On Display with Melissa Gorga - Lasers, Lids, and Lifts (w/ Dr. Mark Karolack)

Episode Date: December 19, 2024

He's worked on some of the most famous faces in Jersey, and Melissa has him on the podcast this week! Melissa welcomes expert plastic surgeon, Dr. Mark Karolack, onto the show to chat about the recent plastic surgery trends amongst the housewives, his subtle approach to enhancing the natural beauty of his clients, and the one procedure he'd highly recommend to anyone that feels like they are looking at little tired. Dr. Karolack also dispels some rumors and shines a light on the reality of fillers, C02 laser treatments, and minor face-lifts.  This week's sponsors: Dime - High-End Skincare: www.DimeBeautyCo.com PlutoTV - Free Streaming TV: www.Pluto.TV Progressive - "Name-Your-Price" Tool: www.Progressive.com Prolon - Fasting with Food: www.ProlonLife.com/OnDisplay (15% off 5-Day Nutrition Plan) ZocDoc - Trusted Doctors Just a Few Taps Away: www.ZocDoc.com/melissa

As simple as it sounds, oh, in 20 minutes I could have a new nose. Yeah, but in 20 minutes you could be blind too. What's up, guys? Welcome to another episode of On Display with Melissa Gorga. I'm so excited to talk to you guys all today. I'm sure you guys are all going crazy with like holiday shopping and just like the presents and the parties and all the things. First of all, I need to say thank you to everyone for ordering sprinkle cookies. I am overwhelmed and like in shock, completely in shock over how much you guys are loving these and

wanting them so just a quick thank you. But turning left here I have the best podcast for you today. You girls have been at the girls and the guys have been asking me for this podcast forever so I am super super excited to have one of the best plastic surgeons in New Jersey. He's worked on some of the most famous faces in New Jersey. Some we know about, some we probably don't know about. He's a household name here in Jersey. He does some incredible work and I'm really looking forward to getting all the scoop about

all plastic surgery today. Ladies and gentlemen, please welcome the amazing plastic surgeon Dr. Karolak on some of the show. Hey, everybody. Wow, that was an amazing introduction. Thank you. You're welcome. It's also true. You are a household name. Everyone knows that like if they want their face to look good, you're the guy like you're the guy. You do amazing work. I'm just going to compliment you. guy. You do amazing work. I'm just going to compliment

you. You really do amazing work because you're extremely modest with how you do things. Anyone who's come to you for, I will say, ladies, I've seen this work up close and personal, anyone who's been to Dr. Karolak for a facelift, their eyes, like you name it, it's so natural and beautiful and just very like well done without looking like the old school cat woman that we're all. We all used to see like on Camp Beverly Hills back in the day. Yes. There's really nothing complimentary about someone asking about who did your face lift or wow, you change your eyes.

Everything looks, you know, you change your eyes, everything looks, you look different. Really, the whole focus is to really take people's beautiful features and put them on display and highlight them. Take away what's maybe aging, areas of looseness, but really to focus in on keeping people looking like themselves, just better versions. Exactly. I feel like most people want to just come to you, see you, or see a plastic

surgeon. They don't want to look like a different person when they leave, but they want people to say like, wow, you look really good. You look very fresh. Like just kind of like wake them up a little bit. They don't want to look like a different person. And I feel like people are more in tune with plastic surgery nowadays than they used to be so people can call it out quicker than back in the day because I just feel like it's become so popular. It's insane how popular it's become. Yeah. I think there are things that go in trends, and I try to stay away from trends. Natural is never trendy. It's always beautiful. So you get certain areas of the country where

people kind of look at their friends who've come to me and we get patients coming over from all over the country, from the West Coast, from North, South. And there are certain areas of the country where if you don't look like you had plastic surgery, you wasted your money. So fortunately for me, and social media nowadays, people know the type of work that I do. So the reach is pretty far. And those people in those areas that don't want to draw attention to their faces, but just want to look like better versions of themselves, they fly up here and they have surgery,

but they'll get comments from their friends sometimes like, Oh, what do you mean you had a facelift? You don't look any different. And that's a compliment to those people because they don't wanna look different. They just wanna look better. And the results are not subtle. That's the one thing that is really always amazing.

You can look at somebody that I've operated on and they'll look just like themselves. But if you look at their before photo, a lot of people forget about how they looked right before surgery or the years coming up to surgery because their neck is really loose, they can't get a good angle in photos or on camera, their eyes look tired. So once all of those areas are tucked and repositioned back to where they used to be, they're feeling more confident in their own skin without feeling like they've distorted their faces.

confident in their own skin without feeling like they've distorted their faces. I think media is catching up to that nowadays. I think it's been a little late to the game, but I'm hearing about these things like the new trend in plastic surgery, the natural look. You're getting high A-list celebrities looking great on the red carpet or making these appearances and people are like, oh my gosh, I never knew that was possible. This has been going on for at you know, at least in my practice for 20 years. Right. I mean, and that's the best part when you can just look refreshed and everyone's like, my God, she looks so good. And they can't totally pinpoint something.

