When Marissa, lead patient coordinator at LJC, moved to the beaches of San Diego from the small town of Bakersfield, she discovered her bikini top was a little less full than she’d like it to be.
Starting as a small A cup, Marissa was looking for a subtle boost and nothing over-the-top. Plastic surgeon Dr. Luke Swistun recommended silicone gel implants and helped her find a size that fit her petite frame just right.
Marissa candidly opens up about her entire experience, from sizing at her initial consultation, to her recovery and the emotional rollercoaster she felt for the first 6 months post-op.
Hear her advice on how to find the right breast surgeon to bring your goals to life.
Meet Marissa’s surgeon, Dr. Luke Swistun
View breast augmentation before and after photos
Monique Ramsey (00:03):
Welcome everyone to The La Jolla Cosmetic Podcast. I’m your hostess, Monique Ramsey. Today I have Marissa, our lead patient coordinator in our surgery center. Welcome, Marissa.
Hi, how are you?
Monique Ramsey (00:16):
Hi, good to see you back again. Hey. So today, rather than talking about something that you do for your job, we’re going to talk about you personally because you are a patient as well, right?
Yeah, yeah. I had my breast augmentation about I believe two years ago now. Time definitely just flew by.
Monique Ramsey (00:34):
Two years. Okay. So tell me a little bit about why you were thinking about having a breast augmentation and why that point in your life.
Yeah, it’s so crazy. I’ve been doing plastic surgery for almost about six years now, and I just did my breast augmentation two years ago and I kind of held off because I wasn’t officially ready. It’s something that you have to come to terms with a mental decision that you have to make, and I just wasn’t ready at the time. And then the opportunity arose and I was like, you know what? Let’s do it. I’m ready. I’ve kind of been thinking about it. The opportunity is available, so I am ready to get scheduled and luckily everything went really smooth and I love my results.
Monique Ramsey (01:18):
What about your previous size or shape were you trying to correct or change? And then what were the things, how did it sort of impact your life, I guess, in how you wore clothes or presented yourself?
So I would say I was starting with a small A cup. Of course at Victoria’s Secret, they sized me as a 32 DD. So when I went back after my breast augmentation, I was still the same size, but I filled out my brass a lot better. And that’s really what I wanted was just when I went and wore cute little tops, or in the summertime when I’m wearing baiting suits, I had something to kind of fill out the top portion of my swimsuits and cute tops before and before I didn’t have much, so it was kind of just flat almost. And so the shape is really nice. It’s round. I can’t even see my incision. I have to lift my breast and look in a mirror to even see it so hidden.
Monique Ramsey (02:15):
Oh wow. Well that’s nice. I think for people who are worried about scarring, that is something that now, so the incision, you were saying if you lift your breast, so your incision is kind of in the crease of your breast?
Yeah, it’s in the crease of my fold. So when I’m wearing my baiting suits, I can’t even see it. Even in a bra, you can’t see it at all either. I would say the first year it took a while for it to kind of start to fade. It was almost like a red line, just like a red pen mark underneath my breast. And then I actually just looked the other day because a patient was asking me about it and I was like, I haven’t looked in a long time. Let me actually see. I forgot about it. And so when I went and looked at my incision, it just is a fine white line now and I can barely even see it. See, and that’s only two years.
Monique Ramsey (03:01):
Awesome. And I think that is something that when you’re having surgery or in that process, you’re kind of hyper fixated on a lot of things, very, very minute details that sort of, you lose it’s, you can’t see the forest for the trees, very, very hyper fixated. And then it gets to a point where all of it becomes so natural to you that you forget that you even had surgery.
I had my breast augmentation. Yeah, I forget all the time. And honestly, I forget that there’s even an implant in there. I’m just so used to them. It’s like I’ve never not had them before. It’s like I have always had them, which is the weirdest thing. And exactly how you said in the beginning I was so fixated. I started to notice, I was like, one’s actually a little bit bigger than the other one and the doctor mentioned it, but I never noticed it before and during my recovery, I was just staring at them all the time and I was like, I see the difference now. And now I’m like, oh, they look great. I don’t even pay attention to them if I want to show them off a little bit more. There’s nothing that a bra can’t help perk up if I want to be a little bit more conservative, my go-to are just these really comfortable sports bras from Target that just cover what it needs to and supports and it’s really light coverage.
