The Cosmetic Procedures for Men That No One Will Notice (But Everyone Will See)

Monique Ramsey (00:04):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. So I want to discuss something today with Dr. Hector Salazar. He's one of our board certified plastic surgeons and he does a lot of specialty things for men. And so I wanted to talk about and sort of explore what those are. My first question is, are men quieter about their plastic surgery or do they want sort of more subtlety than maybe their women counterparts? And what do you think about that and what do you hear from them?

Dr. Salazar (00:35):
Good morning Monique. Thanks so much for the invitation. Originally you would say that nobody, it was the stigma about having something done to improve your look was like, it was so big. And in the 1960s, seventies, eighties, I would say mainly women were having plastic surgery and it was a taboo. It was back then they didn't want any of their friends or any other family to know that they had something done.

Monique Ramsey (01:02):
They went to Europe.

Dr. Salazar (01:04):
They .went to Europe exactly

Monique Ramsey (01:06):
For a few weeks on an art tour, and then magically came back and looked amazing.

Dr. Salazar (01:12):
That's totally right. And then little by little men started looking into it and seeing how of a great change some of these female patients were obtaining and they say, why not? Then men, little by little, have started to get more and more plastic surgery, and there's of course certain procedures that are more popular for man. But you are right to answer your question, I know there's a very long answer, but in reality, yes, I think men tend to be a little bit more quiet. Men just let's say just or more recently got on board with plastic surgery for improving their appearance. So for that reason, I think men, maybe they're a little behind. I mean, some women, they talk to their friends and they say, Hey, look, I got a breast augmentation or I got my eyelids done, and they're more open about it, but men still are a little bit in the closet for that.

Monique Ramsey (02:10):
And I think probably social media is a little bit part of that because they see it everywhere now. You see it more and there's guys having their Botox and getting their skincare regimens and it's like, it's okay to kind of embrace that, which I think is great. And so I first sort of want to talk about the face at first, and so women tend to have their hair in different ways. You can grow it, you can style it differently and you can hide scars if you're thinking about a facelift or some facial rejuvenation. But if it's a guy, maybe he is constrained if maybe he's bald or he's partially bald. And so what do you help men do a refresh without the telltale signs of that refresh or a facelift?

Dr. Salazar (02:59):
We know that we have all these different noninvasive or minimally invasive options. I mean, I really think that maybe all men, we all benefit from a brow lift, right? I mean, we all men benefit from a brow lift at a certain point in our lives, but for instance, the use of Botox actually has decreased the need for a brow lift in general. So then you have that option to lift up that eyebrow a little bit without looking surprised in a very natural way just with neurotoxin, just with Botox. But there's always the option of making a small tiny incision over here, hiding it within the hairline and doing a little brow lift right there. Just temporal, subcutaneous, you do not need to lift this inner part of your eyebrow and look like you're worried. The only thing you might need is to reposition your eyebrow a little bit laterally and with a small incision right here.

Monique Ramsey (03:52):
Your temples, if you're listening, not watching.

Dr. Salazar (03:55):
Exactly.

Monique Ramsey (03:56):
Yeah, you can watch us on Spotify, you can watch us on YouTube, but if you're listening, so he's sort of at the point, at the corner of your eyebrow, at the arch, sort of above that in that little section. So would you call that a temporal tuck?

Dr. Salazar (04:08):
I would say yes. Temporal, subcutaneous brow lift, that's good's a good deal. Of course, if the patient has some hair, you can hide that in the hairline. If you don't have hair, then I wouldn't recommend that operation. Another good refresher in the upper third of the face and that we remember plastic surgeons, it's not that we can do magic. If we are cutting out skin, an incision needs to be there. So we are good at hiding the incision. We're good at making that incision as thin as possible. There's no other specialist in the world of surgery that are committed to create the best incision possible, use the smallest, the thinnest threads that we can use. And one of the questions that we get all the time, and this especially from men, how many stitches did you put in?

Monique Ramsey (04:57):
Is it like a badge of honor thing, like I have 52 stitches.

