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 today I have a real patient for you to meet, her name is Maria. Welcome, Maria. Maria (00:26): Thank you. Thanks for having me. Monique Ramsey (00:28): So, Maria is a patient in our med spa and we're so honored that you're willing to share your story and your experience with our audience. So tell us a little bit about yourself and maybe what brought you to us. Maria (00:40): Yeah. I started coming here in 2016 after one of the nurses that I work with who has excellent Botox. And I was like, "Where do you go?" And she's like, "La Jolla across the street, Ximed building." And so I made an appointment. I had done Botox a couple of times before and it never really set me on fire. And then I came here, I met Brittany Haley and that is where it begins. Monique Ramsey (01:08): She's the best. Yeah. Maria (01:09): She's really, really good. Monique Ramsey (01:12): So you've been our patient for a long time then? Maria (01:14): Yes. Yes I have. Yes, I have. Monique Ramsey (01:16): Wow. That's exciting. Maria (01:18): I would eat cat food if it meant that I could still come here and get all my treatments done. Monique Ramsey (01:24): Well, yeah, I'm pretty much right there with you sister. So yeah. So tell us the first cosmetic treatment you ever did, was that Botox? Maria (01:35): It was. It was. With you guys it was Botox. It was just a very small treatment and it really just helped me kind of dip my toe in and didn't feel any pressure to do anything more. Just kind of gave me what I wanted in the most natural way possible. I guess that was, gosh, was I 34, 35? Something like that at the time. Yeah. Monique Ramsey (01:58): And how old are you now? Do you mind me asking? Maria (01:59): 40. I'm almost 41. Monique Ramsey (02:01): 40. Oh my gosh. Okay. So, well you don't look it at all. Not even close. Maria (02:07): That's the point. Monique Ramsey (02:08): And that's the point, exactly. So was there ever at the beginning, when you were thinking about Botox before even you came to us, was there some moment that pushed you over the edge that said, I got to do this now? Or was it gradual? Maria (02:22): I was living in Philadelphia at the time and I remember seeing photos of myself and all of a sudden being like, oh my God, what is this? I had been on a climbing trip and I had been squinting a lot in the sun. And then when I came back from the climbing trip, I was looking at photos of myself and I had a white spot in the middle of my elevens where I'd been wrinkling so hard and squinting so hard that it didn't tan and the rest of my face did. And then of course you got to look at your mother or your dad and I was like, oh God, I see what's coming. So that was sort of my initial, well, let me at least knock this out. Monique Ramsey (03:04): Well, what's the entry point? It's either sometimes the medical grade facials and skincare or it's Botox because it's the first thing you do notice is that area between... And some people it's just habitual. You find yourself, washing your hair in the shower and you're scowling. You're like why? Because it's a habit and you don't even realize you're doing it. Maria (03:27): I think there's enough bad Botox out there or people that are more frozen than they need to be. And then you've got other, some of my coworkers who are like, I would never, I want to express myself. And I'm like, well, if you're doing it right and you're going to somebody who is good at what they do and understands anatomy and structure and how this product works, then you should still be able to be expressive and convey your emotions without having huge, deep wrinkles in your face. You're going to still have movement and still be yourself. Monique Ramsey (03:57): I think that is a common misconception that you'll look like somebody different or you'll be frozen. Your face isn't frozen, not at all. Maria (04:04): You shouldn't be frozen. You're not going to the right person. Monique Ramsey (04:09): So what was your first impression about coming in for your first consultation in treatment with Brittany? Maria (04:16): Everybody's really nice, really friendly. And I guess the biggest thing was I sort of expected I'm coming in here and I'm in Southern California for the first time and I'm getting Botox in Southern California and I expected just a lot of fakeness and to be pushed into a certain direction. Between Brittany and then there was another provider who's not here anymore, who I saw, who are just very like, "No girl, we're going to give you what you want and we're going to do it well, you just trust me." And so it was just low stress, I think that was the big thing I felt like I was listened to. Nobody pushed anything extra on me. And that was really refreshing. I think I was expecting, you know, you go into a place and you get your lashes done, let's say, and then they're trying to sell you their lash serum, their eyelash