Monique Ramsey (00:02):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And today in the studio I have a patient of ours who's a VIP patient. And the reason I say that, she's been with us now. We just talked about it 17 years. So Jamie, welcome to the podcast.

Jamie (00:22):
Thank you. Yeah, it seems like yesterday.

Monique Ramsey (00:24):
I know. I'm like, God, we've known each other so long. How long has it been? And you said 17 years, and I was just like, how does that time fly? Plus we haven't changed at all. Right?

Jamie (00:34):
Right. No, not at a;;.

Monique Ramsey (00:34):
So tell us a little bit about that very beginning when you came to the center for the first time, why you were coming, who you saw.

Jamie (00:44):
Yeah, for sure. So I made the decision to have an augmentation and lift after giving birth and breastfeeding three kids. So each of my kids kind of sucked the life out of me for a year each and so year plus. And so by the time my daughter was getting ready to wean, I thought, okay, summer's coming up. We spend a lot of time at the river and I'm in a bathing suit a lot. I've never had an issue with being in a bathing suit. And I was getting a little bit like I'm not very comfortable after nursing three kids. So I made an appointment with Dr. Brahme. He was phenomenal. I did see a few other doctors at a few different facilities and just loved his bedside manner. Everything about him made me feel so comfortable. So we went ahead and in the beginning, I wasn't sure what I wanted.

(01:35):
I just wanted to feel normal again, because wearing clothes and bras and bikinis was just almost impossible. And so I wanted them to match my body. And so he kind of had an idea of what size he would try, I guess. But being that I had a really large pocket and grew up with a 34 D breast through high school, he wasn't sure kind of when he got in there. So he had said he would do between a 400 and a 550, and I trusted his judgment. And so I remember waking up the next day thinking, oh my gosh, what size did I get? And I looked over on my card on my side of my bed, my husband had put it there and he had put it in 550. They looked amazing. So that's what I needed. He said that every other implant was kind of swallowed when he sat me up.

Monique Ramsey (02:19):
And that's so interesting. I think about implant sizes, is that a 550 on you versus a 550 on the person next to you can be so different depending on your anatomy. And that patients who are thinking about a breast augmentation shouldn't really get hung up on the numbers because what your friend has is not necessarily what will be the best for you. So that surgery, okay, fast forward because now you came in for a post-op today or a follow-up. And so fast forward to now what surgery did you have and why?

Jamie (02:55):
I had the exact same surgery, but went with a much smaller implant. So I had toyed with the idea. I actually came in a year ago and had talked to my husband. My breasts had changed, and they were just really big. So they change over the years and you get more breast tissue as you age. And so I was 46 at the time and was like, okay, well I'd like to get 'em done before summer. This was last year. And then life happens, and I wasn't really sure what I wanted. I toyed with the idea of actually having an explant because I think I actually reached out to you. I talked a little bit about it and talked to some friends that had had an explant, talked to my husband about it and just figured I'm almost 50 and do I need to get implants put back in?

(03:41):
I do have an autoimmune disease. I have Hashimoto's. So decided to get my blood work done and see how everything was going. My blood work is the best in 10 years, so wasn't worried about any type of the breast implant illness or anything like that. My body was not rejecting anything. So anyway, fast forward a year, I had told my husband, I think I'm ready and decided that I wasn't ready to get an explant. I didn't have any issues associated with it. We still spend a lot of time vacationing and at the river, and I want to feel comfortable in a bathing suit. And my main issue was the size is just I could find bikinis that fit me. It wasn't an issue, but putting clothes on, I just always felt bigger than I was, and I just wasn't happy. Very uncomfortable too. A 550 implant with breast tissue on it, which I didn't have before, was a lot different. So I had had that waterfall kind of effect where the breast tissue was gathering at the bottom of the breast and it just wasn't comfortable anymore. So decided to make an appointment. I had a few friends that had the same procedure done with Smoot, and so I decided to come in and take a visit. And he was phenomenal. Same thing. All the physicians here, the bedside manner is top notch. I would 500% recommend any physician here.

Monique Ramsey (04:56):
And so was it a straight remove and replace, or was there tightening of your skin needed or.

Jamie (05:03):
Oh yeah, I had the full lift again.

Monique Ramsey (05:05):
Okay. Full lift. And then did he use any internal support or did you need that?

