PODCAST: No Surprises: The Cosmetic Consultation

For many people, the first experience in a cosmetic practice is the consultation appointment and the process is a mystery. Here at LJC, we want you to know exactly what to expect from beginning to end! Our lead patient coordinator Riana M. knows this process better than anyone, and she’s here to take us through every step and detail of the consultation journey.
Riana’s perspective on the consultation is informed by her own surgery story. It was her dream for almost 20 years to have her body on the outside match who she is on the inside. That dream turning into reality was life changing, and as a patient coordinator she has the empathy to relate to all patients and help them through difficult decisions to make their own dreams become real.

At LJC, we want you to have a relationship with us for many years to come, and you will find that whether by email, text message, phone, Zoom, or face to face our philosophy is to be helpful and educate first.



Speaker 1 (00:06):

You’re listening to the La Jolla Cosmetic Podcast with the LJC Chief Community Officer Monique Ramsey.

Monique Ramsey (00:15):

Welcome everyone. It’s Monique for the La Jolla Cosmetic Podcast, and we have a great episode for you today. Really we’re going to try to just walk you through the consultation process. You know for many people, the consultation is the first time they’ve ever been to a cosmetic practice and they don’t know what to expect and it’s different. It’s different than when you go to your regular doctor. And so often people are surprised when they come through our doors because it looks more like a hotel than a medical office, but we don’t want you to have too many surprises. We want nice surprises, but we want you to really know what to expect from the beginning to the end. And my guest today, she’s our lead patient coordinator. I want to welcome Riana. Can you tell us a little bit about yourself and your role here at La Jolla Cosmetic?

Riana (01:03):

Hi, good morning, Monique. Absolutely. My name is Riana. I am a patient care coordinator at LA Jolla Cosmetic, and I’ve been with the practice for five and a half years. And, what I do is guide the patient from beginning to end of the surgical process.

Monique Ramsey (01:23):

So if you’re considering surgery or any kind of cosmetic service, and you’ve reached that moment where you’re ready to reach out, what’s the very first step for our patients? You know, they might fill out a form on our website, on our contact us page, or you might call us, but what happens next, Riana? Once you submit that little text message or you submit that web inquiry form, what happens?

Riana (01:50):

So after you contact us, a patient care coordinator will be in contact with you and that’s me or one of my counterparts. And, we are going to gather some information so that we can give you all of the information required to make a decision on whether you’re interested in meeting with one of our surgeons.

Monique Ramsey (02:12):

And about how long does that take? So if it’s during business hours, about how fast could… You know, if you go on the website and you submit a form or if you text us or if you call us, about how long do they have to wait to hear back?

Riana (02:28):

Generally we like to answer an inquiry, if it’s a phone call, we hope to get to you right away so there’s no lapse from phone call to connecting with the patient coordinator. If you submit an inquiry via the internet, either text or email, our goal is to get to you by end of day that same day. And if it’s at night, then by 10:00 AM the next morning.

Monique Ramsey (02:55):

Okay. And, you know, I was hearing one of the girls saying, talking about getting back to people and she’s like, “I try to get back to everybody in 30 minutes.” Is that sort of a…Depending on the day, of course. Now if it’s after business hours, so you say by 10:00 AM, because I do see that, you know, people will message us in the middle of the night and I’m up in the middle of the night too. So I see these people like, oh, they’re a night owl like I am. But I think what’s great about texting or sending an email or whatever, you can get it off your plate and then somebody at the center will message you back during business hours.

Monique Ramsey (03:32):

So if people say, well, what’s the best way? Should I call? Should I email? Should I text? Really it’s whatever’s best for you. We try to meet you where you are. And I saw a review from a consultation and she said, “From the first contact after I emailed requesting a consultation, the communication from the staff was thorough and detailed. I didn’t even have to call. All my questions were answered through emails to meet my busy schedule needs.” There’s somebody who’s sort of like me. I don’t like the phone. I’d much rather text with somebody. And maybe she’s somebody who likes email. And so do you find that most patients you’ll sort of meet them where they are?

Riana (04:18):

Absolutely. When a patient texts, we ask them, do you have time for a phone call? If not, text is fine, because it does take a little bit longer to gather all of that information and to give via written word. A phone call is ideal from our standpoint, but as a patient calling in, I can understand where they are. So I put myself in their shoes and then I make accommodations accordingly.

Monique Ramsey (04:44):

Yeah. I think that’s nice. And whatever your preferred communication style is. And I have a lot of people come through our Facebook, come through Instagram. You know, we get direct messages there all the time too. All of us are keyed in to help answer questions wherever they come. So we’ve always had a complimentary consultation at the center, but that’s not really the norm. I don’t know if you could know what percentage of doctors out there charge for a consultation. Do you have any idea about that?