brush, their cleanser, all these things that I don't need that. So yeah, I wasn't expecting that. Monique Ramsey (05:07): So you had Botox or you continued to have Botox, I'm assuming, and then you also had the Halo laser? Maria (05:15): Yes. So I went through a breakup in 2017 and at the time I came in for my regular Botox treatments and I was seeing Erin Hewitt, I think that day, who was not here anymore but I love her. And I basically explained to her, "Listen, I just, I've gone through a huge breakup." I said, "I want to be refreshed. I need something big." And she's like, "I got you. We're going to do the Halo." And she was like, "It's going to fix a lot of..." I can't say enough about the Halo. It's going to fix a lot of the tone. It's going to fix a lot of the discoloration and just reset you. Maria (05:54): I've never seen so much change with just one treatment. I think my first Halo treatment was just night and day. Unbelievable. I look back at photos of myself and there are age spots, huge freckles. Monique Ramsey (06:08): Really? Maria (06:08): Yes. Sun spots that are gone. I looked at photos of myself and I had freckles, I had completely forgotten that I had freckles. It was amazing. Absolutely amazing. Monique Ramsey (06:19): It's one of our most popular treatments is Halo. And I think it's because it's like, it can help everybody and it can do a lot in one treatment. For the listeners, we have an episode about laser zone than we did another episode with Julia specifically about Halo. So what did they do when you had that, if you remember, to make you comfortable during that treatment and how did you feel later in the day? Maria (06:46): She used numbing cream, I'm almost positive. And then I take the medication. I don't feel like you don't get a prize at the end of the day for being in pain, so I took the pain medication. I'm glad I did because it was uncomfortable and she blasted me and I can honestly say, I don't remember too much of it. And then the next day I was fine. I think a lot of people have limited downtime with the laser and they say, "Oh, it's three days back to work." Let me tell you something, that was not my experience. I'm a slow healer, same thing with tattoos and stuff like that. I am kind of slow to heal. So I needed to lay low for closer to five, but once the swelling went down and that dead skin starts to slough off, my God underneath was insane. So totally worth it. Monique Ramsey (07:40): Yeah. It's really like a five to seven day healing time. And Julia was saying, it kind of doesn't matter. Halo is very customizable where you can dial it down or dial it up. But almost no matter what, or if she adds some other treatments on top, it kind of is if you really plan on that five to seven days it's going to be about right. Three days depends on what you do for a living. If you do what I do for a living, that's fine. Everybody's used to seeing us with fried off faces, but keeping yourself, I think, out of the sun is really important. Monique Ramsey (08:13): So you started to see a difference within that first week at the end of that first week? Maria (08:18): Absolutely. Yes. Yes. And then it's kind of gradual. I mean, once it sloughs off and then you're still red, you're still kind of pink underneath. And then as that kind of goes away, I mean, I looked like a little anime character for a while. I had these huge cheeks. And then once that swelling kind of subsided, I feel like it took at least five years off my skin. Just that one treatment. It really made a huge difference. I can't stress that enough. If anyone asks me, what's the number one thing they should do, I would tell them Halo. Monique Ramsey (08:50): Oh, that's awesome. And I think we have, you can look on our website, there's a lower level called Moxi. Maybe you do six times or you do it eight times, but you don't really have the downtime, but there is some benefit to that. So for people, because I think Halo or any laser, it's kind of does depend on the time of year when you have it done. And so right now if it's warm and you're in the sun a lot or even in the early fall, it's like, well I might want to have my Halo later. But if you wanted to make a difference in your skin earlier than that, then that's where maybe the Moxi comes in or seeing Cameron. I don't know if you've been in to see Cameron yet. Maria (09:29): I have seen Cameron. Monique Ramsey (09:32): So those kinds of things can help your skin in the warmer months or when you might be out in the sun a little bit more, obviously you're always putting on sunscreen, right? Maria (09:41): Yes. Monique Ramsey (09:41): Everybody every day. Maria (09:43): Yes. Monique Ramsey (09:44): So you do it again. You'd recommend it to others. It sounds like. Maria (09:47): Oh absolutely. Absolutely. Monique Ramsey (09:49): Okay. So the other thing on my little list somebody's told me that you had Ultherapy. Maria (09:53): I did have