Louise (00:00): The one that springs to mind is a gentleman who'd had a facelift, and as he was in recovery, he was telling me he loved me and how wonderful I was. And obviously it was the anesthesia talking and that just made me smile. Bill (00:29): So for those of you joining us to this episode of the Aesthetic Appeal Podcast, welcome to newcomers and welcome back to our normal audience that downloads us and listens to us on their drives and their walks. Today on The Aesthetic Appeal, you're listening to Vira Lou, the founder of ViraLou Aftercare. It's a unique business that is filling an insatiable demand signal. She's in Orange County and is providing an incredible service for post-plastic surgery aftercare. Vera Lou, you built this company around a gap that you saw firsthand in postoperative care. What was missing from the patient experience that made you realize that this was a need and it was going to continue to exist in the market and needed to be addressed? Louise (01:24): Well, obviously I'm an RN. My name's Louise, but the company's ViraLou, just to clarify. Bill (01:31): Got it. Louise (01:33): I'm an RN, so I saw firsthand what patients needed after they've had surgery. And so that's why I decided that there was a gap in the market because people were coming in for surgery and then they were being cared for maybe by their husband or their friend who didn't really know what to expect. They didn't know what was normal. They didn't know if the swelling should be as swollen as they are, the bruising. They didn't really know how to take care of the patient. And I did. And that's why I set up this company because I think that the patients need the professionalism to be able to see them through. They're anxious, they've had a big surgery, sometimes they're frightened. They need somebody to hold their hand maybe. And it's not everybody that can do that. Sometimes you think that patient's husband's going to care for them and then when they actually see they've got all these sutures and they're like, "Ah, I can't deal with that." So that's why it's important, I think, to have a professional taking care of these patients and not just a caregiver who's been used to looking after old people or whatever, but somebody that knows about plastic surgery and understands and knows that the patient needs handholding and they need just to know that there's somebody there who knows what they're doing to give them the confidence to get through. Bill (03:06): You bring up a good point, Louise. What does truly high quality postoperative care look like in the first 24 hours or however many hours that you see? Where do you see patients or practices underestimate that period most often? Because you bring up an interesting point about caregivers being loved ones or friends who are not trained. Louise (03:30): Well, I think it's about being prepared so that when that patient goes back home or to the hotel or to the Airbnb, there's food, there's hydration, you're going to make sure that they can walk safely. They've had anesthesia, so there is a fall risk. You need to know that there's going to be someone with them to take them to the bathroom, for instance, and just being prepared. And I think that gives that patient the security that they know there's somebody there who knows what they're doing, basically. Bill (04:07): You make me think about everything that goes into their state of mind after the surgery. I'm thinking about from your perspective, because you see so many surgeries, plastic surgery practices spend so much time focused on the procedure itself. Louise (04:28): That's true. Bill (04:28): How much can the recovery experience shape a patient's overall perception of that practice and the outcome that they got from the practice though? Because you're the person that they're seeing when they wake up. Louise (04:41): Yeah. Well, I think that's extremely important because patients are going to remember the whole experience, not just the surgery. And so if they have a good experience from start to end, that reflects on the surgeon too, because if they have a miserable time recovering, it's going to give them a really negative view about the whole process itself. Whereas if they have a company like myself going in there, everything's prepared, we've got somebody to hold their hand, understand how they feel, explain what they're going through, what's normal, what's not normal, and somebody who recognizes as well if there is a problem, how we can escalate that problem. I mean, we're not there to take over from the surgeon or to diagnose or anything like that, but we are eyes. We can see, we know what to look for, and so we know to escalate if we need to. And I think that's really important too. Bill (05:39): I'm very curious about this. By and large, plastic surgery has a quite large population of male surgeons. How does a female business founder get into this space? What was your journey career-wise to get to this point? Louise (05:57): Okay, so I had worked as an aesthetician for 30 odd years, and I decided at one point that I was going to go back to school to become an RN with in mind