#17: I Trust Life: A Survivor Story

Join us this week as Dr. Barrett speaks with Alessandra, Director of Operations at Barrett Plastic Surgery in Beverly Hills. Alessandra shares her very personal story of her own battle with breast cancer. Alessandra was diagnosed with early stage breast cancer after discovering she had the breast cancer gene BRCA2. She subsequently underwent bilateral prophylactic mastectomy and immediate breast reconstruction.

1 in 8 women will develop breast cancer in their lifetime and if your number comes up someday, you’ll want to go in armed with information and inspiring stories, direct from the survivors. Life can be busy and family may live far away which forces us to face some of these things alone at times and Alessandra had to. On the flip side, hear how family support plays a huge role standing by your side during the big ones. From huge needles and surgeries, to the discomfort of constantly having your body touched all a sudden, Alessandra discusses it all and comes out of it with the motto and tattoo “I Trust Life”

Tune in to this episode to catch Alessandra’s incredible story and learn more about breast cancer awareness.

On this episode of The Natural Plastic Surgeon…

Alessandra Ricciuti:...and so the news came to me and it was very shocking. And I didn't really know how to respond or react and…

Alessandra Ricciuti: What DCIS is, it means, it's just they have basically found cancer that hasn't spread…
Dr. Barrett: Right.
Alessandra Ricciuti:...outside of the milk ducts essentially was where they were, the cancer…
Dr. Barrett: It’s called ductal carcinoma in situ. In situ means, like, in its own home, right? So it hasn't really broken outside the home. It might cause problems elsewhere.

Alessandra Ricciuti:...all entailed. It's pretty scary. It's a very long needle. When I say long.
Dr. Barrett: Oh my gosh.
Alessandra Ricciuti: It’s, like, this long. And...
Dr. Barrett: How could it be that long? You're not even, that's not even, like, your whole chest is, like, half that size.
Alessandra Ricciuti: I know.

Dr. Barrett: Screw cancer. It sucks.

Alessandra Ricciuti: I have a tattoo on my wrist that I got before surgery that says “I trust life.” And I do.

You are listening to The Natural Plastic Surgeon Podcast. I'm Dr. Daniel Barrett, Board-Certified Plastic and Reconstructive Surgeon located right here in Beverly Hills. I specialize in cosmetic surgery of the face, nose, breast and body. This podcast is dedicated to those deciding if plastic surgery is right for them and revealing all the latest beauty secrets. Let’s get started.
Dr. Barrett: Hey folks, this is the Natural Plastic Surgeon Podcast and we have a special guest on the show. Another, everyone’s special, but this one is extremely special because she is our Director of Operations, Alessandra. She's joining us today for this podcast under focus for Breast Cancer Awareness for this month of October. And I, I want to, kind of, dive into Alessandra. She is our Director of Operations. And how long have you been working for us?

01:41 ALESSANDRA IS TODAY’S SPECIAL GUEST

Alessandra Ricciuti: Almost three months.
Dr. Barrett: Almost three months and, you guys, we've come light years from where we started without her. And we've, we've done amazing things for our patients and we really, kind of, streamlined a lot of our processes ever since she joined us. Now Alessandra’s from Boston. Baah-ston.
Alessandra Ricciuti: Bahh-ston.
Dr. Barrett: But you don't have an accent…where?
Alessandra Ricciuti: I don’t.
Dr. Barrett: Okay. What, is that purposeful or is it…?
Alessandra Ricciuti: I’m from outside of Boston, so Newton, Massachusetts.
Dr. Barrett: So Newton, Massachusetts, they, they don't have a Boston accent. It’s just...Newton, it’s, it's perfect English. Okay, so you attended college at USC.
Alessandra Ricciuti: I did.
Dr. Barrett: And you've been in operations for a while now. You've actually worked at Beverly Hills Rejuvenation Center, you've worked at Equinox at, at some of these really high-end luxury places. 13 years of operation management experience. Well, known luxury, luxury brands, lifestyle brands and beauty, fitness and wellness industries. You've been in LA for 18 years now?
Alessandra Ricciuti: 18 years.
Dr. Barrett: Wow, I didn't realize that. And you're an avid Boston sports fan. So what are some teams that you like?

02:47 ALESSANDRA’S SPORTS TEAMS

Alessandra Ricciuti: The Patriots.
Dr. Barrett: Okay, so football.
Alessandra Ricciuti: And Red Sox.
Dr. Barrett: Okay. All right. So I'm a huge Pats fan, too. So that's how you got the job. ‘Cause you're a Pats fan. Go Pats.
Alessandra Ricciuti: Go Pats.
Dr. Barrett: Actually, I have a lot of followers out in Boston. And they send me Patriots gear. They actually, one of our, one of our patients who came, who flew out here from Boston, she gave Audrey a little Patriots outfit. And when we watched them win the Super Bowl she, she got to wear that.
Alessandra Ricciuti: So cute.
Dr. Barrett: Yeah. And you, you live a very healthy lifestyle, you do yoga daily. You are all about the latest restaurants, hanging out Malibu, enjoying life.
Alessandra Ricciuti: Yes.
Dr. Barrett: And, and you're working here and you're doing great. So I, I want to, kind of, dive into how you ended up coming out and, and working in management and operations. And what's, kind of, your, your brief story about your career?
Alessandra Ricciuti: Sure.
Dr. Barrett: Yeah.

