Dhru Purohit Show - Fix Your Diet & Lifestyle to Heal Your Skin: Reverse Acne, Aging & Wrinkles with Dr. Anthony Youn

Episode Date: December 28, 2023

This episode is brought to you by Bioptimizers, Rupa Health, and Armra Colostrum.  We know there are key lifestyle practices that can help us feel good and look good. But with all the latest skin care products and trends, it can be hard to sort through what is actually beneficial, worth investing in, and safe to use as part of our effort to look younger. Today’s guest, America’s Holistic Plastic Surgeon, helps us navigate through what's worth implementing in our busy lives.  Today on The Dhru Purohit Podcast, Dhru sits down with Dr. Anthony Youn, a board-certified plastic surgeon. Dr. Youn guides us through lifestyle factors that prematurely age us, key ingredients to look for in quality skincare products, and his 2-minute skincare routine that can help us look five years younger. Dr. Youn also gives us his hot takes on collagen, botox, microneedling, and fillers and the research that supports his suggestions. If you are curious about the latest in skincare and beauty, this episode is a must-listen.  Dr. Anthony Youn is a nationally recognized, board-certified plastic surgeon. He is known as America’s holistic plastic surgeon and is the author of the best-selling books The Age Fix and Playing God. Dr. Youn also hosts the popular podcast The Holistic Plastic Surgery Show. His new book, Younger for Life, is a complete holistic guide to turning back the clock using the process of Autojuvenation.  In this episode, Dhru and Dr. Youn dive into (audio version / Apple Subscriber version): What is prematurely aging you (2:28 / 2:28) How sugar impacts our skin and body (3:31 / 3:31) The importance of natural skin care products and investigating ingredients (13:56 / 10:40) Is it worth it to take collagen supplements (25:34 / 22:36) The impact of inflammation (35:58 / 31:22) The impact of chronic stress on aging our body (41:46 / 37:13)  Free radical damage and its impact on aging (48:38 / 44:02) Healthy sun exposure, avoiding sun damage, and sunscreen recommendations (57:57 / 53:24) Botox and considerations before use (1:16:50 / 1:11:40) The 2 minute look five years younger skincare routine (1:28:50 / 1:24:20) Skincare interventions that have the best returns (1:36:35 / 1:32:10) The benefits of microneedling (1:47:47 / 1:43:16)  Using fillers appropriately  (1:59:00 / 1:56:15) How to help with thinning hair (2:05:36 / 2:01:04) Also mentioned in this episode: Think Dirty App Younger For Life This holiday season, thrive with Magnesium Breakthrough. Just go to magbreakthrough.com/dhru and enter promo code dhru10 for 10% off any order. Access more than 3,000 specialty lab tests with Rupa Health. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com today. Receive 15% off your first order of Armra Colostrum at tryarmra.com/DHRU, or enter DHRU to get 15% off your first order. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

There was a meta-analysis of over 1,200 people published back in 2021, and they looked at people taking collagen supplements for 90 days, and they found a statistically significant improvement in the hydration of the skin, in fine lines and wrinkles, and in the elasticity of the skin. How do we protect our skin, face, and body from premature or early aging? What treatments actually work, and what treatments are not worth the bother when it comes to helping us age well? If you're curious about this topic, I know I am.

Today's episode with the top holistic plastic surgeon in the nation is absolutely for you. Hi, everyone, welcome to the Drew Perraud Show. This week's guest is Dr. Anthony Yun, known as America's holistic plastic surgeon. Anthony Yun is a nationally recognized board certified plastic surgeon. He's a recognized leader in his field, and he's the author of the best-selling books, The Age Fix and Playing God. Dr. Hewens' public television special, The Age Fix, has been viewed by millions of people. He's also the host of the popular podcast, The Holistic Plastic Surgeon Show.

And he is the most followed plastic surgeon on social media with, get this, over 4.5 million subscribers on his YouTube channel and over 8 million followers on TikTok. His new book, which is today's topic of discussion, Younger for Life, is a complete holistic guide to turning back the clock using the process of auto rejuvenation. You know shows us how simple changes in our diet. Activity and skin care can make us look younger than ever before. And the best part is he starts with the inside. And then he gets to the outside. The inside is what matters. It sets the foundation.

We're going to talk about that. But we're also going to talk about the outside. What are the treatments? What are the procedures that we can use that are also healthy for us and are worth the money? We're chatting about that on today's episode. Stay tuned for a fantastic podcast with Dr. Anthony. Tony, You know.

Tony, welcome to the podcast. Today we're talking about growing younger, looking younger, but both from the inside out and the outside in. So I'd love to jump right in to the first question that we have for you. Help us understand what are the things that people are doing today, both things that they're eating or putting in their body and the things that they're putting on top of their body that are prematurely aging us. So I would always start with food.

You know, when we talk about in general aging, the way I describe it, it's like you're building a house. And when you're building a house, if you think about actual plastic surgery, and I'm a holistic plastic surgeon, plastic surgery is like the spire at the top of the house. So you don't focus there. You want to focus at the base of the house, the foundation in that is food. So the first two things I would look at would be reducing the amount of sugar that you eat, because sugar truly is the great ager of our body, and then reduce the amount of ultra-processed foods. There are different reasons why our skin ages, and especially why it ages prematurely. And the

great thing is that just making simple changes in your diet can make a huge impact on how quickly your skin ages. And so starting really, if I had to start with one thing, I guess I would start with sugar. Talk a little bit more about sugar. Before we talk about things that people put on their skin or, and then we're going to get into what people should actually be doing to protect the skin, both from the inside and also things that we can do externally. Talk about sugar. for a second, what do you mean exactly? Because for a lot of people, that can be confusing. Are we talking about fruit? Are we talking about this? Are we talking about that? What type of sugar are you talking about? And really, like, how much sugar do you see a lot of people eating that

is prematurely aging them? So when I talk about sugar, we're talking really, I mean, everything that we eat eventually gets broken down into sugar. Okay. And so really when I'm talking about sugar, it's going to be the food that you eat that is high and typically refined carbs. Okay, so you're getting essentially sugar spikes. Now, when you look at sugar, the sugar will actually age your skin using two different mechanisms. The first mechanism is called glycation, okay? And so sugar can actually bond to the collagen fibers in your skin and cause the collagen to denature and to actually get older. Now, our skin is composed about 70 to 80 percent of collagen, and that is a part of our skin that caused our skin to feel tight, to feel strong, to look youthful.

And as we get older, we lose about 1% of the thickness of our collagen every year, starting about in our mid-20s. Now, in women who go through menopause, that increases to 2% a year. And so when you look at women, especially, you know, as they get in their 70s and 80s, some of them, their skin gets so, so tissue paper thin that it could actually tear just from getting scratched. And so one of the things we want to do is really focus, once again, on the collagen being such a huge component of the skin.

And the way I describe collagen, they're like the logs of a log cabin. And as you get, and when you're young, those logs are nice and strong and they're tight and they're new. As we get older, those logs start to fall apart. They start to denature. They start to become not as stable. And what sugar does is sugar can come along and it can actually bond then to the collagen fibers, causing those collagen that has already become a bit kinked and starting to fall apart to become even more kinked. and it basically prematurely age it.

So that's one of the reasons why, as we get older, our skin gets rougher, it gets looser, it gets thinner, and if you add sugar into the mix, that can make things worse. And these sugar collagen hybrids, essentially, those combination are called advanced glycation end products or AGEs. It's kind of appropriately titled AGEEs because they basically will age your skin. So that's one way that sugar will age your skin. and a lot of people will then look, okay, then does it matter the types of sugar that you eat? And yes, it does, because on top of that, sugar will age your skin by the process of chronic inflammation.

Now, inflammation in general is not always a bad thing. And we have seen lately in the last five years where a lot of holistic kind of minded and forward-minded physicians and health professionals and biohackers are using acute inflammation as a way to potentially enhance their longevity. In medicine, we look at acute inflammation as being a good thing. If you get a cut on your skin, your body creates acute inflammation around that injury to help heal it faster. When we do laser treatments on our faces or on parts of our body, we're creating acute inflammation, and that can actually enhance or cause that collagen to become tighter and actually more youthful afterwards. But it's the chronic inflammation that can be an issue, and this is something that you've

covered in your podcast and with the information you put out there so well. But when we get chronic spikes of sugar, we get chronic spikes of insulin. Chronic insulin spikes can eventually lead to insulin resistance. And a lot of people look at insulin resistance and they look at sugar and they think about it from more of a metabolic perspective of gaining weight, of energy issues. But you can actually look at it as aging your skin as well, okay? Because chronic inflammation can age the skin. There are even studies that show that when you have high levels of insulin, especially these spikes, you can get more acne and inflammatory skin disorders. This episode is brought to you by Rupa Health.

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Health.com to sign up for free today. This episode is brought to you by Buy Optimizers. So this holiday season is coming up or we're in it, depending on when you're listening this episode. And some of us might be feeling a little bit overwhelmed. I get it. I've been there. November, December, the demands that come with it.

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visit mag breakthrough.com slash drew and enter the code drew 10 for 10% off any order that's mag m a g breakthrough b r e a k t h r o u g h dot com slash drew that's me d hr u and the code d hr u 10 for 10% off any order wow do you ever have a patient come into your office and then you can immediately look at their skin and feel wow i think this person's eating too much refined sugar, refined carbohydrates in their diet? We see it all the time. Yeah, I mean, I get people come in. So, I mean, I still have a full-time plastic surgery practice.

I get patients come in. And I can tell literally than about 10 seconds of sitting down with them if they're a smoker, if they, you know, have a reasonably healthy diet. Now, obviously, I can't tell. There's so much, only so much you can tell it just by looking. But you can really tell. You can see if people are inflamed, you know, your listeners may have friends of theirs. and we see it a lot in, you know, in men and women where their face is just real red,

it's ruddy in texture, there's a difference between a healthy pink color to the skin, which shows good vascularity and somebody who's inflamed. And you can see oftentimes inflammatory patches, eczema, acne breakouts, and then this kind of red patches over their skin, and that's typically a sign of somebody with really just honestly bad lifestyle, especially a bad diet. So we're really talking about pharmacological levels of sugar that a lot of people are eating, and those would be coming from refined, you know, carbohydrates is one, like too many of those

inside of the diet, right? But really in America, primarily that's going to be coming from people doing like a lot of soft drinks and sugar-sweetened beverages. And there was a study I saw that showed that in the standard American diet, 20% of the calories in the standard American diet comes from sugar-sweetened drinks. 20%. And when you think about that, that's like one of every five calories that the standard American diet that Americans essentially eat have absolutely no nutritional value to them. You know, we're talking energy drinks, we're talking soft drinks, we're talking fruit juices.

You know, for me, it's interesting, like yourself, you know, I grew up with Asian parents who, you know, I was given a traditional Korean diet growing up. But I grew up in the middle of Michigan. And so where I grew up in a tiny town in the middle of Michigan, what did my friends eat? it was all meat and potatoes. And so I had this kind of weird dichotomy of I would go home and eat with my parents and we would eat these healthy foods. It would be, you know, rice and fish and kimchi and garlic. And then I would go out with my friends and it would be Big Macs and French fries and Taco Bell. And it's this weird dichotomy. And when you really look at it, there's such a

huge difference when you look at the quality of the food. You know, one set of food you look at and you know where that food came from. The other set of food, you look at, and you don't even know where that came from, like what type of fruit or vegetable created this food and what type of chemicals were put into it to make it taste that way. It's a very interesting thing. When I go back and I think about my childhood, it's like, wow, and I never realized it at that time, you know, that, geez, this is like one set, one diet was keeping me alive and the other diet

was slowly killing me. Are there things that people are putting on their skin that we might want to tell people to pause or stop? Just like you were talking about, things that prematurely age our skin that we're eating. Is there anything that you see on a regular basis? You know, we just did an entire episode with a toxicologist who came on and talked about the concerns around a lot of the toxins that are in our cosmetics and the supplies we're using. So are there things that you worry about as a holistic sort of plastic surgeon that you see people putting on their skin that prematurely ages them? You know, it's interesting. I went through all of traditional medical training.

So I did four years of medical school. I got an MD. And then I did three years as a general surgeon where I worked in surgical ICU. I worked in trauma centers. And then I did two years of plastic and reconstructive surgery. And then I did a year of a cosmetic fellowship out in Beverly Hills here. And interestingly enough, throughout that entire. your time, I had almost zero education in nutrition and even skin care, believe it or not.

You know, because there was actually in my area where I trained, dermatologists and plastic surgeons did not get along. It was a turf war between them for people, you know, for like patients who want Botox and fillers and stuff like that. So even though I was in this plastic surgery residency program, we would never spend any time with dermatologists to learn skin health because they didn't want, dermatologists didn't want to give us their secrets and plastic surgeons, the same thing. So I ended up, you know, starting up my practice, a cosmetic practice in Michigan, and like most plastic surgeons, I sold skincare products. And I sold the medical grade products that they reached out to us, that other practices sold. And I, for many, many years,

I had the secret that I never let my patients know, is that all of these products I was selling to them, these medical grade products that I touted, I could not use them myself. Because if I put them on my skin, my skin would break out in hives. I would get rashes. I would get itchy. I would get red and irritated. And so for years, I used water. I used bar soap and I used basically the most basic cleanser you could think of, all the while selling these products to my patients with, you know, these medically active ingredients. And it didn't come down to, and it really came down to a point my practice were a bad event essentially opened my eyes to the fact that what I was doing was not right and I started looking into holistic medicine and I started actually using

skincare products from natural companies, companies that did not add parabins their products, which are considered potential hormone disruptors. They didn't put fragrance in their products, which could potentially cause skin irritation. Formaldehyde releasers, they kept out as well. And I started using these other products and I go, wow, I could put this on my skin and my skin feels great afterwards. I didn't know that that was even possible. And so that got me in down, looking down really a rabbit hole of skincare and the fact that, you know, when you look at the ingredients of so many skincare products that are sold in department stores, and even in doctor's offices, they're filled with, once again, fragrances that can cause irritation to the skin,

fragrances that really, they don't even have to tell you what's in that fragrance. Basically, they could just put artificial fragrance, and that could be basically a trade secret, and you don't know what's in there, as well as parabins, as well as thallates, and all these other types of potentially harmful ingredients. When you look in the United States, the FDA has banned literally 11 ingredients from skincare products. When you look in the EU, it's hundreds. In Europe. Yeah, in Europe. It's hundreds that they banned. It's a very, very big difference. Wow. So the concern would be, besides these things prematurely aging our skin, the potential for them, and what I found out is that as I started going down this rabbit hole myself, a lot of companies themselves don't actually know because

they, what's in them, because they'll order these fragrances or these proprietary blends from third-party companies. And for that company, they don't want to reveal what's inside of it. So sometimes you'll ask a company, hey, what's in this fragrance? And they actually don't know what's inside of it. Yeah. Because they don't have the information. They order it from somebody else. Yeah, it just says fragrance. So besides these things potentially being irritating to the skin, prematurely aging the skin, they're actually not good for your body. They're going to cause all sorts of downstream issues, which is why there's this entire movement of people moving towards clean beauty and cleaner ingredients. Yeah.

