Speaker 1 (00:07):
You're 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. And today I am joined by Dr. Luke Swistun. He's been on our podcast before. He's a plastic surgeon, and he's gonna talk with all of you men in the audience about procedures that he has done himself and procedures for men, specifically in honor of Father's Day. So welcome Dr. Swistun.

Dr. Swistun (00:41):
Thanks so much, Monique, for having me.

Monique Ramsey (00:44):
So with Father's Day coming up, you know, we just thought we'd get one of our dads. You're, you're a father of three, correct?

Dr. Swistun (00:50):
Correct.

Monique Ramsey (00:51):
And so I don't know how you balance that actually. You've got, you're a busy surgeon. You have three kids? Three boys?

Dr. Swistun (01:00):
Yes. Uh, I, I'm also married to somebody who is better at multitasking than I've ever met. She's a doctor herself and she has a full doctor's schedule and somehow our three kids are still alive. And it's not because of me. <laugh>, she is absolutely amazing, but yeah, she, I think she makes it possible.

Monique Ramsey (01:18):
Yeah. Well that's nice. But I think, you know, don't discount yourself, but yes, you're, you do have a pretty amazing wife and 

Dr. Swistun (01:25):
I help out. 

Monique Ramsey (01:26):
<laugh>. And your boys are how old now?

Dr. Swistun (01:30):
Fifteen, nine and four and a half. Yeah. So it's very eclectic in my house.

Monique Ramsey (01:35):
Yeah, I was gonna say, so who's the handful at the moment, or do you not wanna say <laugh>?

Dr. Swistun (01:39):
No, no. I mean, they're, they're all, they all have their moments. I mean, it's very eclectic in the sense that, you know, I'm teaching the 15 year old how to drive stick shift, and then I'm trying to win the four and a half year old off of the pacifier. And the one in the middle is picking up like his fifth instrument right now because he loves music. So he, he's actually quite good at it, we're, it's turning out. So each one has a different level of attention at different times of the day, but somehow it works out.

Monique Ramsey (02:04):
That's neat. Well, we're gonna dive into some topics as we get going about, you know, things that you've done over the years and, and things that are great for men. So we'll start with you first, Dr. Swistun. So what have you done yourself to yourself or for yourself over the years?

Dr. Swistun (02:21):
Well, I got to experiment a lot, obviously, because in training and residency, all the reps that offer product to the residents kind of give you a lot of free products so that you can learn and get hooked on their products, so to speak. But really get experience with fillers in Botox and so on and so forth, uh, which really gives us an opportunity to get familiar with the techniques and frankly, experiment in general. My intent with everything I've done to myself is really to kind of like preserve what I used to look like before. So, and I, I think that's, in my experience at least, no one that I talk to ever wants to look dramatically different. Some people do, but most of the time the, the goal is to make them look like they looked 10 years ago, 20 years ago, whatever, like when, when they looked like in high school.

(03:05)
That's what I would like. And that kind of goes from, from head to toe. So I'm 47. There are certain things that happen sort of with, with age, uh, that are sort of inevitable. There are some things that you have control over, like if you, you can diet and exercise and stuff. And then there are some things that you can't control, like losing your hair, which sucks. I, no matter how many like pushups and sit ups, I do, my hair doesn't come back. Um, <laugh>, there are some things that change in the body that also you can't control. And one of them is basically there's fat that we lose, let's say, from the face and from the rest of our body that we sort of want to retain that keeps us looking youthful. And that's usually on the face. It's the malar fat over here. It's some of the fat that we have over here, the temporal fat. Uh, those are the features that kind of keep us youthful looking.

Monique Ramsey (03:52):
And let me just interject, because for the people who are listening, not watching the malar fat, the cheek pads, the cheeks, correct. Right. And then you were also kind of pointing to the jawline. And then the temples. Yeah, the temples,

Dr. Swistun (04:06):
Yeah. Yeah. You know, I could name many other areas, but in general that's sort of the areas that sort of tend to atrophy and you lose volume there and that's sort of what makes you look a little older. You know, everybody says that gravity took my face down and that's why I have wrinkles and everything's down. It's really the loss of the volume that allows the skin to re drape lower. It's not so much the gravity. So the treatment for that is really restoring that volume. And the simplest way to do it early on is just with fillers. So that's what I have done. There is, uh, a certain shadow that sort of starts creeping in across the middle of my cheek if, if I lose that volume and first time I noticed it maybe about 10 years ago or so, and, uh, it took about one cc of filler to sort of restore that.