03:40 ALESSANDRA WAS ALWAYS A LEADER

Alessandra Ricciuti: I have always been a leader, I would say. I played sports, I was always Captain oF my team. So leadership came naturally to me. I worked for the Sports Club, LA while I was in college.
Dr. Barrett: Really?
Alessandra Ricciuti: I did.
Dr. Barrett: I didn’t know that. So Sport’s Club LA was bought by Equinox.
Alessandra Ricciuti: Yeah.
Dr. Barrett: So...got it.
Alessandra Ricciuti: So I started there at the front desk, moved into the spa. And took initiative, you know, in my role. I was just working front desk, but created training manuals and, you know, naturally, kind of, took on a leadership role. That always, kind of, seemed to find me. And just realized that I had a knack for operations, for management, for development of training materials, for staff--recruiting staff, training staff--and I just realized it was, you know, something that was niche and interesting to me. And so I've been able to craft and build a really wonderful and successful career in Operations Management. It’s something I'm really passionate about. And yeah, it's all the details that matter, and it’s...
Dr. Barrett: You are very detailed-oriented, I will say. What, now, tell me more about, what really does light your fire, when you get really excited about stuff? What, what...
Alessandra Ricciuti: I'm passionate about culture.
Dr. Barrett: Okay.
Alessandra Ricciuti: You know, I love staff, and I want everyone...you spend more time at work than you spend at home, even with family members. So, you know, hiring the right staff but giving them also the, the tools that they need to be successful at their job, the training materials, the ongoing training and education so that they can feel like they're developing personally and professionally. You know, it's, it's a reason to come to work every day to love the people you work for and with and, you know, ultimately I think creating streamlined processes and operations so that, you know, everything feels organized and you know where things are when you need them. And so it just, it creates, like, a much better environment. I think for everybody when they're at work.
Dr. Barrett: I, I think that especially hones in true for the patient experience.
Alessandra Ricciuti: Absolutely.
Dr. Barrett: You know, if your, your nurse or your doctor is, you know, is not meshing well, there's not a good team environment, it affects your care. So it's not, I know, the Sports Club of LA is a gym. And that's very important to have a team approach there. There's a lot of important things that are happening there. But when it comes to healthcare and people’s surgeries and people's results, and there, we're talking emotional levels, like, times 10. You know? And, and to…and so to really, kind of, I think it comes down to a really strong team. And I'm glad that that's your focus because I think it's kind of taken Barrett Plastic Surgery to--and Ivy Surgical Center--to the next level, in terms of the care that we provide. That's ultimately our angle is providing, you know, really high, highly efficient, great results, streamlined care to all of our patients.
Alessandra Ricciuti: And when we can do that for staff, then it's easier for them to do their jobs and be there for our patients.

06:44 ALESSANDRA HAD BREAST CANCER

Dr. Barrett: Exactly. So, so the reason why we have you on the show is actually you were a patient at, at a recent point, not too long ago and still are. And we, we're talking about breast cancer, Breast Cancer Awareness in October and it can happen to anybody. It happened to you.
Alessandra Ricciuti: It did.
Dr. Barrett: So tell us about this. You were, you, were you at the Sports Club of LA at the time or were you at Beverly Hills Rejuvenation Center.

07:15 SHE HAD INTERMEDIATE STAGE BREAST CANCER

Alessandra Ricciuti: I was at the Beverly Hills Rejuvenation Center. I...so I was diagnosed with intermediate Stage 0 breast cancer.
Dr. Barrett: DCIS.
Alessandra Ricciuti: DCIS. Yeah, exactly. In my right breast and that happened back in November 2018.
Dr. Barrett: So let's, let's, let's back up. So one morning you woke up. It's not like you got an email like, hey, you have breast cancer.
Alessandra Ricciuti: No.
Dr. Barrett: And I’m not trying to make light of this, but tell me about...because you're young, right?
Alessandra Ricciuti: I am.
Dr. Barrett: Tell me about this process. Like what, how did you find it, was this, was this something you noticed or what?
Alessandra Ricciuti: Okay, so my mom actually was diagnosed with the same thing about, I'd say, 16 years ago.
Dr. Barrett: Okay.
Alessandra Ricciuti: And so we also have a unfortunate, like, history of cancer in the family. From pancreatic to lung to breast. So with, kind of, that history in my family, it was recommended, and my mom also did the genetic testing, but it was also recommended by my ob-gyn to follow through and do the genetic testing. And so I did the genetic testing and I found out that I was BRCA2 positive.
Dr. Barrett: Okay.
Alessandra Ricciuti: Which my mom was also, which is why we thought that, you know, there was a high likelihood that I would be also.
Dr. Barrett: So mom had breast cancer before she was 50 years old.
Alessandra Ricciuti: She had it in beginning of 50’s.
Dr. Barrett: Okay, so premenopausal.
Alessandra Ricciuti: Yes.

08:39 PREMENOPAUSAL BREAST CANCER AND GENETIC TESTING

Dr. Barrett: Okay, so premeno, premenopausal breast cancer is a, is a indication to get genetically tested, alone. And then a family member who's had premenopausal breast cancer is a good reason for you to get tested.
Alessandra Ricciuti: Absolutely.
Dr. Barrett: Okay, so she tested BRCA positive, BRCA2 positive, which means there's a good chance that you might have that.
Alessandra Ricciuti: Correct.
Dr. Barrett: So then you got tested.
Alessandra Ricciuti: And I tested positive.
Dr. Barrett: Wait. So now when she got breast cancer, did they test you...
Alessandra Ricciuti: I was in college.
Dr. Barrett: So you were just, like, whatever. When did you decide to actually get tested?
Alessandra Ricciuti: So the recommendation from my mom's doctor, I think, what she understood, was typically, if her onset was like in her early 50’s, would be for anyone closely related to start doing their mammograms about 10 years prior to her onset of breast cancer. So the thought was, I would start doing mammograms at 40.
Dr. Barrett: Okay.
Alessandra Ricciuti: And you know, but I think my mom wanted me to be really proactive and given the cancer history in our family, it was really my ob-gyn as well who was very, kind of, encouraging of getting the genetic testing.
Dr. Barrett: Okay, so mom got genetic testing.
Alessandra Ricciuti: Mom got genetic testing, yes.
Dr. Barrett: And then how long after that, did you get genetic testing?
Alessandra Ricciuti: Years after.
Dr. Barrett: Oh.
Alessandra Ricciuti: Yeah.
Dr. Barrett: So she was BRCA2 and you weren't worried at all.
Alessandra Ricciuti: Not at the time. I was so, I was so young.
Dr. Barrett: Okay.
Alessandra Ricciuti: And I was then, you know, I came out to school around 17-18. And when my mom was diagnosed...
Dr. Barrett: Wow.
Alessandra Ricciuti: So.
Dr. Barrett: That's, that’s difficult in and of itself.
Alessandra Ricciuti: It was. And I was out here in California and she was back home in Boston so.
Dr. Barrett: Right.
Alessandra Ricciuti: It was very challenging.
Dr. Barrett: And so, so some day randomly, you're just like, hey, I'm, my ob-gyn said I should get tested. I'm gonna go get tested.
Alessandra Ricciuti: So I went and did it, yeah. And then the results came back and to be honest, again, I was probably, I think, 33 at the time, so I didn't do anything immediately. The next steps...
Dr. Barrett: So.
Alessandra Ricciuti:...were to get an MRI.