And the term clean beauty is one that it really gets people up in arms because unfortunately the term clean beauty, and I use that term myself fairly loosely, there's no real definition of clean beauty. And so that is something that in general, if you're looking at skincare products, you do want to do your research and really, just look at the ingredients and see what's in there. Now, there are a couple of great resources for people who do want to look at their skincare products very carefully. There's the environmental working group. They have a really good website called Skin Deep where you can look up every single different ingredient in your skincare product, and it will give you essentially a clean rating. Are there any dangers to this ingredient? And even more simply, there's a, and I don't have any ownership interest or connections with these companies, one called the ThinkDirty app.

Now, I'm sure there are other apps with similar names that you don't want to necessarily download, but the ThinkDirty app is one where you can actually use your phone and scan barcodes, and it will actually show the product if it's on their list and give you ratings of what ingredients they have and how safe those ingredients are. That's awesome. Let's use this opportunity to sort of build the foundation of your framework, which you talk about in your new book, can you mention the title? Yeah, it's younger for life. And the idea is using the process of autojuvenation to literally rejuvenate yourself, using your body's own regenerative

abilities to turn back the clock. So as part of that core idea, and I love the book, thank you for sending it to me. You have four things that age us, that you break down. Some we kind of lightly touched on already, but it's worth refreshing. And especially, I think people are going to be very interested to hear the deeper rabbit hole and pulling on the thread of collagen. Because I know that that in particular, I take collagen. Yes. And I want to get your thoughts on it. But I got more excited about the potential of collagen after reading your book. So let's walk through the four things that age us, starting with the basics of nutrient depletion. What is it about nutrient depletion? And why do you want people to prioritize this if they care about not only looking good,

on the outside, which, by the way, you do a great job of. Would you mind mentioning your age? I'm 51. Yeah. You definitely look like you have the skin of somebody who's probably like in their late 30s, mid-30s, at least. You know, the funny thing is I get people ask me all the time on social media how old you are and I joke. I'll put I'm 85 and then people freak out. Like, oh my gosh, you look so great for 85. And then sometimes I'll put I'm 25 and go, oh, really? You are? Oh, you don't look so good. Well, sometimes you also joke. and you're like, oh, it's like, here's how to age like an Asian. Yes.

And you have a whole series on that, which is funny. We'll link to that below. But nutrient depletion, why should you care about that if you care about not only how you look, but also everything you're talking about today is also about how you feel on the inside and it's connected to your health span. So nutrient depletion. Let's start with that. So there was actually a study that looked at fruits and vegetables in the United States from

the years 1950 to 1999. and it looked at their number of different nutrients, and it looked at them year by year and how much of these nutrients they basically had. And they found a statistically significant reduction in at least six different key nutrients in our produce from 1950 to 1999. And those did include three really important ones, vitamin C, protein, and iron. So we do know, you know, there is this claim that holistic health practitioners will make, that our soil is depleted, that our industrial farming practices have caused,

our fruits and vegetables to be less nutritious than they used to be. And this is actually proof for that. This was actually a scientific study that proved that that is true. And that that study ended in 1999. It's like 24 years later. So now we got to wonder just how bad is it now. So nutrient depletion is something that we are dealing with as we get older. That's one reason why I'm a big fan of supplements and supplement is something I do cover in the book. But the other thing that you have to think about is like you mentioned before, is collagen. So nutrient depletion is something I think that's really important. I don't have a lot of solutions for it. You know, really it's going to be looking at your macronutrients. It's going to be potentially taking a multivitamin. But where you really, for me, I get into

the actionable things is when you do look at collagen and how our skin does lose collagen and the thickness of collagen. So I definitely want to get into that because I think nutrient depletion is something that is super important to realize you have covered it so well throughout your podcast. I don't have new solutions there other than making sure that you follow your macros. I think there's definitely a big trend towards protein that people don't realize how protein deficient we are, especially as we get older and with sarcopenia. But I would like to pivot towards collagen if that's okay. Can I know, Jack, before you pivot into college? Sure. Sure. I think you have a few important reminders just going inside of the book and kind of going

through it and looking at your content. One of the most important reminders is because we have people of all different walks of life, some people that are just starting. their health journey is that just moving from an ultra-process diet or getting calories primarily from an ultra-process diet to moving towards a whole food diet with a good diversity, that alone is going to start putting you in the right direction. And then if you find a good quality supplement, you have a few that might be listed inside of the book and resources on your website as well, some that also actually help out with thinning hair that are there. We can go into that later on. So just even getting a good,

quality multivitamin, moving away from ultra-processed foods, minimizing sugar as a percentage of your diet to make more room for better quality calories that are there. And then this kind of overlaps into a few other things that we're going to information, like getting better quality fats, et cetera. So those basic reminders are so key because everybody could use a little bit of tuning up when it comes to just getting out of this sort of environment that we're in where we're surrounded by things that are highly palatable that want us to overeat, which makes little room for the more nutritious things that are there. Well, and I think, and what you're hitting too is that a lot of this overlaps, you know, and so you're talking about ultra-process foods. And ultra-process foods actually

are super important when you look at free radicals and oxidation that a lot of people don't realize, you know, and when you're talking about, you know, also with inflammation and with having whole foods versus some of these ultra-processed foods, the idea really, is that you want to get back to that diet that I mentioned earlier where you can actually name like what that food is made out of versus these products that you don't even know what they're constructed of. And it's the idea of hyper palatibility. I mean, you know, this is something that Dr. Hyman obviously has been great with educating

people. But the fact is, is that there is a difference between the food that you eat that's natural, that really in some ways nature has made food so that naturally you're not going to over-reaching. it. You know, so how often do you have a bowl of strawberries and you overeat those strawberries? You know, how often do you have chicken and you just overeat necessarily just chicken? Whereas you get a, you know, a can of potato chips or a bag of popcorn or French fries and it's so much easier to overeat those because they're hyper palatable. They're literally scientifically made for you to overeat them so that they can essentially make more money off of you. And so yes, I think

when you're looking at nutrient depletion, it's a very simple thing to look at, but it's so, so important, and something that, once again, you and Dr. Hyman have covered so, so well. So you wanted to talk about collagen, and I know our audience wants to hear about it, so let's talk about it. So, you know, I mentioned earlier collagen, 70 to 80 percent of the thickness of what your skin is made out of is composed of collagen. We lose the collagen literally 1% every year. So how do you then replenish the collagen?

Well, once again, like I mentioned earlier, protein. collagen is a large protein. And some people say, ask me, they'll say, well, if I take a collagen supplement and I use a collagen cream, is that going to replenish the collagen in my skin? Well, collagen is a large protein. And the first thing I want your readers or, I'm sorry, your listeners to know is that collagen creams make zero sense. Okay, collagen is a large protein.

Our skin is a barrier and it's made to keep things out. collagen being so large, if you put it on the surface of your skin, it's just going to sit there. It's not going to absorb into your skin, and it's not going to make your skin any more youthful. So the first thing I recommend is staying away from collagen creams. I mean, if you want to spend the extra money for it, that's fine. But essentially, it's just going to be a fancy moisturizer. You can also throw out money out your window in your car just on the freeway if you want to as well. Collagen supplements are a whole different thing.

And as you know, they are very controversial. I made a post on TikTok a couple years ago touting the benefits of a collagen supplement. And oh my gosh, Drew, the hate was everywhere. Who was primarily giving the hate? Was it sort of people that are in the medical space? There are traditional physicians. There are like athletic trainer types, you know, who fashioned themselves as nutritionists and things.

And then just lay people, you know, saying, well, my doctor said this. It's a lot of my doctor said, my family doctor said collagen doesn't work. Interestingly enough, there's a doctor on TikTok, and he's big on social media. He is a cardiologist, traditionally trained. Also, he's had some nutrition training as well. He's got a big bushy beard. He's an older guy, and he speaks with clarity, and he's very positive and confident in what he says and in his conclusions.

And he made a video basically stating that collagen supplements, don't work. And if you want to, if you're going to try a collagen supplement, just save your money and get gelatin. It's the same thing. And I didn't reply to it. I'm not going to get an argument with another physician. But I disagreed with it. And very interestingly, literally like a month and a half ago, I saw that video reappear on social media. And as a video is about over, he shows up, he swipes it out of the screen and he says, I was wrong. Wow. Yeah, he said I did the research. Collagen supplements do work.

They do improve your skin. And I was wrong. It floored me because how often do you see a 65-year-old physician who speaks whenever they're out there, you know, what they say is right to come back and say that what they said was not true. Yeah, it takes a big man. And I hope that we can all do that. We want to encourage that sort of environment where even I've come on this podcast, say,

here's all the things that I've changed my mind on. You know, it's a good trait to have. But that was amazing that he did that. Yeah. And really then when you, so what does a science say? And really that's what it comes down to. Because people say, okay, collagen supplements don't work. The main argument is that it's a large protein, which is true.

And if you ingest it, your body will break it down. And how do you know that it actually gets to your skin or where you want it to go? And really the fact of the matter is, is when you look at collagen supplements, make sure that the supplement that you take is made of hydrolyzed collagen peptides. And that's super important because once again, collagen being a large molecule, when you actually take a hydrolyzed collagen supplement, that collagen protein has been broken down into amino acids, which are the single units of protein,

and they're peptides, which are groups of two or three amino acids or so. And that's done on purpose so that your body can actually absorb it. So it's like the argument that they have in that your body, absorb it, it will break it down. Yeah, that's why it's made the way that it is. That's why it's hydrolyzed, and that's why high-quality collagen supplements typically are hydrolyzed collagen peptides. And then when you actually look at the scientific studies, the studies, there are so many of them, and they're powerful studies that do show collagen supplements do create an effect. There was a meta-analysis of over, I think it was over like 1,200 people published back in

2021. And they looked at people taking collagen supplements for 90 days, and they found a statistically significant improvement in the hydration of the skin, in fine lines and wrinkles, and in the elasticity of the skin. And that was a meta-analysis, so it's a group of multiple studies that they put together for higher power. There even have been studies that have looked at collagen supplements where you put somebody on a collagen supplement for two months, randomized placebo-controlled clinical trials, and then you actually take a biopsy of their skin afterwards, and you can see that the skin has thicker collagen, and the skin is thicker afterwards. I don't know what other proof is needed.

You know, some people will say, well, maybe if you just increase a protein intake, that will do the same thing. And truthfully, I have not seen a study comparing increasing protein intake to taking a collagen supplement. You know, that would be something that would be very interesting. But there are a lot of studies that are out there that do show that taking collagen supplements can create a profound impact on the skin. This episode is sponsored by Arm Rock Colostrum. You guys know I'm always on the lookout for ways to strengthen. my immunity and gut health and improve my fitness and metabolism. While recently I discovered an incredible product that I'm absolutely in love with and it's called Armora Colostrum. Colostrum is a natural

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but how do you typically take your collagen and what should people be looking for when they're thinking about getting supplemental collagen? So full disclosure, I have my own skincare and supplement line. And so we do sell our own supplement. That's actually a collagen supplement. That's our number one seller actually for supplements. As far as me, I think it's pretty simple. The best collagen supplement, and there's some supplements out there, you know, the one that we have, it's tasteless, which is great.

But there's some you can, if you taste it, it does have a little bit of a beefy taste to it. So you got to try them ones and see what you like. But in general, a good hydrolyzed collagen supplement should dissolve into any type of a hot liquid. So if you like tea in the morning or if you like coffee, for me now, I used to drink a lot of decaf coffee and I would put in my decaf coffee. And then I went to the dentist and my dentist's like, you've been drinking a lot of coffee lately. And you're getting some standing of your teeth. So now I actually just mix it with hot water. And it just tastes like hot water.

And so that's what I have a lot of mornings now throughout the week. The other thing you can do is you can mix it into a smoothie or a smoothie bowl. I think that's a nice way to do it as well. Yeah. So it's a powder. You can get in capsule form, but a powder just allows like more quantity. Exactly. Of you being able to get it in.

Otherwise, if you had capsules, you'd have to take like, you know, 20 capsules. Yeah, because those capsules essentially, they're just filled with the powder inside. And, I mean, I take other supplements as capsules. I don't want to take more capsules. I'd rather just put it into my hot drink in the morning and then just drink it up. So we were sharing the four kind of key components. that are related to things that are aging us. And we talked about nutrient depletion.

Then collagen was really collagen degradation. People are not getting enough collagen. Ancestually, it looks like, you know, from the individuals that have come on this podcast, there was more sort of eating the whole animal in different societies. People don't know, but collagen literally comes from the skin, bones of animals. And that was part of what we ate. Yeah. in our, you know, we never wasted an animal. You would always use something. You'd put it in a soup,

a broth, a stew, you know, stew, something. And I think it's important for people to realize, too, that there are five types of collagen. So it's not like there's just one collagen. And that's something you want to look at, too, with the products that you're using. So for example, some people will take collagen supplements because they have joint issues. Maybe if you've got fibromyalgia, if you've got muscle aches. So type one collagen is the one that I typically focus on being a plastic surgeon. That's in our skin, essentially, in our hair and our nans. And there are some collagen that really just supplements that just focus on type 1. Type 2 collagen is collagen that's in our muscles, and type 3 is in our joints.