Riana (05:16):

I would say the vast majority of plastic surgeons do charge for a consultation because they want to make sure the patient is serious, I suppose, about moving forward with them.

Monique Ramsey (05:29):

So we don’t charge, but although we don’t charge a consultation fee, we sort of do ask our prospective patients before they schedule a consultation for a couple of things. We ask them, we want to make sure you’re ready. And so what are the key things you might talk about with a patient to make sure he or she is ready to go to the next step and meet with one of our surgeons?

Riana (05:55):

Well, Monique, some of the things that I would like to know from our patients is what exactly their areas of concern are. In an ideal world, how would they look, within reason? Right? We can’t all look like Barbie, unfortunately.

Monique Ramsey (06:09):

And maybe that’s a good thing.

Riana (06:12):

Yes. You know, what bothers them. And then if there are multiple things, also I would like to know what are their priorities as far as importance. If they can’t have all procedures done at one time necessarily, then we want to target that first area. I would like to know and ask about how many pregnancies they’ve had, what their height and weight is.

Monique Ramsey (06:38):

And why do you ask that?

Riana (06:39):

We want to know a patient’s BMI. We offer that complimentary consultation because we want to make sure that the patient is ready to move forward with surgery. And there are BMI restrictions.

Monique Ramsey (06:51):

There are certain health factors. So if their BMI is too high, it’s not safe for them to have surgery.

Riana (06:58):


Monique Ramsey (06:58):

So we’re trying to sort of get those questions answered ahead of time.

Riana (07:04):

Yeah. And we have anesthesiologists that are board certified at our center and they also have requirements beyond what the surgeon does. And because it is elective surgery, often patients don’t think about it this way. We want to make sure you’re in the safest state possible in order to have that surgery. We’re not talking about a pacemaker or something that’s life saving here. So the risk needs to be very low in order for you to have this elective surgery with us.

Monique Ramsey (07:35):

And you mention pregnancy. I think that’s something else is that, you know, there’s a lot of women out there who may be saying, okay, I’ve just had my last child. I’m ready for my mommy makeover, but maybe their last child was born three months ago and it really isn’t the right time to have that consultation yet because we’re not going to be able to do surgery on you. And so it’s better to wait. So these are the kinds of things that we’re thinking on, you know, some of the questions we might ask you as a patient, are you a candidate? You know, and that maybe has to do with health or maybe it has to do with no, you’re still breastfeeding and you’re not a candidate, or you have to get some cardiac clearance if you’re older or if you’re a diabetic. You know, there’s a lot of different things going on like you said, Riana.

Riana (08:21):

Absolutely. That triggered a thought with pregnancy. When I ask that question, I’ll also ask the ages of their children because I want to help a patient prepare for the recovery time. So if you’re having a tummy tuck and you can’t lift anything heavier than a milk carton for six weeks and you have a one-year-old, is that feasible? So those are all things that you have to take into consideration because you need to prepare. And those are things that people don’t know, it’s not common knowledge.

Monique Ramsey (08:52):

Right. So those are sort of the pre qualifiers maybe that we might talk about on the phone with you prior to scheduling the consultation with the doctor. Do you guys also go over price at all?

Riana (09:07):

Absolutely. We, I think, are one of the few practices in San Diego at least that advertise pricing online, but we also try to tailor that ballpark figure during our phone call or our interaction with you based upon what we think you’re going to need. That’s also why we ask the information that we ask is to get an idea. All of our coordinators have been trained by the surgeons to understand and be able to identify within a few areas what you’re going to need, what their potential recommended surgery will be. So we want to give you an accurate ballpark that you have a true understanding, the patient has a true understanding on what the financial cost is going to be for them.

Monique Ramsey (09:54):

Right. And I think so many practices are not transparent with their fees. Then how is a patient supposed to know what to expect? If it always says, “Oh, come in for a consultation and then we’ll tell you.” You know, that makes it really hard. And I remember a long time ago, we had a patient who came through and maybe we didn’t have as many questions that we asked ahead of time. But, you know, this person really thought liposuction was $1,500. They had no idea that they were looking at something closer to 10 or eight or whatever it was at the time. But they really, I mean, it was so far from reality and it sort of wasted their time and wasted the doctor’s time and they were disappointed.

Monique Ramsey (10:34):

You know, all of that I think can be mitigated, or I don’t know what the right word, by having this good pre-consultation phone call to be able to have you say, “Okay, well, Monique, if it’s a breast aug, here’s what you’re looking at. If it’s breast aug with a lift because you’ve had children, this is what you’re looking at. And then we can talk about financing or we can talk about some of the other things, because we want to be transparent with you because your time’s valuable.”

Riana (11:03):

Absolutely. And if you’re not ready for surgery for whatever reason, then when you do get ready, those procedures are potentially going to change. Your cost is going to change. The recovery could change. All of those things, there are so many little variables that we want to see you when you’re in that ideal state.