the fact that I wanted to still stay in the skin field if possible. And so to become a nurse in plastic surgery and aesthetics was a natural progression for me. And I was lucky enough to get a job in plastic surgery and also a stroke aesthetics nurse. And that's the field I've been in for the last six years. And through that, I saw this gap that patients needed aftercare service and hence ViraLou was born. Bill (06:43): I find this very interesting, Louise. If you would, because you've shared this with me offline a little bit, talk about some of the why behind you creating this company and some of your goals for other people that you want to help bring along, if you would. Louise (06:58): So this is a woman RN-owned business, and I recognize that a lot of women out there, a lot of nurses, they have to work full-time, they're doing 12-hour shifts, and they're absolutely exhausted. And a lot of them have children, families to take care of. With this company, they have the opportunity to work as little or as much as they want. And I think that's a draw to many of the nurses that they can pick and choose the shifts they want to work. They're not told by a hospital, "You have to be here for 36 hours or whatever this week." And I think that's a draw to many of them because of the flexibility it offers. And it's nice to be able to help maybe single moms or working moms and give them that opportunity. So I feel like I'm offering that to women. There are guys as well who can work for us, and some people prefer to have a male, but it's predominantly women in this business, I have to admit. Bill (08:03): Walk me through from the first contact with the plastic surgery practice and their patient, what does that look and feel like all the way through cradle to grave of how you assist in this, and then the patient leaves your care on the backside of monitoring them so that our audience gets a feel for what this aftercare entails and how that goes? Louise (08:30): Yeah. So basically depending on what surgery the patient has had, we will take notes from each particular surgeon for whatever protocol they wish us to follow, and we will pick up the patient safely, make sure they're delivered to their home, their hotel, their Airbnb, wherever they choose. We make sure that they - Bill (08:56): Are you picking them up in an Uber? Louise (08:58): No. Our nurses pick them up in their car and we vet all our nurses beforehand. We make sure they've got cars that are not really, really high trucks or something that we can't get a patient into. They have to be suitable vehicles, of course. And so they're picked up, they're taken to their accommodation then, and we make sure that everything is there that needs to be there. And then that nurse stays with that patient the whole night, holds their hand if they need to. The patients oftentimes are very nervous, and so we can actually contact their relatives for them. They can speak to their relatives to make them feel more calm. And oftentimes they don't sleep. They're very, very anxious. And so just to have that person there who knows exactly what is happening is normal, just gives them that peace of mind. Bill (09:55): I need to think about this. You're probably dealing with a lot of people that they're not in their hometown, right? They're traveling a certain distance. Louise (10:03): Yeah, a lot of people come from out of town. Yeah. And we even offer services like pet sitting because some people want to bring their little doggy with them. So we even thought about that just to try and make our service the best it could be and to think of all reasons why people would feel more at home, if you like, by having their dog or their cat. Bill (10:28): I love that. Louise (10:29): We thought we would offer that too. And we take little bags in there. We have protein shakes, we have coconut water, we have water, we have little snacks, because sometimes they'll come from out of town and not even consider that. So we wanted to cover every eventuality really. Bill (10:47): So this feels very concierge in nature. Louise (10:50): Absolutely. Yeah. And we try to make it as tailor-made as we possibly can, because each patient's different, of course, and some people need things that others don't and vice versa. So we wanted to be a concierge service. That was the idea. Bill (11:09): So how long have you been around the plastic surgery and cosmetic surgery aesthetic space now? Louise (11:16): Around about six years now. Yeah. Bill (11:18): And in doing so, as you see the landscape, plastic surgery interest and activity has been up 22% year over year this year alone. As you see that growth, how do you see this aftercare piece evolving on a regional level and on a national level? Louise (11:37): Well, I think aftercare now, it used to be like an afterthought really. It used to be like an add-on. And I think now it has to be part of the package, and I'm seeing that with a lot of surgeons. They're buying the aftercare within the package and selling that to the patient. And so I think it's going to become more and more popular. And I think people are educated now and they want