Speaker 1 (00:00): Speaker 1 (00:07): You're listening to the La Jolla Cosmetic podcast. Monique Ramsey (00:14): Welcome, everyone, to the La Jolla Cosmetic Podcast, I'm your hostess, Monique Ramsey, and my guest today is Dr. Luke Swistun. He's one of our board certified plastic surgeons here at La Jolla Cosmetic. Welcome, Dr. Swistun. Dr. Luke Swistun (00:29): Thank you, Monique. Nice to be here. Monique Ramsey (00:32): So today we're just going to get to know you. How long have you been a part of our Dream Team here at La Jolla Cosmetic? Dr. Luke Swistun (00:39): Well, I've been operating here since January, 2021, so almost a year now, and I've been in contact with the clinic for a couple months prior to that. It's been the most wonderful year of my life so far, I can't lie about that. Prior to that, I lived in Los Angeles for about three years. That was finishing out my plastic surgery training and fellowship in Beverly Hills in aesthetic plastic surgery, and then working for two different practices over in Los Angeles and in Beverly Hills, just to get my feet wet, I suppose, but just couldn't stay away from San Diego. Monique Ramsey (01:12): So how did you land here, you want to tell everybody? You and I have a secret. Dr. Luke Swistun (01:18): Sure, yes. So a long time ago, probably about three years ago now, I finished the board certification process for plastic surgery and I got my diploma as a board certified plastic surgeon. And I went ahead and I posted that on Instagram, and we were already following each other on Instagram casually, just without any significant contact beyond that. And after I posted my diploma picture, Monique said, "Congratulations," and I said, "Thank you." And then I also said something like, "Oh, and by the way, if you're ever looking for any help in San Diego, let me know because I'd love to live down there." And Monique said, "Oh, really? Well, as a matter of fact, we might, because one of our surgeons is retiring," and the conversation started there. So I can say that I got this job through Instagram, which I think is not common, but very serendipitous in this case. Monique Ramsey (02:06): Yeah. Yeah, it really was. It was a cool conversation to go from being in your DMs and me giving you congratulations, to you in the OR down the hall, which I love. So tell us about what procedures you love to do and why. Dr. Luke Swistun (02:23): I like to do big body transformation procedures, things that strike you as far as differences from across the street, from across the beach. So the very common one is, basically, liposuction fat transfer, also known as Brazilian butt lift, one of those where a patient comes in and maybe doesn't have the curves or the shape that she wants. And then after the procedure and after her healing process, it's a completely different person. And there's a lot of photos of that, those very successful results, that a lot of people don't even believe me that it's the same person until I point out the tattoos and they're like, "Oh, wow, it is the same person." But I think that's the most satisfying outcome. Surprisingly common feedback that I've gotten from these patients is, "I live life differently now. I'm so much more confident. I'm so much more outgoing." And it's a huge mental shift in addition to the physical transformation that we made, but it makes a big difference in their lives. Dr. Luke Swistun (03:17): The second most common surgery that I do actually has to do with breast implants. And there's lots of patients that have breast implants and do really, really well with them, but there's a small subset of patients who don't tolerate them very well. And what I do is I, actually, a lot of times will remove the implant and maybe all the scar tissue that's associated with the implant, and find an aesthetic solution that is acceptable to the patient that does not involve implants. And that can be a very big challenge at times, as you can imagine, but we have lots of different techniques to do that, and that's been a very large part of my practice as well. Monique Ramsey (03:53): So what can patients expect when they come to see you for the first time? Dr. Luke Swistun (03:58): A long conversation. In order for me to find out what the patient wants, I really need to spend the time with them to hear them out. And then we usually discuss a lot of options available, and I let them, basically, lead me in the direction of what they are looking for, and then we discuss the pros and cons of their choice, and so on and so forth. So it's typically a long consult for the body contouring procedures. A lot of times we'll use a vector analysis as well, which is the technology that we have in the office where we do a three dimensional scan of the patient's body. And we can manipulate the body curves right on the screen with the patient giving us feedback right there and then, so it's a really great tool for us to communicate about the result that they're looking for; and it helps me be in their head when they're asleep on the operating table and I'm doing the procedure. Monique Ramsey (04:48): Oh, interesting. So tell us a little bit about your educational path and where you trained. Dr. Luke Swistun (04:55): I was born in Poland, but I lived in Chicago most of my life, and most of my training is from Chicago. It was University of Chicago as undergrad, and then University of Illinois for medical school. And then after that, I went ahead and joined the Navy and subsequently did a one year internship in general surgery at Naval Medical Center San Diego, and that was back in 2004. And that's how my wife and I fell in love with San Diego, basically; that's when we discovered it. We lived here for