Monique Ramsey (11:23):

Right, right. Yeah, because, gosh, you know, if somebody said I want liposuction and they’re 30 pounds overweight, A, they might not be a candidate, but B, that would be a very different surgery than if they’re within 10 pounds of their goal weight or five pounds of their goal weight. It’s going to be an easy recovery. It’s going to take less time. The doctor’s not going to be in there as long so your operating room costs are less, your anesthesiologist costs are less. And so, you know, that makes a lot of sense to sort of we’re doing it really for you. And so that you get the best idea of what that process is going to be. And then let’s say if I don’t know which surgeon, you have five board certified plastic surgeons. And if I haven’t heard about one of them from a friend or if I just don’t know who to choose, is that something that a patient coordinator can help me with?

Riana (12:19):

In selecting a surgeon, patient care coordinators can help identify who we think would be a perfect fit. And those are some of the things when we ask you those questions. We get a feel for you and who you are, your personality, and who we might pair you with could be based upon… If it’s a breast augmentation, all of our doctors do a beautiful job on breast augmentation. So we can kind of tailor it to who we think is going to suit you, who is going to be a good fit for you and who you’re going to feel comfortable with.

Monique Ramsey (12:56):

Okay. And one of the things that I’ve always found really helpful is on our website, we have a really nice gallery, before and after gallery. And what’s great about it is not just that there’s lots of pictures, but you can sort by the procedure, you could sort by the doctors. So you could say, “I want to see all of Dr. Smoot’s facelifts, or I want to see all of Dr. Saltz’s tummy tucks. And then I want to see Dr. Smoot’s tummy tucks.” You can look at each individual variable and be able to kind of get a feel for their work, a feel for…you can see other body types that might be like yours or facial changes that you want to make on somebody else. And then also then we have a lot of reviews by doctors. So that kind of also is a good tool for you as a patient to sort of figure out who maybe you resonate with.

Monique Ramsey (13:53):

But of course, until you meet them in person, that’s hard to say. That, exactly, you don’t know until you’ve met them. Now, what if there’s a patient who let’s say she wants to have her eyes done and a breast lift and say she’s going to have her breast lift with Dr. Saltz, but Dr. Saltz doesn’t work above the neck. So then what, what happens? Do they have to have it in two separate settings or would they be able to sort of have everything done in one sitting with two different doctors?

Riana (14:25):

Absolutely. You can have a co-surgery or a double surgeon surgery. So having Dr. Saltz do your breast lift and then Dr. Smoot do your eyes at the same time. It saves on recovery. It saves on costs. So there’s lots of benefits to being able to do that.

Monique Ramsey (14:44):

Okay. It’s just that popped into my head.

Riana (14:47):

Yeah. That’s a good thought. So, patient coordinators want the patient, and the patient should feel as though we are there for you. We are there supporting you. So being honest with us. After that consultation, if you don’t click with the doctor, let us know because we’re here to help. We won’t be offended. We all want to support you in your journey surgically. And if there’s something that we can help to accomplish, if we can find a solution for you, whether that be meeting with another doctor or what have you, we want to be able to do that for you. And, I don’t know if all patients are 100% honest about how they feel because maybe it’s kind of uncomfortable. You’re thinking, “How can I tell her that I don’t really like that doctor when she works with that doctor?” But it’s not like that. We are there to support the patient. That’s our goal and our role.

Monique Ramsey (15:42):

You’re sort of a patient advocate really. You’re there to, like, hand-hold and walk them through and make sure all their needs are met.

Riana (15:51):


Monique Ramsey (15:52):

And do you really stick with the patient the whole time? Like if you meet with them at the consultation or even before that, are you usually the same person who helps them all the way through surgery?

Riana (16:04):

Yeah. Ideally the patient coordinator that takes the phone call or takes the inquiry is the one that is going to be with you from beginning to end. There are certain times where that won’t happen, maybe schedule or vacation or something like that. It may not happen 100% but that is the goal because we’ve established a relationship on a phone call or via, you know, text or email, and trying to translate that information to somebody else isn’t always going to have the same effect.

Monique Ramsey (16:34):

Yeah. I think the buddy system is nice.

Riana (16:37):

It is absolutely nice. And it’s so much fun for us getting to see that patient go from where they are to being so happy, you know, the post-ops and follow ups.

Monique Ramsey (16:47):

Right. Now, I think it’s important for patients to sort of have buy-in or for some patients from a spouse or a friend and sometimes, or partner, if they come on their own. They have a consultation. Then they get home and then they have to try to translate everything that happened in the consultation, maybe to the spouse. And the spouse is probably going to have a lot of questions. And then they’re feeling like the middleman, you know. And so do you ever recommend that patients, if they have a spouse or a partner, that they bring them with them to the consultation?