Ultherapy. Monique Ramsey (09:55): Tell me about that. Maria (09:56): I am actually having Ultherapy done again next week. I love it so much. So I, just genetics and then some hard years in my 20s when I was a distance runner and didn't feel like I needed to wear sunblock. You know how that is. I just have a lot of creping under my eyes, especially, and I've done so many treatments on my face and I feel like maybe my neck is starting to get a little. Maria (10:16): So a few months ago I was blowing up Brittany and I was like, "Oh my God, I need more laser under my eyes. We got to get rid of this crepiness. And I Googled it and this is what they said." And she wrote me back and she was like, "You're not the expert. Come in for Ultherapy." Monique Ramsey (10:35): Oh good. Maria (10:36): So I went in for that and I had Ultherapy. So I did a Halo laser with Ultherapy under my eyes and then my lower face. And that is supposed to be a spicy treatment. And I got to say I fell asleep. I took the pain medicine. Monique Ramsey (10:50): Did you really? Maria (10:51): I did. I did. I took the pain medicine, I was probably also post night shift so I'm sure that helped. And then I got the numbing and then I know that at one point I was definitely asleep for it. So it wasn't as bad as everyone says. Yeah, everyone was kind of making it seem like it was going to be the gnarliest of the gnarly. Monique Ramsey (11:11): It can be intense. I would say intense or spicy is a good word. Maria (11:14): Spicy. It wasn't spicy. Monique Ramsey (11:16): But again, it depends on whether you have some painkillers. Maria (11:20): Sure, sure. Monique Ramsey (11:21): Because there's some patients and actually we just did Corey Dylan who's on the Big FM 100.7 and we had her on the podcast just a few weeks ago and she had it done. But she was driving herself home so she couldn't take any pain pills or anything to make her relax. So because of that, she used the Pro-Nox which is the laughing gas and you can kind of self administer and take as much as you need. But it wears off within five minutes. So for her, it was definitely more spicy, but she didn't have a choice. Because she had herself needing to drive herself home. Monique Ramsey (11:56): But I would say, I mean if you can have something on board for pain and have somebody drive you home I think that's the best of all possible worlds. But even if you don't have it, I mean, Cory got through it. She just took a few more breaks. But you falling asleep, that's amazing. Maria (12:11): Yeah. I have no anxiety about doing it again. Very happy. Monique Ramsey (12:16): And so how long ago was that you had your... Maria (12:18): Oh gosh. How long ago was that? Was February maybe. And those results take a little bit of time. It's not an immediate thing. And I remember a few months later looking in the mirror and being like, oh my God, a lot of that crepiness and those fine lines and that kind of saggy under eye skin is better. I mean, it has improved so much. So yeah. It's pretty rad. I love it. Monique Ramsey (12:46): So you're doing another one. And actually, so when I talked to Anne, Anne one of our providers, she had done Corey's treatment and I was asking her, how often should you have it done? And she was saying, really, it sort of depends on what your goals are. And for some people we might do one and then six months later do another one. And then to get you to a point where you're like, okay, here's my new baseline. And then you can maybe do it every year or every year and a half. Sort of the Halo too. It's like, you want to keep those results up. We have one patient, we did a Halo episode on and she's like, it's my birthday present to myself every year. Maria (13:22): Exactly, exactly. Brittany and I have kind of come up with a plan at this point, which is Halo yearly, Ultherapy yearly. And then I guess, six weeks after I do my Ultherapy is when I'll just get a refresher of a little filler. Monique Ramsey (13:39): Because you can't do it the other way around. Maria (13:41): Right. Monique Ramsey (13:41): I just had some filler put in and then we were doing these whole therapy episodes and I was getting really jealous and I'm like, I really want them. And they're like, yeah, you have to wait. You have to wait till Christmas time. But that's okay. That's when my birthday is, so I'll do it for my birthday. Monique Ramsey (13:57): So when you get filler, do you mind me asking, where do you like to put it? Maria (14:01): So Brittany will do it kind of in my cheeks and then it just kind of fans out nicely. She gives me great symmetry. Just kind of lifts me a little bit. And then, oh girl, she fills me everywhere. I don't know. At this point I'm like, do what you need. Monique Ramsey (14:14): Do your magic. Maria (14:15): Yeah. And she never comes at me with everything all at once, but she's like, well, let's put a little here to kind of balance this out and let's