That's when you know you've had good work done, right? That's like, and do you see how everybody's like, questioning Lindsay Lohan right now? That's like, and do you see how everybody's like questioning Lindsay Lohan right now? That's like all the craze right now is like, what did she do? Because she looks incredible. She looks incredible. Right. And that's not easy because she was, there were times where when you look at her, you're just like, oh, so beautiful, but she started to look so different. She was always a gorgeous woman and she started to look puffy, different, full. That's one of the mistakes that I think people make as they go through the aging process and they're especially early in it. They don't want to do surgery

and they're really not candidates oftentimes for surgery in their 30s or 40s, but they're doing things because they want to feel better about how they look. But unfortunately, they start doing the wrong procedures. And I think that's something good that we can talk about as far as what procedures are good at what age because there's a lot of confusion about that. Oh, we are going to get very into that today. That is pretty much my solid talking point for the day because even when I told people that I was having you on, that's all every like, what do I do first and when do I start this? So we're definitely

going to get into all of that. I mean, what are you... Yeah, like it's all about that. I mean, what are the most common cosmetic procedures that you're seeing, especially with like the reality TV stars and just celebrities in general, what are the most common things that you're seeing happening? So there's good and bad. So the most common things I'm seeing happening is some of the non-surgical treatments being either overdone or used or done incorrectly in ways that really can damage their tissues, their muscles, and cause aging

to accelerate or make them look different. And then other things that I'm seeing done, you know, and then there's a lot of non-circle treatments that are being done incredibly well. So it's just finding the right time to do the right procedure on the right patient. And that's, you know, that's a really important point. Another, you know, just to kind of go through it quickly, but the other treatments I'm seeing people doing is, their eyelids, their little temporal adjustment.

Facelifts are really big. I think facelifts are the ones that garner most attention because people go from looking maybe tired or drawn to just glowing. And when it's done well, no one knows it's surgery and they're trying to figure out what that was. Insane. There is, so you've done,

we know guys that he's done Dolores Catania, he's done Margaret Josephs, he's done Paul Connolly. You even did Joe Benigno's eyes, correct? Yeah, yeah, I did. See, now is an, correct? Yeah. Yeah, I did. See, now is an amazing one, right? Yeah. I love that. Yeah, he looks great.

So he just looked tired. You know, he had these puffs under his eyes that, you know, Margaret kept pointing out and he kind of like wanted to improve it too. He just felt like he was looking tired. And just something little like that, removing those under eye bags, you look at him and he just looks so good. That change was insane. Like he really, I would say, did need that procedure, right?

He looked so great after. I already told Joe, I'm like, when you get to the point, you're going right to Dr. Karolak and you're doing whatever Joe Benigno did because it works. Like that darkness under his eyes completely gone. I know, I know. He just looks so much more awake, engaged, energetic. I mean, it's amazing what addressing the right area of the face can do for just all the features. And that's one of the things people always comment about too is like, you know, I know

you did maybe their, their facelift or their neck lift, but why does their nose look better? Why does their lips look better? It's because the attention of the attention is being drawn back to the right place. It's not being drawn to like a loose neck or a lot of wrinkling or sagging. We're focusing on the eyes, the features, nose, the lips. So the lips. By the way, I always say that to Margaret, because if you look at Margaret's before and afters, it's incredible. She really had such a beautiful glow up. I always say to her, you did your nose too. She's like, no, I didn't, but it really looks like she's had her nose done. It looks completely different and it's just the shape, the shaping, whatever you did, the shape of her face is so beautiful. She was beautiful before but I mean she really has such a beautiful before and

after and so does Dolores. Yeah one of the great things about Dolores is I met her before she was even on the show and she was in her early 40s. Then she had lost a bunch of weight and just wanted to get more refreshed. So we did like a mini tuck in the neck lift on her. From that point on, she's been just part of our practice. So I get to watch her and help her age throughout the years. And now she's going, it's probably at least 18 years later. She's just looking better and better and better. So it's nice to be able to have a little part in

something like that. Yes. I know she posted not too long ago that you did her eyes, right? What did you do to the eyes? Yeah. So with her eyes, I did something called a temporal lift. So when we talk about face lifts, the face is broken up into three parts and then called a temporal lift. So when we talk about facelifts, the face is broken up into three parts and then you have the neck. So you have the neck, the lower face, the mid face and the brow area. So with her, she had had her neck done, her face done.

And then as aging was going on, she was doing Botox, which works amazing. It's a great preventative treatment and a great treatment to just accent the face in younger patients and even older patients. But she was finding that Botox or actually we're using Dysport in her. It wasn't working as well. And what was happening is as we age we start losing volume in the temples, the bone starts thinning out. So what I did is just a little temple adjustment with an incision behind her hair.

So no scars in front. You couldn't even find this. It's hidden within the hairline. It allowed me to just raise this whole area to open up her eyes. It's not the cat eye. It's very different. So a cat eye is typically achieved by doing something called a mid-facelift where you do a lot more aggressive work to kind of pull things back like that. That's not what I'm doing again. You know, my work is, is more focused on natural

and adjustments. So this was really just raising that heaviness to the brow to a point where now, you know, if she does Botox, she does it a little bit differently and it's going to work a lot better too. So I know like, so temple lift right now is all the craze. I feel like you, we didn't hear about that as much years ago and people are more in tune to it now. What we used to hear about is the eyebrow lift, right? Where, which I'm not a fan of.

I have to be honest because I feel like the eyebrow lifts kind of gives you that like Spock type vibe. I don't know. I guess if it's done right, it doesn't. But I have always been very like, I think that what it sounds like, it sounds like a temple lift would be more, a little bit more subtle and give you that because a lot of women starting at the age, I would say even in their thirties, you start to see the wrinkles around the eyelids, correct? And I feel like that age is where people women started are starting to get concerned even in their late 30s. And that's pretty early,

right? Yeah, yeah. Well, you know, they're they're patients that just they either genetically have heavier lids or they start noticing wrinkling because when we're smiling, we're constantly taking, you know, the skin here and just squeezing it together. So it's almost like if you had, you person, you kept like bending it like this, you might bend it a few times and it's okay, but then after a while, you're going to start to see that purse kind of creasing and wrinkling. It's the same thing with the under eyes, the skin is so thin there. So really small procedures, sometimes just laser and skincare early on to keep that area from

wrinkling is one of the best things you can do preventatively but eventually get to a point where the skin starts wrinkling so much that there's excess so you remove it and do something called a skin pinch which is another popular procedure for younger patients where it's a lower eyelid surgery but it's only removing skin so it's exactly what it sounds like. You go in, it takes maybe 20 minutes to do. Under local anesthesia, there's no pain. You just numb the area, pinch the skin, remove whatever excess is there, a few dissolvable sutures, and then really no pain and recovery, just bruising. So that helps with that. Yeah, that sounds super easy. That sounds so easy. I'm like, well, I want to do it tomorrow.

