Age Is Just a Number, But Timing Is Everything

Announcer (00:09):
Welcome to another episode of The La Jolla Cosmetic Podcast with your host, Monique Ramsey.

Monique Ramsey (00:19):
Is there a right age for plastic surgery? Today we're unpacking the idea that age is just a number and what that really means when it comes to cosmetic procedures. I'd like to welcome back to our studio, Dr. Luke Swistun. We've heard you say Dr. Swistun around the office, that age is just a number. What exactly do you mean by that?

Dr. Swistun (00:41):
Well, I guess, hi, thank you for having me on. So age is just a number. I say that all the time and I think it usually comes up in the context as it relates to patients needing a specific procedure or the patient's candidacy for plastic surgery because ultimately plastic surgery is elective surgery and we want to make sure that the patient is healthy enough to undergo a surgery that they don't necessarily have to have. Those are the two contexts that I look at it. Ultimately, patients come with all kinds of habits and routines and genetics, good and bad, all of which contribute to their basic baseline health and their appearance, and we can't control our genetics. That's the hand that God dealt us. So I'm not really going to focus on that, but I'd rather focus on the things that we can actually control. So several years ago I made this Instagram post, which is still on my feed somewhere.

(01:31):
It's basically titled How to Delay Plastic Surgery, which is kind of funny coming from a surgeon. But I listed four things that I really think make a difference as far as aging with regards to health, but also with regards to appearance. And one is nicotine, which was a huge problem when I grew up in Poland. Everybody smoked back then. Right now smoking is not as much of an issue. There are some people that still smoke, but that's largely gone away. But nicotine is really horrible for us. It is a vasoconstrictor. Nicotine is one of the most addictive substances on earth and it constricts the micro vasculature, the microcirculation. So obviously it's bad for healing when that happens, but it's also bad for to have on board every day of your life because all the tissues that rely on blood supply to regenerate like your skin, your gut, everything else that just does not get good blood flow and it does not regenerate as well.

(02:22):
And that's where you get this premature aging. If anybody's smoking, the best thing you can do for yourself in life is just quit that as soon as you can because that'll buy you decades of happier life. The other thing I mentioned in that post is sunblock and just especially if we live in San Diego and Southern California, I would make sunblock some sort of SPF a routine in your life. The way you brush your teeth in the morning, the way you put on moisturizer, pick the moisturizer that has SPF 15 or 30 even if you're not planning to be outside, just because it's been well proven that sun exposure over time, over your lifetime really does, it contributes to just aging spots and worse quality of skin and so on and so forth. Exercise regularly, that sort of goes without saying. I think that's an understated modality.

(03:11):
We talk about it all the time and everybody's heard about it, but you're really taking it to heart. I think that makes a big difference. People who keep moving continue to move throughout their lives that tend to have a much better health level at any given age, and they frankly look better as well. And I guess the final one that I listed in that particular Instagram post is sleep, protecting your sleep. And that's a very difficult thing to do for as busy as we are because we always overplan and we have so many things to do in any given day that the sleep is always the easiest thing to cut away from in order to accomplish these things. And I think some of us have to just refocus and reprioritize because not getting enough sleep really does have a cognitive effect and an overall health effect on us.

Monique Ramsey (03:57):
Yeah, I think the, I'm Gen X, right? So Gen X is just like we were locked out of the house to go play as little kids and it was like come back at dinnertime. We were on our own a lot and it was sort of like this badge of honor in terms of how hard we work. And I stayed at the office this long and there's this generation of people, I only need five hours of sleep. And these things that when you think about it, it doesn't really make a lot of sense. I mean, sleep is going to help your body do what it needs to do to get you ready for the next day. And so that's a habit I think that people don't think about is sleep, and I love that and we're not going to find the fountain of youth, but these four things that you talk about really are sort of the secrets to delaying plastic surgery.