(04:45)
It's filler that you put deep right on the bone, but it just sort of pops out the rest of your volume back to that original contour. And, uh, and it works really well and it makes, it's a pretty powerful intervention. And you know, this show one example, but you can do that in, in many different places. The Prejowl sulcus, which is basically this area sort of between where the chin ends and where the side of the jaw line and the cheek begins. A youthful jaw jawline is very straight from the angle of mandible from the, the back of the mandible all the way to the tip of the chin. It's kind of a straight line. And as we get older, there are certain things that happen that make that straight line not straight. So you lose volume immediately behind the chin. You gain volume when the skin re drapes downwards. So little interventions to fix those things kind of restore that youthful jawline. So again, filler to that little divot, the little dip right behind the chin is a good idea that sort of restores that jawline. And then, um, a little bit of filler in the very end and like the angle of the mandible. That's something that I'd done recently with Khanh. That was, that actually worked really well, worked out really well.

Monique Ramsey (05:47):
And is that that edge kind of, or closer to your ear? Is it that curve there?

Dr. Swistun (05:52):
Correct, correct. It's that basically that angle of the jaw right under your ear that, you know, if you can define that.

Monique Ramsey (05:59):
And is that done with threads or with filler or,

Dr. Swistun (06:01):
I did it with filler, but it can be done in a couple of different ways. Um, I did not do threads yet, um, <laugh>, but I think the threads are coming into play when you have that redundant extra skin starting to kind of come down and giving you a jowl. Uh, I think the threads are able to sort of red drape that prior to that. I think filler sometimes can be enough. I think I'm getting to the, to the thread part in the near future. <laugh>,

Monique Ramsey (06:25):
Are you?

Dr. Swistun (06:26):
As as I'm getting older, yeah.

Monique Ramsey (06:29):
And then Botox, tell me about, is Botox something that you partake in or take in or <laugh>?

Dr. Swistun (06:35):
Yeah. I mean there's, there's certain amounts of Botox that I occasion I occasionally can obtain. And uh, whenever I take it home immediately my wife claims it. So <laugh>, I, I don't get to do it a lot just because of that. She's like, oh, you don't need it. You're a guy, you look great. But in reality, yes, there's, that's sort of the easiest intervention really to, to take you back 10 years. It's uh, you know, Botox in all the right places really restores youth in the sense that it smooths out the skin. There's a lot of wrinkles that start to creep in. And as they form, if you get them early, your skin will remodel. You know, once the muscle underneath creating that wrinkle is paralyzed your skin, will remodel over that muscle and, and make it smooth again. And that permanent wrinkle can actually go away after about six weeks after Botox or so. And if you maintain that, then that, that wrinkle won't come back until you start animating again.

Monique Ramsey (07:25):
Yeah, I actually noticed that in my late twenties, early thirties, I was always frowning and washing my hair didn't matter, kind of, it was like you concentrate and you do that. And since I've used Botox, I have other wrinkles <laugh>, but that wrinkle, it really did sort of go away. So that's interesting that you said that.

Dr. Swistun (07:44):
Yeah. And I think there's some unspoken alternative sort of benefits to Botox. I mean I, I noticed that I frown a lot all the time and it just kind of gives me a headache or like at the end of the day. And then when I have Botox, I don't only have to even think about it, but I don't frown because I can't, cuz that muscle is paralyzed, but I tend to get less headaches. It's a real effect. And obviously, you know, tension component migraines are treated with Botox by a neurologist all the time, but you don't necessarily have to be diagnosed with attention component migraine to actually benefit from this to a certain extent as I found out.

Monique Ramsey (08:17):
So you also, I remember last year and we did a three-part series of podcast on it was called I'm a Plastic Surgeon, I have Halo laser Treatment and here's what happened. So we'll put that in the show notes. And have you done that before or was that your first time with the, the halo?