That sounds so like easy breezy. Yeah. And I think that's probably one of the most least invasive surgical procedures that I do. Then upper eyelids would be the next one. So you see that happening in patients in their 30s, maybe early 40s. And I've had patients as young as late 20s come in just because they genetically have very heavy eyelids. So just

removing some of that excess skin, or maybe a little bit of fat there just helps them look more bright. So those are the eyes are really, really important in the early aging process. But the most important thing to focus on around the eyes is the amount of change. So it's really a game of millimeters. Now if you think about moving the eyebrow from here to here, watch how much this changes, right? From one side to the other, that difference, that's about three to five millimeters of movement. So when you start to

talk about like brow lifts and things like that, that kind of looks a little bit weird. Well, I think it was like a misunderstanding of how the face ages. So people used to think that the brow is heavy, so they just raise it up like this, and then it looks like the brow is in a completely different universe than the face. It doesn't belong. I don't like that. That's what I don't like. I always feel like that looks crazy when I see the brows up high. Right. Because most of the time it's descent in this area, so people start to look heavy. So if you just move this back up, the middle part typically comes up with it. And

then you adjust how high it goes. There are some patients that truly need, you know, lifting up the brow, but it's not, you know, what you want to make it look like it belongs to their face. It belongs where it belongs. You've been hearing me talk about how much I'm loving the clean and affordable skincare from Dime Beauty. Their work system is the complete skincare package. It's amazing and it's so easy to incorporate into your daily routine. And guys, their tinted glow wonder screen is incredible. I literally use it all day long, every day. I bring it on vacation with me. It is my absolute

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program. Go to prolonlife.com slash on display. That's P-R-O-L-O-N life.com slash on display for the special offer. That's prolonlife.com slash on display. Well, it's funny. There was a plastic surgeon that's pretty popular on TikTok, and she used to be a housewife on the OC or something. So she goes through celebrities. She picks celebrities all the time, and she just puts their face up and analyzes them, which I get. I know a lot of the plastic surgeons do this. It's great for promotion

and whatever it is. So she took my face. I was one that she chose, I have to say. I didn't see that. Oh my goodness. I'll show it to you. I have to say she was probably the kindest to me than she's been to most people, which is, I'm very grateful for. That's going to be easy though. You look amazing. Come, you know, come on, you've aged so great. I mean, you barely. Thank you. You look amazing.

Thank you. She said, like she assumed, well, cause listen, it's also the pictures that you pick. Like sometimes I could have had a really good makeup job that day. You're like. Contouring your nose, you contour the cheeks, right? Like you can make things look.

Yes, let me just tell you, these makeup artists. Overlaying lipstick. You can make your lipstick. Yeah. Yes, you get a good makeup artist. You can look like a different human like legit. Some of these makeup artists are so talented. It's insane. But anyway, she she was very kind to me and everyone was like sending it to me but she thought I had so many procedures done that I did not have she was like, she

definitely got a chin implant. This is my original chin. I have never had a chin implant. She said I had a nose job, which I did. I did have a nose job. She said I had an eyebrow lift. I have never had an eyebrow lift. I might have had bad Botox in that picture that kind of pulled up my eyebrows. Because I have had Botox before that like, you know, you put it in the wrong spot, all of a sudden you're spocking it a little bit, right? So it's like, it happens. She said that she thought I had buccal, what's that called? Oh yeah, buccal fat removal. So that's the fat

underneath the cheekbone just outside the corners of the mouth, like right around here. Okay. So people do that buckle fat removal. That's another one of those trendy procedures for anybody who doesn't know what that is. And it's really to, in the right person, it's really to create more of like a hollow, defined cheek. So it sinks in, but the problem is, is people get it done as they age, that fat,

they lose fat in their face and it can look too hollow. Exactly, right? It's like that really chiseled. So it's that chiseled cheek, which let me just say the one thing I happen to be born with what is really white teeth. These are my real teeth. Everyone always accuses me that my teeth are fake and a cheekbone. Like that was just my natural, like I've always and so I was like, no, I didn't have that. No, I didn't get a fake chin. I have done Botox and I have done filler and I have had my lips done and I've had my nose done.

That is all the procedures that I've ever had at this point on my face, but I was so frustrated because I wanted to be like, I never had my chin done. I've never had my eyebrows done. I didn't do anything yet. I'm going to do it. And Dr. Kara, like, you'll be the one to do it.. I'm going to do it. And Dr. Kara like you'll be the one to do it. But I'm going to do it eventually, right? I'm going to want

these things. I have nothing against it. But I'm like, I get so frustrated because I'm like, I didn't do any of that yet. That is that's me with good makeup or whatever, you know. But isn't that frustrating? It's kind of but it's good that you could laugh at it too, because I mean, you know, you know what, you know the truth and you know that you're aging really well and you take care of yourself You're doing all the right things and then you have somebody saying oh she did this and she did that It's frustrating. You wouldn't even know like somebody literally puts your face up very zoomed in on a screen and just start pointing at it Boom, boom and she did and I'm like, no, I didn, I didn't. Get your finger off my face. What's happening? It's like part of this world, right?