Monique Ramsey (04:14):
When you were looking at the implants during the consultation process, I know we do our curves connection, implant sizing program, and if you want to tell everybody a little bit about what that was, that experience and how you decided on what kind of implant and what size to be.
Yes. I truthfully put a lot of my trust into the doctor. I wanted to give them full range to guide me. Although I’ve been doing this for a long time, I didn’t know what size would be proportionate to my body. Initially when I got my augmentation, I was thinking I wanted 350 ccs. Now I can’t even imagine going larger than what I have my 295. So he recommended silicone. I told him what kind of look I was going for. I wanted something natural, not too out of proportion with my body, just something that fits me and doesn’t look like, wow, she got a breast augmentation or the first thing you see when I turn a corner is my breast. And so I gave him that full guidance to me and he recommended silicone. And then as far as sizing, I told him a couple before and after photos that I saw online that I felt looked similar to me. I was like, this is what I’m liking, what are your thoughts? And he was like, I see what you’re going for. Try on these three sizes. And I tell my patients, this is the funnest part of the consultation when you come in is you get to try them on and see what you’re liking and not liking. I in my mind, thought I wanted 350 ccs, and then once I tried them on, I was like, there’s no way I can go this large. This is just going to tip me over. And so I tried on
Monique Ramsey (05:51):
Because you’re really petite. You’re really petite, right? So how tall are you?
Monique Ramsey (05:56):
Five one. So am I. Oh, but you’re like 40 pounds lighter than I’m, but hey, but really it is so much about your frame because I think we all get stuck on a number. Our friend had this number, but it’s like everybody’s body is going to sort of eat up those implants in a different way, right?
Exactly. Yeah. We all have different breast anatomy, a different breast shape. Again, after my augmentation, I noticed that one of my folds is a little bit more square and the other folds is a little bit more rounded. Now again, I can’t even tell you which one is which. I don’t know. I have 295 and 265 and I don’t even remember which one is and where. But of course, Dr. Swistun, my surgeon, I gave him full control and kind of helped me guide and choose what would be best option for me.
Monique Ramsey (06:45):
I think that’s a really nice collaborative thing where it’s not just the doctor and it’s not just you and it’s you guys working as a team and with the nurse and to really use trying on those different sizes with the implant sizers, did you do any of the Vectra imaging as well?
I didn’t do the Vectra imaging. Everything moved pretty quick for me. I asked if this was something I could do and I was on the operating table that following Friday, so it all went really fast. So I didn’t get to do the Vectra, but my biggest thing I wanted to really see was just trying them on in person. And I did it with my nurse as well too, and she kind of helped me. We took some photos so that I can go home and see which ones I was liking because a few minutes in the office isn’t always enough, so I wanted to look at some at home. And then she was also in the operating room with me as well. So that was really nice because when they sat me up, I guess they all had decided this is what she was wanting. I think that’s exactly what she is going to like, and it was so spot on. And so I felt really comfortable and happy that I did trust my doctor to recommend a size for me and give me the exact result that I wanted.
Monique Ramsey (07:59):
And for the audience, thinking about when you said when they sat me up, so you’re on the operating table, you’re asleep, they’re doing the surgery, and they have some sizers that they put in that are sterile before they actually place the implant itself. And so they can kind of put in different sizers and then sort of move the operating table to a more seated position so that everything is sort of using gravity takes it and the team can help weigh into is that what looks right. And I think that’s kind of a cool thing that not everybody knows that that’s one of the secrets behind the doors of the OR.
I think it’s a great thing that we are able to do in the operating room too. If with asymmetry we don’t know exactly what’s going to look good. So to be able to put those sizers in and get them as symmetrical as possible is a huge benefit.
Monique Ramsey (08:54):
And I think that’s something else that being about back to that idea of being sort of hyper fixated. Some people have very asymmetrical breasts, but almost everybody has some asymmetry whether it may not be a lot, but usually that is the case where one side is a little bit bigger than the other, or like you said, maybe the crease is a little different. And I think trying to correct that through surgery can be, that’s a really nice side benefit of getting the curves you’re looking for, but also achieving more symmetry for the two breasts.
Yeah, I agree.
Monique Ramsey (09:35):
Now, was there a time after surgery in that first week? Was there anything you really couldn’t do or how did you enlist help for that time after?