Riana (17:22):

Absolutely. Anybody that’s going to be involved in the decision-making process should come with you to the consultation because they may think of other questions that you wouldn’t have thought of to ask, other information, and you have another set of ears to be able to gather that information and retain it. So then when home, and you’ve scheduled your surgery and you go home and you are still talking about it, you are both talking about it from a place of knowledge and just discussing everything and being able to plan accordingly.

Monique Ramsey (17:55):

Interesting. So, getting ready for the consultation, you know, what should patients do to prepare for that consultation? Should they save photos from the internet? Should they write down a list of questions ahead of time? What do you really recommend for them to do to be the most prepared on that day?

Riana (18:14):

Yes. Photos from the internet would be a great idea, showing the doctor this is what I really like, this is the look that I’m going for. So then he or she has a clear indication of what your goals are and if it is possible. So being able to let you know what your possible outcome will be, and if you cannot achieve a certain look. Not everybody can have a photoshopped Kim K., butt…

Monique Ramsey (18:47):

Right. What’s realistic? Well, I think that’s really important because, you know, we see so much on the web and a lot of it is photoshopped. How do we…We start to think that that’s all normal and it isn’t. Too bad because some of these filters are really awesome. But what is going to be realistic and I think that’s anything that you can do to help yourself during that moment because I think all of us to some degree, not that we all get white coat syndrome, but that sort of like when the doctor enters the room in a white coat and you freeze and you forget everything you wanted to ask. You know, we’ve all been there. And then you’ve never gone through this before in all likelihood. So being prepared, having some collateral materials with you, whether it’s pictures or something on your phone that you’ve saved, a little list of questions just so that in the moment you know you have everything you need to sort of make the most of that appointment.

Monique Ramsey (19:43):

So, just the day of the consultation. So they come, where should they park? I know that sounds like a silly question, but you get onto the Scripps campus and you’re like, where do I go?

Riana (19:55):

So, being that we’re on a campus of a hospital, it’s very similar to a college campus, in that, if you’re not a student there, you will get lost. Where is building 600? It’s not next to 500, I guarantee it. And GPS gets you lost. It goes kind of wacky when you’re on our campus. So we provide you with directions after you exit the freeway. It’s very simple. And we have a parking structure that is around basically the backside of our building. And we’re the tallest building on our campus, I believe.

Monique Ramsey (20:31):

Yeah. I don’t know that, one right out at Genesee, that big Cardiac Center or whatever it is, that thing’s huge. So we’re the second. We used to be the biggest, but yeah, the XIMED building, and there’s a really pretty round sculpture outside. But yeah, you sort of just drive around to the back of it and then there’s parking. And there’s Valet as well, is there? Or, do they have that back yet from COVID?

Riana (20:52):

No, no valet back yet.

Monique Ramsey (20:53):

Okay. Well, hopefully they’ll come back.

Riana (20:55):

I know.

Monique Ramsey (20:56):

Yeah. So, now, some people might be worried about privacy. Who’s going to see me coming and going from the office? Are there a lot of people in the waiting room? What’s going to happen when I walk in?

Riana (21:08):

If you have concerns about privacy, then please let the patient care coordinator know that during the call so that we can accommodate you if there’s any special needs for that. But there really are not a lot of patients in our waiting room. And, it’s a small intimate area. And upon your arrival, you will be greeted by the front desk and then the front desk will let your coordinator know that you’ve arrived. And at that time we will put you back into a room and make sure you are all settled and ready to go and don’t have anything that you need. But we will provide coffee, water, tea. And then you start interacting with the surgeons.

Monique Ramsey (21:52):

And the nurse I would say probably. A lot of times each surgeon has their own nurse.

Riana (21:57):

That’s what I was going to say. Start interacting with the surgeon’s nurse. And she’s going to go over your health history, make sure that everything that you’ve written down on the forms are accurate and there’s no other little questions that need to be answered. In which time the surgeon comes in and will meet you, talk with you about the consultation agenda, you know, what procedures you’re interested in. And then he does the physical part of the exam. So taking measurements, looking at your tummy if you’re there for a tummy tuck, trying to get an idea on, you know, what areas of your body concern you.

Monique Ramsey (22:38):

So you were talking about the surgeon taking measurements. So I take it if you’re having a, thinking about a body procedure, then you’re going to have to take your clothes off. So do they…How does that happen? Do you put a robe on or a?

Riana (22:52):

If you’re interested in a body procedure, breasts, tummy, lipo, things like that, you will be asked to put on a robe. Obviously if you’re there for a breast surgery, no bra. But for the other body procedures, you can wear your panties and your bra for and a robe. You keep the robe on if possible just to kind of give you a little bit of comfort, but he will kind of open it, maybe lift it a little bit to get an idea on what your body looks like.

