The more you know, the less you worry about ,usually.

Monique Ramsey (29:49):
So true. So to close out our conversation about mommy makeovers, I want to read a review from one of your patients. She said, "Dr. Saltz is very meticulous. So along with her passion for her career, she accomplished outstanding results for my procedure. I had only dreamed of having a body that Dr. Saltz has given me because of her amazing skills. I have become a confident woman". What do you think when you hear that?

Dr Saltz (30:17):
I think that that our bodies, right or wrong, however, you feel about it, we do care about it and it does affect our self-confidence and our self, how we feel about ourself and how we portray ourself. A lot of patients come in after surgery, we're always complimenting, because they'll come in these new tight little clothes or new short, you know, close jeans instead of big baggy sweatshirt or something. And so we're all ... You can just see that they're just walking lighter, their face is lighter, they lit up, their eyes are sparkling and you know, they're so proud of their new shape and you can just tell that it's just changed the whole way that they feel about themselves. And when that changes, you know, speaking, let's speak about husbands for a minute. Okay. Because a lot of them say, "You just need to do more sit-ups" and that's not the case. It's just not the case. If you've had kids-

Monique Ramsey (31:14):
Because really sits don't work necessarily because if the muscles are separated-

Dr Saltz (31:20):
The muscles get separated, the skin get stretched out that it just, it's not going to go back without surgery. I mean, I'm sorry. After the first few months after you deliver, it's pretty much going to be where it is. And it is what it is, and you can't make it better and you just accept it, but it makes you feel less feminine. You feel more like, you know, a mommy and constantly it's somebody else's needs. And what about my needs? I need to feel good about myself too. And when they do, they're just happier people all the way around and everybody, including them benefits from it. And that's, I think the biggest reason for doing it, is to feel better about yourself and then you just come off happier and that makes everybody around you happier.

Monique Ramsey (32:09):
This is true. So in our show notes, you'll see links on some of our other podcasts. You'll see how to reach out for a consultation with Dr. Saltz and questions about pricing, financing, anything else that's on your mind, you can it all there. We have all our prices on our website. So when you go to let's say the mommy makeover page or the breast augmentation page or the breast lift page, you'll see price ranges.

Monique Ramsey (32:35):
And of course, once you have a consultation, then we'll have an exact written quote for you with exactly what you're looking at. And if something you're thinking of doing and you're thinking, "Well, I got to wait till I save up'. You actually don't because there's financing just like your car, you know, you can pay monthly. And so that's sometimes a very nice option for people or they do some combination. So our patient care coordinators are really good about helping you with that side of it. And you'll also find links in our show notes to Dr. Saltz's before and after photos and all of her patients' reviews. So thank you, Dr. Saltz. Is there anything else that we might have failed to cover today?

Dr Saltz (33:18):
Having plastic surgery it's an elective thing and it's always a process. And most people that come in have been thinking about it for a long time. Many of them have done a lot of looking on the internet and I go, "I hope you're not looking at social media that you're just looking at the internet and getting good information". And then eventually they come in, but I like to ask, "Well, why now, if you've been thinking about it for 10 years, what is it about now?". And a lot of times they just say, "Well, it just feels right". And I talk about the light switch one day, it just goes off. I want it. But this one lady says, "Well, I was on The Price is Right. I won $250,000. So now I can afford to have this surgery. I've been wanting for years".

Monique Ramsey (34:03):
How cute is that?

Dr Saltz (34:04):
Sometimes you learn fun things by asking the right question.

Monique Ramsey (34:09):
Yeah, that's right. That's interesting. I love it. Okay. Well thanks Dr. Saltz. It was fabulously informative and I as always, I love talking with you and getting your perspective on these things. And so thank you all for listening and we'll see you again. Next time. Bye-bye

Speaker 1 (34:31):
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 at LJ CSC. The La Jolla Cosmetic Podcast is a production of The Axis. theaxis.io.