fill you a little. So I'll do kind of my smile lines a little bit. Maybe fill along my jaw just a little bit to give it a little bit, just where I'm losing volume just to keep everything a little firmer and a little fuller. I do a little bit in my lips as well just because you know. Monique Ramsey (14:38): I think that's the key is having a provider who will tell you where you need it and where you don't. Because sometimes we think we need something and they're like, no, no you're good. Maria (14:49): Yes. I have actually come here before being like this is what I want and having both Erin and Brittany say no, no. Absolutely not. Showing me before pictures of myself and I remember Erin scrolling all the way back to 2016 and being like, this is what you looked like when you came here and this is what you look like now. Do not lose sight and become one of those overfilled plastic looking people. And she really brought me back to reality. I really appreciate that. Monique Ramsey (15:17): Erin, her husband who's an ex Navy Seal, he retired, and they moved out of the county. So we miss her. I think that's something that a lot of our providers have in common is that you can always put more in that, they're very careful with not doing too much. You can put more in, wait two weeks, see how it is. Let's see what we think. Let's wait a month, whatever. And maybe you need more, maybe you don't. And so being gradual and being conservative so that you look the most natural. I think sometimes we think we want it today. Monique Ramsey (15:55): In fact, I remember a friend of mine, she wanted under eye filler and she'd had it before and they're like, actually you've got too much and it's old and it's not looking right. We need to dissolve it. She was like, no, but I want this today. She had her mind fixed. So they had to dissolve it over a couple sessions, but then they had a nice clean slate to work with and she got some threads, she got some Ultherapy. She did some other things that then gave her a really great result. But you can't really know what you need necessarily as a patient. I think that's where it's have that consult and say, here's the places that bother me and how can we fix them and come up with a plan. Maria (16:39): That's one of the things that I really appreciate about this practice is how conservative they are and the fact that I haven't had anyone who is just like, yep, absolutely everything you want. It's totally fine. It's only been like, let's take this in steps. Let's go slowly. Let's start with this. If you feel like you need more, please come back. Let's talk about it. Let's look at photos of you in six weeks and then reassess. I don't know that I've ever needed more, even when I've been sure that I did, once that six weeks is over and I take a look at myself, I'm like no, actually I look great. Monique Ramsey (17:12): So did anything surprise you about any of these treatments? Was there anything you weren't expecting? Maria (17:19): I wasn't expecting the Ultherapy to make such a big difference. I think because you walk away from it without seeing results. That was honestly the most surprising thing for me was how well it worked and how natural, I mean, it just builds your own collagen. I mean, it's the best case scenario. It's just kind of adding to your collagen base and rewinding the clock a little bit. So I think that's honestly the biggest surprise. I haven't had any negative surprises. Monique Ramsey (17:51): Well, that's good. That's good. Maria (17:53): Other than the Halo's are taking longer than I expected to look normal again, but otherwise no, I haven't really had any issue. Monique Ramsey (18:02): What advice would you give to somebody who's thinking about a treatment? Any of the treatments you've done, maybe they're on the fence about it. Maria (18:08): Biggest advice is, obviously this is The La Jolla Cosmetic Surgery Center Podcast, so go see them. Monique Ramsey (18:14): Don't do it. Maria (18:18): I think if you really need to know and trust the people that are doing the procedures for you. I'm a nurse and I actually took care of both Erin and Brittany when they were having their babies at UCSD. Monique Ramsey (18:30): Oh my gosh. Maria (18:31): They don't remember me. Brittany was having a baby, but I was [inaudible 00:18:35]- Monique Ramsey (18:35): Oh my gosh. Maria (18:35): Anyway. But what I'll say is anybody can take a quick course and be "Certified" in filler and Botox. And that does not mean that they are good at it. It doesn't mean that they have experience. It doesn't mean that they know what they're doing. So I think the biggest thing that I would say to anybody who's considering getting procedures done is please, please, please be sure that you do your research on who you're going to and that you don't shop around for price because that is a problem. Don't look for Groupons because that's a problem. And go with someone that comes