Dr. Salazar (05:01):
Right? Right. It is like they're very interested and in reality the answer is too many because for a very small incision, especially plastic surgeons says, we want to give our patients the best possible scar. We're going to use deep sutures, intermediate sutures, superficial sutures, so three different levels of stitches to decrease the amount of tension on that final scar. And then we're going to be using very, very tiny sutures that are thinner than a hair, and we're going to bringing all those edges together. We lose count because we put too many in a very small space. So we're going to place a scar where you already have a line, and that is for instance, in what we call the super tarsal crease, like the crease that you have in your eyelid when you close your eyelid. Asian patients don't have a super tarsal crease, but the rest of the population there is a super tarsal crease.

(05:49):
And that is that line that it's in your eyelid pretty much around the middle or lower third depending, but we can use that line to make an incision, remove excess skin from your upper eyelid, sometimes tease out a little bit of herniated fat, and just with that, your upper eyelids, your eyes overall open up and you look more rested, you look refreshed. I mean, this is not an operation to change your overall look is just to refresh your eyes. And patients are very, very satisfied with that upper eyelid surgery, which is called blepharoplasty, upper blepharoplasty,

Monique Ramsey (06:27):
Something I see, and I'm sure it happens probably equally in men and women, but I tend to notice it in men, is they can get really heavy bags under their lower eyelids and sort of puffy, what is that? And can you kind of do that all at the same time?

Dr. Salazar (06:43):
Yeah, so that it's taken care of with a lower blepharoplasty, you're right. Basically what you have in your lower eyelid is you have skin, you have a muscle called the orbicularis oculi muscle. Then behind that muscle you have a white layer that's called a septum. And behind the septum,

Monique Ramsey (07:03):
I didn't know, our eyes have a septum?

Dr. Salazar (07:06):
Look at that. I mean, there is a white layer that divides the muscle from the fat.

Monique Ramsey (07:13):
Oh okay.

Dr. Salazar (07:13):
So there's fat behind that white layer. And what happens is with time, that white layer that actually provides some good tension and holds that fat back nicely, tends to get lax. And then that retro sectoral fat or behind the septum fat herniates a little bit or your white layer that should be holding it tightly, allows it to bulge a little bit more. It's not that you gain weight and you just gain fat right there.

Monique Ramsey (07:42):
All of a sudden there's fat there. Yeah, I've always wondered that. And some people, it's quite pronounced. It's really a lot. And so you can go in and sort of take out the fat or take out the skin or both.

Dr. Salazar (07:55):
Right. So again, if we smile really, really strongly, you can see that in your lower eyelids you start to have a crease. So right underneath your eyelashes, along that crease, we can make an incision and then that incision will allow us to gain access to that fat. Sometimes there's different techniques. What we could do is we can tease out a little bit of that fat. You have to be conservative. You're not going to be emptying completely the fat around your eye because you need that fat. So you can be conservative and tease out some of it. You can cauterize it and allow it to shrink a little bit. And you can also reposition that fat depending on the needs of the patient. But in reality, by making that incision, you gain access there. Now that you have decreased the volume, if you had extra skin, now you're going to have a little bit more extra skin and then you can cut that skin out, drape it, and then make some sutures there. And those incisions also heal really, really well because we place that incision along a line that you already have when you smile big time and you can see that line right there. So it hides pretty well.

Monique Ramsey (09:04):
Now for men who maybe can't or don't want, they may not want it, even if they have the hairline to have a facelift, if they don't want a facelift, what else can you do to sort of rejuvenate? I think all of us start to get a little extra around the neck, the chin, or I guess it's not your chin. It really is your neck and your jawline and how to kind of deal with making that a little better without having the full facelift scars.

Dr. Salazar (09:33):
You hit the nail right on the head. This is a classic request from male patients. They come in, you can call it that they have a shorter time for recovery or that they need a quicker procedure, less invasive procedure, or that they don't want the stigma about a facelift that could be also real. They verbalize all these different requests, but what they're asking for sometimes is Why don't I want to get rid of this? And then they hold the skin on their neck. And I know that we talked about in a previous podcast about Turkey gobbler deformity, and that's how it's technically called. So it's that extra skin that actually goes from your chin to your neck and that it starts hanging and they just want that removed. They don't want anything else done. They don't want to change. Sometimes, I mean, you've heard it from friends, family, or maybe even you've thought about it, that man, sometimes they look more attractive with white hair or men sometimes look more attractive with some wrinkles. I mean, showing some experience. So some gentlemen come in saying, you know what, yes, I do have a deep cheek crease here. I don't want to address that. I don't want to anything else change, just get rid of this.