five years. After my internship, I was active duty military with the Navy and I was assigned to two different Marine battalions with two deployments to Iraq and stuff. Dr. Luke Swistun (05:30): But the five years we spent in San Diego while this was happening was pretty much the best time of our lives. So after the active duty obligations were over, I went back into training, so I went back to Chicago for general surgery, and then ended up in Salt Lake City at the University of Utah for plastic surgery training. And by that time, I was pretty sure that I wanted to gear my mindset, my practice, towards aesthetics. Interestingly enough, my undergrad degree was actually in visual arts, and I think it took me about 10 years to figure out that marrying plastic surgery with visual arts was my best forte, the best combination of, I guess, my skill set and my mindset. Dr. Luke Swistun (06:11): But to that end, I went to train for one more year to Beverly Hills, and that's where I did an aesthetic fellowship with lots of plastic surgeries geared specifically towards the aesthetic outcomes, as opposed to reconstructive and hand and cranial-facial, which is something that I've done in my training before. After that, my wife and I settled down in Los Angeles for a couple of years just to see how we like it. I think at the time we were of a mindset that Southern California is Southern California, so LA probably is just as good as San Diego, and why not give it a try? But we quickly found out that- Monique Ramsey (06:45): The horror. The horror of that sentence from a San Diego native's ears. Dr. Luke Swistun (06:50): Yes. Well, again, it took us a little bit of time to figure it out, you know, because we were used to big cities before. Monique Ramsey (06:57): Okay, you came to the right place. Dr. Luke Swistun (06:57): I lived downtown Chicago for a long time when I trained, and that was its own thing, but, again, we just came to the conclusion that San Diego was really the best place that we've ever lived in. And pretty quickly after having spent some time in Los Angeles and getting stuck in traffic and just the inaccessibility of the valley to just general daily life and stuff like that, we quickly tried to start devising a plan how to get back to San Diego. And at first it was more like a remote dream, oh, maybe we'll just retire there. And then we decided, no, life is too short, let's actually just actively figure out a way to get there; and that's when the Instagram event happened. Monique Ramsey (07:33): Yeah, that's right. Dr. Luke Swistun (07:34): So again... Monique Ramsey (07:38): So I have to confess that I... We had our little conversation in the DMs and you offered help, and so I went and stalked you a little bit on Instagram and went through your feed, and that visual arts, to me, that really resonated. I didn't know that about you at the time, but as I scrolled through, I'm looking at before and after pictures, I'm looking at beautifully shot photography that you did, but then I also saw your drawings. You had some hand drawings that represented change in body shape. But that really spoke to me, and I thought, our founder, Dr. Merrel Olesen, he used to do drawings before we had computer imaging where he would do a life sized black and white, put a piece of thin tracing paper over, and draw for the patient so they could see the difference in their face or their nose or profile. And so I immediately thought, wow, there's somebody who has this very artistic eye who is also, seemingly, an amazing surgeon based on these before and afters. Dr. Luke Swistun (08:40): Yeah, so it's interesting, that's actually how I took notes in a lot of the fellowships. Monique Ramsey (08:46): Oh, really? Dr. Luke Swistun (08:46): Yeah, those are cases. Instead of just writing everything down, a lot of times it was just a lot easier for my head to express it in a drawing. So all those drawings that you've seen posted on Instagram early on were basically from different cases that I've done in my aesthetic surgery fellowship that helped me visualize and think about how to do certain procedures and how to approach certain procedures. So there's a lot less writing and a lot more drawing in those, and I think it just worked for me. Monique Ramsey (09:13): So now, was there ever a moment where you thought, okay, I want to be a doctor? Was that when you were a child, or somewhere in the middle of Fallujah? Dr. Luke Swistun (09:23): No, I think it was much earlier on. I think probably sometime in college, just having known some doctors and some surgeons and how they used their skillset, dexterity of the hands, in just making changes in people's lives. I thought doctor, maybe surgeon, but I also thought artist, maybe photographer, and wanted to be a pilot. But somebody told me since my eyes weren't perfect I can't do that, so I abandoned that. Not necessarily true, by the way. If you ever want to be a pilot, somebody tells you your eyes are bad, you can still be a pilot, so don't kill that dream. Monique Ramsey (09:52): Well, being a surgeon, you'd need good eyes too. Dr. Luke Swistun (09:55): Yeah, yeah, true. But I think it materialized probably end of high school before college, because I did end up using... At the time when I was an undergrad, my major, again, was in visual arts, period, the end. I did not have a minor in anything else, but I did do my pre-medical prerequisites just in case. I literally said, "Well, if I want to be a doctor, this needs to be done," which wasn't easy, but it was done. And as life was evolving and as I shadowed more doctors and surgeons in undergrad and after that, I decided that medical school is the way to go. Monique Ramsey (10:29): So