Facial plastic surgeon Dr. Kiersten Riedler shares her unique perspective on preventing aging of the face and her layered approach to preventing wrinkles, replacing lost volume, and reversing the effects of gravity.
Dr. Riedler’s training has made her an expert in facial anatomy, and her specialties include face lift surgery, complex rhinoplasty, and revision rhinoplasty surgery. Thanks to her training, she is also bilingual in Spanish.
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Transcript
Speaker 1 (00:07):
You’re listening to The La Jolla Cosmetic Podcast.
Monique Ramsey (00:15):
Welcome everyone to The La Jolla Cosmetic Podcast. I’m your hostess, Monique Ramsey. And today, we are going to speak to a new physician here at La Jolla Cosmetic. Her name is Dr. Kiersten Riedler. Welcome Dr. Riedler.
Dr. Kiersten Riedler (00:30):
Hi, thanks for having me.
Monique Ramsey (00:32):
So, what inspired you to join the team at La Jolla Cosmetic?
Dr. Kiersten Riedler (00:38):
Being from San Diego and having lived back here for several years, I have always regarded La Jolla Cosmetic as the top plastic surgery practice in San Diego. And I was at a point where I was looking to focus exclusively on cosmetic surgery, and it just turned out that La Jolla Cosmetic was looking for a surgeon focusing on facial plastic surgery, especially complex rhinoplasty and facelift so it was a perfect match.
Monique Ramsey (01:07):
Well, that’s wonderful. So, I’ll ask you more about your educational path in a moment, but I want to start with your philosophy and as it pertains to facial aging and what do you look at?
Dr. Kiersten Riedler (01:19):
Facial aging is a really complex process and it affects every layer of the face not just the skin, but also the fat, the muscle and even the bone and so what I counsel patients about is prevention is really key. So, the main things we can do to prevent our slow aging are reducing our sun exposure using sunscreen every day not just when you’re out in the sun, avoiding tobacco use, just leading a healthy lifestyle, but eventually we all succumb to time and gravity regardless of what we do to prevent it, but luckily we have really effective treatments to reverse aging because aging is a multilayer process that affects the skin quality, the loss and [inaudible 00:02:05] fat, wrinkle formation.
Dr. Kiersten Riedler (02:06):
It’s important to address all of those aspects, all of the layers of the face. We’ve actually learned a lot in facial plastic surgery over the past few decades, about how important it is not just to remove excess skin, but also to reposition the volume, the subcutaneous fat and replace the lost volume to restore a youthful look. Usually, there isn’t just one treatment that I’m going to recommend, it’s going to be a multi-pronged approach with maybe neuromodulators like Botox to prevent wrinkle formation from muscle movement and then also fillers to replace volume, fat transfer to replace volume and then of course, facelift and surgical techniques to reverse gravity.
Monique Ramsey (02:51):
You mentioned bone. I find that interesting. Tell me what you mean by that?
Dr. Kiersten Riedler (02:56):
So, they’ve actually done studies using CT scans of people’s heads and faces over time and have shown that the jawbone actually gets smaller essentially over time, especially in people who don’t have teeth, dental loss causes accelerated aging for sure, but even something called the pyriform aperture, which is the opening of the nasal cavity that actually widens with aging and so that leads to changes in the contours of your face and also the orbital rims, the opening of your eye socket essentially, that also widens because of bone loss as well. And so all of those cause deep structural changes that are going to affect our external appearance.
Monique Ramsey (03:43):
Interesting. That’s why maybe as people get older their eyes almost appear sunk it in a little bit.
Dr. Kiersten Riedler (03:50):
Yeah, it’s because of loss of soft tissue but also loss of bone, it’s actually depressing or disheartening looking at these CT scans over time and see how everything just wastes away but fortunately, it is what happens so we just do our best to undo it.
Monique Ramsey (04:09):
Exactly. In terms of advantages to being a female facial plastic surgeon, what do you think your advantages are?