Dr. Swistun (04:49):
I really was just using them as a springboard for conversation. Sleep, just going back to that, that is a topic we can do in and of itself. My wife is a researcher in sleep, actually. She's a clinical psychologist and a sleep specialist, and she does a lot of research in sleep and that we can talk for an hour about the benefits of actually getting good quality sleep with regards to aging and cognition and basically enjoying your life much more down the line.

Monique Ramsey (05:12):
So those habits that you get ingrained into your routine, they're difficult to break if you have the bad habits and sometimes they're difficult to form when you want to have the good habits. So is it realistic to expect people to sort change their habits or how do you encourage them to do that when you see a patient who maybe needs to be gently curved over to this other side?

Dr. Swistun (05:39):
How do you change habits? Great question. People change habits all the time, but unfortunately a lot of people just need a major trigger to change their habits. I see this in patients who had a heart attack. I see patients who had a stroke or somebody who maybe lost a loved one and they really just kind of have something more to reflect, some profound change in their lives that really makes them rethink their lives. A lot of times those are the triggers. In fact, when we're in medical school, part of our teaching is if somebody actually has an event like that from a psychiatric standpoint, that is a good opportunity for you to actually intervene and say like, Hey, this really tells us you should stop smoking. And people do. That's the most powerful moment to intervene. Obviously those are very unfortunate moments. These are things that we don't want to be involved with.

(06:26):
And so how do you put that sort of focus on someone on any given day? It's very challenging, but ultimately it can be done. That's the bottom line is you don't have to wait for a heart attack to stop smoking. You can do it today, tomorrow. I mean, we talk about willpower. It's easier said than done, but it's as simple as that really. I think the barrier for some people is that they make it too complicated. They get into some specialized non-sustainable elimination diet or some sort of a fa exercise regimen or pick up some very expensive fitness classes or just set unrealistic goals, which are basically not sustainable in the long term. But the reality is the simplest things work the best. For instance, walking in and of itself is one of the most underrated exercises in the world or certainly in this country because nobody walks here, everybody drives. In every other country, most of Europe, people walk to school, people walk to get their groceries, people walk to the train station and they get a lot more walking, and the entire population is a lot leaner and a lot healthier, and they live longer, and there's data showing that. So let's say if you take up walking, that would change a lot in your basic health and maybe weight and things like that. How do you take up walking? Well, you could get do something as simple as buy a dog because if you love dogs, you buy a dog and then the dog will force you to walk twice a day every day. And there you go. You just started on your regimen that.

Monique Ramsey (07:59):
And that's fun. That's not even exercise. That's fun.

Dr. Swistun (08:02):
Right, exactly.

Monique Ramsey (08:02):
So I mean, I'm not a dog person, but if I had a little dog, that would be the thing that would be, I wouldn't see it as because I hate exercise, I wouldn't see it as exercise. I would see it as, well, it's a little bit of a chore because he's got to go do his thing. But it's also like you're enjoying time. And I bet the more you do it, the more you enjoy it.

Dr. Swistun (08:22):
Right. As it relates to aging, a lot of patients notice, myself included, age or time sort of accelerates as you age, as you get older. Why is that? Why is it when I was five years old, to wait until I was six took an eternity? Whereas if I'm 45 until when I hit 46, guess what? It happened. It was yesterday. It was, it just flew by. Why did that year fly by? And I think the answer, and this has actually been studied and it's one of my favorite fascinating topics, is that it's the new experiences that make us remember more, which makes us time slow down. So when you're five years old, everything is new to you. Between five and six, you went to a new school, you made a bunch of new friends, you discovered that you can draw and write and all these things.

(09:05):
So that's every single day something new. When you're 45, everything is the same. You get up in the morning, you brush your teeth, you go to work, you come back from work, you make dinner, you go to sleep, and then same thing over and over again. So if you can introduce a new variable into your life at age of 46, time will slow down. You will be enjoying that again. So think of what is a new variable. Let's say you pick up surfing and then be something you've never done before, but you thought about you get a pilot's license, do something crazy, something wild. You only live once, get a dog, you're going to walk every day. Things like that. That's how you pick up new habits and that's how you slow down time and that's how you live a longer and happier life that you're actually enjoying. That doesn't just fly by.