It's like part of like being in this world, but she was very kind and she said, whatever she's doing, she's doing everything right. So I'll give her a pass for everything. Yeah. Well, it's also partially for entertainment. I think, you know, that's one of the things why some of those doctors do that is, you know, it's kind of like entertainment. It's entertainment. I was entertained. Hey, listen, I was watching it. I was very interested in what she thought. And like, listen, when people are now doing this to Lindsay Lohan, I'm watching it. I want to see like, what did she do? Because she looks exactly like her young self. She doesn't look like she's had a stitch of plastic surgery, but she looks so refreshed and so refined and just great. So-

Well, you'd be surprised how much, how well removing filler from people's faces works to make them look younger and more fresh, and then correcting the things that are truly aging in the right manner. Right. Right. So if you have somebody that comes in and they're starting to get overfilled, and then you try to correct it, they still look overfilled. And, but I think what, whoever did it, did a good job of kind of saying, let's kind of clear this out and dissolve, you and dissolve the lips, the cheeks, reshape things, and then do whatever surgery is going

to be helpful to complement that. Do you recommend getting... So I do notice women who do have a lot of filler. Obviously, you do filler, correct, at your office. There's a need for that. But are you noticing people are doing too much and it actually has reverse effect where it's making them look older or if they had the means to do, you know, the cut and tuck is a better solution than the filler? What are your thoughts on all of that?

So the best way to think about it, it can be really simple. So you just want to follow the aging process. So that, you know, with aging, the three things that we work with is skin volume and muscle. So when we start aging, we usually start noticing loss of elasticity to the skin. And elasticity, and that happens in our 40s, 40s to 50s, but elasticity is the function of the skin. It's the ability for your skin to withstand being compressed. Right? So like if you think about your entire body or someone's entire body as they're going through aging, in their mid 40s, maybe 50s, you look at your knees and you're like, how do I have wrinkles above my kneecaps? Right? Well, you know, when you look at the knee, when it's extended, the skin is compressed.

But when you bring it like that or you know flex it the skin is tight and smooth so like if I pinch my skin on my arm there's really no excess skin here right it's a mound of muscle and skin but if you look closer there's wrinkles here now those wrinkles weren't there ten years ago so the skin is no longer tightening on itself so it's lost elasticity it happens in the chest you know like you go like this and you start seeing wrinkles You bring your chin down it creeps up when you lose elasticity You can't ever get it back and that's the problem with it happens in our stomachs. You know, you're on the beach

That's the worst. Oh my god. I have wrinkles on my stomach. Where did I get that? Right there comes a point where you start seeing these things happening and when it happens, like I said, you can't reverse or fix these things happening. And when it happens, like I said, you can't reverse or fix elasticity. But when skin starts sagging in the face and neck, you can remove it, tighten muscles, make it look better. So the best thing you can do for skin is help maintain it as you're going through the aging process younger. So that's why we see patients in their teens now more skin conscious about wearing sunscreen, moisturizing skincare products, what they're putting on their skin, hydrating, then we get into volume.

That's the second part of aging. Now volume is where fillers come into play. So we lose volume and we usually start noticing that volume loss in our 30s, maybe, early 40s. When we lose volume, fillers are great. You have some volume loss in the cheek, it thins out, or you get folds, you start putting a little bit of filler in there to replace volume. Now, the mistake that people make and how they start to look puffy and distorted and how, to your point, they start to age differently or look more aged is because

they go along this path of doing fillers well. And then you have a good injector, they're telling them, no, that's too much. This is going to be perfect here. And then they get to the point in their 40s, now they're mid-40s. Now here's where things start getting a little tricky because the muscles start to loosen or the whole foundation, which is the muscle starts to drift downwards. So now you can be doing fillers all these years and looking good, and then you get to a point and now all of a sudden you're in your 40s or 50s and you're like, I just feel like I'm so hollow up here

and the filler used to work so well, when in reality what's actually happened is the volume in the face has drifted downwards. So it's sitting, it's still good here, but now what they do is start building filler, putting filler around the cheekbones to build it up. And now they're expanding their faces. So at that point, muscles are loose. When the muscles are loose, you have to at least consider moving them back because a lot of times you don't even need filler after that because the volume's sitting low. You use the muscles to pull it back. That's

why I talk about repositioning volume in people's faces with a facelift using their own volume. And that's because the muscles are being moved and moving that fat pad back up to the cheeks. So like even in my case, you can see like I'm hollowed out a little bit here. It's not that I need filler. It's just I need this to come up. You just need to pull it up. You need to pull it up. So filler filler is good, obviously, in small, you don't want to overdo the filler, because that's when people are looking like little

chipmunks right here. I there's definitely some housewives on like other casts that I'm like, Oh, my God, who is filling their face is not saying any names. But like, definitely, you can tell when someone just has too much filler going on. Yeah. And the other problem is that people don't realize or now they're maybe starting to realize is you go in once a year, once every two years for filler and it's supposed to go away, but it actually stays. So there's some portion of that filler that will stay in the face and sometimes even get into the muscle where it gets a little bit even difficult

to dissolve it if it's overdone. So when you're doing fillers and you're doing them correctly little by little, you have to have somebody who's skilled enough to look at that face and say, you know what, I know we did a full syringe of filler last year, but this year we're going to do half here and put a half somewhere else because you still have filler here. Otherwise you can start building on it. You start to blow up. Is it true that it migrates?

Does filler migrate around and kind of move around sometimes? That's when some people start looking crazy 10 years down the road. Yeah. Yeah. Yeah. There's all different types of fillers. The ones that we're focusing on really are the more common things like hyaluronic acid fillers.