Dr. Kiersten Riedler (04:18):
Well, I think it’s a definite advantage because as a female, I think I can really relate to and understand my patients, their concerns, their aspirations, I as an aging female have a lot of the same experiences and concerns as my patients and so I understand firsthand what aging changes pop up, where, when and what to do about them, and just having the female aesthetic eye I think is invaluable.
Monique Ramsey (04:48):
And what led you to the specialty of aesthetics?
Dr. Kiersten Riedler (04:53):
So, I’ve always been interested in aesthetics and started reading about makeup and skincare as a teenager. And so in retrospect it almost seems like an obvious choice for me, but it really was a long path. When I finished training, I thought I wanted to keep doing the broader scope of practice encompassing all of cosmetic and reconstructive facial plastic surgery and some head and neck surgery and felt like it might be a waste of my training to have spent so many years becoming skilled in so many different types of surgeries, but I’ve always been somebody who really strives to do a smaller number of things to the absolute best of my ability, rather than doing a lot of different things just satisfactorily. And I’ve come to realize how all those years of operating on every part of the head and neck were really critical to building my skill set and my knowledge of face and neck anatomy.
Dr. Kiersten Riedler (05:45):
For example, training in head and neck surgery, we do a lot of cancer resections and basically take the face apart and reconstruct it and so I’ve become intimately aware of all of the structures of the face and the neck, because even though now I’m thinking about what it looks like on the outside, I know what’s beneath it and how that affects the external appearance. And that’s also really important actually with nasals surgery because the structure of the nose is very complex and even the septum and the deeper internal nasal anatomy will affect the external appearance because I realize that aesthetics is really what I love and it’s really my major passion and all of the training is really what makes me a good aesthetic surgeon.
Monique Ramsey (06:42):
So, now what procedures do you love to do and why?
Dr. Kiersten Riedler (06:46):
Rhinoplasty, it’s one of my favorites. It’s really one of the most complex and I think artistic surgical procedures there is, because no two noses are the same and the internal anatomy of the nose is really delicate and complex. And one thing I like about rhinoplasty surgery is that there are hundreds of different maneuvers we use to achieve certain types of changes. So, there’s a lot of creativity involved, it’s like coming up with a recipe, like what combination of techniques or ingredients am I going to use to achieve the desired result? I also love rhinoplasty because it requires a lot of attention to detail and just a half a millimeter difference and suture placement or shaving cartilage will have a noticeable effect on the outcome, which I think that’s why a lot of surgeons don’t love rhinoplasty because it’s high state, but I really like a challenge and I’m very detail oriented so I think it works well for me.
Monique Ramsey (07:53):
So, what have you learned over the years from listening to patients?
Dr. Kiersten Riedler (07:58):
Well, listening to patients is one of the most important parts of my job because every patient has different concerns and goals and that’s what they’re coming to me for is to address those. And so I can’t even become to come up with a treatment plan without first listening to the patient. So, that’s really step number one when a new patient comes to see me is getting to know them, getting to know their motivations for surgery, getting to know what bothers them and what they’re hoping to achieve.
Monique Ramsey (08:32):
And what could a patient expect when they come to see you for the first time?
Dr. Kiersten Riedler (08:37):
The first step like I just mentioned is really just getting to know them. Taking stock of their concerns, what they hope to achieve and then I systematically evaluate their unique facial anatomy focusing on what bothers them because everybody’s anatomy is different and it isn’t just the amount of aging, but it’s the underlying structure that needs to be considered and will determine what the best options are for them. So, then once I do my own facial analysis taking into account what bothers them, I educate the patient about all the different options that we can use to achieve their goals so that they are the one who are making an informed decision with all the available information. And we basically work together as a team to come up with a plan that they’re comfortable with and that they are confident will help achieve their goals.
Monique Ramsey (09:35):
So, you mentioned San Diego, can you tell us about yourself, where you grew up?