Monique Ramsey (23:25):

Yeah. That’s important.

Riana (23:27):

Yeah, it is. It is physical. Also I remember I did a consultation prior to working for La Jolla Cosmetic with Dr. Saltz, and that was my first consultation. And you’re standing on a platform and she’s sitting in a chair and your boobs are just at eye level, her eye level. And it can be a little intimidating. You know, but for the doctor, they’ve seen boobs and see boobs every single day. And so it’s no big deal for them. So just knowing what to expect. We have patients that are very modest and it kind of makes them uncomfortable. But to the doctor, they’re looking at you as their canvas.

Monique Ramsey (24:09):

And if it’s a male surgeon and you’re a female patient, there’s somebody in there with you. So it’s not just a one-on-one. You have another person. And they don’t start off with the medical exam, right? They don’t start off looking at your breasts before they get to know you. So it’s like, buy me coffee first.

Riana (24:26):


Monique Ramsey (24:28):

They’ll get to know you. You’re going to be feeling more comfortable before they’re going to like start to do the exam. But it’s in no way as invasive as going to the gynecologist.

Riana (24:41):

No, it is not that.

Monique Ramsey (24:43):

If you’ve done that, this’ll be easy, right?

Riana (24:46):

Unless it’s Dr. Brahmy doing a vaginoplasty, then it’s quite similar.

Monique Ramsey (24:51):

True. We do have…Speaking of vaginoplasty, we do have a podcast all about that, about revitalizing the lady bits. Okay. So, I wanted to read another review of a consultation with one of our surgeons and this one happens to be about Dr. Swistun and they said, “Genuinely felt a sense of ease and comfort. Extremely thorough. I especially appreciated the honesty about what I would look like with and without a breast lift. This was extremely important to me and no other doctor was able to explain and show me what it would look like after the fact with each option.” So I think that’s something really important . There is the words “show me”: how we can help illustrate different procedures for you so you get an idea. And so how does that, what does that look like in the exam room?

Riana (25:47):

In the exam room, the doctors have some tools they use, TouchMD, up on a big screen to show you some examples of other patients that have done the procedure this way and/or that way. And also we do 3D imaging. So being able to take a photo of a patient and then modify that, alter that photo to give you an idea on what you would look like with a certain CC implanting bigger or smaller. And then Dr. Swistun also uses that 3D imaging, it’s called VECTRA, for his body sculpting patients. So it’s really nice. It gives a patient an idea on…Maybe you’re on the, kind of, borderline of needing a tummy tuck and lipo or tummy tuck versus lipo. And so they can get an idea on what they would look like after just lipo alone. So having that because every patient is going to be different. Every person’s desires of what they want to live with or can live with and be happy with is different. And so it’s nice to be able to be given options, and that patient can then decide on what’s best for them.

Monique Ramsey (27:01):

And so the TouchMD you mentioned, if they do any illustrations in there or they take any pictures, that can be sent to you as a link, right, so you can take it home and look at it again and sort of review it. Is that…Am I right about that?

Riana (27:14):

Yeah, you’re correct. Every patient has their own TouchMD login and the ability to access whatever the doctor puts in that TouchMD. So when you take photos of yourself in different implants, those are uploaded to TouchMD and then you get to go home and show your friends and show, you know, your mom and have a lot of fun with it.

Monique Ramsey (27:35):

Oh, that’s cool. So, you mentioned the VECTRA, which is 3D imaging, but there’s also the Curves Connection, this sort of implant sizing. And I know that there are some little sizers where they’re actually like a little silicone, like an implant but not an implant, where you can put on a bra and you put that little sizer in, and let’s say it’s for 375 CCs. And you actually put the bra on, put the little insert in, put on a t-shirt and then you can sort of wear that size and try different sizes. Do you find that that helps them?

Riana (28:11):

Yes. Wearing the sizers, trying on the sizers and our special little surgical bra really helps a patient get an idea on what they’re comfortable with. In your head you think, okay, I like the way this looks, or when you’re researching and you’re looking at photos, you like the way, you know, a D looks, but then in reality-

Monique Ramsey (28:32):

What’s a D?

Riana (28:34):

Yeah. We don’t speak in that language anyhow, but that’s what you’re thinking. And then once you put on our bra and our fitted v-neck t-shirt with a 380 CC implant in, you go, “Oh no, this is too big, or oh no, I want to be bigger.” And so it really brings it home. It connects the two, your brain and your body, into what you really want, what you can really live with, have on your chest, you know?