That's going to be like your Juvederms, your Restylans, and all those types of products, where hyaluronic acid is a natural sugar, it's a sugar that's in our bodies, and it's reversible. Like you can inject something to make that filler go away, or for the most part go away, versus like some of the other permanent fillers, which is a whole nother topic in itself.

So the ones, the hyaluronic fillers, they like to absorb water, especially as they're breaking down. So some do it more than others. So if you inject them, let's say around the lip area, there's certain fillers that are going to want to, you know, absorb water and they're going to actually kind of migrate up to the top of the lip. So instead of just injecting the lip area over the course of a year or even a few months, you might notice the lips start to get puffy and start to change a little bit in color. So that type of migration, yeah, it does happen.

And that you have to get removed, right? Because I see that on some people. It almost looks like a little duck, right? Up top gets very puffy. Right. They lose that nice profile curvature to the lip where you have that nice sharp border. Instead it looks more, you know, monkeyish. Right. Just like fuller. Right, and it looks thick up there. Yeah, yeah, so but it's not like

if you put filler in the cheek, it's gonna migrate up into your temple or your eyes. It stays local, but it can just get puffy. So that's why you have to understand where to put fillers, which fillers to use where, ones that migrate less, ones that absorb less water. So it's not like you can, you have to be careful who you use as an injector. Of course. No, that's so important.

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Typically within just 24 to 72 hours of booking, you can even score same-day appointments. Guys, we use ZocDoc in the Gorga household and it has saved us so much time and so much of the headache of finding a good doctor. So stop putting off those doctor's appointments and go to zocdoc.com slash Melissa to find and instantly book a top rated doctor today. That's zocdoc.com slash Melissa, zocdoc.com slash Melissa. All right, I want to go through a list of some procedures and just talk about them because I feel like they're the most popular procedures right now. But before we do that, let me ask you this.

I know it's different, right, for everyone as far as ages, but if you're going to go for your first procedure, right, and it's like what are you seeing age-wise? Like, are you seeing a lot of women come in for the eye lifts first or their eyelid surgeries first? Are they coming for the next first? What age do you recommend? Or what would you say to do first if you're starting to feel like you're seeing

the aging happening and you're starting to see a little saggy skin? What do most women do first? So are we talking in our 30s or 40s? Because it's all, the do most women do first? So that you're retarded like in our 30s or 40s because it's all, you know, the best things to do are to do non-surgical treatments until you get to a point when there's nothing non-surgical that'll work. And then you start exploring surgery because it's, you know, surgery can be helpful at all different ages, but why do surgery if there's non-surgical treatments that are as

effective or sometimes even better. But once we get into that portion in our late, maybe late 30s to early 40s, we start getting a, it starts blurring the line between where non-surgical and surgical is going to help. So at that point, the things that I see people doing are, you know, CO2 laser. That's non-surgical, but it's aggressive. So CO2 laser is a pretty strong laser that helps with moderate to fine lines, even some deep lines and wrinkles. And the beautiful part of it is that once the skin heals from that, the skin looks a lot smoother, it improves sun

damage. And you can do that in younger patients. It can be repeated years down the line also, but it gets you to a new set point where after you've done something aggressive like a CO2 laser where the recovery takes about a week or two to look human again. Yes. Margaret just had that done. Is that what Margaret just did, the CO2? Yeah, she did. So I really want to ask you about this because so many people want to know. Because I see what it looks like.

I saw the bleeding. My sisters had it done before as well. Does it really help? Is it really worth the pain and the two weeks of looking crazy? Oh my gosh. Yeah. I mean, you know. I did the laser on my wife when she was 36 years old, maybe, 35, 36, and she didn't have a wrinkle on her face.

But her skin had sun damage. And after that laser, her skin looked better than it did in her 20s. Wow. And then she got into her 40s and she's like, I wanna do the laser again. And she had maybe a few little fine lines or wrinkles. And so I did it again. And she's like, I don't know why you don't recommend this to people who are younger. Like, look, her skin looks absolutely incredible. You know,

she's in her late 40s now. But there's no way it would have looked like that without the CO2 laser twice over 15 years. So, you know So it's worth it in the right patient. Does it take away fine lines? Is it great for texture, the texture of the dark spots obviously? It does help with pores. That's one of the questions I get a lot is I have big pores. I heard the CO2 works for that. It doesn't. I've never seen any benefit to that, but it just makes the skin glow. And it takes you to a point where once you've gotten that, now you do smaller treatments again, and you just do your maintenance. You do your facials, your glycolic peels, you do maybe a little laser where your recovery is a day, two days,

maybe three days versus doing the big CO2 laser. But eventually, most people get to a point where they can benefit from a CO2. And so as bad as the media, as bad as the photos look, a lot of it you have to take into context. There's no pain with it. It looks bad, but there's no pain in recovery. You might feel some burning or zapping sensations during the laser. It's done under local anesthesia also. You don't have to be put out for that. But the whole face is numb.

Now when I say numb, I don't mean numbing creams. Numbing creams will not work for that. No, you need something stronger. You have to have injections to numb everything. So you're completely numb. You don't feel it when it's happening. Yeah, my patients will feel like the corner of the mouth, around the corner of the eye a little bit.

But for the most part, like nothing on the forehead, nothing around the mouth, nose. It's doable. It's a doable amount of pain. It's doable. Okay. Okay. And then once you get home, your face starts swelling. And when you leave after a CO2 laser, because you talk about the bleeding, when you leave

after a CO2 laser, you just have gel on your face and ointment to help with the healing. But the laser goes deep into the skin where all the little blood vessels are. So you're creating all these little microscopic punctures that are controlled down into that layer and those little blood vessels will burst or leak and then you start seeing the blood covering the face. So that ointment keeps it moist so the scabbing doesn't form and feel uncomfortable. The next day you can wash it and get all that off. And when you wash it, it looks pretty good. But when you have that ointment on and there's blood there, people are like, oh my gosh, their face looks like it's peeling and their skin,

it's not. It's all the ointment and just like your own feet. It looks a little scary for the first two days. It looks scary, but your results- It's kind of like when Kim Kardashian did that vampire facelift and she had blood all over her face. Remember how shocking that was? Oh my God, shocking. No, like minimal to no recovery, but it looks gruesome. Gruesome. So does the CO2 laser, there's two things I want to know. Does it help with the fine lines and wrinkles or no? Is it more for texture of the skin? It helps with fine lines and wrinkles.