Dr. Swistun (08:34):
That was my first time actually. I had the chemical peel that I've done on myself, which was a very superficial treatment with an easy recovery. Um, again, just experimenting from <laugh> what I've, I've been able to obtain product-wise earlier. Yeah. But I think the halo was a, is a really good intervention. It's a deeper resurfacing modality than the, the peel that I did. And it definitely had a, a better effect and it just kind of forces your skin to regenerate itself on the surface. And uh, I think it's a really good way of just, uh, really, you know, getting back the glow from a couple years back. <laugh>.

Monique Ramsey (09:07):
Yeah. Yeah.

Dr. Swistun (09:08):
Very effective.

Monique Ramsey (09:09):
And is that something you would see yourself doing again, like on a schedule or do you

Dr. Swistun (09:14):
Absolutely. I think it should be something that is put on my schedule and we should make time for it. That that's, it's a challenge to do that. But yeah, it's interesting how we sort of ignore ourselves when we're in this, you know, because it's, it's almost sometimes we can say it's sort of immediately available to us so we kind of put it off and I end up like having, not having done anything for a very long time at this point. <laugh>.

Monique Ramsey (09:35):
And what was the first procedure you ever did? Was it Botox or a filler or was it something else?

Dr. Swistun (09:40):
Botox I think was the very first, yes.

Monique Ramsey (09:42):
Yeah. And I think that's sort of a easy entry for men. But let's talk about the things that may be more surgical in nature or, and you mentioned hair, so I know that we do P R P, which is platelet-rich plasma, which you can get from your, your own blood and take those regenerative cells to help hair. Can you talk a little bit about that?

Dr. Swistun (10:07):
Yeah, I think it works. Uh, I definitely have done that and there's pictures of before and after on my, one of my Instagram feeds from a long time ago were about, I wanna say about four or five years ago I noticed some pretty significant hair loss. And the way it presented is I got a sunburn one summer, but um, my, the top of my head was burned so much and I was like, what is going on? Why is that? And that's how discovered I lost hair <laugh> because that's the very first, like until then I didn't see the back of my hair, but then I felt it back there. It's like why is my that my scalp sunburn? So that was about five years ago and um, since then I've gotten on a medication called Propecia and I think that's sort of the best mainstay to at least maintain or maybe regrow some of the hair, but anything you can add to that really works well. And for me, P R P worked really, really well. I don't know if it works for everyone in general, when I do it for patients, I tell them that, uh, we should do three or four trials, you know, about six weeks apart. And if you notice a significant difference after three or four months, then you are a good candidate for that and you will respond and it'll work. But if you don't notice a big difference, then you know it may not be the, the best modality for you.

Monique Ramsey (11:13):
And that's just where you're injecting it in that area or the whole head or,

Dr. Swistun (11:18):
Yeah, correct. So P R P is basically derived from your own blood. So we draw blood from the patient and then we spin it in the centrifuge and then we extract a specific layer called the platelet rich plasma, which basically has platelets, which happen to have a lot of growth factors in them. And then we inject that specific layer at a higher concentration back underneath the scalp. And those growth factors from the platelet stimulate a lot of, uh, new tissue generation and uh, sort of wake up the cells that are falling asleep right there and specifically the hair cells. And again, it's made a big difference because I remember being unjust the medication by mouth alone with not a significant effect. But once I added the P R P to it, it made a big difference. You know, those two combined for me made a, made a big difference. I could almost get away with like n not having lost hair unless you look at it from the right angle, then you still see it. But <laugh>

Monique Ramsey (12:09):
Oh wow. That's, that's a pretty big deal. And it's like an office visit, right? Like you can go out to dinner and there's no, is there any short-term effects that like for caring for your hair?

Dr. Swistun (12:19):
No, I mean the procedure itself is fairly straightforward. It takes about an hour and part of it is drying your blood, which is pretty quick. And then you have to wait for the processing until it's ready to be injected. And then we just injected into the scalp. Some people tolerated better than others. There's lots of different modalities that we can do to make patients comfortable. There is nerve blocks and uh, ice and numbing cream and, and a combination of all those things that we can do in advance so that the injection is, is pretty well tolerated. I've sort of gotten used to it, so I don't mind, um, Dr. Salazar did like the last two or three of mine and we just kind of just went right ahead and did it <laugh>.

Monique Ramsey (12:55):
And how often are you keeping up with that?

Dr. Swistun (12:58):
Um, I should do it every three to six months. I think it's been at least that long at this point <laugh>. So I gotta put myself on the schedule again.