the whole journey. It's not just the surgery and then take care of yourself. They're looking at the whole journey and the outcome. And so I think it's something that's really going to expand and become much more popular and needed. Bill (12:17): I agree. I think there's certain things in the industry around surgery that we're finding there's additional value add for the patient. We've seen hyperbaric chamber help recovery. Louise (12:30): Absolutely. Bill (12:31): We've seen new PDGF plus type platelet derived growth formulas that are enhancing healing time when immediately applied. I think the idea of somebody investing a very large sum of money in improving the way they look and feel about themselves, and then coming to out of a anesthesia-based environment and accidentally bumping into something, slipping and falling, you're kind of rolling the dice a little bit on chances of what you're investing in the first place, right? Louise (13:04): Absolutely. A catastrophe could happen. Yeah. So I think that's why it's important to look at the whole picture. They've spent time in looking for a surgeon. They've spent money. They've maybe been saving up for a long time for this procedure. And so I think by having aftercare, it enhances the whole journey for them. And it's just something that people want. People want to feel safe. People want to know there's somebody there who knows what they're doing and somebody who can escalate if need be so that they're not necessarily calling the surgeon in the middle of the night, "Oh, I'm swollen. Is that normal?" We know that's normal, so we can let the surgeon sleep that night because we know what to expect. We know what we're looking for, but by no means are we trying to take over from the surgeon. We're not, but we've got eyes and we know what to look for. Bill (14:06): I think that's a great point from a business standpoint for the doctors. You bring up an excellent topic, which is, yes, as I think about it, doctors are scrubbing in at six o'clock in the morning, right? If they're at the gym, I know some plastic surgeons that are up at 4:00 AM to get a quick exercise workout in just to stay healthy. And then they're scrubbing in sometimes four days a week. And I'm like, my gosh, if you get a sleep disruption for a patient who maybe doesn't have a real imminent concern for how their procedure went, but in their mind they're feeling it's really important and so the surgeon wants to take that call, that I think is time well spent to look into these types of options for surgeons to offer as a service to their patient because it helps the patient. You get a reduced risk for the patient, which means better patient results. (15:09): I think it's such a smart play because it also preserves the integrity of the routine and the sleep cycle for the week for these highly trained, skilled surgeons. Louise (15:20): Absolutely. Bill (15:21): So you guys are a family-run operation, correct? Louise (15:24): Yes. Bill (15:25): Yes. And you've got somebody very special to you that works in your company with you, who I met before we met, which is Liberty. Louise (15:35): Absolutely, yes. Bill (15:36): How did this all come about? Because having family around can be a superpower sometimes, and it can also be craziness. Louise (15:43): Yeah, absolutely. Bill (15:44): How does that feel for you guys? Louise (15:46): Well, it's great. It works really well. Liberty's very business oriented, and she actually just- Bill (15:51): She is. Louise (15:51): Took this and she just ran with it. She did all the marketing. She did everything, made all the brochures. She called surgeons. She made a list of who we needed to visit. We made little gift bags to take into surgeons, and we went around prospecting, and she just basically created the business because I'm still working as well as having the business. And so I wasn't available all the time, but she's just my superstar, and I don't know what I'd do without her. Bill (16:27): So when I think about founders, knowing what you know now, what would you tell yourself five years ago on this journey of being a founder of a business, filling a demand signal in the space that wasn't really there before? Louise (16:45): Well, I think I would've told myself, "Do this 10 years ago." I was 50 when I went back to school to be a nurse, and I've learned so much since then. And then of course, I was in skincare before I became an RN for 30 years, and so moving into the plastic surgery space was the right thing to do for me as a nurse. That was my field. And so I wish I'd done this years ago, but I think you've just got to have a little bit of drive and some positivity and tell yourself you can do this, you can, and I know I can, and I just wish that I'd had the opportunity to do it sooner than I did, but that's okay. Bill (17:32): I love it. I think successful people never can tell you what the size of their shoe print is because they're never looking back, right? Louise (17:39): Exactly. Exactly. Bill (17:41): Yeah. I've got to ask this because this is so fascinating to me. I want you to reach back into the memory bank and if you would