Monique Ramsey (29:01):

And I think the same thing is done like on certain facial surgeries. You know, you can go in and say somebody is thinking about a chin implant, or they’re thinking about having their nose changed. You know, until you see it, it’s hard to imagine. And, I think it’s a good tool for communication because I remember imaging a patient a long time ago and he kept talking about his chin and he wanted his chin to look like his brother’s. And he kept talking about his chin, and so the doctor said, “Okay, let’s do some imaging.” And so I did some imaging and I pulled the chin out a little bit, I’m like, “This just looks terrible.” I’m thinking in my head that he doesn’t need this. I’m so confused. And when the doctor came back in, he said, “I don’t think that’s right.” And he said, “Will you point to the screen and show me where on your face, where does it bother you?”

Monique Ramsey (29:54):

And the man pointed to his, the area next to his chin. And he wanted more of a square jaw line, but they were talking about chins. And so it didn’t come until that imaging appointment where we were there as a group and he pointed, he’s like, “No, this part.” And instead of the chin projecting forward more, he meant he wanted more of a, you know, rugged jawline. And so that’s a different, that’s a whole different thing. We can do that. But until that happened, and I think that was a really good illustration of why technology can be great because sometimes we as a patient might not have the right words to describe what we want. And so , you know, that helps everybody get on the same page, or like you’re saying, you know, what’s a C cup? It’d be different on me than on you than on somebody else. So the more tools we can give you to help you visualize your result, I think it helps and I think our patients appreciate that.

Riana (31:00):

Yeah. I agree with you completely.

Monique Ramsey (31:04):

So, a couple other things. If somebody’s thinking about let’s say their tummy and that bothers them, but they’re also concerned about their neck, is that something they can all talk about in the same consultation or are you limited to one. It’s a free consultation, you get to talk about one thing.

Riana (31:25):

One thing only. We only have time for one thing. No, we can do a consultation and discuss multiple procedures. Letting your patient care coordinator know at the time of that conversation is ideal because we want to make sure that the surgeon has enough time devoted to you for multiple procedures. So if you’re interested in a breast augmentation and a rhinoplasty, then we’re going to give you more time with the doctor to be able to discuss both of those things because as you said, Monique, we do imaging for both rhinoplasty and for the breast augmentation.

Monique Ramsey (32:03):

So we’d want to have enough time really for everything.

Riana (32:06):

Yes. And be able to address all of those things. Plus, what if you’re meeting with Dr. Salazar for breast augmentation and then you just say, hey, I’m also interested in rhinoplasty, which he doesn’t do. So we need to make sure that we are aware of everything that you want to talk about. And if, after you hang up the phone, you decide you are interested in something else, just letting your coordinator know so that we can make sure that we have informed the doctor.

Monique Ramsey (32:37):

Let’s say you’ve gone through your consultation, you have your quote, you understand financing. You really have everything you need to know. But what if you’re just not ready to make your decision? You know, maybe you’re going to see other doctors or maybe you know, you have to wait. Maybe it’s summertime but you know you have to wait till December. Like how long will that quote or the different quotes that you get be honored with that pricing?

Riana (33:02):

That’s a great question. So, another reason why we ask patients about timeframe for surgery during our phone call with them is because we’re taking these kinds of things into consideration. So our quotes are good for 30 days. What that means is if your decision is made outside of that 30 days, there is the possibility for fees to change and also the possibility for fees to change, and the procedures could change as far as the doctor, your body changes, things like that. Yeah, because you know, you can have a baby in nine months. So if you had come in for a consultation in February and next June you call us, then-

Monique Ramsey (33:47):

Yeah, things will be probably different. So who then…Is it the patient coordinator that I hear from after my consultation or who kind of stays… Do you stay in touch with the patients afterwards?

Riana (33:59):

Yeah. So after the consultation with the doctor, you will meet back with your patient coordinator in their office. At that time is when you discuss the official pricing based upon the procedures discussed and recommended by the surgeon. And sometimes this could be multiple quotes. So if that doctor has given you, you know, a breast lift or a breast lift with augmentation as two possible procedures, then you’re going to look at both of those pricings. You don’t necessarily have to decide at that time what you’re going to do, but let’s say, okay, I think I want to do the augmentation and the lift, and this is the date I want. But then a month later or two weeks later you decide you don’t want the implant, that’s totally fine.

Monique Ramsey (34:43):

You’re not locked in.

Riana (34:45):

No. No, you’re not locked in.

Monique Ramsey (34:46):

Sorry, you already made your choice. And then how long do people have to wait to get on the surgery schedule? Let’s say, I mean, I know it’s so funny because I remember I’ve talked to patients who said, you know, the hardest part for me was just making this phone call, making the first phone call. And then like, how fast can I do it? It was like, I’ve waited. I’ve been thinking about it for five years, but can I go next week? And so if they’re ready to move forward, about how long or does it depend on the procedure and the doctor, I guess?

