Monique Ramsey (00:02):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. So if you're out there listening and you're in your twenties, aging might seem like such a distant thing. Why do you have to even think about it, right? And Botox and fillers are there for little tweaks that you might want. But here at La Jolla Cosmetic, we see plenty of young women and men in their twenties who are thinking about specific procedures to enhance certain parts of themselves. And so Dr. Salazar is here with us today. Welcome, Dr. Salazar.

Dr. Salazar (00:37):
Thanks so much for this invitation, Monique. Always a pleasure.

Monique Ramsey (00:39):
So you see a lot of patients in their twenties who are looking to feel fabulous and kind of in your own skin and own yourself in your best self. So let's talk about some of the most popular procedures that people get in that decade of their twenties. So let's start with breast augmentation because I think that's probably the most common procedure that they get in their twenties.

Dr. Salazar (01:07):
Definitely I would say breast augmentation together with liposuction. I mean, not at the same surgery, but I mean along with liposuction, they're at the very top of the most common procedures performed in plastic surgery. And as you're inferring correctly, yes, breast augmentation. It's very, very popular in patients in their twenties.

Monique Ramsey (01:26):
Now, what are the benefits of getting it when you're in your twenties as opposed to when maybe you're older?

Dr. Salazar (01:32):
Well, the thing is that once you're in your, and I know we cannot generalize all these concepts to everybody, but tends to happen that in the early twenties or their twenties, patients haven't had kids yet. So what they tend to look is for a breast enhancement so many, or most of the time they have a nice shape of their breast, but they just lack of volume. Some other patients are going to want to have not only better volume, but also for the implant to provide some reshaping of their breast or have a more aesthetically pleasing shape, and the implant can help with that. So basically that's what we see with younger patients in their twenties and then patients that are maybe in the late twenties or thirties. Then we're talking about doing some, not only augmenting the volume, but also maybe some reshaping of the tissue that has undergone some metamorphosis in life.

Monique Ramsey (02:35):
Now, how much time should they be thinking about setting aside for recovery? Because in your twenties you might be still in college, you might be in your first career, and so everybody's kind of jostling for that In the time off, how much time do we really need?

Dr. Salazar (02:51):
Patients tend to feel well after a breast augmentation, I would say two, three days after, they can feel fine, most likely not taking any medication for pain after three, four days. So if we're talking about an intellectual job or something somewhere where you do not perform a lot of physical activity or as you were saying, you're going back to school. So I would say after a week you can function pretty well, but we don't let them exercise for three weeks. So those patients that require, I mean a lot of their body to perform some heavy weight lifting at work, they typically would need a couple of weeks, two weeks for them to be out of work and then return to work and ramp it up little by little.

Monique Ramsey (03:38):
Now, breast lifts and breast reductions, is that something that you ever see women in their twenties who might need a breast lift or the breast reduction where they're just born, God gave them a little too much in that department and they want to maybe trim it down a bit? What do you see there?

Dr. Salazar (04:01):
Right. That's the other side of the spectrum. So definitely there's women that have developed a significant amount of breast tissue and then it starts getting somewhat functional as well. I mean, it's not only about also the cosmetic part of having very large breasts or breasts that don't match the rest of your body shape and proportions, but also sometimes carrying that weight and having some shoulder pain, some back pain, some shoulder grooving right there. And it's definitely another thing that we do for patients in their twenties to do a breast reduction. It's a life-changing surgery. And I am pretty sure you know this, Monique, but probably our audience does not know that in plastic surgery, studies have shown that the happiest patients or the most highly satisfied patients among all plastic surgery patients are the patients that are undergo breast reduction.

Monique Ramsey (05:00):
Now, one thing also that people may not know is that, and it's probably a much smaller portion of the population, but there's sometimes tuberous breasts or breasts that are shaped, maybe not in an ideal way. Is that something that you can fix and how do you fix that?

Dr. Salazar (05:19):
Yes, correct. So that implies reshaping the breast to create a different look of the breast because as you're saying, there's sometimes a restricted or constricted breast or like a tube breast in which the breast, it's more coney, if you want to call it that way, or what patients sometimes call snoopy breasts. So then for those surgeries, yes, we also perform, it's a good surgery to undergo during your twenties or sometimes even before your twenties because patients have already developed their breast tissue and they don't like the shape.

Monique Ramsey (05:55):
And one last question before we move on down the body is I think people don't realize that our bodies are very asymmetrical. Our faces, one side might be flatter, one side might be more angled, your cheeks, your eyes, your body, your hips, your breasts. It's not normal for everything to be perfectly symmetrical, but when it comes to your breasts, sometimes one is maybe significantly larger than the other. And what do you do in that case, Dr. Salazar?