think of most humorous, most odd, most interesting, maybe a neat little story that comes to mind in aftercare, redacted names of course to protect the innocent, but - Louise (18:03): Oh, absolutely. Bill (18:04): Is there a funny story, an interesting story that you could think of that came across in the space with you? Louise (18:12): The one that springs to mind is a gentleman who'd had a facelift, and as he was in recovery, he was telling me he loved me and how wonderful I was. And obviously it was the anesthesia talking, and that just made me smile. It really did. Yeah. And you get people waking up singing and they're dancing and all sorts of fun things. And then afterwards they'll say, "Did I say anything crazy?" And I say, "No, of course not." Bill (18:49): Aftercare outtakes, we need a karaoke playlist - Louise (18:54): Absolutely. Bill (18:57): Of everybody singing their favorite gym when they're coming out of their post-surgery anesthesia. Yeah. Louise (19:04): And then one lady said to me, "Do I look like Angelina Jolie?" I said, "Absolutely the same. Exactly the same." Bill (19:13): Of course you do. Yeah. Don't be ridiculous, of course. Louise (19:16): Just humor them. Bill (19:18): So Louise, you guys are based originally in Orange County, but you service outside of the greater Orange County area right now, correct? Louise (19:27): Absolutely, yes. San Diego, Inland Empire, Riverside, Corona. We're even going to Santa Barbara too. Bill (19:35): So I have a question about how you select your nurses and the process of your training academy. Could you talk about that a little bit? Louise (19:45): Absolutely. Yeah, we interview our nurses over the phone first, and then we meet in person, and then we can gauge usually if they're going to be a good fit or not, and if we're going to be a good fit for them too. And then we also put them through at the ViraLou Academy, which is a training program for nurses for taking care of patients in the aftercare situation. We like to train them our way so that I know when I'm sending nurses out to a patient that they know exactly what to do. We make sure that they have the surgeon's protocol as well so that they can follow that because every surgeon's different and have different requirements. And so they go through this training academy and at the end they're given a certificate when they pass the training, and then we know they're ready to go and take care of any patient that we need to send them to. (20:41): And then we send them off as well. They have their own wheelchair, they have their own vitals bag, which contains all the things that they would need from gloves to a blood pressure cuff, tissues, you name it, it's in that bag, hand sanitizer, everything, so that they have everything they possibly need when they go out there to be with a patient. Bill (21:05): I love that. I think it's so important, and not to be understated, how at ease it puts people to know that not only are they getting someone who is a quality extender provider of the surgeon when they're offsite, but that they've also been prepared and trained beyond just being an RN or an NP or what have you. They've been trained on what to expect in the scenario to handle complications that pop up for the patient. Louise (21:38): Absolutely. Bill (21:40): I think that's fantastic. Louise (21:42): Thank you. Thank you. Well, we set out to be the best. We set out to be compliant, and that's exactly what we want to do and be recognized as a reliable service for surgeons wherever they may be. Who knows? I may even expand to England one day. Bill (22:06): Well, before you go to England, you better stop south in San Diego and see us first. Louise (22:10): Will do. Absolutely. Bill (22:12): For those of us in the Southern California area, if someone wants to get ahold of you and hear more about your story or your services, what's the best way for them to do that? Louise (22:22): Our website is www.viralouaftercare.com, and it will tell you everything you need to know on there. A little bit about me, a little bit about what we do, what we offer, and the prices, and the different packages we offer too. Bill (22:38): And I'm going to translate British, the Queen's English. It's www. Louise (22:45): Yes. Bill (22:46): And that is Viralou is V-I-R-A-L-O-U. Louise (22:54): Yeah, correct. Bill (22:55): Viralou Aftercare. Louise (22:56): Viralouaftercare.com. Bill (22:58): Aftercare.com. Louise (23:00): Yeah. Bill (23:01): Yeah. Well, it's been an absolute pleasure, Louise. I can't thank you enough for spending time with us today. Louise (23:08): Thank you too. Bill (23:09): For everyone out there, that wraps up this episode of The Aesthetic Appeal. We love hosting regional stories and spotlighting founders that are really making waves in the space and filling a gap for something that's definitely needed in our industry. And so if you like this episode and you want to hear more episodes like this, tune in to Spotify and Apple and all the other channels that will take you to us, and we'll look forward to seeing the successes of ViraLou Aftercare. And until our next episode, be well.