10:47 NEXT STEPS AFTER DIAGNOSIS

Dr. Barrett: Yeah, so let's back up. So BRCA…I have to pull up the stats on this ‘cause I always forget. Basically, like, anywhere from 50 to 70%, 75% likely to get breast cancer.
Alessandra Ricciuti: Yes.
Dr. Barrett: And ovarian cancer too? Or not?
Alessandra Ricciuti: And ovarian cancer.
Dr. Barrett: Okay. So that's kind of a, that's kind of a bad hand to be dealt. Like, you're playing cards and, like, I've got, like, that's, that's not a great hand.
Alessandra Ricciuti: Yeah. And it was shocking. And I don't think I knew what to do with that information at the time. And the next steps being to get an MRI and, but you have to align that with your menstrual cycle.
Dr. Barrett: Okay.
Alessandra Ricciuti: And so I think at that time, I, kind of, put it off and to be honest, I feel like it probably wasn't till about six to eight months later, again with my ob-gyn, and she just, you know, said you really need to follow through on this. And I said okay, and made an appointment to, to do the MRI. And so this is about six to eight months after finding out that I was BRCA2 positive, and then did my MRI, and...
Dr. Barrett: Now did they reco...she recommend an MRI or did you already have a mammogram and didn't show anything?
Alessandra Ricciuti: I hadn't had a mammogram. So actually what they recommended, and I was being seen at Cedars, and so their recommendation for somebody who was BRCA2 positive was to do...every six months, you would come in for testing, so you would do an MRI. And then six months later, you come in and do a mammogram and ultrasound. So you would...and, and I’d do the same testing for ovarian cancer, going in to see my ob-gyn as well to do ultrasounds every six months.
Dr. Barrett: Okay.
Alessandra Ricciuti: So very preventative.
Dr. Barrett: Yeah. So you have to get an ultrasound every six months.
Alessandra Ricciuti: Yes.
Dr. Barrett: Okay, for ovarian. Now, you had the MRI done for the breast. And what happened?

12:53 SHE WENT TO APPOINTMENTS ALONE

Alessandra Ricciuti: So results came back that they...they do that MRI with an, like, a dye injection. And so it showed my right breast, like, had several, like, places that were lit up essentially.
Dr. Barrett: And the left, but the left breast was fine.
Alessandra Ricciuti: The left breast was fine.
Dr. Barrett: Interesting.
Alessandra Ricciuti: Yes.
Dr. Barrett: Okay.
Alessandra Ricciuti: And so then I was asked to come in and do a mammogram and an ultrasound. And I went to those appointments alone. Like, I didn't think, you know, it was one of those things. I think I didn't think that it was...I was so young and I just thought, like, okay...because they can find just like...
Dr. Barrett: How old were you at the, at this time?
Alessandra Ricciuti: So this is 30...34.
Dr. Barrett: Yeah.
Alessandra Ricciuti: Yeah. And so I went to that appointment alone. And, like, lo and behold, I'm sitting after the mammogram, and then they want to confirm findings. And so I have to go back in for the ultrasound. And I remember calling my parents and just saying that, like, something's wrong, like there, you know this, this process is taking longer than expected. And, and sure enough, they called me in to just let me know that they needed to do a biopsy. So I did the biopsy the next day.
Dr. Barrett: Okay, still by yourself.
Alessandra Ricciuti: By myself. I went to the biopsy, though, with my parents.
Dr. Barrett: Okay, so they flew out.
Alessandra Ricciuti: They actually have moved out here at this point. So they actually moved out to California two years ago.
Dr. Barrett: Okay.
Alessandra Ricciuti: So they're close by, I'm in the valley. And they live in Woodland Hills.
Dr. Barrett: Good. The winters are nicer in Woodland Hills versus Boston. Yeah. Newton.
Alessandra Ricciuti: Right? Much nicer. Retirement suits them well.
Dr. Barrett: Yeah. Good for them.
Alessandra Ricciuti: Yes. So they're close by and I have to say I'm very thankful throughout the whole experience that they were by my side. So...
Dr. Barrett: Okay, so have you ever had a biopsy before?