Jamie (05:10):
No, so that was one of my main questions too is I didn't, I was worried that I would kind of fall into the same place as I felt the first time is that my implant would get swallowed into my body and they'd have to put a large implant. And again, but 17 years ago was much different than today. So they have a lot of different options. And Dr. Smoot had said, I have basically three different things I could do. I can shrink it, I can put mesh or I can sew it up. He's like, I think by shrinking it, which he said they basically put hot water on it. I was shocked. He said, that usually does the trick. And so we had decided to go with between 210 and 275 implant. But again, he didn't know what there would be until he got in there. Just wanted the best to fit my body and not be these large breasts that that's the first thing you see when you look at me. And so he did full lift with the 275s and that was I think seven weeks ago today.

Monique Ramsey (06:12):
So how's the healing been? How has it easy or not so easy?

Jamie (06:16):
Super easy. In fact, I will say I wanted to do the surgery on a Friday, and I think because I had had the surgery before, he doesn't typically do surgeries. That meant on Friday he had agreed, and the next morning he had my husband just FaceTime him. And so I'm sitting there and taking the bandage off and I was kind of out of it, but he was really concerned with my right nipple. And so he's like, I don't really like the look of that. And so I'm getting hot thinking, oh no, what's going on? And had my husband take a few pictures of it, sent it in to him, and then I went back up to bed. My husband came and got me and said, he needs us to meet him at the surgery center. And I was like, oh, gosh. So when we got here, he was waiting in valet for us, open the door. There was nobody here, and he had already called his, or in case he needed to take me into surgery and do a graft. He's like, it's okay, don't worry. But these are the three things that could happen. Best case scenario is literally what happened to me. So he sent me home with some nitroglycerin paste and said, had my husband keep an eye on it, sent some more pictures in, and it was great. There was no issue.

Monique Ramsey (07:29):
Oh my gosh. So really, and I think what happens or what can happen with any incision really, whether it's your breast, your tummy, is that if the blood supply to that area is sort of not as strong as it should be, that tissue, the risk is that tissue dies. But that paste is what they can put on it to help prevent that from happening, I think.

Jamie (07:54):
Yeah. And it worked great.

Monique Ramsey (07:56):
So how did you feel as you were having to get back in the car and drive down up in North County?

Jamie (08:03):
We're in Alpine. No, we're in Alpine.

Monique Ramsey (08:05):
Oh you're in Alpine. Oh my gosh. Okay.

Jamie (08:06):
Yeah, I mean, I trusted Dr. Smoot and I just loved that he didn't want to risk it, and he had me come into the office right away on a Saturday morning when nobody was in here. So again, I feel like worst case, he would've had to take me into the OR and do a skin graft. But I mean, I would've been okay with that. I just feel so, yeah, I mean it's just been such a great experience. And then my healing, it's very sore. I don't really remember how I did that with toddlers because my daughter was 11 months old and my son was only 18 months older. So I had two toddlers running around with my first surgery, and I feel like I was pretty sore and laid up for a few days. But other than that, it was easy peasy.

Monique Ramsey (08:53):
And I think you're bringing up that kind of life changes. You know, 17 years, I mean, implants are not lifelong devices, but 17 years is also we're different people than we were then. And we want different things. And of course our bodies have changed. And you mentioned menopause, perimenopause, all the things that can happen hormonally and with tissue, it's like, wait, where is all this coming from? And how to sort of deal with that. And it's interesting that you sort of consider just taking them out completely and that it's good that you sort of had the time to really consider what does that mean? And if I did that, would I be happy? And the fact that you weren't having any issues I think is key. And I think Dr. Smoot really, poor guy, he's really become almost famous for being the secondary implant specialist. If somebody's having another surgery of, let's say a woman's having a lot of capsular contracture, her body's creating all that scar tissue that forms around the implant, and then it makes the breast feel hard, that can get really complicated.

(10:05):
And he's like the guy, the go-to guy for trying to help solve complex issues with breasts. And even if they're not complex, I think speaks to the, we have six plastic surgeons here, and it really speaks to them working as a team that they're like, okay, I might've done this surgery and my friend down down the hall can do a different surgery. And it's nice to know that it's sort of like, this is your home base and we'll help you. We'll help take care of whatever it is. And it was so cute because you're messaging me through Facebook and I'm not in there that much. It's like I've done social media for so long for businesses that I'm kind of like, okay, I'm not in there that, and I was like, oh my gosh, she's messaged me five weeks ago. I'm so sorry to be like, that's okay. But I think having those lifelong relationships with patients, I look at you and I'm like, oh my gosh, I remember us doing, you were in an ad campaign of ours.