Monique Ramsey (09:49):
I love that. I love that advice. And I had heard a podcast and I don't remember who or when, but the nugget I took out of it, they were talking about time and how fast it goes, and they said even if you drive a different way home to work or way to work, just having a whole new route can be helpful in making time seem to draw out and expand. So people are thinking like what's the right age or age is just a number. If you go into maybe the younger patients and we hear a lot of younger patients say, oh, well, I'll wait to do that until after I have kids. Is that a good strategy or could that be delaying something that would benefit them now?

Dr. Swistun (10:33):
I think it's really patient dependent. There is certainly things that we would expect to happen. Let's say having kids, a pregnancy is a lot of stress on that, the patient's body and some patients do go through that really well. Typically the younger the patient is that goes through a pregnancy, the better they do, whereas getting their body back after a single pregnancy, once you have two or three pregnancies, once those pregnancies take place a little bit later in life, like in their late thirties or forties, that has a little bit more of a longer lasting effect on the body, which may be unfavorable. A big factor that I've noticed is patients who gain a lot of weight during their pregnancies tend to need a lot more work, so to speak, only because that extra weight tends to grow skin around that weight. And even if they lose that weight later on, that skin does not shrink back, and now we have to deal with extra skin and that requires additional procedures and things like that.

(11:28):
One way to look at it is would be to just wait until you're done with childbearing and things like that, before you attack all these things. I think a smart thing to consider is sort of think about it preemptively like, I am pregnant, I'm going through this. It's a new experience, but at the same time, how do I optimize my own health? How do I focus? And I think controlling your diet, even during those situations and staying healthy during that, maintaining your exercise regimen may be a huge challenge, but it's a really big payoff in the end.

Monique Ramsey (11:59):
I want to back up to something you said that made my head glitch when you said grow skin. So I assume that when you're pregnant, your skin stretches, but are you saying it actually can grow or is that the same thing?

Dr. Swistun (12:14):
It's not.

Monique Ramsey (12:14):
Do we make more skin cells?

Dr. Swistun (12:15):
And that's a very common misconception. Yeah, exactly. So we make more skin cells. That's great. Another way to put it, but yes, if you think about it, if you take a hundred pound person, and this is a hypothetical extreme, but if you take a hundred pound person and they gain 300, 200 pounds and they're now 300 pound person, you are going to have a lot more skin around that weight. And a lot of that is growth, not just stretching. For some patients who are unfortunately who have the unfortunate, poorer skin quality, sometimes when that skin grows and stretches at the same time due to rapid growth like a pregnancy where the abdomen grows at the very end of the pregnancy, typically the last couple of weeks they actually get stretch marks. Those are permanent. That is actually a skin that is stretched so quickly in a small amount of time in a small area that the skin, the collagen just could not replicate fast enough and they just split.

(13:08):
And those stretch marks are permanent. Really the only way to get rid of stretch marks is to cut them out. You can laser them and try to make 'em look a little bit more even, but that has minimal success. It does grow. And that's the thing is if you lose weight after pregnancy, the skin does not shrink back. And every mom who had one, two, maybe three kids will tell you that the skin around the abdomen is always just a little looser. No matter how well they take care of themselves, no matter how many sits they do, that skin will never feel quite the same because there is actually more skin there now than there used to be.

Monique Ramsey (13:41):
That's so interesting. When you said it, I was like, really? It grows, but we don't know. So that's really new negative information that I learned today, and maybe everybody else out in the audience too.