Dr. Salazar (06:28):
We could have a full podcast about symmetry of your breasts or symmetry of your body or symmetry of the face. One of the things that we do all day every day, Monique, as you know, is we are measuring breasts, right? Patients get surprised when they come to visit for their consultation and we are examining them and they get very, very surprised of how many different measurements we take because that helps us to plan our surgery. And they are surprised to find out that what even they thought they were fairly symmetric, they're very asymmetric. There was a plastic surgery study in which they were taking pictures of celebrities and they were putting two left sides or two right sides of the celebrity, and people were, in some cases were not even recognizing the celebrity just by using the two same sides, of course mirrored in a picture.

(07:22):
And because we are so used to looking at an asymmetric face, and we're used to looking at an asymmetric even image of ourselves in the mirror. So the face, the breast, the rest of the body, the feet, it's completely different. So there's certain cases that it's justifies to use a different implant, and most of the cases it doesn't call for the use of a different size implant. Now, to go a little bit deeper on that along, to answer your question, sometimes there are patients that have a true underdevelopment of one breast and then that also can justify having surgery in their twenties and to even sometimes they might need a couple of surgeries to obtain better symmetry. One surgery to actually, if the breast is so underdeveloped, you need to expand that breast tissue and then to put the implant in. So different things that we can talk about symmetry, but that's another reason why it's good to consider having surgery in your twenties, to try to obtain better symmetry.

Monique Ramsey (08:35):
Right. And I would think, I don't remember my twenties they are so far, I'm so past them, but I think when I was there, you bounce back quicker. It's like that kind of, you feel maybe yourself a little bit faster than you would in your forties or fifties. And the point that you can enjoy it longer is really, really nice. Okay, so moving down the body, let's talk about liposuction because you mentioned that that is also a really popular procedure for men and women in their twenties who are thinking about maybe they're just shaped like their mom and her mom before her. They have a certain propensity to have extra fat in the saddlebags or certain areas. Certain guys maybe have just weight in an area that they don't like. So what are the things you hear from people in their twenties?

Dr. Salazar (09:37):
To bring back the concept of you bounce back faster or you recover faster when you're younger in your twenties? So as a matter of fact, performing liposuction and patients in their twenties, it's something that we enjoy a lot. The tissue in a 20-year-old, 25-year-old, imagine our tissue or skin like a rubber band. So the rubber band is the better it's going to snap back and the more dramatic of a result the patient can get. So when patients come in in their twenties looking for liposuction, it can range from, I have this specific stubborn area to, if you want to talk about, for instance, men looking for surgery, they have a little bit of breast tissue gynecomastia that never resolved after their puberty. And when we perform liposuction to improve that, the tissue snaps back beautifully. When women come in in their twenties and they want to have more accentuated figure and they're in good shape, but they say, I want to have a little bit more of a narrower waist, or I want to transfer some of the fat that you remove to give me a better shape in my buttock, they have amazing results that we perform high definition liposuction, we perform high definition liposuction in male patients that are in their twenties and that they say, I'm in good shape, I exercise, but I want to have more muscle definition. They respond really, really, really well.

Monique Ramsey (11:16):
And that's that six pack or,

Dr. Salazar (11:18):
And that's the six pack.

Monique Ramsey (11:18):
I dunno how many packs there are. I don't have any packs. I'm not carrying, I have zero packs, but for the guys out there, so it's that kind of chiseled look in their, in their abdomen and that V that they're kind of trying to get towards

Dr. Salazar (11:38):
In the lower back.

Monique Ramsey (11:39):
Yeah. And so in the lipo world, you have a lot of tools to use, right? So there's 360 lipo, there's HD lipo, and how do you help the patient know what's the right approach for them?

Dr. Salazar (11:58):
The key there is spending time with the patient. The key there is listening to what they want to obtain. And then little by little as they're giving you the information of how's the improvement, which areas they want to improve, then to start giving them to different options, show them pictures and say, we could perform this not because we can do it, is that you have to do it. This is another option for you, this is another option for you. It depends on literally where they want to go as long as they're candidates. And that's why it's important to have that initial consultation. Once they have the different options, it's a matter of them and the power to the patient. And then they can say, well, I'm interested in having this, this, but don't give me the muscle definition. I do not need it. Okay, perfect, so then this is where we need to go. But as a matter of fact, I would say performing specifically talking about liposuction in this patient population age, I think it's a very good tool and they recover so beautifully and their tissue response so well that it's something that's important for them to consider.