(10:45):
So I think that there's a great operation, the T-Z Plasty, and I know that it's not many plastic surgeons perform that surgery. We're fortunate enough that we learned from the source, we learned that technique from where it was developed. It was developed in the late 1960s, early 1970s. And that is making an incision directly over that area. So you make an incision underneath the chin and from the chin down to the atoms apple, and you remove the skin and that incision heals so well. And it's the most powerful operation that exists to address that extra skin. Why? Because you're going directly to the source. You're just wedging that out, and then you're going to close it in a very nice way for there's going to be a scar, but we're going to make a scar that fuses well with your creases and natural lines that we have, and also we're going to make it as thin as we can, and we're going to hide it from the perspective of a person during a social conversation. For instance, right now you and I are talking and for our audience that actually can see us, you're not seeing anything from my chin to my Adam's apple, and we are having a regular, normal conversation. You don't think that we're awkward.

Monique Ramsey (11:59):
Right. Exactly.

Dr. Salazar (12:00):
And you can't see that part. But when I turn to my side, you're going to see that the wind blows really nicely underneath my chin because

Monique Ramsey (12:10):
There's no resistance.

Dr. Salazar (12:10):
No tissue there, no resistance. So yeah, that's a great tool.

Monique Ramsey (12:16):
Now you mentioned not a lot of doctors do or plastic surgeons do this procedure or anybody. And why is it such a challenging procedure that maybe other doctors don't want to tackle?

Dr. Salazar (12:30):
When you go directly to the problem, you have a lot of power. So we are working not from a distance, we're not working from the distance. I mean, you're not addressing the neck from where the ear is and trying to pull from a distance. You're just going just right there directly. So it's very powerful when you excise that skin, you generate a significant defect in the neck, meaning it's a big incision that you end up making because you're addressing a big problem. So to close that incision, you need to do tricks that we know in plastic surgery, but that sometimes it's a little nerve wracking for some plastic surgeons.

Monique Ramsey (13:10):
So a little magic, even though you say you don't do magic, a little special. And what is that? Is it just because there's so much skin to remove that then closing it is sort of

Dr. Salazar (13:23):
Closing it, you're going to have a lot of tension. And remember, tension doesn't go well with good scarring, but tension is what we want because otherwise then we would just leave it alone and have that Turkey gobbler without any tension. So when we rear approximate it, we have to do a T-Z Plasty, which is making some special cuts and lifting the skin and rearranging some of that skin to break the level of tension and also to give the patients a deep point in their neck. And by doing that, that addresses not only the excess skin, but you know that with age we start to lose some of the transition between your mandible, your lower jaw and your neck, and then it starts all fusing. I mean, if you close your eyes and think about a 95-year-old grandpa, I mean basically from the cheek to the neck is all one structure, and you don't have that jaw line definition.

Monique Ramsey (14:22):
Which is so important I think, for all of us, but especially for guys, it's like that masculine having that chiseled face. The reason it's called a T-Z Plasty, is it because of the shape of the scar?

Dr. Salazar (14:35):
Correct. That's the shape of the scar. It's like a very elegant Roman T with a Z in between. And if patients have any questions of how it looks, they can go into our website and then they can take a look and they're going to have to zoom in to be able to see the scar. It's hard to see and fuses well with the natural lines of the patient's neck and submental below the jawline aspect. So that I think is another great thing that our male patients ask for. Sometimes we had, you know this Monique, and sharing this with our audience, we have patients coming in from Northern California, patients coming in from Arizona, patients coming in from even LA looking for this surgery because they say that, you know what? I've been to a different plastic surgeons. Nobody does this surgery. It's very few very, very few plastic surgeons that can do that.