14:54 BIOPSY PROCESS

Alessandra Ricciuti: No.
Dr. Barrett: Okay.
Alessandra Ricciuti: I’ve never had a biopsy.
Dr. Barrett: So tell us about that. What was that like?
Alessandra Ricciuti: It was weird, I'll be honest. Actually I had a male doctor who did it. So this was, kind of, my first experience too. Like once, I think, you, kind of, get into the breast cancer realm, you start feeling a little bit more open. ‘Cause I was definitely a little bit more private. And, and so all of a sudden, you've got lots of people looking at your boobs and touching your boobs.
Dr. Barrett: Yeah.
Alessandra Ricciuti: You know about this.
Dr. Barrett: Sort of, yeah. Different way.
Alessandra Ricciuti: But you know also how patients, I know, I can really empathize with how patients feel. Because it, it's very nerve-wracking. And so yeah, I just didn't know what to expect with this. And what really was all entailed. It's pretty scary. It's a very long needle. When I say long.
Dr. Barrett: Oh my gosh.
Alessandra Ricciuti: It’s, like, this long. And...
Dr. Barrett: How could it be that long? You're not even, that's not even, like, your whole chest is, like, half that size.
Alessandra Ricciuti: I know.
Dr. Barrett: How, why was it that long?
Alessandra Ricciuti: It’s really crazy. Because they, kind of, they almost do, like, a mammogram and they, like...
Dr. Barrett: Squish it.
Alessandra Ricciuti: Squish your breast.
Dr. Barrett: Yeah.
Alessandra Ricciuti: And essentially they know where, they, the area that they need to target. And so then it's, like, this big long needle that gets injected and it sounds like a gun.
Dr. Barrett: Okay.
Alessandra Ricciuti: That part's the scary part.
Dr. Barrett: Yeah, did it hurt?
Alessandra Ricciuti: They numb it.
Dr. Barrett: Okay.
Alessandra Ricciuti: So I didn't really feel it.
Dr. Barrett: Okay.
Alessandra Ricciuti: Yeah. But you do get a little tiny scar from where they go in and...Yeah, I just remember just being a little traumatized. Like, after it there was, like, blood trickling down and I was just, like, what’s happening? It, it was just very...
Dr. Barrett: Right. Yeah.
Alessandra Ricciuti: Like...
Dr. Barrett: ‘Cause it, was it, was there, like, a YouTube video about breast biopsy that you got to watch beforehand or anything?
Alessandra Ricciuti: No. To be honest, I think, I didn't really seek out a lot of information.
Dr. Barrett: Okay.
Alessandra Ricciuti: I was just, kind of, going with it. I think I was in so, like, shock...
Dr. Barrett: Yeah.
Alessandra Ricciuti:...that I was just, kind of, showing up and going through the motions. And I think I, like, knowing less almost probably made me feel better.
Dr. Barrett: Okay. Yeah. We, I mean, we get, we get, we get patients like that sometimes too. That, that...we get the ones that want to see every single video and every single detail of the surgery that I put out there. And then we get the ones that are, like, I don't want to watch that. I don't want to psych myself out.
Alessandra Ricciuti: Yeah. Exactly.
Dr. Barrett: So biopsy was done.
Alessandra Ricciuti: Biopsy was done. And that happened on a Friday.
Dr. Barrett: Okay.
Alessandra Ricciuti: And...
Dr. Barrett: Which is the worst time because you know they’re not gonna have results. Till, like, next week.
Alessandra Ricciuti: Which...exactly so I was told that they would have results the next week.
Dr. Barrett: Yeah.
Alessandra Ricciuti: So it was...
Dr. Barrett: Great weekend that was.

17:30 A TOUGH WEEKEND WAITING FOR THE RESULTS

Alessandra Ricciuti: Definitely a very tough weekend, just, kind of, waiting for the news. And I actually got the news while I was at work. So my doctor called me on my cell phone, and I didn't really know how to react at that point. You know, I had actually talked to the doctor who had done the biopsy. And he was feeling very optimistic in terms of just looking at, like, kind of, the X-ray that they do. Or in terms of looking at the ultrasound or whatever kind of imaging he was looking at. He, I felt like had, kind of, maybe reassured me that everything maybe didn't look so abnormal or looked fine. So, at the time, I was thinking more positively. And was, you know, I, I, even though I was anxious, I was hoping for the best. And just really hoping that everything was gonna be fine. So the news came to me, and it was very shocking. And I didn't really know how to respond or react. And I can imagine being a doctor on the other end that that’s a very hard call to have to make.
Dr. Barrett: Yeah, I mean, it's like...
Alessandra Ricciuti: And knowing that I was young and...

18:41 RELAYING THE BAD NEWS

Dr. Barrett: Yeah, I mean, I've relayed bad news to people before. You always try to do it in person. That's why I didn't want to be, my first, when I, when I became a doctor I thought I wanted to be a cancer doctor, because my dad had cancer. But I was like, I can't, I can't give the people news like this all the time. I can't do that. You try to do it in person, but sometimes you just, you don't want to, like, say a, you have to come in and, like, we have to talk about this person because then you know it's bad. You just deal with it over the phone.
Alessandra Ricciuti: Yeah.
Dr. Barrett: And so you're at work, though. So like what do you, what do you do?
Alessandra Ricciuti: I was at work. I was shocked. I think little tears rolled down my face. And she just said, you know, can, can you come into the office? And, you know, do you want to bring your parents with you, and I said yes. So it was an immediate call to my parents.
Dr. Barrett: Yeah.
Alessandra Ricciuti: And I was in her office within an hour and a half or so. And she was wonderful. She sat us all down, explained, you know, what they had found and what my options were, and then we made the decision to move forward.
Dr. Barrett: So you're in a unique situation. You're a young woman, but you have a genetic predisposition that really increases your risk of breast cancer and, and, and sure enough, you already had DCIS intermediate. This is probably gonna, you know, it's, it's not full-blown cancer, but it's probably about to go there. So what do they, this probably what, in a nutshell, what they mentioned to or what?

20:10 DCIS EXPLAINED

Alessandra Ricciuti: Yeah, she explained what that actually meant. So what DCIS is, it means, it's just they have basically found cancer that hasn't spread…
Dr. Barrett: Right.
Alessandra Ricciuti:...outside of the milk ducts essentially was where they were, the cancer…
Dr. Barrett: It’s called ductal carcinoma in situ. In situ means, like, in its own home, right? So it hasn't really broken outside the home and, like, caused problems elsewhere.
Alessandra Ricciuti: Yes.
Dr. Barrett: So that's great to catch it at that stage though.
Alessandra Ricciuti: I mean, it's...
Dr. Barrett: It's great.
Alessandra Ricciuti: It's beyond lucky.
Dr. Barrett: Yeah.
Alessandra Ricciuti: And so I'm just, you know, I was grateful. I think that's the place that I tried to come from was just to say, I'm just so happy that I was proactive, and that we caught this as early as we did.
Dr. Barrett: Yeah.