Jamie (11:06):
Yes, I was.

Monique Ramsey (11:07):
A long time ago. I don't even remember what it was, but you were like, yes, I'll be a model. And it was so sweet. So I really appreciate you coming on the podcast to sort of tell the story. And in terms of just mentally going into the surgery this time versus last time, was it easier or about the same or?

Jamie (11:25):
I think my life was, I don't want to say chaotic when 17 years ago, but I was young and I have these babies and I think I was just in a different mindset than this time. I was a little anxious not knowing what the results would be. I wasn't worried about the results, but I just didn't know. When I went with Dr. Brahme, he had the pictures, my inspiration photos on the walls, and I just didn't do that this time because I was just wanting smaller and just to fit my body. So I left it up to him and I just didn't know, and obviously was anxious and excited at the same time, but again, just a different mindset than when I was much younger.

Monique Ramsey (12:06):
So what was it like you're walking into surgery seven weeks ago with 550 cc implants, and then you go home with two something, would you say

Jamie (12:18):
275.

Monique Ramsey (12:21):
275. How did that feel on your chest? How did that feel as a person? And what was your sort of mental state around this new, because it's really probably very different.

Jamie (12:33):
Very different and very exciting. I'd been thinking about it for so long, and again, it wasn't fly by the seat of my pants decision. I really thought hard and long about it. And my husband supported any decision that I made. He is even the first time when I got it done, he is like, you're not doing this for me. I love you regardless. But this time I just thought, yeah, it felt great. I felt lighter. I had these constant knots in my shoulders, and I just thought if it was from working in the computer every day, but to tell you the truth, I haven't had a single knot in my shoulder blade since the surgery. So that was a lot of weight on me and for my frame. And so I think they maybe came out of the pocket a little bit, said I'm very excited for summer and to be able to wear my cute sundresses that I've been holding in my closet that I maybe wasn't comfortable wearing because all you saw was big, large breasts when I put them on. And exercising is a lot easier now.

Monique Ramsey (13:30):
Yeah, I would think. And so when were you cleared to start exercising again?

Jamie (13:37):
So to be honest, I've been traveling a lot and I haven't been exercising a whole lot, but I think now I can go back to normal activities being seven weeks, like lightweights. But I do have a Peloton at home and do a lot of the Peloton classes, so I'll be getting back into that now. But it was hard finding a sports bra that would fit. I had a small rib cage and a small waist, but then these large breasts that, so it was really loose underneath, but it had to fit the top. And so just excited about the normalcy of going to the store and buying a sports bra to put on. It's the simple things.

Monique Ramsey (14:10):
And it fits.

Jamie (14:12):
It fits. So I was wearing a large sports bra or like a bralette, and now I'm in a medium. So that's like, I don't know when I've worn a medium before.

Monique Ramsey (14:24):
Well, that's good. And I think having that continuum of knowing, okay, we had them 17 years ago, you have a new set, but you're young, and so there's still probably something down the road at some point and you might decide, yeah, I just want them out. Or you might say, Nope, I'm going to keep 'em small, but I want to trade it as your body changes. And I think hopefully we've been around almost 36 years now that in 15, 17 years you can do that and you might be messaging me on some whole other platform other than Facebook.

Jamie (15:03):
That's scary.

Monique Ramsey (15:04):
I'm here for you.

Jamie (15:05):
Right.

Monique Ramsey (15:08):
What would you say to a friend or a family member who is thinking about making a change like this?

Jamie (15:15):
I think it's important to do it for yourself and not for your husband or for other people. You really have to be comfortable in your own skin. And it's not that, I mean, if I hadn't have had the surgery, I'd be fine. I still would've been in my bathing suit, no big deal. But again, you just really have to look to yourself and take the time to reflect and really understand what the surgery entails and why you're really doing it in the first place. But ultimately, I feel like if you're doing it for yourself, the only result is going to be happy. I mean.

Monique Ramsey (15:49):
Yeah. And to know that those hiccups that could happen, it's very interesting talking about having to go back into the office that next day, but then it's not like the doctor's blowing off the phone call and Oh, it can wait till Monday. If it had waited till Monday, it might've been a very different outcome.