Riana (35:17):

Yeah. Surgery schedule depends on the surgeon and the procedure. We have some requirements set by the operating room as far as procedures going on the same day. So, you know, we’re going to work with the patient and try and fit their timeline. It’s also great to be able to discuss that with your coordinator at that phone call because if you’re calling me today and you have time off in two weeks and you’re thinking I want to utilize that time to have surgery because whatever I was planning to do fell through. Then I’m going to be able to guide you and make sure that we are able to meet that timeline and give you the best possible chance of getting the perfect date for you.

Monique Ramsey (36:06):

So like you said, the more information that you give to your patient coordinator at the beginning, the better they can help behind the scenes for you…Make that dream become a reality?

Riana (36:18):

Yeah, absolutely. And also coming down to time frame are things that patients don’t consider. So, if you’re a mom and you’re having a tummy tuck and your kids are 7, 8, 9, do you want your kids home with you or do you want them out of school? You know, those kinds of things. Maybe you don’t have a timeframe, but there could be a better time that you hadn’t even have realized. So we do like to have that conversation. Also, we deal with a lot of teachers and they want to have surgery during Christmas break, which is one of our busiest times. So if you’re calling me in October for a December date, I probably won’t have it. But if you’re calling me in July and you’re thinking about Christmas, then I’m going to say, okay, let’s get you in because that’s busy. And so you’re going to get your perfect date for you.

Monique Ramsey (37:07):

Yeah. I was just talking to a college student on one of our social media channels and it was the exact same thing. They want to do it over their winter break. And I’m like, well, it’s a good thing you’re saying it now because it seems like a slam dunk, it should be easy if you do it a couple months in advance, but not when it’s the busiest time of year. And you have to think about sort of we’re busiest when people have time off. So getting those things… The more you can do ahead of time, I think the better it’s going to be.

Monique Ramsey (37:34):

Now, something that we feel is very important is our reviews. And so you can look at different websites. You don’t really see a lot of reviews about the consultation specifically. You tend to see reviews about after surgery. But we actually review all of our patients after the consultation because we know how important that experience is and we’ve made it a priority and you can read them on our website. You can go to the page titled Your Free Consultation and then we’ll link them in the show notes as well. But you can see what people have to say about that consultation and sort of how did it go for them. And on this page, there’s hundreds of reviews of our consultations with all our providers. But I see Riana’s name pops up in some of these pretty often too, which is awesome to see your name come up, and you made somebody’s day. What does that make you feel like, Riana, when you see your name?

Riana (38:33):

The patient care coordinator role can get overlooked a lot. And so I think that when any of our names are mentioned in a review, it feels really good because I know that I have connected in a way that is memorable to that person and that I have made a difference. It’s why I do what I do. It’s why I like my job. It’s because I’m able to guide a person through a life changing, for the positive, event and connecting with them and having that one-on-one relationship is important. My mom, she passed away last year and I had patients reaching out to me. I had cards from them. When my dog got ran over by a car, I had them give him gifts. So, you know, it’s all of these little things. It was really sweet. It’s touching that I make a difference to somebody and that you have that one-on-one, that personal connection. It’s important to us. It means the world.

Monique Ramsey (39:32):

That’s so nice. That’s really sweet and touching. And I would think it’s gratifying, you know? It makes you feel like, okay, I’m doing my job. It’s not just a job. You know, you’re making relationships, and sometimes for years and years, which is a really wonderful thing. So there’s a really neat quote on the website from you and you say, “La Jolla Cosmetic has a culture that will draw you in the moment you step through the front door. I walked in a patient and left with a first class career.” So you walked in as a patient and now you work for La Jolla Cosmetic.

Riana (40:07):

Yeah. It goes back to kind of what you were saying when you are matching a patient with a doctor. I am of the firm belief that when you know, you know, and when I walked in and I met with the nurse and the surgeon, I knew I was at the right place. I knew so much that I wanted to be part of that place. So I did, and the culture is familial. We have been working with one another for 5, 10, 15, 20 years some people have been at La Jolla Cosmetic. And people don’t just stay at a place because it’s convenient. They stay because they like it and it feels like home. And it does. It feels like home. You feel comfortable there, you feel supported there, confident. You know you’re working for or at a place that has morals, ethics, safety. We have your best interests at heart, whatever it may be. Even if it is choosing a different practice, we have so much information that we are providing our patients to educate them on making the right choice.

Monique Ramsey (41:14):

Because really if you come down to patient advocacy, you know, we’re not trying to advocate only our surgeons. We want to advocate the best outcome for you and whatever that is. And I think people, they can tell that, you know, sort of the authenticity behind that. We care about people. And we’ve been around now, we just had our 33rd birthday. So we’re into year 34. And you know, you don’t stay around a community that long if you’re not doing right by people. And I think that we treat each other as that golden rule and it sounds really trite, but it’s true. You know, we want to have everybody feel really comfortable and we want you to have a relationship with us for years and years to come and refer your friends and family and feel confident when you do that. So last question for you Riana. So, our brand promise at La Jolla Cosmetic is where dreams become real. So Riana, tell us about a dream of yours that became real.