Yeah, so actually again, since things moved really quickly, I had my mom drive down to San Diego at three o’clock in the morning to take me to surgery. And luckily she was available, and so she stayed with me for about two days after my procedure. And then I luckily had a really easy recovery. I always tell patients I was one of the smoothest things I’ve ever gone through. I think being sick is honestly worse than my breast augmentation recovery. I didn’t take any pain narcotics, I just took extra strength Tylenol, a muscle relaxer. I was working remote on a Monday and then I was back to driving to the office on Tuesday. It was a little weird to drive. You can’t fully move your arms like you would normally to turn a wheel, but it’s manageable. Yeah.
Monique Ramsey (10:33):
That’s good. And as long as you’re not taking any pain pills, then driving is no problem. So now in terms of getting back into life and with working out or any other things you sort of do outside of the office, how long did you have to wait for some of those things?
So I waited about three months until after my breast augmentation to start doing upper body. And it was so funny, the next day after working out, I came in and I ran to my nurse and I was like, I think I broke something in my implant. And she was like, this is your first time working out. And I was like, yeah. She was like, it’s going to be really, really sore. It’s normal. Your body needs to readjust. We cut that muscle. So just imagine you’re trying to do these weights that you’re lifting and it’s too much. So kind of just take a couple days off and then ease back into it and you’re going to feel this way, but it’s normal. Nothing’s wrong with the implant. So I would say that was the only thing, but again, it was just rebuilding that muscle.
Monique Ramsey (11:32):
Interesting. Yeah. Obviously everything feels new and different and you have to maybe get used to doing some things a little differently. At what point do you remember not even noticing that they were there in terms of feeling, I guess?
Yeah, I would say probably about six months is when I started to feel like it was normal. All of the swelling had pretty much subsided. They didn’t feel hard and firm anymore. Initially, they felt as hard as a rock, which was a little alarming, but again, completely normal, they’re swollen. So I would say around six months and I started wearing normal brass again, they’re not comfortable when you first get your augmentation, you’ll just want to live in those sports brass or something that has no underwire. But then about six months I started wearing brass. I went to Victoria’s Secret. I got to try on some sizing and see what I felt comfortable with then.
Monique Ramsey (12:23):
Now how long during your life as a human on the earth, how long were you maybe self-conscious about the size of your breasts and thinking I would like to be bigger? Was that something early when you were in teens or kind of later in life?
Kind of later in life, once I started in high school, never really did much. I was always with family, so it wasn’t anything that was front of mind. It wasn’t until I moved to San Diego and everybody’s was in these bikinis and cute little tops, and I was like, well, I don’t fill out those little baiting suits like everyone else does. So when I moved to San Diego when I was about 21 is when I started to really consider getting a breast augmentation. And again, I had been in the industry, but it wasn’t something that I was ever wanting so much until I moved out here. And then I realized I want to fill at the tops a little bit more.
Monique Ramsey (13:17):
Now, where did you move from?
Monique Ramsey (13:20):
Bakersfield. Okay. So yeah, it is more little more farming up there. Less beach.
Yah, a lot less beach. We didn’t have a pool, so I was never really in a baiting suit. It was hot in the summer times, but again, I was always just with family. And then when I moved out here, I was like, again, I want to look cute in those baiting suit tops or in the tube tops that everyone’s wearing different things just to feel comfortable in my own skin. And I just wanted just a little something, a little volume, nothing over the top.
Monique Ramsey (13:52):
And after the surgery, when you were in that first, let’s say month, was there anything that happened or that you experienced that you weren’t expecting that sort of surprised you?
No, I think I just didn’t expect when you get your bus augmentation, you can’t sleep on your sides and you can’t sleep on your stomach. And I’m a huge side sleeper, so I didn’t realize for how long you can’t sleep very comfortably. And I think that was honestly the worst part of recovery for me. I’m a huge side sleeper, but other than that, everything was pretty much, it’s an emotional rollercoaster some days and which is normal. I felt like, why did I do this? I should have just left them the way they were. Some days I felt like I was just too big and I was like, I should have went smaller. Why did I do this? And then some days I’m like, they’re not big enough. If I was going to do this, I should have went big and went home. So I felt like it’s just kind of finding this happy medium and it’s going along with the journey. Every day you’re going to feel something different and at one point you’ll just start to feel comfortable and be okay with them and you’ll be like, they’re great. The days you want to push ’em up, wear a bra. The days you want to be more conservative, wear a high collared shirt. And then some days I’m just wearing a sports bra and it’s just something that I feel comfortable with. But it was definitely an emotional roller coaster, I would say the first six months.