20:55 TREATMENT OPTIONS AFTER DIAGNOSIS

Alessandra Ricciuti: And so the options were to do a lumpectomy, which would just be to remove that breast tissue from the right breast. And then I would have to do radiation. And then also take the Tamoxifen which would have put me into early menopause. Or the other option was to do the double mastectomy. And that was highly recommended by my doctor.
Dr. Barrett: You wouldn't need, you wouldn’t need radiation at that point?
Alessandra Ricciuti: At that, ideally with the double mastectomy, then you, you're removing all of the breast tissue.
Dr. Barrett: Yeah.
Alessandra Ricciuti: So, I mean, she would be testing my lymph nodes and the hope was, once they removed the breast tissue, that it hadn't spread.
Dr. Barrett: Spread, got it.
Alessandra Ricciuti: So as long as it hadn't spread, then I wouldn't have to do any radiation.
Dr. Barrett: Got it. What a difficult choice to make.
Alessandra Ricciuti: Mmm hmm.
Dr. Barrett: What a difficult choice, I am going to either remove both my breasts. Or I'm going to, kind of, disfigure one, give it some radiation, totally not gonna be like the other one and then take a medication that's gonna really mess my hormones up.
Alessandra Ricciuti: Yeah. And I don't have kids at this stage of the game, so taking that off the table felt...
Dr. Barrett: Okay.
Alessandra Ricciuti:...you know, that felt big, but I had a lot of questions too, because having a double mastectomy, you can't breastfeed or, you know, so there's, there’s all that. But I almost didn't know, like, what questions to ask, like you have, like, this all happened in a matter of, like, Thursday to Tuesday.
Dr. Barrett: Right? And before all this...
Alessandra Ricciuti: I found out all this information. And so it was, like, so overwhelming. But I have to say, having my mom there, and the fact that she had been through it, she was a great support because, I think you're in such shock and then almost just, like, such disbelief, that it's hard to remember questions that you want to ask or even know what to ask because it's just life-changing information that's coming at you. And so she was well prepared to ask questions and take notes just so we could talk about it afterwards. She had had the same thing. And she had chosen to do the lumpectomy.
Dr. Barrett: Right. Yeah.
Alessandra Ricciuti: And, you know, she's taken the Tamoxifen, she did radiation. And luckily, she's been in remission all these years, but because she didn't remove the breast tissue, she goes in every six months for the mammogram and has to still see her doctor and...
Dr. Barrett: Right and she still may need a mastectomy.
Alessandra Ricciuti: And, yeah, at some point, you know, given, with BRCA2 as well, you're, the likelihood of actually developing cancer even if you were to have a lumpectomy and the radiation and take the Tamoxifen is still very high.
Dr. Barrett: Yeah.
Alessandra Ricciuti: So that's why my doctor really recommended to do the double mastectomy.

23:57 BREAST RECONSTRUCTION AND RADIATION

Dr. Barrett: Yeah, and there, and there's other things to consider too in terms of breast reconstruction. We as plastic surgeons, when we do breast reconstruction, we hate radiation. So it's, like, we would almost rather do, have prophylactic mastectomy because then at least the skin is, kind of, a normal quality. And you could do a reconstructive, reconstruction that is much more beautiful, I guess, or more characteristic of a natural breast, versus dealing with a radiated lumpectomy breast, it's not, that's really challenging to work with.
Alessandra Ricciuti: And that did come up as well, because they said if you did go that route, if it did come back, then the surgery becomes much more challenging. And often you have to do skin grafting, they said, because the skin is essentially dead, you know, from radiation at that point. So all of those things considered...
Dr. Barrett: Yeah, I mean, I've seen, I've seen, and I've done some prophylactic mastectomies, and I've done some bilateral immediate reconstructions, and, and honestly, some of them look like real breasts. It's unbelievable, like, what can be done. So...
Alessandra Ricciuti: It's amazing.
Dr. Barrett: But some are more challenging than others. And it, and it's just, radiation is our biggest enemy. But so all right, so the month before all this happened, what was, like, your biggest thing in life? Like, were you worried about your variance reports from your injectable sales?
Alessandra Ricciuti: Totally.
Dr. Barrett: Were you worried about, like, your dog going to the vet, or, or, or what, what was, like, the biggest thing in your mind until this...?

25:25 BIGGEST WORRY BEFORE CANCER DIAGNOSIS

Alessandra Ricciuti: It was a busy time, actually. I, Where I was working, we were opening a new location in Boca Raton, Florida. I was traveling quite a bit. We had two locations in Las Vegas. So just, you know, I really, kind of, sunk myself into work. And the week before surgery, I was actually in Boca Raton setting up our new location. So, you know, I think twofold, it's, you know, I took a couple days off....
Dr. Barrett: Yeah.
Alessandra Ricciuti:...prior to my surgery, so I had a surgery on a Monday and I took...
Dr. Barrett: Oh, so you just kept rolling right through work?
Alessandra Ricciuti: I kept rolling right through. I took Thursday and Friday off...
Dr. Barrett: Yeah.
Alessandra Ricciuti: And had Saturday, Sunday. And I went to my happy place at the beach in Malibu. And just took some time for me and just to get my head in the right place. And...yeah...just make sure that, you know, I was feeling my best, you know, emotionally, going into it on Monday.
Dr. Barrett: Surgery on Monday. So it, it happened all that fast.
Alessandra Ricciuti: It happened very quickly. So I found out, I found out in November before Thanksgiving and then my surgery was scheduled on December 17. So scheduled right before Christmas.
Dr. Barrett: Wow. Yeah.
Alessandra Ricciuti: Which was tough, but we figured it, it need, they, you know, by the recommendation of the doctor and, and the plastic surgeon needed to be done before the end of the year. It was important that we moved quickly. And you know, we figured it was a good time. You know, I'd have family in town and we'd all be together.
Dr. Barrett: Yeah.
Alessandra Ricciuti: So it made sense, you know, to get it done before Christmas.
Dr. Barrett: So let's talk about that. Like, what, like a woman that has to, like, is, is in the same crossroads where she's, life has just turned upside down. She's just been diagnosed with breast cancer. Whether she's BRCA2 or whatever, but she's given a bunch of treatment options, and her, and she's gone from focus on whatever she's focused on to now she's dealing with breast cancer. What's your, what, what's some of your recommendations, or what are your thoughts to, for this person that, or some recommendations that might be helpful for her to, to, kind of, navigate this? Or what are some tips? I mean, I don't, you know, what do you recommend for this person to do?