Dr. Swistun (13:53):
But it underlines the importance of maintaining weight because again, if a focal growth due into pregnancy is very expected, usually your abdomen obviously will grow, your breasts will grow to a certain extent as well because of the hormonal changes and with breastfeeding afterwards. But if on top of that growth do you then gain 30, 40, 50 pounds, then that makes a much bigger difference in the longterm than not gaining those extra 30, 30, 40, 50 pounds.

Monique Ramsey (14:19):
So how do you counsel maybe a younger patient who, let's take your lipo example of the flanks or banana rolls right at the bottom of the buttock and along the side of the thigh, or I don't know, just tummy or maybe they're back. Is that something that if they think, oh gosh, I should wait till after I have kids. Is there any reason for that or how do you help walk them through what the best time to do something?

Dr. Swistun (14:46):
Well, that sort of goes back to our genetics. I mean, there are some patients who are born with certain areas are very favorable and other areas that may not be so favorable but are correctable. So extra flank fat is one where some patients are born with just, it's kind of like a square look. I've always had more volume here. No matter what weight I am, that proportion is always a little bit off. I'm always disproportionately more full in my flanks or maybe I have saddlebags. That's a very common one as well. That is not going to change with pregnancy. It may increase or decrease with regards to its own volume as you gain or lose weight, but the proportionately, it'll always be there. So that is a very correctable issue that can be addressed at any time.

Monique Ramsey (15:30):
Well, and I think if it is a matter of proportions and you're trying to change that, if you're 25 years old waiting until you're 35 or 38 is one, you're not going to enjoy it as long, which that point enjoying the result and having the benefit of that result. But also if you're younger, wouldn't your skin maybe do better with the retraction that you were talking about?

Dr. Swistun (15:58):
Sure, yeah. To some extent, yes. I mean, there's definitely a higher collagen count in the skin and the younger patients, so it will do a little bit better.

Monique Ramsey (16:07):
Now, on the flip side, some older patients feel like, oh, maybe I missed my window. What do you say to maybe somebody in their sixties or seventies who feels like the window has closed for a particular procedure?

Dr. Swistun (16:22):
Well, we would discuss it, I guess. Obviously everybody's different, but you're talking about age, again, sixties or seventies. When I picture sixties or seventies, I can picture very different patients. I have lots of patients who are in their sixties or seventies who are very active, who are running every day, who are enjoying their lives, enjoying retirement, what have you, and they maybe have a problem area that it just really bothers them. A common phrase that I hear is like, this does not reflect how I feel on the inside. I'm younger, I'm more healthy, and I just don't have control over these jaws that are creeping in because I'm 70 or 60. Can we take care of this? Well, let's see. Are you a good candidate? Do you have any heart problems? No. I run every day. Do you have any diabetes? Are you on any medication? No, I'm fine. I'm healthy. Perfect, perfect candidate for surgery with a very correctable addressable concern that we can definitely improve on. But age is just a number. It's almost irrelevant, honestly, because here you are, you're 70, and if something bothers you and if it's safe to correct it, and if it is correctable, then yes, that's a good candidate for surgery.

Monique Ramsey (17:30):
Because even somebody, maybe they're late, I know you do a lot of explants, so a lot of women who maybe for whatever reason, don't want their implants anymore, and they've had 'em for a long time. They might be close to 80 and say, these aren't serving me right now, or maybe I'm having some that could be tied to that. And so a lot of people might think, oh, you can't be 78 in having surgery. Well, maybe you can be, to your point, if the person's healthy and it makes sense to do a surgery for them. It's a case by case basis obviously, but that it doesn't mean that just because you're a certain number, you can't explore, at least have a consultation about what are the possibilities.