(15:28):
And now I would say if, even if the scar is of a concern that we started doing nano fat injections and nano fat, what it is is processed fat that we steal from anywhere in your body could be the abdomen, could be the flanks, could be the inner thighs. It depends on where you have extra fat, but we just need about five, 10 ccs at the most. We process that fat. We allow it to go through several filters, we break that fat. And in reality, what we're interested is not in the fat per se, but what we're interested is in the healing factors that live around those fat cells. And then once we get those factors purified, what we're going to do is we inject those directly on the incision line and on the scar that actually has demonstrated that improves the aspect of the scar, of the final scar. So now we have another answer to it's not only we're going to be having a meticulous technique, we're going to be hiding the scar. Now we even have something that's very efficient in treating that scar and we can add that to their procedure.

Monique Ramsey (16:36):
I love that because anytime you can give a patient an extra chance for a better outcome, and especially around scarring because it's something you can control it as much as you can up until the time they go to the recovery room, and then it's like all bets are off for your advice. It's going to be the patient and how their body might heal. So having that little extra adding on the nano fat to give that scar the best chance to look great. I mean, why wouldn't you?

Dr. Salazar (17:06):
Exactly.

Monique Ramsey (17:07):
One other question about the T-Z Plasty before we move on. You trained where it was invented. Was it invented for a cosmetic reason or was it invented for some reconstructive reason?

Dr. Salazar (17:18):
No, it was invented for a cosmetic reason. And in reality, it's literally an answer to a problem that we were not addressing right on the spot that we were trying to address, or we try to address it as much as we can from a distance. But then as you move away from the source, then your power goes down. And if you want to increase power, what you need to do is increase the length of the incision, right? Because you're going in a divergent way, you're moving away from where the problem is. So your incision needs to grow, grow, grow, grow in order for you to have the pull that you need.

Monique Ramsey (17:59):
That's cool. Okay, so as we are sitting here talking, I'm going to call it T-Z and eyes for guys, because if you did the T-Z Plasty and their eyes

Dr. Salazar (18:09):
Absolutely,

Monique Ramsey (18:10):
And you're a guy, you're really getting a refresh in a way that's not going to be the same as the face and necklace, but it's also not going to have the complexity of that and the scarring of that. And I think I'm just as the lay person, I would think that's a big, that will make a big difference for guys out there.

Dr. Salazar (18:30):
Absolutely. I think T-Z, you said T-Z and eyes

Monique Ramsey (18:34):
And eyes for guys.

Dr. Salazar (18:35):
It's for guys, right? Exactly. Because you know what those two, so let's say we can combine upper eyelids plus minus lower eyelids depending on the need for that patient. And then you can add a T-Z Plasty. So you're addressing excess skin of the neck, excess skin of the upper eyelids, and patients that have a tired look and a lax look at the bottom. Tired look at the top and lax, look at the bottom of their face, they're going to have a huge improvement. But you know what? While still looking like themselves without changing the overall look of their face, nobody is going to say, who are you? What happened to you? The common, cuz that's what they don't want. That's what men, especially men, don't want to look surprised. They don't want to look like they put the face out of the window and the freeway. They just want to look fresher and with a very small subtle change. And those two areas, if we address them together, that gives a male patient a nice refreshing change.

Monique Ramsey (19:48):
What kind of healing time should they, let's say they do both. Is it a week? Is it, I'm sure it depends on what they do for a living and all that good stuff. But in general.

Dr. Salazar (19:59):
I would say instead of a trip to Europe, they're going to have a trip to Cabo, right? Because this a little, it doesn't need that much time. So it's a little bit of a closer trip, just a fishing trip to Cabo about 10 days to two weeks, and then they can go back to their duties. Here's a little bit of that, they're going to feel fine after two, three days after surgery. They'll feel fine. Nothing happened. Actually, we asked them not to exercise for about three weeks, but in two, three days they're going to feel fine. This is not a very painful surgery at the most, what patients refers a little bit tightness on the neck. I like that's part of the deal. That's why we were doing it. But other than that, it's not very painful. So they're not going to be taking narcotics for a week and then being in bed and crying in pain?