27:33 RECOMMENDATIONS AFTER BREAST CANCER DIAGNOSIS

Alessandra Ricciuti: I would say, you know, what I've learned in life is to lean into what happens. I have a tattoo on my wrist that I got before surgery that says “I trust life.” And I do. And I just feel like whatever is meant to be part of your story is meant to be part of your story. And so, you know, at this point, there was nothing I could do to change what was happening. And I felt like fighting it or feeling sorry for myself was, almost, a waste of energy. And so I was just looking to get myself into the best possible headspace. So that, you know, just wishing for the best possible outcome and I tried to find gratitude in the situation that, you know, look, I'm gonna, I'm doing this. I'm gonna save my life.
Dr. Barrett: Right.
Alessandra Ricciuti: I was proactive, and we found this before I would have to do chemo or you know, any, any of the above.
Dr. Barrett: Yeah. Right.
Alessandra Ricciuti: So I just, you know, kept, you know, I, I guess, finding the gratitude and, and counting my blessings. And just knowing that, you know, on the other side of this, hopefully you know, and, you know, and I'm here today and healthy and happy and hope that I can, you know, encourage other people to be proactive.
Dr. Barrett: Could you, do you recommend someone to do this alone?
Alessandra Ricciuti: No.
Dr. Barrett: Okay. So...
Alessandra Ricciuti: Absolutely not. I think finding a support system. People, I did work with a therapist.
Dr. Barrett: Okay.
Alessandra Ricciuti: By, at recommendation of my doctors, who was extremely helpful. And, you know, there's definitely a lot of support groups as well. There's, it is a really, kind of, amazing thing, there's so much support out there. And I even talked to people who’d been through...
Dr. Barrett: Where, what’s a support group that you can mention?

29:42 SUPPORT GROUPS FOR CANCER PATIENTS

Alessandra Ricciuti: weSPARK, I know of.
Dr. Barrett: weSPARK?
Alessandra Ricciuti: Yeah. That's, kind of, in the valley. I know that there was just other groups that my therapist had recommended that I could attend if I felt like I needed to. And it, they break it up, also, by your stages of cancer, they break it up just by your age. So there's a lot of different options out there. And, you know, for me, I think I wanted to just be around close family and friends. So everyone's different, in terms of what they need and what they want. And I also didn't know necessarily what I needed. And so I think that, you know, I worked right up until the end, and then it was more in the aftermath of surgery, I think, was where things got really emotional for me.
Dr. Barrett: Tell, tell me about that. So you had surgery and then, and then what?

30:33 AFTER SURGERY

Alessandra Ricciuti: So I was home for six weeks...
Dr. Barrett: Wow.
Alessandra Ricciuti:...after surgery. And that's a long time to take off of work...
Dr. Barrett: Yeah.
Alessandra Ricciuti:...which was also hard for me.
Dr. Barrett: Well it’s a, it's a big surgery.
Alessandra Ricciuti: It's a huge surgery. And I'll be honest, I really...I've had three back surgeries. I've had my appendix out. I've had wrist surgery. I’ve had a lot of sports injuries, so, you know, I’ve...
Dr. Barrett: Which sports did you play again?
Alessandra Ricciuti: Soccer, ice hockey, tennis. I was a gymnast, a dancer.
Dr. Barrett: Okay.
Alessandra Ricciuti: Yeah. So, you know, I'd been through a lot early on. I had my first back surgery at 16.
Dr. Barrett: Jesus.
Alessandra Ricciuti: I know, it’s pretty crazy. So I'd been through a lot and, you know, I thought that, okay, I can do this. And I wasn't necessarily, like, attached to my breasts. I'd never thought about doing plastic surgery. It was just such a whirlwind. I was so busy with work prior to surgery that I don't think I thought about it all that much. And then it was the morning of, or the night before, where the nerves, kind of, really set in. But I didn't do, again, I wasn't looking at a lot of videos or, kind of, doing a lot of research. So I went in, kind of, blind to the sitch, which I think was better for me personally.
Dr. Barrett: Yeah.
Alessandra Ricciuti: And then the aftermath of it, though, was more shocking to me. Just because I feel, it's very much emotional. And that was the part that I don't think anyone can prepare you for. And I think it's probably different for everyone, but it comes in waves. And being at home, and I was lucky, I was able to stay with my parents and they were able to care for me for that time. But being away from work, being away from friends, I had visitors... but just recovery, in general, is isolating. And you, kind of, get a little depressed and, you know, physically you're going through so much. And you had so much removed that it also, like, changes hormonally, and you're on a lot of medication. And so just all of it combined, that's the part that I felt like really was, was tough.
Dr. Barrett: Yeah. Do you think in your position now, when you get a chance to interact with patients, do you, do you feel, do you get a new appreciation for, you know, surgery and for what patients go through?
Alessandra Ricciuti: Oh absolutely. I think it's the, having gone through something that I've gone through, and being able to empathize with patients. And, you know, when people wake up from surgery and knowing how they feel. We have a lot of patients who are really scared before surgery, you know? And so being able to just talk them through and say I know what, like, what that feels like. I think that it's helpful...
Dr. Barrett: Yeah.
Alessandra Ricciuti: to have somebody...it's funny because I think a lot of surgeons have, like, never had surgery.
Dr. Barrett: No I, I think you’re right.
Alessandra Ricciuti: Or a lot of nurses have never had surgery, so to have someone...
Dr. Barrett: We're so far removed.
Alessandra Ricciuti: Yeah, who's been through it, who can really, kind of, talk to you and empathize. And know what you're going through and can give you tips and recommendations and, you know, it's, it comes from that genuine place.