Dr. Swistun (18:21):
Absolutely. I mean, some of my most grateful, I suppose, patients who explanted with me are in their seventies, and they were very surprised about how much better they felt afterwards. Implants are a little bit of their own sort of entity, but a lot of times patients get implants early on in life because of a certain look they're going for or a certain sort of level of confidence that they're having. And then over a decade, 2, 3, 4, maybe even that priority shifts to I just want to be comfortable and now I have a foreign object on my chest times too. That just sort of interferes with my comfort level. I can't sleep on my stomach. I can't hug my grandchildren because they sort of get in the way and I feel them every time I hug my grandchildren. I just want them out. And after we get them out, especially at that age of late sixties or seventies, which I do have a big handful of patients that have done that, it's like, oh my God, it's the best thing I've ever done. I mean, I'm so much more comfortable. I'm so much more just back to me again.

Monique Ramsey (19:22):
Yeah, so don't give up just because you're at a certain age. I think it's safe to, it's good to know because I think people don't realize maybe they think, oh, plastic surgery is for the younger crowd, and I'm not in the younger crowd anymore. But goes back to those habits you talked about because you have to obviously be healthy enough to undergo an elective procedure, but it's nice to know that just because you're over a certain threshold of age, that isn't necessarily a no.

Dr. Swistun (19:54):
The other caveat to having plastic surgery is our surgeries typically are not that invasive. I mean, I think the tummy tuck is sort of the most invasive procedure that we do as aesthetic plastic surgeons because it involves a muscle plication. But everything else, the facelift or any sort of breast surgery or brachioplasty or thigh lifts, those are all sort of surface surgeries, as in we are dealing with skin and fat underneath, so they're not very invasive. We're not inside the abdomen, we're not inside of the chest, we're not inside the skull. We are outside of all these things. So really the only question is can this patient tolerate the amount of time under anesthesia that it takes for us to complete this procedure? We're not stressing them physiologically. We're just need the time to do it while they're comfortable. And a lot of patients are very good candidates for that, and it's a very safe procedure to perform. Obviously, we do our due diligence in prescreening them and making sure that they're healthy and running the appropriate tests and maybe getting clearances from their primary providers whenever we necessary, but ultimately, there's plenty of very good candidates for this.

Monique Ramsey (21:01):
So how do you address fears about looking overdone? For an older patient who maybe has waited a long time, but now she's thinking about having some work done, but she doesn't want to look weird, unnatural, or done, how do you sort of help them address that?

Dr. Swistun (21:23):
I think you spend the time to read what they're looking for, and hopefully we have pictures that we can look at and reference. It's like, this is the work that I have done. And which one appeals to you? Those surgeons experience, and then really communication with the patient and being on the same page. This does relate back to breast surgery. They had some patients who were in their sixties, and whenever we talk about planting and doing a lift, most of them actually prefer a nice youthful contour because it's more comfortable. But I did have one patient who said, well, actually, I don't want a youthful contour breast. I don't want to look like I'm in my twenties or thirties, even though I realized it may be comfortable to have a smaller breast that's up here for my exercise, because I am a jogger now and I picked up exercise and yoga, and that would be ideal.

(22:05):
However, I do swim with other women in my age of my age, and we're at the YMCA. We change in front of each other when everybody else's breasts are a little bit lower and age appropriate. I don't want to be the one standing out with breasts, which are sort of too young for me, I suppose. So can you please make them a little bit more age appropriate? And then yes, absolutely. If we have that conversation and if we look at the goals and show the patient reference photos to what the result that they're looking for, then we can tailor it to that preference.

Monique Ramsey (22:45):
That story reminds me of a patient of Dr. Olesen's a long time ago, and she was so cute, and she's probably in her mid sixties and wanted her face done. And so he is talking to her about a very natural result and blah, blah. She goes, oh, no. I don't want a natural result. I want everybody to know I had this surgery. And she really did.

Dr. Swistun (23:13):
Exactly.

Monique Ramsey (23:13):
It was so funny in my 30 something years of being around plastic surgery, I can remember the one lady who said, no, no, no. I want everybody to know that I had my face done.

Dr. Swistun (23:25):
Absolutely.

Monique Ramsey (23:26):
Yeah. So you do have that sometimes.

Dr. Swistun (23:29):
I do. You have that a lot, and that's fine. And that's just a preference. And that comes, that'll come through communication with the patient to make sure exactly what their preferences are.