Monique Ramsey (13:04):
Again, it's putting yourself on the schedule, but I think that makes a lot of sense for men to actually think about this stuff cuz time flies and all of a sudden it's a year and you're like, wait, how did that happen? Where if you actually just put a reminder in your calendar four months after the last one or six or whatever your intervention is, whether it's Botox or, or whether it's P R P or whatever you're looking at Halo every year or two mm-hmm <affirmative>, you know, just, just put it in your calendar because then you'll pay attention to it and get it done. So moving into kind of the surgical things, what do you think as a percentage, and I know, I don't know if you can guess or not, but what percentage of men are doing cosmetic procedures overall do you think?

Dr. Swistun (13:50):
I really don't know how hard to say. I mean, I wanna say

Monique Ramsey (13:53):
I feel like it used to be about 15% and that, but that was a long time ago and it's much bigger now, that there's non-surgical things and a lot of more surgical interventions. Like one of your big things is lipo sculpture and creating, you know, take away the dad bod because I think we moms, we, you know, we want our mommy makeovers after we have kids. And I'm not sure exactly how you guys have the dad bod when you don't have to carry the kids. It's just a cruel joke, right, <laugh>. Yeah.

Dr. Swistun (14:25):
Yeah.

Monique Ramsey (14:25):
But like what is going on? Is it a hormonal thing where guys just, or is it that the fat descending or moving or shifting?

Dr. Swistun (14:35):
I think it's just, um, slow down the metabolism. I mean, and especially for those um, men that had, you know, not really had a problem maintaining a, a reasonable physique with a specific regimen of exercise and diets, you know, they had put a reasonable effort amount, amount effort into it and it worked when they were in their twenties, thirties and maybe forties. But there's a sort of a point in time it's different for everyone, but there's a sort of point in time where metabolism slows down and then whatever you're doing that you're used to doing, if you do the same thing, it's just not gonna cut it anymore. Uh, you're going to gain a little bit of weight and it's usually in the places that you don't want it to be. And sometimes it's just a little but you know, it's just annoying because you're still working out, you're still eating right, but it's just doesn't go away. A lot of times the flanks and the, the lower belly is sort of the thing that collects like you lose your six pack definition, you kind of gain a little bit of weight for that. Targeting specific areas is, is key. And I think, you know, local liposuction is sort of the best answer for that. That's not something I have done yet, but I'm like looking into it right now because there's this one area where it's like 

Monique Ramsey (15:41):
For yourself?

Dr. Swistun (15:42):
Uh, yeah, it's just kind of on the back burner right now. But I used to be pretty athletic in high school I used to swim a lot and you know, maintain a reasonable regimen. And again, it's just if you keep doing the same thing, it's just not enough. And there's certain areas that creep in they just have zero control over unless you intervene on them directly. And I think the lower abdomen and the flanks is sort of one of those areas. Those are early on and eventually other areas as well. And it depends, you know, this is sort of an example for people who sort of maintain their weight but yeah, aging just not fair and uh, <laugh> you gain, you gain those areas anyway even if your weight is maintained.

Monique Ramsey (16:18):
Yeah, yeah. So sort of reversing that dad bod and you were talking about liposuction, so where do guys typically, at what areas are they concerned with that you work on?

Dr. Swistun (16:29):
So again, that would be the sort of the lower abdomen below the belly button tends to push out a little bit. And then the flanks just, uh, the side of the trunk that tends to gain a little bit of weight. So yeah, that would be the area I would target with liposuction. And then the other thing you could do is do some level of a little higher definition if we're already there. It's easy to contour certain lines into the abdomen. It tends to work really well on men. I know Dr. Salazar does a lot of high definition lipo. That is a very good example of that. But even not even without high definition, you can do like liposuction with some conservative lines sort of on the side of the abs and in the center I find that, uh, a big thing to have is like a midline. If you can have a midline shadow that tends to really sep look athletic even if you don't have like a six pack definition or anything like that. So it would simple liposuction that's fairly simple to do. We can just add a couple of strokes and just go above the belly button and just create a midline shadow and that really does wonders.

Monique Ramsey (17:28):
And how long would for a guy to be if they have that kind of liposuction, what's their downtime?