And so you do want to focus on the right types of collagen too. Some collagen, like the one that we have, has all three, in which case, you know, you can kind of help potentially with a number of different potential issues. Type 4 and 5 collagen really don't really enter the conversation so much. Type 4 is in our kidneys, and type 5 is in our placenta. So those you don't really need to worry about. But the other three, I think it's important to realize that if you do get a collagen supplement, find out what types of collagen are in those because you want to make sure that you are taking the right one for your potential, your specific needs.

That's great. Awesome. We'll link to your website. People can learn more in the show notes. So inflammation was another one. We chatted about that briefly. Anything else you want to say about inflammation before we go to free radical damage? Yeah, I think inflammation, you know, sugar is a huge part of it.

And that's, and so as far as avoidance, that's super, super important. But on top, and with AGEs with the advanced glycation end products, the main thing that I look at that causes those to be created basically is sugar. But you can actually get advanced glycation end products in certain types of foods as well. And typically those are animal-based high-fat foods that, worst-case scenario, are ultra-processed and heated to super high temperatures. So for example, and this is really, really sad, but the type of food with the most amount of advanced glycation end products is bacon.

And yeah, not good. And so these advanced glycation end products you can get not just from, unfortunately, just from sugar, but you can also get it from other types of foods. If you grill a steak on the grill, that can also be, you know, potentially high levels of advanced glycation end products. So you're talking once again, things that will age you. Margarine has a lot of advanced location end products as well. Can I chime in on this? I've written a little bit about. about it. And there's a company that's out there. I forgot their name, but they sent me a testing kit. I have no affiliation with them that sort of helps you measure these advanced gligation

end products. A lot of people that have come on this podcast talk about a good proxy measure of it would be hemoglobin A1C. Right. So you look at your hemoglobin A1C, which is your blood, it looks at the sugars binding inside your body to your cells. And over the course of like six to eight weeks, it's a marker that people use for also diabetes, right, to look at pre-diabetes diabetes. So on the side of meat being associated with advanced glycation and products, part of what I've seen is that it's when those foods have been charred or overcooked. Exactly.

So if you have a lot of charring and you have that literally charcoal that's there, like you go from instead of lightly cooked or sort of, you know, medium rare sort of piece of meat, to something that is super charred. The charring is where the extra sort of advanced glycation end products, only to mention in so that people don't get spooked that, oh, I got to stop eating steak or bacon, there can be ways to cook things that can be in a healthier way. We just want to avoid even vegetables that are super highly charred all the time. Once in a while here or there, there's nothing wrong with that.

But if every day as part of a staple of our diet we're eating meat or vegetables that's charred, that seems to be one of the things that is the biggest contribute to these ages in our diet and then being created inside of the body. Correct. And I think that's part of it. One of the things I always try to preach to my followers is, you know, it's like you can follow people on social media who appear to have like the perfect healthy lifestyle where you know, they're doing everything possible. They're eating all whole foods. They're exercising every

day. They're doing coal plunges. They're in the sauna. And reality is, is that the majority of Americans, you know, we're just trying to make a living and stay as healthy as they can while they take care of their kids, while they, you know, try to put food on the table and stuff. And so really what I try to encourage people is just like you said is don't feel guilty if you're at your kids' friends barbecue and you have a dog from the grill. Like that's okay. It's just it's a pattern of behavior where if you're eating so much of that, that it can be very harmful. But at the same time, we do have to live life. And part of living life is enjoying it as well. And I think too, I think you'll see, too, as you get healthier and healthier for those people who are making these changes,

is that you'll find that you don't want to have those foods all the time because they start making you feel kind of crummy. And I do think that there is a huge, huge segment of the American population who just chronically doesn't feel good, but they don't realize they don't because this is just their natural level of living. They didn't know, they don't know what it feels like to truly feel energetic and healthy because they've never been given that type of a diet and have been on that type of activity and all that. It's so true. There's that cheesy old quote from Tony Robbins, but it's so true, and I'm a huge fan of him. You know, nothing taste as good as being healthy feels.

Yes. And when you truly are healthy and obviously people make jokes about that joke, they make jokes about that quote. And they'll see things like, well, you've never had a piece of bacon or you've never had, you know, this or that. But really for our lifespan, when you wake up in the morning and you have energy, when you look in the mirror and you feel like, wow, like I feel healthy, right? Like you're looking at yourself.

You feel healthy both from the outside in but the inside out of, big part of that obviously too. Working out, having a low-stressed life, all the things that we talk about and people practice to the degree, you get started where you are and you continue to make progress. Nothing feels as great as that. You feel like you can conquer the world every single day and you're happy and it's infectious. Everybody around you feels like I want to do what he's doing. Yeah. And I think when you look at me being a plastic surgeon, you look at your outer appearance, that can really impact how you feel about yourself too and about, you know, being healthy. You know, some people say, well, what is beauty?

And my first thing would be beauty is really is health in general. And so being healthy, that's oftentimes really for what I try to recommend as a first step to feeling beautiful about yourself. And so just like you said, that makes complete sense. So you touched on inflammation, you know, you being a plastic surgeon and having gone through your medical training, I mean, we have to just briefly chat about stress in the context, Yeah. You know, do you feel that stress is really one of the top things that if people have

chronic stress, you know, we all have a little bit of stress that we deal with. But what do you want to say about chronic stress? So you only need to look at the U.S. presidents when they enter office and then when they exit office four or eight years later to know that stress is a huge ager of our body. You made a video on this one time, right? Yeah. I mean, it's just, it's obvious that that's what happens. And so, you know, there aren't studies that I know of that have specifically.

look because how do you quantify stress? That's the problem. You know, how do you do a study on somebody who's really stressed, you know, and see their aging process? It's just there is no way I know of to actually do that. But we do know in general that there are certain activities that can reduce your stress that do actually help you to feel and look younger. And so one of the big parts of my book is talking about some of these strategies, including meditation and how meditation can be huge in reducing the amount of stress that you have and even in improving your appearance. I'm a huge fan of yoga. Yoga, I think, especially as we get older, so many benefits, not only just to our stress level,

but also to mobility and to balance, and actually your appearance potentially can be very, very important. And then sleep being a huge part of that as well. I think that's something that our society has really failed us in teaching is how to deal with stress. you know, and really the difference, like I mentioned earlier about acute inflammation and chronic inflammation, there's a big difference between acute stress and chronic stress. And acute stress being something that is a big focus for anti-aging experts and longevity experts is being a good thing. Hence, all these people jumping into cold bathtubs and trying to stay in them for as long as they can versus chronic stress, which is a stress that so many of us here, especially in the

United States and even really around the country, around the world, they're dealing with when you've got stress of paying your bills, when you have stress from work, obligations and all of that. That definitely is aging to our bodies. And so trying to take ourselves out of that as much as we can, I think is so, so important. One of the foremost researchers and scientists in the space is a Dr. Alyssa Appell. I'm not sure you heard of her, but she's from University of San Francisco, University of California, San Francisco.

And she wrote a book, I believe it's called Stress Prescription. she came on this podcast. She actually has a bunch of studies that she's put together about how chronic stress literally ages the body. Interesting. I'll send it to you.

It's a really great sort of pull thread. Yeah. And some studies that she's been involved in as well. But yes, minimizing that sort of chronic stress is, do you think that there's any, I'm just asking for your experience on this? People who have less chronic stress in their life have less wrinkles in their face,

especially if they're eating healthy because they're just not, you know, they're more at peace? Is there any association to that at all? You know, I think that there is. I think once again, the problem is how do you quantify that? You know, when you look at stress, like we have studies that have looked at taking, let's say, vitamin C. People have a high, a diet, high in vitamin C. There are studies that show that they have less wrinkles than people who have lower diets lower

in vitamin C. But the big question is, is how do you quantify stress and its effects on wrinkles? Just real quick, just all of a sudden it brought me back. We talked about collagen. It's the same idea and similar like one of the things I think that there's a, we can make, in medicine, we can make conclusions based off of what we see in general that may not be quote unquote evidence based where we may not actually have a scientific study specifically that can support it.

But we know by looking at the facts on the ground that this is most likely true. Clinical experience. Exactly. And one of those, just to bring up, because it's something that really is kind of becoming dogma and holistic health, but has never actually been proven true, is bone broth and its effects on the skin. Okay, so we talked a lot about collagen just a few minutes ago. And I have friends of mine, colleagues of mine who say, oh, you take bone broth, it's going to make your skin better. It's going to improve the collagen of your skin. And it makes sense because bone broth, you take it and you know, and you cool it down and it becomes a gelatin, and that's basically pure collagen. But there is no study to show that taking a bone broth, that drinking bone broth at all will improve your skin. There's zero studies to support that. But, Drew, there are zero studies to say that it doesn't do it. And the studies just haven't been done.

Yeah. So, you know, unfortunately, like in traditional medicine, then, you know, you will have a physician to say, well, bone broth doesn't make your skin better. Where are the studies to prove it makes your skin better? And there aren't any. But at the same time, does that mean that your negative conclusion is true, that then because there are no studies to support that bone broth doesn't improve your skin, it must not improve your skin? No. Like once again, we can use deductive reasoning to say,

okay, bone broth is filled with collagen. Collagen supplements have been shown to improve the skin so it makes sense that bone broth should improve your skin too. Yeah, not to mention the fact that probably if people are drinking bone broth on a regular basis, they're getting just the hydration aspect that's there. It's kind of like when people would say, hey, juicing, you know, I think that part of what's happening now as the wellness movement and the health movement grows up is that people are being more skeptical about claims that are not backed up by things. Because there's nothing wrong with somebody saying, hey, look, I drink bone broth every

day and my skin looks fantastic versus somebody saying bone broth absolutely is going to transform your skin. And there's so much research that's out there. And they don't point to any research that's there, right? That's where we want to stay away from those individuals that are saying things like that. What you're really talking about is something important that individuals like Dr. Jeffrey Bland, you know, who's the grandfather, father of functional medicine, he says the absence of evidence is not the evidence of absence. There you go. Right. It's just because a study hasn't been done

doesn't mean, and doctors can fall into this too, that, hey, there's no proof that this thing happens. Well, you may have not looked into it, but also maybe a study hasn't been done. Yeah. But All that to be said, you're a fan of bone broth. I am. Yes. Yeah. And I think that that definitely is something that if you do want to improve the collagen of your skin and you like the taste of it, then by all means, that's something that I do definitely recommend. And that goes back to what you mentioned before is that our ancestors would eat the whole animal, you know, and that's when the benefits of bone broth is you take those parts of the animal that normally we wouldn't necessarily consume in our society, and you can

use that for, you know, good means, essentially. We talked about it a little bit, but number four, your list was free radical damage. Do you want to just go into a little bit more about free radical damage and why it's so important to protect our skin from free radical damage? Yeah, so free radicals, once again, that's oxidation, huge cause of aging of the skin. I mean, years ago, people thought that that was the main reason that we age, period, was free radicals. Now I think we know better that that's a component, but not necessarily the only reason why we age. So put it very simply, free radicals can damage collagen, essentially, can damage our DNA of our skin because of the process of oxidation. So free radicals are essentially these molecules that are damaged that try to

steal electrons from essentially our healthy cells. And by doing that, they can actually damage then the DNA of our cells and causes cells to essentially prematurely age. There are, so free radicals are something that is a byproduct of our natural metabolism. So just being alive, your body creates free radicals. So that's not a, you know, necessarily a negative thing. But the problem is that in our society, and even based off the food that we eat, our body can get overrun by free radicals. And so you can get free radicals by eating certain types of food. The type of food that is most filled with free radicals in general are the ultra-processed foods. So yes, foods can contain free radicals. Also, you can get free radicals from things like pollution, from smoking,

from different types of lifestyle things. Actually, exercising can create its own free radicals. That being said, when free radicals can become a problem is when your body gets overrun by them. Your body will create antioxidants naturally. Antioxidants essentially donate the electron to the free radical to neutralize it so that it does not then damage the cells of our body. And our body will generate its own antioxidants as a way to combat free radicals. But when there's so many free radicals that are essentially attacking your body, you know, from once again those types of activities, from those types of foods, and you enter a state of oxidative stress. And that's when the free radicals are excessive and your body is essentially prematurely aging from it. So what is your body's natural

defense against free radicals? Well, once again, antioxidants, and you can actually take antioxidants by mouth and you can apply it onto your skin. And that's what I usually recommend as a kind of a two-pronged approach. Now, interestingly enough, okay, you know, one of the big things with my book, and I'm a big fan of integrative medicine, is combining the whole holistic with the traditional. And as a traditionally trained plastic surgeon, you know, that's something that I always am looking at traditional medicine as, you know, as like the gold standard for evidence-based medicine, but it does lack, unfortunately, a lot of things. Interestingly, Drew, if you were to ask one of our holistic practitioner friends, what's the

best way to get beautiful, healthy skin? They would say heal your gut, and then your skin will follow. If you ask a dermatologist, what's the best way to get healthy, youthful skin? They'll say, wear sunscreen and use a retinol. And if you ask a plastic surgeon, they'll say, have a facelift, get some Botas, maybe a laser treatment. And really in the end, it's combining the best of both worlds, I think, that's going to be your best option. And so when you look at antioxidants, it's consuming them, okay, in foods, but it's also applying it to the surface of your skin as well. What are your favorite foods that you would be telling people, even as basic as it might seen, it's that reminder about the power of like food is medicine.

So let's talk about foods first, and then we'll go to topical. So yeah, the big thing with antioxidants is that you want to eat the rainbow. And this is something you've heard on your show. If you've been following Drew for a long time, you've heard this said before. But eating the rainbow fruits and vegetables is super important because it's the actual pigment in the fruit or the vegetable that is the antioxidant. And so if you eat, let's say, a green leafy vegetable, you're going to get different antioxidants and if you eat like an orange fruit versus if you eat a yellow vegetable.