(20:47):
No, no. They're going to be active. They're going to be mobile active within the limits that we asked them, but they're going to feel fine in two, three days. So if whatever they do involves purely a administrative work, it requires their mental ability, their mind to be clear. Most likely after the weekend, the next week they can be on their computer, they can be working, reading, making decisions that are important. I wouldn't advise them to have meetings or to go on camera for at least the first 10 days to two weeks. And the reason for that is there's going to be some bruising the first week there's going to be some stitches. So we remove the sutures after a week and then we replace those where we remove the stitches, we put some tapes.

Monique Ramsey (21:36):
Camera off

Dr. Salazar (21:37):
Camera off, camera off, I would say camera off for two weeks. Some patients after 10 days, the bruising has resolved. The swelling has resolved. I still ask, especially for the T-Z Plasty, I asked them to wear something that's called the jaw bra because we want the jaw to be supported. So they wear the jaw bra, ask them 24/7 for the first two weeks after that they can take it off and then just wear it at nighttime. That means that on the third week they're going to be out and about without it. But I tell them that if it's has been 10 days and not a lot of bruising, and they have a one hour meeting just like the one you and I are having on camera, or they have to be on a board meeting or something, and again, as I was just telling you, if they just got the T-Z Plasty, they're not going to see an area of operation on camera. And if the eyes are already, there's no bruising, they can take off the jaw bra for about an hour and have that meeting and then put it back on.

Monique Ramsey (22:33):
And if they have, let's say, okay, after the Steri strips with the little tapes come out, so it stitches come out, then Steri strips after that, still have some redness I would assume. And if there's some redness, would you allow them to go to Sephora and get some concealer and have somebody kind of show them how to maybe conceal that redness that they have for a few months or a month?

Dr. Salazar (22:55):
Yes, totally easily. You can go to Sephora actually before surgery, get a good match color of a base or makeup for your skin and just have it available. And if you need to use it, fantastic. Rather than going after surgery, I think it's easier to go before surgery, just get a good match. Just get a good match and then have it available. And then if you want to use it, use it. Some of them, they say, okay, that's a great idea. That's fantastic. Some of them say, who cares?

Monique Ramsey (23:19):
Right? And that's their prerogative. And I think that's the thing. Some guys want to own it and other guys are like, yeah, no, no, thank you. Just pretend that I was born this way.

Dr. Salazar (23:32):
Right? No, and some of them, because they also ask, what could I use as an excuse for that incision? And it's easy. I say, well, you had a little thyroid, they found a little mass that they got to remove and all good. And I'm back in that into action.

Monique Ramsey (23:47):
Perfect, perfect. Okay, moving down the body. I feel like a lot of guys are, maybe it's the spare tire, the dad bod or whatever you want to call it. They lose a little definition, they want some lipo, but you have a technique that is really great for men to add some definition back into maybe that muscle definition they had in their twenties. Now they're a little more squishy and soft and that's okay. So what is your solution to the midsection for men?

Dr. Salazar (24:19):
So for the trunk, for the upper chest and the abdomen, definitely high definition liposuction. It's a great answer. High definition liposuction, it does or it has two attributes that regular liposuction doesn't have. And we've been doing this technique for the last five years, you know that when we started implementing it and we have all of our male patients, they're so satisfied with those results and the results look so natural when they're done correctly. The two attributes, one is yes, it gives you back or if you've never had, it gives you some muscle definition. And we don't create out of our imagination that muscle definition. We use the natural landmarks that the patients have, and if they have a little bit of asymmetry with one muscle more prominent than the other, or the line goes out a little bit more of your six pack, we just reflect what you have. So it's not that we are designing super humans or we're just reflecting what your natural anatomy is. So muscle edging and two, a lot of retraction from the fascia. I want to talk a little bit more about that, Monique, and I know you might know, but I'm not sure, would you say that we should go deeper in explaining to our audience what the fascia is?

Monique Ramsey (25:45):
Yeah, let's do it.