you mentioned that you grew up in Poland. So tell us about that journey from Poland to here. Dr. Luke Swistun (10:35): Well, I was born in Poland and I came to the states when I was 11, so I lived in Poland for about 10 and a half, 11 years in one city called Opole, which is in the Southern part closer to the mountains. It was very different. This is, at the time, late '70s, early '80s when Poland was still under Communist rule, so there was a lot of very, very different structure in government. And I think my dad was the first one to really want to try to break away from that, because he wanted to be an entrepreneur and that was just not possible under that system. So because we had family in the United States, he went ahead and emigrated out. And then about three years later is when the decision was made by my family on my behalf to go ahead and move the whole family to America just because the situation was just so much better at the time, and that's what we did. Dr. Luke Swistun (11:23): We went through the whole visa process, obtaining the visa. And I remember, actually, going to get a visa at one point when we got rejected. And if you get rejected, you have to wait another year to apply for the visa again, so I remember that happening once or twice, and everybody was in tears when that happened, but eventually we actually got the visa. We came over and then we got green cards, and that's another story in itself, but we did it the right way and the time consuming but correct pathways. And so eventually we got citizenship for the entire family, which allowed me to actually join the military as an officer afterwards. Monique Ramsey (12:01): That's wonderful. What were your first impressions of America when you got here? Dr. Luke Swistun (12:06): Well, everybody in Poland has an incredibly skewed... At the time at least, when I was growing up there, they had an incredibly positive skewed vision of what America is like. It's just, everybody likes the country, everybody tries to associate with the country. American TV and American music videos were the hit thing at the time, and everybody tried to imitate that. So for me to be going to America was great. Dr. Luke Swistun (12:28): I arrived to a house that my dad built, he's a general contractor. He owns a little business in construction, but he built our own house. It was a very small house, but, to me, there's all these things that were new that I've never seen before, I think. Because he just built it, it was a fresh, very thick carpet that I remember. That was the thing that stood out the most is that I've never seen a carpet like that before, where you can almost swim in it. It was amazing. So for an 11-year-old to just be stepping on the carpet that you're sinking into was, oh my God, this is America. And then everything was new and fresh and smelled nice, and it was a very positive experience. Even though looking back, it's like, wow, it was a tiny little house in the middle of nowhere, barely anything, but that's not how I read it. Monique Ramsey (13:10): That's the beauty of kids. We get jaded, I think, as we get older, and when you have that fresh perspective... And you've got children, so isn't it fun to see things through their eyes as a dad now? Dr. Luke Swistun (13:24): Yes, it's very interesting. My kids grew up... I've a wide gamut of ages of kids. My oldest one is 14 and my youngest one is three, but we were living in very different places when the 14-year-old was very young and growing up, and we have a little bit more space and stability now since we've moved here, but it doesn't really seem to affect the kids. I think they're going to be happy anywhere as long as you provide a nice nurturing home and environment, and I remember, I think that was my experience as well. Monique Ramsey (13:55): Now, what do you like to do outside of the office? Where could we find you Saturday morning? Dr. Luke Swistun (14:00): Well, since I have three kids like we mentioned, Saturday morning is probably the time that my wife will be sleeping in and I'll be responding to the three-year-old saying that he wants to get out of the crib. So I'll try to make some coffee or he'll make coffee with me, that's the tradition. Every one of my sons, for some reason, wants to make coffee with me on Saturday morning, it's an activity. The first two grew out of it already, but now the third one took over. And we just do family stuff for right now, just because of how involved we are with the kids. Dr. Luke Swistun (14:31): On my own, my big hobby was actually just driving. I have a tiny little sport car that I've had for the last 16 years that was a hobby of mine, but now my 14-year-old is starting to take a lot of interest in that, and a lot of interest in cars, so we go to car shows and little car events here and there, so we have found common ground. I'm actually proud to say I've taught him how to drive stick shift, even though he's only 14. Monique Ramsey (14:54): Wow. Dr. Luke Swistun (14:54): And he was very excited about that. Monique Ramsey (14:56): Well, I'll bet he was. Dr. Luke Swistun (14:57): He considers that something to be proud of. So our goal is for him to- Monique Ramsey (15:02): Can you teach me next? Dr. Luke Swistun (15:03): Sure. We got a couple cars that can do that, we have two cars. Monique Ramsey (15:08): Perfect. I know, I want to be a race car driver, but I don't know how to drive a stick. This is the problem over here. Dr. Luke Swistun (15:13): Well, you don't need to, for the race car driving is very different nowadays. Monique Ramsey (15:16): Pushing the buttons. Dr. Luke Swistun (15:17): Mm-hmm (affirmative). Monique Ramsey (15:19): Yeah. I remember you telling