Monique Ramsey (13:09):
I think also using that fat, if they're not born with quite the curves that they were looking for, maybe behind or the hips maybe that you can help use the fat that you're taking from one place and put it in another place.

Dr. Salazar (13:25):
Exactly. No, totally. Sometimes there is a certain stigma about surgery, or the classic thing is, let's say that this 20-year-old that has been exercising, that's living a good healthy life cannot, she can't get rid of that extra fat extra of her lateral thighs, let's say. And when they, of course, I mean they have family, they have friends, and then they go and then they tell them, you know what I mean, this stubborn fat right here. Then sometimes the answer they get back from their loved ones is like, ah, you don't need it. I mean, you can work it out. You just got to work harder. But it's an area that it's a very, very difficult area to lose some of that fat accumulation. And it's not that you've been eating many hamburgers, and that's the reason why the fat is accumulating there. It's just an area where we can go in and with a small intervention, we can improve that contour again, for patients to open their mind and just come talk to us and see if what we can do for them. It's something that they are interested in and they shouldn't feel guilty by considering that as an option. And to, of course, always get to listen to the advice of those who love you. But sometimes, of course, in an effort to protect them, it's like, no, no, no, you shouldn't do anything. You're fine like that. And we still love you with the big thighs, so it is fine.

Monique Ramsey (15:04):
Yeah, but you go try to find a pair of jeans that's going to fit. I mean, by the time get it over the thigh, then it's so big in the waist, and I've been there. So I think feeling that empowerment to, at the end of the day, we want the support of our friends and family, but we also have to give ourselves some love and some support. And sometimes just having a conversation with a board certified plastic surgeon such as yourself who does a lot of this, is that's the first step, is sort of getting that conversation going and seeing what the possibilities are.

Dr. Salazar (15:44):
Kudos to our, I would say to our entire organization to create, because we all, and I can tell you about this because we hear it all the time, that patients do not feel during that conversation that we are trying to sell them surgeries or sell them a result, or they do not feel pressured. And that I think to reassure our audience and patients or potential patients that are listening to this podcast that they come in and throughout the entire process, even from the first phone call, they will see and they will get that feeling that this is, if it's for you, it's for you. And if it's not for you, we'll rather be good friends, and then you know that you can count on us. But that's it. So that I think there's shouldn't be a barrier. Patient's just like, ah, and if I'm going to call, they're going to be calling me and calling me like 20 times after and, that's not, it doesn't exist.

Monique Ramsey (16:49):
Well, and I think that brings up something that I didn't think we would talk about today, but we'll just talk about the fact that sometimes liposuction is the right answer, and sometimes it might be CoolSculpting or some noninvasive thing that you have patients in our med spa. We'll go up there and maybe that's something that they can consider. I love the way that you and the med spa providers cross refer, because sometimes they might start in the med spa with CoolSculpting and it's not really going to help them. Liposuction is going to be a better answer or vice versa.

Dr. Salazar (17:25):
And that's the advantage when you have that holistic approach that you're not limited. If the only thing we would do, for instance, would be liposuction, and we're restricted to that. So we have anywhere from minimally invasive noninvasive procedures to a surgical procedure that is minimally invasive to a surgical procedure. It's maximally invasive, and that comes with scars and more of a recovery and everything. But I think having the ability to refer those patients to the right source, I think it's what gives them the power to the patient of they're going to tell me exactly what I need to have, and they're not going to try to sell me or oversell me a surgery. And that's important in your twenties, thirties, sixties, fifties.

Monique Ramsey (18:21):
Exactly. Well, and I think you, in your twenties, you've gone to the doctor, but you went to the pediatrician, but you're not the doctor all the time. So it's not like you've done this a bunch of times in your life. And so I think sometimes it can be just a little bit intimidating just to go to the doctor to say, Hey, can you help me? This is what's bothering me.

Dr. Salazar (18:42):
Absolutely.

Monique Ramsey (18:42):
And so I think all of you, you're just so approachable that patients feel that like, oh, this was comfortable, this wasn't scary. And we see that and we send a survey to all our patients after consultation just to see how did it go and to get good feedback and see if there's something we need to improve on. And one of the themes that you see through those post consult surveys is that they felt comfortable.

Dr. Salazar (19:13):
Absolutely.

Monique Ramsey (19:14):
Alright, now, so we went through the breasts and the body. Let's talk about the face. Just a couple things that maybe somebody in their twenties, what kinds of things are they looking to do?