And so the idea is by eating a wide variety of fruits and vegetables in a plethora of different colors and you're going to get a variety of different antioxidants that's going to give you even better protection overall. And so that's in general what I recommend. Now, ideally, too, there are certain, especially fruits that have a higher glycemic index than other types of fruits. and so essentially they may raise your blood pressure faster, and we mentioned earlier about sugar being a cause of inflammation. So ideally staying with some of the lower glycemic index fruits,

if you can, fruits essentially berries are a really good source of great antioxin, lower glycemic index, so you can kind of help with the inflammation part of it, and you can help with the oxidation part of it at the same time. So that's going to be my favorite type of fruit. With vegetables, you know, I'm a big fan of green leafy vegetables and darker green leafy vegetables, like spinach, I think is great, kale. All those I think are really, really good. But ideally you do want to focus, once again, on the rainbow. It's not good if all you eat are green leafy vegetables.

If all you eat are just, you know, orange fruits, you really want to mix it up. Yeah, and people can even toss in things like kimchi, right? Kind of like that. You grew up eating kimchi? Yes. And so, you know, that too, when you're talking about inflammation, there are inflammation reducing foods, I think, that are super important. And, you know, when I look at inflammation reducing foods, you know, going back,

I know we're talking about free radicals, but when you go back to inflammation and kimchi is a huge thing, I look at two main ways to reduce inflammation in the diet, okay? And that would be eating monosaturated fatty acids and omega-3 fatty acid-rich foods, and then eating probiotic rich foods as well. Okay. And so there are foods we mentioned earlier that add to the inflammation in our body. There are foods that can reduce inflammation. So for the omega-3 fatty acids, you're looking at cold water fish, so salmon, tuna, trout, mackerel, that type of thing. For monounoun saturated fatty acids, olive, olive oil, olives, olive oil, avocados, nuts and seeds, I think are great sources. And then the other group, once again, is going to be hitting the microbiome. And I'm happy to go over that.

That is where a kimchi kind of comes into play here. Yeah. I wanted to double click on, you know, one thing that you shared, which was the ultra-processed foods and free radical damage. Yes. And kind of linking that back to also ages is highly fried food is also one of the things because of its nature and ability to sort of create a lot of acrylamide because you have carbohydrates that are highly fried so all the proteins get denatured. We wrote a news there about this. I think it was called the gut, the food mood connection, Tesla, you can bring it up. But basically there was a huge research study that was done that we've highlighted in our newsletter to our listeners talking about there was 140,000 people that were looked at over a period of time and they found, I won't have all the details, but we'll link to it below, that the number one food that was associated with depressive-like symptoms was actually French fries. And when they looked into it, that overconsumption of highly fried food and French fried is the number one. That's why potato. Catoes are one of the top vegetables that we consume here in North America, it was correlated with

these depressive symptoms primarily because they felt that there's this free radical damage that's happening to the body and the brain. So it's not just aging our skin. These things that you're talking about that will make our skin look better, they're also going to be protective for our brain because we're going to be avoiding things like high levels of free radicals from things like acrylamide inside of the diet. Yeah, and that's one thing is when you do look at free radicals and oxidation, fried foods, that's, you know, ultra-processed and fried foods are the two big sources that you want to try to avoid, period. But it's tough because in our society, it's just everywhere, you know.

And so trying to do your best to try to avoid that definitely is a way to go. Yeah, start off with minimizing. Yes. We're not talking about the French fries here and there, the occasional trip to even a place like McDonald's. Yeah, I mean, if you're visiting from the Midwest and you come to Canada, and you come to. California and you want to try and in and out for once, feel free, you know. I mean, it's, you know, it's kind of a right of passage when you come to California because we don't have it out east. But at the same time, you know, it's like my wife used when we, when my, when my,

my kids were young, they would say, okay, this is a sometime food and this isn't all the time food. And that's going to be a very much a sometime food. That's great. So I want to pause on the dietary components and we covered kind of the four things that are the things that age us. Nutrient depletion, inflammation, chronic inflammation. You talked about collagen degradation and what we can be doing. When we talked, you talked about free radical damage and avoiding highly sort of ultra-processed foods, fried foods to minimize that free radical damage. Let's talk about, you talked about those three different areas, what the plastic surgeon

would tell you, what the dermatologist would tell you, and then what the sort of holistic health practitioner would tell you. So let's go to the dermatologist for a second and look at one of the main things that they talk about that ages the skin. So they talk about sun. And people hear it all the time. They hear dermatologists on Instagram, TikTok, maybe podcasts, saying, you got to wear sunscreen pretty much all the time because the sun is so damaging.

Now, on the other side of stuff, people hear individuals like Andrew Huberman and other people talk about the benefits of morning sunlight and how important that is to our circadian rhythm and sort of setting our biological clock and how a lot of people don't get enough sun that's out there. You don't want to over sun. So what's your perspective as you're trying to merge all these things together, specifically with sun and sun damage to the skin? So sun damage, some people ask, okay, doctor, and you're talking about these different reasons why the skin ages. And where does UV radiation come into play? And it comes into play actually in both oxidation and in inflammation. So basically the sun's rays will cause damage using both of those mechanisms. And where I get really concerned is when you get DNA damage from the UVs rays of the sun. So I am all for you get up in the morning, you get the sun on your face, there is also something very therapeutic about getting sun. You know, I live in Detroit. And in the middle of the wintertime, we go weeks without seeing the sun. And when that sun comes out, it is so therapeutic to have it on your skin.

You know, to the point where so many of us, we go down south. And just even for a week in February, just to get some sun, we go to Florida or the Caribbean. That being said, as a plastic surgeon, I've been in private practice for 20 years, I cannot tell you how many people have come into my office with a tiny, dot, let's say, on their nose. They go, yeah, I got a little skin cancer here. I'm going to go see my dermatologist, and then I'll see you know in a few weeks or whatever. And then they come back to my office after getting mose surgery and half their nostril is gone. Wow, because the cancer had spread. Yeah, because in order to get rid of it, they had to remove that or part of their lip is gone

or part of their eyelid is gone. Their eyelid is pulled down. It is, you do not want to get a skin cancer on your face. It is potentially disfiguring. It is devastating. So I see both sides of it, you know, as a plastic surgeon, seeing, trying to reconstruct these types of defects, and at the same time, understand that there are true therapeutic effects of getting the sun. So I think that there is a very reasonable medium ground here. I think like most things in life, you know, there are people who are on extremes and where the truth usually lies for most people is somewhere in the middle. So, you know, yes, dermatologists will say, you know, even if you're sitting in a basement all day in a dark room, you should put your sunscreen on in the morning. I mean, and especially with the sunscreens that we have here in the United States, they're not always the most comfortable on the skin.

You know, sometimes they feel greasy and people don't necessarily like to wear it unless they need to. So in general, my recommendation is, is if you're going to have prolonged exposure to sunlight, you should ideally wear a sunscreen or a sunblock, at least an SPF 30. Then the question comes, because you do not want to get so much sun damage that when you turn 50 or 60 or even younger, you get a skin cancer on your face that you need to get treated. I am fearful for one of my favorite actors, Hugh Jackman. You know, he's, I think he's probably the most talented person in Hollywood, and he has had so many skin cancers removed from his face.

Super handsome guy. At some point, one of those cancers is going to be in the wrong place, and it could really be disfiguring for him. So my goal is a plastic surgeon, number one, is to try to prevent that type of disfigurement that can be absolutely devastating for somebody. And then number two, obviously, to promote their health. So in general, what I recommend is when you're going to get prolonged sunlight, and that does include being in the car, okay, because the car's windows will block UVB rays, so you won't get burned, but they won't

block UVA rays, which can cause premature aging and skin cancer. But if you're going to get prolonged exposure to the sun, I do recommend a sunscreen at least SPF 30. But then the question comes is what type of sunscreen do you recommend? There are, there is a difference between chemical sunscreens and physical sun blocks, okay? Physical sunblocks are made of zinc oxide and titanium dioxide. And these are substances that are meant to sit on the surface of your skin and block the sun's rays from getting through. The old, the old picture that you may have in your head of a lifeguard with this white paste on their nose, that is the old style of a physical sunblock. The newer types of physical sun blocks are micronized, meaning they're in smaller particles, and so they don't quite

create so much of that white pasty look, but they can still create a little bit of a kind of a whitish hue to the skin. Somebody like yourself, myself, if you're African American, you've got darker skin, they may not look so good on your skin. Yeah, I've used them before. They kind of make me a little bit white on my skin and all of a sudden I'm wearing like I'm wearing like some sort of weird makeup or something like that. Exactly. You don't want that. And so then what do you do? You look at the sunscreens. But, you know, holistic health practitioners have been very good with kind of exposing the potential concerns. The real concerns. I mean, a lot of sunscreens that are out there that people buy at the local convenience store or drug store, they have known carcinogens inside of

there. So the two big things that we are concerned with very common are oxybenzo. and octinoxate. So these are the two chemical sunscreen components that are the very controversial concerning ones, and they're in a lot of sunscreens. The fact is, is that for sunscreen to work, it has to be absorbed through the skin, and then when you get UV radiation hits your skin, the sunlight hits your skin, there's a chemical reaction with that product that can, you know, basically deactivate those sun rays and protect your skin from that UV damage. Unfortunately, with oxybenzone and octinoxate, what you find is that they can, you know, can be considered potential hormone disruptors. They are found in literally the urine of almost

everybody in the United States because it absorbs into your bloodstream. And on top of that, there are some studies that do show that they may potentially impact the coral reefs. And so these two ingredients are actually banned if you go to Hawaii, if you go to the Caribbean in a lot of resorts and beach towns and stuff. But there are some actual safe chemical sunscreens that you can consider. and two of them that I would recommend would be avobenzone and Maxoril XL. Okay, so these are chemical sunscreens that have not been shown to be hormone disruptors. To my knowledge, you're not been shown to be harmful in any way, and they do work to block the rays of the sun. And they don't create that whitish hue on your skin.

So in general, my recommendation is that if you're Caucasian, you're an adult, and wearing a mineral sunscreen does not impact the appearance of your skin, then that's what I would recommend in general. If you have children, I recommend using a physical sunblock, you know, mineral-based or physical sunblock because you do not want those chemicals to get into your kids, you know, bloodstream into their body. If you are a darker skin person, however, then what I usually recommend for the face would be a chemical sunscreen with either Megzoril XL or Avobenzone because, once again, you won't get that kind of white issue that you don't want to be walking around with, but you still get that protection safely. If you're going to go to the beach, then I would put that on your face,

then maybe on the body, I would go with the mineral-based or the physical-based sunblock. And then for the kids, the worst thing you can do, and I see at the beach all the time, is there these chemical sunscreen sprays that parents are just spraying all over their kids, you know, up and down. And you know those kids are breathing those fumes into their lungs. Their lungs are rapidly developing, and now you've got these potential hormone disruptors being breathed into their lungs. We don't know what that's going to do. So if you've got one of types of sunscreen sprays, sprayed into your hand and then apply it onto the child. Don't just spray it all over them. Yeah, even though the, what are they called, like titanium dioxide, titanium dioxide,

mineral sunscreen, zinc oxide, even though they make my face a little bit white, I would so much more use them. I'm just so cautious around the chemical sunscreens that are there. Like, who knows whatever we haven't discovered that's inside of these things, especially because they end up a lot of them in the body versus like using things like zinc oxide and other stuff. What do you feel about there's a lot of sunscreens that are on the market today that have a little bit of like, especially for people that are darker skinned or have some pigmentation, yourself, myself, we're not traditionally like, you know, white European Caucasian. They'll have like a little bit of tint inside of there that helps it kind of blend into the skin. What are your thoughts on those?

I think those in general are safe. I haven't looked at the specific ingredients of the actual tint themselves, but there are natural sunscreens out there that do contain that. And I think that in general, that's a good way to stick with the mineral base, the physical sun blocks. And interestingly, one of the big things, and I have to look up what the celebrity is. There is a celebrity that is a celebrity that is spearheading. One of the issues that we have here in the United States is that we have a very limited array of sun blocks and sunscreen's available here in the U.S. It's very different than what you have overseas, which is very interesting because here in the U.S., when you look at the actual chemicals that make up skincare products, you know, there's only like 11 or 12 that are banned here in the United States. In the European Union, there are hundreds that are banned, hundreds of chemicals that you cannot be used in skincare. However, when you look at sun protection here in the U.S., we only have a handful of options. And if you go to South Korea or you go to the EU, there's so many different options. available for sun protection overseas that you don't have here in the United States.

What are some examples? What were they use in Korea? I actually don't even know the names of them because we don't have them available here. Are they things you put on your face? Or they're actually like a physical protection? Like some sort of hat or dome? No, no, no. These are actual products. They're much thinner because one reason why a lot of people don't like to use sun protection is because it just feels greasy on your skin. It feels heavy. And there are products overseas. And I haven't looked at them because I cannot import. It's against the law for me. Let's say, import it and sell it or anything. But I do have relatives of mine who go, oh, I get my sunscreen from Korea. Yeah, I don't get them here in the United States because they are much lighter.

And apparently they work. I haven't researched their ingredients. At some point when they come here to the U.S., I'd like to do that. But there are people who are really trying to push the FDA to open the doors for us to have more options here. Because really, when you go to the store and you look in and you know that oxybenzone and octinoxate are not ideal options, the vast majority of sunscreens, that's what's in them, you know, because they just don't have a lot of options available here in the U.S. A few things that you mentioned that I want to sort of double click on a little bit. So I went down the rabbit hole a little bit of, you know, morning sunlight and speaking with a great cardiologist, the cardiologist that I work with, and he's always talking to individuals about

how important it is to get that morning sunlight and evening sunlight to really sort of not just reset and set our circadian rhythm. but it's also so important to protect our endothelial lining, which is really highly based on sort of this whole classification of photobiology, which he talked about on the podcast we did together. We'll link to it in the show notes. And he said, you know, one important thing for people to remember, especially when it comes to morning and evening sun, and we all have this.

