Monique Ramsey (00:02):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. Today I have a wonderful patient who's with us. She's going to talk about her experience with Dr. Hector Salazar, and her name is Danielle, and so welcome Danielle.

Danielle (00:19):
Good morning, Monique. Thanks for having me.

Monique Ramsey (00:21):
Good morning. So tell me a little bit about yourself and what you do and how you found Dr. Salazar.

Danielle (00:26):
So my name's Danielle. I'm 47 years old, and I am here from San Diego. I'm a native and I'm a trust attorney, so I'm a professional, and I found Dr. Salazar by searching online, actually. As somebody that is a professional, I really understand the importance of picking the right provider for whatever you're doing. So I started looking online and I came across the website for La Jolla Cosmetic Surgery. And in particular, as I was looking through the website, I was really attracted to just what I was seeing, and so I reached out and gave you guys a call.

Monique Ramsey (01:03):
Just that simple, huh?

Danielle (01:04):
Yeah, exactly.

Monique Ramsey (01:05):
Yeah. And so did you end up looking at all the different doctors or did you have a doctor in mind or were you kind of influenced by maybe the before and after pictures, or what was the thought process as you did that?

Danielle (01:21):
Well, I'll say that when I called, it wasn't the first office. I called another office that had done a previous procedure for me, and they were a bit wishy-washy on really wanting to see me because they said, oh, we're not really doing just plastics anymore. We do these other things. And I got this feeling that they didn't really want to see me. So when I called La Jolla Cosmetic, I explained what I was looking for and I said, look, the providers, once I explained to you what I'm looking for, I'm going to take your recommendation on who the right fit is within your office. That's when they had suggested Dr. Salazar, and that's when I started looking at his before and after pictures as well as the other colleagues in the office.

Monique Ramsey (02:06):
Okay. I love that. And it's a good way to go when you're not totally sure to ask for a recommendation based on the procedure because they all specialize in different things. I think they can do just about everything, but truly, even as professionals ourselves, we gravitate and enjoy certain things more than others, and so then we tend to be really good at them.

Danielle (02:31):
Exactly.

Monique Ramsey (02:32):
Yeah. So tell everybody about the procedure that you were looking for and why.

Danielle (02:36):
So I had silicone implants done about 12 or 13 years ago. At that time, those were a replacement of some old saline ones, and I'd also had a breast lift at that time,. About nine, 10 months ago, I had a mammogram, and when I had the mammogram, all of the pushing and pulling, I felt like displaced my implant. And so I started noticing that on the right side, it wasn't in the right place. So I started looking online, bad idea then you think all these bad things, but I determined that I probably needed a revision. And so that's what I reached out to the office for to see if the implants were in the wrong place, if it was time to update it. I really didn't know what the best route was. And so I scheduled that appointment to come in and get that looked at.

Monique Ramsey (03:33):
That's really interesting that you could feel it and then see it later. It's like, oh, but after 13 years, it's probably time like you said. So let's fast forward to that day of the consultation and tell me about that experience.

Danielle (03:51):
Well, I already felt comfortable just coming to the office. One of the things that I was really looking for when I was searching for a surgeon was their experience and their proximity to a hospital. You can look at so many before and after pictures, but everybody's different. And so I didn't want to just kind of grasp onto, oh, I like this person's pictures. I wanted to make sure that the person that I was going to be selecting was board certified, looking up the medical license to make sure it was good. And then I wanted somebody that really focused on this, safety was a big issue for me. And so the fact that the office was really here and attached to Scripps Hospital made me comfortable already going in. And when I came into the office, which was quite funny because I've been to this particular building many times over the last 30 years, and I never really noticed the office. And when I had the consultation scheduling, they said, oh yeah, it's right by the coffee cart. And I really had never even noticed it before. And then when I came in and I opened the door and it just felt so warm and welcoming and comfortable. It wasn't like the typical medical seats, it had lovely couches, and I just was greeted right away and I just felt like I was wanted to be here. It was a good feeling.

Monique Ramsey (05:16):
Well, that's nice. Yeah, it's kind of funny because when you open that door, which it's kind of recessed, so you don't notice it necessarily, and you open, it's like, oh, it's like a little wonderland in there. It's so pretty. I love it. I love our new decorating that we've done. And you're right, it's a very welcoming feeling and not the typical chairs lined up against a wall type of medical office, which we're better than all that.

Danielle (05:43):
Exactly.

Monique Ramsey (05:43):
Aesthetics are important to us, so you might worry about an office that isn't aesthetically pleasing, cuz that's their business. If you're trying to look for somebody who gets you and that you want to look better and have a beautiful self, you want beauty surrounding you, I think. It makes a big difference.