Dr. Salazar (19:27):
Well, they want to maybe work a little bit on their facial features, of course. I mean, to find a patient with the need of a facelift or a need like a blepharoplasty, like eye surgery or reposition the eyebrows. I mean, that is really not common. And I would say it shouldn't even be done. But to have a facelift in your twenties, that would be a little bit or completely out of the norm. But patients want to change some of their facial features that they actually don't like or they think they can improve. For instance, something is that they feel that they have, let's say, much of a rounder face like, oh, I feel like I'm too cheeky. I have prominent cheeks. And that can be addressed, that you can perform a buccal fat pad removal. So there's a little fat pad that it's inside your cheeks.

(20:14):
And if you want to have more of a sharp, chiseled image of your face, of your cheeks, that's something that can be done. It's just a small incision inside the mouth. You go in, you take out in a very conservative way, just the excess amount of fat because we need fat in our faces. It's not that if you take out too much fat, then you skeletonize the face. And that's something that's not good for aesthetics either. And especially down the road, right when you're fifties, sixties, you need a little bit of fat, your face to look young, but totally doable to get a little bit of a better profile of your face by removing that fat. Other patients might go after trying to have a better defined jaw line. And then also that buccal fat pad removal can help with that. Doing some liposuction to the neck can also help with giving you a more defined mandibular angle.

(21:17):
Other patients might feel that their chin is not at the level, especially on a lateral view. And with all the pictures that we take today and with all social media and posts that we're doing, then you become more self-conscious about different facial features. So that's another surgery to perform a chin augmentation. And you make a small incision, it's either inside of the mouth or out here, and you augment the chin. That also is very common in the twenties and other type of surgeries, for instance, that I don't perform, but a rhinoplasty to do a no surgery. It's also very common in patient's twenties to try to improve the profile or how the tip is or how wide their nose is. It's another very common procedure. So I would say, well, there's one more otoplasty. Ear surgery, ear surgery. And that's common in patient's twenties for some reason.

(22:14):
When the ears are extremely prominent, and I say extremely prominent, those are taken care of usually around eight, nine years of age by their parents. But when they're not that prominent, but they're prominent, then those tend not to be fixed. And then when the patient, it's a little bit more self-conscious about their facial aesthetics and they're in their twenties, then they come in and say, I've always thought of me having this ears that are not like the rest. And I would like them to have them set back. And that's another common surgery in their twenties.

Monique Ramsey (22:56):
Yeah, that's such a great procedure. Does that have a big recovery or not really?

Dr. Salazar (23:03):
No, not really. It tends to be a little uncomfortable for the first week or so. We provide a good pain medication for the patients. It involves wearing a little bandana for a couple of weeks to help with keeping the result. But it's life changing. Patients immediately when they see their before and afters and they go like, my goodness, how was I circulating in the world like this?

Monique Ramsey (23:31):
Well, and I think if you're a woman, men, if you don't like your ears, you tend to wear your hair in a way that's going to always cover your ears, cover ears. And that's very restrictive. And it would be, I would think, very freeing. Be able to go, oh, I can wear a ponytail. I can pull my hair back. I could get a haircut and do some things that maybe they were too self-conscious to do prior to having the surgery.

Dr. Salazar (23:58):
And that's exactly why they say, now I wear my hair the way I want it. And before I always had to be covering my ears.

Monique Ramsey (24:05):
Which it's more fun to have some style with

Dr. Salazar (24:11):
Be able to play. Yeah, be able to play with it.

Monique Ramsey (24:12):
Exactly. Exactly. So everybody, thank you for listening. I mean, we covered so many things, Dr. Salazar, but there are a lot of things that people in their twenties might be thinking about. And so we're going to put information in the show notes with links to our gallery, links to some of the procedures we talked about today. And there's also other podcasts. We've got over three years of podcasts now. So we have one that's a great one that you did where we talk about male breast reduction or gynecomastia surgery. And we talk about some of these things, the hd, lipo, different liposuction and body contouring. We have some longer episodes that really go into detail. So we'll put those in the show notes as well. And thank you, Dr. Salazar, for sharing all these fun tips for people in their twenties.

Dr. Salazar (25:03):
Always a pleasure to chat with you about plastic surgery and invite, just want to tell and share with our patients that please, if, do you have a question about a certain body part, a certain facial feature, don't hesitate to have a consultation and chat about it with us. And then maybe there's a solution, maybe there's not, and maybe the solution is something very simple. Thank you so much.

Monique Ramsey (25:28):
Alright, well thanks everybody, and we'll see you on the next podcast. Bye.

Announcer (25:33):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla cosmetic is located just off the I-5 San Diego Freeway in the Ximed Building on the Scripps Memorial Hospital campus. To learn more, go to ljcsc.com or follow the team on Instagram @ljcsc. The La Jolla Cosmetic Podcast is a production of the Axis, theaxis.io.