Dr. Swistun (17:36):
Depends on the extent, but usually about, uh, you know, at six to eight weeks out pretty much everybody's healed and back to their normal routines, I think you have to modify your activity and routine for about two to three weeks. Um, you have to wear a compression garment, ideally about three weeks, uh, 24 hours a day and then for another three weeks maybe when you're active. But that's about it. So

Monique Ramsey (17:56):
I guess it depends on what they do for work. Like you could be, if you had a desk job, could you be back to work in a week or five days or two weeks or?

Dr. Swistun (18:04):
Yeah, a week or two is, is reasonable. Depends on how active you are. And again, depends on the level of intervention.

Monique Ramsey (18:12):
So if we're taking fat out, and I know for women we've talked about this in the past, if you're removing fat from one place and putting it somewhere else, it seems like fat is like gold, right? So if we don't wanna waste it, where do guys typically maybe want fat to go or where do you recommend for them to use that fat?

Dr. Swistun (18:32):
Yeah, well it's always the areas that you wanna work out. So the simplest will be, you know, the pectoral muscle area. If we can take away some fat from underneath the pectorals, like from the abdomen and then and inject it into pectorals, then we're basically reversing that gravitational look that aged look and we're really building up the chest and, and slimming down the, the abdomen. So that's, that's the most obvious. But you can sort of use fat in, in many different places. You can augment, um, the deltoids, the upper arms. There are surgeons, I don't do this specifically, but there are surgeons who actually specialize in uh, augmenting certain specific muscles even. And then, uh, the face is always an option also instead of filler, if you're already undergone a liposuction and the fat is right there in a syringe, it's available for you. Yes, I agree. I wouldn't waste it cuz this is a precious resource on you will only have so much of it in your lifetime. You can use it for, uh, fat grafting to the face and, and put it in the same areas that we talked about for the filler.

Monique Ramsey (19:31):
Mm-hmm <affirmative>. And if you're putting the fat in somewhere, is that a result that will last quite a while?

Dr. Swistun (19:41):
It should. Yes. So the somewhat tricky part about fat grafting is it's a little bit unpredictable and we don't know in that we don't know how much of it will survive. Uh, um, some, some amount always survives so there's always improvement in the goals. But some people retain fat better than others. It depends on where we graft and uh, the quality of tissue that we graft into depends on the technique, which obviously we try to optimize. But in general, I would say 50% of the fat that is grafted will stay long term and the 50 of 50% of it will sort of, uh, not revascularize not not regain blood flow and uh, it'll basically melt away. Uh, but the fat that does revascularize you keep for, for the rest of your life.

Monique Ramsey (20:20):
So, and on the liposuction side, when you know people are, we talk about liposuction is permanent cuz those fat cells have you that you're extracting are gone, but what happens if you gain weight?

Dr. Swistun (20:35):
Hmm. Yeah. So, so excellent point. So think of it this way, to some extent this is true. Like you're, you're born with all the fat cells you're ever gonna have and they are simply distributed in a certain way in your body. And when you gain, each one of those fat cells gets bigger and when you lose weight, each one of the fat cells gets smaller. And so what we're doing with liposuction and fat grafting is we basically are changing the distribution of where they live inside of your body. So in general, when we liposuction, let's say the abdomen and the flanks, we are removing like 90% of the fat cells from those areas. And then when we fat graft somewhere, we are basically adding some fat cells to these other areas. So if you gain weight in the future, you will gain proportionately less in the area we that we liposuction and proportionately more in we in the areas that we grafted.

(21:23)
I think the trick is to really, you know, during the liposuction, and this is something I pay a lot of attention to, is really blending those areas out. I really don't like to draw a line and stop liposuctioning right where the line ends on the body because if that patient does gain weight, then you will see that line sort of become a very strong transition point. Uh, and that's when people say, uh, oh I'm, you know, can you look really lumpy or weird after liposuction? The answer is yes if you gain a lot of weight, if the liposuction wasn't blended into the surrounding areas. And I've seen that sometimes patients would come in and say like, I went somewhere and I just ask for my flanks to be liposuction and they marked me and they basically just took out a bunch of fat from this one specific area and then I gained weight and that area is thin but I'm kind of ballooning everywhere else and it just looks really, really awkward. So, so that blending out those edges is, is really key. And that goes for fat grafting as well as for the liposuction.