Monique Ramsey (23:40):
Now, do you have any, the things that you hear in the consultation room or over zoom, do they have any misconceptions about their age and plastic surgery? Do you hear different things that you think, oh, why are they thinking that way?

Dr. Swistun (23:56):
I suppose with regards to their health, there are some patients who come into your office and you ask them, do you have any medical problems? And they'll say no. And they're like, okay, well, you're on this blood pressure medication, that blood pressure medication. You're also on this cholesterol medication and you're on this diabetic medication. Oh, yeah, yeah. But everything is under control. Who is looking after you? Oh, I have a primary doctor, but I haven't seen him in 10 years. Okay, well, let's check and make sure that these medications are still at the appropriate doses and things like that. So again, that comes down to us doing our due diligence to make sure that the patient is actually a good candidate for the anesthesia and the surgery that they're asking for. I suppose that's something that comes up more often than not.

Monique Ramsey (24:42):
Now, do you think people ever use age as an excuse not to do something that they maybe really want when you hear people trying to talk themselves out of something?

Dr. Swistun (24:53):
Yeah, I think so. I probably don't see those patients because they're not in my office.

Monique Ramsey (24:58):
They're not coming in for the consult.

Dr. Swistun (25:00):
Correct. Yeah, I'm sure it happens. I can think of a few patients who were younger who came in with their parents and their parents were considering really just there for support, but then they sort of got engaged in the consult, and then they basically reflected and it's like, okay, well, I could do this too. And I was always thinking about it, but I thought I was too old. I suppose that has happened in the past. So I guess one way to find out is if you work here, if there's something that honestly is on the back of your mind every day, at least have a conversation about it. I mean, our consultations are complimentary for that reason. You can explore this potential and you don't have to move forward if you don't want to, but at least you're informed.

Monique Ramsey (25:45):
So do you feel like you have any stories of patients who maybe got their spark back after surgery, young or old?

Dr. Swistun (25:52):
I have those stories all the time as it relates to breast implant removal. There's a lot of patients who don't realize how much they're compensating for having foreign objects on their chest and maybe all of the consequences that they cause that have sort of crept in insidiously and slowly over the last two or three decades, and a lot of patients just attribute certain things to aging. It's like, oh, I always have shoulder, neck, and back problems, and I'm always kind of short of breath, and it's may be because I'm 55 or 75, and then we remove the implants and we take away maybe a burden of 550 ccs of volume on each side of our chest, which in and of itself will allow you to have a better posture without even trying and maybe remove some scar tissue because of aa contractured capsule that allows the movement of the muscles to kind of come back to normal and it's not restricted anymore. And maybe they had a shoulder injury, which is now able to heal because the muscle is no longer displaced by the implant. All these things are sometimes very much under appreciated until the patient gets the implants out and then they're like, I should have done this 20 years ago. I can't believe I waited this long, and I didn't know how much they were affecting me until they were out. So that's a whole other discussion we can have as it relates to breast implants removal, but absolutely, absolutely. There's a lot of patients who are surprised.

Monique Ramsey (27:18):
And we can put in the show notes some links to those episodes because we have patients talking about it. And we have, you and I have explored those topics as well specifically. But I think getting that spark back that's not age specific. It doesn't matter if you're 78 or you're 28, if you're removing that barrier of something that's bothering you all of a sudden, whether it's having your profile changed or you're having implants put in or taken out or your waist contoured after some 360 lipo. And we have patients who we have a podcast with your patient, Amy, and she was a gorgeous, beautiful woman and positive and upbeat and successful before and after, but she carried herself in a different way.

Dr. Swistun (28:16):
I mean, she was very diligent in hitting the gym and getting exercise every day, but there are certain things that exercise just couldn't fix, and we had to intervene very focally in order to shift some things around. But I think she was very happy with the outcome.