Dr. Kiersten Riedler (09:40):
So, I was actually born across the street at Scripps, La Jolla.
Monique Ramsey (09:44):
Hey, me too.
Dr. Kiersten Riedler (09:45):
Oh, really? Oh, my gosh.
Monique Ramsey (09:46):
Yes I was, way before you but yeah.
Dr. Kiersten Riedler (09:52):
I guess my mom told me that they used to serve lobster in the [crosstalk 00:09:57].
Monique Ramsey (09:56):
Oh, yes on your last day wait before you went home, you got to have a lobster dinner, yes.
Dr. Kiersten Riedler (10:02):
So, I was born there. My dad was a neurology resident, UCSD at the time, my mom was a music and math teacher and we lived in University City till I was 10 and then moved to Carmel Valley and my parents still live there. I graduated from La Jolla Country Day School where my mom was a music teacher and then I left for training for college, med school, residency, fellowship and then finally got to come back here for good a few years ago and I never want to leave.
Monique Ramsey (10:35):
So, you can’t just skip over that whole educational path. I’m not going to let you skip over that whole educational path. So, tell us what does that look like because not everybody realizes how much time? So, how does it start? So, you were La Jolla Country Day, you graduate and you go off to college, tell us about?
Dr. Kiersten Riedler (10:51):
So, I went to college at Harvard University just outside of Boston and majored in honors neurobiology and minored in romance languages and literatures, and had a really great time in college. It was hard, it was a lot of work but it was also a lot of fun. I made a lot of lifelong friends and it was a really great experience and also being here my whole life and going to the East Coast which was a really different experience, but I loved it. I love San Diego more, but it was a good experience. Then I came back to Southern California and went to medical school at USC, University of Southern California in Los Angeles. So, that was four years of just general medical training and then went on to do five years of residency in otolaryngology, head and neck surgery also at USC.
Dr. Kiersten Riedler (11:48):
I was lucky to be able to stay there, which was a really great training program, got so much experience. Thinking back on it I don’t know how I had the stamina to do all those work hours. I don’t know if I could do it again now, but it was a really great experience, learned a lot and then went on to do facial plastic and reconstructive surgery fellowship, which was an additional year of subspecialty training. And that was with my fellowship director, Dr. Jonathan Sykes, who is a world renowned facial plastic and reconstructive surgeon, professor emeritus at UC Davis and past president of the American Academy of Facial Plastic and Reconstructive Surgery. And during that year, I was all facial plastic surgery and we split our time between Sacramento in Beverly Hills where his two practices are located.
Monique Ramsey (12:43):
Interesting. What would you say you want listeners to take away from listening to this podcast?
Dr. Kiersten Riedler (12:50):
I hope listeners get to know me as a surgeon and as a person and see how passionate I am about facial plastic surgery and helping my patients achieve their goals and know that I’m just here for them.
Monique Ramsey (13:03):
That’s nice. So, tell us about when you’re not being a physician, what do you like to do outside of the office?
Dr. Kiersten Riedler (13:12):
Well, one of my favorite things to do is cooking and baking. There’s actually a lot of parallels I’ve realized between cooking and surgery because just like surgery, cooking starts with devising a plan, compiling the ingredients and instruments and then using your instruments to transform the ingredients into a finished product. And one culinary concept it’s called meson plus I don’t know if you’ve heard of it, but it’s something I always think about when I arrange my instruments at the beginning of each surgical case, I think okay, I’m doing my meson plus I’m just arranging everything just like you do in the kitchen with your ingredients and instruments. So, they’re on parallels but then cooking has the added benefit that you get to eat at the end.
Monique Ramsey (13:57):
Now, I found out something cool: which is that you’re bilingual?
Dr. Kiersten Riedler (14:02):
Yeah.
Monique Ramsey (14:03):
And so tell us about where you learned to speak Spanish in a little bit about the Spanish side of you?