me, because you moved into your house here and you were talking about your garden and having your son design your garden? Dr. Luke Swistun (15:32): Yeah, so our backyard. We bought a house which was fairly plain as far as the backyard goes. There's just a little bit of a concrete space and some bushes and not much else. My son is expressing a little bit of interest in architecture, so that's the project that I gave. And it's, let's see if we can design something for this backyard that is congruent with the continuity of the house, and something that maybe we'll build in the next 10 or 15 years. So that's a project that he's working on right now, and- Monique Ramsey (16:00): This is the three-year-old, right? Dr. Luke Swistun (16:02): No, I'm sorry, this is the 14-year-old. Monique Ramsey (16:03): I'm kidding. Dr. Luke Swistun (16:05): 14-year-old. Monique Ramsey (16:06): So how's that going? Is it going well? Dr. Luke Swistun (16:08): It's good. Yeah, he's got a couple of different versions depending on... There's one that I like more, and then there's another one that mom likes more, depending on the layout. Monique Ramsey (16:16): Oh. Dr. Luke Swistun (16:16): But yeah, he's very good at it. He's thinking of doing this for real, like in school, so we'll see what happens. Monique Ramsey (16:24): So what have you learned from listening to patients over the years? Dr. Luke Swistun (16:28): I think the patients are, basically, by far, the most important teaching experiences that you'll have in your life as a doctor, and that never ends. You'll learn until you retire; and even after you retire, you still learn, I think. And I have a lot of respect for surgeons who are in their 30th year of practice who still listen to patients and still modify their techniques, especially in surgery. So I guess once you know the basics from medical school and from the training in residencies, I think the patients will fine tune your skills, if you just listen to them. They will tell you what they want, and they will tell you how to do things better than what you have ever done. You just have to keep your mind open. Monique Ramsey (17:09): I think that's true in a lot of different professions. The people who do it for a long time have to always remain open to all the things that have changed and progressed since then, that's why you guys do a lot of training. So you get your board certification, you get your pretty thing to put up on the wall. But after that, what are the requirements for ongoing medical education? Dr. Luke Swistun (17:33): So in order to get that diploma in the first place, there's years and years of training. So once you get that diploma, you're in your late 30s, early 40s. In my case, it was early forties, and that's when you start looking for your actual job. To maintain your certification, yes, you have to take a test annually that is devised by the board. The old way of doing it was that you have to recertify every 10 years. So every 10 years you take a huge, huge test that takes all day, but they've changed it now to where we just take a smaller test, but every year; that adds up to the 10-year test. Dr. Luke Swistun (18:10): And on top of that, we have to also prove that we're staying on top of our training. So every year to keep your medical license, you have to submit proof that you've attended so many lectures throughout the year that have to do with patient safety and your skill set and your profession. Monique Ramsey (18:26): So we can find you on ljcsc.com. And then you said on Instagram at... Dr. Luke Swistun (18:31): @SwistunMD. Monique Ramsey (18:31): And then, what would you like listeners to take away from this podcast? Dr. Luke Swistun (18:40): I think more than anything, especially in aesthetic plastic surgery, I've learned that communication is key with patients. So we're going to go over exactly what you're looking for in your result, and then exactly the options that you have, and the pros and cons of each option. And then we're going to make a collective and informed decision on how to proceed after surgery, but I can't do something that I don't have a clear understanding that the patient really, really desires for the right reasons. That's the connection we try to build. Dr. Luke Swistun (19:10): It's interesting that you mentioned the reviews. I know that that's the reality of today is people go to reviews first and foremost. And I think I still have 5.0 stars, which I can only go down from there, but... Monique Ramsey (19:23): All you need is one person to give you a four. Dr. Luke Swistun (19:26): Yeah, but they're telling, because each one of these patients just spent a lot of time on these reviews. I was very blown away by that, just seeing that, oh my God, there's three or four paragraphs about how this patient feels about what happened. But I think they're very genuine and very telling. Monique Ramsey (19:44): Okay, well, this was fun. I hope you had a good time. Thanks for spending time with me. And for everybody listening, if you have any questions about our services or want to schedule a consultation with Dr. Swistun, just let us know. Check out the show notes, we've got all the links, and we will see you again next time. Thank you. Dr. Luke Swistun (20:04): Thank you again for having me. Speaker 1 (20:11): Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment, or mention the promo code "PODCAST" to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla Cosmetic is located just off the I-5 San Diego freeway in the XIMED building on the Scripps Memorial Hospital campus. To learn more, go to ljcsc.com or follow the team on Instagram @LJCSC. The La Jolla Cosmetic podcast is a production of The Axis, theaxis.io.