Monique Ramsey (28:31):
Tell me, are there any differences in results or recovery based on age, or do you find that to be more gene specific, it's her body and how she healed? Or is it a combination?

Dr. Swistun (28:48):
It's definitely a combination. And again, there are some patients who will make hypertrophic scars because of genetic predispositions or keloids on their scars. That's the simplest example. There are some patients who have some diseases that sort of make it more difficult to get a good result, skin laxity or endless down low syndrome is one of those. Those are just factors we can't really control. So we focus on the ones that we can, and then again, that's where age becomes a little bit less relevant and the more relevant is the patient in front of you and their height, their weight, their level of exercise, their tolerance. The common question we ask that, can you walk up a flight of stairs without getting short of breath? That's a very clear screening question for the level of cardiac, their heart function, and how healthy they are to tolerate a surgical intervention.

Monique Ramsey (29:40):
Yeah. Now, what advice would you give to somebody listening who's on the fence because of their age?

Dr. Swistun (29:47):
I think I would just advise them to have a conversation with us and see, I can speak for myself. I don't know if I'm speaking for every other plastic surgeon in the world, but I don't ever make this into a sales pitch. I mean, just because you're here for a facelift, I'm not going to say, yes, that's what you should have. I'm going to give you an honest opinion about what we can do, what we can't do, and if this is going to give you the result that you're looking for versus not, and also, is it safe for us to do this for you? So I think we should just have a conversation about it.

Monique Ramsey (30:19):
And what's the consultation like?

Dr. Swistun (30:21):
Again, we basically get the patient's full history and physical, as in do they have any medical problems? Had they had any surgeries before? Had they had any surgeries in the area that they're actually interested in having corrected? We look at their medications, their allergies. If necessary, we also reach out to their primary doctors to make sure that they're safe for surgery, and then do a full physical exam and make sure that we agree with what we see, and we agree with that. We can intervene in the way that the patient wants us to.

Monique Ramsey (30:59):
Alright.

Dr. Swistun (30:59):
And we give them options.

Monique Ramsey (31:01):
Options are good. And I think that's also something that people don't maybe necessarily realize until they come talk to you that there's more than one way to do something. And whether it's a staged approach surgery in multiple stages, depending on how big of, let's say they needed a whole body lift or after massive weight loss, or it's just having those conversations or, well, we could do this and it would accomplish this goal, and we could do that and we could do them both. And you don't know what you're looking at until you have that consultation.

Dr. Swistun (31:35):
A lot of times there are procedures that patients are not aware of that they basically find out from this conversation like, oh, wow, I didn't know I could do that. A common one is fat grafting, which is very effective. I have plenty of great results with fat grafting, but there are patients who complain about problem areas of fat in certain areas, but they don't really mention the flat spots in other areas that they would filled until I show 'em a picture of like, well, we can use the fat that you had over here and transfer it into here, and this is the result. And they're like, oh, wow. I did not know that that could be done. But yes, I would love that. That's a simple example, but that kind of comes across a lot of conversations. So again, the recommendation stands is just have a conversation about it.

Monique Ramsey (32:20):
Yeah. Well, this was fun to kind of explore what age means and what that number means or not in terms of how that relates to the procedures you might want. And so thank you Dr. Swistun for joining me today and exploring the age is just a number topic. Is there anything else that we need to cover?

Dr. Swistun (32:43):
Yeah. Bottom line is I've seen many patients who are physically fit and excellent candidates for surgery in their sixties and seventies. And conversely, many patients who are uncontrolled diabetic, obese smokers who are very poor candidates to go under anesthesia in their thirties or forties. I've also seen patients who need aggressive wrinkle and skincare early in life because of smoking and sun damage. And then others who religiously use sunblock and refrain from nicotine, which can delay a facelift until their sixties. So in other words, how patients take care of their bodies and their lifelong habits largely determine how young they look and how young they feel, and their age is just a number.

Announcer (33:25):
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.