Dr. Salazar (25:46):
Remember when we were talking about the lower eyelid and we were talking about that white layer, that with age actually relaxes and allows your fat, the fat that you already had inside to protrude to show that happens as well in the abdomen. So we tend to think that our muscles of our abdomen, of our abdominal wall is what keeps us tight and what keeps all the inner structures meaning the bowels, the liver, the stomach, the fat that we have inside, that there are muscles, the obliques, external obliques, internal obliques, transverses, rectus muscles, that's what keeps us together. And no, it's not the muscles, it's the white layer. Remember when you're cutting a steak, when you go through the muscle, it's very easy to go through the muscle because it's not strong, believe it or not. But then when you get to that rindy white part, then with the sharpest knife, you go like, oh, and you can't, because that is where the strength resides for all the structures to be kept together. That's the thing that HD lipo also helps with. It tightens the fascia so much between the skin and the fascia after they start retracting that you can see and you can see that Monique and your audience can go into the website and look at those pictures and you're going to see that those patients that undergo HD lipo, they look like they had a tummy tuck

(27:16):
Because it looks that we were putting some sutures, because that shrinkage of the fascia happens in a very strong way. So it corrects the problem of having that poochie belly without making a big incision like an abdominal plasty or a tummy tuck.

Monique Ramsey (27:35):
And where are your incisions for this?

Dr. Salazar (27:38):
They're very, very discreet. With HD lipo, what we address is we address the chest if the patient's interested. If not, then we're just going to go after abdomen, flanks, meaning the sides and the lower back. And we like to always address that in a 360 way. Because what you want is that 360 tightening of those muscles. Instead of just doing it at the front. Even if they come in looking for hd, but just make my front better. No, because we really, it can look.

Monique Ramsey (28:10):
Cuz then it would look weird, right? Because it would be like then you're soft right adjacent. So you want to have that same natural tightening,

Dr. Salazar (28:18):
Right? Natural tightening, and you want that belt of tightening. So you really get, if you kind of think about it that way, squeezed all the way around your waist. Our incisions go even if we're just only addressing the abdomen, but we hide them, remember? So we are going to hide them in the areola, even if we're going to be doing the abdomen, so in the areola, and then we go and we do it inside the belly button, not above the belly button. When patients get a laparoscopic procedure that they do it at the margin, at the belly button, no, we go inside so nobody can see.

Monique Ramsey (28:53):
Wow, that is tricky.

Dr. Salazar (28:53):
And then the day of surgery, we ask our patients to wear their underwear or their bathing suit or whatever they normally wearing. So then we mark that, and then the other two incisions that go in the lower back and the other two incisions that go in the lower abdomen, we can hide them below the level of the bikini in female patients or their underwear, boxer or boxers that they're wear. And they're going to be hiding because of the size, which is literally imagine the tip of your small fingernail, what they're going to look like when they heal. They're like two very small discreet straight lines that again, if God forbid someone asks, either they can say, mind your own business or they

Monique Ramsey (29:42):
I had a suspicious mole,

Dr. Salazar (29:45):
Or they can claim that they had a small laparoscopic procedure.

Monique Ramsey (29:49):
Those people are too nosy. But you never know.

Dr. Salazar (29:52):
You never know.

Monique Ramsey (29:53):
So you brought up something really good because in a little bit of research I did for this episode, I found that up to 65% of middle-aged or older men end up with extra breast tissue, and we call it gynecomastia, but you are talking about going in for the HD lipo and if you want to address the breast. So how often do you see men to help them just sort of debulk the breast?

Dr. Salazar (30:17):
Relatively speaking, I have a high percentage of male patients just because of the techniques that I have and that we offer to men. So very frequently, men come in and what you want to assess on their chest on their breast is how much of that tissue or bulk that they have is fat and how much is real tough breast tissue for our audience, most likely as civilians, we don't really know or have in our minds that men, we also have breast tissue, breast tissue as women just tissue that it's not fatty, but sometimes it's a little bit harder, a little bit lumpier that is

Monique Ramsey (31:01):
Denser or something, right?