33:45 DOUBLE MASTECTOMY IS A BIG SURGERY

Dr. Barrett: Yeah. Now we don't, we don't do big double mastectomy surgeries and immediate reconstruction. Those are big hospital surgeries and, but, you know, some of the bigger surgeries we do like Tummy Tuck, Mommy Makeovers can get up there, you know, in terms of recovery. And when that patient walks in that first week, I mean, they're going through so much. And I, and I, we have staff members that are not really, they don't really fully understand that. I was like, look, they're going to be, they're going to be short. They're going to be pissed off about something. They're gonna take longer to get here. They're gonna be late because it took them longer to get in and out of the car, you know? Be okay with that, understand that, and, and be there for them. Now if they're doing that in their three-month follow-up, you know, kind of being a jerk, okay, that’s a litle different story. But first week, you know, they're going through a lot. And it's, I do these surgeries every week. And it's, like, you know, it's each one of these patients first time doing it. And so I just think it's great that you, you were able to, kind of, experience that. I understand it was a very difficult situation, but it, it's great that you can, kind of, you, you kind of, use that as your motivation now. And as you mentioned, that's partly why you, you wanted to work here.
Alessandra Ricciuti: Yeah. It’s a way to pay it forward and...
Dr. Barrett: Yeah.
Alessandra Ricciuti:...you know, I think be there for other women. And I think knowing, you know, what someone feels on the inside, and, you know, I've sat in on consultations. And, you know, there are just women who really feel strongly that they do want to get their breasts done, but at the same time, it doesn't, kind of, align with who they are spiritually. Or, you know, they didn't ever think that they would get, you know, big boobs, or you know, and that, that doesn't feel like it fits, like, who they are. And so you see the internal struggle that they're going through. And so just being able to talk them through, like, my own story, or you know, and how I feel afterwards. It's just, I think it, it helps people to feel like they can open up and be honest and talk about those, you know, real feelings.
Dr. Barrett: Yeah, it, it doesn't get any, I mean, your situation is, it was much more dire. You really didn't have it, you were given a choice between two different surgical choices, basically. And you, you didn't have the luxury of not having to do something.
Alessandra Ricciuti: Right.
Dr. Barrett: And so different, different ballgame. But you know, still I think, I mean, that's just an incredibly valuable experience. You survived.
Alessandra Ricciuti: I survived.
Dr. Barrett: They got all the breast cancer out.
Alessandra Ricciuti: Yes.
Dr. Barrett: Right. And guess what, you didn't have to do chemo.
Alessandra Ricciuti: I didn’t.
Dr. Barrett: And you didn't have to do radiation.
Alessandra Ricciuti: I didn’t.
Dr. Barrett: So that's huge. That, that, that's, like, a win.
Alessandra Ricciuti: That’s a huge win.
Dr. Barrett: Yeah, so lots of things to be, to be grateful for.
Alessandra Ricciuti: Very grateful for.
Dr. Barrett: Now at the end of this are you happy? Everything...fell...
Alessandra Ricciuti: I’m very happy.
Dr. Barrett: Yeah.

36:40 ALESSANDRA’S ALL FEMALE SURGICAL TEAM

Alessandra Ricciuti: I’m very happy. I was very lucky. I had an, actually an all-woman surgical team. Both surgeons were women. I even had a women anesthesiologist. So I've been through two surgeries at this point. So the first one was the mastectomy and I had expanders put in.
Dr. Barrett: Okay.
Alessandra Ricciuti: And then the second surgery was to remove the expanders and put the implants in. And it also included lipo with fat transfer.
Dr. Barrett: Bonus.
Alessandra Ricciuti: Yeah. Bonus, exactly.
Dr. Barrett: It's cool. We have nice, we have lots of little tricks to do breast reconstruction. Taking fat from somewhere we don't want it, hey, you know, let’s, let’s, we can use it for the breasts. You know?
Alessandra Ricciuti: Definite bonus. So all in all, I mean, I had, I had an amazing surgeon and I think she did an incredible job. I'm really happy with the results. And, you know, she, they feel and look very natural and she's really proud of them as well. And she does, like, it looks like a breast aug.
Dr. Barrett: Awesome.
Alessandra Ricciuti: Versus a reconstruction. I got very lucky.
Dr. Barrett: That's great.
Alessandra Ricciuti: I got really lucky. Yeah.
Dr. Barrett: Yeah. You know, it's just, it's funny. It's, like, I’ve, I've seen, you know, some breast reconstructions that look better than some people's natural breasts. And it's, like, wow, you know? We're getting pretty good.
Alessandra Ricciuti: It’s amazing.
Dr. Barrett: Yeah. So it, it all worked out well. You know, what do you tell the woman who has just been diagnosed with breast cancer? You know, if you were, if you could go back and, like, were there any thing that you wish you did or wish you didn't do?

38:23 LOVE YOURSELF THROUGHOUT THE PROCESS

Alessandra Ricciuti: Not wish I did or didn't do. I just say, you know, really love yourself through the process. And then give yourself time to heal. Surround yourself with positivity and people who love you, you will need the support. It's definitely an emotional roller coaster. I'm not even a year out. This is Oct, you know, the first October where we have Breast Cancer Awareness Month and I've been emotional here at work. And, you know, it just didn't, it’s, it's the first time this has really been part of my story when we're in Breast Cancer Awareness Month. So it's a journey and it's, you know, allow yourself the time to heal and feel all of those feelings. And reach out for support when you need it.
Dr. Barrett: And personal things that you, you did to, kind of, help your mind. Do you, did you do meditation? Did you do yoga? What, what did you do?

39:15 COPING MECHANISMS

Alessandra Ricciuti: I'm big on meditation and yoga, walks on the beach, for me, lots of sunshine.
Dr. Barrett: Yeah.
Alessandra Ricciuti: Doing things that I know make me happy and feed my soul.
Dr. Barrett: Yeah.
Alessandra Ricciuti: Just being kind and really loving to myself. And also, I think just, you know, like positive affirmations and, you know, your body is going through so much.
Dr. Barrett: Yeah.
Alessandra Ricciuti: And you, it's, it's emotional. It's really emotional. And that was the part that I was really unprepared for, in comparison to all the other...had big back surgeries and things like that. And it, it wasn't the emotional rollercoaster that this really was. And this was truly life-changing.
Dr. Barrett: Yeah.
Alessandra Ricciuti: You know? So, but I've chosen to embrace it, and share my story. And encourage, you know, others to be proactive and get your mammograms.
Dr. Barrett: Right and don't ignore that lump that just came out of nowhere.
Alessandra Ricciuti: Do not ignore.