Riana (42:15):

So my first dream that became reality was a breast reduction. And, that I had wanted since I was 14. And, I didn’t really understand at that time the procedure or the cost or anything like that. I just knew that I wanted smaller breasts. And, so I didn’t have it until I was 33 or something like that. I had already had three children. So I had wanted that procedure. I had dreamt about small boobs for 20 years. And that’s a long time. That’s a lot of tears, a lot of heartache, a lot of, you know, ugly bathing suits.

Monique Ramsey (43:04):

Yeah. The world is not built around that.

Riana (43:08):

No, the world is not built around a 14-year-old with large breasts, especially in the ’90s. It just wasn’t geared towards that at all. And so having that done really changed who I was on the outside. It matched who I was on the inside. Having to accommodate large breasts for 20 years, that was painstaking. And every morning you’re reminded when you’re getting dressed about something that bothers you. And so really having that become reality, having that dream turn into reality was life-changing in a positive way.

Monique Ramsey (43:53):

I love that dream. So, you said you had two dreams that became real. What’s the other dream?

Riana (43:59):

My second dream I didn’t know I had until I had the first dream become real and that was a tummy tuck. So, my breasts had bothered me so much for such a long time that I really didn’t focus on other areas of my body. And once my breasts were smaller, then I realized, you know, I had three children and I had kids young. And so I don’t really even remember my adult body, but I knew I wasn’t really comfortable with my abdomen. It didn’t match my breasts, that’s for sure. So I had a tummy tuck done with Dr. Salazar, and that was amazing. I had the worst horrible scar from a belly button piercing that I got done when I was 16 and I hated that, and that’s gone. So there’s just so many positive things. Again, I can wear a bathing suit and feel comfortable. I can wear a dress and feel comfortable. So that really made the complete package, if you will, that mommy makeover. My breasts, my tummy, it all matches. It’s all proportionate.

Monique Ramsey (45:08):

And I would think that being able to just do simple things like going to trying a bathing suit at a store or pulling your jeans up and knowing that they’re not going to get stuck at the bottom of your abdomen, that they can go all the way up and, oh, I can zip them and I can button them. Like, I don’t think people realize sometimes the mental toll of if something’s bothering you, how little tiny things during the day can sort of… But when it’s no longer an issue, you’re like, oh yeah, I’m just going to throw my clothes on and run out the door and you’re happy. and it’s hard to put it into words until you’ve really been through it. But I think that, you know, it’s that confidence and it’s also just sort of something that you don’t have to live with and don’t have to have gnawing at you. It’s that, I don’t know how to say it.

Riana (45:58):

It’s freeing. There’s a lot of negative talk that we do as women especially, and you don’t even realize you’re doing it until it’s gone and you’ve stopped doing it, but you’re right. Pulling your jeans on and going, oh my gosh, I shouldn’t have had that second slice of pizza last night or , you know I really need to exercise more or what have you. We just beat ourselves up so often that it becomes routine. And so it’s taking that action, finding the solution to solve that and be happy with the body you’re in.

Monique Ramsey (46:30):

Yeah. And I think, you know, having that relationship with your patient coordinator to help that dream become a reality. And sometimes people don’t realize, like they think it’s just unachievable. But, you know, you might sit down with somebody and say, look, we can do this and you can have this for X amount per month. You can finance it. And people go, “Really? I had no idea.” You know, what are the tools that we can do and help you with to help make that dream a reality so that you have those great feelings. And you’re doing it for you. That’s I think something else that’s really important. You may have a spouse or partner or somebody else, significant other in your life that comes along for that consultation. But at the end of the day, you’re doing it for you. And that’s I think the other thing that our patient coordinators want to make sure is that you’re not doing it to please someone else. You have to do it for yourself. And I think that that’s something else that we don’t always talk about.

Riana (47:27):

Absolutely. You’re doing it for you.

Monique Ramsey (47:31):

So, for everyone, thanks for listening. And, you know, who can you talk to if you have questions about our services? There’s ways to contact us in the show notes, you can call us, you can text us, you can email us, you can send a carrier pigeon. We will answer you. Now, the carrier pigeon may not get into the XIMED Building. So give us a heads up. But yeah, we are happy to converse with you wherever is convenient. And so for sure check the show notes for links. And thank you, Riana, for your time and for your honesty and for telling us all about the consultation process and sort of helping us visualize from beginning to end what that’s like. So we really appreciate you.

Riana (48:13):

Thank you for having me.

Monique Ramsey (48:15):

Yeah, absolutely.

Speaker 1 (48:22):

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, T-H-E A-X-I-S.io.