Kiersten Riedler, MD - Facial Plastic Surgeon in San Diego, California

Eva Sheie (00:03):
Whether you're trying injectables for the first time or making a change to a new provider, the more you can learn about who your injector is before you're in the chair, the better that appointment will be. You are listening to Meet the Injector.

Monique Ramsey (00:17):
I'm your hostess, Monique Ramsey. And today we are going to speak to Dr. Kiersten Riedler. Welcome Dr. Riedler.

Dr. Riedler (00:26):
Hi. Thanks for having me.

Monique Ramsey (00:27):
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 kind of look at?

Dr. Riedler (00:38):
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 or 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 multi-layer process that affects the skin quality, the loss and descent of fat, wrinkle formation. 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 wrl 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 (02:10):
You mentioned bone. I find that interesting. Tell me what you mean by that.

Dr. Riedler (02:14):
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. All of those cause deep structural changes that going to affect our external appearance.

Monique Ramsey (03:02):
Interesting.

Dr. Riedler (03:03):
Yeah.

Monique Ramsey (03:03):
That's sort of why maybe as people get older, their eyes almost appear sort of sunken in a little bit?

Dr. Riedler (03:09):
Yeah, it's because of loss of soft tissue, but also loss of bone. It's actually kind of depressing or disheartening looking at these CT scans over time and seeing how everything just kind of wastes away. But fortunately it is what happens, so we just do our best to undo it.

Monique Ramsey (03:27):
Right, right. Exactly. In terms of advantages to being a female facial plastic surgeon, what do you think your advantages are?

Dr. Riedler (03:37):
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 'em. And just having the female aesthetic eye I think is invaluable.

Monique Ramsey (04:07):
And what led you to this specialty of aesthetics?

Dr. Riedler (04:12):
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 skillset and my knowledge of face and neck anatomy.

(05:04):
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 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 nasal 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 realized 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 (06:00):
So what have you learned over the years from listening to patients?

Dr. Riedler (06:04):
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 I mean, that's really step number one when any 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 (06:39):
And what could a patient expect when they come to see you for the first time?

Dr. Riedler (06:44):
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 we'll 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're confident we'll help achieve their goals.

Monique Ramsey (07:41):
So you mentioned San Diego. Can you tell us about yourself, where you grew up?

Dr. Riedler (07:47):
So I was actually born across the street at Scripps La Jolla.

Monique Ramsey (07:51):
Hey, me too.

Dr. Riedler (07:52):
Oh really? Oh my gosh.

Monique Ramsey (07:53):
Yes. I was. I mean, way before you, but yeah.

Dr. Riedler (07:58):
Yeah, I guess my mom told me that they used to serve lobster in the maternity.

Monique Ramsey (08:04):
Oh yes. On your last day, right before you went home, you got to have a lobster dinner. Yes.

Dr. Riedler (08:09):
So I was born there. My dad was a neurology resident at UCSD at the time. My mom was a music and math teacher, and we lived in University City until 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 (08:41):
So you can't just skip over that whole educational path. I'm not going to let you skip over the 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 that.

Dr. Riedler (08:57):
Yeah, 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. 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. I was lucky to be able to stay there, which was a really great training program.

(10:00):
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 yeah, 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 a past president of the American Academy of Facial Plastic and Reconstructive Surgery. And during that year, it was all facial plastic surgery and we split our time between Sacramento and Beverly Hills where his two practices are located.

Monique Ramsey (10:49):
Oh, interesting. What would you say you want listeners to take away from listening to this podcast?

Dr. Riedler (10:56):
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 am just here for them.

Monique Ramsey (11:10):
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. Riedler (11:18):
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 Mise en Place. I dunno if you've heard of it, but it is something I always think about when I arrange my instruments at the beginning of each surgical case. I think, okay, I'm doing my Mise en Place, I'm just arranging everything just like you do in the kitchen with your ingredients and instruments. So there are a lot of parallels, but then cooking has added benefit that you get to eat at the end.

Monique Ramsey (12:04):
Now I found out something cool, which is that you're bilingual.

Dr. Riedler (12:09):
Oh yeah,

Monique Ramsey (12:09):
And so tell us about where you learned to speak Spanish and a little bit about the Spanish side of you.

Dr. Riedler (12:18):
So I actually started learning Spanish in kindergarten at Spreckels Elementary, which is a bilingual magnet school in University City. So that was when 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 and literatures at Harvard. And then as a medical student and resident at 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 and 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. Yeah.

Monique Ramsey (13:29):
Yeah. And how long were you there?

Dr. Riedler (13:30):
I was there for three months.

Monique Ramsey (13:32):
Wow.

Dr. Riedler (13:33):
Yeah. 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 (13:46):
Wow. So maybe we could do some episodes in Spanish.

Dr. Riedler (13:50):
Yeah, sure.

Monique Ramsey (13:50):
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? That'd be fun.

Dr. Riedler (14:01):
Definitely. That'd be fun.

Monique Ramsey (14:03):
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. Do you have a Instagram that you want people to follow?

Dr. Riedler (14:33):
Yeah, it's just Dr. Kiersten Riedler.

Monique Ramsey (14:36):
Well, thank you so much. It was really fun getting to know you this way. I think you and I were 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. Riedler (15:09):
Thank you so much for having me. Looking forward to seeing more of you.

Monique Ramsey (15:12):
Yeah, yeah. Likewise.

Eva Sheie (15:14):
There's no substitute for an in-person appointment, but we hope this comes close. If you're considering an appointment with this provider, be sure you let them know you heard them on the Meet the Injector podcast. Check the show notes for links including the injector's website and Instagram to learn more. Are you an aesthetic injector or do you know one? You can be a guest on Meet the Injector. Book your free recording session at meettheinjector.com. Meet the Injector is Made with Love in Austin, Texas and is a production of The Axis, theaxis.io.