If you have an iPhone, you can click on the weather app. And on the weather app for your local city that you're in, you can scroll down to the bottom. And one thing that you see is that in the morning... Like today in Los Angeles, the sunrise, I think, was like 6.30 or something like that. So I was up early. And from 6.30 to 722, the UV index is zero, even though the sun is out. So the UV index is zero because when the sun is at the closer to the horizon, whether that's morning light or evening light, it is not going through the magnification that has.

happens when it's closer to high noon when the UV index is the highest throughout the day. So naturally we see that the UV index sort of slowly goes up and slowly comes down. So anybody who's afraid of getting morning sunlight, like we're talking about like 10, 20 minutes if you follow like the Andrew Heberman protocol in the morning, which so many people are a fan of. He's been on this podcast before. We're talking about 10, 20 minutes of morning sun. and it's at a zero index of UV for most places on Earth. Interesting enough, you mentioned Hugh Jackman. I know he's from Australia.

And because of their ozone and other stuff that's there, like I'm looking today, the UV index in Sydney, Australia is nine, right? Today, like at high noon. That's like quite high, which is why, have you been to Australia before? I have. There are literally skin cancer clinics all over. the way that we have Starbucks here in the U.S. or fast food, you go to Sydney and other cities that are there, they're everywhere. You got to believe that something is going on with their atmosphere and stuff. I think that's part of it. And I mean, obviously, the other part of it is where do Australians come from? I mean, they come, you know, historically, they're from the U.K. And that's a whole, you know. Different climate. Exactly. They, I think, evolutionarily became who they already got that type of skin for their climate. And now you transport them to a completely. completely different climate. And if you look at the indigenous population of Australia,

they're dark. They don't look anything like Brits. And so, I mean, it's just, it's a part of the world that their body was not meant to essentially like live at, you know, without making these types of changes and protecting yourself. There's these other things, and I don't have any data to back this up or to point, but there's these concerns that a lot of individuals have, which is that is it the overuse of certain products that we're using, even? a lot of sunscreens that we talked about before, could those be linked to some of the bump that we're seeing in skin cancers that are there? People are putting them on their skin, hoping that they're protective. But again, those things being hormone disruptors,

possibly carcinogenic in some cases, carcinogenic and others, could that interaction between those sort of harmful sunscreens, not the ones that you recommend, and the sun, because people sometimes put on sunscreen and they think they're protected. We're here recording in the Los Angeles, you go in the summer, there'll be people that are really tanning in the sun, which is obviously aging them, and they think that they're okay because they have all this product on. But in a way, it's a false protection, and they just shouldn't be spending that much time over tanning or even tanning in the sun. Thoughts on that? Yeah, you know, it's, it is something that is brought up oftentimes. You know, I have friends of mine who are dermatologists, and that's one of the

arguments whenever they recommend sunscreen is that, oh, you know, we have an increasing amount of cancer. My belief, and I don't have any specific studies to prove, because I think really the jury is still out there. You know, why is it that we're using more and more sun protection, yet skin cancer is increasing? My belief is not necessarily that it's what you're putting on your skin, but I think it's our basically Western lifestyle. You know, I think it comes down to multifactorial. It's the stuff that we've talked about. It's the diet, you know, it's the free radicals that we're eating. It's the changes in, you know, free radicals and how that can alter and damage the DNA of our skin.

You know, I think in general our body may just be more cancer-prone, period, because of the lifestyle that we lead. And it's not necessarily because you apply to sunscreen, you know, to your skin that does block those sun's rays, but it's probably the underlying, you know, mechanisms that are going on because of the diet and because of the lifestyle that we lead. I think that probably has more to do with it than, geez, you know, what's in that sunscreen that you're putting on your skin that you put on your skin twice a week or something? Like, I don't think that's the case. And I don't know, honestly, I don't know any, I know a lot of dermatologists and they've got like pale, white, perfect skin.

I don't know any of them that I know of who's actually had a skin cancer. Yeah. That's good. That's good. But it's something that would be very interesting. But my feeling is, is it does come down to really metabolic health. It comes down to all the different things that we're putting into our body. that just is not healthy that's causing inflammation, that's causing oxidation and all these other

processes. Yeah, totally agree with you there. And obviously, that's really the intersection of your book. Your book is talking about how do we age beautifully from the inside out and the outside in? So the first part of our interview, we were mostly focused on inside out because that's what you called the foundation. If you don't have a diet primarily based on whole foods, if you're not minimizing the ultra-refined carbohydrates, the white breads, the things that don't have dietary fiber, which will slow down the absorption of glucose inside of the body, even fruits. You know, fruits generally, people get worried about them a lot, but almost all the fruits that are out there are going to have more fiber per ratio of sugar than a lot of the

super-refined carbohydrates that people are going to be eating with like white breads and pastas and other stuff. Minimizing ultra-processed foods and staying away from highly-free. fried, overcooked, charred things, and then getting all the incredible phytonutrients, antioxidants in our diet by eating the rainbow, good pigmentation. We talked about stress. We talked a little bit about working out, which I've seen some studies that are out there that also a good amount of strain training, you know, three times a week can also be

another way to have our skin be resilient inside of the body. I'll ask you about that later on. Now we're in the part of the interview where we're talking about outside in. So we talked about sunscreen, right? The other one that people want to hear about that you have a great take on inside of your book is Botox. So Botox, okay, great. It has toxin inside of there. But you want people to know something about Botox, which has been used for a really long time here in America.

I think it came out in like the- They started really testing in the 90s. But the FDA approval came, I think, the late 90s. but it really wasn't used a lot until like the early, early, like around 2000 or so. Yeah, and sorry, I didn't mean a really long time in terms of decades. I think I meant more in terms of a lot of people have used it. Oh, yeah, yeah. So let's talk about Botox and then tell us, do you use Botox, right? After you give us the breakdown of why is it so controversial, does it work, and then do you use it?

Do you recommend it? Yeah, so Botas is probably the most popular cosmetic treatment in the history of the world. I mean, every year, at least five million people undergo injections of Botas. Now, Botas is the brand name for Botanin. Is that just in the U.S.? That's just U.S.? Oh, yeah, yeah. And that's just-I figured global population only $5 million?

No, no, it's got to be a lot more. Yeah. And that was probably statistics I'm pulling from about two or three years ago, so that number is probably higher now. So Botas is the brand name for botulinum toxin. And there are other brands, too, that are very similar. There's Disport, there's JuVo. There's a new one called Daxify.

And essentially, what is a brand. it is, is it is one of the most powerful toxins in the world. I mean, going through medical school, we hear about botulism, and that's basically sickness from botulinum toxin. And interestingly, there were some, an ophthalmologist and a dermatologist, a husband-wife, many, many years ago called the Carruthers, where the husband, if I remember, yeah, the husband was the ophthalmologist, was injecting Botox as a treatment for spasticity disorders, especially around the eyes. And so we have these tiny little muscles around our eyes that you can get spasticity problems where it can cause vision issues because your eye doesn't move ideally normally. And if you inject a tiny

bit of Botulinumtostin into that muscle, it can weaken the muscle by preventing the nerve transmission from the nerve to the muscle. It basically blocks that so that the muscle then essentially relaxes. So you cannot flex that muscle. And it has been used therapeutically in a lot of different types of muscle spasticity disorders and cerebral palsy, people have esophageal disorders. And what this ophthalmologist and dermatologist couple found was that after injecting it around the eyes for people with these spasticity disorders, and, you know, you may have some times where your lower eyelid kind of gets a little spastic and quivers and stuff, that the wrinkles would start improving in these people. And after seeing that, they go, well, geez, if the wrinkles get

better, why not we focus on injecting into wrinkles caused by muscles? We call these dynamic wrinkles. So there's certain wrinkles of our face that are caused by muscles and other wrinkles of our face that are caused by essentially just gravity. And the wrinkles of our face that are caused by muscles are typically the wrinkles of our upper face. So that would be our crows feet wrinkles, the frown lines between your eyebrows, and your forehead wrinkles. And if you inject botulinum toxin or Botas into those muscles, you can prevent the transmission of nerve impulses to those muscles and cause those muscles to essentially relax. And that benefit or that impact in effect lasts about three to four months on average. Where it doesn't treat, however, are static wrinkles, wrinkles that are caused more by just

gravity. And so the nasal labial folds, which are the wrinkles going from the sides of the nose to the corners of the mouth, are dynamic wrinkles. Botas doesn't do anything for that because are not actually caused by muscles. And so the controversy is, is that Botox Botanotocin is a real toxin created by a bacteria that if you inject it in even minute amounts into a person, you can kill them. But if you injected in the tiniest little amounts in the right location, you can improve wrinkles. Now, where some holistic health practitioners have issues with it. And I tell you, you know, I go to holistic conferences. I have a lot of friends of mine. so many of our friends and colleagues,

people who've been on your show. They all do Botox. And you may be able to spot it when you're sitting across this table from them. And some of them, I've seen a trend recently in the last couple years, some of them come on and say, hey, listen, I do Botox,

and I still do all the other help things that are there, and it's not an issue for me. And I appreciate that transparency. That's the society that everybody wants to live in. They want you to do whatever you want to do. Just be honest about it. Don't say that it was this supplement that you started taking, you know,

if you're taking Botox. Yeah, it's the lying is the problem here. Yeah. So it's addictive, not that there's a true addictive component to it, but because you see the results usually within like a week or so, and those results can be pretty impressive. And the act of actually having the treatment done is not that painful. I mean, I, you know, when the pandemic hit and I found myself in an office, an empty office, I opened up my fridge one day. And I'm like, oh, crap, I've got a $600 vial of Botox sitting here that's been barely used. And I have no patients. I have no employees. Like, what do I do? with this. So I guess I'll just inject into myself. And so that was the first time I ever actually put a needle into my own body. I'm like, well, there's nobody here to inject me. It's literally $600. It's going to go down the drain. And so I actually injected. And I only do a little bit. I do it like right between my eyebrows. The key with Botox, number one, you want to make sure that you have it done at a reputable place. And number two, less is often more, you know. And so really,

if you're going to consider doing something like that, start small. The best place to start it, usually are the frown lines between the eyebrows, maybe the crow's feet, where you want to be careful with is in the forehead, and that's where people can really look funky. Because if you've got horizontal wrinkles in your forehead, yes, Botas can smooth those wrinkles out, but the problem is it can also impact how your eyebrows look, you know, and you can kind of see this kind of spokization of eyebrows in Hollywood sometimes from Botox, because if you cause certain parts of the muscles not to work and other parts actually can work, can actually make up. And they start working even more because parts of the muscle are paralyzed, then that can cause these eyebrows to look how funky and you look

like Cruella Deville and all that type of stuff. Well, okay, so less is more. It's one of the most highly used treatments, you know, for skin out there in the world. Right now, the big fear and concern that people have that there would be other damages just has not been shown. So there are studies, there are rat studies that have shown that if Botas is injected into the facial muscles of rats, you can actually find minuscule amounts of it in the spinal cord fluid. And that was something that has been very concerning when we've seen the results of that study. The big question is, are there any systemic concerns regarding that? And we have not found any so far. You know, I have in my office, we have injected literally, I mean, in the last 20 years, probably

at least 20 to 40,000 injections of Botox, we have not had one single serious complication from all those injections, not one. The worst that we've seen is a temporary droopy eyelid. If Botas, if you inject it too close to the eyelid, it can spread a little bit. And if it spreads to the mechanism, the muscle that opens up your eyelid, you can get a bit of a droopy eye. And that lasts a couple months at the longest. That's the worst that we've seen as far as a complication from Botox. However, to be perfectly honest, there are websites and there are support groups online of people who do believe that they have had systemic reactions to Botox, that they feel that they have had certain types of illnesses from it, similar to breast implant

illness. I've really scoured the literature to try to find anything, any data on that, and there just isn't anything. I've taught to many dermatologists. I had a friend of mine who's a holistic health practitioner was a very prominent one in her field. And this person called me one day saying, you know, I've got these weird neurologic issues. And my doctor can't figure it out. You know, I had some Botas at one point. Do you think it could be that? And after hearing that, this was many years ago, I really went on a search to find. Is there any evidence of systemic, you know, neurologic, long-term issues of Botas? And I was not able to find anything. Have you seen these memes online? It's kind of like, you know,

know, guys' skin care routine. And it shows like, like, just like a, you know, a bar soap. And then a girl's skincare routine. Obviously, it has all the different things. Yeah, 12 steps every morning. Yeah. 12 steps. Yes.

What I read a little bit more about this, you know, online, there is something that actually men have thicker skin. Is that true? It is true. Yeah. Yes. Is that, do you feel that plays into part of the reasoning that women actually have to besides, you know, the natural sort of differences in genders and what appeals to

us and other stuff, that is there an actual scientific basis for why women might need to use more products because their skin may not have the same thickness as men? Is there any truth to that? I don't, there may be a little bit. I don't know that it has so much to do with thickness. There are certain factors that can come into play here. So I mentioned earlier how collagen, once women go through menopause, you start losing about 2% of the thickness of collagen every year. So I do think that after menopause, the loss of collagen does in significantly, and that has been shown. So I think that's one part of it. The other part of it is that men have beard hair. And with beard hair, you have more vascularity. So you have more blood

supply to the area. And that could also potentially play into it, because the more blood supply you have to an area, in general, the more robust that body part technically is. You know, one of the reasons why I can see, I can spot a smoker the moment they walk in my office is because of lack of blood supply. Okay, when we smoke, it constricts the blood vessels, and so we get less blood supply. That's why surgeons don't operate on smokers, or they're very cautious, because if you smoke, you constrict the blood vessels that go to a certain body part. If that body part that's been operated on does not have enough blood supply, because it's been constricted, that body part can die. And it's the same thing as if you take a string and you tie it real tight around your finger,

like a tourniquet, eventually, you know, that cuts off the blood supply, eventually your finger, if you don't let it go, we'll die. It's the same thing with smoking. So we do know that men, we have beard hair, and so that beard hair, those follicles, it does cause an increase in the amount of vascularity to that area. And that may, you know, result in potentially, potentially, not that I know it's proven, slower aging, okay? And you combine that with thicker skin, maybe a little more oily skin. It's just, it's different. And I'm sure hormones have something to do with it. Yeah, I think hormones play a big role. The interesting thing, Drew, is that, If I do a facelift, and I have done husband-wife facelifts, the wise facelifts lasts so much longer

than the husbands. And I do think it's just because of taking care of their skin. Yeah, women are so much better in general, typically. Obviously, a lot of that's changing younger. I even see friends of mine, their kids who are now in high school, it's like cool to like wear sunscreen and take care of your hair. I'm sorry, take care of your face. And, you know, all these young men have like skincare routines because they're like,

wow, like I actually can stay looking good longer if I implement some of these things. And there are some negatives to social media, but that's one of the big positives in social media. There was an influencer. His name is Hiram. He's a 20-something guy. He has zero, zero true educated. Like he doesn't, he's not an aesthetician. He's not a nurse.