40:20 URGENT CARE FOR BREASTS

Dr. Barrett: Yeah. So we actually had Dr. Grumley on Episode 16 where she, and right here in LA she's, she opens up, she, she helped open up a, like, urgent care for breast lumps. So if you feel a breast lump in your breast, you can just pop over to the Margie Peterson Breast Cancer Urgent Care. And they check your lump, they can do imaging right away, and you get the results right away. So this is no, like, waiting for, like, several days. Or going to see different doctors. This is a multidisciplinary, disciplinary approach. And I know Cedars has a really good team over there. But I don't think they have this urgent care that they…
Alessandra Ricciuti: No that’s amazing.
Dr. Barrett: So that's, like, that's, like, a huge thing. Because I think from hearing your story, from getting to work with breast cancer reconstructive patients, especially earlier on in my career when I was doing a lot more of it, the mental game is such a huge component and the emotional, the emotional thing. And it's, like, having a good team, good communication, learning more about it, educating yourself, all of that stuff is, is really important.
Alessandra Ricciuti: It is. And I think for some people...yeah everyone's different in terms of what they need, but in terms of people who are supporting loved ones or family members who have cancer, I think just asking, you know, what they need, what they want, being there physically for people and just showing your love and support is the best thing you can possibly do.
Dr. Barrett: Yep.
Alessandra Ricciuti: It is. It's such a traumatic experience and it's hard to know what you need, but just lots of love, lots of love. And the support.
Dr. Barrett: ‘Cause it’s, it’s what, what something, what a person is going through one particular day is not gonna be the same thing the next day, you know? People are gonna have bad days when they're recovering from stuff like this. And it's, like, you just have to be there for people, you know? So I think that's so incredible. Thank you for sharing your story.
Alessandra Ricciuti: Thank you for having me.
Dr. Barrett: Yeah. What, is there anything else you want to share about your journey or anything else that was, was particularly important for you throughout, throughout your experience and moving forward, you know, work-life balance? I noticed, I know that you came to work here because you wanted to have a little more purpose. And that really, that really meant a lot to me, because I can think of better ways to make money. I'm not here to make money. I'm here to, kind of, run a business, but also to really, kind of, positively impact peoples’ lives. I, I, I looked in the mirror one day and I was, like, well, what do I get really excited about? I was like, I get excited at week six when people, people come back and they're really happy about their transformations. I just get fueled by that. And I, and then I, like, I, I follow a few people--all my patients on social media--and I see them out there enjoying living life and they’re so much happier. And they’re...or moms getting their body back and, and I still have some breast reconstruction patients that are out there really enjoying their bodies as well. That's, that's what, kind of, really motivated me. What, what, what's, kind of, did this, did this change your, your mindset about what really matters in the end of the day and where you want to spend your time and your energy?
Alessandra Ricciuti: Absolutely.
Dr. Barrett: Yeah.

43:27 LIFE IS SHORT, BE HAPPY

Alessandra Ricciuti: You know, I think at the end of day, you realize how short life really is. And it really puts into perspective what is important, and...
Dr. Barrett: Yeah.
Alessandra Ricciuti: You know, I do a lot more of the things that make me happy. And surround myself with people who really make me happy. And so, you know, I'd, I’d say just...make me a better person also, you know? And I think this was an amazing opportunity to be a support to other women, and...
Dr. Barrett: Has anybody reached out to you that's going through this process? I know you've been very private about it and this is, kind of, this is really special. ‘Cause this is, kind of, one of those first times that you've actually, kind of, opened up. I, I didn't know very much about this at all. And has anybody actually reached out to you about supportive... support or, or going through this or advice?
Alessandra Ricciuti: Not, not really. But, you know, I, the people that do know, I'm always willing to talk about it. And to share my story and, you know, certainly in my family, you know, and, you know, encouraging cousins and, you know...
Dr. Barrett: To get tested?
Alessandra Ricciuti: To get tested. And I know after seeing what I went through and just, you know, just really with my girlfriends, with everyone here at work, just really encouraging everyone to, to be proactive about their health, and...

44:46 SCREENING IS CRITICAL

Dr. Barrett: Yeah. So if, if you've had a family member premenopausal breast cancer and, or a male in your family got breast cancer, you should be screened. And if you're just curious, you could definitely do a 23andMe test. They're, like, 100 bucks online. That's not the most accurate one. So if you have the family indication, you need to go to a actual doctor and get the one that's fully detailed. But the 23andMe one is, kind of, a nice one too. I'm negative on that one, but I don't have any family history of breast cancer. So you know. But, yeah, I think that's so important. I think educating, raising awareness, one in eight women are gonna get breast cancer, catching it early, doing all this stuff, doing all the screening, all this stuff is going to save lives. So what else?
Alessandra Ricciuti: Well, and we're doing a great thing this month as well.
Dr. Barrett: That's right.
Alessandra Ricciuti: So we're donating 5% of all of our surgeons fees.
Dr. Barrett: And this was your idea, by the way. I really love, I love getting involved with charities and, but this one really hit home. I was like, look, we deal with breast surgery, we do breast surgery all the time. You've had breast cancer. We've all been affected by somebody’s who had breast cancer. And so we decided to donate 5% of all the surgeon’s fees for this month to the Breast Cancer Research Foundation. So this is a, this is a really good charity that donates over 95% of whatever it gets to actual research. To curing, finding a cure, and finding preventative measures for breast cancer. So it's, like, big picture stuff. And you found this charity. Tell us about this.

46:20 CHARITY FOUNDATION

Alessandra Ricciuti: Yeah, so BCRF.org.
Dr. Barrett: Yeah. Okay.
Alessandra Ricciuti: And, you know, I'm really excited that we were all able to support a great cause. And, you know, really put awareness out there and, and what better platform, you know, then with all of our patients, and on this podcast.
Dr. Barrett: Absolutely. Yeah. So if you were thinking about booking your surgery, let's book it this month. 5% is gonna go to the Research Foundation. It’s gonna help somebody and their research to really, to get this figured out. Right? Screw cancer. It sucks. You know, it's, like, let's get it figured out and, and do something about it. Not only that, but if you do, if you, if you are over 40, get your mammogram. If you have a lump, get it checked out, go, go some, go see your doctor. And if you have a family member--immediate family member--who's less than 50 that had breast cancer, get screened, and, or get tested, and then, or if you had a male in the family with breast cancer, get, get your BRCA testing as well. So, great. All right, Alessandra, thank you so much agreeing, and being a great new member of the team. And you've brought us already so far and thanks for sharing your story.
Alessandra Ricciuti: Thank you.

Thank you for tuning into our podcast. If you liked today's podcast, don't forget to share, rate, review and subscribe. Also, find out if plastic surgery is right for you by using our virtual consultation at DrDanielBarrett.com/virtual-consultation. See you soon.

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