Danielle (06:06):
Yeah, that attention to detail really called out to me, cuz if they're going to make sure their waiting room looks good, what about the procedure that I'm here for? So that was really comforting.

Monique Ramsey (06:15):
That's nice.

Danielle (06:16):
And then I met Carmen and I met Dr. Salazar, and you could just see the passion that they had for giving somebody the best results, and it just really shone through. And it was really nice because I felt like they both really heard me and listened to me and what I was after. And they didn't also try and be like, oh, well, you need this too. And that too. I was a little worried that I would be told I needed other things, like, oh, well, we're in there, let's just do some lipo or whatever. And so I felt really comfortable because they were just listening to what I wanted.

Monique Ramsey (06:58):
So tell me what they recommended.

Danielle (07:01):
Dr. Salazar recommended a revision surgery where they take out the old implants and put in new ones, and also did a lift at the same time. The problem on the right side, my old implant had kind of fallen out of the pocket, so that nice crease that somebody has under their breast kind of was gone. And so he was going to do something with that. I forget the term that he used a medical term, but he explained it very well and basically was kind of redoing that crease for me, and then replacing the implants, and then tightening them all up for a nice new lift.

Monique Ramsey (07:46):
And did they do a capsulectomy, do you know?

Danielle (07:48):
Yes.

Monique Ramsey (07:48):
They take, okay. So they remove the old capsule, which is the tissue that your body builds around the implant. So it's kind of like this little coating in a way, but not like a skin, a little skin around the implant. So they take out the implant, they take out the capsule, and so he probably just did a pocket revision where he had to maybe tack you down. And then with the implants now, did you pick silicone again and did you pick the same size or did you end up changing the look at all?

Danielle (08:18):
I said that I really wanted to stay the same size, but if you wanted to go a little bigger to kind of fill that extra skin, that was fine. And so we did go a little bigger, like 492 was the old, and then 520 was the new.

Monique Ramsey (08:37):
Okay.

Danielle (08:38):
So slightly bigger. And the two sides were different. So one was 520 and one was 560, and he said that he chose different implant sizes to make me look even in the end.

Monique Ramsey (08:51):
Yeah, a lot of times we don't realize how asymmetrical we might be, and it's just normal. I don't know what the percentage is, how often women will end up with different size breast implants, but it's pretty frequent. And it's nice that it doesn't have to be like when you buy a bikini off the rack that it comes automatically with that you can mix and match. And so tell me about the day of surgery, how that felt, and then immediately after, how was the post-op? You've been through it before, so you kind of knew what to expect.

Danielle (09:29):
I did, but even though I'd been through it before, Carmen spent a lot of time before the surgery day, on the day that she did my labs and everything, just going through everything, and I felt really prepared. I'm like, I got a booklet and I'm somebody that goes into the hotel and I read all the books and go, okay, I got everything. I know what I need. And so that was really nice because I had this personalized book about what to expect, what was happening, what medications I needed, what things I should be prepared for just to be set up for success. So going into the very first day, I had my medications, I had everything. I wasn't too nervous, I was very nervous about the pain, and I was very nervous about the pain because the last time I had this done, I remember being in a lot of pain and it was really bad, and that was really my only concern. And when I shared that with him, he said, no, don't worry about it. We're going to make sure you have everything you need. So I felt comforted knowing that I pretty much had every possible medication for everything that I could need at home. So when I went home, I really was not ever in pain. I took pain medication for a couple days. I had surgery on a Monday, and by Wednesday afternoon I wasn't taking anything anymore. So I was pleasantly surprised at how good I felt.

Monique Ramsey (11:00):
That's so nice, especially when I think anything, whatever the topic is that is giving you kind of anxiety, whether it's pain, whether it's just going under anesthesia, maybe you've never experienced that before, whatever it is, it does kind of create that tension. But I think all that preparation that you're talking about ahead of time and that pre-op visit and that booklet, some people don't read the booklet at all, and other people, it's like, this is my Bible, this is my surgery Bible, and I'm reading every section ahead of time, and then I'm rereading it when I get to the point. And it's, we've been doing this, so I'm coming up on my 33rd year at La Jolla Cosmetic Surgery, and one of the first jobs they gave me to do was to take all the procedures and the doctors had written out the pre-op, the risks, the post-op as you're getting into healing with all of that for every procedure.