Yeah, but you have to be a great candidate for it because someone with olive skin like yours, you have to be very careful because the amount of heat that gets generated with the CO2 can cause pigmentation. Pugmentation, yeah, or darkening of the skin, which you can pre treat before to help minimize that and treat afterwards to help Improve it, but there's a lot of thing of someone like you who has really amazing skin I mean, it's almost like it is like porcelain There's other types of treatments to do just because just because people are out there doing these Aggressive lasers doesn't mean it's for everybody. So you want to write treatments. You don't need it. You can prevent ever having to do it by doing smaller things early on.

So like we get back to that whole maintenance thing, doing the right things when we're younger can help prevent needing a CO2 laser later. Right. So, okay, so I am a person who always kind of, because I do have olive skin, when I go in the sun too much, I will get the melasma on my cheeks, right? And I know a lot of women get melasma when they're pregnant as well. If you're someone who would be prone to the heat with melasma, would you suggest the CO2 laser or would you go the other route? Go the other route, yeah.

Go the other route. So for those patients, so then you get into other treatments like non-laser-based treatments like radio frequency. So you'll hear different types of- Without the heat, right? Things that don't cause all of the heat. Well, they're still gonna do heat, but they're gonna do it in a different way

with sound waves or radio waves. So the benefit to that is it'll target deeper areas of the skin without affecting the heat on the surface. So you can actually create skin tightening still with something like that rather than peeling the skin with a laser or chemical peel. Okay. So for someone like me who has pretty good skin and I could get a little prone to melasma if I get in the sun too much, what should I do right now to maintain?

What little procedures, in other words, would you say to do the vampire facial instead? Is there a certain thing that I should be doing for... This is getting personal now, ladies. I want to know what I need to do to keep my skin. So, um, you know, I don't, I like to do treatments that I know and have confidence that they're going to work. All right. So there's a little improvement and you know, there's not, not debatable improvement. So I think, you know, using the right skincare retinols, using, um, growth

factors, good cleansers, things like that, even hyaluronic serums, vitamin C serum, all those things are gonna work really nice, you know, on your skin. Then as you move through and maybe that's not doing enough, you can do, you know, there's different things like a clear and brilliant laser, that's a type of laser. Oh, that's the one I wanna ask you about.

How's clear and brilliant? I've heard about that a lot. And is that a safe laser for someone who has melasma? It can be. Yes. Yeah. So you just have to have it, use it gently. Okay. Okay. But that one's good as well. It's a little bit like a lighter. Yeah, it's gentle, but it's like a baby. So you call it like a baby fraxel laser, which is another good laser. I mean, there's plenty of them. I mean, you can go down the list of things like halo, um, you know,

profound radio frequency is non-laser. That's a great treatment. I think you do well with, um, it's a, it's a micro-needling, well, it's radio frequency needling where the, the skin gets injected with little needles and it sounds sound waves into the skin to tighten it. I mean, there's all these different ones and I don't wanna necessarily name pick and bash ones. I know, cause it's hard.

It's hard because it's individualized for each person. Right. Right. And then a lot of them are operator dependent. So, you know, there are times where I'm like, this is the worst treatment. I can't believe people ever do it. And then I'll see someone come in who had it done by someone who actually knew what they were doing. And you're like, wow, actually, that was pretty good. Right. Yeah. So, but yeah, I don't want to,

I don't want to go like fashion agreements, but the ones that I, that I talk about are definitely ones I know work really well. Um, and there's benefit to it and I would do it. I would have it, you know, I would do it in my office for patients. You don't wanna do things that people aren't gonna see any benefit to. Of course. Or damage things later down the line where surgery is now compromised.

Right, or like, you know, you always, with all the lasers I know, you have to be so careful afterwards with the sun. It's almost like you never can be, like your face could never be fully in the sun again without sunblock or a hat or something. I am that girl. Like you will never, I'll be in Aruba in two weeks for, you will never see me without like a white sunblocked face and a hat on.

My family laughs at me. I'm a psycho. Everyone wants to know where my skin comes from. I do not let sun touch my face ever, ever, ever. That's the key. But then there's people who don't. And then there's people who don't follow those rules and they'll get a CO2 laser and they'll- And they'll just fix it. Yes. But that's the beauty of cosmetic surgery and rejuvenation surgery is you can improve things. So there's a treatment for all different lifestyles, I think. Agree. On display with Melissa Gorga is brought to you by Progressive Insurance. Hey guys,

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to try the name your price tool for yourself and join the over 28 million drivers who trust progressive. Progressive casualtyive Casualty Insurance Company and affiliates price and coverage match limited by state law. Let's talk about facelifts for a second because you're the master of the facelift. You do such an incredible facelift. Ladies, if you're looking for some, oh my God, like incredible, incredible facelifts. There's just so many different types of facelifts. So can you tell me the difference between like a deep plane facelift, a mini lift, there's so many different types of facelifts. Can you explain the difference between them?