Dr. Kiersten Riedler (14:11):
So, I actually started learning Spanish in kindergarten at Freckles Elementary, which is bilingual magnet school in University City. So, that was my first exposure but then I continued to take Spanish all throughout elementary school and then high school and it was always one of my favorite subjects. I continued studying it through college and I got a minor in romance languages in literature at Harvard. And then as a medical student and resident in USC, the majority of my clinical training took place at LA County Hospital, where about 70% of my patients were Spanish speakers. And while I could read and write Spanish really well, I wasn’t quite fluent in spoken Spanish and especially medical Spanish, so knowing how much speaking Spanish fluently would help me communicate with my patients, I decided to spend the summer after my first year in med school living in Guatemala and I divided my time between medical volunteering and one-on-one medical Spanish instruction and I think living in a Spanish speaking country was really key because I actually started thinking and dreaming in Spanish. So, at that point I knew I was probably bilingual.
Monique Ramsey (15:22):
And how long were you there?
Dr. Kiersten Riedler (15:24):
I was there for three months.
Monique Ramsey (15:25):
Wow.
Dr. Kiersten Riedler (15:27):
And then I’ve kept it up because I’ve had so many Spanish speaking patients throughout the years. A lot of days in residency I was spending more of the day speaking Spanish than English actually.
Monique Ramsey (15:39):
Wow. So, maybe we could do some episodes in Spanish.
Dr. Kiersten Riedler (15:42):
Yeah, sure.
Monique Ramsey (15:44):
I think that’d be so helpful for people who are thinking about a surgery and to be able to…. We have a lot of parts of our website in Spanish, so why not?
Dr. Kiersten Riedler (15:54):
Yeah.
Monique Ramsey (15:54):
That’d be fun.
Dr. Kiersten Riedler (15:55):
Definitely, that would be fun.
Monique Ramsey (15:57):
So, as you listeners are out there thinking, how do I learn more about Dr. Riedler? So, you can find her on our website, which is ljcsc.com and we have her bio up there and we’ll be putting all her before and afters on there as we go. You’ll be able to over time see some of the reviews and do you have an Instagram that you want people to follow?
Dr. Kiersten Riedler (16:26):
Yeah, it’s just Dr. Kiersten Riedler.
Monique Ramsey (16:30):
We’ll stick that in the show notes so everybody can link over there. And so before we wrap it up, there’s one question that we ask everybody who’s on our podcast for the first time. Our brand promise is where dreams become real, so what is a dream of yours that became real?
Dr. Kiersten Riedler (16:50):
Well, a dream of mine was to be a doctor to help people and one thing I love about aesthetics is that even though it’s not about curing cancer or some of the typical maladies that we’re dealing with people, it’s nice that my patients come here excited to see me and that I’m really helping them in a different way, but in a way that’s really impactful to their sense of self-esteem, self-confidence and something that affects them in their daily lives. So, I just feel like that’s so rewarding and I couldn’t be happier. I feel I’m so lucky to have this opportunity to join La Jolla Cosmetic and live out my dreams.
Monique Ramsey (17:37):
Nice. And you’re doing it in your hometown.
Dr. Kiersten Riedler (17:39):
Yes, definitely. That was one of my dreams always to come back to San Diego.
Monique Ramsey (17:44):
Well, thank you so much and it was really fun getting to know you this way because I think you and I are meeting for the first time and so it’s fun to be able to meet you and hear you and hear what your vision is for your patients and why you love being a surgeon. And so if any of you out there are interested in learning more about the things that Dr. Riedler does or want to schedule a consultation, all of our links in the show notes, all the contact info, everything is there that we talked about today and so thank you again for coming.
Dr. Kiersten Riedler (18:17):
Thank you so much for having me, looking forward to seeing more of you.
Monique Ramsey (18:22):
Likewise.
Speaker 1 (18:29):
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 at LJCSC. The La Jolla Cosmetic Podcast is a production of The Axis.