Dr. Salazar (31:02):
Right. And that's literally breast tissue what you want to, and that's important. That's why a consultation in person and good assessment is crucial because you're going to determine how much of this is fat, how much of this is breast tissue, why? I mean, fat responds really well to liposuction. Breast tissue partially responds to liposuction. It depends and it depends on how hard it is. And so you can determine if what that patient would benefit from would be from liposuction. It could be regular liposuction, it could be high definition liposuction and demarcate that pectorals major muscle better. And sometimes even do some fat grafting, put a little bit of fat on the pec muscle so it looks a little bit bulkier, it looks a little stronger. The patient would benefit from scooping out the breast content that wouldn't respond well to liposuction. So that's very important to differentiate between the two. And sometimes what we recommend to patients that are in a gray zone area is why don't we go after some great liposuction, decrease as much as we can with it. Maybe that's it. Maybe you do not need anything else. Or maybe then we reduce the amount of gynecomastia and then you would benefit from a second procedure. But then instead of removing a big golf ball, you're just going to remove a little pea or a little, it will be a much, much smaller surgery and then that would allow you to look better.

Monique Ramsey (32:36):
They can have that at the same time as the HD lipo, or by itself, it's standalone or can be combined?

Dr. Salazar (32:43):
Standalone, and the only thing that I would not recommend combining would be HD liposuction with the scooping out at the same time because that's too much for the tissue. Remember that we are working with human tissue, we're not working with metal wood or, I mean, things need to heal. And that's something that I always share with my patients that, and that even goes for how much, I mean the amount of surgery, I mean when we take our car for service at the dealership, we say like, oh, and by the way, change this and do that and do this, but that's going to take a couple of weeks. But yeah, keep the card Just do as much as you can and then I'll come and pick it up. You're working with human tissue, so you've got to pick your battles and your tissue needs to heal. It is a process. And patients especially that was undergoing HD liposuction, they look at the pictures. I have several patients throughout their journey for them to see and understand how they're going to be healing. And they realize that yes, this is going to be a process. This is going to be,

Monique Ramsey (33:44):
It's not an overnight quick fix.

Dr. Salazar (33:45):
It's not an overnight quick fix. And in our world, that's what we're looking for, like immediate satisfaction, overnight results. But with this, I mean, I tend to tell patients you're going to feel fine two, three days after surgery. You're not going to be able to exercise for about two weeks. You're going to have to wear compression for about six weeks. If they're doing high definition liposuction, they must get four lymphatic massages, lymphatic drainage massage. They need to get four at least. And they're not going to be, speaking of going and having a trip to Cabo, they're not going to be ready after one month to go ahead and take off their shirt, their t-shirt with their buddies at the boat because they're going to be still bruised, things are going to be still swollen, things are going to go up and down. They can function in life perfectly well, but not without a T-shirt, without being questioned or asked by their buddies, Hey, what happened over there? So if they want to do that, I always tell them, three months for you to be able to take off your t-shirt, jump into a pool with a bunch of friends that most likely or a family because they're going to be asking you what happened. But after that, they're going to enjoy that result. So, so much.

Monique Ramsey (34:55):
Oh my gosh. And we'll put in the show notes. We have a lot of great pictures, we'll put a link to the gallery. We also have done other podcasts about it, some on demand webinars that you can take a look. It's a great procedure. And the last two things I think we want to address for men that really you're kind of the go-to guy for the guys is hair. So you do, and we just recently did a podcast about it, so I'll put that link in so we won't go into detail there. But hair transplants.

Dr. Salazar (35:28):
Right. No, just to touch on hair, I mean I think I would say that we can break it down into I would say minimally invasive and noninvasive. So remember noninvasive, we have a holistic approach to hair restoration. We have a great line of products for our patients to starting anywhere from vitamins to topicals to, and again, we already had done this in a podcast, but for them to know that it's not that you come here and you go like, oh, let me give you a transplant and that's it. We address and assess what's better for them. Imagine someone that gets hair restoration, someone that gets upper eyelid surgery, someone that gets a T-Z Plasty, imagine the level of rejuvenation that you get.

Monique Ramsey (36:09):
Huge.

Dr. Salazar (36:09):
And then later you come from HD of your abdomen, it would be abdomen, flanks, lower back, so well got better shape. You truly took the time machine and traveled back 20 years.

Monique Ramsey (36:24):
Well, and I think it's a really nice thing when you can do these things that are long lasting. I mean really, essentially permanent.

Dr. Salazar (36:31):
Totally long lasting, permanent.

Monique Ramsey (36:32):
Right? Be able to, I mean, we're all living longer, let's face it.

Dr. Salazar (36:35):
Exactly.