Monique Ramsey (22:16):
Yeah, I remember in the early, early days of the laser skin resurfacing when they had in the early nineties the CO2 laser and the doctors didn't know at the time they would do the face and like stop right along the jawline and then not feather it out into the neck and it was exactly what you're talking about cuz you could end up with this line of demarcation or something where it's like, oh that's really awkward and strange. So that makes it a lot of sense. But it takes longer I'm sure to kind of do that artistic blending. 

Dr. Swistun (22:48):
Yeah. Which is, which is why a lot of times I, you know, patients will ask for a specific area and I'll tell them about that and it's, you know, a lot of times my surgeries end up being like a 360 liposuction because you really can't just address one area without addressing the other and have a nicely contoured congruent result. It's not always the case, obviously it's not always necessary to do the entire trunk, but um, a lot of times it's a little bit more, you know, it, it goes a little bit beyond what they think is the problem. You do have to blend out a little bit further just to get that nice transition.

Monique Ramsey (23:21):
Now men and this, you know, back in the day in probably the nineties I guess was you were talking about the pectoalas muscles and area, you know, there were pec implants and calf implants. And tell me a little bit about kind of your philosophy on those kinds of implants. Do you use them and if you don't, why not? Or where's kind of the industry on those, on those implants?

Dr. Swistun (23:49):
I mean, I, I think they're still there. There's a lot of doctors that do put 'em in. I, I personally just think that they are a little bit of a, a risky thing. It is a foreign body that is inside that is prone to all kinds of complications. It'll encapsulate, it'll scar in, it can get infected, it might have to come out, it can cause systemic problems potentially as we're maybe trying to, you know, sometimes finding out. So because of all those things, you know, I, I think those are the sort of the reasons that I avoid avoid those. I think the uh, the fat grafting is a little bit safer in the sense that this is your own tissue and it will make a little bit of a difference. Um, maybe not as a specific difference as a, as a specific implant somewhere, but it will make a difference and it's, you're not, uh, fraught with the potential complications of having foreign body in that specific area, especially if it's an area that's moving a lot. I mean that, that's the other, one of the problems with implants and limbs is that they can migrate a little bit as you're moving as for the athletic patients specifically. And when it migrates out of place, it starts looking really awkward really fast because it's like, well that muscle doesn't belong there and <laugh>, you know, so.

Monique Ramsey (24:56):
And those kind of implants are more thick, right? They're not like a gel. Right. They're like, not plastic.

Dr. Swistun (25:03):
Yeah, they're almost like plastic, correct.

Monique Ramsey (25:05):
Yeah. Like a, in an eraser in terms of like it can be, it's bendable but not liquid.

Dr. Swistun (25:13):
They can be uncomfortable as well.

Monique Ramsey (25:15):
Yeah, I would think so personally, but, and I haven't seen a ton of them over the years and I figure that's the reason is that just sometimes you might want something and it's, there's a better way to get there or a safer way.

Dr. Swistun (25:28):
Yeah. Let's just say I've removed my fair share of, um, for complications and um, you know, there's patients that came in with from elsewhere and it's like, I don't like it, it's uncomfortable, it looks okay, but it's just, I feel it every time I move I, you know, this and that. And there there's many reasons that people are just uh, kind of up against it, um, after they tried it. And I think that may be the reason why they're not the first thing that we think of when we want to augment.

Monique Ramsey (25:53):
Now another area, the kind of the last area I think that we have to talk about, unless you think of something else, but I was thinking women and men alike, we all get, and I think men especially tend to get that heaviness around the neck and the jowls and we talked about some ways, is liposuction a good, I know they can do some cool sculpting there. Is liposuction something that you find does the trick to help that eliminate that heaviness?

Dr. Swistun (26:20):
Yeah, so every patient's different and we would have to examine them. Um, but yeah, definitely there are a lot of patients who are candidates for liposuction alone of that area. I just literally did it right before I came up here.

Monique Ramsey (26:30):
Oh really? <laugh>.

Dr. Swistun (26:31):
Yeah. But uh, it's a patient that doesn't have a lot of redundant skin. It's typically, uh, somebody that's a little bit younger, but they always had this, this extra volume that kind of never goes away. And if you feel that, and if the muscles are in good place and they're, if they're really high and that the excess is really just fat, that's a great candidate to go ahead and just liposuction that area and, and it can really help their jawline and help their profile.