Yeah. So I mean, it's a good way to start when someone's interested in having a facelift is just understanding what the terminology is, because you're going to see people calling things different things and it really is pretty simple. So when we talk about facelifts nowadays and someone's talking about they had a facelift, most people are referring to what's called a lower facelift. So it addresses the lower part of the face. A lower facelift could be anything from a mini facelift to a SMAS

facelift, to a deep plane facelift. They anything from a mini facelift to a smaz facelift to a deep plane facelift. They're all addressing areas around here. Now full facelift would just mean you're doing your full face. So you're lifting your brow, you're doing a mid facelift, but that's again associated more with that little bit of the cat eye look and you're doing a lower facelift. So that would be a full facelift. Most people-

Is literally the whole entire face. Right. So that's a full face. It's exactly what it sounds like. It's not a better type of facelift. So then you talk about the main facelift. Mini lifts are small incision facelifts. They go by short scar or they're called a J lift or an S lift. And that has to do with the shape of the incision. A little J-shaped incision or an S-shaped incision allows you to do with the shape of the incision. Little J-shaped incision or an S-shaped incision allows you to go under the skin and just tuck the muscle maybe a little bit, remove a little excess skin. And unfortunately, a lot of times when surgeons

are doing it, they're gonna try to recompensate and pull the skin more. And that's where I see patients coming in to me where they've had previous mini face lifts and their ear lobes are pulled down or their pixie ear where the ear lobe is now stuck and stretched to the face. Oh, I don't like that. When you pull something, when the skin that's elastic will pull and it's going to pull back,

so it starts to pull that earlobe. So, I typically, I don't do many, many facelifts anymore. I did those maybe 18 years ago. I just don't find that it impacts things enough. And there's a lot of non surgical treatments that work pretty well to that help avoid that scar. Next thing is a SMAS facelift and deep plane facelift. Those are the two more common types of facelifts nowadays, and they're probably the most

studied and most performed. So the difference is well, the common the common part of it is that there's an incision in the hair, follows a curve of the ear, then it goes behind the ear and along the hairline. So it's like this shaped incision. In both of those facelifts, you go under the skin, and I get up to the point where we call it the deep plane entry or where the muscles

that we really wanna tighten in a facelift are. Now in a SMAS facelift, S-M-A-S, you go under that skin up to that point and now you have to lift up a lot more of the skin so you can actually take that muscle, grab it and pull it. And what that does is then moves the skin and you can remove that excess skin. The only problem there is that this muscle in front,

so like from this area forward, has a lot of attachments. So you're pulling against something that wants to pull back. So what a deep plane lift does and why it's become so popular and looks so natural is that you go under the skin through that same incision, you get up to that point, and instead of going past that point under the skin and separating the skin and muscle to be able to grab it and pull it, you actually stop there, make an incision just right in front of that muscle, go underneath it so the skin and muscle will stay attached here. And then you're able to get to this one point right here where there's a ligament that you can't treat with a

SMAS lift and that's why a lot of times if this ligament is holding the muscle down and you do a SMAS lift what you end up doing is creating like this little bit of a sweep because this is that cheekbone look like that lift yeah right there so with a deep plane lift you can actually go under that skin keep the skin under the muscle keep the skin and muscle attached, release these ligaments here. And now instead of pulling the muscle, you actually raise it, lay it down in its new position, it'll heal in its new position without pulling it. So you recommend the deep plane facelift.

Yeah, nowadays. There's been debates over the years, but I think it's pretty much understood that the deep plane lift is probably the most consistent, most natural result. I've done them all, but again, it's my preference. You might have somebody argue something different, but I think it's pretty well known that the deep plane lift is one of the best types of face lifts to do. It sounds wonderful. Gives you the most control. I feel like everyone too, like women especially, they feel like they age the most through their

necks. It's this area here, your neck and your chest. It's the first sign, like we're all botoxed all over our faces and then there's the chest and the neck. Do you do a lot of neck lifts as well? Do a lot of women do that together with the facelift? Yeah. I think that's a great, great question because then you get into, all right, well, I just want to do my neck or I want to do my face and how does that all play into it? So it's very unusual for me to do a neck lift by itself. And the reason is just if you understand what happens in the neck, the neck lift by itself. And the reason is, is just if you understand what happens

in the neck, the neck lift procedure affects two muscles, one on each side of the neck. And it's like a sheet of muscle. So there's an edge that goes from the chin on each side down to the collarbone. So people talk about like those bands or cords. That's the middle edge of that muscle. When it attaches to the collarbone,

it goes along the collarbone, up to the jawline and back down. So it attaches to here, it attaches this area. So this is the muscle we're talking about. It's like this rectangular sheet here. So as we age, these muscles have fibers that hold them together and those fibers weaken and the muscles start to sag and come apart.

So the treatment for a neck lift is you have to make an incision under the chin, go under the skin, actually remove those fibers and stitch those muscles back together. But then there's also this edge, this edge and this edge. This is fixed. So the next part is to now tighten this edge of the muscle right here. So you can improve the lower part of the neck and move things back. And improve the lower part of the neck and move things back. And then the last part of the neck muscle to tighten runs along your jawline and that blends into your facial muscles. So that's why most neck lifts typically involve a lower

facelift because you have to move the lower face. And if you go like this, a lot of times you'll see the neck is improving just from the face. So that's why there's those three areas. So most neck lifts involve lower face lifts as well. Right, or else you're just gonna have this like tight neck and it's not, you gotta keep going. You gotta finish the- Otherwise, you got a tight neck and you got this like lump of nothing here, right?

Just loose. So you have to move that up too. So, but especially like in the lower, like this part or the decolletage, that's different. That doesn't get treated with surgery. So, everything more from like the collarbones up. So, this is going to be more like laser-based or energy-based like radio frequency treatments or even, you know, skincare and things like that.