Jamie (16:07):
And he was actually surprised that this happened to me because I had had the same surgery previously. So I loved, not that I loved seeing concern on his face, but you can genuinely see the concern. And he was a hundred percent about just making sure everything was right with me. He did continual follow-ups, Shelly, his nurse is phenomenal. And she was saying, okay, send us more pictures. He wants to make sure everything's okay. And just the follow-up in the bedside manner is second to none.

Monique Ramsey (16:37):
Yeah, I think, and I've been so spoiled because I've almost grown up in this practice, but it is interesting to find out from people who have surgery elsewhere or if they're even just coming to us and asking for a consultation, and they'll say, how many post-op visits does this include? We're like all of them. It's unlimited. That's not something that we even think about because it's just how we operate and how we operate in wanting you to have the safest, best experience, and that it doesn't, we're not going to clock you out like, oh, sorry, we can't see you. We'll see you over and over. And I think that really is sort of a practice differentiator because we have six amazing surgeons, but there's other good surgeons out there. And so when it comes down to that connection with the practice and that your nurse, Shelly, she's been around a long time.

(17:36):
I love it. Back when we had a dermatology division, kind of between 2005 and 2010 is when we hired Shelly.

Jamie (17:44):
Oh. That's awesome.

Monique Ramsey (17:45):
And now we're 2024. So our team's been around a long time, but it's also that we will take care of it, and we're not going to nickel and dime you on a post-op visit or something like that, which wouldn't even cross our minds. But I like what you said, doing it for yourself. And I think the key, because the end of the day, it doesn't matter what anybody else thinks, it's how you feel. And so, okay, did you have to go get all new bras?

Jamie (18:16):
So I'm just wearing little bralettes. I mean, before I actually was only wearing a bralette too. The only issue before was just the breast tissue that had formed below, but I could get away with wearing or bralette. They weren't like, it wasn't terrible. And plus I didn't want to accentuate the size, so I would just wear bralette. So I'm wearing the same brand of bralette now, but just in a size medium. So I'm not wearing a regular bra and they don't want me wearing underwire anyway. And there's nothing to underwire.

Monique Ramsey (18:46):
Nice. Well, that's so exciting. And do you feel, okay, I know that as my breast size have changed over the years, you can feel fatter or thinner almost. And you're pretty petite, right? You're not very tall.

Jamie (19:00):
No, I'm five five.

Monique Ramsey (19:02):
Yeah. So do you think that that's helped you kind of feel,

Jamie (19:05):
Oh gosh.

Monique Ramsey (19:06):
More proportionate, I guess?

Jamie (19:08):
Yes, a hundred percent. I mean, in every picture, they just made me look larger in photos and in my clothes. In fact, this blouse that I have on, I've had for a while, and every time I would put it on, I'm like, my breasts would be from here to my rib cage, because once I had the bralette on and it just made me look a lot heavier than I was, so it was an insecurity of mine is that everything I put on, I just looked bigger. And no matter how hard I worked out, that would never change. So that was one of the deciding factors as well, is that I'd buy these new sweaters and tops that I liked wearing form fitting things, because if I wore baggy, then you wouldn't see my waist. I had a smaller waist, but then it just accentuated the top and yeah, it just got to be too much.

Monique Ramsey (19:56):
Yeah. Well, thank agains Jamie.

Jamie (19:57):
You're welcome.

Monique Ramsey (19:58):
And it was really fun to catch up with you.

Jamie (20:00):
I know.

Monique Ramsey (20:00):
And I hope that maybe in 17 years we'll be able to have this same conversation.

Jamie (20:05):
Alright, thank you.

Monique Ramsey (20:08):
And everybody who's listening, thanks for listening. We'll put links in the show notes and if you'll subscribe, that would be great. And just so you know, if you're listening on a podcast platform like Spotify or Apple, that's great, but we also have video of all of our sessions over on YouTube, on our YouTube channel, so we'll put that in the show notes as well. Thanks everybody, and have a great day.

Jamie (20:33):
Thank you.

Announcer (20:34):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment, or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla cosmetic is located just off the I-5 San Diego Freeway in the XiMed Building on the Scripps Memorial Hospital campus. To learn more, go to lj csc.com or follow the team on Instagram at lj csc. The La Jolla Cosmetic Podcast is a production of The Axis, THE AXIS. io.