Monique Ramsey (15:16):
That’s I think really important for the people who are considering having a surgery, any kind of surgery really, but that it is, you do have the emotional component to healing. And that is so normal to have that, why did I do this yesterday? I was fine. Today I’m in pain or whatever the thing is. It’s so hard.
Of course. And I remember I was so excited to get my breast augmentation. Everyone was like, are you nervous? Are you nervous? I was like, no, I’m ready to jump on that table tomorrow. I’m excited. I can’t sleep. I just want it to be tomorrow morning already so I can just get this over with. And then a week later I was like, oh my God, what did I do? This is permanent. I can’t reverse it. Everybody goes through it. It’s emotional rollercoaster that you just got to ride out.
Monique Ramsey (16:05):
And I think it’s really helpful for patients who are considering a surgery to know that so many people in our office, we’ve all done something. So it’s nice to be able to say, Hey, you’ve got a partner in this and you can ask your coordinator, your nurse, there’s somebody around who’s been through what you’re going through, and we’re really there to be with you through the whole journey. And I think that’s something that our office is known for that sort of family care environment and that we’re sticking with you through this. It’s not going to be that we take your money, throw you on the table and send you home. It’s not like that. And we’ve been around 35 years now and have a lot of experience. And you want, I think all of us kind of live by that golden rule, treat others the way you’d want to be treated. And we’ve all been there. And so I think that is really nice that there is that connection with the staff and that you’ve got people on your side and we’ll answer any question you’ve got. What’s normal?
I tell patients, I’m like, there is no dumb question. There’s no bad question. If you’re asking, I’ve probably thought it myself and asked the doctor just to get an answer. Trust me, anything that you have questions on we’re here to answer for. And like you mentioned, the family connection. I love the bond that I build with my patients. I’ve even sat with them before while they’re waiting in the lobby or in their room, and I’m like, you’re going to do great, trust me. And I’m just holding their hand being a supportive friend to them. And then even after surgery, I love seeing them in their post-op appointments. And when I catch them in between walking to the rooms and I’m like, how are things going? And we kind of just get to talking. And it’s nice just to be someone who understands and who has gone through something with the surgery. And to have, like you said, a whole team of other people who have had different types of surgeries in the office to be like, no, I actually talked to somebody about this. And if you want, she can come talk to you as well. I think we’re all really open and willing to lend a helping hand whenever needed when someone’s down.
Monique Ramsey (18:15):
And nothing ever goes perfectly for any one person is like, there might be a bump in the road with post-op nausea or you somebody else might have feel more pain because everybody experiences pain differently or someone else might have quicker healing than the person who’s going to go next week. And so I think it’s that 35 years of experience and having all these different hundreds of and thousands now with all our patients, but with a team that everybody’s had something done and we’ve all been there and we’ve seen it and we can help get you through that, whatever the issue is, and you might not have any issues. And it’s just, but kind of what’s normal and what I think in social media, you see stuff on TikTok or you see stuff on Instagram and it’s like you don’t know what to believe, whether somebody’s making it be the easiest thing ever to somebody else saying, oh my gosh, that was the worst thing I’ve ever done. So it’s like, what’s the real information?
It’s all real. Yeah, it’s all real. I mean, I had a super easy recovery. I could not have had a better experience the following week I was out having dinner with some girlfriends and it was totally fine. No pain, wasn’t taking any narcotics. And then we do have patients where they’re like, I was in bed all week. I just felt so tired. I felt like an elephant was sitting on my chest. And everyone has such a different experience. There’s not one way that this is exactly what’s going to happen. It’s not a black and white path. But that’s the nice thing about it is that we all get to experience something different in it.
Monique Ramsey (19:56):
And have a beautiful outcome.
Monique Ramsey (19:59):
So Marissa, something that I think the audience should know about you is that you’ve got a little gig going with Dr. Salazar on Instagram where you guys are talking about something that might be trending. So tell everybody about that.
So we’re doing reaction videos, which is really fun to do. And me and Dr. Salazar, we have these conversations on a daily basis. So it’s nice to get to show everybody what we actually do talk about when we’re seeing patients or when I see something, I’m always on TikTok for one, I have an obsession. And so I’ll even send him videos and I’m like, can this really happen? And so to show everybody and share that connection that Dr. Salazar and I have with these videos and learning from each other I think is really fun.