He's not a doctor. But gosh, probably about seven, eight years ago, he started doing reactions to celebrity skincare routines online. And he exploded in popularity. and he really, for Gen Z, was the one that put skin care routines on the map. And that's something I think that, you know, my generation, your generation, we really didn't think about it as much, especially as men, but that generation now is thinking about a lot more. We're going to get back to the treatments that we can do, and I want you to think about them in terms of what are the biggest bang for the buck, and we can kind of increase.

You have it laid out this way in kind of your book. What's the biggest bang for the buck of things that work, you know, especially if somebody like, I don't have any interest in Botox, maybe I'll do it in the future. But I do want to keep my skin healthy. Yeah. But before we get to there and we go through a bunch of treatments that you've outlined, since we're talking about skin care routine, you have one in your book. It's called the two-minute five-year younger skincare routine. Yes.

Can you break it down? So we did this study in my office where we, you know, everybody's asking like, what do I do for a skincare routine? And I said, look, for me, I like to simplify things because, yes, I know, my ancestors come from South Korea, and South Korea is famous for having like a 12-step skincare routine. But who wants to seriously do 12 steps? And if you look at celebrities who, they'll make videos on YouTube of like, oh, this is my skincare routine. And it's like 10, 12, 15 steps. Who has a time for that?

The vast majority of us don't. So what I want to do is basically try to create a skincare routine that is scientifically based, that anybody can do, and let's put people on it, and let's see what happens if they do it. So we took people who had really not taken care of their skin. Like, they weren't people who are like sun worshipers, but they also weren't people who have been doing a lot of skincare in general. And we put them on this very basic skincare routine for two months. Literally, it took two minutes a day to apply it.

That's it. And after two months, we actually put their photos online, and we surveyed the audience, say, how much younger do they look? And the average was about five years younger, literally after just two months of doing a very simple, simple skincare routine. Now I'm going to tell you, Drew, if you start this skincare routine, you are not going to look five years younger in two months because your skin looks great. Okay? So we're talking people who have like normal skin, like, you know, they don't look old, but they don't look young. You look young, so it's different. And that skin curtin is

very simple. So you start in the morning, you cleanse your skin. You want to pick an appropriate cleanser for your skin type. And so very simply, if you have oily skin, go with a foaming type cleanser. If you have dry, a real sensitive skin, then go with a hydrating or a milky cleanser. After that, I recommend applying an antioxidant serum. The most common antioxidant, almost all skincare lines have it, is vitamin C. Just like we mentioned earlier, hitting the aging process, that oxidation from the inside and the outside. And here's a little tip for your listeners.

If there was a study that showed that if you combine vitamin C and vitamin E, that you get a synergistic effect. So it's not just you get the antiosin effect of one plus the other, but they actually work synergistically for an even better combined effect. And then the third step in general would be to apply a sunscreen, at least in SPF30. We've kind of talked about that. If you're not going to be in the sun, you don't want to wear it, then obviously that's up to you. That's all you have to do in the morning. Cleanse, antioacin serum, sunscreen, and that's it. In the evening, so important to cleanse. You have to cleanse your skin. You've got to get rid of the days worth of grime and dust and dirt and oil and sweat. And if you've got makeup, some people will even do a double cleanse to get

rid of that makeup. If you only wash your skin once a day, make sure it's at night, okay, because you've got to let your skin breathe at night. And then the second step is to apply an anti-aging cream. And the one we usually recommend are retinoids. The easiest one is retinol. So retinodes are derivatives of vitamin A, and prescription strength of retinodes are retin A or tritonoin, that you have to get from a dermatologist, you know, or a doctor. And then non-prescription strength is retinol. Non-prescription strength retinol, essentially the reason why it's not prescription is that it goes on your skin inactive and then your skin actually will convert it to the active form tritonoin, which is what is in the prescription, essentially. But it's less aggressive. It's usually

in smaller amounts and it's much more easily tolerated. There are scientific studies to show that applying prescription strength tritonoin can improve wrinkles, fine lines. It can thicken the skin. It can improve blemishes. And it can even reverse early pre-skin cancers. And that's something a lot of people don't realize, is if you have a history of skin cancer, I strongly encourage you to talk to your doctor about using tritone or retinae prescription strength because it may reverse early pre-cancers that haven't quite come up to the surface yet. You'll not know what it does because it just prevents them essentially. But that's prescription strength.

Most people can go with a retinol that most skincare companies have a version of that. And then if you want to apply a moisturizer on top of that, feel free to do that. Moisturizers are meant for comfort. They're not truly anti-aging. So there's a fallacy that people have of, oh, my mom looks really young

because she wears a moisturizer. She's put a moisturizer on every day. That's not the case. Moistrarizer will not de-age your skin. it just makes it more comfortable and plump and hydrated. That's all you have to do at night. Cleanse, an anti-aging cream, ideally a retinoid. I can talk about some other options too,

and then following that up with a moisturizer as desired. And then the only other thing I recommend is maybe twice a week, once a week if you have sense of skin, you want to exfoliate your skin. Exfoling your skin either with a simple scrub or with like an alpha hydroxy acid like at-home peel, that helps to get rid of the upper layer of dead skin cells. by getting rid of that upper layer of dead skin cells, it sends a cellular signal to the deeper layer

of skin cells to start turning over and moving more quickly, essentially. So when we have a cell, a skin cell that's formed, it's formed in the deeper skin, and as it gets older, it basically comes more and more superficial, eventually gets to the top surface of skin and eventually sloughs off. When we're young, that process happens typically about every six weeks. As we get older, that process slows down. It becomes eight weeks, 10 weeks, 12 weeks for that skin to, to turn. turn over, and that's one reason why your skin kind of gets drier and rougher as well as we get older. And so by exfolying your skin, you can cause that cellular signal to happen and cause your skin to turn over more quickly. And that's it. Literally two minutes a day, you know, if you've got

kind of average-looking skin, you can potentially look in two months of doing that five years younger after those two months. That's great. Love it. Love the simplicity. With retinol, is it accurate, you really shouldn't be taking it if you're trying to get pregnant or if you are pregnant? So retinol, retinoids, whether it's prescription strength or retinol, if you're pregnant or breastfeeding, we don't recommend it. I haven't seen any true science to show that it's harmful, but we do know that it can cross into the milk and potentially through the placenta, into the baby. So it's something that we definitely discourage. It's different than acutane, which is isotretanone, that we do know can cause birth defects and things like that. So that is a whole other story.

Yeah, I think same with Botox, which my wife is not happy about. right now because we're in the process of wanting to start a family one day. You can't have Botox. And we do know Botas can potentially cross once can. We don't know of any potential harm for it, but we're not going to conduct those studies. Yeah, yeah. You don't want to be messing around. No, exactly. So the foundation of what's there is just even with the two minute skincare routine, you can be proactive and take care of your skin. Unfortunately, I feel like, you know, a lot of probably Gen X and older. I'm right on the cusp.

I'm millennials. I consider you a millennial. I was born at 82. Yeah, yeah. So I'm right on the cusp. But a lot of things that I hear from my friends and family who's right in that Gen X and definitely in that boomer generation above that is I wish I got started on taking care of my skin earlier.

Yeah. And primarily I wish I didn't damage my skin as much as I did, which of course, a big part of that is son. But it's all these other things that we talked about in the beginning part of the interview that even a lot of people are not aware of diet, lifestyle, stress, etc. So having a good foundational skincare routine, guys and girls, we all want to look good as we get older and we want to feel better. Now, let's talk about some of the other interventions that we can stack, starting with

cost per intervention or time or downtime. What would you start with? What would you start off with? What is the high return on investment? that would follow. So the first thing that I would recommend, and it's very interesting because this is a favorite of holistic health practitioners and plastic surgeons and dermatologists don't talk about it at all, is red light therapy.

So red light therapy comes in many forms. There's handheld red light devices, which honestly I don't like because I think there are pain, where you essentially treat a quadrant of your face at a time. So you may do a few minutes in one quarter of your face and a few minutes in another quarter and you move along, which to me just seems kind of onerous. There are tabletop devices, which I think are really good, where they're usually kind of rectangular, and they sit on the top of a table, and you just basically look into it for several minutes. Yeah, I have one of those, like a juve light. Yeah, yeah. And so those I think are really good.

And then there are full body ones that you can put your whole body into. And then there are these creepy-looking mask ones that a lot of people like, where it's a mask that you put on your face that has little holes for your eyes and your nose and your mouth. And it lights up, and you look really creepy wearing it, but it's kind of funny. Yeah, you look like Jason on Halloween. Yes, exactly. So all of these devices work. You know, the interesting thing, what is the science behind it? And we don't know exactly why they seem to help.

But the belief is that the red light, essentially, it's energy. Now, red lights, so for people who have not used it before, it is, it's like laser light, but the best way describe it, it's like a cold laser, like a laser pointer. So if you take a laser pointer and you're pointing at your skin, you can point at your skin for 10 hours. and you're not going to cause a burn on your skin. There's no heat energy to it. The lasers that we use in our office do create heat because there's a chromophore, basically,

there's a target color that they heat up. And so that's a different type of a laser than red light therapy and some of the at-home laser type devices that we use. Red light therapy is believed that the laser light, the red light essentially, the energy from that light is transferred to the mitochondria of your cells.

and it helps to increase ATP production, which essentially is energy. This is the belief. I have not seen any proof that this is exactly how it works, but this is how we believe that it works. But when you actually do look at scientific studies on red light therapy for anti-aging, they are positive. There was one study that looked at 90 days that their subjects used red light therapy for their face. And they found in 90% of them, they appeared to have an improvement in the scale,

tone and 80% in skin hydration. So it does appear to help. There are even split-face studies where they literally treat half of the face. There was one saying where they treated half the face on patients and found improvement in wrinkles and elasticity on the side of the face that was treated with the red light therapy. So there are multiple studies that do show that red light therapy definitely works for anti-aging of the skin. That's how we believe it works, but we're not 100% sure. But there is a lot of studies on red light therapy, right? I think there's like over like a thousand PubMed studies that are there. So it's like hardly regarded as safe.

And red light therapy, you know, has been used for so many other things with recovery from injuries. And, you know, I use it for my hair. I have a red light therapy device, a helmet for my hair that I use. So there are studies with other things. But when you look at just anti-aging of your skin, there are some, not tons, but there are, there is scientific support to prove it. That's why I find it fascinating that dermatologists and plastic surgeons, like if you go

to our meetings, nobody's talking about red light therapy. It's kind of strange. It's like this weird black box that's never been opened. But it does seem to help. And so they're not that expensive. You can do this at home. If you're looking for the least cost, the most cost effective, the least expensive way, and especially if you live, let's say, and you don't have access to a med spa or a dermatologist, this is a great way that you can take matters into your own hands and rejuvenate your skin just by doing this at home. That's awesome. And, people can look up brands online. I think you have one on your website as well, too. Yeah. Yeah. Yeah. So I like there's, there's so many brands. There's a loom. There's a juve. Yeah. And

we've got one. Yeah. That I'm a fan out. Awesome. That's great. Okay. So red light therapy. That's one. So that would be, yeah. So go. Yeah. No, sorry. Let's go from there. So that would be, if you're going to buy anything for home, then red light therapy is definitely the way to go. Now, there's also other at home devices for people that do seem to help as well. So not anti-aging so much, but if you are looking for like, laser hair removal. There's actually at-home laser hair removal devices that can work pretty well. They were 10, 15 years ago. They're kind of so-so. They've gotten much better now. So there are options for you. There are even blue light devices that can help potentially with acne. And so for people who are, let's say, listening to this podcast and they, you know,

don't have the money to go to med spond get all these treatments. Then look at for some of these at-home treatments. But once again, red light is where I would start. The next step is going to be going to see an actual provider. And there are med spas all over the country that have relatively inexpensive treatments. And the first thing I would look at that I think is a great bang for the buck is IPL, intense pulse light. IPL essentially is similar to a laser. But where it's a little bit different, honestly, is that you tune the laser to different frequencies, and it's a lot less expensive to buy than a actual laser. And the reason why that's important is that when you get laser treatments, you know, I may buy a laser and it can cost me $125,000 to $150,000 just to buy that laser.