What about, let me ask you about the liquid nose job. Do you do those? Yeah, I do. I do. So, when I start- Do a lot of people come in for that as well and do you recommend? I'll do it as part of a surgical plan for patients. So I don't, I'm so busy operating, I operate Monday through Thursday. So it's hard to take a lot of non-surgical patients, at least right now, because I do it all myself. But I'll

do it as part of a surgical plan for patients, meaning they don't want a nose job or a rhinoplasty, but they have a bump or they want to adjust their tips. So yeah, it works really well. It's probably one of the most amazing procedures that had come across in the past maybe 15 years, I think. It's just because it's so simple, could be dangerous because you have to know where you're getting. That's what I heard. If you hit the wrong spot, right? Yeah.

You could go blind. You could cause skin to die off. So as simple as it sounds, oh, in 20 minutes I could have a new nose. Yeah, but with the wrong injector in 20 minutes you could be blind. So it's not as, you know, there's, there's risks to these things, but for such a, like a very like simple or theoretical, you know, in context, simple procedure, it does amazing. That really changes amazingly. I know I've seen before and afters of some and I'm like, wow, that's insane.

But I also heard that can be very scary and dangerous. So I think that's where a lot of people get their reservations about that as well. Right. So everything has pros and cons and you have to weigh, take it into the context. The more you know, the better. Okay. Well, I can literally talk to you about plastic surgery all day, but in just tying it up here a little bit, give us what you think if someone's starting to feel in their late 30s, early

40s, even mid 40s, they're starting to see the signs, they're feeling like they look tired. I feel like that's the first thing women start to notice that we start to feel, and including myself, starting to feel like, ugh, we start to feel, and including myself, starting to feel like, oh, I want to feel just a little brighter. I feel like I look tired. What's the first procedure that you really recommend when people just starting to feel like they look tired? Yeah. Tired is the key word for eyes. So it's going to be up here. So no one really feels like

they look tired because their jowls are down or they're. So no one really feels like they look tired because their jowls are down or they're frowning. They feel like they look mad. Tired is the eyes. So probably the most natural looking and probably one of the nicest procedures, I think. And I do it in very young patients also, meaning early 30s, is just opening up the eyes a little bit. So a temporal lift, the temporal lift is amazing. It's so subtle and I have patients who will look at the before and after and say, oh, I don't see it. But the patients who got it done really see it because the easiest way to see what's going on

is put a photo on top of the other photo and make it go back and forth. And I have that on some of my posts on Instagram, but you'll see the brow going like this, right? So three to five millimeters of movement is a lot around the eyes. So something like that can just make things look more bright and open. Really fresh and really new. Yeah. You go a centimeter, now you're like that, right? So that's a little bit more aggressive.

That doesn't look rested. So I think eyes, temporal lift is a great treatment. Upper eyelid skin, even millimeters, lower eyelid skin pinch or bags removed. Mid-20s to 30s, they'll get puffiness from allergies and things like that. So they'll get their lower eyelids done too. Under the eyes. Tired means eyes. Tired means eyes. That's the best way. That's kind of like the... And I feel like that's what I hear a lot of my girlfriends say. Just like, I feel tired.

And so I feel like everyone just, you know, wants their eyes done. That's how I feel. They don't realize it. That's just what it sounds like. And then I've had a couple girlfriends do it and I look at them, I'm like, you just look refreshed. Like, you look bright again. And they say they did their eyelids or they did, you know, the temple lift, I feel like,

is something new. People used to just always do eyebrows. I feel like, is temple lift a little bit new, a newer procedure? You know, I started doing it maybe about seven years ago or so. So yeah, I think it was the answer to people feeling like they looked surprised when they had a brow lift because that was always the treatment. I don't know exactly how long ago it dates back to, but I know in my practice it's been about seven years. Okay. It's not that new. It's new work, but

it's not that new. Yeah. It work, but it's not that new. Yeah, it's more about it. It's more about rebalancing the face. It's a nice procedure for that. So it's a very smaller version of a brow lift. Well, listen, Dr. Karolak, it's been amazing. Thank you so much for coming on the show today. My girls are gonna go nuts listening to this

because I know everyone just wants to sit and have a consultation and talk to you and hear everything that you have to say. I know my sister is dying to come to you as well. She'll be in your office soon. So I'm very, very excited. Yes. And then we're gonna have you come back on again with maybe Dolores or Margaret both of them so we can talk about, you know, more plastic surgery because people love to hear it. And you just so great. Guys, make sure

you guys follow him on social media. You're just Dr. Karolak on social. Yeah, that's Dr. Karolak, D-R-K-A-R-O-L-A-K. He's in New Jersey. You're in like Central Jersey, I would say, right? Yeah, by the shore. So right by like Spring Lake, Seager, Point Pleasant. Manisquan. Yes. Yes. Yes. Exit 98 on the Parkway. Yeah. Right off the Parkway. Boom. Everyone has an exit off the Parkway, right? Or else you don't live in Jersey. But thank you so much for coming on and we're going to see you again soon with Dolores and Margaret. I'm so excited. I cannot wait. This has been a blast. Thanks for having me on. wait, this has been a blast. Thanks for having me on. Thank you. Ciao. Ciao. Hi, I'm Lauren.

And I'm Chandler. And we're the hosts of Pop Apologist Podcast, a weekly podcast devoted to celebrity gossip, Hollywood deep dives, real housewives drama and anything and everything Taylor Swift. We're two sisters who make no apologies for our love of pop culture and the fact that A-listers might mean more to us than each other. Join us on your favorite podcast app every Wednesday for Pop Apologists. Pop Apologists, your new favorite sister and celeb podcast. day. Survivor, I'm free all night. With hundreds of free reality shows, you are totally free to watch what you love on Pluto TV. Pluto TV, stream now, pay never.