from a reputable practice where they've been trained and vetted and have years of experience. Monique Ramsey (19:13): Actually that's a really good point that you bring up. We do, when we have a new provider come in and almost exclusively the reason we've got new providers is somebody goes out on maternity leave or goes out on maternity leave again. Thank you Brittany. Thank you Erin. But we vet them on every single procedure. Even if they've been doing it for five years somewhere else, we have to see that they know how to... We don't just take their word for it. They have to prove that they know how to do it and that they understand. Because our standards are really high because we have a reputation. We have a lot of really good reviews and so we don't want to have somebody who's going to disappoint. So we do vet everybody on each procedure and they can't do it until we've signed off. I guess from a nursing point of view, that's interesting that you bring that up. Maria (20:05): I've had friends say to me like, oh, you're such an advocate for this stuff. I've sent, I don't know, half the staff at UCSD here at this point, because I also think that aside from learning how to do it there's something about having that aesthetic eye. I'm a great labor and delivery nurse. I know that and I know how to do that and I know how to do that well, but I don't have that artistic eye to be able to look at a face and say, this is where the asymmetry is or this is how it's going to be better. I don't know that that's something you can really teach. Maybe you can and I'm wrong, but- Monique Ramsey (20:40): There's some of it I think, but you're right that having that artistic eye and in 3D too, because so much of it has to do with bone and the muscles and all your anatomy, the facial structure. So it's the artistic eye and the facial anatomy knowledge and then they're constantly learning on how to inject different areas of the face or the mouth. Cannula injection versus the syringe and all these different... I mean, there's all kinds of stuff and they're constantly learning and finding new ways to do things better. So that sort of continuing education component, I think is really important. And Lauren's a master injector and a trainer for Allergan and for Galderma, Brittany's a national trainer for Sciton, for the lasers. Con goes and trains on the Nova threads. They train other injectors. And so they really are the best at what they do and they do a lot of it. Monique Ramsey (21:34): I think that's the other point is, how long have they been doing it and are they doing it on a frequency basis? But I love the fact that you were referring your friends. Bring them all over. Maria (21:45): I don't ever stop talking about it. So I really think that at 40, I think I look better than I did at 35. I definitely feel better than I did at 35. And these women have done more for my self-esteem, getting me back on my feet, making me feel good about myself again, giving me confidence again, getting me through personal trauma than a therapist has. I can say that definitely in terms of my self-esteem. I hope that Brittany especially knows what she's done and how important her work is because, I mean, it's made a huge difference in my life. It really has. Monique Ramsey (22:21): Oh, that's so nice. And I think that's a testament to our team. They really are wonderful people who genuinely care. And that's what I really love is even though I work there, when I come in and I don't work in the office, there's no room for me, they're so busy. I have to work from home, which I love because I have my cats. But when I come in, it's that feeling you get when you're there and you're like that coming home and family and just making you feel welcome and that they really appreciate you and they're going to do their very best for you. And I always feel that way. I feel like that's a typical patient reaction. Maria (22:57): Yeah. Good, good. It's not just me. Okay. Monique Ramsey (23:01): So is there anything else that we haven't addressed today that you might want to talk about? Maria (23:07): Oh, I think we hit all the finer points. Botox, filler, Halo, Ultherapy. Monique Ramsey (23:13): Yeah, the hot tickets. Maria (23:15): The hot tickets. Monique Ramsey (23:16): And they really are, and they're popular for a reason just because they work. They really, really work. Monique Ramsey (23:22): Anyway, but thanks again for joining us, Maria. Maria (23:25): Well, thank you. Thank you for having me. This was fun. Monique Ramsey (23:27): I'm glad. I'm glad you had fun. And for everybody check the show notes for all the links of things we talked about. And thanks again for joining us today. Speaker 1 (23:41): 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 I5 San Diego Freeway in the Ximed building on the Scripps Memorial Hospital Campus. Speaker 1 (24:03): 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, the axis.io.