(12:03):
And I had to tipity type it into a word processor, and we created those booklets. And then it became its own software package that doctors use all around the country. But it really was so much of a leap in terms of before that it was like, here's your photocopy of the one pager of what you're to expect. And it's like you're not really prepared unless you have all of this, which medications not to be taken ahead of time and what you'll feel like emotionally, there's all that. There's one page that's the best page about what to expect. Yeah, it's got what you feel like 24 hours after. Why did I do this? And then, but all the emotional rollercoaster and what your body's doing physiologically, and really when can I shower? What did they say? What about the bandages? And it's all customized for you. So whichever procedures you're having, it just pulls it all together and it's super, super helpful and I'm glad you appreciated it because we worked hard. But it really is something that's kind of above and beyond that a lot of patients are like, wow, this is so helpful and it's nice for their caregivers too. So who took care of you after surgery?

Danielle (13:22):
My husband did, and he's very concerned, as any husband would be about when his wife is having something done. And so I made him come to the consultation and he came to every appointment because I was like, I don't want to hear you asking me questions and being concerned. You're going to come and you're going to ask him yourself, and then you're going to make sure that you're comfortable. He was treated very well. Every question he had was answered. He was never viewed as this annoying person that she kept bringing along. He was really part of the process. Again, all those little details, like the book makes me, made me comfortable going, okay, they know what they're doing because if they can get all these little pieces correct, the surgery is going to be no problem.

Monique Ramsey (14:10):
Yeah, I think having the person in your life who is, whether it's a spouse, whether it's significant other, whether it's your parent, your sister, whoever, getting them on board, there's kind of no better way than them seeing for themselves, hearing from themselves because it's almost like they're not going to believe you if you go home and tell 'em, he's really great. Well, they're going to be, they're protective. They're trying to protect you. And so I think it is really nice to have that person along to help validate the visit and do we feel good about and do I feel at home here and they're going to take care of me no matter what happens. And you can kind of tell when you go somewhere where you're like, I don't know if I'm vibing with this place. So did you end up seeing any other doctors?

Danielle (15:08):
I did not. I didn't feel the need to. I was comfortable coming to the consultation that as long as I continued to feel that way, I was going to go with this office. And then like I said, it brought my husband along, which made it really nice because when I came out of surgery, Dr. Salazar calls your caregiver to give them an update. And so it was a nice kind of warm call because they had already spoken before.

Monique Ramsey (15:33):
They knew each other. Well and Dr. Salazar is a super warm person, and I think Carmen is such a great nurse. She's been with our practice now 11 years, but she was with Dr. Smoot's practice before he moved in, joined us 11 years ago. So she's been a plastic surgery nurse for a long time. And having that experience I think is so nice to know even if you don't need it, but if you do need it and you have some weird question, it's not weird to them. You think it's weird. Now did because since you had a lift and you've had two breast surgeries before, did he end up using any internal support like the internal bra or mesh or anything like that?

Danielle (16:14):
I can't recall.

Monique Ramsey (16:15):
So probably not. Okay. Sometimes, so sometimes for those listening, sometimes depending on what they're dealing with, and especially I think the tissue, if your skin is really thin and the implants have dropped too much, they can use, there's some different support systems that are sort of a mesh that they can use almost as an internal bra or a sling. And so sometimes that's needed and sometimes it's not. And if it's not, that's great because it's less expensive. Those little things were expensive.

Danielle (16:51):
Of course.

Monique Ramsey (16:51):
Yeah. So how long ago was your surgery?

Danielle (16:55):
Six weeks today.

Monique Ramsey (16:56):
Oh, six weeks. Okay. So how are you feeling?

Danielle (17:00):
I feel great. I feel ready to do anything. I went to the gym this morning and my trainer says, oh no, you're not doing anything above your head until that doctor says okay. And I'm like, okay. So six weeks and I feel fully healed and ready to go tackle anything.

Monique Ramsey (17:17):
Well, good. That's so good. So in that first, let's say week after surgery, how were you feeling and was it hard to not do stuff?

Danielle (17:29):
I was feeling pretty good, and I feel like as women, we do so much already that I was like, oh, I can't do dishes. I can't do any laundry. So I really took it as a good two weeks off and I wasn't going to do anything, and I relaxed. So it was good, my whole family kind of that I was having this done. And so between my husband and my stepson, they took care of all those things and I just relaxed.

Monique Ramsey (17:56):
That's nice. That's nice that you took the opening to let yourself heal because I think you're right. We do tend to do so much, and especially if we start to feel good, then we think, oh, I'm good. I can do this or I can do that, and we kind of push it too much. And things aren't quite healed inside, even if we feel good, you really want to give everything time to mend and so that you don't have any issues going forward. So I'm glad that you were smart enough to listen to what they tell you and just enjoy.

Danielle (18:34):
Well, I'm a rule follower, and so I got this schedule and it was day one to two and three to five and what you could do, and I looked at that every day and I really followed the rules because these people know what they're doing. It's not like they just give you rules because they feel like it. They know. So if you're going to put your trust in somebody, you should follow their advice. So I did a good job in doing that, and I think that's what made me heal so well and be feeling as good as I am right now.