Monique Ramsey (26:55):
Yeah, I remember a patient a long time ago did that and it was really pretty hereditary cuz they were young and like late twenties, maybe early thirties, but it was sort of a hereditary thing and they wanted it done before their wedding and I was like, genius <laugh>, you know, and it was not a really huge procedure. Is that something that's kind of a quick healing time procedure?

Dr. Swistun (27:18):
Yeah. And that's actually, you described the perfect candidate for that because this is a younger patient whose skin will retract really, really well, but they're just born with this. Yeah, the downtime is pretty minimal, especially if that's the only intervention. Um, you know, the incisions are not even incisions. I use a 14 gauge needle, which is basically a big needle to, to get access points and there's just three little holes that I poke through the skin underneath the chin and, and under both ears. And that's enough to get the cannula inside to do all the work. So when it heals, it's, it's almost like, you know, the equivalent of when you get your blood drawn through your arm, it's, it's basically scarless. Wow. So it's, it's pretty effective and yeah, we can get all that fat out and really contour that line and make a kind of a lifetime difference for that patient.

Monique Ramsey (28:02):
Right. It's, that's a huge, that's a huge thing and I think any of us who have extra skin and fat under that, that area is like what can we do to camouflage? So I think for our guys, I think that's a great one. Well, do you have any thoughts that we haven't crossed in terms of sort of some of the typical man procedures?

Dr. Swistun (28:24):
Not really. I think the only other one that we haven't talked about yet is of patients who have gained a lot of weight. Uh, you know, liposuction is never a weight loss procedure. So some of those patients who need bariatric surgery, I think, um, right now medications like Ozempic are getting a lot of interest. So I think we're gonna see more and more of patients who have been a little bit heavier and then who have lost a significant amount of weight. And those patients tend to need skin resection procedures. So like a tummy tuck, uh, you know, women get those all the time because they carry the pregnancy unfairly, but they, after a pregnancy, the skin grows in response to the volume of, of that pregnancy. And when the, the pregnancy goes away, the skin does not retract to the same extent. Sometimes it retracts pretty favorably, but sometimes it just kind of overhangs. And really the, the best way to treat it is, is remove the extra skin that has grown and that's what a tummy tuck is. Men who have gained a lot of weight and then lost it, present themselves in that similar light. And they also benefit from, you know, tummy tucks, sometimes arm skin removal procedures like arm lifts or thigh lifts, things like that. So all those, all those are also options for men as well.

Monique Ramsey (29:33):
That's good to know. And I just thought of this, and this isn't your specialty and I won't put you on the spot about it, but we need to do an episode. We do the P shot. So we, there's an O shot for women to help with orgasm. There's a P shot for men and we have that available in our med spa. So we're gonna do a separate episode about sort of sexual health type things, but if that peaks anybody's interest in the audience, <laugh>, we'll put the link in the website so you can read about it. But it's a no downtime sort of situation. And it also uses what we talked about earlier, the P R P, the platelet rich plasma. So thanks Dr. Swistun for coming on our dad's episode and being so honest about what you've done and, you know, sharing with all of us sort of what are the things that, you know, men can do to still feel really good. And even as you age, you can age in a way that you feel healthy and confident. So.

Dr. Swistun (30:30):
Yeah, I think that's the biggest underlying thing is that we don't have to sort of give into the aging process. There are things we can do to kind of maintain a certain age level, at least for a little bit <laugh>. 

Monique Ramsey (30:41):
Yeah, <laugh> 

Dr. Swistun (30:42):
A little bit longer.

Monique Ramsey (30:43):
Yeah, exactly. Well you're, you're doing whatever you're doing. It's working. Cuz I wouldn't have thought you were 47. So congratulations on that, <laugh>.  Keep it up. <laugh>. 

Dr. Swistun (30:51):
Thank you. 

Monique Ramsey (30:52):
We'll get you penciled in for your next treatment. 

Dr. Swistun (30:55):
Yes. Need that. Need that. 

Monique Ramsey (30:57):
Thanks everybody and happy Father's Day To all the dads out there.

Dr. Swistun (31:00):
Thanks so much.

Speaker 1 (31:07):
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 five 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 ljcsc. The La Jolla Cosmetic Podcast is a production of The Axis, t h e a x i s. io.