Monique Ramsey (20:48):
And so tell everybody where they can find those or when do you guys do ’em on a certain day of the week or just every so often?
So we do reaction videos on Tuesdays, usually about once a month is when we’re starting to do them. And you can find them on our Instagram at LJCSC or you can find them on our YouTube as well.
Monique Ramsey (21:06):
What piece of advice, now that you’ve been through it as a patient, what would you tell them?
I would say, give us a call. Let’s talk through what your goals are and then let’s get you scheduled for a consult. You’re not signing or committing to anything. You’re just coming in, getting an evaluation, finding the office, getting to know the staff and seeing who you feel more comfortable and confident in. And then whenever you’re ready, we’re here for you.
Monique Ramsey (21:32):
Yeah. Some people might say, oh yeah, I know Dr. Brahme from a friend of mine, but what if the patient, how do you help patients decide which surgeon if they don’t already know which surgeon? We have six amazing plastic surgeons.
So I kind of help navigate by gathering information. I want to know what their goals are, what their aesthetic look that they’re going for is, and then that’ll help me navigate and recommend a doctor. So if you’re wanting a liposuction and you want to really contour defined, look, I usually recommend Dr. Salazar. He specializes in HD standard 360 lipo. He’s going to be your go-to for that, who’s going to give you a really good outcome if you’re wanting facial procedures. We have Dr. Breister who does facial procedures, Dr. Riedler, and then if you’re wanting a breast reconstruction, we have Dr. Smoot. So they all kind of have their own niche. And depending on what the patient wants their aesthetic goals to look like, I can help navigate and say, you know what? This doctor, he’s really aggressive with his lipo. He’s going to do a fabulous job. Or This doctor really specializes in breast reconstruction. They’re going to be your go-to and give you all the options available.
Monique Ramsey (22:42):
Yeah, I think that’s having somebody to help you through. And I think another way, and we’ll put the links in the show notes is to look at the gallery. You can look at the gallery of before and afters for lots of different procedures. You can see which doctor did the different procedures. And I think that’s another way to help get an idea for the kinds of results. But if a patient, let’s say they see one doctor and they’re like, I don’t know, do you recommend that they also maybe have a consultation with another?
I actually love this because I’ve had this happen on occasion, and I tell them, I’m like, the benefit of having a practice with six different doctors is we can get you scheduled with another one to see if you guys have a better connection. Not just, oh, this is a result that I like. It’s also a personal connection as well that you want with your doctor to build trust with them. It’s really important. And you can meet with different doctors and there’s no fees for it. There’s no weird feelings. It’s the good thing about having so many options available is that we can find the one going to fit best for you.
Monique Ramsey (23:46):
Yeah, I think that’s something that not everybody knows that they can be like, yeah, we want you to click with your doctor and we want you to feel really confident. And if you’re just not sure, that’s okay. And they might recommend different things depending on what you’re trying to achieve and the type of procedure, they might have a different approach. So it is something that we deal with all the time, and all the doctors are cool about it. There’s no competition. It really is kind of a unique situation so that people can feel comfortable about saying, okay, well,
Yeah. Or even the doctors themselves, they’ll be like, after reviewing the case, it’s a little bit more complex. Or, you know what? I don’t think I’m the doctor that’s going to give you this result, but I have just the one in mind who does exactly what you’re looking for. And they’ll even refer to one of the other doctors in the practice. We’ve done a really good job just building a family within each other in the office, and the doctors have as well too, and we always want what’s best for the patient.
Monique Ramsey (24:44):
And that’s really the end of the day. What it is, is having that you don’t stick around for 35 years and have thousands of five-star reviews without having those kind of connections and seeing it through. And we’re at the point now we’ve seen generations of patients, which is so fun to know that. Yeah, here’s my plastic surgeon.
Yeah. We have the grandmas now. The moms are coming in and now the daughters are coming in. It is a whole generation. Yes.
Monique Ramsey (25:12):
Yeah. Well, Marissa, thank you so much for just joining us today, sharing your personal story and your journey, and we’ll put links in the show notes to the social media so you can check out Dr. Salazar and Marissa’s reaction videos. There’s some pretty interesting ones. So anyway, thank you again, and we will see you all on the next one. Bye
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 lj csc.com or follow the team on Instagram @LJCSC. The La Jolla Cosmetic Podcast is a production of The Axis.