And you're going to bet that the cost of that laser purchase is going to be passed off onto the patient. So whenever you get a treatment at a med spa or a doctor's office, the cost of that technology is going to be imparted to your bill. And you want to then keep that in mind when you're looking at cost-benefit analysis. An IPL device for that type of technology is the least expensive, but most effective when you look at cost. And so whenever I talk to young plastic surgeons, I say, hey, what device should I start out with? I tell them, look, get an IPL device because I can do the most things and it's the least expensive to buy. As a patient or prospective patient, that falls in your favor because the device is not that expensive and it really is very helpful for treating one

specific thing and that's unwanted pigmentation. So the term sunspots, age spots, liver spots, they all are different terms for the same thing. And that is pigment, unwanted pigment in your skin due to excess UV radiation. Okay. So what happens when we get sunlight on our skin? The sunlight on our skin basically damages the DNA of our skin, but what protects our skin is melanin. Okay, melanin is the color of your skin, the pigment of your skin. As a melanin itself gets overrun, however, it can cause haphazard deposition throughout the skin. So if you get a lot of sun damage, then you can get these spots, which essentially is a melanin coming out in ways that it's not supposed to. And those spots will not go away unless you actively

get rid of them. Now, the term liver spot is very funny because people don't really use that much anymore, but it has been used a lot in the past. And people think, well, geez, I've got these spots because there's something wrong with my liver because somebody called it a liver spot. But it's called a liver spot just because it's a color brown, not that has anything to do with the liver. But these are all different names for the same thing. It's basically unwanted pigmentation due to your melanin, kind of going haywire from all this UV radiation. And you cannot, it won't go away on its own unless you get rid of it. The easiest way to get rid of it would be do IPL treatments. Those IPL treatments use light energy to basically heat up that pigment and cause that pigment to be destroyed. And

you get this spot that turns darker and after about a week, it sluffs off and it's gone. And the great thing about IPL is there's zero chemicals. It's literally just light energy. I mean, what is more natural than just light? And that's great thing. It doesn't hurt. There's like very low risk of burns or anything like that. It's very well tolerated and it's pretty inexpensive when you're considering what you get.

Yeah, I know that my sisters have been a fan of that. I think I might have gotten some treatment like early days. And I know that for a lot of people who are brown or darker skin. You have to be careful. You have to really go to a provider who's worked with individuals that have darker skin or brown skin because there's different lasers that I understand that are good for certain skin types. Because if you get the wrong laser done in your darker skin like myself, then it can be problematic. So it comes down to- But I think there's a lot more awareness these days. Yeah, it comes down to something called P-IH, post-inflammatory hyperpigmentation.

And what that basically means is that if you have more pigment, more melanin in your skin, and you get inflammation in the skin, it can cause the body to create a melanin patch essentially in that area. So if you or I, we get a pimple and it turns dark afterwards, we can get this dark dot or patch on our skin that can last for months. My wife is Caucasian, and if she gets a pimple, it gets red, and then three weeks later, there's no sign of it. If I get one, three months later, I still see a dark spot there.

And that's post-inflammatory hyperpigmentation, and that's, like, once again, due to inflammation. Now just imagine if you get a laser treatment to your face, the whole face, and you get that type of pigment deposition on your entire face. That's what can happen. And so it's very important for people who have darker skin colors. And this is just a real simple test if you're at risk, is if you get a pimple, does it turn dark and stay dark for a while? Then that says you're definitely at risk of P-I-H, and you have to be really careful with any type of cosmetic treatment that creates inflammation of your skin. Yeah, a lot of times providers will do a test. Patch test on another part of the body. Yes. And then see how you respond and then decide to go from there. Yeah. And sometimes, you know, there are certain lasers that you can do, let's say, for laser

hair removal that will work for darker skin. But there are some treatments that you just can't do, you know, and that's problematic. I get patients who come to see me who are African American, who are Indian, and they say, hey, I want to get like a laser treatment to really or a deeper chemical piece. to really help to rejuvenate my skin. And we just don't have good options, you know, because you don't want to create that acute inflammation that can create that pigment tissue.

So these lasers that are called, again, IPL? So IPL is a great option for people in general with lighter skin. You can use it very sparingly once again. You want to do some patch testing if you have a little more melanin in your skin. But there, I think, a great option for people who do have spots because it really can effectively get rid of them. If you want to hit that from an inside-outside perspective, then you combine the IPL with a brightening type of a cream.

When you're looking at brightening creams, the ingredients I would look for would be licorice root extract, cogic acid, and niacinamide. And these are three very safe ingredients in brightening creams that will help with the pigment from the inside out, and then you can do the IPL from the outside in. So let's go from there. As we're sort of looking for bang for the buck and dollar invested into it, what would you look at next? So the next one I would look at would probably be microneedling.

Okay, so microneedling had its debut, I guess, in dermal rollers. And so there's these rollers that look like kind of paint rollers, but they have tiny little pins or needles on the ends, and people use it over to roll over their face. This horrifies dermatologists because of a couple things. Sometimes those pins can be really long. In general, if you get them from a reputable company, let's say, based in the United States, usually that's not a big risk. But if you go online and you buy one, let's say, on Amazon or on eBay or something like that,

and those pins are really long, you can create real trauma to your skin. That trauma can create inflammation. And especially if you've got somebody with darker skin color, now if you're creating all that inflammation on your face, not knowing what you're doing, you could create some major problems. So it started off by these dermal rollers. Now, the mechanism of action of these rollers is that they create acute inflammation or acute injury to the collagen of your skin.

So remember earlier we talked about how the collagen skin is like the logs of a log cabin. And as we get older, those logs start to become frayed. They start to fall apart. What we find is if we do an acute injury to that collagen, as that collagen heals from that injury, it heals in a tighter fashion. And almost all of the cosmetic treatments to tighten skin or to rejuvenate the skin, do that by creating a controlled trauma to the collagen of your skin. So lasers do that by creating heat using light energy.

Chemical peels do that by using an acid to create a chemical reaction. And microneedling does that by creating literally physical trauma by putting a needle into your skin and creating that trauma. Now, when the trauma is too severe, you create a scar. And that's what you don't want. Okay. So the idea is you want to create enough trauma to the skin that the skin will, that that collagen will create that tighter fibers as it heals, but not so much that it creates an actual scar. So microneedling is a way to essentially do that dermal rolling in a more controlled fashion where you can literally set the depth

of how deep those needles go, and it can go anywhere from one to two millimeters, create that controlled trauma, and that controlled trauma once again will create tighter skin. And the reason why this is a good bang for your buck comes down to once again cost. For me to buy a laser, like said, that's probably around $150,000. An IPL, probably about $80,000. a microneedaling device, three or $4,000. Okay, so that cost of the actual treatment is not going to be as much. So you can get a microneedling treatment for $80, $150 and get a nice improvement. Now, what can you do to supercharge that microneedling treatment?

Okay, there are a number of things you can do. If you are a fan of regenerative therapies using your body's own rejuvenative abilities to turn back the clock, this idea of autojuvenation, then you can use your body's own PRP. So you take blood from your arm, you spin it down for the platelets. A platelets are filled with growth factors. You make those tiny little holes in your skin by doing the microneedling. Those holes connect as channels to the deep skin, okay? Because studies show that those holes will remain open for a couple of hours.

So now if you apply an onlay, you apply your PRP on the surface of the skin after you do microneedling, that PRP will seep into those tiny little holes, get into the deeper skin, and rejuvenate the skin from the inside out. And so that's a way to supercharge it, but that also adds a bit of cost to it as well. So if I were to pick Great Bank for your buck, just for overall facial rejuvenation, microneedling, maybe one of the best ones because it's so inexpensive for what you get. You can add things on top of it, like I said, like the PRP to even supercharge it more. Is it true that you get a boost in sort of collagen growth right afterwards from microneedling?

I don't know that it's been studied to show as far as the timing of it, but yes, those treatments do improve the collagen and can potentially increase the thickness of collagen. The issue, you know, it's funny because if you talk to dermatologists, you know, and I put stuff out there on collagen supplements and stuff, and, you know, you get dermatitis, ah, no, no, no. The only real way to improve collagen skin is to do fillers, you know, and there are collagen stimulating fillers out there, but come on, like, there's other ways you can stimulate collagen if we just talked about. Other people will say, oh, you got to do fillers or laser treatments, but I think this is kind of the commoditization of the anti-aging part of it. And it's like, well, you know, you can do the things that I make money off of that will make you look younger. So there are ways to improve collagen. I do think, you know, there is, there are studies to my knowledge that laser treatments can help to thicken collagen potentially.

I'm not sure with mycone that I've actually seen those studies, but I do believe that that should be true. Where do you go from there? Okay. So the next step that I would look at bang for your buck is going to be tightening of the skin more aggressively. Okay. So we're kind of talking about surface treatments. one of the things that we see as we get older, especially once you hit your 50s, is the skin starts to get looser.

And one great way, and probably the gold standard right now to tighten up the skin would be radio frequency microneedling. Okay, so how does that work? Okay, so basic microneedling, you make the poke in the skin, create controlled trauma, skin, the collagen gets tighter, those log cabins get better. The laws and log cabin get better. You second step, you put the PRP on top of it. It seeps into the skin. That helps with the growth factors to rejuvenate the skin from the inside out. You take that to the next level and now those needles

as they go into the skin, the needle itself is insulated all the way up to the tip of the needle. That tip of the needle emits radio frequency energy or heat. Now you're creating heat to the deeper skin and studies show that if you heat the skin temperature to a certain amount, typically it's 42 degrees on the surface, you can cause that collagen to denature once again and heal into a tighter fashion. And so that's taken that really up to the next level. It's called radio frequency microneedling. It's done with a device called the Morpheus 8, and there's very minimal downtime. But if you're looking for effective skin tightening without surgery or true invasiveness, then that right now is a gold standard. Do you think that for, let's say,

somebody like myself, who generally like, you know, I'm not afraid of the sun, but I don't over-exploven I have a simple skincare routine. I'm going to add a few things after talking to you and reading your book that's there. I will wear some of the sunscreens like the mineral-based ones, even on a day like that I'm coming into the studio because I learned that a lot of these lights that we use are also damaging to the skin and we're sitting underneath them for like two hours at a time, computer lights sometimes. Do you think that for me who is more on the, even though I've been convinced that Botox is generally fine for most people, right? There's going to be extreme cases that you mentioned earlier. And some of the studies that people have talked about, well, it doesn't

let you express your full emotions or other stuff because you can't feel those wrinkles in the body. I looked at some of those studies. They're super, super small, like they're super tiny. And they are outweighed by the vast majority of studies showing that like Botox has generally been safe. Right. So, so for me, who's still on the more precautionary side, like, okay, I don't see me sort of using Botox anytime soon. I'm 41, so it may change when I get into my 50s. Do you think that regular usage of microneedling could give me a lot of the benefits that would be there for my skin that would help me potentially maybe avoid having to, you know, go down the Botox rabbit hole in the future? To an extent, yes, the microneedling, though, treats something different than Botox does. That's the

difference. So Botos will treat those dinas. dynamic lines because those dynamic lines are made by those muscles, and the only way to truly prevent those wrinkles from coming is not using those muscles. Now, there is something called muscle training where there's a story long ago, and I don't know if it's true, but supposedly Elvis prohibited Priscilla Presley from elevating her eyebrows because he did not want her to make wrinkles of her forehead. Wow, that sounds super toxic. Yes, not good. There are actual things that people do now to try to train their facial muscles not to create lines. So for example, there are tape, certain types of facial tapes and even silicone pads people will put on their forehead,

on their crow's feet, in areas like that. There's a belief that I think is false that that will help splint wrinkles and make wrinkles smoother. I don't think that's true. There's no science. I know of the show that that's true. But there is a sense, there is a belief that I think that does make sense that you can, by putting, let's say, these type, one's called frownies where it's like an adhesive that you put on your skin, typically at night, then I think that it can remind you not to create certain lines. So for me in general, you know, I have Botox literally just right between my brows. That's it. You know, that's the only place I get it. I wouldn't mind getting it here on my crow's feet. And I'm

starting to get the permafrown that my dad and grandpa had. So if you inject a tiny bit of Botas under each corner of the mouth, they can help reverse the permafrown, which I'm like deathly afraid of having, not Botas, but I'm definitely afraid of having the permafrown, not the Botox. But there, you know, so the Botos will treat certain things. Microneedling is going to be more for overall skin tone and texture and overall tightness. It's not going to prevent you from getting crow's feet. Yeah. The only way to prevent you from getting crow's feet or, or forehead lines, is just not to create those lines over and over and over again. And so can you train yourself not to do that? You know, I love Jim Carrey. I think he's absolutely hilarious. As he's getting older,

He's got a lot of lines. And why does he have so many lines? I think one of the reasons why is because he is so expressive. And I see patients of mine who they come and talk to me and they're so expressive. They're always eyebrows are moving up and down and they're making all these faces and stuff like that. Those lines are going to be built in. And that's one of you know, I'm a huge fan of yoga. But there's this phenomenon called face yoga that I wasn't sure if you wanted to talk about today.

Yeah, let's talk about it. But there's this phenomenon called face yoga that's out there where people, are taught to make these very extreme facial expressions, and they claim that that helps to reduce the wrinkles of the face and make you look younger. And so you can see these videos of people online where they're making these just weird expressions. Things like, if you're on public doing that, people would look like, what is wrong with this person? And there's this belief, then by doing that, you're going to strengthen the facial muscles and tighten them because they get droopy as you get older. And that is actually completely false. Face yoga,

Interestingly, there was a study that looked at face yoga and did find beneficial effects of it in one specific way. So when you're doing these facial muscle exercises essentially is what face yoga is, is exercising muscles of your face. You will make the wrinkles deeper by making those expressions over and over and over again and especially extreme expressions. But you actually do, like working out your biceps or your triceps or your pecks, you can make those muscles slightly bigger.

and there are studies that show that the volume of those muscles increases. So you get a little bit of a three-dimensional volume enhancement by doing those exercises, but the negative is probably as time goes on, those wrinkles are going to get deeper. So there's kind of that trade-off. One of the things we haven't mentioned are fillers. Fillers hugely popular in throughout the country, where we're recording here in L.A. I mean, it seems like everybody on the street has filler. And years ago back in 2004, I published one of the seminal papers in our plastic surgery literature

called the volumetric facelift. And this was one of the first papers that described facial aging in three dimensions. And before that, people always taught plastic surgeons talked about aging in two dimensions. So as you age, it's gravity pulling your skin down, so you want to lift everything. So hence, facelifts, brow lifts, eyelid lifts, breast lifts, all that. And this was one of the first things my old mentor in L.A. here, Dr. Richard Ellenbogan, taught me when I came here that was absolutely mind-blowing to me, was looking at facial aging in three dimensions. and the fact that we lose volume as we get older.