Monique Ramsey (36:36):
If you do this earlier, you're going to enjoy it for longer. And like you say, you're freezing the clock or turning back the clock and you're just going to enjoy it, I think what is your advice to guys who just might be holding back? They have got those concerns about their appearance better might be holding back from seeking help.

Dr. Salazar (36:55):
There's no better advice that you can get than the one you're going to get for these problems that the one you're going to obtain from a board certified plastic surgeon. Classic thing is they'll ask their friends. They'll ask either someone that had something done or they'll talk to their wives or they'll talk to another friend that had something done. And maybe they're going to either have a little bit of a misconception or they're not going to get the very precise answer. We give away one free consultation for our patients that are interested in a procedure. So they have that great advantage. They can start the conversation on camera through Zoom or they can come in, dedicate 45 minutes to an hour of their lifetime and know exactly how they can benefit if they're good candidates, where the incisions are, look at pictures together with us. Because also, it's not the same if you go in online and it's great that we have a fantastic gallery and you can browse through those pictures, but God knows, I mean, I don't know if I'm a great candidate for that or not. And then we look at the next picture. Oh, that guy, look at that neck. Well, yeah, but he had a huge Turkey gobbler. Maybe in your case incision is going to be shorter and smaller. So for them to, and guess what? If they want to have their privacy respected and everything, they don't not need to inform anyone that they're coming and seeing us. Then they walk into our office and just remember, I mean we also, we abide our practice through HIPAA laws and they come in, they're just meeting the coordinator, the nurse and the doctor having a very confidential conversation, nothing else. Looking through pictures and then getting an idea from an economical standpoint if it's something that fits them well. And in terms of recovery, if it's something that fits them well. Then they leave, then they have that information, they can pull the trigger whenever they want.

Monique Ramsey (38:57):
I think that's great because then you know exactly what you're looking at. And I will say something about when you said looking at pictures. So some of our patients allow for to be on the internet. You can use me in social media, you can use me in the web gallery. But some patients say, yeah, I want you to use my pictures for patients in consultation in the office.

Dr. Salazar (39:18):
Exactly.

Monique Ramsey (39:19):
And so you have a lot more pictures to show. And I think that's something also, it's like that gallery is expanded when you have the consultation just because there's some patients who just didn't want that other level of being out there.

Dr. Salazar (39:34):
Exposure.

Monique Ramsey (39:34):
Yeah. And I think that's good because you can see more people who you go, oh, that kind of looks like me, or that's like my problem. And let's see how he healed and the difference at six months and how they look.

Dr. Salazar (39:48):
But yeah, that's why it's better, much better, give us a call, talk to a coordinator, establish contact, come in, visit us. Spend a nice hour. You'll see that the same way that patients are getting to know us over here on our podcast. We're as friendly as we are and we project exactly the same way during your consultation. It's a non-pressure environment because we will rather establish a nice relationship with a patient than try to sell surgery to someone that's not good. That has never been our seal at La Jolla Cosmetic.

Monique Ramsey (40:21):
So we'll put in the show notes, like I said, because we've got some really good episodes that take a deeper dive into some of these topics, especially hair transplant. We just did one about the myth busting of like, you're not going to look like some weird doll with goofy hair coming out. So we'll put those in the show notes. And for you guys out there, having that conversation is an easy step. And I think you made a really good point, Dr. Salazar, of when we do these podcasts, you're you, you're not putting on some special face when we talk in the morning about different topics. That's who you are. And I think patients then can say, oh yeah, he seems like a cool guy and I could talk to him about this, and this is normal. It's normal to feel maybe self-conscious about something and want to look into explore if it can get better and how it could get better and how long that would take. And so thank you so much for joining us today everybody out there listening. Thank you, Dr. Salazar. Such wise words. It was a really fun episode. Here's what I learned, one thing besides T-Z and eyes for guys, is if you want that HD lipo, come in soon for your consult because then you're going to enjoy it this summer, right?

Dr. Salazar (41:34):
Oh yeah. Absolutely.

Monique Ramsey (41:34):
Absolutely right. This is a good time of year, so all right, everybody. Well thanks and we'll see you on the next one. Bye.

Announcer (41:40):
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.