Monique Ramsey (19:04):
I'm a rule follower too, so I can totally get that. Unless it comes to speeding on the freeway, then I'm not so good at it. But I'm the same as you where it's just like, yeah, if they're telling me what to do, I'm going to do it because exactly why not. Did you have any surprises either the day of or during or after anything that you weren't expecting?

Danielle (19:28):
No, I don't think I did. Maybe the fact that I felt so good that night, I was really concerned that I would go home and the pain medication would wear off and I would be in agony or something, and I wasn't. So I was surprised at how I felt so good. That's really it.

Monique Ramsey (19:47):
I love that. I love that. And especially because that was your number one concern was pain. So what would you tell someone, Danielle, who's thinking about having a breast revision?

Danielle (19:58):
I would tell them to do your homework and talk to the staff, bring up those concerns, because if I didn't say, oh, I'm really concerned about pain, then they wouldn't have made me feel better. So I have absolutely no regrets. I am thrilled that I did it. I'm happy that I chose La Jolla Cosmetic because I felt like I just got all the support I need, so don't hesitate. It was a great decision.

Monique Ramsey (20:26):
Well, we're honored that you're telling your story to everybody. I think there are people out there who aren't sure, and especially if you've done the procedure somewhere else before, it's like you feel like, am I supposed to go there? And if you're not necessarily feeling it to go back then, and it is perfectly okay, nobody's, it's not like you're in an HMO and you have nowhere else to go.

Danielle (20:53):
Exactly.

Monique Ramsey (20:53):
And so it is sort of like you can treat it as a new procedure and do your homework all over again, because 13 years is a lot of time, and you want to be able to know going into it, and I'm glad you chose us, obviously, but having that, going through that process and allowing yourself to say, okay, it's all right. If I'm not feeling it over here, I want to make sure that wherever I go and however many consults it takes that I'm going to be feeling good about that decision because there's nothing worse than having those doubts. And if you're having doubts or red flags, pay attention to your gut.

(21:32):
There's even people who will come in, they'll meet with one of the surgeons, and if they just don't vibe together, they'll say, but I like this place. Who else could I talk to just for another second opinion? And we have patients do that a lot, and because we want you to connect, and I think it is, it's not just about the surgeon and their ability, all of them are so good or they wouldn't be with us, but it's also that connection it and feeling like you're on the same page and that you're being heard. So I'm glad that you found that with Dr. Salazar right away and that your husband felt good about it too. And again, thank you for coming on the show and sharing. Are there any last tips you want to tell?

Danielle (22:16):
One thing that comes to mind is I never felt pressure. I felt wanted. They would love to have me, and they would take as much time as I needed to ask questions, but it wasn't like, oh, do this, sign up today. I never felt that pressure, and I really appreciate that because a lot of times you go somewhere, whether it's just to the store to buy a shirt or to buy a car or whatever. And so I think a lot of people might be concerned about having a consult because they're going to get forced into something. And I never felt that I felt wanted and it was available, but never pressured.

Monique Ramsey (22:52):
I'm so glad you said that because it is true. And we've all been there. We've all been somewhere where, oh, today for you only we're going to give you this price. It's like, really to me, if I come back tomorrow, it's not. It's like we're not that dumb. And I think we really do try to be there for you and not bug you at the same time and not pressure you, but to let you know, please, we're here and we want to take care of you if you want us to.

Danielle (23:25):
And I had that the whole process, not just the consult. I knew anytime, even if I needed right now, to call and ask a question, that I would get an answer, even if it was on the weekend and I had had surgery and I had questions, you guys were there. So that was also throughout the whole process. So I enjoyed that.

Monique Ramsey (23:43):
Yeah, because heard people say, oh, he was great until he did my surgery, and then I never heard from him again. I only saw the nurse. And it's like certain times you will see the nurse, that's normal, but we never want you to feel like, oops, now he's off. He's not important to him anymore. And having that connection throughout is really important. And it is special because I've heard patients who've gone other places say that, and it's like, well, wait a minute. I'm paying all this money for not just a result, but for an experience. And that whole experience is part of it. Well, Danielle, thank you again. It was just wonderful to talk to you, and I appreciate bringing your experience as a professional to the consultation in terms of what you were looking for and how you went about doing your research. That's very cool.

Danielle (24:39):
Awesome. Well, thanks Monique.

Monique Ramsey (24:40):
Thank you. And for all of you listening, check the show notes for any links. We'll put in links on the galleries about Dr. Salazar the procedure because she had a couple different things and any other podcast that we might've talked about this topic before, we'll stick that in there as well. Again, thanks and we'll see you on the next show. Bye-Bye.

Announcer (25:04):
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.