And so this paper explained how you could combine lifting in a two-dimensional fashion with adding volume as that third dimension for the most natural rejuvenation. And like anything in plastic surgery, you take an idea that has a lot of sense, makes a lot of sense, and if you apply it conservatively, it can really work well for people. But of Hollywood especially, they take that and they think more is better, and now you get these pillow faces that are people who are just overly pumped up and stuff. So long story short, face yoga does help because you can cause those muscles to get bigger. If you've got a real skinny, thin face and you say, hey, I'm aging because my face is too narrow and thin and I don't want filler, then you can try face yoga, but the side effect potentially is deeper wrinkles.

Okay, got it. All right, so fillers, while we have some time here as we're winding down, do you want to touch on that for a moment? Is it something that you recommend? Is it one of those things where it's about, hey, do it the right way? Are there any concerns about sort of the same concerns that people generally have about injecting or placing something that's a foreign object inside of the body? We've done episodes on breast implant illness and how the body can develop an autoimmunity type reaction.

For years, the FDA said that there was no problem. These are completely safe. And now out of just thousands of women sort of speaking up and about their own testimonials, that the tide has turned a little bit. So do fillers work? Do you recommend them? And is there any sort of long-term concerns with sort of injecting a foreign object inside of your body? So, yeah, fillers are the number two most popular cosmetic treatment in the country.

The fillers started off with collagen. So this is back before your time. There was an actress named Barbara Hershey, who was in a movie called Beaches. And she got a lot of flack because reportedly she had collagen injections into her lips prior to this movie. Collagen was popular in the 90s, typically. That was kind of when it was real popular as the only filler that was. available. But the problem with collagen, injectable collagen, is that, number one, for most of the time, when we had available, you had to do skin testing to make sure you didn't react to it. And number

two, it went away very quickly. It only lasts maybe two or three months. And so hyleronic acid filler started to become popular in their early 2000s, and they have been very popular ever since then. Hyderonic acid is a naturally occurring moisturizer of the skin. And now the benefit of pheyloronic acid filler mainly is that it can be very adaptable. So there are certain hyluronic acid fillers that are very thin and can be used in parts of the face that have thinner tissue, like let's say under the eyes. And then there are other types of hyluronic acid fillers that are very thick and have a lot of stiffness to them where they can create actual contours like putting it into the cheeks. And the main benefit of a HAFiller, hylronic acid filler,

is that it is completely reversible. There is a an antidote, an enzyme called Hyleronidonidase, where if you inject it into an H.A. filler, it can cause that filler to melt away, some of it immediately. So once again, you know, I wrote this paper back in 2000, I co-wrote it back in 2004, the idea of that adding volume can be beneficial. Filler started coming out before that, but we really started using it in the cheeks in the last 10 to 15 years and in other parts of the face to add volume and to literally reshape the face. And it can be a very, very powerful way to help reverse the appearance of aging. The problem with fillers, though, is that unlike Botox, if it's injected improperly, you could have absolutely devastating complications. And the one

that you have to worry about is intravascular injection. I mentioned earlier that when we do surgery, we need blood supply to heal a body part because you need blood supply to body parts for them to function and to be alive, essentially. If you inject filler improperly, you or accidentally into a blood vessel that supplies a part of your face, and it clogs that artery up, that part of your face will not get enough blood supply and can literally die. That is not a danger that you see in Botox. And so there are people who have had filler injected into accidentally into blood vessels. They've lost parts of their nose, parts of their lip. And there's even a mechanism where you inject into the face. If it's injected, it's kind of like the perfect storm of horrible

situation where people have gone blind from injections of filler. So you've got to be very careful. You have to make sure that you have a good injector and ideally use an HA filler. There are other fillers out there that are not made of hytheronic acid that if you actually inject those into the blood vessel, essentially you're just screwed. And there are doctors who are still injecting those types of things. And so really with filler, filler can be very powerful. Honestly, bang for your buck with filler is pretty poor because it's really expensive and you buy typically one cc at a time which is like a minuscule amount and so usually people need to get a couple of one cc syringes to even get much of a visible

result and so it doesn't go as far as let's say botas bang for your buckwise so filler is good if you want to pump up your lips if you want to add volume to your cheeks if you want to fill in your nasal labial folds or your smile lines it can be very powerful to do that you just have have to be very careful with it. As we're winding down here, before we talk about, you know, all the great ways that people can keep in touch with you, where they can pick up your book, other things like that, is there anything else that you want to say about maybe a treatment you didn't mention? Like if you really have the resources and somebody wants to go all out or something that you

want people to avoid, you know? Well, one thing that we haven't touched on, I think that is a huge deal for people is hair and thinning hair. Yeah, you recently did a whole podcast episode. I believe you were on a hike with your wife, and she noticed that your hair was thinning. My podcast audience gets a nice little view of my hair in the upper right-hand side.

It's thinning a little bit. Oh, no, you get good. So my wife, years ago, when we did some type of couples thing, and we had to write, like, what is the thing that you find about your spouse that's most attractive? And she put my hair. And so that was always something

that was in the back of my mind, and so we were on this trip to Jamest, Jamaica, and we were doing this cliff jumping, and I was about to jump off the cliff, and my wife was on a rock above me, because she's shorter than me. She never sees the top my head. She goes, oh my gosh, you're balding on top. And I was like, what? And I almost fell off the cliff at that time because I was like, no. So thinning hair is something that affects men and women. And I think that's one thing that a lot of people don't realize is it is a big issue for a lot of women as they get older as well. And the thing with thinning hair is that

there are so many things that you can do naturally to rejuvenate that part of the of the scalp. And so for me, just to tell my story, when that happened to me, I said, look, I'm not going to, you could think, oh, get on propitia, get on monocidal. And I said, look, I want to do this naturally. I don't want to take an actual medication. So. Because there's some concerns with those that they, like, reduce libido and other things like that, right? Like, that's the concern with a lot of those. Mainly propitia, that's going to be more hormone mediated. Rogain is actually more of a side effect of this medication. It's topical. So I don't know that it has a whole lot of systemic effects. But still there are other options that can work just as well that are natural.

So you want to do it naturally. So yeah, you want to start naturally. The first thing that I started is to get on a supplement. So there are multiple different nutritional deficiencies that can predispose to thinning hair. Iron deficiency is one of them. Zinc deficiency, vitamin D. I didn't want to go through all the labs and stuff. And there are commercially available. kind of all-in-one thinning hair supplements. You know, the one that I used was neutrophol that people can take. And so I started taking a supplement just in case this was more nutrition deficiency type of an issue. We mentioned earlier red light therapy. There are devices now. And, you know, I mentioned a couple of studies for red light therapy for anti-aging of the face, but there is a ton of studies on low-light laser

therapy or essentially red light therapy for thinning hair. And I have one that's a helmet. that has like over 200 lasers inside of it. I wear it for half an hour every other day. It's a cold laser, so you put it on, you don't feel anything. You just watch TV while you have it working. And there are so many studies to show that that can help. And it's the same idea. The idea is that you impart that laser energy to your follicles.

It helps the follicles hopefully go into a growth phase from more of the transient kind of quiet phase, essentially. And then the other thing is using a topical treatment. there was a study actually that compared monoxidil to topical rosemary oil. So for rosemary oil, you want to take the essential oil and then you want to put a carrier oil with it or there are actual commercially available forms of rosemary oil for the scalp. And this study compared monoxidil to topical rosemary oil

and found very similar effects for thinning hair, except the rosemary oil had a lower rate of skin irritation, scalp irritation from it. And so using some type of a topical, one that ideally contains rosemary oil would be what I would recommend. Once again, if you're looking for a pharmaceutical, monoxa would be the other option. And that's really it. The other thing that I've added more recently is dermal stamping. So I mentioned earlier the idea of dermal rolling.

And more people have now gone to a stamping as a better option. And essentially, it's those little needles on a round stamp that you can stamp on your scalp. Some people do that for their face. Same idea. you get that controlled trauma. I do that prior to applying my topical. The idea is the same thing. You can maybe get some seepage of that topical

into the deeper scalp area to potentially help to grow hair. So that's very simple ways to do it. And I encourage people, if you're having thinning hair, take those steps where you do the supplement. You add the low light laser or the red light laser to your scalp

and then use some type of a natural topical, whether it's rosemary oil. If you want to go inoxal, you can do that. and then ideally the dermal stamping. If those don't quite get it, then the next step would be injections of PRP, platelet rich plasma. Instead of putting it out as an onlay,

you know, you actually will inject it into the scalp. Have you noticed a difference? I have. Yeah, yeah. It's slow. You have to literally give it four to six months to really see a significant improvement.

But I have, especially after I started doing the dermal stamping, which I've done more in the past like four to six months or so. As we wind down here, anything that you want to say about sort of the topic of, you know, beauty kind of gotten out of control or like the obsession. And I feel preemptively before you chime in, a big part of your work is that everything you've been talking about and the way that you highlight it inside of your book has been really not just about looking a particular way because there's plenty of treatments that are available for people. and we're in Los Angeles, you can see it all over the place, but you're really focused on the foundational things that are also beauty as a reflection of health, right? Like why are certain attributes like clean skin? Why are certain things like aging well? Why is that attractive to us? Because it's a sign

of sort of internal health that's there inside of the body, right? Regardless of what age people are, right? Yes. Do you want to expand on that a little bit? You know, I think that health, you know, if I think about what is beautiful, health always is kind of the starting point for it. But at the same time, you know, one of the things that I'm really very cognizant of on social media, and I've got a big social media following, as you mentioned, is that I do believe strongly that there's beauty in everybody. And, you know, just for example, there was a video that somebody put that a wedding dress company posted.

And it was a, basically, it was women who were model. a wedding dress. And it started out with extra, extra small, and then it went all the way up to like a triple XL. And each of these women modeled it and they had big smiles on their faces and they felt beautiful. They looked like they did. And I actually, as a physician, I look at it one way, but as a human being, I look at a different way. As a human being, I looked at this and I thought, how awesome is it for women of all different sizes and shapes to feel beautiful? Like I think we all deserve to feel beautiful no matter what. Interestingly, I posted this video just as like, you know, I think it's empowering for people because I think there's beauty and everybody, and I had

so much hate on this video. There was a plastic surgeon, actually, a real plastic surgeon who commented that overweight women are, what did you say? He said that they are displeasing to the male eye and that overweight women are disgusting and they need to change. Wow. And I would never, it was like, it was this long diatribe. I mean, from a physician, God, I mean, now you and I, you know, we are in the job of helping people to be healthier. And people got mad because I said, you're a physician. Why aren't you telling these women that they need to lose weight, that they're unhealthy? You know, they're not beautiful. They're unhealthy. And the fact is, is that there are so many people out there, you know, if you are listening to this and you are overweight, you don't need

me to tell you that you're overweight. You don't need me to tell you that being overweight can create many health potential health issues. You know that. But how many people are out there saying that you are beautiful inside and out and that making simple changes to your health can help you feel even more beautiful? And I think that's for me the key, is that, you know, it's all about positivity. I think there's so much negativity out there. And as physicians and as health care, influencers, you know, we have a lot of power to shape this discussion. And so I, for me, just being a simple doctor going out there saying, you know what, you're beautiful. And yes, you know, if you want help to get healthier, I'm here for you. But it does no good I feel

to make them feel even worse about themselves. So true. And so that's kind of for me, that's what my big thing is, is that, you know, my book is written for everybody. It's written for people who are biohackers, who are really focused in on their health. But it's also written for those people who, you know, live in the quote-unquote flyover states who laugh along with some of my videos who really don't know a lot about how the physiology of how the food they eat can really be impacting their skin and their health. And if I can help them to make small changes in their lives to feel better about themselves, then that's a privilege, you know. And that's, I guess, the way I look at it is none of us are perfect, you know. I mean, I'm here in California. I come

here many times a year. And every once in a while, I just got to stop with my kids to in and out because they love it. And like, you know, and as I put in the book is like, you may see me there and I'm not going to be there looking at you eating it. But if I eat it, then, you know what, this is life. And you got to enjoy life. Well said. Tony, the new book, is out younger for life, feel great and look your best with the new science of autojuvenation. Congratulations. People can pick it up wherever books are sold. And I think also depending on when this episode comes out, you might be doing some fun things,

like a pre-order campaign. Yeah. So if you go to autojuvenation.com, we have got over $100 in free gifts, including an additional recipe book, a gift certificate for the online store, and even actually a sweepstakes where we're giving a ton of prizes and stuff. Amazing. Check out autojuvenation. and your own personal website if people want to follow you on social media and keep in touch with

all the great things you're up to and check out some of the products you might have mentioned yeah so eune beauty is my website and you can find me on all the different social media networks just look for dr yune you'll you'll find me it's not hard to track me down well i appreciate you being on the podcast and also on both ends of it reminding everybody that beauty truly comes from the inside out and it's okay to also work on the outside in because there's parts of us that are driven by vanity and that's not a bad thing. That's okay. We want to look our best. We want to feel good. The thing that got me into health in the first place was that I had terrible acne and I found out that I had a dairy allergy and I had to get off of it and immediately when I got off of it,

highly processed commercial dairy, my acne went away. I felt better about myself. I felt more confident as a young man. I felt excited, but that took me down the rabbit hole of learning about all these other things about health and made me and many other people healthy. So it's okay to want to look better as long as we understand that really along the way, we want to make sure that we focus on feeling better as well. Exactly. If vanity is your path to better health, then by all means to take that path, it's better than the alternative. Tony, thank you so much for being on the podcast. Thank you so much, Drew. Appreciate it. Hi, everyone. Drew here. Two quick things. Thank you so much for listening to this podcast.

If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend. Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter. And it's called Try This. Every Friday.

Yes, every Friday, 52 weeks. a year, I send down an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole-body health and optimization, click the link in the show notes that's called Try This, or just go to Drew Perot.com. That's d hr u p u r o hit dot com and click on the tab that says try this